International Journal of Vascular Medicine最新文献

{"title":"Retrograde Popliteal Access for Challenging Superficial Femoral Artery Occlusion.","authors":"Georges Ibrahim,&nbsp;Sami Nabhani,&nbsp;Michel Feghaly","doi":"10.1155/2021/8833025","DOIUrl":"https://doi.org/10.1155/2021/8833025","url":null,"abstract":"<p><p>Retrograde popliteal access has long been established as an alternative to the antegrade approach to occlusive lesions in the superficial femoral artery (SFA). However, early reports with high complication rates (dissection, hematomas, aneurysms, and arteriovenous shunts at the puncture site) reduced enthusiasm for this technique. In recent years, with the development of thinner sheaths and low profile angioplasty devices, retrograde popliteal access has resurfaced as a viable technique, mostly in combination with or after failure of the more classical antegrade approach. In this retrospective study, we will report the safety and efficacy of the retrograde popliteal approach in the treatment of superficial femoral artery chronic total occlusions, in 13 consecutive patients between January 2017 and January 2021. The results showed 100% successful puncture of the popliteal artery and 100% successful recanalization and stenting of the superficial femoral artery with a total of 2 complications related to the puncture site and zero periprocedural mortality. In conclusion, the retrograde popliteal approach appears to be an effective and safe alternative to the common SFA complete total occlusion (CTO) treatment approach.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2021 ","pages":"8833025"},"PeriodicalIF":1.3,"publicationDate":"2021-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8149250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39032806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting to the Heart of the Matter: Myocardial Injury, Coagulopathy, and Other Potential Cardiovascular Implications of COVID-19.","authors":"Aaron Schmid,&nbsp;Marija Petrovic,&nbsp;Kavya Akella,&nbsp;Anisha Pareddy,&nbsp;Sumathilatha Sakthi Velavan","doi":"10.1155/2021/6693895","DOIUrl":"https://doi.org/10.1155/2021/6693895","url":null,"abstract":"<p><p>COVID-19 was primarily identified as a respiratory illness, but reports of patients presenting initially with cardiovascular complaints are rapidly emerging. Many patients also develop cardiovascular complications during and after COVID-19 infection. Underlying cardiovascular disease increases the severity of COVID-19 infection; however, it is unclear if COVID-19 increases the risk of or causes cardiovascular complications in patients without preexisting cardiovascular disease. The review is aimed at informing the primary care physicians of the potential cardiovascular complications, especially in patients without underlying cardiovascular disease. A comprehensive literature review was performed on cardiac and vascular complications of COVID-19. The primary cardiac and vascular complications include myocarditis, acute coronary syndrome, myocardial injury, arrhythmia, heart failure, shock, multisystem inflammatory syndrome, venous and arterial thrombotic events, stroke, and coagulopathy. A detailed analysis of the pathogenesis revealed six possible mechanisms: direct cardiac damage, hypoxia-induced injury, inflammation, a dysfunctional endothelial response, coagulopathy, and the catecholamine stress response. Autopsy reports from studies show cardiomegaly, hypertrophy, ventricular dilation, infarction, and fibrosis. A wide range of cardiac and vascular complications should be considered when treating patients with confirmed or suspected COVID-19 infection. Elevated troponin and natriuretic peptides indicate an early cardiac involvement in COVID-19. Continuous monitoring of coagulation by measuring serum D-dimer can potentially prevent vascular complications. A long-term screening protocol to follow-up the patients in the primary care settings is needed to follow-up with the patients who recovered from COVID cardiovascular complications.