Longer indwelling times usually result in vena caval perforation by retrievable Günther Tulip and Celect IVC filters. Although infrequently reported in the literature, clinical sequelae from IVC filter components breaching the vena cava can be significant. We advocate filter retrieval as early as clinically indicated and increased attention to the appearance of IVC filters on all follow-up imaging studies.
Delayed duplex ultrasound assessment after ETA of the GSV comes with associated health care costs but does yield a significant number of patients with progression to EHIT. Better understanding of the timing, risk factors, and significance of EHIT is needed to cost-effectively care for patients after ETA for varicose veins.
mortality were increased when surgery was performed by the lowest volume providers (quintile 1: 0-11 CEA/y; odds ratio, 2.62 [95% confidence interval, 1.3-5.28]) or a nonspecialty-trained (general) surgeon (1.64 [1.01-2.67]). After adjustment for all patient-level factors, provider volume remained an independent predictor of outcome, with significantly increased odds of mortality for volume quintile 1 (odds ratio, 2.57 [95% confidence interval, 1.27-5.23]) and quintile 2 (12-22 CEA/y: 0.30%; 2.07 [1-4.27]) surgeons. Conclusions: Adverse events after CEA for asymptomatic disease are comparatively rare. However, surgeon characteristics affect outcome, with the best results offered by high-volume, midcareer, specialty-trained surgeons. Efforts to define the optimal treatment of asymptomatic carotid atherosclerosis must account for the effect of surgeon characteristics on patient outcomes.
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