2024
Long‐Term Mortality Predictors Using a Machine‐Learning Approach in Patients With Chronic Limb‐Threatening Ischemia After Peripheral Vascular Intervention
Callegari S, Romain G, Cleman J, Scierka L, Jacque F, Smolderen K, Mena‐Hurtado C. Long‐Term Mortality Predictors Using a Machine‐Learning Approach in Patients With Chronic Limb‐Threatening Ischemia After Peripheral Vascular Intervention. Journal Of The American Heart Association 2024, 13: e034477. PMID: 38761075, PMCID: PMC11179837, DOI: 10.1161/jaha.124.034477.Peer-Reviewed Original ResearchConceptsChronic limb-threatening ischemiaPeripheral vascular interventionsHealth careLimb-threatening ischemiaMortality predictorsLong-term mortality riskMultidimensional risk factorsBody mass indexLong-term mortality predictorsImprove individualized careVascular interventionsIndividualized careAssisted careBiopsychosocial modelMortality riskCareMass indexRisk factorsMedical comorbiditiesRisk profileInterventionMortality rateChronic kidney diseaseMortalityPredictive variablesClinician perspectives regarding CYP2C19 genotype testing in patients with critical limb ischemia: A Delphi approach.
Regan C, Scierka L, Dardik A, Tonnessen B, Iyad Ochoa Chaar C, Ionescu C, Aboian E, Cardella J, Nassiri N, Guzman R, Attaran R, Nagpal S, Shah S, Smolderen K, Mena-Hurtado C. Clinician perspectives regarding CYP2C19 genotype testing in patients with critical limb ischemia: A Delphi approach. Vascular 2024, 17085381241246318. PMID: 38669051, DOI: 10.1177/17085381241246318.Peer-Reviewed Original ResearchDual antiplatelet therapyPeripheral arterial diseaseCYP2C19 testingCYP2C19 mutationsHeterogeneity of treatment effectsPeripheral vascular interventionsConsensus statementKnowledge questionsAntiplatelet therapyGenetic testingVascular surgeryAcademic health systemBarriers to implementationInterquartile rangeCYP2C19 genotype testingVascular diseaseInterventional cardiologyModified Delphi methodPatient's metabolic statusManagement of patientsCritical limb ischemiaPerceived barriersPeripheral vascular diseaseArterial vascular diseaseClinician perspectivesComparison of mortality and amputation after lower extremity bypass versus peripheral vascular intervention in patients with chronic limb-threatening ischemia and comorbid chronic kidney disease
Cleman J, Sierra J, Romain G, Capuano B, Scierka L, Callegari S, Jacque F, Peri-Okonny P, Nagpal S, Smolderen K, Mena-Hurtado C. Comparison of mortality and amputation after lower extremity bypass versus peripheral vascular intervention in patients with chronic limb-threatening ischemia and comorbid chronic kidney disease. Journal Of Vascular Surgery 2024, 80: 480-489.e5. PMID: 38608966, DOI: 10.1016/j.jvs.2024.04.016.Peer-Reviewed Original ResearchChronic limb-threatening ischemiaAll-cause mortalityLower extremity bypassPeripheral vascular interventionsComorbid chronic kidney diseaseLimb-threatening ischemiaComparison of mortalityPreference-sensitive treatment decisionsCox proportional hazards modelsRisk of deathInteraction termsProportional hazards modelLower-extremity bypassChronic kidney diseaseFine-Gray modelMortality riskVascular interventionsAmputationHazards modelOutcome dataFine-GrayAssociated with worse outcomesHigh riskKidney diseasePropensity scoreASSOCIATION BETWEEN CHRONIC PAIN DISORDERS IN CHRONIC LIMB THREATENING ISCHEMIA AND 30-DAY, 90-DAY AMPUTATION RISK FOLLOWING PERIPHERAL VASCULAR INTERVENTIONS
Nandigam M, Romain G, Callegari S, Cuppen S, Mares A, Hurtado C, Smolderen K. ASSOCIATION BETWEEN CHRONIC PAIN DISORDERS IN CHRONIC LIMB THREATENING ISCHEMIA AND 30-DAY, 90-DAY AMPUTATION RISK FOLLOWING PERIPHERAL VASCULAR INTERVENTIONS. Journal Of The American College Of Cardiology 2024, 83: 2307. DOI: 10.1016/s0735-1097(24)04297-9.Peer-Reviewed Original ResearchINSTITUTIONAL AND OPERATOR VARIABILITY OF IMAGING SURVEILLANCE WITHIN ONE YEAR FOLLOWING PERIPHERAL VASCULAR INTERVENTIONS FOR CHRONIC LIMB-THREATENING ISCHEMIA
