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Fate assessment of the ectatic common iliac artery using flared limb during endovascular aneurysm repair. 在血管内动脉瘤修补术中使用扩张肢评估异位髂总动脉的命运。
IF 0.9 4区 医学
Vascular Pub Date : 2025-08-01 Epub Date: 2024-08-08 DOI: 10.1177/17085381241273140
Choshin Kim, Yang-Jin Park, Joon-Kee Park, Young-Wook Kim, Dong-Ik Kim, Shin-Seok Yang, Taek Kyu Park, Seung-Hyuk Choi
{"title":"Fate assessment of the ectatic common iliac artery using flared limb during endovascular aneurysm repair.","authors":"Choshin Kim, Yang-Jin Park, Joon-Kee Park, Young-Wook Kim, Dong-Ik Kim, Shin-Seok Yang, Taek Kyu Park, Seung-Hyuk Choi","doi":"10.1177/17085381241273140","DOIUrl":"10.1177/17085381241273140","url":null,"abstract":"<p><p>ObjectivesThis study aimed to evaluate the outcomes and anatomical predictors of the complications of flared limb (FL) use for ectatic common iliac arteries accompanied by abdominal aortic aneurysm treated with endovascular aneurysm repair (EVAR).MethodsIn this single-center retrospective study, we reviewed data from 391 patients (638 limbs) treated between 2005 and 2020. The cohort was divided into two groups. The standard limbs (SLs, <i>n</i> = 403) included stent graft (SG) of <20 mm in diameter and the FLs (<i>n</i> = 235) included stent graft of ≥20 mm in diameter. Complications within 30 days were investigated as the short-term outcome. Limb events during follow-up including type Ib endoleak (EL), type IIIa EL, and limb occlusion were compared between SLs and FLs using log-rank test.ResultsEarly results indicated that the FL group had a significantly higher incidence of intraoperative type Ib EL at 5.1% (12), than 1.7% (7) in the SLs (<i>p</i> = .016). For 19 patients in whom intraoperative type Ib EL was discovered, SG extension alone or internal iliac artery embolization was all performed before completing the procedure. Overall, we noted one case of type Ib EL and two cases of limb events in each group at 30 days. Over a median follow-up of 39 months, 31 (4.9%) events (17 type Ib EL, 2 type IIIa EL, and 12 limb events), 13 (5.5%) in FLs and 18 (4.5%) in SLs (<i>p</i> = .984), were observed. The FLs had significantly higher rates of aortic sac enlargement, with 46 (19.6%) cases for FLs and 36 (8.9%) for SLs (<i>p</i> < .001). The Kaplan-Meier analysis revealed significant differences at 5 years in SLs versus FLs for freedom from type Ib EL (96.6% vs 82.4%, respectively; <i>p</i> < .001) and no difference in freedom from limb events (94.7% vs 84.5%, respectively; <i>p</i> = .519). Furthermore, no difference was observed for overall survival and aneurysm-related mortality.ConclusionsAlthough an FL for EVAR is used to treat dilated iliac arteries, there is an increased risk of intraoperative and late type Ib EL and aortic sac enlargement. Long-term close follow-up is mandatory, especially in the patients who undergo EVAR using FLs.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"796-802"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903059","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}
引用次数: 0
A systematic review and meta-analysis of the relative safety and efficacy of treating lower extremity deep vein thrombosis via pharmacomechanical thrombectomy and catheter-directed thrombolysis. 通过药物机械溶栓和导管引导溶栓治疗下肢深静脉血栓的相对安全性和有效性的系统回顾和荟萃分析。
IF 0.9 4区 医学
Vascular Pub Date : 2025-08-01 Epub Date: 2024-08-12 DOI: 10.1177/17085381241274556
Zhong Tian, Hao Han, Zhilong Tian, Pengcheng Sun, Ruihao Qin, Fukang Yuan
{"title":"A systematic review and meta-analysis of the relative safety and efficacy of treating lower extremity deep vein thrombosis via pharmacomechanical thrombectomy and catheter-directed thrombolysis.","authors":"Zhong Tian, Hao Han, Zhilong Tian, Pengcheng Sun, Ruihao Qin, Fukang Yuan","doi":"10.1177/17085381241274556","DOIUrl":"10.1177/17085381241274556","url":null,"abstract":"<p><p>ObjectiveTo evaluate the safety and efficacy of pharmacomechanical thrombectomy and catheter-directed thrombolysis (CDT) as approaches to treating deep venous thrombosis of lower extremities (LEDVT).MethodsThe PubMed, Web of Science, Wanfang, Embase, Chinese Science and Technology Journal, Cochrane, and China National Knowledge Infrastructure (CNKI) databases