Remote endarterectomy

Saaya S, et al. A prospective randomized trial on endovascular recanalization with stenting vs. remote endarterectomy for the superficial femoral artery total occlusive lesions. J Vasc Surg. 2022 Feb 26:S0741-5214(22)00380-9. Full-text for Emory users.

Key Findings: In patients with superficial femoral artery total occlusive lesions of size greater than 250 mm, the 1-year and 4-year cumulative primary patencies of stenting (EI) and remote endarterectomy (RE) were 83% vs 82% and 28% vs 46% (P = .04), respectively. Patencies of endovascular reintervention subgroups (65 patients in the EI subgroup and 32 patients in the RE subgroup) were 37% and 60% (P = .04), respectively.

Take Home Message: RE has a better 4-year primary patency compared with stenting in patients with superficial femoral artery total occlusive lesions of size greater than 250 mm. Endovascular reinterventions after RE showed a higher patency compared with reinterventions after EI.

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15-Year Patency and Life Expectancy After Primary Stenting Guided by Intravascular Ultrasound for Iliac Artery Lesions in Peripheral Arterial Disease

Kumakura H, et al. 15-Year Patency and Life Expectancy After Primary Stenting Guided by Intravascular Ultrasound for Iliac Artery Lesions in Peripheral Arterial Disease. JACC Cardiovasc Interv. 2015 Dec 21;8(14): 1893-901.

Full-text for Emory users.

Methods: EVT was performed for 507 lesions in 455 patients with PAD. The 15-year endpoints were primary, primary-assisted, and secondary patency; overall survival; freedom from major adverse cardiovascular events (MACE); and freedom from major adverse cardiovascular and limb events (MACLE).

Results: The 5-, 10-, and 15-year primary and secondary patencies were 89%, 83%, and 75%, respectively, and 92%, 91%, and 91%, respectively. There were no significant differences among TASC-II categories.

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Perioperative morbidity in patients randomized to epidural or general anesthesia for lower extremity vascular surgery.

Christopherson R, Beattie C, Frank SM, Norris EJ, Meinert CL, Gottlieb SO, Yates H, Rock P, Parker SD, Perler BA, et al. Perioperative morbidity in patients randomized to epidural or general anesthesia for lower extremity vascular surgery. Anesthesiology. 1993 Sep;79(3): 422-34.

Full-text for Emory users.

Background: Perioperative morbidity may be modifiable in high risk patients by the anesthesiologist’s choice of either regional or general anesthesia. This clinical trial compared outcomes between epidural (EA) and general (GA) anesthesia/analgesia regimens in a group of patients at high risk for cardiac and other morbidity who were undergoing similarly stressful surgical procedures.

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