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Hoek VT, Edomskis PP, Stark PW, Lambrichts DPV, Draaisma WA, Consten ECJ, Lange JF, Bemelman WA, Hop WC, Opmeer BC, Reitsma JB, Scholte RA, Waltmann EWH, Legemate A, Bartelsman JF, Meijer DW, de Brouwer M, van Dalen J, Durbridge M, Geerdink M, Ilbrink GJ, Mehmedovic S, Middelhoek P, Boom MJ, Consten ECJ, van der Bilt JDW, van Olden GDJ, Stam MAW, Verweij MS, Vennix S, Musters GD, Swank HA, Boermeester MA, Busch ORC, Buskens CJ, El-Massoudi Y, Kluit AB, van Rossem CC, Schijven MP, Tanis PJ, Unlu C, van Dieren S, Gerhards MF, Karsten TM, de Nes LC, Rijna H, van Wagensveld BA, Koff eman GI, Steller EP, Tuynman JB, Bruin SC, van der Peet DL, Blanken-Peeters CFJM, Cense HA, Jutte E, Crolla RMPH, van der Schelling GP, van Zeeland M, de Graaf EJR, Groenendijk RPR, Karsten TM, Vermaas M, Schouten O, de Vries MR, Prins HA, Lips DJ, Bosker RJI, van der Hoeven JAB, Diks J, Plaisier PW, Kruyt PM, Sietses C, Stommel MWJ, Nienhuijs SW, de Hingh IHJT, Luyer MDP, van Montfort G, Ponten EH, Smulders JF, van Duyn EB, Klaase JM, Swank DJ, Ottow RT, Stockmann HBAC, Vermeulen J, Vuylsteke RJCLM, Belgers HJ, Fransen S, von Meijenfeldt EM, Sosef MN, van Geloven AAW, Hendriks ER, ter Horst B, Leeuwenburgh MMN, van Ruler O, Vogten JM, Vriens EJC, Westerterp M, Eijsbouts QAJ, Bentohami A, Bijlsma TS, de Korte N, Nio D, Govaert MJPM, Joosten JJA, Tollenaar RAEM, Stassen LPS, Wiezer MJ, Hazebroek EJ, Smits AB, van Westreenen HL, Lange JF, Brandt A, Nijboer WN, Mulder IM, Toorenvliet BR, Weidema WF, Coene PPLO, Mannaerts GHH, den Hartog D, de Vos RJ, Zengerink JF, Hoofwijk AGM, Hulsewé KWE, Melenhorst J, Stoot JHMB, Steup WH, Huijstee PJ, Merkus JWS, Wever JJ, Maring JK, Heisterkamp J, van Grevenstein WMU, Vriens MR, Besselink MGH, Borel Rinkes IHM, Witkamp AJ, Slooter GD, Konsten JLM, Engel AF, Pierik EGJM, Frakking TG, van Geldere D, Patijn GA, D’Hoore BAJL, de Buck AVO, Miserez M, Terrasson I, Wolthuis A, di Saverio S, de Blasiis MG. Laparoscopic peritoneal lavage versus sigmoidectomy for perforated diverticulitis with purulent peritonitis: three-year follow-up of the randomised LOLA trial. Surg Endosc 2022; 36:7764-7774. [PMID: 35606544 PMCID: PMC9485102 DOI: 10.1007/s00464-022-09326-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/01/2022] [Indexed: 10/31/2022]
Abstract
Abstract
Background
This study aimed to compare laparoscopic lavage and sigmoidectomy as treatment for perforated diverticulitis with purulent peritonitis during a 36 month follow-up of the LOLA trial.
Methods
Within the LOLA arm of the international, multicentre LADIES trial, patients with perforated diverticulitis with purulent peritonitis were randomised between laparoscopic lavage and sigmoidectomy. Outcomes were collected up to 36 months. The primary outcome of the present study was cumulative morbidity and mortality. Secondary outcomes included reoperations (including stoma reversals), stoma rates, and sigmoidectomy rates in the lavage group.
Results
Long-term follow-up was recorded in 77 of the 88 originally included patients, 39 were randomised to sigmoidectomy (51%) and 38 to laparoscopic lavage (49%). After 36 months, overall cumulative morbidity (sigmoidectomy 28/39 (72%) versus lavage 32/38 (84%), p = 0·272) and mortality (sigmoidectomy 7/39 (18%) versus lavage 6/38 (16%), p = 1·000) did not differ. The number of patients who underwent a reoperation was significantly lower for lavage compared to sigmoidectomy (sigmoidectomy 27/39 (69%) versus lavage 17/38 (45%), p = 0·039). After 36 months, patients alive with stoma in situ was lower in the lavage group (proportion calculated from the Kaplan–Meier life table, sigmoidectomy 17% vs lavage 11%, log-rank p = 0·0268). Eventually, 17 of 38 (45%) patients allocated to lavage underwent sigmoidectomy.
Conclusion
Long-term outcomes showed that laparoscopic lavage was associated with less patients who underwent reoperations and lower stoma rates in patients alive after 36 months compared to sigmoidectomy. No differences were found in terms of cumulative morbidity or mortality. Patient selection should be improved to reduce risk for short-term complications after which lavage could still be a valuable treatment option.
