International Angiology最新文献

{"title":"Implications of abdominal aortic aneurysm rupture at a lower diameter than the recommended threshold for AAA repair.","authors":"Kosmas I Paraskevas, Armando Mansilha","doi":"10.23736/S0392-9590.23.05076-9","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05076-9","url":null,"abstract":"","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"279-281"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10225664","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":"Randomized controlled trial on occupational graduated compression clinical and cost-effectiveness.","authors":"Sergio Gianesini,&nbsp;Emidia Vagnoni,&nbsp;Caterina Cavicchi,&nbsp;Yung-Wei Chi,&nbsp;Anselmo Pagani,&nbsp;Mirko Tessari,&nbsp;Paolo Zamboni,&nbsp;Erica Menegatti","doi":"10.23736/S0392-9590.23.05030-7","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05030-7","url":null,"abstract":"<p><strong>Background: </strong>Subjects exposed to occupational standing are at risk of developing chronic venous disease. Graduated compression stockings (GCS) counteract venous hypertension. Aim of the present investigation was to assess GCS clinical and cost effectiveness in prolonged standing up workers.</p><p><strong>Methods: </strong>Randomized controlled trial involving 75 healthy healthcare professionals working in 6 hours standing up shifts without or with GCS (group A and B, respectively). Outcome measures were performed before and after the shift, at baseline (T0), at 1 (T1), 6 (T6) and 12 (T12) months and included lower limb volume, air plethysmography (APG), quality of life, and dedicated cost-effectiveness questionnaires.</p><p><strong>Results: </strong>Seventy-two subjects completed the data collection. Leg volume increased in group A and decreased in B at all assessment points (T0, 1, 6, 12) (P<0.0001). Venous filling index did not change within the 12 months, but, after every shift, its value was lower in B compared to A (P<0.0001). At 12 months, VVSymQ worsened in A and improved in B (P<0.0001) and CIVIQ significantly worsened in A (P<0.0001), while in B it significantly improved (P<0.0001). Perceived disability was higher in A at 12 months (P<0.001) and the cost calculation revealed a saving of 1510 euro per year in B.</p><p><strong>Conclusions: </strong>GCS counteracted occupational oedema and positively influenced venous filling index, while improving vein specific quality of life measurements in addition to cost savings.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"344-351"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9899231","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":"Varicose veins are associated with an increased risk of mitral valve regurgitation: a nationwide population-based cohort study.","authors":"Meng-Lin Lee,&nbsp;Wan-Yun Chou,&nbsp;Yi-Wei Kao,&nbsp;Ming-Chih Chen,&nbsp;Ben-Chang Shia,&nbsp;Pei-Shyuan Lee,&nbsp;Thay-Hsiung Chen,&nbsp;Ting-Yuan Lin,&nbsp;Shih-Yu Huang,&nbsp;Yen-Bo Su,&nbsp;Wei-Che Chiu","doi":"10.23736/S0392-9590.23.05053-8","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05053-8","url":null,"abstract":"<p><strong>Background: </strong>Varicose veins (VV) and mitral valve regurgitation (MR) are both common diseases. The aim was to investigate whether VV are associated with an increased risk of MR.</p><p><strong>Methods: </strong>We conducted a nationwide cohort study to assess the association between VV and risk of developing MR. Drawn from the Taiwan National Health Insurance Research Database (NHIRD), the records of 56,898 patients with VV (the VV cohort) and 56,898 propensity score-matched patients without VV (the non-VV cohort) in the years 2007 to 2015 were identified. Follow-up duration was calculated from the date of entry in the cohort until the occurrence of a first MR diagnosis, death, or the end of the observation period (December 31, 2015), whichever occurred first. Hazard ratios (HRs) and accompanying 95% confidence intervals (CIs) derived from the Cox proportional hazards model were used to estimate the association between VV and MR risks.</p><p><strong>Results: </strong>After multivariable adjustment, VV was associated with an increased risk of MR (adjusted HR, 1.63; 95% CI: 1.52-1.74). Notably, significant associations between VV and MR risk were evident in both genders and in all age groups. A trend of significant increase of MR risk was also observed with increasing frequency of annual clinical visits for VV. Within the VV cohort, the subgroup of MR presence had higher incidences of atrial fibrillation, heart failure, valve-related surgeries, and mortality (P<0.001).