Search

Your search keyword '"Wisselink, W."' showing total 34 results
Start Over Author "Wisselink, W." Publisher elsevier b.v.
34 results on '"Wisselink, W."'

1. A Composite Measure for Quality of Care in Patients with Symptomatic Carotid Stenosis Using Textbook Outcome

Author

Van den Akker, P.J., Akkersdijk, G.J., Akkersdijk, G.P., Akkersdijk, W.L., van Andringa de Kempenaer, M.G., Arts, C.H., Avontuur, J.A., Bakker, O.J., Balm, R., Barendregt, W.B., Bekken, J.A., Bender, M.H., Bendermacher, B.L., van den Berg, M., Berger, P., Beuk, R.J., Blankensteijn, J.D., Bleker, R.J., Blok, J.J., Bode, A.S., Bodegom, M.E., van der Bogt, K.E., Boll, A.P., Booster, M.H., Borger van der Burg, B.L., de Borst, G.J., Bos-van Rossum, W.T., Bosma, J., Botman, J.M., Bouwman, L.H., Brehm, V., de Bruijn, M.T., de Bruin, J.L., Brummel, P., van Brussel, J.P., Buijk, S.E., Buijs, M.A., Buimer, M.G., Burger, D.H., Buscher, H.C., Cancrinus, E., Castenmiller, P.H., Cazander, G., Coester, A.M., Cuypers, P.H., Daemen, J.H., Dawson, I., Dierikx, J.E., Dijkstra, M.L., Diks, J., Dinkelman, M.K., Dirven, M., Dolmans, D.E., van Doorn, R.C., van Dortmont, L.M., Drouven, J.W., van der Eb, M.M., Eefting, D., van Eijck, G.J., Elshof, J.W., Elsman, B.H., van der Elst, A., van Engeland, M.I., van Eps, R.G., Faber, M.J., de Fijter, W.M., Fioole, B., Fokkema, T.M., Frans, F.A., Fritschy, W.M., Fung Kon Jin, P.H., Geelkerken, R.H., van Gent, W.B., Glade, G.J., Govaert, B., Groenendijk, R.P., de Groot, H.G., van den Haak, R.F., de Haan, E.F., Hajer, G.F., Hamming, J.F., van Hattum, E.S., Hazenberg, C.E., Hedeman Joosten, P.P., Helleman, J.N., van der Hem, L.G., Hendriks, J.M., van Herwaarden, J.A., Heyligers, J.M., Hinnen, J.W., Hissink, R.J., Ho, G.H., den Hoed, P.T., Hoedt, M.T., van Hoek, F., Hoencamp, R., Hoffmann, W.H., Hogendoorn, W., Hoksbergen, A.W., Hollander, E.J., Hommes, M., Hopmans, C.J., Huisman, L.C., Hulsebos, R.G., Huntjens, K.M., Idu, M.M., Jacobs, M.J., van der Jagt, M.F., Jansbeken, J.R., Janssen, R.J., Jiang, H.H., de Jong, S.C., Jongbloed-Winkel, T.A., Jongkind, V., Kapma, M.R., Keller, B.P., Khodadade Jahrome, A., Kievit, J.K., Klemm, P.L., Klinkert, P., Koedam, N.A., Koelemaij, M.J., Kolkert, J.L., Koning, G.G., Koning, O.H., Konings, R., Krasznai, A.G., Krol, R.M., Kropman, R.H., Kruse, R.R., van der Laan, L., van der Laan, M.J., van Laanen, J.H., van Lammeren, G.W., Lamprou, D.A., Lardenoye, J.H., Lauret, G.J., Leenders, B.J., Legemate, D.A., Leijdekkers, V.J., Lemson, M.S., Lensvelt, M.M., Lijkwan, M.A., Lind, R.C., van der Linden, F.T., Liqui Lung, P.F., Loos, M.J., Loubert, M.C., van