Vascular最新文献

{"title":"Acute ischemic stroke: The role of emergency carotid endarterectomy in isolated extracranial internal carotid artery occlusion.","authors":"Pierfilippo Acciarri, Alice Camagni, Maddalena Bressan, Gladiol Zenunaj, Ilaria Casetta, Andrea Bernardoni, Vincenzo Gasbarro, Luca Traina","doi":"10.1177/17085381231192712","DOIUrl":"10.1177/17085381231192712","url":null,"abstract":"<p><strong>Objectives: </strong>The treatment of choice for acute and isolated extracranial internal carotid artery (eICA) occlusion remains, to date, controversial. Although intravenous thrombolysis is recommended, its effectiveness is generally low. This retrospective study aims to assess the clinical outcome and the role of CT perfusion in symptomatic patients who underwent carotid endarterectomy (CEA) for acute occlusion of the eICA.</p><p><strong>Materials and methods: </strong>All the 21 patients presented with stroke-in-evolution, complete patency of intracranial circulation, no evidence of hemorrhagic transformation at CT and a minimum ASPECTS of 6. Clinical improvement was assessed by evaluating the variation of NIHSS and the mRS. We investigated the relationship between NIHSS and the timing of the surgery, the ASPECT score, and the volume of ischemic penumbra at CT perfusion.</p><p><strong>Results: </strong>Median NIHSS on admission was 9 (range 1-24) and it decreased to 4 (range 0-35) 24 h after surgery, improving in 76.2% of patients. Patients with an ASPECTS of 6 (3 patients) showed an improvement of 66.7%, while it was of 81.8% in those starting with a score of 9 or 10 (11 patients). A mRS between 0 and 2 after 3 months was achieved in 12 out of 21 patients. The average time elapsing between surgery and symptom onset was 410 min (range 70-1070 min). Fourteen patients treated within 8 h from symptoms onset showed a clinical improvement of 85.7%, compared to a 57.1% for those which underwent later surgery. Four patients underwent thrombolytic therapy before CEA showing postoperative clinical improvement and no intracranial hemorrhage. Among the 14 patients who underwent CT perfusion, the median ischemic penumbra volume was 112 cc in those with clinical improvement (10 patients) and only 84 cc in those with worse clinical outcomes (4 patients).</p><p><strong>Conclusions: </strong>Emergency CEA in isolated eICA occlusion has proved to be a safe and effective treatment option in selected patients. CT perfusion, imaging the ischemic penumbra and quantifying the tissue suitable for reperfusion, offers a valid support in the diagnostic-therapeutic workup. Indeed, we can infer that the area of the ischemic penumbra is directly proportional to the margin of clinical improvement after revascularization, supposing that the appropriate intervention timing is respect.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1295-1303"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10024152","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":"Identifying venous clinical severity score thresholds for Clinical-Etiology-Anatomy-Pathophysiology classifications of venous edema and higher.","authors":"Halbert Bai, Jason B Storch, Vishal Gokani, Pavel Kibrik, Jenny Chen, Windsor Ting","doi":"10.1177/17085381231193510","DOIUrl":"10.1177/17085381231193510","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Venous Clinical Severity Score (VCSS) is a widely used standard for assessing and grading the severity of chronic venous disease (CVD). Prior research highlighted its high validity in detecting and quantifying venous disease. However, there is little, if any, known about the precise thresholds at which VCSS discriminates important stages of deep venous disease. This study sought to elucidate the diagnostic accuracy, thresholds, and correlation at which VCSS detects salient CEAP (Clinical-Etiology-Anatomy-Pathophysiology) classes in deep venous disease progression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A registry of 840 patients who presented with chronic proximal venous outflow obstruction (PVOO) secondary to non-thrombotic iliac vein lesions from August 2011 to June 2021 was retrospectively analyzed. VCSS and CEAP classifications were used to evaluate preoperative symptoms. VCSS was compared to CEAP classes to determine the precise VCSS composite values at which the instrument was able to detect CEAP C3 and higher, C4 and higher, and C5 and higher. Receiver operative characteristic (ROC) curve and area under the curve (AUC) were used to evaluate VCSS for its ability to discriminate disease at these stages of CEAP classification. Spearman's rank coefficient was used to determine the correlation between CEAP VCSS composite as well as individual VCSS components (pain, varicose vein, edema, pigmentation, inflammation, induration, ulcer number, ulcer size, ulcer duration, compression).