Journal of vascular surgery
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The chief of surgery at a large private hospital read a paper reporting that implementation of a comprehensive surgical checklist greatly improved mortality and morbidity. The hospital has agreed to cover the cost of implementation. A special meeting of the surgical staff on implementing the checklist did not go well. ⋯ Start a pilot study with volunteer surgeons. E. Move to a new hospital where the staff is more progressive.
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Review Meta Analysis
A systematic review and meta-analysis of the treatments of varicose veins.
Several treatment options exist for varicose veins. In this review we summarize the available evidence derived from comparative studies about the relative safety and efficacy of these treatments. ⋯ Low-quality evidence supports long-term safety and efficacy of surgery for the treatment of varicose veins. Short-term studies support the efficacy of less invasive treatments, which are associated with less periprocedural disability and pain.
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Randomized Controlled Trial Multicenter Study Comparative Study
A randomized controlled trial of endovascular aneurysm repair versus open surgery for abdominal aortic aneurysms in low- to moderate-risk patients.
Several studies, including three randomized controlled trials (RCTs), have shown that endovascular repair (EVAR) of abdominal aortic aneurysms (AAA) offered better early results than open surgical repair (OSR) but a similar medium-term to long-term mortality and a higher incidence of reinterventions. Thus, the role of EVAR, most notably in low-risk patients, remains debated. ⋯ In patients with low to intermediate risk factors, open repair of AAA is as safe as EVAR and remains a more durable option.
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Thoracic endograft collapse after thoracic endovascular aortic repair (TEVAR) is a potentially devastating complication. This study evaluates the management of thoracic stent graft collapse. ⋯ Endograft collapse can be successfully managed by endovascular techniques in most cases. Redo-TEVAR using high radial force devices should be considered the initial treatment of choice. Late endograft-related complications after treatment of collapsed endografts are not uncommon and can be safely managed by open conversion.