EJVES Vascular Forum最新文献

筛选
英文 中文
Association Between the Effectiveness and Magnitude of Foot Microcirculation Assessed by Radionuclide Angiography and One Year Limb Outcomes in Patients with Chronic Limb Threatening Ischaemia
IF 1.4
EJVES Vascular Forum Pub Date : 2025-01-01 DOI: 10.1016/j.ejvsvf.2024.11.002
Takuya Hashimoto , Yoshitaka Kumakura , Kenichi Ichikawa , Satoshi Yamamoto , Takashi Endo , Masaya Sano , Osamu Sato , Juno Deguchi
{"title":"Association Between the Effectiveness and Magnitude of Foot Microcirculation Assessed by Radionuclide Angiography and One Year Limb Outcomes in Patients with Chronic Limb Threatening Ischaemia","authors":"Takuya Hashimoto ,&nbsp;Yoshitaka Kumakura ,&nbsp;Kenichi Ichikawa ,&nbsp;Satoshi Yamamoto ,&nbsp;Takashi Endo ,&nbsp;Masaya Sano ,&nbsp;Osamu Sato ,&nbsp;Juno Deguchi","doi":"10.1016/j.ejvsvf.2024.11.002","DOIUrl":"10.1016/j.ejvsvf.2024.11.002","url":null,"abstract":"<div><h3>Objective</h3><div>Microcirculation focused evaluations may provide physiological insights that complement those of the established clinical criteria for patients with chronic limb threatening ischaemia (CLTI), since complex treatments are needed in this high risk population. However, current methods for quantitatively assessing foot microcirculation are limited. Thus, in this study, the aim was to demonstrate a proof of concept non-invasive method with novel parameters for assessing foot microcirculation.</div></div><div><h3>Methods</h3><div>This was a single centre prospective cohort pilot study. The lower limbs of 13 patients diagnosed with CLTI were evaluated by radionuclide (RN) angiography with <sup>99m</sup>Tc-tetrofosmin two weeks after revascularisation or non-revascularisation procedures. Novel parameters (pedal transit time and peak pedal count) were derived by processing the time–activity curves of the detected tracers in each region of interest in the limbs. The Mann–Whitney <em>U</em> test was used for the analysis of associations between these two parameters and limb fate at one year, and Pearson and Spearman tests were used to analyse associations with transcutaneous partial oxygen pressure (tcPO<sub>2</sub>), a conventional perfusion test result.</div></div><div><h3>Results</h3><div>The mean pedal transit time of the affected limbs in the non-healing group was longer than that in the healing group (19.1 ± 18.6 <em>vs</em>. 2.9 ± 2.1 seconds, <em>p</em> = .001). The mean peak pedal count of nucleotides in the non-healing group was lower than that in the healing group (24.4 ± 19.0 <em>vs</em>. 72.0 ± 36.1 counts/sec/GBq, <em>p</em> = .008). The pedal transit time and peak pedal count showed little to no correlation with the conventional tcPO<sub>2</sub> at the midfoot (<em>r</em> = 0.26 for pedal transit time; <em>r</em> = −0.11 for peak pedal count).</div></div><div><h3>Conclusion</h3><div>Two novel microcirculation parameters derived from RN angiography were associated with one year limb outcomes in patients with CLTI. Non-invasive radiotracer imaging derived parameters may provide an additional dimension to indices of pathophysiological microcirculation in CLTI.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"63 ","pages":"Pages 11-19"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143105331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Primary Intra-operative Embolisation During Urgent Parallel Graft Endovascular Repair in Paravisceral Symptomatic Aortic Pseudoaneurysm 急性平行血管内移植修复内脏旁症状性主动脉假性动脉瘤的术中栓塞。
IF 1.4
EJVES Vascular Forum Pub Date : 2025-01-01 DOI: 10.1016/j.ejvsvf.2024.11.001
Paolo Spath , Federica Campana , Enrico Gallitto , Chiara Mascoli , Stefania Caputo , Rodolfo Pini , Gianluca Faggioli , Mauro Gargiulo
{"title":"Primary Intra-operative Embolisation During Urgent Parallel Graft Endovascular Repair in Paravisceral Symptomatic Aortic Pseudoaneurysm","authors":"Paolo Spath ,&nbsp;Federica Campana ,&nbsp;Enrico Gallitto ,&nbsp;Chiara Mascoli ,&nbsp;Stefania Caputo ,&nbsp;Rodolfo Pini ,&nbsp;Gianluca Faggioli ,&nbsp;Mauro Gargiulo","doi":"10.1016/j.ejvsvf.2024.11.001","DOIUrl":"10.1016/j.ejvsvf.2024.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>Paravisceral aortic lesions present significant challenges for endovascular treatment. This retrospective analysis of consecutively treated patients from April 2017 to June 2021 aimed to analyse the outcome of primary intra-operative embolisation of aortic complicated pseudoaneurysms and gutter channels during parallel graft (PG) repair of paravisceral symptomatic aortic pseudoaneurysms.