Vascular最新文献

{"title":"Long-term outcomes of carotid endarterectomy with eversion technique in patients with an open circle of Willis: A multicenter registry study.","authors":"Anton N Kazantsev, Alexander V Korotkikh, Sergey V Artyukhov, Dmitry V Shmatov, Maxim P Chernyavin, Roman Yu Leader, Elizaveta G Kazantseva, Vyacheslav V Matusevich, Aslan B Zakeryaev, Yury V Belov","doi":"10.1177/17085381241307750","DOIUrl":"https://doi.org/10.1177/17085381241307750","url":null,"abstract":"<p><strong>Introduction: </strong>Carotid endarterectomy (CEA) is a surgery aimed at removing atherosclerotic plaque from the carotid artery. There are classical and eversion CEA techniques. The eversion technique is the most popular because it does not require the use of implants. Eversion CEA is also associated with a lower risk of restenosis in the late postoperative period. During the surgery, the carotid artery is clamped and blood flow to the brain comes from the contralateral carotid artery and vertebral arteries. However, if the circle of Willis (COW) is not closed, compensatory mechanisms for protecting the brain are reduced, which can lead to the development of an intraoperative stroke.</p><p><strong>Purpose: </strong>To analysis of in-hospital and long-term CEA outcomes in patients with different types of closed and non-closed COW.</p><p><strong>Methods: </strong>This is a multicenter Russian study. In the period from 2010 to 2020. 641 eversion CEA were performed. Depending on the type of structure of the COW, six groups of patients were formed: Type 1 - Closed posterior part (CRS) - in the presence of the posterior communicating (PCOMA) and P1 segment of the posterior cerebral (PCA) arteries; Type 2 - Intermediate type of structure of the posterior part (ISRP) - with hypoplasia of PCOMA or PCA; Type 3 - Open back part (OBP) - in the absence of PCOMA or PCA; Type 4 - Closed anterior part (CFS) - in the presence of the anterior communicating artery (ACOMA) and the A1 segment of the anterior cerebral artery (ACA); Type 5 - Intermediate type of anterior part structure (IFPS) - with ACOMA or ACA hypoplasia; Type 6 - Open Front Section (OFS) - in the absence of ACOMA or ACA. The long-term follow-up period was 107.3 ± 14.6 months. The end points of the study were death, ischemic stroke, transient ischemic attack (TIA), myocardial infarction (MI), ICA thrombosis, hemodynamically significant restenosis of the internal carotid artery, bleeding, and combined endpoint (death + ischemic stroke + TIA + MI).The type of distribution was determined using the Kolmogorov-Smirnov criterion. Group comparisons were performed using the Kruskal-Wallis and Pearson chi-square tests. Differences were assessed as significant at <i>p</i> < .05. According to clinical and demographic characteristics, the majority of patients were male and elderly. In 20% of cases, patients had a history of MI and/or stroke/TIA. Diabetes mellitus was diagnosed in 10%. There were no significant differences between groups in EuroSCOREII.</p><p><strong>Results: </strong>In the long-term postoperative period, the largest number of deaths occurred in groups 5 and 6 (13 (45.1%) and 12 (30.1%)). The majority of strokes were diagnosed in groups 3 (OBP) and 5 (IFPS) (7 (13.5%) and 9 (17.6%)). The highest value of the combined end point (death + stroke/TIA + MI) was obtained in groups 3 (OBP), 5 (IFPS), and 6 (OFS) (23 (44.2%), 26 (50.1%), and 23 (58.9%)).</p><p><strong>Conclusion: </strong>T","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"17085381241307750"},"PeriodicalIF":1.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792396","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":"Intercostal bypass graft pseudoaneurysm repaired with percutaneous glue embolization utilizing CT needle guidance: A case report.","authors":"James Moroney, Andrew Plumb, Matthew Scheidt, Michael Malinowski","doi":"10.1177/17085381241305177","DOIUrl":"https://doi.org/10.1177/17085381241305177","url":null,"abstract":"<p><strong>Objectives: </strong>Pseudoaneurysm formation in connective tissue patients postoperatively can be a challenging and life-threatening problem to treat. Repair of an aorta to intercostal bypass graft pseudoaneurysm post open thoracoabdominal aortic aneurysm repair by percutaneous glue embolization utilizing Dyna CT Needle Guidance technology is a safe, minimally invasive method with low morbidity and short post-procedural recovery.</p><p><strong>Methods: </strong>A 30-year-old male with suspected connective tissue disorder who developed a Type B aortic dissection complicated by limb threatening right lower extremity ischemia treated with left-to-right fem-fem bypass and RLE fasciotomies. His thoracic aortic dissection subsequently was repaired urgently for persistent chest pain and rapid aortic expansion by open thoracoabdominal aortic aneurysm repair with aorta to intercostal bypass graft. Seven weeks postop patient presented with hemoptysis and was noted to have an enlarging T9 intercostal pseudoaneurysm requiring repair.