Featured Publications
Guideline-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 dataInter-Rater Reliability for the Amputation Endpoint in the National Vascular Quality Initiative
Smolderen K, Romain G, Scierka L, Cleman J, Rahman M, Siddiqui W, Lau F, Mao J, Akhlaghi N, Higaki A, Fowler X, Carroll M, Telma K, Alvermann T, Baribeau V, Goodney P, Mena-Hurtado C. Inter-Rater Reliability for the Amputation Endpoint in the National Vascular Quality Initiative. JACC Cardiovascular Interventions 2024, 17: 622-631. PMID: 38479964, DOI: 10.1016/j.jcin.2024.01.003.Peer-Reviewed Original ResearchConceptsElectronic health recordsElectronic health record reviewAmputation dataPeripheral arterial diseaseInterrater reliabilityVQI registryAcademic health systemTrained data collectorsNational quality registryInter-rater reliabilityEvaluate interrater reliabilityNational reporting systemHealth recordsQuality registryHealth systemCurrent Procedural Terminology codesInter-raterVascular Quality Initiative registryVascular Quality InitiativeProcedural Terminology codesNational Vascular Quality InitiativeRegistryQuality InitiativeAmputationSpearman's r
2024
Combining electronic health records data from a clinical research network with registry data to examine long-term outcomes of interventions and devices: an observational cohort study
Mao J, Matheny M, Smolderen K, Mena-Hurtado C, Sedrakyan A, Goodney P. Combining electronic health records data from a clinical research network with registry data to examine long-term outcomes of interventions and devices: an observational cohort study. BMJ Open 2024, 14: e085806. PMID: 39327057, PMCID: PMC11429269, DOI: 10.1136/bmjopen-2024-085806.Peer-Reviewed Original ResearchConceptsElectronic health recordsElectronic health record dataClinical Research NetworkAmputation-free survivalPeripheral vascular interventionsResearch NetworkINSIGHT Clinical Research NetworkNew York CityHealth record dataIncreased riskLong-term outcomes of interventionsSecondary outcome measuresOutcomes of interventionsIncreased risk of deathYork CityRisk of deathObservational cohort studyHealth recordsRegistry dataClinical registryVascular Quality Initiative registryCohort studyOutcome assessmentRecord dataLong-term outcomes
2022
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
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 reinterventionsStatins and statin intensity in peripheral artery disease.
Sagris M, Katsaros I, Giannopoulos S, Rosenberg RD, Altin SE, Rallidis L, Mena-Hurtado C, Armstrong EJ, Kokkinidis DG. Statins and statin intensity in peripheral artery disease. Vasa 2022, 51: 198-211. PMID: 35673949, DOI: 10.1024/0301-1526/a001012.Peer-Reviewed Original ResearchMeSH KeywordsAmputation, SurgicalHumansHydroxymethylglutaryl-CoA Reductase InhibitorsLower ExtremityPeripheral Arterial DiseaseRisk FactorsTreatment OutcomeConceptsMajor adverse cardiovascular eventsPeripheral artery diseaseLow-intensity statinsLoss of patencyStatin useStatin doseIntensity statinsArtery diseaseFirst-line lipid-lowering therapyAdverse cardiovascular eventsAmputation-free survivalHigher statin doseLipid-lowering therapyMyocardial infarction rateRisk of amputationImpact of statinsStatin intensityCardiovascular eventsPAD patientsCardiovascular deathCardiovascular mortalityCause mortalityInfarction rateIschemia patientsStatin treatmentVariability 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
Contemporary 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
Outcomes of treatment with paclitaxel-coated devices for peripheral arterial disease
