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151. The Dutch Audit of Carotid Interventions: Transparency in Quality of Carotid Endarterectomy in Symptomatic Patients in the Netherlands

Author

Karthaus, Eleonora G., Karthaus, Eleonora G., Vahl, Anco, Kuhrij, Laurien S., Elsman, Bernard H. P., Geelkerken, Robert H., Wouters, Michel W. J. M., Hamming, Jaap F., de Borst, Gert J., Teijink, Joep, Collaboration Dutch Soc Vasc Surg, Steering Comm Dutch Audit Caroti, Karthaus, Eleonora G., Karthaus, Eleonora G., Vahl, Anco, Kuhrij, Laurien S., Elsman, Bernard H. P., Geelkerken, Robert H., Wouters, Michel W. J. M., Hamming, Jaap F., de Borst, Gert J., Teijink, Joep, Collaboration Dutch Soc Vasc Surg, and Steering Comm Dutch Audit Caroti

Abstract

Background: The Dutch Audit for Carotid Interventions (DACI) registers all patients undergoing interventions for carotid artery stenosis in the Netherlands. This study describes the design of the DACI and results of patients with a symptomatic stenosis undergoing carotid endarterectomy (CEA). It aimed to evaluate variation between hospitals in process of care and (adjusted) outcomes, as well as predictors of major stroke/death after CEA.Methods: All patients with a symptomatic stenosis, who underwent CEA and were registered in the DACI between 2014 and 2016 were included in this cohort. Descriptive analyses of patient characteristics, process of care, and outcomes were performed. Casemix adjusted hospital procedural outcomes as (30 day/in hospital) mortality, stroke/death, and major stroke/death, were compared with the national mean. A multivariable logistic regression model (backward elimination at p > 0.10) was used to identify predictors of major stroke/death.Results: A total of 6459 patients, registered by 52 hospitals, were included. The majority (4,832, 75%) were treated <2 weeks after their first hospital consultation, varying from 40% to 93% between hospitals. Mortality, stroke/death, and major stroke/death were, respectively, 1.1%, 3.6%, and 1.8%. Adjusted major stroke/death rates for hospital comparison varied between 0 and 6.5%. Nine hospitals performed significantly better, none performed significantly worse. Predictors of major stroke/death were sex, age, pulmonary disease, presenting neurological symptoms, and peri-operative shunt.Conclusion: CEA in The Netherlands is associated with an overall low mortality and (major) stroke/death rate. Whereas the indicator time to intervention varied between hospitals, mortality and (major) stroke/death were not significantly distinctive enough to identify worse practices and therefore were unsuitable for hospital comparison in the Dutch setting. Additionally, predictors of major strok

Published
2018

152. Failure to Rescue - a Closer Look at Mortality Rates Has No Added Value for Hospital Comparisons but Is Useful for Team Quality Assessment in Abdominal Aortic Aneurysm Surgery in The Netherlands

Author

Lijftogt, Niki, Lijftogt, Niki, Karthaus, Eleonora G., Vahl, Anco, van Zwet, Erik W., van der Willik, Esmee M., Tollenaar, Robertus A. E. M., Hamming, Jaap F., Wouters, Michel W. J. M., Teijink, Joep, Collaboration Dutch Soc Vasc Surg, Steering Comm Dutch Surgical Aneur, Lijftogt, Niki, Lijftogt, Niki, Karthaus, Eleonora G., Vahl, Anco, van Zwet, Erik W., van der Willik, Esmee M., Tollenaar, Robertus A. E. M., Hamming, Jaap F., Wouters, Michel W. J. M., Teijink, Joep, Collaboration Dutch Soc Vasc Surg, and Steering Comm Dutch Surgical Aneur

Abstract

Objectives: Failure to rescue (FTR) is a composite quality indicator, defined as the proportion of deceased patients following major complications. The aims of this study were to compare FTR with mortality for hospital comparisons in abdominal aortic aneurysm (AAA) surgery in The Netherlands and investigate hospital volume and associated factors.Methods: Patients prospectively registered between 2013 and 2015 in the Dutch Surgical Aneurysm Audit (DSAA) were analysed. FTR was analysed for AAA patients and subgroups elective (EAAA) and acute (AAAA; symptomatic or ruptured) aneurysms. Variables and hospital volume were analysed by uni- and multivariable regression analysis. Adjusted hospital comparisons for mortality, major complications, and FTR were presented in funnel plots. Isomortality lines were constructed when presenting FTR and major complication rates.Results: A total of 9258 patients were analysed in 61 hospitals: 7149 EAAA patients (77.2%) and 2109 AAAA patients (22.8%). There were 2785 (30.1%) patients with complications (unadjusted range 5-65% per hospital): 2161 (77.6%) with major and 624 (28.4%) patients with minor complications. Overall mortality was 6.6% (adjusted range 0-16% per hospital) and FTR was 28.4% (n = 613) (adjusted range 0-60% per hospital). Glasgow Coma Scale, age, pulse, creatinine, electrocardiography, and operative setting were independently associated with FTR. Hospital volume was not associated with FTR. In AAAA patients hospital volume was significantly associated with a lower adjusted major complication and mortality rate (OR 0.62, 95% CI 0.49-0.78; and 0.64, 95% CI 0.48-0.87). Four hospitals had a significant lower adjusted FTR with different major complication rates on different isomortality lines.Conclusions: There was more variation in FTR than in mortality between hospitals. FTR identified the same best performing hospitals as for mortality and therefore was of limited additional value in measuring qual

