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1. Lower extremity amputation protocol: a pilot enhanced recovery pathway for vascular amputees

Author

O’Banion, Leigh Ann, Qumsiyeh, Yazen, Matheny, Heather, Siada, Sammy S, Yan, Yueqi, Hiramoto, Jade S, Rome, Cambia, Dirks, Rachel C, and Prentice, Anne

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Physical Rehabilitation, Rehabilitation, Clinical Research, Prevention, Amputation, ERAS, LEAP, Vascular amputee, Clinical sciences
Abstract

Vascular patients, an inherently older, frail population, account for >80% of major lower extremity amputations (transtibial or transfemoral) in the United States. Retrospective data have shown that early physical therapy and discharge to an acute rehabilitation facility decreases the postoperative length of stay (LOS) and expedites ambulation. In the present study, we sought to determine whether patients treated with the lower extremity amputation protocol (LEAP) will have improved outcomes. We performed a nonrandomized prospective study of vascular patients undergoing an amputation from January 2019 to February 2020. Patients who were nonambulatory or had undergone a previous contralateral major amputation were excluded. LEAP is a multidisciplinary team approach to the perioperative care of amputees using an outlined protocol. The prospective patients were compared with historic controls treated before the initiation of LEAP (January 2016 to December 2018). The primary outcomes included the postoperative LOS, time to receipt of a prosthesis, and time to ambulation. Of the 141 included patients, 130 were in the retrospective group and 11 in the LEAP group. The demographics and comorbidities were similar. All 11 LEAP patients had undergone a below-the-knee amputation, with 1 requiring revision to an above-the-knee amputation. Of the 130 retrospective patients, 122 (94%) had undergone a below-the-knee amputation, with 1 requiring revision to an above-the-knee amputation. The LEAP patients were more likely to be discharged to acute rehabilitation (100% vs 27%; P more...

Published
2022

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3. Carotid Artery Operation Delay During the Covid-19 Pandemic: Results of a Multicenter International Study

Author

Kabeil, Mahmood, Wohlauer, Max V., D’Oria, Mario, Khetarpaul, Vipul, Gillette, Riley, Moore, Ethan, Colborn, Kathryn, Cuff, Robert F., O’Banion, Leigh Ann, Ali, Amna, Lucero, Leah, Costanza, Michael, Hammond, Eric, Motaganahalli, Raghunandan L., Samra, Humraaz, Westin, Gregory G., Allen, Kara, Sachdev, Ulka, Andraska, Elizabeth A., Sharafuddin, Mel, Pena-Quevedo, Judith, Koleilat, Issam, Carnevale, Matthew, Batarseh, Paola, Tonnessen, Britt H., Harroun, Nikolai, Sataviciute, Agnese, Aziz, Faisal, Tinelli, Giovanni, Chuen, Jason, Bath, Jonathan, Mills, Joseph L., Afifi, Rana O., Coscas, Raphaël, Shalhub, Sherene, Nkansah, Reggie, Beck, Adam W., St. John, Rebecca, Malekpour, Fatemeh, Siah, Michael, Kim, Sooyeon, Davies, Mark G., Todd, Grace Ihsiu, Busby, Courtney, Nelson, Peter R., Wyatt, Sydney, Ahmed, Sana, Cosentino, Ashley, Ghosh, Ahana, Miranda, Jorge A., Torres, Inez, Fakhradiyev, Ildar, Kota, Albert, Mier y Teran-Ellis, Santiago, Lopez, Gabriel, Hinojosa, Carlos A., Gunawansa, Nalaka, Mouawad, Nicolas J., Singh, Kuldeep, D'Oria, Mario, and O'Banion, Leigh Ann more...

Published
2023
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4. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Author

