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  1. Article: A prebifurcated axillobifemoral polytetrafluoroethylene graft simplifies carotid to carotid to subclavian bypass.

    Perry, Thomas J / Sarac, Timur P / Orion, Kristine / Bozinovski, John / Haurani, Mounir / Tillman, Bryan W

    Journal of vascular surgery cases and innovative techniques

    2022  Volume 8, Issue 4, Page(s) 664–666

    Abstract: The use of thoracic endovascular aortic repair for thoracic aortic disease will necessitate cervical debranching in cases involving the proximal arch. We have presented the case of a 57-year-old athletic woman who had developed a type A dissection that ... ...

    Abstract The use of thoracic endovascular aortic repair for thoracic aortic disease will necessitate cervical debranching in cases involving the proximal arch. We have presented the case of a 57-year-old athletic woman who had developed a type A dissection that extended to the bilateral iliac arteries. After hemiarch repair, she underwent staged cervical debranching with carotid-carotid-subclavian bypass using a prebifurcated axillobifemoral graft and subsequent thoracic endovascular aortic repair. We have detailed her successful clinical course and described the benefits of using a prebifurcated graft for cervical debranching in hybrid repairs of aortic arch pathology.
    Language English
    Publishing date 2022-09-17
    Publishing country United States
    Document type Journal Article
    ISSN 2468-4287
    ISSN 2468-4287
    DOI 10.1016/j.jvscit.2022.08.029
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  2. Article ; Online: Physician Reimbursement for Vascular Surgery Procedures and Vascular Laboratory Studies Before and After the Affordable Care Act.

    Haurani, Mounir J / Chou, Daisy / Vaccaro, Patrick S / Satiani, Bhagwan

    Annals of vascular surgery

    2021  Volume 81, Page(s) 89–97

    Abstract: Objectives: The Patient Protection and Affordable Care Act (ACA), fully implemented by 2015, has significantly increased the number of Americans with health insurance. However, its impact on physician reimbursement (PR) is not well studied. Our ... ...

    Abstract Objectives: The Patient Protection and Affordable Care Act (ACA), fully implemented by 2015, has significantly increased the number of Americans with health insurance. However, its impact on physician reimbursement (PR) is not well studied. Our objective was to determine the ACA's impact on the professional component of PR for selected vascular surgery (VS) procedures and vascular laboratory (VL) studies at our institution.
    Methods: PR for the following 5 VS procedures and 4 VL studies were obtained from our billing department: CPT 34803 (Endovascular aortic repair, EVAR), 35301 (carotid endarterectomy, CEA), 35656 (lower extremity bypass, LEB), 36010 (introduction of catheter into vena cava, ICVC), 36200 first, 93922 (ankle brachial index, ABI), 93925 (lower extremity arterial duplex, LEA duplex), 93970 (lower extremity venous duplex, LEV Duplex), and 93990 (hemodialysis duplex). The data was organized by payer: Medicare, Medicaid, Commercial Insurers (CI), and Other. PR was studied pre-ACA (January 2008 through December 2009) and post-ACA (January 2015 through December 2016). The post-ACA PR and inflation adjusted reimbursement (IAR) in 2016 dollars using the consumer price index (CPI) were calculated and compared using one-sample t-test. The percent difference between the post-ACA PR and IAR was also compared.
    Results: PR for 1,637 VS procedures and 16,333 VL studies was analyzed. The post-ACA PR was significantly lower than the IAR for most Medicare and Medicaid procedures. For EVAR, post-ACA reimbursement was overall on par with the IAR but significantly lower for Medicare. For CEA, post-ACA reimbursement was overall lower than IAR. For LEB, overall average PR was lower than IAR, with statistically significant lower Medicare and Medicaid (P < 0.001) payments. For ICAo, overall PR was significantly lower than the IAR and this was true across all insurance types. In contrast, for ICV, the post-ACA reimbursement was higher than IAR for all payers but did not reach statistical significance (P = 0.25). The post-ACA PR was significantly higher than the IAR for most VL studies, except for Medicare PR. The percent change for VS procedures were mostly negative for the Medicaid and Medicare groups. This results in potential annual shortcomings of $2, 862 and $20,923 respectively.
    Conclusion: When comparing reimbursement before and after ACA implementation, Medicare and Medicaid PR for most VS procedures has not kept up with inflation. However, for most VL procedures, PR has exceeded inflation. Further efforts are needed to support Vascular Surgery reimbursement including higher valuation of the Medicare Conversion factor.
    MeSH term(s) Aged ; Humans ; Insurance, Health, Reimbursement ; Medicaid ; Medicare ; Patient Protection and Affordable Care Act ; Physicians ; Treatment Outcome ; United States ; Vascular Surgical Procedures
    Language English
    Publishing date 2021-11-12
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1027366-9
    ISSN 1615-5947 ; 0890-5096
    ISSN (online) 1615-5947
    ISSN 0890-5096
    DOI 10.1016/j.avsg.2021.09.051
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  3. Article ; Online: Revascularization Outcomes Stratified by Glycemic Control in Patients with Diabetes Mellitus and Chronic Limb-Threatening Ischemia.

