Pub Date : 2022-09-01DOI: 10.4103/ijves.ijves_73_22
S. Prasath, Arunagiri Viruthagiri, Nedounsejiane Mandjini
Background: Peripheral arterial disease is a significant health care burden globally. Treatment options for limb salvage include open surgical bypass or endovascular revascularization. One of the vital prerequisite for successful infrainguinal bypass is the availability of good conduit. Not all patients have good quality great saphenous vein of adequate length to facilitate bypass. In these scenarios, splicing of available autologous veins and synthetic graft with vein cuff are alternate options. Aim: To compare the outcomes of infrainguinal bypass done for patients with chronic limb threatening ischemia in two groups In Group I, non spliced GSV was the conduit used. In Group II, either spliced vein graft or synthetic graft with vein cuff was used. Materials and Methods: This is a retrospective study done in a tertiary care centre over a period of 40 months. Ipsilateral Great Saphenous Vein (GSV) was our preferred conduit. In the absence of good calibre GSV, splicing of available autologous veins were done. Only when autologous veins were not available synthetic graft was used with distal vein cuff. Results: A total of 52 patients have undergone bypass during the study period of which 15 patients (28.8%) did not have good calibre GSV. Splicing of autologous veins were done for 10 patients (19.2 %) and synthetic graft with vein cuff was used for 5 patients (9.6%). One year graft patency in group I was 81% and in group II was 66.6%. Limbs were salvaged in 86% of patients in either groups. The mortality rate was 8.1% and 6.6% in groups I & II respectively. Conclusion: When good caliber GSV is not available, splicing of available autologous veins provide comparable patency and should be preferred over synthetic graft. Synthetic graft provides acceptable limb salvage rate when used with an adjunctive procedure like vein cuff for tibial bypasses and should be used when autologous veins are not available or when the patient carries a high risk for major surgery.
{"title":"Outcomes following spliced vein graft and composite graft as conduit for infrainguinal bypass: An institutional experience","authors":"S. Prasath, Arunagiri Viruthagiri, Nedounsejiane Mandjini","doi":"10.4103/ijves.ijves_73_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_73_22","url":null,"abstract":"Background: Peripheral arterial disease is a significant health care burden globally. Treatment options for limb salvage include open surgical bypass or endovascular revascularization. One of the vital prerequisite for successful infrainguinal bypass is the availability of good conduit. Not all patients have good quality great saphenous vein of adequate length to facilitate bypass. In these scenarios, splicing of available autologous veins and synthetic graft with vein cuff are alternate options. Aim: To compare the outcomes of infrainguinal bypass done for patients with chronic limb threatening ischemia in two groups In Group I, non spliced GSV was the conduit used. In Group II, either spliced vein graft or synthetic graft with vein cuff was used. Materials and Methods: This is a retrospective study done in a tertiary care centre over a period of 40 months. Ipsilateral Great Saphenous Vein (GSV) was our preferred conduit. In the absence of good calibre GSV, splicing of available autologous veins were done. Only when autologous veins were not available synthetic graft was used with distal vein cuff. Results: A total of 52 patients have undergone bypass during the study period of which 15 patients (28.8%) did not have good calibre GSV. Splicing of autologous veins were done for 10 patients (19.2 %) and synthetic graft with vein cuff was used for 5 patients (9.6%). One year graft patency in group I was 81% and in group II was 66.6%. Limbs were salvaged in 86% of patients in either groups. The mortality rate was 8.1% and 6.6% in groups I & II respectively. Conclusion: When good caliber GSV is not available, splicing of available autologous veins provide comparable patency and should be preferred over synthetic graft. Synthetic graft provides acceptable limb salvage rate when used with an adjunctive procedure like vein cuff for tibial bypasses and should be used when autologous veins are not available or when the patient carries a high risk for major surgery.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46163863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.4103/ijves.ijves_90_22
V. Patra, R. Dhillan, Rohit Mehra, A. Dabas, Rahul Merkhed, Vnm Chamiraju
Background: Optical coherence tomography (OCT) has been a cornerstone for intracoronary interventions for substantial years. The extrapolation of the benefits of this cutting-edge technology to the peripheral vasculature is still in its nascent stage. This pictorial essay was an endeavor to exhibit the role of OCT as a tool for visualization of peripheral vasculature. Aim: To ascertain adjunctive use of intravascular imaging through OCT of in vivo peripheral human arterial vasculature and to distinguish between lipid-rich, fibrous, and calcified atherosclerotic plaques and other lesions of peripheral vasculature. Subjects and Methods: OCT imaging was performed with commercially available OCT system which is a short mono-rail design with a fiberoptic imaging core integrated into a catheter. The optic imaging core rotates at a rate of 100–180 revolutions/s. OCT pull backs were performed in an automated fashion with simultaneous flushing of iso-osmolar contrast (Visipaque) and normal saline. The visualization of different lesions of peripheral human vasculature through the eye of OCT is presented here as a pictorial essay. Results: OCT has an evolving potential as a tool for monitoring, lesion characterization, assessment of retrogression, progression, and disease stabilization in peripheral vasculature. The technique provides optimal high-resolution lesion characterization akin to an optical biopsy. Conclusions: OCT as a tool for in vivo analysis of human peripheral vasculature provides superlative results. Larger studies will be required to validate a protocol for optimal usage in the peripheral human arteries.