</div></div><div><h3>Methods</h3><div>Patients with symptomatic pseudoaneurysms of the paravisceral aorta treated with PGs using chimney or periscope configurations were included. Thoracic endografts were positioned to exclude the aortic lesions. Coil embolisation of both the lesions and gutter channels was performed after graft deployment and prior to ballooning of the stent grafts. The primary endpoints were technical success (defined as exclusion of the pseudoaneurysm, target visceral vessel [TVV] patency, absence of gutter endoleaks) and clinical success (technical success + resolution of symptoms + absence of major adverse events) at 30 days. Secondary endpoints included overall survival, TVV patency, gutter endoleaks, and freedom from re-interventions during follow up.</div></div><div><h3>Results</h3><div>Six patients (four women) were treated for pseudoaneurysm rupture (three cases) and symptomatic aortic pseudoaneurysm (three cases) of the paravisceral aorta. The patients' anatomies were unsuitable for off the shelf devices and patients were all deemed to be at prohibitive surgical risk. A total of 15 TVVs were revascularised (comprising three coeliac arteries, five superior mesenteric arteries, and seven renal arteries) using 10 chimney and five periscope PGs. One coeliac artery was occluded. Seventy coils were deployed to embolise both the aortic ruptures and gutter channels. Both technical and clinical success rates were 100%. The median follow up was 17 months (IQR 5, 35), during which time three patients died due to non-aortic related causes. One coeliac artery (6%) was occluded, and no endoleak evidence was found.</div></div><div><h3>Conclusion</h3><div>Primary intra-operative embolisation during parallel graft endovascular repair of paravisceral symptomatic aortic pseudoaneurysms may be both safe and effective in excluding the pseudoaneurysm when other options are unavailable.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"63 ","pages":"Pages 1-10"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Immediate Carotid Artery Stenting or Deferred Treatment in Patients With Tandem Carotid Lesions Treated Endovascularly for Acute Ischaemic Stroke 急性缺血性脑卒中血管内治疗颈动脉串联病变患者立即接受颈动脉支架植入术还是推迟治疗
IF 0.6
EJVES Vascular Forum Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2023.12.002
Theodora van Elk , Louise Maes , Anne van der Meij , Robin Lemmens , Maarten Uyttenboogaart , Gert J. de Borst , Clark J. Zeebregts , Paul J. Nederkoorn
{"title":"Immediate Carotid Artery Stenting or Deferred Treatment in Patients With Tandem Carotid Lesions Treated Endovascularly for Acute Ischaemic Stroke","authors":"Theodora van Elk ,&nbsp;Louise Maes ,&nbsp;Anne van der Meij ,&nbsp;Robin Lemmens ,&nbsp;Maarten Uyttenboogaart ,&nbsp;Gert J. de Borst ,&nbsp;Clark J. Zeebregts ,&nbsp;Paul J. Nederkoorn","doi":"10.1016/j.ejvsvf.2023.12.002","DOIUrl":"10.1016/j.ejvsvf.2023.12.002","url":null,"abstract":"<div><p>Fifteen to 20% of patients with an acute ischaemic stroke have a tandem lesion defined by the combination of an intracranial large vessel thrombo-embolic occlusion and a high grade stenosis or occlusion of the ipsilateral internal carotid artery. These patients tend to have worse outcomes than patients with isolated intracranial occlusions, with higher rates of disability and death. The introduction of endovascular thrombectomy to treat the intracranial lesion clearly improved the outcome compared with treatment with intravenous thrombolysis alone. However, the best treatment strategy for managing the extracranial carotid artery lesion in patients with tandem lesions remains unknown. Current guidelines recommend carotid endarterectomy for patients with transient ischaemic attack or non-disabling stroke and moderate or severe stenosis of the internal carotid artery, within two weeks of the initial event, to prevent major stroke recurrence and death. Alternatively, the symptomatic carotid artery could be treated by endovascular placement of a stent during endovascular thrombectomy (EVT). This would negate the need for a second procedure, immediately reduce the risk of stroke recurrence, increase patient satisfaction, and could be cost effective. However, the administration of dual antiplatelet therapy could potentially increase the risk of symptomatic intracranial haemorrhage in patients with acute ischaemic stroke. Randomised controlled trials evaluating the efficacy and safety of immediate carotid artery stenting during EVT in acute stroke patients with tandem lesions are currently ongoing and will impact the current guidelines regarding the treatment of patients with acute ischaemic stroke due to these tandem lesions.