The Journal of cardiovascular surgery最新文献_第9页

Warm humidified CO2 insufflation improves pericardial integrity for cardiac surgery. A randomized control study. 在心脏手术中，温加湿CO2充气可改善心包完整性。随机对照研究。

The Journal of cardiovascular surgery Pub Date : 2022-03-01 DOI: 10.23736/S0021-9509.22.12004-5

R. Segal, P. Mezzavia, R. Krieser, Shienny Sampurno, M. Taylor, R. Ramsay, Michael Kluger, Keat Lee, F. Loh, J. Tatoulis, Michael O’Keefe, Yinwei Chen, Teresa Sindoni, Irene Ng

{"title":"Warm humidified CO2 insufflation improves pericardial integrity for cardiac surgery. A randomized control study.","authors":"R. Segal, P. Mezzavia, R. Krieser, Shienny Sampurno, M. Taylor, R. Ramsay, Michael Kluger, Keat Lee, F. Loh, J. Tatoulis, Michael O’Keefe, Yinwei Chen, Teresa Sindoni, Irene Ng","doi":"10.23736/S0021-9509.22.12004-5","DOIUrl":"https://doi.org/10.23736/S0021-9509.22.12004-5","url":null,"abstract":"BACKGROUND\u0000Flooding the surgical field with dry cold CO2 during open-chamber cardiac surgery has been used to mitigate air entrainment into the systemic circulation. However, exposing epithelial surfaces to cold, dry gas causes tissue desiccation. This randomised controlled study was designed to investigate whether the use of humidified warm CO2 insufflation into the cardiac cavity could reduce pericardial tissue damage and the incidence of micro-emboli when compared to dry cold CO2 insufflation.\u0000\u0000\u0000METHODS\u0000Forty adult patients requiring elective open-chamber cardiac surgery were randomised to have either dry cold CO2 insufflation via a standard catheter or humidified warm CO2 insufflation via the HumiGard device. The primary endpoint was biopsied pericardial tissue damage, assessed using electron microscopy. We assessed the percentage of microvilli and mesothelial damage, using a damage severity score (DSS) system. We compared the proportion of patients who had less damage, defined as DSS < 2. Secondary endpoints included the severity of micro-emboli, by visual assessment of bubble load on transoesophageal echocardiogram; lowest near infrared spectroscopy; total de-airing time; highest cardio-pulmonary bypass sweep speed; hospital length of stay and complications.\u0000\u0000\u0000RESULTS\u0000A higher proportion of patients in the humidified warm CO2 group displayed conserved microvilli (47% vs 11%, p=0.03) and preserved mesothelium (42% vs 5%, p=0.02) compared to the control group. There were no differences in the secondary outcomes.\u0000\u0000\u0000CONCLUSIONS\u0000Humidified warm CO2 insufflation significantly reduced pericardial epithelial damage when compared to dry cold CO2 insufflation in open-chamber cardiac surgery. Further studies are warranted to look into its potential clinical benefits.","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132794012","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

Frontiers in aortic arch surgery: partem futuri! 主动脉弓外科的前沿:部分未来!

The Journal of cardiovascular surgery Pub Date : 2022-03-01 DOI: 10.23736/S0021-9509.22.12332-3

M. Bashir, E. Chen, L. Girardi

引用次数: 0

The STABILISE technique to address malperfusion on acute-subacute type B aortic dissections. 稳定治疗急性-亚急性B型主动脉夹层灌注不良的技术。

The Journal of cardiovascular surgery Pub Date : 2022-03-01 DOI: 10.23736/S0021-9509.22.12249-4

D. Mascia, E. Rinaldi, A. Kahlberg, F. Monaco, M. De Luca, R. Chiesa, G. Melissano

引用次数: 2

Five-year outcomes of the Bi- versus Trimodular EndurantTM stent-graft in 100 patients with infrarenal abdominal aortic repair. 双模与三模endururttm支架在100例肾下腹主动脉修复患者中的5年预后。

The Journal of cardiovascular surgery Pub Date : 2022-03-01 DOI: 10.23736/S0021-9509.22.11947-6

Susanne Kemmling, M. Wiedner, E. Stahlberg, M. Sieren, F. Jacob, J. Barkhausen, J. Goltz