de Luijtgaarden, K.M., Mahmoud, D.E., Manshanden, C.G., Mattens, E.C., Meerwaldt, R., Mees, B.M., von Meijenfeldt, G.C., Menting, T.P., Metz, R., Minnee, R.C., de Mol van Otterloo, J.C., Molegraaf, M.J., Montauban van Swijndregt, Y.C., Morak, M.J., van de Mortel, R.H., Mulder, W., Nagesser, S.K., Naves, C.C., Nederhoed, J.H., Nevenzel-Putters, A.M., de Nie, A.J., Nieuwenhuis, D.H., Nieuwenhuizen, J., van Nieuwenhuizen, R.C., Nio, D., Noyez, V.J., Oomen, A.P., Oranen, B.I., Oskam, J., Palamba, H.W., Peppelenbosch, A.G., van Petersen, A.S., Petri, B.J., Pierie, M.E., Ploeg, A.J., Pol, R.A., Ponfoort, E.D., Post, I.C., Poyck, P.P., Prent, A., ten Raa, S., Raymakers, J.T., Reichart, M., Reichmann, B.L., Reijnen, M.M., de Ridder, J.A., Rijbroek, A., van Rijn, M.J., de Roo, R.A., Rouwet, E.V., Saleem, B.R., Salemans, P.B., van Sambeek, M.R., Samyn, M.G., van ’t Sant, H.P., van Schaik, J., van Schaik, P.M., Scharn, D.M., Scheltinga, M.R., Schepers, A., Schlejen, P.M., Schlosser, F.J., Schol, F.P., Scholtes, V.P., Schouten, O., Schreve, M.A., Schurink, G.W., Sikkink, C.J., te Slaa, A., Smeets, H.J., Smeets, L., Smeets, R.R., de Smet, A.A., Smit, P.C., Smits, T.M., Snoeijs, M.G., Sondakh, A.O., Speijers, M.J., van der Steenhoven, T.J., van Sterkenburg, S.M., Stigter, D.A., Stokmans, R.A., Strating, R.P., Stultiëns, G.N., Sybrandy, J.E., Teijink, J.A., Telgenkamp, B.J., Teraa, M., Testroote, M.J., Tha-In, T., The, R.M., Thijsse, W.J., Thomassen, I., Tielliu, I.F., van Tongeren, R.B., Toorop, R.J., Tournoij, E., Truijers, M., Türkcan, K., Tutein Nolthenius, R.P., Ünlü, Ç., Vaes, R.H., Vafi, A.A., Vahl, A.C., Veen, E.J., Veger, H.T., Veldman, M.G., Velthuis, S., Verhagen, H.J., Verhoeven, B.A., Vermeulen, C.F., Vermeulen, E.G., Vierhout, B.P., van der Vijver-Coppen, R.J., Visser, M.J., van der Vliet, J.A., Vlijmen - van Keulen, C.J., Voorhoeve, R., van der Vorst, J.R., Vos, A.W., de Vos, B., Vos, C.G., Vos, G.A., Voute, M.T., Vriens, B.H., Vriens, P.W., de Vries, A.C., de Vries, D.K., de Vries, J.P., de Vries, M., van der Waal, C., Waasdorp, E.J., Wallis de Vries, B.M., van Walraven, L.A., van Wanroij, J.L., Warlé, M.C., van de Water, W., van Weel, V., van Well, A.M., Welten, G.M., Welten, R.J., Wever, J.J., Wiersema, A.M., Wikkeling, O.R., Willaert, W.I., Wille, J., Willems, M.C., Willigendael, E.M., Wilschut, E.D., Wisselink, W., Witte, M.E., Wittens, C.H., Wong, C.Y., Wouda, R., Yazar, O., Yeung, K.K., Zeebregts, C.J., van Zeeland, M.L., Kuhrij, Laurien S., Karthaus, Eleonora G., Vahl, Anco C., Willems, Martine C.M., Elshof, Jan W., and de Borst, Gert J.

