Seminars in Vascular Surgery最新文献_第7页

Appropriate Use Criteria Committees: The professional society role in the development and implementation of Appropriate Use Criteria 适当使用标准委员会：专业学会在制定和实施适当使用标准中的作用

IF 3.3 3区医学

Seminars in Vascular Surgery Pub Date : 2024-06-01 DOI: 10.1053/j.semvascsurg.2024.04.004

{"title":"Appropriate Use Criteria Committees: The professional society role in the development and implementation of Appropriate Use Criteria","authors":"","doi":"10.1053/j.semvascsurg.2024.04.004","DOIUrl":"10.1053/j.semvascsurg.2024.04.004","url":null,"abstract":"<div><p><span><span>Vascular surgeons have the ability to manage and intervene on numerous vascular diseases of both the arterial and venous systems. With the growing number of interventions available as endovascular technology evolves, it is important to determine when a procedure is safely indicated for a </span>vascular surgery<span><span> patient. Appropriate Use Criteria (AUC) offer synthesized clinical information and practice standards that can aid clinicians in making these management decisions. Professional societies, such as the Society for Vascular Surgery, bring experts in the field together to collaborate and create AUC for various vascular diseases and interventions. It is essential to publish these criteria in peer-reviewed journals, as well as make them available on public websites so the information is available to vascular surgeons and interventionalists from other specialties who also treat patients with vascular disease. Cardiology, </span>interventional radiology, and interventional </span></span>nephrology<span><span> are some other specialties that perform procedures for vascular disease, and vascular interventions by nonsurgeon specialists continue to increase. The Society for Vascular Surgery has published AUC on intermittent claudication, </span>carotid disease, and abdominal aneurysm management. These are intended to guide practice, but also have highlighted areas for improvement that would allow for more universal implementation of AUC in vascular patient care across medical specialties. Increased intersocietal participation and perhaps inclusion of government and other payer participation will allow professional society–sponsored AUC to evolve, resulting in coordinated, appropriate care for vascular surgery patients.</span></p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 2","pages":"Pages 111-117"},"PeriodicalIF":3.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141051332","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

Appropriateness of care: Asymptomatic carotid stenosis including transcarotid artery revascularization 治疗的适当性：无症状颈动脉狭窄，包括经颈动脉血管重建术

IF 3.3 3区医学

Seminars in Vascular Surgery Pub Date : 2024-06-01 DOI: 10.1053/j.semvascsurg.2024.03.002

{"title":"Appropriateness of care: Asymptomatic carotid stenosis including transcarotid artery revascularization","authors":"","doi":"10.1053/j.semvascsurg.2024.03.002","DOIUrl":"10.1053/j.semvascsurg.2024.03.002","url":null,"abstract":"<div><p><span>Carotid artery stenosis is one of the most common diagnoses treated by vascular specialists in the United States. The optimal management of carotid stenosis remains controversial, however, with notable variation surrounding diagnostic imaging modalities, longitudinal surveillance, medical therapies, and procedural interventions. Data from high-quality </span>randomized controlled trials<span><span><span> and observational studies form the foundation for current management paradigms and societal guidelines that inform clinical practice. Presently, a diagnosis of carotid disease<span> is most often established with duplex ultrasound and supplemental cross-sectional imaging using computed tomography<span><span> or magnetic resonance angiography as needed to provide additional anatomic information. All patients with documented occlusive disease should receive goal-directed medical therapy with </span>antiplatelet agents and a lipid-reduction strategy, most commonly with a statin. Those with severe carotid stenosis and an acceptable life expectancy may be considered for </span></span></span>carotid artery<span> revascularization. The proceduralist should optimally consider a shared decision-making approach in which the tradeoffs of revascularization can be carefully considered with the patient to optimize informed therapeutic decision making. In current practice, three distinct procedure options exist to treat carotid artery stenosis, including </span></span>carotid endarterectomy<span>, transfemoral carotid artery stenting, and transcarotid artery revascularization. It should be noted that each procedure, although often used interchangeably in most clinical settings, carry technical nuances and outcome disparities. In this review, each of these topics are explored and various approaches are outlined surrounding the appropriate use of treatments for patients with asymptomatic carotid artery stenosis.</span></span></p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 2","pages":"Pages 179-187"},"PeriodicalIF":3.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140928486","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

First do no harm (and do what's right) 首先是不伤害（做正确的事）

IF 3.3 3区医学

Seminars in Vascular Surgery Pub Date : 2024-06-01 DOI: 10.1053/j.semvascsurg.2024.05.004

引用次数: 0

Appropriateness of care in complex fenestrated-branched aortic endografting 复杂带瓣主动脉内膜移植术的护理适宜性

IF 3.3 3区医学

Seminars in Vascular Surgery Pub Date : 2024-06-01 DOI: 10.1053/j.semvascsurg.2024.05.002

