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Joseph P Archie - One of the best experts on this subject based on the ideXlab platform.
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carotid endarterectomy saphenous Vein patch rupture revisited selective use on the basis of Vein Diameter
Journal of Vascular Surgery, 1996Co-Authors: Joseph P ArchieAbstract:Abstract Purpose: The single major disadvantage of carotid endarterectomy (CEA) patch reconstruction with greater saphenous Vein (GSV) is central patch rupture, which has a reported incidence of 0.5% to 4%. This is a prospective evaluation of the selective use of GSV for a CEA patch based on previously established Vein Diameter criteria. Methods: Between 1988 and mid-1995, 534 of 671 CEAs (80%) were reconstructed with GSVs that had a distended Diameter ≥3.5 mm. Thigh Veins were used in all 252 women who underwent CEA. Of the 282 men who underwent CEA, 265 GSVs (94%) were harvested from below the knee and 17 from the thigh. During this period four thigh and 13 below-knee Veins (3.2%) were rejected because the Diameter was Results: No GSV patches ruptured in this series. This compares favorably with three patch ruptures in 239 previous CEAs when no Vein Diameter criteria was used ( p = 0.03). This also compares favorably with a multicenter series of 13 GSV patch ruptures (0.73%) in 1773 CEAs ( p = 0.03) and with a single-center series of eight ruptures (0.47%) in 1699 CEAs ( p = 0.05) . GSV Diameters were 4.9 ± 0.9 mm (mean ± 1 SD); Vein rupture pressures, 3.9 ± 1.5 atmospheres; carotid bulb major axis Diameters, 12.5 ± 1.6 mm; carotid bulb maximum Diameters of curvature, 14.2 ± 2.2 mm; and CEA patch rupture pressures, 1.3 ± 0.6 atmospheres (range, 280 mm Hg to 4 atmospheres). CEA Vein patch rupture pressure correlates positively with Vein Diameter ( p 12 mm (mean, 15.3 mm). Eight of these CEAs were reconstructed with thigh Veins. Conclusions: Use of GSVs with a distended Diameter ≥3.5 mm for CEA patch reconstruction significantly reduces the probability of central patch rupture; however, a few CEAs reconstructed with Veins >3.5 mm in Diameter and large carotid bulbs have predicted patch rupture pressures
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Carotid endarterectomy saphenous Vein patch rupture revisited: Selective use on the basis of Vein Diameter ☆ ☆☆ ★
Journal of vascular surgery, 1996Co-Authors: Joseph P ArchieAbstract:Abstract Purpose: The single major disadvantage of carotid endarterectomy (CEA) patch reconstruction with greater saphenous Vein (GSV) is central patch rupture, which has a reported incidence of 0.5% to 4%. This is a prospective evaluation of the selective use of GSV for a CEA patch based on previously established Vein Diameter criteria. Methods: Between 1988 and mid-1995, 534 of 671 CEAs (80%) were reconstructed with GSVs that had a distended Diameter ≥3.5 mm. Thigh Veins were used in all 252 women who underwent CEA. Of the 282 men who underwent CEA, 265 GSVs (94%) were harvested from below the knee and 17 from the thigh. During this period four thigh and 13 below-knee Veins (3.2%) were rejected because the Diameter was Results: No GSV patches ruptured in this series. This compares favorably with three patch ruptures in 239 previous CEAs when no Vein Diameter criteria was used ( p = 0.03). This also compares favorably with a multicenter series of 13 GSV patch ruptures (0.73%) in 1773 CEAs ( p = 0.03) and with a single-center series of eight ruptures (0.47%) in 1699 CEAs ( p = 0.05) . GSV Diameters were 4.9 ± 0.9 mm (mean ± 1 SD); Vein rupture pressures, 3.9 ± 1.5 atmospheres; carotid bulb major axis Diameters, 12.5 ± 1.6 mm; carotid bulb maximum Diameters of curvature, 14.2 ± 2.2 mm; and CEA patch rupture pressures, 1.3 ± 0.6 atmospheres (range, 280 mm Hg to 4 atmospheres). CEA Vein patch rupture pressure correlates positively with Vein Diameter ( p 12 mm (mean, 15.3 mm). Eight of these CEAs were reconstructed with thigh Veins. Conclusions: Use of GSVs with a distended Diameter ≥3.5 mm for CEA patch reconstruction significantly reduces the probability of central patch rupture; however, a few CEAs reconstructed with Veins >3.5 mm in Diameter and large carotid bulbs have predicted patch rupture pressures
James W. Leatherman - One of the best experts on this subject based on the ideXlab platform.