    Campbell, Drayson B / Sobol, Carly G / Stacy, Mitchel R / Atway, Said / Teng, Xiaoyi / Haurani, Mounir J / Go, Michael R

    Annals of vascular surgery

    2023  Volume 100, Page(s) 91–100

    Abstract: Background: The prevalence of chronic limb-threatening ischemia (CLTI) has increased alongside rising rates of diabetes mellitus (DM). While diabetic patients with CLTI have worse outcomes compared to patients without diabetes, conflicting data exist on ...

    Abstract Background: The prevalence of chronic limb-threatening ischemia (CLTI) has increased alongside rising rates of diabetes mellitus (DM). While diabetic patients with CLTI have worse outcomes compared to patients without diabetes, conflicting data exist on the relationship between the severity of DM and CLTI outcomes. Close inspection of the relationship between DM severity and outcomes in CLTI may benefit surgical decision-making and patient education.
    Methods: We retrospectively reviewed patients who received endovascular intervention or surgical bypass for CLTI at our multidisciplinary Limb Preservation Program from 2013 to 2019 to collect patient characteristics using Society for Vascular Surgery (SVS) reporting standards, arterial lesion characteristics from recorded angiograms, and outcomes, including survival, amputation, wound healing, and revascularization patency. Controlled DM was defined as SVS Grade 1 (controlled, not requiring insulin) and Grade 2 (controlled, requiring insulin), while uncontrolled DM was defined as SVS Grade 3 (uncontrolled), and DM severity was assessed using preoperative hemoglobin A1c (HgbA1c) values. Product-limit Kaplan-Meier was used to estimate survival functions. Univariable Cox proportional hazards analyses guided variable selection for multivariable analyses.
    Results: Our Limb Preservation Program treated 177 limbs from 141 patients with DM. Patients with uncontrolled DM were younger (60.44 ± 10.67 vs. 65.93 ± 10.89 years old, P = 0.0009) and had higher HgbA1c values (8.97 ± 1.85% vs. 6.79 ± 1.10%, P < 0.0001). Fewer patients with uncontrolled DM were on dialysis compared to patients with controlled DM (15.6% vs. 30.9%, P = 0.0278). By Kaplan-Meier analysis, DM control did not affect time to mortality, limb salvage, wound healing, or loss of patency. However, multivariable proportional hazards analysis demonstrated increased risk of limb loss in patients with increasing HgbA1C (hazard ratio (HR) = 1.96 [1.42-2.80], P < 0.0001) or dialysis dependence (HR = 15.37 [3.44-68.73], P = 0.0003), increased risk of death in patients with worsening pulmonary status (HR = 1.70 [1.20-2.39], P = 0.0026), and increased risk of delayed wound healing in patients who are male (HR = 0.48 [0.29-0.79], P = 0.0495). No independent association existed between loss of patency with any of the variables we collected.
    Conclusions: Patients with uncontrolled DM, as defined by SVS reporting standards, do not have worse outcomes following revascularization for CLTI compared to patients with controlled DM. However, increasing HgbA1c is associated with a greater risk for early amputation. Before revascularization, specific attention to the level of glycemic control in patients with DM is important, even if DM is "controlled." In addition to aggressive attempts at improved glycemic control, those with elevated HgbA1c should receive careful education regarding their increased risk of amputation despite revascularization. Future work is necessary to incorporate the severity of DM into risk models of revascularization for the CLTI population.
    MeSH term(s) Humans ; Male ; Middle Aged ; Aged ; Female ; Chronic Limb-Threatening Ischemia ; Glycemic Control ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Ischemia/diagnostic imaging ; Ischemia/surgery ; Peripheral Arterial Disease/diagnostic imaging ; Peripheral Arterial Disease/therapy ; Diabetes Mellitus/diagnosis ; Diabetes Mellitus/epidemiology ; Vascular Surgical Procedures/adverse effects ; Limb Salvage ; Insulin ; Endovascular Procedures/adverse effects
    Chemical Substances Insulin
    Language English
    Publishing date 2023-12-18
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1027366-9
    ISSN 1615-5947 ; 0890-5096
    ISSN (online) 1615-5947
    ISSN 0890-5096
    DOI 10.1016/j.avsg.2023.10.018
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  4. Article ; Online: Addition of Efficiency Measures to Current Accuracy Measures in the Vascular Laboratory Can Be Used for Future Accreditation and Payment Models.