Published
2018

153. Mortality after amputation in dialysis patients is high but not modified by diabetes status.

Author

Schroijen, Marielle A, Diepen, Merel van, Hamming, Jaap F, Dekker, Friedo W, and Dekkers, Olaf M

Subjects
HEMODIALYSIS patients, TRAUMATIC amputation, AMPUTATION, CHRONIC kidney failure, PEOPLE with diabetes, POISSON regression
Abstract

Background Survival among dialysis patients with diabetes mellitus (DM) is inferior to survival of non-diabetic dialysis patients, probably due to the higher prevalence of diabetes-related comorbid conditions. One could hypothesize that these comorbid conditions also contribute to a decreased survival after amputation in diabetic patients compared with non-diabetic patients on dialysis. Methods Data were collected from the Netherlands Cooperative Study on the Adequacy of Dialysis, a multicentre, prospective cohort study in which new patients with end-stage renal disease were monitored until transplantation or death. Amputation rates (incident cases) were calculated in patients with and without DM. The primary endpoint was all-cause survival after first amputation during dialysis therapy in diabetic patients compared with non-diabetic dialysis patients with an amputation. This was formally assessed using interaction analysis (Poisson regression). Results During follow-up (mean duration 2.9 years), 50 of the 413 diabetic patients had a new amputation (12.1%), compared with 20 of 1553 non-diabetic patients (1.2%). Amputation rates/1000 person-years were 47.9 [95% confidence interval (CI) 36.3–63.2] and 4.1 (95% CI 2.7–6.4), respectively, for diabetic patients and non-diabetic patients. Amputation increased mortality risk more than 4-fold in patients without diabetes [hazard ratio (HR) 4.6 (95% CI 2.8–7.6)] as well as in patients with diabetes [HR 4.6 (95% CI 3.3–6.4)]. No formal interaction between diabetes and amputation was found (P = 0.12). Conclusions Amputation in dialysis patients is associated with a 4-fold increased mortality risk; this mortality risk was similar for diabetes and non-diabetes patients. Importantly, the risk for amputation is 10-fold higher in DM compared with non-diabetic dialysis patients. [ABSTRACT FROM AUTHOR]

Published
2020
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154. The Dutch Audit of Carotid Interventions: Transparency in Quality of Carotid Endarterectomy in Symptomatic Patients in the Netherlands

