2020
Hemodynamic events during carotid stenting are associated with significant periprocedural stroke and adverse events
Arhuidese I, Ottinger M, Shukla A, Moudgil N, Armstrong P, Illig K, Johnson B, Shames M. Hemodynamic events during carotid stenting are associated with significant periprocedural stroke and adverse events. Journal Of Vascular Surgery 2020, 71: 1941-1953.e1. PMID: 32085961, DOI: 10.1016/j.jvs.2019.05.056.Peer-Reviewed Original ResearchConceptsPeriprocedural strokePeriprocedural hypertensionHemodynamic eventsLength of stayCarotid symptomsPreprocedure medicationsMyocardial infarctionAngiotensin-converting enzyme inhibitorsCox regression analysisSymptomatic carotid diseaseVascular Quality InitiativePopulation-based cohortAssociated with significant increasesSusceptible patientsPeriprocedural outcomesBeta-blockersAdverse eventsKaplan-MeierComparing patientsCAS proceduresPeriprocedural hypotensionCardiac diseaseCarotid angioplastyCarotid stentingCarotid disease
2017
Concurrent renal artery stent during endovascular infrarenal aortic aneurysm repair confers higher risk for 30-day acute renal failure
Nejim B, Arhuidese I, Rizwan M, Khalil L, Locham S, Zarkowsky D, Goodney P, Malas M. Concurrent renal artery stent during endovascular infrarenal aortic aneurysm repair confers higher risk for 30-day acute renal failure. Journal Of Vascular Surgery 2017, 65: 1080-1088. PMID: 28222985, PMCID: PMC5960977, DOI: 10.1016/j.jvs.2016.10.112.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAgedAged, 80 and overAngioplastyAortic Aneurysm, AbdominalChi-Square DistributionEndovascular ProceduresFemaleHumansLogistic ModelsMaleMultivariate AnalysisOdds RatioRegistriesRenal Artery ObstructionRetrospective StudiesRisk AssessmentRisk FactorsStentsTime FactorsTreatment OutcomeUnited StatesConceptsInfrarenal abdominal aortic aneurysmAcute renal failureEndovascular aneurysm repairAbdominal aortic aneurysmGlomerular filtration rateRenal outcomesAneurysm repairRenal failureFiltration rateDevelopment of acute renal failureAmerican College of Surgeons National Surgical Quality Improvement ProgramPostoperative acute renal failureSurgeons National Surgical Quality Improvement ProgramInfrarenal aortic aneurysm repairNational Surgical Quality Improvement ProgramRuptured abdominal aortic aneurysmBaseline characteristics of patientsProportion of female patientsSurgical Quality Improvement ProgramMultivariate logistic regression analysisPerioperative renal outcomeAdverse renal outcomesAortic aneurysm repairRenal artery angioplastyProportion of patientsFixed and variable cost of carotid endarterectomy and stenting in the United States: A comparative study
Obeid T, Alshaikh H, Nejim B, Arhuidese I, Locham S, Malas M. Fixed and variable cost of carotid endarterectomy and stenting in the United States: A comparative study. Journal Of Vascular Surgery 2017, 65: 1398-1406.e1. PMID: 28216356, DOI: 10.1016/j.jvs.2016.11.062.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAngioplastyAsymptomatic DiseasesCarotid StenosisChi-Square DistributionDatabases, FactualDecision Support TechniquesEndarterectomy, CarotidFemaleHospital CostsHumansMaleMiddle AgedModels, EconomicPatient SelectionProcess Assessment, Health CarePropensity ScoreRetrospective StudiesStentsTime FactorsTreatment OutcomeUnited StatesConceptsCost of carotid artery stentingSymptomatic patientsHospital costsPropensity score matchingSymptomatic statusScore matchingPremier Perspective databaseCarotid artery stentingComorbidities of patientsStudent's t-testIn-hospital costsActual hospital costsAsymptomatic patientsSurgeon specialtyHospital characteristicsMale patientsCosts of carotid endarterectomyAsymptomatic cohortPerspective databaseArtery stentingPrimary outcomeCarotid endarterectomyPatientsClinical comorbiditiesHospital dischargeEndarterectomy versus stenting in patients with prior ipsilateral carotid artery stenting
Arhuidese I, Nejim B, Chavali S, Locham S, Obeid T, Hicks C, Malas M. Endarterectomy versus stenting in patients with prior ipsilateral carotid artery stenting. Journal Of Vascular Surgery 2017, 65: 1418-1428. PMID: 28190720, DOI: 10.1016/j.jvs.2016.11.041.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplastyCarotid StenosisChi-Square DistributionDatabases, FactualDisease-Free SurvivalEndarterectomy, CarotidFemaleHumansKaplan-Meier EstimateLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPatient SelectionProportional Hazards ModelsRecurrenceRetreatmentRetrospective StudiesRisk AssessmentRisk FactorsStentsTime FactorsTreatment OutcomeConceptsCohort of patientsCarotid endarterectomyIpsilateral CAIn-stent restenosisPerioperative stroke/deathAsymptomatic patientsMyocardial infarctionNo significant differenceVascular Quality Initiative (VQI) databaseTreatment of in-stent restenosisSignificant differenceComplication of carotid angioplastyCox regression analysisCompare carotid endarterectomyAdverse event ratesIncreased risk of strokeCarotid artery stentingOverall stroke rateRisk of strokeSymptomatic patientsIV statusPostoperative strokeCase seriesKaplan-MeierPatient characteristics
