EJVES Vascular Forum最新文献

{"title":"Strategies for Antithrombotic Management During Non-cardiac Arterial Procedures: Results of the International ACTION Survey","authors":"Max Hoebink ,&nbsp;Vincent Jongkind","doi":"10.1016/j.ejvsvf.2025.01.005","DOIUrl":"10.1016/j.ejvsvf.2025.01.005","url":null,"abstract":"<div><h3>Objective</h3><div>Peri-procedural antithrombotics are used extensively to prevent thromboembolic complications during non-cardiac arterial procedures (NCAP) worldwide. However, there is a lack of evidence to support recommendations on antithrombotic strategies, possibly leading to substantial variation in local practices. A comprehensive overview of antithrombotic strategies is needed to identify the most widely accepted protocols employed during NCAP, highlight variations in local practices, and identify new research targets to establish evidence based peri-procedural anticoagulation management.</div></div><div><h3>Methods</h3><div>An international, web based survey study was conducted from March to October 2023, targeting vascular clinical specialists who applied antithrombotic strategies during NCAP in daily practice.</div></div><div><h3>Results</h3><div>The survey was completed by 436 vascular clinical specialists from 45 countries (Europeans: 93%, vascular surgeons or vascular surgery residents: 98%). Systemic unfractionated heparin was used by nearly all vascular specialists during all procedures (varying between 98–99%, depending on the procedure type), but could vary depending on specific NCAP. A fixed starting dose (39–52%, most often 5 000 IU [80–89%]) or an actual bodyweight dependent dose (42–52%, most commonly 100 IU/kg [40–67%] or 50 IU/kg [17–40%]) was mainly used. Except during fenestrated or branched endovascular aneurysm repair procedures (51%), activated clotting time (ACT) was employed by a minority (26–31%). A large variety in measurement protocols was observed, yet a target ACT of 200 seconds was most often used for all NCAP types (44–54%). Most vascular specialists considered a heparin follow up dose (61–81%) and heparin reversal using protamine (54–63%), both for a variety of indications. Of the participants, 68% expressed discontent with their current antithrombotic protocol(s).</div></div><div><h3>Conclusion</h3><div>This comprehensive, international survey study revealed large variation among vascular clinical specialists’ heparinisation strategies during NCAP. Together with the considerable discontent expressed regarding protocols, this emphasises the urgent need for comparative, randomised studies on antithrombotic management during NCAP.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 8-15"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Repair of a Subclavian Artery Aneurysm With Re-purposed Aorto-Iliac Stent Graft Components","authors":"Tomohiro Nakajima,&nbsp;Tsuyoshi Shibata,&nbsp;Yutaka Iba,&nbsp;Nobuyoshi Kawaharada","doi":"10.1016/j.ejvsvf.2025.05.001","DOIUrl":"10.1016/j.ejvsvf.2025.05.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Subclavian artery aneurysms (SAAs) are rare, and reports on their treatment remain limited.</div></div><div><h3>Report</h3><div>An 83 year old male patient who had undergone endovascular aortic repair (EVAR) for an abdominal aortic aneurysm two years previously was referred to the institution for endovascular treatment of a SAA which he preferred over open surgery. Endovascular repair was undertaken under general anaesthesia and open, access of the right axillary artery with introduction of a 14 F guide sheath; subsequently a 23 × 16 × 100 mm limb graft (Gore Excluder, WL Gore and Associates, Flagstaff, USA) was deployed distally with an additional 23 × 23 × 33 mm proximal cuff (Excluder) with successful SAA exclusion.</div></div><div><h3>Discussion</h3><div>A case of endovascular treatment for a right subclavian artery aneurysm is reported. A successful stent graft from the abdominal EVAR device portfolio was successfully employed.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 62-65"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reasons for Delayed Carotid Endarterectomy for Symptomatic Carotid Stenosis in Norway 2018–2019: A National Audit","authors":"Martin Altreuther ,&nbsp;Celine Harlinn Sørlie ,&nbsp;Benedicte Skaug Hansen ,&nbsp;Christian Lyng ,&nbsp;Karsten Myhre ,&nbsp;Toril Rabben ,&nbsp;Ramez Bahar ,&nbsp;Tonje Berglund ,&nbsp;Dorte Bundgaard ,&nbsp;Erik Mulder Pettersen","doi":"10.1016/j.ejvsvf.2025.07.003","DOIUrl":"10.1016/j.ejvsvf.2025.07.003","url":null,"abstract":"<div><h3>Objective</h3><div>Symptomatic carotid stenosis is one of the main causes of <em>amaurosis fugax</em>, transient ischaemic attack (TIA), and stroke. National and international guidelines recommend treatment with carotid endarterectomy (CEA) within 14 days of the index event. In Norway, the proportion of patients operated on within 14 days increased from 65% in 2015 to 83% in 2020. A national clinical audit cross sectional study was performed to identify the reasons for delayed CEA that could be addressed by quality improvement.