</p><p><strong>Conclusions: </strong>This population-based cohort study revealed that VV was associated with an increased risk of MR in a Taiwanese population. Vigilance of MR existence should be emphasized in patients of VV due to its potentially poor long-term outcomes.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"352-361"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10275085","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":"Preoperative factors affecting long-term mortality in patients survived to ruptured abdominal aortic aneurysm repair.","authors":"Nicola Troisi,&nbsp;Giacomo Isernia,&nbsp;Giulia Bertagna,&nbsp;Daniele Adami,&nbsp;Luigi Baccani,&nbsp;Gianbattista Parlani,&nbsp;Raffaella Berchiolli,&nbsp;Gioele Simonte","doi":"10.23736/S0392-9590.23.05058-7","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05058-7","url":null,"abstract":"<p><strong>Background: </strong>Aim of this study was to retrospectively evaluate preoperative factors affecting long-term mortality in patients survived to surgical repair for ruptured abdominal aortic aneurysms (rAAAs).</p><p><strong>Methods: </strong>From January 2007 to December 2021, 444 patients have been treated for symptomatic or ruptured aortoiliac aneurysms in two tertiary referral centers. Only 405 with diagnosis of rAAA at computed tomography were included in the present study. Initial outcome measures were assessed during at 30 and 90 days post-treatment. Estimated 10-year survival of patients survived after 90 days from the index procedure was evaluated with Kaplan-Meier Test. Uni- and multivariate analyses of the preoperative factors affecting 10-year survival in survivor patients was performed by means of log-rank and multivariate Cox regression analysis.</p><p><strong>Results: </strong>Among included patients, 94 (23.3%) underwent endovascular aortic repair (EVAR) and 311 (76.8%) open surgical repair (OSR). Intraoperative death occurred in 29 patients (7.2%). At 30 days, overall death rate was 24.2% (98/405 cases). Hemorrhagic shock (HR 15.5, 95% CI 3.5 to 41.1, P<0.001) was an independent predictor for 30-day mortality. The overall rate of 90-day mortality was 32.6%. In survivors estimated survival rates at 1, 5, and 10 years were 84.2%, 58.2%, and 33.3%, respectively. Type of treatment (OSR vs. EVAR) did not affect long-term freedom from AAA-related death (HR 0.6, P=0.42). In survivor patients, multivariate analysis confirmed the association between late mortality and female sex (HR 4.7, 95% CI 3.8 to 5.9, P=0.03), age >80 years (HR 28.5, 95% CI 25.1 to 32.3, P<0.001), and chronic obstructive pulmonary disease (HR 5.2, 95% CI 4.3 to 6.3, P=0.02).</p><p><strong>Conclusions: </strong>Late freedom from AAA-related death was not affected by the type of treatment (EVAR vs. OSR) in patients undergoing urgent repair for rAAA. In survivors, female gender, elderly age, and chronic obstructive pulmonary disease negatively affected long-term survival.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"318-326"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10277750","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-iliac and infrainguinal artery occlusive disease: different revascularization options according to the critical limb threatening ischemia category.","authors":"Rodolfo Pini,&nbsp;Gianluca Faggioli,&nbsp;Cecilia Angherà,&nbsp;Antonio Cappiello,&nbsp;Mohammad Abualhin,&nbsp;Sara Pomatto,&nbsp;Enrico Gallitto,&nbsp;Mauro Gargiulo","doi":"10.23736/S0392-9590.23.04992-1","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.04992-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Critical limb threatening-ischemia (CLTI) can be due to an extensive involvement of both the aorto-iliac (AI) and the infra-inguinal (II) districts and the efficacy of and extensive AI+II vs. only AI revascularization is still matter of debate. The aim of the present study was to evaluate the outcome in CLTI patients with concomitant AI and II peripheral artery disease (PAD) after revascularization limited to the AI or extended also to the II segment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients with CLTI and concomitant AI (TransAtlantic InterSociety Consensus: C-D) and II PAD (Global-Anatomic-Staging-System: II-III) from 2016 to 2021 were retrospectively evaluated. Patients were compared according to type of revascularization: limited to AI vs. AI+II. Common femoral and profunda artery endarterectomy (C/P-TEA) was considered in both groups. Perioperative mortality, limb salvage, foot healing (within 6 months after surgery), necessity of adjunctive revascularization and survival were analyzed and the follow-up