2023
Comparison of lower extremity bypass and peripheral vascular intervention for chronic limb-threatening ischemia in the Medicare-linked Vascular Quality Initiative
Cleman J, Romain G, Grubman S, Guzman R, Smolderen K, Mena-Hurtado C. Comparison of lower extremity bypass and peripheral vascular intervention for chronic limb-threatening ischemia in the Medicare-linked Vascular Quality Initiative. Journal Of Vascular Surgery 2023, 78: 745-753.e6. PMID: 37207790, PMCID: PMC10964324, DOI: 10.1016/j.jvs.2023.05.015.Peer-Reviewed Original ResearchConceptsChronic limb-threatening ischemiaLower extremity bypassPeripheral vascular interventionsVascular Quality InitiativeLimb-threatening ischemiaCause mortalityRisk of deathExtremity bypassVascular interventionsQuality InitiativeCox proportional hazards regressionKaplan-Meier survival curvesProportional hazards regressionOverall mean ageLogistic regression modelsComparative effectiveness researchKnee poplitealMedicare registryInfrapopliteal arteriesHazards regressionMean ageThirty-dayHispanic ethnicityOutcome dataTreatment groups
2022
Variability in Antithrombotic Therapy after Infrainguinal Lower Extremity Bypass
Brahmandam A, Lee M, Bellamkonda K, Provance JB, Sumpio B, Ochoa Chaar CI, Smolderen KG, Mena-Hurtado C, Guzman RJ. Variability in Antithrombotic Therapy after Infrainguinal Lower Extremity Bypass. Annals Of Vascular Surgery 2022, 88: 51-62. PMID: 36245106, DOI: 10.1016/j.avsg.2022.08.016.Peer-Reviewed Original ResearchConceptsInfrainguinal lower extremity bypassLower extremity bypassDual antiplatelet therapySingle antiplatelet therapyAntithrombotic therapyCombination therapyAntiplatelet therapyMedian odds ratioExtremity bypassDistal targetsHierarchical multivariable logistic regressionCenter-level variabilityCommon combination therapyPatient-level factorsPercutaneous coronary interventionPeripheral vascular interventionsMultivariable logistic regressionMultivariable regression modelsAntiplatelet monotherapyBypass targetAntithrombotic regimensPostoperative bleedingTriple therapyCoronary interventionAntithrombotic strategiesAssociation of depression and anxiety disorders with outcomes after revascularization in chronic limb-threatening ischemia hospitalizations nationwide
Harris KM, Mena-Hurtado C, Burg MM, Vriens PW, Heyligers J, Smolderen KG. Association of depression and anxiety disorders with outcomes after revascularization in chronic limb-threatening ischemia hospitalizations nationwide. Journal Of Vascular Surgery 2022, 77: 480-489. PMID: 36115521, DOI: 10.1016/j.jvs.2022.09.008.Peer-Reviewed Original ResearchConceptsLength of stayChronic limb-threatening ischemiaAnxiety disorder diagnosisAssociation of depressionRevascularization cohortMajor amputationDisorder diagnosisSurgical revascularizationEndovascular revascularizationHigher oddsLonger median LOSMedian LOSLonger LOSAnxiety disordersDocumentation of depressionPeripheral artery diseaseLimb-threatening ischemiaRisk of amputationNational Inpatient SamplePatients' sociodemographic dataHigher median costArtery diseaseIllness severityPsychiatric comorbidityComorbid depressionMajor Adverse Limb Events Among Patients with Premature Peripheral Artery Disease Compared with Those at the Common Age Undergoing Revascularization in the Vascular Quality Initiative
Kim TI, Loh S, DeWan A, Murray M, Mojibian H, Mani A, Mena-Hurtado C, Ochoa Chaar CI. Major Adverse Limb Events Among Patients with Premature Peripheral Artery Disease Compared with Those at the Common Age Undergoing Revascularization in the Vascular Quality Initiative. Annals Of Vascular Surgery 2022, 87: 188-197. PMID: 35926786, DOI: 10.1016/j.avsg.2022.07.007.Peer-Reviewed Original ResearchConceptsMajor adverse limb eventsChronic limb-threatening ischemiaLower extremity revascularizationAdverse limb eventsVascular Quality InitiativePeripheral artery diseaseYears of ageCommon ageLimb eventsArtery diseaseOutcomes of patientsLimb-threatening ischemiaGroup of patientsInsulin-dependent diabetesProportional hazards regressionQuality InitiativeUndergoing revascularizationMedical optimizationCurrent smokersD diseaseExtremity revascularizationPatient agePatients 60Medical therapyHazards regressionThe Impact of Clinical Follow-Up After Revascularization on the Outcomes of Patients with Chronic Limb Threatening Ischemia