Knight D, Romain G, Cleman J, Peri-Okonny P, Callegari S, Jacque F, Smolderen K, Hurtado C. INSTITUTIONAL AND OPERATOR VARIABILITY OF IMAGING SURVEILLANCE WITHIN ONE YEAR FOLLOWING PERIPHERAL VASCULAR INTERVENTIONS FOR CHRONIC LIMB-THREATENING ISCHEMIA. Journal Of The American College Of Cardiology 2024, 83: 960. DOI: 10.1016/s0735-1097(24)02950-4.Peer-Reviewed Original ResearchPATIENT'S CHARACTERISTICS ASSOCIATED WITH AN IMPROVEMENT OF HEALTH STATUS QUALITY OF LIFE-RELATED AT 1 YEAR FOLLOWING PERIPHERAL VASCULAR INTERVENTIONS
Romain G, Peri-Okonny P, Cleman J, Callegari S, Jacque F, Smolderen K, Hurtado C. PATIENT'S CHARACTERISTICS ASSOCIATED WITH AN IMPROVEMENT OF HEALTH STATUS QUALITY OF LIFE-RELATED AT 1 YEAR FOLLOWING PERIPHERAL VASCULAR INTERVENTIONS. Journal Of The American College Of Cardiology 2024, 83: 2306. DOI: 10.1016/s0735-1097(24)04296-7.Peer-Reviewed Original ResearchPeripheral vascular interventionsCharacteristic associationsLife-relatedVascular interventionsHealthInterventionAssociationEvaluation of short-term mortality in patients with Medicare undergoing endovascular interventions for chronic limb-threatening ischemia
Cleman J, Romain G, Callegari S, Scierka L, Jacque F, Smolderen K, Mena-Hurtado C. Evaluation of short-term mortality in patients with Medicare undergoing endovascular interventions for chronic limb-threatening ischemia. Vascular Medicine 2024, 29: 172-181. PMID: 38334045, DOI: 10.1177/1358863x231224335.Peer-Reviewed Original ResearchChronic limb-threatening ischemiaPeripheral vascular interventionsAssisted careLimb-threatening ischemiaCongestive heart failureFunctional status variablesCrude mortality ratePredictive variablesMortality rateStatus variablesRandom survival forest modelShort-term mortalityStage 5 chronic kidney diseaseQuality InitiativeRandom survival forestTreatment conversionMedical comorbiditiesShort-term outcomesHarrell's C-indexVascular Quality InitiativeCareDementiaInterventionMortalityRisk stratificationVariability in guideline-directed medical therapy across sites and operators and long-term mortality and amputation outcomes risk in patients undergoing peripheral vascular interventions
Smolderen K, Romain G, Cleman J, Scierka L, Mena-Hurtado C. Variability in guideline-directed medical therapy across sites and operators and long-term mortality and amputation outcomes risk in patients undergoing peripheral vascular interventions. American Heart Journal 2024, 270: 75-85. PMID: 38307364, DOI: 10.1016/j.ahj.2024.01.008.Peer-Reviewed Original ResearchMedian odds ratioGuideline-directed medical therapy prescriptionGuideline-directed medical therapy ratesPeripheral vascular interventionsGuideline-directed medical therapyIntraclass correlationHealth system levelDecrease hospital readmissionsPatient-level factorsGuideline-directed medical therapy useAssociated with higher riskAngiotensin-converting enzyme inhibitor/angiotensin receptor blockerRisk of deathParametric survival modelsInhibitor/angiotensin receptor blockerProportion of riskHospital readmissionVascular Quality Initiative registryLong-term mortalityOdds ratioReadmission riskVascular interventionsLogistic regressionDose-response relationshipAmputation
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 groupsCommunity distress and risk of adverse outcomes after peripheral vascular intervention
