Subhash Thakur - Academia.edu (original) (raw)

Papers by Subhash Thakur

Vascular, 2008

ly important in the management of patients with vascular disease, whether it is on the arterial o... more ly important in the management of patients with vascular disease, whether it is on the arterial or the venous side of the circulation. Anticoagulation for patients with thromboembolic disease is continually being refined, and platelet inhibition is a mainstay of treatment for all patients with atherosclerotic disease. The astute vascular surgeon begins planning a successful reconstruction before entering the operating room. It is well established that platelet deposition at the site of carotid endarterectomy and in bypass grafts can be significantly reduced by proper preoperative platelet inhibition, which translates into fewer postoperative ischemic events. Intraoperative pharmacotherapy likewise can reduce the risk of operative and postoperative ischemic complications. The appropriate use of postoperative antithrombotics improves survival, reduces other vascular bed ischemic events, and improves the long-term success of the target revascularization procedure. This article provides...

Page 1. Macroeconomic Accounting and Analysis in Transition Economies Abdessatar Ouanes and Subha... more Page 1. Macroeconomic Accounting and Analysis in Transition Economies Abdessatar Ouanes and Subhash Thakur International Monetary Fund Page 2. Page 3. Page 4. Page 5. Page 6. Page 7. Macroeconomic Accounting and ...

Handbook of Endovascular Interventions, 2012

Three sets of paired venae comitantes paralleling the course of three named arteries begin in the... more Three sets of paired venae comitantes paralleling the course of three named arteries begin in the distal calf. The paired veins join in the mid calf. The anterior tibial vein drains the anterior compartment, the posterior tibial vein drains the posterior compartment, and the peroneal vein drains the lateral compartment of the leg. They join to form the popliteal vein in the popliteal fossa.

A dynamic model of public investment, private investment, savings, and growth is developed and ap... more A dynamic model of public investment, private investment, savings, and growth is developed and applied to India and Korea. The model highlights the impact of public investment on private investment and growth by incorporating the various channels of influence that public investment has on private investment. Public investment crowds out private investment in the short term; however, it also raises

Paving Materials and Pavement Analysis, 2010

Laboratory Evaluation of Physical and Mechanical Properties of Recycled Asphalt Pavement. [ASCE C... more Laboratory Evaluation of Physical and Mechanical Properties of Recycled Asphalt Pavement. [ASCE Conference Proceedings 377, 31 (2010)]. Subhash C. Thakur, Jie Han, Wai Kiong Chong, Robert L. Parsons. Abstract. In many ...

Geo-Frontiers 2011, 2011

Comparison of Properties of RAP Aggregates Extracted by Ignition and Centrifuge Methods. [ASCE Co... more Comparison of Properties of RAP Aggregates Extracted by Ignition and Centrifuge Methods. [ASCE Conference Proceedings 397, 463 (2011)]. Subhash C. Thakur, Jie Han, Wai Kiong Chong, Robert L. Parsons. Abstract. Recycled ...

Journal of Vascular Surgery, 2012

Background: Perforation of the inferior vena cava (IVC) and its surrounding structures by filter ... more Background: Perforation of the inferior vena cava (IVC) and its surrounding structures by filter struts is a known complication. The goal of our review is to gauge the impact of IVC perforation by filters based on a 'real world' open database provided by users, facilities and manufacturers. Methods: We reviewed 3,123 adverse events of IVC filters reported in the Food and Drug Administration MAUDE (Manufacturer and User Facility Device Experience) database from January 2000 to June 2011. Outcomes of interest were incidence of IVC perforation, type of filter, clinical presentation, and management of the perforation, including irretrievability rates. Results: Three hundred sixty-seven cases of IVC perforation (12%) were reported. The annual distribution of IVC perforation was 32 (11%) cases, varying from 7 (6%) to 70 (17%). A threefold increase in the number of adverse events related to IVC filters has been noted since 2004; however, the accrual numbers of IVC perforation have not significantly changed over the years (Graph 1). The most common IVC filter involved in IVC perforation was the Bard G2 Filter Platform System (225, 61%), followed by the Cook Celect in 38 cases (10%). Vein wall perforation as an incidental finding was the most common presentation described in 171 (47%) patients. Surrounding organ involvement was found in 121 (33%) cases, with the aorta involved in 40 (33%) and the duodenum in 26 (21%) cases. The filter retrieval rate was 84% regardless of vein wall perforation. Forty (11%) cases required an open procedure to remove the filter due to either multi-organ involvement or a failed attempt at retrieval. Neither major bleeding requiring further intervention nor mortality was reported secondary to filter retrieval. Conclusions: IVC perforations by filters remain stable over the past decade despite increasing numbers of adverse events reported. The majority of filters involved in perforation were retrievable and had a multi-prong design for better attachment to the vein wall. Endovascular filter retrieval, regardless of IVC wall perforation, is feasible and must be attempted as it is associated with a higher success rate, and no mortality or major bleeding events have been reported.

