Twenty Years with the Swedvasc Registry

Björck, Martin; Bergqvist, David; Eliasson, Keith; Jansson, I; Karlström, Lars; Kragsterman, Björn; Lundell, Anna‐Carin; Malmstedt, Jonas; Nordanstig, Joakim; Norgren, Lars; Troëng, Thomas

doi:10.1016/j.ejvs.2007.11.007

Cited by 37 publications

(26 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The improved imaging routines, including duplex ultrasound, computed tomography angiography and magnetic resonance angiography may result in a thrombosed PA being detected more frequently in a patient with acute ischaemia. Finally, there may be issues concerning the structure of the Swedvasc, which was changed in 2008 7 permitting a more precise registration of patients treated for PA. Even before 2008, however, there was a specific procedure code for PA repair in the Inpatient Registry.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Popliteal Aneurysm by Open and Endovascular Surgery: A Contemporary Study of 592 Procedures in Sweden

Cervin¹,

Tjärnström²,

Ravn³

et al. 2015

Journal of Vascular Surgery

Self Cite

View full text Add to dashboard Cite

Treatment of Popliteal Aneurysm by Open and Endovascular Surgery: A Contemporary Study of 592 Procedures in SwedenCervin, A.; Tjarnstrom, J.; Ravn, H.; Acosta, Stefan; Hultgren, R.; Welander, M.; Bjorck, M. Link to publication Citation for published version (APA): Cervin, A., Tjarnstrom, J., Ravn, H., Acosta, S., Hultgren, R., Welander, M., & Bjorck, M. (2015). Treatment of Popliteal Aneurysm by Open and Endovascular Surgery: A Contemporary Study of 592 Procedures in Sweden. European Journal of Vascular and Endovascular Surgery, 50(3), 342-350. DOI: 10.1016/j.ejvs.2015.03.026 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal WHAT THIS STUDY ADDSPrevious comparisons between open and endovascular repair of popliteal aneurysms have focused on asymptomatic patients, and have short follow up. This study is strengthened by the fact that it is contemporary, population based, without any selection bias, reporting on all kinds of presentations, and has approximately 90% 1 year follow up data. It shows that endovascular repair has significantly inferior results compared with open repair, in particular in the group of patients who present with acute ischaemia. We believe these results will make many vascular surgeons think twice before they treat patients endovascularly in the future. Background: Popliteal aneurysm (PA) is traditionally treated by open repair (OR). Endovascular repair (ER) has become more common. The aim was to describe time trends and compare results (OR/ER).Methods: The Swedish vascular registry, Swedvasc, has a specific PA module. Data were collected (2008e2012) and supplemented with a specific protocol (response rate 99.1%). Data were compared with previously published data (1994e2002) from the same database.Results: The number of operations for PA was 15.7/million person-years (8.3 during 1994e2001). Of 592 interventions for PA (499 patients), 174 (29.4%) were treated for acute ischaemia, 13 (2.2%) for rupture, 105 (17.7%) for other symptoms, and 300 (50.7%) were asymptomatic (31.5% were treated for acute ischaemia, 1994e2002, p ¼ .58). There were no differences in background characteristics between OR and ER in the acute ischaemia group. The symptomatic and asymptomatic groups treated with ER were older (p ¼ .006, p < .001). ER increased 3.6 fold (4.7% 1994e2002, 16.7% 2008e2012, p ¼ .0001 Conclusions: The number of operations for PA doubled while the indications remained similar. ER patency was inferior to OR, especially after treatment for acute...

show abstract

Section: Discussionmentioning

confidence: 99%

Treatment of Popliteal Aneurysm by Open and Endovascular Surgery: A Contemporary Study of 592 Procedures in Sweden

Cervin¹,

Tjärnström²,

Ravn³

et al. 2015

Journal of Vascular Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…These results have shown 93.7% to 100% completeness. 20,21 Several articles have also studied the external and internal validation of Swedvasc showing high accuracy regarding stroke and death within 30 days postoperatively. [22][23][24] We obtained data for patients who underwent intervention for symptomatic carotid stenosis in Sweden between May 12, 2008, and May 31, 2011, and were recorded in Swedvasc (nϭ2763).…”

Section: Study Populationmentioning

confidence: 99%

Very Urgent Carotid Endarterectomy Confers Increased Procedural Risk

Strömberg

Gélin

Österberg

et al. 2012

Stroke

168

View full text Add to dashboard Cite

Background and Purpose— Current Swedish guidelines recommend that carotid endarterectomy should be performed within 14 days of a qualifying neurological event, but it is not clear if very urgent surgery after an event is associated with increased perioperative risk. The aim of this study was to determine how the time between the event and carotid endarterectomy affects the procedural risk of mortality and stroke. Methods— We prospectively analyzed data on all patients who underwent carotid endarterectomies for symptomatic carotid stenosis between May 12, 2008, and May 31, 2011, with records in the Swedish Vascular Registry (Swedvasc). Patients were divided according to time between the qualifying event and surgery (0–2 days, 3–7 days, 8–14 days, 15–180 days). Stroke rate and mortality at 30 days postsurgery were determined. Results— We analyzed data for 2596 patients and found that the combined mortality and stroke rate for patients treated 0 to 2 days after qualifying event was 11.5% (17 of 148) versus 3.6% (29 of 804), 4.0% (27 of 677), and 5.4% (52 of 967) for the groups treated at 3 to 7 days, 8 to 14 days, and 15 to 180 days, respectively. In a multivariate analysis, time was an independent risk factor for perioperative complications: patients treated at 0 to 2 days had a relative OR of 4.24 (CI, 2.07–8.70; P <0.001) compared with the reference 3- to 7-day group. Conclusions— In this study of patients treated for symptomatic carotid disease, it was safe to perform surgery as early as Day 3 after a qualifying neurological event in contrast to patients treated within 0 to 2 days, which has a significantly increased perioperative risk.

show abstract

“…1 We would add that key indicators (such as 30-day periprocedural stroke/death rates) must be accurately measured in routine (real-world) practice, particularly as stroke and death rates here may be unacceptably higher than in trials. [3][4][5] Therefore, it is most appropriate, as suggested by White and Jaff, 1 that coverage for carotid procedures be dependent on facility accreditation and audited measurement of key standards indicators in all practices performing these procedures. This is a priority issue.…”

mentioning

confidence: 99%