{"title":"Our initial experience in optical coherence tomography in peripheral vasculature: A pictorial essay","authors":"V. Patra, R. Dhillan, Rohit Mehra, A. Dabas, Rahul Merkhed, Vnm Chamiraju","doi":"10.4103/ijves.ijves_90_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_90_22","url":null,"abstract":"Background: Optical coherence tomography (OCT) has been a cornerstone for intracoronary interventions for substantial years. The extrapolation of the benefits of this cutting-edge technology to the peripheral vasculature is still in its nascent stage. This pictorial essay was an endeavor to exhibit the role of OCT as a tool for visualization of peripheral vasculature. Aim: To ascertain adjunctive use of intravascular imaging through OCT of in vivo peripheral human arterial vasculature and to distinguish between lipid-rich, fibrous, and calcified atherosclerotic plaques and other lesions of peripheral vasculature. Subjects and Methods: OCT imaging was performed with commercially available OCT system which is a short mono-rail design with a fiberoptic imaging core integrated into a catheter. The optic imaging core rotates at a rate of 100–180 revolutions/s. OCT pull backs were performed in an automated fashion with simultaneous flushing of iso-osmolar contrast (Visipaque) and normal saline. The visualization of different lesions of peripheral human vasculature through the eye of OCT is presented here as a pictorial essay. Results: OCT has an evolving potential as a tool for monitoring, lesion characterization, assessment of retrogression, progression, and disease stabilization in peripheral vasculature. The technique provides optimal high-resolution lesion characterization akin to an optical biopsy. Conclusions: OCT as a tool for in vivo analysis of human peripheral vasculature provides superlative results. Larger studies will be required to validate a protocol for optimal usage in the peripheral human arteries.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45587377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.4103/ijves.ijves_45_22
Rahul Sima, N. Sekar, A. Gopalamurugan, A. Rajan, J. Sebastian
Aortocutaneous fistula is an extremely rare complication after aortic endograft infection. We report on the management of a patient who presented with aortocutaneous fistula following emergency endovascular aneurysm repair (EVAR) of an aortoenteric fistula (AEF). A 50-year-old female with Takayasu arteritis who had undergone thoracic endovascular aortic repair (TEVAR) for a thoracic aortic aneurysm, 23 years ago presented with a spontaneous abdominal AEF and another contained ruptured descending thoracic aortic aneurysm distal to the previous endograft. She underwent emergency bridge EVAR and redo-TEVAR. Thirteen months following EVAR, she presented with endograft infection and a spontaneous aortocutaneous fistula. She was successfully managed with an axillo-unifemoral bypass followed by EVAR endograft explantation. She was discharged on long-term antibiotics and has been symptom free for 12 months.
{"title":"Successful management of abdominal aortocutaneous fistula following emergency endovascular aneurysm repair for aortoenteric fistula in a patient with Takayasu arteritis","authors":"Rahul Sima, N. Sekar, A. Gopalamurugan, A. Rajan, J. Sebastian","doi":"10.4103/ijves.ijves_45_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_45_22","url":null,"abstract":"Aortocutaneous fistula is an extremely rare complication after aortic endograft infection. We report on the management of a patient who presented with aortocutaneous fistula following emergency endovascular aneurysm repair (EVAR) of an aortoenteric fistula (AEF). A 50-year-old female with Takayasu arteritis who had undergone thoracic endovascular aortic repair (TEVAR) for a thoracic aortic aneurysm, 23 years ago presented with a spontaneous abdominal AEF and another contained ruptured descending thoracic aortic aneurysm distal to the previous endograft. She underwent emergency bridge EVAR and redo-TEVAR. Thirteen months following EVAR, she presented with endograft infection and a spontaneous aortocutaneous fistula. She was successfully managed with an axillo-unifemoral bypass followed by EVAR endograft explantation. She was discharged on long-term antibiotics and has been symptom free for 12 months.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41538733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.4103/ijves.ijves_99_22
J. Patel, Manisha Asrani, Arya Patel, Gazal Patel
Postthrombotic syndrome (PTS) will develop in 20% to 50% of patients within 1 to 2 years of symptomatic deep venous thrombosis (DVT). Limbs afflicted with PTS have more than three times the odds of having combined reflux and obstruction compared with limbs without PTS. Here, we present a case of an involvement of the right lower limb with classical features of PTS. Due to its low prevalence and similar presentations as those of chronic venous insufficiency lead to a missed diagnosis and prolonged follow up and complications of PTS. This can be prevented by employing CT venography as an early investigation modality. Here we treated the patient with open method as endovascular procedure was not successful.