collaborative, The VERN COVER study, Ruffino, Maria Antonella, Chan, Sharon, Coughlin, Patrick, Awopetu, Ayoola, Stather, Philip, Lane, Tristan, Theodosiou, Dimitrios, Ahmed, Mohamed Abozeid, Vasudevan, Thodur, Ibrahim, Mohammed, Maadany, Faraj Al, Eljareh, Mohamed, Alkhafeefi, Fatimah Saad, Coscas, Raphael, Ünal, Ertekin Utku, Pulli, Raffaele, Zacà, Sergio, Angiletta, Domenico, Kotsis, Thomas, Moawad, Magdy, Tozzi, Matteo, Patelis, Nikolaos, Lazaris, Andreas M, Chuen, Jason, Croo, Alexander, Tsolaki, Elpiniki, Zenunaj, Gladiol, Kamal, Dhafer, Tolba, Mahmoud MH, Maresch, Martin, Khetarpaul, Vipul, Mills, Joseph, Gangwani, Gaurav, Elahwal, Mohamed, Khalil, Rana, Azab, Mohammed A, Mahomed, Anver, Whiston, Richard, Contractor, Ummul, Esposito, Davide, Pratesi, Carlo, Giacomelli, Elena, Troncoso, Martín Veras, Elkouri, Stephane, Johansson, Flavia Gentile, Dodos, Ilias, Benezit, Marie, Vidoedo, José, Rocha-Neves, João, Pereira-Neves, António Henrique, Dias-Neto, Marina Felicidade, Jácome, Ana Filipa Campos, Loureiro, Luis, Silva, Ivone, Garza-Herrera, Rodrigo, Canata, Victor, Bezard, Charlotte, Bowser, Kathryn, Tobar, Jorge Felipe, Vera, Carlos Gomez, Parra, Carolina Salinas, Lopez, Eugenia, Serra, Yvis Gadelha, Varela, Juan, Rubio, Vanessa, Victoria, Gerardo, Johnson, Adam, O’Banion, Leigh Ann, Makar, Ragai, Tantawy, Tamer Ghatwary, Storck, Martin, Jongkind, Vincent, falah, Orwa, McBride, Olivia, Isik, Arda, Papaioannou, Athanasios, Reis, Paulo Eduardo Ocke, Bracale, Umberto Marcello, Atkins, Ellie, Tinelli, Giovanni, Scott, Emma, Wales, Lucy, Sivaharan, Ashwin, Priona, Georgia, Nesbitt, Craig, Grainger, Tabitha, Shelmerdine, Lauren, Chong, Patrick, Bajwa, Adnan, Arwynck, Luke, Hadjievangelou, Nancy, Elbasty, Ahmed, Rubio, Oscar, Ricardo, Michael, Ulloa, Jorge H, Tarazona, Marcos, Pabon, Manuel, Pitoulias, Georgios, and Corless, Kevin more...

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Dentistry, Pediatric Research Initiative, Prevention, 6.4 Surgery, Evaluation of treatments and therapeutic interventions, VERN COVER study collaborative, AAA, COVID-19, PAD, Survey, Vascular surgery, Cardiovascular medicine and haematology, Clinical sciences
Abstract

ObjectiveTo document the recovery of vascular services in Europe following the first COVID-19 pandemic peak.MethodsAn online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March - May 2020, "period 1"), and then again between May and June ("period 2") and June and July 2020 ("period 3"). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume.ResultsThe impact of the pandemic continued to be felt well after countries' first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence.ConclusionCentres reported a broad return of services approaching pre-pandemic "normal" by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries. more...

Published
2022

5. Contemporary outcomes of traumatic popliteal artery injury repair from the popliteal scoring assessment for vascular extremity injury in trauma study

Author

O'Banion, Leigh Ann, Dirks, Rachel, Saldana-Ruiz, Nallely, Farooqui, Emaad, Yoon, William J, Pozolo, Cara, Fox, Charles J, Crally, Alexis, Siada, Sammy, Nehler, Mark R, Brooke, Benjamin S, Beckstrom, Julie L, Kiang, Sharon, Boggs, Hans K, Chandra, Venita, Ho, Vy T, Zhou, Wei, Lee, Ashton, Bowens, Nina, Cho, Yan, Woo, Karen, Ulloa, Jesus, and Magee, Gregory A more...