were systematically searched for relevant articles published through October 2023, after which appropriate inclusion and exclusion criteria were used to screen out relevant articles. Review Manager 5.4.1 was used to extract key data from these studies, and pooled analyses were conducted based on mead difference (MD) or odds ratio (OR) values and corresponding 95% confidence interval (CI). Study quality was assessed with the Newcastle-Ottawa scale.Trial registrationThis study has been registered at INPLASY.COM (No. INPLASY2023100075).ResultsIn total, 31 relevant studies enrolling 2413 patients were included in this meta-analysis, with 1184 and 1229 patients in the AngioJet and CDT groups, respectively. These analyses revealed that the AngioJet group exhibited significantly higher rates of early postoperative deep vein patency (MD = 7.73, 95% CI (3.29, 12.17), <i>p</i> = .0006) and affected limb symptom improvement (MD = 6.31, 95% CI (1.82,10.80), <i>p</i> = .006) relative to the CDT group, whereas no differences in grade II or III thrombus clearance rates (OR = 1.30, 95% CI (0.95, 1.77), <i>p</i> = .10) or changes in thigh circumference before and after treatment (MD = 0.01, 95% CI (-0.80, 0.83), <i>p</i> = .97) were observed. The AngioJet group also exhibited lower urokinase doses (MD = -145.33, 95% CI (-164.28,126.38), <i>p</i> < .00001), shorter thrombolysis time (MD = -2.35, 95% CI(-2.80, -1.90), <i>p</i> < .00001), a less prolonged hospital stay (MD = -3.13, 95% CI(-3.81, -2.45), <i>p</i> < .00001), lower rates of PTS incidence (OR = 0.56, 95% CI(0.36, 0.88), <i>p</i> = .01), and reduced complication rates (OR = 0.51, 95% CI(0.31, 0.83), <i>p</i> = .0007).ConclusionStudies published to date suggest that relative to CDT treatment, pharmacomechanical thrombectomy is associated with improved thrombus clearance, fewer complications, and lower complication rates in LEDVT patients, underscoring the safety and efficacy of this therapeutic strategy.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"910-923"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917575","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}
引用次数: 0
Predictors of overall mortality after endovascular abdominal aortic repair - A single centre study. 血管内腹主动脉修补术后总死亡率的预测因素 - 一项单中心研究。
IF 0.9 4区 医学
Vascular Pub Date : 2025-08-01 Epub Date: 2024-06-13 DOI: 10.1177/17085381241262350
Mária Rašiová, Martin Koščo, Veronika Pavlíková, Marek Hudák, Matej Moščovič, Ladislav Kočan
{"title":"Predictors of overall mortality after endovascular abdominal aortic repair - A single centre study.","authors":"Mária Rašiová, Martin Koščo, Veronika Pavlíková, Marek Hudák, Matej Moščovič, Ladislav Kočan","doi":"10.1177/17085381241262350","DOIUrl":"10.1177/17085381241262350","url":null,"abstract":"<p><p>ObjectivesA current and ongoing challenge is to reduce patient mortality after endovascular abdominal aortic repair (EVAR). This study aimed to assess the predictors of all-cause mortality after EVAR.MethodsData regarding the demographic characteristics, comorbidities, laboratory values, selected anatomical factors, post-EVAR treatment, surveillance and complications of patients who underwent elective EVAR for non-ruptured abdominal aortic aneurysm (AAA) between January 2010 and January 2021 were evaluated. Mortality was assessed until 10 October 2023. Multivariate analyses were performed after adjusting for age, hypertension, diabetes mellitus, dyslipidaemia, sex, smoking, number of lumbar arteries, patency of inferior mesenteric artery (IMA), IMA diameter and reinterventions.ResultsThis study included 196 patients (183 men and 13 women) with a mean age of 72.4 ± 7.67 years. The overall mortality rate during a mean follow-up period of 5.75 ± 3.1 years was 50.0% (<i>N</i> = 98). The 2-, 5- and 10-year mortality rates were 9.7%, 32.0% and 66.6%, respectively. The mortality rates decreased by 59% in patients with reinterventions (hazard ratio [HR]: 0.41; 95% confidence interval [CI]: 0.23-0.73; <i>p</i> = .002) and by 59% in patients treated with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) (HR: 0.41; 95% CI: 0.26-0.66; <i>p</i> < .001). Chronic anticoagulation was associated with 2.09-fold higher mortality (HR: 2.09; 95% CI: 