Vascular最新文献

{"title":"Readmission following early thoracic endovascular aortic repair compared to optimal medical treatment for uncomplicated acute type B aortic dissection.","authors":"Elliott A Orloff, Li Ding, Jeniann Yi, Sukgu M Han, Gregory A Magee","doi":"10.1177/17085381251379293","DOIUrl":"10.1177/17085381251379293","url":null,"abstract":"<p><p>BackgroundThere is a lack of consensus on the benefit of early thoracic endovascular aortic repair (TEVAR) over medical management for uncomplicated acute type B aortic dissection (aTBAD). The aim of this study is to compare readmissions of TEVAR versus medical management as the initial treatment strategy for uncomplicated aTBAD using the Nationwide Readmissions Database (NRD).MethodsThe NRD was created under the Healthcare Cost and Utilization Project, comprising over half of the U.S. inpatient population. Patients admitted for uncomplicated aTBAD were queried from the NRD from 2016 to 2018. Risk of index admission mortality, spinal cord ischemia, stroke, and overall major complication; 90-day readmission and 90-day treatment failure, between TEVAR and medical management alone.ResultsA total of 12,645 patients with an uncomplicated aTBAD were identified (TEVAR 12% and medical management 88%). Overall major complications during index admission were higher in the medical management group (27% vs 40%, <i>p</i> < .0001). On multivariate analysis TEVAR was associated with lower mortality (OR: 0.47, <i>p</i> < .0001), but a significantly higher rate of spinal cord ischemia (OR: 2.49, <i>p</i> < .0001), with no difference in stroke (OR: 0.93, <i>p</i> = .73). 90-day readmission rates were high but were not significantly different between treatment types (22% vs 25%, OR: 0.88, <i>p</i> = .14). Similarly, TEVAR was not associated with a lower rate of 90-day treatment failure (OR: 0.61, <i>p</i> = .22). Four TEVAR (0.3%) and 40 medical management (0.5%) patients were readmitted for treatment failure due to retrograde type A dissection.ConclusionsTEVAR for uncomplicated aTBAD was not associated with a lower 90-day readmission rate. Similarly, TEVAR was not associated with a lower rate of 90-day treatment failure. These findings provide further evidence to the equipoise of treatment options and support the need for the randomized trials currently ongoing in the U.S. and Europe investigating outcomes of TEVAR versus medical management for the treatment of uncomplicated aTBAD.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"561-571"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076269","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":"Comparison of long-term clinical and anatomical results of endovenous cyanoacrylate embolization and endovenous laser ablation methods in the treatment of great saphenous vein insufficiency.","authors":"Atilla Saraç","doi":"10.1177/17085381251379841","DOIUrl":"10.1177/17085381251379841","url":null,"abstract":"<p><p>ObjectiveAlthough some publications are comparing the early clinical and anatomical results of endovenous laser ablation and endovenous cyanoacrylate embolization in great saphenous vein insufficiency, according to our knowledge, there are limited publications comparing the long-term clinical and anatomical results of these methods. I aimed to compare the long-term clinical and anatomical outcomes of these endovenous treatment methods.MethodsA total of 248 patients over the age of 18 who underwent endovenous laser ablation or endovenous cyanoacrylate embolization for the treatment of great saphenous vein insufficiency were included in the study. Patients who have been treated with a treatment method other than these methods were not included in this study. The equal numbers of patients were included in two groups according to the applied treatment methods. The groups were not fully matched in terms of baseline characteristics in this study, and significant differences were detected in age and preoperative reflux duration values (<i>p</i> < .05), and therefore, the results were re-analyzed with models (ANCOVA) adjusted for age and clinical severity parameters.ResultsEndovenous laser ablation or endovenous cyanoacrylate embolization procedures were performed in a total of 248 patients with a mean age of 51.22 ± 13.20 years. There was a statistically significant difference in mean age between the groups (<i>p</i> = .017). The mean preoperative CEAP score of study patients was 3.07 ± 0.57 (between 2 and 6), and the mean preoperative VCSS value was 6.85 ± 1.18. The average follow-up period of the study patients was 3.5 ± 0.50 years and at the end of the follow-up, a decrease in CEAP stage and VCSS values was observed in both groups.ConclusionsThe endovenous cyanoacrylate embolization offers similar long-term success rates to endovenous laser ablation, is a shorter procedure time, and offers advantages in returning to daily activities after the procedure. Both treatment methods, with effective and accessible healthcare systems, offer a variety of treatment options. The results of this study suggest that while both methods reduce the CEAP stage in the long term, endovenous cyanoacrylate embolization may provide a greater reduction. However, endovenous laser ablation may be more effective in reducing symptom severity (VCSS) and may offer an effective treatment option with lower complication rates and similar outpatient benefits and cost-effectiveness.