performed with clinical and duplex assessment every six months. The primary endpoint was to evaluate the composite event of limb salvage, wound healing and necessity of adjunctive revascularization during follow-up in AI vs. AI+II groups, through Kaplan Meier and Cox regression analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Over a total of 1105 peripheral revascularizations for CLTI, 96 (8.7%) patients met the inclusion criteria for the study. AI revascularization was performed in 38 (40%) and AI+II in 58 (60%). AI and AI+II groups were similar for preoperative risk factors and extension of PAD with the exception of American Society of Anesthesiology (ASA) Classification (ASA IV: 50% vs. 25%, P=0.02, respectively). The AI group was treated with angioplasty/stenting in all cases and with C/P-TEA in 20 (52%) cases. In the AI+II group, the AI district was treated by angioplasty/stenting in 55 (95%) and by aorto-bifemoral bypass in 3 (5%) and C/P-TEA in 20 (34%). The II revascularization was performed by femoro-popliteal/tibial bypass in 27 (47%); and endovascular revascularization in 31 (53%) patients. Minor amputation rate was similar between AI and AI+II revascularization (39% vs. 48%, P=1.0); length of stay, blood transfusion units, were significantly higher in AI+II group: 7±4 days vs. 12±5 days, P=0.04 and 2±2 vs. 4±2, P=0.02. The 30-day mortality was 7% with no differences according to the type of treatment. At a mean follow-up of 28±10 months, the overall limb salvage was 87±4% with similar results in AI vs. AI+II revascularization (95±5% vs. 86±6%; P=0.56). AI had a higher necessity of adjunctive revascularization and lower wound healing compared to AI+II (18±9% vs. 0%, P=0.02; 72% vs. 100%, P=0.001, respectively). AI+II was associated with a better primary endpoint compared to AI (87±5% vs. 53±9%, P=0.01), and it was confirmed in Rutherford 5 and 6 patients (100% vs. 54±14%, P=0.01; 78±9 vs. 50±13%, P=0.04), an","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 3","pages":"209-215"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9891221","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":"Machine learning models for diabetic neuropathy diagnosis using microcirculatory parameters in type 2 diabetes patients.","authors":"Xiaoyu Zhang,&nbsp;Yining Sun,&nbsp;Zuchang Ma,&nbsp;Liang Lu,&nbsp;Mengyuan Li,&nbsp;Xueya Ma","doi":"10.23736/S0392-9590.23.05008-3","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05008-3","url":null,"abstract":"<p><strong>Background: </strong>Diabetic peripheral neuropathy (DPN) is a primary cause of diabetic foot, early detection of DPN is essential. This study aimed to construct a machine learning model for DPN diagnosis based on microcirculatory parameters, and identify the most predictive parameters for DPN.</p><p><strong>Methods: </strong>Our study involved 261 subjects, including 102 diabetics with neuropathy (DMN), 73 diabetics without neuropathy (DM), and 86 healthy controls (HC). DPN was confirmed by nerve conduction velocity and clinical sensory tests. Microvascular function was measured by postocclusion reactive hyperemia (PORH), local thermal hyperemia (LTH), and transcutaneous oxygen pressure (TcPO<inf>2</inf>). Other physiological information was also investigated. Logistic regression (LR) and other machine learning (ML) algorithms were used to develop the model for DPN diagnosis. Kruskal-Wallis Test (non-parametric) were performed for multiple comparisons. Several performance measures, such as accuracy, sensitivity and specificity, were used to access the efficacy of the developed model. All the features were ranked based on the importance score to find features with higher DPN predictions.</p><p><strong>Results: </strong>There was an overall decrease in microcirculatory parameters in response to PORH and LTH, as well as TcPO<inf>2</inf>, in DMN group compared to DM group and HC group. Random forest (RF) was found to be the best model, and achieved 84.6% accuracy along with 90.2% sensitivity and 76.7% specificity. RF_PF% of PORH was the main predictor of DPN. In addition, diabetic duration was also an important risk factor.</p><p><strong>Conclusions: </strong>PORH Test is a reliable screening tool for DPN, which can accurately distinguish DPN from diabetics using RF.