</div></div><div><h3>Methods</h3><div>Patients operated on by CEA for symptomatic stenosis more than 14 days after the index event in 2018 and 2019 were identified from the Norwegian Registry for Vascular Surgery. The local registrar assessed the reason for the delay, based on the medical record. Possible reasons for delay were categorised as medical reasons, doctor delay, patient delay, and other reasons.</div></div><div><h3>Results</h3><div>Fourteen units performed 686 CEA for symptomatic stenosis in Norway in the study period, of which 179 (26%) were delayed. Ten units participated in the audit, accounting for 120 of 179 (67%) delayed CEAs. The reason for delay was identified for all patients in the participating units. There was a medical reason for the delay in 23 patients. There was doctor delay in 54 cases, patient delay in 28 cases, and a combination of patient delay and doctor delay in 10 cases. The reason for the delay was travel abroad in five cases.</div></div><div><h3>Conclusion</h3><div>Delayed CEA for symptomatic stenosis is usually due to doctor delay or patient delay. Medical reasons account for 19% of delayed operations. This implies that quality improvement is feasible by addressing doctor and patient delay. Healthcare providers should implement strategies to decrease the proportion of delayed CEA for symptomatic stenosis. Patient delay should be addressed with regular information campaigns.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 78-82"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards an Off the Shelf Multibranch Device for Endovascular Aortic Arch Repair?","authors":"Salomé Kuntz ,&nbsp;Nabil Chakfe","doi":"10.1016/j.ejvsvf.2025.06.001","DOIUrl":"10.1016/j.ejvsvf.2025.06.001","url":null,"abstract":"","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 101-102"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long Term Follow Up of Abdominal Aortic Aneurysms Treated With Endovascular Aneurysm Sealing (EVAS) and Endovascular Aneurysm Repair (EVAR): A Single Centre Retrospective Cohort","authors":"Simen Tveten Berge ,&nbsp;Konstantin Valerievitch Naletov ,&nbsp;Sven Ross Mathisen","doi":"10.1016/j.ejvsvf.2025.05.003","DOIUrl":"10.1016/j.ejvsvf.2025.05.003","url":null,"abstract":"<div><h3>Objective</h3><div>The Nellix endovascular aneurysm sealing (EVAS) system demonstrated promising short and midterm outcomes following its introduction in 2011. However, long term results have shown a high incidence of graft failure. This study aimed to compare the long term outcomes of EVAS compared with standard endovascular aneurysm repair (EVAR).</div></div><div><h3>Methods</h3><div>This single centre, retrospective, comparative cohort analysis used prospectively registered data from an internal quality control registry at Innlandet Hospital Trust, Hamar Hospital, Norway. Two hundred and eighty-one patients underwent elective endovascular repair for aorto-iliac aneurysm disease between 2013 – 2016. Primary elective EVAR (<em>n</em> = 164) was compared with primary elective EVAS (<em>n</em> = 117).</div></div><div><h3>Results</h3><div>Technical success was achieved in 100% of the EVAR and EVAS cases. The EVAS patients had a shorter hospital stay (3.7 <em>vs</em>. 4.7 days; <em>p</em> = 0.008), and lower post-procedural C reactive protein (CRP) levels (<em>p</em> &lt; 0.001). No statistically significant differences were found in 30 day (<em>p</em> = 0.79), one year (<em>p</em> = 0.97), or long term all cause mortality rates, with a median follow up of 9.3 years (<em>p</em> = 0.93). During long term follow up, type II endoleaks were significantly less common in EVAS patients (2.6% <em>vs.</em> 32.3%; <em>p</em> &lt; 0.001). However, EVAS had lower device durability, with freedom from device failure at five years of 54% compared with 98% for EVAR (<em>p</em> &lt; 0.001). Open surgical conversion was required in 31% of EVAS patients and 2.4% of EVAR patients (<em>p</em> &lt; 0.001). Aneurysm sac growth ≥5 mm was recorded in 47% of EVAS cases compared with 17.1% of EVAR cases (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>While long term all cause mortality was comparable between EVAS and EVAR, EVAS was associated with statistically significantly higher rates of graft failure, aneurysm sac growth, aneurysm related death, and open surgical conversion. Close monitoring of new prosthetic devices in registries is essential to identify early signs of device failure.