Vascular最新文献

{"title":"No clear benefit with the use of onlay mesh by vascular surgeons for incisional hernia prevention in patients with abdominal aortic aneurysm repair.","authors":"Marta Fernández Reyes Doallo, Laura Boado Rey, José Acosta Batle, Martín Fabregate, Antonio Ricardo Chinchilla Molina, Andrés Reyes Valdivia","doi":"10.1177/17085381261485665","DOIUrl":"https://doi.org/10.1177/17085381261485665","url":null,"abstract":"<p><p>ObjectiveThe aim of the study was to compare the incidence of IH after abdominal aortic aneurysm (AAA) open repair according to the abdominal wall closure technique used.MethodsThis is a longitudinal, monocentric, and observational study including patients who underwent AAA open repair by midline laparotomy from January 2019 to December 2021 at our institution. Patients were divided in two groups, fascial closure with small bites and prophylactic mesh reinforcement (Group A); and primary fascial closure with small bites alone (Group B). Primary endpoints were the presence of IH during follow-up in both groups and a comparison represented in a Kaplan-Meier curve. Secondary endpoints were to describe the differences between both groups in surgical wound complications, surgical, hospitalization times, and need for reintervention due to IH.ResultsSeventy-five patients underwent AAA open repair and 50 were included after exclusions, 23 in group A and 27 in the group B. Patients were followed-up by, at least, one clinical appointment with image test during first 24 month post-surgery. Six (26%) patients in group A and nine (33%) in group B developed IH during the 24-month follow-up (<i>p</i> = .29). Surgical wound complications were not statistically different, where group A had seven patients (30.4%) and four (14.8%) in group B (<i>p</i> = .30). No statistically significant differences were found in the surgical time (<i>p</i> = .59) in both groups.ConclusionIn this limited cohort, no statistically significant difference was observed in the occurrence of IH with the use of small-bites primary closure plus mesh versus primary closure with small bites alone at 2-year follow-up. Further studies with larger numbers and adequate design are needed to support the use of mesh for IH prevention as stated in current guidelines.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"17085381261485665"},"PeriodicalIF":0.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of aortic aneurysm/aortic dissection associated with fluoroquinolones use: A meta-analysis of cohort studies.","authors":"Qiuyan Chen, Yuyue Jiang, Yuezhong Shen, Xuqing Huang","doi":"10.1177/17085381261425725","DOIUrl":"10.1177/17085381261425725","url":null,"abstract":"<p><p>BackgroundIt has been shown that fluoroquinolones (FQs) use may be associated with an increased risk of aortic aneurysm (AA) and/or aortic dissection (AD).ObjectivesThe aim of this meta-analysis was to systematically review and summarize the epidemiological evidence on the risk of aortic AA and/or AD following FQs use.DesignSystematic review and meta-analysis.Data Sources and MethodsWe performed a meta-analysis using data from PubMed, Embase, and the Cochrane Library, with research conducted up to March 15, 2025. Cohort studies examining the association between FQs use and AA or AD were included. The quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). A combined HR with 95% CI was calculated using either a random-effects or fixed-effects model, and robustness was assessed using sensitivity analysis. This meta-analysis was registered with PROSPERO (CRD 420251012072).Results11 studies were included, with 81,976,958 participants. The risk of AA/AD among FQs users was found to be elevated (HR = 1.20, 95% CI: 1.06-1.35). Similar results were found for AA (HR = 1.47, 95% CI: 1.24-1.73) and AD (HR = 1.12, 95% CI: 1.04-1.22). In subgroup analysis, the gender subgroup analysis revealed a higher risk of AA/AD for males (HR = 1.16, 95% CI: 1.06-1.27) compared to females (HR = 1.09, 95% CI: 1.00-1.20). Regionally, the risk was higher in America (HR = 1.47, 95% CI: 1.12-1.93) than Europe (HR = 1.08, 95% CI: 0.98-1.19) and Asia (HR = 0.80, 95% CI: 0.61-1.05). Risk associated with FQs use within 90 days (HR = 1.20, 95% CI: 1.13-1.26) was significantly higher, while no significant increase was observed for ≥365 days (HR = 1.00, 95% CI: 0.90-1.12). The presence of hypertension (HR = 1.24, 95% CI: 1.14-1.36) was associated with a significantly higher risk of AA/AD.ConclusionThis meta-analysis demonstrates that the use of FQs is associated with a significant risk of AA/AD. Clinicians should be aware of this risk in patients prescribed FQs, and further research is needed to elucidate the role of FQs in the development of AA/AD.