Journal of Vascular Surgery最新文献

{"title":"Information for Readers","authors":"","doi":"10.1016/S0741-5214(24)01843-3","DOIUrl":"10.1016/S0741-5214(24)01843-3","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"80 5","pages":"Page A10"},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531532","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":"Biodesign: Engineering an aortic endograft explantation tool","authors":"S. Hatami, V. Maturi, A. Mathew, S. Lu, P. Haddad, D. Sheikh, M. Rahimi","doi":"10.1016/j.jvs.2024.09.022","DOIUrl":"10.1016/j.jvs.2024.09.022","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"80 5","pages":"Page A15"},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531536","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":"Association of serum vitamin D with diagnosis and growth of abdominal aortic aneurysm","authors":"S. Thanigaimani, R.E. Neale, M. Waterhouse, J.V. Moxon, B.B. Yeap, P.E. Norman, L. Flicker, G.J. Hankey, J. Jenkins, F. Quigley, M.W. Clarke, J. Golledge","doi":"10.1016/j.jvs.2024.09.024","DOIUrl":"10.1016/j.jvs.2024.09.024","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"80 5","pages":"Page A15"},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531538","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":"Adjunctive electroseptotomy for endovascular repair of aortic dissections: Disruptive technique with shocking value or just playing with fire?","authors":"Sukgu M. Han MD","doi":"10.1016/j.jvs.2024.07.088","DOIUrl":"10.1016/j.jvs.2024.07.088","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"80 5","pages":"Page 1407"},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468759","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":"Safety and efficacy of home-based walking exercise for peripheral artery disease.","authors":"Neela D Thangada, Dongxue Zhang, Lihui Zhao, Lu Tian, Mary M McDermott","doi":"10.1016/j.jvs.2024.10.013","DOIUrl":"10.1016/j.jvs.2024.10.013","url":null,"abstract":"<p><strong>Objective: </strong>Home-based walking exercise is first-line therapy for peripheral artery disease (PAD), but benefits of home-based walking exercise are variable. This study evaluated whether specific clinical characteristics were associated with greater improvement after home-based walking exercise or with higher rates of serious adverse events (SAEs).</p><p><strong>Methods: </strong>Data were combined from two randomized clinical trials comparing home-based walking exercise with control in PAD. The home-based exercise interventions used behavioral interventions to help participants adhere to exercise. The primary outcome was the proportion of PAD participants who improved 6-minute walk (6 MW) by at least 20 meters. Serious adverse events consisted of overnight hospitalizations or death that occurred during the randomized clinical trial.</p><p><strong>Results: </strong>Of 376 participants with PAD (69.6 years; 54.5% Black; 49.5% women), 217 were randomized to exercise and 159 to control. Home-based exercise improved 6 MW by at least 20 meters in 100 participants (54.9%), compared with 37 (28.0%) in control (odds ratio, 3.13; 95% confidence interval, 1.94-5.06; P < .001. Age, sex, race, comorbidities, baseline 6 MW, and income did not significantly alter the effect of home-based exercise on improved 6 MW. SAEs occurred in 28.1% and 23.3% of participants randomized to exercise and control, respectively (P = .29). There were statistically significant interactions, indicating that home-based exercise increased SAE rates, compared with control, in Black compared with non-Black participants (P interaction < .001), in those with vs without coronary artery disease (CAD) (P interaction < .001), and in people with vs without history of heart failure (P interaction = .005).</p><p><strong>Conclusions: </strong>Among people with PAD, home-based exercise improved 6 MW by at least 20 meters in 54.9% of people. Older age, female sex, Black race, and specific comorbidities were not associated with lower rates of attaining meaningful improvement in 6 MW following home-based exercise. Further study is needed to establish whether certain patient characteristics, such as history of coronary artery disease, may affect SAE rates in patients with PAD participating in home-based exercise.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468757","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":"Difference in risk factor profile for abdominal aortic aneurysm and thoracic aortic aneurysm.","authors":"Sven-Erik Persson, Mari Holsti, Kevin Mani, Anders Wanhainen","doi":"10.1016/j.jvs.2024.10.012","DOIUrl":"10.1016/j.jvs.2024.10.012","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies suggest partly different risk factor profiles of thoracic aortic aneurysms (TAAs) and abdominal aortic aneurysms (AAAs), but prospective data are scarce. The purpose of this prospective population-based case-control study was to investigate differences in risk factor profile between TAAs and AAAs.