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 50-56"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open Repair of Isolated Internal Iliac Artery Aneurysm in a Young Patient With Loeys–Dietz Syndrome","authors":"Ezra Y. Koh ,&nbsp;Dianna M. Milewicz ,&nbsp;Thanila A. Macedo ,&nbsp;Gustavo S. Oderich","doi":"10.1016/j.ejvsvf.2025.04.006","DOIUrl":"10.1016/j.ejvsvf.2025.04.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Isolated internal iliac artery aneurysms in the absence of aorto-iliac disease are exceedingly rare. The case of a 41 year old woman who presented after experiencing several weeks of lower abdominal pain is reported. She was diagnosed with a large, isolated right internal iliac artery aneurysm.</div></div><div><h3>Report</h3><div>Patient medical records were reviewed retrospectively. The patient underwent genetic evaluation, after which she was diagnosed with Loeys–Dietz syndrome type I. Given her age and heritable aortic disease, her aneurysm was treated by open surgical repair via a right retroperitoneal approach with an interposition bypass graft. The patient's hospital course was uneventful, and she was discharged home in good condition.</div></div><div><h3>Discussion</h3><div>This report demonstrates an open surgical technique to treat an isolated iliac aneurysm in a patient with underlying heritable vascular disease.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 96-100"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remember Chylous Ascites After Open Aneurysm Repair","authors":"Arindam Chaudhuri","doi":"10.1016/j.ejvsvf.2025.05.007","DOIUrl":"10.1016/j.ejvsvf.2025.05.007","url":null,"abstract":"","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Page 49"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence (AI) in Imaging Characterisation: Universality and Availability Will Rule Them All","authors":"Eduardo Arrea Salto ,&nbsp;Marion Carrier","doi":"10.1016/j.ejvsvf.2025.08.001","DOIUrl":"10.1016/j.ejvsvf.2025.08.001","url":null,"abstract":"","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 103-104"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145117679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Implantation Syndromes After Endovascular Aneurysm Repair: Not Good, But Not Bad Either","authors":"Andrés Reyes Valdivia","doi":"10.1016/j.ejvsvf.2025.04.001","DOIUrl":"10.1016/j.ejvsvf.2025.04.001","url":null,"abstract":"","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 32-33"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Coil Embolisation With Isolation Technique of Ulnar Artery Aneurysm in Hypothenar Hammer Syndrome: A Case Report","authors":"Hiroshi Yukimoto ,&nbsp;Takayuki Miyauchi ,&nbsp;Takashi Nakamura","doi":"10.1016/j.ejvsvf.2025.04.002","DOIUrl":"10.1016/j.ejvsvf.2025.04.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypothenar hammer syndrome is a rare vascular condition characterised by ulnar artery damage, which can manifest as thrombosis or aneurysm formation. While surgical treatment has been the mainstay of therapy, endovascular treatment may offer a minimally invasive alternative. Reports of successful coil embolisation of ulnar artery aneurysms in hypothenar hammer syndrome are extremely limited in the literature.</div></div><div><h3>Report</h3><div>A woman in her sixties with a history of smoking and atrial fibrillation on anticoagulants presented with a one month history of a painful pulsatile mass in her dominant right hypothenar eminence. Imaging revealed a 15 mm ulnar artery aneurysm with corkscrew deformity characteristic of hypothenar hammer syndrome. Digital subtraction angiography demonstrated adequate collateral circulation through palmar arches during selective compression tests. Endovascular coil embolisation using isolation technique was performed via the ipsilateral brachial artery access under axillary nerve block. A triple coaxial system was used to deploy detachable coils for aneurysm isolation. The procedure achieved complete aneurysm occlusion while maintaining adequate blood flow to all digits through collateral circulation from the radial artery via the palmar arch. Three month follow up contrast enhanced magnetic resonance imaging demonstrated complete resolution of the ulnar artery aneurysm with no evidence of ischaemic complications.</div></div><div><h3>Discussion</h3><div>Pre-procedural confirmation of adequate collateral circulation is essential for endovascular treatment, which can provide effective minimally invasive treatment for ulnar artery aneurysm in hypothenar hammer syndrome without leaving a palmar surgical scar. While the initial results are promising, careful patient selection and longer follow up are needed to establish the durability of this treatment approach.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 57-61"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}