Stratification of chronic and complex wounds according to healing characteristics: a retrospective study.

Objective: Wound risk-stratified analyses are clinically relevant as they can assist in identifying hard-to-heal wounds. The aim of the study is to develop risk categories for wound healing based on a limited number of reliably recordable clinical data.

Method: This retrospective study used observational data.

Use of epidermal skin grafts in chronic wounds: a case series.

In stalled, chronic wounds, more aggressive and proactive wound closure efforts are needed. We describe adjunctive use of epidermal grafting in patients with chronic wounds. Wound bed preparation consisted of surgical necrotectomy or sharp debridement, hyperbaric oxygen therapy, negative pressure wound therapy, compression therapy, platelet-rich plasma therapy and/or heparan sulphate agents.

Sex differences in 30-day and 5-year outcomes after endovascular repair of abdominal aortic aneurysms in the EUROSTAR study.

Objective: The purpose of this study was to determine the effect of sex on 30-day and long-term outcomes after elective endovascular aneurysm repair.

Methods: Patients entered into the European collaborators on stent graft techniques for abdominal aortic aneurysm repair (EUROSTAR) study formed the basis of our study. Data were analyzed by means of multivariable logistic regression for 30-day mortality and composite outcome of mortality, systemic complication, or conversion.

Long-term outcome of open or endovascular repair of abdominal aortic aneurysm.

Background: For patients with large abdominal aortic aneurysms, randomized trials have shown an initial overall survival benefit for elective endovascular repair over conventional open repair. This survival difference, however, was no longer significant in the second year after the procedure. Information regarding the comparative outcome more than 2 years after surgery is important for clinical decision making.

Infrarenal abdominal aortic aneurysm with concomitant urologic malignancy: treatment results in the era of endovascular aneurysm repair.

During diagnostic workup for urologic malignancies, an abdominal aortic aneurysm (AAA) is identified in a proportion of patients. In the era of open AAA repair, these patients presented a surgical dilemma with regard to the sequence of the operations: cancer treatment first or AAA repair first? Previous assessments have concluded that irrespective of the followed strategy, the early and mediumterm mortality from the two operative procedures in this patient category was significant. With the introduction of endovascular aneurysm repair (EVAR), the mortality and morbidity associated with the treatment of both pathologic conditions may be more favorable than with open aneurysm repair.

The mechanical role of thrombus on the growth rate of an abdominal aortic aneurysm.

Objectives: In the decision for surgical repair of abdominal aortic aneurysms (AAAs), the maximum diameter is the main factor. Several studies have concluded that the diameter may not be reliable as rupture risk criterion for the individual patient and wall stress was found to have a higher sensitivity and specificity. The AAA wall stress may also be an influential factor in growth of the AAA.

Biomechanical properties of abdominal aortic aneurysms assessed by simultaneously measured pressure and volume changes in humans.

Background: Abdominal aortic aneurysms (AAA) are at risk of rupture when the internal load (blood pressure) exceeds the aneurysm wall strength. Generally, the maximal diameter of the aneurysm is used as a predictor of rupture; however, biomechanical properties may be a better predictor than the maximal diameter. Compliance and distensibility are two biomechanical properties that can be determined from the pressure-volume relationship of the aneurysm.

Collective experience with hybrid procedures for suprarenal and thoracoabdominal aneurysms.

Not every patient is fit for open thoracoabdominal aortic aneurysm (TAAA) repair, nor is every TAAA or juxtarenal abdominal aortic aneurysm suitable for branched or fenestrated endovascular exclusion. The hybrid procedure consists of debranching of the renal and visceral arteries followed by endovascular exclusion of the aneurysm and might be an alternative in these patients. Between May 2004 and March 2006, 16 patients were treated with a hybrid procedure.

Multicenter randomized controlled trial of the costs and effects of noninvasive diagnostic imaging in patients with peripheral arterial disease: the DIPAD trial.