2016
Stenting versus endarterectomy after prior ipsilateral carotid endarterectomy
Arhuidese I, Obeid T, Nejim B, Locham S, Hicks C, Malas M. Stenting versus endarterectomy after prior ipsilateral carotid endarterectomy. Journal Of Vascular Surgery 2016, 65: 1-11. PMID: 27707617, DOI: 10.1016/j.jvs.2016.07.115.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplastyCarotid StenosisChi-Square DistributionCranial Nerve InjuriesDatabases, FactualEndarterectomy, CarotidFemaleHumansKaplan-Meier EstimateMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionPatient SelectionPropensity ScoreProportional Hazards ModelsRecurrenceReoperationRetrospective StudiesRisk FactorsStentsStrokeTime FactorsTreatment OutcomeUnited StatesConceptsIpsilateral CEACohort of patientsCarotid endarterectomyMyocardial infarctionPatient characteristicsOutcomes of carotid revascularizationVascular Quality Initiative (VQI) databaseSuperiority of carotid endarterectomyAssociated with high mortalityCranial nerve injuryIpsilateral carotid endarterectomyCompare patient characteristicsCox regression analysisRedo carotid endarterectomyIncreased risk of strokeAccess site complicationsPopulation-based studyPopulation-based evaluationRisk of strokeIpsilateral eventsAsymptomatic patientsSymptomatic patientsPeriprocedural periodPostoperative strokeCAS patientsCarotid Revascularization in Asymptomatic Patients after Renal Transplantation
Arhuidese I, Craig-Schapiro R, Obeid T, Nejim B, Hicks C, Malas M. Carotid Revascularization in Asymptomatic Patients after Renal Transplantation. Annals Of Vascular Surgery 2016, 38: 130-135. PMID: 27522968, DOI: 10.1016/j.avsg.2016.06.008.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplastyCarotid Artery DiseasesChi-Square DistributionEndarterectomy, CarotidFemaleHumansIncidenceKaplan-Meier EstimateKidney TransplantationLogistic ModelsMaleMiddle AgedMyocardial InfarctionOdds RatioPropensity ScoreProportional Hazards ModelsRetrospective StudiesRisk AssessmentRisk FactorsStentsStrokeTime FactorsTreatment OutcomeUnited StatesConceptsRenal transplant patientsCarotid artery stentingCox regression analysisTransplant patientsLong-term strokeCarotid endarterectomyCarotid revascularizationPerioperative strokeMyocardial infarctionRenal transplantationCarotid artery stenting cohortIncidence of perioperative complicationsCohort of renal transplant patientsChronic renal insufficiencyAssociated with increased riskAsymptomatic carotid artery stenosisRisk of periprocedural strokeRisk of perioperative strokeStroke-free survivalPropensity scoreSociety of Vascular SurgeryBaseline medical characteristicsUnited States Renal Data SystemBenefit of revascularizationCarotid artery stenosisOutcomes after carotid artery stenting in hemodialysis patients
Arhuidese I, Obeid T, Hicks C, Yin K, Canner J, Segev D, Malas M. Outcomes after carotid artery stenting in hemodialysis patients. Journal Of Vascular Surgery 2016, 63: 1511-1516. PMID: 27106247, DOI: 10.1016/j.jvs.2016.02.044.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAngioplastyCarotid Artery DiseasesChi-Square DistributionDatabases, FactualDisease-Free SurvivalFemaleHumansKidney DiseasesLogistic ModelsMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionPatient SelectionProportional Hazards ModelsRenal DialysisRetrospective StudiesRisk AssessmentRisk FactorsStentsStrokeTime FactorsTreatment OutcomeUnited StatesConceptsCarotid artery stentingHemodialysis patientsStudy of outcomesArtery stentingObservational study of outcomesCohort of hemodialysis patientsAsymptomatic dialysis patientsSingle-institution seriesMedian follow-upLong-term freedomPerceived poor outcomesLong-term outcomesPlanning carotid artery stentingLong-term survivalPopulation-based studyPredictors of strokeSymptomatic patientsPopulation-based study of outcomesPatient survivalRandomized studySymptomatic statusPoor outcomeFollow-upCox regressionDialysis patients
2015
Beta-blocker use is associated with lower stroke and death after carotid artery stenting
