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Johnson M, Spies J, Scott K, Kato B, Mu X, Rectenwald J, White R, Khaja M, Zuckerman D, Casciani T, Gillespie D. Abstract No. 274 ▪ FEATURED ABSTRACT Predicting the Safety and Effectiveness of Inferior Vena Cava Filters (PRESERVE): Outcomes at 12 Months. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Smith BK, Rectenwald J, Yudkowsky R, Hirshfield LE. A Framework for Understanding the Association Between Training Paradigm and Trainee Preparedness for Independent Surgical Practice. JAMA Surg 2021; 156:535-540. [PMID: 33759997 DOI: 10.1001/jamasurg.2021.0031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance The sociopolitical and cultural context of graduate surgical education has changed considerably over the past 2 decades. Although new structures of graduate surgical training programs have been developed in response and the comparative value of formats are continually debated, it remains unclear how different time-based structural paradigms are preparing trainees for independent practice after program completion. Objective To investigate the factors associated with trainees' and program directors' perception of trainee preparedness for independent surgical practice. Design, Setting, and Participants This qualitative study used an instrumental case study approach and obtained information through semistructured interviews, which were analyzed using open-and-focused coding. Participants were recent graduates and program directors of vascular surgery training programs in the United States. The 2 training paradigms analyzed were the integrated vascular surgery residency program (0 + 5, with 0 indicating that the general surgery training experiences are fully integrated into the 5 years of overall training and 5 indicating the total number of years of training) and the traditional vascular surgery fellowship program (5 + 2, with 5 indicating the number of years of general surgery training and 2 indicating the number of years of vascular surgery training). All graduates completed their training in 2018. All interviews were conducted between July 1, 2018, and September 30, 2018. Main Outcomes and Measures A conceptual framework to inform current and ongoing efforts to optimize graduate surgical training programs across specialties. Results A total of 22 semistructured interviews were completed, involving 7 graduates of 5 + 2 programs, 9 graduates of 0 + 5 programs, and 6 vascular surgery program directors. Of the 22 participants, 15 were men (68%). Participants described 4 interconnected domains that were associated with trainees' perceived preparedness for practice: structural, individual, relational, and organizational. Structural factors included the overall and vascular surgery-specific time spent in training, whereas individual factors included innate technical skills, confidence, maturity, and motivation. Faculty-trainee relationships (or relational factors) were deemed important for building trust and granting of autonomy. Organizational factors included features of the local organization, including patient population, case volume, and case mix. Conclusions and Relevance Findings suggest that restructuring training paradigms alone is insufficient to address the issue of trainees' perceived preparedness for practice. A framework was created from the results for evaluating and improving residency and fellowship programs as well as for developing graduate surgical training paradigms that incorporate all 4 domains associated with preparedness.
