Vascular最新文献

{"title":"Epidemiology, clinical features and prognostic factors in patients with Covid-19 and acute limb ischaemia - A single center study.","authors":"Irina Ciumanghel, Iulian Buzincu, Adi Ionut Ciumanghel, Eliza Barbuta, Diana Cimpoesu","doi":"10.1177/17085381241236932","DOIUrl":"10.1177/17085381241236932","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to determine the incidence, clinical and paraclinical characteristics and outcomes of Covid-19 positive patients presenting in the Emergency Department (ED) with and treated for acute limb ischaemia (ALI) during a 2-year period.</p><p><strong>Methods: </strong>This retrospective study was conducted in the ED of St. Spiridon County Clinical Emergency Hospital in Iasi, north-east region of Romania. The patients included in this study presented in the ED between March 1^st, 2020 and February 28^th, 2022 with ALI and Covid-19.</p><p><strong>Results: </strong>During the study period, a total number of 141018 patients were evaluated in our ED, 8578 (representing 6,08%) patients being diagnosed with Covid-19. Of them, 98 (1.14% of all with Covid-19) presented ALI. The mean age was 70.9 ± 10.23 and 67.3% of the patients were males. At admission, 57% of patients had Covid-19-related pneumonia, identified on X-ray or CT scan. Of all patients, 81 (82%) were diagnosed with ALI in lower limbs with 10% of them having affected both limbs. 95% of the patients presented comorbidities, the main being cardiac (85%), diabetes mellitus (37%), vascular (24%) and neurological (22.6%). Non-survivor patients were more likely to have Covid-19 pneumonia on chest X-ray or CT scan, 92% versus 44% (OR 15, CI 3.3; 68, <i>p</i> < .01), lymphopenia 96% versus 70% (OR 10.2, CI 1.30; 80.9, <i>p</i> < .01), a NLR over 9.77% versus 30% (OR 7.5, CI 2.6; 21.4, <i>p</i> < .01), acidosis 65% versus 33% (OR 3.8, CI 1.4; 9.7, <i>p</i> < .01), abnormal AST, 69% versus 29% (OR 5.4, CI 2; 14.5, <i>p</i> < .01) and secondary amputation, 38.5 versus 11.1% (OR 5, CI 1.7; 14.7, <i>p</i> < 0.1). Overall, the mortality rate was 26.5%.</p><p><strong>Conclusion: </strong>The prevalence of ALI in patients infected with Covid-19 who were evaluated in our ED was 1.14%. The highest mortality rate was probably related to Covid-19 pneumonia. We observed that patients with Covid-19 pneumonia, lymphopenia, a NLR >9, metabolic acidosis, increased AST at ED admission and secondary amputation had a higher mortality.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"50-57"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991334","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":"Pharmacomechanical thrombectomy with Angiojet in acute arterial occlusions: A prospective study among the results and outcomes.","authors":"Rafael de Athayde Soares, Ana Beatriz Campelo Campos, Matheus Veras Viana Portela, Carolina Sabadoto Brienze, Giovana Quarentei Barros Brancher, Roberto Sacilotto","doi":"10.1177/17085381241237559","DOIUrl":"10.1177/17085381241237559","url":null,"abstract":"<p><strong>Objective: </strong>The main objective of this present paper was to evaluate the results and outcomes of patients with acute limb ischemia (ALI) submitted to pharmacomechanical thrombectomy (PMT) endovascular surgery with Angiojet, regarding the number of cycles/pumps.</p><p><strong>Methods: </strong>Prospective, consecutive cohort study of ALI patients submitted to PMT endovascular intervention subdivided into two groups according to the number of cycles in the Angiojet technique: Group 1 higher than 150 cycles/second and Group 2 lesser than 150 cycles/second (cycles/s).