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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 6 of 6 Research Studies DisplayedRastogi V, Marcaccio CL, Kim NH
The effect of supraceliac versus infraceliac landing zone on outcomes following fenestrated endovascular repair of juxta-/pararenal aortic aneurysms.
The purpose of this study was to assess perioperative outcomes in patients in the Vascular Quality Initiative who underwent juxta-/pararenal FEVAR with supraceliac vs infraceliac sealing. 1,486 Patients who received an elective FEVAR for juxta-/pararenal aortic aneurysms in the Vascular Quality Initiative between 2014 and 2021were identified and included.
The researchers defined supraceliac sealing as proximal sealing in aortic zone 5, or zone 6 with a celiac scallop/fenestration/branch or celiac occlusion. The study’s primary outcomes were perioperative and 3-year mortality, and secondary outcomes were completion endoleaks, in-hospital complications, and variables related with 3-year mortality. The study found that of the included patients, 84% underwent infraceliac sealing, and 16% underwent supraceliac sealing. Of the supraceliac patients, 60% had a celiac fenestration/branch, 31% had a celiac scallop, and 9.2% had a celiac occlusion (intentional or unintentional). Compared with infraceliac sealing, there were no differences after risk-adjusted analysis in perioperative mortality following supraceliac sealing. Supraceliac sealing was associated with lower odds of type-IA completion endoleaks, but higher odds of any complication including cardiac complications, lower extremity ischemia and acute kidney injury when compared with infraceliac sealing. The researchers concluded that supraceliac sealing was associated with lower risk of type IA endoleaks and similar mortality compared with sealing at an infraceliac level. The researchers advise that providers should be aware that supraceliac sealing was related with higher perioperative morbidity.
The researchers defined supraceliac sealing as proximal sealing in aortic zone 5, or zone 6 with a celiac scallop/fenestration/branch or celiac occlusion. The study’s primary outcomes were perioperative and 3-year mortality, and secondary outcomes were completion endoleaks, in-hospital complications, and variables related with 3-year mortality. The study found that of the included patients, 84% underwent infraceliac sealing, and 16% underwent supraceliac sealing. Of the supraceliac patients, 60% had a celiac fenestration/branch, 31% had a celiac scallop, and 9.2% had a celiac occlusion (intentional or unintentional). Compared with infraceliac sealing, there were no differences after risk-adjusted analysis in perioperative mortality following supraceliac sealing. Supraceliac sealing was associated with lower odds of type-IA completion endoleaks, but higher odds of any complication including cardiac complications, lower extremity ischemia and acute kidney injury when compared with infraceliac sealing. The researchers concluded that supraceliac sealing was associated with lower risk of type IA endoleaks and similar mortality compared with sealing at an infraceliac level. The researchers advise that providers should be aware that supraceliac sealing was related with higher perioperative morbidity.
AHRQ-funded; HS027285.
Citation: Rastogi V, Marcaccio CL, Kim NH .
The effect of supraceliac versus infraceliac landing zone on outcomes following fenestrated endovascular repair of juxta-/pararenal aortic aneurysms.
J Vasc Surg 2023 Jan;77(1):9-19.e2. doi: 10.1016/j.jvs.2022.08.007..
Keywords: Cardiovascular Conditions, Surgery, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes, Comparative Effectiveness, Treatments
Kundi H, Popma JJ, Reynolds MR
Frailty and related outcomes in patients undergoing transcatheter valve therapies in a nationwide cohort.
In this study, the investigators sought to identify the prevalence and related outcomes of frail individuals undergoing transcatheter mitral valve repair and transcatheter aortic valve replacement (TAVR). Patients aged 65 and older were included in the study if they had at least one procedural code for transcatheter mitral valve repair or TAVR between 1 January 2016 and 31 December 2016 in the Centers for Medicare and Medicaid Services Medicare Provider and Review database.
Citation: Kundi H, Popma JJ, Reynolds MR .
Frailty and related outcomes in patients undergoing transcatheter valve therapies in a nationwide cohort.
Eur Heart J 2019 Jul 14;40(27):2231-39. doi: 10.1093/eurheartj/ehz187.
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Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions, Surgery, Outcomes, Treatments
Shahu A, Schwartz J, Perez M
Discerning quality: an analysis of informed consent documents for common cardiovascular procedures.
In this study, the investigators aimed to assess variation in quality of informed consent documents associated with three commonly performed cardiovascular procedures: left heart catheterisation, transesophageal echocardiography and implantation of a cardioverter defibrillator. The authors focused on basic elements of consent documents with the goal of illuminating opportunities to establish minimum standards for informed consent.
AHRQ-funded; HS023000.
Citation: Shahu A, Schwartz J, Perez M .
Discerning quality: an analysis of informed consent documents for common cardiovascular procedures.
BMJ Qual Saf 2017 Jul;26(7):569-71. doi: 10.1136/bmjqs-2016-005663..
Keywords: Cardiovascular Conditions, Surgery, Treatments, Quality of Care
Piccini JP, Fauchier L
Rhythm control in atrial fibrillation.
Many patients with atrial fibrillation have substantial symptoms despite ventricular rate control and require restoration of sinus rhythm to improve their quality of life. In patients who continue to have recurrent atrial fibrillation despite medical therapy, catheter ablation has been shown to substantially reduce recurrent atrial fibrillation, decrease symptoms, and improve quality of life.
AHRQ-funded; HS021092.
Citation: Piccini JP, Fauchier L .
Rhythm control in atrial fibrillation.
Lancet 2016 Aug 20;388(10046):829-40. doi: 10.1016/s0140-6736(16)31277-6.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Treatments
Barnett AS, Bahnson TD, Piccini JP
Recent advances in lesion formation for catheter ablation of atrial fibrillation.
This review summarized several recent advancements in catheter technology for atrial fibrillation (AF ablation) aimed at improving lesion formation It concluded that despite advances during the past decade, recurrence of AF after ablation is common. Recent technological innovations are likely to increase the safety, efficiency, and durability of lesion formation.
AHRQ-funded; HS021092.
Citation: Barnett AS, Bahnson TD, Piccini JP .
Recent advances in lesion formation for catheter ablation of atrial fibrillation.
Circ Arrhythm Electrophysiol 2016 May;9(5). doi: 10.1161/circep.115.003299.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Treatments
Tangri N, Miskulin DC, Zhou J
Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study.
The researchers studied the association of receipt of intravenous iron with hospitalizations in an incident cohort of hemodialysis patients. They concluded that a higher cumulative dose of intravenous iron may not be associated with increased risk of hospitalizations in hemodialysis patients. While clinical trials are needed, employing higher iron doses to reduce erythropoiesis-stimulating agents does not appear to increase morbidity in routine clinical care.
AHRQ-funded; 290200500341I.
Citation: Tangri N, Miskulin DC, Zhou J .
Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study.
Nephrol Dial Transplant 2015 Apr;30(4):667-75. doi: 10.1093/ndt/gfu349.
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Keywords: Comparative Effectiveness, Hospitalization, Kidney Disease and Health, Cardiovascular Conditions, Treatments