Kim TI, Kiwan G, Mohamedali A, Zhang Y, Mena-Hurtado C, Mojibian H, Guzman RJ, Ochoa Chaar CI. Outcomes of treatment with paclitaxel-coated devices for peripheral arterial disease. Journal Of Vascular Surgery 2020, 73: 911-917. PMID: 33038480, DOI: 10.1016/j.jvs.2020.08.146.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAmputation, SurgicalCardiovascular AgentsCoated Materials, BiocompatibleDrug-Eluting StentsEndovascular ProceduresFemaleHumansLimb SalvageMaleMiddle AgedPaclitaxelPeripheral Arterial DiseaseProsthesis DesignRetreatmentRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeVascular PatencyConceptsPaclitaxel-coated devicesPeripheral artery diseaseCause of mortalityPCD useRisk of mortalityCumulative doseFemoropopliteal peripheral artery diseaseKaplan-Meier survival curvesLong-term mortalityPeripheral arterial diseaseCox regression analysisDrug-coated balloonsOutcome of treatmentDrug-eluting stentsMajor amputationPrimary patencyReintervention rateArtery diseaseArterial diseaseRandomized trialsOpen surgeryPresent studySingle institutionEndovascular interventionPatientsSeasonal 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-AnalysisUtility 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
2019
Drug‐coated balloon versus plain old balloon angioplasty in femoropopliteal disease: An updated meta‐analysis of randomized controlled trials
Anantha‐Narayanan M, Shah SM, Jelani Q, Garcia S, Ionescu C, Regan C, Mena‐Hurtado C. Drug‐coated balloon versus plain old balloon angioplasty in femoropopliteal disease: An updated meta‐analysis of randomized controlled trials. Catheterization And Cardiovascular Interventions 2019, 94: 139-148. PMID: 30838719, DOI: 10.1002/ccd.28176.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmputation, SurgicalAngioplasty, BalloonCardiovascular AgentsCoated Materials, BiocompatibleEquipment DesignFemaleFemoral ArteryHumansLimb SalvageMalePeripheral Arterial DiseasePopliteal ArteryRandomized Controlled Trials as TopicRisk FactorsTreatment OutcomeVascular Access DevicesVascular PatencyConceptsTarget vessel revascularizationPeripheral arterial diseaseFemoropopliteal diseaseBalloon angioplastyRate of TVRDrug-coated balloon angioplastyPlain old balloon angioplastyAvailable RCT dataDevice-related mortalityImproved vessel patencyPrimary safety endpointMainstay of therapyCochrane's Q statisticLate lumen lossDrug-coated balloonsRandom-effects modelQ statisticMajor amputationSafety endpointVessel revascularizationDCB groupPopliteal arteryArterial diseaseUse of DCBLumen lossMultidisciplinary 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
Acute 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
2017
Management of Isolated Atherosclerotic Stenosis of the Common Femoral Artery: A Review of the Literature
Halpin D, Erben Y, Jayasuriya S, Cua B, Jhamnani S, Mena-Hurtado C. Management of Isolated Atherosclerotic Stenosis of the Common Femoral Artery: A Review of the Literature. Vascular And Endovascular Surgery 2017, 51: 220-227. PMID: 28376704, DOI: 10.1177/1538574417702773.Peer-Reviewed Original ResearchConceptsCommon femoral endarterectomyTarget lesion revascularizationCommon femoral arteryCFA stenosisEndovascular therapyEndovascular studiesPrimary patencyAtherosclerotic stenosisTechnical successEndovascular interventionFemoral arteryGood short-term patencyFurther trial dataFirst-line therapyPercentage of patientsCritical limb ischemiaStandard of careNumber of patientsShort-term patencyLower ratesHigh rateEndovascular literatureFemoropopliteal systemLesion revascularizationLimb ischemia
2016
Impact of Glycoprotein IIb/IIIa Inhibitors Use on Outcomes After Lower Extremity Endovascular Interventions From Nationwide Inpatient Sample (2006–2011)
Arora S, Panaich SS, Patel N, Patel NJ, Lahewala S, Thakkar B, Savani C, Jhamnani S, Singh V, Patel N, Patel S, Sonani R, Patel A, Tripathi B, Deshmukh A, Chothani A, Patel J, Bhatt P, Mohamad T, Remetz MS, Curtis JP, Attaran RR, Mena CI, Schreiber T, Grines C, Cleman M, Forrest JK, Badheka AO. Impact of Glycoprotein IIb/IIIa Inhibitors Use on Outcomes After Lower Extremity Endovascular Interventions From Nationwide Inpatient Sample (2006–2011). Catheterization And Cardiovascular Interventions 2016, 88: 605-616. PMID: 26914274, DOI: 10.1002/ccd.26452.