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Onohara T, Handa N, Kawasaki M, Kasashima F, Saito T, Nakamura T, Une D, Nakai M, Shiraya S, Maeda K, Imai K, Yamamoto T, Shimoe Y, Okamoto M, Kawazu Y. Long-Term Outcomes of Endovascular Aneurysm Repair in Patients Aged ≤70 Years. Ann Vasc Dis 2024; 17:25-33. [PMID: 38628930 PMCID: PMC11018108 DOI: 10.3400/avd.oa.23-00072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/15/2024] [Indexed: 04/19/2024] Open
Abstract
Objectives: The efficacy of endovascular aneurysm repair (EVAR) against abdominal aortic aneurysm (AAA) in younger patients remains unknown. Hence, the current study aimed to investigate whether the aneurysm-related mortality rate of EVAR is acceptable among patients aged ≤70 years. Methods: Among 644 patients, 148 underwent EVAR (EVAR group), and 496 received open surgical repair (OSR group). The cumulative incidence rates of aneurysm-related death, any intervention, and serious aneurysm-related events after AAA repair were evaluated using the cumulative incidence function in the presence of competing risks. Results: The EVAR group had higher prevalences of several comorbidities, and overall survival for the EVAR group was significantly inferior to that of the OSR group. The cumulative incidence rates of aneurysm-related death, any intervention, and serious aneurysm-related events at 5 years were 1.5%, 11.7%, and 6.4% in the EVAR group and 1.3%, 5.3%, and 5.9% in the OSR group, respectively. EVAR was not a significant prognostic factor of aneurysm-related mortality and serious aneurysm-related events. However, it was an independent poor prognostic factor of any intervention. Conclusion: EVAR was not a significant prognostic factor of aneurysm-related mortality and serious aneurysm-related events. Therefore, it demonstrated acceptable procedure-related long-term outcomes, at least in high-risk young patients.
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Affiliation(s)
- Toshihiro Onohara
- Department of Vascular Surgery, Kyushu Medical Center, Fukuoka, Fukuoka, Japan
| | - Nobuhiro Handa
- Department of Cardiovascular Surgery, Nagara Medical Center, Gifu, Gifu, Japan
| | - Masakazu Kawasaki
- Department of Cardiovascular Surgery, Hokkaido Medical Center, Sapporo, Hokkaido, Japan
| | - Fuminori Kasashima
- Department of Cardiovascular Surgery, Kanazawa Medical Center, Kanazawa, Ishikawa, Japan
| | - Tetsuya Saito
- Department of Cardiovascular Surgery, Osaka National Hospital, Osaka, Osaka, Japan
| | - Teruya Nakamura
- Department of Cardiovascular Surgery, Osaka Minami Medical Center, Kawachinagano, Osaka, Japan
| | - Dai Une
- Department of Cardiovascular Surgery, Okayama Medical Center, Okayama, Okayama, Japan
| | - Mikizo Nakai
- Department of Cardiovascular Surgery, Okayama Medical Center, Okayama, Okayama, Japan
| | - Suguru Shiraya
- Department of Cardiovascular Surgery, Hamada Medical Center, Hamada, Shimane, Japan
| | - Kazuki Maeda
- Department of Cardiovascular Surgery, Higashihiroshima Medical Center, Higashihiroshima, Hiroshima, Japan
| | - Katsuhiko Imai
- Department of Cardiovascular Surgery, Kure Medical Center, Kure, Hiroshima, Japan
| | - Tsuyoshi Yamamoto
- Department of Cardiovascular Surgery, Iwakuni Medical Center, Iwakuni, Yamaguchi, Japan
| | - Yasushi Shimoe
- Department of Cardiovascular Surgery, Shikoku Medical Center for Children and Adults, Zentsu¯ji, Kagawa, Japan
| | - Minoru Okamoto
- Department of Cardiovascular Surgery, Kumamoto Medical Center, Kumamoto, Kumamoto, Japan
| | - Yoshikazu Kawazu
- Department of Cardiovascular Surgery, Kagoshima Medical Center, Kagoshima, Kagoshima, Japan