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Affiliation(s)
- Brigitte K Smith
- Division of Vascular Surgery, Department of Surgery, University of Utah, Salt Lake City
| | - John Rectenwald
- Division of Vascular Surgery, Department of Surgery, University of Wisconsin, Madison
| | - Rachel Yudkowsky
- Department of Medical Education, University of Illinois at Chicago, Chicago
| | - Laura E Hirshfield
- Department of Medical Education, University of Illinois at Chicago, Chicago
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Brahmandam A, Skrip L, Sumpio B, Indes J, Dardik A, Sarac T, Rectenwald J, Chaar CIO. A survey of vascular specialists' practice patterns of inferior vena cava filter placement and retrieval. Vascular 2018; 27:291-298. [PMID: 30501583 DOI: 10.1177/1708538118815394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The placement of inferior vena cava filters (IVCF) continues to rise. Vascular specialists adopt different practices based on local expertise. This study was performed to assess the attitudes of vascular specialists towards the placement and retrieval of IVCF. METHODS An online survey of 28 questions related to practice patterns regarding IVCF was administered to 1429 vascular specialists. Vascular specialists were categorized as low volume if they place less than three IVCF per month and high volume if they place at least three IVCF per month. The responses of high volume and low volume were compared using two-sample t-tests and Chi-square tests. RESULTS A total of 259 vascular specialists completed the survey (18% response rate). There were 191 vascular surgeons (74%) and 68 interventional radiologists (26%). The majority of responders were in academic practice (67%) and worked in tertiary care centers (73%). The retrievable IVCF of choice was Celect (27%) followed by Denali (20%). Forty-two percent used a temporary IVCF and left it in situ instead of using a permanent IVCF. Eighty-two percent preferred placing the tip of the IVCF at or just below the lowest renal vein. Thirty-one percent obtained a venous duplex of the lower extremities prior to retrieval while 24% did not do any imaging. There were 132 (51%) low volume vascular specialists and 127 (49%) high volume vascular specialists. Compared to low volume vascular specialists, significantly more high volume vascular specialists reported procedural times of less than 30 min for IVCF retrieval (57% vs. 42%, P = 0.026). There was a trend for high volume to have fewer unsuccessful attempts at IVCF retrieval but that did not reach statistical significance ( P = .061). High volume were more likely to have attempted multiple times to retrieve an IVCF (66% vs. 33%, P < .001), and to have used bronchoscopy forceps (32% vs. 14%, P = .001) or a laser sheath (14% vs. 2%, P < .001) for IVCF retrieval. In general, vascular specialists were not comfortable using bronchoscopy forceps (65%) or a laser sheath (82%) for IVCF retrieval. CONCLUSIONS This study underscores significant variability in vascular specialists practice patterns regarding IVCF. More studies and societal guidelines are needed to define best practices.
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Affiliation(s)
- Anand Brahmandam
- 1 Section of Vascular Surgery, Yale University School of Medicine, New Haven, USA
| | - Laura Skrip
- 2 National Public Health Institute of Liberia, Monrovia, Liberia
| | - Bauer Sumpio
- 1 Section of Vascular Surgery, Yale University School of Medicine, New Haven, USA
| | - Jeffrey Indes
- 3 Section of Vascular Surgery, Montefiore Medical Center, New York, USA
| | - Alan Dardik
- 1 Section of Vascular Surgery, Yale University School of Medicine, New Haven, USA
| | - Timur Sarac
- 4 Section of Vascular Surgery, Ohio State University Wexner Medical Center, Columbus, USA
| | - John Rectenwald
- 5 Section of Vascular Surgery, University of Wisconsin, Madison, USA
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Kirkwood ML, Arbique GM, Guild JB, Zeng K, Xi Y, Rectenwald J, Anderson JA, Timaran C. Radiation brain dose to vascular surgeons during fluoroscopically guided interventions is not effectively reduced by wearing lead equivalent surgical caps. J Vasc Surg 2018; 68:567-571. [DOI: 10.1016/j.jvs.2017.12.054] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 12/17/2017] [Indexed: 10/17/2022]
