Database : MEDLINE
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[PMID]: 29523749
[Au] Autor:Wilson MP; Murad MH; Krings T; Pereira VM; O'Kelly C; Rempel J; Hilditch CA; Brinjikji W
[Ad] Address:Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.
[Ti] Title:Management of tandem occlusions in acute ischemic stroke - intracranial versus extracranial first and extracranial stenting versus angioplasty alone: a systematic review and meta-analysis.
[So] Source:J Neurointerv Surg;, 2018 Mar 09.
[Is] ISSN:1759-8486
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Optimal technical approaches of large-vessel anterior circulation acute ischemic strokes with concomitant extracranial internal carotid artery tandem occlusions is controversial. PURPOSE: This systematic review and meta-analysis evaluates: the overall outcomes of patients with tandem occlusions treated with second-generation mechanical thrombectomy devices; differences in outcomes of extracranial versus intracranial first approaches; and differences in outcomes of extracranial stenting at time of procedure versus angioplasty alone. METHODS: MEDLINE, EMBASE, and the Web of Science was searched through September 2017 for studies evaluating patients presenting with acute tandem occlusions of the extracranial ICA and intracranial ICA, and/or proximal MCA treated with second-generation mechanical thrombectomy devices. Outcomes were pooled across studies using the random-effects model and expressed as cumulative incidence (event rate) and 95% CI. RESULTS: Thirty-three studies were included in analysis. Overall mRS≤0-2 at 90 days was 47% (95% CI 42% to 51%). No statistical difference was seen in 90-day mRS≤0-2 for patients treated with extracranial versus intracranial first approaches, 53% (95% CI 44% to 61%) vs 49% (95% CI 44% to 57%) (P=0.58). No statistical difference was seen in 90-day mRS≤0-2 for patients treated with extracranial stenting versus angioplasty alone, 49% (95% CI 42% to 56%) vs 49% (95% CI 33% to 65%) (P=0.39). No other statistical differences in outcome or safety were identified. CONCLUSIONS: Nearly half of all tandem occlusion patients treated with mechanical thrombectomy have good neurological outcomes. No statistical differences in outcome are identified between extracranial first versus intracranial first approaches, nor extracranial stenting versus angioplasty alone.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 72387 MEDLINE  
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[PMID]: 29522872
[Au] Autor:Sahin M; El H
[Ad] Address:Department of Cardiovascular Surgery, Haseki Teaching and Research Hospital, Health Sciences University, Istanbul, Turkey; Department of Cardiovascular Surgery, Sisli Teaching and Research Hospital, Health Sciences University, Istanbul, Turkey. Electronic address: mzlmshn@gmail.com.
[Ti] Title:External Validation and Evaluation of Reliability of The FARP Score To Predict Early Graft Failure After Infrainguinal Bypass.
[So] Source:Ann Vasc Surg;, 2018 Mar 06.
[Is] ISSN:1615-5947
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:AIM: To evaluate the accuracy of the FARP scoring system in predicting early graft failure after infrainguinal bypass surgery (IBS). METHODS: Patient charts which underwent IBS between January 2014 and January 2017 , in two tertiary academic centers were evaluated retrospectively. In follow ups, one week after operation, detailed physical examination was done and doppler ultrasonography was performed one month after operation and integrity of the graft was evaluated. Calculation of FARP score was performed by a single surgeon, who was well informed regarding FARP scoring system. The FARP scoring system was evaluated as following: female gender 1 point, bypass after a previous angioplasty 1 point, redo bypass 1 point and pedal bypass 2 points. RESULTS: Totally, 231 patients (180 male and 51 female) were enrolled in the study. The mean FARP score was 0.52±0.73. The graft occlusion was occurred in 23 patients (10%). Presence of critical leg ischemia was lower in patients who faced early graft occlusion (p= 0.002). On the other hand, Rutherford classification score was significantly higher in patients who did not face graft occlusion (4.1 vs 3.4, p= 0.007). Moreover, unsuccessful angioplasty history and history of previous surgery was more common in that group (p < 0.001 and p <0.001, respectively). None of the patients faced acute pulse lose, numbness loss or ulcerative lesion following unsuccessful angioplasty. The mean interval between unsuccessful angioplasty and bypass was 1±1.2 days in our study that may have a role to prevent undesirable clinical consequences. The FARP score was 1.5±1.2 and 0.4±0.6 in patients that faced with graft occlusion and in patient that without occlusion (p < 0.001). Multivariate regression analysis identified that critical leg scheme, presence of unsuccessful angioplasty history and history of previous bypass operation were found as a predictive factor for early graft failure (EGF) (p=0.044, p< 0.001 and p= 0.003, respectively). Lastly, our study demonstrated that patients with FARP score 3-4 has 2.88 fold increased graft occlusion risk when compare to patients with FARP score 1-2. CONCLUSION: Our study externally validates that the FARP scoring system is related with EGF after IBS. The FARP score may be an effective practice in prediction of EGF in patients with peripheral arterial bypass surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  3 / 72387 MEDLINE  
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[PMID]: 29209780
[Au] Autor:Miglioretti M; Gragnano A; Baiardo G; Savioli G; Corsiglia L; Griffo R
[Ad] Address:Università degli Studi di Milano-Bicocca, Milan, Italy. massimo.miglioretti@unimib.it.