Kiwan G, Mohamedali A, Kim T, Zhuo H, Zhang Y, Mena-Hurtado C, Mojibian H, Cardella J, Ochoa Chaar CI. The Impact of Clinical Follow-Up After Revascularization on the Outcomes of Patients with Chronic Limb Threatening Ischemia. Annals Of Vascular Surgery 2022, 86: 286-294. PMID: 35803459, DOI: 10.1016/j.avsg.2022.05.043.Peer-Reviewed Original ResearchConceptsLower extremity revascularizationReintervention rateCompliant patientsNoncompliant patientsLimb amputationSingle-center retrospective chart reviewChronic limb threatening ischemiaOverall reintervention rateOutcomes of patientsLimb threatening ischemiaMajor amputation ratePeripheral arterial diseaseRetrospective chart reviewLong-term outcomesMajor limb amputationImpact of ClinicalSignificant differencesMajor amputationAmputation ratePerioperative outcomesBaseline characteristicsChart reviewExtremity revascularizationIschemia patientsMore reinterventionsVariability in 30-day major amputation rates following endovascular peripheral vascular intervention for critical limb ischemia
Provance JB, Spertus JA, Jones PG, Hoffman MA, Bunte MC, Vogel TR, Mena-Hurtado C, Smolderen KG. Variability in 30-day major amputation rates following endovascular peripheral vascular intervention for critical limb ischemia. Vascular Medicine 2022, 27: 350-357. PMID: 35603755, DOI: 10.1177/1358863x221098097.Peer-Reviewed Original ResearchConceptsPeripheral vascular interventionsCritical limb ischemiaMedian risk ratioEndovascular peripheral vascular interventionsMajor amputation ratePatient-level factorsAmputation ratePVI procedureLimb ischemiaRisk ratioVascular interventionsNational electronic health record databaseElectronic health record databasePredictors of amputationRate of amputationMixed effects Poisson regression modelHealth record databaseEffects Poisson regression modelPoisson regression modelsCLI carePrevious amputationClinical factorsCLI treatmentBlack raceDiagnosis codesImpact of malnutrition and frailty on mortality and major amputation in patients with CLTI
Karim AM, Li J, Panhwar MS, Arshad S, Shalabi S, Mena‐Hurtado C, Aronow HD, Secemsky EA, Shishehbor MH. Impact of malnutrition and frailty on mortality and major amputation in patients with CLTI. Catheterization And Cardiovascular Interventions 2022, 99: 1300-1309. PMID: 35114067, DOI: 10.1002/ccd.30113.Peer-Reviewed Original ResearchConceptsFrail patientsMajor amputationFrailty Risk ScoreClinical Modification codesImpact of malnutritionManagement of frailtyNational Inpatient SamplePrevalence of malnutritionMultivariable regression analysisOutcomes of interestCLTI patientsHospital mortalityEndovascular revascularizationMortality benefitAdverse eventsFrailty statusRevascularization methodInpatient SampleHospital costsInvasive approachRisk scoreInternational ClassificationCLTIPatientsNutritional status
2021
Guideline-Directed Medical Therapy in Patients with Chronic Kidney Disease Undergoing Peripheral Vascular Intervention
Jelani QU, Llanos-Chea F, Bogra P, Trejo-Paredes C, Huang J, Provance JB, Turner J, Anantha-Narayanan M, Sheikh AB, Smolderen KG, Mena-Hurtado C. Guideline-Directed Medical Therapy in Patients with Chronic Kidney Disease Undergoing Peripheral Vascular Intervention. American Journal Of Nephrology 2021, 52: 845-853. PMID: 34706363, DOI: 10.1159/000519484.Peer-Reviewed Original ResearchConceptsComorbid chronic kidney diseaseGuideline-directed medical therapyPeripheral vascular interventionsCritical limb ischemiaMedian odds ratioMedical therapyPrescription ratesVascular interventionsHigh riskUse of GDMTAdjusted median odds ratioVascular Quality Initiative databaseAngiotensin-converting enzyme inhibitorAngiotensin receptor blockersChronic kidney diseaseLower prescription ratesPoor clinical outcomeCKD groupCKD statusAntiplatelet therapyReceptor blockersLimb ischemiaLimb outcomesClinical outcomesMedical managementLack of Guideline-Directed Medical Therapy in Patients Undergoing Endovascular Procedures for Critical Limb Ischemia
