Evidence map›Paper›PMID 34186165›Full record

ArticleJournal of vascular surgery2022

Connective tissue disease type mediates branch patency of grafts in open thoracoabdominal aortic reconstruction.

Rebecca Sorber, Caitlin J Bowen, Caitlin W Hicks, James H Black

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of vascular surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Rebecca SorberDepartment of Vascular Surgery and Endovascular Therapy, The Johns Hopkins Hospital, Baltimore, Md; Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Md. Electronic address: rsorber1@jhmi.edu.
Caitlin J BowenDepartment of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Md.
Caitlin W HicksDepartment of Vascular Surgery and Endovascular Therapy, The Johns Hopkins Hospital, Baltimore, Md; Johns Hopkins Surgery Center For Outcomes Research (JSCOR), Johns Hopkins University School of Medicine, Baltimore, Md.
James H BlackDepartment of Vascular Surgery and Endovascular Therapy, The Johns Hopkins Hospital, Baltimore, Md.
Johns Hopkins University · USJohns Hopkins Hospital · US

Funding

Medical Scientist Training ProgramT32GM136577 · NIGMS · JOHNS HOPKINS UNIVERSITY · PI ANDREA L COX · 2020 to 2026
$13.4M
NIGMS NIH HHS T32 GM136577
6 · The paper itself

Abstract

objectiveDespite a shared degenerative vascular phenotype, Marfan syndrome (MFS), Loeys-Dietz syndrome (LDS), and other genetically distinct connective tissue diseases (CTDs) have unique extravascular pathologies that impact the outcomes of aortic replacement. The aim of our study was to investigate the association of CTD genotype with postoperative outcomes and branch patency following open thoracoabdominal aortic replacement in a large institutional cohort.

methodsAll patients undergoing open branched thoracoabdominal aortic replacement at a single academic center from 2006 to 2020 were included and classified as CTD or non-CTD based on the presence of genotypic documentation. Outcomes were compared using analysis of variance and χ

resultsOverall, 172 patients were included, with a mean follow-up of 30.5 ± 34.9 months. CTD was present in 45 patients (26%); specifically, 32 had MFS, five had LDS, and eight had another CTD. Patients with CTDs had more extent II thoracoabdominal aneurysms (40% vs 15%), more reconstructed branches (3.5 vs 1.8), more frequently reconstructed visceral branches (86.7% vs 22.7%), and higher intraoperative blood loss (13.3 vs 6.8 L; all P < .05) compared with non-CTD patients. Patients with MFS were more frequently systemically anticoagulated preoperatively (50% vs 5%) and demonstrated higher rates of postoperative deep vein thrombosis/pulmonary embolism compared with non-CTD patients (9% vs 2%; both P < .05). Five-year renal branch patency was decreased among all patients compared with visceral branches (87.3% vs 95.6%; P = .05), but there were no individual branch patency differences between patients with and without CTDs (P = .086). Overall branch patency at 1 and 5 years was significantly higher in patients with MFS than in non-CTD patients (98.9% vs 89.1% at 5 years); there were no significant patency differences between non-CTD patients and any other CTD subgroup, mostly due to early patency loss.

conclusionsOpen thoracoabdominal reconstruction in patients with CTD is technically challenging and associated with increased transfusion and postoperative thromboembolic events when compared with non-CTD patients. Technical outcomes of the procedure are excellent and are differentially associated with genotype, with patients with MFS experiencing significantly improved branch patency over both non-CTD patients and patients with other CTDs, a finding which has multifactorial drivers.

Indexed as

AdolescentAdultAgedAortic Aneurysm, ThoracicBlood Vessel Prosthesis ImplantationCase-Control StudiesChildFemaleGraft Occlusion, VascularHumansLoeys-Dietz SyndromeMaleMarfan SyndromeMiddle AgedRetrospective StudiesStentsConnective tissue diseaseLoeys-Dietz syndromeMarfan syndromeOpen aortic repairThoracoabdominal aortic repair

Identifiers

PMID34186165
PMCPMC8710179
OpenAlexW3176999491

What OpenQuestion holds

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LicenceTDM
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.