JVS-vascular insights最新文献

{"title":"Sustainability of a “just in time” educational strategy to optimize opioid prescribing in outpatient dialysis access surgery","authors":"Riley Brian MD, MAEd ,&nbsp;Elizabeth Lancaster MD, MAS ,&nbsp;Jade Hiramoto MD, MAS","doi":"10.1016/j.jvsvi.2024.100167","DOIUrl":"10.1016/j.jvsvi.2024.100167","url":null,"abstract":"<div><h3>Objective</h3><div>Surgeons continue to contribute to opioid overprescribing. Although many prior interventions have effectively addressed this problem, intervention sustainability remains an important aspect of combatting the opioid epidemic. In this study, we sought to determine the sustainability of a “just in time” educational strategy to optimize opioid prescribing in outpatient dialysis access surgery.</div></div><div><h3>Methods</h3><div>We distributed an informational handout with opioid prescribing recommendations to residents at the start of their vascular surgery rotations. We then reviewed patient charts from 4 years before and 2 years after the start of this intervention (January 1, 2018-December 1, 2023). We compared the percentage of patients prescribed opioids during the pre-intervention and intervention periods. To determine the role of possible confounders, we also performed logistic regression controlling for patient characteristics. For patients prescribed opioids, we compared the total oral morphine equivalents (OMEs) prescribed during the pre-intervention and intervention periods. We further assessed whether opioid prescribing or OMEs prescribed changed from the first to the second years of the intervention.</div></div><div><h3>Results</h3><div>During the 6-year study period, 368 patients underwent upper extremity dialysis access procedures. Significantly fewer patients received opioids during the intervention period, with 58% of patients (140 of 241) receiving a prescription in the pre-intervention period and 35% (44 of 127) receiving a prescription in the post-intervention period (<em>P</em> &lt; .001). In a regression model controlling for patient characteristics, only the intervention and use of regional block were associated with decreased risk of being prescribed opioids (<em>P</em> &lt; .001). Among patients who received opioid prescriptions, the median OMEs prescribed decreased from 90 in the pre-intervention period to 45 in the intervention period (<em>P</em> &lt; .001). Opioid prescribing did not change significantly between the first and second years of the intervention, but there was an improvement in adherence to prescribing guidelines in the second year.</div></div><div><h3>Conclusions</h3><div>We identified that a simple, low-resource, email-based intervention was associated with a significant, sustained decrease in opioid prescriptions for patients undergoing dialysis access surgery. Other programs may consider adopting such an approach given its ease of implementation with few resources.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100167"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143105158","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":"Preliminary results of carbon dioxide computed tomography angiogram for the technical assessment of aorto-iliac endovascular procedures","authors":"Michele Antonello MD, PhD ,&nbsp;Giorgio De Conti MD ,&nbsp;Marco James Bilato MD ,&nbsp;Elda Chiara Colacchio MD ,&nbsp;Franco Grego MD ,&nbsp;Michele Piazza MD ,&nbsp;Francesco Squizzato MD","doi":"10.1016/j.jvsvi.2024.100157","DOIUrl":"10.1016/j.jvsvi.2024.100157","url":null,"abstract":"<div><h3>Objective</h3><div>Carbon dioxide (CO₂) has shown potential as a contrast agent in endovascular procedures, but its efficacy in computed tomography angiogram (CTA) (CO₂-CTA) remains unexplored. The aim of this report is to describe feasibility and safety of CO₂-CTA for the technical assessment of aorto-iliac endovascular procedures and evaluate the quality of images.</div></div><div><h3>Methods</h3><div>CO₂-CTA was considered for the technical assessment of aorto-iliac endovascular procedures in patients at risk for contrast-induced nephrotoxicity operated on from March 2023 to April 2024. Procedures were performed in a hybrid CT/angiography system room equipped with a ArtisPheno angiographer and Somatom CT 128-slice sliding gantry (Siemens) and an automatic CO₂ injector (Angiodroid Spa). Imaging quality was assessed by two operators; pre-specified vessels of interest were manually segmented and classified based on their size as small, medium, and large. Luminal imaging quality was defined by the percentage of vessel lumen area occupied by contrast on axial views, and was graded as excellent (100%), high (75%-99%), moderate (50%-74%), or low (&lt;50%). Arterial wall imaging quality was defined by the capability to discriminate the arterial wall circumference from the arterial lumen on axial views and was graded as excellent (100% of circumference), high (75%-99%), moderate (50%-74%), or low (&lt;50%).