Subjects
Patient Safety, Clinical Research, Physical Injury - Accidents and Adverse Effects, Injuries and accidents, Good Health and Well Being, Adult, Amputation, Arterial Pressure, Decision Support Techniques, Female, Humans, Injury Severity Score, Limb Salvage, Male, Platelet Aggregation Inhibitors, Popliteal Artery, Predictive Value of Tests, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Ultrasonography, Doppler, United States, Vascular Patency, Vascular Surgical Procedures, Vascular System Injuries, Young Adult, Lower extremity trauma, Popliteal artery, Popliteal injury, Popliteal vein, Vascular trauma, Amputation, Surgical, Medical and Health Sciences, Cardiovascular System & Hematology
Abstract

ObjectiveTraumatic popliteal artery injuries are associated with the greatest risk of limb loss of all peripheral vascular injuries, with amputation rates of 10% to 15%. The purpose of the present study was to examine the outcomes of patients who had undergone operative repair for traumatic popliteal arterial injuries and identify the factors independently associated with limb loss.MethodsA multi-institutional retrospective review of all patients with traumatic popliteal artery injuries from 2007 to 2018 was performed. All the patients who had undergone operative repair of popliteal arterial injuries were included in the present analysis. The patients who had required a major lower extremity amputation (transtibial or transfemoral) were compared with those with successful limb salvage at the last follow-up. The significant predictors (P < .05) for amputation on univariate analysis were included in a multivariable analysis.ResultsA total of 302 patients from 11 institutions were included in the present analysis. The median age was 32 years (interquartile range, 21-40 years), and 79% were men. The median follow-up was 72 days (interquartile range, 20-366 days). The overall major amputation rate was 13%. Primary repair had been performed in 17% of patients, patch repair in 2%, and interposition or bypass in 81%. One patient had undergone endovascular repair with stenting. The overall 1-year primary patency was 89%. Of the patients who had lost primary patency, 46% ultimately required major amputation. Early loss (within 30 days postoperatively) of primary patency was five times more frequent for the patients who had subsequently required amputation. On multivariate regression, the significant perioperative factors independently associated with major amputation included the initial POPSAVEIT (popliteal scoring assessment for vascular extremity injury in trauma) score, loss of primary patency, absence of detectable immediate postoperative pedal Doppler signals, and lack of postoperative antiplatelet therapy. Concomitant popliteal vein injury, popliteal injury location (P1, P2, P3), injury severity score, and tibial vs popliteal distal bypass target were not independently associated with amputation.ConclusionsTraumatic popliteal artery injuries are associated with a significant rate of major amputation. The preoperative POPSAVEIT score remained independently associated with amputation after including the perioperative factors. The lack of postoperative pedal Doppler signals and loss of primary patency were highly associated with major amputation. The use of postoperative antiplatelet therapy was inversely associated with amputation, perhaps indicating a protective effect. more...

Published
2021

6. A framework for perioperative care in lower extremity major limb amputation: a consensus statement by the Enhanced Recovery After Surgery (ERAS) Society and Society for Vascular Surgery

Author

McGinigle, Katharine L., O'Banion, Leigh Ann, Settembrini, Alberto M., Vavra, Ashley K., Garg, Joy, Ayyash, Katie, Arya, Shipra, Thomas, Merin M., Dell, Kate E., Swiderski, Iris J., Davies, Mark G., Setacci, Carlo, Urman, Richard D., Howell, Simon J., Spangler, Emily L., and de Boer, Hans D. more...

Published
2024
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8. Popliteal scoring assessment for vascular extremity injuries in trauma study.

Author

O'Banion, Leigh Ann, Dirks, Rachel, Farooqui, Emaad, Saldana-Ruiz, Nallely, Yoon, William J, Pozolo, Cara, Fox, Charles, Crally, Alexis, Siada, Sammy, Nehler, Mark R, Brooke, Benjamin S, Beckstrom, Julie L, Kiang, Sharon, Boggs, Hans K, Chandra, Venita, Ho, Vy T, Zhou, Wei, Lee, Ashton, Bowens, Nina, Cho, Yan, Woo, Karen, Ulloa, Jesus, and Magee, Gregory A more...

Subjects
Knee Joint, Popliteal Artery, Humans, Knee Injuries, Ultrasonography, Doppler, Blood Pressure Determination, Prognosis, Limb Salvage, Injury Severity Score, Risk Assessment, Risk Factors, Retrospective Studies, Reproducibility of Results, Predictive Value of Tests, Blood Pressure, Decision Support Techniques, Time Factors, Adult, Middle Aged, United States, Female, Male, Fractures, Bone, Young Adult, Vascular System Injuries, Joint Dislocations, Amputation, Surgical, Lower extremity trauma, Popliteal artery, Popliteal injury, Vascular trauma, Physical Injury - Accidents and Adverse Effects, Clinical Research, Patient Safety, Detection, screening and diagnosis, 4.2 Evaluation of markers and technologies, Injuries and accidents, Good Health and Well Being, Amputation, Medical and Health Sciences, Cardiovascular System & Hematology
Abstract

