Annals of vascular surgery
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Multicenter Study Comparative Study
Elective versus ruptured abdominal aortic aneurysm repair: a 1-year cost-effectiveness analysis.
Abdominal aortic aneurysm (AAA) is a life-threatening condition with an overall mortality of 80%. It predominantly affects men 65-74 years of age and is caused by focal distension of the main blood vessel in the abdomen. Most patients go undetected until their aneurysm ruptures. ⋯ The total costs of emergency AAA repair were pounds sterling 96,700.69, with a cost per life saved of pounds sterling 24,175.17. The total cost of elective AAA repair was pounds sterling 76,583.22, with a cost per life saved of pounds sterling 5,470.23. Emergency intervention for AAA was found to cost five times more than a planned intervention per life saved per year.
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Transluminal arterial stenting reduces vessel compliance and may alter accurate interpretation of flow velocities. We reviewed duplex ultrasonography (DUS) following carotid stenting to identify criteria indicative of severe recurrent stenosis. This is a single-center retrospective review of 158 carotid stenoses treated with carotid angioplasty and stenting (CAS) from April 2001 to December 2004. ⋯ Presumed restenosis and occlusion detected by DUS were confirmed in all cases with angiography. Restenosis or occlusion after CAS at our institution can reliably be detected by carotid duplex using cut-off values of 170 cm/sec PSV, 120 cm/sec EDV, and >50% increase over immediate postoperative values. While these criteria are applied to patients undergoing CAS at our institution, they serve only as suggested guidelines for patient populations at other centers and must be customized to each Intersocietal Commission for the Accreditation of Vascular Laboratories-accredited vascular laboratory.