</p><p><strong>Methods: </strong>Participants in two prospective population-based studies, the Västerbotten Intervention Project (VIP) and the Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study, between 1986 and 2010, underwent cardiovascular risk assessments, including blood samples, oral glucose tolerance test, blood pressure readings, and a self-reported health questionnaire. All individuals who were later diagnosed with TAAs or AAAs were identified. Age, sex, and time-matched controls were selected from the same cohorts, aiming at four controls/case. Adjusted odds ratios (aORs) for potential risk factors for later diagnosis of TAAs and AAAs, respectively, were estimated by multivariate conditional logistic regression analyses.</p><p><strong>Results: </strong>From a total of 96,196 individuals with prospectively collected data in the VIP/MONICA cohort, a total of 236 individuals with AAAs (181 men and 55 women) and 935 matched controls, and 168 individuals with TAAs (115 men and 53 women) and 662 controls were included. The average age at baseline examination was 57.0 ± 5.7 years for AAA cases and controls, and 52.1 ± 8.8 years for TAA cases and controls. Mean time between baseline examination and diagnosis of AAAs/TAAs was 12.1 and 11.7 years, respectively. There was a clear difference in risk factor profile between AAAs and TAAs. Smoking, hypertension, and coronary artery disease were significantly associated with later diagnosis of AAAs, with highest aORs for a history of smoking (aOR, 10.3; 95% confidence interval [CI], 6.3-16.8). For TAAs, hypertension was the only positive risk factor (aOR, 1.7; 95% CI, 1.1-2.7), whereas smoking was not associated. Diabetes was not associated with either AAAs or TAAs; neither was self-reported physical activity.</p><p><strong>Conclusions: </strong>In this prospective, population-based, case-control study, risk factor profile differed between AAAs and TAAs. This suggests a partially different etiology for TAAs and AAAs.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468810","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":"Endovascular versus open repair of ruptured abdominal aortic aneurysms with hostile neck anatomy.","authors":"Grayson S Pitcher, Indrani Sen, Karina S Newhall, Michael C Stoner, Bernardo C Mendes, Doran Mix","doi":"10.1016/j.jvs.2024.10.010","DOIUrl":"https://doi.org/10.1016/j.jvs.2024.10.010","url":null,"abstract":"<p><strong>Objective: </strong>Aneurysm neck anatomy in ruptured abdominal aortic aneurysms (rAAAs) is often complex, limiting the feasibility of endovascular repair (EVAR). The objective of this study was to compare the outcomes of EVAR and open surgical repair (OSR) for treatment of rAAAs in patients with hostile neck anatomy (HNA). The secondary aim was to review the clinical characteristics and anatomic risk factors predictive of mortality.</p><p><strong>Methods: </strong>A multi-center retrospective review was performed to identify patients with rAAAs and HNA between 2004 and 2021. HNA was defined as infrarenal aortic neck diameter >28 mm, infrarenal neck length <15 mm or angulation >60 degrees. The primary end point was 30-day all-cause mortality. Secondary end points included 90-day, 1-year and 5-year mortality. Preoperative computed tomography was analyzed using an Aquarius workstation. The Kaplan-Meier method was used to estimate survival, and univariate and multivariate Cox proportional hazard regression analysis was used to assess variables that influenced survival.</p><p><strong>Results: </strong>137 patients with rAAAs and HNA underwent infrarenal EVAR or OSR. Overall mean age was 74 ± 10 years and 72% were male. 85 patients (62%) underwent infrarenal EVAR and 52 (38%) underwent OSR. Mean aneurysm size at the time of rupture was 86 ± 22 mm. Patients who underwent OSR were more likely to present with a higher Garland preoperative risk score (P = .05), have a lower pH (P < .001), lower SBP (P < .001) and higher lactate (P = .005). Patients with an infrarenal neck length <15 mm were more likely to undergo OSR (EVAR 64% vs. OSR 87%, P = .004) and patients with an infrarenal neck angle >60 degrees were more likely to undergo EVAR (60% vs. 39%, P = .01). EVAR was associated with lower 30-day (17% vs. 27%; OR 0.6; 95% CI, 0.3-1.2; P = .14) and 90-day (22% vs. 33%; HR 0.6; 95% CI, 0.3-1.2; P = .17) all-cause mortality, however, this was not statistically significant. The overall median follow-up time was 19 (2-66) months. 