Journal of Vascular Surgery最新文献

{"title":"Utilizing Natural Language Processing to Improve Abdominal Aortic Aneurysm Surveillance.","authors":"Kathryn DiLosa, Matthew Schneck, Emily Xu, Aida Mushell, Dena Sayrafi, Steven Maximus, Matthew Mell, Misty Humphries","doi":"10.1016/j.jvs.2025.05.035","DOIUrl":"https://doi.org/10.1016/j.jvs.2025.05.035","url":null,"abstract":"<p><strong>Background: </strong>Screening and surveillance are essential to prevent aneurysm rupture. We employed natural language processing (NLP) software to evaluate efficacy of aneurysm surveillance.</p><p><strong>Methods: </strong>NLP software was employed to review 7 years of imaging reports at a single institution to identify patients with an abdominal aortic aneurysm. After identification of a patient cohort, review of the electronic medical record was completed to collect patient demographics and information about a compliance with nationally recommended aneurysm surveillance protocols.</p><p><strong>Results: </strong>NLP identified a cohort of 1424 patients with a AAA, 1105 (77.6%) were male and the mean age was 74 years (±10). 76% of patients were white, 6% were black, 7% were Asian, 1% was Native American or Pacific Islander, and 11% identified as another race. At the time of data collection, 552 patients (39%) were under active surveillance, 346 patients (24%) had previously been under surveillance and subsequently lost to follow-up, and 523 patients (37%) had incidental findings without initiation of surveillance. In total, more than half of the cohort (869 patients, 61%) were not participating in recommended aneurysm surveillance. Findings did not differ significantly by gender, race, or ethnicity.</p><p><strong>Conclusion: </strong>In the cohort, 39% of patients were compliant with recommended surveillance. Incorporating NLP into traditional screening and surveillance practices can allow providers to identify patients outside of recommended surveillance bridging gaps in care.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142801","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":"Effect of Interfenestration Distance in Target Vessel Instability in Patients Undergoing FBEVAR","authors":"Armin Tabiei ,&nbsp;Jesse Chait ,&nbsp;Guilherme Baumgardt Barbosa Lima ,&nbsp;William S. Harmsen ,&nbsp;Fahad Shuja ,&nbsp;Emanuel R. Tenorio ,&nbsp;Randall R. Demartino ,&nbsp;Gustavo Oderich ,&nbsp;Bernardo C. Mendes","doi":"10.1016/j.jvs.2025.03.086","DOIUrl":"10.1016/j.jvs.2025.03.086","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"81 6","pages":"Pages e26-e27"},"PeriodicalIF":3.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115091","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":"Predictors of Extended Length of Stay Following Transcarotid Artery Revascularization","authors":"Arjun Kumar ,&nbsp;Patrick D. Conroy ,&nbsp;Shivani Raizada ,&nbsp;Alec Schubert ,&nbsp;Mikael Fadoul ,&nbsp;Bruce L. Tjaden Jr. ,&nbsp;Katherine McMackin ,&nbsp;Laurel H. Hastings ,&nbsp;Joseph V. Lombardi ,&nbsp;Philip M. Batista","doi":"10.1016/j.jvs.2025.03.108","DOIUrl":"10.1016/j.jvs.2025.03.108","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"81 6","pages":"Page e43"},"PeriodicalIF":3.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115176","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":"Evaluation of sex-based differences in below-the-knee plaque histology in patients who underwent amputation for chronic limb-threatening ischemia","authors":"F. Kansul,&nbsp;D. Vela,&nbsp;J. Csore,&nbsp;B. Benfor,&nbsp;S. Suarez,&nbsp;A. Dua,&nbsp;T.L. Roy","doi":"10.1016/j.jvs.2025.03.173","DOIUrl":"10.1016/j.jvs.2025.03.173","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"81 6","pages":"Page A16"},"PeriodicalIF":3.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115255","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":"Assessment of Added Utility of Atherectomy for SFA Angioplasty With Stenting Procedures in the Office-based Laboratory","authors":"Samantha N. Fountain ,&nbsp;Peter Deckerman ,&nbsp;Brandon E. Ruggeberg ,&nbsp;Harris Amir ,&nbsp;Zachary McSween ,&nbsp;Matthew Deckerman ,&nbsp;Saige Gitlin ,&nbsp;Valerie Fiore ,&nbsp;Soumith Sanka ,&nbsp;Anil Hingorani","doi":"10.1016/j.jvs.2025.03.098","DOIUrl":"10.1016/j.jvs.2025.03.098","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"81 6","pages":"Pages e35-e36"},"PeriodicalIF":3.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115355","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":"Information for Readers","authors":"","doi":"10.1016/S0741-5214(25)00966-8","DOIUrl":"10.1016/S0741-5214(25)00966-8","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"81 6","pages":"Page A13"},"PeriodicalIF":3.