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Randomized controlled trials of interventions for acute iliofemoral deep venous thrombosis. 干预急性髂股深静脉血栓形成的随机对照试验。
The Journal of cardiovascular surgery Pub Date : 2024-02-01 Epub Date: 2024-01-16 DOI: 10.23736/S0021-9509.23.12926-0
Benedict R Turner, Adam M Gwozdz, Alun H Davies, Stephen A Black
{"title":"Randomized controlled trials of interventions for acute iliofemoral deep venous thrombosis.","authors":"Benedict R Turner, Adam M Gwozdz, Alun H Davies, Stephen A Black","doi":"10.23736/S0021-9509.23.12926-0","DOIUrl":"10.23736/S0021-9509.23.12926-0","url":null,"abstract":"<p><p>Venous thromboembolism (VTE), notably deep venous thrombosis (DVT), represents a significant cardiovascular disease with high morbidity from post-thrombotic syndrome (PTS). Recent advancements in early thrombus removal technologies have prompted randomized controlled trials (RCT) to assess their efficacy and safety, particularly for iliofemoral DVT (IF-DVT), which carries the greatest risk of developing PTS. This narrative review summarizes these trials and introduces upcoming innovations to evaluate acute intervention for IF-DVT. Specific technologies discussed include catheter-directed thrombolysis, pharmacomechanical catheter-directed thrombolysis, ultrasound-accelerated catheter-directed thrombolysis, and non-lytic mechanical thrombectomy. This review underscores the importance of patient selection, with those presenting with extensive, symptomatic IF-DVT likely to benefit most.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"42-48"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
European and US guidelines on acute DVT management. 欧洲和美国急性深静脉血栓管理指南。
The Journal of cardiovascular surgery Pub Date : 2024-02-01 DOI: 10.23736/S0021-9509.23.12861-8
Loukia Alexopoulou-Prounia, Stavros K Kakkos, Manjit Gohel
{"title":"European and US guidelines on acute DVT management.","authors":"Loukia Alexopoulou-Prounia, Stavros K Kakkos, Manjit Gohel","doi":"10.23736/S0021-9509.23.12861-8","DOIUrl":"10.23736/S0021-9509.23.12861-8","url":null,"abstract":"<p><p>Acute deep venous thrombosis (DVT) is a common health problem, affecting millions of patients in Europe and the United States annually. Europe and US national clinical practice guidelines are formulated by evaluation of the available scientific evidence, with expert opinion to create pragmatic guidance for the optimal patient management, representing the best available knowledge at the time of publication, and providing the best evidence-based recommendations for vascular patient care and venous pathologies. We here focus on the novel recommendations proposed by European and US guidelines for acute DVT, denoting main differences between the two panels. This review gives vascular surgeons the opportunity to identify the key points of the two largest Vascular Committees guidelines, in order to use them and offer their best individualized treatment approach to the specific patient's anatomy, lesion, and history.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"5-11"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endovenous treatment strategies for iliofemoral deep venous thrombosis. 髂股深静脉血栓的静脉内治疗策略。
The Journal of cardiovascular surgery Pub Date : 2024-02-01 DOI: 10.23736/S0021-9509.24.12971-0
Niels Bækgaard, Stephen A Black
{"title":"Endovenous treatment strategies for iliofemoral deep venous thrombosis.","authors":"Niels Bækgaard, Stephen A Black","doi":"10.23736/S0021-9509.24.12971-0","DOIUrl":"10.23736/S0021-9509.24.12971-0","url":null,"abstract":"","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"3-4"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transcatheter pulmonary valve replacement after pulmonary homograft dysfunction. 肺动脉同种移植功能障碍后的经导管肺动脉瓣置换术。
The Journal of cardiovascular surgery Pub Date : 2024-02-01 Epub Date: 2024-02-12 DOI: 10.23736/S0021-9509.24.12725-5
Marie-Catherine Morgant, Chloé Bernard, Luc Lorgis, Olivier Bouchot
{"title":"Transcatheter pulmonary valve replacement after pulmonary homograft dysfunction.","authors":"Marie-Catherine Morgant, Chloé Bernard, Luc Lorgis, Olivier Bouchot","doi":"10.23736/S0021-9509.24.12725-5","DOIUrl":"10.23736/S0021-9509.24.12725-5","url":null,"abstract":"<p><p>Pulmonary homograft dysfunction is challenging to treat in patients with a previous Ross procedure, and results in significant morbidity and mortality in case of reoperation. We report the case of a patient with early severe pulmonary homograft stenosis 18 months after a Ross procedure and successful management using transcatheter pulmonary valve replacement.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"76-78"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The toolbox of acute DVT intervention. 急性深静脉血栓干预工具箱。
