No abstract available.
Fibrinolytic Agents*

No abstract available.
Peripheral Arterial Disease*

No abstract available.
Humans ; Peripheral Arterial Disease*

No abstract available.
Drug Therapy* ; Humans ; Peripheral Vascular Diseases* ; Thrombolytic Therapy*

The rapid expansion of biomedical knowledge has made the challenge to acquire and evaluate new information quite formidable. Evidence-based medicine (EBM), a clinical problem-solving approach designed to help clinicians meet the challenge of incorporating the best available external evidence in caring for patients, consists of the following 5 steps: (1) defining the clinical problem presented by the patient and formulating an answerable question, (2) searching for the best reported evidence, (3) critically appraising the validity and clinical importance of this evidence, (4) applying it to clinical practice, and (5) evaluating the effectiveness and efficiency in executing steps 1~4 and seeking ways to improve both the next time. This paper describes the definition of EBM, background of its development, and the five steps that are involved.
Evidence-Based Medicine* ; Humans

PURPOSE: We report early experiences on endovascular abdominal aortic aneurysm repair (EVAR). METHOD: We reviewed the results of 15 patients underwent EVAR between 2003 and 2007 in the Kyung Hee University Medical Center, retrospectively. RESULT: Mean age of patients was 71.2 years (range, 51~85 years). 14 patients (93.3%) had comorbidities. All of AAAs were infrarenal types. The mean size of AAA was 58.5 mm (38~91 mm), and the mean length, diameter, and angle of neck was 26.4 mm, 19.9 mm, and 37.7degrees, respectively. Ten patients were accompanied with iliac aneurysm. 14 were bifurcated grafts and 1 was straight tubular graft. Mean procedure time was 100.6 minutes. Mean length of hospitalization was 6.5 days (2~10 days). There was no need of transfusion or use of an intensive care unit. Fever of unknown origin occurred in 7 cases but resolved spontaneously. Device deployment was successful in 100% (primary 9 cases, assisted-primary 6 cases). There were seven endoleaks during interventions. One patient with secondary type II endoleak and suprarenal enlargement of AAA sac died from aortoenteric fistula. In one patient with perigraft abscess after EVAR, surgical drainage was performed. Decrease of AAA diameter > or =5 mm in two patients, newly developed suprarenal aortic aneurysm in one patient were detected on CT scan during mean follow-up of 11.4 months (2-29 months) and remained unchanged in other twelve cases. CONCLUSION: These early results suggest that EVAR offers considerable benefits for appropriate patients, but is thought to need more experiences and long-term outcomes.
Abscess ; Academic Medical Centers ; Aneurysm* ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Comorbidity ; Drainage ; Endoleak ; Fever of Unknown Origin ; Fistula ; Follow-Up Studies ; Hospitalization ; Humans ; Iliac Aneurysm ; Intensive Care Units ; Neck ; Retrospective Studies ; Tomography, X-Ray Computed ; Transplants

PURPOSE: Cardiovascular risk assessment of atherosclerotic arterial occlusive diseases is a critical component of preoperative care. Many indexes have been developed to help identify patients at high risk for perioperative cardiac events. We sought to study guideline implementation and clinical outcomes in cardiovascular risk assessment. METHOD: We studied 75 patients who underwent preoperative cardiac risk assessment between 2003 and 2006 at the Kyung Hee University Medical Center. The American College of Cardiology/American Heart Association (ACC/AHA) guidelines were used to stratify the patients. RESULT: The mean age of patients was 67.9 years. When stratified into risk categories according to the ACC/AHA guidelines, 2 patients was high risk group, 51 intermediate risk group, and 22 low risk group. There were 3 perioperative cardiac complications (4.0%) including 2 mortalities (2.7%). There was a trend toward a higher frequency of cardiac complications when there was discordance with the ACC/AHA guidelines, but there was no significant difference (discordance 7.1%, concordance 0%, P=0.251). The guidelines recommended cardiac testing for 44 patients, but 12 patients (27.3%) were tested. The guidelines did not recommend for 31 patients, but additional cardiac tests were done for 10 patients (32.3%) and mainly associated with low risk group. CONCLUSION: Differences between clinician practice and guideline recommendations existed and did not result in a higher frequency of cardiac complications.
Academic Medical Centers ; Arterial Occlusive Diseases* ; Heart ; Humans ; Mortality ; Preoperative Care ; Risk Assessment*

PURPOSE: In the present study, the effects of autologous peripheral blood mononuclear cells (PBMNC) transplantation after granulocyte colony stimulation factor (G-CSF)-induced mobilization was investigated in patient with severe peripheral arterial disease. METHOD: 4 cases were enrolled: 3 cases are atherosclerosis obliterance and 1 case is thromboangitis obliterance. Following administration of G-CSF (10microgram/kg, maximum 600microgram), 4 times for 4 days. PBMNC were harvest and injected via femoral artery to vascular foot bed. RESULT: No serious complication was observed during G-CSF injection, harvest and injection. Improvement in the ankle brachial pressure index was seen in all patients at 4 weeks and ischemic ulcer improved in 2 of 3 patients. Using of pain control decreased in all cases and increased blood flow at 99 m-Tc perfusion scan in 2 of 2 patients. CONCLUSION: These favorable outcomes strongly suggest a therapeutic impact of transplantation PBMNC in clinical setting.
Ankle ; Atherosclerosis ; Cell Transplantation* ; Extremities* ; Femoral Artery ; Foot ; Granulocyte Colony-Stimulating Factor ; Granulocytes ; Humans ; Perfusion ; Peripheral Arterial Disease ; Transplants* ; Ulcer

No abstract available.
Anticoagulants ; Venous Thrombosis

No abstract available.
Venous Thromboembolism