Graphical abstract
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Oussoren FK, Maldonado TS, Reijnen MMPJ, Heyligers JMM, Akkersdijk G, Attisani L, Bellosta R, Heyligers JMM, Hoencamp R, Garrard L, Maldonado T, Naslund TC, Nolthenius RT, Oderich GS, Ponfoort ED, Reijnen MMPJ, Schouten O, Sybrandi JEM, Tenorio ER, Trimarchi S, Verhagen HJM, Veroux P, Wever J, Wiersema A, Wikkeling ORM. Solitary Iliac Branch Endoprosthesis placement for iliac aneurysms. J Vasc Surg 2021; 75:1268-1275.e1. [PMID: 34655682 DOI: 10.1016/j.jvs.2021.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 10/05/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Isolated iliac artery aneurysms (IAA), accounting for 2-7 percent of all abdominal aneurysms, are nowadays often treated with the use of iliac branched endografts. Although outside of the manufacturer's instructions for use, iliac branched devices can be used solely, without the adjunctive placement of an EVAR device, for the treatment of isolated IAA. In this study we aim to describe the outcomes of the use of the Gore IBE device, without support of an infrarenal EVAR device, for the exclusion of isolated IAA. DESIGN This study is an international multicenter retrospective cohort analysis. METHOD All patients that were treated with a solitary IBE for IAA exclusion from 11-01-2013 up to 31-12-2018 were retrospectively reviewed. The primary outcome was technical success. Secondary outcomes included mortality, intraoperative and postoperative complications, and re-interventions. RESULTS In total 18 European and American centers participated, including 51 patients in which 54 IAAs were excluded. The technical success rate was 94.1%, with an assisted technical success rate of 96.1%. There was no 30-day mortality and a 98.1% patency of both the internal and external iliac artery was found at 24-months follow-up. At 24-months follow-up, 81.5% of patients were free of complications and 90% were free of a secondary intervention. CONCLUSION Treatment with a solitary IBE is a safe and, at midterm, effective treatment strategy in selected patients with a solitary IAA.
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Gargano A, Schouten O, van Schaick G, Roca L, van den Berg-Verleg J, Haselberg R, Akeroyd M, Abello N, Somsen G. Profiling of a high mannose-type N-glycosylated lipase using hydrophilic interaction chromatography-mass spectrometry. Anal Chim Acta 2020; 1109:69-77. [DOI: 10.1016/j.aca.2020.02.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/17/2020] [Accepted: 02/23/2020] [Indexed: 10/24/2022]
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Jalalzadeh H, Indrakusuma R, Koelemay MJW, Balm R, Van den Akker LH, Van den Akker PJ, Akkersdijk GJ, Akkersdijk GP, Akkersdijk WL, van Andringa de Kempenaer MG, Arts CH, Avontuur JA, Baal JG, Bakker OJ, Balm R, Barendregt WB, Bender MH, Bendermacher BL, van den Berg M, Berger P, Beuk RJ, Blankensteijn JD, Bleker RJ, Bockel JH, Bodegom ME, Bogt KE, Boll AP, Booster MH, Borger van der Burg BL, de Borst GJ, Bos-van Rossum WT, Bosma J, Botman JM, Bouwman LH, Breek JC, Brehm V, Brinckman MJ, van den Broek TH, Brom HL, de Bruijn MT, de Bruin JL, Brummel P, van Brussel JP, Buijk SE, Buimer MG, Burger DH, Buscher HC, den Butter G, Cancrinus E, Castenmiller PH, Cazander G, Coveliers HM, Cuypers PH, Daemen JH, Dawson I, Derom AF, Dijkema AR, Diks J, Dinkelman MK, Dirven M, Dolmans DE, van Doorn RC, van Dortmont LM, van der Eb MM, Eefting D, van Eijck GJ, Elshof JW, Elsman BH, van der Elst A, van Engeland MI, van Eps RG, Faber MJ, de Fijter WM, Fioole B, Fritschy WM, Geelkerken RH, van Gent WB, Glade GJ, Govaert B, Groenendijk RP, de Groot HG, van den Haak RF, de Haan EF, Hajer GF, Hamming JF, van Hattum ES, Hazenberg CE, Hedeman Joosten PP, Helleman JN, van der Hem LG, Hendriks JM, van Herwaarden JA, Heyligers JM, Hinnen JW, Hissink RJ, Ho GH, den Hoed PT, Hoedt MT, van Hoek F, Hoencamp R, Hoffmann WH, Hoksbergen AW, Hollander EJ, Huisman LC, Hulsebos RG, Huntjens KM, Idu MM, Jacobs MJ, van der Jagt MF, Jansbeken JR, Janssen RJ, Jiang HH, de Jong SC, Jongkind V, Kapma MR, Keller BP, Khodadade Jahrome A, Kievit JK, Klemm PL, Klinkert P, Knippenberg B, Koedam NA, Koelemay MJ, Kolkert JL, Koning GG, Koning OH, Krasznai AG, Krol RM, Kropman RH, Kruse RR, van der Laan L, van der Laan MJ, van Laanen