    Haurani, Mounir J / Kiser, Denis / Vaccaro, Patrick S / Satiani, Bhagwan

    Annals of vascular surgery

    2020  Volume 65, Page(s) 145–151

    Abstract: Background: The Medicare Access and CHIP Reauthorization Act (MACRA) brings with it increased regulatory requirements not traditionally addressed by standard vascular laboratory accreditation, which is based on accuracy. The new quality improvement ... ...

    Abstract Background: The Medicare Access and CHIP Reauthorization Act (MACRA) brings with it increased regulatory requirements not traditionally addressed by standard vascular laboratory accreditation, which is based on accuracy. The new quality improvement project of the Intersocietal Accreditation Commission (IAC) may satisfy an improvement activity (IA) of the MACRA. We hypothesize that other IAs in the MACRA such as timeliness of test results or patient care quality performance requirements can be met by analyzing data already being collected by the vascular laboratory. After a process improvement strategy, we chose to review progress in our vascular laboratory related to time to interpretation (TI), patient check-in to study completion (study time), wait time for first available outpatient venous duplex scan (wait time), technologist productivity, and critical results reporting.
    Methods: Data from our hospital-based vascular laboratory were collected from 2010 to 2016. TI was collected through our reporting software VascuPro (Consensus Medical), and study time and wait time were obtained from electronic medical records (EMR) (Epic). Technologist productivity was calculated by commercially available productivity tools, and compliance with critical results reporting was calculated quarterly as per our quality assurance program. Appropriateness of carotid duplex scan testing was performed by expert review of International Classification of Disease codes used to request the test.
    Results: TI analysis comprised 91,352 studies with a mean of 3.3 hr between test completion and final interpretation. The TI improved from 5.0 to 2.1 hr on weekdays and was longer on weekends (4.9 hr; P < 0.001). The study time improved from 29.8 to 27.2 min and was 14.9 min shorter on the weekends (P < 0.001). The wait time ranged from a mean of 1-2.08 days. Technologist productivity improved from 90.7% to 93.6%. Critical results reporting quarterly audits showed a 100% compliance rate. On expert review, the International Classification of Disease code on carotid duplex scan requests in the EMR was deemed inaccurate in 17.4% of cases.
    Conclusions: TI and study time improved; wait time and critical results reporting remained steady. Most of the data are readily available in a vascular laboratory standard EMR. The plan-do-study-act (PDSA or Shewhart Cycle) principle is critical to process improvement and needed as we transition from traditional accreditation mostly based on test accuracy to one demanding efficiency, timeliness, patient satisfaction, productivity, accountability, and appropriateness of testing. Process improvement studies will improve patient care and satisfaction, increase efficiency and throughput, while satisfying changing IAC standards and preparing for upcoming regulatory requirements of the MACRA.
    MeSH term(s) Accreditation/economics ; Accreditation/standards ; Appointments and Schedules ; Carotid Arteries/diagnostic imaging ; Clinical Laboratory Services/economics ; Clinical Laboratory Services/standards ; Efficiency ; Humans ; Medicare Access and CHIP Reauthorization Act of 2015/economics ; Medicare Access and CHIP Reauthorization Act of 2015/standards ; Policy Making ; Quality Improvement/economics ; Quality Improvement/standards ; Quality Indicators, Health Care/economics ; Quality Indicators, Health Care/standards ; Retrospective Studies ; Time Factors ; Ultrasonography, Doppler, Duplex/economics ; Ultrasonography, Doppler, Duplex/standards ; United States ; Workflow
    Language English
    Publishing date 2020-01-03
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1027366-9
    ISSN 1615-5947 ; 0890-5096
    ISSN (online) 1615-5947
    ISSN 0890-5096
    DOI 10.1016/j.avsg.2019.11.028
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  5. Article ; Online: Extra-Anatomic Bypass and Excision is Superior to Graft Salvage Attempts with Antibiotic Beads to Treat Vascular Graft Infections in the Groin.

