International Journal of Vascular Medicine最新文献

{"title":"Use of Drugs Associated with QT Interval Prolongation at the Hospital Level during the COVID-19 Pandemic in Colombia.","authors":"Andrés Gaviria-Mendoza,&nbsp;Manuel Enrique Machado-Duque,&nbsp;Luis Fernando Valladales-Restrepo,&nbsp;Carlos Fernando Tovar-Yepes,&nbsp;Jorge Enrique Machado-Alba","doi":"10.1155/2022/3045942","DOIUrl":"https://doi.org/10.1155/2022/3045942","url":null,"abstract":"<p><strong>Background: </strong>Many of the therapeutic proposals for COVID-19 have been associated with adverse effects, including the risk of QT interval prolongation and torsades de pointes (TdP). The objective was to determine the use of drugs with a risk of QT interval prolongation in 21 clinics/hospitals in Colombia from January to December 2020.</p><p><strong>Methods: </strong>This cross-sectional study identified drug use according to pharmacological groups with potential risk of QT interval prolongation according to a risk classification: conditional, possible, and known risk of TdP. Descriptive analyses were performed.</p><p><strong>Results: </strong>A total of 355,574 patients who received QT-prolonging drugs were identified (equivalent to 51.4% of all inpatients treated during the study period). Of the group of patients on QT drugs, 54.4% used at least one drug with conditional risk, 52.6% with possible risk, and 40.3% with known risk. The most commonly used belonged to the group of drugs for the nervous system (63.0%), alimentary tract and metabolism (56.8%), anti-infectives for systemic use (13.0%), and the cardiovascular system (11.7%). On average, patients received 2.0 ± 1.5 risk drugs. Regarding drugs initially considered against COVID-19, 2,120 patients (0.6%) received azithromycin, 802 (0.2%) received chloroquine, 517 received hydroxychloroquine (0.1%), and 265 received lopinavir/ritonavir (0.1%).</p><p><strong>Conclusion: </strong>The high proportion of patients treated at the hospital level who receive drugs with risk of prolonging the QT interval should alert those responsible for their care to avoid fatal outcomes, especially during the COVID-19 epidemic, when some QT drugs are being used more frequently.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":" ","pages":"3045942"},"PeriodicalIF":1.3,"publicationDate":"2022-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9520316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40391083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Evaluation of Efficacy and Safety of the Diode Laser (980 nm) and Sclerotherapy in the Treatment of Oral Vascular Malformations.","authors":"Peeyush Shivhare,&nbsp;Naqoosh Haidry,&nbsp;Neha Sah,&nbsp;Ajay Kumar,&nbsp;Abhishek Gupta,&nbsp;Ankur Singh,&nbsp;Mohan Raju Penumatcha,&nbsp;Shalini Subramanyam","doi":"10.1155/2022/2785859","DOIUrl":"https://doi.org/10.1155/2022/2785859","url":null,"abstract":"<p><strong>Background: </strong>Vascular malformations are structural abnormalities which are formed by progressively enlarging aberrant and ecstatic vessels without endothelial cell proliferation and composed of the type of vessel involved, i.e., capillary, veins, and arteriovenous. Treatment of vascular malformations may involve many techniques like sclerotherapy, embolization, surgical resection, cryotherapy, laser treatment, or medical therapy. This observational prospective study is aimed at evaluating and comparing the effects and efficacy of diode laser and sclerotherapy in the treatment of oral vascular malformation.</p><p><strong>Materials and methods: </strong>40 patients presenting with oral vascular malformation were included in the present study. The patients were divided equally (20 in each) into two groups, i.e., the laser group and sclerotherapy group. Sclerotherapy was performed with 3% sodium tetradecyl sulfate while the laser group was treated with diode laser 980 nm with transmucosal thermophotocoagulation. The patients were assessed for the response, remission, and side effects. The results obtained were tabulated and compared with the chi-square test.</p><p><strong>Results: </strong>Side effects were found significantly lesser in the laser group compared to the sclerotherapy group (<i>p</i> < 0.05). Statistically significant difference was seen for postoperative pain between two groups. The laser group had mild to moderate pain compared to severe pain in the sclerotherapy group. Recurrence was observed more in the laser group compared to the sclerotherapy group.