{"title":"Obscure presentation of postthrombotic syndrome","authors":"J. Patel, Manisha Asrani, Arya Patel, Gazal Patel","doi":"10.4103/ijves.ijves_99_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_99_22","url":null,"abstract":"Postthrombotic syndrome (PTS) will develop in 20% to 50% of patients within 1 to 2 years of symptomatic deep venous thrombosis (DVT). Limbs afflicted with PTS have more than three times the odds of having combined reflux and obstruction compared with limbs without PTS. Here, we present a case of an involvement of the right lower limb with classical features of PTS. Due to its low prevalence and similar presentations as those of chronic venous insufficiency lead to a missed diagnosis and prolonged follow up and complications of PTS. This can be prevented by employing CT venography as an early investigation modality. Here we treated the patient with open method as endovascular procedure was not successful.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46628231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.4103/ijves.ijves_62_22
A. Savlania, V. Vaddavalli, Sriharsha Balraj, P. Jain, Aswitha Ravi, M. Ananthakumar, A. Behera, U. Gorsi, L. Kaman
Objectives: The objective is to decide the site of aortic clamping based on preoperative imaging and intraoperative findings and assess the outcomes on midterm follow-up in patients with juxtarenal aortoiliac occlusion (JRAIO) managed with aortic thromboendarterectomy and bypass grafting. Methods: Forty patients (39 males and one female) with JRAIO were managed with aortobifemoral bypass (ABFB). Two patients required concomitant superior mesenteric artery (SMA) bypass. The aortic clamping site was inter-renal, suprarenal, or supra-celiac, depending on the extent of thrombus relative to the renal artery and SMA ostia. We compared serum creatinine levels with renal ischemic time in the postoperative period. At the mean follow-up of 26.7 months, patients were assessed for graft patency, limb salvage, and survival rate. Results: The mean age of patients was 53.9 years, and 97.5% of patients were heavy smokers. Of the total patients, inter-renal clamping was done in 12.5%, suprarenal clamping in 70%, and supra-celiac clamping in 17.5%. Perioperative morbidity and mortality were 22.5% and 5%, respectively. Five patients with renal ischemic time ≥20 min developed acute kidney injury, showing a significant positive correlation (r = 0.465; P < 0.0001) with clamp time. Postoperative mean serum creatinine values also showed a significant difference (P = 0.0001) between <20 and ≥20 min groups. At follow-up, graft patency and limb salvage rates were 100%, and the survival rate was 97.4%. Conclusion: The risk of atheroembolic renal ischemia in ABFB for JRAIO can be lowered by good preoperative planning and safe intraoperative clamping technique, based on a simple classification for aortic clamping.
