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1. Endovascular Therapy Versus Bypass Surgery as First-Line Treatment Strategies for Critical Limb Ischemia: Results of the Interim Analysis of the CRITISCH Registry

Author

Adili, Farzin, Balzer, Kai, Billing, Arend, Böckler, Dittmar, Brixner, Daniel, Debus, Sebastian E., Eckstein, Hans-Henning, Florek, Hans-Joachim, Gkremoutis, Asimakis, Grundmann, Reinhardt, Hupp, Thomas, Keck, Tobias, Gerß, Joachim, Klonek, Wojciech, Lang, Werner, May, Björn, Meyer, Alexander, Mühling, Bernhard, Oberhuber, Alexander, Reinecke, Holger, Reinhold, Christian, Ritter, Ralf-Gerhard, Schelzig, Hubert, Schlensack, Christian, Schmitz-Rixen, Thomas, Schulte, Karl-Ludwig, Spohn, Matthias, Steinbauer, Markus, Storck, Martin, Trede, Matthias, Uhl, Christian, Weis-Müller, Barbara, Wenk, Heiner, Zeller, Thomas, Zhorzel, Sven, Zimmermann, Alexander, Bisdas, Theodosios, Borowski, Matthias, Stavroulakis, Konstantinos, and Torsello, Giovanni

Published
2016
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3. Association between statin therapy and amputation-free survival in patients with critical limb ischemia in the CRITISCH registry

Author

Stavroulakis, Konstantinos, Borowski, Matthias, Torsello, Giovanni, Bisdas, Theodosios, Adili, Farzin, Balzer, Kai, Billing, Arend, Böckler, Dittmar, Brixner, Daniel, Debus, Sebastian E., Eckstein, Hans-Henning, Florek, Hans-Joachim, Gkremoutis, Asimakis, Grundmann, Reinhardt, Hupp, Thomas, Keck, Tobias, Gerß, Joachim, Klonek, Wojciech, Lang, Werner, May, Björn, Meyer, Alexander, Mühling, Bernhard, Oberhuber, Alexander, Reinecke, Holger, Reinhold, Christian, Ritter, Ralf-Gerhard, Schelzig, Hubert, Schlensack, Christian, Schmitz-Rixen, Thomas, Schulte, Karl-Ludwig, Spohn, Matthias, Steinbauer, Markus, Storck, Martin, Trede, Matthias, Uhl, Christian, Weis-Müller, Barbara, Wenk, Heiner, Zeller, Thomas, Zhorzel, Sven, and Zimmermann, Alexander

Published
2017
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6. Bypass Grafting vs Endovascular Therapy in Patients With Non-Dialysis-Dependent Chronic Kidney Disease and Chronic Limb-Threatening Ischemia (CRITISCH Registry)

Author

Stavroulakis, Konstantinos, primary, Gkremoutis, Asimakis, additional, Borowski, Matthias, additional, Torsello, Giovanni, additional, Böckler, Dittmar, additional, Zeller, Thomas, additional, Steinbauer, Markus, additional, Tsilimparis, Nikolaos, additional, Bisdas, Theodosios, additional, Adili, Farzin, additional, Balzer, Kai, additional, Billing, Arend, additional, Brixner, Daniel, additional, Debus, Sebastian E., additional, Florek, Hans-Joachim, additional, Grundmann, Reinhardt, additional, Hupp, Thomas, additional, Keck, Tobias, additional, Gerß, Joachim, additional, Wojciech, Klonek, additional, Lang, Werner, additional, May, Björn, additional, Meyer, Alexander, additional, Mühling, Bernhard, additional, Oberhuber, Alexander, additional, Reinecke, Holger, additional, Reinhold, Christian, additional, Ritter, Ralf-Gerhard, additional, Schelzig, Hubert, additional, Schlensack, Christian, additional, Schmitz-Rixen, Thomas, additional, Schulte, Karl-Ludwig, additional, Spohn, Matthias, additional, Storck, Martin, additional, Trede, Matthias, additional, Uhl, Christian, additional, Weis-Müller, Barbara, additional, Wenk, Heiner, additional, Zhorzel, Sven, additional, and Zimmermann, Alexander, additional

Published
2020
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9. One-Year Results of First-Line Treatment Strategies in Patients With Critical Limb Ischemia (CRITISCH Registry)