JH, Lardenoye JH, Lawson JA, Legemate DA, Leijdekkers VJ, Lemson MS, Lensvelt MM, Lijkwan MA, Lind RC, van der Linden FT, Liqui Lung PF, Loos MJ, Loubert MC, Mahmoud DE, Manshanden CG, Mattens EC, Meerwaldt R, Mees BM, Metz R, Minnee RC, de Mol van Otterloo JC, Moll FL, Montauban van Swijndregt YC, Morak MJ, van de Mortel RH, Mulder W, Nagesser SK, Naves CC, Nederhoed JH, Nevenzel-Putters AM, de Nie AJ, Nieuwenhuis DH, Nieuwenhuizen J, van Nieuwenhuizen RC, Nio D, Oomen AP, Oranen BI, Oskam J, Palamba HW, Peppelenbosch AG, van Petersen AS, Peterson TF, Petri BJ, Pierie ME, Ploeg AJ, Pol RA, Ponfoort ED, Poyck PP, Prent A, Ten Raa S, Raymakers JT, Reichart M, Reichmann BL, Reijnen MM, Rijbroek A, van Rijn MJ, de Roo RA, Rouwet EV, Rupert CG, Saleem BR, van Sambeek MR, Samyn MG, van 't Sant HP, van Schaik J, van Schaik PM, Scharn DM, Scheltinga MR, Schepers A, Schlejen PM, Schlosser FJ, Schol FP, Schouten O, Schreinemacher MH, Schreve MA, Schurink GW, Sikkink CJ, Siroen MP, Te Slaa A, Smeets HJ, Smeets L, de Smet AA, de Smit P, Smit PC, Smits TM, Snoeijs MG, Sondakh AO, van der Steenhoven TJ, van Sterkenburg SM, Stigter DA, Stigter H, Strating RP, Stultiëns GN, Sybrandy JE, Teijink JA, Telgenkamp BJ, Testroote MJ, The RM, Thijsse WJ, Tielliu IF, van Tongeren RB, Toorop RJ, Tordoir JH, Tournoij E, Truijers M, Türkcan K, Tutein Nolthenius RP, Ünlü Ç, Vafi AA, Vahl AC, Veen EJ, Veger HT, Veldman MG, Verhagen HJ, Verhoeven BA, Vermeulen CF, Vermeulen EG, Vierhout BP, Visser MJ, van der Vliet JA, Vlijmen-van Keulen CJ, Voesten HG, Voorhoeve R, Vos AW, de Vos B, Vos GA, Vriens BH, Vriens PW, de Vries AC, de Vries JP, de Vries M, van der Waal C, Waasdorp EJ, Wallis de Vries BM, van Walraven LA, van Wanroij JL, Warlé MC, van Weel V, van Well AM, Welten GM, Welten RJ, Wever JJ, Wiersema AM, Wikkeling OR, Willaert WI, Wille J, Willems MC, Willigendael EM, Wisselink W, Witte ME, Wittens CH, Wolf-de Jonge IC, Yazar O, Zeebregts CJ, van Zeeland ML. Editor's Choice - Nationwide Analysis of Patients Undergoing Iliac Artery Aneurysm Repair in the Netherlands. Eur J Vasc Endovasc Surg 2020; 60:49-55. [PMID: 32331994 DOI: 10.1016/j.ejvs.2020.02.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/04/2020] [Accepted: 02/25/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The new 2019 guideline of the European Society for Vascular Surgery (ESVS) recommends consideration for elective iliac artery aneurysm (eIAA) repair when the iliac diameter exceeds 3.5 cm, as opposed to 3.0 cm previously. The current study assessed diameters at time of eIAA repair and ruptured IAA (rIAA) repair and compared clinical outcomes after open surgical repair (OSR) and endovascular aneurysm repair (EVAR). METHODS This retrospective observational study used the nationwide Dutch Surgical Aneurysm Audit (DSAA) registry that includes all patients who undergo aorto-iliac aneurysm repair in the Netherlands. All patients who underwent primary IAA repair between 1 January 2014 and 1 January 2018 were included. Diameters at time of eIAA and rIAA repair were compared in a descriptive fashion. The anatomical location of the IAA was not registered in the registry. Patient characteristics and outcomes of OSR and EVAR were compared with appropriate statistical tests. RESULTS The DSAA registry comprised 974 patients who underwent IAA repair. A total of 851 patients were included after exclusion of patients undergoing revision surgery and patients with missing essential variables. eIAA repair was carried out in 713 patients, rIAA repair in 102, and symptomatic IAA repair in 36. OSR was performed in 205, EVAR in 618, and hybrid repairs and conversions in 28. The median maximum IAA diameter at the time of eIAA and rIAA repair was 43 (IQR 38-50) mm and 68 (IQR 58-85) mm, respectively. Mortality was 1.3% (95% CI 0.7-2.4) after eIAA repair and 25.5% (95% CI 18.0-34.7) after rIAA repair. Mortality was not significantly different between the OSR and EVAR subgroups. Elective OSR was associated with significantly more complications than EVAR (intra-operative: 9.8% vs. 3.6%, post-operative: 34.0% vs. 13.8%, respectively). CONCLUSION In the Netherlands, most eIAA repairs are performed at diameters larger than recommended by the ESVS guideline. These findings appear to support the recent increase in the threshold diameter for eIAA repair.
