Diagnosis of Pulmonary Embolism: A Review of Evidence-Based Approaches.

Venous thromboembolism, commonly presented as pulmonary embolism and deep-vein thrombosis, is a paramount and potentially fatal condition with variable clinical presentation. Diagnosis is key to providing appropriate treatment in a safe and timely fashion. Clinical judgment and assessment using clinical scoring systems should guide diagnostic testing, including laboratory and imaging modalities, for optimal results and to avoid unnecessary testing.

Statin use improves limb salvage after intervention for peripheral arterial disease.

Background: Statin use is recommended in all patients with peripheral arterial disease (PAD) owing to its morbidity and mortality benefits. However, the effect of statin use on limb salvage in patients with PAD after intervention is unclear. We examined the effect of statin use on limb salvage and survival among patients with PAD undergoing surgical or endovascular intervention.

Influence of Age on Warfarin Dose, Anticoagulation Control, and Risk of Hemorrhage.

Objective: We assessed the influence of age on warfarin dose, percentage time in target range (PTTR), and risk of major hemorrhage.

Design: Warfarin users recruited into a large prospective inception cohort study were categorized into three age groups: young (younger than 50 yrs), middle aged (50-70 yrs), and elderly (older than 70 yrs). The influence of age on warfarin dose and PTTR was assessed using regression analysis; risk of major hemorrhage was assessed using proportional hazards analysis.

Effect of lipid-modifying drug therapy on survival after abdominal aortic aneurysm repair.

Background: Lipid-modifying drug therapy (LMDT) is recommended in all patients having coronary or noncoronary atherosclerotic disease. However, the effect of LMDT after abdominal aortic aneurysm (AAA) repair, especially in the absence of other atherosclerotic manifestations, is unclear. We examined the distribution of prevalence of LMDT among patients undergoing AAA repair and its effect on survival in the presence and absence of other atherosclerotic diseases.

Long-term single institution comparison of endovascular aneurysm repair and open aortic aneurysm repair.

Introduction: Since the development of endovascular aneurysm repair (EVAR), there remains concerns regarding its durability, need for secondary procedures, and associated long-term morbidity. We compared these two approaches to evaluate secondary interventions and their respective long-term durability.

Methods: All patients who had undergone endovascular and open abdominal aortic aneurysm (AAA) repair were identified from a prospectively maintained registry.

Protocol implementation of selective postoperative lumbar spinal drainage after thoracic aortic endograft.

Background: Spinal cord ischemia (SCI) remains a significant concern in patients undergoing endovascular repair involving the thoracic aorta (thoracic endovascular aortic repair [TEVAR]). Perioperative lumbar spinal drainage has been widely practiced for open repair, but there is no consensus treatment protocol using lumbar drainage for SCI associated with TEVAR. This study analyzes the efficacy of an institutional protocol using selective lumbar drainage reserved for patients experiencing SCI following TEVAR.