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5 results on '"Marc Schermerhorn"'

1. Association of Frailty With Treatment Selection and Long‐Term Outcomes Among Patients With Chronic Limb‐Threatening Ischemia

Author

Neel M. Butala, Aishwarya Raja, Jiaman Xu, Jordan B. Strom, Marc Schermerhorn, Joshua A. Beckman, Mehdi H. Shishehbor, Changyu Shen, Robert W. Yeh, and Eric A. Secemsky

Subjects
chronic limb‐threatening ischemia, frailty, outcomes, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background The optimal treatment strategy for patients with chronic limb‐threatening ischemia (CLTI) is often unclear. Frailty has emerged as an important factor that can identify patients at greater risk of poor outcomes and guide treatment selection, but few studies have explored its utility among the CLTI population. We examine the association of a health record‐based frailty measure with treatment choice and long‐term outcomes among patients hospitalized with CLTI. Methods and Results We included patients aged >65 years hospitalized with CLTI in the Medicare Provider Analysis and Review data set between October 1, 2009 and September 30, 2015. The primary exposure was frailty, defined by the Claims‐based Frailty Indicator. Baseline frailty status and revascularization choice were examined using logistic regression. Cox proportional hazards regression was used to determine the association between frailty and death or amputation, stratifying by treatment strategy. Of 85 060 patients, 35 484 (42%) were classified as frail. Frail patients had lower likelihood of revascularization (adjusted odds ratio [OR], 0.78; 95% CI, 0.75‒0.82). Among those revascularized, frailty was associated with lower likelihood of surgical versus endovascular treatment (adjusted OR, 0.76; CI, 0.72‒0.81). Frail patients experienced increased risk of amputation or death, regardless of revascularization status (revascularized: adjusted hazard ratio [HR], 1.34; CI, 1.30‒1.38; non‐revascularized: adjusted HR, 1.22; CI, 1.17‒1.27). Among those revascularized, frailty was independently associated with amputation or death irrespective of revascularization strategy (surgical: adjusted HR, 1.36; CI, 1.31‒1.42; endovascular: aHR, 1.29; CI, 1.243‒1.35). Conclusions Among patients hospitalized with CLTI, frailty is an important independent predictor of revascularization strategy and longitudinal adverse outcomes.

Published
2021
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2. European society for vascular surgery (ESVS) 2023 Clinical practice guidelines on the management of atherosclerotic carotid and vertebral artery disease

Author

Ross Naylor, Barbara Rantner, Stefano Ancetti, Gert J. de Borst, Marco De Carlo, Alison Halliday, Stavros K. Kakkos, Hugh S. Markus, Dominick J.H. McCabe, Henrik Sillesen, Jos C. van den Berg, Melina Vega de Ceniga, Maarit A. Venermo, Frank E.G. Vermassen, null ESVS Guidelines Committee, George A. Antoniou, Frederico Bastos Goncalves, Martin Bjorck, Nabil Chakfe, Raphael Coscas, Nuno V. Dias, Florian Dick, Robert J. Hinchliffe, Philippe Kolh, Igor B. Koncar, Jes S. Lindholt, Barend M.E. Mees, Timothy A. Resch, Santi Trimarchi, Riikka Tulamo, Christopher P. Twine, Anders Wanhainen, null Document Reviewers, Sergi Bellmunt-Montoya, Richard Bulbulia, R Clement Darling, Hans-Henning Eckstein, Athanasios Giannoukas, Mark J.W. Koelemay, David Lindström, Marc Schermerhorn, David H. Stone, Surgery, ACS - Atherosclerosis & ischemic syndromes, and Radiation Oncology

Subjects
HSM CIR VASC, Surgery, 610 Medicine & health, Guidelines, Cardiology and Cardiovascular Medicine, Vertebral Artery Disease, Atherosclerotic Carotid
Abstract

info:eu-repo/semantics/publishedVersion

Published
2023

3. A Multi-Institutional Experience in Vascular Ehlers-Danlos Syndrome

Author

Sherene, Shalhub, Kelli, Hicks, Karen, Woo, Dawn, Coleman, Frank, Davis, DE CARIDI, Giovanni, Nicole Weaver, K., Erin, Miller, Marc, Schermerhorn, Katie, Shean, Gustavo, Oderich, Mauricio, Ribiero, Cole, Nishikawa, Charlton-Ouw, Kristofer M., Christian-Alexander, Behrendt, Sebastian, Debus, Yskert von Kodolitsch, Devin, Zarkowsky, Powell, Richard J., Melanie, Pepin, Peter, Byers, and Peter, Lawrence

Subjects
03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, Ehlers–Danlos syndrome, business.industry, medicine, Surgery, 030212 general & internal medicine, 030204 cardiovascular system & hematology, Cardiology and Cardiovascular Medicine, medicine.disease, business, Dermatology
Published
2017