</p><p><strong>Results: </strong>Overall, 92 patients with ALI submitted to PMT were evaluated. Two groups of patients were identified: Group 1 higher than 150 cycles/s with 60 patients and Group 2 lesser than 150 cycles/s with 32 patients. The overall mortality rate (OMR) was 15.1% (13 patients) in total cohort within the first 30 days. Group 1 had a higher OMR than Group 2 (16.1% vs 9.3%, <i>p</i> = 0.007). There were 4 cases of hematuria (4.3%), all of them in Group 1. We have performed a Kaplan-Meier regarding limb salvage rates: Group 1 had 85% and Group 2 had 95.7% at 1057 days. P = 0.081. Among the factors evaluated, the following were related to overall mortality rate: PMT with higher >150 cycles/s (HR = 7.17, <i>p</i> = 0.007, CI: 1.38-8.89), COVID-19 infection (HR = 2.75, <i>p</i> = 0.010, CI = 1.73-5.97), and post-operative acute kidney injury (HR = 2.97, <i>p</i> < 0.001, CI = 1.32-8.13). Among the factors evaluated, the following was related to limb loss: post-operative acute kidney injury (HR = 4.41, <i>p</i> = 0.036, CI: 1.771-7.132), probably because patients experiencing limb loss have a higher incidence of acute renal insufficiency due to higher circulating myoglobin higher hemolysis from the increased Angiojet cycles inducing rhabdomyolysis.</p><p><strong>Conclusion: </strong>PMT with Angiojet is a safe and effective therapy in patients with ALI. However, patients receiving greater than 150 cycles/s were noted to have higher rates of acute kidney injury and mortality. This is likely reflective of increased thrombus burden and higher rates of hemolysis. Acute kidney injury, greater than 150 cycles/s, and COVID-19 infection were the variables with the strongest association to perioperative mortality.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"42-49"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013366","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":"CO₂ is the contrast media to choose in patients with initial Chronic Kidney Disease undergoing endovascular aneurysm repair to prevent further renal function deterioration.","authors":"Flavio Villani, Davide Esposito, Aaron T Fargion, Walter Dorigo, Roberto Falso, Serena De Blasis, Marco Campolmi, Nabile Belouafa, Raffaele Pulli","doi":"10.1177/17085381241238044","DOIUrl":"10.1177/17085381241238044","url":null,"abstract":"<p><strong>Objective: </strong>Even low quantities of iodine contrast media (ICM) could be responsible for exacerbation of a chronic kidney disease (CKD). Aim of this study was to determine whether it is more reasonable to perform endovascular aneurysm repair (EVAR) procedures in patients with initial CKD using CO₂ rather than ICM to prevent further kidney deterioration.</p><p><strong>Methods: </strong>A retrospective analysis was performed at our institution to identify patients with preoperative CKD at initial stage (class G3a-G3b according to KDOQI-KDIGO classification) who underwent either CO₂-EVAR or ICM-EVAR. Primary endpoint was renal function evaluation; secondary endpoints were technical success, perioperative complications, hospital stay, and reinterventions and overall mortality at follow-up.</p><p><strong>Results: </strong>Both CO₂-EVAR and ICM-EVAR groups were composed of 21 patients. There were no differences in demographics, anatomy, and comorbidities, apart from worse ASA score in CO₂-EVAR group (100% vs 57.1%, <i>p</i> = .001). Preoperative serum creatinine and glomerular filtration rates (GFR) were comparable (1.73 vs 1.6 mg/dl, <i>p</i> = .082 and 39.71 vs 43.04 mL/min/1.73 m², <i>p</i> = .935). At follow-up (16.7 ± 18.1 months), CO₂-EVAR was not associated with significant changes in creatinine and GFR, whereas ICM-EVAR determined a significant increase in creatinine (1.6 mg/dl vs 1.91 mg/dl, <i>p</i> = .04) and decrease in GFR values (43 vs 37.9 mL/min/1.73 m², <i>p</i> = .04), determining the need for dialysis in one patient.</p><p><strong>Conclusions: </strong>ICM seems to be a determining factor in worsening renal function; therefore, an effort should be made to standardize the use of CO₂ as the contrast medium of choice in patients with initial renal insufficiency undergoing EVAR.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"116-126"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029053","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":"Generative artificial intelligence chatbots may provide appropriate informational responses to common vascular surgery questions by patients.","authors":"Ethan Chervonski, Keerthi B Harish, Caron B Rockman, Mikel Sadek, Katherine A Teter, Glenn R Jacobowitz, Todd L Berland, Joann Lohr, Colleen Moore, Thomas S Maldonado","doi":"10.1177/17085381241240550","DOIUrl":"10.1177/17085381241240550","url":null,"abstract":"<p><strong>Objectives: </strong>Generative artificial intelligence (AI) has emerged as a promising tool to engage with patients. The objective of this study was to assess the quality of AI responses to common patient questions regarding vascular surgery disease processes.