</p><p><strong>Results and conclusions: </strong>Post discharge follow-up thoracic CTA performed showed complete resolution of the T9 intercostal pseudoaneurysm. Therefore, percutaneous NBCA glue embolization with iGuide technology is a viable alternative to open thoracic pseudoaneurysm repair and offers distinct advantages over other imaging modalities for localization.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"17085381241305177"},"PeriodicalIF":1.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786714","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 non-pneumatic compression device results in reduced foot and ankle swelling in patients with venous and lymphatic edema.","authors":"Abhishek Rao, Todd Berland, Amir Mullick, Thomas S Maldonado, Sheila N Blumberg","doi":"10.1177/17085381241305898","DOIUrl":"10.1177/17085381241305898","url":null,"abstract":"<p><strong>Objectives: </strong>Non-pneumatic compression devices (NPCDs) rely on shape-memory alloy technology that allows patients to ambulate and remain active during lymphedema treatment. This study examines the effect of the NPCD on foot and ankle swelling.</p><p><strong>Methods: </strong>This was a prospective, non-randomized study of patients with phlebolymphedema (venous insufficiency-related lymphedema) treated with a novel NPCD for 4 weeks. Ankle and foot circumference (cm), and volume measurements (ml water displacement using immersion) of the foot and ankle were obtained at enrollment, 2-weeks, and 4-weeks, and ambulation was tracked with a wearable exercise monitoring device.</p><p><strong>Results: </strong>This study included 13 patients (21 limbs). A significant reduction in circumference (ankle (-0.84 ± 0.22 cm, <i>p</i> < .01) and metatarsal bed (-0.55 ± 0.95, <i>p</i> < .01)) and volume (foot/ankle (-52 ± 22 mL, <i>p</i> = .032)) was observed. Patients reported a mean of 8100 steps per day (±6100).</p><p><strong>Conclusions: </strong>NPCD results in significant reduction in edema in the foot and ankle despite garments lacking a foot piece. Patients remained mobile while adhering to therapy.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"17085381241305898"},"PeriodicalIF":1.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781228","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":"Reliability of a portable toe pressure photoplethysmography device compared to a stationary laser doppler flowmeter.","authors":"Perttu Laamanen, Mirjami Laivuori, Katariina Noronen, Maarit Venermo","doi":"10.1177/17085381241305192","DOIUrl":"https://doi.org/10.1177/17085381241305192","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to investigate the reliability of a portable toe pressure (TP) photoplethysmography device (PPG) by comparing it to a stationary laser Doppler flowmeter (LD) used in the Helsinki University Hospital. The study evaluated if lower limb arterial circulation could be reliably evaluated with the portable PPG which is more affordable and mobile than the stationary LD.</p><p><strong>Methods: </strong>TPs were measured from 102 toes of 54 patients in the vascular surgery outpatient clinic, vascular surgery ward and interventional radiology recovery ward of Helsinki University Hospital. According to the study protocol TPs were measured twice with the PPG device. If the difference between the values was over 10 mmHg, a third measurement was done and two of the closest values were selected for the final analysis. The lowest value displayed by the PPG device was 30 mmHg. Lower than 30 mmHg values were reported as 25 mmHg in the analysis. The repeatability and reliability of the PPG measurements were compared to the LD with Bland Altman plots.</p><p><strong>Results: </strong>Most patients had rest pain (<i>n</i> = 29) or claudication (<i>n</i> = 9). Prior to TP measurement, 24 patients had undergone lower limb revascularization through either a hybrid (<i>n</i> = 3), open (<i>n</i> = 10) or endovascular (<i>n</i> = 11) procedure. The mean absolute difference between PPG and LD measurement values was 15 mmHg (95% confidence interval 12-18 mmHg). 87.5% of lower limbs with significant arterial insufficiency (TP <60 mmHg with LD, <i>n</i> = 49) had a PPG measurement value of <60 mmHg. Conversely, 84.8% of lower limbs that did not exceed the ischemia criterion of TP ≥60 mmHg with LD had a PPG measurement value of ≥60 mmHg. Mean absolute difference of two consecutive PPG measurement values was 4 mmHg (95% CI 3-5 mmHg).</p><p><strong>Conclusions: </strong>The PPG device is a light and affordable option for the assessment of lower limb arterial circulation in primary health care. It is moderately reliable to exclude significant lower limb arterial insufficiency and may reduce unnecessary referrals to the vascular surgery clinic. The repeatability of the PPG device is satisfactory. However, it requires training to use, and the results must always be interpreted with consideration for the patient's clinical status.