2023
Perioperative complications following open or endovascular revascularization for chronic limb-threatening ischemia in the BEST-CLI Trial
Siracuse J, Farber A, Menard M, Conte M, Kaufman J, Jaff M, Kiang S, Ochoa Chaar C, Osborne N, Singh N, Tan T, Guzman R, Strong M, Hamza T, Doros G, Rosenfield K. Perioperative complications following open or endovascular revascularization for chronic limb-threatening ischemia in the BEST-CLI Trial. Journal Of Vascular Surgery 2023, 78: 1012-1020.e2. PMID: 37318428, DOI: 10.1016/j.jvs.2023.05.040.Peer-Reviewed Original ResearchConceptsChronic limb-threatening ischemiaSingle-segment great saphenous veinLimb-threatening ischemiaRisk-adjusted analysisCohort 2Cohort 1BEST-CLICardiovascular eventsEndovascular revascularizationPerioperative complicationsRevascularization strategyLower extremity bypass surgeryMajor adverse cardiovascular eventsBest Surgical TherapyBEST-CLI trialPeri-procedure complicationsAdverse cardiovascular eventsPeri-procedural complicationsThirty-day mortalityAcute renal failureGreat saphenous veinEndovascular revascularization strategiesBest EndovascularPerioperative morbidityBypass surgery
2021
Strategies to Minimize Iodinated Contrast Volume in Patients with Chronic Kidney Disease Undergoing Peripheral Vascular Interventions
Lee SR, Dardik A, Chaar CIO. Strategies to Minimize Iodinated Contrast Volume in Patients with Chronic Kidney Disease Undergoing Peripheral Vascular Interventions. Annals Of Vascular Surgery 2021, 73: 490-495. PMID: 33556507, DOI: 10.1016/j.avsg.2021.01.081.Peer-Reviewed Original ResearchConceptsPeripheral vascular interventionsChronic kidney diseaseVascular interventionsPostcontrast acute kidney injuryChronic limb threatening ischemiaSuccessful endovascular revascularizationAcute kidney injuryCKD stage 4Limb threatening ischemiaPC-AKIEndovascular revascularizationKidney injuryUse of ICMContrast volumeKidney diseaseIntravascular lesionsContrast mediumPatientsStage 4InterventionRiskRevascularizationIschemiaInjuryTherapy
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 procedureClaudicationOutcomes 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 interventionPatientsLower 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 analysisSystematic 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 ResearchMeSH KeywordsEndovascular ProceduresHumansKidney Failure, ChronicLower ExtremityPeripheral Arterial DiseaseRenal Insufficiency, ChronicRisk FactorsConceptsCKD/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 strategiesDiscrepancy 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 Use of Embolic Protection Devices during Lower Extremity Peripheral Vascular Interventions
Ochoa Chaar CI, Kim TI, Shebl FM, Dardik A. The Use of Embolic Protection Devices during Lower Extremity Peripheral Vascular Interventions. Annals Of Vascular Surgery 2020, 69: 9-16. PMID: 32554197, DOI: 10.1016/j.avsg.2020.06.014.Peer-Reviewed Original ResearchConceptsPeripheral vascular interventionsEmbolic protection devicesDistal embolizationMultivariable analysisFluoroscopy timeVascular interventionsEPD useLower extremity peripheral vascular interventionsUse of EPDPropensity-matched control groupChronic obstructive pulmonary diseaseSignificant differencesVascular Study GroupCharacteristics of patientsObstructive pulmonary diseaseCoronary artery diseaseNew England databaseSuperficial femoral arteryExcisional atherectomyArtery diseaseCommon indicationPropensity matchingPulmonary diseaseEndovascular treatmentFemoral arteryComparison 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 proceduresReinterventionPostcontrast Acute Kidney Injury after Peripheral Vascular Interventions in Kidney Transplant Recipients
Lee SR, Dardik A, Ochoa Chaar CI. Postcontrast Acute Kidney Injury after Peripheral Vascular Interventions in Kidney Transplant Recipients. Annals Of Vascular Surgery 2020, 68: 8-14. PMID: 32428641, DOI: 10.1016/j.avsg.2020.04.057.Peer-Reviewed Original ResearchConceptsKidney transplant recipientsPeripheral vascular interventionsPostcontrast acute kidney injuryPC-AKIAcute kidney injuryKidney transplantKidney injuryTransplant recipientsRisk factorsVascular interventionsNew dialysis requirementPoor allograft functionPropensity-matched patientsPeripheral artery diseaseVascular Quality InitiativeGroup of patientsKaplan-Meier analysisMultivariable logistic regressionLong-term survivalAllograft functionBaseline warfarinHospital mortalityDialysis requirementPerioperative outcomesFeared complicationVariations 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
Risk factors and safe contrast volume thresholds for postcontrast acute kidney injury after peripheral vascular interventions
Lee SR, Zhuo H, Zhang Y, Dahl N, Dardik A, Ochoa Chaar CI. Risk factors and safe contrast volume thresholds for postcontrast acute kidney injury after peripheral vascular interventions. Journal Of Vascular Surgery 2019, 72: 603-610.e1. PMID: 31843298, DOI: 10.1016/j.jvs.2019.09.059.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAgedCanadaContrast MediaDatabases, FactualEndovascular ProceduresFemaleHumansIncidenceKidneyMaleMiddle AgedPatient SafetyPeripheral Arterial DiseaseRadiography, InterventionalRenal Insufficiency, ChronicRetrospective StudiesRisk AssessmentRisk FactorsTreatment OutcomeUnited StatesConceptsAdvanced chronic kidney diseaseChronic kidney diseasePeripheral vascular interventionsStages of CKDPostcontrast acute kidney injuryBaseline kidney functionPC-AKIAcute kidney injuryContrast volumeVolume of contrastRisk factorsKidney injuryCumulative incidenceLimb ischemiaKidney functionVascular interventionsMultivariable Cox proportional hazards regressionCox proportional hazards regressionAcute limb ischemiaLong-term mortalityCritical limb ischemiaNormal kidney functionMultivariable logistic regressionProportional hazards regressionLong-term survivalPerioperative 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 ischemiaA Pilot Study of a Standardized Smoking Cessation Intervention for Patients with Vascular Disease
Rajaee S, Holder T, Indes JE, Muhs B, Sarac T, Sumpio B, Toll BA, Ochoa Chaar CI. A Pilot Study of a Standardized Smoking Cessation Intervention for Patients with Vascular Disease. Annals Of Vascular Surgery 2019, 61: 91-99.e3. PMID: 31449932, DOI: 10.1016/j.avsg.2019.06.017.Peer-Reviewed Original ResearchMeSH KeywordsAneurysmCardiovascular AgentsCholinergic AgentsConnecticutEndovascular ProceduresFemaleHumansMaleMiddle AgedNicotinePatient Education as TopicPeripheral Arterial DiseasePilot ProjectsRisk FactorsRisk Reduction BehaviorSmokersSmokingSmoking CessationTime FactorsTobacco Use Cessation DevicesTransdermal PatchTreatment OutcomeVascular Surgical ProceduresConceptsSmoking cessation interventionIntervention groupSurgery providersPrimary outcomeCessation interventionsExact testBrief smoking cessation counselingCurrent smoking cessation practicesCarbon monoxide breath testingSmoking cessation counselingSmoking cessation practicesVascular surgery serviceSmoking cessation counseling sessionsTertiary care centerFree nicotine patchesSmoking cessation programOpen surgical proceduresOutpatient smoking cessation programFisher's exact testCessation counselingVascular complicationsStandard careNicotine patchNicotine replacementVascular patientsOne-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