1.19-3.67; <i>p</i> = .010), and coronary artery disease (CAD) was associated with 1.74-fold higher mortality (HR: 1.74; 95% CI: 1.09-2.78; <i>p</i> = .021). Pre-EVAR AAA diameter and 1-year post-EVAR sac diameter were positively associated with mortality (HR: 1.05; 95% CI: 1.03-1.08; <i>p</i> < .001, and HR: 1.05; 95% CI: 1.03-1.07; <i>p</i> < .001, respectively), that is, an increase of pre-EVAR and/or 1-year post-EVAR AAA diameter by 1 mm was associated with a 5% higher risk of all-cause mortality.ConclusionsReinterventions and treatment with ACE inhibitors or ARBs may be associated with decreased post-EVAR mortality. A greater pre-EVAR, a post-EVAR AAA diameter, CAD and chronic anticoagulation were associated with higher all-cause mortality post-EVAR.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"746-755"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318368","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}
引用次数: 0
Optimal medical therapy is lacking in patients undergoing intervention for symptomatic carotid artery stenosis and protects against larger areas of cerebral infarction. 因无症状颈动脉狭窄而接受介入治疗的患者缺乏最佳的药物治疗,而最佳的药物治疗可防止大面积脑梗死的发生。
IF 0.9 4区 医学
Vascular Pub Date : 2025-08-01 Epub Date: 2024-06-14 DOI: 10.1177/17085381241262927
Katherine Teter, Loes Willems, Keerthi Harish, Bruck Negash, Michiel Warle, Caron Rockman, Jose Torres, Koto Ishida, Glenn Jacobowitz, Karan Garg, Thomas Maldonado
{"title":"Optimal medical therapy is lacking in patients undergoing intervention for symptomatic carotid artery stenosis and protects against larger areas of cerebral infarction.","authors":"Katherine Teter, Loes Willems, Keerthi Harish, Bruck Negash, Michiel Warle, Caron Rockman, Jose Torres, Koto Ishida, Glenn Jacobowitz, Karan Garg, Thomas Maldonado","doi":"10.1177/17085381241262927","DOIUrl":"10.1177/17085381241262927","url":null,"abstract":"<p><p>ObjectivesCarotid interventions are indicated for both patients with symptomatic and a subset of patients with severe asymptomatic carotid artery stenosis (CAS). Symptomatic CAS accounts for up to 12%-25% of overall carotid interventions, but predictors of symptomatic presentation remain poorly defined. The aim of this study was to identify factors associated with symptomatic CAS in our patient population.MethodsBetween January 2015 and February 2022, an institutional retrospective cohort study of prospectively collected data on patients undergoing interventions for CAS was performed. Procedures included carotid endarterectomy (CEA), transcarotid artery revascularization (TCAR), and transfemoral carotid artery stenting (TF-CAS). Demographic data, comorbidities, procedural details, and anatomic features from various imaging modalities were collected. Comparisons were made between symptomatic (symptoms within the prior 6 months) and asymptomatic patients.ResultsDuring the study period, 279 patients who underwent intervention for symptomatic CAS were paired with a randomly selected cohort of 300 patients who underwent intervention for asymptomatic CAS from a total patient cohort of 1143 patients undergoing interventions for asymptomatic CAS. Demographic data did not differ between groups. Patients with symptomatic CAS more frequently had prior TIA/stroke (>6 months remote to the current event), but less frequently had coronary artery disease or chronic kidney disease and were less likely to receive adequate medical management including antihypertensive agents, lipid-lowering agents, and anti-platelet therapy. On multivariate analysis, remote prior TIA/stroke and lack of anti-platelet therapy remained significant. Among symptomatic patients presenting with stroke, lack of anti-platelet therapy was associated with an overall larger area of parenchymal involvement. No difference was observed with single versus dual anti-platelet therapy. Furthermore, symptomatic patients were more likely to have ulcerated plaques (30.9% vs 18%, <i>p</i> < .001), and symptomatic patients with ulcerated plaques more frequently had less than 50% compared to moderate/severe CAS. Nine patients who presented with symptoms had mild CAS and underwent intervention.ConclusionsSymptomatic CAS was associated with a history of remote prior symptoms and lack of anti-platelet therapy at time of presentation. Furthermore, symptomatic patients not on anti-platelet agents were more likely to have a greater area of parenchymal involvement when presenting with stroke and symptomatic patients with ulcerated plaques were more likely to have mild CAS, suggesting the role of plaque instability in symptomatic presentation. These findings underscore the importance of appropriate medical management and adherence in all patients with CAS and perhaps a role for more frequent surveillance in those with potentially unstable plaque morphology.