Published
2020
Full Text
View/download PDF

2. Editor's Choice – Nationwide Analysis of Patients Undergoing Iliac Artery Aneurysm Repair in the Netherlands

Author

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

Published
2020
Full Text
View/download PDF

3. 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

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

Published
2018
Full Text
View/download PDF

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

Author

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

Published
2018
Full Text
View/download PDF

8. Peroxynitrite Footprint in Circulating Neutrophils of Abdominal Aortic Aneurysm Patients is Lower in Statin than in Non-statin Users.

Author

Groeneveld, M.E., van der Reijden, J.J., Tangelder, G.J., Westin, L.C., Renwarin, L., Musters, R.J.P., Wisselink, W., and Yeung, K.K.

Abstract

Objectives Extensive reactive oxygen and nitrogen species (also reactive species) production is a mechanism involved in abdominal aortic aneurysm (AAA) development. White blood cells (WBCs) are a known source of reactive species. Their production may be decreased by statins, thereby reducing the AAA growth rate. Reactive species production in circulating WBCs of AAA patients and the effect of statins on their production was investigated. Methods This observational study investigated reactive species production in vivo and ex vivo in circulating WBCs of AAA patients, using venous blood from patients prior to elective AAA repair ( n = 34; 18 statin users) and from healthy volunteers ( n = 10). Reactive species production was quantified in circulating WBCs using immunofluorescence microscopy: nitrotyrosine (footprint of peroxynitrite, a potent reactive nitrogen species) in snap frozen blood smears; mitochondrial superoxide and cytoplasmic hydrogen peroxide (both reactive oxygen species) by live cell imaging. Neutrophils, lymphocytes, and monocytes were examined individually. Results In AAA patients using statins, the median nitrotyrosine level in neutrophils was 646 (range 422–2059), in lymphocytes 125 (range 74–343), and in monocytes 586 (range 291–663). Median levels in AAA patients not using statins were for neutrophils 928 (range 552–2095, p = .03), lymphocytes 156 (101–273, NS), and for monocytes 536 (range 535–1635, NS). The statin dose tended to correlate negatively with nitrotyrosine in neutrophils ( R s −0.32, p = .06). The median levels in controls were lower for neutrophils 466 (range 340–820, p < .01) and for monocytes 191 (range 102–386, p = .03), but similar for lymphocytes 99 (range 82–246) when compared to the AAA patients. There were no differences in mitochondrial superoxide and cytoplasmic hydrogen peroxide between statin and non-statin users within AAA patients. Conclusions It was found that the peroxynitrite footprint in circulating neutrophils and monocytes of AAA patients is higher than in controls. AAA patients treated with statins had a lower peroxynitrite footprint in neutrophils than non-statin users. [ABSTRACT FROM AUTHOR]

Published
2017
Full Text
View/download PDF

9. Development and External Validation of a Model Predicting Death After Surgery in Patients With a Ruptured Abdominal Aortic Aneurysm: The Dutch Aneurysm Score.

Author

von Meijenfeldt, G.C.I., van Beek, S.C., Bastos Gonçalves, F., Verhagen, H.J.M., Zeebregts, C.J., Vahl, A.C., Wisselink, W., van der Laan, M.J., and Balm, R.

Abstract

Objective The decision whether or not to proceed with surgical intervention of a patient with a ruptured abdominal aortic aneurysm (rAAA) is very difficult in daily practice. The primary objective of the present study was to develop and to externally validate a new prediction model: the Dutch Aneurysm Score (DAS). Methods With a prospective cohort of 10 hospitals ( n = 508) the DAS was developed using a multivariate logistic regression model. Two retrospective cohorts with rAAA patients from two hospitals ( n = 373) were used for external validation. The primary outcome was the combined 30 day and in-hospital death rate. Discrimination (AUC), calibration plots, and the ability to identify high risk patients were compared with the more commonly used Glasgow Aneurysm Score (GAS). Results After multivariate logistic regression, four pre-operative variables were identified: age, lowest in hospital systolic blood pressure, cardiopulmonary resuscitation, and haemoglobin level. The area under the receiver operating curve (AUC) for the DAS was 0.77 (95% CI 0.72–0.82) compared with the GAS with an AUC of 0.72 (95% CI 0.67–0.77). The DAS showed a death rate in patients with a predicted death rate ≥80% of 83%. Conclusions The present study shows that the DAS has a higher discriminative performance (AUC) compared with the GAS. All clinical variables used for the DAS are easy to obtain. Identification of low risk patients with the DAS can potentially reduce turndown rates. The DAS can reliably be used by clinicians to make a more informed decision in dialogue with the patient and their family whether or not to proceed with surgical intervention. [ABSTRACT FROM AUTHOR]

Published
2017
Full Text
View/download PDF

10. Editor's Choice - External Validation of Models Predicting Survival After Ruptured Abdominal Aortic Aneurysm Repair.

Author

van Beek, S.C., Reimerink, J.J., Vahl, A.C., Wisselink, W., Peters, R.J.G., Legemate, D.A., and Balm, R.

