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Article ; Online: Long-term prognostic implications of hemodynamic and plaque assessment using coronary CT angiography.

Yang, Seokhun / Lesina, Krista / Doh, Joon-Hyung / Jegere, Sanda / Erglis, Andrejs / Leipsic, Jonathon A / Chun, Eun Ju / Choi, Gilwoo / Schaap, Michiel / Zarins, Christopher / Taylor, Charles A / Fearon, William F / Narula, Jagat / Koo, Bon-Kwon

Atherosclerosis

2023 Volume 373, Page(s) 58–65

Abstract: Background and aims: Hemodynamic and plaque characteristics can be analyzed using coronary CT angiography (CTA). We aimed to explore long-term prognostic implications of hemodynamic and plaque characteristics using coronary CT angiography (CTA).: ... ...

Abstract	Background and aims: Hemodynamic and plaque characteristics can be analyzed using coronary CT angiography (CTA). We aimed to explore long-term prognostic implications of hemodynamic and plaque characteristics using coronary CT angiography (CTA). Methods: Invasive fractional flow reserve (FFR) and CTA-derived FFR (FFR Results: During a median follow-up of 10.1 years, PAV[V] (per 10% increase, HR 2.32 [95% CI 1.11-4.86], p = 0.025), and FFR Conclusions: Vessel- and lesion-level hemodynamic characteristics, and vessel-level plaque quantity, and lesion-level plaque compositional characteristics assessed by CTA offer independent and additive long-term prognostic value.
MeSH term(s)	Humans ; Plaque, Atherosclerotic/pathology ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/pathology ; Computed Tomography Angiography ; Prognosis ; Fractional Flow Reserve, Myocardial ; Coronary Vessels/diagnostic imaging ; Coronary Vessels/pathology ; Predictive Value of Tests ; Coronary Angiography ; Tomography, X-Ray Computed ; Hemodynamics ; Coronary Stenosis/pathology
Language	English
Publishing date	2023-02-27
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	80061-2
ISSN	1879-1484 ; 0021-9150
ISSN (online)	1879-1484
ISSN	0021-9150
DOI	10.1016/j.atherosclerosis.2023.02.005
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Article ; Online: Three-Year Patency Results following Endovascular Transvenous Femoropopliteal Bypass

Roberts Rumba / Dainis Krievins / Janis Savlovskis / Natalija Ezite / Aigars Lacis / Eva Petrosina / Ludovic Mouttet / Janis Gardovskis / Christopher K. Zarins

Medicina, Vol 59, Iss 462, p

2023 Volume 462

Abstract: ... Patients with complex TASC-C and D SFA lesions who had indications for revascularization were identified ...

Abstract	Background and Objectives : Peripheral artery disease is one of the most common vascular pathologies. There is an ongoing debate among specialists on whether open or endovascular revascularization is preferred in cases of complex superficial femoral artery (SFA) lesions. The purpose of this study was to assess patency results of a relatively new transvenous endovascular bypass device. This could add to existing evidence and aid in comparison between open and endovascular bypass. Materials and Methods : Patients with complex TASC-C and D SFA lesions who had indications for revascularization were identified. Prospective analysis of stent graft patency from 54 transvenous femoropopliteal bypass procedures was performed. Patency was assessed by Duplex ultrasound every six months. Kaplan–Meier analysis was performed to assess primary, primary-assisted, and secondary patency of transvenous bypass. Results : Following endovascular transvenous femoropopliteal bypass, 3-year graft primary, primary-assisted, and secondary patency was 43.8%, 66.3%, and 73.9%, respectively. Conclusions : Transvenous endovascular femoropopliteal bypass is a viable option for selected patients who lack adequate saphenous vein or have comorbidities that increase the risk of open femoropopliteal bypass. Strict post-operative follow-up is necessary to improve patency rates.
Keywords	transvenous femoropopliteal bypass ; patency data ; endovascular femoropopliteal bypass ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Ruptured abdominal aortic aneurysm: a surgical emergency with many clinical presentations.

Assar, A N / Zarins, C K

Postgraduate medical journal

2009 Volume 85, Issue 1003, Page(s) 268–273

Abstract: Ruptured abdominal aortic aneurysm (AAA) is one of the most fatal surgical emergencies, with an overall mortality rate of 90%. Most AAAs rupture into the retroperitoneal cavity, which results in the classical triad of pain, hypotension, and a pulsatile ... ...

