Publications by authors named "Halbert Bai"
Article Synopsis
- - The study aims to reevaluate the relevance of contraindications for transcatheter tissue plasminogen activator (tPA) thrombolysis in treating acute limb ischemia (ALI), given recent advancements in medical techniques and technology.
- - Researchers conducted a retrospective analysis of medical records from patients treated with tPA for ALI between September 2016 and April 2022, identifying contraindications as defined by previous trials which grouped patients into "contraindicated" and "non-contraindicated" categories based on specific health conditions.
- - The findings showed that out of 76 patients, 24 (32%) had contraindications for tPA treatment, primarily due to factors like uncontrolled hypertension and recent invasive procedures,
Indications, technical aspects, and outcomes of stent placement in chronic iliofemoral venous obstruction.
J Vasc Surg Venous Lymphat Disord
September 2024
Background: Iliofemoral venous stent placement (IVS) has evolved to a well-established endovascular treatment modality for chronic iliofemoral venous obstruction (CIVO). Dedicated venous stents gained approval from the US Food and Drug Administration in 2019 and solidified IVS as a defined intervention with clear indications, contraindications, risks, benefits, and procedural management principles. This review focuses on the indications, technical aspects and outcomes of stenting for CIVO.
View Article and Find Full Text PDFBackground: Diabetes, hypertension, and smoking are well-recognized risk factors for peripheral artery disease (PAD), but little is known of their impact on chronic venous insufficiency (CVI). This study evaluates these factors in patients undergoing iliac vein stenting (IVS) for CVI.
Methods: A registry of 708 patients who underwent IVS from August 2011 to June 2021 was retrospectively analyzed.
Article Synopsis
- The study aimed to analyze TEVAR outcomes among different weight classes (normal, overweight, and obese) to identify complications, reintervention rates, and short-term mortality.
- A total of 204 patients were analyzed, revealing that obese patients were generally younger and had higher rates of type B aortic dissection, compared to normal-weight patients who mostly had thoracic aortic aneurysms.
- Despite the differences in patient characteristics, the study found no significant differences in intraoperative or postoperative complications, reintervention rates, or survival outcomes across the weight categories.
A comparison of below-knee vs above-knee endovenous ablation of varicose veins.
J Vasc Surg Venous Lymphat Disord
March 2024
Objective: Varicose veins have a significant impact on quality of life and can commonly occur in the thigh and calves. However, there has been no large-scale investigation examining the relationship between anatomic distribution and outcomes after varicose vein treatment. This study sought to compare below-the-knee (BTK) and above-the-knee (ATK) varicose vein treatment outcomes.
View Article and Find Full Text PDFArticle Synopsis
- The study aims to determine how accurately the Venous Clinical Severity Score (VCSS) can identify different stages of chronic venous disease (CVD) by correlating it with CEAP classification.
- Researchers analyzed data from 840 patients with chronic proximal venous outflow obstruction, assessing how well VCSS scores correspond to severities defined by CEAP (like edema and ulceration).
- Results indicate specific VCSS thresholds can effectively detect stages of CVD, with the following findings: a threshold of 8.5 for edema (C3) and 11.5 for skin changes (C4), showing varying sensitivity and specificity for each threshold.
We aimed to understand clinician perspectives on mental healthcare delivery during COVID-19 and the utility of tele-mental health services in carceral settings. A survey was administered in November 2022 through the American College of Correctional Physicians listserv. A nationwide sample of 55 respondents included 78.
View Article and Find Full Text PDFBackground: Our objective was to compare short-term and long-term differences in reintervention-free and major amputation-free survival between female and male patients undergoing lower extremity atherectomy for peripheral artery disease.
Methods: We analyzed lower extremity atherectomy procedures performed on 294 patients between January 2014 and September 2019. Reintervention was defined as either open bypass or endovascular procedure to the same region following the index operation.
Venous Clinical Severity Score has a suboptimal ability to detect improvement after iliac vein stenting across three years of follow-up.
J Vasc Surg Venous Lymphat Disord
July 2023
Article Synopsis
- The study evaluated the effectiveness of the Venous Clinical Severity Score (VCSS) in measuring clinical improvement after iliac venous stenting in patients with chronic venous disease, specifically focusing on those with non-thrombotic iliac vein lesions.
- A retrospective analysis was conducted on 433 patients who underwent stenting, using both VCSS and Clinical Assessment Scores (CAS) to assess changes in symptoms over time.
- The results indicated that change in VCSS was suboptimal for detecting clinical improvement, with area under the curve (AUC) values indicating limited discriminative ability at one, two, and three-year follow-ups.
Gender Differences in Iliofemoral Vein Stenting for Chronic Venous Insufficiency.
Vasc Endovascular Surg
July 2023
Introduction: Little is known about gender's role in chronic venous insufficiency (CVI). The aim of this study was to evaluate the impact of gender on outcomes of iliac vein stenting(IVS) for CVI.
Methods: 866 patients who underwent vein stenting for CVI at one institution from August 2011 to June 2021 were analyzed via retrospective review.
Article Synopsis
- This study investigates how race influences the outcomes of iliac vein stenting procedures for chronic venous insufficiency, revealing significant disparities across different racial groups.
- Data from 827 patients were analyzed, showing that Asian patients tended to be younger, healthier, and had fewer reinterventions compared to Black patients, who had the highest number of reinterventions and the longest follow-up.