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Sorokin I, Johnson B, Nelson J, Rectenwald J, Cadeddu J. V04-02 ROBOT-ASSISTED LAPAROSCOPIC EXTRAVASCULAR STENT FOR NUTCRACKER SYNDROME. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kirkwood ML, Arbique G, Guild J, Xi Y, Zeng K, Rectenwald J, Anderson J, Timaran C. Radiation Brain Dose to Vascular Surgeons During Fluoroscopically Guided Interventions Is Not Effectively Reduced by Wearing Lead Equivalent Surgical Caps. J Vasc Surg 2017. [DOI: 10.1016/j.jvs.2017.05.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kirkwood ML, Guild JB, Arbique GM, Tsai S, Modrall JG, Anderson JA, Rectenwald J, Timaran C. New image-processing and noise-reduction software reduces radiation dose during complex endovascular procedures. J Vasc Surg 2016; 64:1357-1365. [DOI: 10.1016/j.jvs.2016.04.062] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 04/29/2016] [Indexed: 10/21/2022]
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Timaran DE, Knowles M, Soto-Gonzalez M, Modrall JG, Tsai S, Kirkwood M, Rectenwald J, Timaran CH. Gender and perioperative outcomes after fenestrated endovascular repair using custom-made and off-the-shelf devices. J Vasc Surg 2016; 64:267-272. [DOI: 10.1016/j.jvs.2016.02.062] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 02/23/2016] [Indexed: 11/27/2022]
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Campbell D, Andraska E, Rectenwald J, Gallagher K. Intravascular ultrasound imaging as a novel tool for the diagnosis of endofibrosis. J Vasc Surg Cases Innov Tech 2016; 2:59-61. [PMID: 31193347 PMCID: PMC6526332 DOI: 10.1016/j.jvsc.2016.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 03/23/2016] [Indexed: 10/30/2022]
Abstract
Given the rise of high-intensity sport athletes and the paucity of literature on endofibrosis, we describe a novel adjunctive imaging technique to aid in diagnosis. A 41-year-old female triathlete presented with exercise-limiting claudication. Results of lower extremity magnetic resonance angiography, provocative Doppler, angiogram, and digital subtraction angiography with papaverine were nondiagnostic. Intravascular ultrasound imaging was able to delineate an abnormal segment of the proximal external iliac artery with intimal hypertrophy. We report intravascular ultrasound imaging as a superior imaging modality to definitively diagnose endofibrosis and assist proper planning and operative treatment of patients with endofibrosis.
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Affiliation(s)
- Danielle Campbell
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich
| | - Elizabeth Andraska
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich
| | - John Rectenwald
- Section of Vascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Tex
| | - Katherine Gallagher
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich
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Affiliation(s)
- Seth Toomay
- Division of Interventional Radiology; Department of Radiology; University of Texas Southwestern Medical Center; Dallas Texas
| | - John Rectenwald
- Division of Vascular Surgery; Department of Surgery; University of Texas Southwestern Medical Center; Dallas Texas
| | - Miguel A. Vazquez
- Division of Nephrology; Department of Internal Medicine; University of Texas Southwestern Medical Center; Dallas Texas
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Modrall JG, Rosero EB, Tsai S, Kirkwood ML, Ali M, Rectenwald J, Timaran CH, Trimmer C. Renal Salvage After Renal Artery Stenting Improves Long-Term Survival. J Vasc Surg 2016. [DOI: 10.1016/j.jvs.2015.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kirkwood ML, Guild J, Arbique G, Tsai S, Modrall G, Anderson JA, Rectenwald J, Timaran C. Radiation Dose During Complex Endovascular Procedures. J Vasc Surg 2016. [DOI: 10.1016/j.jvs.2015.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Colvard B, Shames M, Schanzer A, Rectenwald J, Chaer R, Lee JT. A Comparison of Training Experience, Training Satisfaction, and Job Search Experiences between Integrated Vascular Surgery Residency and Traditional Vascular Surgery Fellowship Graduates. Ann Vasc Surg 2015; 29:1333-8. [DOI: 10.1016/j.avsg.2015.04.078] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 03/17/2015] [Accepted: 04/17/2015] [Indexed: 11/16/2022]