ObjectiveTraumatic popliteal vascular injuries are associated with the highest risk of limb loss of all peripheral vascular injuries. A method to evaluate the predictors of amputation is needed because previous scores could not be validated. In the present study, we aimed to provide a simplified scoring system (POPSAVEIT [popliteal scoring assessment for vascular extremity injuries in trauma]) that could be used preoperatively to risk stratify patients with traumatic popliteal vascular injuries for amputation.MethodsA review of patients sustaining traumatic popliteal artery injuries was performed. Patients requiring amputation were compared with those with limb salvage at the last follow-up. Of these patients, 80% were randomly assigned to a training group for score generation and 20% to a testing group for validation. Significant predictors of amputation (P < .1) on univariate analysis were included in a multivariable analysis. Those with P < .05 on multivariable analysis were assigned points according to the relative value of their odds ratios (ORs). Receiver operating characteristic curves were generated to determine low- vs high-risk scores. An area under the curve of >0.65 was considered adequate for validation.ResultsA total of 355 patients were included, with an overall amputation rate of 16%. On multivariate regression analysis, the risk factors independently associated with amputation in the final model were as follows: systolic blood pressure more...

Published
2021

9. The impact of the COVID-19 pandemic on wellness among vascular surgeons

Author

Drudi, Laura M, Nishath, Thamanna, Ma, Xiya, Mouawad, Nicolas J, O'Banion, Leigh Ann, and Shalhub, Sherene

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Clinical Research, Mental Health, Health Services, Behavioral and Social Science, Management of diseases and conditions, 7.1 Individual care needs, Good Health and Well Being, Burnout, Professional, COVID-19, Humans, Surgeons, Vascular Surgical Procedures, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences
Abstract

The coronavirus disease 2019 (COVID-19) pandemic has placed significant strain on the health and welfare of all health care professionals, including vascular surgeons. This review summarizes the implications of the pandemic on the health and wellness of surgeons and trainees, with a particular focus on those in vascular surgery (VS). A literature review was completed using common resource databases. We provide a brief history of burnout in VS and explore burnout and wellness in VS during this unprecedented pandemic. We then offer recommendations to address mental health needs by the VS workforce and highlight opportunities to address the gaps in the literature. The impact of COVID-19 on the professional and personal lives of surgeons and trainees in VS is notable. More than half of vascular surgeons reported some degree of anxiety. Factors associated with anxiety and burnout include COVID-19 exposure, moral injury, practice changes, and financial impacts. Trainees appeared to have more active coping strategies with dampened rates of anxiety compared to those in practice. Women appear to be disproportionately affected by the pandemic, with higher rates of anxiety and burnout. Groups underrepresented in medicine seemed to have more resilience when it came to burnout, but struggled with other inequities in the health care environment, such as structural racism and isolation. Strategies for addressing burnout include mindfulness practices, exercise, and peer and institutional support. The COVID-19 pandemic has had a substantial mental health impact on the VS workforce globally, as shifts were made in patient care, surgical practice, and work-home life concerns. more...

