International Angiology最新文献

{"title":"Diagnostic criteria for Buerger's disease: International Consensus of VAS - European Independent Foundation in Angiology/Vascular Medicine.","authors":"Bahare Fazeli, Pavel Poredos, Matija Kozak, Zsolt Pecsvarady, Mariella Catalano, Mussaad M Al Salman, Louay Altarazi, Abrar A Ali, Abul H Bashar, Kursat Bozkurt, Daniel Cacione, Benjamin Chua, Ivan Cvjetko, Sanjay Desai, Dilek Erer, Katalin Farkas, Phaniraj Gaddikeri, Georgios Geroulakos, Orkut Guclu, Emad Hussein, Mihai Ionac, Takehisa Iwai, Oguz Karahan, Daniel Kashani, Albert Kota, Knut Kroger, Emre Kubat, Prabhu P Kumar, Werner Lang, Kirill Lobastov, Rafal Malecki, Antonella Marcoccia, Alper Ozbakkaloglu, Sandeep R Pandey, Malay Patel, Adil Polat, Angampally Rajeev, Hassan Ravari, Vimalin Samuel, Gerit Schernthaner, Dheepak Selvaraj, Umut S Sanri, Nuttawut Sermsathanasawadi, Hiva Sharebiani, Agata Stanek, Edwin Stephen, Andrzej Szuba, Wassila Taha, Hossein Taheri, Jean-Claude Wautrecht, Hendro S Yuwono, Mustafa H Zor, Aaron Liew","doi":"10.23736/S0392-9590.23.05098-8","DOIUrl":"10.23736/S0392-9590.23.05098-8","url":null,"abstract":"<p><p>Buerger's disease (BD) remains a debilitating condition and early diagnosis is paramount for its effective management. Despite many published diagnostic criteria for BD, selective criteria have been utilized in different vascular centers to manage patients with BD worldwide. A recent international Delphi Consensus Study on the diagnostic criteria of BD showed that none of these published diagnostic criteria have been universally accepted as a gold standard. Apart from the presence of smoking, these published diagnostic criteria have distinct differences between them, rendering the direct comparison of patient outcomes difficult. Hence, the expert committees from the Working Group of the VAS-European Independent Foundation in Angiology/Vascular Medicine critically reviewed the findings from the Delphi study and provided practical recommendations on the diagnostic criteria for BD, facilitating its universal use. We recommend that the 'definitive' diagnosis of BD must require the presence of three features (history of smoking, typical angiographic features and typical histopathological features) and the use of a combination of major and minor criteria for the 'suspected' diagnosis of BD. The major criterion is the history of active tobacco smoking. The five minor criteria are disease onset at age less than 45 years, ischemic involvement of the lower limbs, ischemic involvement of one or both of the upper limbs, thrombophlebitis migrans and red-blue shade of purple discoloration on edematous toes or fingers. We recommend that a 'suspected' diagnosis of BD is confirmed in the presence of a major criterion plus four or more minor criteria. In the absence of the major criterion or in cases of fewer than four minor criteria, imaging and laboratory data could facilitate the diagnosis. Validation studies on the use of these major and minor criteria are underway.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 5","pages":"396-401"},"PeriodicalIF":1.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138444587","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":"Intraoperative predictors of in-hospital mortality after open repair of ruptured abdominal aortic aneurysms.","authors":"Nicola Troisi,&nbsp;Giulia Bertagna,&nbsp;Athanasios Saratzis,&nbsp;Simone Guadagni,&nbsp;Fabrizio Minichilli,&nbsp;Daniele Adami,&nbsp;Mauro Ferrari,&nbsp;Raffaella Berchiolli","doi":"10.23736/S0392-9590.23.04941-6","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.04941-6","url":null,"abstract":"<p><strong>Background: </strong>Several models and scores have been released to predict early mortality in patients undergoing surgery for a ruptured abdominal aortic aneurysm (rAAA). These scores included above all preoperative factors and they could be useful to deny surgical repair. The aim of the study was to evaluate intraoperative predictors of in-hospital mortality in patients undergoing open surgical repair (OSR) for a rAAA.</p><p><strong>Methods: </strong>Between January 2007 and December 2020, 265 patients were admitted at our tertiary referral hospital for a rAAA. Two-hundred-twenty-two patients underwent OSR. Intra-operative factors were analyzed by means of univariate analysis (step 1). Associations of procedure variables with in-hospital mortality rates were sought based on a multivariate Cox regression analysis (step 2).</p><p><strong>Results: </strong>Overall, in-hospital mortality rate was 28.8% (64 cases). Multivariate Cox regression analysis reported that operation time >240 minutes (P=0.032, OR 2.155, CI 95% 1.068-4.349), and hemoperitoneum (P<0.001, OR 3.582, CI 95% 1.749-7.335) were negative predictive factors for in-hospital mortality. Patency of at least one hypogastric artery (P=0.010; OR 0.128, CI 95% 0.271-0.609), and infrarenal clamping (P=0.001; OR 0.157, CI 95% 0.052-0.483) had a protective role in reducing in-hospital mortality rate.