Author

Karthaus, Eleonora G., primary, Vahl, Anco, additional, Kuhrij, Laurien S., additional, Elsman, Bernard H.P., additional, Geelkerken, Robert H., additional, Wouters, Michel W.J.M., additional, Hamming, Jaap F., additional, de Borst, Gert J., additional, Van den Akker, L.H., additional, Van den Akker, P.J., additional, Akkersdijk, G.J., additional, Akkersdijk, G.P., additional, Akkersdijk, W.L., additional, van Andringa de Kempenaer, M.G., additional, Arts, C.H., additional, Avontuur, J.A., additional, Baal, J.G., additional, Bakker, O.J., additional, Balm, R., additional, Barendregt, W.B., additional, Bender, M.H., additional, Bendermacher, B.L., additional, van den Berg, M., additional, Berger, P., additional, Beuk, R.J., additional, Blankensteijn, J.D., additional, Bleker, R.J., additional, Bockel, J.H., additional, Bodegom, M.E., additional, Bogt, K.E., additional, Boll, A.P., additional, Booster, M.H., additional, Borger van der Burg, B.L., additional, de Borst, G.J., additional, Bos- van Rossum, W.T., additional, Bosma, J., additional, Botman, J.M., additional, Bouwman, L.H., additional, Breek, J.C., additional, Brehm, V., additional, Brinckman, M.J., additional, van den Broek, T.H., additional, Brom, H.L., additional, de Bruijn, M.T., additional, de Bruin, J.L., additional, Brummel, P., additional, van Brussel, J.P., additional, Buijk, S.E., additional, Buimer, M.G., additional, Burger, D.H., additional, Buscher, H.C., additional, den Butter, G., additional, Cancrinus, E., additional, Castenmiller, P.H., additional, Cazander, G., additional, Coveliers, H.M., additional, Cuypers, P.H., additional, Daemen, J.H., additional, Dawson, I., additional, Derom, A.F., additional, Dijkema, A.R., additional, Diks, J., additional, Dinkelman, M.K., additional, Dirven, M., additional, Dolmans, D.E., additional, van Doorn, R.C., additional, van Dortmont, L.M., additional, van der Eb, M.M., additional, Eefting, D., additional, van Eijck, G.J., additional, Elshof, J.W., additional, Elsman, B.H., additional, van der Elst, A., additional, van Engeland, M.I., additional, van Eps, R.G., additional, Faber, M.J., additional, de Fijter, W.M., additional, Fioole, B., additional, Fritschy, W.M., additional, Geelkerken, R.H., additional, van Gent, W.B., additional, Glade, G.J., additional, Govaert, B., additional, Groenendijk, R.P., additional, de Groot, H.G., additional, van den Haak, R.F., additional, de Haan, E.F., additional, Hajer, G.F., additional, Hamming, J.F., additional, van Hattum, E.S., additional, Hazenberg, C.E., additional, Hedeman Joosten, P.P., additional, Helleman, J.N., additional, van der Hem, L.G., additional, Hendriks, J.M., additional, van Herwaarden, J.A., additional, Heyligers, J.M., additional, Hinnen, J.W., additional, Hissink, R.J., additional, Ho, G.H., additional, den Hoed, P.T., additional, Hoedt, M.T., additional, van Hoek, F., additional, Hoencamp, R., additional, Hoffmann, W.H., additional, Hoksbergen, A.W., additional, Hollander, E.J., additional, Huisman, L.C., additional, Hulsebos, R.G., additional, Huntjens, K.M., additional, Idu, M.M., additional, Jacobs, M.J., additional, van der Jagt, M.F., additional, Jansbeken, J.R., additional, Janssen, R.J., additional, Jiang, H.H., additional, de Jong, S.C., additional, Jongkind, V., additional, Kapma, M.R., additional, Keller, B.P., additional, Khodadade Jahrome, A., additional, Kievit, J.K., additional, Klemm, P.L., additional, Klinkert, P., additional, Knippenberg, B., additional, Koedam, N.A., additional, Koelemaij, M.J., additional, Kolkert, J.L., additional, Koning, G.G., additional, Koning, O.H., additional, Krasznai, A.G., additional, Krol, R.M., additional, Kropman, R.H., additional, Kruse, R.R., additional, van der Laan, L., additional, van der Laan, M.J., additional, van Laanen, J.H., additional, Lardenoye, J.H., additional, Lawson, J.A., additional, Legemate, D.A., additional, Leijdekkers, V.J., additional, Lemson, M.S., additional, Lensvelt, M.M., additional, Lijkwan, M.A., additional, Lind, R.C., additional, van der Linden, F.T., additional, Liqui Lung, P.F., additional, Loos, M.J., additional, Loubert, M.C., additional, Mahmoud, D.E., additional, Manshanden, C.G., additional, Mattens, E.C., additional, Meerwaldt, R., additional, Mees, B.M., additional, Metz, R., additional, Minnee, R.C., additional, de Mol van Otterloo, J.C., additional, Moll, F.L., additional, Montauban van Swijndregt, Y.C., additional, Morak, M.J., additional, van de Mortel, R.H., additional, Mulder, W., additional, Nagesser, S.K., additional, Naves, C.C., additional, Nederhoed, J.H., additional, Nevenzel-Putters, A.M., additional, de Nie, A.J., additional, Nieuwenhuis, D.H., additional, Nieuwenhuizen, J., additional, van Nieuwenhuizen, R.C., additional, Nio, D., additional, Oomen, A.P., additional, Oranen, B.I., additional, Oskam, J., additional, Palamba, H.W., additional, Peppelenbosch, A.G., additional, van Petersen, A.S., additional, Peterson, T.F., additional, Petri, B.J., additional, Pierie, M.E., additional, Ploeg, A.J., additional, Pol, R.A., additional, Ponfoort, E.D., additional, Poyck, P.P., additional, Prent, A., additional, ten Raa, S., additional, Raymakers, J.T., additional, Reichart, M., additional, Reichmann, B.L., additional, Reijnen, M.M., additional, Rijbroek, A., additional, van Rijn, M.J., additional, de Roo, R.A., additional, Rouwet, E.V., additional, Rupert, C.G., additional, Saleem, B.R., additional, van Sambeek, M.R., additional, Samyn, M.G., additional, van 't Sant, H.P., additional, van Schaik, J., additional, van Schaik, P.M., additional, Scharn, D.M., additional, Scheltinga, M.R., additional, Schepers, A., additional, Schlejen, P.M., additional, Schlosser, F.J., additional, Schol, F.P., additional, Schouten, O., additional, Schreinemacher, M.H., additional, Schreve, M.A., additional, Schurink, G.W., additional, Sikkink, C.J., additional, Siroen, M.P., additional, te Slaa, A., additional, Smeets, H.J., additional, Smeets, L., additional, de Smet, A.A., additional, de Smit, P., additional, Smit, P.C., additional, Smits, T.M., additional, Snoeijs, M.G., additional, Sondakh, A.O., additional, van der Steenhoven, T.J., additional, van Sterkenburg, S.M., additional, Stigter, D.A., additional, Stigter, H., additional, Strating, R.P., additional, Stultiëns, D., additional, Sybrandy, J.E., additional, Teijink, J.A., additional, Telgenkamp, B.J., additional, Testroote, M.J., additional, The, R.M., additional, Thijsse, W.J., additional, Tielliu, I.F., additional, van Tongeren, R.B., additional, Toorop, R.J., additional, Tordoir, J.H., additional, Tournoij, E., additional, Truijers, M., additional, Türkcan, K., additional, Tutein Nolthenius, R.P., additional, Ünlü, Ç., additional, Vafi, A.A., additional, Vahl, A.C., additional, Veen, E.J., additional, Veger, H.T., additional, Veldman, M.G., additional, Verhagen, H.J., additional, Verhoeven, B.A., additional, Vermeulen, C.F., additional, Vermeulen, E.G., additional, Vierhout, B.P., additional, Visser, M.J., additional, van der Vliet, J.A., additional, Vlijmen - van Keulen, C.J., additional, Voesten, H.G., additional, Voorhoeve, R., additional, Vos, A.W., additional, de Vos, B., additional, Vos, G.A., additional, Vriens, B.H., additional, Vriens, P.W., additional, de Vries, A.C., additional, de Vries, J.P., additional, de Vries, M., additional, van der Waal, C., additional, Waasdorp, E.J., additional, Wallis de Vries, B.M., additional, van Walraven, L.A., additional, van Wanroij, J.L., additional, Warlé, M.C., additional, van Weel, V., additional, van Well, A.M., additional, Welten, G.M., additional, Welten, R.J., additional, Wever, J.J., additional, Wiersema, A.M., additional, Wikkeling, O.R., additional, Willaert, W.I., additional, Wille, J., additional, Willems, M.C., additional, Willigendael, E.M., additional, Wisselink, W., additional, Witte, M.E., additional, Wittens, C.H., additional, Wolf-de Jonge, I.C., additional, Yazar, O., additional, Zeebregts, C.J., additional, van Zeeland, M.L., additional, Elshof, Jan-Willem, additional, and Willems, Martine C., additional