</div></div><div><h3>Results</h3><div>We performed CO₂-CTA in 10 patients for the technical assessment of eight standard endovascular aortic repairs (EVARs), one complex EVAR, and one endovascular reconstruction of the aortic bifurcation. CO₂-CTA was feasible in all cases, and there were no related adverse events. A total of 222 vessels (large size, n = 50; medium size, n = 80; small size, n = 92) were analyzed for image quality. Overall, wall image quality was excellent in 206 arteries (92%), and luminal image quality was excellent in 208 (93.7%); CO₂ layering was detected in nine large arteries (18%). After EVAR, air trapping was detected in two patients (20%) and a type II endoleak in two patients (20%).</div></div><div><h3>Conclusions</h3><div>These preliminary findings demonstrate that CO₂-CTA is feasible and safe for the technical assessment of aorto-iliac endovascular interventions and provides satisfactory imaging quality. CO₂-CTA eliminates the necessity for nephrotoxic agents, making it a viable option for patients with severe chronic renal insufficiency at risk of dialysis. Further studies are warranted to optimize the acquisition protocol and explore the applicability of CO₂-CTA in clinical practice.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100157"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143105203","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":"Primary care physicians’ diagnosis and management of vascular pathologies","authors":"Noash Julia-Rios MD,&nbsp;Jose Ortiz-Fullana MD,&nbsp;Rafael Santini-Dominguez MD","doi":"10.1016/j.jvsvi.2024.100168","DOIUrl":"10.1016/j.jvsvi.2024.100168","url":null,"abstract":"<div><h3>Objective</h3><div>The United States is currently facing a shortage of vascular surgeons, a trend expected to worsen in the coming years. Recent data underscore the need for 1.4 vascular specialists per 100,000 population, revealing a shortage exceeding 25 surgeons in Puerto Rico. The escalating incidence of vascular pathologies, coupled with the lack of vascular specialists, emphasizes the crucial role of primary care physicians (PCPs) in diagnosing and managing these conditions. This study aims to assess the confidence and preparedness of PCPs in Puerto Rico regarding the diagnosis and management of vascular diseases.</div></div><div><h3>Methods</h3><div>An 18-question survey, encompassing physicians’ demographics, preparedness, and confidence in diagnosing and managing vascular pathologies, was distributed by the Association of Medical College of Puerto Rico. A Likert scale ranging from 1 to 5 was employed for quality and confidence assessment, with a score of 3 or less deemed inadequate. The survey also explored factors influencing transfers and referrals to vascular specialists.</div></div><div><h3>Results</h3><div>A total of 162 physicians participated in the survey, with 50% females and 50% males. Of the respondents, 67% reported insufficient training since medical school, 44% noted inadequate training during residency, and 41% lacked adequate training during fellowship. Additionally, 43% stated they did not receive sufficient training during continued education, such as conferences or symposiums. Regarding confidence in treatment and management, 67% expressed feeling insufficiently confident in treating aortic diseases, 46% in arterial diseases, 47% in venous diseases, and 64% in carotid disease. A substantial 90% expressed a desire for more knowledge on the diagnosis and management of vascular pathologies. When comparing general practitioners with internal medicine specialists, the former exhibited lower confidence in treating vascular pathologies. Survey responses identified the primary factor influencing transfers or referrals to a vascular specialist as the inability to contact one.</div></div><div><h3>Conclusions</h3><div>Given the increasing prevalence and incidence of vascular pathologies coupled with the shortage of vascular specialists, it is imperative to reevaluate medical school and residency training in the diagnosis and management of these conditions. Many PCPs perceive their training quality and confidence in the diagnosis and management of vascular pathologies as inadequate, necessitating attention to address this gap.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100168"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135726","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":"Study protocol for a French multicenter randomized controlled trial evaluating the medicoeconomic impact of Surgical vs Endovascular Arteriovenous Access Creation for Hemodialysis in End-stage Renal Disease (ENDO-FAV)","authors":"Caroline Caradu MD, PhD ,&nbsp;Eric Ducasse MD, PhD ,&nbsp;Edwin Ripoche MD ,&nbsp;Audrey Cordon MSc (Health Economics) ,&nbsp;Antoine Bénard MD, PhD ,&nbsp;Alexandros Mallios MD","doi":"10.1016/j.jvsvi.2024.100163","DOIUrl":"10.1016/j.jvsvi.2024.100163","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Vascular access is indispensable for performing hemodialysis in patients with end-stage renal disease. The Kidney Disease Outcome Quality Initiative and the French Health Authority advocate for native arteriovenous fistulas (AVFs) as a primary option owing to their association with lower