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"702-710"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309397","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":"Physician-modified endograft for repairing iatrogenic innominate artery injury: A case report and literature review.","authors":"Yongpan Cui, Jiawei Fan, Wenfei Guan, Peng Jiang, Chengpeng Tan, Wuming Zhang, Fei Mei","doi":"10.1177/17085381251379106","DOIUrl":"10.1177/17085381251379106","url":null,"abstract":"<p><p>BackgroundInnominate artery (IA) injury resulting from right subclavian vein (RSV) puncture is a relatively rare and life-threatening iatrogenic vascular injury.MethodsIn a 72-year-old female patient, in whom iatrogenic IA injury occurred during the RSV puncture, a 6-Fr sheath had entered into ascending aorta through IA. Due to the concern about the difficulty in hemostasis after removing the sheath, the patient was immediately transferred to our hospital. In emergency situations, when there were no covered stents of appropriate sizes available, we ultimately opted to physician-modified endograft (PMEG) for endovascular repair. A 16 × 124 mm Medtronic iliac branch (Endurant, Medtronic Vascular, Santa Rosa, CA, USA) was released on a sterile operating table, trimmed to 16 × 37 mm, and then reassembled into the delivery sheath.ResultsThe right subclavian artery (RSA) was exposed in the right supraclavicular fossa and punctured. After established the guidewire pathway from the RSA puncture site to the ascending aorta, the PMEG was delivered to IA and precisely deployed. Subsequently, the 6-Fr sheath was removed, and final angiography confirmed patent blood flow in IA, right common carotid artery, and RSA, with no bleeding. The patient recovered well and discharged.ConclusionIn emergencies, PMEG can be tailored to fit the anatomical structure of IA, providing a viable and effective alternative for managing complex iatrogenic IA injury.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"543-548"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041345","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":"Comparison of a cadaveric pressurized circulation model and an electronic simulator for vascular and endovascular surgery training.","authors":"Hugo Laparra-Escareño, Alejandro Cancino-Escobar, Carlos A Vergara-Ascencio, Jose R García-Alva, Alberto M Angeles-Castellanos, Ruben Argüero-Sánchez, Eduardo E Montalvo-Javé, Omar Sánches-Ramírez, Benjamin León-Mancilla, Carolina Baños-Galeana, José J García-Loyola Bioeng, Javier E Anaya-Ayala, Carlos A Hinojosa","doi":"10.1177/17085381251379298","DOIUrl":"10.1177/17085381251379298","url":null,"abstract":"<p><p>BackgroundSimulators are used for improvement of vascular surgical skills. This study compares a cadaveric pressurized circulation model (CPCM) with electronic simulators to perform of endovascular and open procedures.MethodsA cadaveric pressurized simulation model was developed and implemented for Endovascular Aortic Repair and peripheral arterial angioplasties. We utilized a system to infuse the body with an extracorporeal perfusion pump; and participants performed the same endovascular procedures on an electronic simulator. Addtionally, simulation for an open aortic repair was also conducted and evaluated. Data were analyzed with the statistical package SPSS version 22.ResultsWe found significant differences in median comparison between simulators; 100% agree CPCM is very similar to an actual patient, median 5 IQR (4-5) (<i>p</i> = 0.001), it enhances the acquisition of endovascular skills (<i>p</i> = 0.001), offers benefits over other simulators (<i>p</i> = 0.001), and simulated conditions of a real procedure (<i>p</i> = 0.01), likewise can replace animal models (<i>p</i> = 0.001). All participants agree or strongly agree it could help improve the success rate and minimize complications in real patients (<i>p</i> = 0.01).ConclusionsThe cadaveric model provides superior experience fidelity for endovascular training over an electronic simulator.