International Angiology最新文献

{"title":"Prescription versus over-the-counter venotonics: HPLC-DAD and static digestive model simulation comparison.","authors":"Robert Novotny, Matyas Orsak, Jaromir Lachman, Kotikova Zora, Barbora Novotna, Jaroslav Hlubocky, Jan Pitha, Libor Janousek","doi":"10.23736/S0392-9590.24.05291-X","DOIUrl":"https://doi.org/10.23736/S0392-9590.24.05291-X","url":null,"abstract":"<p><strong>Background: </strong>Venotonics are a class of therapeutically active molecules that have vaso-protective effects. They are used to alleviate venous diseases and disorders, particularly venous insufficiency. We compared the composition of prescription versus over-the-counter (OTC) venotonics using high-performance liquid chromatography with UV detection (HPLC-DAD) and simulating their digestion using a static digestive model.</p><p><strong>Methods: </strong>From each drug, five tablets were weighed. A homogenate was prepared, and 25 mg of crushed homogenized tablets were weighed into 25 ml volumetric flasks. Dissolved in MeOH and added two drops of saturated NaOH solution. The samples were filtered into vials (Teflon, 0.45 μm) and used for analysis. An Ultimate 3000 HPLC system (Thermo Fisher Scientific, Waltham, MA, USA) consisting of a quaternization pump, autosampler, column thermostat and DAD (UV/VIS detector) was used. The composition of the mobile phase proceeded in a linear gradient from 30% methanol and 70% phosphoric acid (0.15%) in water at time t=0 min. to 80% methanol and 20% phosphoric acid (0.15%) at time t=15 min., at a constant mobile phase flow rate of 1.2 mL/min. Detection was performed using a DAD detector in the 190-450 nm wavelength range. The content of monitored flavonoids was calculated from peaks at a wavelength of 277 nm, in which both flavonoids have their absorption maxima. The static digestive model was used to simulate the digestive phase from the oral cavity to the corresponding intestinal phase.</p><p><strong>Results: </strong>The content of diosmin and hesperidin (mg per table) for a prescription drug: Detralex: 480 mg, 26 mg. The content of diosmin and hesperidin (mg per tablet) for OTC drugs: Venostop: 502 mg, 48 mg, Diosminol: 520 mg, 50 mg, Devenal: 496 mg, 49 mg, Diohes: 493 mg, 46 mg. Digestion did not affect the solubility of all tested drugs. The active substances could not be determined in the non-alkalized sample. After alkalization, part of the insoluble matter was visibly dissolved and converted to a yellow flavonoid complex. Neither diosmin nor hesperidin could be identified afterwards.</p><p><strong>Conclusions: </strong>Our experimental results show that the contents of both listed active substances, diosmin and hesperidin, met the declared amounts in all tested medicaments. Digestion simulation showed identical behaviour in prescription and OTC venotonics. The active substances could not be determined in the non-alkalized sample. Digestion did not affect the solubility of the tested drugs.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"43 5","pages":"469-475"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mini-skin longitudinal incision versus traditional longitudinal incision for carotid endarterectomy in patients with carotid artery stenosis: a systematic review and meta-analysis.","authors":"Filipa Jácome, José Oliveira-Pinto, Ana Dionísio, Andreia Coelho, José F Ramos, Armando Mansilha","doi":"10.23736/S0392-9590.24.05300-8","DOIUrl":"10.23736/S0392-9590.24.05300-8","url":null,"abstract":"<p><strong>Introduction: </strong>Carotid endarterectomy (CEA) remains the gold standard intervention for stroke prevention in patients with carotid artery stenosis but the surgical technique continues evolving with research being conducted on minimally invasive alternatives. Mini-skin incision CEA has emerged as a more aesthetically appealing and less painful alternative to the traditional technique with a potential impact on main procedural events. We aimed to provide a review of the literature and to compare the mini-skin incision with the traditional approach.</p><p><strong>Evidence acquisition: </strong>A systematic review was conducted following the PRISMA guidelines. Databases PubMed and Scopus were last searched on 20^th July 2023. Procedural stroke, cranial/cervical nerves injury and mortality were defined as primary outcomes and length of hospitalization and minor complications as secondary outcomes. We included manuscripts comparing mini-skin with traditional incision CEA, and reporting our pre-established outcomes. The quality of studies was evaluated using the Newcastle-Ottawa Scale. We assessed heterogeneity and performed a meta-analysis for quantitative analysis when appropriate.