morbidity, mortality, and enhanced quality of life. However, a significant proportion of AVFs fail to mature, and many require multiple re-interventions, increasing overall costs. To address these issues, endovascular techniques for AVF creation have been developed. These methods use energy-based technologies, avoiding vessel dissection and preserving perivascular tissues. Initial results are promising, but these devices are expensive, and the technical act of creating an endovenous fistula is not recorded in the coding of the common classification of medical procedures and, as such, cannot be reimbursed by health insurance in France. Although international studies suggest their effectiveness, no French studies have yet replicated or confirmed these findings in the local context, which would help to support a reimbursement request from health insurance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This protocol represents the first French medicoeconomic study to compare the two available endovascular AVF creation devices (Ellipsys and WaveLinQ) with traditional open surgery. This multicenter, comparative clinical trial will randomize patients into two parallel groups: (1) endovascular AVF creation using either the WaveLinQ or Ellipsys device, and (2) surgical proximal AVF creation (brachiocephalic/brachiobasilic). Randomization will be balanced and stratified by center and dialysis timing. Follow-up assessments will occur at 1 week and 1, 3, 6, 12, and 18 months. The primary objective is to evaluate the cost effectiveness of endovascular AVF creation compared with open surgery from the perspective of the French health care system. The primary end point is the cost-utility ratio (cost per quality-adjusted life year gained) of endovascular AVF vs open surgery. Utility is assessed using the EQ-5D-5 L questionnaire, with costs derived from micro-costing and the National Health Data System. Secondary outcomes include health economics with total costs at 18 and 36 months, success rate of vascular access creation, AVF maturation and functionality, recirculation rates, early and late access failures, cannulation success, primary and secondary patency, reintervention rates, and adverse events. Based on a cost-utility threshold of €30,000 per quality-adjusted life year, cost difference estimates, and standard deviations from previous studies, anticipated sample size is 126 patients per group (endovascular and surgical), totaling 252 patients with approximately 142 patients for the Ellipsys device and 110 patients for WaveLinQ, based on the capacity of 7 centers using Ellipsys and 4 centers using WaveLinQ.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This m","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100163"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135727","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":"Short review of diagnosis and revascularization for thromboangiitis obliterans","authors":"Yoshiko Watanabe PhD, MD ,&nbsp;Natarajan Sekar MS, MNAMS, MCh, FICS, FRCS, DSc ,&nbsp;Tapish Sahu MBBS, DNB ,&nbsp;Pranay Pawar MS, MCH, FVES, FACS ,&nbsp;Prabhu Premkumar ,&nbsp;Palma M. Shaw MD, MBA, FACS, RPVI ,&nbsp;Prem Chand Gupta MBBS, MS","doi":"10.1016/j.jvsvi.2024.100162","DOIUrl":"10.1016/j.jvsvi.2024.100162","url":null,"abstract":"<div><div>This short review focuses on recent diagnostic criteria and outcomes after revascularization in thromboangiitis obliterans (TAO) (Buerger disease). The incidence and disease have decreased worldwide, including in Eastern Asia, except in regions where inexpensive tobacco products are consumed widely. However, the global epidemiology remains unclear owing to the lack of definitive diagnostic biomarkers. Clinical diagnostic criteria are also not standardized, but have been updated according to medical advances and current patient characteristics. Notably, neither of the two recently proposed criteria excludes patients with risk factors for atherosclerosis, because these conditions may coexist with TAO and are often seen in young patients. Young age at onset is no longer essential. Objective test findings are required, and typical vascular imaging findings are essential for definitive diagnosis. Suspected diagnosis is allowed for patients who have difficulty undergoing tests. Revascularization for TAO is typically directed at below-the-knee lesions, which are characterized by poor distal runoff, associated inflammation, and prone to spasm. Recently, both bypass surgery (BS) and endovascular treatment (EVT) have shown improved outcomes. Two studies on BS published after 2000 reported primary patency rates of &gt;50% at 3 years. A systematic review and meta-analysis of EVT, which mostly consisted of balloon angioplasty, revealed that multiple reinterventions were often required; however, the secondary patency and limb salvage rates at 3 years were comparable with those of BS. Short-term arterial patency, whether achieved by BS or EVT, can be sufficient for ulcer healing. Given that TAO is a highly thrombogenic condition, the administration of potent antithrombotic therapy during and after revascularization is crucial to maintain arterial patency.