</p><p><strong>Methods: </strong>OpenAI's ChatGPT-3.5 and Google Bard were queried with 24 mock patient questions spanning seven vascular surgery disease domains. Six experienced vascular surgery faculty at a tertiary academic center independently graded AI responses on their accuracy (rated 1-4 from completely inaccurate to completely accurate), completeness (rated 1-4 from totally incomplete to totally complete), and appropriateness (binary). Responses were also evaluated with three readability scales.</p><p><strong>Results: </strong>ChatGPT responses were rated, on average, more accurate than Bard responses (3.08 ± 0.33 vs 2.82 ± 0.40, <i>p</i> < .01). ChatGPT responses were scored, on average, more complete than Bard responses (2.98 ± 0.34 vs 2.62 ± 0.36, <i>p</i> < .01). Most ChatGPT responses (75.0%, <i>n</i> = 18) and almost half of Bard responses (45.8%, <i>n</i> = 11) were unanimously deemed appropriate. Almost one-third of Bard responses (29.2%, <i>n</i> = 7) were deemed inappropriate by at least two reviewers (29.2%), and two Bard responses (8.4%) were considered inappropriate by the majority. The mean Flesch Reading Ease, Flesch-Kincaid Grade Level, and Gunning Fog Index of ChatGPT responses were 29.4 ± 10.8, 14.5 ± 2.2, and 17.7 ± 3.1, respectively, indicating that responses were readable with a post-secondary education. Bard's mean readability scores were 58.9 ± 10.5, 8.2 ± 1.7, and 11.0 ± 2.0, respectively, indicating that responses were readable with a high-school education (<i>p</i> < .0001 for three metrics). ChatGPT's mean response length (332 ± 79 words) was higher than Bard's mean response length (183 ± 53 words, <i>p</i> < .001). There was no difference in the accuracy, completeness, readability, or response length of ChatGPT or Bard between disease domains (<i>p</i> > .05 for all analyses).</p><p><strong>Conclusions: </strong>AI offers a novel means of educating patients that avoids the inundation of information from \"Dr Google\" and the time barriers of physician-patient encounters. ChatGPT provides largely valid, though imperfect, responses to myriad patient questions at the expense of readability. While Bard responses are more readable and concise, their quality is poorer. Further research is warranted to better understand failure points for large language models in vascular surgery patient education.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"229-237"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159166","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":"Assessment of atherosclerotic plaque morphology using contrast-enhanced ultrasound and its impact on primary cardiovascular events following simultaneous carotid endarterectomy and coronary artery bypass grafting.","authors":"Agnė Gimžauskaitė, Einius Trumpa, Saulius Lukoševičius, Jurgita Plisienė, Aleksandras Antuševas, Linas Velička, Rimantas Benetis, Algidas Basevičius, Donatas Inčiūra","doi":"10.1177/17085381241239499","DOIUrl":"10.1177/17085381241239499","url":null,"abstract":"<p><strong>Objective: </strong>The incidence of stroke after on-pump cardiac surgery during the perioperative period can affect up to 2% of patients, and is frequently linked to carotid artery disease. Notably, in patients with significant unilateral carotid artery stenosis of 80%-99%, the risk of stroke reaches 4%. Among individuals undergoing coronary artery bypass grafting (CABG), 3% to 10% exhibit significant carotid artery stenosis. To mitigate the risk of stroke and mortality, patients can undergo either simultaneous or staged carotid endarterectomy and CABG. The aim of this study was to assess whether early postoperative complications, including stroke, following simultaneous CABG/CAE procedures, correlate with morphological attributes of carotid plaque, assessed via contrast-enhanced ultrasound.