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"751-761"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conservative management of ruptured abdominal aortic aneurysm secondary to type II endoleak.","authors":"Cheok Lam Chan, Arvind Dhas Lee","doi":"10.1177/17085381261425718","DOIUrl":"10.1177/17085381261425718","url":null,"abstract":"<p><p>ObjectivesPrimary ruptured abdominal aortic aneurysm (rAAA) survival has been described in a few case reports; however, to our knowledge, there is no existing literature regarding rAAA survival secondary to isolated type II endoleak (T2EL). We aim to report a rare case of non-operative management for a T2EL-associated rAAA.MethodsAn 89-year-old man with a history of endovascular aneurysm repair (EVAR) and persistent T2EL presented with acute abdominal pain and hypotension. Computed topography angiography (CTA) confirmed rAAA with retroperitoneal haematoma. Given his advanced age, comorbidities, and initial preference against surgery, non-operative management was chosen.ResultsAfter resuscitation, the patient remained stable and was discharged 5 days later. A 4-week follow-up CTA showed haematoma resolution, despite mild enlargement of the aneurysm sac. He underwent elective embolization 2- and 4-month post-rupture. One year later, he represented with acute limb ischaemia. At the time, the treated aneurysm remained stable without endoleak.ConclusionThis case study sheds light on the possible different natural history between post-EVAR rAAA and primary rAAA, highlighting the possibility of non-operative management in select hemodynamically stable patients with rAAA after EVAR. While rare, rupture can occur from T2EL, underscoring the need for close surveillance among at risk population.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"762-765"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting treatment outcome in sclerotherapy of reticular veins and telangiectasia using machine learning: A comprehensive analysis and performance evaluation.","authors":"Cesur Samancı, Gökçen Yıldız Civan, Vefa Salt, Rauf Hamid, Orkun Civan, Ömer Faruk Sarıahmetoğlu, Seyfullah Halit Karagöz, Tuğba Bayraktar, Kıymet Sena Mucuk, Raziye Sena Yılmaz, Sahar Alizade, Tuğbanur Güleç, Fatih Gülşen, Ahmet Baş","doi":"10.1177/17085381261425716","DOIUrl":"10.1177/17085381261425716","url":null,"abstract":"<p><p>BackgroundAccurately predicting treatment responses in varicose vein sclerotherapy is crucial for improving patient quality of life and optimizing overall healthcare costs.PurposeOur study aims to accurately predict treatment responses in telangiectasia and reticular vein treatment in lower extremity sclerotherapy, by taking advantage of machine learning's (ML) ability to navigate complex data sets and provide personalized predictions.Materials and MethodsML algorithms were used to predict outcomes in 99 patients with varicose veins. The data set, which included patient characteristics such as age, gender, dosage, and photographs, was analyzed using six ML methods. Response to treatment was divided into three groups as \"poor,\" \"moderate,\" and \"good\" as a result of clinical visual evaluation.ResultsIndividuals with no prior treatment exhibited a notably higher rate of \"Good\" responses than those who had received prior treatment. (p < .001) The group receiving a 2% polidocanol dosage showed a higher rate of \"Good\" responses than the group receiving a 1% polidocanol dosage. (p = .008) XGBoost outperformed other ML algorithms, particularly excelling in predicting \"Poor\" responses.DiscussionML-based predictive models for assessing sclerotherapy outcomes in varicose veins, uncovering significant efficacy determinants such as dosage and prior treatment history. While pioneering ML in sclerotherapy prediction, our study acknowledges limitations and proposes future research directions, including additional variable incorporation and real-time predictive tool development.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"786-794"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed paraplegia after thoracic endovascular aortic repair (TEVAR) successfully reversed with midodrine - A case report.","authors":"Wan Suen Cheung, Yiu Che Chan, Grace C Cheung, Stephen W Cheng","doi":"10.1177/17085381261425738","DOIUrl":"10.1177/17085381261425738","url":null,"abstract":"<p><p><b>Introduction:</b> Most existing management strategies for spinal cord ischaemia (SCI) after thoracic endovascular aortic repair (TEVAR) are invasive in nature, including intravenous vasopressors, cerebrospinal fluid drainage, and segmental artery embolization. Non-invasive pharmacological adjuncts have been described without established effectiveness. <b>Clinical Case:</b> This case report describes the use of midodrine, an alpha 1-adrenoreceptor agonist, as a rescue therapy adjunctive to phenylephrine to successfully reverse post-TEVAR delayed paraplegia in a 73-year-old patient with ruptured thoracic aortic aneurysm. The initial episode of paraplegia was completely reversed with lumbar drainage, while the second episode was effectively corrected with phenylephrine and subsequently midodrine alone. He had complete neurological recovery, and could mobilize independently. <b>Conclusion:</b> Midodrine is a safe and non-invasive treatment to increase spinal cord perfusion pressure, which could improve or even reverse symptoms of spinal cord ischemia in patients post-TEVAR.