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"870-878"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141321727","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}
引用次数: 0
Thoracic aortic pseudoaneurysm: Inside its pathophysiology. 胸主动脉假性动脉瘤:病理生理学内幕
IF 0.9 4区 医学
Vascular Pub Date : 2025-08-01 Epub Date: 2024-08-08 DOI: 10.1177/17085381241273314
Antonio Manenti, Luca Roncati, Lorena Sorrentino, Alberto Farinetti, Massimo Borri, Giuseppe Manco, Giovanni Coppi, Anna Vittoria Mattioli, Roberta Gelmini, Francesca Coppi
{"title":"Thoracic aortic pseudoaneurysm: Inside its pathophysiology.","authors":"Antonio Manenti, Luca Roncati, Lorena Sorrentino, Alberto Farinetti, Massimo Borri, Giuseppe Manco, Giovanni Coppi, Anna Vittoria Mattioli, Roberta Gelmini, Francesca Coppi","doi":"10.1177/17085381241273314","DOIUrl":"10.1177/17085381241273314","url":null,"abstract":"<p><p>ObjectivesOur aim was to investigate pathophysiology of pseudoaneurysm of the thoracic aorta, an acute or chronic pathology, respectively, secondary to blunt thoracic trauma and aortitis, or complicating a deep penetrating aortic ulcer, intraparietal hematoma, aortic aneurysm, and even aortic graft, often with atherosclerosis as a common background.MethodsGiven the relative rarity of this disease, an \"inductive\" retrospective method made it possible to retrieve clinical, radiological, and histopathological elements, which were mutually compared and validated through a \"deductive\" process of reinterpretation.ResultsWe have identified three main structural constituents of this disease: a cavity, a single blood entry port, communicating with the aortic lumen, and a pseudocapsule. It is often caused by a chronic degenerative pathology of the intima and medial layers of the aorta, typically involving elastic fibers and smooth muscle cells, with possible intermediate stages of deep aortic ulcer or intraparietal hematoma. Otherwise, the acute onset may be secondary to acute aortitis or aortic injury.ConclusionsToday, thanks to the current angiographic tools represented by 3-D high resolution multidetector CT and MRI angiography, the diagnosis of thoracic aortic pseudoaneurysm is easier, as well as its surgical indications.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"821-828"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907728","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}
引用次数: 0
International cross-sectional survey on attitudes and practices regarding use of contrast-enhanced ULTRAsound in VASCular surgery: The I-ULTRA-VASC study. 关于在 VASCular 手术中使用造影剂增强超音波的态度和做法的国际横断面调查:I-ULTRA-VASC 研究。
IF 0.9 4区 医学
Vascular Pub Date : 2025-08-01 Epub Date: 2024-08-12 DOI: 10.1177/17085381241273221
Giulia Bertagna, Nicola Troisi, Petar Zlatanovic, Joao Rocha-Neves, Emiliano Chisci, Raffaella Berchiolli, Sandro Lepidi, Mario D'Oria
{"title":"International cross-sectional survey on attitudes and practices regarding use of contrast-enhanced ULTRAsound in VASCular surgery: The I-ULTRA-VASC study.","authors":"Giulia Bertagna, Nicola Troisi, Petar Zlatanovic, Joao Rocha-Neves, Emiliano Chisci, Raffaella Berchiolli, Sandro Lepidi, Mario D'Oria","doi":"10.1177/17085381241273221","DOIUrl":"10.1177/17085381241273221","url":null,"abstract":"<p><p>ObjectivesThe aim of this cross-sectional survey was to gather attitudes and practices of physicians from different countries regarding the implementation of contrast-enhanced ULTRAsound (CEUS) for vascular diseases in clinical practice as well as in academic research.MethodsA web-based survey was developed in English, including 35 questions. Two-hundred sixty physicians were invited by email to fill in the survey anonymously on Google Forms