Published
2018
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158. Autologous iPSC-Based Vaccines Elicit Anti-tumor Responses In Vivo

Author

Kooreman, Nigel G., primary, Kim, Youngkyun, additional, de Almeida, Patricia E., additional, Termglinchan, Vittavat, additional, Diecke, Sebastian, additional, Shao, Ning-Yi, additional, Wei, Tzu-Tang, additional, Yi, Hyoju, additional, Dey, Devaveena, additional, Nelakanti, Raman, additional, Brouwer, Thomas P., additional, Paik, David T., additional, Sagiv-Barfi, Idit, additional, Han, Arnold, additional, Quax, Paul H.A., additional, Hamming, Jaap F., additional, Levy, Ronald, additional, Davis, Mark M., additional, and Wu, Joseph C., additional

Published
2018
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160. Reply

Author

Tomee, Stephanie M., primary, Hamming, Jaap F., additional, and Lindeman, Jan H., additional

Published
2018
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161. Randomized trial of one-hour sodium bicarbonate vs standard periprocedural saline hydration in chronic kidney disease patients undergoing cardiovascular contrast procedures

Author

Kooiman, Judith, primary, de Vries, Jean-Paul P. M., additional, Van der Heyden, Jan, additional, Sijpkens, Yvo W. J., additional, van Dijkman, Paul R. M., additional, Wever, Jan J., additional, van Overhagen, Hans, additional, Vahl, Antonie C., additional, Aarts, Nico, additional, Verberk-Jonkers, Iris J. A. M., additional, Brulez, Harald F. H., additional, Hamming, Jaap F., additional, van der Molen, Aart J., additional, Cannegieter, Suzanne C., additional, Putter, Hein, additional, van den Hout, Wilbert B., additional, Kilicsoy, Inci, additional, Rabelink, Ton J., additional, and Huisman, Menno V., additional

Published
2018
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164. Textbook Outcome

Author

Karthaus, Eleonora G., primary, Lijftogt, Niki, additional, Busweiler, Linde A. D., additional, Elsman, Bernard H. P., additional, Wouters, Michel W. J. M., additional, Vahl, Anco C., additional, and Hamming, Jaap F., additional

Published
2017
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168. Alloimmune Responses of Humanized Mice to Human Pluripotent Stem Cell Therapeutics

Author

Kooreman, Nigel G., primary, de Almeida, Patricia E., additional, Stack, Jonathan P., additional, Nelakanti, Raman V., additional, Diecke, Sebastian, additional, Shao, Ning-Yi, additional, Swijnenburg, Rutger-Jan, additional, Sanchez-Freire, Veronica, additional, Matsa, Elena, additional, Liu, Chun, additional, Connolly, Andrew J., additional, Hamming, Jaap F., additional, Quax, Paul H.A., additional, Brehm, Michael A., additional, Greiner, Dale L., additional, Shultz, Leonard D., additional, and Wu, Joseph C., additional

Published
2017
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170. Connecting perspectives on quality and safety: patient-level linkage of incident, adverse event and complaint data.

Author

de Vos, Marit S., Hamming, Jaap F., CChua-Hendriks, Jolanda J., and Marang-van de Mheen, Perla J.

Subjects
ACADEMIC medical centers, CHI-squared test, CONFIDENCE intervals, MEDICAL quality control, MEDICAL errors, MULTIVARIATE analysis, HEALTH outcome assessment, PATIENT satisfaction, PATIENTS, PATIENT safety, RESEARCH funding, RISK management in business, SURGERY, LOGISTIC regression analysis, RETROSPECTIVE studies, DATA analysis software, ODDS ratio, MANN Whitney U Test, KRUSKAL-Wallis Test
Published
2019
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171. No Clinical Benefit of Intramuscular Delivery of Bone Marrow-derived Mononuclear Cells in Nonreconstructable Peripheral Arterial Disease: Results of a Phase-III Randomized-controlled Trial.

Author

Lindeman, Jan H. N., Zwaginga, Jaap Jan, Kallenberg-Lantrua, Graziella, van Wissen, Rob C., Schepers, Abbey, van Bockel, Hajo J., Fibbe, Willem E., and Hamming, Jaap F.