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;VCSS composite was able to detect venous edema (C3) and higher at a sensitivity of 68.9% and a specificity of 54.8% at an optimized threshold of 8.5 (AUC = 0.648; 95% C.I. = 0.575-0.721). To detect changes in skin and subcutaneous tissue from CVD (C4) and higher, an optimal threshold of 11.5 was found with a sensitivity of 51.7% and specificity of 76.5% (AUC = 0.694; 95% C.I. = 0.656-0.731). Healed venous ulcer (C4) and higher was detectable at an optimized threshold of 13.5 at a sensitivity of 67.7% and a specificity of 88.9% (AUC = 0.819; 95% C.I. = 0.766-0.873). The correlation between VCSS composites and CEAP was weak (&lt;i&gt;ρ&lt;/i&gt; = 0.372; &lt;i&gt;p&lt;/i&gt; &lt; .001). Attributes of VCSS that reflect more severe venous disease correlated more closely with CEAP classes, namely pigmentation (&lt;i&gt;ρ&lt;/i&gt; = 0.444; &lt;i&gt;p&lt;/i&gt; &lt; .001), inflammation (&lt;i&gt;ρ&lt;/i&gt; = 0.348; &lt;i&gt;p&lt;/i&gt; &lt; .001), induration (&lt;i&gt;ρ&lt;/i&gt; = 0.352; &lt;i&gt;p&lt;/i&gt; &lt; .001), number of active ulcers (&lt;i&gt;ρ&lt;/i&gt; = 0.497; &lt;i&gt;p&lt;/i&gt; &lt; .001), active ulcer size (&lt;i&gt;ρ&lt;/i&gt; = 0.485; &lt;i&gt;p&lt;/i&gt; &lt; .001), and ulcer duration (&lt;i&gt;ρ&lt;/i&gt; = 0.497; &lt;i&gt;p&lt;/i&gt; &lt; .001). The correlation between CEAP class and the other four components of VCSS were not statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;VCSS composite thresholds of 8.5, 11.5, and 13.5 are threshold values for detecting CEAP classification C3 and higher, C4 and higher, and C5 and higher, respectively. Consistent with prior work, V","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1322-1329"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9940368","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":"Age-related difference in acute type B aortic dissection.","authors":"Zhigong Zhang, Feng Lin, Xiaoci Huang, Zhipeng He, Haoran Wang, Tingting Cheng","doi":"10.1177/17085381231214720","DOIUrl":"10.1177/17085381231214720","url":null,"abstract":"<p><strong>Objective: </strong>The objective is to compare the characteristics of clinical data, imaging data, and treatment methods of young and old patients with acute type B aortic dissection (ABAD).</p><p><strong>Methods: </strong>ABAD patients admitted to the Department of Vascular Surgery of the First Affiliated Hospital of Anhui Medical University from January 2012 to December 2018 were retrospectively reviewed. Patient demographics, such as gender, age, diabetes, hypertension, presenting symptoms, imaging characteristics, laboratory data on admission, hemodynamics on admission and in-hospital management, and mortality of different age groups were compared and analyzed. Categorical variables were compared using χ² tests or Fisher's exact test. Continuous variables were compared using Student's t-test or Mann-Whitney U-test.</p><p><strong>Results: </strong>A total of 141 ABAD patients were included in this study. Old ABAD patients were more likely to have a prior history of hypertension (88.6% vs 70.4%, <i>p</i> = 0.037) and atherosclerosis (29.8% vs 7.4%, <i>p</i> = 0.016). In the young group, Marfan syndrome was significantly higher (14.8% vs 0.9%; <i>p</i> = 0.005). Compared with the old group, the number of distal tears in the young group was significantly higher (62.3% vs 39.5%, <i>p</i> = 0.027). The proportion of patients with malperfusion of lower limbs in the young group was significantly higher than that in the old group (22.2% vs 6.1%, <i>p</i> = 0.026). There was no significant difference in the treatment methods and in-hospital mortality between the two groups.</p><p><strong>Conclusion: </strong>Compared with old ABAD patients, young ABAD patients had more distal tears and a higher proportion of lower limbs malperfusion.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1385-1390"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522661","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":"Association between statin-use and mobility and long-term survival after major lower limb amputation.","authors":"Arsalan Wafi, Vijay Kolli, Luis Ribeiro, Bilal Azhar, James Budge, Shreya Chawla, Paul Moxey, Ian M Loftus, Peter J E Holt","doi":"10.1177/17085381231192724","DOIUrl":"10.1177/17085381231192724","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to determine if there is an association between statin-use and prosthetic mobility and long-term survival in patients receiving rehabilitation after major amputation for lower limb arterial disease.