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"604-611"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070648","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":"Enhancing readability and understandability of vascular surgery discharge summaries using artificial intelligence.","authors":"Federico Francisco Pennetta, Ciro Ferrer, Rocco Giudice, Roberto Chiappa, Fabio Massimo Oddi, Carlo Coscarella","doi":"10.1177/17085381261425721","DOIUrl":"10.1177/17085381261425721","url":null,"abstract":"<p><p>ObjectivesThis study aimed to assess whether Large Language Models (LLMs), like ChatGPT-4, could simplify discharge summaries for vascular surgery patients while maintaining accuracy and completeness, ultimately improving patient comprehension and engagement in their postoperative care.MethodsIn this cross-sectional multicentric study, discharge summaries from 90 vascular surgery patients across three centers were collected. These were divided into three groups based on patient pathology: aortic pathology, peripheral artery disease, and carotid artery disease. Summaries were processed by LLMs to create patient-friendly versions with a target reading level suitable for a 6th-grade education. The readability of the original and AI-generated summaries was evaluated using the Flesch-Kincaid Grade Level and Ease Score. Understandability and actionability were assessed with the Patient Education Materials Assessment Tool for Print (PEMAT-P), which evaluates the clarity, organization, and actionable nature of the text. Accuracy and completeness were rated using a 6-point Likert scale and a 3-point Likert scale, respectively. Statistical analyses, including paired-samples t-tests, ANOVA, and post-hoc tests, were performed to assess the differences between the original and AI-modified summaries.ResultsAI-generated summaries demonstrated significant improvements in readability, with a 39.6% reduction in Flesch-Kincaid Grade Level and a 106.37% increase in Ease Score. The mean understandability score based on PEMAT-P was 77.71, while the actionability score was 52.12. Accuracy was rated highly (mean score of 5.21), and completeness had a mean score of 2.61. However, 10.8% of summaries had omissions, and 7.5% had hallucinations, with corrections made in some cases.ConclusionsLLMs like ChatGPT-4 can significantly improve the readability and accessibility of discharge summaries for vascular surgery patients, enhancing their understanding and engagement in postoperative care. While the summaries were accurate and complete, the occurrence of errors suggests the need for further refinement to minimize omissions and hallucinations. These findings indicate that AI can be a valuable tool in improving communication between healthcare providers and patients. Future research should focus on reducing errors and enhancing actionability.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"711-716"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150683","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":"Iliofemoral endarterectomy and stenting improves mid-term patency for advanced aortoiliac disease with concomitant common femoral disease.","authors":"Nathan J Reinert, Francis J Caputo, Natasha Ahuja, Alice Alexander, James Bena, Andrew Smith, Ali Khalifeh, Courtney Hanak, Ravi Ambani, Nicholas G Hoell, Levester Kirksey, Sean P Lyden, Jon G Quatromoni","doi":"10.1177/17085381251377294","DOIUrl":"10.1177/17085381251377294","url":null,"abstract":"<p><p>ObjectiveCombined iliofemoral endarterectomy and iliac stenting (IFE + S) is a proven surgical approach for TransAtlantic Inter-society Consensus (TASC) C and D aortoiliac occlusive disease (AIOD). Iliac stenting alone (ISA) may be an attractive, minimally invasive option in select cases; however, untreated moderate-to-severe common femoral disease may threaten iliac stent patency and limit symptom improvement. This study evaluates the mid-term patency rates after IFE + S versus ISA for TASC C and D AIOD as well as the rate of interval femoral endarterectomies in those who underwent ISA.MethodsThis is a retrospective, single-center analysis of patients from 2011 to 2018 with TASC C or D AIOD and concomitant femoral artery stenosis of >50% who underwent IFE + S or ISA. Baseline lesion and patient characteristics such as TASC classification, degree of stenosis, calcification severity, lesion length, and baseline ankle-brachial index (ABI) were collected. Primary, primary-assisted, and secondary patency rates were calculated over three years with Kaplan-Meier estimates. The rate of interval femoral endarterectomies in the ISA cohort was measured at the same time endpoint.ResultsOf the 78 limbs identified, 64 (82.1%) underwent IFE + S and 14 (17.9%) underwent ISA. No significant differences in aortoiliac or femoral lesion characteristics existed. Iliac stent primary patency was significantly improved in the IFE + S group at three years [85.1% versus 55.6%, HR 3.96 (95% CI 1.54, 10.2, p = .004)]. Primary-assisted and secondary patency rates were not significantly different. Five (35.7%) patients in the ISA cohort required an interval femoral endarterectomy for ischemic symptoms over the three-year endpoint.<b>Conclusions:</b> In select patient populations with concomitant TASC C or D AIOD and common femoral artery disease, IFE + S may provide improved mid-term primary stent patency when compared to ISA. A subset of patients who undergo ISA may require future femoral endarterectomies for ischemic symptoms.