</p><p><strong>Conclusions: </strong>Operation time >240 minutes, and hemoperitoneum affected in-hospital mortality in patients undergoing OSR for rAAA. Patency of at least one hypogastric artery, and infrarenal clamping had a protective role. Further studies are needed to validate these outcomes. A validated predictive model could be useful to help the physicians in communication with patients' relatives.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"310-317"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9901937","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":"Factors associated with difficulty in stenting the chronic iliofemoral venous obstruction.","authors":"Moustafa Elfeky,&nbsp;Mohammad E Barbati,&nbsp;Karina Schleimer,&nbsp;Alexander Gombert,&nbsp;Long Piao,&nbsp;Soroosh Shekarchian,&nbsp;Michael Jacobs,&nbsp;Mahmood Razavi,&nbsp;Houman Jalaie","doi":"10.23736/S0392-9590.23.05001-0","DOIUrl":"10.23736/S0392-9590.23.05001-0","url":null,"abstract":"<p><strong>Background: </strong>The main aim of this article is to investigate the causes of technical failure during endovascular recanalization in patients with post-thrombotic syndrome with occluded iliofemoral veins and to suggest alternative techniques to improve outcomes in such challenging cases.</p><p><strong>Methods: </strong>Between November 2015 and August 2020, 230 patients (274 limbs) treated in our institution with symptomatic chronic iliofemoral venous obstruction underwent endovascular recanalization with angioplasty and stent placement. Overall, the initial attempt was unsuccessful in 15 limbs. We retrospectively analyzed the basic demographic and health characteristics of the involved patients and evaluated the endovascular procedures and techniques that resulted in a successful second intervention.</p><p><strong>Results: </strong>The first attempts at endovascular intervention were unsuccessful in 15 of the 274 limbs (5.4%). Failures were attributed to hostile groin areas in intravenous drug abusers caused by multiple punctures in six cases. In addition, five interventions failed due to prior surgery at the site of venous occlusion and in retroperitoneal space, three patients due to severe stent deformity, and one patient due to congenital venous aplasia. Of the 15 patients, 11 underwent a subsequent attempt that included six successful recanalizations. The mean follow-up time of the six patients with successful recanalization was 27 months (5-62 months). The primary, assisted primary and secondary patency rates were 83.3%, 100%, and 100%, respectively. The remaining five patients, in whom the second recanalization attempt failed, received conservative treatment.</p><p><strong>Conclusions: </strong>Recanalization failure is rare in chronic venous obstruction patients. Severe stent deformities have the lowest chance of successful second intervention. Patients with a hostile groin or prior open surgeries at the occlusion site may be considered for reintervention with a success rate of nearly 50%.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"337-343"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9891901","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":"Comparison of angiography and ultrasound for femoropopliteal angioplasty: decision-making and 12-month outcomes.","authors":"Yuchi Zou,&nbsp;Qiang Tong,&nbsp;Xuehu Wang,&nbsp;Chuli Jiang,&nbsp;Zheng Qin,&nbsp;Yu Zhao,&nbsp;Jun Cheng","doi":"10.23736/S0392-9590.23.05064-2","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05064-2","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate whether intravascular ultrasound (IVUS) combined with angiography during percutaneous transluminal angioplasty impacts treatment strategies and the 12-month patency of the femoropopliteal artery, compared to angiography alone.</p><p><strong>Methods: </strong>This retrospective, single-center study enrolled 137 patients who underwent a femoropopliteal endovascular intervention between February 2020 and May 2021. Among these interventions, 43 were guided by IVUS combined with angiography and the remaining 94 were guided by angiography only. Treatment strategies and 12-month patency were analyzed in both groups. Multivariable analysis was performed to clarify the predictors of restenosis within 12 months.</p><p><strong>Results: </strong>Primary patency at 12 months was significantly higher in the IVUS group than in the angiography group (56.4% vs. 76.7%, P=0.047). The reference diameter on IVUS images was greater than that on angiography images. Therefore, the IVUS group presented a higher balloon-to-vessel ratio [1.0 (0.97, 1.01) vs. 1.06 (1.0.1.25)]. More adjunctive stents were required in the angiography group. However, more dissections were performed in the IVUS group, with no difference in flow-limiting dissections between groups. Target disease length (odds ratio 1.02, P=0.021) and balloon-to-vessel ratio (odds ratio 0.01, P=0.021) were independent predictors of restenosis.</p><p><strong>Conclusions: </strong>Compared with angiography guidance alone, IVUS guidance for femoropopliteal artery-related treatment can significantly increase primary patency. This finding may be explained by the selection of larger balloons in IVUS and the resulting sufficient plaque compression and elastic membrane stretch. Moreover, IVUS was shown to detect more non-flow-limiting dissections than angiography.