RESUMO
Purpose@#We compared the outcomes between the total endovascular approach using a unibody bifurcated aortoiliac endograft and the gold standard aortobifemoral bypass (ABF) surgery for the management of extensive aortoiliac occlusive disease (AIOD). @*Materials and Methods@#This retrospective observational study compared the outcomes of endovascular technique with unibody bifurcated endograft (UBE) using the Endologix AFX unibody stent-graft and a standard surgical approach (ABF) in the management of AIOD based on patient records in Western Vascular Institute, Galway University Hospital, National University of Ireland. Procedural details and outcomes were documented to compare both groups. @*Results@#From January 2002 to December 2018, 67 patients underwent AIOD (20 UBE and 47 ABF). Both the ABF and UBE groups showed 100% immediate clinical and technical successes without 30-day mortality. There were no statistical differences in the overall survival and sustained clinical improvement between the bypass and the UBE groups; however, statistically significant differences were observed in 3-year freedom from re-intervention and amputation-free survival. Furthermore, the mean length of the intensive care unit (ICU) stay was significantly lower in the UBE group than that in the ABF group (0.75 days vs. 3.1 days, P=0.001). @*Conclusion@#Total endovascular reconstruction of AIOD is an alternative to invasive bypass procedures, with a shorter ICU stay.
RESUMO
Purpose@#We compared the outcomes between the total endovascular approach using a unibody bifurcated aortoiliac endograft and the gold standard aortobifemoral bypass (ABF) surgery for the management of extensive aortoiliac occlusive disease (AIOD). @*Materials and Methods@#This retrospective observational study compared the outcomes of endovascular technique with unibody bifurcated endograft (UBE) using the Endologix AFX unibody stent-graft and a standard surgical approach (ABF) in the management of AIOD based on patient records in Western Vascular Institute, Galway University Hospital, National University of Ireland. Procedural details and outcomes were documented to compare both groups. @*Results@#From January 2002 to December 2018, 67 patients underwent AIOD (20 UBE and 47 ABF). Both the ABF and UBE groups showed 100% immediate clinical and technical successes without 30-day mortality. There were no statistical differences in the overall survival and sustained clinical improvement between the bypass and the UBE groups; however, statistically significant differences were observed in 3-year freedom from re-intervention and amputation-free survival. Furthermore, the mean length of the intensive care unit (ICU) stay was significantly lower in the UBE group than that in the ABF group (0.75 days vs. 3.1 days, P=0.001). @*Conclusion@#Total endovascular reconstruction of AIOD is an alternative to invasive bypass procedures, with a shorter ICU stay.
RESUMO
Introduction: the standardized Patient Program [SPP] is a standard educational training method which provides the preclinical students a better clinical foundation by linking the realm of clinical medicine to basic sciences. It incorporates a modern simulation technique and enhances the ability of the students wherein they can practice, apply and learn the basics of patient encounter. The main objective of this study was to analyze the implementation and efficiency of the SPP in Avalon University School of Medicine [AUSOM]
Methods: a quasi-experimental "before-and-after" study design was conducted among the 3rd Semester [MD3] medical students at AUSOM. 24 students voluntarily participated in the study. The effectiveness of the program was evaluated after comparing the summative examination scores before and after implementation of the SPP [graded in 100 points system]. Mean scores were calculated and a comparison of the change in scores was made, using a paired t-test in Stata [©Stata corp]
Results: the mean final summative clinical skills examination scores of the students before and after the introduction of the SPP were 78.46 +/- 6.62 [SEM: 1.35, range: 89-70] and 86.54 +/- 6.41 [SEM: 1.31, range: 98-65], respectively. There was a statistically significant increment [t=5.5058, p=0.0001] in the scores of the students after the introduction of the SPP
Conclusion: introduction and implementation of SPP at AUSOM at preclinical years increased the overall students' performance in clinical skills. It is necessary that medical schools implement SPP early in preclinical years to strengthen learning and inoculate necessary clinical skills in medical students