{"title":"Five-year outcomes of the Bi- versus Trimodular EndurantTM stent-graft in 100 patients with infrarenal abdominal aortic repair.","authors":"Susanne Kemmling, M. Wiedner, E. Stahlberg, M. Sieren, F. Jacob, J. Barkhausen, J. Goltz","doi":"10.23736/S0021-9509.22.11947-6","DOIUrl":"https://doi.org/10.23736/S0021-9509.22.11947-6","url":null,"abstract":"BACKGROUND\u0000Recent studies on the Endurant™ endografts mainly compared outcomes of the bimodular stent graft to other manufacturer's endografts or reported results for cases outside manufacturer's instructions for use (IFU), while data on the experience of standard endovascular aortic repair (EVAR) of infrarenal abdominal aortic aneurysms (AAA) inside manufacturer's IFU comparing the bi- with the trimodular device is limited.\u0000\u0000\u0000METHODS\u0000Inclusion criteria were 1) infrarenal aneurysms (>50 mm diameter) treated by EndurantTM II (END II) or EndurantTM IIs (END IIs) stent graft inside manufacturer's IFU 2) available CTA with 1 mm reconstruction of the entire aorta prior to intervention. Endpoints comparing the devices included technical success, 30d mortality, rate of complications (bleeding with conversion to open repair, stent graft stenosis/occlusion, acute distal embolism, infection or postprocedural necessity of dialysis), endoleaks and re-interventions (5-year follow-up). Aneurysm sac diameters were compared between baseline pre-interventional CTA and last post-interventional CTA.\u0000\u0000\u0000RESULTS\u0000100 patients (90% male, mean age 74y.) treated with END II (n=66) or END IIs (n=34) were included. Technical success was 99%. One procedure-related active bleeding occurred ending up in surgical conversion (END II n=1). 30d mortality was 0%. No initial type I/III endoleaks were present. Re-interventions were required in 19/100 (19%) of patients (END II n=10; END IIs n=9, p= 0.17). The outcome of EVAR including technical success, 30d mortality, rate of complications, endoleaks and re-interventions showed no significant differences comparing END II/IIs.\u0000\u0000\u0000CONCLUSIONS\u0000Five-year outcomes of EVAR show consistently safe and effective results for either END II or IIs device.","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133439207","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

Risk factors associated with mortality in the infective endocarditis patients requiring cardiac surgery: a study based on Latvian population. 与需要心脏手术的感染性心内膜炎患者死亡率相关的危险因素:一项基于拉脱维亚人口的研究

The Journal of cardiovascular surgery Pub Date : 2022-03-01 DOI: 10.23736/S0021-9509.22.12092-6

K. Meidrops, J. D. Osipovs, Arina Zuravlova, V. Groma, Mārtiņš Kalējs, E. Petrošina, Roberts Leibuss, E. Strīķe, U. Dumpis, A. Erglis, P. Stradins

{"title":"Risk factors associated with mortality in the infective endocarditis patients requiring cardiac surgery: a study based on Latvian population.","authors":"K. Meidrops, J. D. Osipovs, Arina Zuravlova, V. Groma, Mārtiņš Kalējs, E. Petrošina, Roberts Leibuss, E. Strīķe, U. Dumpis, A. Erglis, P. Stradins","doi":"10.23736/S0021-9509.22.12092-6","DOIUrl":"https://doi.org/10.23736/S0021-9509.22.12092-6","url":null,"abstract":"BACKGROUND\u0000Increased life expectancy, developments in medicine and intracardiac devices, accessibility of cardiac surgery, decrease in the prevalence of rheumatic heart disease are changing infective endocarditis patient profile and thus risk factors for the adverse events. This single-center-based study covering the whole Latvian population aimed to assess the intrahospital and 3-year mortality of infective endocarditis patients who underwent cardiac surgery, as well risk factors and laboratory indices predictive of adverse outcomes of the disease.\u0000\u0000\u0000METHODS\u0000Clinical profiles, data of laboratory and instrumental analyses, operation and intensive care unit records of cardiac surgery patients treated in Pauls Stradins Clinical University Hospital, Riga, Latvia between 2015 and 2019 were analysed.\u0000\u0000\u0000RESULTS\u0000We analysed data from 242 episodes of surgically treated infective endocarditis in 233 patients. The median age of patients was 57.00 (45.00-68.00) years. The rate of intrahospital mortality was 11.16%. Risk factors associated with mortality in the univariate analyses were S.aureus infection (HR 2.27, 95% CI 1.36-3.80; p=0.002) and systemic embolization of vegetations (HR 1.63, 95% CI 1.00-2.64; p=0.048). Perivalvular complications (HR 1.98, 95% CI 1.19-3.29; p=0.009) were found to be independently associated with mortality in multivariate analysis (HR 1.99, 95% CI 1.05-3.78; p=0.035). One-year survival was 78.3%, whereas three-year ‒ 71.3%.\u0000\u0000\u0000CONCLUSIONS\u0000Intrahospital mortality of surgically treated IE patients was 11.2%, however one- and three-year mortality was 21.7 and 28.7%, respectively. Perivalvular complications were independently associated with mortality. Laboratory indices were not predictive of adverse outcomes.","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122787216","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