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Mohammad F, Kabbani L, Taylor A, Cuff R, Rectenwald J, Brown O, Olmo CD, Mattos M. Novel Open Vascular Surgery Skills Training Model Accurately Differentiates Level of Vascular Surgical Skills (Forceps Handling, Needle Driving, and Knot Tying) in General Surgery Residents, Vascular Surgery Residents, Fellows, and Faculty. J Vasc Surg 2015. [DOI: 10.1016/j.jvs.2015.06.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Arabi M, Krishnamurthy V, Cwikiel W, Vellody R, Wakefield TW, Rectenwald J, Williams D. Endovascular treatment of thrombosed inferior vena cava filters: Techniques and short-term outcomes. Indian J Radiol Imaging 2015; 25:233-8. [PMID: 26288516 PMCID: PMC4531446 DOI: 10.4103/0971-3026.161436] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE To present the techniques for endovascular treatment of thrombosed filter-bearing inferior vena cavae (IVCs), along with short-term clinical and imaging follow-up. MATERIALS AND METHODS A total of 45 consecutive patients (17 females and 28 males), aged 19-79 years (mean age of 49 years), who had IVC filter placement complicated by symptomatic acute or chronic iliocaval thrombosis and underwent endovascular therapy were studied. All patients presented with lower extremity swelling and/or pain. One patient also had bilateral lower extremity swelling and chronic gastrointestinal (GI) bleeding which was secondary to chronic systemic to portal venous collaterals. Patients underwent one or more of the following endovascular treatments depending on the chronicity and extent of thrombosis: (a) catheter-directed thrombolysis (CDT) (n = 25), (b) pharmacomechanical thrombolysis (PMT) (n = 15), (c) balloon angioplasty (n = 45), and/or (d) stent placement across the filter (n = 42). In addition, 16 patients underwent groin arteriovenous fistula (AVF) creation (36%) and 3 (7%) had femoral venous thrombectomy to improve flow in the recanalized iliac veins and IVCs. RESULTS Anatomical success was achieved in all patients. Follow-up was not available in 10 patients (lost to follow-up, n = 4; expired due to comorbidities, n = 2; lost to follow-up after re-intervention, n = 4). At a mean follow-up time of 13.3 months (range 1-48 months), clinical success was achieved in 27 patients (60%), i.e. in 21 patients without re-intervention and in 6 patients with re-intervention. Clinical success was not achieved despite re-intervention in eight patients. Higher clinical success was noted in patients who did not require repeat interventions (P = 0.03) and the time to re-intervention was significantly shorter in patients who had clinical failure (P = 0.01). AVF creation did not improve the clinical success rate (P = 1). There was no significant difference in clinical success between patients who had acute or subacute thrombosis compared to those who had chronically occluded filter-bearing IVCs (P = 1). CONCLUSION This study suggests that endovascular therapy for thrombosed filter-bearing IVCs is safe and technically feasible.
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Affiliation(s)
- Mohammad Arabi
- Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan, USA
| | | | - Wojciech Cwikiel
- Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Ranjith Vellody
- Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Thomas W Wakefield
- Department of Vascular Surgery, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - John Rectenwald
- Department of Vascular Surgery, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - David Williams
- Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan, USA
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Mitchell EL, Eidt JF, Rhodes RS, Valentine RJ, Valentine RJ, Chaer R, Dalman R, Duncan A, Eidt J, Edgar L, Harris L, Mitchell E, Rectenwald J, Rhodes R, Ricotta J, Shames M, Simpson P. The Vascular Surgical Milestones Project. J Vasc Surg 2015; 62:251-255.e1. [DOI: 10.1016/j.jvs.2015.03.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 03/01/2015] [Indexed: 10/23/2022]