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116129","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":"Vascular surgery in children.","authors":"David H Rothstein, John V White, Regan F Williams, Dawn M Coleman","doi":"10.1016/j.jvs.2025.03.204","DOIUrl":"https://doi.org/10.1016/j.jvs.2025.03.204","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199522","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":"Vascular and wound healing outcomes after puncture of small or stenotic inframalleolar arteries in patients with chronic limb-threatening ischemia.","authors":"Shuko Iwata, Michinao Tan, Takashi Miwa, Wataru Sasaki, Kazushi Urasawa","doi":"10.1016/j.jvs.2025.05.028","DOIUrl":"https://doi.org/10.1016/j.jvs.2025.05.028","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the safety of below-the-ankle distal punctures, including stenotic or small-diameter inframalleolar arteries, on vessel integrity and wound healing in patients with chronic limb-threatening ischemia and infrapopliteal artery disease.</p><p><strong>Methods: </strong>This single-center, retrospective, nonrandomized, observational study analyzed 171 limbs from 155 patients (mean age: 76.1 ± 9.4 years; 74.2% with diabetes mellitus; 48.4% undergoing hemodialysis) with chronic limb-threatening ischemia (Rutherford classification 5-6) who underwent endovascular therapy using below-the-ankle distal punctures for de novo infrapopliteal disease (97.1% occlusion) between January 2014 and December 2024.</p><p><strong>Results: </strong>Stenosis at puncture sites were observed in 83.0% of the cases, with a median vessel diameter of 1.8 mm. During a median follow-up of 13.1 months, the Kaplan-Meier-estimated 1-year wound healing rate was 57.3%. Chronic occlusion at puncture sites, defined as vessel occlusion after initial revascularization, occurred in 32.2% of the cases. Multivariate analysis identified renal failure on hemodialysis (odds ratio [OR]: 2.76; 95% confidence interval [CI]: 1.12-6.81; p = 0.028), the Global Limb Anatomical Staging System P2 modifier (OR: 2.89; 95% CI: 1.15-7.28; p = 0.024), and smaller distal puncture vessel sizes (scored as 0 [>2.0 mm], 1 [1.5-2.0 mm], or 2 [<1.5 mm]; OR: 10.8; 95% CI: 4.11-28.3; p < 0.001) as independent predictors of chronic occlusion at the puncture sites. The area under the receiver operating characteristic curve for vessel diameter in predicting chronic occlusion at the puncture site was 0.88, with the Youden J statistic indicating a cutoff value of 1.7 mm. Multivariate analysis showed that an increased foot infection grade (hazard ratio [HR]: 0.71; 95% CI: 0.51-0.99; p = 0.043), a small artery disease score of 2 (HR: 0.54; 95% CI: 0.30-0.98; p = 0.042), and a chronic occlusion at the puncture site (HR: 0.51; 95% CI: 0.28-0.92; p = 0.025) were independent risk factors for impaired wound healing.</p><p><strong>Conclusions: </strong>Below-the-ankle distal punctures in stenotic arteries may cause puncture site occlusions before wound healing. If distal vessels at the puncture site supply the wound, close monitoring with Doppler or other imaging is essential to detect occlusions until the wound heals. When distal puncture is needed, selecting a target vessel with a larger diameter and minimal disease burden may lower the risk of chronic occlusions and help prevent delays in wound healing.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132532","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":"Increasing clinical experience and changes in practice protocols improved outcomes of fenestrated branched endovascular repair of complex aortic aneurysms.","authors":"Dora Babocs, Lucas Ruiter Kanamori, Bruno Pagnin Schmid, Emanuel Tenorio, Steven Maximus, Bernardo C Mendes, Thanila A Macedo, Ying Huang, Gustavo S Oderich","doi":"10.1016/j.jvs.2025.05.031","DOIUrl":"https://doi.org/10.1016/j.jvs.2025.05.031","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of increased clinical experience and changes in practice protocols on the incidence of early major adverse events (MAEs) during fenestrated-branched endovascular aortic repair (FB-EVAR) of complex abdominal (CAAAs) and thoracoabdominal aortic aneurysms (TAAAs).