| | - on behalf of National Hospital Organization Network Study Group in Japan for Abdominal Aortic Aneurysm
- Department of Vascular Surgery, Kyushu Medical Center, Fukuoka, Fukuoka, Japan
- Department of Cardiovascular Surgery, Nagara Medical Center, Gifu, Gifu, Japan
- Department of Cardiovascular Surgery, Hokkaido Medical Center, Sapporo, Hokkaido, Japan
- Department of Cardiovascular Surgery, Kanazawa Medical Center, Kanazawa, Ishikawa, Japan
- Department of Cardiovascular Surgery, Osaka National Hospital, Osaka, Osaka, Japan
- Department of Cardiovascular Surgery, Osaka Minami Medical Center, Kawachinagano, Osaka, Japan
- Department of Cardiovascular Surgery, Okayama Medical Center, Okayama, Okayama, Japan
- Department of Cardiovascular Surgery, Hamada Medical Center, Hamada, Shimane, Japan
- Department of Cardiovascular Surgery, Higashihiroshima Medical Center, Higashihiroshima, Hiroshima, Japan
- Department of Cardiovascular Surgery, Kure Medical Center, Kure, Hiroshima, Japan
- Department of Cardiovascular Surgery, Iwakuni Medical Center, Iwakuni, Yamaguchi, Japan
- Department of Cardiovascular Surgery, Shikoku Medical Center for Children and Adults, Zentsu¯ji, Kagawa, Japan
- Department of Cardiovascular Surgery, Kumamoto Medical Center, Kumamoto, Kumamoto, Japan
- Department of Cardiovascular Surgery, Kagoshima Medical Center, Kagoshima, Kagoshima, Japan
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Siribumrungwong B, Kurita J, Ueda T, Yasui D, Takahashi KI, Sasaki T, Miyagi Y, Sakamoto SI, Ishii Y, Morota T, Nitta T. Outcomes of abdominal aortic aneurysm repairs: Endovascular aneurysm vs open surgical repairs. Asian J Surg 2021; 45:346-352. [PMID: 34193387 DOI: 10.1016/j.asjsur.2021.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/29/2021] [Accepted: 06/08/2021] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Operative mortality after endovascular aneurysm repair (EVAR) has been reported as lower than open surgical repair (OSR) for abdominal aortic aneurysm (AAA) in randomized controlled trials. However, many cohort studies have demonstrated similar mortality rates for both procedures. We compared operative mortality between EVAR and OSR, at our institution. METHODS All AAA operations from 2012 to 2017 were reviewed, and baseline characteristics were collected. Outcomes included 30-day mortality, operative data, complications, length of hospital stay (LOS), costs, re-intervention, and survival rates were compared. A multivariable analysis with unbalanced characteristics was performed. RESULTS We had a total of 162 patients, 100 having OSR and 62 for EVAR. The EVAR group was older, with higher ASA classification. Thirty-day mortality rate did not significantly differ (0/100 for OSR and 2/62 (3%) for EVAR; p = 0.145), while the EVAR group had less blood loss, shorter operative times, and LOS, but higher re-intervention rates (adjusted hazard ratio 6.4 (95%CI: 1.4, 26.8)). Survival rates did not significantly differ between the groups. EVAR cost approximately 1-million yen more. CONCLUSIONS OSR had low 30-day mortality rate in selected low-risk patients whereas EVAR had less blood loss, shorter operative times, LOS and could be done in high-risk patients with low 30-day mortality but with higher re-intervention rate.
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Affiliation(s)
- Boonying Siribumrungwong
- Division of Vascular and Endovascular Surgery, Department of Surgery, Thammasat University Hospital, Pathum Thani, Thailand; Center of Excellence in Applied Epidemiology, Thammasat University, Thailand.