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Colvard BD, Shames M, Schanzer A, Rectenwald J, Chaer R, Lee JT. Survey of the Initial Cohort of Graduating Integrated 0+5 Residents and Vascular Fellows: Experiences During the Job Hunt. J Vasc Surg 2013. [DOI: 10.1016/j.jvs.2013.05.066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Vandy FC, Campbell D, Eliassen A, Rectenwald J, Eliason JL, Criado E, Escobar G, Upchurch GR. Specialized vascular floors after open aortic surgery: cost containment while preserving quality outcomes. Ann Vasc Surg 2013; 27:45-52. [PMID: 23257073 DOI: 10.1016/j.avsg.2012.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 09/01/2012] [Accepted: 09/07/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Postoperative care of open abdominal aortic surgery (OAAS) traditionally involves the intensive care unit (ICU). We hypothesized that in patients without an indication for postoperative ICU admission, admission to a specialized vascular floor unit (hemodynamic monitoring, 2:1 nursing) offers cost savings to both payer and institution without compromising care. METHODS The electronic medical record was used to collect perioperative data for patients who underwent OAAS between July 2007 and July 2011. The university's cost accounting system provided information on revenue, total margin, and professional billing. Patients with ICU indications (spinal drain, Swan-Ganz monitoring, vasopressors, intubation, or blood product resuscitation) were excluded. Comparative cost and outcome analysis was performed on vascular ward and ICU admissions using the Fisher's exact test for dichotomous categorical variables and the Student's t-test for continuous variables. Long-term survival comparison was calculated using Kaplan-Meier survival estimates. RESULTS One hundred thirty of 215 patients were included for analysis (85 excluded, 51 floor, 79 ICU). Perioperative data amongst the floor and ICU cohorts were similar. Day of operation professional billing fees were comparable (ICU $13,365 vs. floor $12,626; P = 0.18); however, postoperative professional fees were significantly higher in the ICU cohort (ICU $3,258 vs. floor $2,101; P = 0.001) primarily because of intensivist billing. The hospital generated an average of 8.7% more revenue from the ICU cohort (ICU $37,770 vs. floor $34,756; P = 0.023). This was offset by greater expenses in the ICU cohort (ICU $30,756 vs. floor $25,144; P = 0.02), yielding a hospital profit margin of 107.5% favoring floor admission (ICU $2,858 vs. floor $5,931; P = 0.19). Duration of stay was similar (ICU 8.0 days vs. floor 7.8 days; P = 0.86). Kaplan-Meier survival analysis was not significantly different between cohorts (ICU 10.1%, median follow-up, 1,070 days vs. floor 0%, median follow-up, 405 days; P = 0.13). CONCLUSIONS Postoperative admission to the ICU is not always necessary after OAAS. Specialized vascular floors offer a financial savings to both payer and institution, which allows for simultaneous cost containment while preserving quality outcomes.
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Affiliation(s)
- Frank C Vandy
- University of Michigan Cardiovascular Center, Ann Arbor, MI, USA
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Colvard BD, Lee J, Schanzer A, Rectenwald J, Shames M. Survey of the First Wave of Graduating Integrated 0+5 Integrated Residents Versus Vascular Fellows: Experiences in the Job Market. J Vasc Surg 2013. [DOI: 10.1016/j.jvs.2013.02.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Coleman DM, Chen H, Eliassen A, Arya S, Criado E, Eliason JL, Rectenwald J, Stanley JC. A Review of the Contemporary and Historical Management of 134 Patients With Splenic Artery Aneurysms. J Vasc Surg 2013. [DOI: 10.1016/j.jvs.2013.02.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kabnick L, Wakefield T, Almeida J, Raffetto J, McLafferty R, Pappas P, Rectenwald J, Blebea J, Gillespie D, Onyeachom U, Kinsman R, Lal B. Use of Compression Therapy in Patients with Chronic Venous Insufficiency Undergoing Ablation Therapy: A Report from the American Venous Registry. J Vasc Surg Venous Lymphat Disord 2013; 1:107. [DOI: 10.1016/j.jvsv.2012.10.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Jacobs B, Obi A, Arya S, Rectenwald J, Henke P, Wakefield T, Napolitano L. Is There an Indication for Therapuetic Anticoagulation for Venous Thromboembolism (VTE) Prophylaxis in Critically Ill H1N1 Influenza A Patients? Chest 2012. [DOI: 10.1378/chest.1389804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Laser A, Baker N, Rectenwald J, Eliason JL, Criado-Pallares E, Upchurch GR. Graft infection after endovascular abdominal aortic aneurysm repair. J Vasc Surg 2011; 54:58-63. [DOI: 10.1016/j.jvs.2010.11.111] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Revised: 11/17/2010] [Accepted: 11/18/2010] [Indexed: 11/25/2022]