</p><p><strong>Methods: </strong>A retrospective analysis of prospectively maintained data (2008-2020) from a centre for rehabilitation was performed. Patients were grouped by statin-use status and sub-grouped by the combination of statin and antithrombotic drugs (antiplatelets or anticoagulants). Outcomes were prosthetic mobility (SIGAM score, timed-up-go and 2-min walking distance) and long-term survival. Regression, Kaplan-Meier and Cox-proportional hazard analyses were performed to test associations adjusted to confounders.</p><p><strong>Results: </strong>Of 771 patients, 499 (64.7%) were on a statin before amputation or prescribed a statin peri-operatively. Rate of statin-use was significantly lower among female (53.3%) compared to male (68.2%) patients, <i>P</i> < 0.001. Statin-use was associated with significantly better prosthetic independence (53.1% vs 44.1%, <i>P</i> = 0.017), timed-up-go (mean difference of 4 s, <i>P</i> = 0.04) and long-term survival HR 0.59 (0.48-0.72, <i>P</i> < 0.001). Significance persisted after adjusting for confounding factors and in subgroup analyses. The combination of statin with antiplatelet was associated with the most superior survival, HR 0.51 (0.40-0.65, <i>P</i> < 0.001). Sensitivity analysis (exclusion of non-users of prosthesis) showed that statin-use remained a significant indicator of longer survival, maximally when combined with antiplatelet use HR 0.52 (0.39-0.68, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Statin-use is associated with better mobility and long-term survival in rehabilitees after limb loss, particularly when used in combination with antiplatelets. Significantly lower rates of statin-use were observed in female patients. Further research is warranted on gender disparities in statin-use and causality in their association with improved mobility and survival.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1240-1249"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9902502","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":"Impact of cilostazol on prevention of late failure of autologous vein grafts.","authors":"Shinsuke Mii, Atsushi Guntani, Sosei Kuma, Masaru Ishida, Sho Yamashita, Kiyoshi Tanaka, Jin Okazaki","doi":"10.1177/17085381231192730","DOIUrl":"10.1177/17085381231192730","url":null,"abstract":"<p><strong>Objectives: </strong>The effectiveness of postoperative medication for the prevention of late graft failure is controversial. We conducted the present study to investigate whether cilostazol improved the mid-term outcomes after infrainguinal autologous vein bypass for chronic limb-threatening ischemia (CLTI).</p><p><strong>Methods: </strong>From April 1994 to March 2022, we performed 590 de novo infrainguinal bypass procedures using autologous vein grafts (AVGs) in three hospitals. The bypass grafts were classified according to the postoperative prescription of cilostazol. The loss of graft patency and major adverse limb events (MALEs) were set as endpoints. Patients who died within 30 days and grafts that lost primary patency within 30 days after surgery were excluded. Data up to 3 years were analyzed. The cumulative primary patency (PP), assisted primary patency (AP), secondary patency (SP), and freedom from MALE (ffMALE) rates were calculated by the Kaplan-Meier method and compared between the cilostazol group and the non-cilostazol group. After a propensity score matching, same statistical analyses were performed. In addition, a Cox proportional hazards regression analysis that included preoperative factors, intraoperative factors, and postoperative medications was performed to identify whether cilostazol is an independent predictor for the outcomes.</p><p><strong>Results: </strong>A total of 523 AVGs met inclusion criteria. Kaplan-Meier curves showed that the cilostazol group was superior to the non-cilostazol group in all outcomes, while the cilostazol group was superior to the non-cilostazol group in AP and SP after a propensity score matching. A multivariable analysis showed that non-use of cilostazol was identified as an independent predictor for loss of AP, SP, and ffMALE.</p><p><strong>Conclusions: </strong>Cilostazol improved the mid-term outcomes after infrainguinal autologous vein bypass.