Llanos-Chea F, Jelani QU, Trejo-Paredes C, Curtis JP, Parzynski CS, Huang J, Faridi KF, Turner J, Smolderen KG, Mena-Hurtado C. Lack of Guideline-Directed Medical Therapy in Patients Undergoing Endovascular Procedures for Critical Limb Ischemia. Journal Of The American College Of Cardiology 2021, 77: 1374-1375. PMID: 33706882, DOI: 10.1016/j.jacc.2020.12.063.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAngiotensin Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsCohort StudiesEndovascular ProceduresFemaleGuideline AdherenceHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIschemiaMaleMiddle AgedPeripheral Arterial DiseasePlatelet Aggregation InhibitorsContemporary Trends in Hospital Admissions and Outcomes in Patients With Critical Limb Ischemia
Anantha-Narayanan M, Doshi RP, Patel K, Sheikh AB, Llanos-Chea F, Abbott JD, Shishehbor MH, Guzman RJ, Hiatt WR, Duval S, Mena-Hurtado C, Smolderen KG. Contemporary Trends in Hospital Admissions and Outcomes in Patients With Critical Limb Ischemia. Circulation Cardiovascular Quality And Outcomes 2021, 14: e007539. PMID: 33541110, DOI: 10.1161/circoutcomes.120.007539.Peer-Reviewed Original ResearchConceptsLength of stayMajor amputationCost of hospitalizationHospital mortalitySurgical interventionEndovascular interventionBlack raceHigh-risk patient profileNational Inpatient Sample dataHigher major amputationMore endovascular interventionsRisk patient profileCritical limb ischemiaOpen surgical interventionMultivariable regression analysisHierarchical multivariable regression analysisCLI cohortHospital admissionLimb ischemiaPrimary outcomeRevascularization proceduresSecondary outcomesAtherosclerotic diseaseMale sexFemale sex
2020
Prognostic Value of Radiotracer-Based Perfusion Imaging in Critical Limb Ischemia Patients Undergoing Lower Extremity Revascularization
Chou TH, Alvelo JL, Janse S, Papademetris X, Sumpio BE, Mena-Hurtado C, Sinusas AJ, Stacy MR. Prognostic Value of Radiotracer-Based Perfusion Imaging in Critical Limb Ischemia Patients Undergoing Lower Extremity Revascularization. JACC Cardiovascular Imaging 2020, 14: 1614-1624. PMID: 33221224, PMCID: PMC8113329, DOI: 10.1016/j.jcmg.2020.09.033.Peer-Reviewed Original ResearchConceptsCritical limb ischemiaLower extremity revascularizationDiabetes mellitusSPECT/CTPrognostic valuePerfusion responseAmputation outcomesExtremity revascularizationFoot perfusionCritical limb ischemia patientsAmputation-free survivalIncidence of amputationSubsequent clinical outcomesRegional perfusion abnormalitiesSingle photon emissionIschemia patientsLimb ischemiaClinical outcomesFoot ulcersPerfusion abnormalitiesCT perfusionRevascularizationRadiotracer uptakePatientsPerfusion imagingSeasonal variation in U.S. hospitalizations for chronic limb‐threatening ischemia
Altin SE, Kim YG, Aronow HD, Armstrong EJ, Goldsweig AM, Dardik A, Lanksy AJ, Mena‐Hurtado C, Abbott JD. Seasonal variation in U.S. hospitalizations for chronic limb‐threatening ischemia. Catheterization And Cardiovascular Interventions 2020, 96: 1473-1480. PMID: 32902126, DOI: 10.1002/ccd.29261.Peer-Reviewed Original ResearchConceptsCritical limb-threatening ischemiaLimb-threatening ischemiaNational Inpatient SampleMinor amputationChronic limb-threatening ischemiaUtilization Project National Inpatient SampleProvider education effortsCoronary artery diseaseAmputation rateHospital mortalityImportant comorbidityDiabetic statusOverall cohortSecondary outcomesArtery diseaseHospital admissionPrimary outcomeHospitalization incidenceU.S. hospitalizationsDiagnosis codesInpatient SampleHigher oddsAdmission seasonHealthcare costsMortality rateImpact of Kidney Disease on Peripheral Arterial Interventions: A Systematic Review and Meta-Analysis
Anantha-Narayanan M, Sheikh AB, Nagpal S, Smolderen KG, Turner J, Schneider M, Llanos-Chea F, Mena-Hurtado C. Impact of Kidney Disease on Peripheral Arterial Interventions: A Systematic Review and Meta-Analysis. American Journal Of Nephrology 2020, 51: 527-533. PMID: 32570255, DOI: 10.1159/000508575.Peer-Reviewed Original ResearchConceptsCKD/ESRDCritical limb ischemiaPAD interventionsMajor amputationEarly mortalitySystematic reviewCKD/ESRD patientsPeripheral arterial disease interventionsHigher major amputationOutcomes of patientsPeripheral arterial interventionsSuch comorbid conditionsESRD patientsLimb ischemiaArterial interventionsComorbid conditionsRandomized trialsKidney diseasePatient populationESRDObservational studyRisk populationsFunnel plotPatientsMeta-Analysis