</p><p><strong>Methods: </strong>A single centre retrospective analysis was performed including 62 patients who underwent simultaneous CABG/CEA between 2019 and 2022. Our study excluded patients who underwent staged carotid endarterectomy and CABG procedures, off-pump CABG, or those necessitating urgent CABG. Our analysis focused on patients meeting elective CABG criteria, diagnosed with symptomatic triple-vessel or left main trunk coronary artery disease (CAD), alongside asymptomatic carotid stenosis (a. carotis internae) exceeding 70% or symptomatic ipsilateral carotid stenosis surpassing 50%. The extent of contralateral carotid artery stenosis was not taken into account. Prior to the CEA/CABG procedure, each patient underwent contrast-enhanced ultrasound to assess atherosclerotic lesions, which were classified using Nakamura et al.'s classification. Among the patients, 37.1% exhibited no neovascularisation within the atherosclerotic plaque, 56.5% showed insignificant neovascularisation, and 6.5% displayed notable neovascularization within the plaque. Our study aimed to establish a connection between the degree of plaque vascularisation identified through contrast-enhanced ultrasound and subsequent postoperative complications.</p><p><strong>Results: </strong>Upon evaluating postoperative complications occurring within 30 days after the surgery and the plaque morphology identified through contrast-enhanced ultrasound, a statistically significant correlation was observed between a higher grade of plaque vascularisation and the occurrence of ischaemic stroke (r = 0.329, <i>p</i> = .008). Monte Carlo calculations of the Chi-square test indicated a significant association between a higher grade of plaque vascularisation and the presence of peripheral artery disease (χ2 = 15.175, lls = 2, <i>p</i> = .003).</p><p><strong>Conclusion: </strong>Within 30 days of surgery, a significant correlation exists between the occurrence of ischaemic stroke following carotid endarterectomy subsequent to CABG and the presence of a higher grade plaque vascularisation as identified by contrast-enhanced ultrasound.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"205-211"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120798","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":"Short-term outcomes of endovascular management of acute limb ischemia using aspiration mechanical thrombectomy.","authors":"Matthew E Auda, Molly Ratner, Michael Pezold, Caron Rockman, Mikel Sadek, Glenn Jacobowitz, Todd Berland, Jeffrey J Siracuse, Katherine Teter, William Johnson, Karan Garg","doi":"10.1177/17085381241236923","DOIUrl":"10.1177/17085381241236923","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Management of acute limb ischemia (ALI) has seen greater utilization of catheter-based interventions over the last two decades. Data on their efficacy is largely based on comparisons of catheter-directed thrombolysis (CDT) and open thrombectomy. During this time, many adjuncts to CDT have emerged with different mechanisms of action, including pharmacomechanical thrombolysis (PMT) and aspiration mechanical thrombectomy (AMT). However, the safety and efficacy of newer adjuncts like AMT have not been well established. This study is a retrospective analysis of the contemporary management of ALI comparing patients treated with aspiration mechanical thrombectomy to patients treated with the more established CDT adjunct, pharmacomechanical thrombolysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients undergoing peripheral endovascular intervention for ALI using an adjunctive device were identified through query of the Vascular Quality Initiative (VQI) Peripheral Vascular Intervention (PVI) module from 2014 to 2019. Patients with a nonviable extremity (Rutherford ALI Stage 3), prior history of ipsilateral major amputation, popliteal aneurysm, procedures that were deemed elective (&gt;72 h from admission), procedures that did not utilize an endovascular adjunctive device, and patients without short-term follow-up were all excluded from analysis. The primary outcome was a composite outcome of freedom from major amputation and/or death in the perioperative time period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified 528 patients with Rutherford ALI Stage 1 or 2 who were treated with an endovascular adjunct. 