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2021 ","pages":"6693895"},"PeriodicalIF":1.3,"publicationDate":"2021-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8118745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39018619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to the 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline on the Use of Oral Anticoagulant Agents in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study.","authors":"Ayman J Hammoudeh, Yousef Khader, Nazih Kadri, Eyas Al-Mousa, Yahya Badaineh, Laith Habahbeh, Ramzi Tabbalat, Hesham Janabi, Imad A Alhaddad","doi":"10.1155/2021/5515089","DOIUrl":"10.1155/2021/5515089","url":null,"abstract":"<p><strong>Background: </strong>There is a scarcity of studies that evaluate adherence to the utilization of guideline-recommended oral anticoagulant agents (OACs) in patients with atrial fibrillation (AF) in the Middle East. The Jordan Atrial Fibrillation (JoFib) Study evaluated baseline clinical profiles and the utilization of OACs, including vitamin K antagonists (VKAs) and direct OACs (DOACs), in patients with valvular AF (VAF) and nonvalvular AF (NVAF) according to the 2019 focused update of the 2014 AHA/ACC/HRS guidelines.</p><p><strong>Methods: </strong>Consecutive patients with AF were enrolled in 29 hospitals and outpatient clinics. The use of OACs was evaluated in patients with VAF and NVAF according to the prespecified guideline.</p><p><strong>Results: </strong>Of 2000 patients, 177 (8.9%) had VAF and 1823 (91.1%) had NVAF. A VKA was prescribed for 88.1% of the VAF group. In the NVAF group, 1468 (80.5%) of patients had a high CHA₂DS₂-VASc score, i.e., a score of ≥3 in women and ≥2 in men; 202 (11.1%) patients had an intermediate CHA₂DS₂-VASc score, i.e., a score of 2 in women and 1 in men; and 153 (8.4%) patients had a low CHA₂DS₂-VASc score, i.e., a score of 1 in women and 0 in men. Of patients with a high CHA₂DS₂-VASc score, 1204 (82.0%) received OACs, including DOACs for 784 (53.4%) and VKA for 420 (28.6%) patients. Among patients with an intermediate score, OACs were prescribed for 148 (73.3%) patients, including 107 (53.0%) who received DOACs and 41 (20.3%) patients who received VKA. In patients with a low score, OACs were omitted in 94 (61.4%) patients and prescribed for 59 (38.6%) patients. Multivariate analysis showed that age between 50 and 70 years, CHA₂DS₂-VASc score of ≥2, a diagnosis of stroke or systemic embolization, and nonparoxysmal AF were significantly associated with increased odds of OAC prescription.</p><p><strong>Conclusions: </strong>The current status of the utilization of OACs in Middle Eastern AF patients appears to be promising and is consistent with the 2019 focused update of the 2014 AHA/ACC/HRS guideline. This trial is registered with NCT03917992.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2021 ","pages":"5515089"},"PeriodicalIF":1.3,"publicationDate":"2021-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8052172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38914989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thermal Disparity among Fingers and Its Amelioration by CO2-Water Bathing in Connective Tissue Disease Patients","authors":"S. Inokuma, Y. Kijima","doi":"10.1155/2021/6699029","DOIUrl":"https://doi.org/10.1155/2021/6699029","url":null,"abstract":"Objective. Correlation between a low finger temperature and thermal disparity among fingers was studied in connective tissue disease (CTD) patients. Whether the thermal disparity may be ameliorated by hand immersion in a warm carbon dioxide(CO2-) water bath was analyzed. Methods. CTD patients with suspected peripheral circulation disorder underwent a thermography test. From before to 30min after hand immersion in CO2-water (CO2 bathing; 1000 ppm CO2, 42 C, 10min), the nailfold temperatures were measured. The mean temperature (m-Temp) and the coefficient of variation of the temperature (CV = SD/m‐Temp of one hand; the mean of CVs of both hands was adopted as the indicator of thermal disparity) were monitored. The correlation between m-Temp and CV was also analyzed. Results. Forty-seven (45 females and 2 males) patients were included, 32 of whom had Raynaud’s phenomenon. The m-Temp was 30:8 ± 3:0°C at the baseline, increased to 35:3 ± 1:0°C immediately after CO2 bathing, and remained significantly higher than that at the baseline until 30min after (32:1 ± 1:9°C). The CV was 0:0291 ± 0:0247 at the baseline, decreased to 0:0135 ± 0:0039 immediately after CO2 bathing, and remained significantly lower than the baseline until 30min after (0:0163 ± 0:0143). Between m-Temp and CV, a negative correlation was observed throughout the measurements. Conclusion. Thermal disparity was observed at baseline