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measurement of femoral Vein Diameter by ultrasound to estimate central venous pressure
Annals of the American Thoracic Society, 2016Co-Authors: Roy J. Cho, David R. Williams, James W. LeathermanAbstract:Rationale: Central venous pressure (CVP) can be estimated by ultrasound of the inferior vena cava (IVC), but imaging the IVC is sometimes challenging. The femoral Vein is easily imaged by ultrasound and might therefore provide an alternate target for estimating CVP.Objectives: To assess femoral Vein Diameter (FVD) measured by ultrasound imaging for estimating CVP.Methods: We prospectively measured CVP and FVD in 97 patients. Receiver operating characteristic curves were used to assess the ability of FVD to predict specific CVP values: less than 10 mm Hg, less than 8 mm Hg (low CVP), and greater than 12 mm Hg (high CVP). Interobserver variability of FVD measurement was assessed in 20 patients.Measurements and Main Results: There was moderate correlation between FVD and CVP (r = 0.66, P < 0.001). FVD less than or equal to 0.8 cm was the best predictor of CVP < 10 mm Hg, with an area under the curve (AUC) of 0.894 and a 95% confidence interval (CI) of 0.82 to 0.97. FVD less than or equal to 0.7 cm performed ...
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Measurement of Femoral Vein Diameter by Ultrasound to Estimate Central Venous Pressure
Annals of the American Thoracic Society, 2016Co-Authors: Roy J. Cho, David R. Williams, James W. LeathermanAbstract:Rationale: Central venous pressure (CVP) can be estimated by ultrasound of the inferior vena cava (IVC), but imaging the IVC is sometimes challenging. The femoral Vein is easily imaged by ultrasound and might therefore provide an alternate target for estimating CVP.Objectives: To assess femoral Vein Diameter (FVD) measured by ultrasound imaging for estimating CVP.Methods: We prospectively measured CVP and FVD in 97 patients. Receiver operating characteristic curves were used to assess the ability of FVD to predict specific CVP values: less than 10 mm Hg, less than 8 mm Hg (low CVP), and greater than 12 mm Hg (high CVP). Interobserver variability of FVD measurement was assessed in 20 patients.Measurements and Main Results: There was moderate correlation between FVD and CVP (r = 0.66, P
Jason Chuen - One of the best experts on this subject based on the ideXlab platform.
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Vein Diameter is a predictive factor for recanalization in treatment with ultrasound-guided foam sclerotherapy.
Journal of vascular surgery. Venous and lymphatic disorders, 2018Co-Authors: Jason Toniolo, Nathaniel Chiang, Diana Munteanu, Amelia Russell, Huming Hao, Jason ChuenAbstract:Abstract Objective Ultrasound-guided foam sclerotherapy (UGFS) is a low-cost and minimally invasive treatment option for varicose Veins. There is a relative paucity of outcome reports. Methods UGFS procedures at a tertiary public hospital between 2010 and 2017 were studied. Either the great saphenous Vein (GSV) or small saphenous Vein (SSV) was treated. Pretreatment, in-treatment, 6-week, and 1-year post-treatment ultrasound reports were analyzed. The primary outcome was to determine whether Vein Diameter predicts obliteration failure. Results There were 457 treatments completed in 290 patients. The GSV was targeted in 372 (81%). Mean Vein Diameters of the GSV were not different from those of the SSV (GSV, 5.7 mm; SSV, 6.2 mm; P = .18); 109 (24%) had a Clinical, Etiology, Anatomy, and Pathophysiology score of at least 4. Of the 457 UGFS procedures, 360 (78.8%) were for primary Veins. Baseline information, including Vein Diameter, was not different between primary and recurrent Veins. At 6 weeks, complete obliteration, partial recanalization, and complete recanalization rates were 54.9%, 29.1%, and 16%, respectively. Of those with complete obliteration at 6 weeks, the recanalization rate at 1 year was 25%. Increasing Vein Diameter was associated with recanalization at 1 year (obliteration, 4.9 mm; recanalization, 5.7 mm; P = .03), especially for primary Veins (4.8 vs 5.8 mm; P = .009). Multivariate analysis showed similar outcome. Vein Diameter of >6 mm had good specificity (88%) but poor sensitivity (43%) for predicting obliteration failure. There were 15 (3%) new-onset deep venous thromboses reported on follow-up, all of which were from treatment of primary Veins (P = .049). Conclusions Only 44% of UGFS procedures were observed to have complete obliteration at 1 year after a single intervention. Significant recanalization developed at 1 year. Increased Vein Diameter was associated with recanalization. The impact on clinical recurrence is unknown.
Roy J. Cho - One of the best experts on this subject based on the ideXlab platform.