[Ti] Title:Quality of work experience after angioplasty or heart surgery: a monocentric cohort study.
[So] Source:Int Arch Occup Environ Health;91(3):337-348, 2018 Apr.
[Is] ISSN:1432-1246
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:PURPOSE: The study evaluated work experience changes and its determinants after return to work (RTW) in angioplasty or heart surgery patients. METHODS: During a 1-year period (2014) in a Rehabilitation Hospital in northwestern Italy, we approached 253 patients (19.3% of inpatients). 199 patients consented to complete a survey on job characteristics, job satisfaction, job involvement, illness perception, depression, anxiety, adherence to therapy, and sociodemographic characteristics. The data were analysed with paired sample t tests and random intercept regression models. RESULTS: 156 patients completed both the baseline and the 6-month follow-up assessments. After 6 months, 137 (88%) patients return to work (86% male, M age = 51.9 ± 8.1). The patients predominantly underwent angioplasty/bypass (46%) or valve replacement/repair (38%). Work hours (WO), job satisfaction (JS), and job involvement (JI) significantly decreased after RTW (WO: t = 2.07, p < 0.05; JS: t = 2.56, p < 0.05; JI: t = 4.14, p < 0.001). The decrease in work hours over time was associated with a within-subjects decrease in psychological job demands (ß = 5.107, t ) = 2.21, p < 0.05) and job satisfaction (ß = 2.498, t = 2.265, p < 0.05) and an increase in physical job demands (ß = - 1.314, t = - 2.416, p < 0.05). The decrease in job satisfaction over time was related to a within-subjects decrease in decision latitude (ß = 0.505, t = 2.825, p < 0.01) and an increase in psychological job demand (ß = - 0.586, t = - 3.141, p < 0.01). The decrease in job involvement over time was associated with a decrease in physical job demands (ß = 0.063, t ) = 2.157, p < 0.05) within-subjects. CONCLUSIONS: The study showed that many patients who RTW after angioplasty or heart surgery have poorer work experiences relative to changes in psychological and physical demands and more passive roles.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:In-Data-Review
[do] DOI:10.1007/s00420-017-1282-3

  4 / 72387 MEDLINE  
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[PMID]: 29521477
[Au] Autor:Barreira G; Costa JR; Costa R; Staico R; Chamie D; Slhessarenko JR; Tanajura LF; Abizaid A; Sousa A; Abizaid A
[Ad] Address:Department of Invasive Cardiology, Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
[Ti] Title:Serial intravascular ultrasound evaluation of the DESolve™ novolimus-eluting bioresorbable coronary scaffold system.
[So] Source:Catheter Cardiovasc Interv;, 2018 Mar 09.
