Seminars in Vascular Surgery最新文献

{"title":"A scoping review of female sex–related outcomes after endovascular intervention for lifestyle-limiting claudication and chronic limb-threatening ischemia","authors":"Pallavi Manvar-Singh ,&nbsp;Alicia Folk ,&nbsp;Elizabeth A. Genovese","doi":"10.1053/j.semvascsurg.2023.10.001","DOIUrl":"10.1053/j.semvascsurg.2023.10.001","url":null,"abstract":"<div><p><span>Peripheral arterial disease<span> (PAD) is on the rise, with a growing prevalence in an aging population and increasing rates of diabetes. Chronic limb-threatening ischemia poses a significant risk of limb loss. PAD is common in females, particularly after menopause, with a 35% prevalence rate in females older than 65 years. Studies have suggested that females have inferior outcomes compared with men after endovascular </span></span>revascularization<span><span> for PAD. With the rising utilization of endovascular interventions for the treatment of PAD, we sought to perform a review of sex-based outcomes of peripheral endovascular interventions for the treatment of symptomatic PAD. A scoping literature review was conducted to evaluate outcomes in females patients undergoing endovascular peripheral interventions for PAD. Eligibility criteria included studies focusing on adult females with lifestyle-limiting </span>claudication<span><span> or chronic limb-threatening ischemia who underwent endovascular intervention. Various endovascular procedures were considered and outcomes of interest included mortality, amputations, reinterventions, bleeding complications, and major adverse cardiac events. A systematic search was conducted in PubMed, Embase, Web of Science, and Cochrane Library databases. Sixteen studies were included in the review. Females patients undergoing endovascular interventions were associated with bleeding complications, higher rates of reintervention, and a risk of nonfatal strokes. However, females sex was not linked to higher rates of amputation or conclusively higher mortality rates post intervention. The comprehensive scoping review reveals important sex-related </span>disparities in outcomes after endovascular procedures for symptomatic PAD. Females patients have been reported to experience worse outcomes in terms of reinterventions and bleeding complications. These findings emphasize the need for future trials focusing specifically on females patients to develop sex-inclusive treatment recommendations for advanced PAD.</span></span></p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 4","pages":"Pages 541-549"},"PeriodicalIF":2.5,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135762733","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}

{"title":"Presentation and outcomes of thoracic and thoracoabdominal aortic aneurysms in females, existing gaps, and future directions: A descriptive review","authors":"Sharon C. Kiang ,&nbsp;Mary M. Lee ,&nbsp;Hanaa Dakour-Aridi ,&nbsp;Madiha Hassan ,&nbsp;Rana O. Afifi","doi":"10.1053/j.semvascsurg.2023.10.004","DOIUrl":"10.1053/j.semvascsurg.2023.10.004","url":null,"abstract":"<div><p>Thoracic and thoracoabdominal aortic aneurysms<span><span> are more common in men. Yet, females often have worse outcomes, fewer interventions, and lower treatment rates. Females have also benefited less from the research and treatment of those diseases than men. Understanding sex- and sex-specific differences in thoracic and thoracoabdominal aortic aneurysms can improve care delivery, reduce </span>disparities<span>, and optimize outcomes for females with thoracic aortic aneurysms and thoracoabdominal aortic aneurysms. The authors reviewed the literature on the presentation and outcomes of thoracic and thoracoabdominal aortic aneurysms in females, discussing the existing gaps and future directions to address them.</span></span></p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 4","pages":"Pages 501-507"},"PeriodicalIF":2.5,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135656347","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}

