Clinical Impact of Intravascular Ultrasound Guidance During Endovascular Treatment of Subclavian Artery Disease

2017 ◽  
Vol 24 (5) ◽  
pp. 731-738 ◽  
Author(s):  
Wen-Jung Chung ◽  
Yoshimitsu Soga ◽  
Yusuke Tomoi ◽  
Masahiko Fujihara ◽  
Shinya Okazaki ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Endovascular Treatment ◽  
Intravascular Ultrasound ◽  
Subclavian Artery ◽  
Primary Patency ◽  
Secondary Patency ◽  
Complication Rates ◽  
All Cause Mortality ◽  
Artery Disease

Purpose: To evaluate the short- and long-term efficacy of intravascular ultrasound (IVUS) guidance during endovascular treatment (EVT) of subclavian artery disease. Methods: The multicenter SCALLOP registry (SubClavian Artery disease treated with endovascuLar therapy; muLticenter retrOsPective registry) was interrogated to identify 542 patients who underwent successful EVT for SCAD between January 2003 and December 2012. Lesions were classified according to the use of IVUS guidance: 177 patients (mean age 68.9±8.6 years; 149 men) with and 373 patients (mean age 69.9±8.7 years; 275 men) without. The main outcome was the difference in primary patency; secondary outcomes were differences in assisted primary patency, secondary patency, overall survival, freedom from major adverse cardiovascular events [MACE; all-cause mortality, myocardial infarction (MI), and stroke], and freedom from major adverse events (MAE). Multivariate analysis of the IVUS+ group was performed to identify predictors of failure; results are presented as the hazard ratio (HR) and 95% confidence interval (CI). Results: In total, 538 (97.8%) lesions were treated with stents and 12 lesions by balloon angioplasty alone. Periprocedural and in-hospital overall complication rates did not differ significantly between IVUS+ (10.2%) and IVUS– (8.8%, p=0.617). Long-term follow-up demonstrated no significant difference between IVUS+ and IVUS– groups in 5-year all-cause mortality (p=0.37), MI (p=0.07), stroke (p=0.31), or MACE (p=0.07). However, 5-year primary patency was significantly higher in the IVUS+ group (88.5% vs 77.7%, p=0.03). There were no group differences in 5-year assisted primary patency (90.4% vs 89.9%, p=0.81) or secondary patency (99.4% vs 97.1%, p=0.25). Multivariate analysis of the IVUS+ group identified in-hospital stroke (HR 16.92, 95% CI 3.60 to 79.42, p<0.01) and combined use of balloon-expandable and self-expanding stents (HR 5.59, 95% CI 1.22 to 25.65, p=0.02) as independent negative predictors of primary patency. Conclusion: These results suggest that IVUS guidance can significantly improve long-term primary patency following endovascular treatment of subclavian artery disease.

Endovascular treatment for chronic atherosclerotic occlusive mesenteric disease: Is stenting superior to balloon angioplasty?

VASA ◽  
2010 ◽  
Vol 39 (4) ◽  
pp. 319-324 ◽  
Author(s):  
Daliri ◽  
Grunwald ◽  
Jobst ◽  
Szucs-Farkas ◽  
Diehm ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Patency Rate ◽  
Celiac Artery ◽  
Primary Patency ◽  
Secondary Patency ◽  
Chronic Mesenteric Ischemia ◽  
Primary Patency Rate ◽  
Secondary Patency Rate

Background: Endovascular treatment is an increasingly used therapeutic option in patients with chronic atherosclerotic occlusive mesenteric disease. Purpose of this study was evaluation of patency and mortality in patients treated with visceral artery percutaneous transluminal angioplasty (PTA) or stenting including follow-up. Patients and methods: A retrospective review of 17 consecutive patients (4 women, 13 men) with endovascular treatment for symptomatic chronic mesenteric ischemia from 1998 to 2004 was performed. Mean follow-up period was 42 months. Patient demographics, interventional details, primary and/or secondary patency and mortality were recorded. Cumulative mortality and patency rates were determined using Kaplan-Meier life table analysis. Results: Twenty-six interventions (PTA alone n = 13, PTA and stenting n = 13) were performed in 17 patients. Interventions were performed in the superior mesenteric artery (n = 13) and celiac artery (n = 13). The re-intervention rate was 30 % (6/26). Re-interventions were performed for the superior mesenteric artery (n = 4) and celiac artery (n = 2). Cumulative overall 1-year results were primary patency rate 81 %, secondary patency rate 94 %, and survival rate 82 %. Cumulative 10-year results were primary patency rate 73 %, secondary patency rate 94 %, and survival rate 65 %. The 10-year secondary patency rate was 100 % in patients post initial stenting and 86 % in patients post initial PTA. Conclusions: Long-term follow-up post endovascular treatment for chronic mesenteric ischemia demonstrated a considerable overall secondary patency rate of 94 %. However, the long-term secondary patency rate was higher in patients post initial stenting compared to PTA alone.

scholarly journals Transposition of Subclavian Artery – Is It the Appropriate Choice?

