Seminars in Vascular Surgery最新文献_第10页

Considerations in the Application of Artificial Intelligence in Vascular Surgical Education 人工智能在血管外科教学中应用的思考

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2023-08-01 DOI: 10.1053/j.semvascsurg.2023.07.004

D. Rigberg, J. Jim

引用次数: 0

Emergencies during oncovascular surgery: Strategies and pitfalls 肿瘤手术中的紧急情况:策略和陷阱

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2023-06-01 DOI: 10.1053/j.semvascsurg.2023.04.018

Pirkka Vikatmaa

{"title":"Emergencies during oncovascular surgery: Strategies and pitfalls","authors":"Pirkka Vikatmaa","doi":"10.1053/j.semvascsurg.2023.04.018","DOIUrl":"10.1053/j.semvascsurg.2023.04.018","url":null,"abstract":"<div><p><span>In a growing number of pathologies, vascular invasion is no longer considered a contraindication for surgery with a curative intention. This has led vascular surgeons to be more involved in the treatment<span> of pathologies that they are not used to. These patients should be managed in a multidisciplinary manner. New types of emergencies and complications have emerged. Emergencies in oncovascular surgery are mostly avoidable with careful planning and good collaboration between oncological surgeons and a dedicated vascular surgery team. The operations often involve difficult vascular dissection and complex reconstructive techniques in a potentially contaminated and irradiated field, and the risk of </span></span>postoperative complications and blow out is increased. However, after a successful operation and immediate postoperative course, the patients often recover faster than the typical fragile vascular surgical patient. This narrative review focuses on emergencies that are more or less specific to oncovascular procedures. A scientific approach and international collaboration are needed, so that we can better identify which patients should be operated, what problems to anticipate and could be avoided with better planning, and which solutions improve patient outcome.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 2","pages":"Pages 157-162"},"PeriodicalIF":2.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10017425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

The role of multimodal imaging in emergency vascular conditions: The journey from diagnosis to hybrid operating rooms 多模式成像在急诊血管疾病中的作用：从诊断到混合手术室

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2023-06-01 DOI: 10.1053/j.semvascsurg.2023.04.001

Elda Chiara Colacchio, Mariagiovanna Berton, Francesco Squizzato, Mirko Menegolo, Michele Piazza, Franco Grego, Michele Antonello

{"title":"The role of multimodal imaging in emergency vascular conditions: The journey from diagnosis to hybrid operating rooms","authors":"Elda Chiara Colacchio, Mariagiovanna Berton, Francesco Squizzato, Mirko Menegolo, Michele Piazza, Franco Grego, Michele Antonello","doi":"10.1053/j.semvascsurg.2023.04.001","DOIUrl":"10.1053/j.semvascsurg.2023.04.001","url":null,"abstract":"<div><p>Multimodal imaging is the incorporation of two or more imaging modalities during the same examination, and it has both diagnostic and treatment applications. The use of image fusion for intraoperative guidance in endovascular interventions is being extended increasingly to the field of vascular surgery, especially in the context of hybrid operating rooms. The aim of this work was to perform a review and narrative synthesis of the available literature in order to report on current applications of multimodal imaging in diagnosis and treatment of emergent vascular conditions. Of 311 records selected in the initial search, 10 articles were included in the present review: 4 cohort studies and 6 case reports. The authors have presented their experience in treating ruptured abdominal aortic aneurysms; aortic dissections; traumas; standard endovascular aortic aneurysm repair, with or without deterioration of renal function; and complex endovascular aortic aneurysm repair, and reported on the long-term clinical results. Although the current literature about multimodal imaging application in emergency vascular conditions is limited, this review highlights the potential of image fusion in hybrid angio-surgical suites, especially for diagnosing and performing treatment in the same operating room, avoiding patient transfer, and allowing procedures with zero or low-dose contrast mean.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 2","pages":"Pages 355-362"},"PeriodicalIF":2.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9662176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 emergencies involving the aortic arch: An integrated cardiovascular surgical treatment approach 涉及主动脉弓的胸主动脉急症:一种综合心血管外科治疗方法

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2023-06-01 DOI: 10.1053/j.semvascsurg.2023.04.016

Tim Walter , Tim Berger , Stoyan Kondov , Roman Gottardi , Julia Benk , Phillip Discher , Bartosz Rylski , Martin Czerny , Maximilian Kreibich

{"title":"Thoracic aortic emergencies involving the aortic arch: An integrated cardiovascular surgical treatment approach","authors":"Tim Walter , Tim Berger , Stoyan Kondov , Roman Gottardi , Julia Benk , Phillip Discher , Bartosz Rylski , Martin Czerny , Maximilian Kreibich","doi":"10.1053/j.semvascsurg.2023.04.016","DOIUrl":"10.1053/j.semvascsurg.2023.04.016","url":null,"abstract":"<div><p>Thoracic aortic emergencies involving the aortic arch are potentially fatal conditions that require the entire surgical repertoire of conventional surgery, such as complete aortic arch replacement using the frozen-elephant-trunk technique, through hybrid procedures, to full surgical endovascular options with conventional or delivered/fenestrated stent-grafts. An interdisciplinary aortic team should choose the optimal treatment of the pathologies of the aortic arch, considering the morphology of the entire aorta, from the root to beyond the bifurcation, as well as the clinical comorbidities. The treatment goal is a complication-free postoperative result and lasting freedom from aortic reinterventions. Irrespective of the selected therapy method, patients should then be connected to a specialized aortic outpatient clinic. The aim of this review was to provide an overview of pathophysiology and current treatment options in emergencies of the thoracic aorta, also involving the aortic arch. We wanted to summarize the preoperative considerations, intraoperative settings, and strategies, as well the postoperative follow-up.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 2","pages":"Pages 150-156"},"PeriodicalIF":2.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10017419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