1-year survival for EVAR and OSR were 75% and 64% (Log-rank P = .14) and 5-year survival for EVAR and OSR were 65% and 55% (Log-rank P = .28). Hemoglobin (P = .009), increasing calcification score (P = .002) and infrarenal neck length <10 mm (P = .01) were associated with all-cause mortality at 30-days for EVAR on multivariate Cox regression analysis. Lactate (P <.001) was the only variable associated with all-cause mortality at 30-days for OSR on multivariate Cox analysis.</p><p><strong>Conclusion: </strong>Early and long-term survival favored EVAR in comparison to OSR in patients with rAAAs and HNA, however, this was not statistically significant. Calcification of the infrarenal neck and neck length <10 mm were associated with increased 30-day mortality for EVAR while no anatomic variables were specifically associated with 30-day mortality for OSR.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468811","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":"Popliteal-distal bypass affords better limb salvage than tibial angioplasty for chronic limb-threatening ischemia.","authors":"Melina Recarey, Renxi Li, Stephanie Rodriguez, Emanuela Peshel, Richard Amdur, Salim Lala, Anton Sidawy, Bao-Ngoc Nguyen","doi":"10.1016/j.jvs.2024.10.011","DOIUrl":"10.1016/j.jvs.2024.10.011","url":null,"abstract":"<p><strong>Objective: </strong>Chronic limb-threatening ischemia (CLTI) due to isolated tibial occlusive disease is treated by either popliteal-distal bypass (PDB) or tibial angioplasty (TA), although there is limited data directly comparing efficacy and outcomes between these two treatment modalities. This study compares 30-day mortality and major adverse limb events following infrapopliteal bypass and TA in patients with CLTI.</p><p><strong>Methods: </strong>Patients who underwent PDB for CLTI were extracted from American College of Surgeons National Surgical Quality Improvement Program targeted lower extremity open database, whereas patient with CLTI who underwent isolated TA were identified in the targeted lower extremity endovascular database. Any case with more proximal angioplasty such as femoral/popliteal/iliac was excluded. The time interval was 2011 through 2022. The two groups were comparable in demographics, and preoperative comorbidities were obtained using propensity matching. Mortality, systemic complications, and major adverse limb events were measured. Multivariable logistic regression was used for data analysis. To obtain granular data on the angiographic characteristics of patients undergoing PDB or TA, The George Washington University institutional data from 2014 to 2019 was used as a supplement to the database.</p><p><strong>Results: </strong>There were 1947 and 3423 cases identified in the bypass and endovascular groups, respectively. After propensity matching for all preoperative variables, 1747 cases remained in each group. Although bypass was associated with higher major adverse cardiovascular events, pulmonary, renal, and wound complications, bypass had significantly better 30-day limb salvage when compared with TA (major amputation rate, 3.32% vs 6.12%; P < .01). Institutional data identified 69 patients with CLTI due to isolated tibial occlusive disease; 25 (36.2%) underwent PDB and 44 (63.8%) underwent TA. Review of angiographic details revealed patients who underwent PDB had better pedal targets (inframalleolar/pedal score of P0 [24.0% vs 15.9%] or P1 [68.0% vs 61.3%]) than TA patients (inframalleolar/pedal score of P2 [22.7% vs 8.0%]).</p><p><strong>Conclusions: </strong>PDB was associated with higher morbidity but better limb salvage than endovascular interventions. However, this could be explained by the association with better pedal targets in patients who underwent popliteal-tibial bypass. Prospective studies should be done comparing PDB and TA in cases with similar pedal targets.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468756","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":"Graduating vascular surgery trainee proficiency in endovascular and open peripheral revascularization procedures.","authors":"Erin Buchanan, Ting Sun, Brigitte K Smith, M Libby Weaver","doi":"10.1016/j.jvs.2024.09.037","DOIUrl":"10.1016/j.jvs.2024.09.037","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Endovascular interventions for peripheral artery disease have increased in prevalence over time given the inherent benefits of minimally invasive approaches. Although it is essential that vascular surgery graduates are facile with endovascular techniques, the results of the BEST-CLI (Best Endovascular vs. Best Surgical Therapy in Patients With Critical Limb Ischemia) trial highlight the equivalent importance of ensuring trainee competence in open skills. Recent studies demonstrate increasing case volume