</p><p><strong>Evidence synthesis: </strong>Five studies comprising a total of 2912 CEA procedures (2738 patients; 75.7% males) were included in both the qualitative and quantitative analysis. Compared with the traditional CEA, mini-skin incision led to a statistically significant decrease in periprocedural cranial/cervical nerve injury (OR 0.30, 95% CI 0.21, 0.43; P<0.01). Length of hospital stay and minor complications were significantly decreased in the mini-skin incision group (P<0.05). Concerning 30-day stroke rate and mortality no differences were attained.</p><p><strong>Conclusions: </strong>Our results suggest that mini-skin incision CEA might be a safer approach, with the potential to significantly decrease the perioperative morbidity. Further studies are needed to confirm these preliminary findings and to reinforce the role of mini-skin incision CEA as a promising, less invasive alternative in the treatment armamentarium of carotid artery stenosis.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"43 5","pages":"533-540"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organization of angiology in countries with associate societies of International Union of Angiology.","authors":"Pavel Poredos, Pier L Antignani, Peter Poredos, Armando Mansilha","doi":"10.23736/S0392-9590.24.05336-7","DOIUrl":"https://doi.org/10.23736/S0392-9590.24.05336-7","url":null,"abstract":"<p><p>Angiology is a multidisciplinary medical discipline, consequently in some countries multidisciplinary vascular centres were organized, which provide comprehensive management of patients with different vascular diseases. However, the organization of the care for vascular patients differs between the countries. Therefore, we aimed to check the organization of angiology (vascular surgery and vascular medicine) in countries-associate members of IUA and to stimulate the development of multidisciplinary vascular centres. The questionnaire was sent to 60 countries- associate members of IUA, and 35 societies from 30 countries responded. The responses showed that in most countries vascular patients are treated by vascular surgeons. Vascular surgeons and radiologists are also main providers of peripheral arterial diagnostics and invasive treatment. In most countries vascular medicine is marginalized. With the exception of some west European countries multidisciplinary vascular centres are rare and facilities for management of vascular patients insufficient. National societies expect from IUA more educational activities and creating consensus documents. Therefore, IUA should promote the foundation of vascular centres and provide systemic education in angiology.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"43 5","pages":"548-552"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current evidence on the effectiveness and safety of oral anticoagulants in superficial venous thrombosis: a systematic review and meta-analysis.","authors":"Vito A Damay, Ignatius Ivan, Marc Vuylsteke","doi":"10.23736/S0392-9590.24.05309-4","DOIUrl":"10.23736/S0392-9590.24.05309-4","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies suggest fondaparinux as an effective regimen for superficial venous thrombosis (SVT), but the inconvenience of prolonged parenteral injections has prompted investigations into oral anticoagulants (OACs). This study aims to evaluate the current evidence on the effectiveness and safety of OACs in the treatment of SVT.</p><p><strong>Evidence acquisition: </strong>Following the PRISMA 2020 guidelines, we conducted a systematic review and meta-analysis registered in PROSPERO (CRD42024535625). A comprehensive literature search was performed across multiple databases up to April 2024. Studies were included if they involved adult patients diagnosed with SVT, treated with OACs, and reported relevant efficacy and safety outcomes. Both randomized controlled trials (RCTs) and observational studies were considered. Data extraction and risk of bias assessments were independently performed by two authors.</p><p><strong>Evidence synthesis: </strong>The search identified 1531 studies, with six studies (three RCTs and three prospective cohort studies) meeting inclusion criteria. Meta-analysis for Rivaroxaban-treated group showed DVT occurrence was 1.30% (95% CI 0.17-3.07%), SVT extension was 0.32% (95% CI: 0.00-1.58%), SVT recurrence was 0.75% (95% CI: 0.00-3.30%), clinically relevant non-major bleeding was 1.95% (95% CI: 0.46-4.11%), minor bleeding was 5.68% (95% CI: 3.02-9.01%). These estimates were for patients treated with rivaroxaban 10-20 mg once daily over 42 days to 37 months. No major bleeding was reported with rivaroxaban 10 mg once daily.