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"766-771"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A seven-year single-center experience with large-bore percutaneous closure in endovascular aneurysm repair.","authors":"Sven Ross Mathisen, Simen Tveten Berge","doi":"10.1177/17085381261429288","DOIUrl":"10.1177/17085381261429288","url":null,"abstract":"<p><p>ObjectivesTo evaluate efficacy and safety of percutaneous-endovascular aneurysm repair (p-EVAR) where large-bore access puncture holes were closed with a suture mediated closure device (SMCD) in all eligible patients.MethodsA single-center cohort of prospectively collected data in an Internal Quality Control Registry (IQCR). An \"All Comers\" cohort of 368 patients with 736 access groins was assessed. All abdominal aortic aneurysm (AAA) patients eligible for p-EVAR after CTA evaluation were included. Patients with stenosis and occlusions requiring vascular Interventions during EVAR were excluded. The groins were stratified into two groups: low-profile (12Fr - 16Fr) and high-profile introducers (18Fr - 20Fr). PerClose ProGlide (Abbott Cardiovascular, IL, USA) and later the newer version PerClose ProStyle (Abbott Cardiovascular, IL, USA) SMCD devices were assessed. Primary endpoints were: <i>Primary ProGlide technical success and Primary assisted percutaneous and non-invasive technical success. Secondary cutdown was an exclusions criterion.</i> Safety endpoints were Freedom from early peri-operative and late 30-day groin access complications requiring vascular surgical intervention.Results<i>Primary technical success</i> was achieved in 66.4 % (473/712) groins<i>. Primary assisted percutaneous and non-invasive technical success</i> was achieved in 32.2 % (229/712) groins. Continuous hemorrhage in 1.4 % (10/712) groins required a cutdown. 98.6 % (712/736) of the groins were successfully closed percutaneously. Median age was 76 years (IQR 71, 80). 78.8 % were male. 92 % (330/368) of the p-EVAR were elective. Median AAA diameter was 57mm (IQR 53, 63). Few groins required surgical intervention. No statically significant differences were found between the PerClose ProGlide and the ProStyle (p < .05).ConclusionsPercutaneous closure is efficient and safe. Low-profile introducers and EVAR components (12Fr - 16Fr) had slightly better primary technical and assisted technical success. 83.5 % of the patient groins were treated with low-profile introducers reflecting the drive in the vascular field toward lower-profile devices. No statistical difference between groups was observed for primary technical success and complication rate.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"810-818"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computational fluid hemodynamic based analyisis of the aorto iliac segment before the development of post EVAR iliac branch occlusion.","authors":"Han Yang, Qian-Hui Tang, Ming Hu, Zhong Qin, Si-En Guo, Hai-Lin Lu, Wen-Hong Jiang, Zhan-Man Zhang, Xiao Qin","doi":"10.1177/17085381261425714","DOIUrl":"10.1177/17085381261425714","url":null,"abstract":"<p><p>ObjectiveIliac limb branch occlusion after endovascular aneurysm repair (EVAR) creates risk for limb or pelvic ischemia. This study aims to explore the hemodynamic factors associated with eventual iliac branch occlusion after EVAR for abdominal aortic aneurysm.MethodsSix patients with different causes of iliac branch occlusion were selected between January 2013 and December 2023, and computed tomography angiography (CTA) images were acquired at the time of preoperative and postoperative occlusion of EVAR. Specific CTA images were applied for modeling and computational fluid dynamics (CFD) analysis was implemented.ResultsPressure, velocity, wall shear stress (WSS), time-averaged wall shear stress (TAWSS), oscillatory Shear Index (OSI), and relative residence time (RRT) were calculated. Velocity, WSS, and TAWSS were elevated at the stenosis, and pressure, OSI, and RRT were decreased at the stenosis. Streamlines were reduced at stenotic sites. Iliac branch locations that eventually occluded had more disturbed flow compared to non-occluded sites. Both pressure and flow velocity gradient variations are greater on the occluded side than on the non-occluded side.ConclusionsComputational fluid hemodynamic analysis identified consistent flow disturbances associated with eventual iliac limb occlusion following EVAR. These findings suggest that CFD-based hemodynamic assessment may help stratify patients at risk of iliac branch occlusion before clinical manifestation.