2024
Open and Endovascular Treatment of the Common Femoral Artery in a Tertiary Care Center
Wells N, Hundito A, Tuttle M, Alameddine D, Aboian E, Arhuidese I, Fischer U, Perez Lozada J, Guzman R, Ochoa Chaar C. Open and Endovascular Treatment of the Common Femoral Artery in a Tertiary Care Center. Journal Of Vascular Surgery 2024 PMID: 39442735, DOI: 10.1016/j.jvs.2024.10.027.Peer-Reviewed Original ResearchLower extremity revascularizationTreated with open surgeryPeripheral arterial diseaseCFA endarterectomyEndovascular therapyOpen surgeryEndovascular treatmentEndovascular lower extremity revascularizationTreated with endovascular therapyCompared to open surgeryAssociated with higher perioperative complicationsLower extremity revascularization proceduresPost-operative bleedingFemoral arteryImprove patient selectionKaplan-Meier analysisTertiary care centerTertiary-care centerLong-term outcomesEndovascular treatment of peripheral arterial diseaseLonger hospital lengthMALE-free survivalMultivariate logistic regressionTreatment of peripheral arterial diseaseCommon femoral arteryThe Incidence and Impact of Cardiac Function Decline after Lower Extremity Revascularization
Jamil Y, Huttler J, Alameddine D, Wu Z, Mena-Hurtado C, Velazquez E, Guzman R, Ochoa Chaar C. The Incidence and Impact of Cardiac Function Decline after Lower Extremity Revascularization. Annals Of Vascular Surgery 2024 PMID: 39343374, DOI: 10.1016/j.avsg.2024.07.119.Peer-Reviewed Original ResearchCardiac functional declineStable cardiac functionLower extremity revascularizationPeripheral arterial diseaseCardiac functionFollow-upExtremity revascularizationFunctional declineElectronic records of patientsKaplan-Meier analysisRecords of patientsMode of revascularizationAdverse limb eventsLower-extremity revascularizationTransthoracic echocardiogramReintervention rateHeart failureDiabetes mellitusPeriprocedural bleedingPatient characteristicsArtery diseasePatientsLimb eventsIncreased mortalityRevascularizationThe Impact of Diabetes Mellitus on the Outcomes of Revascularization for Chronic Limb-Threatening Ischemia in the BEST-CLI trial
Ochoa Chaar C, Malas M, Doros G, Schermerhorn M, Conte M, Alameddine D, Siracuse J, Yadavalli S, Dake M, Creager M, Tan T, Rosenfield K, Menard M, Farber A, Hamdan A. The Impact of Diabetes Mellitus on the Outcomes of Revascularization for Chronic Limb-Threatening Ischemia in the BEST-CLI trial. Journal Of Vascular Surgery 2024 PMID: 39332785, DOI: 10.1016/j.jvs.2024.09.026.Peer-Reviewed Original ResearchChronic limb-threatening ischemiaAnkle amputationLower extremity revascularizationBEST-CLI trialBEST-CLILimb-threatening ischemiaAll-cause deathDiabetes mellitusChronic obstructive pulmonary diseaseImpact of diabetes mellitusImpact of DMObstructive pulmonary diseasePotential confoundersBest Surgical TherapyAnkleAdverse limb eventsToe pressureBest EndovascularAnkle pressureRenal diseaseAmputationObservational studyOptimal medical therapyOutcomes of patientsCompared to patientsPresentation and patterns of reinterventions after revascularization in patients with premature peripheral arterial disease
Sivakumar A, Satam K, Wu Z, Alameddine D, Aboian E, Chaer R, Schermerhorn M, Moreira C, Guzman R, Ochoa Chaar C. Presentation and patterns of reinterventions after revascularization in patients with premature peripheral arterial disease. Journal Of Vascular Surgery 2024, 80: 1776-1785.e1. PMID: 39002606, DOI: 10.1016/j.jvs.2024.07.021.Peer-Reviewed Original ResearchPremature peripheral arterial diseaseLower extremity revascularizationOlder patientsPeripheral arterial diseaseArtery diseaseRetrospective review of consecutive patientsReview of consecutive patientsDistressed Communities IndexAge of presentationFrequency of reinterventionsEnd-stage renal diseaseKaplan-Meier curvesOutcomes of lower extremity revascularizationLong-term outcomesCoronary artery diseaseMALE-free survivalAdverse limb eventsOverall survivalReintervention rateConsecutive patientsFrequent reinterventionsPerioperative complicationsRetrospective reviewNo significant differenceInstitutional experienceAnticoagulation in Patients with Premature Peripheral Artery Disease Undergoing Lower Extremity Revascularization