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100162"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135766","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":"Potential long-term hospital-level economic impact of anticoagulation alone vs endovascular treatment in patients with deep vein thrombosis-related leg ulcers","authors":"Lorena De Marco Garcia MD","doi":"10.1016/j.jvsvi.2024.100160","DOIUrl":"10.1016/j.jvsvi.2024.100160","url":null,"abstract":"<div><h3>Objectives</h3><div>Endovascular treatments for deep vein thrombosis (DVT) have shown effectiveness at rapidly restoring flow, which may help to decrease chronic venous disease (CVD) and venous leg ulcer (VLU) incidence. However, data describing such long-term outcomes are sparse. We analyze the location of thrombus at the incident acute DVT event in patients who subsequently developed VLUs. Further, we establish a model to estimate the long-term hospital level economic impact associated with endovascular DVT treatment compared with the standard of care, anticoagulation (AC).</div></div><div><h3>Methods</h3><div>This analysis consisted of a single-center retrospective chart review and hypothetical cost model. Patients were identified by <em>International Classification of Diseases,</em> 10th edition clinical modification, codes, chart, and imaging review. The economic model evaluated a hypothetical cohort of 100 patients through three distinct health care phases: initial DVT management, a period of worsening CVD symptoms, and long-term VLU wound care. Model parameters were derived from prior literature. Patients were simulated to receive endovascular treatment or AC over a period of 12 years. Cumulative costs were estimated assuming 20%, 40%, 50% (base case), 60%, and 80% effectiveness of endovascular treatment to prevent worsening CVD symptoms and VLU development.</div></div><div><h3>Results</h3><div>In total, 73 patients were identified and included. Incident DVTs were iliofemoral-popliteal in 4 of 73 (5.5%), isolated femoropopliteal in 43 of 73 (58.9%), femoropopliteal with below-the-knee-involvement in 11 of 73 (15.1%), and isolated below the knee in 15 of 73 (20.5%). The median initial DVT event occurred in July 2020 (interquartile range, June 2018 to January 2022) and the median time to VLU onset was 466 days (interquartile range, 51-1190 days). Per patient long-term cost estimates were $100,186 for AC and $100,100, $80,245, $70,318, $60,391, and $40,536 for endovascular treatment that is 20%, 40%, 50%, 60%, and 80% effective, respectively. The initial cost benefit compared with AC was anticipated at 11.4, 3.7, 2.8, 2.3, and 1.9 years for endovascular treatment that is 20%, 40%, 50%, 60%, and 80% effective, respectively.</div></div><div><h3>Conclusions</h3><div>This retrospective analysis identified a high incidence of femoral and below DVTs associated with VLU development, with little iliac involvement. Identifying at-risk patients with DVT is crucial for decreasing chronic complications; current technologies can treat femoropopliteal or more proximal disease effectively. Additionally, the hypothetical economic model suggests that endovascular DVT treatments could provide long-term savings if demonstrated to moderately decreasing VLU incidence.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100160"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143096040","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":"Evaluation of CellerateRX Surgical Powder utility in reducing groin complications after femoral exposure","authors":"Vy C. Dang BS ,&nbsp;Eric K. Peden MD ,&nbsp;Trisha Roy MD, PhD ,&nbsp;Alan B. Lumsden MD ,&nbsp;Linda Le MD ,&nbsp;Charudatta S. Bavare MD ,&nbsp;Sohaib K. Mhaidi MD ,&nbsp;Maham Rahimi MD, PhD","doi":"10.1016/j.jvsvi.2024.100165","DOIUrl":"10.1016/j.jvsvi.2024.100165","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Vascular procedures involving groin incisions for femoral exposure often have complications that delay wound healing. These complications include but are not limited to the development of seromas, hematomas, skin necrosis, or infection requiring reintervention leading to readmission, increased length of stay, and increased morbidity and mortality, including limb loss. In this non-concurrent cohort study, we evaluate the usefulness of CellerateRX Surgical Powder in preventing postoperative groin complications. We compare the outcomes of groin incisions that received standard surgical wound care and those in which CellerateRX Surgical Powder was applied to the surgical incision prior to primary closure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Groin incisions required for femoral exposure in vascular surgery procedures were considered. The control group included cases between 2020 and 2021. Exclusion criteria included patients &lt;18 years of age, those with a bovine allergy, those with an active groin infection, and those undergoing a repeat femoral exposure. Bilateral groin incisions were counted as two separate constituents in the overall