Schenck C, Strand E, Smolderen K, Romain G, Nagpal S, Cleman J, Blume P, Mena-Hurtado C. Community distress and risk of adverse outcomes after peripheral vascular intervention. Journal Of Vascular Surgery 2023, 78: 166-174.e3. PMID: 36944389, PMCID: PMC11146282, DOI: 10.1016/j.jvs.2023.03.027.Peer-Reviewed Original ResearchConceptsPeripheral vascular interventionsDistressed Communities IndexMajor amputationRisk of mortalityAdverse outcomesVascular interventionsVascular Quality Initiative databaseDCI scoresCommunity distressCox regression modelTime-dependent receiverCharacteristic curve analysisClinical characteristicsFinal cohortPrimary outcomeClinical outcomesCardiovascular diseasePatientsAmputationZip code dataMortalityRisk categoriesCurve analysisInitiative databaseOutcomesGuideline-Directed Medical Therapy and Long-Term Mortality and Amputation Outcomes in Patients Undergoing Peripheral Vascular Interventions
Smolderen K, Romain G, Provance J, Scierka L, Mao J, Goodney P, Henke P, Sedrakyan A, Mena-Hurtado C. Guideline-Directed Medical Therapy and Long-Term Mortality and Amputation Outcomes in Patients Undergoing Peripheral Vascular Interventions. JACC Cardiovascular Interventions 2023, 16: 332-343. PMID: 36792257, PMCID: PMC10359106, DOI: 10.1016/j.jcin.2022.09.022.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyPeripheral vascular interventionsMedical therapyVascular interventionsEnzyme inhibitors/angiotensin receptor blockersVascular Quality Initiative registryAngiotensin receptor blockersLong-term mortalityRisk of amputationRisk of mortalityNational quality registryQuality improvement effortsAmputation outcomesAmputation riskMajor amputationAntiplatelet therapyCause mortalityReceptor blockersMean ageVascular careQuality registryObservational studyMortality riskHigh riskAmputation data
2022
Real‐world VASCADE closure device versus manual compression use and outcomes in patients with severe common femoral artery disease
Nagpal S, Scierka LE, Castro‐Dominguez Y, Kansal D, Kunnirickal S, Hussain Y, Love K, Aboian E, Smolderen KG, Mena‐Hurtado C. Real‐world VASCADE closure device versus manual compression use and outcomes in patients with severe common femoral artery disease. Catheterization And Cardiovascular Interventions 2022, 100: 776-784. PMID: 36129818, DOI: 10.1002/ccd.30405.Peer-Reviewed Original ResearchConceptsPeripheral vascular interventionsManual compressionClosure deviceCommon femoral artery diseaseVascular Quality Initiative databaseFemoral artery diseasePropensity-matched cohortPseudoaneurysm rateRetroperitoneal bleedingArtery diseaseRetrospective reviewMean ageBaseline variablesInstitutional databaseNonsignificant reductionNonsignificant decreaseVascular interventionsMortality ratePatientsCompression useCollagen plugDiseaseInitiative databaseProcedural metricsDevice useVariability 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 strategiesPeripheral Artery Disease Screening in the Community and 1-Year Mortality, Cardiovascular Events, and Adverse Limb Events
Smolderen K, Ameli O, Chaisson C, Heath K, Mena-Hurtado C. Peripheral Artery Disease Screening in the Community and 1-Year Mortality, Cardiovascular Events, and Adverse Limb Events. AJPM Focus 2022, 1: 100016. PMID: 37791014, PMCID: PMC10546509, DOI: 10.1016/j.focus.2022.100016.Peer-Reviewed Original ResearchMajor adverse limb eventsPeripheral artery diseaseAdverse limb eventsMajor cardiovascular eventsPeripheral artery disease (PAD) screeningArtery diseaseCardiovascular eventsLimb eventsCause mortalityOne-yearDisease screeningPeripheral vascular interventionsCardiovascular risk managementCause mortality ratesHome health visitsMedicare Advantage beneficiariesCardiovascular medicationsHealth visitsRevascularization proceduresHealthcare utilizationLandmark analysisSimilar riskVascular interventionsClaims dataMortality rateVariability 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 codes
