Annals of vascular surgery
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Observational Study
Permanent Decline of Renal Function after Infrarenal Abdominal Aortic Aneurysm Repair-Frequency and Risk Factors.
Permanent renal function decline, and development and deterioration of chronic kidney disease (CKD) are associated with serious complications. How frequent is renal function decline after infrarenal abdominal aortic aneurysm (iAAA) repair according to current definitions and what are its risk factors, especially potentially modifiable ones? ⋯ A permanent decline of renal function 1 year after iAAA repair is frequent. Preexisting CKD, RAS ≥70%, OAR, and periprocedural AKI are independent risk factors, the latter 2 with additive effect.
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Comparative Study
The Value of Carotid Endarterectomy as a Learning Tool for Trainees.
Carotid endarterectomy (CEA) intervention needs a specific training and a sufficient learning curve to obtain optimal results in terms of outcome. A formative program was settled up in a single academic center to optimize training of standard CEA procedures. This study aims to evaluate the 11-year results of the teaching CEA program. ⋯ With a defined CEA teaching program, trainees can obtain results similar to those of more experienced surgeons in terms of clinical outcome at the price of an increased intervention time.
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Identifying the risk factors predisposing to aortic enlargement after thoracic endovascular aortic repair (TEVAR) is needed for DeBakey IIIb aortic dissection. The aim of the study is to assess the novel morphological features for DeBakey IIIb aortic dissection in predicting distal thoracic aortic enlargement after TEVAR. ⋯ The CTA-based morphological features described in this study might improve preoperative risk stratification of DeBakey IIIb aortic dissection, with categories II and III having higher risk of distal thoracic aortic enlargement after TEVAR.
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Frailty has been increasingly used as a prognostic indicator for various surgical operations. Patients with peripheral arterial disease represent a cohort of population with advanced medical comorbidities. The aim of this study is to correlate the postoperative outcomes after lower extremity bypass surgery with preoperative modified frailty index (mFI). ⋯ This study demonstrates that the mFI can be used as a valuable tool to identify patients at a higher risk for developing postoperative complications after lower extremity revascularization. For patients with mFI score of 0.54-0.63, the risk of mortality and complications increases significantly. mFI can be used as a useful screening tool to identify patients who are at a high risk for developing complications.
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Comparative Study
Rapid Methods for Routine Frailty Assessment during Vascular Surgery Clinic Visits.
Frailty assessment can help vascular surgeons predict perioperative risk and long-term mortality for their patients. Unfortunately, comprehensive frailty assessments take too long to integrate into clinic workflow. This study was designed to evaluate 2 rapid methods for assessing frailty during vascular clinics-a short patient-reported survey and a provider-reported frailty scale. ⋯ Frailty can be quickly and effectively assessed during vascular surgery clinic using a combination of patient-reported (FiND) and provider-reported (CFS) methods to improve diagnostic accuracy. Implementing routine frailty assessment into clinic workflow can be a valuable tool for risk prediction and surgical decision-making.