Objective: The risk of endoleak and reintervention after endovascular abdominal aortic aneurysm repair necessitates lifelong surveillance, which has associated costs, radiation exposure, and risk of nephrotoxicity. The best imaging method and timing of surveillance remain controversial. We sought to determine if a negative result of first postoperative imaging by computed tomography (CT) scan was predictive of decreased need for reintervention. We hypothesized that initial negative postoperative imaging could identify a low-risk cohort of patients who could be observed less frequently.
Methods: Retrospective review of prospectively collected institutional outcomes data (2004-2009) included stratification according to postoperative imaging results. Baseline characteristics and aneurysm morphology were compared between the two groups. Cox regression analysis was used to identify risk factors predictive for endoleak-related reintervention. Kaplan-Meier survival curves were used to plot freedom from all-cause reintervention and endoleak-related reintervention for the two groups.
Results: A total of 134 patients were included in the analysis. A total of 107 patients (80%) had negative initial postoperative imaging, whereas 27 patients (20%) had evidence of an endoleak. There were no significant differences between the two groups in terms of comorbidities or anticoagulation status. Kaplan-Meier survival curves showed that there was a significant difference between those patients who had a negative initial CT scan and those who had a positive scan for endoleak in terms of both overall reintervention rates and leak-related reintervention rates. Endoleak on the first postoperative CT scan was associated with a hazard ratio of 6.37 (confidence interval, 2.02-20.10; P = .002) for leak-related reintervention and a hazard ratio of 6.01 (confidence interval, 2.24-16.17; P < .001) for all-cause reintervention.
Conclusions: Patients with negative initial postoperative imaging were significantly less likely to require repeated interventions. These data suggest that these patients are candidates for less rigorous screening protocols.
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http://dx.doi.org/10.1016/j.jvs.2014.03.005 | DOI Listing |
Ann Surg Open
December 2024
From the Department of Visceral, Transplant, Thoracic and Vascular Surgery, Division of Hepatobiliary Surgery and Visceral Transplant Surgery, University Clinic Leipzig, Germany.
Objective: This study explored the novel application of hyperspectral imaging (HSI) for in vivo allograft perfusion assessment during liver transplantation (LT) and its potential value for predicting early allograft dysfunction (EAD), graft, and overall survival (OS).
Background: LT is a well-established therapy for acute and chronic liver diseases, with excellent outcomes. However, a significant proportion of recipients experience EAD, which affects graft and OS.
Orthop Surg
December 2024
Department of Orthopedics, The 960th Hospital of the People's Liberation Army, Jinan, China.
Objective: Aseptic loosening (AL) is a common mechanical complication following reconstruction of the distal femoral cemented prosthesis (DFCP), often resulting in severe bone loss, which complicates prosthesis revision. 3D-printed personalized implants represent an emerging solution for the reconstruction of complex bone defects. This study aimed to investigate the early therapeutic effects of using a 3D-printed, customized, uncemented stem prosthesis for revising aseptic AL in DFCP.
View Article and Find Full Text PDFInfect Disord Drug Targets
December 2024
Diagnostic Radiography Technology Department, Faculty of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia.
Introduction: Spinal schwannomas are benign intradural extramedullary tumors of Schwann cells, while hemangiomas are common benign vascular tumors found in the vertebral column.
Case Representation: This case study presents a 32-year-old male who developed both a spinal schwannoma and multiple thoracic vertebral haemangiomas following a COVID-19 infection and subsequent vaccination. The patient reported intermittent lumbar and thigh pain over 6-8 months.
Eur J Med Res
December 2024
Department of Neurosurgery, Neuromedicine Center, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038, People's Republic of China.
Background: Full-endoscopic microvascular decompression (fE-MVD) is an emerging treatment option for trigeminal neuralgia (TN). However, the risk factors associated with postoperative recurrence of TN after fE-MVD procedure remain controversial. The aim of the present study was to summarize the surgical technique of fE-MVD for the treatment of TN and to develop a predictive model for recurrence at 1 year postoperatively based on independent risk factors.
View Article and Find Full Text PDFJ Orthop Surg Res
December 2024
The First School of Clinical Medicine, Southern Medical University, No.1838 North of Guangzhou Road, Guangzhou, 510515, People's Republic of China.
Background: This study is aimed to compare the differences in clinical outcomes between the crossed rod configuration and the parallel rod configuration applied in posterior occipitocervical and atlantoaxial fixations, and to assess the clinical applicability of crossed rods.
Methods: From January 2015 to December 2021, 21 patients with craniocervical junction disorders were treated surgically with the crossed rod technique (CR group). Meanwhile, 27 corresponding patients treated with the conventional parallel rod technique were included as control (PR group).
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