دورية أكاديمية
Arterial dissection during peripheral vascular interventions.
| العنوان: | Arterial dissection during peripheral vascular interventions. |
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| المؤلفون: | Damara FA; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT. Electronic address: damaraf@ccf.org., Alameddine D; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT., Slade M; Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, CT., Cardella J; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT., Tonnessen B; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT., Guzman RJ; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT., Ochoa Chaar CI; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT. |
| المصدر: | Journal of vascular surgery [J Vasc Surg] 2024 Feb; Vol. 79 (2), pp. 339-347.e6. Date of Electronic Publication: 2023 Oct 12. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 8407742 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6809 (Electronic) Linking ISSN: 07415214 NLM ISO Abbreviation: J Vasc Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2008-> : New York, NY : Elsevier Original Publication: St. Louis, Mo. : Mosby, [c1984- |
| مواضيع طبية MeSH: | Peripheral Arterial Disease*/diagnostic imaging , Peripheral Arterial Disease*/epidemiology , Peripheral Arterial Disease*/therapy , Endovascular Procedures*/adverse effects , Dissection, Blood Vessel*, Humans ; Female ; Male ; Treatment Outcome ; Risk Factors ; Limb Salvage ; Vascular Patency ; Retrospective Studies ; Femoral Artery/surgery |
| مستخلص: | Objective: Arterial dissection (AD) is a known complication of peripheral vascular interventions (PVIs), but its incidence and significance have not been well-characterized. This study examines AD in the Vascular Quality Initiative database for patients treated for peripheral arterial disease. Our hypothesis is that AD is associated with decreased patency and worse limb outcomes. Methods: The Vascular Quality Initiative PVI registry (2016-2021) was reviewed. Patients were divided based on the presence or absence of reported AD during the procedure. Trend of incidence and management of AD was derived. The characteristics and outcomes of patients with and without AD were compared. The primary endpoint was primary patency. Results: There was a total of 177,790 cases, and 3% had AD. The incidence of AD significantly increased over the study period from 2.4% to 3.6% (P = .007). Endovascular therapy was used to treat AD in 83.7% of cases, 14.5% were treated medically, and only 1.8% required open surgery. Patients with AD were significantly more likely to be female (47.4% vs 39.7%; P < .001). Patient with AD were more likely to have a history of smoking (79.7% vs 77.2%; P < .001), but were significantly less likely to be on dialysis (8.2% vs 9.3%; P < .001) compared with patients without AD. Patients with AD were more likely to have femoropopliteal disease (45.2% vs 38.0%; P < .001) and undergo treatment of more complex disease as denoted by higher mean number of lesions treated (1.95 ± 1.01 vs 1.71 ± 0.89; P < .001), longer occlusion length (8 ± 16 vs 7 ± 15 cm; P < .001), and more severe TransAtlantic Inter-Society Consensus grade (Grade D: 36.2% vs 29.1%; P < .001). The proportion of stenting as a treatment modality was higher in the dissection group (55.4% vs 41.1%; P < .001). After a mean follow-up of 828 days, patients with AD had significantly lower primary patency than patients without AD. Kaplan-Meier curves demonstrated that the AD group had lower primary patency (86.9% vs 91%; P < .001) and reintervention-free survival (79.5 % vs 84.1%; P < .001) at 1 year with difference in amputation-free survival. Cox proportional hazard regression confirmed the independent association of AD with primary patency and reintervention-free survival. Conclusions: AD is more common in women and is more likely to occur during treatment of the femoropopliteal segment. AD is associated with decreased primary patency and reintervention-free survival after PVI for peripheral arterial disease. Competing Interests: Disclosures None. (Copyright © 2023 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Arterial dissection; Peripheral arterial disease; Peripheral vascular interventions |
| تواريخ الأحداث: | Date Created: 20231014 Date Completed: 20240122 Latest Revision: 20240122 |
| رمز التحديث: | 20240122 |
| DOI: | 10.1016/j.jvs.2023.10.004 |
| PMID: | 37838217 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1097-6809 |
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| DOI: | 10.1016/j.jvs.2023.10.004 |