    Perry, Thomas J / Fraser, Simon / Orion, Kristine / Haurani, Mounir / Tillman, Bryan / Vaccaro, Patrick / Go, Michael R / Sarac, Timur P

    Annals of vascular surgery

    2022  

    Abstract: Background: This study aimed to determine if conventional extra-anatomic bypass and graft removal versus aggressive attempts at graft preservation have better survival and limb salvage in patients with localized groin wound infections of vascular grafts. ...

    Abstract Background: This study aimed to determine if conventional extra-anatomic bypass and graft removal versus aggressive attempts at graft preservation have better survival and limb salvage in patients with localized groin wound infections of vascular grafts.
    Methods: We conducted a retrospective review of 53 consecutive patients with vascular graft infections presenting in the groin. Treatment groups consisted of group 1 (extra-anatomic bypass and graft excision, n = 22) and group 2 (initial graft preservation attempts with utilization of antibiotic beads, n = 31). In group 2, patients underwent serial debridement and placement of antibiotic beads until culture-negative wounds were achieved. Significantly more patients underwent muscle flap coverage in group 2 (27/31) compared with group 1 (7/22; P < 0.001). Data collected included demographics, comorbidities, intraoperative details, and outcomes, including patency, limb salvage, mortality, and number of procedures. Continuous variables were examined with Student's t-test, and dichotomous variables were examined with chi-squared test. Linear and logistic regressions were used to analyze factors associated with outcomes, in addition to Kaplan-Meier analysis with log rank for actuarial analysis.
    Results: Both groups were similar with respect to demographics. The overall Kaplan-Meier 1- and 3-year survival rates were 66.2% and 34.1%, with no statistically significant difference between groups. The Kaplan-Meier 1- and 3-year limb salvage rates were 68.8% and 36.6% for group 1 vs. 58.5% and 38.7% for group 2 (P = not significant [NS]). The 1- and 3-year primary patency rates were 71% and 71% in traditional group 1 vs. 72% and 56% in group 2 (P = NS). One-year and 3-year secondary patency rates in traditional group 1 were 83% and 71% vs. 85% and 61% in group 2 (P = NS). Patients in group 1 underwent fewer total procedures when compared with group 2 (2.3 ± 0.2 vs. 5.1 ± 0.7, P = 0.03). The late reinfection rate was significantly less in group 1 (4.5%) compared with group 2 (26%; P = 0.04). Freedom from reinfection at 1 and 3 years were 94% and 94% in traditional group 1 vs. 74% and 62% in group 2 (P = 0.03). Multivariable analysis showed a higher incidence of amputation in patients who suffered reinfection (n = 13, P = 0.049). There was a higher mortality in patients with septic shock (n = 10, P = 0.007) and reinfection (n = 13, P = 0.036). Reinfection was associated with the highest mortality (P = 0.03).
    Conclusions: Conventional graft excision with extra-anatomic bypass resulted in similar mortality when compared with aggressive attempts at graft preservation and trended toward improved limb salvage and patency. However, attempts at graft preservation with antibiotic beads resulted in a significantly higher reinfection rate and greater number of procedures, and therefore, this approach should be used very selectively.
    Language English
    Publishing date 2022-09-01
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1027366-9
    ISSN 1615-5947 ; 0890-5096
    ISSN (online) 1615-5947
    ISSN 0890-5096
    DOI 10.1016/j.avsg.2022.08.008
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  6. Article ; Online: eComment. Application of prostaglandin E1 and pentoxyphylline in clinical mesenteric ischaemia.

