Methods: From September 21, 1998, to May 30, 2008, 250 patients underwent EVAR at our hospital. Before July 1, 2004, EVAR patients underwent CT and DU imaging performed every 6 months during the first year and then annually if no problems were identified (group 1). We compared aneurysm sac size, presence of endoleak, and graft patency between the two scanning modalities. After
July 1, 2004, patients underwent surveillance using DU imaging as the sole surveillance study unless a problem was detected (group 2). CT and DU imaging Dabrafenib chemical structure charges for each regimen were compared using our 2008 health system pricing and Medicare reimbursements. All DU examinations were performed in our accredited noninvasive vascular laboratory by experienced technologists. Statistical analysis was performed using Pearson correlation coefficient.
Results: DU BMS345541 and CT scans were equivalent in determining aneurysm sac diameter after EVAR (P < .001). DU and CT were each as likely to falsely suggest
an endoleak when none existed and were as likely to miss an endoleak. Using DU imaging alone would have reduced cost of EVAR surveillance by 29% ($534,356) in group 1. Cost savings of $1595 per patient per year were realized in group 2 by eliminating CT scan surveillance. None of the group 2 patients sustained an adverse event such as rupture, graft migration, or limb occlusion as a result of having DU imaging performed as the sole follow-up
modality.
Conclusion: Surveillance of EVAR patients can be performed accurately, safely, and cost-effectively with DU as the sole imaging study. (J Vasc Surg 2009;50:1019-24.)”
“OBJECTIVE: To evaluate the safety of manual compression and early ambulation after diagnostic and therapeutic neuroendovascular procedures.
METHODS: Data were prospectively collected and retrospectively analyzed for consecutive patients undergoing diagnostic or therapeutic neuroendovascular procedures. Manual compression at the femoral access site was applied. The target for early ambulation was 2 hours after compression.
RESULTS: Three hundred forty-three ADAMTS5 patients were enrolled, of whom 295 were eligible for early ambulation. Diagnostic procedures totaled 214 (72.5%); therapeutic procedures, 81 (27.5%). Ambulation occurred at 2 hours for 82 patients who underwent a diagnostic and 11 patients who underwent a therapeutic procedure. Overall, 142 patients (66.4%) after a diagnostic and 21 patients (25.9%) after a therapeutic procedure ambulated within 3 hours; 94% of outpatients ambulated within 2 to 3 hours and were dismissed shortly thereafter. Delayed ambulation was related to nursing staff delays, recovery from general anesthesia, or patient preference. Fourteen patients (4.7%)-9 (4.2%) who had a diagnostic and 5 (6.