Kim T, DeWan A, Murray M, Wang H, Mani A, Mena-Hurtado C, Guzman R, Ochoa Chaar C. Anticoagulation in Patients with Premature Peripheral Artery Disease Undergoing Lower Extremity Revascularization. Annals Of Vascular Surgery 2024, 105: 150-157. PMID: 38593922, DOI: 10.1016/j.avsg.2024.02.006.Peer-Reviewed Original ResearchPremature peripheral arterial diseaseAntiplatelet therapyVascular Quality InitiativeArtery diseaseAdjunct to antiplatelet therapyReturn to the operating roomPost-operative anticoagulationCompared to patientsPostoperative antiplatelet therapyOne-year outcomesCongestive heart failureLower extremity revascularizationMajor adverse limb eventsCoronary artery diseaseEffects of anticoagulantsAmputation-free survivalEarly onset of diseaseAdverse limb eventsPeripheral vascular interventionsOnset of diseasePeripheral arterial diseaseLower-extremity revascularizationPropensity score matchingPerioperative mortalityBaseline characteristicsInsulin Requirement and Infrainguinal Bypass Outcomes in Patients with Peripheral Arterial Disease
Alameddine D, Satam K, Slade M, Wang H, Mena-Hurtado C, Turner J, Inzucchi S, Ochoa Chaar C. Insulin Requirement and Infrainguinal Bypass Outcomes in Patients with Peripheral Arterial Disease. Annals Of Vascular Surgery 2024, 102: 25-34. PMID: 38307234, DOI: 10.1016/j.avsg.2023.11.044.Peer-Reviewed Original ResearchInsulin-requiring diabetes mellitusPeripheral arterial diseaseDiabetes mellitusInfrainguinal bypassInsulin requirementsArtery diseaseRisk of MALEBypass surgeryImpact of insulin useRates of primary patencyVascular Quality Initiative databaseOutcomes of patientsPeripheral arterial bypass surgeryInfrainguinal bypass surgeryStratification of patientsCrude rateElevated hemoglobin A1cArtery bypass surgeryAssociation of DMChronic limb-threatening ischemiaIncreased risk of MALEVascular Quality InitiativeLower extremity revascularizationAdverse limb eventsLimb-threatening ischemia
2023
The Impact of Ejection Fraction on Major Adverse Limb Events after Lower Extremity Revascularization
Jamil Y, Huttler J, Alameddine D, Wu Z, Zhuo H, Mena-Hurtado C, Velazquez E, Guzman R, Ochoa Chaar C. The Impact of Ejection Fraction on Major Adverse Limb Events after Lower Extremity Revascularization. Annals Of Vascular Surgery 2023, 98: 210-219. PMID: 37802138, DOI: 10.1016/j.avsg.2023.08.009.Peer-Reviewed Original ResearchMajor adverse limb eventsReduced ejection fractionLower extremity revascularizationPeripheral arterial diseaseMALE-free survivalAdverse limb eventsCoronary artery diseaseEjection fractionExtremity revascularizationArtery diseaseLimb eventsChronic limb-threatening ischemiaLimb-threatening ischemiaTricuspid valve regurgitationKaplan-Meier curvesElectronic medical recordsMajor amputationSevere mitralDiastolic dysfunctionEchocardiographic findingsTransthoracic echocardiogramHeart failureValve regurgitationArterial diseaseSingle centerHigh-Risk Characteristics for Clinical Failure after Isolated Femoropopliteal Peripheral Vascular Interventions
Kim T, Schneider P, Iannuzzi J, Ochoa Chaar C. High-Risk Characteristics for Clinical Failure after Isolated Femoropopliteal Peripheral Vascular Interventions. Annals Of Vascular Surgery 2023, 96: 253-260. PMID: 37088359, DOI: 10.1016/j.avsg.2023.04.010.Peer-Reviewed Original ResearchConceptsPaclitaxel-coated devicesPeripheral vascular interventionsClinical failureHigh riskRisk scoreRest painVascular interventionsMultivariable hierarchical logistic regressionRisk score developmentPrimary end pointHigh-risk patientsVascular Quality InitiativeLower extremity revascularizationTrans-Atlantic InterInsulin-dependent diabetesNovel risk scoreHigh-risk characteristicsLoss of patencyHierarchical logistic regressionMajor amputationLate mortalityMinor amputationExtremity revascularizationOcclusion lengthFemale sex
2020
Multiple Reinterventions for Claudication are Associated with Progression to Chronic Limb-Threatening Ischemia