[Is] ISSN:1522-726X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Bioresorbable coronary scaffolds (BRS) have been developed to increase the late safety of coronary angioplasty by providing transitory coronary support and then being fully incorporated to the vessel wall. In the present trial, we sought to evaluate the performance and changes over time in the DESolve™ novolimus-eluting BRS using serial intravascular ultrasound (IVUS) in patients submitted to percutaneous coronary interventions. METHODS: Single-center, prospective, non-randomized study involving 17 consecutive patients submitted to implantation of the DESolve™ scaffold and serial evaluated with IVUS at different time points (post procedure, 6 and 18 months). Primary endpoint included the variation in lumen, scaffold, and vessel diameter and area along the months. RESULTS: Angiographic success was achieved in all cases. Scaffold area and volume on IVUS were significantly greater at 6 months than at baseline (6.41 ± 1.35 mm vs. 7.35 ± 1.53 mm , P < 0.002; and 101.19 ± 20.9 mm vs. 118.51 ± 26.6 mm , P = 0.001). Late lumen loss was 0.22 ± 0.30 mm at 6 months and 0.33 ± 0.44 mm at 18 months. No major adverse cardiac events occurred. At late follow-up (18 months) the scaffold was not visualized by IVUS; therefore the evaluation was restricted to lumen and vessel at that time point. CONCLUSIONS: IVUS serial evaluation of the novel DESolve BRS showed an increase in the device dimensions between baseline and 6 months, with concomitant enlargement of lumen dimensions and effective suppression of neointimal proliferation. At 18 months, no footprint of the scaffold was detected and the initial lumen enlargement was sustained.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1002/ccd.27591

  5 / 72387 MEDLINE  
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[PMID]: 29521479
[Au] Autor:Almasoud A; Walters D; Mahmud E
[Ad] Address:Division of Cardiovascular Medicine, University of California, San Diego Sulpizio Cardiovascular Center, La Jolla, California.
[Ti] Title:Robotically performed excimer laser coronary atherectomy: Proof of feasibility.
[So] Source:Catheter Cardiovasc Interv;, 2018 Mar 09.
[Is] ISSN:1522-726X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The feasibility, safety, and high technical success of robotically assisted percutaneous coronary intervention (PCI) for the treatment of both simple and complex coronary disease has been demonstrated. As the current generation robotic platform is limited to a rapid exchange system, orbital or rotational atherectomy cannot be performed robotically. However, excimer laser coronary atherectomy is performed with a rapid exchange catheter but its feasibility during robotically assisted PCI is unknown. We report the successful use of laser atherectomy during two complex robotically assisted PCI procedures using the CorPath GRX robotic system.
[Pt] Publication type:CASE REPORTS
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1002/ccd.27589

  6 / 72387 MEDLINE  
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[PMID]: 29521465
[Au] Autor:Kokkinidis DG; Alvandi B; Cotter R; Hossain P; Foley TR; Singh GD; Waldo SW; Laird JR; Armstrong EJ
[Ad] Address:Division of Cardiology, Denver VA Medical Center and University of Colorado, Denver, Colorado.
[Ti] Title:Long-term outcomes after re-entry device use for recanalization of common iliac artery chronic total occlusions.
[So] Source:Catheter Cardiovasc Interv;, 2018 Mar 09.
[Is] ISSN:1522-726X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To examine the impact of re-entry device (RED) use on 1- and 5-year outcomes after endovascular treatment of common iliac artery (CIA) chronic total Occlusions (CTOs). BACKGROUND: There are not enough data regarding the long-term safety and efficacy of RED. METHODS: We performed a two-center retrospective study of 115 patients (140 lesions) undergoing CIA CTO endovascular intervention between 2006 and 2016. Baseline characteristics and long-term outcomes were described. A Cox proportional hazard model was developed to determine if REDs were associated with target lesion revascularization (TLR) or major adverse limb events (MALE) after 1 and 5 years. RESULTS: Among 140 lesions, 43 (31%) required use of a RED. The mean age was 63.9 years and the majority (n = 80) of patients were male. An antegrade crossing approach and treatment of restenotic lesions were less common in the RED group (10% vs. 29%, P < .05 and 0% vs. 21%, P < .05, respectively). There were no significant differences in Rutherford class, pre-procedure ABI, or patient presentation. The procedural complication rates were similar between the two groups. The 1- and 5-year TLR rates for lesions treated with re-entry device vs. standard approaches were 11% vs. 9%; P = 0.8 and 29% vs. 29%; P = 0.9 respectively. The 1 and 5-year MALE rates for lesions treated with re-entry device were 5% vs. 6%; P = 0.8 and 11% vs. 11%; P = 0.9 respectively. CONCLUSIONS: This retrospective analysis found that recanalization of CIA occlusions using a RED is safe and is associated with long-term clinical outcomes similar to that of standard crossing techniques.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1002/ccd.27583

  7 / 72387 MEDLINE  
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[PMID]: 29521415
[Au] Autor:Fowkes G; Gillespie IN
[Ad] Address:Department of Public Health Sciences, The University of Edinburgh, Teviot Place, Edinburgh, UK, EH8 9AG.