Abstract

Background and Aims: Prospects for no-option, end-stage peripheral artery disease (PAD) patients remain poor. Although results from open and semiblinded studies fuel hope for cell-based strategies in no-option patients, so far conclusions from the available placebo-controlled studies are not supportive. With the intention to end the remaining controversy with regard to cell therapy for PAD we conducted a confirmatory, double-blinded randomized placebo-controlled phase 3 trial. Study Design: This randomized controlled trial was registered (NCT00539266). Inclusion criteria included stable or progressive disabling PAD, no imminent need for amputation, absent accepted options for revascularization. Diabetic disease was an exclusion criterion. Bone marrow (500–700 mL) was harvested and bone marrow-derived mononuclear cells were concentrated to 40 mL. Concentrated cells or placebo (diluted blood) were intramuscularly injected at 40 locations of the calf muscle. Results: Fifty-four patients (mean (sd) age 58.2 (14.2) yrs, 58% males) were randomized. Twenty-eight patients received BM-MNCs, 26 placebo. Baseline criteria were similar in the 2 groups. No significant differences were observed for the primary (number of amputations, (pain free) walking distance) and secondary outcome parameters (ankle brachial index, pain scores, quality of life (SF-36)). Discussion: This fully blinded replication trial of autologous BM-MNC fails to confirm a benefit for cell therapy in no-option PAD patients, consequently BM-MNC therapy should not be offered as a clinical treatment. Apparent contrasting conclusions from open and controlled studies underscore the importance of a controlled trial design in evaluating cell-based interventions in PAD. [ABSTRACT FROM AUTHOR]

Published
2018
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172. Identifying Patients at High Risk for Post-EVAR Aneurysm Sac Growth

Author

Bruijn, Laura E., Louhichi, Jihene, Veger, Hugo T. C., Wever, Jan J., van Dijk, Lukas C., van Overhagen, Hendrik, Hamming, Jaap F., and Statius van Eps, Randolph G. S.

Abstract

Purpose: Post-EVAR (endovascular aneurysm repair) aneurysm sac growth can be seen as therapy failure as it is a risk factor for post-EVAR aneurysm rupture. This study sought to identify preoperative patient predictors for developing post-EVAR aneurysm sac growth.Material and Methods: A systematic review was conducted to select potential predictive preoperative factors for post-EVAR sac growth (including a total of 34.886 patients), which were evaluated by a retrospective single-center analysis of patients undergoing EVAR between 2009 and 2019 (N=247) with pre-EVAR computed tomography scans and at least 1 year follow-up. The primary study outcome was post-EVAR abdominal aortic aneurysm (AAA) sac enlargement (≥5 mm diameter increase). Multivariate Cox regression and Kaplan-Meier survival curves were constructed.Results: Potential correlative factors for post-EVAR sac growth included in the cohort analysis were age, sex, anticoagulants, antiplatelets, renal insufficiency, anemia, low thrombocyte count, pulmonary comorbidities, aneurysm diameter, neck diameter, neck angle, neck length, configuration of intraluminal thrombus, common iliac artery diameter, the number of patent lumbar arteries, and a patent inferior mesenteric artery. Multivariate analysis showed that infrarenal neck angulation (hazard ratio, 1.014; confidence interval (CI), 1.001–1.026; p=0.034) and the number of patent lumbar arteries (hazard ratio, 1.340; CI, 1.131–1.588; p<0.001) were associated with post-EVAR growth. Difference in estimated freedom from post-EVAR sac growth for patients with ≥4 patent lumbar arteries versus <4 patent lumbar arteries became clear after 2 years: 88.5% versus 100%, respectively (p<0.001). Of note, 31% of the patients (n=51) with ≥4 patent lumbar arteries (n=167) developed post-EVAR sac growth. In our cohort, the median maximum AAA diameter was 57 mm (interquartile range [IQR] = 54–62) and the median postoperative follow-up time was 54 months (IQR = 34–79). In all, 23% (n=57) of the patients suffered from post-EVAR growth. The median time for post-EVAR growth was 37 months (IQR = 24–63). In 46 of the 57 post-EVAR growth cases (81%), an endoleak was observed; 2.4% (n=6) of the patients suffered from post-EVAR rupture. The total mortality in the cohort was 24% (n=60); 4% (n=10) was AAA related.Conclusions: This study showed that having 4 or more patent lumbar arteries is an important predictive factor for postoperative sac growth in patients undergoing EVAR.Clinical Impact This study strongly suggests that having 4 or more patent lumbar arteries should be included in preoperative counseling for EVAR, in conjunction to the instructions for use (IFU).

Published
2024
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173. Elastic Deformation Measurement Using Duplex Ultrasound for the Detection of High Aneurysm Sac Pressure Following EVAR

Author

van Genderen, Olton S., van Wissen, Rob C., Hamming, Jaap F., van Schaik, Jan, and van der Vorst, Joost R.

Abstract

Purpose: To describe the concept of aortic elastic deformation (ED) measurement using duplex ultrasonography (DUS) as a tool for detection of high aneurysm sac pressure following endovascular aortic repair (EVAR).Technique: High aneurysm sac pressure, with or without proven endoleak, will result in a less compressible aneurysm. Using the dual image function in B-mode of the DUS device and a standardized amount of applied probe pressure, ED can be measured. It is defined as the percentage of deformation of the aneurysm sac on probe pressure application. We hypothesize that less ED of the aneurysm sac can be related with high aneurysm sac pressure and possibly the presence of clinically relevant endoleak. In this note, we describe the technical details of the procedure and report on the applicability and results of ED measurements in the framework of aortic aneurysm and EVAR follow-up in a cohort of 109 patients.Conclusion: ED measurement is the first noninvasive pressure-based method in the quest to find a practical and reliable diagnostic tool to exclude high aneurysm sac pressure. In our patient cohort, patients with proven endoleak showed a smaller ED (less compressible), implying the presence of high aneurysm sac pressure. Further research should confirm whether ED measurement using DUS could reliably exclude endoleak after EVAR and further explore its potential for clinical application in EVAR follow-up.Clinical Impact For the first time, a simple, fast, and inexpensive diagnostic tool is presented in this study for detecting high sac pressure following EVAR. High sac pressure is typically caused by clinically significant endoleaks, which can have significant consequences. Currently, computed tomography scanning is the most common method used to identify and characterize endoleaks. However, measuring elastic deformation may potentially replace more invasive and expensive modalities, such as the computed tomography in the future.