sample. The perioperative protocol in the management of these patients included 1-hour preoperative vancomycin (15 mg/kg intravenously [IV])/ceftriaxone (2 g IV), double skin preparation with 4% chlorhexidine, hair removal with surgical clippers, Ioban, postoperative doxycycline (100 mg oral or IV twice daily for 24 hours), and negative pressure wound therapy or a muscle flap in high-risk patients. Patients between 2022 and 2023 who met the described inclusion criteria were enrolled into the experimental group. The only change to the perioperative protocol of the experimental group was the addition of CellerateRX Surgical Powder to the surgical wound before closure. Patients were followed for 6 months. The primary outcome was the number of groin complications that required return to the operating room (eg, seroma, hematoma, and infection).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The control group consisted of 136 groins, 17 (13%) of which developed complications—7 (5.1%) seromas, 2 (1.5%) hematomas, 5 (3.7%) soft tissue infections, and 3 (2.2%) skin necrosis cases. The treatment group consisted of 20 groins, 3 (15%) of which developed complications—two seromas and one soft tissue infection. A two-tailed Fisher's exact test demonstrated no statistically significant association between the presence of complications and the treatment group (&lt;em&gt;P&lt;/em&gt; = .49, α = 0.05); however, patients in the experimental cohort were found to be a higher risk group, having significantly higher prevalence of diabetes and surgeries using a prosthetic.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Based on the results of this study, we cannot conclude that a packing application of CellerateRX Surgical Powder alters the risk of developing postoperative groin complications compared with standard wound care. No hematoma","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100165"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135723","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":"Prevalence and 30-day mortality of aortitis among Medicare beneficiaries undergoing unruptured abdominal aortic aneurysm repair","authors":"Benjamin D. Pollock PhD, MSPH ,&nbsp;Razvan M. Chirila MD ,&nbsp;Annette M. Danks MBA ,&nbsp;Jennifer B. Cowart MD","doi":"10.1016/j.jvsvi.2024.100178","DOIUrl":"10.1016/j.jvsvi.2024.100178","url":null,"abstract":"<div><h3>Background</h3><div>The <em>US News &amp; World Report'</em>s Best Hospitals Procedures and Conditions ratings aim to assess hospital performance for routine inpatient care. Aortitis is a complicating factor for abdominal aortic aneurysm (AAA) repair, but aortitis diagnoses are not currently an exclusion criteria for the AAA repair rating. We assessed 30-day mortality among patients with aortitis during AAA repair to determine whether aortitis should be an exclusion criterion.</div></div><div><h3>Methods</h3><div>We used the Medicare Beneficiary Summary File and Inpatient Limited Data Sets from January 1, 2019, to December 1, 2022. We included all encounters for AAA repair with a diagnosis code for unruptured AAA. We excluded encounters with a diagnosis code for ruptured AAA. We calculated the prevalence of aortitis (defined using <em>International Classification of Diseases</em>, 10th edition, codes) in this population, and used log-linear regression to compare the age- and sex-adjusted risk of 30-day mortality in patients with aortitis vs those without aortitis. We reported the adjusted risk ratio and 95% confidence interval.</div></div><div><h3>Results</h3><div>There were 51,508 AAA repair encounters. The prevalence of aortitis was 2.3% (1167/51,508); 30-day mortality occurred in 37/1167 (3.2%) encounters with an aortitis diagnosis vs 998/50,341 (2.0%) without aortitis (adjusted risk ratio, 1.50; 95% confidence interval,1.09-2.07; <em>P</em> = .01).</div></div><div><h3>Conclusions</h3><div>AAA repair with concurrent aortitis should be excluded from quality outcome measures.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100178"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387238","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":"Determinants for non-attendance in abdominal aortic aneurysm (AAA) screening","authors":"Saira Mauland Mansoor, J. J. Jørgensen, Tonje Grønvold, J. Hisdal, Toril Rabben","doi":"10.1016/j.jvsvi.2024.100070","DOIUrl":"https://doi.org/10.1016/j.jvsvi.2024.100070","url":null,"abstract":"","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"211 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276592","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":"Room for improvement in patient compliance during peripheral vascular interventions","authors":"C. Png, L. Boitano, Sunita D. Srivastava, A. Mohapatra, Junaid Malek, Jordan R. Stern, M. Eagleton, A. Dua","doi":"10.1016/j.jvsvi.2024.100059","DOIUrl":"https://doi.org/10.1016/j.jvsvi.2024.100059","url":null,"abstract":"","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"60 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139887966","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}