[Ti] Title:WITHDRAWN: Angioplasty (versus non surgical management) for intermittent claudication.
[So] Source:Cochrane Database Syst Rev;3:CD000017, 2018 Mar 09.
[Is] ISSN:1469-493X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Intermittent claudication is pain in the legs due to muscle ischaemia associated with arterial stenosis or occlusion. Angioplasty is a technique that involves dilatation and recanalisation of a stenosed or occluded artery. OBJECTIVES: The objective of this review was to determine the effects of angioplasty of arteries in the leg when compared with non surgical therapy, or no therapy, for people with mild to moderate intermittent claudication. SEARCH METHODS: Sources searched include the Cochrane Peripheral Vascular Diseases Group's Specialized Trials Register (August 2006), the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 3, 2006) and reference lists of relevant articles. The review authors also contacted investigators in the field and handsearched relevant conference proceedings (August 2006). SELECTION CRITERIA: Randomised trials of angioplasty for mild or moderate intermittent claudication. DATA COLLECTION AND ANALYSIS: The contact author selected suitable trials and this was checked by the other review author. Both review authors assessed trial quality independently. The contact author extracted data and this was cross checked by the other review author. MAIN RESULTS: Two trials with a total of 98 participants were included. The average age was 62 years old with 20 women and 78 men. Participants were followed for two years in one trial and six years in the other.At six months follow up, mean ankle brachial pressure indices were higher in the angioplasty groups than control groups (mean difference 0.17; 95% confidence interval (CI) 0.11 to 0.24). In one trial, walking distances were greater in the angioplasty group, but in the other trial, in which controls underwent an exercise programme, walking distances did not show a greater improvement in the angioplasty group. At two years follow up in one trial, the angioplasty group were more likely to have a patent artery (odds ratio 5.5; 95% CI 1.8 to 17.0) but not a significantly better walking distance or quality of life. In the other trial, long term follow up at six years demonstrated no significant differences in outcome between the angioplasty and control groups. AUTHORS' CONCLUSIONS: These limited results suggest that angioplasty may have had a short term benefit, but this may not have been sustained.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1002/14651858.CD000017.pub2

  8 / 72387 MEDLINE  
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[PMID]: 29519202
[Au] Autor:Varetto G; Trevisan A; Barile G; Gibello L; Spalla F; Frola E; Pennica D; PhD PR
[Ad] Address:1 Division of Vascular Surgery, University of Turin, Turin, Italy.
[Ti] Title:Carotid Pseudoaneurysm After Eversion Endarterectomy: A Case Report and Review of the Literature.
[So] Source:Vasc Endovascular Surg;:1538574418761981, 2018 Jan 01.
[Is] ISSN:1938-9116
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Pseudoaneurysm (PA) after carotid endarterectomy (CEA) is a rare and potentially life-threatening complication, with an incidence lower than 1%. Most of the cases described report PAs after carotid patch angioplasty and are associated with infection, often caused by Staphylococci. The management of PAs can be surgical, endovascular, or hybrid. METHODS: We herein present the case of an infected carotid PA 27 days after an eversion CEA. We performed a common to internal carotid bypass with the interposition of great saphenous vein (GSV) associated with specific polyantibiotic therapy for 4 weeks. We searched the PubMed database for reviews and cases reports for patients who developed carotid PA after primary repair CEA in the period between 1969 and 2017. RESULTS: We identified 21 cases of primary closure post-CEA PAs in the literature. In almost 60% of patients, infection was detected. Open surgery was performed in all the cases; in 1 case, an hybrid approach was preferred. In 52% of cases, a vein graft/patch or primary closure was chosen; in 3 cases, ligation was preferred, and in 1 case, a polyester graft was used. CONCLUSION: In our experience and with the evidence observed in the literature, open surgery with GSV interposition is the safest treatment in infected carotid PAs. The endovascular approach must be performed only in proven noninfectious cases. A bridge technique with the insertion of a stent followed by open surgery repair can be an option in emergency cases.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1177/1538574418761981

  9 / 72387 MEDLINE  
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[PMID]: 29518519
[Au] Autor:Kuan Kok H; Prabhudesai SG; Ahmed I; Karunanithy N; Abisi S; Katsanos K; Diamantopoulos A
[Ad] Address:Department of Interventional Radiology, Guy's and St Thomas' NHS Foundation Trust, Lambeth Wing, Westminster Bridge Road, London SE1 7EH, United Kingdom. Electronic address: terrykok@gmail.com.