PRILOZI ◽  
2017 ◽  
Vol 38 (1) ◽  
pp. 47-51
Author(s):  
Nikola Lazovski ◽  
Sasko Jovev ◽  
Dusan Babic ◽  
Srdjan Babic ◽  
Omer Dzemali
Keyword(s):  
Surgical Treatment ◽  
Treatment Failure ◽  
Endovascular Treatment ◽  
Subclavian Artery ◽  
Artery Occlusion ◽  
Long Term Results ◽  
Duplex Scan ◽  
Subclavian Artery Occlusion ◽  
Artery Disease

Abstract Introduction: To present patients with symptomatic subclavian artery disease and treatment possibility. Case report: A 53-year-old female was admitted with vertigo and left arm claudication. Duplex-scan and MSCT arteriography verified subclavian artery occlusion. After the endovascular treatment failure, the patient was switched to surgical treatment - subclavian artery transposition. After the successful surgical treatment, the patient was discharged on the second postoperative day. If the patient is a candidate for surgery, the literature review shows good initial and long-term results after the subclavian artery transposition, and emphasizes this technique as superior. Conclusion: Subclavian carotid transposition is a safe and effective method of treatment in patients after endovascular treatment failure or other indication. Also, the surgical treatment is technically demanding because of the difficult access to the vessel origin, and it requires experienced surgeons.

Perioperative and Long-term Outcomes of Endovascular Treatment for Subclavian Artery Disease From a Large Multicenter Registry

2015 ◽  
Vol 22 (4) ◽  
pp. 626-633 ◽  
Author(s):  
Yoshimitsu Soga ◽  
Yusuke Tomoi ◽  
Masahiko Fujihara ◽  
Shinya Okazaki ◽  
Yasutaka Yamauchi ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Subclavian Artery ◽  
Long Term Outcomes ◽  
Artery Disease ◽  
Multicenter Registry

Midterm Outcomes on Primary Endovascular Treatment of 395 Aortoiliac Occlusive Disease Patients: A Single-Center Experience

Angiology ◽  
2021 ◽  
pp. 000331972199137
Author(s):  
Ender Özgün Çakmak ◽  
Emrah Bayam ◽  
Fatih Yilmaz ◽  
Muzaffer Kahyaoğlu ◽  
Mehmet Çelik ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Primary Patency ◽  
Occlusive Disease ◽  
Secondary Patency ◽  
Aortoiliac Occlusive Disease ◽  
Single Center Experience ◽  
Observational Cohort ◽  
Vascular Center

We report the results of endovascular treatment of Trans-Atlantic Inter-Society Consensus II (TASC) A&B, TASC C, and TASC D aortoiliac lesions in a single vascular center. In this retrospective, observational cohort study, we analyzed 395 patients (mean age 61.2 ± 9.0; 359 men) between January 2015 and December 2017. Technical success was achieved in 96.5%; in-hospital mortality was 1.2% (n = 5). Median follow-up was 36 months (range 24-49 months). After 1 and 5 years, the primary patency rates were 99% and 85% for TASC A&B, 90%, and 78% for TASC C, and 90% and 74% for TASC D. Secondary patency rates were 99% and 90% for TASC A&B, 98% and 65% for TASC C, and 97% and 65% for TASC D. Previous peripheral revascularization (hazard ratio: 1.76, 95% CI: 1.01-3.08, P = .04) was associated with decreased primary patency along with lower age, TASC C, and TASC D class. This analysis reported the acceptable effectiveness and safety of stenting for all types of aortoiliac occlusive disease in a modern setting, with few complications and excellent long-term primary and secondary patency rates.