    Mouawad, Nicolas J / Haurani, Mounir J

    Interactive cardiovascular and thoracic surgery

    2014  Volume 18, Issue 4, Page(s) 474

    MeSH term(s) Alprostadil/administration & dosage ; Animals ; Ileal Diseases/prevention & control ; Ileum/blood supply ; Ileum/drug effects ; Mesenteric Vascular Occlusion/drug therapy ; Protective Agents/administration & dosage ; Reperfusion Injury/prevention & control
    Chemical Substances Protective Agents ; Alprostadil (F5TD010360)
    Language English
    Publishing date 2014-03-18
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 2095298-3
    ISSN 1569-9285 ; 1569-9293
    ISSN (online) 1569-9285
    ISSN 1569-9293
    DOI 10.1093/icvts/ivu017
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    Zs.A 5730: Show issues Location:
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  7. Article ; Online: A Case of Acute Iliocaval Thrombosis in the Setting of a Suprarenal Inferior Vena Cava Saccular Aneurysm.

    Wu, Jaclyn / Strosberg, David S / Pollock, Raphael / Haurani, Mounir J

    Annals of vascular surgery

    2018  Volume 53, Page(s) 271.e7–271.e10

    Abstract: Inferior vena cava (IVC) aneurysms are a rare finding, whose management and outcomes remain uncertain due to their low incidence and long-term follow-up. As IVC aneurysms remain a poorly understood clinical entity, it is important to expand upon our ... ...

    Abstract Inferior vena cava (IVC) aneurysms are a rare finding, whose management and outcomes remain uncertain due to their low incidence and long-term follow-up. As IVC aneurysms remain a poorly understood clinical entity, it is important to expand upon our existing knowledge base as new cases arise. We present a patient with a suprarenal IVC saccular aneurysm and an overview of the current literature regarding IVC aneurysm classification, presentation, and management. Based on the expanding literature, we propose that IVC aneurysms may be simplified into a 2-type classification, which can further guide clinicians on management of the aneurysm.
    MeSH term(s) Adult ; Aneurysm/complications ; Aneurysm/diagnostic imaging ; Aneurysm/therapy ; Anticoagulants/administration & dosage ; Computed Tomography Angiography ; Conservative Treatment ; Humans ; Iliac Vein/diagnostic imaging ; Male ; Phlebography/methods ; Stockings, Compression ; Treatment Outcome ; Vena Cava, Inferior/diagnostic imaging ; Venous Thrombosis/diagnostic imaging ; Venous Thrombosis/etiology ; Venous Thrombosis/therapy
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2018-08-06
    Publishing country Netherlands
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 1027366-9
    ISSN 1615-5947 ; 0890-5096
    ISSN (online) 1615-5947
    ISSN 0890-5096
    DOI 10.1016/j.avsg.2018.05.065
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  8. Article ; Online: Four-extremity venous duplex ultrasound for suspected deep venous thrombosis is an anachronism.

    Yoo, Taehwan / Aggarwal, Rishav / Brathwaite, Shayna / Satiani, Bhagwan / Haurani, Mounir J

    Journal of vascular surgery. Venous and lymphatic disorders

    2019  Volume 7, Issue 3, Page(s) 325–332.e1

    Abstract: Background: Duplex ultrasound is the "gold standard" for diagnosis of acute deep venous thrombosis (DVT) because of its high specificity, sensitivity, safety, and portability. However, unnecessary testing epitomizes inefficient use of scarce health care ...