Author

Stavroulakis, Konstantinos, primary, Borowski, Matthias, additional, Torsello, Giovanni, additional, Bisdas, Theodosios, additional, Adili, Farzin, additional, Balzer, Kai, additional, Billing, Arend, additional, Böckler, Dittmar, additional, Brixner, Daniel, additional, Debus, E. Sebastian, additional, Eckstein, Hans-Henning, additional, Florek, Hans-Joachim, additional, Gkremoutis, Asimakis, additional, Grundmann, Reinhardt, additional, Hupp, Thomas, additional, Keck, Tobias, additional, Gerß, Joachim, additional, Wojciech, Klonek, additional, Lang, Werner, additional, May, Björn, additional, Meyer, Alexander, additional, Mühling, Bernhard, additional, Oberhuber, Alexander, additional, Reinecke, Holger, additional, Reinhold, Christian, additional, Ritter, Ralf-Gerhard, additional, Schelzig, Hubert, additional, Schlensack, Christian, additional, Schmitz-Rixen, Thomas, additional, Schulte, Karl-Ludwig, additional, Spohn, Matthias, additional, Steinbauer, Markus, additional, Storck, Martin, additional, Trede, Matthias, additional, Uhl, Christian, additional, Weis-Müller, Barbara, additional, Wenk, Heiner, additional, Zeller, Thomas, additional, Zhorzel, Sven, additional, and Zimmermann, Alexander, additional

Published
2018
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10. Bypass Grafting vs Endovascular Therapy in Patients With Non-Dialysis-Dependent Chronic Kidney Disease and Chronic Limb-Threatening Ischemia (CRITISCH Registry)

Author

Armstrong, Ehrin J., Stavroulakis, Konstantinos, Gkremoutis, Asimakis, Borowski, Matthias, Torsello, Giovanni, Böckler, Dittmar, Zeller, Thomas, Steinbauer, Markus, Tsilimparis, Nikolaos, Bisdas, Theodosios, Adili, Farzin, Balzer, Kai, Billing, Arend, Brixner, Daniel, Debus, Sebastian E., Florek, Hans-Joachim, Grundmann, Reinhardt, Hupp, Thomas, Keck, Tobias, Gerß, Joachim, Wojciech, Klonek, Lang, Werner, May, Björn, Meyer, Alexander, Mühling, Bernhard, Oberhuber, Alexander, Reinecke, Holger, Reinhold, Christian, Ritter, Ralf-Gerhard, Schelzig, Hubert, Schlensack, Christian, Schmitz-Rixen, Thomas, Schulte, Karl-Ludwig, Spohn, Matthias, Storck, Martin, Trede, Matthias, Uhl, Christian, Weis-Müller, Barbara, Wenk, Heiner, Zhorzel, Sven, and Zimmermann, Alexander

Abstract

Purpose:To report the outcomes of bypass grafting (BG) vs endovascular therapy (EVT) in patients with non-dialysis-dependent chronic kidney disease (CKD) and chronic limb-threatening ischemia (CLTI). Materials and Methods:The CRITISCH Registry is a prospective, national, interdisciplinary, multicenter registry evaluating the current practice of all available treatment options in 1200 consecutive CLTI patients. For the purposes of this analysis, only the 337 patients with non-dialysis-dependent CKD treated by either BG (n=86; median 78 years, 48 men) or EVT (n=251; median age 80 years, 135 men) were analyzed. The primary composite outcome was amputation-free survival (AFS); secondary outcomes were overall survival (OS) and amputation-free time (AFT). All outcomes were evaluated in Cox proportional hazards models; the results are reported as the hazard ratio (HR) and 95% confidence interval (CI). Results:The Cox regression analysis revealed a significantly greater hazard of amputation or death after BG (HR 1.78, 95% CI 1.05 to 3.03, p=0.028). The models for AFT and overall survival also suggested a higher hazard for BG, but the differences were not significant (AFT: HR 1.66, 95% CI 0.78 to 3.53, p=0.188; OS: HR 1.41, 95% CI 0.80 to 2.47, p=0.348). The absence of runoff vessels (HR 1.73, 95% CI 1.15 to 2.60, p=0.008) was associated with a decreased AFS. The likelihood of amputation was higher in male patients (HR 2.21, 95% CI 1.10 to 4.45, p=0.027) and was associated with a lack of runoff vessels (HR 1.95, 95% CI 0.96 to 3.95, p=0.065) and myocardial infarction (HR 3.74, 95% CI 1.23 to 11.35, p=0.020). Death was more likely in patients without runoff vessels (HR 1.76, 95% CI 1.11 to 2.80, p=0.016) and those with a higher risk score (HR 1.73, 95% CI 1.03 to 2.91, p=0.038). Conclusion:This analysis suggested that BG was associated with poorer AFS than EVT in patients with non-dialysis-dependent CKD and CLTI. Male sex, previous myocardial infarction, and the absence of runoff vessels were additionally identified as predictors of poorer outcomes.

