1,721,075 research outputs found
Covered versus Bare-metal Kissing Stents for the Reconstruction of the Aortic Bifurcation in the ILIACS registry
No full textTo compare early and mid-term outcomes of polytetrafluoroethylene-covered stents (CS) versus bare-metal stents (BMS) used in the kissing conformation for the reconstruction of the aortic bifurcation in aorto-iliac obstructive disease
Early and Long-Term Results of Open and Endovascular Treatment of Visceral Artery Aneurysms
No full textObjectives
This study retrospectively analyzed early and follow-up results of open and endovascular management of visceral artery aneurysms in two Italian teaching hospitals.
Methods
From January 1982 to December 2014, 144 consecutive elective interventions for visceral artery aneurysms were performed in 144 patients; in 76 cases an endovascular intervention was performed (group 1), while in the remaining 68, an open procedure was carried out. Pre-, intra-, and postoperative data were prospectively collected in a dedicated database. Early (<30 days) and follow-up results were evaluated and compared with χ2 test and Kaplan-Meier curves.
Results
The site of aneurysm was the splenic artery in 43 patients in group 1 and in 34 patients in group 2, the common hepatic artery in 6 and 7 patients, and the renal artery in 8 cases for each group. Perigastric and peripancreatic aneurysms were present in 20 patients (11 and 9, respectively), while the celiac trunk was involved in 6 cases (5 and 1, respectively). Colic and mesenteric aneurysms were found in three cases in group 1 and in two cases in group 2. Finally, seven patients in group had multiple vessel involvement; 10 patients (6.9%) had rupture. In group 1 interventions consisted in coiling in 59 cases; in 17 patients, a covered or a multilayer stent was placed. In group 2, 58 patients had aneurysmectomy with reconstitution of the arterial patency in different fashions; nine patients with distal splenic aneurysm had splenectomy and arterial ligature, and one patient had aneurysmal wrapping. Technical success in group 1 was 96%. There were three perioperative deaths, two in group 1 (2.6%) and one in group 1 (1.4%; P = .6). Local and systemic complications occurred in nine patients in group 1 (11.8%) and in seven patients in group 2 (10.2%; P = .7). Three patients in group 1 underwent early reintervention (3.9%), while in group 2, no early reintervention was required (P = .08). Median duration of follow-up was 48 months (range, 1-324). Estimated 7-year survival was 83.4% in group 1 and 85.2% in group 2 (P = .2, log-rank 1.2). Also the rates of freedom from aneurysm-related complications and of reinterventions were similar between the two groups (P = .3 and P = .7, respectively).
Conclusions
Elective open and endovascular treatment of visceral artery aneurysm provided excellent early results, with low mortality and reinterventions rates, even in the presence of a not negligible rate of perioperative complications. Also long-term results were equally satisfactory, suggesting the effectiveness of a single patient-based therapeutic choice
A comparison between aortobifemoral bypass and aortoiliac kissing stents in patients with complex aortoiliac obstructive disease
No full textObjective The aim of this study was to retrospectively compare early and late results of aortobifemoral bypass and endovascular recanalization with the kissing stent technique in the management of TransAtlantic Inter-Society Consensus II (TASC II) C and D lesions in the aortoiliac district in a multicenter study. Methods From January 2006 to December 2013, 210 open and endovascular interventions for TASC II class C and D aortoiliac obstructive lesions were performed at three Italian teaching hospitals. In all the cases, the intervention was performed for aortic and bilateral iliac involvement. An aortobifemoral bypass was performed in 82 patients (group 1); in the remaining 128, an endovascular recanalization with the kissing stent technique was carried out (group 2). Early results in the two groups were compared with the χ2 test. Follow-up results were analyzed with Kaplan-Meier curves and compared with log-rank test. Univariate and multivariate (forward Cox regression) analysis to identify potentially significant predictors of primary patency in the whole study group was performed. Results Patients in group 2 were more frequently female and more frequently had diabetes and arterial hypertension than patients in group 1. The indication for surgical intervention was the presence of critical limb ischemia in 29 cases in group 1 (35%) and in 31 cases in group 2 (24%; P = .07). Technical success in group 2 was 98.5%; two