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"683-692"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001131","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":"Mid-term outcomes of covered and bare metal stents for femoropopliteal atherosclerotic disease.","authors":"Margaret Kurop, Andrew Bedford, Sara Beudoin, Jennifer Huffman, Chase Schlesselman, Todd R Vogel, Steven Cheung, Jonathan Bath","doi":"10.1177/17085381251379289","DOIUrl":"10.1177/17085381251379289","url":null,"abstract":"<p><p>ObjectiveEndovascular modality used in peripheral vascular intervention (PVI) varies widely. Long-term outcomes are poorly studied between covered stents (CS) and bare metal stents (BMS) for the SFA.MethodsPatients (2017-2021) undergoing CS and BMS to the SFA were identified at an academic institution. Comparative statistics and Kaplan-Meier analysis were used to evaluate outcomes by group.ResultsOne hundred and nineteen patients undergoing stenting were included with 60 patients undergoing CS (50%) and BMS in 59 (50%). There were no differences in sex (<i>p</i> = 0.5), preoperative ABI (<i>p</i> = 0.2) or indication for surgery between groups (<i>p</i> = 0.8). CS patients had undergone more prior SFA interventions (<i>p</i> = 0.03) and were younger (62 vs. 66 years; <i>p</i> = 0.04). Regarding anatomic and operative characteristics, CS patients had more TASC C/D lesions (69 vs. 47%; <i>p</i> = 0.006) less severe calcification (8 vs.17%; <i>p</i> = 0.0006) and more often underwent angioplasty and stenting (90 vs 51%; <i>p</i> < 0.0001) and less often angioplasty, DCB and stenting (5 vs. 43%; <i>p</i> < 0.0001). CS patients had larger SFA (5.7 vs 4; <i>p</i> < .0001), longer lesions (119 vs. 89 mm; <i>p</i> = 0.0008), higher popliteal runoff score (8.3 vs. 6.4; <i>p</i> = 0.02), longer surgery (140 vs. 118 min; <i>p</i> = 0.03), less fluoroscopy time (21 vs. 26 min; <i>p</i> = 0.03), larger SFA stent (6.2 vs. 5.6 mm; <i>p</i> < 0.0001), and longer stented length (260 vs. 171 mm; <i>p</i> < 0.0001). There were no differences in concomitant iliac/tibial treatment between groups (<i>p</i> = 0.3). Regarding outcomes, there were no differences in amputation (CS 10 vs. BMS 10.2%; <i>p</i> = 1) but overall mortality was lower in CS patients (8 vs 22%; <i>p</i> = 0.04) as was acute limb ischemia (17 vs. 34%; <i>p</i> = 0.03). CS patients underwent fewer endovascular (<i>p</i> = 0.03) and open reinterventions (<i>p</i> = 0.005) but a shorter time to first endovascular reintervention (5.6 vs. 17.8 months; <i>p</i> = 0.0002) on unadjusted analysis. Kaplan-Meier estimated survival at 48 months was 83% for CS and 75% for BMS (<i>p</i> = 0.28). At 36 months, primary patency was 35% for CS vs. 41% for BMS (<i>p</i> = 0.09), primary-assisted patency was 57% for CS vs. 68% for BMS (<i>p</i> = 0.04) and secondary patency for CS was 61% vs. 61% for BMS (<i>p</i> = 0.99).ConclusionsIn this series, CS was associated with lower reintervention rates than BMS despite higher TASC classification, longer lesions, and higher popliteal runoff scores. CS was more often used to salvage previous SFA intervention. At 3 years, however, patency was similar between groups. These data suggest some advantages for CS over BMS in endovascular salvage of failed SFA intervention and potentially a preferred modality for more complex SFA lesions than BMS.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"641-657"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041515","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":"Two-dimensional versus three-dimensional registration for image fusion in endovascular aortic surgery.","authors":"Kirsten Dansey, Nicholas J Swerdlow, Thomas F X O'Donnell, Sara L Zettervall, Marc L Schermerhorn, Lars Stangenberg","doi":"10.1177/17085381251381002","DOIUrl":"10.1177/17085381251381002","url":null,"abstract":"<p><p>ObjectiveImage fusion allows for reduced operative time and radiation exposure during endovascular aortic operations. There are two approaches to register a preoperative CT scan to the patient; two X-ray images (2D) or a cone beam CT (CBCT, 3D). The goal of this study was to compare accuracy of initial image fusion alignment and time for image fusion setup using 2D versus 3D registration.MethodsWe performed an analysis of patients who underwent endovascular aortic aneurysm repair at our institution. Offline, we re-registered the patient's preoperative CT scan to the images stored from the procedure. We used an anterior-posterior image and a lateral image to register for the 2D approach and used a CBCT for the 3D registration. We then used the patient's initial aortogram to assess accuracy between the actual aortogram and the created virtual mask for both 2D and 3D registration. We chose the inferior angle between renal artery and aorta as the fiducial marker. We measured the time to complete two registration processes. We employed the Wilcoxon matched-pairs signed-rank test to compare the two populations.ResultsA total of 27 patients were evaluated; 11 patients underwent EVAR, 3 FEVAR, 13 PMEG. The median (Q1,Q3) distance between the aortogram and the virtual mask for 3D registration was 8 mm (4,11) and for 2D was 14 mm (9,18.75), (p < .001). 