The anesthesiologist's perspective on emergency aortic surgery: Preoperative optimization, intraoperative management, and postoperative surveillance 麻醉师对主动脉紧急手术的看法：术前优化、术中管理和术后监测

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2023-06-01 DOI: 10.1053/j.semvascsurg.2023.04.017

Fulvio Nisi , Luca Carenzo , Nadia Ruggieri , Antonio Reda , Maria Giulia Pascucci , Arianna Pignataro , Efrem Civilini , Federico Piccioni , Enrico Giustiniano

{"title":"The anesthesiologist's perspective on emergency aortic surgery: Preoperative optimization, intraoperative management, and postoperative surveillance","authors":"Fulvio Nisi , Luca Carenzo , Nadia Ruggieri , Antonio Reda , Maria Giulia Pascucci , Arianna Pignataro , Efrem Civilini , Federico Piccioni , Enrico Giustiniano","doi":"10.1053/j.semvascsurg.2023.04.017","DOIUrl":"10.1053/j.semvascsurg.2023.04.017","url":null,"abstract":"<div><p><span><span>The management of emergencies related to the aorta requires a multidisciplinary approach involving various health care<span> professionals. Despite technological advancements in treatment methods, the risks and mortality rates associated with surgery remain high. In the </span></span>emergency department<span>, definitive diagnosis is usually obtained through computed tomography angiography, and management focuses on controlling blood pressure and treating symptoms to prevent further deterioration. Preoperative resuscitation is the main focus, followed by intraoperative management aimed at stabilizing the patient's </span></span>hemodynamics<span>, controlling bleeding, and protecting vital organs. After the operation, factors such as organ protection, transfusion management, pain control, and overall patient care must be taken into account. Endovascular techniques are becoming more common in surgical treatment, but they also present new challenges in terms of complications and outcomes. It is recommended that patients with suspected ruptured abdominal aortic aneurysms be transferred to facilities with both open and endovascular treatment options and a track record of successful outcomes to ensure the best patient care and long-term results. To achieve optimal patient outcomes, close collaboration and regular case discussions between health care professionals are necessary, as well as participation in educational programs to promote a culture of teamwork and continuous improvement.</span></p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 2","pages":"Pages 363-379"},"PeriodicalIF":2.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9662172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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: 2

Emergent vessel embolization for major traumatic and non-traumatic hemorrhage: Indications, tools and outcomes 急诊血管栓塞治疗创伤性和非创伤性大出血:适应症，工具和结果

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2023-06-01 DOI: 10.1053/j.semvascsurg.2023.04.011

Tal M. Hörer , Anna Maria Ierardi , Serena Carriero , Carolina Lanza , Gianpaolo Carrafiello , David T. McGreevy

引用次数: 1

Recent advances and the future of abdominopelvic and lower extremity vascular injury management 骨盆和下肢血管损伤处理的最新进展和未来

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2023-06-01 DOI: 10.1053/j.semvascsurg.2023.03.005

Mahmood Kabeil , David S. Kauvar , Lisa Bennett , Max V. Wohlauer

{"title":"Recent advances and the future of abdominopelvic and lower extremity vascular injury management","authors":"Mahmood Kabeil , David S. Kauvar , Lisa Bennett , Max V. Wohlauer","doi":"10.1053/j.semvascsurg.2023.03.005","DOIUrl":"10.1053/j.semvascsurg.2023.03.005","url":null,"abstract":"<div><p><span><span>Despite advances in open and endovascular management of trauma, vascular injuries remain a source of devastating outcomes. This narrative review of the literature between 2018 and 2023 explored recent advances in abdominopelvic and lower extremity vascular injury management. New conduit choices, use of temporary intravascular shunts, and advances in endovascular management of vascular trauma were reviewed. Although endovascular techniques are being applied more frequently, there is a paucity of reporting on long-term outcomes. Open surgery is durable and effective and remains the gold standard for repairing most abdominal, pelvic, and lower extremity vascular injuries. </span>Vascular reconstruction<span><span><span> conduit options are currently limited to the autologous vein, prosthetic grafts, and cryopreserved cadaveric xenografts; each type has its own application challenges. The temporary intravascular shunts can be used to restore early perfusion to ischemic limbs and increase the chances of </span>limb salvage<span>, or when transfer of care is needed. Resuscitative balloon occlusion of the </span></span>inferior vena cava has been a research-heavy topic to investigate the possible implications </span></span>in patients<span><span> with trauma. Early diagnosis, appropriate use of technology, and time-sensitive management can make all the difference in the lives of patients with vascular trauma. Endovascular management of vascular trauma is evolving and gaining wider acceptance for treatment of vascular injuries. </span>Computed tomography angiography is widely available and is the current gold standard for diagnosis. Autologous vein remains the gold standard for conduit with the future promise of new innovative conduits. Vascular surgeons have an important role in vascular trauma management.</span></p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 2","pages":"Pages 268-282"},"PeriodicalIF":2.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9715756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Resuscitative balloon occlusion of the aorta in the modern era: Expanding indications, optimal techniques, unresolved issues, and current results 现代主动脉球囊复苏闭塞：扩大适应症、最佳技术、未解决的问题和当前结果