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"772-785"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of open endarterectomy versus endovascular treatments in common femoral artery stenocclusive disease: A Bayesian hierarchical meta-analysis.","authors":"Nikolaos-Nektarios Giannakopoulos, Sofia Tzamtzidou, Dimitra Manou, Konstantinos Nakas, Konstantinos Seretis, Paraskevi Tsiantoula, Konstantinos Roditis, Vasileios Papaioannou, Theofanis Papas","doi":"10.1177/17085381261426647","DOIUrl":"10.1177/17085381261426647","url":null,"abstract":"<p><p>BackgroundThe management of Common Femoral Artery (CFA) stenocclusive disease presents unique challenges, with debates persisting regarding the optimal treatment strategy between Open Common Femoral Endarterectomy (CFE) and Endovascular Therapy (EVT). This study aimed to compare the efficacy of CFE versus EVT, as well as simple versus advanced EVT (aEVT), using a Bayesian hierarchical framework.MethodsA systematic review was conducted according to PRISMA guidelines by querying PubMed, ScienceDirect, Scopus, and the Cochrane Library for articles published through June 2024. The study included randomized controlled trials and retrospective observational studies with a minimum of 40 patients per cohort. Data were synthesized using a Bayesian random-intercept logistic model to estimate pooled Odds Ratios (OR) for primary patency, freedom from reintervention, and limb salvage.ResultsThe analysis included 10 comparative studies encompassing 1452 patients. Open CFE demonstrated superior outcomes compared to EVT, with a significantly reduced odds of patency loss (OR 0.480; 95% CrI: 0.367-0.626) and lower reintervention rates (OR 0.534; 95% CrI: 0.391-0.718). Limb salvage rates also favored CFE (OR 0.548; 95% CrI: 0.402-0.737). In subgroup analyses, advanced EVT (involving atherectomy) improved primary patency compared to simple EVT (OR 0.520; 95% CrI: 0.306-0.883) but did not statistically significantly reduce the need for reintervention (OR 0.910; 95% CrI: 0.427-1.894).ConclusionOpen CFE remains the gold standard for CFA stenocclusive disease, offering superior long-term durability and limb salvage compared to endovascular interventions. While advanced endovascular techniques improve patency rates compared to simple balloon angioplasty, they fail to significantly reduce reintervention rates, likely due to the biomechanical stress of the femoral region. EVT should be considered a pragmatic option reserved primarily for high-surgical-risk patients.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"795-809"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Basilic vein access as an effective alternative for endovascular embolization of pelvic varicose veins: A retrospective-cohort based population study.","authors":"Mariana Pinzón-Pinto, Esteban Portilla-Rojas, Alejandra González-Córdoba, Roxana Arráiz, Laura Alejandra Rodríguez, Martín Contreras, Leonardo Randial, Luis F Cabrera-Vargas","doi":"10.1177/17085381261425712","DOIUrl":"10.1177/17085381261425712","url":null,"abstract":"<p><p>ObjectivesPelvic congestion syndrome (PCS), often underdiagnosed, is a cause of chronic pelvic pain in women and is frequently associated with pelvic varicose veins. Endovascular embolization is an established treatment, traditionally performed via femoral or jugular access. However, these approaches may carry higher risks of complications. This study aimed to evaluate the safety, feasibility, and clinical outcomes of using basilic vein percutaneous access for pelvic vein embolization in patients with PCS.MethodsA retrospective cohort study was conducted on 292 women of reproductive age with symptomatic PCS who underwent pelvic varicose vein embolization using percutaneous access via the distal third of the right basilic vein. The study spanned from 2018 to 2023 and was carried out at two hospitals in Bogotá, Colombia. Inclusion criteria comprised chronic pelvic postcoital pain and Doppler-confirmed pelvic varicosities with reflux diameters >6 mm. Data collected included demographics, CEAP and Symptoms-Varices-Pathophysiology classifications, intraoperative details (access approach, duration, coil usage, complications), and postoperative outcomes (symptom resolution, complications, reintervention, ICU/hospital stay, and