Published
2024
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178. Development and evaluation of in vivo tissue engineered blood vessels in a porcine model

Author

Rothuizen, Tonia C, Damanik, Febriyani F R, Lavrijsen, Tom, Visser, Michel J T, Hamming, Jaap F, Lalai, Reshma A, Duijs, Jacques M G J, van Zonneveld, Anton Jan, Höfer, Imo E., van Blitterswijk, Clemens A, Rabelink, T J, Moroni, Lorenzo, Rotmans, Joris I, Rothuizen, Tonia C, Damanik, Febriyani F R, Lavrijsen, Tom, Visser, Michel J T, Hamming, Jaap F, Lalai, Reshma A, Duijs, Jacques M G J, van Zonneveld, Anton Jan, Höfer, Imo E., van Blitterswijk, Clemens A, Rabelink, T J, Moroni, Lorenzo, and Rotmans, Joris I

Published
2016

179. Development and evaluation of in vivo tissue engineered blood vessels in a porcine model

Author

Rothuizen, Tonia C., Rothuizen, Tonia C., Damanik, Febriyani F. R., Lavrijsen, Tom, Visser, Michel J. T., Hamming, Jaap F., Lalai, Reshma A., Duijs, Jacques M. G. J., van Zonneveld, Anton Jan, Hoefer, Imo E., van Blitterswijk, Clemens A., Rabelink, T. J., Moroni, Lorenzo, Rotmans, Joris I., Rothuizen, Tonia C., Rothuizen, Tonia C., Damanik, Febriyani F. R., Lavrijsen, Tom, Visser, Michel J. T., Hamming, Jaap F., Lalai, Reshma A., Duijs, Jacques M. G. J., van Zonneveld, Anton Jan, Hoefer, Imo E., van Blitterswijk, Clemens A., Rabelink, T. J., Moroni, Lorenzo, and Rotmans, Joris I.

Abstract

Background: There's a large clinical need for novel vascular grafts. Tissue engineered blood vessels (TEBVs) have great potential to improve the outcome of vascular grafting procedures. Here, we present a novel approach to generate autologous TEBV in vivo. Polymer rods were engineered and implanted, evoking an inflammatory response that culminates in encapsulation by a fibrocellular capsule. We hypothesized that, after extrusion of the rod, the fibrocellular capsule differentiates into an adequate vascular conduit once grafted into the vasculature. Methods and results: Rods were implanted subcutaneously in pigs. After 4 weeks, rods with tissue capsules grown around it were harvested. Tissue capsules were grafted bilaterally as carotid artery interposition. One and 4-week patency were evaluated by angiography whereupon pigs were sacrificed. Tissue capsules before and after grafting were evaluated on tissue remodeling using immunohistochemistry, RNA profiling and mechanical testing. Rods were encapsulated by thick, well-vascularized tissue capsules, composed of circumferentially aligned fibroblasts, collagen and few leukocytes, with adequate mechanical strength. Patency was 100% after 1 week and 87.5% after 4 weeks. After grafting, tissue capsules remodeled towards a vascular phenotype. Gene profiles of TEBVs gained more similarity with carotid artery. Wall thickness and alpha SMA-positive area significantly increased. Interestingly, a substantial portion of (myo)fibroblasts present before grafting expressed smooth muscle cell markers. While leukocytes were hardly present anymore, the lumen was largely covered with endothelial cells. Burst pressure remained stable after grafting. Conclusions: Autologous TEBVs were created in vivo with sufficient mechanical strength enabling vascular grafting. Grafts differentiated towards a vascular phenotype upon grafting.

Published
2016

180. Combat related vascular injuries: Dutch experiences from a role 2 MTF in Afghanistan

Author

Epi Methoden Team 1, Zorgeenheid Traumatologie, Infection & Immunity, Van Dongen, Thijs T C F, Idenburg, Floris J., Tan, Edward C T H, Rasmussen, Todd E., Hamming, Jaap F., Leenen, Luke P H, Hoencamp, Rigo, Epi Methoden Team 1, Zorgeenheid Traumatologie, Infection & Immunity, Van Dongen, Thijs T C F, Idenburg, Floris J., Tan, Edward C T H, Rasmussen, Todd E., Hamming, Jaap F., Leenen, Luke P H, and Hoencamp, Rigo

Published
2016

181. Development and evaluation of in vivo tissue engineered blood vessels in a porcine model

Author

Circulatory Health, CDL Arcadia, Rothuizen, Tonia C, Damanik, Febriyani F R, Lavrijsen, Tom, Visser, Michel J T, Hamming, Jaap F, Lalai, Reshma A, Duijs, Jacques M G J, van Zonneveld, Anton Jan, Höfer, Imo E., van Blitterswijk, Clemens A, Rabelink, T J, Moroni, Lorenzo, Rotmans, Joris I, Circulatory Health, CDL Arcadia, Rothuizen, Tonia C, Damanik, Febriyani F R, Lavrijsen, Tom, Visser, Michel J T, Hamming, Jaap F, Lalai, Reshma A, Duijs, Jacques M G J, van Zonneveld, Anton Jan, Höfer, Imo E., van Blitterswijk, Clemens A, Rabelink, T J, Moroni, Lorenzo, and Rotmans, Joris I