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"17085381241305192"},"PeriodicalIF":1.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772705","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":"Acute ischemic stroke: The role of emergency carotid endarterectomy in isolated extracranial internal carotid artery occlusion.","authors":"Pierfilippo Acciarri, Alice Camagni, Maddalena Bressan, Gladiol Zenunaj, Ilaria Casetta, Andrea Bernardoni, Vincenzo Gasbarro, Luca Traina","doi":"10.1177/17085381231192712","DOIUrl":"10.1177/17085381231192712","url":null,"abstract":"<p><strong>Objectives: </strong>The treatment of choice for acute and isolated extracranial internal carotid artery (eICA) occlusion remains, to date, controversial. Although intravenous thrombolysis is recommended, its effectiveness is generally low. This retrospective study aims to assess the clinical outcome and the role of CT perfusion in symptomatic patients who underwent carotid endarterectomy (CEA) for acute occlusion of the eICA.</p><p><strong>Materials and methods: </strong>All the 21 patients presented with stroke-in-evolution, complete patency of intracranial circulation, no evidence of hemorrhagic transformation at CT and a minimum ASPECTS of 6. Clinical improvement was assessed by evaluating the variation of NIHSS and the mRS. We investigated the relationship between NIHSS and the timing of the surgery, the ASPECT score, and the volume of ischemic penumbra at CT perfusion.</p><p><strong>Results: </strong>Median NIHSS on admission was 9 (range 1-24) and it decreased to 4 (range 0-35) 24 h after surgery, improving in 76.2% of patients. Patients with an ASPECTS of 6 (3 patients) showed an improvement of 66.7%, while it was of 81.8% in those starting with a score of 9 or 10 (11 patients). A mRS between 0 and 2 after 3 months was achieved in 12 out of 21 patients. The average time elapsing between surgery and symptom onset was 410 min (range 70-1070 min). Fourteen patients treated within 8 h from symptoms onset showed a clinical improvement of 85.7%, compared to a 57.1% for those which underwent later surgery. Four patients underwent thrombolytic therapy before CEA showing postoperative clinical improvement and no intracranial hemorrhage. Among the 14 patients who underwent CT perfusion, the median ischemic penumbra volume was 112 cc in those with clinical improvement (10 patients) and only 84 cc in those with worse clinical outcomes (4 patients).</p><p><strong>Conclusions: </strong>Emergency CEA in isolated eICA occlusion has proved to be a safe and effective treatment option in selected patients. CT perfusion, imaging the ischemic penumbra and quantifying the tissue suitable for reperfusion, offers a valid support in the diagnostic-therapeutic workup. Indeed, we can infer that the area of the ischemic penumbra is directly proportional to the margin of clinical improvement after revascularization, supposing that the appropriate intervention timing is respect.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1295-1303"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10024152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying venous clinical severity score thresholds for Clinical-Etiology-Anatomy-Pathophysiology classifications of venous edema and higher.","authors":"Halbert Bai, Jason B Storch, Vishal Gokani, Pavel Kibrik, Jenny Chen, Windsor Ting","doi":"10.1177/17085381231193510","DOIUrl":"10.1177/17085381231193510","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Venous Clinical Severity Score (VCSS) is a widely used standard for assessing and grading the severity of chronic venous disease (CVD). Prior research highlighted its high validity in detecting and quantifying venous disease. However, there is little, if any, known about the precise thresholds at which VCSS discriminates important stages of deep venous disease. This study sought to elucidate the diagnostic accuracy, thresholds, and correlation at which VCSS detects salient CEAP (Clinical-Etiology-Anatomy-Pathophysiology) classes in deep venous disease progression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A registry of 840 patients who presented with chronic proximal venous outflow obstruction (PVOO) secondary to non-thrombotic iliac vein lesions from August 2011 to June 2021 was retrospectively analyzed. VCSS and CEAP classifications were used to evaluate preoperative symptoms. VCSS was compared to CEAP classes to determine the precise VCSS composite values at which the instrument was able to detect CEAP C3 and higher, C4 and higher, and C5 and higher. Receiver operative characteristic (ROC) curve and area under the curve (AUC) were used to evaluate VCSS for its ability to discriminate disease at these stages of CEAP classification. Spearman's rank coefficient was used to determine the correlation between CEAP VCSS composite as well as individual VCSS components (pain, varicose vein, edema, pigmentation, inflammation, induration, ulcer number, ulcer size, ulcer duration, compression).