Adverse Prognosis of Peripheral Artery Disease Treatments Associated With Diabetes: A Comprehensive Meta-Analysis

Angiology ◽  
2021 ◽  
pp. 000331972110424
Author(s):  
Jingyang Luan ◽  
Jie Xu ◽  
Weiquan Zhong ◽  
Yan Zhou ◽  
Hao Liu ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Meta Analysis ◽  
Primary Patency ◽  
Secondary Patency ◽  
Peripheral Artery ◽  
Secondary Endpoints ◽  
Artery Disease ◽  
Long Term Mortality

Many studies have investigated the influence of diabetes mellitus (DM) on outcomes in patients with peripheral artery disease (PAD). We performed a meta-analysis of the outcomes of PAD treatments in DM patients compared with those without DM. Long-term mortality was the primary endpoint. Secondary endpoints were in-hospital/30-day mortality, primary/secondary patency, amputation, and limb salvage. Thirty-one studies reporting 58113 patients were eligible for enrollment. The mean follow-up duration ranged from 1 to 89 months. DM was significantly associated with long-term mortality (relative risk (RR) = 1.67; 95% confidence intervals (CI), 1.43–1.94; P < .001). DM was also associated with significantly lower primary patency (RR = 0.74; 95% CI, 0.58–0.95; P = .001) and secondary patency (RR = 0.80; 95% CI, 0.67–0.96; P = .009). DM is associated with worse outcomes and adverse prognosis of treatment in patients with PAD, and may therefore be a modifiable risk factor for poor prognosis in PAD patients.

Patency Rates Among Heparin-Bonded and Conventional Polytetrafluoroethylene Grafts for Upper Extremity Hemodialysis Access

2014 ◽  
Vol 19 (3) ◽  
pp. 153-157 ◽  
Author(s):  
Samantha R. Cox ◽  
John A. Moawad ◽  
Lee Anne Marshall ◽  
Drazen Petrinec ◽  
Joseph R. McShannic ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Retrospective Chart Review ◽  
Primary Patency ◽  
Secondary Patency ◽  
Complication Rates ◽  
Arteriovenous Fistulae ◽  
Institutional Review ◽  
Therapeutic Anticoagulation ◽  
Significant Difference

Abstract Background: Although arteriovenous fistulae are the gold standard for vascular access, many patients do not have veins that are suitable for arteriovenous fistulae. These patients require arteriovenous grafts (AVGs). There have been no long-term trials designed to analyze the complication and patency rates of heparin-bonded versus conventional upper extremity AVGs. We aimed to compare patency and complication rates of upper extremity conventional versus heparin-bonded AVGs. Methods: A retrospective chart review from 2008 through 2012 was conducted. Institutional review board approval was obtained. Patients with an upper extremity conventional or heparin-bonded AVG were included. Exclusion criteria included use of therapeutic anticoagulation and forearm loop grafts. Complication rates, reinterventions, and primary and secondary patency rates were compared using logistic regression analysis. Results: The cohort consisted of 93 patients. Conventional and heparin-bonded grafts were compared and there was no statistically significant difference between the median time to use (29 vs 32 days; P =.440) or primary patency (P =.673). The duration of time elapsed until intervention was a median of 69 days (mean ±standard error =94.7 ± 10.4 days). Demographic characteristics of patients did not differ between the graft types (61% women; P =0.342). No statistically significant differences were seen between comorbidities in the 2 groups and body mass index did not differ (P =.986). Conclusions: There is no improved primary patency, secondary patency, or difference in complication rates between patients who received conventional versus heparin-bonded AVGs.

Mid-term outcome after endovascular therapy in the superficial femoral and popliteal artery using long stents

VASA ◽  
2012 ◽  
Vol 41 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Schoenefeld ◽  
P. Donas ◽  
Schönefeld ◽  
Osada ◽  
Austermann ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Popliteal Artery ◽  
Primary Patency ◽  
Stent Fracture ◽  
Fracture Rate ◽  
Term Outcome ◽  
Technical Success Rate ◽  
Endovascular Interventions ◽  
Artery Disease

Background: Peripheral artery disease (PAD) affecting the femoropopliteal artery is treated by endovascular interventions [2, 5, 13] increasingly. Aim of the study was to evaluate mid-term efficacy and patency of long stents in the superficial femoral and popliteal artery. Patients and methods: Between September 2006 and September 2007 103 patients received 128 stents for endovascular treatment of femoropopliteal vascular stenosis or occlusion. Clinical and hemodynamic parameters were collected. Risk factors, popliteal involvement and TASC classification, were documented and evaluated. Results: Immediate outcome was satisfactory with a technical success rate of 100 %. After a mean follow-up period of 21 months, primary patency was 83.6 %. Potential risk factor analysis for restenosis and fracture demonstrated hypertension to have borderline significance (P = 0.06). In normotensive patients no restenosis occurred. Further pre-conditions, e.g. smoking, metabolic syndrome, age, gender and previous intervention did not show any influence on restenosis or stent fracture. TASC C and D lesion had similar patency rates compared to TASC A and B lesions. Most of the restenoses (13 out of 16) were observed within the first six months of follow-up. Six stent fracture were observed (4.7 %). Conclusions: Long stents had convincing results after endovascular treatment of the femoropopliteal PAD. The used stent was an efficacious endovascular tool for long athersclerotic lesions in the superficial femoral and popliteal artery. Fracture rate was low with an incidence of 4.7 %. Most restenoses occurred within the first six months so that careful follow-up would be necessary.