Abstract

Objective Prediction of survival after intervention for ruptured abdominal aortic aneurysms (RAAA) may support case mix comparison and tailor the prognosis for patients and relatives. The objective of this study was to assess the performance of four prediction models: the updated Glasgow Aneurysm Score (GAS), the Vancouver scoring system, the Edinburgh Ruptured Aneurysm Score (ERAS), and the Hardman index. Design, materials, and methods This was a retrospective cohort study in 449 patients in ten hospitals with a RAAA (intervention between 2004 and 2011). The primary endpoint was combined 30 day or in hospital death. The accuracy of the prediction models was assessed for discrimination (area under the curve [AUC]). An AUC >0.70 was considered sufficiently accurate. In studies with sufficiently accurate discrimination, correspondence between the predicted and observed outcomes (i.e. calibration) was recalculated. Results The AUC of the updated GAS was 0.71 (95% confidence interval [CI] 0.66–0.76), of the Vancouver score was 0.72 (95% CI 0.67–0.77), and of the ERAS was 0.58 (95% CI 0.52–0.65). After recalibration, predictions by the updated GAS slightly overestimated the death rate, with a predicted death rate 60% versus observed death rate 54% (95% CI 44–64%). After recalibration, predictions by the Vancouver score considerably overestimated the death rate, with a predicted death rate 82% versus observed death rate 62% (95% CI 52–71%). Performance of the Hardman index could not be assessed on discrimination and calibration, because in 57% of patients electrocardiograms were missing. Conclusions Concerning discrimination and calibration, the updated GAS most accurately predicted death after intervention for a RAAA. However, the updated GAS did not identify patients with a ≥95% predicted death rate, and therefore cannot reliably support the decision to withhold intervention. [ABSTRACT FROM AUTHOR]

Published
2015
Full Text
View/download PDF

11. Low-dose Thrombolysis for Thromboembolic Lower Extremity Arterial Occlusions is Effective Without Major Hemorrhagic Complications.

Author

Ebben, H.P., Nederhoed, J.H., Lely, R.J., Meijerink, M.R., van der Meijs, B.B., Wisselink, W., Yeung, K.K., and Hoksbergen, A.W.J.

Abstract

Objective To evaluate the efficacy and bleeding complications associated with a low-dose thrombolysis protocol for thromboembolic lower extremity arterial occlusions. Design A retrospective cohort study. Materials and methods A retrospective analysis was performed using data from all consecutive patients who underwent catheter-directed, intra-arterial thrombolysis for thromboembolic lower extremity arterial occlusions between January 2004 and May 2013. All patients were treated on a standard surgical ward. Endpoints were incidence of bleeding complications, duration of thrombolysis, angiographic patency rate, 30-day mortality rate, and amputation-free rate at 6 months. Results Of the 171 cases analyzed, 129 cases underwent low-dose thrombolysis and 42 underwent high-dose thrombolysis. No major bleeding complications occurred in the low-dose group versus 5% in the high-dose group ( p = .01). The median duration of thrombolysis was 67 hours (4–304 hours) in the low-dose and 49 hours (2–171 hours) in the high-dose group ( p = .027). Angiographic patency was restored in 67% of the cases in the low-dose group versus 79% of the high-dose group ( p = .17). The 30-day mortality rates were 1% in the low-dose versus 5% in the high-dose group ( p = .09). However, this higher mortality rate was not related to bleeding complications. Major amputation-free rates at 6 months were 81% in the low-dose group and 88% in the high-dose group ( p = .22). Conclusions Based on this data series, low-dose thrombolysis for thromboembolic lower extremity arterial occlusions is as effective as high-dose thrombolysis; however, the risk of major bleeding complications is substantially lower when using low-dose thrombolysis. [ABSTRACT FROM AUTHOR]

Published
2014
Full Text
View/download PDF

12. Outcomes After Open Repair for Ruptured Abdominal Aortic Aneurysms in Patients with Friendly Versus Hostile Aortoiliac Anatomy.

Author

van Beek, S.C., Reimerink, J.J., Vahl, A.C., Wisselink, W., Reekers, J.A., Legemate, D.A., and Balm, R.