22 patients (81%) had a more accurate registration with 3D image fusion. 2D fusion on average was faster by 93 seconds (p < .001) where time to register was 105 seconds for 2D and 197 seconds for 3D registration.ConclusionsIn the current study, 3D registration showed improved alignment of the fusion image over the 2D registration, at the expense of a longer registration time. This should be further evaluated in larger studies. Despite this added effort, we believe that 3D registration should be considered the preferred initial approach given the importance of an accurate mask for complex procedures.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"581-586"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081563","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 factors associated with reoperation following major lower limb amputations for peripheral vascular disease: A single centre prospective observational study.","authors":"Mayank Badkur, Yash Kumar Parihar, Palash Sawhney, Mahaveer Rodha, Mahendra Lodha, Indra Singh Choudhary, Niladri Banerjee, Ravi Gaur, Aishwarya Kumari Sah, Mohit Rakhecha","doi":"10.1177/17085381261425734","DOIUrl":"10.1177/17085381261425734","url":null,"abstract":"<p><p>BackgroundMajor lower limb amputations, often performed as lifesaving procedures in patients with advanced peripheral vascular disease (PVD), are associated with high rates of postoperative complications and reoperations. Identification of risk factors associated with reoperation is crucial for targeted perioperative management. The objective of the study is to identify the factors associated with increased risk of reoperation following major amputation and to develop and evaluate a predictive model for the same.MethodsA prospective observational study was conducted at our tertiary care centre between October 2022 and December 2023. After taking institutional ethical committee clearance, 83 patients undergoing major lower limb amputations (above or below the knee) for PVD were included in study. Demographic, clinical, and radiological variables were collected and analyzed. Reoperation was defined as any additional procedure requiring revision of the stump within 30 days, excluding minor wound interventions. Multivariable binomial logistic regression analysis was performed to identify independent risk factors associated with reoperation.ResultsThe reoperation rate following major amputation was 44.57%, the two common causes were stump necrosis (40.54%) and wound infections (29.72%). On multivariable analysis, age >60 years (OR: 8.26, <i>p</i> = .001) and arterial blockage above the common femoral artery (CFA) (OR: 4.32, <i>p</i> = .038) emerged as significant independent risk factors. The regression model demonstrated moderate predictive strength with a Nagelkerke R² value of 40.9% and good model fit (<i>p</i> = .724).ConclusionAdvanced age and proximal arterial occlusion are significant predictors of reoperation after major amputation. The proposed model offers a practical tool for risk stratification, patient counselling, and surgical planning. Multicentre validation is needed to refine its predictive accuracy.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"669-674"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166770","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":"Mycotic internal carotid artery aneurysm: A literature review inspired by a case.","authors":"Madeleine de Boer, Connor Greatbatch, David Cottier, Catherine Thoo","doi":"10.1177/17085381251379290","DOIUrl":"10.1177/17085381251379290","url":null,"abstract":"<p><p>BackgroundMycotic aneurysms of the extracranial carotid artery are a rare consequence of localised or systemic infection. Typically caused by <i>Staphylococcal</i> infections, sequelae include further bacterial dissemination, stroke, rupture and death. Scarcely discussed in literature, the management of this pathology is limited to case reports and general consensus.MethodThe case of an internal carotid artery mycotic aneurysm in the setting of contralateral internal carotid artery occlusion managed with urgent endovascular repair is discussed. A systematic review was subsequently conducted according to PRISMA guidelines to further review the preferred management for this uncommon pathology.ResultA total of 38 articles discussing the clinical details of 48 mycotic ICA aneurysms in the adult population were reviewed. Similarly to the described case, the majority of infections were due to <i>Staphylococcus</i> species; however, contrary to the present case, most were managed with open repair. All cases were managed with antibiotic therapy.ConclusionWhilst most cases previously described in the literature have been managed with open bypass grafting, the present case describes an alternative treatment method with endovascular management in the emergent setting with good outcomes at 1-year post-stent placement.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"725-735"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076227","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}