Forearm brachial artery to brachial vein looped arteriovenous grafts: A single center, single surgeon observational study

2021 ◽  
pp. 112972982110150
Author(s):  
Jeremy Liu ◽  
Josiah Situmeang ◽  
Devin Takahashi ◽  
Russell Harada
Keyword(s):  
Primary Patency ◽  
The Body ◽  
Secondary Patency ◽  
Close Monitoring ◽  
Arteriovenous Graft ◽  
Inclusion Criteria ◽  
Kaplan Meier ◽  
Brachial Vein ◽  
Arteriovenous Grafts

Background: Long-term hemodialysis (HD) treatment requires the establishment of a cannulatable vascular access (VA) point. While the arteriovenous fistula (AVF) is considered the gold standard, the arteriovenous graft (AVG) is a viable alternative especially in patients with poor superficial venous anatomy. Few studies have assessed the efficacy of the brachial-brachial arteriovenous graft (BB-AVG) for long-term HD access. By analyzing one surgeon’s experience in creating, surveilling and maintaining BB-AVGs, this retrospective study aims to add to the body of literature in assessing patency outcomes of BB-AVGs. Methods: We identified 57 BB-AVGs that met inclusion criteria and were created between October 6, 2005 and May 1, 2019 by a single surgeon in 54 patients. We analyzed primary failures, patency, complications and interventions. Patency rates were calculated by the Kaplan–Meier method. The incidence of complications and interventions were expressed as number of events per person-year. Results: A total of 54 patients (median age of 65 years) were analyzed. Primary patency rates at 12, 24, and 36 months were 20.4% 7.4%, and 5.0%. Primary assisted patency rates at 12, 24, and 36 months were 46.7%, 33.5%, and 15.1%. The secondary patency rates at 12, 24, and 36 months were 81.8%, 63.8%, and 60.1%, respectively. The incidence of complications and interventions was 2.164 per person-year. Most complications and interventions were due to stenosis (1.202 per person-year) or thrombosis (0.802 per person-year). Conclusion: In patients with poor superficial veins, the brachial vein is a reasonable alternative to use as the venous outflow. However, in order to achieve acceptable patency rates, close monitoring of the VA, as well as aggressive treatment of complications within the brachial vein is necessary. Overall, the BB-AVG should be considered in patients who lack adequate superficial veins and require preservation of the more proximal veins.

Prognostic Impact of Red Cell Distribution Width on the Development of Contrast Induced Nephropathy, Major Adverse Cardiac Events, and Mortality in Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention.

2021 ◽  
Vol 17 ◽  
Author(s):  
Azka Latif ◽  
Muhammad Junaid Ahsan ◽  
Noman Lateef ◽  
Vikas Kapoor ◽  
Hafiz Muhammad Fazeel ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Cardiac Events ◽  
Distribution Width ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary ◽  
All Cause Mortality ◽  
Artery Disease

: Red cell distribution width (RDW) serves as an independent predictor towards the prognosis of coronary artery disease (CAD) in patients undergoing percutaneous coronary intervention (PCI). A systematic search of databases such as PubMed, Embase, Web of Science, and Cochrane library was performed on October 10th, 2019 to elaborate the relationship between RDW and in hospital and long term follow up all-cause and cardiovascular mortality, major adverse cardiac events (MACE) and development of contrast-induced nephropathy (CIN) in patients with CAD undergoing PCI. Twenty-one studies qualified this strict selection criteria (number of patients = 56,425): one study was prospective, and the rest were retrospective cohorts. Our analysis showed that patients undergoing PCI with high RDW had a significantly higher risk of in-hospital all-cause mortality (OR 2.41), long-term all-cause mortality (OR 2.44), cardiac mortality (OR 2.65), MACE (OR: 2.16) and odds of developing CIN (OR: 1.42) when compared to the patients with low RDW. Therefore, incorporating RDW in the predictive models for the development of CIN, MACE, and mortality can help in triage to improve the outcomes in coronary artery disease patients who undergo PCI.

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