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;VCSS composite was able to detect venous edema (C3) and higher at a sensitivity of 68.9% and a specificity of 54.8% at an optimized threshold of 8.5 (AUC = 0.648; 95% C.I. = 0.575-0.721). To detect changes in skin and subcutaneous tissue from CVD (C4) and higher, an optimal threshold of 11.5 was found with a sensitivity of 51.7% and specificity of 76.5% (AUC = 0.694; 95% C.I. = 0.656-0.731). Healed venous ulcer (C4) and higher was detectable at an optimized threshold of 13.5 at a sensitivity of 67.7% and a specificity of 88.9% (AUC = 0.819; 95% C.I. = 0.766-0.873). The correlation between VCSS composites and CEAP was weak (&lt;i&gt;ρ&lt;/i&gt; = 0.372; &lt;i&gt;p&lt;/i&gt; &lt; .001). Attributes of VCSS that reflect more severe venous disease correlated more closely with CEAP classes, namely pigmentation (&lt;i&gt;ρ&lt;/i&gt; = 0.444; &lt;i&gt;p&lt;/i&gt; &lt; .001), inflammation (&lt;i&gt;ρ&lt;/i&gt; = 0.348; &lt;i&gt;p&lt;/i&gt; &lt; .001), induration (&lt;i&gt;ρ&lt;/i&gt; = 0.352; &lt;i&gt;p&lt;/i&gt; &lt; .001), number of active ulcers (&lt;i&gt;ρ&lt;/i&gt; = 0.497; &lt;i&gt;p&lt;/i&gt; &lt; .001), active ulcer size (&lt;i&gt;ρ&lt;/i&gt; = 0.485; &lt;i&gt;p&lt;/i&gt; &lt; .001), and ulcer duration (&lt;i&gt;ρ&lt;/i&gt; = 0.497; &lt;i&gt;p&lt;/i&gt; &lt; .001). The correlation between CEAP class and the other four components of VCSS were not statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;VCSS composite thresholds of 8.5, 11.5, and 13.5 are threshold values for detecting CEAP classification C3 and higher, C4 and higher, and C5 and higher, respectively. Consistent with prior work, V","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1322-1329"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9940368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-related difference in acute type B aortic dissection.","authors":"Zhigong Zhang, Feng Lin, Xiaoci Huang, Zhipeng He, Haoran Wang, Tingting Cheng","doi":"10.1177/17085381231214720","DOIUrl":"10.1177/17085381231214720","url":null,"abstract":"<p><strong>Objective: </strong>The objective is to compare the characteristics of clinical data, imaging data, and treatment methods of young and old patients with acute type B aortic dissection (ABAD).</p><p><strong>Methods: </strong>ABAD patients admitted to the Department of Vascular Surgery of the First Affiliated Hospital of Anhui Medical University from January 2012 to December 2018 were retrospectively reviewed. Patient demographics, such as gender, age, diabetes, hypertension, presenting symptoms, imaging characteristics, laboratory data on admission, hemodynamics on admission and in-hospital management, and mortality of different age groups were compared and analyzed. Categorical variables were compared using χ² tests or Fisher's exact test. Continuous variables were compared using Student's t-test or Mann-Whitney U-test.</p><p><strong>Results: </strong>A total of 141 ABAD patients were included in this study. Old ABAD patients were more likely to have a prior history of hypertension (88.6% vs 70.4%, <i>p</i> = 0.037) and atherosclerosis (29.8% vs 7.4%, <i>p</i> = 0.016). In the young group, Marfan syndrome was significantly higher (14.8% vs 0.9%; <i>p</i> = 0.005). Compared with the old group, the number of distal tears in the young group was significantly higher (62.3% vs 39.5%, <i>p</i> = 0.027). The proportion of patients with malperfusion of lower limbs in the young group was significantly higher than that in the old group (22.2% vs 6.1%, <i>p</i> = 0.026). There was no significant difference in the treatment methods and in-hospital mortality between the two groups.</p><p><strong>Conclusion: </strong>Compared with old ABAD patients, young ABAD patients had more distal tears and a higher proportion of lower limbs malperfusion.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1385-1390"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between statin-use and mobility and long-term survival after major lower limb amputation.","authors":"Arsalan Wafi, Vijay Kolli, Luis Ribeiro, Bilal Azhar, James Budge, Shreya Chawla, Paul Moxey, Ian M Loftus, Peter J E Holt","doi":"10.1177/17085381231192724","DOIUrl":"10.1177/17085381231192724","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to determine if there is an association between statin-use and prosthetic mobility and long-term survival in patients receiving rehabilitation after major amputation for lower limb arterial disease.