using a dedicated link. The survey started on 25<sup>th</sup> February 2024 and was closed on 13<sup>th</sup> March 2024 (17 days). A reminder was sent after the first 10 days. In addition to descriptive statistics, sub-analyses of answers according to country of origin (Italy vs other States), years of experience (≤20 years vs > 20 years), and type of institution (Academic/University vs Non-Academic/Private) were also established a priori.ResultsA total of 121 practitioners from 20 countries completed our survey (response rate 121/260, 46%). Most responders were males (95/121, 78.5%). Most participants were vascular surgeons (118/121, 97.5%). CEUS was available in 87/121, 70.2% of the centers involved, even though a standardized protocol was present in 54/121, and 44% of surveyed institutions. Italian institutions presented greater CEUS availability (62/72, 86.1% vs 25/49, 51.0%; <i>p</i> = .001) and higher presence of standardized protocols (38/72, 52.8% vs 16/49, 32.6%; <i>p</i> = .022) than foreign institutions. The diagnostic tool was thought to be more useful for carotid artery stenosis in the postoperative phase, while for abdominal aortic aneurysms (AAAs) in the preoperative phase. For diagnosis and/or preoperative management of carotid stenosis 53/121, 44% of physicians believed that CEUS should be performed only in selected cases, while for AAA 42/121, 35% of them believed that it could be useful only for scientific purposes. Similarly, 99/121, 82% of participants answered that CEUS was usually prescribed in 0%-20% of the cases during the preoperative diagnostic pathway of patients with peripheral arterial disease. No differences between country of origin, years of experience, and type of institution were found for the reported items. There was also 106/121, 88% of respondents agreed upon the need for better integration of CEUS in current guidelines and 114/121, 94% of them upon the need for further studies.ConclusionsThis ULTRA-VASC survey has demonstrated that CEUS is still rarely used in current practice for many vascular diseases despite the availability of this tool in most centers Future studies are needed, as well as enhanced guidance on the proper implementation of CEUS from guidelines.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"924-932"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971947","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}
引用次数: 0
Intraoperative evaluation for endoleaks using the SCORPION procedure during endovascular aortic repair. 在血管内主动脉修复术中使用 SCORPION 程序对内漏进行术中评估。
IF 0.9 4区 医学
Vascular Pub Date : 2025-08-01 Epub Date: 2024-06-24 DOI: 10.1177/17085381241264719
Itaru Hosaka, Takeshi Uzuka, Kyousuke Miki, Tsuyoshi Shibata, Akihiko Sasaki, Nobuyoshi Kawaharada
{"title":"Intraoperative evaluation for endoleaks using the SCORPION procedure during endovascular aortic repair.","authors":"Itaru Hosaka, Takeshi Uzuka, Kyousuke Miki, Tsuyoshi Shibata, Akihiko Sasaki, Nobuyoshi Kawaharada","doi":"10.1177/17085381241264719","DOIUrl":"10.1177/17085381241264719","url":null,"abstract":"<p><p>ObjectivesEndoleaks are important complications of endovascular aortic repair. Usually, endoleaks are judged indirectly by aortography or postoperative computed tomography. However, findings from these modalities are difficult to distinguish because of the divergency of endoleaks. Few studies have reported direct visualization of endoleaks. Herein, we introduce a direct procedure for intraoperatively evaluating endoleaks using angioscopy.MethodsFrom April 2023, consecutive patients with an abdominal aortic aneurysm, except emergency cases and those of narrow access, seen at Sunagawa City Medical Center were enrolled in our study. Endoleaks were detected by intraoperative angioscopy using a novel endovascular procedure.ResultsSeven patients underwent endovascular aortic repair of an abdominal aortic aneurysm with intraoperative angioscopy. None of the enrolled patients experienced complications. The procedure revealed types 2, 3a, and 4 endoleaks.ConclusionsThis is the first study to demonstrate intraoperative visualization of endoleaks using angioscopy. Direct findings observed by this novel procedure might provide information on the velocity and volume of the endoleak, providing comprehensive insights into the intra-sac hemodynamics after the endovascular aortic repair.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"764-769"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443397","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}
