International Angiology最新文献

{"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}

{"title":"Aorto caval fistulas.","authors":"Lazar B Davidovic, Igor B Koncar, Aleksa L Jovanovic, Marko V Dragas, Nikola S Ilic, Milos M Sladojevic, Andreja D Dimic, Filip B Petrovic","doi":"10.23736/S0392-9590.24.05221-0","DOIUrl":"10.23736/S0392-9590.24.05221-0","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this paper is to examine and assess the outcomes following open repair in 39 patients who experienced aorto-caval fistula (ACF) resulting from the spontaneous rupture of an abdominal aortic aneurysm (AAA).</p><p><strong>Methods: </strong>We reviewed the clinical records of all patients surgically treated with open repair for ACF at the Clinic for Vascular and Endovascular Surgery of the Serbian Clinical Center in Belgrade, Serbia, from January 2012 to February 2023. All of the patients in this series were consecutive and had aorto-caval fistula from AAA. No patients were excluded from the procedure due to the life-threatening nature of the state. A follow-up assessment was performed during the follow-up examination or by telephone interview with the patient or a family member.</p><p><strong>Results: </strong>All patients were male, with mean age 67.4±8.3 years (range: 52-83 years). The 30-day mortality rate in our cohort was 35.9%, with three (7.7%) intraoperative deaths, and 11 deaths in the postoperative period (28.2%). A total of 25 patients out of 39 (64.1%) in the original cohort have survived the surgery and the postoperative period and were followed-up for a total of 67.1 person-years. The mean follow-up was 3.7±2.2 years (range 0.25-8.4 years). Two patients (8.0%) died during the follow-up, 16 patients (64.0%) survived, and seven (28.0%) were lost to follow-up. The long-term mortality rate in the cohort that survived the postoperative period was 3.0/100 person-years.</p><p><strong>Conclusions: </strong>ACF caused by spontaneous AAA rupture into the inferior caval vein or iliac veins is a relatively rare, life-threatening condition which requires prompt treatment. An exact preoperative diagnosis is essential for perioperative strategy. As the comparison of our results with the results from contemporary literature indicates, wherever possible endovascular repair should be considered since it results might be superior to open repair.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"394-403"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153902","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":"Superficial temporal artery access for transfemoral or transbrachial carotid artery stenting in selected patients considered unfit for carotid surgery.","authors":"Piotr Myrcha, Izabela Taranta, Włodzimierz Hendiger, João Rocha-Neves, Kosmas I Paraskevas, Peter Gloviczki","doi":"10.23736/S0392-9590.24.05231-3","DOIUrl":"10.23736/S0392-9590.24.05231-3","url":null,"abstract":"<p><strong>Background: </strong>Transfemoral (TFCAS) or transbrachial carotid artery stenting (TBCAS) is an alternative to carotid endarterectomy (CEA) for treatment of high-grade internal carotid artery (ICA) stenosis. A difficult aortic arch (i.e., type III or bovine arch) and/or a tortuous/stenosed common carotid artery (CCA) are potential reasons for technical failure. This study explores the benefits of superficial temporal artery access (STAA) in aiding TFCAS or TBCAS for patients with challenging anatomical conditions.</p><p><strong>Methods: </strong>Clinical data of patients who underwent TFCAS or TBCAS using STAA between January and November 2023 were prospectively collected. Demographics, comorbidities, clinical presentation, and imaging studies were reviewed. Primary outcomes included 30-day stroke/death and technical success. Secondary outcomes and causes of failures were assessed.</p><p><strong>Results: </strong>Ten patients (mean age: 74 [range: 66-84] years) with difficult aortic arch (N.=2), CCA tortuosity (N.=2), proximal CCA stenosis (N.=2), previous technical TFCAS failure (N.=2) and aortoiliac occlusive disease (AIOD) (N.=2) underwent TFCAS or TBCAS supported by STAA. Successful STAA was possible in eight patients (six facilitated TFCAS and two TBCAS. after TBCAS occurred TIA). In two cases STAA was not successful. There were no deaths or strokes within 30 days, transient ischemic attack (TIA) occurred in one patient. Follow-up Duplex ultrasound confirmed occlusion of the STA in all patients, without clinical consequences.</p><p><strong>Conclusions: </strong>This prospective study suggests that TFCAS/TBCAS supported by STAA is a viable and safe approach when traditional access methods are ineffective and transcarotid artery stenting in not available or not possible. Despite a 20% technical failure in the current series, this technique may be useful for challenging anatomy of the aortic arch, CCA stenosis and tortuosity, and AIOD. When feasible, STAA may be a promising adjunct to TFCAS/TBCAS.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"421-429"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616318","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":"Dyslipidemia and lower extremity arterial disease.","authors":"Kosmas I Paraskevas, Pavel Poredos, Agata Stanek, Ales Blinc, Arkadiusz Jawien, Pier Luigi Antignani, Armando Mansilha, Dimitri P Mikhailidis","doi":"10.23736/S0392-9590.24.05266-0","DOIUrl":"10.23736/S0392-9590.24.05266-0","url":null,"abstract":"<p><strong>Introduction: </strong>Dyslipidemia is an established risk factor for cardiovascular diseases. We aimed to review its role in the pathogenesis of lower extremity arterial disease (LEAD), as well as the effect of lipid-lowering treatment on the progression of LEAD.