The Journal of cardiovascular surgery Pub Date : 2024-02-01 Epub Date: 2024-01-23 DOI: 10.23736/S0021-9509.23.12897-7
Rick de Graaf, Houman Jalaie
{"title":"The toolbox of acute DVT intervention.","authors":"Rick de Graaf, Houman Jalaie","doi":"10.23736/S0021-9509.23.12897-7","DOIUrl":"10.23736/S0021-9509.23.12897-7","url":null,"abstract":"<p><p>Although the thrombectomy system is very important, there are many other devices and supportive tools that build the foundation for a successful interventional procedure. We suggest a toolbox of acute DVT intervention to aid in all likely strategies to effectively remove thrombus from the deep venous vasculature.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"38-41"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139522015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The changing face of surgical education: transfer of surgical and endovascular knowledge to young surgeons. 不断变化的外科教育：向年轻外科医生传授外科和血管内知识。
The Journal of cardiovascular surgery Pub Date : 2024-02-01 Epub Date: 2024-02-23 DOI: 10.23736/S0021-9509.24.12791-7
Peter Gloviczki
{"title":"The changing face of surgical education: transfer of surgical and endovascular knowledge to young surgeons.","authors":"Peter Gloviczki","doi":"10.23736/S0021-9509.24.12791-7","DOIUrl":"10.23736/S0021-9509.24.12791-7","url":null,"abstract":"<p><p>The goal of vascular surgery education is to provide the best possible training to vascular residents and fellows and to assure the highest standards of care for patients with vascular disease. In the USA, the currently used Vascular Surgery Milestones Program includes milestones as set targets at five levels, from novice to expertise, to assess the trainees' performance in knowledge, skills, attitudes, and other attributes of competencies. Competencies are broad and foundational domains of ability, the most important being the care of the patient. The soon to be introduced Entrustable Professional Activities (EPA) Project, a competency-based assessment, appears to be the best way to evaluate that trainees are ready to practice independently. Transferring surgical and endovascular skills to trainees has been, however, a challenge, because of the decreased number of open surgical procedures, the increasing number of the endovascular interventions, the decreased work hours for residents and that learning on patients in the operating room is no longer acceptable. Simulation laboratories, using 3D reconstructions of real patient's aneurysms has been most helpful to teach even complex endovascular procedures. In open or endovascular simulation laboratories, deliberate practice with focused attention and specific goals of improving performance should be combined with expert feedback. Greatness is not coded into our DNA but comes from deliberate practice, dedication and perseverance.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"64-68"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139935000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is a severe preoperative condition a contraindication for aortic valve-sparing reimplantation in type A aortic dissection? A 型主动脉夹层患者术前病情严重是否是主动脉瓣保留再植术的禁忌症？
The Journal of cardiovascular surgery Pub Date : 2024-02-01 DOI: 10.23736/S0021-9509.24.12638-9
Joël Lapeze, Jacques Robin, Jean Ninet, Jean-François Obadia, Fadi Farhat
{"title":"Is a severe preoperative condition a contraindication for aortic valve-sparing reimplantation in type A aortic dissection?","authors":"Joël Lapeze, Jacques Robin, Jean Ninet, Jean-François Obadia, Fadi Farhat","doi":"10.23736/S0021-9509.24.12638-9","DOIUrl":"10.23736/S0021-9509.24.12638-9","url":null,"abstract":"<p><strong>Background: </strong>Type A aortic dissection (TAAD) surgical management is still under debate. The purpose of this study was to demonstrate the feasibility and safety of the aortic valve-sparing root reconstruction (AVSR) procedure in 92 consecutive patients operated for TAAD, even when preoperative condition was severe (malperfusion, shock or both).</p><p><strong>Methods: </strong>Our hospital database was reviewed to identify all patients who underwent an AVSR procedure for TAAD over 14 years. From May 2000 to June 2014, 92 consecutive patients were studied regarding to their preoperative condition.</p><p><strong>Results: </strong>Age (61±13 years) and logistic Euroscore (23.4±15.3%) as well as cross-clamping (113±39 min), cardiopulmonary bypass (142±49 min) and circulatory arrest (22±13 min) times were collected. Hospital mortality was 16.3%. Mean follow-up was complete for a mean period of 27.6 months. One patient had early reoperation for aortic insufficiency. Actuarial survival at 1 year was 82.5%. The analysis of each group showed comparable mortality and morbidity in between patients.</p><p><strong>Conclusions: </strong>Based upon our experience in the management of TAAD, a reimplantation procedure could be performed regardless preoperative malperfusion or shock, with an acceptable postoperative over mortality or morbidity. A word of caution should be brought to patients over 70 years old.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"69-75"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The emerging role of mechanical thrombectomy in acute DVT management. 机械血栓切除术在急性深静脉血栓治疗中的新作用。