Abstract	Ruptured abdominal aortic aneurysm (AAA) is one of the most fatal surgical emergencies, with an overall mortality rate of 90%. Most AAAs rupture into the retroperitoneal cavity, which results in the classical triad of pain, hypotension, and a pulsatile mass. However, this triad is seen in only 25-50% of patients, and many patients with ruptured AAA are misdiagnosed. It is likely that different sites of rupture of AAA determine a variety of common and uncommon clinical presentations, the recognition of which can save many lives. This article reviews the different sites of rupture of infrarenal AAA and explores the evidence behind the various clinical presentations seen in patients with ruptured AAA.
MeSH term(s)	Aortic Aneurysm, Abdominal/diagnosis ; Aortic Aneurysm, Abdominal/surgery ; Aortic Rupture/diagnosis ; Aortic Rupture/surgery ; Arteriovenous Fistula/etiology ; Chronic Disease ; Duodenal Diseases/etiology ; Emergencies ; Humans ; Intestinal Fistula/etiology ; Renal Veins/surgery ; Vena Cava, Inferior/surgery
Language	English
Publishing date	2009-05
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	80325-x
ISSN	1469-0756 ; 0032-5473
ISSN (online)	1469-0756
ISSN	0032-5473
DOI	10.1136/pgmj.2008.074666
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Article: Endovascular proximal control of ruptured abdominal aortic aneurysms: the internal aortic clamp.

Assar, A N / Zarins, C K

The Journal of cardiovascular surgery

2009 Volume 50, Issue 3, Page(s) 381–385

Abstract: Ruptured abdominal aortic aneurysm (RAAA) is the most common and devastating complication affecting a patient with abdominal aortic aneurysm (AAA). Despite advances in surgery and critical care, the mortality rate associated with RAAA remains largely ... ...

Abstract	Ruptured abdominal aortic aneurysm (RAAA) is the most common and devastating complication affecting a patient with abdominal aortic aneurysm (AAA). Despite advances in surgery and critical care, the mortality rate associated with RAAA remains largely unchanged. Emergency open repair is the gold standard conventional treatment of RAAA but is associated with a high mortality rate. The physiologic challenges associated with general anaesthetic induction such as loss of the sympathetic vasoconstrictor tone with consequent hypotension, and the anatomic challenges associated with external aortic cross-clamping such as calcification, friability, or poor visualisation of the aneurysm neck, have led to the adoption of endovascular techniques in the surgical treatment of RAAA. Promising results of endovascular repair of ruptured abdominal aortic aneurysm (REVAR) have been reported. In addition, the provision of endovascular aortic control by inflating a compliant aortic occlusion balloon (AOB) proximal to the ruptured aneurysm, as an internal aortic clamp, has been successfully used in haemodynamically unstable patients undergoing either REVAR or emergency open repair of RAAA. An AOB is inserted under local anaesthesia and can be introduced through either the transbrachial or the transfemoral routes, each with its own advantages and disadvantages. This review aimed at providing an up-to-date overview of the current knowledge concerning endovascular proximal aortic control using an AOB with emphasis on the rationale, position, benefits, and drawbacks of its use.
MeSH term(s)	Aorta, Abdominal/diagnostic imaging ; Aorta, Abdominal/physiopathology ; Aorta, Abdominal/surgery ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/physiopathology ; Aortic Aneurysm, Abdominal/surgery ; Aortic Rupture/diagnostic imaging ; Aortic Rupture/physiopathology ; Aortic Rupture/surgery ; Balloon Occlusion ; Constriction ; Emergency Treatment ; Hemodynamics ; Humans ; Radiography ; Treatment Outcome ; Vascular Surgical Procedures
Language	English
Publishing date	2009-06
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	80143-4
ISSN	1827-191X ; 0021-9509
ISSN (online)	1827-191X
ISSN	0021-9509
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Article: Presidential address: time for the future of vascular surgery.