[Ti] Title:Techniques for infrapopliteal arterial bifurcation stenting.
[So] Source:Ann Vasc Surg;, 2018 Mar 05.
[Is] ISSN:1615-5947
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:PURPOSE: Endovascular treatment of infrapopliteal peripheral arterial disease (PAD) is an established and effective treatment strategy for patients with symptomatic PAD. Increasingly, complex infrapopliteal lesions are treated with an endovascular first approach, especially in the setting of critical limb ischemia for limb salvage, avoiding major amputations which impact on mobility and quality of life. However, many complex infrapopliteal lesions involving the bifurcation of the tibial arteries remain challenging to treat due to recoil or acute dissection following angioplasty and may require stenting using specialized techniques. TECHNIQUE: We illustrate techniques for infrapopliteal arterial bifurcation stenting using case-based examples. The techniques covered include the single stent, culottes, kissing, crush and T-stenting techniques and each is considered based on individual strengths and limitations. CONCLUSION: Infrapopliteal bifurcation stenting allows complex bifurcation lesions to be treated effectively when flow-limiting complications are encountered following angioplasty.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher

  10 / 72387 MEDLINE  
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[PMID]: 29518503
[Au] Autor:Davis FM; Albright J; Gallagher KA; Gurm HS; Koenig GC; Schreiber T; Grossman PM; Henke PK
[Ad] Address:Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI.
[Ti] Title:Early outcomes following endovascular, open surgical, and hybrid revascularization for lower extremity acute limb ischemia.
[So] Source:Ann Vasc Surg;, 2018 Mar 05.
[Is] ISSN:1615-5947
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Acute limb ischemia (ALI) of the lower extremity is a potentially devastating condition that requires urgent and definitive management. This challenging scenario is often treated with endovascular, open surgical, or hybrid revascularization in an urgent basis, but the comparative effects of such therapies remain poorly defined. The purpose of this study was to compare outcomes of endovascular, open surgical, and hybrid revascularization for ALI in the contemporary era. METHODS: A large statewide cardiovascular consortium of 45 hospitals was queried for patients between January 2012 and June 2015 who underwent an endovascular, open surgical, or hybrid revascularization for ALI deemed at high risk of limb loss if not treated within 24 hours (Rutherford class IIA or IIB). A propensity score weighted analysis was performed controlling for demographics, medical history, and procedure type for patients. The primary outcomes were 30-day morbidity and mortality. RESULTS: A total of 1,480 patients underwent endovascular (ER; n=818), open surgical (OSR; n=195), or hybrid revascularization (HyR; n=467) for ALI. The mean age was similar across revascularization technique with an increased predominance of male gender in open surgery cohort. Comorbidities for all groups were consistent with peripheral arterial disease. The most common endovascular procedures were angioplasty (93%) and thrombolysis (49.8%), while the most common surgical revascularization was femoral to popliteal bypass (32.8%), femoral to tibial bypass (28.2%), and thrombectomy (19.0%), ER as compared to OSR and HyR procedures was associated with less transfusion (OSR vs. ER, Odds ratio (OR) 2.7; HyR vs. ER, OR 2.8; P < .001) and major amputation (OSR vs. ER, OR 3.4; HyR vs. ER, OR 4.0; P < .001) within 30-days of intervention. There was no difference in 30-day freedom from reintervention, myocardial infarction, or mortality. CONCLUSIONS: Amongst patients requiring urgent revascularization for Rutherford grade IIA and IIB ischemia, endovascular revascularization has lower 30-day morbidity but similar mortality and rates of reintervention. Although long-term patency rates were not compared, endovascular revascularization may offer superior short-term outcomes compared to open surgery and hybrid revascularization.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher


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