The Journal of cardiovascular surgery Pub Date : 2024-02-01 Epub Date: 2024-01-17 DOI: 10.23736/S0021-9509.23.12871-0
Efthymios D Avgerinos, Vasileios Bouris, Houman Jalaie
{"title":"The emerging role of mechanical thrombectomy in acute DVT management.","authors":"Efthymios D Avgerinos, Vasileios Bouris, Houman Jalaie","doi":"10.23736/S0021-9509.23.12871-0","DOIUrl":"10.23736/S0021-9509.23.12871-0","url":null,"abstract":"<p><p>Catheter directed thrombolysis (CDT) and pharmacomechanical thrombectomy in various technical combinations have been the main driver of acute deep venous interventions for over a decade. While the majority of high-level evidence was based on it, CDT requires longer procedural care and is associated to a small but not negligible bleeding risk. Contemporary DVT intervention, following the paradigm shift in myocardial infarction and stroke management, has steadily migrated towards minimizing or eliminating thrombolytics due to the introduction of mechanical/aspiration thrombectomy. Mechanical thrombectomy (MT) devices are undoubtedly improving our ability to remove thrombus more efficiently in a single session without the adverse events and complex logistics related to the use of thrombolytics.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"23-31"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The background and role of catheter-directed thrombolysis evolving procedures for acute iliofemoral deep venous thrombosis. 导管引导溶栓治疗急性髂股深静脉血栓的背景和作用。
The Journal of cardiovascular surgery Pub Date : 2024-02-01 Epub Date: 2024-01-23 DOI: 10.23736/S0021-9509.23.12860-6
Niels Bækgaard, Marie Josee E van Rijn
{"title":"The background and role of catheter-directed thrombolysis evolving procedures for acute iliofemoral deep venous thrombosis.","authors":"Niels Bækgaard, Marie Josee E van Rijn","doi":"10.23736/S0021-9509.23.12860-6","DOIUrl":"10.23736/S0021-9509.23.12860-6","url":null,"abstract":"<p><p>Minimal invasive treatment such as early endovenous thrombus removal for iliofemoral deep venous thrombosis (DVT) emerged in the end of last century. The principle is catheter-directed thrombolysis (CDT) using either plasminogen activating agents alone, as ultrasound-assisted CDT, or in combination with mechanical devices as pharmaco-mechanical CDT. The interest for this treatment modality is the high rate of post-thrombotic syndrome (PTS) with anticoagulation (AC) alone, especially after iliofemoral DVT. Recently published randomized controlled trials (RCTs) comparing early thrombus removal with AC alone, as well as non-randomized studies, have demonstrated favorable rates, or at least a decrease of moderate and severe PTS, in favor of these procedures. This article will summarize the background and evolution of the procedures in the last three decades and discuss fundamental criteria for inclusion and exclusion, focusing on the procedures regarding thrombus age and location, technical issues, complications and results including different outcome measures for PTS, for which iliac DVT involvement is a massive risk factor to be prevented.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"12-22"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139522063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of great saphenous vein quality on clinical outcomes after CABG in the REGROUP Trial. REGROUP 试验中大隐静脉质量对 CABG 术后临床效果的影响。
The Journal of cardiovascular surgery Pub Date : 2024-02-01 Epub Date: 2023-12-21 DOI: 10.23736/S0021-9509.23.12916-8
Ajami Gikandi, Jacquelyn Quin, Eileen M Stock, Ellen Dematt, Sameer Hirji, Miguel Haime, Kousick Biswas, Marco A Zenati
{"title":"Impact of great saphenous vein quality on clinical outcomes after CABG in the REGROUP Trial.","authors":"Ajami Gikandi, Jacquelyn Quin, Eileen M Stock, Ellen Dematt, Sameer Hirji, Miguel Haime, Kousick Biswas, Marco A Zenati","doi":"10.23736/S0021-9509.23.12916-8","DOIUrl":"10.23736/S0021-9509.23.12916-8","url":null,"abstract":"","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"79-81"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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