4%) cases, and
gastroduodenal, inferior mesenteric, middle colic and right gastroepiploic in one (1.7%) case for each artery. Two (3.6%) patients had multiple VAAs. In five (9.1%) patients, an abdominal aortic aneurysm coexisted. Early results in terms of mortality and major complications were assessed. Follow-up consisted of clinical and ultrasound examinations at 1 and 12 months, and yearly thereafter. Long-term results in terms EPZ5676 nmr of survival and aneurysm-related complications were analyzed.
Results: In all but two cases, elective intervention in asymptomatic patients was performed. Two (3.6%) patients had a ruptured aneurysm (one pancreaticoduodenal artery and one middle colic artery). The one perioperative death was due to an acute pancreatitis in a patient operated on for a giant inflammatory splenic artery aneurysm, yielding a perioperative mortality rate of 1.8%. Two major complications (retroperitoneal hematoma and acute pancreatitis) were recorded. Mean selleck products duration of follow-up was 82.1 months (range, 0-324 months). Estimated 10-year survival rate was 79.5%. During follow-up two aneurysm-related complications occurred, with an estimated 10-year, aneurysm-related, complication-free survival rate of 75.2%.
Conclusion: In the era of minimally
invasive therapeutic approaches, elective open surgical treatment of visceral artery aneurysms is safe and effective, and offers satisfactory early and long-term results.”
“Objective: We aimed to achieve accurate statistical modeling of a putative relationship between carotid endarterectomy (CEA) annual surgeon and hospital volume and in-hospital mortality.
Design of Study. We performed a secondary data analysis of 10 years (1994-2003) of the Maryland hospital discharge database. Annual volume was defined as the total number of procedures performed for the time in the dataset divided
by the total years in the dataset. Non-linear relationships between death and average volumes were explored with logit-transformed lowess smoothing functions, followed by random effect models and inspection of data likelihood under each combination of spline knots. A marginal model with generalized estimating equations was used to represent population-average response as a function of covariates and to account for clustering in AG-120 supplier the data. Patient comorbidity was assessed using the Deyo modification of the Charlson Index.
Setting. The Maryland hospital discharge database is a 100% sample of all hospitals in the state.
Subjects: CEA was identified through ICD-9 and diagnosis codes, using a previously reported algorithm.
Main Outcome Measure: Estimated odds ratios predicting in-hospital death, a set at 0.05.
Results: During the study period, 22,772 patients with surgeon identifiers underwent CEA in Maryland, resulting in 123 in-hospital deaths (0.54%). The crude odds ratio of death for the entire surgeon dataset was 0.9838, meaning that the odds of death decreased by an average of 0.