Abstract

Objectives: In patients with a ruptured abdominal aortic aneurysm (RAAA), anatomic suitability for endovascular aneurysm repair (EVAR) depends on aortic neck and iliac artery characteristics. If the aortoiliac anatomy is unsuitable for EVAR (“hostile anatomy”), open repair (OR) is the next option. We hypothesized that the death rate for OR is higher in patients with hostile anatomy than in patients with friendly anatomy. Methods: We conducted an observational cohort study in 279 consecutive patients with an RAAA treated with OR between 2004 and 2011. The primary endpoint was 30-day or in-hospital death. Aortoiliac anatomy (friendly vs. hostile) was determined prospectively by the vascular surgeon and the interventional radiologist treating the patient. A multivariable logistic regression analysis was done to assess the risk of dying in patients with hostile anatomy after adjustment for age, sex, comorbidity, and hemodynamic stability. Results: Aortoiliac anatomy was friendly in 71 patients and hostile in 208 patients. Death rate was 38% (95% confidence interval (CI): 28 to 50%) in patients with friendly anatomy and 30% (95% CI: 24 to 37%) in patients with hostile anatomy (p = .23). After multivariable adjustment, the risk of dying was not higher in patients with hostile anatomy (adjusted odds ratio 0.744, 95% CI 0.394 to 1.404). Conclusion: The death rate after open repair for an RAAA is comparable in patients with friendly and hostile aortoiliac anatomy. [Copyright &y& Elsevier]

Published
2014
Full Text
View/download PDF

14. Sarcopenic obesity is associated with adverse clinical outcome after cardiac surgery.

Author

Visser, M., van Venrooij, L.M.W., Vulperhorst, L., de Vos, R., Wisselink, W., van Leeuwen, P.A.M., and de Mol, B.A.J.M.

Abstract

Abstract: Background & aims: Both undernutrition – low fat free mass (FFM) – and obesity – high fat mass (FM) – have been associated with adverse outcome in cardiac surgical patients. However, whether there is an additional effect on outcome of these risk factors present at the same time, that is sarcopenic obesity (SO), is unknown. Furthermore, the association between SO and muscle function is unidentified. Methods and results: In 325 cardiac surgical patients, we prospectively analysed the association between preoperative FFM and FM, measured by bioelectrical impedance spectroscopy, and postoperative adverse outcomes, and their correlation with muscle function – handgrip strength (HGS). SO was associated with postoperative infections (28.2% vs. 5.3%, adj. odds ratio (OR): 7.9; 95% confidence interval (CI): 1.2–54.1; p =0.04). Further, a low FFM index (FFMI; kgm−2) was associated with postoperative infections (18.5% vs. 4.7%, adj. OR: 6.6; 95% CI: 1.7–25.2; p =0.01) while a high FM index (FMI; kgm−2) was not. Both components of SO, FFMI and FMI, correlated with HGS (FFMI: r =0.570; p <0.001, FMI: r =−0.263; p <0.001). Conclusion: SO is associated with an increased occurrence of adverse outcome after cardiac surgery. Our results suggest an additional risk of a low FFMI and high FMI present at the same time. Furthermore, SO is characterised by less muscle function. We advocate determining body composition in cardiac surgical patients to classify and treat undernourished patients, in particular those who are also obese. [Copyright &y& Elsevier]

Published
2013
Full Text
View/download PDF

15. Controlled Hypotension in Patients Suspected of a Ruptured Abdominal Aortic Aneurysm: Feasibility during Transport by Ambulance Services and Possible Harm.

Author

Reimerink, J.J., Hoornweg, L.L., Vahl, A.C., Wisselink, W., and Balm, R.

Subjects
CONTROLLED hypotension, ABDOMINAL aortic aneurysms, RUPTURED aneurysms, BLOOD pressure, AMBULANCE service
Abstract