Objective: The purpose of our study was to compare the costs and effects of three noninvasive imaging tests as the initial imaging test in the diagnostic workup of patients with peripheral arterial disease.

Materials And Methods: Of 984 patients assessed for eligibility, 514 patients with peripheral arterial disease were randomized to MR angiography (MRA) or duplex sonography in three hospitals and to MRA or CT angiography (CTA) in one hospital. The outcome measures included the clinical utility, functional patient outcomes, quality of life, and actual diagnostic and therapeutic costs related to the initial imaging test during 6 months of follow-up.

Outpatient treatment of arterial inflow stenoses of dysfunctional hemodialysis access fistulas by retrograde venous access puncture and catheterization.

Objective: To determine the feasibility of endovascular treatment of inflow stenoses in arteriovenous fistulae (AVFs) through retrograde venous access catheterization.

Methods: We included all 22 dysfunctional AVFs with arterial inflow stenoses at access imaging between January 2002 and September 2006. Following retrograde venous access puncture, an interventional radiologist intended to cross the arteriovenous anastomosis and advance a catheter into the aortic arch.

Non-linear viscoelastic behavior of abdominal aortic aneurysm thrombus.

The objective of this work was to determine the linear and non-linear viscoelastic behavior of abdominal aortic aneurysm thrombus and to study the changes in mechanical properties throughout the thickness of the thrombus. Samples are gathered from thrombi of seven patients. Linear viscoelastic data from oscillatory shear experiments show that the change of properties throughout the thrombus is different for each thrombus.

Influence of pulmonary status and diabetes mellitus on aortic neck dilatation following endovascular repair of abdominal aortic aneurysms: a EUROSTAR report.

Purpose: To elucidate the association of impaired pulmonary status (IPS) and diabetes mellitus (DM) with clinical outcome and the incidences of aortic neck dilatation and type I endoleak after elective endovascular infrarenal aortic aneurysm repair (EVAR).

Methods: In 164 European institutions participating in the EUROSTAR registry, 6383 patients (5985 men; mean age 72.4+/-7.

Determination of linear viscoelastic behavior of abdominal aortic aneurysm thrombus.

The objective of this study is to determine whether the linear viscoelastic properties of an abdominal aortic aneurysm thrombus can be determined by rheometry. Although large strains occur in the in vivo situation, in this work only linear behavior is studied to show the applicability of the described methods. A thrombus exists of several layers that vary in composition, structure and mechanical properties.

Statin use is associated with reduced all-cause mortality after endovascular abdominal aortic aneurysm repair.

It has been shown that preoperative statin therapy reduces all-cause and cardiovascular mortality in patients undergoing major noncardiac vascular surgery. In this report, we investigated the influence of statin use on early and late outcome following endovascular abdominal aortic aneurysm repair (EVAR). The study population, consisting of patients collated in the EUROSTAR registry, was stratified in two groups according to statin use.

Endograft treatment of ruptured abdominal aortic aneurysms using the Talent aortouniiliac system: an international multicenter study.

Objective: To understand the potential of endovascular aneurysm repair (EVAR) in patients presenting with a ruptured abdominal aortic aneurysm (rAAA), the proportion in whom this procedure was applicable was assessed. Mortality and morbidity was also determined in patients treated with emergency EVAR (eEVAR) when anatomic and hemodynamic conditions allowed (ie, in the entire cohort with patients receiving endovascular and open repair combined). In addition, a comparison was made between the treatment group with eEVAR and open repair.

Dutch iliac stent trial: long-term results in patients randomized for primary or selective stent placement.

Purpose: To determine long-term results of the prospective Dutch Iliac Stent Trial.

Materials And Methods: The study protocol was approved by local institutional review boards. All patients gave written informed consent.

Adverse events at the aneurysmal neck identified at follow-up after endovascular abdominal aortic aneursym repair: how do they correlate?