Branch-first continuous perfusion aortic arch replacement. Insight into our results. 分支优先连续灌注主动脉弓置换术。洞察我们的结果。

The Journal of cardiovascular surgery Pub Date : 2022-03-01 DOI: 10.23736/S0021-9509.22.12272-X

G. Matalanis, Varun J. Sharma

{"title":"Branch-first continuous perfusion aortic arch replacement. Insight into our results.","authors":"G. Matalanis, Varun J. Sharma","doi":"10.23736/S0021-9509.22.12272-X","DOIUrl":"https://doi.org/10.23736/S0021-9509.22.12272-X","url":null,"abstract":"BACKGROUND\u0000Aortic-arch surgery often necessitates interruption of perfusion conferring higher morbidity and mortality compared to other aortic segments. We describe our Branch-first continuous-perfusion aortic-arch replacement (BF-CPAR) technique which overcomes these shortcomings, describing technique, results and improved outcomes.\u0000\u0000\u0000METHODS\u0000This represents the senior author's 15-year experience with BF-CPAR. Description of demographics, procedures and outcomes have been stratified by dissection and aneurysm aetiology, with prediction of mortality, cerebro -vascular events, renal failure, and end-organ ischaemia undertaken using multivariable logistic regression analysis.\u0000\u0000\u0000RESULTS\u0000From July 2005-February 2021, 155 patients underwent BF-CPAR, 93 for aneurysms and 62 for dissections. Median age at intervention was 66.8 years, 96 (61.9%) male, 18 (11.6%) with history of previous dissection repair, and 49 (31.6%) on an emergent basis. We observed an overall mortality of 4.5% (n=7) and stroke of 3.2% (n=5). Comparing elective to urgent cases, the mortality and stroke rates were significantly lower at 0.0% and 1.9% versus 14.2% and 6.1% (Risk Differences: 14.3% and 2.3%, p<0.01) respectively. Predictors of mortality were age (1.11 per year, 95%CI 1.00-1.23, p=0.05); of stroke were hypercholesterolaemia (14.4, 1.84-111.9, p=0.01) and hypertension (0.07, 0.01-0.84, p<0.01); and of dialysis were dissection (6.60, 1.76-24.7, p<0.01).\u0000\u0000\u0000CONCLUSIONS\u0000BF-CPAR is safe and adds to the armamentarium of Aortic Arch Repair. In elective and uncomplicated acute-dissection cases, it has no mortality and low stroke (1.9%), and vital organ dysfunction risk. Its results which are comparable to many of the best currently reported series, is driven by avoidance of cerebral circulatory arrest and reduction of cardiac and visceral ischemic time.","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123598767","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: 2

Long-term outcomes of endovascular aortic repair with flared iliac limb endografts in patients with abdominal aortic aneurysm and aneurysmal common iliac arteries. 腹主动脉瘤及髂总动脉动脉瘤患者行髂外展肢腔内修复的远期疗效。

The Journal of cardiovascular surgery Pub Date : 2022-03-01 DOI: 10.23736/S0021-9509.22.12040-9

S. Bonardelli, F. Verzini, N. Rivolta, G. Pagliariccio, Camilla Zanotti, M. Boero, M. Franchin, L. Carbonari, P. Baggi, L. Gibello, G. Parlani, Raffaella Cavi, G. Piffaretti

