International Angiology最新文献

{"title":"Midterm results after FEVAR and open surgery for infrarenal aortic aneurysms with short proximal necks: systematic review with meta-analysis of comparative studies.","authors":"Diana Lopes, José Oliveira-Pinto, Armando Mansilha","doi":"10.23736/S0392-9590.24.05283-0","DOIUrl":"10.23736/S0392-9590.24.05283-0","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review with meta-analysis aimed to compare short and midterm outcomes between fenestrated endovascular aneurysm repair and open surgery in repair of infrarenal abdominal aortic aneurysms with short necks.</p><p><strong>Evidence acquisition: </strong>PubMed, Web of Science and Scopus electronic databases were searched for studies referring to fenestrated endovascular aneurysm repair (FEVAR) or open surgery (OSR) in patients with infrarenal abdominal aortic aneurysms with neck length <15 mm. The primary endpoint of interest was early mortality. Secondary outcomes included major adverse cardiovascular events (MACE), bowel ischemia, acute kidney injury (AKI), late mortality and secondary interventions.</p><p><strong>Evidence synthesis: </strong>Overall, 21 studies were included, with a total of 3084 patients (1157 FEVAR and 1927 OSR). The pooled rate of early mortality following FEVAR was 2.7% (95%CI: 1.6, 4.0; I²=27.7%), compared with 3.7% (95%CI: 1.9, 6.0; I²=78.1%) after OSR. Comparative studies demonstrated no significant differences in 30-day mortality (odds ratio [OR] 0.79; 95%CI: 0.37, 1.68). A decreased risk of postoperative MACE (OR=0.51; 95%CI: 0.28, 0.95) and bowel ischemia (OR=0.30; 95%CI: 0.11, 0.86) was observed in FEVAR patients although no significant differences were seen regarding AKI (OR=0.62; 95%CI: 0.23, 1.67). Late mortality (OR=1.68; 95%CI: 1.03, 2.74) and reintervention risk (OR=4.17; 95%CI: 2.05, 8.50) were both significantly higher in FEVAR group.</p><p><strong>Conclusions: </strong>FEVAR and OSR showed no statistically significant differences in postoperative mortality in the treatment of patients with AAA with short neck length, despite lower morbidity in the former. Oppositely, FEVAR present with greater mortality and reintervention risk in the midterm. Randomized controlled trials are needed to provide secure recommendations towards preferential use of either technique for juxtarenal AAA repair.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"597-605"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785547","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":"The impact of intraoperative Fogarty balloon dilation on arteriovenous fistula success: clinical and functional outcomes.","authors":"Güler G Ersoy, Burak Tamtekin, İsmail Taskent","doi":"10.23736/S0392-9590.24.05351-3","DOIUrl":"https://doi.org/10.23736/S0392-9590.24.05351-3","url":null,"abstract":"<p><strong>Background: </strong>An effectively functioning arteriovenous fistula (AVF) is vital for end-stage renal disease patients. This study aims to evaluate the effects of Fogarty^® balloon catheter dilation on creating an effectively functioning AVF.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at our clinic between 2020 and 2022. A total of 120 patients underwent arteriovenous fistula (AVF) creation with intraoperative Fogarty^® balloon catheter dilation. Inclusion criteria required the presence of a palpable radial artery and superficial vein in the non-dominant arm, which was confirmed via Doppler ultrasound when necessary. The surgical approach involved side-to-side anastomosis between the radial artery and cephalic vein, followed by intraoperative dilation of the artery, vein, and anastomotic area using a Fogarty^® balloon catheter after completion of the anastomosis.</p><p><strong>Results: </strong>The study included 120 patients aged between 26 and 89 years, with a nearly equal gender distribution (57 females, 47.5%; and 63 males, 52.5%). The success rate of arteriovenous fistulas (AVFs) was evaluated according to the number of patients who were able to start adequate hemodialysis 6 weeks after surgery. At 6-week follow-up, 114 patients successfully started hemodialysis through these AVFs. In contrast, six patients could not obtain an adequate AVF for effective hemodialysis. As a result, the overall success rate was calculated as 95%.</p><p><strong>Conclusions: </strong>This study suggests that intraoperative Fogarty balloon dilatation may contribute positively to the success rate of AVF creation. The findings indicate that this technique could be considered as a potential intraoperative strategy to optimize AVF outcomes, especially in patients with challenging vascular anatomy or a history of AVF failure.