Published
2020
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11. Open Versus Endovascular Repair of Isolated Iliac Artery Aneurysms.

Author

Zhorzel, Sven, Busch, Albert, Trenner, Matthias, Reutersberg, Benedikt, Salvermoser, Michael, Eckstein, Hans-Henning, and Zimmermann, Alexander

Subjects
*ANEURYSM surgery, *ANEURYSMS, *ENDOVASCULAR surgery, *COMPUTED tomography, *CONFIDENCE intervals, *CORONARY disease, *DISEASES, *OUTPATIENT services in hospitals, *ILIAC artery, *MEDICAL appointments, *MEDICAL protocols, *MEDICAL referrals, *MULTIVARIATE analysis, *PUBLIC health surveillance, *REOPERATION, *SURVIVAL, *TREATMENT effectiveness, *MEDICAL records, *RETROSPECTIVE studies, *TERTIARY care, *ODDS ratio, *PROGNOSIS, MORTALITY risk factors
Abstract

Purpose: Outcomes of open iliac artery repair (OIR) and endovascular iliac artery repair (EVIR) were compared at a tertiary referral vascular center. Methods: From 2004 to 2015, all patients treated for isolated iliac artery aneurysms (IAAs) were retrospectively identified, and patient records and computed tomography (CT) scans were analyzed. The primary end point was overall survival; secondary end points were 30-day mortality and morbidity and freedom from reintervention. For follow-up, data from outpatient visits and CT scans following a standard surveillance protocol were used. Results: A total of 106 IAAs in 94 patients were treated (mean follow-up: 35.7 months; 66 OIR; 40 EVIR). Six (15%) aneurysms from the EVIR group and 4 (6.1%) from open-operated IAA presented in the state of rupture. There was no difference in overall survival between EVIR and OIR (P = .14). In multivariable analysis, higher risk of death was associated with ruptured IAA (rIAA; hazard ratio [HR]: 40.44, 95% confidence interval [CI]: 2.05-796.18; P = .02) and coronary heart disease (HR: 11.07, 95% CI: 1.94-63.36; P < .01). The 30-day mortality was 1.9% overall (0% OIR, 5.0% EVIR, P = .27), but there were no differences between OIR and EVIR in 30-day morbidity (P = .11). Freedom from reintervention was higher for OIR than for EVIR (P < .01). In multivariable analysis, a higher reintervention rate was seen in EVIR (HR: 10.80, 95% CI: 2.20-53.01; P < .01) and in rIAA (HR: 12.02, 95% CI: 1.31-111.11; P = .03). Conclusion: Iliac artery aneurysmss can be safely and effectively treated by EVIR or OIR regarding 30-day morbidity, mortality, and long-term survival, although freedom from reintervention is significantly lower after EVIR. [ABSTRACT FROM AUTHOR]

Published
2019
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12. Endovascular Therapy Versus Bypass Surgery as First-Line Treatment Strategies for Critical Limb Ischemia

Author

Bisdas, Theodosios, primary, Borowski, Matthias, additional, Stavroulakis, Konstantinos, additional, Torsello, Giovanni, additional, Adili, Farzin, additional, Balzer, Kai, additional, Billing, Arend, additional, Böckler, Dittmar, additional, Brixner, Daniel, additional, Debus, Sebastian E., additional, Eckstein, Hans-Henning, additional, Florek, Hans-Joachim, additional, Gkremoutis, Asimakis, additional, Grundmann, Reinhardt, additional, Hupp, Thomas, additional, Keck, Tobias, additional, Gerß, Joachim, additional, Klonek, Wojciech, additional, Lang, Werner, additional, May, Björn, additional, Meyer, Alexander, additional, Mühling, Bernhard, additional, Oberhuber, Alexander, additional, Reinecke, Holger, additional, Reinhold, Christian, additional, Ritter, Ralf-Gerhard, additional, Schelzig, Hubert, additional, Schlensack, Christian, additional, Schmitz-Rixen, Thomas, additional, Schulte, Karl-Ludwig, additional, Spohn, Matthias, additional, Steinbauer, Markus, additional, Storck, Martin, additional, Trede, Matthias, additional, Uhl, Christian, additional, Weis-Müller, Barbara, additional, Wenk, Heiner, additional, Zeller, Thomas, additional, Zhorzel, Sven, additional, and Zimmermann, Alexander, additional

Published
2016
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13. Outcomes After Endovascular Revascularization in Octogenarians and Non-Octogenarians With Critical Limb Ischemia