{"title":"New classification for juxta renal aortoiliac occlusion-based on imaging for safe clamping and contemporary surgical management results","authors":"A. Savlania, V. Vaddavalli, Sriharsha Balraj, P. Jain, Aswitha Ravi, M. Ananthakumar, A. Behera, U. Gorsi, L. Kaman","doi":"10.4103/ijves.ijves_62_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_62_22","url":null,"abstract":"Objectives: The objective is to decide the site of aortic clamping based on preoperative imaging and intraoperative findings and assess the outcomes on midterm follow-up in patients with juxtarenal aortoiliac occlusion (JRAIO) managed with aortic thromboendarterectomy and bypass grafting. Methods: Forty patients (39 males and one female) with JRAIO were managed with aortobifemoral bypass (ABFB). Two patients required concomitant superior mesenteric artery (SMA) bypass. The aortic clamping site was inter-renal, suprarenal, or supra-celiac, depending on the extent of thrombus relative to the renal artery and SMA ostia. We compared serum creatinine levels with renal ischemic time in the postoperative period. At the mean follow-up of 26.7 months, patients were assessed for graft patency, limb salvage, and survival rate. Results: The mean age of patients was 53.9 years, and 97.5% of patients were heavy smokers. Of the total patients, inter-renal clamping was done in 12.5%, suprarenal clamping in 70%, and supra-celiac clamping in 17.5%. Perioperative morbidity and mortality were 22.5% and 5%, respectively. Five patients with renal ischemic time ≥20 min developed acute kidney injury, showing a significant positive correlation (r = 0.465; P < 0.0001) with clamp time. Postoperative mean serum creatinine values also showed a significant difference (P = 0.0001) between <20 and ≥20 min groups. At follow-up, graft patency and limb salvage rates were 100%, and the survival rate was 97.4%. Conclusion: The risk of atheroembolic renal ischemia in ABFB for JRAIO can be lowered by good preoperative planning and safe intraoperative clamping technique, based on a simple classification for aortic clamping.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45717195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.4103/ijves.ijves_93_22
Saeed S Alqahtani, Bader M Albilasi, Osama Alenzi, Saleh A Almoallem, A. Alruwaili, Mohammed Alkhaldi, A. Alruwaili, Raid Almassaeed
Although the incidence of chronic mesenteric ischemia (CMI) is uncommon, it could become life threatening. With improvements in diagnostic imaging and endovascular therapy over the past few decades, the treatment of CMI has evolved. Even though endovascular revascularization for CMI is prominent, it is unclear if the early advantages outweigh the long-term patency rates. This study conducts a systematic review and meta-analysis to present comprehensive insights into the validity of endovascular revascularization versus open revascularization as effective therapeutic modalities. Studies up to 2022 were searched in MEDLINE, Cochrane Database of Systematic Reviews, Scopus, and Embase. Additionally, references from earlier studies and review papers were manually searched for additional relevant reports. At least two authors examined all the results, making sure they fit the inclusion and exclusion criteria. In the event of disagreement, the authors were able to reach an understanding. Open revascularization is superior to endovascular approaches in maintaining vessel patency and reducing symptoms over the long term. Perioperative problems are more common in patients undergoing open procedures. Each patient's anatomy and physiology call for a different revascularization approach to be applied in treating this condition.
{"title":"Comparing endovascular revascularization to open surgical revascularization for chronic mesenteric ischemia: A systematic review and meta-analysis","authors":"Saeed S Alqahtani, Bader M Albilasi, Osama Alenzi, Saleh A Almoallem, A. Alruwaili, Mohammed Alkhaldi, A. Alruwaili, Raid Almassaeed","doi":"10.4103/ijves.ijves_93_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_93_22","url":null,"abstract":"Although the incidence of chronic mesenteric ischemia (CMI) is uncommon, it could become life threatening. With improvements in diagnostic imaging and endovascular therapy over the past few decades, the treatment of CMI has evolved. Even though endovascular revascularization for CMI is prominent, it is unclear if the early advantages outweigh the long-term patency rates. This study conducts a systematic review and meta-analysis to present comprehensive insights into the validity of endovascular revascularization versus open revascularization as effective therapeutic modalities. Studies up to 2022 were searched in MEDLINE, Cochrane Database of Systematic Reviews, Scopus, and Embase. Additionally, references from earlier studies and review papers were manually searched for additional relevant reports. At least two authors examined all the results, making sure they fit the inclusion and exclusion criteria. In the event of disagreement, the authors were able to reach an understanding. Open revascularization is superior to endovascular approaches in maintaining vessel patency and reducing symptoms over the long term. Perioperative problems are more common in patients undergoing open procedures. Each patient's anatomy and physiology call for a different revascularization approach to be applied in treating this condition.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43548256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.4103/ijves.ijves_54_22
Divij Jayant, A. Behera, Cherring Tandup, S. Nagaraj, Saroj S. Yadav
Although abdominal aortic aneurysm (AAA) is common in the atherosclerotic aorta in the elderly, isolated AAA (IAAA) is a rare entity. Only few case reports of IAAA associated with concomitant dissection are reported in the literature. Here, we present a case of a middle-aged male who presented with abdominal pain with stable hemodynamics. Abdominal examination revealed a pulsatile mass in the left paraumbilical region. CT angiography of the abdomen revealed an isolated infrarenal AAA with dissection extending into the bilateral common iliac arteries and an eccentric partial thrombosis of the false lumen. The patient underwent successful open aneurysmorrhaphy with PTFE graft. Postoperative course was uneventful, and the patient was discharged to follow up in clinics.