433 patients did not undergo aspiration mechanical thrombectomy (no AMT group) and 95 patients did undergo aspiration mechanical thrombectomy (AMT group). The amputation-free survival across all patients was 93.4%. There were significant differences in demographic, comorbidity, and treatment variables between groups (e.g., gender, prior percutaneous coronary intervention (PCI), history of prior peripheral artery disease intervention, and history of prior infra-inguinal PVI), so a propensity score matched analysis was included to account for these group differences. In the propensity score matched analysis, there was no significant difference in major amputation (AMT 7.4% vs no AMT 3.2%, &lt;i&gt;p&lt;/i&gt; = 0.13) or death (AMT 95.8% survival vs no AMT 98.4% survival, &lt;i&gt;p&lt;/i&gt; = 0.23) with the use of aspiration mechanical thrombectomy. However, there was significantly worse amputation-free survival with the use of aspiration mechanical thrombectomy (AMT 88.4% vs no AMT 95.3%, &lt;i&gt;p&lt;/i&gt; = 0.03). On multivariate analysis, prior supra-inguinal bypass (OR 4.85, 1.70-13.84, &lt;i&gt;p&lt;/i&gt; = 0.003), Rutherford ALI Stage 2B (OR 3.13, 1.47-6.67, &lt;i&gt;p&lt;/i&gt; = 0.003), and aspiration mechanical thrombectomy (OR 2.71, 1.03-7.17, &lt;i&gt;p&lt;/i&gt; = 0.05) were associated with the composite outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Short-term amputation-free survival rates o","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"34-41"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983884","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 novel risk assessment tool for postoperative delirium in vascular surgery: The stress model (Siena posTopeRative dElirium in vaScular Surgery).","authors":"Edoardo Pasqui, Gianmarco de Donato, Brenda Brancaccio, Giulia Casilli, Giulia Ferrante, Giancarlo Palasciano","doi":"10.1177/17085381241236926","DOIUrl":"10.1177/17085381241236926","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative delirium (POD) is a common complication with a high health-related impact. The creation of a model (Siena posTopeRative dElirium in vaScular Surgery) to identify high-risk patients with consecutive prompt diagnosis and correct management.</p><p><strong>Methods: </strong>This is an observational retrospective study to evaluate POD incidence in patients who underwent elective vascular surgery procedures between 2018 and 2020. POD was detected using CAM and defined as the onset of an acute confusional state, clinically manifesting as a disturbed state of consciousness, cognitive dysfunction, or alteration in perception and behavior. The total population was divided in the development and validation subsamples. Multivariable logistic regression analysis was performed, identifying variables related to the occurrence of POD. An additive score was created and the STRESS score was internally validated using the Validation subgroup.</p><p><strong>Results: </strong>A total of 1067 patients were enrolled. POD occurred in 111 cases (10.4%). Multivariable logistic regression analysis for POD occurrence revealed as significant predictors: age>75 years, CKD, dyslipidaemia, psychiatric disease, CAD, hospitalization in the previous month, preoperative NLR >3.59, preoperative Hb < 12 g/dl, preoperative Barthel score <75, major amputation, CLTI revascularization, general anesthesia, and postoperative urinary catheter. These variables were used to create the STRESS score. The model was applied to both development and validation subgroups; AUC was respectively 0.7079 (<i>p</i> < .0001) and 0.7270 (<i>p</i> < .0001).</p><p><strong>Conclusion: </strong>The STRESS score has a good predictive potentiality for POD occurrence in elective vascular surgery procedures. However, implementation and external validation are needed to be correctly used in everyday clinical practice.