</p><p><strong>Methods: </strong>A retrospective analysis of prospectively maintained data (2008-2020) from a centre for rehabilitation was performed. Patients were grouped by statin-use status and sub-grouped by the combination of statin and antithrombotic drugs (antiplatelets or anticoagulants). Outcomes were prosthetic mobility (SIGAM score, timed-up-go and 2-min walking distance) and long-term survival. Regression, Kaplan-Meier and Cox-proportional hazard analyses were performed to test associations adjusted to confounders.</p><p><strong>Results: </strong>Of 771 patients, 499 (64.7%) were on a statin before amputation or prescribed a statin peri-operatively. Rate of statin-use was significantly lower among female (53.3%) compared to male (68.2%) patients, <i>P</i> < 0.001. Statin-use was associated with significantly better prosthetic independence (53.1% vs 44.1%, <i>P</i> = 0.017), timed-up-go (mean difference of 4 s, <i>P</i> = 0.04) and long-term survival HR 0.59 (0.48-0.72, <i>P</i> < 0.001). Significance persisted after adjusting for confounding factors and in subgroup analyses. The combination of statin with antiplatelet was associated with the most superior survival, HR 0.51 (0.40-0.65, <i>P</i> < 0.001). Sensitivity analysis (exclusion of non-users of prosthesis) showed that statin-use remained a significant indicator of longer survival, maximally when combined with antiplatelet use HR 0.52 (0.39-0.68, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Statin-use is associated with better mobility and long-term survival in rehabilitees after limb loss, particularly when used in combination with antiplatelets. Significantly lower rates of statin-use were observed in female patients. Further research is warranted on gender disparities in statin-use and causality in their association with improved mobility and survival.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1240-1249"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9902502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in normalizing pulse wave velocity scores: Implications for assessing central artery stiffness.","authors":"Alessandro Gentilin","doi":"10.1177/17085381231194145","DOIUrl":"10.1177/17085381231194145","url":null,"abstract":"","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1410-1411"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9959874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of high quality team medicine on outcomes of chronic limb-threatening ischemia patients with infrapopliteal bypass.","authors":"Taira Kobayashi, Masaki Hamamoto, Takanobu Okazaki, Ryo Okusako, Misa Hasegawa, Kazufumi Ishida, Tomoaki Honma, Masamichi Ozawa, Shinya Takahashi","doi":"10.1177/17085381231194959","DOIUrl":"10.1177/17085381231194959","url":null,"abstract":"<p><strong>Objectives: </strong>A team approach for treatment of patients with CLTI is used worldwide. However, the quality of team medicine is a concern. The Global Vascular Guidelines provide recommendations for high quality team medicine, but there is limited knowledge of the significance of team quality in CLTI treatment. The objective of this study is to evaluate the effects of team quality on clinical outcomes after infrapopliteal bypass.</p><p><strong>Methods: </strong>A retrospective analysis was performed in 337 patients who underwent 414 infrapopliteal bypasses under a team medicine approach at a single center between 2009 and 2021. In 2017, team medicine was reorganized for improvement of quality. Comparisons were made between before (Group 1; 160 patients, 195 limbs) and after (Group 2; 177 patients, 219 limbs) reorganization. The primary endpoints were limb salvage and wound healing after infrapopliteal bypass.</p><p><strong>Results: </strong>The patients included 227 males (67%) and had a median age of 76 [68-83] years. Diabetes mellitus was present in 67% and end-stage renal disease with hemodialysis in 37%. The follow-up rate was 96% in a mean follow-up period of 31±30 months. The 3-year limb salvage rate was significantly lower in Group 1 (before reorganization) than in Group 2 (after reorganization) (84% vs 95%, <i>p</i> = .001). The wound healing rates in the whole cohort were 72% at 6 months and 85% at 12 months, with no significant differences between the groups. In multivariate analysis, the risk factors for major amputation were treatment before reorganization (HR 2.68; <i>p</i> = .017), hemodialysis (HR 2.27; <i>p</i> = .017), and non-ambulatory status (HR 2.63; <i>p</i> = .005).</p><p><strong>Conclusions: </strong>A reorganized team approach with the goal of higher quality was independently associated with reduced major amputation for patients with CLTI treated with infrapopliteal bypass. This result indicates the importance of a high quality team approach for success of this treatment.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1202-1211"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9954638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}