    Abstract Background: Duplex ultrasound is the "gold standard" for diagnosis of acute deep venous thrombosis (DVT) because of its high specificity, sensitivity, safety, and portability. However, unnecessary testing epitomizes inefficient use of scarce health care resources. Here we hypothesize that the majority of simultaneous four-extremity duplex ultrasound (FED) examinations are unnecessary. By analyzing clinical factors of patients with acute DVT found on FED, we aimed to identify a subset of high-risk patients who may have a valid indication for four-extremity testing.
    Methods: We retrospectively reviewed all venous duplex ultrasound examinations performed in our Intersocietal Accreditation Commission-accredited vascular laboratory from January 1, 2009, to December 31, 2016. Patients with duplex ultrasound scans of all four limbs were included. DVT risk factors and indication for duplex ultrasound examination were recorded. The primary outcome was finding of acute DVT.
    Results: There were 188 patients who met our search criteria, of whom 31 patients (16.5%) had acute DVT (11 upper extremity, 16 lower extremity, and 4 upper and lower extremity). Fever of unknown origin (FUO) was the main indication for requesting FED (53.7%). Patients who underwent FED for FUO had a significantly lower likelihood of DVT (odds ratio, 0.21; P = .01). DVT was rarely the proximate cause (<1% of all cases) as follow-up culture results and clinical course most often revealed other sources of fever. Only patients with an upper extremity central venous catheter (CVC; n = 103) with at least two associated risk factors had an upper extremity DVT, which was usually line associated (93%). Only patients with at least two associated risk factors had a lower extremity DVT.
    Conclusions: FED for FUO is inefficient, given that DVT was rarely the proximate cause of fever. Acute upper extremity DVT was found only in patients with an upper extremity CVC, demonstrating that patients without upper extremity CVC do not benefit from upper extremity duplex ultrasound examination. Upper extremity DVT is usually line associated and dependent on the number of cumulative risk factors present, suggesting that only the extremity associated with the CVC in the right clinical context should be imaged. Lower extremity DVT is also dependent on the number of cumulative risk factors present, and testing should be reserved for patients according to the clinical context. Our results indicate that a restrictive strategy can reduce testing inefficiency and health care cost without compromising patients' safety.
    MeSH term(s) Catheterization, Central Venous/adverse effects ; Female ; Fever of Unknown Origin/diagnostic imaging ; Fever of Unknown Origin/etiology ; Humans ; Lower Extremity/blood supply ; Male ; Middle Aged ; Predictive Value of Tests ; Reproducibility of Results ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Ultrasonography, Doppler, Duplex ; Unnecessary Procedures ; Upper Extremity/blood supply ; Upper Extremity Deep Vein Thrombosis/diagnostic imaging ; Upper Extremity Deep Vein Thrombosis/etiology ; Venous Thrombosis/diagnostic imaging ; Venous Thrombosis/etiology
    Language English
    Publishing date 2019-03-15
    Publishing country United States
    Document type Journal Article
    ISSN 2213-3348
    ISSN (online) 2213-3348
    DOI 10.1016/j.jvsv.2018.11.004
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  9. Article ; Online: Common carotid artery end-diastolic velocity and acceleration time can predict degree of internal carotid artery stenosis.

    Strosberg, David S / Haurani, Mounir J / Satiani, Bhagwan / Go, Michael R

    Journal of vascular surgery

    2017  Volume 66, Issue 1, Page(s) 226–231

    Abstract: Objective: Whereas duplex ultrasound parameters for predicting internal carotid artery (ICA) stenosis are well defined, the use of common carotid artery (CCA) Doppler characteristics to predict ICA stenosis when the ICA cannot be insonated directly or ... ...

