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2. Treatment Outcome Trends for Non-Ruptured Abdominal Aortic Aneurysms: A Nationwide Prospective Cohort Study

Author

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

Published
2022
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5. Biomechanical studies on type B aortic dissection

Author

Veger, H.T.C., Hamming, J.F., Eps, R.G.S. van, Quax, P.H.A., Westenberg, J.J.M., Ackermann, M.D., Schepers, A., Herwaarden, J.A. van, and Leiden University

Subjects
TBAD, cardiovascular system, nutritional and metabolic diseases, False Lumen, In-vitro study, nervous system diseases, Type B Aortic Dissection
Abstract

The first part (Chapter 2) of this dissertation gives an introduction to Type B Aortic Dissection (TBAD). This overview shows several prognostic predictors of dissection related events (dissection related death or need for intervention) after initial medical management in acute uncomplicated TBAD. Predictors of complications in acute uTBAD during admission are aortic diameter ≥40mm, a primary entry tear >10mm, primary entry tear located on the concavity (undersurface) of the distal aortic arch, a FL diameter > 22mm, a peak CRP level >96mg/L and patency of the false lumen (defined as the concurrent presence of both flow and thrombus). The blood flow in the false lumen is highly variable due to morphological differences between various types of dissections. It is conceivable that patent branch vessels originating from the false lumen in an aortic dissection type B may contribute to persistent blood flow and patent false lumen, and thus to prognosis. Therefore, an in-vitro study was performed with a surgically constructed false lumen and an adjustable outflow branch (Chapter 3.). This in-vitro study show that different outflow from branch vessels originating from the false lumen in TBAD result in expansion of cross-sectional false lumen area. This might have important consequences for patients with uTBAD when patent branch vessel(s) originating from the false lumen and partial thrombosis (occluding distal tears) or no distal tear are present, as these patients might be more at risk for developing complicated TBAD. Haemodynamics, dissection morphology and aortic wall elasticity have a major influence onthe pressure in the false lumen. The influence of haemodynamics and dissection morphology have been investigated often in multiple in-vitro and ex-vivo studies in contrast to aortic wall elasticity.In Chapter 4 the influence of aortic wall elasticity on the diameter and pressure of the false lumen in aortic dissection is studied in-vitro. It shows that aortic wall elasticity is an important parameter altering the false lumen. This in-vitro study showed that an aortic wall with reduced elasticity results in an increased false lumen diameter in the mid and distal part of the false lumen. False lumen expansion might result in higher stress of the aortic wall and at the ending of the dissection. More insight in the hemodynamic changes during cardiac cycle in the true and false lumen of uncomplicated TBAD might result in prediction of adverse outcomes. Four-Dimensional flow Magnetic Resonance Imaging (4D flow MRI) compared to CTA provides insight into hemodynamic dimensions such as Wall Shear Stress. In arterial blood flow, the WSS expresses the viscous force per unit area applied by the fluid on the wall in a direction at the local interface. In Chapter 5. our ex-vivo research illustrates that an increase in heart rate (HR) from 60 to 80 bpm resultedin a significantly increase of the False Lumen Volume (FLV) and Wall Shear Stress (WSS) of the false lumen. Hereby we confirm that strict HR control is of major importance and reduces the mean and peak WSS in uncomplicated TBAD. The first line therapy in TBAD with malperfusion syndrome is coverage of the proximalentry tear by Thoracic Endo-Vascular Aortic Repair (TEVAR). When this method is unfeasible, endovascular aortic fenestration has been proposed as an alternative technique. Fenestration is a minimally invasive alternative for the treatment of acute symptomatic aortic dissections because it may quickly decrease the pressure gradient of the false lumen. It remains unclear where the optimal location of these fenestrations should be chosen. In Chapter 6. the false lumen volume after different fenestration strategies was studied. This in-vitro study showed that distal fenestration of the false lumen in aortic dissection will result in the largest false lumen reduction.

Published
2022

6. Treatment Outcome Trends for Non-Ruptured Abdominal Aortic Aneurysms: A Nationwide Prospective Cohort Study

Author

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

Published
2022
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8. Nationwide Study to Predict Colonic Ischemia after Abdominal Aortic Aneurysm Repair in The Netherlands

Author

Willemsen, S.I., Berge, M.G. Ten, Eps, R.G. Statius van, Veger, H.T.C., Overhagen, H. van, Dijk, L.C. van, Warle, M.C., Putter, H., Wever, J.J., Willemsen, S.I., Berge, M.G. Ten, Eps, R.G. Statius van, Veger, H.T.C., Overhagen, H. van, Dijk, L.C. van, Warle, M.C., Putter, H., and Wever, J.J.