</p><p><strong>Conclusions: </strong>Laser and sclerotherapy with 3% sodium tetradecyl sulfate both are effective in the treatment of vascular malformations. Diode laser seems to be better than sclerotherapy given lesser side effects and comfort to the patients while sclerotherapy seems to be better in respect to recurrences.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":" ","pages":"2785859"},"PeriodicalIF":1.3,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40359661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic Cigarette and Atherosclerosis: A Comprehensive Literature Review of Latest Evidences.","authors":"Vito Anggarino Damay,&nbsp;Setiawan,&nbsp;Ronny Lesmana,&nbsp;M Rizki Akbar,&nbsp;Antonia Anna Lukito,&nbsp;Vita M Tarawan,&nbsp;Januar W Martha,&nbsp;J Nugroho","doi":"10.1155/2022/4136811","DOIUrl":"https://doi.org/10.1155/2022/4136811","url":null,"abstract":"<p><p>Coronary artery diseases (CAD), also known as coronary heart disease (CHD), are the world's leading cause of death. The basis of coronary artery disease is the narrowing of the heart coronary artery lumen due to atherosclerosis. The use of electronic cigarettes has increased significantly over the years. However, harmful effects of electronic cigarettes are still not firm. The aim of this article is to review the impact of electronic cigarette and its role in the pathogenesis of atherosclerosis from recent studies. The results showed that several chemical compounds, such as nicotine, propylene glycol, particulate matters, heavy metals, and flavorings, in electronic cigarette induce atherosclerosis with each molecular mechanism that lead to atherosclerosis progression by formation of ROS, endothelial dysfunction, and inflammation. Further research is still needed to determine the exact mechanism and provide more clinical evidence.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2022 ","pages":"4136811"},"PeriodicalIF":1.3,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9453087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33461494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Reduction in Adverse Events and Cost with Novel Anticoagulants among Patients with Acute Limb Ischemia","authors":"S. Freeman, Piper C. M. Williams, A. Barón, M. Plomondon, Stephen W. Waldo","doi":"10.1155/2022/3786815","DOIUrl":"https://doi.org/10.1155/2022/3786815","url":null,"abstract":"Background Acute limb ischemia (ALI) is associated with significant morbidity and mortality. Novel anticoagulants reduce adverse events among patients with peripheral artery disease, though the potential effect of these therapies is unclear in patients with ALI. The present study thus sought to evaluate the potential clinical benefit of universal application of novel anticoagulants to a high-risk population of patients with ALI. Methods In this retrospective cohort study, we identified patients diagnosed with ALI in the Veterans Affairs Healthcare System between 2015 and 2016. We then calculated the incidence of adverse cardiovascular events (death/stroke/myocardial infarction/amputation/repeat intervention) as if they were treated with rivaroxaban using published data. Further, we calculated the cost to treat a Veteran diagnosed with one of these outcomes, and the potential savings had patients been universally treated with novel anticoagulants. Results We identified 286 patients that presented with lower extremity ALI and were not treated with anticoagulation. Potential treatment of these patients with rivaroxaban resulted in significantly fewer adverse events, with an 11.9% reduction in cases at 21 months (95% CI: 5.5-17.8%) and a 13.4% reduction in cases at 47 months (95% CI: 5.6-20.5%). This corresponded to significant decreases in healthcare spending for patients with ALI who were treated with rivaroxaban. Conclusions Among patients with ALI, treatment with rivaroxaban could result in a significant reduction in adverse cardiovascular events. The reduction in events would in turn lead to significant decreases in healthcare spending for this population.","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2022 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48725112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Year Clinical Outcome in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study","authors":"A. Hammoudeh, Yousef Khader, R. Tabbalat, Y. Badaineh, N. Kadri, H. Shawer, E. Al-Mousa, R. Ibdah, Batool A. Shawer, I. Alhaddad","doi":"10.1155/2022/4240999","DOIUrl":"https://doi.org/10.1155/2022/4240999","url":null,"abstract":"Background Prevention of stroke and systemic embolism (SE) prevention in patients with atrial fibrillation (AF) has radically changed in recent years. Data on contemporary utilization of oral anticoagulants (OACs) and cardiovascular outcome in Middle Eastern patients with AF are needed. Methods The Jordan atrial fibrillation (JoFib) study enrolled consecutive patients with AF in Jordan from May 2019 through October 2020 and were followed up for one year after enrollment. Results Overall, 2020 patients were enrolled. The mean age was 67.9 + 13.0 years. Nonvalvular (NVAF) was diagnosed in 1849 (91.5%) patients. OACs were used in 85.7% of high-risk patients with NVAF (CHA2DS2-VASc score>3 in women, and>2 in men), including direct OACs (DOACs) in 64.1% and vitamin K antagonists (VKA) in 35.9%. Adherence rate to the use of the same OAC agent was 90.6% of patients. One-year cardiovascular (CV) mortality was 7.8%, stroke/SE was 4.5%, and major bleeding events were 2.6%. Independent predictors for all-cause mortality in patients with NVAF were age>75 years, heart failure, major bleeding event, type 2 diabetes mellitus, study enrollment as an in-patient, and coronary heart disease. The use of OACs was associated with lower all-cause mortality. The strongest independent predictors for stroke/SE were high-risk CHA2DS2-VASc score and prior history of stroke. Conclusions This study of Middle Eastern AF patients has reported high adherence to OACs. The use of OACs was associated with a lower risk for all-cause mortality. One-year rates of stroke and major bleeding events were comparable to those reported from other regions in the world.","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2022 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64777590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Frequency of Microvascular Dysfunction in US Outpatient Clinics: A Sign of High Residual Risk? Data from 7,105 Patients.","authors":"Morteza Naghavi,&nbsp;Stanley Kleis,&nbsp;Hirofumi Tanaka,&nbsp;Albert A Yen,&nbsp;Ruoyu Zhuang,&nbsp;Ahmed Gul,&nbsp;Yasamin Naghavi,&nbsp;Ralph Metcalfe","doi":"10.1155/2022/4224975","DOIUrl":"https://doi.org/10.1155/2022/4224975","url":null,"abstract":"<p><p>Previous studies have linked peripheral microvascular dysfunction measured by arterial tonometry to high residual risk in on-statin patients. Digital thermal monitoring (DTM) of microvascular function is a new and simplified technique based on fingertip temperature measurements that has been correlated with the burden of atherosclerosis and its risk factors. Here, we report analyses of DTM data from two large US registries: Registry-I (6,084 cases) and Registry-II (1,021 cases) across 49 US outpatient clinics. DTM tests were performed using a VENDYS device during a 5-minute arm-cuff reactive hyperemia. Fingertip temperature falls during cuff inflation and rebounds after deflation. Adjusted maximum temperature rebound was reported as vascular reactivity index (VRI). VRI distributions were similar in both registries, with mean ± SD of 1.58 ± 0.53 in Registry-I and 1.52 ± 0.43 in Registry-II. In the combined dataset, only 18% had optimal VRI (≥2.0) and 82% were either poor (<1.0) or intermediate (1.0-2.0). Women had slightly higher VRI than men (1.62 ± 0.56 vs. 1.54 ± 0.47, <i>p</i> < 0.001). VRI was inversely but mildly correlated with age (<i>r</i> = -0.19, <i>p</i> < 0.001). Suboptimal VRI was found in 72% of patients <50 years, 82% of 50-70 years, and 86% of ≥70 years. Blood pressure was not correlated with VRI. In this largest registry of peripheral microvascular function measurements, suboptimal scores were highly frequent among on-treatment patients, possibly suggesting a significant residual risk. Prospective studies are warranted to validate microvascular dysfunction as an indicator of residual risk.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2022 ","pages":"4224975"},"PeriodicalIF":1.3,"publicationDate":"2022-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8758294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39939543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Practitioners' Knowledge of Lymphedema.","authors":"Hossein Yarmohammadi,&nbsp;Amirhossein Rooddehghan,&nbsp;Masood Soltanipur,&nbsp;Amirabbas Sarafraz,&nbsp;Seyed Fatah Mahdavi Anari","doi":"10.1155/2021/3806150","DOIUrl":"https://doi.org/10.1155/2021/3806150","url":null,"abstract":"<p><strong>Objectives: </strong>Lymphedema is neglected in medical education, and a review on healthcare practitioners' (HCPs) knowledge is necessary to shed light on gaps and to provide evidence for establishing educational programs on lymphedema.