scholarly journals Hybrid approach to complex thoracic aortic aneurysms in high-risk patients: Surgical challenges and clinical outcomes

2006 ◽  
Vol 44 (4) ◽  
pp. 688-693 ◽  
Author(s):  
Wei Zhou ◽  
Michael Reardon ◽  
Eric K. Peden ◽  
Peter H. Lin ◽  
Alan B. Lumsden
Keyword(s):  
High Risk ◽  
Clinical Outcomes ◽  
Hybrid Approach ◽  
Aortic Aneurysms ◽  
Thoracic Aortic Aneurysms ◽  
High Risk Patients ◽  
Risk Patients

Prognostic implications of pre-ablation stimulated Tg: a retrospective analysis of 2500 thyroid cancer patients

2021 ◽  
Author(s):  
Tian Tian ◽  
Yangmengyuan Xu ◽  
Xinyue Zhang ◽  
Bin Liu
Keyword(s):  
Thyroid Cancer ◽  
High Risk ◽  
Risk Stratification ◽  
Clinical Outcomes ◽  
Recurrent Disease ◽  
Clinicopathological Parameters ◽  
Characteristic Analysis ◽  
High Risk Patients ◽  
Risk Patients ◽  
Risk Categories

Abstract Context The risk of persistent and recurrent disease in patients with differentiated thyroid cancer (DTC) is a continuum that ranges from very low to very high, even within the three primary risk categories. It is important to identify independent clinicopathological parameters to accurately predict clinical outcomes. Objective To examine the association between pre-ablation stimulated thyroglobulin (ps-Tg) and persistent and recurrent disease in DTC patients and investigate whether incorporation of ps-Tg could provide a more individualized estimate of clinical outcomes. Design, Setting, and Participants Medical records of 2524 DTC patients who underwent total thyroidectomy and radioiodine ablation between 2006 and 2018 were retrospectively reviewed. Main Outcome Measure Ps-Tg was measured under thyroid hormone withdrawal before remnant ablation. Association of ps-Tg and clinical outcomes. Results In multivariate analysis, age, ATA risk stratification, M1, ps-Tg and cumulative administered activities were the independent predictive factors for persistent/ recurrent disease. Receiver operating characteristic analysis identified ps-Tg cutoff (≤ 10.1 ng/mL) to predict disease free status with a negative predictive value of 95%, and validated for all ATA categories. Integration of ps-Tg into ATA risk categories indicated that the presence of ps-Tg ≤ 10.1 ng/mL was associated with a significantly decreased chance of having persistent/recurrent disease in intermediate- and high-risk patients (9.9 to 4.1% in intermediate-risk patients, and 33.1 to 8.5% in high-risk patients). Conclusion Ps-Tg (≤ 10.1 ng/mL) was a key predictor of clinical outcomes in DTC patients. Its incorporation as a variable in the ATA risk stratification system could more accurately predict clinical outcomes.

Thoracic Aortic Aneurysm Repair with Endovascular Stent-Grafts

1997 ◽  
Vol 2 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Charles P Semba ◽  
R Scott Mitchell ◽  
D Craig Miller ◽  
Noriyuki Kato ◽  
Stephen T Kee ◽  
...  
Keyword(s):  
High Risk ◽  
Aortic Aneurysm ◽  
Stent Graft ◽  
Aortic Aneurysms ◽  
Stent Grafts ◽  
Thoracic Aortic Aneurysms ◽  
Risk Patients ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair ◽  
Endoluminal Stent

The purpose of the study was to describe the clinical experience in using endoluminal stent-grafts for the treatment of thoracic aortic aneurysms in high-risk patients. Patients with aneurysms of the descending thoracic aorta who were considered high surgical risks underwent evaluation for endoluminal repair. The prosthesis was constructed from Z stents covered with polyester fabric using dimensions based upon preprocedural computed tomography scans and angiography. Through a femoral arteriotomy or left retroperitoneal flank incision, a 22–24 Fr delivery catheter was inserted and advanced through the aorta to the target site under fluoroscopic guidance in the operating suite. The stent-graft prosthesis was deployed at the site of the aneurysm. 44 patients (36 male, 8 female; mean age 36 years) underwent stent-graft repair for thoracic aneurysms (mean diameter 6.3 cm). The deployment was technically successful in all cases, with complete aneurysm thrombosis in 88%. The 30-day perioperative mortality rate was 6.8% and 35-month actuarial survival was 82%. There were no cases of stent migration, surgical conversion or intraprocedural death. Paraplegia occurred in two patients who underwent simultaneous surgical infrarenal aortic aneurysm repair immediately followed by stent-graft placement for a coexisting thoracic aneurysm. The conclusion was that placement of endoluminal stent-grafts for repair of thoracic aortic aneurysms is technically feasible in high-risk patients in whom conventional surgery is contraindicated. Long-term studies are needed to determine protection against aneurysm rupture and patient survival.

Dementia screening in elderly high-risk patients following heart failure decompensation may predict unfavorable long-term clinical outcomes

2021 ◽  
Vol 69 (3) ◽  
Author(s):  
Konrad STEPIEN ◽  
Patrycja FURCZYNSKA ◽  
Magdalena ZALEWSKA ◽  
Karol NOWAK ◽  
Aleksandra WLODARCZYK ◽  
...  
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Clinical Outcomes ◽  
High Risk Patients ◽  
Dementia Screening ◽  
Risk Patients ◽  
Heart Failure Decompensation

Su2061 CLINICAL OUTCOMES OF HIGH-RISK PATIENTS TREATED OF PERCUTANEOUS CHOLECYSTOSTOMY TUBE DRAINAGE

2020 ◽  
Vol 158 (6) ◽  
pp. S-1567
Author(s):  
Krishnamurthy B. Vaishnavi ◽  
Christopher P. Rice ◽  
Celia Chao ◽  
Farhan Ahmad ◽  
William J. Mileski
Keyword(s):  
High Risk ◽  
Clinical Outcomes ◽  
Percutaneous Cholecystostomy ◽  
Tube Drainage ◽  
High Risk Patients ◽  
Risk Patients ◽  
Cholecystostomy Tube ◽  
Percutaneous Cholecystostomy Tube

Mid-Term Results After Endovascular Stent-Grafting of Descending Aortic Aneurysms in High-Risk Patients

2006 ◽  
Vol 29 (5) ◽  
pp. 739-744 ◽  
Author(s):  
Michael Brandt ◽  
Knut P. Walluscheck ◽  
Thomas Jahnke ◽  
Tim Attmann ◽  
Martin Heller ◽  
...  
Keyword(s):  
High Risk ◽  
Aortic Aneurysms ◽  
Endovascular Stent ◽  
Stent Grafting ◽  
High Risk Patients ◽  
Endovascular Stent Grafting ◽  
Risk Patients ◽  
Mid Term Results
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