</p></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"61 ","pages":"Pages 31-35"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X23000941/pdfft?md5=769eb62096929f360595d75df811e67a&pid=1-s2.0-S2666688X23000941-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139016765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Validity of Ultrasound for the Diagnosis of Arterial Thoracic Outlet Syndrome 超声波诊断胸廓出口动脉综合征的有效性
IF 0.6
EJVES Vascular Forum Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.02.003
Emilia Stegemann , Jana Larbig , Berthold Stegemann , Irene Portig , Hans Prescher , Thomas Bürger
{"title":"Validity of Ultrasound for the Diagnosis of Arterial Thoracic Outlet Syndrome","authors":"Emilia Stegemann ,&nbsp;Jana Larbig ,&nbsp;Berthold Stegemann ,&nbsp;Irene Portig ,&nbsp;Hans Prescher ,&nbsp;Thomas Bürger","doi":"10.1016/j.ejvsvf.2024.02.003","DOIUrl":"10.1016/j.ejvsvf.2024.02.003","url":null,"abstract":"<div><h3>Objective</h3><p>Thoracic outlet syndrome (TOS) is a rare disorder mostly seen in younger individuals. Although patient wellbeing is relevantly impaired, it often takes a long time before the diagnosis is made. Digital subtraction angiography (DSA) is routinely used despite its radiation exposure, which is a major concern in this young patient population. Moreover, DSA offers limited opportunities for functional assessment. By contrast, ultrasonography is widely accessible without causing radiation exposure and allows for flexible functional assessment. The main goal of the study was to investigate whether ultrasound (US) was a viable alternative to DSA in diagnosing arterial TOS (aTOS).</p></div><div><h3>Methods</h3><p>Patients, referred to a tertiary centre for evaluation of suspected TOS, were recruited into the study. DSA was routinely performed with the patient's arms both in the raised (abducted) and neutral (adducted) position. Two vascular surgeons and two radiologists assessed the resulting images for the presence of aTOS. Additionally, two examiners performed US according to a standardised protocol. The reference for presence of aTOS was the DSA based interdisciplinary vascular conference consensus. Inter-rater agreement and latent class analysis (LCA) were performed between assessors and diagnostic methods.</p></div><div><h3>Results</h3><p>Fifty one consecutive patients (two thirds female) aged 39.3 ± 13.0 years were included within 11 months. US agreement was excellent at 0.94 (0.841–0.980), DSA agreement for vascular surgeons was good at 0.779 (0.479–1.000), whereas it was moderate at 0.546 (0.046–1.000) for radiologists. Results suggest that DSA is untenable as the gold standard for aTOS diagnosis. In LCA, US was shown to be a reliable diagnostic tool for the detection of aTOS.</p></div><div><h3>Conclusion</h3><p>US examination is a valid test for the detection of haemodynamically relevant compression of arteries in the diagnostic work up of aTOS using a standardised protocol. The role of DSA as the gold standard should be reviewed and needs to be reconsidered.</p></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"61 ","pages":"Pages 92-98"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000741/pdfft?md5=4a8589826fa1be077c2e2cf259161e9b&pid=1-s2.0-S2666688X24000741-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139823996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
EJVES Vascular Forum Moves Forward 欧洲血管与血管内外科杂志》血管论坛向前迈进
IF 0.6
EJVES Vascular Forum Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.02.001
Melina Vega de Ceniga, Arindam Chaudhuri
{"title":"EJVES Vascular Forum Moves Forward","authors":"Melina Vega de Ceniga,&nbsp;Arindam Chaudhuri","doi":"10.1016/j.ejvsvf.2024.02.001","DOIUrl":"10.1016/j.ejvsvf.2024.02.001","url":null,"abstract":"","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"61 ","pages":"Pages 89-91"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000571/pdfft?md5=db1cf6102432c8502bf70576d7ea18e8&pid=1-s2.0-S2666688X24000571-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139880156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of Endovascular Management of Chronic Pelvic Pain in Pelvic Congestion Syndrome Type I 盆腔充血综合征 I 型慢性盆腔疼痛的血管内治疗效果
