Impacts of lesion angle on incidence and distribution of acute vessel wall injuries and strut malapposition after drug-eluting stent implantation assessed by optical coherence tomography.

Aims: To investigate the impact of lesion angle on the incidence and distribution of acute vessel wall injuries and incomplete stent apposition (ISA) following second-generation drug-eluting stent (DES) implantation using optical coherence tomography (OCT). Several ex vivo studies demonstrated that angled arterial walls are exposed to imbalanced mechanical stress from deployed stents.

Methods And Results: We included 243 lesions treated with a single DES (148 everolimus-eluting stent and 95 zotarolimus-eluting stent).

A propensity-matched comparison of outcomes for fenestrated endovascular aneurysm repair and open surgical repair of complex abdominal aortic aneurysms.

Objective: The benefit of fenestrated endovascular aortic aneurysm repair (FEVAR) compared with open surgical repair (OSR) of complex abdominal aortic aneurysms (CAAAs) is unknown. This study compares 30-day outcomes of these procedures from two high-volume centers where FEVAR was undertaken for high-risk patients.

Methods: Patients undergoing FEVAR with commercially available devices and OSR of CAAAs (total suprarenal/supravisceral clamp position) were propensity matched by demographic, clinical, and anatomic criteria to identify similar patient cohorts.

Clinical and anatomic outcomes after carotid endarterectomy.

Objective: The purpose of this study was to examine 30-day and long-term outcomes after carotid endarterectomy (CEA) in a contemporary series and to identify variables associated with stroke and death after CEA.

Methods: This was a retrospective review of patients undergoing an isolated CEA at a single institution between January 1989 and December 2005. Primary study end points were 30-day and long-term overall stroke, ipsilateral stroke, and death.

Impact of severe chronic kidney disease on outcomes of infrainguinal peripheral arterial intervention.

Objective: Patients with severe chronic kidney disease (CKD) and peripheral vascular disease are at increased risk of major adverse limb events (MALEs) and death; however, patients with end-stage renal disease have been excluded in current objective performance goals. We evaluated the effect of severe (class 4 and 5) CKD on outcomes after infrainguinal endovascular arterial interventions.

Methods: All primary peripheral vascular interventions (PVIs) performed at a single institution (January 2002 through December 2009) were included.

A risk prediction model for determining appropriateness of CEA in patients with asymptomatic carotid artery stenosis.

Objective: The benefit of carotid endarterectomy (CEA) over medical therapy in patients with asymptomatic carotid artery stenosis is predicated upon a life expectancy of at least 5 years after the procedure. The goal of this study was to create a scoring system for prediction of 5-year survival after CEA that can be used to triage patients with ACAS.

Methods: All patients who underwent CEA for severe asymptomatic carotid stenosis from 1989 to 2005 were identified.

Progression of asymptomatic carotid stenosis despite optimal medical therapy.

Background: Despite level 1 evidence in support of carotid endarterectomy vs medical therapy in selected asymptomatic patients, an alternative posture is that optimal medical therapy (OMT) has not been adequately studied and that such OMT has reduced stroke risk in asymptomatic patients to levels wherein carotid endarterectomy is no longer justified. The goal of this study was to determine the natural history of patients with asymptomatic moderate (50%-69%) carotid artery stenosis (AMCAS) in a contemporary cohort as a function of their associated medical therapy.

Methods: Patients with AMCAS determined by duplex ultrasound (DUS) from 2005-2006 were identified in our hospital database.

Impact of hospital volume and type on outcomes of open and endovascular repair of descending thoracic aneurysms in the United States Medicare population.

Objective: Favorable outcomes of thoracic endovascular aortic repair (TEVAR) compared with open repair for descending thoracic aortic aneurysms (DTAs) have led to increasing TEVAR use. We evaluated the effect of case volume and hospital teaching status on clinical outcomes of intact DTA repair.

Methods: The Medicare Provider Analysis and Review (MEDPAR) data set (2004 to 2007) was queried to identify open repair or TEVAR for DTA.

Impact of chronic kidney disease on outcomes after abdominal aortic aneurysm repair.

Objective: Chronic kidney disease (CKD) is associated with increased morbidity and death after open abdominal aortic aneurysm (AAA) repair (OAR). This study highlights the effect of CKD on outcomes after endovascular AAA (EVAR) and OAR in contemporary practice.

Methods: The National Surgical Quality Improvement Program (NSQIP) Participant Use File (2005-2008) was queried by Current Procedural Terminology (American Medical Association, Chicago, Ill) code to identify EVAR or OAR patients, who were grouped by CKD class as having mild (CKD class 1 or 2), moderate (CKD class 3), or severe (CKD class 4 or 5) renal disease.

Smoking and risk of preterm birth among predominantly Puerto Rican women.

Purpose: Studies of smoking during pregnancy and preterm birth among Hispanic women are sparse. Our goal was to evaluate the effect of cigarette smoking during pre-pregnancy, early pregnancy, and mid pregnancy on preterm birth among Hispanic women, the fastest growing ethnic group in the United States.

Methods: We evaluated data from a prospective cohort study of 1,041 Hispanic (predominantly Puerto Rican) women recruited between 2000 and 2004 in Springfield, Massachusetts.