4. Analysis of EndoAnchors for endovascular aneurysm repair by indications for use

Author

Jean-Paul P.M. de Vries, Kenneth Ouriel, Manish Mehta, David Varnagy, William M. Moore, Frank R. Arko, James Joye, William D. Jordan, Jean Paul de Vries, H.H. Eckstein, Joost van Herwaarden, Paul Bove, William Bohannon, Bram Fioole, Carlo Setacci, Timothy Resch, Vicente Riambau, Dierk Scheinert, Daniel Clair, Mohammed Moursi, Mark Farber, Joerg Tessarek, Giovanni Torsello, Mark Fillinger, Marc Glickman, John Henretta, Kim Hodgson, Jeffrey Jim, Barry Katzen, Evan Lipsitz, Mitchell Cox, Thomas Naslund, Venkatesh Ramaiah, Marc Schermerhorn, Peter Schneider, Benjamin Ware Starnes, Carlos Donayre, Burkhart Zipfel, Nitin Malhotra, William Moore, Nick Cheshire, Colin Bicknell, Martin Back, Bart Muhs, Mahmoud B. Malas, Syed Hussain, NavYash Gupta, Dittmar Bockler, Eric Verhoeven, and Michel Reijnen

Subjects
Male, medicine.medical_specialty, Time Factors, Endoleak, medicine.medical_treatment, Endovascular aneurysm repair, Aortography, Aortic aneurysm, Blood Vessel Prosthesis Implantation, Foreign-Body Migration, Aneurysm treatment, Blood vessel prosthesis, Risk Factors, Suture Anchors, medicine, Product Surveillance, Postmarketing, Humans, Prospective Studies, Registries, Prospective cohort study, Aged, Aged, 80 and over, medicine.diagnostic_test, business.industry, Endovascular Procedures, Equipment Design, Middle Aged, medicine.disease, Surgery, Blood Vessel Prosthesis, Prosthesis Failure, Treatment Outcome, Angiography, Female, Radiology, Core laboratory, business, Cardiology and Cardiovascular Medicine, Tomography, X-Ray Computed, Abdominal surgery, Aortic Aneurysm, Abdominal
Abstract

Objective The proximal aortic neck remains one of the challenges of endovascular aneurysm repair (EVAR), and the risk of type Ia endoleak and endograft migration is increased in patients with short, large-diameter, or highly angulated necks. EndoAnchors have been used as an adjunct to EVAR in such patients, and the aim of this study was to assess their benefit analyzed by indication for use. Methods During a 2-year period, 319 patients were enrolled at 43 sites in the Aneurysm Treatment Using the Heli-FX Aortic Securement System Global Registry (ANCHOR) study. This prospective, multinational, real-world analysis of EndoAnchors comprised two groups of patients, those undergoing first-time EVAR (primary arm, 242) and those with proximal neck complications remote from the time of an initial endograft implantation (revision arm, 77). The primary arm was further subdivided into patients undergoing prophylactic EndoAnchor use for hostile proximal neck anatomy (178), with a type Ia endoleak evident during initial endograft deployment (60), and in conjunction with extender cuffs after unsatisfactory endograft deployment distally in the neck (four). The revision arm was subdivided into patients presenting with a type Ia endoleak alone (45), endograft migration alone (11), and migration with endoleak (21). Technical success was site reported as satisfactory deployment of the desired number of EndoAnchors without fracture or loss of integrity. Procedural success was defined as technical success without type Ia endoleak at completion arteriography. Core laboratory analysis was performed on 249 baseline and 192 follow-up computed tomographic studies, 66 of which were available within the 1-year window. Results Technical and procedural success rates were highest in the prophylactically treated subset (172 of 178; 96.6%). Whereas the technical success of EndoAnchor deployment was also high in the other subsets, residual type Ia endoleaks were more frequent at completion angiography when the indication for EndoAnchor use was type Ia endoleak, both in the primary arm (17 of 60; 28%) and in the revision arm (9 of 45; 20%). During a median imaging follow-up of 7 months, 183 of 202 patients (90.1%) remained free of type Ia endoleaks. Primary prophylactic patients were free from type Ia endoleak in 110 of 114 cases (96.5%). The most challenging subset was revision patients treated for type Ia endoleak; type Ia endoleaks were evident during follow-up in 10 of 29 of the cases (34%). Sac regression >5 mm in patients with 1-year imaging was observed in 26 of 66 patients (39%) and was highest in the primary prophylaxis subset (20 of 43; 47%). Conclusions EndoAnchor implantation can be a useful adjunct to EVAR as prophylaxis against proximal attachment site complications in patients with hostile aortic neck anatomy, as treatment for early and late type Ia endoleaks, or, in conjunction with aortic extension cuffs, for endograft migration. Whereas the most challenging patients are those who present with type Ia endoleaks remote from initial EVAR, EndoAnchors are still effective in treating the majority of these cases.

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