{"title":"Isolated giant infrarenal abdominal aortic aneurysm with dissection: Case report of an extremely rare entity","authors":"Divij Jayant, A. Behera, Cherring Tandup, S. Nagaraj, Saroj S. Yadav","doi":"10.4103/ijves.ijves_54_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_54_22","url":null,"abstract":"Although abdominal aortic aneurysm (AAA) is common in the atherosclerotic aorta in the elderly, isolated AAA (IAAA) is a rare entity. Only few case reports of IAAA associated with concomitant dissection are reported in the literature. Here, we present a case of a middle-aged male who presented with abdominal pain with stable hemodynamics. Abdominal examination revealed a pulsatile mass in the left paraumbilical region. CT angiography of the abdomen revealed an isolated infrarenal AAA with dissection extending into the bilateral common iliac arteries and an eccentric partial thrombosis of the false lumen. The patient underwent successful open aneurysmorrhaphy with PTFE graft. Postoperative course was uneventful, and the patient was discharged to follow up in clinics.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45119482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.4103/ijves.ijves_3_23
R. George
{"title":"Work and life – A surgical challenge","authors":"R. George","doi":"10.4103/ijves.ijves_3_23","DOIUrl":"https://doi.org/10.4103/ijves.ijves_3_23","url":null,"abstract":"","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45402997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.4103/ijves.ijves_23_22
Arunkumar Arasappa, N. Kumar, M. Anto, G. Manoharan, Duraipandian Selvanathan
Objective: The aim was to compare the cost of treating deep-vein thrombosis (DVT) using unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) among patients in rural tertiary care hospitals. Materials and Methods: A retrospective study was conducted at a Rural Tertiary Care Hospital from April 2017 to April 2019. Fifty-four patients who had symptoms of swelling of the unilateral or bilateral lower limb with or without pain were subjected to Padua prediction score and Doppler study of both lower limbs. Confirmed cases of DVT were treated with UFH or LMWH. The cost of these two treatments was compared. Results: The mean cost of heparin was 2493.33 ± 1406.27 Indian rupee (INR) in the study population. The mean cost of LMWH was 13,520 ± 9806.35 (INR) in the study population. There was a statistically significant difference between UFH and LMWH with regard to the cost of drugs (INR) for treatment (P < 0.001), which indicated that UFH was a cost-effective treatment compared to LMWH. Conclusions: The study's findings prove that UFH is a cost-effective treatment compared to LMWH in Rural Tertiary Care Hospitals for DVT. Based on the patient's affordability, the treatment decision can be made.
{"title":"Cost-effective treatment for deep-vein thrombosis in rural tertiary care hospital","authors":"Arunkumar Arasappa, N. Kumar, M. Anto, G. Manoharan, Duraipandian Selvanathan","doi":"10.4103/ijves.ijves_23_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_23_22","url":null,"abstract":"Objective: The aim was to compare the cost of treating deep-vein thrombosis (DVT) using unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) among patients in rural tertiary care hospitals. Materials and Methods: A retrospective study was conducted at a Rural Tertiary Care Hospital from April 2017 to April 2019. Fifty-four patients who had symptoms of swelling of the unilateral or bilateral lower limb with or without pain were subjected to Padua prediction score and Doppler study of both lower limbs. Confirmed cases of DVT were treated with UFH or LMWH. The cost of these two treatments was compared. Results: The mean cost of heparin was 2493.33 ± 1406.27 Indian rupee (INR) in the study population. The mean cost of LMWH was 13,520 ± 9806.35 (INR) in the study population. There was a statistically significant difference between UFH and LMWH with regard to the cost of drugs (INR) for treatment (P < 0.001), which indicated that UFH was a cost-effective treatment compared to LMWH. Conclusions: The study's findings prove that UFH is a cost-effective treatment compared to LMWH in Rural Tertiary Care Hospitals for DVT. Based on the patient's affordability, the treatment decision can be made.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49648588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.4103/ijves.ijves_118_21
Devender Singh, S. Aryala
{"title":"Friedrich Trendelenburg (1844–1924): A surgeon who opened the door for venous disorders","authors":"Devender Singh, S. Aryala","doi":"10.4103/ijves.ijves_118_21","DOIUrl":"https://doi.org/10.4103/ijves.ijves_118_21","url":null,"abstract":"","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48809597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：