引用次数: 0

A review of arterial thoracic outlet syndrome 胸廓出口动脉综合征综述

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.02.001

Vamsi K. Potluri Ruojia D. Li Paul Crisostomo Carlos F. Bechara

{"title":"A review of arterial thoracic outlet syndrome","authors":"Vamsi K. Potluri, Ruojia D. Li, Paul Crisostomo, Carlos F. Bechara","doi":"10.1053/j.semvascsurg.2024.02.001","DOIUrl":"10.1053/j.semvascsurg.2024.02.001","url":null,"abstract":"<div><p>Arterial thoracic outlet syndrome (TOS) is a condition in which anatomic abnormalities in the thoracic outlet cause compression of the subclavian or, less commonly, axillary artery. Patients are usually younger and typically have an anatomic abnormality causing the compression. The condition usually goes undiagnosed until patients present with signs of acute or chronic hand or arm ischemia. Workup of this condition includes a thorough history and physical examination; chest x-ray to identify potential anatomic abnormalities; and arterial imaging, such as computed tomographic angiography or duplex to identify arterial abnormalities. Patients will usually require operative intervention, given their symptomatic presentation. Intervention should always include decompression of the thoracic outlet with at least a first-rib resection and any other structures causing external compression. If the artery is identified to have intimal damage, mural thrombus, or is aneurysmal, then arterial reconstruction is warranted. Stenting should be avoided due to external compression. In patients with symptoms of embolization, a combination of embolectomy, lytic catheter placement, and/or therapeutic anticoagulation should be done. Typically, patients have excellent outcomes, with resolution of symptoms and high patency of the bypass graft, although patients with distal embolization may require finger amputation.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 1","pages":"Pages 12-19"},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0895796724000097/pdfft?md5=d724161cf1aaa38c9fde345efe2e703a&pid=1-s2.0-S0895796724000097-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139814305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The infraclavicular approach for venous thoracic outlet syndrome 锁骨下入路治疗胸廓出口静脉综合征

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.01.003

Sarah A. Loh Britt H. Tonnessen

引用次数: 0

Neurogenic thoracic outlet syndrome and controversies in diagnosis and management 神经源性胸廓出口综合征和诊断/管理方面的争议

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.02.002

J. Westley Ohman Ramesh K. Tripathi Erin McIntosh

{"title":"Neurogenic thoracic outlet syndrome and controversies in diagnosis and management","authors":"Erin McIntosh , Ramesh K. Tripathi , J. Westley Ohman","doi":"10.1053/j.semvascsurg.2024.02.002","DOIUrl":"10.1053/j.semvascsurg.2024.02.002","url":null,"abstract":"<div><p>Compression of the neurovascular structures at the level of the scalene triangle and pectoralis minor space is rare, but increasing awareness and understanding is allowing for the treatment of more individuals than in the past. We outlined the recognition, preoperative evaluation, and treatment of patients with neurogenic thoracic outlet syndrome. Recent work has illustrated the role of imaging and centrality of the physical examination on the diagnosis. However, a fuller understanding of the spatial biomechanics of the shoulder, scalene triangle, and pectoralis minor musculotendinous complex has shown that, although physical therapy is a mainstay of treatment, a poor response to physical therapy with a sound diagnosis should not preclude decompression. Modes of failure of surgical decompression stress the importance of full resection of the anterior scalene muscle and all posterior rib impinging elements to minimize the risk of recurrence of symptoms. Neurogenic thoracic outlet syndrome is a rare but critical cause of disability of the upper extremity. Modern understanding of the pathophysiology and evaluation have led to a sounder diagnosis. Although physical therapy is a mainstay, surgical decompression remains the gold standard to preserve and recover function of the upper extremity. Understanding these principles will be central to further developments in the treatment of this patient population.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 1","pages":"Pages 20-25"},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0895796724000085/pdfft?md5=507694d0dfd52fd9d6eeb9df752d6ff6&pid=1-s2.0-S0895796724000085-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139924808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trans-axillary thoracic outlet decompression 经腋窝胸廓出口减压术

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.02.006

Bart F.L. van Nuenen Niels Pesser Joep A.W. Teijink Jens Goeteyn Stijn B.J. Teijink Marc R.H.M. van Sambeek

引用次数: 0

Current concepts in clinical features and diagnosis of thoracic outlet syndrome 胸廓出口综合征临床特征和诊断的最新概念

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.01.005

Katharine L. McGinigle Prem Chand Gupta Ehsan Benrashid Alexis Betancourt

引用次数: 0

Diagnosis and management of thoracic outlet syndrome in athletes 运动员胸廓出口综合征的诊断和治疗

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.01.007

Andrea T. Fisher, Jason T. Lee

{"title":"Diagnosis and management of thoracic outlet syndrome in athletes","authors":"Andrea T. Fisher, Jason T. Lee","doi":"10.1053/j.semvascsurg.2024.01.007","DOIUrl":"10.1053/j.semvascsurg.2024.01.007","url":null,"abstract":"<div><p>The physical demands of sports can place patients at elevated risk of use-related pathologies, including thoracic outlet syndrome (TOS). Overhead athletes in particular (eg, baseball and football players, swimmers, divers, and weightlifters) often subject their subclavian vessels and brachial plexuses to repetitive trauma, resulting in venous effort thrombosis, arterial occlusions, brachial plexopathy, and more. This patient population is at higher risk for Paget-Schroetter syndrome, or effort thrombosis, although neurogenic TOS (nTOS) is still the predominant form of the disease among all groups. First-rib resection is almost always recommended for vascular TOS in a young, active population, although a surgical benefit for patients with nTOS is less clear. Practitioners specializing in upper extremity disorders should take care to differentiate TOS from other repetitive use–related disorders, including shoulder orthopedic injuries and nerve entrapments at other areas of the neck and arm, as TOS is usually a diagnosis of exclusion. For nTOS, physical therapy is a cornerstone of diagnosis, along with response to injections. Most patients first undergo some period of nonoperative management with intense physical therapy and training before proceeding with rib resection. It is particularly essential for ensuring that athletes can return to their baselines of flexibility, strength, and stamina in the upper extremity. Botulinum toxin and lidocaine injections in the anterior scalene muscle might predict which patients will likely benefit from first-rib resection. Athletes are usually satisfied with their decisions to undergo first-rib resection, although the risk of rare but potentially career- or life-threatening complications, such as brachial plexus injury or subclavian vessel injury, must be considered. Frequently, they are able to return to the same or a higher level of play after full recovery.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 1","pages":"Pages 35-43"},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139670275","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