Journal of Vascular Surgery最新文献

{"title":"Prevalence and clinical significance of mesenteric artery stenosis in elderly patients with acute abdomen.","authors":"Pasi Pengermä, Erik Palm, Eszter Bako, Sari Venesmaa, Jari Karjalainen, Petri Saari, Mika Ukkonen, Jussi M Kärkkäinen","doi":"10.1016/j.jvs.2025.08.036","DOIUrl":"10.1016/j.jvs.2025.08.036","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the prevalence of mesenteric artery stenosis and its association with acute mesenteric ischemia (AMI) among elderly patients presenting to the emergency department with acute abdominal pain.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 500 consecutive patients aged ≥65 years who underwent contrast-enhanced computed tomography in the emergency department owing to acute abdominal pain between 2013 and 2014. Imaging data were retrospectively evaluated by a consultant interventional radiologist for 50% or greater stenosis of the superior mesenteric artery (SMA), celiac artery (CA), and inferior mesenteric artery (IMA). The main outcomes of interest were the prevalence of atherosclerotic mesenteric artery stenosis in patients with acute abdominal pain, the prevalence of AMI in patients with mesenteric artery stenosis, and later presentation of mesenteric ischemia until the end of the follow-up, August 2025.</p><p><strong>Results: </strong>Altogether, 123 patients (25%) had a mesenteric artery stenosis. Fifty-nine patients (12%) had ≥50% stenosis of the SMA, of whom 28 (5.6%) had 50% to 69% SMA stenosis and 31 (6.2%) had ≥70% SMA stenosis or total occlusion. In patients with SMA stenosis, a concomitant CA stenosis was recorded in 22 patients (37%) and 11 (19%) had a three-vessel disease involving the SMA, CA, and IMA. Forty patients (8.0%) had multivessel stenosis (SMA + CA, SMA + IMA, CA + IMA or SMA + CA + IMA). The prevalence of SMA stenosis increased with age; it was observed in 22 (6.9%) patients aged 65 to 79 years and in 37 (20%) patients aged ≥80 years. There were 14 patients (2.8%) with isolated 50% to 69% stenosis of the SMA of whom none had AMI at presentation; patients 9 (1.8%) had isolated ≥70% SMA stenosis of whom 2 (22%) presented with AMI. Of all patients with ≥70% SMA stenosis, 12 of 31 (39%) presented with AMI, and 12 of 40 (30%) with any multivessel stenosis presented with AMI. One of the patients with incidental mesenteric artery stenosis (ie, no AMI at presentation) developed symptomatic mesenteric ischemia during follow-up.</p><p><strong>Conclusions: </strong>Mesenteric artery stenosis is a relatively common clinical problem in elderly patients with acute abdomen. The risk of AMI is significant in emergency room patients with ≥70% SMA stenosis and involvement of other mesenteric arteries (multivessel disease). Occurrence of later symptoms seems to be rare in patients with incidental asymptomatic mesenteric artery stenosis.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multimethod assessment of the vascular surgery program director experience in creating effective training environments.","authors":"Margaret A Reilly, Christina L Cui, Yue Jiang, Eric B Pillado, Ruojia Debbie Li, Joshua S Eng, Leanne E Grafmuller, Kathryn L DiLosa, Palma M Shaw, Yue-Yung Hu, Karl Y Bilimoria, Dawn M Coleman, Malachi G Sheahan","doi":"10.1016/j.jvs.2025.08.034","DOIUrl":"10.1016/j.jvs.2025.08.034","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Surgical training has received significant attention in recent years with efforts to improve trainee wellness. Vascular surgery training is subject to unique challenges, and vascular program directors (PDs) are tasked with providing learning environments that produce effective and competent surgeons. The aim of this study was to examine the experience of vascular surgery PDs in promoting effective learning environments for vascular trainees.