IF 0.6
EJVES Vascular Forum Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.063
Mohamed Hagag , Mostafa soliman Abdelbary , Mohamed Ismail ∗ , Mohamed Emam fakhr
{"title":"Effectiveness of Endovascular Management of Chronic Pelvic Pain in Pelvic Congestion Syndrome Type I","authors":"Mohamed Hagag ,&nbsp;Mostafa soliman Abdelbary ,&nbsp;Mohamed Ismail ∗ ,&nbsp;Mohamed Emam fakhr","doi":"10.1016/j.ejvsvf.2024.01.063","DOIUrl":"https://doi.org/10.1016/j.ejvsvf.2024.01.063","url":null,"abstract":"","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"61 ","pages":"Pages S43-S44"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000662/pdfft?md5=39a3de0283df1fe6b0986182fe133120&pid=1-s2.0-S2666688X24000662-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Iatrogenic Aorta-Iliac laparoscopic Injuries 主动脉-髂腹腔镜手术的先天性损伤
IF 0.6
EJVES Vascular Forum Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.030
Asiyah Shafi ∗ , Taohid Oshodi
{"title":"Iatrogenic Aorta-Iliac laparoscopic Injuries","authors":"Asiyah Shafi ∗ ,&nbsp;Taohid Oshodi","doi":"10.1016/j.ejvsvf.2024.01.030","DOIUrl":"https://doi.org/10.1016/j.ejvsvf.2024.01.030","url":null,"abstract":"","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"61 ","pages":"Pages S21-S22"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000315/pdfft?md5=30879a44bb649bdf443d862eeeea647d&pid=1-s2.0-S2666688X24000315-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Arterial Blood Flow and Effects on Limb Tissue Perfusion During Endoshunting of the Common Iliac Artery in an Experimental Porcine Model 实验猪模型髂总动脉内窥过程中的动脉血流及其对肢体组织灌注的影响
IF 0.6
EJVES Vascular Forum Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.053
Johan Millinger , Marcus Langenskiöld , Andreas Nygren , Klas Österberg , Joakim Nordanstig
{"title":"Arterial Blood Flow and Effects on Limb Tissue Perfusion During Endoshunting of the Common Iliac Artery in an Experimental Porcine Model","authors":"Johan Millinger ,&nbsp;Marcus Langenskiöld ,&nbsp;Andreas Nygren ,&nbsp;Klas Österberg ,&nbsp;Joakim Nordanstig","doi":"10.1016/j.ejvsvf.2024.01.053","DOIUrl":"10.1016/j.ejvsvf.2024.01.053","url":null,"abstract":"<div><h3>Objective</h3><p>Temporary arterial shunting is an established method to prevent tissue ischaemia. Although less well established, shunting might also be achieved through endovascular and hybrid techniques, known as endoshunting. Endoshunting offers advantages, for example, enabling minimally invasive access and avoiding complete occlusion of the donor artery. In an <em>ex vivo</em> bench test, volume flow in various interconnected endoshunt systems has been tested previously. This study aimed to investigate the capacity of the best performing endoshunt system <em>in vivo</em>.</p></div><div><h3>Methods</h3><p>Six anaesthetised pigs had their common iliac arteries (CIAs) explored, with the left CIA serving as the experimental and the right CIA as the control. Mean arterial pressure, regional blood flow, endoshunt flow, and regional oxygen extraction and lactate production were recorded. Distal muscle perfusion was monitored using near infrared spectroscopy (NIRS). Each experiment involved baseline registration, cross clamping of the left CIA, a 120 minute endoshunt session, and restoration of native flow.</p></div><div><h3>Results</h3><p>During cross clamping, NIRS values on the experimental side reached the lowest measurable value. Following endoshunt activation, there were no NIRS value differences between the experimental and control extremities whereas the average arterial flow decreased in both the experimental (270–140 mL/min, <em>p</em> = .028) and control extremities (245–190 mL/min, <em>p</em> = .25), with a greater drop on the endoshunted side (48% <em>vs.</em> 22%, respectively). Lactate levels temporarily increased by 42% in the endoshunted limb on endoshunt activation but were normalised within an hour. Oxygen extraction remained constant at 55% on the control side but increased to 70% on the endoshunted side (<em>p</em> = .068).</p></div><div><h3>Conclusion</h3><p>In this animal model, a flow optimised endoshunt system appeared to provide sufficient blood flow and restored stable tissue perfusion. Although arterial flow was slightly lower and oxygen extraction slightly higher on the endoshunted side, the endoshunt seemed to deliver adequate perfusion to prevent significant ischaemia.</p></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"61 ","pages":"Pages 54-61"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000546/pdfft?md5=c0b8a6a14da3121115e5c222a598a45a&pid=1-s2.0-S2666688X24000546-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139634457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Two Stage Open and Interventional Therapeutic Approach for an Inferior Pancreaticoduodenal Artery Aneurysm With Coeliac Artery Occlusion 胰十二指肠下动脉瘤伴腹腔动脉闭塞的两阶段开放和介入治疗方法