</p><p><strong>Methods: </strong>This systematic review was performed based on the PRISMA guideline in PubMed, Scopus, Web of Science, and Google Scholar databases. There was no limitation on the type of lymphedema or HCPs. The quality assessment was performed based on QATSDD. Data regarding study characteristics, questionnaire context, and findings of the study were summarized from each article.</p><p><strong>Results: </strong>After the screening, 16 articles were included that 12 were cross-sectional, two were qualitative, and two were interventional pilot studies. Breast cancer and other cancer-related lymphedema, lymphatic filariasis, and podoconiosis were included, and the majority of articles were focused on primary HCPs. The overall knowledge was low and average in five and 11 articles, respectively, and prior education was a significant factor related to higher knowledge of lymphedema in two studies.</p><p><strong>Conclusion: </strong>Structured education of lymphedema is needed to increase the knowledge of HCPs and to enhance their collaboration in multidisciplinary care teams. Improvement of HCPs' knowledge may lead to better outcomes of lymphedema patients' management which are neglected.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2021 ","pages":"3806150"},"PeriodicalIF":1.3,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8741388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39800928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of Risk Factors and Predictors for Hemorrhagic Transformation in Patients with Acute Ischemic Stroke.","authors":"Sneha E Thomas,&nbsp;Noorine Plumber,&nbsp;Priyanka Venkatapathappa,&nbsp;Vasavi Gorantla","doi":"10.1155/2021/4244267","DOIUrl":"https://doi.org/10.1155/2021/4244267","url":null,"abstract":"<p><p>Acute ischemic strokes (AIS) and hemorrhagic strokes lead to disabling neuropsychiatric and cognitive deficits. A serious and fatal complication of AIS is the occurrence of hemorrhagic transformation (HT). HT is cerebral bleeding that occurs after an ischemic event in the infarcted areas. This review summarises how specific risk factors such as demographic factors like age, gender, and race/ethnicity, comorbidities including essential hypertension, atrial fibrillation, diabetes mellitus, congestive heart failure, and ischemic heart disease along with predictors like higher NIHSS score, larger infarction size, cardioembolic strokes, systolic blood pressure/pulse pressure variability, higher plasma glucose levels, and higher body temperature during ischemic event, lower low-density lipoprotein and total cholesterol, early ischemic changes on imaging modalities, and some rare causes make an individual more susceptible to developing HT. We also discuss few other risk factors such as the role of blood-brain barrier, increased arterial stiffness, and globulin levels in patients postreperfusion using thrombolysis and mechanical thrombectomy. In addition, we discuss the implications of dual antiplatelet therapy and the length of treatment in reference to the incidence of developing HT. Current research into inflammatory mediators and biomarkers such as Cyclooxygenase-2, matrix metalloproteinases, and soluble ST2 and their potential role as treatment options for HT is also briefly discussed. Finally, this review calls for more research into use of dual antiplatelet and the timing of antiplatelet and anticoagulant use in reference to hemorrhagic transformation.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2021 ","pages":"4244267"},"PeriodicalIF":1.3,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8668348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39730394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Segmental Arterial Mediolysis: A Multiguised Vasospastic Arteriopathy with Collateral Mesangial Cell Hyperplasia and Cardiac Toxicity Generated by Norepinephrine and Hyperdense Adrenoceptors Alone or by Crosstalk with Other Pressor Agents.","authors":"Richard E Slavin","doi":"10.1155/2021/2046566","DOIUrl":"https://doi.org/10.1155/2021/2046566","url":null,"abstract":"<p><p>Segmental arterial mediolysis (SAM), an uncommon vasospastic arteriopathy occurring in the muscular arteries innervated by the peripheral sympathetic nervous system, usually presents with catastrophic abdominal and retroperitoneal hemorrhages in elderly patients. SAM is initiated by the coupling of norepinephrine to plastically derived hyperdense foci of alpha-1 adrenergic receptors on the sarcolemma of arterial