</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis demonstrate that OACs, especially rivaroxaban, are effective and safe for the treatment of SVT. They offer a convenient alternative to parenteral anticoagulants, potentially improving patient compliance and outcomes. However, further large-scale studies are warranted to confirm these findings.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"497-506"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of light compression on chronic venous disease, edema and comfort in women during pregnancy and postpartum period: a prospective randomized study.","authors":"Aleksandra Frydrych-Szymonik, Katarzyna Ochałek, Agnieszka Jankowicz-Szymańska, Zbigniew Szyguła","doi":"10.23736/S0392-9590.24.05208-8","DOIUrl":"10.23736/S0392-9590.24.05208-8","url":null,"abstract":"<p><strong>Background: </strong>Lower limb edema associated with venous disorders is an increasingly common problem in pregnant women. The study aimed to assess the use of compression class 1 (ccl1=18-21 mmHg) in lower limb edema and CVD prevention in pregnant and postpartum women.</p><p><strong>Methods: </strong>51 pregnant women (second trimester) were randomly recruited into either a study group CG with compression ccl1 or a control group NCG, both with physical activity (PA) recommendation. The assessment concerned venous system condition, limb size, and compression comfort. Edema was diagnosed as ≥10% measurement increase.</p><p><strong>Results: </strong>Venous reflux (8/22 CG, 1/16 NCG) and an onset of CVD (6/22 CG, 1/16 NCG) were diagnosed in the first measurement. After postpartum, a significant reduction of the great saphenous vein (GSV) diameter in the proximal part of the left lower limb in CG (P=0.014) and expansion of the small saphenous vein (SSV) in the proximal part of the left lower limb in NCG (P=0.028) were observed. An analysis of the limb sizes in the second measurement revealed a significant increase of all circumferences and volumes in the NCG, and of lower leg volumes in the CG. Edema was diagnosed in five women in the NCG in the second measurement. Consequently, compression was recommended for the new group (NCG+C), and a significant edema reduction (P=0.026) occurred in the third measurement.</p><p><strong>Conclusions: </strong>Compression ccl1 reduces the risk of edema, venous insufficiency, and improves women's quality of life during pregnancy and postpartum.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"476-484"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atherosclerotic cardiovascular disease risk based on SCORE algorithms and reclassification based on preclinical atherosclerotic plaques.","authors":"Andrew N Nicolaides, Andrie G Panayiotou, Maura B Griffin, Theodosis Tyllis, Efthyvoulos Kyriacou, Costantinos Avraamides, Dawn Bond, Niki Georgiou, Despo Ierodiakonou, Christiana A Demetriou, Richard M Martin","doi":"10.23736/S0392-9590.24.05248-9","DOIUrl":"https://doi.org/10.23736/S0392-9590.24.05248-9","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to determine the efficacy of the number of carotid and common femoral bifurcations with plaque (NBP) detected by ultrasound in reclassifying atherosclerotic cardiovascular disease (ASCVD) risk obtained from SCORE algorithms. Data from the cohort of 1000 individuals free from ASCVD in the Cyprus Epidemiological Study on Atherosclerosis was used.</p><p><strong>Methods: </strong>In each predicted ASCVD risk class (low, moderate, high) based on SCORE algorithms and baseline data, the observed 10-year risk of subgroups according to the NBP was used to reclassify participants.</p><p><strong>Results: </strong>There were 222 ASCVD events during a mean follow-up of 15.2±4.9 years. In each predicted risk class, the observed 10-year ASCVD event risk increased progressively in the subgroups across the presence of 1, 2, 3 and 4 bifurcations with plaque (P<0.001); Hazard Ratios (crude and adjusted for conventional risk factors) also increased progressively (P<0.001). There was a correct down classification in 152 and correct up classification in 99 participants. Total correct reclassification improvement was in 251 (25.1%).</p><p><strong>Conclusions: </strong>The results demonstrate that the NBP which is easy to detect is an independent predictor of ASCVD events and can be used to reclassify individuals into a different risk class by improving on the predicted SCORE risk.