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Lijftogt N, Karthaus EG, Vahl A, van Zwet EW, van der Willik EM, Tollenaar RA, Hamming JF, Wouters MW, Van den Akker L, Van den Akker P, Akkersdijk G, Akkersdijk G, Akkersdijk W, van Andringa de Kempenaer M, Arts C, Avontuur J, Baal J, Bakker O, Balm R, Barendregt W, Bender M, Bendermacher B, van den Berg M, Berger P, Beuk R, Blankensteijn J, Bleker R, Bockel J, Bodegom M, Bogt K, Boll A, Booster M, Borger van der Burg B, de Borst G, Bos-van Rossum W, Bosma J, Botman J, Bouwman L, Breek J, Brehm V, Brinckman M, van den Broek T, Brom H, de Bruijn M, de Bruin J, Brummel P, van Brussel J, Buijk S, Buimer M, Burger D, Buscher H, den Butter G, Cancrinus E, Castenmiller P, Cazander G, Coveliers H, Cuypers P, Daemen J, Dawson I, Derom A, Dijkema A, Diks J, Dinkelman M, Dirven M, Dolmans D, van Doorn R, van Dortmont L, van der Eb M, Eefting D, van Eijck G, Elshof J, Elsman B, van der Elst A, van Engeland M, van Eps R, Faber M, de Fijter W, Fioole B, Fritschy W, Geelkerken R, van Gent W, Glade G, Govaert B, Groenendijk R, de Groot H, van den Haak R, de Haan E, Hajer G, Hamming J, van Hattum E, Hazenberg C, Hedeman Joosten P, Helleman J, van der Hem L, Hendriks J, van Herwaarden J, Heyligers J, Hinnen J, Hissink R, Ho G, den Hoed P, Hoedt M, van Hoek F, Hoencamp R, Hoffmann W, Hoksbergen A, Hollander E, Huisman L, Hulsebos R, Huntjens K, Idu M, Jacobs M, van der Jagt M, Jansbeken J, Janssen R, Jiang H, de Jong S, Jongkind V, Kapma M, Keller B, Khodadade Jahrome A, Kievit J, Klemm P, Klinkert P, Knippenberg B, Koedam N, Koelemaij M, Kolkert J, Koning G, Koning O, Krasznai A, Krol R, Kropman R, Kruse R, van der Laan L, van der Laan M, van Laanen J, Lardenoye J, Lawson J, Legemate D, Leijdekkers V, Lemson M, Lensvelt M, Lijkwan M, Lind R, van der Linden F, Liqui Lung P, Loos M, Loubert M, Mahmoud D, Manshanden C, Mattens E, Meerwaldt R, Mees B, Metz R, Minnee R, de Mol van Otterloo J, Moll F, Montauban van Swijndregt Y, Morak M, van de Mortel R, Mulder W, Nagesser S, Naves C, Nederhoed J, Nevenzel-Putters A, de Nie A, Nieuwenhuis D, Nieuwenhuizen J, van Nieuwenhuizen R, Nio D, Oomen A, Oranen B, Oskam J, Palamba H, Peppelenbosch A, van Petersen A, Peterson T, Petri B, Pierie M, Ploeg A, Pol R, Ponfoort E, Poyck P, Prent A, ten Raa S, Raymakers J, Reichart M, Reichmann B, Reijnen M, Rijbroek A, van Rijn M, de Roo R, Rouwet E, Rupert C, Saleem B, van Sambeek M, Samyn M, van ’t Sant H, van Schaik J, van Schaik P, Scharn D, Scheltinga M, Schepers A, Schlejen P, Schlosser F, Schol F, Schouten O, Schreinemacher M, Schreve M, Schurink G, Sikkink C, Siroen M, te Slaa A, Smeets H, Smeets L, de Smet A, de Smit P, Smit P, Smits T, Snoeijs M, Sondakh A, van der Steenhoven T, van Sterkenburg S, Stigter D, Stigter H, Strating R, Stultiëns G, Sybrandy J, Teijink J, Telgenkamp B, Testroote M, The R, Thijsse W, Tielliu I, van Tongeren R, Toorop R, Tordoir J, Tournoij E, Truijers M, Türkcan K, Tutein Nolthenius R, Ünlü Ç, Vafi A, Vahl A, Veen E, Veger H, Veldman M, Verhagen H, Verhoeven B, Vermeulen C, Vermeulen E, Vierhout B, Visser M, van der Vliet J, Vlijmen-van Keulen C, Voesten H, Voorhoeve R, Vos A, de Vos B, Vos G, Vriens B, Vriens P, de Vries A, de Vries J, de Vries M, van der Waal C, Waasdorp E, Wallis de Vries B, van Walraven L, van Wanroij J, Warlé M, van Weel V, van Well A, Welten G, Welten R, Wever J, Wiersema A, Wikkeling O, Willaert W, Wille J, Willems M, Willigendael E, Wisselink W, Witte M, Wittens C, Wolf-de Jonge I, Yazar O, Zeebregts C, van Zeeland M, Van den Akker L, Van den Akker P, Akkersdijk G, Akkersdijk G, Akkersdijk W, van Andringa de Kempenaer M, Arts C, Avontuur J, Baal J, Bakker O, Balm R, Barendregt W, Bender M, Bendermacher B, van den Berg M, Berger P, Beuk R, Blankensteijn J, Bleker R, Bockel J, Bodegom M, Bogt K, Boll A, Booster M, Borger van der Burg B, de Borst G, Bos-van Rossum W, Bosma J, Botman J, Bouwman L, Breek J, Brehm V, Brinckman M, van den Broek T, Brom H, de Bruijn M, de Bruin J, Brummel P, van Brussel J, Buijk S, Buimer M, Burger D, Buscher H, den Butter G, Cancrinus E, Castenmiller P, Cazander G, Coveliers H, Cuypers P, Daemen J, Dawson I, Derom A, Dijkema A, Diks J, Dinkelman M, Dirven M, Dolmans D, van Doorn R, van Dortmont L, van der Eb M, Eefting D, van Eijck G, Elshof J, Elsman B, van der Elst A, van Engeland M, van Eps R, Faber M, de Fijter W, Fioole B, Fritschy W, Geelkerken R, van Gent W, Glade G, Govaert B, Groenendijk R, de Groot H, van den Haak R, de Haan E, Hajer G, Hamming J, van Hattum E, Hazenberg C, Hedeman Joosten P, Helleman J, van der Hem L, Hendriks J, van Herwaarden J, Heyligers J, Hinnen J, Hissink R, Ho G, den Hoed P, Hoedt M, van Hoek F, Hoencamp R, Hoffmann W, Hoksbergen A, Hollander E, Huisman L, Hulsebos R, Huntjens K, Idu M, Jacobs M, van