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measurement of femoral Vein Diameter by ultrasound to estimate central venous pressure
Annals of the American Thoracic Society, 2016Co-Authors: Roy J. Cho, David R. Williams, James W. LeathermanAbstract:Rationale: Central venous pressure (CVP) can be estimated by ultrasound of the inferior vena cava (IVC), but imaging the IVC is sometimes challenging. The femoral Vein is easily imaged by ultrasound and might therefore provide an alternate target for estimating CVP.Objectives: To assess femoral Vein Diameter (FVD) measured by ultrasound imaging for estimating CVP.Methods: We prospectively measured CVP and FVD in 97 patients. Receiver operating characteristic curves were used to assess the ability of FVD to predict specific CVP values: less than 10 mm Hg, less than 8 mm Hg (low CVP), and greater than 12 mm Hg (high CVP). Interobserver variability of FVD measurement was assessed in 20 patients.Measurements and Main Results: There was moderate correlation between FVD and CVP (r = 0.66, P < 0.001). FVD less than or equal to 0.8 cm was the best predictor of CVP < 10 mm Hg, with an area under the curve (AUC) of 0.894 and a 95% confidence interval (CI) of 0.82 to 0.97. FVD less than or equal to 0.7 cm performed ...
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Measurement of Femoral Vein Diameter by Ultrasound to Estimate Central Venous Pressure
Annals of the American Thoracic Society, 2016Co-Authors: Roy J. Cho, David R. Williams, James W. LeathermanAbstract:Rationale: Central venous pressure (CVP) can be estimated by ultrasound of the inferior vena cava (IVC), but imaging the IVC is sometimes challenging. The femoral Vein is easily imaged by ultrasound and might therefore provide an alternate target for estimating CVP.Objectives: To assess femoral Vein Diameter (FVD) measured by ultrasound imaging for estimating CVP.Methods: We prospectively measured CVP and FVD in 97 patients. Receiver operating characteristic curves were used to assess the ability of FVD to predict specific CVP values: less than 10 mm Hg, less than 8 mm Hg (low CVP), and greater than 12 mm Hg (high CVP). Interobserver variability of FVD measurement was assessed in 20 patients.Measurements and Main Results: There was moderate correlation between FVD and CVP (r = 0.66, P
Jason Toniolo - One of the best experts on this subject based on the ideXlab platform.
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Vein Diameter is a predictive factor for recanalization in treatment with ultrasound-guided foam sclerotherapy.
Journal of vascular surgery. Venous and lymphatic disorders, 2018Co-Authors: Jason Toniolo, Nathaniel Chiang, Diana Munteanu, Amelia Russell, Huming Hao, Jason ChuenAbstract:Abstract Objective Ultrasound-guided foam sclerotherapy (UGFS) is a low-cost and minimally invasive treatment option for varicose Veins. There is a relative paucity of outcome reports. Methods UGFS procedures at a tertiary public hospital between 2010 and 2017 were studied. Either the great saphenous Vein (GSV) or small saphenous Vein (SSV) was treated. Pretreatment, in-treatment, 6-week, and 1-year post-treatment ultrasound reports were analyzed. The primary outcome was to determine whether Vein Diameter predicts obliteration failure. Results There were 457 treatments completed in 290 patients. The GSV was targeted in 372 (81%). Mean Vein Diameters of the GSV were not different from those of the SSV (GSV, 5.7 mm; SSV, 6.2 mm; P = .18); 109 (24%) had a Clinical, Etiology, Anatomy, and Pathophysiology score of at least 4. Of the 457 UGFS procedures, 360 (78.8%) were for primary Veins. Baseline information, including Vein Diameter, was not different between primary and recurrent Veins. At 6 weeks, complete obliteration, partial recanalization, and complete recanalization rates were 54.9%, 29.1%, and 16%, respectively. Of those with complete obliteration at 6 weeks, the recanalization rate at 1 year was 25%. Increasing Vein Diameter was associated with recanalization at 1 year (obliteration, 4.9 mm; recanalization, 5.7 mm; P = .03), especially for primary Veins (4.8 vs 5.8 mm; P = .009). Multivariate analysis showed similar outcome. Vein Diameter of >6 mm had good specificity (88%) but poor sensitivity (43%) for predicting obliteration failure. There were 15 (3%) new-onset deep venous thromboses reported on follow-up, all of which were from treatment of primary Veins (P = .049). Conclusions Only 44% of UGFS procedures were observed to have complete obliteration at 1 year after a single intervention. Significant recanalization developed at 1 year. Increased Vein Diameter was associated with recanalization. The impact on clinical recurrence is unknown.