{"title":"Long-term outcomes of endovascular aortic repair with flared iliac limb endografts in patients with abdominal aortic aneurysm and aneurysmal common iliac arteries.","authors":"S. Bonardelli, F. Verzini, N. Rivolta, G. Pagliariccio, Camilla Zanotti, M. Boero, M. Franchin, L. Carbonari, P. Baggi, L. Gibello, G. Parlani, Raffaella Cavi, G. Piffaretti","doi":"10.23736/S0021-9509.22.12040-9","DOIUrl":"https://doi.org/10.23736/S0021-9509.22.12040-9","url":null,"abstract":"BACKGROUND\u0000To evaluate the long-term outcomes of endovascular aneurysm repair with flared iliac limb grafts in patients with abdominal aortic aneurysm (AAA) and aneurysmal common iliac arteries (CIAs).\u0000\u0000\u0000METHODS\u0000This is a multicenter, retrospective, observational cohort study that involves four tertiary referral hospitals between May 1st 2005 and April 30th 2019. Primary outcomes were freedom from aneurysm-related mortality (ARM), and freedom from iliac-related reintervention.\u0000\u0000\u0000RESULTS\u0000We studied 995 aneurysmal iliac limbs in 795 (85.2%) patients who met the inclusion criteria. Median AAA diameter was 55mm (IQR, 51-60). Early mortality occurred in 3 (0.4%) patients. The median of follow-up time was 52 months (IQR, 26-88). Estimated freedom from ARM was 99% ± 0.002 (95%CI: 99-99.9) at 1 year, and 99% ± 0.004 (95%CI: 97.9-99.6) at 5-years. Chronic obstructive pulmonary disease (HR: 6.4, 95%CI: 1.7-24.0, p = 0.006), chronic kidney disease (HR: 5.5, 95%CI: 1.4-21.9, p = 0.016), and the presence of an aneurysmal left CIA (HR: 5.3, 95%CI: 1.0.5-27.4, p = 0.044) was associated with ARM. There were 42 (7.3%) late iliac-related events (limb occlusion, n = 5; iliac-related endoleaks, n = 37). Estimated freedom from iliac-related reintervention was 98% ± 0.003 (95%CI: 97-99) at 1 year, and 95% ± 0.01 (95%CI: 92.7-96.7) at 5-years, which was associated with an aneurysmal right CIA (HR: 2.2, 95%CI: 1.3-3.9; p = 0.005), and age ≥ 78 years (HR: 1.9, 95%CI: 1.01-1.3; p = 0.039).\u0000\u0000\u0000CONCLUSIONS\u0000EVAR flared iliac limb grafts showed a high rate of freedom from ARM and a low reintervention rate. Owing to these results, it can be a durable and stable alternative for patients aged >78 years.","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132877337","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: 1

Institutional practice in sizing of the hybrid prosthesis in frozen elephant trunk surgery. 冷冻象鼻手术中混合假体尺寸确定的制度实践。

The Journal of cardiovascular surgery Pub Date : 2022-03-01 DOI: 10.23736/S0021-9509.22.12303-7

Idhrees Mohammed, S. Z. Tan, Matti Jubouri, M. Shaw, M. Bashir

{"title":"Institutional practice in sizing of the hybrid prosthesis in frozen elephant trunk surgery.","authors":"Idhrees Mohammed, S. Z. Tan, Matti Jubouri, M. Shaw, M. Bashir","doi":"10.23736/S0021-9509.22.12303-7","DOIUrl":"https://doi.org/10.23736/S0021-9509.22.12303-7","url":null,"abstract":"BACKGROUND\u0000The frozen elephant trunk (FET) technique for total arch replacement (TAR) is widely used for repair of aortic arch dissections and aneurysms. Despite its widespread adoption, there are no international or regional guidelines for the sizing of FET prostheses in TAR. We seek to highlight the heterogeneity thereof and pave the way for evidence-based guidelines to advise FET prosthesis sizing in TAR.\u0000\u0000\u0000METHODS\u0000An online questionnaire was sent to 22 specialist aortic surgeons from 13 different countries across North America, Europe, Asia, and Australia, inquiring about each surgeon's approach to FET prosthesis sizing. The results were then pooled for frequency analysis.\u0000\u0000\u0000RESULTS\u0000All 22 surgeons responded to the questionnaire. Zone 2 is preferred implantation zone for AAD, CAD, and TAA (selected by 72.7%, 72.7%, and 68.2% respectively). The maximal diameter of the true lumen in the DTA is the most common index measurement for AAD and CAD (40.9% and 59.1% respectively). Stent-graft diameters equal to the index measurement is the most common approach for AAD and CAD (77.3% and 45.5% respectively) while 59.1% of surgeons oversize the index diameter by 10% for TAA. 100 mm is the preferred length for 50.0%, 27.3%, and 40.9% of surgeons in AAD, CAD, and TAA respectively.\u0000\u0000\u0000CONCLUSIONS\u0000There is considerable heterogeneity in sizing practices for FET prostheses internationally, with variable evidence for its impact on clinical outcomes. This issue would be aided by the development of evidence-based guidelines to inform clinical decision making.","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128636659","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: 3

Hybrid revascularization vs coronary bypass for coronary artery disease: a systematic review and meta-analysis. 混合血运重建术vs冠状动脉搭桥术治疗冠状动脉疾病:系统回顾和荟萃分析。

The Journal of cardiovascular surgery Pub Date : 2022-03-01 DOI: 10.23736/S0021-9509.22.12163-4

D. Hinojosa-González, L. C. Bueno-Gutierrez, M. Salán-Gomez, Eduardo Tellez-Garcia, Isabela Ramirez-Mulhern, Diego Sepulveda-Gonzalez, D. Ramonfaur, A. Roblesgil-Medrano, E. Flores-Villalba