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"43 6","pages":"629-635"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052418","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":"Oral rivaroxaban for the treatment of deep vein thrombosis in outpatients: a propensity score-matched comparison with a historical inpatient population.","authors":"Ilya V Schastlivtsev, Kirill V Lobastov, Emel Dubar, Athena V Matveeva, Anna V Kovalchuk, Sergey N Tsaplin, Leonid A Laberko","doi":"10.23736/S0392-9590.24.05352-5","DOIUrl":"https://doi.org/10.23736/S0392-9590.24.05352-5","url":null,"abstract":"<p><strong>Background: </strong>Despite the guidelines' appeal to treat patients with deep vein thrombosis and low-risk pulmonary embolism in outpatient settings, the real-world evidence shows a high prevalence of inpatient therapy leading to unwarranted health resource utilization. The study aimed to assess the efficacy and safety of rivaroxaban in outpatient settings compared to inpatient treatment.</p><p><strong>Methods: </strong>A propensity score-matched comparison with a historical inpatient population was performed based on a retrospective analysis of patients with deep vein thrombosis and without pulmonary embolism treated as outpatients with oral rivaroxaban. Inpatient controls were treated with oral rivaroxaban following a short-term initial therapy with low-molecular-weight heparins. The relevant outcomes extracted from electronic medical records were as follows: recurrent deep vein thrombosis and symptomatic pulmonary embolism, major bleeding, clinically relevant non-major bleeding, minor bleeding, unscheduled hospitalization, and death.</p><p><strong>Results: </strong>Among 209 outpatients who were never admitted to the hospital the deep vein thrombosis recurrence rate was 3.3% (95%CI, 1.6-6.8%), clinically relevant non-major bleeding rate 2.9% (95%CI, 1.3-6.1), minor bleeding rate 6.2% (95%CI, 3.7-10.0%), unscheduled hospitalization rate 1.4% (95%CI, 0.5- 4.1%), mortality rate 1.4% (95%CI, 0.5-4.1%). No symptomatic pulmonary embolism or major bleeding was detected. No statistically significant differences were observed when compared with inpatient controls.</p><p><strong>Conclusions: </strong>The outpatient use of rivaroxaban for deep vein thrombosis treatment is a safe and effective approach for patients without pulmonary embolism, with no significant differences when compared to inpatient therapy with oral rivaroxaban following a short-term initial therapy with low-molecular-weight heparins.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"43 6","pages":"553-562"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052403","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":"Characteristics and percutaneous transluminal angioplasty treatment outcomes of superior vena cava obstruction in patients undergoing hemodialysis.","authors":"Ran Tian, Zhengli Tan, Zhengya Yu","doi":"10.23736/S0392-9590.24.05347-1","DOIUrl":"https://doi.org/10.23736/S0392-9590.24.05347-1","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the clinical outcomes of percutaneous transluminal angioplasty (PTA) in patients undergoing hemodialysis with different types of superior vena cava obstruction (SVCO) lesions.</p><p><strong>Methods: </strong>This retrospective observational study recruited patients undergoing hemodialysis with SVCO and analyzed the clinical characteristics of SVCO. Patency rates were collected for patients treated with PTA and were assessed using the t-test, U-test, log-rank test and survival analyses such as the Kaplan-Meier method.</p><p><strong>Results: </strong>A total of 49 patients undergoing hemodialysis with SVCO were classified as type I (N.=17), type II (N.=7), type III (N.=15) and type IV (N.=10). All patients had a history of catheter placement. There were 14 cases of SVCO-related catheter dysfunction, and PTA was performed in 35 patients with a technical success rate of 77.14% (27/35). Failures were observed exclusively in eight patients with type III or IV lesions. The median follow-up was 15 (1.5-58) months, with 6- and 12-month post-PTA primary patency rates of 51.9% and 14.4%, respectively. The primary assisted patency rates were 70.2% and 55.2%, and the secondary patency rates were 92.6% and 78.0%, requiring 2.68 PTAs per patient per year to maintain them. Type I-II lesions demonstrated significantly higher primary patency and primary assisted patency rates than type III-IV lesions (P=0.007 and P=0.002).</p><p><strong>Conclusions: </strong>Percutaneous transluminal angioplasty may be used to treat type I or II SVCO, achieving high technical success and patency rates. Patients undergoing hemodialysis with SVCO may have a condition related more to catheter placement than to arteriovenous fistula.