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were collected from confidential, voluntary surveys of vascular surgery residency PDs with multiple choice and free response questions as part of the Surgical Education Culture Optimization Through Targeted Interventions based on National Comparative Data (SECOND) trial. PDs were asked about their use of wellness interventions, resources available through their institution, and resources still required. PDs indicated the most rewarding and challenging aspects of their role. Program-level wellness data were aggregated from trainee responses to an annual survey of trainee wellness. Associations between program wellness metrics and the number of interventions used by PDs were assessed with Wilcoxon rank-sum tests. Qualitative data were analyzed with inductive reasoning to identify themes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 33 PDs who participated in the survey (76.7% of programs enrolled in the Vascular SECOND trial), most PDs had opportunities to engage with other faculty (n = 27 [81.8%]), support from Graduate Medical Education (n = 27 [81.8%]), and administrative support from program coordinators (n = 26 [78.8%]). Many PDs reported a need for additional salary/stipend support to incentivize program leadership (n = 23 [69.7%]), funded protected effort to decrease clinical responsibilities (n = 18 [54.6%]), and discretionary educational funds (n = 13 [39.4%]). The trainee-related issues most frequently encountered by PDs were performance challenges (n = 15 [45.5%]) and interpersonal issues between trainees and ancillary staff (n = 9 [27.3%]). The most common institutional-level issues were incongruence between hospital administration goals and clinical priorities (n = 9 [27.3%]) and protected time for administrative responsibilities (n = 8 [24.2%]). There were no significant associations between trainee wellness and perception of program responsiveness or resources needed or available to PDs. Themes of the most rewarding aspects of the PD job were participating in trainee growth, training the next generation, and interpersonal relationships. Themes of most challenging aspects were generational differences, interpersonal challenges, lack of resources, and administrative tasks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Vascular surgery PDs assume a challenging role with unique responsibilities. Certain barriers and facilitators of wellness may be experienced by a majority of PDs, which allows for identification of potentially widely effective intervent","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rationale for expanding abdominal aortic aneurysm screening programs.","authors":"Kosmas I Paraskevas, Marc L Schermerhorn","doi":"10.1016/j.jvs.2025.04.059","DOIUrl":"https://doi.org/10.1016/j.jvs.2025.04.059","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 3","pages":"1127"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply.","authors":"Isa F van Galen, Marc L Schermerhorn","doi":"10.1016/j.jvs.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.jvs.2025.05.012","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 3","pages":"1130-1131"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the hybrid armamentarium for adult aortic coarctation with arch aneurysm.","authors":"Mehmet Alagoz, Alejandro Pizano, Ciro Amodio","doi":"10.1016/j.jvs.2025.04.068","DOIUrl":"https://doi.org/10.1016/j.jvs.2025.04.068","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 3","pages":"1131-1132"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RE: \"Carotid endarterectomy is less expensive than TCAR\".","authors":"Amir Reza Akbari, Benyamin Alam","doi":"10.1016/j.jvs.2025.05.044","DOIUrl":"https://doi.org/10.1016/j.jvs.2025.05.044","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 3","pages":"1133"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of chronic kidney disease in the BEST-CLI trial.","authors":"Benyamin Alam, Amir Reza Akbari","doi":"10.1016/j.jvs.2025.04.066","DOIUrl":"https://doi.org/10.1016/j.jvs.2025.04.066","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 3","pages":"1128-1129"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply.","authors":"Hongwei Zhang, Peng Yang, Jia Hu","doi":"10.1016/j.jvs.2025.05.024","DOIUrl":"https://doi.org/10.1016/j.jvs.2025.05.024","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 3","pages":"1132-1133"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply.","authors":"Paarth Jain, Paul DiMuzio, Michael Nooromid, Dawn Salvatore, Babak Abai","doi":"10.1016/j.jvs.2025.04.060","DOIUrl":"https://doi.org/10.1016/j.jvs.2025.04.060","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 3","pages":"1127-1128"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of aneurysm diameter on perioperative outcomes in complex endovascular repair: Study limitations and future directions.","authors":"Donglin Li","doi":"10.1016/j.jvs.2025.04.067","DOIUrl":"https://doi.org/10.1016/j.jvs.2025.04.067","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 3","pages":"1130"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}