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Vandy F, Blackburn S, Bloom J, Clay A, Fellows E, Guire K, Kantola M, Laforge W, Stabler C, Baker N, Cummings E, Pavone L, Rectenwald J, Wakefield T. PVSS19. Performing Complete Superficial Vein Ablation in Patients with Obesity and Severe Chronic Venous Disease: Who Benefits? J Vasc Surg 2011. [DOI: 10.1016/j.jvs.2011.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Patel HJ, Upchurch GR, Eliason JL, Criado E, Rectenwald J, Williams DM, Deeb GM. Hybrid Debranching With Endovascular Repair for Thoracoabdominal Aneurysms: A Comparison With Open Repair. Ann Thorac Surg 2010; 89:1475-81. [DOI: 10.1016/j.athoracsur.2010.01.062] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Revised: 01/25/2010] [Accepted: 01/29/2010] [Indexed: 10/19/2022]
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Kabbani LS, Criado E, Upchurch GR, Patel HJ, Eliason JL, Rectenwald J, Berguer R. Hybrid Repair of Aortic Aneurysms Involving the Visceral and Renal Vessels. Ann Vasc Surg 2010; 24:219-24. [DOI: 10.1016/j.avsg.2009.08.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2009] [Revised: 07/21/2009] [Accepted: 08/18/2009] [Indexed: 11/17/2022]
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Kaufman JA, Rundback JH, Kee ST, Geerts W, Gillespie D, Kahn SR, Kearon C, Rectenwald J, Rogers FB, Stavropoulos SW, Streiff M, Vedantham S, Venbrux A. Development of a Research Agenda for Inferior Vena Cava Filters: Proceedings from a Multidisciplinary Research Consensus Panel. J Vasc Interv Radiol 2009; 20:697-707. [DOI: 10.1016/j.jvir.2009.03.007] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Revised: 02/18/2009] [Accepted: 03/02/2009] [Indexed: 12/21/2022] Open
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Vandy F, Criado E, Upchurch GR, Williams DM, Rectenwald J, Eliason J. Transluminal hypogastric artery occlusion with an Amplatzer vascular plug during endovascular aortic aneurysm repair. J Vasc Surg 2008; 48:1121-4. [PMID: 18692350 DOI: 10.1016/j.jvs.2008.06.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2008] [Revised: 05/15/2008] [Accepted: 06/01/2008] [Indexed: 11/26/2022]
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Cowan JA, Dimick JB, Henke PK, Rectenwald J, Stanley JC, Upchurch GR. Epidemiology of aortic aneurysm repair in the United States from 1993 to 2003. Ann N Y Acad Sci 2007; 1085:1-10. [PMID: 17182917 DOI: 10.1196/annals.1383.030] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The epidemiology of abdominal aortic aneurysm (AAA) disease has been well described over the preceding 50 years. This disease primarily affects elderly males with smoking, hypertension, and a positive family history contributing to an increased risk of aneurysm formation. The aging population as well as increased screening in high-risk populations has led some to suggest that the incidence of AAAs is increasing. The National Inpatient Sample (1993-2003), a national representative database, was used in this study to determine trends in mortality following AAA repair in the United States. In addition, the impact of the introduction of less invasive endovascular AAA repair was assessed. Overall rates of treated unruptured and ruptured AAAs remained stable (unruptured 12 to 15/100,000; ruptured 1 to 3/100,000). In 2003, 42.7% of unruptured and 8.8% of ruptured AAAs were repaired through an endovascular approach. Inhospital mortality following unruptured AAA repair continues to decline for open repair (5.3% to 4.7%, P = 0.007). Mortality after elective endovascular AAA repair also has statistically decreased (2.1% to 1.0%, P = 0.024) and remains lower than open repair. Mortality rates for ruptured AAAs following repair remain high (open: 46.5% to 40.7%, P = 0.01; endovascular: 40.0% to 35.3%, P = 0.823). These data suggest that the numbers of patients undergoing elective AAA repair have remained relatively stable despite the introduction of less invasive technology. A shift in the treatment paradigm is occurring with a higher percentage of patients subjected to elective endovascular AAA repair compared to open repair. This shift, at least in the short term, appears justified as the mortality in patients undergoing elective endovascular AAA repair is significantly reduced compared to patients undergoing open AAA repair.
