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Outcomes in Establishing Individual Vessel Patency for Pediatric Pulmonary Vein Stenosis

The purpose of this study was to determine what patient and pulmonary vein characteristics at the diagnosis of intraluminal pulmonary vein stenosis (PVS) are predictive of individual vein outcomes. A retrospective, single-center, cohort sub-analysis of individual pulmonary veins of patients enrolled...

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Autores principales: Callahan, Ryan, Gauvreau, Kimberlee, Marshall, Audrey C., Sena, Laureen M., Baird, Christopher W., Ireland, Christina M., McEnaney, Kerry, Bjornlund, Elsa C., Mendonca, Juliana T., Jenkins, Kathy J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000090/
https://www.ncbi.nlm.nih.gov/pubmed/33802089
http://dx.doi.org/10.3390/children8030210
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author Callahan, Ryan
Gauvreau, Kimberlee
Marshall, Audrey C.
Sena, Laureen M.
Baird, Christopher W.
Ireland, Christina M.
McEnaney, Kerry
Bjornlund, Elsa C.
Mendonca, Juliana T.
Jenkins, Kathy J.
author_facet Callahan, Ryan
Gauvreau, Kimberlee
Marshall, Audrey C.
Sena, Laureen M.
Baird, Christopher W.
Ireland, Christina M.
McEnaney, Kerry
Bjornlund, Elsa C.
Mendonca, Juliana T.
Jenkins, Kathy J.
author_sort Callahan, Ryan
collection PubMed
description The purpose of this study was to determine what patient and pulmonary vein characteristics at the diagnosis of intraluminal pulmonary vein stenosis (PVS) are predictive of individual vein outcomes. A retrospective, single-center, cohort sub-analysis of individual pulmonary veins of patients enrolled in the clinical trial NCT00891527 using imatinib mesylate +/− bevacizumab as adjunct therapy for the treatment of multi-vessel pediatric PVS between March 2009 and December 2014 was performed. The 72-week outcomes of the individual veins are reported. Among the 48 enrolled patients, 46 patients and 182 pulmonary veins were included in the study. Multivariable analysis demonstrated that patients with veins without distal disease at baseline (odds ratio, OR 3.69, 95% confidence interval, CI [1.52, 8.94], p = 0.004), location other than left upper vein (OR 2.58, 95% CI [1.07, 6.19], p = 0.034), or veins in patients ≥ 1 y/o (OR 5.59, 95% CI [1.81, 17.3], p = 0.003) were at higher odds of having minimal disease at the end of the study. Veins in patients who received a higher percentage of eligible drug doses required fewer reinterventions (IRR 0.76, 95% CI [0.68, 0.85], p < 0.001). The success of a multi-modal treatment approach to aggressive PVS depends on the vein location, disease severity, and drug dose intensity.
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spelling pubmed-80000902021-03-28 Outcomes in Establishing Individual Vessel Patency for Pediatric Pulmonary Vein Stenosis Callahan, Ryan Gauvreau, Kimberlee Marshall, Audrey C. Sena, Laureen M. Baird, Christopher W. Ireland, Christina M. McEnaney, Kerry Bjornlund, Elsa C. Mendonca, Juliana T. Jenkins, Kathy J. Children (Basel) Article The purpose of this study was to determine what patient and pulmonary vein characteristics at the diagnosis of intraluminal pulmonary vein stenosis (PVS) are predictive of individual vein outcomes. A retrospective, single-center, cohort sub-analysis of individual pulmonary veins of patients enrolled in the clinical trial NCT00891527 using imatinib mesylate +/− bevacizumab as adjunct therapy for the treatment of multi-vessel pediatric PVS between March 2009 and December 2014 was performed. The 72-week outcomes of the individual veins are reported. Among the 48 enrolled patients, 46 patients and 182 pulmonary veins were included in the study. Multivariable analysis demonstrated that patients with veins without distal disease at baseline (odds ratio, OR 3.69, 95% confidence interval, CI [1.52, 8.94], p = 0.004), location other than left upper vein (OR 2.58, 95% CI [1.07, 6.19], p = 0.034), or veins in patients ≥ 1 y/o (OR 5.59, 95% CI [1.81, 17.3], p = 0.003) were at higher odds of having minimal disease at the end of the study. Veins in patients who received a higher percentage of eligible drug doses required fewer reinterventions (IRR 0.76, 95% CI [0.68, 0.85], p < 0.001). The success of a multi-modal treatment approach to aggressive PVS depends on the vein location, disease severity, and drug dose intensity. MDPI 2021-03-10 /pmc/articles/PMC8000090/ /pubmed/33802089 http://dx.doi.org/10.3390/children8030210 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Callahan, Ryan
Gauvreau, Kimberlee
Marshall, Audrey C.
Sena, Laureen M.
Baird, Christopher W.
Ireland, Christina M.
McEnaney, Kerry
Bjornlund, Elsa C.
Mendonca, Juliana T.
Jenkins, Kathy J.
Outcomes in Establishing Individual Vessel Patency for Pediatric Pulmonary Vein Stenosis
title Outcomes in Establishing Individual Vessel Patency for Pediatric Pulmonary Vein Stenosis
title_full Outcomes in Establishing Individual Vessel Patency for Pediatric Pulmonary Vein Stenosis
title_fullStr Outcomes in Establishing Individual Vessel Patency for Pediatric Pulmonary Vein Stenosis
title_full_unstemmed Outcomes in Establishing Individual Vessel Patency for Pediatric Pulmonary Vein Stenosis
title_short Outcomes in Establishing Individual Vessel Patency for Pediatric Pulmonary Vein Stenosis
title_sort outcomes in establishing individual vessel patency for pediatric pulmonary vein stenosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000090/
https://www.ncbi.nlm.nih.gov/pubmed/33802089
http://dx.doi.org/10.3390/children8030210
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