Abstract: Objective: To evaluate a controlled hypotension protocol for patients suspected of a ruptured aneurysm of the abdominal aorta (RAAA) and to identify possible harm to patients with a final diagnosis other than RAAA. Design: Retrospective analysis of patients suspected of RAAA and transported by Amsterdam ambulance services between January 2006 and October 2007. Patients and methods: Protocol was assessed by reviewing systolic blood pressure (<80mmHg, 80–100mmHg or >100mmHg), administered fluid volume and verbal responsiveness during transport. Patients who could possibly have been harmed by controlled hypotension were identified by final diagnoses. Results: Fluid administration was according to protocol in 220 of 266 patients analysed for protocol adherence. The remaining patients received too much (21 patients) or too little fluid (25 patients). Data were missing in 29 patients. A RAAA was diagnosed in 81 (27%) of all 295 patients analysed for final diagnosis. Controlled hypotension was achieved in 10% of all patients and in 17% of patients with RAAA. Three patients (1%) with diagnosis other than RAAA were possibly at risk by implementing controlled hypotension. Conclusions: Protocol was followed in 83% and protocol violations occurred in 17% of patients. The risk of implementing controlled hypotension for all patients suspected of an RAAA by the ambulance staff was low. [Copyright &y& Elsevier]

Published
2010
Full Text
View/download PDF

16. Predicting Patient-Specific Expansion of Abdominal Aortic Aneurysms.

Author

Helderman, F., Manoch, I.J., Breeuwer, M., Kose, U., Boersma, H., van Sambeek, M.R.H.M., Pattynama, P.M.T., Schouten, O., Poldermans, D., Wisselink, W., van der Steen, A.F.W., and Krams, R.

Subjects
ABDOMINAL surgery, ABDOMINAL aortic aneurysms, AORTIC aneurysms, FINITE element method, TOMOGRAPHY, ULTRASONICS in surgery, DISEASE risk factors
Abstract

Abstract: Objective: Local anatomy and the patient''s risk profile independently affect the expansion rate of an abdominal aortic aneurysm. We describe a hybrid method that combines finite element modelling and statistical methods to predict patient-specific aneurysm expansion. Methods: The 3-D geometry of the aneurysm was imaged with computed tomography. We used finite element methods to calculate wall stress and aneurysm expansion. Expansion rate was adjusted by risk factors obtained from a database of 80 patients. Aneurysm diameters predicted with and without the risk profiles were compared with diameters measured with ultrasound for 11 patients. Results: For this specific group of patients, local anatomy contributed 62% and the risk profile 38% to the aneurysmal expansion rate. Predictions with risk profiles resulted in smaller root mean square errors than predictions without risk profiles (2.9 vs. 4.0 mm, p < 0.01). Conclusions: This hybrid approach predicted aneurysmal expansion for a period of 30 months with high accuracy. [Copyright &y& Elsevier]

Published
2010
Full Text
View/download PDF

17. Routine Continuous Cold Perfusion of the Kidneys during Elective Juxtarenal Aortic Aneurysm Repair.

Author

Yeung, K.K., Jongkind, V., Coveliers, H.M.E., Tangelder, G.J., and Wisselink, W.

Subjects
AORTIC aneurysms, AORTA surgery, ELECTIVE surgery, ACUTE kidney failure, ARTERIAL occlusions
Abstract

Objectives: Surgical treatment of JAAs (juxtarenal aortic aneurysms) requires suprarenal aortic cross-clamping, causing temporary renal artery occlusion. We implemented a standardized protocol of hypothermic renal perfusion for all elective JAA operations. Design: Retrospective study. Materials and methods: Over a period of 6 years, 23 consecutive patients received a 300ml bolus followed by an infusion (20ml/minute) of cold (4°C) saline to each kidney during suprarenal aortic clamping. We assessed outcome in terms of rise in serum creatinine, new onset of dialysis and mortality. Results: None of the patients suffered from postoperative acute renal failure and in-hospital mortality was zero. Five patients did not show any rise in serum creatinine level, whereas in the others rises were <25% in comparison with the admission level, except for one patient (38%). Postoperative rise in serum creatinine level was not related to renal ischemia time (Spearman rank correlation=0.24, p =0.27), preoperative renal function, total aortic clamping time or renal re-implantation. There were no renal complications at 6 months. Conclusions: Our results suggest that a standardized strategy to apply renal hypothermia during the ischemic period of elective JAA surgery may reduce postoperative renal failure. [Copyright &y& Elsevier]

Published
2008
Full Text
View/download PDF

18. Interobserver and Intraobserver Variability of Interpretation of CT-angiography in Patients with a Suspected Abdominal Aortic Aneurysm Rupture.

Author

Hoornweg, L.L., Wisselink, W., Vahl, A.C., Reekers, J.A., van Delden, O.M., Legemate, D.A., and Balm, R.