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAmputation, SurgicalCross-Sectional StudiesDatabases, FactualDrug CostsEndovascular ProceduresFemaleHospital CostsHospital MortalityHumansLimb SalvageLogistic ModelsLower ExtremityMaleMiddle AgedMultivariate AnalysisOdds RatioPeripheral Arterial DiseasePlatelet Aggregation InhibitorsPlatelet Glycoprotein GPIIb-IIIa ComplexPropensity ScoreRisk FactorsTime FactorsTreatment OutcomeUnited StatesYoung AdultConceptsGlycoprotein IIb/IIIa inhibitorsPeripheral endovascular interventionsHospital mortalityHospitalization costsEndovascular interventionGPI useAmputation rateUtilization Project Nationwide Inpatient Sample databaseTwo-level hierarchical multivariateIIb/IIIa inhibitorsNationwide Inpatient Sample databaseLower amputation ratesPaucity of dataHospital outcomesPostprocedural complicationsSecondary outcomesPropensity matchingStudy cohortHealthcare costsICD-9Multivariate analysisStudy outcomesSample databaseMortalityHierarchical multivariate
2015
Intravascular Ultrasound in Lower Extremity Peripheral Vascular Interventions
Panaich SS, Arora S, Patel N, Patel NJ, Savani C, Patel A, Thakkar B, Singh V, Patel S, Patel N, Agnihotri K, Bhatt P, Deshmukh A, Gupta V, Attaran RR, Mena CI, Grines CL, Cleman M, Forrest JK, Badheka AO. Intravascular Ultrasound in Lower Extremity Peripheral Vascular Interventions. Journal Of Endovascular Therapy 2015, 23: 65-75. PMID: 26637836, DOI: 10.1177/1526602815620780.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAmputation, SurgicalChi-Square DistributionCost-Benefit AnalysisDatabases, FactualEndovascular ProceduresFemaleHospital CostsHospital MortalityHumansLimb SalvageLinear ModelsLower ExtremityMaleMiddle AgedMultivariate AnalysisOdds RatioPeripheral Vascular DiseasesPractice Patterns, Physicians'Risk FactorsTime FactorsTreatment OutcomeUltrasonography, InterventionalUnited StatesYoung AdultConceptsLower limb endovascular interventionsPostprocedural complicationsHospitalization costsEndovascular interventionHospital mortalityAmputation rateOdds ratioNonsignificant increaseUtilization Project Nationwide Inpatient Sample databaseTwo-level hierarchical multivariateICD-9 procedure codesNationwide Inpatient Sample databasePeripheral vascular proceduresCo-primary outcomesLower amputation ratesPeripheral vascular interventionsPeripheral endovascular interventionsConfidence intervalsIVUS useIVUS utilizationSecondary outcomesStudy cohortVascular proceduresVascular interventionsHealthcare costs
2014
Randomized Controlled Study of Excimer Laser Atherectomy for Treatment of Femoropopliteal In-Stent Restenosis Initial Results From the EXCITE ISR Trial (EXCImer Laser Randomized Controlled Study for Treatment of FemoropopliTEal In-Stent Restenosis)
Dippel EJ, Makam P, Kovach R, George JC, Patlola R, Metzger DC, Mena-Hurtado C, Beasley R, Soukas P, Colon-Hernandez PJ, Stark MA, Walker C, Investigators E. Randomized Controlled Study of Excimer Laser Atherectomy for Treatment of Femoropopliteal In-Stent Restenosis Initial Results From the EXCITE ISR Trial (EXCImer Laser Randomized Controlled Study for Treatment of FemoropopliTEal In-Stent Restenosis). JACC Cardiovascular Interventions 2014, 8: 92-101. PMID: 25499305, DOI: 10.1016/j.jcin.2014.09.009.Peer-Reviewed Original ResearchMeSH KeywordsAgedAlloysAmputation, SurgicalAngioplasty, BalloonAtherectomyChronic DiseaseCombined Modality TherapyConstriction, PathologicFemaleFemoral ArteryHumansLaser TherapyLasers, ExcimerLimb SalvageMaleMiddle AgedPeripheral Arterial DiseasePopliteal ArteryProspective StudiesProsthesis DesignRecurrenceStentsTime FactorsTreatment OutcomeUnited StatesVascular PatencyConceptsPercutaneous transluminal angioplastyTarget lesion revascularizationExcimer laser atherectomyLaser atherectomyAdjunctive percutaneous transluminal angioplastyMajor adverse event rateChronic peripheral artery diseaseLesion lengthLifestyle-limiting claudicationPrimary safety endpointRutherford class 1Target lesion lengthPrimary efficacy endpointMajor adverse eventsPeripheral artery diseaseAdverse event ratesCritical limb ischemiaFemoropopliteal ISRLesion revascularizationEfficacy endpointSafety endpointAdverse eventsLimb ischemiaTransluminal angioplastyArtery disease