{"title":"Hybrid revascularization vs coronary bypass for coronary artery disease: a systematic review and meta-analysis.","authors":"D. Hinojosa-González, L. C. Bueno-Gutierrez, M. Salán-Gomez, Eduardo Tellez-Garcia, Isabela Ramirez-Mulhern, Diego Sepulveda-Gonzalez, D. Ramonfaur, A. Roblesgil-Medrano, E. Flores-Villalba","doi":"10.23736/S0021-9509.22.12163-4","DOIUrl":"https://doi.org/10.23736/S0021-9509.22.12163-4","url":null,"abstract":"INTRODUCTION\u0000Coronary artery bypass graft is the mainstay of treatment for multivessel coronary artery disease and is superior to percutaneous coronary intervention. Combined approaches such as hybrid coronary revascularization integrate coronary artery bypass grafting with percutaneous coronary intervention during the same procedure or weeks apart. These attempt to improve surgical morbidity and long-term outcomes.\u0000\u0000\u0000EVIDENCE ACQUISITION\u0000Per PRISMA criteria, a systematic review of keywords \"Hybrid revascularization\", \"Hybrid Coronary Revascularization\", \"Surgical\", \"Surgery\", \"Treatment\", \"CABG\", \"HCR\" and \"PCI\" was conducted in PubMed, EMBASE and SCOPUS. Studies comparing this technique's performance on either single or two-stage approach against traditional multiple vessel coronary artery bypass grafting were screened and analyzed for our review.\u0000\u0000\u0000EVIDENCE SYNTHESIS\u0000Twenty-two studies totaling 6,981 participants were ultimately included for analysis. Mean differences in operative time, bleeding, ventilator time and length of stay were significantly lower in the hybrid coronary revascularization group. Odds ratios in transfusions and in-hospital myocardial infarction were also lower in the hybrid coronary revascularization group. Results for in-hospital and all-cause mortality, major adverse cardiac events (MACE), stroke, reintervention, and complete revascularization were not significantly different.\u0000\u0000\u0000CONCLUSIONS\u0000Our analysis shows hybrid coronary revascularization is a feasible alternative to traditional coronary artery bypass grafting. Short-and long-term outcomes including mortality, MACE, and postoperative morbidity are similar between both groups, while hybrid approaches are associated with decreased perioperative morbidity.","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124678157","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: 1

Evidence for treatment of lower limb in-stent restenosis with drug eluting balloons. 药物洗脱球囊治疗支架内下肢再狭窄的证据。

The Journal of cardiovascular surgery Pub Date : 2020-10-01 DOI: 10.23736/S0021-9509.20.07968-9

Brian H Li, Y. Chan, Stephen W. K. Cheng

{"title":"Evidence for treatment of lower limb in-stent restenosis with drug eluting balloons.","authors":"Brian H Li, Y. Chan, Stephen W. K. Cheng","doi":"10.23736/S0021-9509.20.07968-9","DOIUrl":"https://doi.org/10.23736/S0021-9509.20.07968-9","url":null,"abstract":"INTRODUCTION\u0000Restenosis by myointimal hyperplasia after peripheral arterial angioplasty or stenting often limits long term patency. Drug-eluting balloons (DEBs) which inhibit the proliferation of neo-intimal growth of vascular smooth muscle cells may prevent restenosis. The aim of this paper was to examine the evidence in published literature on the use of DEBs in the treatment of peripheral arterial in-stent restenosis (ISR).\u0000\u0000\u0000EVIDENCE ACQUISITION\u0000A systematic literature review was undertaken of all published literature on the treatment of peripheral ISR with drug eluting balloon using Medline and cross-referenced. All published papers on the use of DEBs in peripheral arterial disease (PAD) were used. Cochrane Central Register of Controlled Trials and electronic databases were also searched for on-going studies.\u0000\u0000\u0000EVIDENCE SYNTHESIS\u0000There were no level 1 or 2 evidence published on this subject. The number of high-quality publications is few, and consequently a sufficient analysis is not possible. Recently data from non-randomized cohort studies showed encouraging results with DEB as treatment modality for ISR, whether used alone or as combined strategies.\u0000\u0000\u0000CONCLUSIONS\u0000Evidence from the published literature suggests that DEBs are safe in preventing peripheral ISR. Despite strong corporate pressure for the use of DEBs, there is only circumstantial evidence that this is a useful modality for ISR. Results from on-going studies may allow further meta-analysis for efficiency and cost-effectiveness.","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133270711","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