- Despite these differences in demographics and outcomes, the stenting technique and overall changes in venous severity scores were similar across racial groups, indicating a need for further research into the underlying factors contributing to these disparities.
Sentiment Analysis of Online Patient-Written Reviews of Vascular Surgeons.
Ann Vasc Surg
January 2023
Article Synopsis
- * Data was gathered from 1,799 surgeons by cross-referencing directories and review sites, focusing on demographics, star ratings, and written feedback.
- * Results show that female surgeons received lower ratings and sentiment scores compared to male surgeons, while younger surgeons had higher star ratings; common positive terms included "Care" and "Kind," while negative reviews often mentioned "Pain" and "Rude."
Iliac vein stenting outcomes for patients with superficial venous insufficiency concurrent with deep venous disease.
J Vasc Surg Venous Lymphat Disord
November 2022
Article Synopsis
- The study investigated outcomes of iliac vein stenting in patients with chronic proximal venous outflow obstruction, comparing those with and without superficial venous insufficiency (SVI).
- A total of 553 patients were analyzed, with two groups: one without SVI (178 patients) and another with SVI (375 patients), showing significant differences in age, body mass index, diabetes, hypertension, and coronary artery disease.
- Results indicated that while both groups had similar improvements in symptoms, patients with SVI were significantly more likely to require additional minor postoperative procedures.
Background: Medical schools have increasingly integrated social justice, anti-racism, and health equity training into their curricula. Yet, no research examines whether medical students understand the complex history of racial injustice. We sought to investigate the relationship between medical students' historical knowledge and their perceptions regarding health equity.
View Article and Find Full Text PDFPatients with active venous leg ulcers at the time of iliac vein stenting require more reoperations.
J Vasc Surg Venous Lymphat Disord
November 2022
Article Synopsis
- The study investigated the effectiveness of iliac vein stenting (IVS) in treating patients with active venous leg ulcers (VLU+) compared to those without (VLU-), focusing on reoperation needs and symptom outcomes.
- A total of 872 patients were analyzed, revealing that the VLU+ group had a higher average number of reoperations (1.4) compared to the VLU- group (1.0) and a greater continued need for surgeries among those who underwent reoperation.
- Ulcer healing rates for the VLU+ group improved over time, reaching 59% at 36 months, but recurrence rates increased, indicating ongoing challenges in treatment for this cohort.
Article Synopsis
- This study evaluated the effectiveness of iliac vein stenting (IVS) for long-term relief of symptoms in patients with chronic venous outflow obstruction, analyzing data from over 700 patients from 2011 to 2021.
- Patients were categorized by the CEAP classification system to assess differences in outcomes like symptom relief and need for additional procedures (reintervention).
- Results showed that the severity of clinical classification impacted reintervention rates and symptom improvement, with most patients reporting better outcomes over a mean follow-up of 6 years, despite some differences among the cohorts.
Background: Atherectomy is associated with a risk of distal embolization, but the role of embolic protection devices (EPDs) during atherectomy is not well-defined. This study examines the utilization and impact of EPD on the outcomes of atherectomy during peripheral vascular interventions (PVIs).
Methods: The annual trend in utilization of EPD during atherectomy in the Vascular Quality Initiative PVI files (2010-2018) was derived.
The collapse of an abdominal aortic endograft is a rare event. We present the case of a 60-year-old man with an abdominal endograft who came to the emergency department with chest, back, abdominal, and lower extremity pain in addition to a cool left foot. On imaging, he was found to have a type B aortic dissection and a collapsed abdominal endograft.
View Article and Find Full Text PDFMay-Thurner syndrome (MTS) is a known structural risk factor for deep vein thrombosis (DVT) and embolism. In patients with a patent foramen ovale (PFO), emboli originating from the deep veins are able to paradoxically reach the systemic circulation via the PFO, consequently resulting in transient ischemic attacks (TIA) or stroke.We report the case of a 31-year-old pregnant woman, with a recent history of TIA, who presented with chronic bilateral numbness, pain, and swelling in the lower extremities.
View Article and Find Full Text PDFBackground: Medical compression stocking (MCS) therapy remains a core treatment for chronic venous disease, particularly in patients with lower extremity edema. This study investigated the impact of postoperative MCS adherence on patients with moderate to severe edema who underwent iliac vein stenting (IVS).
Methods: Patients at a large tertiary care center who underwent IVS from August 2011 to June 2021 were analyzed.
Purpose: The aim of this study is to analyze the utilization pattern of atherectomy modalities and compare their outcomes.
Materials And Methods: All patients undergoing atherectomy in the 2010-2016 Vascular Quality Initiative Database were identified. Utilization of orbital, laser, or excisional atherectomy was obtained.
The Flexner Report of 1910 transformed medical education and ushered in over a century of major medical advances and improvements in the practice of medicine. The requirements set forth by the report grounded modern medicine in the biomedical sciences and equipped physicians with the competencies to become excellent clinicians, researchers, and educators. However, rapid changes in the complexity and scale of the American health care system present today's physicians with a set of unique challenges.
View Article and Find Full Text PDFBackground: The use of atherectomy for lower extremity revascularization is increasing despite concerning reports about its long-term safety and effectiveness. This study compares the outcomes of atherectomy to percutaneous transluminal angioplasty (PTA) and stenting for treatment of isolated femoropopliteal disease.
Methods: All patients undergoing endovascular treatment of isolated femoropopliteal lesions in the Vascular Quality Initiative (2009-2018) were identified.