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 3","pages":"191-200"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892787","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 and outcomes of calf deep vein thrombosis in patients with contraindication to full anticoagulation due to bleeding.","authors":"Giovanna Elmi,&nbsp;Davide Allegri,&nbsp;Leonardo Aluigi,&nbsp;Pier L Antignani,&nbsp;Raffaele Aspide,&nbsp;Valeria Camaggi,&nbsp;Rosella DI Giulio,&nbsp;Andrea Domanico,&nbsp;Elisa R Rinaldi,&nbsp;Alberto Martignani,&nbsp;Gualtiero Palareti","doi":"10.23736/S0392-9590.23.04947-7","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.04947-7","url":null,"abstract":"<p><strong>Background: </strong>This prospective observational study was aimed at assessing early outcomes of inpatients with isolated distal deep vein thrombosis (IDDVT) and coexisting bleeding.</p><p><strong>Methods: </strong>Patients received enoxaparin 4000 units daily or intermediate doses, and ultrasound surveillance (US). Primary outcomes were extension to the popliteal vein (PDVT) or symptomatic pulmonary embolism (PE), bleeding complications during the treatment and the composite of PDVT and bleeding complications. Secondary outcomes were recurrent IDDVTs and death.</p><p><strong>Results: </strong>90/95 patients completed the study period (30 days). PDVT occurred in 2/41 (4.9%) and in 3/45 (6.7%) subjects receiving enoxaparin 4000 units and intermediate doses respectively (OR 1.39; 95% CI: 0.22-11; P=0.72). PE occurred in only one of the 4 untreated subjects (25% vs. 0 patients taking enoxaparin 4000 units or intermediate doses; P=1.0). Recurrent IDDVTs occurred in 29 subjects (32.2%), more frequently during enoxaparin 4000 (19/29, 65.5%). Four patients died (4.4%). Bleeding complications occurred in 8 subjects (8.9%), all treated with intermediate doses (0 vs. 17.8%; P=1.0). Enoxaparin 4000 units significantly reduced the risk of the composite outcome compared with higher doses (4.9% vs. 24.4%; OR 6.31; 95% CI: 1.56-42.65; P=0.02). Major trauma significantly increased the risk of PDVT (OR 20.92; 95% CI: 2.82-427.51, P=0.01; logistic regression P=0.01). Patients with major trauma are also at increased bleeding risk (OR 5; 95% CI: 1.06-23.76, P=0.04; logistic regression P=0.03).</p><p><strong>Conclusions: </strong>Enoxaparin 4000 units daily, supported by US, may be an option for selected patients.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 3","pages":"229-238"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9524084","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":"From varicose veins to venous thromboembolic events.","authors":"Pavel Poredos,&nbsp;Matija Kozak,&nbsp;Pier L Antignani,&nbsp;Mateja K Jezovnik","doi":"10.23736/S0392-9590.23.04948-9","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.04948-9","url":null,"abstract":"<p><p>Varicose veins (VVs) mostly represent benign disease. However, in some cases, they can lead to serious complications including deep venous thrombosis (DVT) and pulmonary embolism (PE). Besides deteriorated blood flow caused by VVs inflammation is most probably a common denominator of VVs and DVT, which promotes a procoagulant state and thrombus formation also in deep veins. Patients with VVs have increased levels of interleukins, the most specific inflammatory markers of vascular wall inflammation that promote coagulation. The studies showed that VVs may increase the risk for DVT. However, the evidence of the risk and incidence of DVT in patients with VVs and without additional risk factors is poor. The increased risk is associated with previous venous thromboembolism (VTE), malignancy, estrogen use, pregnancy and postpartum, hospitalization in the last 6 months, age, and obesity. Varicose veins represent also an increased risk for VTE during long-term immobilization and long air travel or road trip. Further, superficial venous thrombosis is related to an increased risk for DVT, particularly if the thrombus in the superficial vein extends close to the saphenofemoral or femoropopliteal junction. Increased risk for DVT is increased during and after invasive treatment of VVs. Thromboprophylaxis after invasive procedures is recommended in subjects older than 60 years and those with another thrombophilic state.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 3","pages":"254-259"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9572509","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 comparison of graduated compression stockings of different length and pressure gradients combined with ankle pump movement on femoral vein blood velocity: a pilot study.","authors":"Fan Yang,&nbsp;Dingyi Wang,&nbsp;Guohui Fan,&nbsp;Tingting Zhao,&nbsp;Wei Wang,&nbsp;Yaping Xu","doi":"10.23736/S0392-9590.23.04944-1","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.04944-1","url":null,"abstract":"<p><strong>Background: </strong>Graduated compression stocking (GCS) is one the most widely used intervention methods in decreasing venous stasis and preventing deep venous thrombosis in hospital patients. However, changes of femoral vein speed after using GCS, combining ankle pump movement or not, and the efficacy difference of GCS among brands are still unclear.