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1232-1239"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9949122","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":"Challenges in normalizing pulse wave velocity scores: Implications for assessing central artery stiffness.","authors":"Alessandro Gentilin","doi":"10.1177/17085381231194145","DOIUrl":"10.1177/17085381231194145","url":null,"abstract":"","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1410-1411"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9959874","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":"The effects of high quality team medicine on outcomes of chronic limb-threatening ischemia patients with infrapopliteal bypass.","authors":"Taira Kobayashi, Masaki Hamamoto, Takanobu Okazaki, Ryo Okusako, Misa Hasegawa, Kazufumi Ishida, Tomoaki Honma, Masamichi Ozawa, Shinya Takahashi","doi":"10.1177/17085381231194959","DOIUrl":"10.1177/17085381231194959","url":null,"abstract":"<p><strong>Objectives: </strong>A team approach for treatment of patients with CLTI is used worldwide. However, the quality of team medicine is a concern. The Global Vascular Guidelines provide recommendations for high quality team medicine, but there is limited knowledge of the significance of team quality in CLTI treatment. The objective of this study is to evaluate the effects of team quality on clinical outcomes after infrapopliteal bypass.</p><p><strong>Methods: </strong>A retrospective analysis was performed in 337 patients who underwent 414 infrapopliteal bypasses under a team medicine approach at a single center between 2009 and 2021. In 2017, team medicine was reorganized for improvement of quality. Comparisons were made between before (Group 1; 160 patients, 195 limbs) and after (Group 2; 177 patients, 219 limbs) reorganization. The primary endpoints were limb salvage and wound healing after infrapopliteal bypass.</p><p><strong>Results: </strong>The patients included 227 males (67%) and had a median age of 76 [68-83] years. Diabetes mellitus was present in 67% and end-stage renal disease with hemodialysis in 37%. The follow-up rate was 96% in a mean follow-up period of 31±30 months. The 3-year limb salvage rate was significantly lower in Group 1 (before reorganization) than in Group 2 (after reorganization) (84% vs 95%, <i>p</i> = .001). The wound healing rates in the whole cohort were 72% at 6 months and 85% at 12 months, with no significant differences between the groups. In multivariate analysis, the risk factors for major amputation were treatment before reorganization (HR 2.68; <i>p</i> = .017), hemodialysis (HR 2.27; <i>p</i> = .017), and non-ambulatory status (HR 2.63; <i>p</i> = .005).</p><p><strong>Conclusions: </strong>A reorganized team approach with the goal of higher quality was independently associated with reduced major amputation for patients with CLTI treated with infrapopliteal bypass. This result indicates the importance of a high quality team approach for success of this treatment.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1202-1211"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9954638","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":"Retrograde tibial access for revascularization of chronic total occlusions in patients with chronic limb-threatening ischemia.","authors":"Daniel Raskin, Yiftach Barash, Daniel Silverberg, Moshe Halak, Hatem Hater, Boris Khaitovich","doi":"10.1177/17085381231192691","DOIUrl":"10.1177/17085381231192691","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate tibial single access in treatment of chronic total occlusions (CTO) in patients with ipsilateral chronic-limb ischemia (CLTI).</p><p><strong>Materials and methods: </strong>In this retrospective study, data was collected on patients treated for ipsilateral CTO via a tibial artery access between March 2017 and March 2021. Fifty-nine limbs in 57 patients, (42 men, average age 73 years; range 47-96) were treated. Patient's symptoms were classified in accordance with the Rutherford category. The end points were freedom from major amputation and the need for reintervention up to 1 year of follow up.</p><p><strong>Results: </strong>Out of the 59 treated limbs, technical success was achieved in 57 (97%). The treated multilevel segments involved 5 common and 12 external iliac arteries, 23 common and 37 superficial femoral arteries, 23 femoropopliteal segments, 14 popliteal arteries, and 4 bypasses. Mean length of occlusion was 186 mm (range 7-670). Rutherford classification of the treated limbs was category 5 and 6 in 45 patients and category 4 in 14 patients. Three procedural complications occurred and were successfully treated during the same procedure. No immediate post-procedural complication was encountered. Median follow-up was 13 months (range 1-45.3). Reintervention was required in 9 limbs, after an average of 6 months. One year free from amputation rate was 91.2%.