muscle. This ligand is created by stimuli signaled by iatrogenic sympathomimetic agonists, some beta-2 agonists, or an excessive release of adrenal catecholamines. Coupling of this ligand with cytoplasmic heterotrimeric Gq protein excessively signals a cascade of biochemical events generating two principal lesions of injurious-phase SAM-the shearing of the outer media from the adventitia and an overload of cytoplasmic calcium ions toxic to mitochondria causing mediolysis and/or apoptosis. The massive hemorrhages are caused by ruptured gap aneurysms created by the transmedial loss of the medial muscle. A norepinephrine-directed reparative response rapidly develops either resolving angiographic injurious lesions or creating a body of vascular disorders, the new guises of SAM with ischemic clinical profiles. These present in the epicardial, vertebral, intestinal, and retroperitoneal arteries, often in younger females as fibromuscular dysplasia, dissecting hematomas, and persistent aneurysms. Norepinephrine can crosstalk with other pressor agents to create SAM lesions-serotonin with idiopathic pulmonary hypertension and persistent pulmonary hypertension in the newborn, histamine in spontaneous coronary artery dissections with eosinophilia, and endothelin-1 in a field effect generated by SAM that creates venous fibromuscular dysplasia. Norepinephrine also participates in the collateral development of mesangial hyperplasia with focal segmental glomerulosclerosis and myocardial mediolysis and apoptosis in subjects with markedly elevated heart rates. <i>Conclusion</i>. Norepinephrine coupling with plastically elevated alpha-1 adrenoceptor or other pressor agents generates SAM, a histologically recognizable vasospastic arteriopathy, that with repair is transformed into several different standardized arterial diseases that alter SAM's clinical profile from a hemorrhagic to an ischemic disorder.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2021 ","pages":"2046566"},"PeriodicalIF":1.3,"publicationDate":"2021-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8646181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39703875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of the AFX Stent Graft in Patients with Extremely Narrow Aortic Bifurcation: A Multicenter Retrospective Study.","authors":"M U Wagenhäuser,&nbsp;N Floros,&nbsp;E Nikitina,&nbsp;J Mulorz,&nbsp;K M Balzer,&nbsp;S Goulas,&nbsp;M Petrich,&nbsp;P Dueppers,&nbsp;F Simon,&nbsp;H Schelzig,&nbsp;A Oberhuber","doi":"10.1155/2021/7439173","DOIUrl":"https://doi.org/10.1155/2021/7439173","url":null,"abstract":"<p><strong>Introduction: </strong>This study analyzed the patient outcomes following endovascular aortic aneurysm repair (EVAR) for infrarenal aortic pathologies with very narrow aortic bifurcations using the AFX stent graft.</p><p><strong>Methods: </strong>The data was retrieved from the archived medical records of 35 patients treated for abdominal aortic aneurysm (AAA) (48.6%) or penetrating aortic ulcer (PAU) (51.4%) with very narrow aortic bifurcation between January 2013 and May 2020. Patient survival, freedom from endoleak (EL), and limb occlusion were estimated applying the Kaplan-Meier method.</p><p><strong>Results: </strong>The mean follow-up time was 20.4 ± 22.8 months. The mean aortic bifurcation diameter was 15.8 ± 2.2 mm. Technical success was 100%, and no procedure-related deaths occurred. Two type II ELs occurred within 30-day follow-up. We observed one common iliac artery stenosis at four months and one type III EL at 54 months in the same patient, both of which required re-intervention. Overall patient survival was 95 ± 5% (AAA: 100%; PAU: 89 ± 10%), freedom from limb occlusion was 94 ± 5% (AAA: 91 ± 9%; PAU: 100%), freedom from type II EL was 94 ± 4% (AAA: 88 ± 8%; PAU: 100%), and freedom from EL type III was 83 ± 15% (AAA: 80 ± 18%; PAU: 100%) at the end of the follow-up period.</p><p><strong>Conclusions: </strong>Very narrow aortic bifurcations may predispose patients to procedure-related complications following EVAR. Our results suggest a safe use of the AFX stent graft in such scenarios. The overall short- and long-term procedure-related patient outcomes are satisfying albeit they may seem superior for PAU when compared to AAA.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2021 ","pages":"7439173"},"PeriodicalIF":1.3,"publicationDate":"2021-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8505088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39515698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}