Journal of vascular surgery
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Review Meta Analysis Comparative Study
Endovascular vs open repair of acute abdominal aortic aneurysms--a systematic review and meta-analysis.
To compare the results of emergency open repair of acute (ruptured or symptomatic intact) abdominal aortic aneurysms with that of endovascular repair. ⋯ This meta-analysis suggests benefits to the selected group of patients undergoing this minimally invasive procedure. There is a reduction in the high mortality, prolonged intensive care requirement and total hospital stay, which are historically associated with open repair. It also indicates that most patients are fit enough to undergo computerized tomography (CT) scanning in acute settings. However, because of heterogeneity and bias in the outcomes these results should be interpreted with caution.
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Randomized Controlled Trial Comparative Study
Alert for increased long-term follow-up after carotid artery stenting: results of a prospective, randomized, single-center trial of carotid artery stenting vs carotid endarterectomy.
Carotid endarterectomy (CEA) has been shown to be effective in stroke prevention for patients with symptomatic or asymptomatic carotid artery stenosis. Although several prospective randomized trials indicate that carotid artery stenting (CAS) is an alternative but not superior treatment modality, there is still a significant lack of long-term data comparing CAS with CEA. This study presents long-term results of a prospective, randomized, single-center trial. ⋯ The long-term results of this prospective, randomized, single-center study revealed a high incidence of relevant restenosis and neurologic symptoms after CAS. CEA seems to be superior to CAS concerning the development of restenosis and significant prevention of stroke. However, the long-term results of the ongoing multicenter trials have to be awaited for a final conclusion.
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To determine whether the introduction of endovascular technology changed the relationship of hospital volume to mortality with abdominal aortic aneurysm repair. ⋯ As the endovascular repair becomes more widespread, the relationship between hospital volume and operative mortality still remains. High-volume hospitals are more likely to use the endovascular approach, and this explains a significant portion of the observed impact of hospital volume on mortality.
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Randomized Controlled Trial Multicenter Study Comparative Study
A comparison of recombinant thrombin to bovine thrombin as a hemostatic ancillary in patients undergoing peripheral arterial bypass and arteriovenous graft procedures.
Recombinant thrombin (rThrombin) is a potential hemostatic alternative to bovine and human plasma-derived thrombin. This report examines the clinical results for the vascular surgery subgroup of patients enrolled in a larger double-blind, randomized, multicenter trial, which evaluated the comparative safety and efficacy of rThrombin and bovine plasma-derived thrombin (bThrombin) when used as adjuncts to surgical hemostasis. ⋯ rThrombin or bThrombin used as a hemostatic ancillary for anastomotic bleeding was equally effective at 10 minutes; however, rThrombin compared with bThrombin may provide a more rapid onset of hemostasis at 3 minutes in PAB procedures. Adverse events were similar between the two thrombins. In patients undergoing vascular surgery, both treatments were similarly well tolerated, although rThrombin demonstrated a superior immunogenicity profile.