measurement in CTD patients. Warm CO2 bathing markedly ameliorated the disparity, and this amelioration remained until after 30min. Throughout the observation, the lower the m-Temp, the more severe the thermal disparity among fingers.","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2021 1","pages":"1-5"},"PeriodicalIF":1.3,"publicationDate":"2021-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49504833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Angiotensin Antagonism in Coronary Plaque Regression: Insights from the Glagovian Model.","authors":"Abdul H Alkatiri,&nbsp;Dony Firman,&nbsp;Amir A Alkatiri,&nbsp;Paskalis I Suryajaya,&nbsp;Albert Sudharsono","doi":"10.1155/2021/8887248","DOIUrl":"https://doi.org/10.1155/2021/8887248","url":null,"abstract":"<p><p>The benefit of antagonizing the effect of the renin angiotensin aldosterone system (RAAS), notably by the use of angiotensin-converting enzyme inhibitor (ACEi) and angiotensin II type 1 receptor blocker (ARB) for coronary artery disease (CAD), has been demonstrated in multiple studies, which may be attributed to their ability to inhibit the deleterious effect of RAAS to the cardiovascular system. It is well known that angiotensin II (Ang II) plays a vital role in atheromatous plaque formation and progression through multiple pathways, including inflammatory and arterial remodeling aspects. Significant coronary atheromatous plaque regression has been previously demonstrated in various studies using statin agents. Similar results have been reported in different studies using angiotensin inhibitor agents, notably ARB agents. Analysis from various trials utilizing ARB showed a significant plaque regression using olmesartan and telmisartan as evaluated by IVUS studies. In contrary, the use of ACEi did not demonstrated significant plaque regression, which may be attributed to the heavy plaque calcification in respective studies. On this review, we aim to present the basic mechanism on the role of RAAS in plaque modulation and its arterial remodeling aspect, which is then integrated with the clinical evidence based on the available intravascular ultrasonography (IVUS) studies on coronary arteries.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2021 ","pages":"8887248"},"PeriodicalIF":1.3,"publicationDate":"2021-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8046567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38893762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Vascular Response to Angiotensin II Administration in Two Kidneys-One Clip Hypertensive Rats Treated with High Dose of Estradiol: The Role of Mas Receptor.","authors":"Samira Choopani,&nbsp;Mehdi Nematbakhsh","doi":"10.1155/2021/6643485","DOIUrl":"https://doi.org/10.1155/2021/6643485","url":null,"abstract":"<p><strong>Backgrounds: </strong>High blood pressure is one of the most important causes of death around the world. The renin-angiotensin system (RAS) and estradiol are two important items that regulate arterial blood pressure in women. However, hypertension, RAS, and sex hormone estradiol may influence renal vascular responses. This study was designed to determine the role of Mas receptor (MasR) on renal vascular response to angiotensin II (Ang II) administration in two kidneys-one clip (2K1C) hypertensive rats treated with estradiol.</p><p><strong>Method: </strong>The ovariectomized rats were subjected to 2K1C or non-2K1C and simultaneously treated with estradiol (500 <i>μ</i>g/kg/weekly) or placebo for a period of 4 weeks. Subsequently, under anesthesia, renal vascular responses to graded doses of Ang II administration with MasR blockade (A779) or its vehicle were determined.</p><p><strong>Results: </strong>A779 or its vehicle did not alter mean arterial pressure (MAP), renal perfusion pressure (RPP), and renal blood flow (RBF). However, in non-2K1C rats, Ang II infusion decreased RBF and increased renal vascular resistance (RVR) responses in a dose-related manner (<i>P</i>treat < 0.0001). The greatest responses were found in ovariectomized estradiol-treated rats that received A779 (<i>P</i>group < 0.05) in non-2K1C rats. Such findings were not detected in 2K1C hypertensive rats. For example, in estradiol-treated rats that received A779, at 1000 ng/kg/min of Ang II infusion, RBF reduced from 1.6 ± 0.2 to 0.89 ± 0.19 ml/min in non-2K1C rats, and it reduced from 1.6 ± 0.2 to 1.2 ± 0.2 ml/min in 2K1C rats.