Zarins, C K

Journal of vascular surgery

2000 Volume 31, Issue 2, Page(s) 207–216

MeSH term(s)	Forecasting ; Health Care Reform/trends ; Humans ; Medical Laboratory Science/trends ; Physician-Patient Relations ; Professional Competence ; Vascular Surgical Procedures/trends
Language	English
Publishing date	2000-02
Publishing country	United States
Document type	Address
ZDB-ID	605700-7
ISSN	1097-6809 ; 0741-5214
ISSN (online)	1097-6809
ISSN	0741-5214
DOI	10.1016/s0741-5214(00)90151-4
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Article: The limits of endovascular aortic aneurysm repair.

Zarins, C K

Journal of vascular surgery

1999 Volume 29, Issue 6, Page(s) 1164–1166

MeSH term(s)	Aortic Aneurysm, Abdominal/surgery ; Endoscopy ; Humans ; Vascular Surgical Procedures
Language	English
Publishing date	1999-06
Publishing country	United States
Document type	Comment ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605700-7
ISSN	1097-6809 ; 0741-5214
ISSN (online)	1097-6809
ISSN	0741-5214
DOI	10.1016/s0741-5214(99)70256-9
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Article: Outpatient carotid stenting: feasible, yes, but advisable?

Zarins, C K

Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery

1999 Volume 6, Issue 4, Page(s) 319–320

MeSH term(s)	Ambulatory Surgical Procedures ; Blood Vessel Prosthesis Implantation ; Carotid Stenosis/surgery ; Feasibility Studies ; Humans ; Stents ; Stroke/prevention & control
Language	English
Publishing date	1999-11
Publishing country	United States
Document type	Case Reports ; Comment ; Journal Article ; Review
ZDB-ID	1327353-x
ISSN	1074-6218
ISSN	1074-6218
DOI	10.1583/1074-6218(1999)006<0319:OCSFYB>2.0.CO;2
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Article ; Online: Catheter-based renal sympathetic denervation: chronic preclinical evidence for renal artery safety.

Rippy, Marian K / Zarins, Denise / Barman, Neil C / Wu, Andrew / Duncan, Keith L / Zarins, Christopher K

Clinical research in cardiology : official journal of the German Cardiac Society

2011 Volume 100, Issue 12, Page(s) 1095–1101

Abstract: Background: Renal sympathetic hyperactivity is associated with hypertension, a leading cause of mortality worldwide. Renal sympathetic denervation via the Symplicity Catheter System has been shown to decrease blood pressure by 33/11 mmHg by 6 months, ... ...

Abstract	Background: Renal sympathetic hyperactivity is associated with hypertension, a leading cause of mortality worldwide. Renal sympathetic denervation via the Symplicity Catheter System has been shown to decrease blood pressure by 33/11 mmHg by 6 months, with no radiofrequency (RF)-related adverse sequelae visible by CT/MR angiography or renal duplex ultrasound 6 months after the procedure. Here, we present preclinical work predating those clinical results. We performed therapeutic renal sympathetic denervation in a swine animal model to characterize the vascular safety and healing response 6 months after renal denervation therapy. Methods: In December 2007, seven domestic swine received a total of 32 radiofrequency ablations via the Symplicity Catheter System and were euthanatized 6 months later. Renal angiography was done before, immediately after, and 6 months after procedure. The renal vessels were examined histologically with H&E and Movat pentachrome stains to identify evidence of vascular and neural injury. The kidneys and urinary system were also examined for evidence of gross and microscopic abnormalities. Results: Renal nerve injury involved primarily nerve fibrosis, replacement of nerve fascicles with fibrous connective tissue, and thickening of the epineurium and perineurium. Renal arterial findings included fibrosis of 10-25% of the total media and underlying adventitia, with mild disruption of the external elastic lamina. No significant smooth muscle hyperplasia or inflammatory components were observed. There was no renal arterial stenosis or thrombosis observed by angiography or histology. No gross or microscopic device-related abnormalities were noted in the kidney, surrounding stroma, or urinary bladder. Conclusions: In a swine model, renal denervation via the Symplicity Catheter System resulted in no clinically significant adverse renal artery or renal findings 6 months after the procedure. This is corroborated by the vascular safety profile demonstrated in subsequent human clinical studies.
MeSH term(s)	Animals ; Catheter Ablation/adverse effects ; Catheter Ablation/instrumentation ; Catheters ; Equipment Design ; Kidney/innervation ; Models, Animal ; Radiography ; Renal Artery/diagnostic imaging ; Renal Artery/injuries ; Renal Artery/pathology ; Sus scrofa ; Sympathectomy/adverse effects ; Sympathectomy/instrumentation ; Sympathectomy/methods ; Sympathetic Nervous System/surgery ; Time Factors ; Vascular System Injuries/diagnosis ; Vascular System Injuries/etiology ; Vascular System Injuries/prevention & control
Language	English
Publishing date	2011-07-28
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2213295-8
ISSN	1861-0692 ; 1861-0684
ISSN (online)	1861-0692
ISSN	1861-0684
DOI	10.1007/s00392-011-0346-8
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Article ; Online: Selecting the Next Class: The "Virtual Orthopaedic Rotation".