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"212-222"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991333","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":"Clinical value of foot thermometry in patients with acute limb ischemia.","authors":"Dumitru Casian, Alexandru Predenciuc, Vasile Culiuc","doi":"10.1177/17085381241237494","DOIUrl":"10.1177/17085381241237494","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We hypothesized that the severity of foot poikilothermy can be used for better differentiation of grades of acute limb ischemia. Thus, the study aim was evaluation of the value of non-contact foot thermometry, performed using a low-cost infrared medical thermometer, as an adjunct for clinical diagnosis of immediately threatened acute limb ischemia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;It was a single-center observational prospective study performed over 3 years. Patients with acute limb ischemia of lower limbs grade I-IIB Rutherford treated with urgent revascularization were included. Grade of ischemia was determined independently by two experienced vascular surgeons. Thermometry of the ischemic foot was performed using a medical digital infrared non-contact thermometer (CK-T1501, Cooligg, China) with measuring accuracy of ±0.2°C. Temperature was measured in three points: the dorsal surface of the foot, plantar surface of the foot (both in the metatarsal region), and forehead. The maximal temperature gradient between patient's forehead and foot (∆T&lt;sub&gt;max&lt;/sub&gt; F-F) was calculated. Measurements were repeated 6-12 h after revascularization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 147 patients were included. Only 3 (2%) patients presented rest pain without sensory loss and motor deficit, while the majority were diagnosed with mild (63/147, 42.8%) or moderate (27/147, 18.3%) motor deficit. The temperature of the ischemic foot varied from 20 to 36.1°C, while median value of the temperature was 26.7 [24.5-29.9] °C on the dorsal surface and 26.8 [24.5-29.6] °C on the plantar surface of the foot (&lt;i&gt;p&lt;/i&gt; = 0.85). Patients with Grade IIB ischemia had significantly lower dorsal foot temperature, plantar foot temperature, and larger ∆T&lt;sub&gt;max&lt;/sub&gt; F-F than the patients with grades I-IIA: 25.1 [23.9-26.8] °C versus 29.9 [27.6-30.8] °C; 25.2 [23.8-27.5] °C versus 29.6 [28-31.1] °C; and 11.6 [9.7-12.8] °C versus 7.2 [6-9] °C (&lt;i&gt;p&lt;/i&gt; &lt; 0.0001). Areas under ROC curve for diagnosis of Grade IIB ischemia were similar for dorsal foot temperature (0.82), plantar temperature (0.81), and ∆T&lt;sub&gt;max&lt;/sub&gt; F-F (0.82). The best cutoff value by Youden was ≥9.5°C for ∆T&lt;sub&gt;max&lt;/sub&gt; F-F, ≤26.8°C for dorsal, and ≤27.7°C for plantar temperature. Criterion ∆T&lt;sub&gt;max&lt;/sub&gt; F-F offered the highest specificity of 86% (95%CI 74.2-93.7) and positive predictive value of 89.2% (95%CI 79.5-93.2), while plantar temperature offered sensitivity of 82.5% (95%CI 70.1-91.3) and negative predictive value of 69.1% (95%CI 57.6-83.2). In multivariate analysis including age, gender, and etiology of arterial occlusion, the criterion ∆T&lt;sub&gt;max&lt;/sub&gt; F-F of ≥9.5°C was a unique variable significantly associated with risk of amputation (adjusted OR 2.6, 95%CI 1.2-5.9, &lt;i&gt;p&lt;/i&gt; = 0.01).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Current study demonstrated that patients with immediately threatening ALI have significantly lower foot temperature than those with viable and ","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"58-65"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997568","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":"Endovascular treatment with interwoven nitinol stent for common femoral artery lesions: 2-year outcomes of a single center experience.","authors":"Veera Suwanruangsri, Surakiat Bokerd, Virapat Chanchitsopon, Sirakarn Jowcharoen","doi":"10.1177/17085381241236564","DOIUrl":"10.1177/17085381241236564","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed was to report 2-year outcomes of endovascular treatment with interwoven nitinol (Supera™) stent for common femoral artery (CFA) lesions.</p><p><strong>Methods: </strong>We reviewed the clinical data of 20 patients who presented with CFA stenosis or occlusion and underwent balloon angioplasty followed by Supera™ stenting in CFA between February 2016 and January 2022. The outcomes were evaluated in these patients in terms of technical success, post-intervention complications, reintervention, and cumulative patency (1 year, and 2 years).