of both endovascular and open procedures during vascular surgery training. Case volume is merely a surrogate marker for competence, however, and the objective competence attained by trainees at the time of graduation is unknown. We sought to investigate operative autonomy and competence of graduating vascular surgery trainees performing endovascular as compared with open peripheral vascular revascularization procedures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Operative performance and autonomy ratings for infrainguinal endovascular and open revascularizations from the Society for Improving Professional Learning Operative application database were collected for all vascular surgery participating institutions from 2018 to 2023. The distribution for autonomy and performance ratings were determined by training level for endovascular and open procedures, respectively. Mixed effects logistic regressions were conducted to estimate the predictive association between procedure type and autonomy and performance assessment, adjusting for training level and case complexity. Subsequently, the estimated model was applied to predict the probability of a graduating trainee being rated as meaningfully autonomous or competent while performing endovascular and open procedures across various case complexities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Sixty-nine residents from 23 programs (12 fellowship, 11 residency) were assessed on 706 revascularization procedures (n = 383 endovascular; n = 323 open). When controlling for training level and case complexity, there were no differences in autonomy (odds ratio [OR], 1.11; 95% confidence interval [CI], 0.62-1.99) or competency assessment (OR, 0.86; 95% CI, 0.46-1.59) for endovascular, as compared with open, peripheral revascularization procedures. For average complexity procedures, the predicted probability of a trainee being assessed as competent and autonomous at the time of graduation was high (competent: 88% endovascular, 86% open; autonomous: 96% endovascular, 97% open). The predicted probability of competence and autonomy for complex procedures was lower, but remained similar between groups (competent: 73% endovascular, 70% open; autonomous: 92% endovascular, 92% open).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;There is no difference in the graduating level of autonomy and competence of endovascular as compared with open peripheral revascularization procedures for vascular surgery trainees. These findings","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391463","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 three-year experience with the balloon expandable GORE VIABAHN VBX in the treatment of thoraco-abdominal aortic aneurysms within the EXPAND trial.","authors":"Marco V Usai, Mauro Gargiulo, Stéphan Haulon, Ignace Tielliu, Dittmar Böckler, Hence Verhagen, Alba Méndez Fernández, Martin J Austermann","doi":"10.1016/j.jvs.2024.10.002","DOIUrl":"10.1016/j.jvs.2024.10.002","url":null,"abstract":"<p><strong>Objective: </strong>The EXPAND registry is a post-market, multicenter registry that aims at evaluating the safety and performance of the GORE VIABAHN VBX balloon expandable endoprosthesis (VBX stent) implanted in peripheral vessels. This subgroup analysis assesses the 3-year outcomes of the VBX stent as a bridging stent graft for visceral vessels during branched endovascular aortic repair.</p><p><strong>Methods: </strong>This prospective, multicenter, observational registry includes 16 European sites. Patients were enrolled from November 2018 to March 2022. Endpoints included 3-year primary patency (PP), secondary patency (SP), and stent graft-related death and serious adverse events.</p><p><strong>Results: </strong>Seventy-three patients, of whom 57 (78.1%) were male, with a mean age of 73 years (±8.1 years) were included. At 3 years, 42 patients (57.5%) returned for follow-up. Overall, 223 target vessels (TVs) were treated. The estimated freedom from loss of TV PP was 93.6%. Per TV PP rates were 97.0% for the celiac trunk, 93.9% for the superior mesenteric artery, 91.2% for the left renal artery, and 92.5% for the right renal artery. The overall estimated freedom from loss of SP was 96.8%, and freedom from TV instability was 94.5%.</p><p><strong>Conclusions: </strong>The VBX stent demonstrated excellent sustained results at 3 years with almost 94% PP, 97% SP, and 94.5% freedom from TV instability. Patency in the renal arteries was lower than in the celiac trunk and superior mesenteric artery. The VBX stent appears to be a reliable bridging stent for target vessels in branched endovascular aortic repair.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400629","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}