mortality). Follow-up evaluations were conducted at 15 days, 3 months, and 6 months post-procedure. Descriptive statistics were used for analysis. A detailed description of the surgical technique used for basilic vein access and embolization was included.ResultsAll 292 procedures were successfully performed using basilic vein access with no access-related complications such as bleeding, thrombosis, or hematoma. The average surgical duration was 41.1 min (SD = 4.1), and a mean of 2.6 coils (SD = 0.7) was used per case. The left gonadal vein was embolized in all patients, with additional embolization of the right gonadal (68.8%) and hypogastric veins (6.8%) when indicated. Only one patient (0.3%) experienced a coil migration resulting in pulmonary embolism, requiring reintervention and a short ICU stay. No mortalities were reported. Symptom resolution was achieved in 278 patients (95.2%), indicating high procedural effectiveness.ConclusionsBasilic vein access is a feasible and safe alternative for pelvic vein embolization in patients with PCS. This approach demonstrated excellent technical success, a low complication rate, and high symptom resolution, with the added benefits of shorter procedure time and reduced coil usage compared to traditional access routes. These findings suggest potential procedural and resource efficiency advantages. However, due to the study's retrospective nature and lack of comparative controls, prospective studies are necessary to further assess the long-term efficacy and cost-effectiveness of basilic access in comparison to femoral and jugular approaches. Establishing standardized guidelines for vascular access in PCS treatment could enhance outcomes and procedural safety.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"819-824"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contralateral disease is not a determining factor for revascularization procedure in the carotid arterial diseases.","authors":"Murat Ugur, Muhammet Turhan, Ege Dursun, Ozgur Ozsoy","doi":"10.1177/17085381261425727","DOIUrl":"10.1177/17085381261425727","url":null,"abstract":"<p><p>ObjectivesCarotid arterial disease is one of the most important causes of stroke and the gold standard in its treatment is surgical endarterectomy. Different approaches have been reported regarding revascularization methods (stent/surgery) and surgical methods (with shunting/with-out shunting) in patients with contralateral carotid stenosis. In this study, revascularization methods and postoperative follow-up of patients with contralateral carotid arterial stenosis in our clinic were investigated.MethodsPatients who underwent carotid endarterectomy in our clinic between 01.04.2019 and 30.04.2024 were retrospectively analyzed. Patients were divided into 4 groups according to contralateral carotid artery stenosis. On the contralateral side; patients with <50% stenosis constituted Group 1, patients with 50-69% stenosis constituted Group 2, patients with 70-99% stenosis constituted Group 3, and patients with total occlusion constituted Group 4. In all patients, the operation was performed with NIRS monitoring. The groups were compared in terms of postoperative neurological events and mortality.ResultsThere were 248 patients, who had undergone carotid endarterectomy during the study period. There were 143 patients in Group 1, 47 patients in Group 2, 44 patients in Group 3, and 14 patients in Group 4. Demographics, preoperative findings and cross clamping times were similar between the groups. All of the operations except 2 with regional anesthesia were performed under general anesthesia. Shunting was required in 6 patients and arteriotomy was closed with patchplasty in 17 patients. In the comparison of postoperative events, there was no statistically significant difference between the groups in the terms of early-term minor (1.4%, 2.1%, 2.3%, and 0, respectively) and major (0.007%, 0, 2.3%, and 0, respectively) neurological events. There were 5 reoperations due to bleeding (3 in Group 1 and 2 in Group 2) 3 mortalities (1 in Group 1 and 2 in Group 3). There was no neurological event and mortality and 1 restenosis in Group 1 in the follow-up period.ConclusionIn carotid artery stenosis, contralateral carotid artery stenosis is not a marker for determining the revascularization method. Performing the operation with standard precautions without deviating from routine practice has similar results to the surgical approach applied in unilateral stenosis. In these patients, the operation might be performed safely with precautions such as cerebral monitoring and not lowering blood pressure during the operation.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"741-746"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}