2019
Review of the Current Basic Science Strategies to Treat Critical Limb Ischemia
Haghighat L, Ionescu CN, Regan CJ, Altin SE, Attaran RR, Mena-Hurtado CI. Review of the Current Basic Science Strategies to Treat Critical Limb Ischemia. Vascular And Endovascular Surgery 2019, 53: 316-324. PMID: 30808262, DOI: 10.1177/1538574419831489.Peer-Reviewed Original ResearchConceptsCritical limb ischemiaLimb ischemiaDevelopment of CLIMolecular therapyPoor surgical candidatesImpairment of angiogenesisSurgical candidatesMicrovascular changesNovel imaging modalityTreatment optionsMorbid diseaseTranslational medicine studiesTherapyMedicine studiesImaging modalitiesIschemiaDiseasePatientsPathophysiologyArteriogenesisImpairmentTrialsMultidisciplinary Care for Critical Limb Ischemia: Current Gaps and Opportunities for Improvement
Armstrong EJ, Alam S, Henao S, Lee AC, DeRubertis BG, Montero-Baker M, Mena C, Cua B, Palena LM, Kovach R, Chandra V, AlMahameed A, Walker CM. Multidisciplinary Care for Critical Limb Ischemia: Current Gaps and Opportunities for Improvement. Journal Of Endovascular Therapy 2019, 26: 199-212. PMID: 30706755, DOI: 10.1177/1526602819826593.Peer-Reviewed Original ResearchConceptsCritical limb ischemiaCare of patientsComplex patient populationMultidisciplinary careLimb ischemiaPatient populationIschemic rest painLimb-related morbidityPeripheral artery diseaseFacets of careRest painArterial insufficiencyRevascularization strategyArtery diseaseTimely referralSingle medical specialtyOptimal treatmentPatient outcomesSocietal guidelinesWound careTreatment teamMultiple specialtiesPatientsCareMedical specialties
2018
Radiotracer Imaging Allows for Noninvasive Detection and Quantification of Abnormalities in Angiosome Foot Perfusion in Diabetic Patients With Critical Limb Ischemia and Nonhealing Wounds
Alvelo JL, Papademetris X, Mena-Hurtado C, Jeon S, Sumpio BE, Sinusas AJ, Stacy MR. Radiotracer Imaging Allows for Noninvasive Detection and Quantification of Abnormalities in Angiosome Foot Perfusion in Diabetic Patients With Critical Limb Ischemia and Nonhealing Wounds. Circulation Cardiovascular Imaging 2018, 11: e006932. PMID: 29748311, PMCID: PMC5951395, DOI: 10.1161/circimaging.117.006932.Peer-Reviewed Original ResearchMeSH KeywordsAnkle Brachial IndexCase-Control StudiesCritical IllnessDiabetic FootHumansIschemiaMicrocirculationOrganophosphorus CompoundsOrganotechnetium CompoundsPerfusion ImagingPredictive Value of TestsRadiopharmaceuticalsRegional Blood FlowSingle Photon Emission Computed Tomography Computed TomographyWound HealingConceptsCritical limb ischemiaAnkle-brachial indexStandardized uptake valueSPECT/CT imagingDiabetic patientsHealthy subjectsSPECT/CTFoot perfusionUptake valueLimb ischemiaMicrovascular perfusionSkeletal muscle microvascular perfusionCT imagingDiabetic CLI patientsMuscle microvascular perfusionPeripheral artery diseaseSingle photon emissionIntraclass correlation coefficientAngiosome perfusionCLI subjectsCLI patientsArtery diseaseDiabetes mellitusCT perfusionVascular territoriesAcute Limb Ischemia in an 8-Year-Old Patient: A Case Report
Erben Y, Miller SM, Sumpio BJ, Dillon BJ, Lee AI, Blume P, Sumpio BE, Mena-Hurtado C. Acute Limb Ischemia in an 8-Year-Old Patient: A Case Report. Annals Of Vascular Surgery 2018, 51: 327.e1-327.e8. PMID: 29655809, DOI: 10.1016/j.avsg.2018.02.012.Peer-Reviewed Original ResearchConceptsAnkle-brachial indexNormal ankle-brachial indexRight foot painAcute limb ischemiaLower extremity angiographyLeg length discrepancyFoot insertsIntermittent painIntravenous heparinFoot painLimb ischemiaOlder patientsNephrotic syndromeEmergency departmentPhysical examinationCapillary refillCase reportLength discrepancyLeft footPatient's motherPatientsPainMothersFootFasciotomy