der Jagt M, Jansbeken J, Janssen R, Jiang H, de Jong S, Jongkind V, Kapma M, Keller B, Khodadade Jahrome A, Kievit J, Klemm P, Klinkert P, Knippenberg B, Koedam N, Koelemaij M, Kolkert J, Koning G, Koning O, Krasznai A, Krol R, Kropman R, Kruse R, van der Laan L, van der Laan M, van Laanen J, Lardenoye J, Lawson J, Legemate D, Leijdekkers V, Lemson M, Lensvelt M, Lijkwan M, Lind R, van der Linden F, Liqui Lung P, Loos M, Loubert M, Mahmoud D, Manshanden C, Mattens E, Meerwaldt R, Mees B, Metz R, Minnee R, de Mol van Otterloo J, Moll F, Montauban van Swijndregt Y, Morak M, van de Mortel R, Mulder W, Nagesser S, Naves C, Nederhoed J, Nevenzel-Putters A, de Nie A, Nieuwenhuis D, Nieuwenhuizen J, van Nieuwenhuizen R, Nio D, Oomen A, Oranen B, Oskam J, Palamba H, Peppelenbosch A, van Petersen A, Peterson T, Petri B, Pierie M, Ploeg A, Pol R, Ponfoort E, Poyck P, Prent A, ten Raa S, Raymakers J, Reichart M, Reichmann B, Reijnen M, Rijbroek A, van Rijn M, de Roo R, Rouwet E, Rupert C, Saleem B, van Sambeek M, Samyn M, van ’t Sant H, van Schaik J, van Schaik P, Scharn D, Scheltinga M, Schepers A, Schlejen P, Schlosser F, Schol F, Schouten O, Schreinemacher M, Schreve M, Schurink G, Sikkink C, Siroen M, te Slaa A, Smeets H, Smeets L, de Smet A, de Smit P, Smit P, Smits T, Snoeijs M, Sondakh A, van der Steenhoven T, van Sterkenburg S, Stigter D, Stigter H, Strating R, Stultiëns G, Sybrandy J, Teijink J, Telgenkamp B, Testroote M, The R, Thijsse W, Tielliu I, van Tongeren R, Toorop R, Tordoir J, Tournoij E, Truijers M, Türkcan K, Tutein Nolthenius R, Ünlü Ç, Vafi A, Vahl A, Veen E, Veger H, Veldman M, Verhagen H, Verhoeven B, Vermeulen C, Vermeulen E, Vierhout B, Visser M, van der Vliet J, Vlijmen-van Keulen C, Voesten H, Voorhoeve R, Vos A, de Vos B, Vos G, Vriens B, Vriens P, de Vries A, de Vries J, de Vries M, van der Waal C, Waasdorp E, Wallis de Vries B, van Walraven L, van Wanroij J, Warlé M, van Weel V, van Well A, Welten G, Welten R, Wever J, Wiersema A, Wikkeling O, Willaert W, Wille J, Willems M, Willigendael E, Wisselink W, Witte M, Wittens C, Wolf-de Jonge I, Yazar O, Zeebregts C, van Zeeland M. Failure to Rescue – a Closer Look at Mortality Rates Has No Added Value for Hospital Comparisons but Is Useful for Team Quality Assessment in Abdominal Aortic Aneurysm Surgery in The Netherlands. Eur J Vasc Endovasc Surg 2018; 56:652-661. [DOI: 10.1016/j.ejvs.2018.06.062] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 06/24/2018] [Indexed: 01/14/2023]
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Feringa HHH, Bax JJ, Schouten O, Poldermans D. Protecting the Heart with Cardiac Medication in Patients with Left Ventricular Dysfunction Undergoing Major Noncardiac Vascular Surgery. Semin Cardiothorac Vasc Anesth 2016; 10:25-31. [PMID: 16703231 DOI: 10.1177/108925320601000106] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patients with left ventricular dysfunction who are undergoing major noncardiac vascular surgery are at increased risk of adverse postoperative events. We sought to evaluate whether perioperative medication use, including angiotensin-converting enzyme (ACE) inhibitors,b-blockers, statins, and aspirin, was associated with a reduced incidence of postoperative in-hospital mortality in these high-risk patients. The study enrolled 511 patients with left ventricular dysfunction (left ventricular ejection fraction <30%) who were undergoing major noncardiac vascular surgery. Cardiac risk factors and medication use were noted before surgery. Preoperative dobutamine stress echocardiography (DSE) was performed to identify patients with stress-induced myocardial ischemia. The end point was postoperative in-hospital mortality. Univariate and multivariate logistic regression analyses were performed to evaluate the relation between perioperative medication use and mortality. The mean age of the study population was 64 ± 11 years, and 75% were men. Perioperative use of ACE inhibitors, b-blockers, statins, and aspirin was recorded in 215 (48%), 139 (27%), 107 (21%), and 125 patients (24%), respectively. Stress-induced myocardial ischemia occurred in 82 patients (16%). Sixty-four patients (13%) died. Perioperative use of ACE inhibitors (odds ratio [OR], 0.33; 95% confidence interval [CI], 0.12-0.91), b-blockers (OR, 0.03; 95% CI, 0.01-0.26), statins (OR, 0.06; 95% CI, 0.01-0.53), and aspirin (OR, 0.13; 95% CI, 0.03-0.55), was significantly associated with a reduced incidence of mortality, after adjusting for cardiac risk factors and DSE results. In conclusion, the present study showed that the perioperative use of ACE inhibitors,b-blockers, statins, and aspirin is independently associated with a reduced incidence of in-hospital mortality in patients with left ventricular dysfunction who are undergoing major noncardiac vascular surgery.
