Journal of Vascular Surgery最新文献

{"title":"Midterm single center results with the use of custom-made endografts with inner branches, a call for attention.","authors":"Jose I Torrealba, Giuseppe Panuccio, Petroula Nana, Antonino Giordano, Daour Yousef Al Sarhan, Tilo Kölbel","doi":"10.1016/j.jvs.2024.09.039","DOIUrl":"https://doi.org/10.1016/j.jvs.2024.09.039","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the patency of bridging covered stents (BCS) bridged to inner branches in custom-made thoracoabdominal endografts.</p><p><strong>Methods: </strong>Single-center retrospective study identifying all patients undergoing fenestrated or branched endovascular aortic repair (f/b EVAR) in whom the reno-visceral target vessels (TV) were bridged with a BCS to an inner branch of a custom made (CMD) endograft.. Technical success and perioperative complications were noted. Follow-up BCS patency were evaluated and in patients with follow-up, two groups based on BCS were created, a group with BCS occlusion and a group with BCS patent. Uni und multivariable analysis were performed to analyze factors related to visceral and renal bridging stent occlusion.</p><p><strong>Results: </strong>From 2019-2022, 69 patients undergoing complex aortic repair had at least one TV bridged to an inner branch built into a CMD endograft. 86% of the grafts had only inner branches, whereas 14% had a mix of fenestrations for the visceral TV and inner branches for the renal arteries. Twenty-five percent of patients presented as urgency and received an endograft originally designed for another patient and available on our shelf at the time. 245 TVs were connected to inner branches: celiac trunk (CT): 54, superior mesenteric artery (SMA): 59, renal artery (RA): 132. Technical success was 99%. There was a 23% complication and 9% perioperative mortality rate. At follow-up, we identified 6% of visceral and 14% of renal BCS occlusions. The primary patency for RA BCS was 83% at 12 months and 58% at 24 months. For the CT-SMA BCS, Kaplan-Maier (KM) showed a patency of 99% and 96% at 12 and 24 months. In the univariate analysis a misaligned TV ostium (p 0.001), the postoperative BCS diameter on postoperative CTA (p 0.02) and the preoperative infrarenal aortic angle >60º (0.007) were correlated with RA BCS occlusion. In the multivariate analysis only the misaligned TV ostium (p 0.002) and infrarenal angle > 60° (p 0.01) were significantly correlated.</p><p><strong>Conclusions: </strong>In our series of complex aortic repair, the incorporation of inner branches to bridge TVs is associated with a high renal BCS occlusion rate. Improper alignment of the branches with the TV ostium and acute aortic angles might play a significant role. Further research on this technology is needed.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468755","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":"Comparison of Open and Endovascular Repair of Complex Abdominal Aortic Aneurysms.","authors":"Sai Divya Yadavalli, Vinamr Rastogi, Ambar Mehta, Sara Allievi, Yoel Solomon, Jorg L de Bruin, Shipra Arya, Lars Stangenberg, Hence J M Verhagen, Marc L Schermerhorn","doi":"10.1016/j.jvs.2024.10.016","DOIUrl":"https://doi.org/10.1016/j.jvs.2024.10.016","url":null,"abstract":"<p><strong>Objective: </strong>To compare perioperative and 5-year outcomes following endovascular (FEVAR) and open repair (OAR) of complex abdominal aortic aneurysms (cAAA) in males and females separately, given the known sex related differences in perioperative outcomes.</p><p><strong>Methods: </strong>We studied all elective cAAA repairs between 2014-2019 in the Vascular Implant Surveillance and Interventional Outcomes Network (VISION) registry. We stratified patients based on sex. We calculated propensity scores for assignment to either OAR or FEVAR. Covariates including age, race, diameter, baseline comorbidities, proximal extent of repair, annual center volumes, and annual surgeon volumes were introduced into the model for estimating propensity scores. Within matched cohorts, perioperative outcomes and 5-year outcomes (mortality, reinterventions, and ruptures) were evaluated using multivariable logistic and Cox regression models.