    Abstract Objective: Whereas duplex ultrasound parameters for predicting internal carotid artery (ICA) stenosis are well defined, the use of common carotid artery (CCA) Doppler characteristics to predict ICA stenosis when the ICA cannot be insonated directly or accurately because of anatomy, calcification, or tortuosity has not been studied. The objective of this study was to identify CCA Doppler parameters that may predict ICA stenosis.
    Methods: We reviewed all patients at our institution who underwent carotid duplex ultrasound (CDU) from 2008 to 2015 and also had a comparison computed tomography, magnetic resonance, or catheter angiogram. We excluded patients whose CDU examination did not correlate with the comparison study, those whose arteries were not visualized on the comparison study, and those with complete occlusion of the CCA. We collected CCA peak systolic velocity (PSV), end-diastolic velocity (EDV), and acceleration time (AT) in addition to CDU and comparison imaging interpretation of degree of stenosis. A multivariate model was used to identify predictors of ICA stenosis.
    Results: There were 99 CDU examinations with corresponding comparison imaging included. For every increase of 10 cm/s in EDV in the CCA, the odds of a >50% ICA stenosis being present vs a ≤50% ICA stenosis decreased by 37% (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.41-0.97; P = .03). For every increase of 10 cm/s in EDV in the CCA, the odds of a 70% to 99% ICA stenosis being present vs a ≤50% ICA stenosis decreased by 48% (OR, 0.52; 95% CI, 0.28-0.94; P = .03). A CCA EDV of 19 cm/s or below was associated with a 64% probability of a 70% to 99% ICA stenosis. For every 50-millisecond increase in AT in the CCA, the odds of a >50% stenosis being present vs a ≤50% ICA stenosis increased by 56% (OR, 1.56; 95% CI, 1.03-2.35; P = .04). A CCA AT of 80 milliseconds or above was associated with a 69% probability of a >50% ICA stenosis. There was no correlation between CCA PSV and ICA stenosis.
    Conclusions: CCA EDV and AT are independent predictors of ICA stenosis and may be used in the setting of patients whose ICA cannot be directly insonated or when standard duplex ultrasound parameters of ICA PSV, EDV, or ICA/CCA ratio conflict.
    MeSH term(s) Acceleration ; Blood Flow Velocity ; Carotid Artery, Common/diagnostic imaging ; Carotid Artery, Common/physiopathology ; Carotid Stenosis/diagnostic imaging ; Carotid Stenosis/etiology ; Carotid Stenosis/physiopathology ; Humans ; Logistic Models ; Multivariate Analysis ; Odds Ratio ; Ohio ; Predictive Value of Tests ; Regional Blood Flow ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Time Factors ; Ultrasonography, Doppler
    Language English
    Publishing date 2017-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605700-7
    ISSN 1097-6809 ; 0741-5214
    ISSN (online) 1097-6809
    ISSN 0741-5214
    DOI 10.1016/j.jvs.2017.01.041
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: The Society for Vascular Surgery clinical practice guidelines on popliteal artery aneurysms.

    Farber, Alik / Angle, Niren / Avgerinos, Efthymios / Dubois, Luc / Eslami, Mohammad / Geraghty, Patrick / Haurani, Mounir / Jim, Jeffrey / Ketteler, Erika / Pulli, Raffaele / Siracuse, Jeffrey J / Murad, M Hassan

    Journal of vascular surgery

    2021  Volume 75, Issue 1S, Page(s) 109S–120S

    Abstract: The Society for Vascular Surgery clinical practice guidelines on popliteal artery aneurysms (PAAs) leverage the work of a panel of experts chosen by the Society for Vascular Surgery to review the current world literature as it applies to PAAs to extract ... ...

    Abstract The Society for Vascular Surgery clinical practice guidelines on popliteal artery aneurysms (PAAs) leverage the work of a panel of experts chosen by the Society for Vascular Surgery to review the current world literature as it applies to PAAs to extract the most salient, evidence-based recommendations for the treatment of these patients. These guidelines focus on PAA screening, indications for intervention, choice of repair strategy, management of asymptomatic and symptomatic PAAs (including those presenting with acute limb ischemia), and follow-up of both untreated and treated PAAs. They offer long-awaited evidence-based recommendations for physicians taking care of these patients.
    MeSH term(s) Aneurysm/diagnostic imaging ; Aneurysm/epidemiology ; Aneurysm/surgery ; Clinical Decision-Making ; Consensus ; Endovascular Procedures/adverse effects ; Endovascular Procedures/standards ; Evidence-Based Medicine ; Humans ; Popliteal Artery/diagnostic imaging ; Popliteal Artery/surgery ; Risk Assessment ; Risk Factors ; Treatment Outcome ; Vascular Surgical Procedures/adverse effects ; Vascular Surgical Procedures/standards
    Language English
    Publishing date 2021-05-20
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Practice Guideline ; Systematic Review
    ZDB-ID 605700-7
    ISSN 1097-6809 ; 0741-5214
    ISSN (online) 1097-6809
    ISSN 0741-5214
    DOI 10.1016/j.jvs.2021.04.040
    Database MEDical Literature Analysis and Retrieval System OnLINE

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