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Winkle T, Schouten O, Hoeks S. Risk Factors and Outcome of New-Onset Cardiac Arrhythmias in Vascular Surgery Patients. J Vasc Surg 2010. [DOI: 10.1016/j.jvs.2010.09.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Winkel TA, Schouten O, Hoeks SE, Voûte MT, Chonchol M, Goei D, Flu WJ, van Kuijk JP, Lindemans J, Verhagen HJM, Bax JJ, Poldermans D. Prognosis of vascular surgery patients using a quantitative assessment of troponin T release: is the crystal ball still clear? Eur J Vasc Endovasc Surg 2010; 40:739-46. [PMID: 20884259 DOI: 10.1016/j.ejvs.2010.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 08/14/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cardiac troponin T (cTnT) assays with increased sensitivity might increase the number of positive tests. Using the area under the curve (AUC) with serial sampling of cTnT an exact quantification of the myocardial damage size can be made. We compared the prognosis of vascular surgery patients with integrated cTnT-AUC values to continuous and standard 12-lead electrocardiography (ECG) changes. METHODS 513 Patients were monitored. cTnT sampling was performed on postoperative days 1, 3, 7, 30 and/or at discharge or whenever clinically indicated. If cTnT release occurred, daily measurements of cTnT were performed, until baseline was achieved. CTnT-AUC was quantified and divided in tertiles. All-cause mortality and cardiovascular events (cardiac death and myocardial infarction) were noted during follow-up. RESULTS 81/513 (16%) Patients had cTnT release. After adjustment for gender, cardiac risk factors, and site and type of surgery, those in the highest cTnT-AUC tertile were associated with a significantly worse cardiovascular outcome and long-term mortality (HR 20.2; 95% CI 10.2-40.0 and HR 4.0; 95% CI 2.0-7.8 respectively). Receiver operator analysis showed that the best cut-off value for cTnT-AUC was <0.01 days*ng m for predicting long-term cardiovascular events and all-cause mortality. CONCLUSION In vascular surgery patients quantitative assessment of cTnT strongly predicts long-term outcome.
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Flu WJ, Schouten O, van Kuijk JP, Poldermans D. Perioperative Cardiac Damage in Vascular Surgery Patients. J Vasc Surg 2010. [DOI: 10.1016/j.jvs.2010.05.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Helderman F, Manoch I, Breeuwer M, Kose U, Boersma H, van Sambeek M, Pattynama P, Schouten O, Poldermans D, Wisselink W, van der Steen A, Krams R. Predicting Patient-Specific Expansion of Abdominal Aortic Aneurysms. J Vasc Surg 2010. [DOI: 10.1016/j.jvs.2010.05.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Flu WJ, Schouten O, van Kuijk JP, Poldermans D. Perioperative cardiac damage in vascular surgery patients. Eur J Vasc Endovasc Surg 2010; 40:1-8. [PMID: 20400340 DOI: 10.1016/j.ejvs.2010.03.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Accepted: 03/11/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Patients undergoing vascular surgery are at increased risk for developing cardiac complications. Majority of patients with perioperative myocardial damage are asymptomatic. Our objective is to review the available literature addressing the prevalence and prognostic implications of perioperative myocardial damage in vascular surgery patients. METHODS An Internet-based literature search was performed using MEDLINE to identify all published reports on perioperative myocardial damage in vascular surgery patients. Only those studies published from 2000 to 2010 evaluating myocardial damage using troponin I or T, with or without symptoms of angina pectoris were included. RESULTS Thirteen studies evaluating the prevalence of perioperative myocardial ischaemia or infarction were included in the study. The incidence of perioperative myocardial ischaemia ranged from 14% to 47% and the incidence of perioperative myocardial infarction ranged from 1% to 26%. In addition, 10 studies evaluating the prognostic value of perioperative myocardial ischaemia towards postoperative mortality or the occurrence of major adverse cardiac events were included. In the retrieved studies, hazard ratios varied from 1.9 to 9.0. CONCLUSION The high prevalence and asymptomatic nature of perioperative myocardial damage, combined with a substantial influence on postoperative mortality of vascular surgery patients, underline the importance of early detection and adequate management of perioperative myocardial damage. This article provides an extended overview regarding the prevalence and prognostic value of perioperative myocardial ischaemia and infarction in vascular surgery patients. In addition, treatment options to reduce the risk of perioperative myocardial damage are provided based on the current available literature.