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"43 6","pages":"621-628"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052341","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":"Management of arterial hypertension in patients with peripheral arterial disease.","authors":"Pavel Poredoš, Dimitri P Mikhailidis, Kosmas I Paraskevas, Aleš Blinc, Pier L Antignani, Agata Stanek, Armando Mansilha, Matija Cevc","doi":"10.23736/S0392-9590.24.05242-8","DOIUrl":"10.23736/S0392-9590.24.05242-8","url":null,"abstract":"<p><p>Hypertension is a major risk factor for peripheral arterial atherosclerotic disease (PAD). Hypertension deteriorates arterial wall function and the morphology of all layers of arteries. Endothelial cell injury enhances permeability and promotes migration of cholesterol and monocytes into the vessel wall. Increased blood pressure (BP) through hyperplasia of smooth muscle cells initiates remodeling of the arterial wall that increases peripheral resistance. Further, hypertension, particularly in patients with dyslipidemia, provokes atherosclerosis in different vascular territories, including the lower legs. Guidelines recommend treatment of hypertension in patients with PAD to reach the target BP of <130/80 mmHg. However, systolic BP (SBP) <120 mmHg may worsen oxygen delivery to the diseased leg and is related to a higher rate of cardiovascular (CV) events. Therefore, there is a J-shape relationship between SBP and the rate of primary outcomes. Any class of antihypertensive drugs, including beta-blockers, can be used for the treatment of hypertension in patients with PAD. Angiotensin converting enzyme (ACE) inhibitors may have some additional benefit over other antihypertensive drugs including improvement of perfusion of the diseased leg and are recommended even in patients with critical limb ischemia. In conclusion: hypertensive patients with PAD are at increased risk for CV events and treatment of raised BP is indicated, but SBP <120 mmHg and DBP <70 mmHg may contribute to adverse limb outcomes and other CV events. Consequently, PAD patients may require a different BP target than those without PAD.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"541-547"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667851","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":"Interventions for the treatment of recurrent varicose vein disease arising from the saphenofemoral junction or the great saphenous vein: a systematic review and meta-analysis.","authors":"Alkis Bontinis, Vangelis Bontinis, Georgios Koudounas, Argirios Giannopoulos, Christos Karkos, Dimitrios Virvilis, Angeliki Chorti, Kiriakos Ktenidis","doi":"10.23736/S0392-9590.24.05323-9","DOIUrl":"10.23736/S0392-9590.24.05323-9","url":null,"abstract":"<p><strong>Introduction: </strong>We investigated the safety and feasibility of the available interventions in the treatment of recurrent varicose vein disease.</p><p><strong>Evidence acquisition: </strong>A systematic search on Medline, Scopus, and Web of Science for articles published by August 2024 was performed. Primary endpoints included duplex ultrasonography (DUS)-identified recurrence and clinical recurrence.</p><p><strong>Evidence synthesis: </strong>Twenty-eight studies, eleven describing endovenous thermal ablation (EVTA), four ultrasound-guided foam sclerotherapy (UGFS), and thirteen surgery (high ligation with or without stripping) encompassing 2228 limbs, were included. The overall DUS-detected recurrence estimate was 11.84% (95% CI: 7.15-17.40). EVTA displayed the lowest recurrence of 4.27% (95% CI: 0.37-10.75), followed by UGFS 11.19% (95% CI: 6.80-16.42) and surgery 23.27% (95% CI: 15.35-32.19). Statistically significant differences were observed between surgery and both EVTA (P<0.01) and UGFS (P=0.01). The overall clinical recurrence estimate was 24.91% (95% CI: 10.40-42.96) with EVTA portraying the lowest clinical recurrence of 2.37% (95% CI: 0.00-16.81), followed by surgery 31.08% (95% CI: 14.43-50.63). Subgroup analysis identified statistically significant differences between EVTA and surgery (P=0.01). Whereas non-statistically significant differences were identified between the included interventions regarding paresthesia and deep vein thrombosis (DVT), surgery exhibited higher wound infection estimates compared to EVTA of 0.00% (95% CI: 0.00-0.80) versus 4.34% (95% CI: 2.21-7.02, P<0.01). The pooled hematoma and lymphatic complication estimates for surgery were 5.04% (95% CI: 0.50-12.87) and 5.71% (95% CI: 2.91-9.22) respectively.</p><p><strong>Conclusions: </strong>This review demonstrated the superior efficacy of EVTA over surgery in treating recurrent varicose vein disease corroborating its use as the preferred treatment, when feasible. Additionally, UGFS displayed comparable outcomes to EVTA. The notable recurrence estimates associated with surgery call into question its suitability within this context.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"485-496"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667844","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":"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}