引用次数: 0
Impact of operative approach and patient frailty on outcomes for aorto-iliac occlusive disease with critical limb threatening ischemia. 髂主动脉闭塞症伴有危重肢体缺血时,手术方法和患者虚弱程度对治疗效果的影响。
IF 0.9 4区 医学
Vascular Pub Date : 2025-08-01 Epub Date: 2024-07-30 DOI: 10.1177/17085381241269742
Benjamin Ross Zambetti, Joshua Plant, Willie Liang, Shahab Toursavadkohi
{"title":"Impact of operative approach and patient frailty on outcomes for aorto-iliac occlusive disease with critical limb threatening ischemia.","authors":"Benjamin Ross Zambetti, Joshua Plant, Willie Liang, Shahab Toursavadkohi","doi":"10.1177/17085381241269742","DOIUrl":"10.1177/17085381241269742","url":null,"abstract":"<p><p>ObjectivesMultiple treatment modalities exist for the management of aorto-iliac occlusive disease (AIOD) including endovascular (endo), extra-anatomic bypass (EAB), and anatomic bypass (AB). The goal of this study was to examine the impact of revascularization strategy and patient frailty on outcomes for AIOD in patients with critical limb threatening ischemia (CLTI).MethodsPatients undergoing revascularization for CLTI and AIOD were identified from the NSQIP database over 5 years. Demographics, procedural characteristics, and outcomes were recorded. Modified frailty index (mFI-5) was calculated for each patient. Patients were compared based on the type of procedure and frailty (mFi<u>></u>0.6).ResultsFrom 2017 to 2021, 1777 patients underwent revascularization for CLTI from AIOD. Patients were majority male (56%) with a mean age of 68. A total of 1346 patients (76%) underwent an open operation of which 669 were EAB. When endo (431 patients) was compared with open repair, endo was associated with a higher incidence of tissue loss at presentation (42% vs 33%, <i>p</i> < 0.001), lower rates of bleeding (6.5% vs 15.5%, <i>p</i> < 0.001), fewer MI/stroke (1.6% vs 4.6%, <i>p</i> = 0.004), and fewer wound complications (2.6% vs 11.2%, <i>p</i> < 0.001). There was no difference in re-intervention, amputation, or death based on frailty. For frail patients (184 patients), type of repair did not impact re-intervention, major amputation, or mortality, though there was increased MI/stroke with EAB and increased wound complications with AB/EAB.ConclusionsAIOD revascularization strategies for patients with CLTI have similar 30-day re-intervention, major amputation, and mortality rates. Endovascular repair has less surgical wound complications and is better suited for frail patients.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"853-860"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856583","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}
引用次数: 0
Comparative analysis of perioperative outcomes in endovascular abdominal aortic aneurysm repair: Fascia iliaca block versus general anesthesia, a retrospective study. 腹主动脉瘤血管内修复术围手术期结果的比较分析:髂筋膜阻滞与全身麻醉的回顾性研究。
IF 0.9 4区 医学
Vascular Pub Date : 2025-08-01 Epub Date: 2024-08-09 DOI: 10.1177/17085381241273306
Surakiat Bokerd, Veera Suwanruangsri, Wanchai Chinchalongporn, Virapat Chanchitsopon
{"title":"Comparative analysis of perioperative outcomes in endovascular abdominal aortic aneurysm repair: Fascia iliaca block versus general anesthesia, a retrospective study.","authors":"Surakiat Bokerd, Veera Suwanruangsri, Wanchai Chinchalongporn, Virapat Chanchitsopon","doi":"10.1177/17085381241273306","DOIUrl":"10.1177/17085381241273306","url":null,"abstract":"<p><p>ObjectiveThis retrospective study aimed to compare rates of perioperative mortality and morbidity, especially pulmonary complication, between endovascular aneurysm repair (EVAR) performed under general anesthesia (GA) and under fascia iliaca block (FIB).MethodsPatients diagnosed with infrarenal abdominal aortic aneurysm (AAA) who were treated with EVAR were included. Retrospective review of electronic medical records was performed. Patient characteristics, operative details, and postoperative results including mortality and morbidity within 