Abstract

Item does not contain fulltext, BACKGROUND: Colonic ischemia remains a severe complication after abdominal aortic aneurysm (AAA) repair and is associated with a high mortality. With open repair being one of the main risk factors of colonic ischemia, deciding between endovascular or open aneurysm repair should be based on tailor-made medicine. This study aims to identify high-risk patients of colonic ischemia, a risk that can be taken into account while deciding on AAA treatment strategy. METHODS: A nationwide population-based cohort study of 9,433 patients who underwent an AAA operation between 2014 and 2016 was conducted. Potential risk factors were determined by reviewing prior studies and univariate analysis. With logistic regression analysis, independent predictors of intestinal ischemia were established. These variables were used to form a prediction model. RESULTS: Intestinal ischemia occurred in 267 patients (2.8%). Occurrence of intestinal ischemia was seen significantly more in open repair versus endovascular aneurysm repair (7.6% vs. 0.9%; P < 0.001). This difference remained significant after stratification by urgency of the procedure, in both intact open (4.2% vs. 0.4%; P < 0.001) and ruptured open repair (15.0% vs. 6.2%); P < 0.001). Rupture of the AAA was the most important predictor of developing intestinal ischemia (odds ratio [OR], 5.9, 95% confidence interval [CI] 4.4-8.0), followed by having a suprarenal AAA (OR 3.4; CI 1.1-10.6). Associated procedural factors were open repair (OR 2.8; 95% CI 1.9-4.2), blood loss >1L (OR 3.6; 95% CI 1.7-7.5), and prolonged operating time (OR 2.0; 95% CI 1.4-2.8). Patient characteristics included having peripheral arterial disease (OR 2.4; 95% CI 1.3-4.4), female gender (OR 1.7; 95% CI 1.2-2.4), renal insufficiency (OR 1.7; 1.3-2.2), and pulmonary history (OR 1.6; 95% CI 1.2-2.2). Age <68 years proved to be a protective factor (OR 0.5; 95% CI 0.4-0.8). Associated mortality was higher in patients with intestinal ischemia versus patients without (5

Published
2021

9. Association of Hospital Volume with Perioperative Mortality of Endovascular Repair of Complex Aortic Aneurysms

Author

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

Published
2023
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10. Clinical outcomes of postcarotid endarterectomy hypertension

Author

Ngo, H.T.N., Nemeth, B., Wever, J.J., Veger, H.T.C., Mairuhu, A.T.A., Laat, K.F. de, and Eps, R.G.S. van

Subjects
Risk factors, Carotid endarterectomy, Hypertension, Length of stay, Postcarotid endarterectomy hypertension
Abstract

Objective: The objective of this study was to determine the clinical relevance of postcarotid endarterectomy hypertension (PEH) by investigating the effect of PEH on hospital length of stay (LOS) and by investigating short-term and long-term complications of PEH. In addition, risk factors for PEH were determined.Methods: A single-center retrospective cohort study was performed. Demographic, preoperative, intraoperative, and postoperative outcomes of 192 patients undergoing carotid endarterectomy were evaluated. Outcomes were compared between patients with PEH and patients without PEH. PEH was defined as an acute systolic blood pressure (SBP) rise >170 mm Hg or persistent SBP >150 mm Hg on the ward and leading to the consultation of an internist. The overall survival and event-free survival were compared using a Kaplan-Meier analysis and a Cox regression analysis. A multivariate logistic regression analysis was performed to determine risk factors for PEH.Results: PEH developed in 44 of 192 patients (25%). Preoperative hypertension (SBP >150 mm Hg) was determined to be a risk factor for PEH (odds ratio, 3.3; 95% confidence interval [CI], 1.6-6.9). Hospital LOS was prolonged in patients with PEH compared with patients without PEH (median LOS of 5 days vs 3 days, respectively; P

Published
2020

11. Nationwide study of the treatment of mycotic abdominal aortic aneurysms comparing open and endovascular repair in The Netherlands

Author

Dang, Q., Statius van Eps, R.G., Wever, J.J., Warle, M.C., Veger, H.T.C., Dang, Q., Statius van Eps, R.G., Wever, J.J., Warle, M.C., and Veger, H.T.C.

Abstract

Contains fulltext : 226470.pdf (Publisher’s version ) (Closed access), OBJECTIVE: Mycotic aneurysms of the abdominal aorta (MAAA) can be treated by open repair (OR) or endovascular aneurysm repair (EVAR). This nationwide study provides an overview of the situation of MAAA treatment in The Netherlands in 2016. METHODS: A retrospective cohort study was conducted with all centers that registered aortic abdominal aneurysms in the Dutch Surgical Aneurysm Audit in 2016. Questionnaires on 1-year outcomes were sent to all centers that treated patients with MAAA. The primary aim was to determine 30-day and 1-year mortality and morbidity of OR- and EVAR-treated patients. Morbidity was determined by the need for reoperations and the number of readmissions to the hospital. RESULTS: Twenty-six MAAA were detected in the Dutch Surgical Aneurysm Audit database of 2016, resulting in an incidence of 0.7% of all registered abdominal aortic aneurysms. The 30-day mortality for OR and EVAR treated patients was 1 in 13 and 0 in 13, respectively. Major and minor reinterventions within 30 days were needed for two (one OR and one EVAR) and two (one OR and one EVAR) patients, respectively. Two patients (15.4%) in the OR group and one patient (7.7%) in the EVAR group were readmitted to hospital within 30 days. In total, 1-year outcomes of 23 patients were available. In the OR group, one patient (9.1%) died in the first postoperative year. There was one major reintervention (removal of endoprosthesis and spiralvein reconstruction) in the EVAR group. Two patients (18.2%) treated with OR and two (16.7%) treated with EVAR required a minor reintervention. In both groups, four patients (OR, 36.4%; EVAR, 33.3%) were readmitted to hospital within 1 year postoperatively. CONCLUSIONS: Both OR- and EVAR-treated patients show acceptable clinical outcomes after 30 days and at the 1-year follow-up. Depending on the clinical course of the patient, EVAR may be considered in the management of this disease.