Kim TI, Kiwan G, Mohamedali A, Zhang Y, Dardik A, Guzman RJ, Ochoa Chaar CI. Multiple Reinterventions for Claudication are Associated with Progression to Chronic Limb-Threatening Ischemia. Annals Of Vascular Surgery 2020, 72: 166-174. PMID: 33227462, DOI: 10.1016/j.avsg.2020.10.004.Peer-Reviewed Original ResearchConceptsChronic limb-threatening ischemiaLower extremity revascularizationCongestive heart failureHeart failureOpen revascularizationMultiple reinterventionsSingle-center retrospective reviewChronic limb threatening ischemiaLimb threatening ischemiaLimb-threatening ischemiaNumber of reinterventionsLong-term outcomesMultivariable logistic regressionRate of progressionBenign natural historyIndex revascularizationMajor amputationRest painPerioperative complicationsExtremity revascularizationRetrospective reviewRisk factorsDisease progressionOpen procedureClaudicationLower Extremity Revascularization for Chronic Limb-Threatening Ischemia among Patients at the Extremes of Age
Kim TI, Aboian E, Fischer U, Zhang Y, Guzman RJ, Ochoa Chaar CI. Lower Extremity Revascularization for Chronic Limb-Threatening Ischemia among Patients at the Extremes of Age. Annals Of Vascular Surgery 2020, 72: 517-528. PMID: 32927042, DOI: 10.1016/j.avsg.2020.08.135.Peer-Reviewed Original ResearchMeSH KeywordsAge of OnsetAgedAged, 80 and overAgingAmputation, SurgicalChronic DiseaseDatabases, FactualEndovascular ProceduresFemaleHumansIschemiaLimb SalvageLower ExtremityMaleMiddle AgedPeripheral Arterial DiseaseRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeVascular Surgical ProceduresConceptsChronic limb-threatening ischemiaLower extremity revascularizationExtremes of ageRisk factor profileMajor amputationPatients 51Extremity revascularizationFactor profileDistinct risk factor profilesAge groupsChronic limb threatening ischemiaLimb threatening ischemiaLimb-threatening ischemiaMajor amputation ratePeripheral artery diseaseGroup of patientsInsulin-dependent diabetesExtreme age groupsSuprainguinal bypassAmputation rateElderly patientsInfrainguinal bypassActive smokersArtery diseaseMultivariable analysisDiscrepancy in Outcomes after Revascularization for Chronic Limb-Threatening Ischemia Warrants Separate Reporting of Rest Pain and Tissue Loss
Brahmandam A, Gholitabar N, Cardella J, Nassiri N, Dardik A, Georgi M, Ochoa Chaar CI. Discrepancy in Outcomes after Revascularization for Chronic Limb-Threatening Ischemia Warrants Separate Reporting of Rest Pain and Tissue Loss. Annals Of Vascular Surgery 2020, 70: 237-244. PMID: 32659417, DOI: 10.1016/j.avsg.2020.06.057.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmputation, SurgicalBenchmarkingChronic DiseaseComorbidityDatabases, FactualFemaleHospital MortalityHumansInpatientsIntermittent ClaudicationIschemiaMalePeripheral Arterial DiseaseQuality Indicators, Health CareRetrospective StudiesRisk AssessmentRisk FactorsTreatment OutcomeUnited StatesVascular Surgical ProceduresConceptsLower extremity revascularizationCharlson Comorbidity IndexRest painMajor amputationInpatient mortalityTissue lossEndovascular lower extremity revascularizationWorse short-term outcomesShort-term outcomesNational Inpatient SampleLength of stayMultivariable regression analysisComorbidity indexExtremity revascularizationPatient characteristicsMultivariable analysisInpatient SampleHigh comorbidityMean costPatientsAmputationMortalityTL groupOutcomesRevascularizationComparison of Atherectomy to Balloon Angioplasty and Stenting for Isolated Femoropopliteal Revascularization
Bai H, Fereydooni A, Zhuo H, Zhang Y, Tonnessen B, Guzman RJ, Ochoa Chaar CI. Comparison of Atherectomy to Balloon Angioplasty and Stenting for Isolated Femoropopliteal Revascularization. Annals Of Vascular Surgery 2020, 69: 261-273. PMID: 32512112, DOI: 10.1016/j.avsg.2020.05.019.Peer-Reviewed Original ResearchConceptsPercutaneous transluminal angioplastyMajor ipsilateral amputationIpsilateral amputationPrimary patencyDistal embolizationFemoropopliteal diseaseBalloon angioplastyTechnical successStatus improvementAnkle-brachial index improvementSignificant additional clinical benefitSociety Consensus (TASC) II classificationChronic obstructive pulmonary diseaseConcomitant open surgeryLower ratesOutcomes of atherectomyUse of atherectomyAcute limb ischemiaOne-year outcomesVascular Quality InitiativeCongestive heart failureHigher reintervention rateLower extremity revascularizationObstructive pulmonary diseaseAdditional clinical benefitThe Reintervention Index: A New Outcome Measure for Comparative Effectiveness of Lower Extremity Revascularization