Journal of Vascular Surgery, 2009

The proprietary heparin-bonded expanded polytetrafluoroethylene graft appears to be an attractive... more The proprietary heparin-bonded expanded polytetrafluoroethylene graft appears to be an attractive option for lower extremity revascularization in patients with compromised runoff and no autogenous vein. There is no detectable elution of heparin from the graft surface, but antithrombotic activity has been detected in devices implanted for >2 years. Although 15,000 Propaten (W. L. Gore and Associates, Flagstaff, Ariz) grafts have been implanted, to our knowledge, this is the first report of heparin-induced thrombocytopenia developing from this heparin-bonded graft. The heparininduced thrombocytopenia responded promptly to graft explantation. A management plan is suggested for patients being considered for this graft.

Journal of Vascular Surgery, 2013

Background: Extensive deep venous thrombosis (DVT) during pregnancy is usually treated with antic... more Background: Extensive deep venous thrombosis (DVT) during pregnancy is usually treated with anticoagulation alone, risking significant post-thrombotic syndrome (PTS) in young patients. Catheter-directed thrombolysis (CDT) and operative venous thrombectomy have been safely and effectively used in nonpregnant patients, demonstrating significant reduction in post-thrombotic morbidity. This report reviews short-and long-term outcomes of 13 patients with extensive DVT of pregnancy treated with a strategy of thrombus removal. Methods: From 1999 to 2013, 13 patients with iliofemoral DVT during pregnancy were offered CDT, pharmacomechanical thrombolysis (PMT), and/or venous thrombectomy. Gestational age ranged from 8 to 34 weeks. Fetal monitoring was performed throughout hospitalization. Radiation exposure was minimized with pelvic lead shields, focal fluoroscopy, and limited angiographic runs. Follow-up included objective vein evaluation using venous duplex and PTS assessment using the Villalta scale. Results: CDT and/or PMT were used in 11 patients. Two patients underwent venous thrombectomy alone, and one patient had operative thrombectomy as an adjunct to CDT and PMT. Each patient had complete or near-complete thrombus resolution and rapid improvement in clinical symptoms. Eight of 11 having CDT or PMT underwent venoplasty and stenting of the involved iliac veins. Twelve of the 13 delivered healthy infants at term. One patient opted for termination of her pregnancy. Mean patient and gestational ages were 26 years and 26 weeks, respectively. Mean followup was 1.3 years, with only one recurrence. Duplex ultrasonography demonstrated patent veins in all but one patient and normal valve function in 10 patients. Eleven patients had Villalta scores <5 (considered normal), with a mean score of 0.7. Conclusions: Extensive DVT of pregnancy can be effectively and safely treated with a strategy of thrombus removal, resulting in a patent venous system, normal valve function in many, prevention of PTS, and reduction in recurrence.

Carbon, 1982

AMrae&-This study investigated how differing nonreactive atmospheres affected the properties of c... more AMrae&-This study investigated how differing nonreactive atmospheres affected the properties of chars produced by coal pyrolysis. Samples of a Wyoming subbituminous coal were first heated at 586°C in helium for 6 hr. They were then heated for another 6 hr at 300°C higher in helium, argon or nitrogen. Weight losses in the chars during the second step were apparently unaffected by the choice of inert environment. Surface characteristics, pore structures, and reactivities of the resulting chars were, however, significantly different as shown by the results of scanning electron microscopy, nitrogen adsorption, carbon dioxide adsorption, and reactivity of the chars in carbon dioxide. Smoothness of the surface, adsorption capacities, N2 and CO1 surface areas, and reactivity during gasification all decreased in the direction (in order of inert atmospheres employed) He > Ar > NP In addition, there were strong indications that trace contaminants in the inert gases could alter the characteristics of the resulting char markedly.

Annals of Surgery, 2013

This study examined the frequency and reason for reinterventions and their impact on survival in ... more This study examined the frequency and reason for reinterventions and their impact on survival in contemporaneously treated cohorts of EVAR and open surgical repair (OSR) patients. EVAR has largely replaced OSR for anatomically appropriate AAA because of improved short-term outcomes. However, EVAR is associated with a notable reintervention rate. Data for patients undergoing elective AAA repair between 1996 and 2011 were collected and analyzed to assess time from initial procedure to reintervention and rate of reintervention. Patient demographics, comorbidities, number and type of reinterventions, graft type, and timing of reintervention were analyzed. A total of 1144 patients underwent AAA repair; 558 had EVAR and 586 had OSR. In 76 EVAR patients, 123 reinterventions were performed; 46 reinterventions were performed in 30 OSR patients (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). Endoleak was responsible for 66% of EVAR reinterventions; colonic ischemia, bleeding, and incisional hernias caused 30%, 22%, and 22% of OSR reinterventions, respectively. Time to first reintervention was shorter in OSR patients (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and was related to AAA size (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Early reintervention at the index procedure in OSR patients had a 23% mortality rate. If reinterventions were not required, survival curves were similar. Current endografts require fewer reinterventions than earlier generation endografts. Reintervention was more common with EVAR and occurred later. Early reintervention after OSR is associated with significant mortality. If early reintervention in OSR patients can be avoided, there is no early survival advantage to EVAR. Current endografts require fewer reinterventions than earlier devices.