The objective of this study was to assess the prevalence of and the correlation between dilatation of the infrarenal neck and proximal device migration after endovascular abdominal aortic aneurysm repair (EVAR). The analysis made use of the EUROSTAR registry. Between 1994 and 2004, 4,233 patients with an abdominal aortic aneurysm larger than 4 cm underwent EVAR.

Stenosis detection in failing hemodialysis access fistulas and grafts: comparison of color Doppler ultrasonography, contrast-enhanced magnetic resonance angiography, and digital subtraction angiography.

Objective: Several imaging modalities are available for the evaluation of dysfunctional hemodialysis shunts. Color Doppler ultrasonography (CDUS) and digital subtraction angiography (DSA) are most widely used for the detection of access stenoses, and contrast-enhanced magnetic resonance angiography (CE-MRA) of shunts has recently been introduced. To date, no study has compared the value of these three modalities for stenosis detection in dysfunctional shunts.

Endovascular repair of abdominal aortic aneurysm in octogenarians: an analysis based on EUROSTAR data.

Purpose: To investigate the early and late outcome after endovascular treatment of abdominal aortic aneurysm (EVAR) in octogenarians compared with patients aged < 80 years.

Methods: Patients treated for abdominal aortic aneurysm (AAA) with endovascular repair during the period 1996 to 2004 were collated in the EUROSTAR registry. This study group consisted of 697 patients aged > or = 80 years.

Aneurysm diameter and proximal aortic neck diameter influence clinical outcome of endovascular abdominal aortic repair: a 4-year EUROSTAR experience.

Our objective was to evaluate the effect of preoperative aneurysm and aortic neck diameter on clinical outcome after infrarenal abdominal endovascular aneurysm repair (EVAR). Data of patients in the European Collaborators Registry on Stent-Graft Techniques for Abdominal Aortic Aneurysm Repair (EUROSTAR) registry base who underwent EVAR with Talent stent grafts were analyzed. Patient characteristics and clinical outcomes were compared among four groups defined by preoperative abdominal aortic aneurysm (AAA) and proximal aortic neck diameter: A, AAA < or =60 mm and neck < or =26 mm; B, AAA >60 mm and neck < or =26 mm; C, AAA < or =60 mm and neck >26 mm; and D, AAA >60 mm and neck >26 mm.

What determines and are the consequences of surveillance intensity after endovascular abdominal aortic aneurysm repair?

Follow-up examinations are advised 1, 3, 6, 12, 18, and 24 months and yearly thereafter by the European Collaborating Group on Stent-Graft Techniques for Abdominal Aortic Aneurysm Repair (EUROSTAR). The aim of this study was to evaluate the determinants and consequences of surveillance completeness. Patients who underwent endovascular abdominal aortic aneurysm repair between October 1996 and August 2004 and enrolled in the EUROSTAR registry were analyzed.

Two-year outcomes after conventional or endovascular repair of abdominal aortic aneurysms.

Background: Two randomized trials have shown better outcomes with elective endovascular repair of abdominal aortic aneurysms than with conventional open repair in the first month after the procedure. We investigated whether this advantage is sustained beyond the perioperative period.

Methods: We conducted a multicenter, randomized trial comparing open repair with endovascular repair in 351 patients who had received a diagnosis of abdominal aortic aneurysm of at least 5 cm in diameter and who were considered suitable candidates for both techniques.

Stenosis detection with MR angiography and digital subtraction angiography in dysfunctional hemodialysis access fistulas and grafts.

Purpose: To prospectively assess three-dimensional contrast material-enhanced magnetic resonance (MR) angiography for stenosis depiction in malfunctioning hemodialysis arteriovenous fistulas (AVFs) and grafts (AVGs), as compared with digital subtraction angiography (DSA).

Materials And Methods: Ethical review board approval and written informed consent were obtained. MR angiography and DSA were performed in 51 dysfunctional hemodialysis fistulas and grafts in 48 consecutive patients.