Published
2020

13. Perprocedural Heparinization in Non-cardiac Arterial Procedures: The Current Practice in the Netherlands

Author

Roosendaal, Liliane C., Hoebink, Max, Wiersema, Arno M., Yeung, Kak K., Blankensteijn, Jan D., Jongkind, Vincent, Akkersdijk, W.L., Bender, M.H.M., Bendermacher, B., de Borst, G.J., Rossum, W.T.G.J. Bos–van, Brummel, P., Buscher, H.C.J.L., Cazander, G., Dijkstra, M.L., Ebben, H.P., Eefting, D., Elshof, J.W.M., Elsman, B.H.P., Faber, M.J., Fioole, B., Heyligers, J.M.M., Hoencamp, R., Hollander, E.J.F., de Jong, S.C., Koelemay, M.J.W., Koning, O.H.J., Kropman, R.H.J., van der Laan, L., Lemson, M.S., Lijkwan, M.A., Mees, B.M.E., Menting, T.P., Metz, R., Oomen, A.P.A., van Petersen, A.S., Pierie, M.E.N., Ponfoort, E.D., Reichmann, B.L., Reijnen, M.M.P.J., Saleem, B.R., van Schaik, J., Schlejen, P.M., Schlösser, F.J.V., Schouten, O., Teijink, J.A.W., Ünlü, Ç., Vahl, A.C., Veger, H.T.C., de Vos, B., Vos, C.G., de Vries, M., Welten, G., Wikkeling, O.R.M., Willems, M.C.M., and Verhagen, H.J.M.

Abstract

Purpose: Heparin is the most widely-used anticoagulant to prevent thrombo-embolic complications during non-cardiac arterial procedures (NCAP). Unfortunately, there is a lack of evidence and consequently non-uniformity in guidelines on perprocedural heparin management. Detailed insight into the current practice of antithrombotic strategies during NCAP in the Netherlands is important, aiming to identify potential optimal protocols and local differences concerning perprocedural heparinization.Materials and Methods: A comprehensive online survey was distributed electronically to vascular surgeons of every hospital in the Netherlands in which NCAP were performed. Data were collected from September 2020 to October 2021.Results: The response rate was 90% (53/59 hospitals). During NCAP, all surgeons generally administered heparin before arterial clamping. In 74% (39/54) of hospitals, a single heparin dosing protocol was used for all types of patients and vascular procedures. In 40%, there was no uniformity in heparin dosing between vascular surgeons. Depending on the procedure, a fixed bolus heparin, predominantly 5000 IU, was administered in 73% to 93%. In the remaining hospitals (7%–27%), a bodyweight-based heparin protocol was used, with an initial dose of 70 or 100 IU/kg. A minority (28%) monitored the effect of heparin in patients using the activated clotting time add (ACT) after activated clotting time. Target values varied between 180 and 250 seconds or 2 times the baseline ACT.Conclusion: This survey demonstrates considerable variability in perprocedural heparinization during NCAP in the Netherlands. Future research on heparin dosing is needed to harmonize and optimize heparin dosage protocols and contemporary guidelines during NCAP, and thereby improve vascular surgical care and patient safety.Clinical Impact This survey demonstrated persisting intra- and inter-hospital variability in perprocedural heparinization during non-cardiac arterial procedures (NCAP) in the Netherlands. The observed variability in heparinization strategies highlights the need for high quality evidence on perprocedural anticoagulation strategies. This is needed in order to harmonize and optimize heparin dosage protocols and contemporary guidelines and thereby improve vascular surgical patient care. Based on the current results, an international survey will be conducted by the authors to gain additional insight into the antithrombotic strategies used during NCAP, aiming to harmonize anticoagulation protocols worldwide.

Published
2024
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14. A Peculiar Case of a Floating Angio-Seal

Author

Dettmers, R.C., primary, Bosman, W.M.P.F., additional, van den Broek, M.A.J., additional, Veger, H.T.C., additional, Hedeman Joosten, P.Ph.A., additional, and Borger van der Burg, B.L.S., additional

Published
2016
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