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Affiliation(s)
- John A Cowan
- University of Michigan Cardiovascular Center, Ann Arbor, Michigan, USA
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Nowak M, Gaines GC, Rosenberg J, Minter R, Bahjat FR, Rectenwald J, MacKay SL, Edwards CK, Moldawer LL. LPS-induced liver injury in D-galactosamine-sensitized mice requires secreted TNF-alpha and the TNF-p55 receptor. Am J Physiol Regul Integr Comp Physiol 2000; 278:R1202-9. [PMID: 10801288 DOI: 10.1152/ajpregu.2000.278.5.r1202] [Citation(s) in RCA: 132] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Lipopolysaccharide and D-galactosamine induced lethality and apoptotic liver injury is dependent on endogenously produced tumor necrosis factor (TNF)-alpha. The present study was undertaken to determine whether membrane-associated or secreted TNF-alpha signaling through the p55 or p75 receptor was responsible for survival and hepatic injury after lipopolysaccharide administration in D-galactosamine-sensitized mice. Transgenic mice expressing null forms of TNF-alpha, the p55 and p75 receptor, and mice expressing only a cell-associated form of TNF-alpha were challenged with 8 mg D-galactosamine and 100 ng lipopolysaccharide. Mortality and apoptotic liver injury were only seen in wild-type and p75 knockout mice. p75 Knockout mice had significantly higher concentrations of plasma TNF-alpha than any other experimental group (P </= 0.05) and tended to have the highest mortality and liver injury. In contrast, p55 and TNF-alpha knockout mice and animals expressing only a cell-associated form of TNF-alpha exhibited no mortality or liver injury. We conclude that survival and apoptotic liver injury in response to lipopolysaccharide and D-galactosamine are dependent exclusively on secreted TNF-alpha signaling through the p55 receptor.
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Affiliation(s)
- M Nowak
- Department of Surgery, University of Florida College of Medicine, Gainesville, Florida 32610, USA
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Fukuzuka K, Minter R, Rectenwald J, Edwards CK, Moldawer L, Mozingo D. ORGAN APOPTOSIS IS DEPENDENT ON GLUCOCORTICOIDS BUT NOT FasL EARLY AFTER BURN INJURY. Shock 1999. [DOI: 10.1097/00024382-199906001-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Walker PG, Cranney GB, Grimes RY, Delatore J, Rectenwald J, Pohost GM, Yoganathan AP. Three-dimensional reconstruction of the flow in a human left heart by using magnetic resonance phase velocity encoding. Ann Biomed Eng 1996; 24:139-47. [PMID: 8669711 DOI: 10.1007/bf02771002] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Intraventricular flows have been correlated with disease and are of interest to cardiologists as a possible means of diagnosis. This study extends a method that use magnetic resonance (MR) to measure the three-dimensional nature of these flows. Four coplanar, sagittal MR slices were located that spanned the left ventricle of a healthy human. All three velocity components were measured in each slice and 18 phases were obtained per beat. With use of the MR magnitude images, masks were created to isolate the velocity data within the heart. These data were read into the software package, Data Visualizer, and the data from the four slices were aligned so as to reconstruct the three-dimensional volume of the left ventricle and atrium. By representing the velocity in vectorial form, the three-dimensional intraventricular flow field was visualized. This revealed the presence of one large line vortex in the ventricle during late diastole but a more ordered flow during early diastole and systole. In conclusion, the use of MR velocity acquisition is a suitable method to obtain the complex intraventricular flow fields in humans and may lead to a better understanding of the importance of these flows.
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Affiliation(s)
- P G Walker
- School of Chemical Engineering, Georgia Institute of Technology, Atlanta 30332-0100, USA
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