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 groupOutcomesRevascularizationThe 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 protocol
2019
Perioperative Outcomes of Lower Extremity Revascularization for Rest Pain and Tissue Loss
Tsay C, Luo J, Zhang Y, Attaran R, Dardik A, Ochoa Chaar CI. Perioperative Outcomes of Lower Extremity Revascularization for Rest Pain and Tissue Loss. Annals Of Vascular Surgery 2019, 66: 493-501. PMID: 31756416, DOI: 10.1016/j.avsg.2019.11.019.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAmputation, SurgicalCritical IllnessDatabases, FactualFemaleGangreneHumansIschemiaLeg UlcerLength of StayLimb SalvageLower ExtremityMaleMiddle AgedPainPatient ReadmissionPeripheral Arterial DiseasePostoperative ComplicationsRetrospective StudiesRisk AssessmentRisk FactorsSeverity of Illness IndexTime FactorsTreatment OutcomeUnited StatesVascular GraftingYoung AdultConceptsCritical limb ischemiaRest painMajor amputationTissue lossPerioperative outcomesTL patientsSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseSevere peripheral artery diseaseQuality Improvement Program databaseTerms of pneumoniaWorse perioperative outcomesLonger hospital stayHigher American SocietyImprovement Program databasePeripheral artery diseaseCongestive heart failureLower Extremity RevascularizationICD-10 codesAnesthesiologists classUnplanned intubationHospital stayPerioperative mortalityExtremity revascularizationLimb ischemiaUse 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 matching