Developing a complex endovascular fenestrated and branched aortic program
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Authors
Schanzer, AndresBaril, Donald
Robinson, William P. III
Simons, Jessica P.
Aiello, Francesco A.
Messina, Louis M.
UMass Chan Affiliations
Department of Surgery, Division of Vascular SurgeryDocument Type
Journal ArticlePublication Date
2015-03-01Keywords
AgedAortic Diseases
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation
effects
Clinical Competence
Cooperative Behavior
Education, Medical, Graduate
Endovascular Procedures
effects
Female
Health Care Sector
Humans
Interdisciplinary Communication
Interinstitutional Relations
Kaplan-Meier Estimate
Male
Models, Organizational
Organizational Objectives
Patient Care Team
Practice Management, Medical
Program Development
Program Evaluation
Prosthesis Design
Quality Improvement
Quality Indicators, Health Care
Retrospective Studies
Time Factors
Treatment Outcome
Health and Medical Administration
Surgery
Metadata
Show full item recordAbstract
In 2008, the top priority in our division's 5-year strategic plan was "to become an internationally recognized center of excellence for the endovascular treatment of complex aortic pathology extending from the aortic valve to the external iliac artery." Five components were identified as "most critical" to achieve this strategic priority: (1) training at centers of excellence in complex endovascular repair; (2) industry partnership to improve access to developing technologies; (3) a fully integrated team approach with one leader involved in all steps of all cases; (4) prospective data collection; and (5) development and implementation of a physician-sponsored investigational device exemption for juxtarenal, pararenal, and thoracoabdominal aneurysms. We have now performed 49 repairs (16 commercially manufactured devices, 33 physician-modified devices) for 3 common iliac, 20 juxtarenal, 9 pararenal, and 17 thoracoabdominal aneurysms, using 142 fenestrations, branches, and scallops. All patients had complete 30-day follow-up for calculation of 30-day events. Kaplan-Meier analysis was used to calculate 1-year events. In 5 years, we developed a successful complex endovascular aortic program that uses fenestrated/branched repair techniques. A focused team strategic planning approach to program development is an effective way for vascular surgery divisions to gain experience and expertise with new complex technologies while ensuring acceptable patient outcomes.Source
J Vasc Surg. 2015 Mar;61(3):826-31. doi: 10.1016/j.jvs.2014.08.121. Epub 2015 Jan 13. Link to article on publisher's siteDOI
10.1016/j.jvs.2014.08.121Permanent Link to this Item
http://hdl.handle.net/20.500.14038/30357PubMed ID
25595400Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.jvs.2014.08.121