IF 1.4
EJVES Vascular Forum Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.06.005
Polina Shabes , Waseem Garabet , Peter Minko , Joscha Mulorz , Julian-Dario Rembe , Hubert Schelzig , Markus U. Wagenhäuser
{"title":"A Two Stage Open and Interventional Therapeutic Approach for an Inferior Pancreaticoduodenal Artery Aneurysm With Coeliac Artery Occlusion","authors":"Polina Shabes ,&nbsp;Waseem Garabet ,&nbsp;Peter Minko ,&nbsp;Joscha Mulorz ,&nbsp;Julian-Dario Rembe ,&nbsp;Hubert Schelzig ,&nbsp;Markus U. Wagenhäuser","doi":"10.1016/j.ejvsvf.2024.06.005","DOIUrl":"10.1016/j.ejvsvf.2024.06.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Visceral artery aneurysms (VAAs) are rare but have a high mortality rate in cases of rupture, especially for pancreaticoduodenal artery aneurysms (PDAAs). A hybrid approach is presented for a challenging case with inferior PDAA (iPDAA) with concomitant coeliac artery (CA) occlusion and a variant arterial supply to the liver.</p></div><div><h3>Report</h3><p>A 61 year old patient complained of postprandial pain associated with elevated liver enzymes and impaired hepatic synthesis capacity. The left hepatic artery (LHA) originated from an occluded CA, whereas the right hepatic artery (RHA) originated directly from the superior mesenteric artery (SMA) proximal to the iPDAA. Due to the anatomical variant, an endovascular only approach via iPDAA embolisation could have posed a critical risk to the arterial supply of the liver. Therefore, the initial plan was to first secure liver perfusion via endovascular revascularisation of the CA, before conducting a coil embolisation of the iPDAA. However, endovascular CA revascularisation failed due to a complete and fixed occlusion. As an alternative therapeutic approach, open surgical aorto-visceral autologous bypass ensured arterial supply of the liver, which now enabled safe exclusion of the iPDAA via interventional coil embolisation. This two stage hybrid strategy resulted in iPDAA exclusion and was followed by symptom relief and normalised hepatic synthesis capacity.</p></div><div><h3>Discussion</h3><p>This case demonstrates the continued need for open visceral bypass surgery to ensure organ perfusion, if the latter depends on an aneurysmal artery. In such a situation, visceral bypass surgery can be considered in challenging anatomical scenarios, which demonstrates the relevance of endovascular and open procedures. In conclusion, both procedures can be combined in individualised therapy approaches to maximise patient benefit.</p></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"62 ","pages":"Pages 25-29"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000960/pdfft?md5=15cef10ecddb49a86874c3a960be6183&pid=1-s2.0-S2666688X24000960-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141695381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Novel Modified Inner Branched Arch Endograft for Pseudoaneurysm Post Type A Dissection Repair 用于 A 型动脉夹层后假性动脉瘤修复的新型改良内分支弓内膜移植物
IF 0.6
EJVES Vascular Forum Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.006
Eric Lim ∗ , Ruth Benson , Oliver Lyons , Andrew Laing , Adib Khanafer
{"title":"Novel Modified Inner Branched Arch Endograft for Pseudoaneurysm Post Type A Dissection Repair","authors":"Eric Lim ∗ ,&nbsp;Ruth Benson ,&nbsp;Oliver Lyons ,&nbsp;Andrew Laing ,&nbsp;Adib Khanafer","doi":"10.1016/j.ejvsvf.2024.01.006","DOIUrl":"https://doi.org/10.1016/j.ejvsvf.2024.01.006","url":null,"abstract":"","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"61 ","pages":"Pages S1-S2"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000078/pdfft?md5=9a2b53bfb5e42e6d8de81890890a8b0d&pid=1-s2.0-S2666688X24000078-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140052382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信