</p><p><strong>Results: </strong>We identified 2,825 patients of whom 29% were female. Within both the sexes, OAR was more commonly performed (OAR vs FEVAR: males: 53% vs 47%; females: 63% vs 37%). After matching, among males (n=1326), FEVAR was associated with lower perioperative mortality (FEVAR vs OAR: 2.3% vs 5.1%; p<.001). However, FEVAR was associated with comparable 5-year mortality (38% vs 28%; hazard ratio (HR) 1.2 [0.92-1.4]; p=.22) and a higher hazard of 5-year reintervention (19% vs 3.7%; aHR: 4.5 [2.6-7.6], p<.001). Among females (n=456), FEVAR and OAR showed similar perioperative mortality (8.3% vs 7.0%; p=.73). At 5 years, FEVAR was associated with higher hazards of mortality (43% vs 32%; aHR: 1.5 [1.03-2.2], p=.034) and reintervention (20% vs 3.0%; aHR: 4.8 [2.1-11], p<.001) compared with OAR.</p><p><strong>Conclusions: </strong>Among males, FEVAR was associated with favorable perioperative outcomes compared with OAR, though these advantages attenuate over time. However, among females, FEVAR was associated with similar perioperative outcomes, eventually leading to higher reinterventions and possibly higher mortality within 5 years. Future efforts should focus on determining the factors associated with these sex disparities to improve outcomes following FEVAR in females. Based on current evidence, females undergoing elective cAAA repair should be selected with due caution, especially for endovascular repair.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468809","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":"Prognostic Factors and Models to Predict Mortality Outcomes in Patients with Peripheral Arterial Disease: A Systematic Review","authors":"C.P. Porras,&nbsp;M. Teraa,&nbsp;J.A.A. Damen,&nbsp;C.E.V.B. Hazenberg,&nbsp;M.L. Bots,&nbsp;M.C. Verhaar,&nbsp;R.W.M. Vernooij","doi":"10.1016/j.jvs.2024.08.042","DOIUrl":"10.1016/j.jvs.2024.08.042","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531130","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":"Intraoperative cell salvage technique in patients undergoing complex endovascular aortic repair","authors":"S.S. Park,&nbsp;L. Weise,&nbsp;C.F. Bechara,&nbsp;P.J. DeChristopher","doi":"10.1016/j.jvs.2024.09.023","DOIUrl":"10.1016/j.jvs.2024.09.023","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531537","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":"Events of Interest","authors":"","doi":"10.1016/S0741-5214(24)01845-7","DOIUrl":"10.1016/S0741-5214(24)01845-7","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531533","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":"Covered Stents Versus Bare Metal Stents in the Treatment of Aorto-iliac Disease: A Systematic Review and Individual Participant Data Meta-analysis","authors":"V. Bontinis,&nbsp;A. Bontinis,&nbsp;A. Giannopoulos,&nbsp;V. Manaki,&nbsp;I. Kontes,&nbsp;V. Rafailidis,&nbsp;C.N. Antonopoulos,&nbsp;K. Ktenidis","doi":"10.1016/j.jvs.2024.08.041","DOIUrl":"10.1016/j.jvs.2024.08.041","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531129","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 Core Outcome Set for Intact Abdominal Aortic Aneurysm Repair","authors":"M. Machin,&nbsp;A. Wanhainen,&nbsp;M. D'Oria,&nbsp;M. Koelemaij,&nbsp;S. Kakkos,&nbsp;M.J. Grima,&nbsp;J.T. Powell,&nbsp;collaborators","doi":"10.1016/j.jvs.2024.08.038","DOIUrl":"10.1016/j.jvs.2024.08.038","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531133","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":"Sex Comparative Analysis of Branched and Fenestrated Endovascular Aortic Arch Repair Outcomes","authors":"P. Nana,&nbsp;G. Panuccio,&nbsp;J.I. Torrealba,&nbsp;F. Rohlffs,&nbsp;K. Spanos,&nbsp;T. Kölbel","doi":"10.1016/j.jvs.2024.08.039","DOIUrl":"10.1016/j.jvs.2024.08.039","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531519","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 anterior saphenous vein. Part 2. Anatomic considerations in normal and refluxing patients. Endorsed by the American Vein and Lymphatic Society, the American Venous Forum, and the International Union of Phlebology","authors":"A. Caggiati,&nbsp;N. Labropoulos,&nbsp;E.M. Boyle,&nbsp;R. Drgastin,&nbsp;A. Gasparis,&nbsp;S. Doganci,&nbsp;M. Meissner","doi":"10.1016/j.jvs.2024.09.021","DOIUrl":"10.1016/j.jvs.2024.09.021","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531535","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":"Nonstenotic symptomatic internal carotid artery plaques: Epidemiology, pathophysiology, and treatment","authors":"M.S. Schaller,&nbsp;L. Rinaldo,&nbsp;J.C. Benson,&nbsp;Z. Keser,&nbsp;V. Nardi,&nbsp;L. Saba,&nbsp;G. Lanzino","doi":"10.1016/j.jvs.2024.09.025","DOIUrl":"10.1016/j.jvs.2024.09.025","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531539","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}