</p><p><strong>Evidence acquisition: </strong>PubMed/MedLine, EMBASE and Scopus were searched between January 1990 and January 2024 for articles investigating the role of dyslipidemias and hyperlipidemias in the pathogenesis of LEAD. A separate search focused on the effects of lipid-lowering therapy on patients with LEAD.</p><p><strong>Evidence synthesis: </strong>There is evidence that dyslipidemias play a major role in the development of LEAD. All patients with LEAD should receive intensive lipid-lowering therapy for the reduction not only of claudication symptoms and amputation rates, but also of myocardial infarction and cardiovascular event rates.</p><p><strong>Conclusions: </strong>Vascular specialists should keep in mind the pivotal role of dyslipidemia in the pathogenesis and progression of LEAD.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"450-457"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286289","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":"Diet and exercise in relation to lower extremity artery disease.","authors":"Aleš Blinc, Kosmas I Paraskevas, Agata Stanek, Arkadiusz Jawien, Pier Luigi Antignani, Armando Mansilha, Dimitri P Mikhailidis, Pavel Poredoš","doi":"10.23736/S0392-9590.24.05310-0","DOIUrl":"https://doi.org/10.23736/S0392-9590.24.05310-0","url":null,"abstract":"<p><p>Adherence to the Mediterranean diet (MeD) has been associated with a reduced incidence of peripheral arterial disease (PAD)/lower extremity arterial disease (LEAD) in observational trials and in a randomized trial. In secondary prevention, a lower hazard ratio for composite major adverse cardiovascular events has been associated with better adherence to MeD in a relatively small, randomized trial. This has not been confirmed in a sub-analysis of a large interventional trial of dual antithrombotic treatment. The effects of vegetarian, vegan or low carbohydrate/ketogenic diets on the incidence and outcomes of PAD/LEAD are not known. While abdominal obesity is associated with diabetes mellitus and PAD/LEAD, the lowest incidence of PAD/LEAD has been found in subjects with a body mass index 25-29.9 kg/m². Malnutrition is a negative prognostic factor for survival of patients with chronic limb threatening ischemia. Physical activity (PA) is an acute stressor, but habitual recreational PA results in beneficial adaptations and improved health. In observational studies, lower levels of exercise and lower physical fitness have been associated with more prevalent PAD/LEAD. In contrast to coronary artery disease, that shows a reverse J-shaped relationship between long-term endurance exercise and coronary atherosclerosis, such a relationship is not known for PAD/LEAD. A general recommendation for maintaining cardiovascular health is performing regular moderate-intensity exercise with some vigorous-intensity aerobic PA, and resistance exercise at least twice a week. Combinations of healthy behaviors are more effective in preventing PAD/LEAD than a single behavioral component. In treatment of PAD/LEAD causing intermittent claudication, supervised walking training is recommended among measures of first-line treatment, while unsupervised walking training should be considered as an alternative.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"43 4","pages":"458-467"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499683","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":"Prognostic value of body composition parameters by computed tomography in patients with lower extremity arterial disease: a single-center retrospective-prospective analysis.","authors":"Natalia Mysiak, Agata Staniewska, Beata Szukay, Krzysztof Tojek, Jacek Budzyński","doi":"10.23736/S0392-9590.24.05227-1","DOIUrl":"10.23736/S0392-9590.24.05227-1","url":null,"abstract":"<p><strong>Background: </strong>In this study, we examine the associations between cross-sectional areas (CSAs) of skeletal muscle (SM), subcutaneous, visceral, and total adipose tissue (SAT, VAT, and TAT) measured by computed tomography (CT), and clinical outcomes in patients with lower extremity arterial disease (LEAD).</p><p><strong>Methods: </strong>Images obtained by lower extremity CT arteriography in 177 consecutive LEAD patients were retrospectively reviewed. The CSAs of SM, SAT, VAT, and TAT were determined at various body levels using OsiriX software. The outcomes measured were: target lesion revascularization (TLR), leg amputation, and composite endpoints.</p><p><strong>Results: </strong>A high prevalence of sarcopenia (45.2%), low SAT (48.0%), high VAT (44.6%), and high TAT (55.4%) was found among the patients studied. Patients who underwent leg revascularization had a lower SAT CSA at the third and fourth lumbar vertebrae (L3, L4), thigh, and calf compared to those who did not undergo vascular intervention. Compared to patients without a major adverse cardiovascular and limb event (MACLE), those with a MACLE had lower SM, SAT, VAT, and TAT values. Low SM and SAT CSAs were also associated with risk of TLR, MACLE, symptom severity, and impairment in functional status. These relationships remained statistically significant after adjustment for the presence of diabetes mellitus, hypertension, and chronic kidney disease, but disappeared after adjusting for smoking.