Published
2021

10. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Author

Ruffino, Maria Antonella, Chan, Sharon, Coughlin, Patrick, Awopetu, Ayoola, Stather, Philip, Lane, Tristan, Theodosiou, Dimitrios, Ahmed, Mohamed Abozeid, Vasudevan, Thodur, Ibrahim, Mohammed, Al Maadany, Faraj, Eljareh, Mohamed, Alkhafeefi, Fatimah Saad, Coscas, Raphael, Ünal, Ertekin Utku, Pulli, Raffaele, Zacà, Sergio, Angiletta, Domenico, Kotsis, Thomas, Moawad, Magdy, Tozzi, Matteo, Patelis, Nikolaos, Lazaris, Andreas M., Chuen, Jason, Croo, Alexander, Tsolaki, Elpiniki, Zenunaj, Gladiol, Kamal, Dhafer, Tolba, Mahmoud MH., Maresch, Martin, Khetarpaul, Vipul, Mills, Joseph, Gangwani, Gaurav, Elahwal, Mohamed, Khalil, Rana, Azab, Mohammed A., Mahomed, Anver, Whiston, Richard, Contractor, Ummul, Esposito, Davide, Pratesi, Carlo, Giacomelli, Elena, Troncoso, Martín Veras, Elkouri, Stephane, Johansson, Flavia Gentile, Dodos, Ilias, Benezit, Marie, Vidoedo, José, Rocha-Neves, João, Pereira-Neves, António Henrique, Dias-Neto, Marina Felicidade, Campos Jácome, Ana Filipa, Loureiro, Luis, Silva, Ivone, Garza-Herrera, Rodrigo, Canata, Victor, Bezard, Charlotte, Bowser, Kathryn, Tobar, Jorge Felipe, Vera, Carlos Gomez, Parra, Carolina Salinas, Lopez, Eugenia, Serra, Yvis Gadelha, Varela, Juan, Rubio, Vanessa, Victoria, Gerardo, Johnson, Adam, O’Banion, Leigh Ann, Makar, Ragai, Tantawy, Tamer Ghatwary, Storck, Martin, Jongkind, Vincent, falah, Orwa, McBride, Olivia, Isik, Arda, Papaioannou, Athanasios, Ocke Reis, Paulo Eduardo, Bracale, Umberto Marcello, Atkins, Ellie, Tinelli, Giovanni, Scott, Emma, Wales, Lucy, Sivaharan, Ashwin, Priona, Georgia, Nesbitt, Craig, Grainger, Tabitha, Shelmerdine, Lauren, Chong, Patrick, Bajwa, Adnan, Arwynck, Luke, Hadjievangelou, Nancy, Elbasty, Ahmed, Rubio, Oscar, Ricardo, Michael, Ulloa, Jorge H., Tarazona, Marcos, Pabon, Manuel, Pitoulias, Georgios, Corless, Kevin, Ioannidis, Orestis, Friedrich, Oliver, Van Herzeele, Isabelle, Vijaynagar, Badri, Cohnert, Tina, Bell, Rachel, Moore, Hayley, Saha, Prakash, Gifford, Edward, Laine, Matti, Barkat, Adel, Karkos, Christos, Binti Safri, Lenny Suryani, Buitron, Gabriel, Del Castillo, Javier, Carrera, Paul, Salinas, Nilson, Biagioni, Rodrigo Bruno, Benites, Sergio, Mafla, César Andrés, Pian, Putera Mas, Albino, Pereira, Serrano, Ernesto, Marin, Andres, González, Marco, Foreroga, Marsha, Russo, Alejandro, Reyes, Andrés, Guglielmone, Daniel, Grillo, Lorena, Flumignan, Ronald, Palones, Francisco Gomez, Silveira, Pierre Galvagni, Ramely, Rosnelifaizur Bin, Edeiken, Sara, Chetter, Ian, Green, Lucy, Sudarsanam, Abhilash, Lyons, Oliver, Lemmon, Gary, Neville, Richard, Castelli, Mariano, Hinojosa, Carlos A., Carvajal, Rubén Rodríguez, Rivera, Aksim, Wong, Peng, Drudi, Laura, Perkins, Jeremy, Sieunarine, Kishore, Attia, Doaa, Atef, Mahmoud, Eftychios, Lostoridis, Weaver, Fred, Ren, Leong