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 managementReal-world antithrombotic treatment variability in patients undergoing peripheral vascular intervention: Insights from the VQI registry
Lee M, Ahmed ZV, Huang J, Jelani QU, Aboian E, Peri-Okonny PA, Smolderen KG, Mena-Hurtado C. Real-world antithrombotic treatment variability in patients undergoing peripheral vascular intervention: Insights from the VQI registry. American Heart Journal 2021, 244: 31-35. PMID: 34688650, DOI: 10.1016/j.ahj.2021.10.186.Peer-Reviewed Original ResearchConceptsPeripheral vascular interventionsDual antiplatelet therapySingle antiplatelet therapyAntiplatelet therapyVascular interventionsOptimal medical therapyNew trial dataAntithrombotic prescriptionMedical therapyPrescription ratesProvider factorsVQI registryTrial dataTherapyHealth systemPatientsTreatment variabilityPractice levelInterventionHigh levelsRegistryPhysiciansREAL-WORLD ANTITHROMBOTIC TREATMENT REGIMENS IN PATIENTS UNDERGOING PERIPHERAL VASCULAR INTERVENTION: INSIGHTS FROM THE VQI REGISTRY
Lee M, Ahmed Z, Huang J, Jelani Q, Aboian E, Peri-Okonny P, Smolderen K. REAL-WORLD ANTITHROMBOTIC TREATMENT REGIMENS IN PATIENTS UNDERGOING PERIPHERAL VASCULAR INTERVENTION: INSIGHTS FROM THE VQI REGISTRY. Journal Of The American College Of Cardiology 2021, 77: 1799. DOI: 10.1016/s0735-1097(21)03155-7.Peer-Reviewed Original ResearchAntithrombotic treatment regimensPeripheral vascular interventionsTreatment regimensVQI registryVascular interventionsRegimensPatientsRegistry
2020
Utility of Intravascular Ultrasound in Peripheral Vascular Interventions: Systematic Review and Meta-Analysis
Sheikh AB, Anantha-Narayanan M, Smolderen KG, Jelani QU, Nagpal S, Schneider M, Llanos F, Ionescu C, Regan C, Attaran R, Altin SE, Mena-Hurtado C. Utility of Intravascular Ultrasound in Peripheral Vascular Interventions: Systematic Review and Meta-Analysis. Vascular And Endovascular Surgery 2020, 54: 413-422. PMID: 32338163, DOI: 10.1177/1538574420920998.Peer-Reviewed Original ResearchConceptsPeripheral vascular interventionsPeriprocedural adverse eventsVascular complicationsAdverse eventsIntravascular ultrasoundPrimary patencyCause mortalityTechnical successMyocardial infarctionObservational studyVascular interventionsEnd pointSimilar patency ratesSimilar primary patencyPrimary end pointRate of reinterventionSecondary end pointsPeripheral arterial diseaseImproved clinical outcomesIVUS groupAmputation rateArterial diseaseClinical outcomesPatency ratesLower risk
2018
Depression and long-term prognostic outcomes following peripheral endovascular interventions in the VA Healthcare System
Smolderen KG, Plomondon ME, Armstrong EJ, Hess E, Waldo S, Tsai TT, Maddox TM. Depression and long-term prognostic outcomes following peripheral endovascular interventions in the VA Healthcare System. Vascular Medicine 2018, 23: 454-460. PMID: 29801427, DOI: 10.1177/1358863x18770275.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedChi-Square DistributionComorbidityDepressionEndovascular ProceduresFemaleHumansHypertensionKaplan-Meier EstimateMaleMiddle AgedMyocardial InfarctionPeripheral Arterial DiseaseProportional Hazards ModelsRetrospective StudiesRisk FactorsStrokeTime FactorsTreatment OutcomeUnited StatesUnited States Department of Veterans AffairsConceptsNon-fatal cardiovascular eventsPeripheral vascular interventionsCardiovascular eventsDiagnosis of depressionHazard ratioMedical recordsAge-adjusted hazard ratioLong-term prognostic outcomesNon-fatal cardiovascular outcomesPeripheral endovascular interventionsLong-term outcomesPatients' medical recordsVA healthcare systemVeterans Affairs centersCause deathCardiovascular outcomesConsecutive patientsAdditional covariatesEndovascular interventionRecent diagnosisPrognostic outcomesDepressed patientsDisease outcomeVascular interventionsHigh risk