</p><p><strong>Conclusions: </strong>Low SM and SAT CSAs were related to symptom severity, impairment in functional status, and prognosis. Analysis of body component CSAs by CT seems to be a valuable method of stratifying LEAD patients.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"437-449"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132635","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":"Automated 3D ultrasound bridges the gap between novices and experts in diameter assessment of abdominal aortic aneurysms.","authors":"Natasha M Svendsen, Jonas P Eiberg, Laurence Rouet, Qasam M Ghulam, Lene T Skovgaard, Magdalena Broda, Alexander Zielinski, Karin Yeung, Ulver S Lorenzen","doi":"10.23736/S0392-9590.24.05278-7","DOIUrl":"10.23736/S0392-9590.24.05278-7","url":null,"abstract":"<p><strong>Background: </strong>The current management of abdominal aortic aneurysm (AAA) hinges upon assessing diameter using ultrasound (US). Diameter reproducibility with conventional two-dimensional ultrasound (2D-US) is challenging and requires experienced operators. A novel automatic three-dimensional ultrasound (3D-US) system enables on-cart software-assisted diameter estimation (3D-SAUS), potentially facilitating more precise diameter measurements than 2D-US. This study aimed to assess the variance of AAA diameter measurements among US novices and experts by comparing 2D-US with 3D-SAUS in a clinical setting.</p><p><strong>Methods: </strong>A total of 580 US scans were scheduled by 29 US operators (13 experts and 16 novices) on 10 patients with AAAs. Experts and novices measured all patients' AAA anterior-posterior (AP) diameters with 2D-US and 3D-SAUS. Outcomes were limits of agreement (LoA) using a mixed-effects model.</p><p><strong>Results: </strong>In total, 564 of 580 planned US scans were performed. 500 US scans were automatically analyzed by the software and included. When using 3D-SAUS instead of 2D-US, novices reduced their LoA from ±16.5% to ±10.2% (P<0.001), reaching the experts' LoA of ±10.5% (P=0.782 for difference). The experts' LoA was ±10.5% for 2D-US and ±9.7% for 3D-SAUS, with no statistically significant difference between the two modalities (P=0.423).</p><p><strong>Conclusions: </strong>Clinical implementation of the 3D-SAUS demonstrates a substantial reduction in variance in AAA diameter measurements among novice sonographers, surpassing the performance of conventional 2D-US techniques. Additionally, using the 3D-SAUS tool enables novice sonographers to achieve proficiency levels comparable to those of experts employing conventional 2D-US.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"387-393"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346037","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":"Mid-term outcomes of sartorius flap reconstruction in groin infection following vascular procedures or intravenous drug injections.","authors":"Nicola Troisi, Giulia Bertagna, Valerio Artini, Patrizia Dalla Caneva, Valentina Scarati, Daniele Adami, Stefano Michelagnoli, Raffaella Berchiolli","doi":"10.23736/S0392-9590.24.05263-5","DOIUrl":"10.23736/S0392-9590.24.05263-5","url":null,"abstract":"<p><strong>Background: </strong>In this study, the early and mid-term outcomes of sartorius flap reconstruction after the development of a prior groin infection were investigated.</p><p><strong>Methods: </strong>From January 2017 until June 2023, 44 patients from 2 centers in Italy underwent sartorius flap reconstruction after the development of a prior groin infection. Thirty-day outcome measures including major morbidity, amputation-free survival, and mortality were assessed. At 2-year follow-up, estimated outcomes of freedom from hemorrhagic complications, freedom from recurrent infection, freedom from reintervention, and amputation-free survival were analyzed using Kaplan-Meier curves.</p><p><strong>Results: </strong>In 35 cases (79.5%) a previous vascular procedure was performed, whilst in the remaining 9 cases (20.5%) the patient was an intravenous drug abuser. Thirty-day mortality and major amputation rates were 4.5%, and 2.3%, respectively. Overall 30-day wound healing rate was 56.8% (25 cases). The overall median duration of follow-up was 12 months (IQR 4-24). Complete wound healing was obtained in 36 cases (81.8%) after a median period of 1 month (IQR 1-3). The 2-year Kaplan-Meier estimates of freedom from hemorrhagic complications, freedom from recurrent infection, freedom from reintervention, and amputation-free survival were 82.1%, 70%, 71.9%, and 97.7%, respectively. Multivariate analysis confirmed the association of female sex with recurrent infection (HR 3.4, P=.05).</p><p><strong>Conclusions: </strong>Sartorius flap reconstruction after the development of a prior groin infection following vascular procedures or intravenous drug injections yielded acceptable mid-term outcomes in terms of freedom from hemorrhagic complications, and freedom from recurrent infection. Female sex seemed to affect the rate of recurrent infection.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"378-386"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751621","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}