Featured Publications
Risk profiles, access to care, and outcomes in Hispanics hospitalized for lower extremity peripheral artery disease
Luna P, Harris K, Castro-Dominguez Y, Algara M, Severiche-Mena C, Smolderen KG, Mena-Hurtado C. Risk profiles, access to care, and outcomes in Hispanics hospitalized for lower extremity peripheral artery disease. Journal Of Vascular Surgery 2022, 77: 216-224.e15. PMID: 36037965, DOI: 10.1016/j.jvs.2022.08.021.Peer-Reviewed Original ResearchConceptsPeripheral artery diseaseLower extremity peripheral artery diseaseNon-Hispanic whitesEmergency departmentPAD careArtery diseaseRisk factorsSevere peripheral artery diseaseChronic limb-threatening ischemiaRisk profileNational Inpatient Sample dataCardiovascular risk factorsLimb-threatening ischemiaPatients' sociodemographic characteristicsWorse clinical outcomesMultivariable logistic regressionAssociation of ethnicityLength of stayHealth care consumptionHealth care coveragePAD hospitalizationsPrior amputationEndovascular revascularizationED admissionRenal failureFrailty and outcomes following revascularization of lower-extremity peripheral artery disease: Insights from the Vascular Quality Initiative (VQI)
Al-Damluji MS, Smolderen KG, Meng C, Dai F, Nanna MG, Sumpio B, Henke P, Mena-Hurtado C. Frailty and outcomes following revascularization of lower-extremity peripheral artery disease: Insights from the Vascular Quality Initiative (VQI). Vascular Medicine 2022, 27: 251-257. PMID: 35485400, DOI: 10.1177/1358863x221083701.Peer-Reviewed Original ResearchConceptsRisk Analysis IndexVascular Quality InitiativeLower extremity revascularizationFrailty screening toolsMFI-5Lower extremity peripheral artery diseaseScreening toolFrailty detectionAddition of frailtyPAD risk factorsPeripheral artery diseasePAD populationRevascularization typeVascular cohortMajor amputationPerioperative outcomesArtery diseaseFrailty indexFrailty toolsAdjusted analysisUnplanned amputationRisk factorsHigher oddsPredictive valuePatientsThe Vascular Quality Initiative assessment of the Bard Lifestent for the treatment of popliteal artery occlusive disease
Bertges D, Eldrup-Jorgensen J, Eskandari M, Hamdan A, Mena-Hurtado C, Mewissen M, Smith T, Woo E, Cronenwett J, Initiative S. The Vascular Quality Initiative assessment of the Bard Lifestent for the treatment of popliteal artery occlusive disease. Journal Of Vascular Surgery 2023, 78: 1489-1496.e1. PMID: 37648091, DOI: 10.1016/j.jvs.2023.08.122.Peer-Reviewed Original ResearchMeSH KeywordsAgedChronic Limb-Threatening IschemiaFemaleFemoral ArteryHumansLower ExtremityMalePopliteal ArteryProspective StudiesConceptsTarget lesion revascularizationChronic limb-threatening ischemiaTarget vessel revascularizationMajor adverse eventsLimb-threatening ischemiaPopliteal arteryLesion revascularizationMajor amputationVessel revascularizationHemodynamic successSecondary patencyAdverse eventsOcclusive diseaseProcedural successSingle-arm prospective studyProximal popliteal arterySustained clinical successPrimary efficacy outcomePrimary safety outcomeArtery occlusive diseaseComposite primary endpointPrimary-assisted patencyKaplan-Meier analysisSuperficial femoral arteryMajority of stents
2023
Representativeness of Peripheral Artery Disease Randomized Clinical Trials Supporting Current Guidelines