</p><p><strong>Conclusions: </strong>Single access via the ipsilateral tibial artery can be a useful, effective, and safe approach for treating CTO in CLTI patients.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1220-1225"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10331809","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 case series of image-guided percutaneous drainage of abdominal aortic graft infection as bridge therapy.","authors":"Helena Baffoe-Bonnie, Khaled I Alnahhal, Kristin Englund, Mark E Baker, Lee Kirksey","doi":"10.1177/17085381231214318","DOIUrl":"10.1177/17085381231214318","url":null,"abstract":"<p><strong>Introduction: </strong>Aortic graft infection (AGI) is a rare complication following endovascular aneurysm repair and is associated with substantial morbidity and mortality. The traditional management of AGI is intravenous antibiotic therapy and surgical explantation. In this case series, percutaneous drainage was used as a bridge therapy in the treatment of AGI.</p><p><strong>Methods: </strong>We report two cases, 78-year-old male and 57-year-old female, in whom image-guided percutaneous drainage was used to treat AGI in two contrasting contexts. Informed consent was obtained from both cases/relatives for publication.</p><p><strong>Results: </strong>Both cases underwent successful percutaneous drainage of AGI utilized as a bridge therapy before definitive surgical reconstruction and graft explantation. Each patient had a different outcome. In the first case, the patient's comorbidities and severe disease state could not be overcome, resulting in his death. The second patient benefitted from the percutaneous drainage by allowing her more time ameliorate her malnutrition before definitive surgery.</p><p><strong>Conclusion: </strong>Data on the outcomes of percutaneous drainage of AGI is limited. The successful procedure described in this case series emphasizes the need to conduct more research to evaluate the safety and efficacy of this treatment approach before the surgical explantation.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1309-1313"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138462906","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":"Factors affecting lower extremity venous insufficiency recurrence following radiofrequency ablation.","authors":"Hakki Kursat Cetin, Eyup Murat Kanber","doi":"10.1177/17085381231193512","DOIUrl":"10.1177/17085381231193512","url":null,"abstract":"<p><strong>Objective: </strong>To clarify possible factors for recurrence of venous insufficiency following radiofrequency ablation (RFA) for the treatment of lower extremity chronic venous insufficiency (CVI).</p><p><strong>Methods: </strong>Patients with lower extremity CVI who underwent RFA therapy were reviewed for inclusion in the study. Patients' characteristics, operative parameters and follow-up outcomes were recorded. Patients were divided into two groups (patients with successful RFA and patients with recurrent venous insufficiency). Groups were compared according to patient demographic features, treated vein characteristics, operative data and follow-up duration.</p><p><strong>Results: </strong>In total, 313 patients matched the study inclusion criteria and 48 patients encountered RFA failure during follow-up. Mean BMI and ratio of COPD were significantly higher in patients with RFA failure (<i>p</i> = .002 and <i>p</i> = .007). The CEAP classification was significantly different between the groups (<i>p</i> = .007). Mean follow-up time was significantly longer in patients with RFA failure (<i>p</i> = .011). Presence of COPD and BMI ≥30 kg/m² increased RFA failure 4.187 times and 2.255 times, respectively (<i>p</i> = .002 and <i>p</i> = .022). Additionally, CEAP C4 significantly increased RFA failure (<i>p</i> = .001). Lastly, longer follow-up time was a predictive factor for RF failure (<i>p</i> = .024).</p><p><strong>Conclusion: </strong>Our study findings demonstrated for the first time that obesity, presence of COPD, presence of veins classified as CEAP C4 before RFA, and follow-up period longer than 48 months were predictive factors for venous insufficiency recurrence following RFA.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1335-1339"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9925466","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}