Chuo, Alomari, Mohannad, Jamjoom, Reda, Aljarrah, Qusai, Abbas, Ayman, Alomran, Faris, Kumar, Ambrish, Altoijri, Abdulmajeed, ElSanhoury, Kareem T., Alhumaid, Ahmed, Fekry, Tamer, Sekhar, Raghuram, Theodoridis, Panagiotis, Panagiotis, Theodoridis, Roditis, Konstantinos, Tsiantoula, Paraskevi, Antoniou, Afroditi, Soler, Raphael, Hasemaki, Natasha, Baili, Efstratia, Mpaili, Eustratia, Huasen, Bella, Wallace, Tom, Duncan, Andrew, Metcalfe, Matthew, Mannoia, Kristyn, Bechara, Carlos F., Tsilimparis, Nikolaos, Aranson, Nathan, Riding, David, Palena, Mariano, McDonnell, Ciarán, Mouawad, Nicolas J., Banegas, Shonda, Rossi, Peter, Oshodi, Taohid, Diaz, Rodney, Afifi, Rana, Dindyal, Shiva, Thapar, Ankur, Kordzadeh, Ali, Pullas, Gonzalo, Lin, Stephanie, Davies, Chris, Darvall, Katy, Kodama, Akio, Gooneratne, Thushan, Gunawansa, Nalaka, Munoz, Alberto, Jie, Ng Jun, Bradley, Nicholas, Al-Jundi, Wissam, Meyer, Felicity, Lee, Cheong, Malina, Martin, Renton, Sophie, Lui, Dennis, Batchelder, Andrew, Oszkinis, Grzegorz, Freyrie, Antonio, Giordano, Jacopo, Saratzis, Nikolaos, Tigkiropoulos, Konstantinos, Kyriakos, Stavridis, Popov, Guriy, Cheema, Muhammad Usman, Lapolla, Pierfrancesco, Ling Patricia, Yih Chun, Ennab, Raed, Ullery, Brant W., Pasenidou, Ketino, Tam, Jacky, Sidel, Gabriel, Jayaprakash, Vivek Vardhan, Bennett, Lisa, Hardy, Simon, Davies, Emma, Baker, Sara, Wijesinghe, Lasantha, Tam, Adam, McCune, Ken, Chana, Manik, Lowe, Chris, Goh, Aaron, Powezka, Katarzyna, Kyrou, Ioanna, Altaf, Nishath, Harkin, Denis, Travers, Hannah, Cragg, James, sharif, Atif, Akhtar, Tasleem, Chávez, José Antonio, Ordonez, Claudia, Mazzurco, Martin, Choke, Edward, Asghar, Imran, Summerour, Virginia, Dunlop, Paul, Morley, Rachel, Hardy, Thomas, Bevis, Paul, Cuff, Robert, Stavroulakis, Konstantinos, Beropoulis, Efthymios, Argyriou, Angeliki, Loftus, Ian, Azhar, Bilal, Sheth, Sharvil, Usai, Marco Virgilio, Choudhry, Asad, Nicole, Kira, Boyle, Emily, Joyce, Doireann, Abdelaty Hassan, Mohammed Hassan, Saltiel, Alberto, Frahm-Jensen, Gert, Antoniou, George, Elhadi, Muhammed, Kimyaghalam, Ali, Malgor, Rafael, O'Banion, Leigh Ann, Telve, Diego, Isaak, Andrej, Schmidli, Jürg, McKevitt, Kevin, Siddiqui, Tam, Asciutto, Giuseppe, Floros, Nikolaos, Papadopoulos, George, Kafetzakis, Alexandros, Koutsias, Stylianos G., Nana, Petroula, Giannoukas, Athanasios, Kakkos, Stavros, Moulakakis, Konstantinos G., Shafique, Natasha, Jawien, Arkadiusz, Popplewell, Matthew, Imray, Chris, Abayasekara, Kumar, Rowlands, Timothy, Kuhan, Ganesh, Rajagopalan, Sriram, Jaipersad, Anthony, Sadia, Uzma, Kobe, Isaac, Mittapalli, Devender, Enemosah, Ibrahim, Behrendt, Christian-Alexander, Beck, Adam, Almudhafer, Muayyad, Ancetti, Stefano, Jacobs, Donald, Jayakumar, Priya, Malekpour, Fatemeh, Shalhub, Sherene, Keldiyorov, Boboyor, Simon, Meryl, Khashram, Manar, Rich, Nicole, Shepherd, Amanda, Meecham, Lewis, Doherty, Daniel, and Benson, Ruth A. more...