Ochoa Chaar CI, Gholitabar N, DeTrani M, Jorshery S, Zhuo H, Zhang Y, Dardik A. The Reintervention Index: A New Outcome Measure for Comparative Effectiveness of Lower Extremity Revascularization. Annals Of Vascular Surgery 2020, 69: 52-61. PMID: 32474144, DOI: 10.1016/j.avsg.2020.05.040.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAmputation, SurgicalComparative Effectiveness ResearchEndarterectomyEndovascular ProceduresFemaleHumansLimb SalvageLower ExtremityMaleMiddle AgedPeripheral Arterial DiseasePostoperative ComplicationsRetreatmentRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeVascular GraftingConceptsOpen lower extremity revascularizationLower extremity revascularizationPeripheral artery diseaseEndovascular groupExtremity revascularizationOutcome measuresEndovascular lower extremity revascularizationFrequency of reinterventionsTertiary care centerCurrent outcome measuresNew outcome measureType of procedureCardiovascular comorbiditiesMajor amputationEndovascular revascularizationReintervention ratePatient characteristicsArtery diseaseConsecutive patientsMultivariable analysisRetrospective reviewOpen groupCare centerEndovascular proceduresReinterventionVariations in the Management of Claudication in a Tertiary Care Center
Ochoa Chaar CI, Gholitabar N, Detrani M, Jorshery SD, Kim TI, Zhuo H, Zhang Y, Dardik A. Variations in the Management of Claudication in a Tertiary Care Center. Annals Of Vascular Surgery 2020, 67: 395-402. PMID: 32179142, DOI: 10.1016/j.avsg.2020.02.015.Peer-Reviewed Original ResearchMeSH KeywordsAgedConservative TreatmentElectronic Health RecordsEndovascular ProceduresFemaleGuideline AdherenceHealthcare DisparitiesHumansIntermittent ClaudicationLower ExtremityMaleMiddle AgedPeripheral Arterial DiseasePractice Guidelines as TopicPractice Patterns, Physicians'Retrospective StudiesRisk FactorsRisk Reduction BehaviorTertiary Care CentersTime FactorsTreatment OutcomeVascular Surgical ProceduresConceptsLower extremity revascularizationAnkle-brachial indexVascular surgeonsConservative therapyWalking exercisesSmoking cessationMean ankle-brachial indexManagement of claudicationTertiary care centerRecords of patientsCoronary artery diseaseStandard of carePattern of symptomsQuality of lifeMajor amputationVascular claudicationMedical optimizationStatin medicationExtremity revascularizationArtery diseaseOpen revascularizationMedical managementSingle centerEndovascular interventionInstitutional protocolRapid increase in hybrid surgery for the treatment of peripheral artery disease in the Vascular Quality Initiative database
Fereydooni A, Zhou B, Xu Y, Deng Y, Dardik A, Ochoa Chaar CI. Rapid increase in hybrid surgery for the treatment of peripheral artery disease in the Vascular Quality Initiative database. Journal Of Vascular Surgery 2020, 72: 977-986.e1. PMID: 32067877, DOI: 10.1016/j.jvs.2019.11.041.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmputation, SurgicalCombined Modality TherapyDatabases, FactualEndarterectomyEndovascular ProceduresFemaleFemoral ArteryHumansLimb SalvageMaleMiddle AgedPeripheral Arterial DiseasePopliteal ArteryPostoperative ComplicationsRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeVascular GraftingVascular PatencyConceptsLower extremity revascularizationOpen lower extremity revascularizationVascular Quality Initiative databaseFemoropopliteal revascularizationHybrid surgeryAmbulatory statusFemoropopliteal bypassArtery diseaseFemoral endarterectomyChronic obstructive pulmonary diseaseAmputation-free survivalHigh-risk patientsPeripheral artery diseaseVascular Quality InitiativeObstructive pulmonary diseaseCoronary artery diseaseGroup of patientsKaplan-Meier analysisInitiative databaseLength of stayContemporary national trendsBYP groupFemoropopliteal vesselsHYB groupPerioperative advantages