Published
2016

189. Development and evaluation of in vivo tissue engineered blood vessels in a porcine model

Author

Rothuizen, Tonia C., primary, Damanik, Febriyani F.R., additional, Lavrijsen, Tom, additional, Visser, Michel J.T., additional, Hamming, Jaap F., additional, Lalai, Reshma A., additional, Duijs, Jacques M.G.J., additional, van Zonneveld, Anton Jan, additional, Hoefer, Imo E., additional, van Blitterswijk, Clemens A., additional, Rabelink, T.J., additional, Moroni, Lorenzo, additional, and Rotmans, Joris I., additional

Published
2016
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191. Long-term impact of battle injuries; Five-year follow-up of injured dutch servicemen in afghanistan 2006-2010

Author

Hoencamp, Rigo, Idenburg, Floris J., Van Dongen, Thijs T C F, De Kruijff, Loes G M, Huizinga, Eelco P., Plat, Marie Christine J, Hoencamp, Erik, Leenen, Luke P H, Hamming, Jaap F., Vermetten, Eric, Hoencamp, Rigo, Idenburg, Floris J., Van Dongen, Thijs T C F, De Kruijff, Loes G M, Huizinga, Eelco P., Plat, Marie Christine J, Hoencamp, Erik, Leenen, Luke P H, Hamming, Jaap F., and Vermetten, Eric

Published
2015

192. Impact of combat events on first responders: Experiences of the armed conflict in Uruzgan, Afghanistan

Author

MGGZ, Verpleegafd Vaatchirurgie D4 Oost, Zorgeenheid Traumatologie, Infection & Immunity, Hoencamp, Rigo, Idenburg, Floris J., Vermetten, Eric, Tan, Edward, Plat, Marie Christine, Hoencamp, Erik, Leenen, Luke P H, Hamming, Jaap F., MGGZ, Verpleegafd Vaatchirurgie D4 Oost, Zorgeenheid Traumatologie, Infection & Immunity, Hoencamp, Rigo, Idenburg, Floris J., Vermetten, Eric, Tan, Edward, Plat, Marie Christine, Hoencamp, Erik, Leenen, Luke P H, and Hamming, Jaap F.

Published
2015

193. Long-term impact of battle injuries; Five-year follow-up of injured dutch servicemen in afghanistan 2006-2010

Author

Verpleegafd Vaatchirurgie D4 Oost, Epi Methoden Team 1, Zorgeenheid Traumatologie, Infection & Immunity, MGGZ, Hoencamp, Rigo, Idenburg, Floris J., Van Dongen, Thijs T C F, De Kruijff, Loes G M, Huizinga, Eelco P., Plat, Marie Christine J, Hoencamp, Erik, Leenen, Luke P H, Hamming, Jaap F., Vermetten, Eric, Verpleegafd Vaatchirurgie D4 Oost, Epi Methoden Team 1, Zorgeenheid Traumatologie, Infection & Immunity, MGGZ, Hoencamp, Rigo, Idenburg, Floris J., Van Dongen, Thijs T C F, De Kruijff, Loes G M, Huizinga, Eelco P., Plat, Marie Christine J, Hoencamp, Erik, Leenen, Luke P H, Hamming, Jaap F., and Vermetten, Eric

Published
2015

195. Inhibition of MicroRNA-494 Reduces Carotid Artery Atherosclerotic Lesion Development and Increases Plaque Stability

Author

Wezel, Anouk, primary, Welten, Sabine M. J., additional, Razawy, Wida, additional, Lagraauw, H. Maxime, additional, de Vries, Margreet R., additional, Goossens, Eveline A. C., additional, Boonstra, Martin C., additional, Hamming, Jaap F., additional, Kandimalla, Ekambar R., additional, Kuiper, Johan, additional, Quax, Paul H. A., additional, Nossent, A. Yaël, additional, and Bot, Ilze, additional

Published
2015
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197. Systemic Upregulation of IL-10 (Interleukin-10) Using a Nonimmunogenic Vector Reduces Growth and Rate of Dissecting Abdominal Aortic Aneurysm.

Author

Adam, Matti, Kooreman, Nigel Geoffrey, Jagger, Ann, Wagenhäuser, Markus U., Mehrkens, Dennis, Wang, Yongming, Kayama, Yosuke, Toyama, Kensuke, Raaz, Uwe, Schellinger, Isabel N., Maegdefessel, Lars, Spin, Joshua M., Hamming, Jaap F., Quax, Paul H.A., Baldus, Stephan, Wu, Joseph C., and Tsao, Philip S.

Published
2018
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198. The center effect in liver transplantation in the Eurotransplant region: a retrospective database analysis.