</p><p><strong>Conclusion: </strong>Hypertension induced by 2K1C may attenuate the role of A779 and estradiol in renal vascular responses to Ang II infusion. Perhaps, this response can be explained by the reduction of Ang II type 1 receptor (AT1R) expression in the 2K1C hypertensive rats.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2021 ","pages":"6643485"},"PeriodicalIF":1.3,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7943267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25511695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Follow-Up of Contrast-Induced Acute Kidney Injury: A Study from a Developing Country.","authors":"Ashraf O Oweis,&nbsp;Sameeha A Alshelleh,&nbsp;Nesreen Saadeh,&nbsp;Mohamad I Jarrah,&nbsp;Rasheed Ibdah,&nbsp;Karem H Alzoubi","doi":"10.1155/2020/8864056","DOIUrl":"https://doi.org/10.1155/2020/8864056","url":null,"abstract":"<p><strong>Introduction: </strong>Contrast-induced acute kidney injury (CI-AKI) is a worldwide known complication related to the use of contrast media with either imaging or angiography; it carries its own complications and effect on both morbidity and mortality; early identification of patients at risk and addressing modifiable risk factors may help reducing risk for this disease and its complications.</p><p><strong>Methods: </strong>This was a prospective observational study, where all patients admitted for cardiac catheterization between June 2015 and January 2016 were evaluated for CI-AKI. There were two study groups: contrast-induced acute kidney injury (CI-AKI) group, and noncontrast-induced acute kidney injury (non-CI-AKI) group.</p><p><strong>Results: </strong>Patients (<i>n</i> = 202) were included and followed up for 4 years. Death and development of chronic kidney disease (CKD) need for another revascularization were the end points. The incidence of CI-AKI was 14.8%.In univariate analysis, age (<i>P</i> = 0.016) and serum albumin at admission (<i>P</i> = 0.001) were statistically significant predictors of overall death. Age (<i>P</i> = 0.002), HTN (<i>P</i> = 0.002), DM (<i>P</i> = 0.02), and the use of diuretics (<i>P</i> = 0.001) had a statistically significant impact on eGFR. The rate of recatheterization was not statistically significant between the two groups (61 (35.5%) for the non-CI-AKI vs. 12 (40%) for the other group; <i>P</i> = 0.63). Some inflammatory markers (NGAL <i>P</i> = 0.06, IL-19 <i>P</i> = 0.08) and serum albumin at admission <i>P</i> = 0.07 had a trend toward a statistically significant impact on recatheterization. Death (<i>P</i> = 0.66) and need for recatheterization (<i>P</i> = 0.63) were not statistically different between the 2 groups, while the rate of eGFR decline in for the CI-AKI was significant (<i>P</i> = 0.004).</p><p><strong>Conclusion: </strong>CI-AKI is a common complication post percutaneous catheterization (PCI), which may increase the risk for CKD, but not death or the need for recatheterization. Preventive measures must be taken early to decrease the morbidity.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2020 ","pages":"8864056"},"PeriodicalIF":1.3,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38794612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Evaluation of the Correlation between Serum Concentrations of Asymmetric Dimethylarginine and Corrected TIMI Frame Count in Patients with Slow Coronary Flow\".","authors":"Mahshid Naserifar,&nbsp;Mahshid Ataei,&nbsp;Nadia Behzadian,&nbsp;Amir Hooshang Mohammadpour,&nbsp;Mostafa Dastani,&nbsp;Jamal Shamsara,&nbsp;Sepideh Elyasi,&nbsp;Amirhossein Sahebkar,&nbsp;Hesamoddin Hosseinjani","doi":"10.1155/2020/9796012","DOIUrl":"https://doi.org/10.1155/2020/9796012","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1155/2020/4592190.].