| | - Jiro Kurita
- Department of Cardiovascular Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Tatsuo Ueda
- Department of Radiology, Nippon Medical School Hospital, Tokyo, Japan
| | - Daisuke Yasui
- Department of Radiology, Nippon Medical School Hospital, Tokyo, Japan
| | - Ken-Ichiro Takahashi
- Department of Cardiovascular Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Takashi Sasaki
- Department of Cardiovascular Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Yasuo Miyagi
- Department of Cardiovascular Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Shun-Ichiro Sakamoto
- Department of Cardiovascular Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Yosuke Ishii
- Department of Cardiovascular Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Tetsuro Morota
- Department of Cardiovascular Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Takashi Nitta
- Department of Cardiovascular Surgery, Nippon Medical School Hospital, Tokyo, Japan
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Midorikawa H, Takano T, Ueno K, Takinami G, Kageyama R, Seki H, Kanno M, Satou K. What Did Endovascular Aortic Repair Bring for the Treatment Strategy of Abdominal Aortic Aneurysm? Ann Vasc Dis 2018; 11:484-489. [PMID: 30637003 PMCID: PMC6326053 DOI: 10.3400/avd.oa.18-00099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Objective: We examined the effects of the introduction of endovascular aortic repair (EVAR) on treatment for abdominal aortic aneurysms (AAAs). Subjects: We compared patients in the following three periods: period I (January 2002–December 2006, 105 patients), period II (January 2007–December 2011, 242 patients, duration of 5 years after the introduction of EVAR), and period III (January 2012–December 2016, 237 patients, duration of 5 years after period II). We used the American Society of Anesthesiologists (ASA) classification for risk assessment. Results: In the Open repair (OR) group, the incidences of ASA class 2 increased and classes 3 and 4 decreased significantly in periods II and III compared with period I. In all periods, there were no in-hospital deaths. Suprarenal aortic cross-clamping was required in 18 patients (19.1%) in period III and 5 patients (6.3) in period I, and the difference was significant (P<0.05). In the EVAR group, no differences in age, sex, or ASA classification class were observed between periods II and III. In period II, one patient died due to aneurysm rupture during surgery. Significant differences were observed when comparing both groups in periods II and III: patients in the EVAR group were older (P<0.01) and the OR group had a higher proportion of ASA class 2 patients and the EVAR group had a higher proportion of ASA class 3 or 4 patients (P<0.01). Among all AAA surgeries, rupture occurred in 25 patients (23.8%) in period I, 18 patients (7.4) in period II, and 16 patients (6.8) in period III. The number of ruptures was significantly lower in periods II and III than in period I (P<0.01). Conclusions: The findings of this study suggest that EVAR should be indicated for high-risk patients and had the good outcome of AAA treatment. (This is a translation of Jpn J Vasc Surg 2018; 27: 27–32.)
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Affiliation(s)
- Hirofumi Midorikawa
- Department of Cardiovascular Surgery, Southern TOHOKU General Hospital, Koriyama, Fukushima, Japan
| | - Takashi Takano
- Department of Cardiovascular Surgery, Southern TOHOKU General Hospital, Koriyama, Fukushima, Japan
| | - Kyohei Ueno
- Department of Cardiovascular Surgery, Southern TOHOKU General Hospital, Koriyama, Fukushima, Japan
| | - Gaku Takinami
- Department of Cardiovascular Surgery, Southern TOHOKU General Hospital, Koriyama, Fukushima, Japan
| | - Rie Kageyama
- Department of Cardiovascular Surgery, Southern TOHOKU General Hospital, Koriyama, Fukushima, Japan
| | - Haruna Seki
- Department of Cardiovascular Surgery, Southern TOHOKU General Hospital, Koriyama, Fukushima, Japan
| | - Megumu Kanno
- Department of Cardiovascular Surgery, Southern TOHOKU General Hospital, Koriyama, Fukushima, Japan
| | - Kouichi Satou
- Department of Cardiovascular Surgery, Sukagawa Hospital, Sukagawa, Fukushima, Japan
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4
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Hiraoka A, Chikazawa G, Ishida A, Totsugawa T, Tamura K, Sakaguchi T, Yoshitaka H. Preoperative Coil Embolization of Side Branches and Postoperative Antifibrinolytic Therapy in Endovascular Aneurysm Repair: A Propensity Score Analysis. J Vasc Interv Radiol 2017; 28:550-557. [DOI: 10.1016/j.jvir.2016.12.1223] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 12/21/2016] [Accepted: 12/21/2016] [Indexed: 11/29/2022] Open
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Okada M, Handa N, Onohara T, Okamoto M, Yamamoto T, Shimoe Y, Yamashita M, Takahashi T, Kishimoto J, Mizuno A, Kei J, Nakai M, Sakaki M, Suhara H, Kasashima F, Endo M, Nishina T, Furuyama T, Kawasaki M, Iwata K, Marumoto A, Urata Y, Sato K, Ryugo M. Late Sac Behavior after Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm. Ann Vasc Dis 2016; 9:102-7. [PMID: 27375803 DOI: 10.3400/avd.oa.15-00125] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 04/28/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sac behavior after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs) is considered as a surrogate for the risk of late rupture. The purpose of the study is to assess the sac behavior of AAAs after EVAR. METHODS AND RESULTS Late sac enlargement (LSE) (≥5 mm) and late sac shrinkage (LSS) (≥5 mm) were analyzed in 589 consecutive patients who were registered at 14 national centers in Japan. The proportions of patients who had LSE at 1, 3 and 5 years were 2.6% ± 0.7%, 10.0% ± 1.6% and 19.0% ± 2.9%. The proportions of patients who had LSS at 1, 3 and 5 years were 50.1% ± 0.7%, 59.2% ± 2.3% and 61.7% ± 2.7%. Multiple logistic regression analysis identified two variables as a risk factor for LSE; persistent endoleak (Odds ratio 9.56 (4.84-19.49), P <0.001) and low platelet count (Odds ratio 0.92 (0.86-0.99), P = 0.0224). The leading cause of endoleak in patients with LSE was type II. CONCLUSIONS The incidence of LSE is not negligible over 5 year period. Patients with persistent endoleak and/or low platelet count should carefully be observed for LSE. CLINICAL TRIAL REGISTRATION UMIN-CTR (UMIN000008345).
