scholarly journals Duplex scan surveillance during the first year after infrainguinal autologous vein bypass grafting surgery: Costs and clinical outcomes compared with other surveillance programs

2001 ◽  
Vol 33 (1) ◽  
pp. 123-130 ◽  
Author(s):  
Karen Visser ◽  
Mirza M. Idu ◽  
Jacob Buth ◽  
Gerard L. Engel ◽  
M.G.Myriam Hunink
Keyword(s):  
Clinical Outcomes ◽  
First Year ◽  
Bypass Grafting ◽  
Duplex Scan ◽  
Autologous Vein ◽  
Vein Bypass ◽  
Surveillance Programs

Very distal vein bypass in patients with thromboangiitis obliterans

VASA ◽  
2017 ◽  
Vol 46 (4) ◽  
pp. 304-309 ◽  
Author(s):  
Achim Neufang ◽  
Carolina Vargas-Gomez ◽  
Patrick Ewald ◽  
Nicolaos Vitolianos ◽  
Tolga Coskun ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Vein Graft ◽  
Duplex Ultrasound ◽  
Critical Limb Ischaemia ◽  
Thromboangiitis Obliterans ◽  
Surgical Revascularization ◽  
Autologous Vein ◽  
Therapeutic Concept ◽  
Autologous Vein Graft ◽  
Vein Bypass

Abstract. Background: Surgical revascularization for chronic critical limb ischaemia in patients with thromboangiitis obliterans (TAO) still remains controversial. Generally, besides cessation of smoking, conservative treatment supported by intravenous administration of vasoactive agents is regarded as the treatment of choice, in combination with local wound therapy or minor amputation. Patients and methods: In four male patients (42-47 years) surgical revascularization was chosen as therapy for established gangrene or non-healing ulceration after unsuccessful conservative treatment and cessation of smoking. Angiography was able to identify a suitable distal arterial segment for the bypass which was revascularized by means of an autologous vein graft. Grafts were followed with repetitive duplex ultrasound. Revision of the bypass graft was initiated if indicated by pathological duplex findings. Results: In all cases a bypass could be constructed with either the ipsilateral greater saphenous vein or arm veins. A distal origin configuration was possible in three cases with popliteo-pedal or cruro-pedal bypasses. In the fourth case the distal superficial femoral artery was used for inflow. Two early graft thromboses underwent successful revision. During follow-up, duplex ultrasound identified graft stenoses in three bypasses which were successfully treated with endovascular techniques. All grafts are patent with complete resolution of ischaemic symptoms after 46, 42, 32, and 29 months. The patients remained non-smokers and returned to a professional life. Conclusions: Surgical therapy with distal vein bypass for persistent ischaemic symptoms after definitive cessation of smoking seems feasible in selected cases with TAO and a suitable distal artery. Close follow-ups of the patients with duplex ultrasound are necessary to identify developing vein graft stenoses. Angioplasty seems to be an important part of the long-term therapeutic concept.

Influence of External Stent Size on Early Medial and Neointimal Thickening in a Pig Model of Saphenous Vein Bypass Grafting

Circulation ◽  
1996 ◽  
Vol 94 (7) ◽  
pp. 1741-1745 ◽  
Author(s):  
Mohammad Bashar Izzat ◽  
Dheeraj Mehta ◽  
Alan J. Bryan ◽  
Barnaby Reeves ◽  
Andrew C. Newby ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Pig Model ◽  
Bypass Grafting ◽  
Neointimal Thickening ◽  
Saphenous Vein Bypass ◽  
Vein Bypass

scholarly journals One‐year clinically important deterioration and long‐term clinical course in Japanese patients with COPD: a multicenter observational cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuki Abe ◽  
Masaru Suzuki ◽  
Hironi Makita ◽  
Hirokazu Kimura ◽  
Kaoruko Shimizu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Disease Progression ◽  
Clinical Outcomes ◽  
Japanese Patients ◽  
Drop Out ◽  
Chronic Obstructive ◽  
First Year ◽  
Severe Exacerbation ◽  
Clinically Important Deterioration

Abstract Background Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with a complex progression of many clinical presentations, and clinically important deterioration (CID) has been proposed in the Western studies as a composite endpoint of disease progression. The aim of this study was to investigate the relationships between 1-year CID and the following long-term clinical outcomes in Japanese patients with COPD who have been reported to have different characteristics compared to the Westerners. Methods Among Japanese patients with COPD enrolled in the Hokkaido COPD cohort study, 259 patients who did not drop out within the first year were analyzed in this study. Two definitions of CID were used. Definition 1 comprised ≥ 100 mL decrease in forced expiratory volume in 1 s (FEV1), ≥ 4-unit increase in St George’s Respiratory Questionnaire (SGRQ) score from baseline, or moderate or severe exacerbation. For Definition 2, the thresholds for the FEV1 and SGRQ score components were doubled. The presence of CID was evaluated within the first year from enrollment, and analyzed the association of the presence of CID with following 4-year risk of exacerbations and 9-year mortality. Results Patients with CID using Definition 1, but not any single CID component, during the first year had a significantly worse mortality compared with those without CID. Patients with CID using Definition 2 showed a similar trend on mortality, and had a shorter exacerbation-free survival compared with those without CID. Conclusions Adoption of CID is a beneficial and useful way for the assessment of long-term disease progression and clinical outcomes even in Japanese population with COPD. The definition of CID might be optimized according to the characteristics of COPD population and the observation period for CID.

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