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Schouten O, van Kuijk J, Flu W. Long-Term Outcome of Prophylactic Coronary Revascularization in Cardiac High-Risk Patients Undergoing Major Vascular Surgery (from the randomized DECREASE-V pilot study). J Vasc Surg 2010. [DOI: 10.1016/j.jvs.2009.11.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Schouten O, Sillesen H, Poldermans D. New Guidelines from the European Society of Cardiology for Perioperative Cardiac Care: A Summary of Implications for Elective Vascular Surgery Patients. Eur J Vasc Endovasc Surg 2010; 39:1-4. [DOI: 10.1016/j.ejvs.2009.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2009] [Accepted: 10/05/2009] [Indexed: 11/26/2022]
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Winkel T, Schouten O, Voûte M, Hoeks S, Welten G, Bax J, Verhagen H, Poldermans D. The effect of statins on perioperative events in patients undergoing vascular surgery. Acta Chir Belg 2010; 110:28-31. [PMID: 20306905 DOI: 10.1080/00015458.2010.11680560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Despite recent advancements in perioperative care and guideline recommendations, patients undergoing vascular surgery remain at risk for perioperative cardiovascular complications. In this review, the results are summarized of the most recent studies on the effectiveness and safety of perioperative statin use for the prevention of these perioperative cardiovascular complications. Perioperative statin therapy was associated with an improvement in postoperative cardiovascular outcome and a reduction in serum lipid levels and levels of inflammation markers.
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Winkel T, Schouten O, Hoeks S, Verhagen H, Bax J, Poldermans D. Prognosis of Transient New-Onset Atrial Fibrillation During Vascular Surgery. J Vasc Surg 2009. [DOI: 10.1016/j.jvs.2009.10.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Schouten O, Boersma E, Hoeks S. Fluvastatin and Perioperative Events in Patients Undergoing Vascular Surgery. J Vasc Surg 2009. [DOI: 10.1016/j.jvs.2009.10.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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van Kuijk J, Schouten O, Flu W, den Uil C, Bax J, Poldermans D. Perioperative Blood Glucose Monitoring and Control in Major Vascular Surgery Patients. J Vasc Surg 2009. [DOI: 10.1016/j.jvs.2009.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Vidakovic R, Schouten O, Kuiper R, Hoeks S, Flu WJ, van Kuijk J, Goei D, Verhagen H, Neskovic A, Poldermans D. The Prevalence of Polyvascular Disease in Patients Referred for Peripheral Arterial Disease. J Vasc Surg 2009. [DOI: 10.1016/j.jvs.2009.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Vidakovic R, Schouten O, Kuiper R, Hoeks S, Flu WJ, van Kuijk J, Goei D, Verhagen H, Neskovic A, Poldermans D. The Prevalence of Polyvascular Disease in Patients Referred for Peripheral Arterial Disease. Eur J Vasc Endovasc Surg 2009; 38:435-40. [DOI: 10.1016/j.ejvs.2009.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Accepted: 05/10/2009] [Indexed: 11/16/2022]
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Winkel TA, Schouten O, Hoeks SE, Verhagen HJM, Bax JJ, Poldermans D. Prognosis of transient new-onset atrial fibrillation during vascular surgery. Eur J Vasc Endovasc Surg 2009; 38:683-8. [PMID: 19683947 DOI: 10.1016/j.ejvs.2009.07.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Accepted: 07/10/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Chronic atrial fibrillation (AF) in a non-surgical setting is associated with cardiovascular events. However, the prognosis of transient new-onset AF during vascular surgery is unknown. OBJECTIVE The purpose of this study is to investigate the prognosis of new-onset AF during vascular surgery using continuous electrocardiographic monitoring (continuous-ECG). METHODS In this study, 317 patients, all in sinus rhythm, scheduled for major vascular surgery were screened for cardiac risk factors. Continuous-ECG recordings for 72h and standard ECG on days 3, 7 and 30 were used to identify new-onset AF. Cardiac troponin T (cTnT) was measured routinely after surgery. Study endpoint was a composite of cardiac death, myocardial infarction, unstable angina and stroke (cardiovascular events) at 30 days after surgery and during late follow-up. Median follow-up was 12 (interquartile range 2-28) months. RESULTS New-onset AF was noted in 15 (4.7%) patients. All but three patients returned spontaneously to sinus rhythm. The composite endpoint of cardiovascular events within 30 days and during late follow-up occurred in 34 (11%) and 62 (20%) patients, respectively. Multivariate regression analysis showed that new-onset AF was associated with perioperative (hazard ratio (HR) 6.0; 95% CI: 2.4-15) and late cardiovascular events (HR 4.2, 95% CI: 2.1-8.8). CONCLUSION New-onset AF during vascular surgery is associated with an increased incidence of 30-day and late cardiovascular events.
