Research Profile
Dr. Louis Nguyen has focused his vascular research interests on clinical outcomes of percutaneous interventions. The growth of percutaneous vascular interventional techniques had resulted in many unaswered questions that required novel studies and analytical techniques. One group of questions deals with determining the outcomes of interventions as they compare with well-established open techniques -- these are best addressed through clinical trials. A second set of questions deals with measuring quality of life and other socioeconomic outcomes that have not been well measured. For life-style limiting conditions such as claudication, quality of life and overall functional status are important outcomes not well captured by traditional measurements like survival and limb salvage. Finally, with the rapid development and adoption of technology in all medical fields, the long-term impact to the healthcare system needs to be examined in light of decreasing national resources.
Dr. Nguyen believes that clinical trials should be complemented by more general inquiries into financial and policy implications. Likewise, he feels that policy research in isolation cannot entirely guide the care of patients because of the inherent individual complexity and variation of patients. As a practicing vascular surgeon who is also trained in health services research, he is uniquely qualified to bridge the gap between innovative clinical practice and the effect of technology on the healthcare system. This "outcomes translational research", analogous to translational research for the basic sciences, will extend the application of new technologies and techniques to better fit with the changing socioeconomic demands in healthcare.
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Projects
Percutaneous Treatment of Claudication: The Role of Diabetes and Inflammation
Diabetes (DM) and peripheral artery disease (PAD) are rapidly growing health concerns among Americans. In particular, intermittent claudication (IC) affects walking function, general quality of life (QOL), and can herald worsening ischemia. The use of arterial angioplasty and stenting to treat lower extremity arterial occlusive disease has increased recently. However, clinical outcomes have been mixed and their impact on patient QOL difficult to measure; especially for patients with DM who may have additional biological and functional obstacles to treatment success.
The first aim of Dr. Louis Nguyen's prospective observational cohort study is to examine hemodynamic outcomes using arterial duplex. The second aim examines functional outcomes using treadmill walking performance and QOL surveys. The third aim combines these findings to examine larger treatment implications with a cost analysis and CMS database analysis specific to the care of DM patients. It is anticipated that his research will contribute to the better clinical and economic understanding of IC treatment outcomes for DM patients with PAD risk factors.
Drs. Michael Conte (Vascular Surgery), John Ayanian (Medicine and Harvard School of Public Health (HSPH)), and Mark Creager (Cardiovascular Medicine) will comprise the Advisory COmmittee. Drs. Allison Goldfine (Joslin Diabetes Center) and Myriam Hunink (HSPH) will serve as consultants. All five are internationally recognized clinician-researchers in their fields.
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Funding
Principal Investigator: Louis Nguyen, M.D., M.B.A., M.P.H.
Source: NIH K23
Title of Project: Percutaneous Treatment of Claudication: The Role of Diabetes and Inflammation
Project Period: 08/01/06 - 06/30/2011
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Publications
For the latest articles by Dr. Louis Nguyen, please visit 
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Brahmanandam S, Ding EL, Conte MS, Belkin M, Nguyen LL. Clinical results of carotid artery stenting compared with carotid endarterectomy. J Vasc Surg. 2008 Feb;47(2):343-9.
Nguyen LL, Brahmanandam S, Bandyk DF, Belkin M, Clowes AW, Moneta GL, Conte MS. Female gender and oral anticoagulants are associated with wound complications in lower extremity vein bypass: an analysis of 1404 operations for critical limb ischemia. J Vasc Surg. 2007 Dec;46(6):1191-1197.
Nguyen LL. Percutaneous treatment of peripheral vascular disease: the role of diabetes and inflammation. J Vasc Surg. 2007 Jun;45 Suppl A:A149-57. Review.
Schanzer A, Hoel A, Owens CD, Wake N, Nguyen LL, Conte MS, Belkin M. Restenosis after carotid endarterectomy performed with routine intraoperative duplex ultrasonography and arterial patch closure: a contemporary series. Vasc Endovascular Surg. 2007 Jun-Jul;41(3):200-5.
Schanzer A, Nguyen LL, Owens CD, Schanzer H. Use of digital pressure measurements for the diagnosis of AV access-induced hand ischemia. Vasc Med. 2006 Nov;11(4):227-31.
Nguyen LL, Moneta GL, Conte MS, Bandyk DF, Clowes AW, Seely BL; PREVENT III Investigators. Prospective multicenter study of quality of life before and after lower extremity vein bypass in 1404 patients with critical limb ischemia. J Vasc Surg. 2006 Nov;44(5):977-83; discussion 983-4.
Nguyen LL, Lipsitz SR, Bandyk DF, Clowes AW, Moneta GL, Belkin M, Conte MS. Resource utilization in the treatment of critical limb ischemia: The effect of tissue loss, comorbidities, and graft-related events. J Vasc Surg. 2006 Nov;44(5):971-5; discussion 975-6.
Chew DK, Nguyen LL, Owens CD, Conte MS, Whittemore AD, Gravereaux EC, Menard MT, Belkin M. Comparative analysis of autogenous infrainguinal bypass grafts in African Americans and Caucasians: the association of race with graft function and limb salvage. J Vasc Surg. 2005 Oct;42(4):695-701.
Nguyen LL, Gates JD. Simultaneous azygous vein and aortic injury from blunt trauma: Case report and review of the literature. J Trauma. 2006 Aug;61(2):444-6. Review.
Nguyen LL, Conte MS, Menard MT, Gravereaux EC, Chew DK, Donaldson MC, Whittemore AD, Belkin M. Infrainguinal vein bypass graft revision: factors affecting long-term outcome. J Vasc Surg. 2004 Nov;40(5):916-23.
Nguyen LL, Conte MS, Reed AB, Belkin M. Carotid endarterectomy: who is the high-risk patient? Semin Vasc Surg. 2004 Sep;17(3):219-23.
Menard MT, Nguyen LL, Chan RK, Conte MS, Fahy L, Chew DK, Donaldson MC, Mannick JA, Whittemore AD, Belkin M. Thoracovisceral segment aneurysm repair after previous infrarenal abdominal aortic aneurysm surgery. J Vasc Surg. 2004 Jun;39(6):1163-70.
Gravereaux EC, Nguyen LL, Cunningham LD. Congenital Vascular Anomalies. Curr Treat Options Cardiovasc Med. 2004 Apr;6(2):129-138.
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