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"43 5","pages":"519-532"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of hemodynamic suppression on cognitive function in patients after carotid artery stenting.","authors":"Weidong Fan, Kun Liu, Xingyou Guo, Tuo Zhang, Ming Li, Tong Qiao","doi":"10.23736/S0392-9590.24.05318-5","DOIUrl":"https://doi.org/10.23736/S0392-9590.24.05318-5","url":null,"abstract":"<p><strong>Background: </strong>This study examines the impact of carotid artery stenting (CAS) on cognitive function in stroke patients, particularly in relation to hemodynamic depression (HD).</p><p><strong>Methods: </strong>Patients undergoing CAS between January 1, 2019 and June 1, 2023 were included in our study. Depending on whether hemodynamic depression happened, they were separated into two groups: HD and non-HD. Prior to surgery, one month, three months, six months, and a year following surgery, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), and cognitive function scores were compared.</p><p><strong>Results: </strong>130 patients were included in the study, with an HD incidence rate of 51.54%. The comparison of MMSE and MoCA scores revealed that the HD group showed declining cognitive function post-surgery (P<0.05). Specifically, the MMSE and MoCA scores were significantly lower in the HD group compared to the non-HD group at 3, 6, and 12 months after CAS (P<0.05). Additionally, attention, computation, and memory were significantly lower in the HD group at these time points (P<0.05). The non-HD group demonstrated improvement in MMSE and MoCA scores compared to preoperative levels at 6- and 12-months post-surgery (P<0.05).</p><p><strong>Conclusions: </strong>Following CAS, patients' cognitive ability would briefly drop before returning to baseline and improving even more. Clinical focus should be given to HD prevention because its presence would exacerbate the cognitive function impairment and lengthen the recovery period.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"43 5","pages":"507-518"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of adjuvant open axillary access during complex thoracoabdominal aortic endovascular procedures.","authors":"Fabricio Barahona, Gaspar Mestres, Xavier Yugueros, Donovan Ruiz, Victoria Gamé, Daniel Gil-Sala, Carla Blanco, Vicente Riambau","doi":"10.23736/S0392-9590.24.05258-1","DOIUrl":"10.23736/S0392-9590.24.05258-1","url":null,"abstract":"<p><strong>Background: </strong>Endovascular treatment of aortic diseases with complex anatomy may require an additional upper extremity arterial access (like axillary access) for support during aortic navigation and allowing the use of larger sheaths for thoracoabdominal antegrade access. The objective of this study is to evaluate the safety of the open axillary approach as adjuvant access in complex thoracoabdominal aortic endovascular interventions.</p><p><strong>Methods: </strong>A monocentric retrospective study was performed, including all patients with a complex aortic endovascular procedure (fEVAR, bEVAR, chEVAR or TEVAR), elective or urgent, with open surgical exposure of the axillary artery as adjuvant access, between 2012 and 2022. Demographic data, diagnosis and urgency criteria, type of aortic intervention, size of axillary sheath, use of through-and-through maneuver, and features by computed tomography angiography (CTA) of the axillary artery and aortic arch were recorded. The appearance of local and aortic postoperative complications were described, and possible prognostic factors were analyzed.</p><p><strong>Results: </strong>Forty-eight patients (38 men) were included, median age 78 years (range 50-87), 33 with intact thoracoabdominal aneurysms, eight previous EVAR endoleaks and seven aortic aneurysm ruptures. 28 fEVAR/bEVAR, 17 chEVAR and three TEVAR procedures with axillary access were performed. Left infraclavicular axillary access was the most common approach (94%), along with a 12 French (F) median sheath (range 7-20). Eight (16.7%) local complications were identified: three bleedings, one hematoma, three focal dissections in the subclavian artery, and one brachial embolism, all successfully resolved. The only factor related to local complications was small axillary diameter (median 10.7 vs. 14.6 mm; P<0.001), a subclavian/sheath ratio less than one was associated to more local complications (P=0.02). Regarding aortic complications, two (4.1%) type B asymptomatic aortic dissections with left juxta-subclavian tear were found, attributed to local manipulation, occurring only in urgent procedures (P=0.032).