Brian Wheatley - Academia.edu (original) (raw)
Uploads
Papers by Brian Wheatley
The American Journal of Surgery, 2014
BACKGROUND: Surgical pulmonary embolectomy (SPE) is indicated for a pulmonary embolism associated... more BACKGROUND: Surgical pulmonary embolectomy (SPE) is indicated for a pulmonary embolism associated with hemodynamic instability. A review of the literature demonstrates that most studies of SPE are conducted at large academic medical centers. This series is from a 325-bed community hospital.
Archives of Surgery, 2011
The antegrade access (AA) for percutaneous arterial interventions is associated with a higher com... more The antegrade access (AA) for percutaneous arterial interventions is associated with a higher complication rate than is the retrograde access (RA). Retrospective case review. A statewide consortium for peripheral vascular interventions consisting of 13 Michigan hospitals collecting data on their endovascular procedures. Demographic and procedure data on all patients receiving a percutaneous peripheral arterial intervention were entered prospectively by a full-time clinical nurse specialist in each hospital site. We evaluated vascular complications as a composite of retroperitoneal hematoma, pseudoaneurysm, hematoma requiring blood transfusion, arteriovenous fistula, acute thrombosis, or the need for surgical repair of the access site. In a 2-year period, we collected 6343 cases, of which 5918 had complete data regarding arterial access; of these, 745 (12.6%) were performed via an AA. There were fewer women and smokers (P < .001) in the AA group but more diabetic patients (P < .001). The indications for intervention were more frequently rest pain (P < .001) and limb salvage (P < .001) in the AA group. Multivariate regression analysis showed that the odds of complications were significantly higher with a larger sheath (95% confidence interval, 1.53-4.06; P < .001). Also, the incidence of blood transfusion and subsequent amputation was significantly higher in the AA group (P < .001). Endovascular procedures performed via an AA are more likely to result in perioperative complications and therefore should be used cautiously.
The American Journal of Surgery, 2011
BACKGROUND: An increasing number of elderly patients present for elective and emergent vascular p... more BACKGROUND: An increasing number of elderly patients present for elective and emergent vascular procedures. The purpose of this study was to analyze the 30-day and long-term outcome of patients in their 10th decade of life undergoing vascular procedures.
The American Journal of Surgery, 2014
BACKGROUND: Surgical pulmonary embolectomy (SPE) is indicated for a pulmonary embolism associated... more BACKGROUND: Surgical pulmonary embolectomy (SPE) is indicated for a pulmonary embolism associated with hemodynamic instability. A review of the literature demonstrates that most studies of SPE are conducted at large academic medical centers. This series is from a 325-bed community hospital.
Archives of Surgery, 2011
The antegrade access (AA) for percutaneous arterial interventions is associated with a higher com... more The antegrade access (AA) for percutaneous arterial interventions is associated with a higher complication rate than is the retrograde access (RA). Retrospective case review. A statewide consortium for peripheral vascular interventions consisting of 13 Michigan hospitals collecting data on their endovascular procedures. Demographic and procedure data on all patients receiving a percutaneous peripheral arterial intervention were entered prospectively by a full-time clinical nurse specialist in each hospital site. We evaluated vascular complications as a composite of retroperitoneal hematoma, pseudoaneurysm, hematoma requiring blood transfusion, arteriovenous fistula, acute thrombosis, or the need for surgical repair of the access site. In a 2-year period, we collected 6343 cases, of which 5918 had complete data regarding arterial access; of these, 745 (12.6%) were performed via an AA. There were fewer women and smokers (P < .001) in the AA group but more diabetic patients (P < .001). The indications for intervention were more frequently rest pain (P < .001) and limb salvage (P < .001) in the AA group. Multivariate regression analysis showed that the odds of complications were significantly higher with a larger sheath (95% confidence interval, 1.53-4.06; P < .001). Also, the incidence of blood transfusion and subsequent amputation was significantly higher in the AA group (P < .001). Endovascular procedures performed via an AA are more likely to result in perioperative complications and therefore should be used cautiously.
The American Journal of Surgery, 2011
BACKGROUND: An increasing number of elderly patients present for elective and emergent vascular p... more BACKGROUND: An increasing number of elderly patients present for elective and emergent vascular procedures. The purpose of this study was to analyze the 30-day and long-term outcome of patients in their 10th decade of life undergoing vascular procedures.