Castro-Dominguez Y, Mena-Hurtado C, Algara M, Obas V, Ahmed Z, Romain G, Solaru K, Smolderen K. Representativeness of Peripheral Artery Disease Randomized Clinical Trials Supporting Current Guidelines. The American Journal Of Cardiology 2023, 201: 166-169. PMID: 37385170, DOI: 10.1016/j.amjcard.2023.05.053.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiologyEthnicityFemaleHumansLower ExtremityPeripheral Arterial DiseaseRandomized Controlled Trials as TopicUnited StatesConceptsPeripheral artery diseasePAD guidelinesArtery diseaseRecent American Heart Association/American CollegeAmerican Heart Association/American CollegeLower extremity peripheral artery diseaseOlder adult patientsRace/ethnicity distributionAdult patientsPooled proportionMean ageClinical trialsCurrent guidelinesEpidemiologic studiesAmerican CollegeTrial participantsRCTsEthnicity distributionOlder adultsTrialsWomenPatientsDiseaseGuidelinesEthnic groupsComparison 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 groupsLower extremity symptoms and ankle–brachial index screening as predictors of cardiovascular outcomes in Black adults
Lee M, Smolderen K, Ionescu C, Hillegass W, Romain G, Mena-Hurtado C. Lower extremity symptoms and ankle–brachial index screening as predictors of cardiovascular outcomes in Black adults. Vascular Medicine 2023, 28: 197-204. PMID: 37293738, DOI: 10.1177/1358863x231151729.Peer-Reviewed Original ResearchConceptsPeripheral artery diseaseAbnormal ABILower extremity symptomsNormal ABILeg symptomsHigh riskBlack adultsExtremity symptomsStepwise Cox proportional hazards modelKaplan-Meier survival curvesCox proportional hazards modelAnkle-brachial indexFramingham risk factorsJackson Heart StudyProportional hazards modelCardiovascular outcomesCause mortalityArtery diseaseAsymptomatic diseaseAdverse outcomesMean ageSymptom assessmentAsymptomatic participantsRisk factorsSymptomatic participants
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 strategiesMajor 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 regressionStatins 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 ResearchConceptsMajor 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 treatmentThe Nevada peripheral artery disease screening effort in a Medicare Advantage population and subsequent mortality and major adverse cardiovascular event risk
Smolderen KG, Heath K, Scherr T, Bauzon SR, Howell AN, Mena-Hurtado C. The Nevada peripheral artery disease screening effort in a Medicare Advantage population and subsequent mortality and major adverse cardiovascular event risk. Journal Of Vascular Surgery 2022, 75: 2054-2064.e3. PMID: 35181520, DOI: 10.1016/j.jvs.2022.01.134.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overFemaleHumansLower ExtremityMaleMedicare Part CNevadaPeripheral Arterial DiseaseRisk FactorsUnited StatesConceptsMajor adverse cardiovascular eventsPeripheral artery diseaseUnadjusted hazard ratioLower extremity peripheral artery diseaseHazard ratioMedicare Advantage beneficiariesCause mortalityElectronic medical recordsArtery diseaseMajor adverse cardiovascular event riskAdverse cardiovascular eventsAtherosclerotic risk factorsMedicare Advantage populationCardiovascular event riskAnnual health assessmentPrimary care providersPatients' electronic medical recordsRisk of mortalityScreening resultsPositive screening resultsMACE ratePAD screeningCardiovascular eventsMultivariable adjustmentScreening status
2021
Safety and efficacy outcomes of the Pioneer Plus catheter in endovascular revascularization of lower extremity chronic total occlusions