Yellin, Joseph L / Lu, Laura Y / Bauer, Andrea S / Duane, Jennifer / Appleton, Paul T / Berkson, Eric M / Bluman, Eric M / Bono, Christopher M / Drew, Jacob M / Duffy, Kaitlin / Fogel, Harold A / May, Collin / Ready, John E / Weaver, Michael J / Zarins, Bertram / Dyer, George S M

Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews

2022 Volume 6, Issue 1

Abstract: Introduction: When the COVID-19 pandemic forced the cancellation of visiting subinternships, we pivoted to create a virtual orthopaedic rotation (VOR). The purpose of this study was to assess the effect of the VOR on the residency selection process and ... ...

Abstract	Introduction: When the COVID-19 pandemic forced the cancellation of visiting subinternships, we pivoted to create a virtual orthopaedic rotation (VOR). The purpose of this study was to assess the effect of the VOR on the residency selection process and determine the role of such a rotation in the future. Methods: A committee was convened to create a VOR to replace visiting orthopaedic rotations for medical students who are interested in pursuing a career in orthopaedic surgery. The VOR was reviewed and sanctioned by our medical school, but no academic credit was granted. We conducted three 3-week VOR sessions. During each session, virtual rotators participated in regularly scheduled educational conferences and attended an invitation-only daily conference in the evenings that was designed for a medical student audience. In addition, students were paired with faculty and resident mentors in a structured mentorship program. Students' orthopaedic knowledge was assessed using prerotation and postrotation tests. Results: From July to September 2020, 61 students from 37 distinct medical schools participated in the VOR. Notable improvements were observed in prerotation and postrotation orthopaedic knowledge test scores. In postrotation surveys, both students and faculty expressed high satisfaction with the curriculum but less certainty about how well they got to know each other. In the subsequent residency application cycle, 27.9% of the students who participated in the VOR were selected to interview, compared with 8.7% of the total application pool. Discussion: The VOR was a valuable substitute for in-person clinical rotations during the COVID-19 pandemic. Although not likely to be a replacement for conventional away rotations, the VOR is a possible adjunct to in-person clinical rotations in the future.
MeSH term(s)	COVID-19 ; Humans ; Internship and Residency ; Orthopedics/education ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2022-01-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2898328-2
ISSN	2474-7661 ; 1067-151X
ISSN (online)	2474-7661
ISSN	1067-151X
DOI	10.5435/JAAOSGlobal-D-21-00151
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Article: A comparison of recombinant urokinase with vascular surgery for acute arterial occlusion of the legs.

Zarins, C K

The New England journal of medicine

1998 Volume 339, Issue 8, Page(s) 564; author reply 564–5

MeSH term(s)	Arterial Occlusive Diseases/drug therapy ; Arterial Occlusive Diseases/surgery ; Humans ; Leg/blood supply ; Peripheral Vascular Diseases/drug therapy ; Peripheral Vascular Diseases/surgery ; Plasminogen Activators/therapeutic use ; Recombinant Proteins/therapeutic use ; Thrombolytic Therapy ; Urokinase-Type Plasminogen Activator/therapeutic use
Chemical Substances	Recombinant Proteins ; Plasminogen Activators (EC 3.4.21.-) ; Urokinase-Type Plasminogen Activator (EC 3.4.21.73)
Language	English
Publishing date	1998-08-20
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJM199808203390813
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