</p><p><strong>Methods: </strong>Clinical outcomes of 847 consecutive patients (72% males, median age 74 [69, 79] years) treated by the same operator in two centers were reviewed (2007-2024). Of these, 590 patients were treated under a prospective investigational device exemption study. Changes in practice protocols included routine use of fusion/cone beam computed tomography (F/CBCT, 2012), therapeutic instead of prophylactic cerebrospinal fluid drainage (T-CSFD, 2019, Q3) and preferential use of total transfemoral access (TTFA, 2020, Q4). Primary end-point was 30-day/in-hospital MAE assessment using learning curve cumulative sum (LC-CUSUM) analysis per quartiles of experience. The study period was divided into four quartiles: Q1 (2007-2014), Q2 (2014-2017), Q3 (2017-2020), and Q4 (2020-2024).</p><p><strong>Results: </strong>There was a significant increase in the proportion of Extent I-III TAAA (16% to 58%, p<.001), chronic post-dissection aneurysms (1.9% to 21%; p<.001), symptomatic aneurysms (5.2% to 10%; p<.001), heritable thoracic aortic diseases (0.5% to 4.2%, p=.011) and prior endovascular aortic repair (8.5% to 51%, <.001) between Q1 and Q4 experience. Despite the increased aneurysm complexity, MAEs significantly decreased over time and across quartiles (p<.01). Use of F/CBCT associated with significant reduction in total operative time and radiation exposure (p<.001). Overall 30-day mortality was 1.7% (14/847). Incidence of MAEs significantly decreased for CAAAs and Extent IV TAAAs (P<.01) and remained stable for Extent I-III TAAAs after institution of T-CSFD and TTFA. LC-CUSUM analysis indicates that 32 consecutive cases were needed to reach a learning curve, 100 cases to reach plateau, with significantly improved outcomes in the 4^th quartile of experience.</p><p><strong>Conclusions: </strong>FB-EVAR was performed with low mortality (1.7%) in a large cumulative experience. Increased clinical experience and changes in practice protocol associated with significantly improved outcomes of FB-EVAR, despite a significant increase in anatomic and patient complexity. Institution of T-CSFD and TTFA had no deleterious effect on outcomes of Extent I-III TAAAs but improved outcomes in patients with less extensive aneurysms. Among CAAA patients, 21.2% had T-CSFD, and 10.7% had TTFA. For Extent IV aneurysms, 47.3% had T-CSFD, and 22.5% had TTFA.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132527","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":"Weighted 10-year survival and neurological outcomes after zone 2 thoracic endovascular aortic repair for acute type B aortic dissection.","authors":"Zhongze Cao, Ziting Wu, Huiwen Gao, Kexin Zhao, Shufen Zhou, Yahui Zhang, Mingyao Luo, Chang Shu","doi":"10.1016/j.jvs.2025.05.026","DOIUrl":"https://doi.org/10.1016/j.jvs.2025.05.026","url":null,"abstract":"<p><strong>Objective: </strong>The long-term benefits of left subclavian artery (LSA) revascularization during thoracic endovascular aortic repair (TEVAR) for patients with acute type B aortic dissection (aTBAD) remain controversial. This study aimed to evaluate the impact of LSA revascularization during TEVAR on short- and long-term survival and neurological outcomes in aTBAD patients.</p><p><strong>Methods: </strong>We retrospectively analyzed data from consecutive aTBAD patients undergoing zone 2 TEVAR between 2010 and 2020 at one Chinese national aortic center. Inverse probability of treatment weighting (IPTW) was employed to mitigate baseline differences between LSA coverage and revascularization groups. Long-term survival, freedom from major adverse cardiovascular events (MACE), ischemic stroke rates, and cerebrovascular accident (CVA) rates were assessed using the Kaplan-Meier analysis. Weighted logistic and Cox regression models was applied to identify predictors of short- and long-term outcomes.</p><p><strong>Results: </strong>The final analysis included 253 patients. Intergroup balance was achieved after IPTW. After LSA revascularization, incidences of postoperative type II endoleak (38.9% vs. 38.2%, p=0.91), post implantation syndrome (38.0% vs. 38.5%, p=0.938), 30-day mortality (0.6% vs. 1.1%, p=0.568), and early CVA (0.6% vs. 0.5%, p=0.931) were comparable between groups. There was no significant difference in CVA incidence (4.8% vs. 12.1%, p=0.34) or freedom from MACE (91.2% vs. 78.5%, p=0.55) at 10-year follow-up. Weighted multivariable analysis identified post implantation syndrome (PIS) after TEVAR as an independent predictor of CVA (HR=2.65, 95% CI 1.10-6.42, p=0.03).</p><p><strong>Conclusion: </strong>LSA revascularization during TEVAR does not increase risks for perioperative or long-term morbidities. Ischemic stroke rates, CVA rates, survival, and MACE-free survival were statistically comparable between groups at 5- and 10-year follow-up. PIS emerged as a significant CVA risk factor after zone 2 TEVAR for aTBAD.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132470","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}