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"327-336"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10335450","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":"International Union of Angiology consensus document on vascular compression syndromes.","authors":"Mario D'Oria,&nbsp;Petar Zlatanovic,&nbsp;Anthony Anthony,&nbsp;Anahita Dua,&nbsp;Alyssa M Flores,&nbsp;Adam Tanious,&nbsp;Alejandro Rodríguez Morata,&nbsp;Alba Scerrati,&nbsp;Domenico Baccellieri,&nbsp;Federico Biscetti,&nbsp;Giulia Baldazzi,&nbsp;Giorgio Mantovani,&nbsp;Indrani Sen,&nbsp;Javier Peinado Cebrian,&nbsp;Joao Rocha-Neves,&nbsp;Joel Sousa,&nbsp;Lazar Davidovic,&nbsp;Michal Juszynski,&nbsp;Miroslav Markovic,&nbsp;Mar Oller Grau,&nbsp;Mirko Tessari,&nbsp;Niamh Hynes,&nbsp;Peter Gloviczki,&nbsp;Palma Shaw,&nbsp;Paolo Zamboni,&nbsp;Robert Hinchliffe,&nbsp;Roberta Ricci,&nbsp;Sherif Sultan,&nbsp;Yogesh Acharya,&nbsp;Nicola Troisi,&nbsp;Pier Luigi Antignani,&nbsp;Armando Mansilha,&nbsp;Pedro P Komlos","doi":"10.23736/S0392-9590.23.05100-3","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05100-3","url":null,"abstract":"<p><p>Vascular compression syndromes (VCS) are rare diseases, but they may cause significant symptoms interfering with the quality of life (QoL) of patients who are often in their younger age. Given their infrequent occurrence, multiform clinical and anatomical presentation, and absence of dedicated guidelines from scientific societies, further knowledge of these conditions is required to investigate and treat them using modern imaging and surgical (open or endovascular) techniques. This consensus document will focus on known VCS, affecting the arterial and venous system. The position paper, written by members of International Union of Angiology (IUA) Youth Committee and senior experts, will show an overview of pathophysiology, diagnostic, and therapeutical approaches for patients with VCS. Furthermore, this document will provide also unresolved issues that require more research that need to be addressed in the future.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"282-309"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9902989","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":"Transformational features of the vein wall during a long-term period of endovenous laser ablation using 1910 nm laser radiation. Results of in-vivo experiments.","authors":"Sergey A Artemov,&nbsp;Alexander N Belyaev,&nbsp;Olga S Bushukina,&nbsp;Vasiliy I Davydkin,&nbsp;Svetlana A Khrushchalina,&nbsp;Sergey V Kostin,&nbsp;Polina A Ryabochkina,&nbsp;Alina D Taratynova","doi":"10.23736/S0392-9590.23.05013-7","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05013-7","url":null,"abstract":"<p><strong>Background: </strong>In this paper, results of in-vivo experiments on the animals of endovenous laser ablation (EVLA) using laser radiation with the wavelength 1910 nm are reported. The results of histological studies of the vein segments removed immediately after the procedure and in a long-term period (30 days and 3 months) are presented. Their structural transformation and the obliteration degree of the vein lumen using different values of the linear energy density of laser radiation (LEED=7.5; 15; 20 J/cm) are estimated.</p><p><strong>Methods: </strong>Edilbay breed of sheep (males) were used as experimental animals. Laser radiation with a wavelength of λ=1910 nm and power of Р<inf>rad</inf> = 1.5, 3, 4 W was used for EVLA experiments, and speed of fiber traction (v) was 2 mm/s. 8 days after EVLA stitches and an elastic bandage were removed. Animals were observed for 3 months in the vivarium. Animals have duplex ultrasound scanning of coagulation veins under anesthesia, after analysis vein segments were excised for histological examination. As a result, the damage degree to the vein wall tissues (intima, media, adventitia) and peri-venous tissues was revealed.</p><p><strong>Results: </strong>It is shown that in the long-time period, the intima and partial muscle layer transformed to connective tissue. EVLA using laser radiation with a higher value of LEED led to the growth of connective tissue, oedema of all vein layers and peri-venous tissue. The lumen closure occurred due to clot and the vein wall transformation, a maximum value was 25% using LEED=20 J/cm.</p><p><strong>Conclusions: </strong>The connective-tissue transformation of the coagulated vein occurs in a long-term period and more pronounced for higher LEED. However, features of vein hemodynamics of animals and differences between the clot formation process of human varicose veins and healthy animal veins lead to incomplete occlusion. These features should be taken into account during extrapolation results of experiments on animals in clinical practice.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"362-370"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9905286","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":"Implications of abdominal aortic aneurysm rupture at a lower diameter than the recommended threshold for AAA repair.","authors":"Kosmas I Paraskevas,&nbsp;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}