Published
2022
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11. Managing central venous access during a health care crisis

Author

Chun, Tristen T, Judelson, Dejah R, Rigberg, David, Lawrence, Peter F, Cuff, Robert, Shalhub, Sherene, Wohlauer, Max, Abularrage, Christopher J, Anastasios, Papapetrou, Arya, Shipra, Aulivola, Bernadette, Baldwin, Melissa, Baril, Donald, Bechara, Carlos F, Beckerman, William E, Behrendt, Christian-Alexander, Benedetto, Filippo, Bennett, Lisa F, Charlton-Ouw, Kristofer M, Chawla, Amit, Chia, Matthew C, Cho, Sungsin, Choong, Andrew MTL, Chou, Elizabeth L, Christiana, Anastasiadou, Coscas, Raphael, De Caridi, Giovanni, Ellozy, Sharif, Etkin, Yana, Faries, Peter, Fung, Adrian T, Gonzalez, Andrew, Griffin, Claire L, Guidry, London, Gunawansa, Nalaka, Gwertzman, Gary, Han, Daniel K, Hicks, Caitlin W, Hinojosa, Carlos A, Hsiang, York, Ilonzo, Nicole, Jayakumar, Lalithapriya, Joh, Jin Hyun, Johnson, Adam P, Kabbani, Loay S, Keller, Melissa R, Khashram, Manar, Koleilat, Issam, Krueger, Bernard, Kumar, Akshay, Lee, Cheong Jun, Lee, Alice, Levy, Mark M, Lewis, C Taylor, Lind, Benjamin, Lopez-Pena, Gabriel, Mohebali, Jahan, Molnar, Robert G, Morrissey, Nicholas J, Motaganahalli, Raghu L, Mouawad, Nicolas J, Newton, Daniel H, Ng, Jun Jie, O'Banion, Leigh Ann, Phair, John, Rancic, Zoran, Rao, Ajit, Ray, Hunter M, Rivera, Aksim G, Rodriguez, Limael, Sales, Clifford M, Salzman, Garrett, Sarfati, Mark, Savlania, Ajay, Schanzer, Andres, Sharafuddin, Mel J, Sheahan, Malachi, Siada, Sammy, Siracuse, Jeffrey J, Smith, Brigitte K, Smith, Matthew, Soh, Ina, Sorber, Rebecca, Sundaram, Varuna, Sundick, Scott, Tomita, Tadaki M, Trinidad, Bradley, Tsai, Shirling, Vouyouka, Ageliki G, Westin, Gregory G, Williams, Michael S, Wren, Sherry M, Yang, Jane K, Yi, Jeniann, Zhou, Wei, Zia, Saqib, and Woo, Karen more...

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Coronaviruses, Patient Safety, Health Services, Clinical Trials and Supportive Activities, Infectious Diseases, Clinical Research, Emerging Infectious Diseases, 8.1 Organisation and delivery of services, Good Health and Well Being, Betacoronavirus, COVID-19, Catheterization, Central Venous, Coronavirus Infections, Cross-Sectional Studies, Delivery of Health Care, Integrated, Health Care Surveys, Health Services Needs and Demand, Host-Pathogen Interactions, Humans, Iatrogenic Disease, Infection Control, Pandemics, Pneumonia, Viral, Risk Assessment, Risk Factors, SARS-CoV-2, Central venous access, Central line teams, Iatrogenic injuries, Medical and Health Sciences, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences
Abstract

ObjectiveDuring the COVID-19 pandemic, central venous access line teams were implemented at many hospitals throughout the world to provide access for critically ill patients. The objective of this study was to describe the structure, practice patterns, and outcomes of these vascular access teams during the COVID-19 pandemic.MethodsWe conducted a cross-sectional, self-reported study of central venous access line teams in hospitals afflicted with the COVID-19 pandemic. To participate in the study, hospitals were required to meet one of the following criteria: development of a formal plan for a central venous access line team during the pandemic; implementation of a central venous access line team during the pandemic; placement of central venous access by a designated practice group during the pandemic as part of routine clinical practice; or management of an iatrogenic complication related to central venous access in a patient with COVID-19.ResultsParticipants from 60 hospitals in 13 countries contributed data to the study. Central venous line teams were most commonly composed of vascular surgery and general surgery attending physicians and trainees. Twenty sites had 2657 lines placed by their central venous access line team or designated practice group. During that time, there were 11 (0.4%) iatrogenic complications associated with central venous access procedures performed by the line team or group at those 20 sites. Triple lumen catheters, Cordis (Santa Clara, Calif) catheters, and nontunneled hemodialysis catheters were the most common types of central venous lines placed by the teams. Eight (14%) sites reported experience in placing central venous lines in prone, ventilated patients with COVID-19. A dedicated line cart was used by 35 (59%) of the hospitals. Less than 50% (24 [41%]) of the participating sites reported managing thrombosed central lines in COVID-19 patients. Twenty-three of the sites managed 48 iatrogenic complications in patients with COVID-19 (including complications caused by providers outside of the line team or designated practice group).ConclusionsImplementation of a dedicated central venous access line team during a pandemic or other health care crisis is a way by which physicians trained in central venous access can contribute their expertise to a stressed health care system. A line team composed of physicians with vascular skill sets provides relief to resource-constrained intensive care unit, ward, and emergency medicine teams with a low rate of iatrogenic complications relative to historical reports. We recommend that a plan for central venous access line team implementation be in place for future health care crises. more...