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van Kuijk JP, Schouten O, Flu WJ, den Uil CA, Bax JJ, Poldermans D. Perioperative blood glucose monitoring and control in major vascular surgery patients. Eur J Vasc Endovasc Surg 2009; 38:627-34. [PMID: 19608440 DOI: 10.1016/j.ejvs.2009.06.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Accepted: 06/13/2009] [Indexed: 01/08/2023]
Abstract
Diabetes mellitus (DM) is an independent predictor for morbidity and mortality in the general population, which is even more apparent in patients with concomitant cardiovascular risk factors. As the prevalence of DM is increasing, with an ageing general population, it is expected that the number of diabetic patients requiring surgical interventions will increase. Perioperative hyperglycaemia, without known DM, has been identified as a predictor for morbidity and mortality in patients undergoing surgery. Moreover, early studies showed that intensive blood-glucose-lowering therapy reduced both morbidity and mortality among patients admitted to the postoperative intensive care unit (ICU). However, later studies have doubted the benefit of intensive glucose control in medical-surgical ICU patients. This article aims to comprehensively review the evidence on the use of perioperative intensive glucose control, and to provide recommendations for current clinical practice. A systematic review was performed of the literature on perioperative intensive glucose control. Based on this literature review, we observed that intensive glucose control in the perioperative period has no clear benefit on short-term mortality. Intensive glucose control may even have a net harmful effect in selected patients. In addition, concerns on the external validity of some studies are important barriers for widespread recommendation of intensive glucose control in the perioperative setting. We propose that guidelines recommending intensive glucose control should be re-evaluated. In addition, moderate tight glucose control should currently be regarded as the safest and most efficient approach to patients undergoing major vascular surgery.
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Poldermans D, Schouten O, Bax J, Winkel TA. Reducing cardiac risk in non-cardiac surgery: evidence from the DECREASE studies. Eur Heart J Suppl 2009. [DOI: 10.1093/eurheartj/sup004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Welten GMJM, Schouten O, Chonchol M, Hoeks SE, Bax JJ, Van Domburg RT, Poldermans D. Prognosis of patients with peripheral arterial disease. THE JOURNAL OF CARDIOVASCULAR SURGERY 2009; 50:109-121. [PMID: 19179996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The incidence of peripheral arterial disease (PAD) is on the increase and is associated with a major health concern in current practical care. The most common disease process underlying PAD is atherosclerosis. Atherosclerosis is a complex generalized disease affecting several arterial beds, including the peripheral and coronary circulation. Especially in patients with PAD, high incidences of coronary artery disease (CAD) have been observed, which may be asymptomatic or symptomatic. The prognosis of patients with PAD is related to the presence and extent of underlying CAD. In patients with PAD undergoing major vascular surgery, cardiac complications are the major cause of perioperative morbidity and mortality and indicate a high-risk for adverse long-term cardiac outcome. In order to improve outcome for PAD patients, assessment and aggressive therapy of atherosclerotic risk factors and usage of cardio-protective medications is recommended. Unfortunately, substantial differences in risk factor management and treatment and long-term outcome have been reported between PAD and CAD patients.
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Schouten O, Lever T, Welten G, Winkel T, Dols L, Bax J, van Domburg R, Verhagen H, Poldermans D. Long-Term Cardiac Outcome in High-Risk Patients Undergoing Elective Endovascular or Open Infrarenal Abdominal Aortic Aneurysm Repair. J Vasc Surg 2008. [DOI: 10.1016/j.jvs.2008.10.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schouten O, Lever TM, Welten GMJM, Winkel TA, Dols LFC, Bax JJ, van Domburg RT, Verhagen HJM, Poldermans D. Long-term cardiac outcome in high-risk patients undergoing elective endovascular or open infrarenal abdominal aortic aneurysm repair. Eur J Vasc Endovasc Surg 2008; 36:646-52. [PMID: 18922711 DOI: 10.1016/j.ejvs.2008.09.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Accepted: 09/11/2008] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To assess long-term outcome of patients at high cardiac risk undergoing endovascular or open AAA repair. METHODS Patients undergoing open or endovascular infrarenal AAA repair with >or=3 cardiac risk factors and preoperative cardiac stress testing (DSE) at 2 university hospitals were studied. Main outcome was cardiac event free and overall survival. Multivariate Cox regression analysis was used to evaluate the influence of type of AAA repair on long-term outcome. RESULTS In 124 patients (55 endovascular, 69 open) the number and type of cardiac risk factors, medication use and DSE results were similar in both groups. In multivariable analysis, adjusting for cardiac risk factors, stress test results, medication use, and propensity score endovascular repair was associated with improved cardiac event free survival (HR 0.54; 95% CI 0.30-0.98) but not with an overall survival benefit (HR 0.73; 95% CI 0.37-1.46). Importantly, statin therapy was associated with both improved overall survival (HR 0.42; 95% CI 0.21-0.83) and cardiac event free survival (HR 0.45; 95% CI 0.23-0.86). CONCLUSIONS The perioperative cardiac benefit of endovascular AAA repair in high cardiac risk patients is sustained during long-term follow-up provided patients are on optimal medical therapy but it is not associated with improved overall long-term survival.
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