Subjects
ANGIOGRAPHY, AORTIC aneurysms, VASCULAR diseases, DIAGNOSTIC imaging
Abstract

Purpose: To assess interobserver and intraobserver agreement on presence of rupture and determining suitability for endovascular repair (EVAR) on CT angiography (CTA) of patients with a suspected ruptured abdominal aortic aneurysm (RAAA). Methods: For the Amsterdam Acute Aneurysm study, a randomised multicenter trial (ISRCTN66212637), we register all patients with suspected RAAA in the Amsterdam region. For the current analysis 51 consecutive patients were included from this prospective database. Pre operative CT scans were assessed twice with a six-week interval by three vascular surgeons and two interventional radiologists. Variables recorded were presence of rupture, diameter and length of the infrarenal aortic neck, diameters of both iliac arteries and final judgement on anatomical suitability for EVAR. Kappa values for dichotomous outcomes were calculated as a measure of agreement above chance. Continuous outcomes were investigated by calculating the intraclass correlation coefficient (ICC) and by Bland-Altman plots. Results: For presence of rupture group kappa was 0.59 (CI: 0.42–0.77). The group kappa of suitability for EVAR was 0.38 (CI: 0.24–0.51). The ICC for diameter and length of the infrarenal aortic neck and diameters of left and right iliac arteries were 0.40 (CI: 0.26–0.56), 0.47 (CI: 0.32–0.62), 0.61 (CI: 0.48–0.74) and 0.35 (CI: 0.21–0.50) respectively. The Bland-Altman plots confirmed the large variation among observers. Intraobserver kappa ranged from 0.57–0.78 for presence of rupture and 0.40–0.80 for suitability for EVAR. Conclusion: Moderate interobserver agreement was found for presence of rupture and fair agreement for suitability for EVAR. Intraobserver agreement ranged from moderate to almost perfect. Based on this data, optimization of the protocol is mandatory to identify uniform measuring techniques of well defined anatomical criteria for endovascular repair of ruptured aneurysms. [Copyright &y& Elsevier]

Published
2008
Full Text
View/download PDF

19. The Amsterdam Acute Aneurysm Trial: Suitability and Application Rate for Endovascular Repair of Ruptured Abdominal Aortic Aneurysms.

Author

Hoornweg, L.L., Wisselink, W., Vahl, A., and Balm, R.

Subjects
MEDICAL sciences, VASCULAR surgery, BIOLOGY, LIFE sciences
Abstract

Purpose: To evaluate anatomical suitability and application rate for endovascular repair of patients with a ruptured abdominal aortic aneurysm (RAAA). Methods: The Amsterdam Acute Aneurysm trial is a multicenter randomised trial comparing open with endovascular treatment in patients with a RAAA (International Standard Randomized Controlled Trial Number (ISRCTN) 66212637). Between April 2004 and January 2006, all consecutive patients with clinical suspicion of a RAAA at presentation were assessed prospectively. Anatomical suitability for endovascular repair was based on use of an aorto-uni-iliac endovascular graft and assessed in patients with a proven aortic rupture on CT angiography (CTA). Results: In 128/256 patients, presenting with clinical suspicion of a ruptured aneurysm, RAAA was diagnosed. 105 patients were brought to a trial center and CTA confirmed RAAA in 83 patients. In 38 of 83 patients (45.8%) with positive CTA, the anatomy of the aorta and iliac arteries was considered suitable for endovascular repair. Exclusion from endovascular repair was due to unsuitable infrarenal neck or iliac anatomy (37 and 8 patients respectively). Overall, endovascular treatment was applicable in 38/128 patients (29.7%) with a RAAA in the Amsterdam region and in 38 out of 105 patients (35.5%) admitted to the trial centers. Conclusion: In this prospective cohort of all patients with a RAAA in the Amsterdam Acute Aneurysm Trial region, the suitability for endovascular repair in patients with a RAAA confirmed on CTA is 45.8%, but the application rate was lower. [Copyright &y& Elsevier]

Published
2007
Full Text
View/download PDF

20. Laparoscopic Vascular Surgery: A Systematic Review.

Author

Nio, D., Diks, J., Bemelman, W.A., Wisselink, W., and Legemate, D.A.