Author

Uhl, Christian, Steinbauer, Markus, Torsello, Giovanni, Bisdas, Theodosios, Adili, Farzin, Balzer, Kai, Billing, Arend, Böckler, Dittmar, Brixner, Daniel, Debus, Sebastian E., Eckstein, Hans-Henning, Florek, Hans-Joachim, Gkremoutis, Asimakis, Grundmann, Reinhardt, Hupp, Thomas, Hwang, Se-Won, Keck, Tobias, Wojciech, Klonek, Lang, Werner, May, Björn, Meyer, Alexander, Mühling, Bernhard, Oberhuber, Alexander, Reinecke, Holger, Reinhold, Christian, Ritter, Ralf-Gerhard, Schelzig, Hubert, Schlensack, Christian, Schmitz-Rixen, Thomas, Schulte, Karl-Ludwig, Spohn, Matthias, Stavroulakis, Konstantinos, Storck, Martin, Trede, Matthias, Weis-Müller, Barbara, Wenk, Heiner, Zeller, Thomas, Zhorzel, Sven, and Zimmermann, Alexander

Abstract

Purpose:To determine the outcome and periprocedural risk of endovascular revascularization in octogenarians with critical limb ischemia (CLI) compared with their younger counterparts. Methods:The multicenter, prospective registry for First-line Treatments in Patients With Critical Limb Ischemia (CRITISCH) enrolled 642 patients treated with endovascular techniques (ClinicalTrials.govidentifier NCT01877252). The patients were dichotomized according to age <80 years (n=421; mean age 69 years, 292 men; group 1) or ≥80 years (n=221; mean age 85 years, 113 men; group 2). The groups had similar distributions in Rutherford categories 4 to 6, but group 1 had more men, smokers, diabetics, and patients on dialysis. The primary composite endpoint of the study was amputation and/or death. Key secondary endpoints were in-hospital mortality and major amputation, as well as major adverse limb events (MALE; any reintervention or major amputation involving the index limb) at 1 year. Results:The in-hospital mortality was 1% in group 1 and 2% in group 2 (p=0.204) and the major amputation rates were 4% and 2% (p=0.169), respectively. Amputation-free survival at 1 year was 75% in group 1 and 77% in group 2 (p=0.340), whereas freedom from MALE was significantly different between the groups [62% group 1 vs 72% group 2; hazard ratio (HR) 1.45, 95% confidence interval (CI) 1.09 to 1.93, p=0.016). Limb salvage was 90% in group 1 and 95% in group 2 (HR 2.16, 95% CI 1.27 to 3.69, p=0.01). Conclusion:Octogenarians with CLI treated by endovascular means showed comparable early and 1-year amputation-free survival rates vs their younger counterparts, and limb salvage and freedom from MALE rates were even higher in octogenarians.

Published
2017
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18. [Traumatic thyroid rupture: case report and review of the literature].

Author

von Ahnen T, von Ahnen M, Wirth U, Zhorzel S, Kober E, Habbel C, Schardey HM, and Schopf S

Subjects
Accidents, Traffic, Airway Obstruction diagnosis, Airway Obstruction etiology, Airway Obstruction surgery, Angiography, Arteries injuries, Arteries surgery, Athletic Injuries surgery, Follow-Up Studies, Hematoma diagnosis, Hematoma surgery, Humans, Image Interpretation, Computer-Assisted, Imaging, Three-Dimensional, Lacerations diagnosis, Lacerations surgery, Male, Rupture, Thyroid Cartilage injuries, Thyroid Cartilage pathology, Thyroid Cartilage surgery, Thyroid Gland blood supply, Thyroid Gland pathology, Tomography, X-Ray Computed, Ultrasonography, Young Adult, Athletic Injuries diagnosis, Soccer injuries, Thyroid Gland injuries
Abstract

Background: Traumatic rupture of the thyroid gland is rare. A common approach does not exist. Surgical and nonsurgical management have been advocated., Method: This work summarizes the publications in PubMed including an own case. This study will analyse the accident mechanism, the underlying thyroid pathologies, possible pathogenetic mechanisms of airway obstruction and the therapeutic options. A present classification is revised in order to develop it into a treatment proposal., Results: A total of 34 case reports were analysed. The first half had to be performed a surgery on, the other half was observed without surgical treatment. None of the patients died of his injury. 59% of the patients, that had to be performed a surgery on had thyroid pathology before rupture. 50% of all patients had a road accident as a cause for the rupture., Conclusion: The revised classification and treatment proposal developed here presents a clinically-viable approach.

Published
2014
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