</p><p><strong>Methods: </strong>In this single-center cross-sectional study, healthy participants were assigned to wear one of the three different GCSs (type A, B and C) on both legs. Type B was with lower compressions at popliteal fossa, middle thigh and upper thigh, compared with type A and C. Blood flow velocity of femoral veins was measured with a Doppler ultrasound scanner in the following four conditions: Lying, ankle pump movement, wearing GCS, and GCS combining ankle pump movement. The differences of femoral vein velocity between conditions in each GCS type, and differences of femoral vein velocity changes between GCS type B and type C were compared, respectively.</p><p><strong>Results: </strong>A total of 26 participants enrolled and 6 wore type A, 10 wore type B and 10 wore type C GCS. Compared with lying, participants wearing type B GCS had significant higher left femoral vein peak velocity (PV<inf>L</inf>) and left femoral vein trough velocity (TV<inf>L</inf>) (absolute difference [AD] 10.63, 95% confidence interval [95% CI] 3.17-18.09, P=0.0210; AD 8.65, 95% CI: 2.84-14.46, P=0.0171, respectively). Compared with ankle pump movement only, TV<inf>L</inf> significantly increased in participants wearing type B GCS and so did right femoral vein trough velocity (TV<inf>R</inf>) in in participants wearing type C GCS. Comparing with lying, the AD of PV<inf>L</inf> was significantly higher in participants wearing type B GCS than those wearing type C GCS (10.63±12.03 vs. -0.23±8.89, P<0.05).</p><p><strong>Conclusions: </strong>GCS with lower compressions at popliteal fossa, middle thigh and upper thigh was related with higher femoral vein velocity. Femoral vein velocity of left leg increased much more than that of right leg in participants wearing GCS with/without ankle pump movement. Further investigations are needed to translate the herein reported hemodynamic effect of different compression dosages into a potentially different clinical benefit.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 3","pages":"239-246"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9873537","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":"Significance of perioperative intrasac pressure in sac shrinkage after endovascular abdominal aneurysm repair.","authors":"Masaki Kano,&nbsp;Toshiya Nishibe,&nbsp;Ryumon Matsumoto,&nbsp;Toshiki Fujiyoshi,&nbsp;Nobuyuki Toya,&nbsp;Alan Dardik,&nbsp;Hitoshi Ogino","doi":"10.23736/S0392-9590.23.05004-6","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05004-6","url":null,"abstract":"<p><strong>Background: </strong>Endovascular aneurysm repair (EVAR) results in a marked reduction of intrasac pressure, which is the likely cause of aneurysm sac shrinkage. We evaluated the change of intrasac pressure during operation and its association with aneurysm sac shrinkage one year after EVAR.</p><p><strong>Methods: </strong>This study included 113 patients undergoing EVAR using the Gore C3 Excluder at our university hospital between March 2016 and December 2020. A direct intrasac pressure was measured before and after stent deployment. The Pressure Index (PI) was defined as the ratio of intrasac pressure to systemic blood pressure.</p><p><strong>Results: </strong>Patients were divided into two groups: patients with aneurysm sac shrinkage (N.=33, 29%) and those without (N.=80, 71%). Systolic and diastolic PI after stent graft deployment were significantly higher in patients with aneurysm sac shrinkage than those without, respectively (systolic PI, 64.6±13.9% vs. 58.1±12.0%, P=0.014; diastolic PI, 103.8±24.7% vs. 96.4±12.9%, P=0.039). Multivariable analysis revealed post-deployment systolic PI as an independent risk factor predictive of aneurysm sac shrinkage (odds ratio 1.04; 95% CI 1.01-1.08; P=0.016).</p><p><strong>Conclusions: </strong>Although systolic intrasac pressure, described as systolic PI, was an independent risk factor for aneurysm sac shrinkage, contrary to our expectation, it was significantly higher in patients with aneurysm sac shrinkage than those without. This seemingly contradictory result may be explained by the properties of an aneurysm sac, which influence the change of intrasac pressure.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 3","pages":"201-208"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9874552","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}