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Affiliation(s)
- Masahiro Okada
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Nobuhiro Handa
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Toshihiro Onohara
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Minoru Okamoto
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Tsuyoshi Yamamoto
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Yasushi Shimoe
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Masafumi Yamashita
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Toshiki Takahashi
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Jyunji Kishimoto
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Akihiro Mizuno
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Junichi Kei
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Mikizou Nakai
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Masayuki Sakaki
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Hitoshi Suhara
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Fuminori Kasashima
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Masamitsu Endo
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Takeshi Nishina
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Tadashi Furuyama
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Masakazu Kawasaki
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Keiji Iwata
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Akira Marumoto
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Yasuhisa Urata
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Katsutoshi Sato
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Masahiro Ryugo
- Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
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6
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Ogino H. Current Treatment Strategy for Spontaneous Isolated Dissection of the Superior Mesenteric Artery. Circ J 2016; 80:1323-5. [PMID: 27194374 DOI: 10.1253/circj.cj-16-0406] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hitoshi Ogino
- Department of Cardiovascular Surgery, Tokyo Medical University
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7
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Ueki Y, Mohri M, Matoba T, Tsujita Y, Yamasaki M, Tachibana E, Yonemoto N, Nagao K. Characteristics and Predictors of Mortality in Patients With Cardiovascular Shock in Japan – Results From the Japanese Circulation Society Cardiovascular Shock Registry –. Circ J 2016; 80:852-9. [DOI: 10.1253/circj.cj-16-0125] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yasushi Ueki
- JCS Shock Registry Scientific Committee
- Emergency and Critical Care Center, Shinshu University School of Medicine
| | - Masahiro Mohri
- JCS Shock Registry Scientific Committee
- Department of Cardiology, Japan Community Healthcare Organization Kyushu Hospital
| | - Tetsuya Matoba
- JCS Shock Registry Scientific Committee
- Department of Cardiovascular Medicine, Kyushu University Hospital
| | - Yasuyuki Tsujita
- JCS Shock Registry Scientific Committee
- Department of Critical and Intensive Care Medicine, Shiga University of Medical Science
| | - Masao Yamasaki
- JCS Shock Registry Scientific Committee
- Department of Cardiovascular Medicine, NTT Medical Center
| | - Eizo Tachibana
- JCS Shock Registry Scientific Committee
- Department of Cardiology, Kawaguchi Municipal Medical Center
| | - Naohiro Yonemoto
- JCS Shock Registry Scientific Committee
- Department of Biostatistics, Yokohama City University Graduate School of Medicine
| | - Ken Nagao
- JCS Shock Registry Scientific Committee
- Cardiovascular Center, Nihon University Hospital
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8
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Fujimura N, Obara H, Matsubara K, Watada S, Shibutani S, Akiyoshi T, Harada H, Kitagawa Y. Characteristics and Risk Factors for Type 2 Endoleak in an East Asian Population From a Japanese Multicenter Database. Circ J 2015; 80:118-23. [PMID: 26567485 DOI: 10.1253/circj.cj-15-0850] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Clinically distinct differences exist between East Asian and Caucasian subjects, but data for type 2 endoleak (T2EL) are limited in the East Asian population. The aim of this study was to analyze the characteristics of East Asian T2EL using a Japanese multicenter database. METHODS AND RESULTS Retrospective analysis of 832 endovascular aneurysm repairs performed from 2008 to 2014 were conducted. T2EL was observed in 234 cases (28.1%), and in 32 cases (3.8%) it led to sac expansion >5 mm caused by isolated T2EL (median follow-up, 35.6 months). On univariate and multivariate analysis, non-smoker status (odds ratio [OR], 2.216; P<0.001), Excluder stent graft (OR, 2.027; P<0.001), and T2EL at final angiogram (OR, 2.080; P<0.001) were risk factors for T2EL. On multivariate analysis for isolated T2EL with sac expansion, only non-smoker status remained (OR, 2.671; P<0.001). Other than T1EL, isolated T2EL was the most significant risk factor for sac expansion (OR, 18.486; P<0.001). Furthermore, out of 11 transarterial embolization procedures initiated, 4 led to rupture during follow-up. CONCLUSIONS East Asian T2EL had a strong relationship with non-smoker status. Also, T2EL was a significant risk factor for sac expansion, which sometimes led to rupture even after intervention. Along with the high prevalence of T2EL observed, East Asian T2EL may not always be benign.