30 days were collected. Statistical analysis to compare postoperative outcomes between EVAR under FIB and EVAR under GA was performed. A univariate analysis was conducted to identify factors associated with increased 30-day mortality.ResultsThis study included 119 patients, 75 in the FIB group and 44 in the GA group. Most patients were male, with 62 (82.5%) in the FIB group and 31 (70.2%) in the GA group, and most patients were hypertensive, with 57 (76%) in the FIB group and 36 (81.8%) in the GA group. Smoking and coronary artery disease (CAD) was more prevalent in the FIB group, <i>p</i> < .05. Thirty-day mortality was not significantly different between the FIB group and the GA group (1 (1.3%) vs 2 (4.5%), <i>p</i> = .554). Pulmonary complication was lower in the FIB group than in the GA group (1.3% vs 11.4%, <i>p</i> = .026). ICU stay was shorter in the FIB group than in the GA group (0.2 vs 4.5 days, <i>p</i> = .012). Univariate analysis showed that chronic obstructive pulmonary disease (COPD) was associated with higher 30-day mortality.ConclusionsEndovascular aneurysm repair under FIB was feasible. Compared to GA, this approach resulted in lower postoperative pulmonary complications and shorter ICU stay.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"814-820"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914163","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}
引用次数: 0
Can BlueDop be used as an alternative for diagnosing peripheral arterial disease? A prospective comparison of traditional ABPI and TBPI with BlueDop. BlueDop可以作为外周动脉疾病的替代诊断方法吗?传统ABPI和TBPI与BlueDop的前瞻性比较。
IF 0.9 4区 医学
Vascular Pub Date : 2025-07-30 DOI: 10.1177/17085381251359309
Lucy Fligelstone, Brenig Llwyd Gwilym, Melissa Blow, Julie Lee, Annie Clothier, Kristian Glover, Tracey Hutchings, David C Bosanquet
{"title":"Can BlueDop be used as an alternative for diagnosing peripheral arterial disease? A prospective comparison of traditional ABPI and TBPI with BlueDop.","authors":"Lucy Fligelstone, Brenig Llwyd Gwilym, Melissa Blow, Julie Lee, Annie Clothier, Kristian Glover, Tracey Hutchings, David C Bosanquet","doi":"10.1177/17085381251359309","DOIUrl":"https://doi.org/10.1177/17085381251359309","url":null,"abstract":"<p><p>ObjectivesAnkle and toe brachial pressure index are recommended globally as first line non-invasive screening tests for peripheral arterial disease. However, they can be inaccurate and have limited utility in patients with incompressible arteries, lower limb wounds and/or lack of digits. This study aims to evaluate BlueDop, a novel device that purports to assess peripheral perfusion without the need for a lower limb tourniquet or patients lying flat.MethodsPatients attending vascular and podiatry clinic at Aneurin Bevan University Health Board were recruited between May 2022 and May 2023. A BlueDop reading was recorded in addition to ankle and/or toe brachial pressure index. Satisfaction and preference of each method was recorded using an electronic proforma.Results176 patients were included. BlueDop ABPI was shown to be moderately correlated with cuff-ABPI (r<sub>s</sub> = 0.42, <i>p</i> = .001) and weakly correlated with TBPI (r<sub>s</sub> = 0.22, <i>p</i> = .04). BlueDop had moderate accuracy in diagnosing PAD (C statistic = 0.653) and was more accurate in diagnosing severe PAD (C statistic = 0.706). Diagnostic accuracy appeared to be improved when PAD was defined according to cuff-ABPI only. Patients were more satisfied with BlueDop (mean satisfaction score (MSS) = 4.33) compared to cuff-ABPI (MSS = 2.89, mean difference = 0.544, <i>p</i> < .001) and TBPI (MSS = 3.82, mean difference = 0.579, <i>p</i> < .001) while operator satisfaction was equal.ConclusionsThere is moderate correlation between BlueDop and cuff-ABPI. Patients prefer BlueDop to cuff-ABPI or TBPI. BlueDop appears to be an acceptable method of non-invasive assessment of PAD, although users must appreciate there is a discrepancy between it and cuff-ABPI/TBPI.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"17085381251359309"},"PeriodicalIF":0.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754427","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}
引用次数: 0
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