</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2020 ","pages":"9796012"},"PeriodicalIF":1.3,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9796012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38794613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beneficial Effects of Spirulina Aqueous Extract on Vasodilator Function of Arteries from Hypertensive Rats.","authors":"Diva M Villalpando, Carlos M Verdasco-Martín, Ignacio Plaza, Juan Gómez-Rivas, Fermín R de Bethencourt, Morris Villarroel, José L García, Cristina Otero, Mercedes Ferrer","doi":"10.1155/2020/6657077","DOIUrl":"10.1155/2020/6657077","url":null,"abstract":"<p><p>Hypertension is a multifactorial disorder considered one of the major causes of premature death worldwide. This pathology is associated with vascular functional/structural alterations in which nitric oxide (NO) and oxygen reactive species participate. On the other hand, the use of microalgae extracts in the treatment of cardiovascular diseases is increasing. Based on the antioxidant and antihypertensive properties of Spirulina, this study aims to investigate the effect of an aqueous extract of Spirulina on the vasodilator function of the aorta from spontaneously hypertensive rats (SHR), analyzing the functional role of NO. For this, aortic segments from male SHR were divided into two groups, one control and the other exposed to an Spirulina aqueous extract (0.1% w/v, for 3 hours), to analyze (i) the production of NO, superoxide anion, and hydrogen peroxide; (ii) the vasodilator response induced by acetylcholine (ACh), by the NO donor and sodium nitroprusside (SNP), and by the K_ATP channel opener and pinacidil; and (iii) the expression of the p-Akt, p-eNOS, and HO-1 proteins. The results showed that the aqueous Spirulina extract (i) increased the production of NO, did not significantly modify that of superoxide, while decreased that of hydrogen peroxide; (ii) increased the vasodilatory responses induced by ACh, NPS, and pinacidil; and (iii) increased the expression of p-Akt and HO-1. These results suggest that incubation with the aqueous Spirulina extract improves the vascular function of arteries from SHR by increasing the release/bioavailability/function of NO. Increased K_ATP channel activation and expression of pAkt and HO-1 appear to be participating in these actions.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2020 ","pages":"6657077"},"PeriodicalIF":1.3,"publicationDate":"2020-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38827875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing and Correlating Outcomes between Open and Percutaneous Access in Endovascular Aneurysm Repair in Aortic Aneurysms Using a Retrospective Cohort Study Design.","authors":"Peter DeVito,&nbsp;Ali Kimyaghalam,&nbsp;Sameh Shoukry,&nbsp;Robert DeVito,&nbsp;John Williams,&nbsp;Eashaa Kumar,&nbsp;Eugene Vitvitsky","doi":"10.1155/2020/8823039","DOIUrl":"https://doi.org/10.1155/2020/8823039","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective cohort study is aimed at determining the safety and efficacy between Femoral Open-Cutdown access and Percutaneous access with Endovascular Aneurysm Repair (EVAR) by contrasting perioperative complication rates. We hypothesized that the percutaneous approach is a better alternative for aortic aneurysm patients as it is minimally invasive and has been demonstrated to decrease the length of hospital stay.</p><p><strong>Methods: </strong>We retrospectively reviewed data for patients undergoing EVAR between the years of 2005 and 2013. We then compared overall mortality, hematoma or seroma formation, graft infection, arterio-venous injury, distal embolization, limb loss, myocardial infarction or arrhythmia, and renal dysfunction. Results were demonstrated using a retrospective cohort study design to confirm the hematoma rate associated with EVAR open compared to percutaneous access.</p><p><strong>Results: </strong>Our series involves 73 patients who underwent percutaneous access for EVAR (<i>n</i> = 49) or traditional open cutdown (<i>n</i> = 24). Percutaneous access resulted in significantly less hematoma formation when compared to the traditional open cutdown (4% vs. 12.5%; <i>p</i> < 0.059). Our analysis suggests decreased mortality rates associated with EVAR as compared to the Open-Cutdown method using Northside Medical Center's Study and the OVER Veterans Affairs Cooperative Study (<i>p</i> = 0.0053).</p><p><strong>Conclusion: </strong>Percutaneous access for EVAR is safe and effective when compared to Open-Cutdown access for aortic aneurysm patients. Percutaneous access was associated with decreased rates of in-hospital mortality, hematoma formation, graft infection, and respiratory failure.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2020 ","pages":"8823039"},"PeriodicalIF":1.3,"publicationDate":"2020-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8823039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38708522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}