patients required immediate conversion to open surgery for iliac rupture. There was one perioperative death in group 1 (mortality rate, 1%; P = .2 in comparison with group 2). Four perioperative thromboses occurred, two in group 1 and two in group 2 (in one case requiring conversion to open surgical intervention), and no amputations at 30 days were recorded. Cumulative postoperative local and systemic complications occurred in 17 patients in group 1 (20.5%) and in 9 patients in group 2 (7%; P < .001). Mean duration of follow-up was 38 months (range, 1-96 months). Survival rates at 6 years were 65.5% (standard error [SE], 0.08) in group 1 and 83.5% (SE, 0.08) in group 2 (P = .08; log-rank, 2.2). At the same time interval, primary, assisted primary, and secondary patency rates were similar; reintervention rates were 6% in group 1 (SE, 0.05) and 11% in group 2 (SE, 0.04; P = .3; log-rank, 0.8). Univariate and multivariate analysis showed that only the presence of critical limb ischemia was independently associated with poorer primary patency during follow-up (hazard ratio, 2.4; 95% confidence interval, 0.9-6.4; P = .05). Conclusions In this multicenter experience, endovascular repair of aortoiliac complex lesions with the kissing stent technique provided similar satisfactory early and late results to those obtained with open surgery
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Results of the multicenter pELVIS Registry for isolated common iliac aneurysms treated by the iliac branch device
No full textObjective: We evaluated the short-and long-term results of off-label use of iliac branch devices (IBDs) in isolated common iliac artery aneurysms compared with the manufacturer-recommended configuration with additional extension in the infrarenal aorta based on the pELVIS Registry (pErformance of iLiac branch deVIces for aneurysmS involving the iliac bifurcation).Methods: Between January 2005 and April 2017, 804 patients underwent endovascular aneurysm repair with 910 IBDs owingto aneurysmal involvement of the iliac bifurcationinnine high-volumeEuropeanvascular centers. Amongthis cohort, 231 IBDs were implanted in 207 patients to treat an isolated common iliac aneurysm; 91 IBDs (group 1) were implanted without proximal aortic extension in the infrarenal aorta, and in the remaining cases (n = 140; group 2) an aortic bifurcated stent graft was deployed proximally as stated in the instructions for use. Primary outcomes were IBD and target hypogastric artery occlusions, type I and III endoleaks, procedure-related reinterventions, and aneurysm-related deaths.Results: Technical success was achieved in 90 cases (98.9%) in group 1 versus 137 cases (97.8%) in group 2 (P=.55). The overall aneurysm-related early reintervention rate for the two groups was 4.4% (4 of 91) and 2.1% (3 of 140), respectively (P=.33). The 30-day mortality was 1.1% in group 1 (n = 1), and 0% in group 2 (P=.21). The median postoperative follow-up in groups 1 and 2 were 34.1 months (range, 1-108 months) and 17.5 months (range, 1-90 months), respectively. The estimated rates of freedom from IBD occlusion at 60 months were 86% in group 1 and 83% in group 2 (P=.69). The estimated rates of freedom from target hypogastric artery occlusion at 60 months were 98.3% in group 1 and 91.3% in group 2 (P=.45). The estimated freedom from reintervention rates at 60 months for types I, types III, and IBD stenosis-occlusion were 78.2% in group 1 and 79.9% in group 2 (P=.79). The estimated freedom from all cause reintervention at 60 months was 64.5% in group 1 and 66.1% in group 2 (P=.44). The estimated freedom from aneurysm-related death at 60 months was 97.9% in group 1 and 100% in group 2 (P=.83).Conclusions: Single IBD placement for isolated common iliac artery aneurysms seems to be a safe and effective treatment option, when a proper anatomic patient selection is provided. Major benefits are represented by the decrease in X ray exposure, overall procedural time, and use of contrast medium, without affecting perioperative and long-term results in comparison with more extensive procedures
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
A Retrospective Comparison Between Hybrid Treatment and Prosthetic Above-the-Knee Femoro-Popliteal Bypass in the Management of the Obstructive Disease of the Superficial Femoral Artery
No full textObjective: We assessed early and late outcomes following hybrid intervention (common femoral artery endarterectomy and superficial femoral artery (SFA) stenting) versus above-the-knee (AK) femoro-popliteal bypass performed for peripheral artery occlusive disease (PAOD) in a double-center retrospective comparative cohort study.