Obeid T, Arhuidese I, Gaidry A, Qazi U, Abularrage C, Goodney P, Cronenwett J, Malas M. Beta-blocker use is associated with lower stroke and death after carotid artery stenting. Journal Of Vascular Surgery 2015, 63: 363-369. PMID: 26526052, PMCID: PMC5292260, DOI: 10.1016/j.jvs.2015.08.108.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdrenergic beta-AntagonistsAdultAgedAged, 80 and overAngioplastyCarotid Artery DiseasesChi-Square DistributionDatabases, FactualFemaleHemodynamicsHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioProtective FactorsRetrospective StudiesRisk AssessmentRisk FactorsStentsStrokeTime FactorsTreatment OutcomeUnited StatesYoung AdultConceptsCarotid artery stentingBeta-blocker usePostprocedural hypertensionPostprocedural hypotensionBeta-blockersArtery stentingAssociated with postprocedural hypotensionEffect of preoperative medicationOutcomes of carotid artery stentingPredictors of postoperative strokeAssociated with lower strokeSelection of patientsMultivariate logistic regression modelDistal embolic protection useVascular Quality InitiativeMyocardial infarction rateGranular clinical dataMultiple controlled trialsPreoperative medicationsPostoperative strokeBeta blockersPeriprocedural stroke/deathStroke/death rateLogistic regression modelsStroke/death risk
2014
Design of the Revascularization With Open Bypass vs Angioplasty and Stenting of the Lower Extremity Trial (ROBUST): A Randomized Clinical Trial
Malas M, Qazi U, Glebova N, Arhuidese I, Reifsnyder T, Black J, Perler B, Freischlag J. Design of the Revascularization With Open Bypass vs Angioplasty and Stenting of the Lower Extremity Trial (ROBUST): A Randomized Clinical Trial. JAMA Surgery 2014, 149: 1289-1295. PMID: 25353642, DOI: 10.1001/jamasurg.2014.369.Peer-Reviewed Original ResearchConceptsReduce health care costsRandomized clinical trialsOpen bypassPercutaneous transluminal angioplastyCritical limb ischemiaHospital admission costsQuality-of-life questionnaireHealth care costsAnkle brachial indexQuality of lifeImprovement of quality of lifeEXTREME trialClinical trialsTransluminal angioplastyLimb ischemiaAmputation-free survivalTransAtlantic Inter-Society ConsensusCare costsRobust trialsFemoropopliteal bypassTASC II BSecondary aimAdmission costsBrachial indexSuperficial femoral artery lesionsSurgeon’s 30-Day Outcomes Supporting the Carotid Revascularization Endarterectomy versus Stenting Trial
Grimm J, Arhuidese I, Beaulieu R, Qazi U, Perler B, Freischlag J, Malas M. Surgeon’s 30-Day Outcomes Supporting the Carotid Revascularization Endarterectomy versus Stenting Trial. JAMA Surgery 2014, 149: 1314-1318. PMID: 25391047, DOI: 10.1001/jamasurg.2014.1762.Peer-Reviewed Original ResearchConceptsComposite major adverse eventsCarotid Revascularization Endarterectomy Versus Stenting TrialCarotid artery stentingMajor adverse eventsAdverse eventsRisk of strokeCarotid endarterectomyMyocardial infarctionVascular surgeonsTreatment modalitiesHigh-risk patient characteristicsRisk of myocardial infarctionRetrospective analysis of patientsPeriprocedural risk of strokeComposite adverse eventsImprove patient selectionAnalysis of patientsRates of myocardial infarctionIncidence of perioperative strokeFisher's exact testPeriprocedural stroke rateCarotid Revascularization EndarterectomyNo significant differencePeriprocedural riskPatient selectionRisk of Disease Progression in Patients with Moderate Asymptomatic Carotid Artery Stenosis: Implications of Tobacco Use and Dual Antiplatelet Therapy
Hicks C, Talbott K, Canner J, Qazi U, Arhuidese I, Glebova N, Freischlag J, Perler B, Malas M. Risk of Disease Progression in Patients with Moderate Asymptomatic Carotid Artery Stenosis: Implications of Tobacco Use and Dual Antiplatelet Therapy. Annals Of Vascular Surgery 2014, 29: 1-8. PMID: 24530720, DOI: 10.1016/j.avsg.2014.02.007.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplastyAsymptomatic DiseasesBaltimoreCarotid StenosisChi-Square DistributionDisease ProgressionDrug Therapy, CombinationEndarterectomy, CarotidFemaleHumansIncidenceIschemic Attack, TransientLinear ModelsMaleMultivariate AnalysisPlatelet Aggregation InhibitorsPredictive Value of TestsProportional Hazards ModelsRetrospective StudiesRisk FactorsSeverity of Illness IndexSmokingStentsStrokeTertiary Care CentersTime FactorsTreatment OutcomeUltrasonography, Doppler, DuplexConceptsProgression to severe stenosisAsymptomatic carotid artery stenosisDual antiplatelet therapyCarotid artery stenosisDisease progressionRisk factorsSevere stenosisIncidence of symptomsAntiplatelet therapyArtery stenosisPatient populationMean follow-up timeRisk of disease progressionSevere diseaseCox proportional hazards regression modelsRisk of progressionProportional hazards regression modelsFollow-up timeCarotid artery duplexAll-cause mortalityHazards regression modelsImproved medical therapyTransient ischemic attackTobacco useAsymptomatic carotid disease