</p><p><strong>Conclusions: </strong>The use of open axillary access as an adjuvant approach in complex aortic endovascular surgery, although it is very useful and usually safe, can be associated with subclavian or even aortic complications (not reported until now), especially in cases with small subclavian diameters and urgent cases.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"404-410"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"STABILISE for acute type B aortic dissection.","authors":"Tatiana Cotão, Joel Sousa, Armando Mansilha","doi":"10.23736/S0392-9590.24.05279-9","DOIUrl":"10.23736/S0392-9590.24.05279-9","url":null,"abstract":"<p><strong>Introduction: </strong>Stent-assisted, balloon-induced intimal disruption and relamination of aortic dissection (STABILISE) is an extended downstream endovascular management technique for acute type B aortic dissection (TBAD), that aimed to achieve complete aortic remodeling. This systematic review aimed to assess the early and mid-term clinical outcomes with STABILISE in the management of TBAD.</p><p><strong>Evidence acquisition: </strong>A literature search was performed on the Medline, Web of Science, Scopus, and SciELO databases, which returned 195 studies. Five studies were included. Data were extracted using predefined forms.</p><p><strong>Evidence synthesis: </strong>In total, one hundred patients with acute or subacute TBAD managed with STABILISE were included. All studies reported a technical success of 100%. Thirty-day mortality was estimated at 4% (4/100) with no further deaths documented during an estimated mean follow-up of 12.7 months (range 12-15 months). Five percent developed spinal cord ischemia and another 5% developed visceral artery occlusions. One case of aortic rupture during time of balloon inflation was reported. Rare complications included delayed retrograde dissection (1%), aortobronchial fistula (1%), and renal failure (1%). One case of disconnection between stent-graft and bare stent was documented. Six percent of patients developed endoleak, predominately type I. Overall re-intervention rate was 21%, as reported in all studies. Complete obliteration of the false lumen in the thoracic aorta was achieved in 99% of patients and in the abdominal aorta in 96% of patients.</p><p><strong>Conclusions: </strong>STABILISE technique carries promising early and mid-term outcomes with high technical success and low mortality and morbidity. Excellent results on complete false lumen obliteration were observed. However, the heterogeneity among available studies' methodology does not permit firm conclusions, and further prospective analyses are needed to study the long-term outcomes of STABILISE.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"411-420"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful treatment of chronic venous in-stent restenosis using a Phoenix atherectomy device.","authors":"Fabian Linden, Thomas Mihu, Norbert Frey, Christian Erbel","doi":"10.23736/S0392-9590.24.05229-5","DOIUrl":"10.23736/S0392-9590.24.05229-5","url":null,"abstract":"<p><strong>Background: </strong>Although endovascular treatment of venous obstruction with percutaneous transluminal angioplasty (PTA) and stenting is a safe and effective alternative to conservative treatment, the overall prevalence of in-stent restenosis (ISR) remains high in this patient population. This study reports a novel treatment option for patients with chronic ISR (C-ISR).</p><p><strong>Methods: </strong>At our center, all patients with ISR were treated based on the time since the initial intervention. Acute in-stent restenosis (A-ISR) was preferably treated with catheter-directed thrombolysis or a pharmacomechanical peripheral thrombectomy device and PTA. Selected patients with chronic ISR (C-ISR) (greater than 30 days) were treated with a catheter- guided unidirectional atherectomy in addition to PTA, under the assumption of a non-thrombotic mechanism in the development of C-ISR.</p><p><strong>Results: </strong>We demonstrate a safe and practical treatment option for chronic ISR using a catheter- guided technical approach with the Phoenix atherectomy device in four patients. Technical success was achieved in every case, and mid-term patency was restored in three out of four patients.</p><p><strong>Conclusions: </strong>Restenosis following venous stenting is highly complex. Patients must be treated individually, with a focus on anticoagulation and antiplatelet therapy regimens, as well as the appropriate interventional treatment. Catheter- guided atherectomy is a viable option for this heterogeneous group of patients. Further studies are required to understand the etiology of chronic ISR.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"430-436"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}