Materials and methods: From January 2006 to December 2017, 82 hybrid revascularizations with femoral endarterectomy and SFA stenting (HY Group) and 98 AK femoro-popliteal bypasses with femoral endarterectomy (BP Group) were performed at two academic vascular centers. The two groups were compared in terms of preoperative and intraoperative details and of perioperative (<30 days) outcomes with χ2 test. Long-term results were compared using Kaplan-Meier curves and log-rank test.
Results: No differences were found in demographics variables, risk factors, comorbidities and clinical presentation between the two groups. Also perioperative outcomes were similar between the two groups. Median duration of follow-up was 38 months. At five years, the estimated survival rate was 60% in HY Group and 77.5% in BP Group (p = 0.002) Five-year primary patency rates were 46% in HY Group and 64% in BP Group (p = 0.005). Overall, 13 patients in HY Group required conversion to open surgery and 6 patients in BP Group underwent below-knee (n = 4) or distal (n = 2) bypass. The 5-year rate of limb maintenance was 85% in HY Group and 94% in BP Group (p = 0.1) and was not significantly different regardless of presentation, claudication or critical limb ischemia.
Conclusions: In patients with PAOD due to complex long lesions of the infrainguinal arteries, open-surgical treatment with AK bypass provided better long-term survival and patency rates compared to a hybrid approach
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
A 33-year experience with surgical management of popliteal artery aneurysms Presented in the poster session at the 2014 Vascular Annual Meeting of the Society for Vascular Surgery, Boston, Mass, June 5-7, 2014
No full textObjective This study retrospectively analyzed our 33-year experience with surgical management of popliteal artery aneurysms (PAAs), with particular attention paid to early and long-term results. Methods From January 1981 to December 2013, 234 open surgical interventions for PAA were performed in 196 patients. Data concerning these interventions were collected in a dedicated database containing main preoperative, intraoperative, and postoperative features. Early (intraoperative and <30 days) results were analyzed for mortality, thrombosis, reintervention, and amputation rates. The follow-up program consisted of clinical and duplex ultrasound examinations at 1 month and yearly thereafter. Patients who did not accomplish follow-up examinations were interviewed by telephone. Additional data regarding long-term survival and major clinical events were obtained from the Regional Health Care database. Follow-up results were analyzed for survival, primary and secondary patency, and amputations rates. Results Patients were predominantly males (186 [95%]), with a mean age of 68.5 ± 9.9 years. The PAA was asymptomatic in 97 limbs, intermittent claudication was present in 68, and limb-threatening ischemia was present in 62. Aneurysmal rupture occurred in six patients, and venous compression with leg swelling and pain was present in one patient. The intervention consisted of aneurysmal ligation and bypass grafting in 122 interventions, aneurysmectomy with graft interposition was used in 108, and four patients underwent aneurysmectomy with an end-to-end anastomosis. An autologous vein was used in 49 interventions, and a prosthetic graft was used in 181. In 71 interventions a posterior approach was used, and in the remaining 163, a medial approach was preferred. There were two perioperative deaths, with a cumulative mortality rate of 1%. Perioperative thrombosis occurred after 18 interventions (7.7%). A successful reintervention was performed in 10 of those patients, whereas surgical thrombectomy was ineffective in one patient and leg amputation was necessary. The remaining seven patients underwent major amputation without any new surgical attempt. An adjunctive major amputation was necessary in a patient with a patent bypass for irreversible foot ischemia. The cumulative rate of amputations at 30 days was 3.8% (9 of 234 limbs). Mean duration of follow-up was 62 months (range 1-312 months). During follow-up, 31 deaths, 45 thromboses, and 10 amputations were recorded. The estimated 13-year survival rate was 50.8% (standard error [SE], 0.07%); during the same interval, primary patency, secondary patency, and limb preservation rates were 55.1% (SE, 0.05%), 68% (SE, 0.05%), and 86% (SE, 0.04%). Conclusions Open surgical repair of PAAs provided good results in our experience, with low rates of perioperative complications and an excellent durability in the very long-term setting, representing the benchmark for alternative techniques such as endovascular repair
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