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Affiliation(s)
- Naoki Fujimura
- Department of Surgery, Keio University School of Medicine
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9
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Eslami MH, Rybin D, Doros G, McPhee JT, Farber A. Mortality of acute mesenteric ischemia remains unchanged despite significant increase in utilization of endovascular techniques. Vascular 2015; 24:44-52. [DOI: 10.1177/1708538115577730] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Introduction In this study, we evaluated if increase in utilization of endovascular surgery has affected in-hospital mortality rates among patients with acute mesenteric ischemia. Methods The National Inpatient Sample (2003–2011) was queried for acute mesenteric ischemia using ICD-9 code for acute mesenteric ischemia (557.1). This cohort was divided into patients treated with open vascular surgery (open vascular group) and by endovascular therapies (endovascular group) based on the ICD-9CM procedure codes. Multivariable logistic regression was used to determine temporal trend for mortality while adjusting for confounding variables. Results There was 1.45-fold increase in utilization of endovascular techniques in this study. In-hospital mortality rate, total median charges and length of stay were significantly lower among the endovascular group than the open vascular group despite having significantly higher Elixhauser comorbidities index (3 ± 0.1 vs. 2.7 ± 0.1, p = .003). Over the course of the study period, there was no change in the overall mortality rate despite higher endovascular utilization. Factors associated with increased mortality included age, open surgical repair (Odds ratio: 1.45, 95% Confidence Interval: 1.10–1.91, p = .016) and bowel resection Odds ratio: 2.88, 95% Confidence Interval: 2.01–4.12). Conclusion The mortality rate for acute mesenteric ischemia remains unchanged throughout this contemporary study. Open surgical intervention, bowel resection and age were associated with increased mortality. Endovascular group patients had better survival despite higher morbidity indices.