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2023-06-01 DOI: 10.1053/j.semvascsurg.2023.04.005

Joanna Shaw, Megan Brenner

引用次数: 0

Diagnosis and management of acute conditions of the extracranial carotid artery 颅外颈动脉急性病变的诊断和处理

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2023-06-01 DOI: 10.1053/j.semvascsurg.2023.04.003

Rodolfo Pini , Enrico Gallitto , Sara Fronterrè , Cristina Rocchi , Marcello Lodato , Betti Shyti , Gianluca Faggioli , Mauro Gargiulo

{"title":"Diagnosis and management of acute conditions of the extracranial carotid artery","authors":"Rodolfo Pini , Enrico Gallitto , Sara Fronterrè , Cristina Rocchi , Marcello Lodato , Betti Shyti , Gianluca Faggioli , Mauro Gargiulo","doi":"10.1053/j.semvascsurg.2023.04.003","DOIUrl":"10.1053/j.semvascsurg.2023.04.003","url":null,"abstract":"<div><p><span><span><span>Symptomatic carotid stenosis and carotid dissection are acute conditions of extracranial cerebrovascular vessels determining </span>transient ischemic attack<span> or stroke. Medical, surgical, or endovascular management are different options to treat these pathologies. This narrative review focused on the management, from symptoms to treatment, of the acute conditions of extracranial cerebrovascular vessels, including post–carotid </span></span>revascularization stroke. Symptomatic carotid stenosis (> 50% according to North American Symptomatic </span>Carotid Endarterectomy<span> Trial criteria) with transient ischemic attack or stroke benefits from carotid revascularization—primarily with carotid endarterectomy associated with medical therapy—within 2 weeks from symptom onset to reduce the risk of stroke recurrence. Different from acute extracranial carotid dissection, medical management with antiplatelet<span> or anticoagulant therapy<span> can prevent new neurologic ischemic events, considering stenting only in case of symptom recurrence. Stroke after carotid revascularization can be associated with the following etiologies: carotid manipulation, plaque fragmentation, or clamping ischemia. Medical or surgical management is therefore influenced by the cause and timing of the neurologic events after carotid revascularization. Acute conditions of the extracranial cerebrovascular vessels include a heterogeneous group of pathologies and correct management can reduce symptom recurrence substantially.</span></span></span></p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 2","pages":"Pages 130-138"},"PeriodicalIF":2.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9659880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

The role of big data, risk prediction, simulation, and centralization for emergency vascular problems: Lessons learned and future directions 大数据、风险预测、模拟和集中在急诊血管问题中的作用：经验教训和未来方向

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2023-06-01 DOI: 10.1053/j.semvascsurg.2023.03.003

Salvatore T. Scali , David H. Stone

{"title":"The role of big data, risk prediction, simulation, and centralization for emergency vascular problems: Lessons learned and future directions","authors":"Salvatore T. Scali , David H. Stone","doi":"10.1053/j.semvascsurg.2023.03.003","DOIUrl":"10.1053/j.semvascsurg.2023.03.003","url":null,"abstract":"<div><p>Vascular specialists remain in high demand in current practice and commonly oversee care delivery for a variety of clinical emergencies. Accordingly, the contemporary vascular surgeon must be facile with treating a spectrum of problems, including a complex, heterogeneous group of acute arteriovenous thromboembolic and bleeding diatheses. It has been documented previously that there are substantial current workforce limitations placing constraints on vascular surgical care provision. Moreover, with the aging at-risk population, there remains a considerable national urgency to improve timely diagnoses, specialty consultation, and appropriate transfer of patients to centers of excellence capable of providing a comprehensive compendium of emergency vascular services. Clinical decision aids, simulation training, and regionalization of nonelective vascular problems are all strategies that have been increasingly recognized to address these service gaps. Notably, clinical research in vascular surgery has traditionally focused on identification of patient- and procedure-related factors that influence outcomes by using resource-intensive causal inference methodology. By comparison, large data sets have only more recently been recognized to be a valuable tool that can provide heuristic algorithms to address more complex health care problems. Such data can be manipulated to generate clinical risk scores and decision aids, as well as robust outcome descriptions, which stand to inform stakeholders regarding best practice. The purpose of this review was to provide a robust overview of the lessons derived from the application of big data, risk prediction, and simulation in the management of vascular emergencies.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 2","pages":"Pages 380-391"},"PeriodicalIF":2.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9662173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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: 1