2019
Use of neuraxial anesthesia for hybrid lower extremity revascularization is associated with reduced perioperative morbidity
Fereydooni A, O'Meara T, Popescu WM, Dardik A, Ochoa Chaar CI. Use of neuraxial anesthesia for hybrid lower extremity revascularization is associated with reduced perioperative morbidity. Journal Of Vascular Surgery 2019, 71: 1296-1304.e7. PMID: 31708304, DOI: 10.1016/j.jvs.2019.07.072.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseLower extremity revascularizationPeripheral arterial diseaseObstructive pulmonary diseaseNeuraxial anesthesiaGeneral anesthesiaPulmonary diseaseVentilator requirementHospital stayPerioperative morbidityBaseline characteristicsExtremity revascularizationWound infectionFunctional statusSurgeons National Surgical Quality Improvement Program datasetNational Surgical Quality Improvement Program datasetComplex peripheral arterial diseaseUse of NADependent functional statusInvasive hybrid proceduresPrimary anesthetic techniqueSicker patient populationGroup of patientsNAA groupHybrid procedureOne-Year Readmission after Open and Endovascular Revascularization for Critical Limb Ischemia
Ochoa Chaar CI, Gholitabar N, Goodney P, Dardik A, Abougergi MS. One-Year Readmission after Open and Endovascular Revascularization for Critical Limb Ischemia. Annals Of Vascular Surgery 2019, 61: 25-32.e2. PMID: 31376536, DOI: 10.1016/j.avsg.2019.07.003.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmputation, SurgicalCritical IllnessDatabases, FactualEndovascular ProceduresFemaleHospital MortalityHumansIschemiaLower ExtremityMalePatient ReadmissionPeripheral Arterial DiseaseReoperationRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesVascular Surgical ProceduresConceptsEndovascular lower extremity revascularizationLower extremity revascularizationCritical limb ischemiaCharlson Comorbidity IndexNationwide Readmissions DatabaseExtremity revascularizationMajor amputationEndovascular groupLimb ischemiaHigher Charlson comorbidity indexOne-year readmissionCohort of patientsClinical Modification codesHigher readmission ratesRisk-adjusted outcomesCost of careComorbidity indexEndovascular revascularizationInpatient mortalityReadmission ratesSubsequent readmissionPatient characteristicsInitial treatmentOpen revascularizationNinth RevisionNational trends of hybrid lower extremity revascularization in the ACS-NSQIP database
Fereydooni A, Zhou B, Jorshery SD, Deng Y, Dardik A, Chaar CIO. National trends of hybrid lower extremity revascularization in the ACS-NSQIP database. Vascular 2019, 27: 653-662. PMID: 31126228, DOI: 10.1177/1708538119852019.Peer-Reviewed Original ResearchConceptsLower extremity revascularizationExtremity revascularizationPeripheral artery diseaseVascular surgeonsSurgical specialistsPerioperative outcomesArtery diseaseHybrid surgeryHybrid procedureNational Surgical Quality Improvement Project databaseSurgeons National Surgical Quality Improvement Project databaseDisease codes -9Non-vascular surgeonsCurrent Procedural Terminology codesACS-NSQIP databaseProcedural Terminology codesNational trendsContemporary national trendsAnesthesiologists classificationEmergent surgeryOverall morbidityOnly patientsFemoral endarterectomyPropensity matchingHybrid surgery for bilateral lower extremity inflow revascularization
Jorshery SD, Luo J, Zhang Y, Sarac T, Ochoa Chaar CI. Hybrid surgery for bilateral lower extremity inflow revascularization. Journal Of Vascular Surgery 2019, 70: 768-775.e2. PMID: 30837177, DOI: 10.1016/j.jvs.2018.11.037.Peer-Reviewed Original ResearchConceptsABF bypassSurgery patientsHybrid surgeryAmerican CollegeSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseSurgeons National Surgical Quality Improvement Program filesTotal hospital lengthHigh-risk patientsImprovement Program databasePropensity-matched analysisCritical limb ischemiaLower extremity revascularizationPopulation of patientsAxillobifemoral bypassComposite morbidityFemorofemoral bypassLess pneumoniaUnplanned intubationAortobifemoral bypassMajor amputationHospital lengthPerioperative outcomesBypass patients