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Affiliation(s)
- Mohammad H Eslami
- Division of Vascular and Endovascular Surgery, Boston University School of Medicine, Boston, MA, USA
| | - Denis Rybin
- Department of Biostatistics, Boston School of Public Health, Boston, MA, USA
| | - Gheorghe Doros
- Department of Biostatistics, Boston School of Public Health, Boston, MA, USA
| | - James T McPhee
- Division of Vascular Surgery, Boston VA Medical Center, West Roxbury, MA, USA
| | - Alik Farber
- Division of Vascular and Endovascular Surgery, Boston University School of Medicine, Boston, MA, USA
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10
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Yamamoto K, Komori K, Banno H, Narita H, Kodama A, Sugimoto M. Validation of Patient Selection for Endovascular Aneurysm Repair or Open Repair of Abdominal Aortic Aneurysm – Single-Center Study –. Circ J 2015; 79:1699-705. [DOI: 10.1253/circj.cj-14-1160] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kiyohito Yamamoto
- Department of Surgery, Division of Vascular Surgery, Nagoya University Graduate School of Medicine
| | - Kimihiro Komori
- Department of Surgery, Division of Vascular Surgery, Nagoya University Graduate School of Medicine
| | - Hiroshi Banno
- Department of Surgery, Division of Vascular Surgery, Nagoya University Graduate School of Medicine
| | - Hiroshi Narita
- Department of Surgery, Division of Vascular Surgery, Nagoya University Graduate School of Medicine
| | - Akio Kodama
- Department of Surgery, Division of Vascular Surgery, Nagoya University Graduate School of Medicine
| | - Masayuki Sugimoto
- Department of Surgery, Division of Vascular Surgery, Nagoya University Graduate School of Medicine
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11
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Kobayashi M, Hoshina K, Yamamoto S, Nemoto Y, Akai T, Shigematsu K, Watanabe T, Ohshima M. Development of an Image-Based Modeling System to Investigate Evolutional Geometric Changes of a Stent Graft in an Abdominal Aortic Aneurysm. Circ J 2015; 79:1534-41. [DOI: 10.1253/circj.cj-15-0037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Masaharu Kobayashi
- Interfaculty Initiative in Information Studies/Institute of Industrial Science, The University of Tokyo
| | - Katsuyuki Hoshina
- Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo
| | - Sota Yamamoto
- Department of Mechanical Engineering, Graduate School, Shibaura Institute of Technology
| | - Youkou Nemoto
- Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo
| | - Takafumi Akai
- Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo
| | - Kunihiro Shigematsu
- Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo
| | - Toshiaki Watanabe
- Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo
| | - Marie Ohshima
- Interfaculty Initiative in Information Studies/Institute of Industrial Science, The University of Tokyo
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12
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Komatsu S, Ohara T, Takahashi S, Takewa M, Minamiguchi H, Imai A, Kobayashi Y, Iwa N, Yutani C, Hirayama A, Kodama K. Early Detection of Vulnerable Atherosclerotic Plaque for Risk Reduction of Acute Aortic Rupture and Thromboemboli and Atheroemboli Using Non-Obstructive Angioscopy. Circ J 2015; 79:742-50. [DOI: 10.1253/circj.cj-15-0126] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Sei Komatsu
- Cardiovascular Center, Amagasaki Central Hospital
| | - Tomoki Ohara
- Cardiovascular Center, Amagasaki Central Hospital
| | | | | | - Hitoshi Minamiguchi
- Department of Cardiology, Osaka University School of Medicine
- Cardiovascular Center, Amagasaki Central Hospital
| | - Atsuko Imai
- Department of Cardiology, Osaka University School of Medicine
- Cardiovascular Center, Amagasaki Central Hospital
| | | | - Nobuzo Iwa
- Department of Pathology, Amagasaki Central Hospital
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13
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Bando YK, Murohara T. UltraSound of Silence Abdominal Aortic Aneurysm. Circ J 2015; 79:503-4. [DOI: 10.1253/circj.cj-15-0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yasuko K. Bando
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine
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14
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Tagami T, Matsui H, Horiguchi H, Fushimi K, Yasunaga H. Thoracic aortic injury in Japan--nationwide retrospective cohort study. Circ J 2014; 79:55-60. [PMID: 25399756 DOI: 10.1253/circj.cj-14-0916] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The epidemiology of traumatic thoracic aortic injury has not been reported in many countries, so we investigated the current trends in Japan. METHODS AND RESULTS Patients with traumatic thoracic aortic injury from July 2007 to March 2013 were identified using a Japanese nationwide administrative database, the Diagnosis Procedure Combination inpatient database. The trends in crude in-hospital mortality and proportion of endovascular repair use among patients with repair were evaluated over time. A total of 617 incident cases of thoracic aortic injury were identified at 234 hospitals, and categorized into endovascular repair (n=126), open repair (n=76), and non-repair (n=415) groups. The in-hospital mortality rate for each of these groups was 5.6%, 15.8%, and 45.3%, respectively. The in-hospital survival rate was higher in the endovascular repair group than in the open repair group (log-rank χ(2)=4.9; P=0.03). Although the crude in-hospital mortality did not change significantly during the study period (Mantel-Haenszel trend test, P=0.10), the proportion of endovascular repair use among all repair cases increased significantly (P<0.001). CONCLUSIONS The results of the present nationwide study suggest that the endovascular approach to treatment of thoracic aortic injury in Japan gained in popularity from 2007 to 2012.
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Affiliation(s)
- Takashi Tagami
- Department of Clinical Epidemiology and Health Economics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo; Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo.
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