</p><p><strong>Results: </strong>The study included 20 patients (22 lesions) who presented with isolated CFA lesions (3), iliac lesions involving CFA (6), superficial femoral artery (SFA) lesions involving CFA (8), and extensive lesions from the iliac artery to SFA (5). There were 16 men (80%) with a mean age of 69.7 years (range, 34-83). Hypertension, smoking, and diabetes were found in 15 (75%), 7 (35%), and 7 patients (35%), respectively. Clinical presentations were Rutherford stage 5 (9, 45%), Rutherford stage 4 (5, 25%), Rutherford stage 6 (4, 20%), and Rutherford stage 3 (2, 10%). Technical success was achieved in all patients (100%). The procedures for treatment were isolated CFA Supera™ stenting (1, 4.5%), CFA plus DFA Supera™ stenting (jailed SFA) (2, 9.1%), CFA plus SFA Supera™ stenting (jailed DFA) (8, 36.4%), CFA Supera™ stenting plus bare iliac stenting (Astron) (6, 27.3%), CFA plus SFA Supera™ stenting (jailed DFA) plus bare iliac stenting (Astron) (5, 22.7%), and additional DFA angioplasty (7, 31.8%). The rate of in-hospital mortality and morbidity were 0% and 10%, respectively. Distal embolization after pre-dilatation occurred in 1 patient, and cerebral infarction occurred 12 h after the procedure in 1 patient. The mean follow-up time was 23 months (range, 2-64). During the follow-up period, in-stent occlusion occurred in 2 patients at 9 and 46 months. Re-intervention was performed in 1 patient due to recurrent symptom of claudication. The cumulative primary patency at 1 year and 2 years were 93.3% and 93.3%, respectively.</p><p><strong>Conclusion: </strong>Endovascular treatment with interwoven nitinol (Supera™) stent for CFA lesions was associated with acceptable outcomes at 2 years.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"19-25"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973727","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":"Efficacy and safety analysis of AcoStream thrombus aspiration device in the treatment of acute superior mesenteric artery embolism.","authors":"Qiyang Xu, Yi Wang, Bin Xu, Dehai Lang, Zuodong Lin","doi":"10.1177/17085381241240865","DOIUrl":"10.1177/17085381241240865","url":null,"abstract":"<p><strong>Objective: </strong>Acute superior mesenteric artery embolism is a life-threatening disease caused by the abrupt interruption of mesenteric blood circulation, and the prognosis is very poor. Several studies have confirmed the efficacy and safety of percutaneous mechanical thrombectomy in acute superior mesenteric artery embolism, however, there are currently no literature reports on the latest percutaneous mechanical thrombectomy device-AcoStream™. In the present report, we summarize a series of cases and share our surgical experiences.</p><p><strong>Methods: </strong>The clinical data of 10 patients (six men and four women, mean age 77.6 ± 7.4 years) with acute superior mesenteric artery embolism treated by AcoStream™ in our center from December 2022 to December 2023 were retrospectively analyzed. Based on the literature, we summarized the diagnosis, therapy, and surgical experience of acute superior mesenteric artery embolism.</p><p><strong>Results: </strong>Percutaneous mechanical thrombectomy was performed for all the patients. The success rate of surgery reached 100% and no perioperative complications occurred. Abdominal pain was significantly relieved and the abdominal signs gradually disappeared in eight patients, while the other two patients still complained of abdominal pain during hospitalization, and eventually, they underwent resection of necrotic bowel. All the patients' symptoms were significantly relieved and they were smoothly discharged from the hospital.</p><p><strong>Conclusions: </strong>As shown in the present study, percutaneous mechanical thrombectomy using AcoStream™ is minimally invasive, safe, and efficient in the initial stage of acute superior mesenteric artery embolism. We believe that percutaneous mechanical thrombectomy can be a promising alternative in selected cases.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"102-107"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176735","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}