Sheikh AB, Llanos-Chea F, Jelani QU, Anantha-Narayanan M, Attaran R, Schneider M, Ionescu C, Regan C, Nagpal S, Smolderen KG, Mena-Hurtado C. Safety and efficacy outcomes of the Pioneer Plus catheter in endovascular revascularization of lower extremity chronic total occlusions. Journal Of Vascular Surgery 2021, 74: 746-755. PMID: 33592298, DOI: 10.1016/j.jvs.2021.01.045.Peer-Reviewed Original ResearchConceptsMajor adverse limb eventsAdverse limb eventsDevice-related complicationsProcedure-related complicationsProcedure-related outcomesProcedural successEfficacy outcomesPseudoaneurysm formationSafety outcomesLimb eventsLower extremity chronic total occlusionMajor adverse cardiovascular eventsChronic total occlusion interventionAccess site hematomaAcute arterial thrombosisAcute limb ischemiaAdverse cardiovascular eventsProvider-level factorsArteriovenous fistula formationHigh-volume centersChronic total occlusionMajor bleedingPreprocedural symptomsCardiovascular eventsCatheter useContemporary 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 ResearchMeSH KeywordsHumansIschemiaLower ExtremityPerfusion ImagingPredictive Value of TestsPrognosisVascular Surgical ProceduresConceptsCritical 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 imagingSystematic review and meta-analysis of outcomes of lower extremity peripheral arterial interventions in patients with and without chronic kidney disease or end-stage renal disease
Anantha-Narayanan M, Sheikh AB, Nagpal S, Jelani QU, Smolderen KG, Regan C, Ionescu C, Ochoa Chaar CI, Schneider M, Llanos-Chea F, Mena-Hurtado C. Systematic review and meta-analysis of outcomes of lower extremity peripheral arterial interventions in patients with and without chronic kidney disease or end-stage renal disease. Journal Of Vascular Surgery 2020, 73: 331-340.e4. PMID: 32889074, DOI: 10.1016/j.jvs.2020.08.032.Peer-Reviewed Original ResearchConceptsCKD/end-stage renal diseaseEnd-stage renal diseaseNormal renal functionChronic kidney diseaseTarget lesion revascularizationLong-term mortalityPeripheral arterial diseaseRenal functionPAD interventionsMajor amputationRenal diseaseKidney diseaseOdds ratioNormal renal function groupIntervention typeRenal function groupCritical limb ischemiaPeripheral arterial interventionsConfidence intervalsPooled odds ratioOpen surgical approachMultivariable regression analysisCase-control matchingRandom-effects modelEvidence-based strategies
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
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 costsImpact of Hospital Volume on Outcomes of Lower Extremity Endovascular Interventions (Insights from the Nationwide Inpatient Sample [2006 to 2011])
Arora S, Panaich SS, Patel N, Patel N, Lahewala S, Solanki S, Patel P, Patel A, Manvar S, Savani C, Tripathi B, Thakkar B, Jhamnani S, Singh V, Patel S, Patel J, Bhimani R, Mohamad T, Remetz MS, Curtis JP, Attaran RR, Grines C, Mena CI, Cleman M, Forrest J, Badheka AO. Impact of Hospital Volume on Outcomes of Lower Extremity Endovascular Interventions (Insights from the Nationwide Inpatient Sample [2006 to 2011]). The American Journal Of Cardiology 2015, 116: 791-800. PMID: 26100585, DOI: 10.1016/j.amjcard.2015.05.050.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overEndovascular ProceduresFemaleFollow-Up StudiesHospital CostsHospital MortalityHospitals, High-VolumeHospitals, Low-VolumeHumansIncidenceInpatientsLower ExtremityMaleMiddle AgedPeripheral Arterial DiseasePostoperative ComplicationsPostoperative PeriodPrognosisRegistriesRetrospective StudiesUnited StatesYoung AdultConceptsPeripheral endovascular interventionsHospitalization costsEndovascular interventionInhospital mortalityAmputation rateHospital volumePrimary outcomeCharlson co-morbidity index scoreUtilization Project Nationwide Inpatient Sample databaseLower Extremity Endovascular InterventionsTwo-level hierarchical multivariateNationwide Inpatient Sample databaseHospital volume quartilesCo-morbidity statusHospital procedural volumeLower amputation ratesAppropriate International ClassificationHigh-volume centersAnnual institutional volumeWeekend admissionSecondary outcomesPostprocedural complicationsStudy cohortNinth RevisionVolume centers