Author

Blok, Joris J., de Boer, Jacob D., Putter, Hein, Rogiers, Xavier, Guba, Markus O., Strassburg, Christian P., Samuel, Undine, van Hoek, Bart, Hamming, Jaap F., Braat, Andries E., and the Eurotransplant Liver Intestine Advisory Committee

Subjects
LIVER transplantation, ORGAN donors, TRANSPLANTATION of organs, tissues, etc., UNIVERSITY hospitals, KIDNEY transplantation
Abstract

Summary: Apart from donor and recipient risk factors, the effect of center‐related factors has significant impact on graft survival after liver transplantation (LT). To investigate this effect in Eurotransplant, a retrospective database analysis was performed, including all LT's in adult recipients (≥18 years) in the Eurotransplant region from 1.1.2007 until 31.12.2013. Additionally, a survey was sent out to all transplant centers requesting information on surgeons’ experience and exposure. In total, 10 265 LT's were included (median follow‐up 3.3 years), performed in 39 transplant centers. Funnel plots showed significant differences in graft survival between the transplant centers. After correction for donor and recipient risk, with the Eurotransplant donor risk index (ET‐DRI) and the simplified recipient risk index (sRRI) and random effects, these differences diminished. Mean historical volume (in the preceding 5 years) was a significant (P < 0.001), nonlinear marker for graft survival in the multivariate analysis. This study demonstrates that funnel plots can be used for benchmarking purposes in LT. Case‐mix correction can be performed with the use of the ET‐DRI and sRRI. The center effect encompasses the entire complex process of preoperative workup, operation to follow‐up. [ABSTRACT FROM AUTHOR]

Published
2018
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199. Patients' perceptions of conservative treatment for a small abdominal aortic aneurysm.

Author

Tomee, Stephanie M, Gebhardt, Winifred A, Vries, Jean-Paul PM de, Hamelinck, Victoria C, Hamming, Jaap F, and Lindeman, Jan HN

Subjects
ANEURYSMS, ANEURYSM treatment, ABDOMINAL diseases, ANEURYSM diagnosis, PATIENT satisfaction, PATIENTS, THERAPEUTICS
Abstract

Background: An abdominal aortic aneurysm (AAA) is a progressive, generally symptomless disease that could ultimately result in a fatal rupture. Current guidelines advise conservative follow-up, and preventive surgical repair once the risk of rupture outweighs the cost of repair (55 mm in men). In developed countries, the majority of patients are diagnosed with AAAs less than 55 mm, and so enter a period of conservative surveillance. An important question is how patients perceive and cope with risk of rupture, AAA diagnosis and treatment, and presented AAA information. The goal of this study was to gain insight into patients' perceptions of conservative treatment for a small AAA to increase patient satisfaction. Methods: We conducted semistructured in-depth interviews and used questionnaires measuring health-related quality of life (RAND 36-Item Health Survey 1.0), illness-perceptions (Illness Perception Questionnaire - Revised), and anxiety and depression (Hospital Anxiety and Depression Scale). Interviews were audio recorded and transcript contents were analyzed based on grounded theory. Mean scores of the questionnaires were compared to (population) reference groups. Results: This study included ten male patients under surveillance for a small AAA from two hospitals in the Netherlands. Patients expressed no fear for AAA rupture, and also reported low levels of anxiety and depression in both the interviews and the Hospital Anxiety and Depression Scale. The presence of an AAA did not affect their social life or emotional wellbeing. The reported poorer physical health on RAND 36-Item Health Survey 1.0 presumably reflected common presence of comorbidities. Participants stated to that they were content with the frequency and setup of AAA surveillance. However, they generally lacked knowledge about AAA disease and/or treatment options. Conclusion: Conservative AAA follow-up ensures patients that the risks of AAA disease are limited. The vascular surgeon is the most important source of AAA information to patients, and patients fully rely on their vascular surgeon to take control in AAA treatment. [ABSTRACT FROM AUTHOR]

Published
2018
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200. Textbook Outcome: A Composite Measure for Quality of Elective Aneurysm Surgery.

Author

Karthaus, Eleonora G., Lijftogt, Niki, Busweiler, Linde A. D., Elsman, Bernard H. P., Wouters, Michel W. J. M., Vahl, Anco C., and Hamming, Jaap F.

Abstract

Objective: To investigate a new composite quality measurement, which comprises a desirable outcome for elective aneurysm surgery, called "Textbook Outcome" (TO). Background: Single-quality indicators in vascular surgery are often not distinctive and insufficiently reflect the quality of care. Methods: All patients undergoing elective abdominal aortic aneurysm repair, registered in the Dutch Surgical Aneurysm Audit between 2014 and 2015 were included. TO was defined as the percentage of patients who had abdominal aortic aneurysm-repair without intraoperative complications, postoperative surgical complications, reinterventions, prolonged hospital stay [endovascular aneurysm repair (EVAR) ≤4 d, open surgical repair (OSR) ≤10 d], readmissions, and postoperative mortality (≤30 d after surgery/at discharge). Case-mix adjusted TO rates were used to compare hospitals and to compare individual hospital results for different procedures. Results: Five thousand one hundred seventy patients were included, of whom 4039 were treated with EVAR and 1131 with OSR. TO was achieved in 71%of EVARand 53%ofOSR. Important obstacles for achievingTOwere a prolonged hospital stay, postoperative complications, and readmissions. Adjusted TOrates varied from 38% to 89% (EVAR) and from 0% to 97% (OSR) between individual hospitals. Hospitals with a high TO for OSR also had a high TO for EVAR; however, a high TO for EVAR did not implicate a high TO for OSR. Conclusions: TO generates additional information to evaluate the overall quality of the care of elective aneurysm surgery, which subsequently can be used by hospitals to improve the quality of their care. [ABSTRACT FROM AUTHOR]

Published
2017
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