Published
2020

12. Contemporary Outcomes of Traumatic Popliteal Artery Injury Repair

Author

O'Banion, Leigh Ann, Pozolo, Cara G, Fox, Charles, Brooke, Benjamin, Kiang, Sharon, Chandra, Venita, Zhou, Wei, Cho, Yan, Ulloa, Jesus, and Magee, Gregory A

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Medical and Health Sciences, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences
Published
2020

38. Study design of the VenaSeal Spectrum Program: Two randomized controlled trials and one single-arm prospective study of a cyanoacrylate closure system to treat early to advanced chronic venous disease

Author

Jha, Pankaj, Villalba, Laurencia, Kayssi, Ahmed, Loffroy, Romaric, Nicolini, Philippe, Neaume, Nicolas, Hirsch, Tobias, Pavei, Patrizia, Stegher, Silvia, Kim, Tae-Hoon, Song, Suk-won, Park, Sang Woo, Min, Seung-Kee, Kim, Jang Yong, Reijnen, Michel, Salmerón, Luis Miguel, Fontcuberta, Juan, Gohel, Manjit, Davies, Alun, Najem, Mojahid, Hussain, Tahir, Khilnani, Neil, Bhalla, Karan, Balderman, Joshua, Kiguchi, Misaki, Gibson, Kathleen, Stoughton, Julianne, Phillips, John, Gagne, Paul, Lancaster, Todd, O'Banion, Leigh Ann, Attaran, Robert, Morse, Keith, Saina, Attaran, Anil, Kumar, Kim, Sue, Peng, Yun, and Ortiz, Sara more...

Published
2024
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39. Lower extremity amputation protocol: a pilot enhanced recovery pathway for vascular amputees.

Author

O'Banion, Leigh Ann, O'Banion, Leigh Ann, Qumsiyeh, Yazen, Matheny, Heather, Siada, Sammy S, Yan, Yueqi, Hiramoto, Jade S, Rome, Cambia, Dirks, Rachel C, Prentice, Anne, O'Banion, Leigh Ann, O'Banion, Leigh Ann, Qumsiyeh, Yazen, Matheny, Heather, Siada, Sammy S, Yan, Yueqi, Hiramoto, Jade S, Rome, Cambia, Dirks, Rachel C, and Prentice, Anne more...

Abstract

Vascular patients, an inherently older, frail population, account for >80% of major lower extremity amputations (transtibial or transfemoral) in the United States. Retrospective data have shown that early physical therapy and discharge to an acute rehabilitation facility decreases the postoperative length of stay (LOS) and expedites ambulation. In the present study, we sought to determine whether patients treated with the lower extremity amputation protocol (LEAP) will have improved outcomes. We performed a nonrandomized prospective study of vascular patients undergoing an amputation from January 2019 to February 2020. Patients who were nonambulatory or had undergone a previous contralateral major amputation were excluded. LEAP is a multidisciplinary team approach to the perioperative care of amputees using an outlined protocol. The prospective patients were compared with historic controls treated before the initiation of LEAP (January 2016 to December 2018). The primary outcomes included the postoperative LOS, time to receipt of a prosthesis, and time to ambulation. Of the 141 included patients, 130 were in the retrospective group and 11 in the LEAP group. The demographics and comorbidities were similar. All 11 LEAP patients had undergone a below-the-knee amputation, with 1 requiring revision to an above-the-knee amputation. Of the 130 retrospective patients, 122 (94%) had undergone a below-the-knee amputation, with 1 requiring revision to an above-the-knee amputation. The LEAP patients were more likely to be discharged to acute rehabilitation (100% vs 27%; P < .001), receive a prosthesis (100% vs 45%; P < .001), and ambulate with the prosthesis (100% vs 43%; P < .001). The LEAP patients had received physical therapy 2 days sooner than had the retrospective controls (P = .006) with a shorter postoperative LOS (3 days vs 6 days; P < .001). Of the patients who had received their prosthesis, the LEAP pat more...

Published
2022