Subjects
LAPAROSCOPIC surgery, VASCULAR surgery, CORONARY artery bypass, SYSTEMATIC reviews
Abstract

Objective: The objective of this systematic review is to evaluate the results of clinical studies on laparoscopic surgery for aorto-iliac disease. Methods: A systematic review of the literature from 1966 to September 2006 on laparoscopic and robotic vascular surgery was performed. Only patient series containing more than 5 cases were included. Operative, clamping and anastomosis times, conversion, mortality and morbidity and hospital stay were evaluated. Results: Thirty studies were identified. These were all descriptive and included 9 comparative studies. Operative times varied widely, the shortest being for hand-assisted procedures (2.5–4 hours) and the longest for totally laparoscopic procedures (4–6.5 hours). Clamping times were all<1 hour in hand-assisted procedures while in other techniques clamping times from 1–2.5 hours were seen. The conversion rate varied from <5% up to 16% in smaller series. The mortality rate was approximately 5% and frequently caused by cardiac ischemia. A variety of problems ranging from minor local wound problems to cardiopulmonary- and renal insufficiency, bleeding, ureter lesions and graft thrombosis were described. Mean hospital stay for nearly all procedures was <1 week. Conclusions: Experience of laparoscopic surgery for aorto-iliac disease is still limited. Most study results are biased by patient selection. Only a few surgeons have mastered the required surgical technique and more data are needed to asses the clinical potential of this type of surgery, in comparison with the endovascular alternative. For wider implementation simplification of the surgical procedure seems necessary. [Copyright &y& Elsevier]

Published
2007
Full Text
View/download PDF

22. Robot-assisted Laparoscopic Aortobifemoral Bypass for Aortoiliac Occlusive Disease: Early Clinical Experience.

Author

Nio, D., Diks, J., Linsen, M.A.M., Cuesta, M.A., Gracia, C., Rauwerda, J.A., and Wisselink, W.

Subjects
ENDOVASCULAR surgery, BLOOD circulation, MYOCARDIAL infarction, ENDOSCOPIC surgery
Abstract

Abstract: Background: Robotic technology may facilitate laparoscopic aortic reconstruction. We present our early clinical experience with laparoscopic aortobifemoral bypass, aided by two different robotic surgical systems. Methods: Between February 2002 and April 2004, we performed eight robot-assisted laparoscopic aorto-bifemoral bypasses for aortoiliac occlusive disease. All patients were male; median age was 55 years (range: 36–64). Dissection was performed laparoscopically and the robotic system was used to construct the aortic anastomosis. Results: A robot-assisted anastomosis was successfully performed in seven patients. Median operative time was 405min (range: 260–589), with a median clamp-time of 111min (range: 85–205). Median blood loss was 900ml (range: 200–5800). Median anastomosis time was 74min (range 40–110). In two patients conversion was necessary, one due to bleeding of an earlier clipped lumbar artery after completion of the anastomosis, the other because of difficulties with the laparoscopic exposure of the aorta. On post-operative day 3 one patient died unexpectedly as a result of a massive myocardial infarction. Median hospital stay was 7.5 days (range: 3–57). Conclusion: Our initial experience with robotic assisted laparoscopic surgery (RALS) shows it is a feasible technique for aortoiliac bypass surgery. However, laparoscopic aortoiliac surgery demands considerable experience and operative times need to be reduced before this technique can be widely implemented. [Copyright &y& Elsevier]

Published
2005
Full Text
View/download PDF

23. Fate of Patients Unwilling or Unsuitable to Undergo Surgical Intervention for a Ruptured Abdominal Aortic Aneurysm.

Author

van Beek, S.C., Vahl, A.C., Wisselink, W., and Balm, R.

Abstract

Introduction The primary objective of this study was to assess the duration of in-hospital survival in 57 patients with ruptured abdominal aortic aneurysms (RAAA) who did not undergo surgical intervention. Report Two hours after registration in the emergency room, 58% (95% CI 45–71) of patients were still alive. The median survival was 2.2 hours (interquartile range 1–18). In a subgroup including 26 haemodynamically stable patients, survival after 2 hours was 96% (95% CI 89–100). Conclusion In patients with an RAAA without surgical intervention, the duration of in-hospital survival is limited. However, a group of haemodynamically stable patients can be identified in whom survival is much longer. [ABSTRACT FROM AUTHOR]

Published
2015
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results