{"title":"Prevalence and outcomes of select rare vascular conditions in females: A descriptive review","authors":"Rebecca Sorber ,&nbsp;Caitlin J. Bowen ,&nbsp;Shannon N. Radomski ,&nbsp;Sherene Shalhub","doi":"10.1053/j.semvascsurg.2023.10.003","DOIUrl":"10.1053/j.semvascsurg.2023.10.003","url":null,"abstract":"<div><p>Rare vascular conditions frequently pose a diagnostic and therapeutic dilemma for health care providers. Several of these conditions have distinct relevance to females populations but, due to their infrequency, there has been little reported on the outcomes of rare vascular conditions specifically in females populations. We performed a literature review of a selection of three rare vascular conditions known to either disproportionately affect females (median arcuate ligament syndrome and fibromuscular dysplasia) or have unique manifestations in females populations (vascular Ehlers-Danlos syndrome). We performed a descriptive review of the literature focused on these three vascular conditions and identified aspects of the current available research describing sex-based differences in prevalence, any pathophysiology explaining the observed sex-based differences, and the contribution of sex to outcomes for each disease process. In addition, considerations for pregnant females with respect to each rare vascular disease process are discussed.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 4","pages":"Pages 571-578"},"PeriodicalIF":2.5,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135605562","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}

{"title":"Sex disparities in outcomes after carotid artery interventions: A systematic review","authors":"Yana Etkin ,&nbsp;Lisa Iyeke ,&nbsp;Grace Yu ,&nbsp;Isra Ahmed ,&nbsp;Pasquale Matera ,&nbsp;Jonathan Aminov ,&nbsp;Angela Kokkosis ,&nbsp;Laurel Hastings ,&nbsp;Karan Garg ,&nbsp;Caron Rockman","doi":"10.1053/j.semvascsurg.2023.09.004","DOIUrl":"10.1053/j.semvascsurg.2023.09.004","url":null,"abstract":"<div><p><span><span><span>This systematic review aimed to identify sex-specific outcomes in men and women after </span>carotid endarterectomy<span> (CEA) and carotid artery stenting (CAS), including transfemoral and transcarotid. A search of literature published from January 2000 through December 2022 was conducted using key terms attributed to </span></span>carotid interventions<span> on PubMed. Studies comparing outcome metrics post intervention (ie, myocardial infarction [MI], cerebral vascular accident [CVA] or stroke, and long-term mortality) among male and female patients were reviewed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Overall, all studies reported low rates of perioperative complications. Among the studies that did not stratify outcomes by the preoperative symptom status, there were no significant sex differences in rates of perioperative strokes or MIs. Two studies, however, noted a higher rate of 30-day mortality in male patients undergoing CEA than in female patients. Analysis of asymptomatic patients undergoing CEA revealed no difference in perioperative MIs (female: 0% to 1.8% </span></span><em>v</em> male: 0.4% to 4.3%), similar rates of CVAs (female: 0.8% to 5% <em>v</em> male: 0.8% to 4.9%), and no significant differences in the long-term mortality outcomes. Alternatively, symptomatic patients undergoing CEA reported a higher rate of CVAs in female patients vs. male patients (7.7% <em>v</em> 6.2%) and showed a higher rate of death in female patients (1% <em>v</em><span> 0.7%). Among studies that did not stratify outcome by symptomatology, there was no difference in the 30-day outcomes between sexes for patients undergoing CAS. Asymptomatic patients undergoing CAS demonstrated similar incident rates across perioperative MIs (female: 0% to 5.9% </span><em>v</em> male: 0.28% to 3.3%), CVAs (female: 0.5% to 4.1% <em>v</em> male: 0.4% to 6.2%), and long-term mortality outcomes (female: 0% to 1.75% <em>v</em> male: 0.2% to 1.5%). Symptomatic patients undergoing CAS similarly reported higher incidences of perioperative MIs (female: 0.3% to 7.1% <em>v</em> male: 0% to 5.5%), CVAs (female: 0% to 9.9% <em>v</em> male: 0% to 7.6%), and long-term mortality outcomes (female: 0.6% to 7.1% <em>v</em> male: 0.5% to 8.2%). Sex-specific differences in outcomes after major vascular procedures are well recognized. Our review suggests that symptomatic female patients have a higher incidence of neurologic and cardiac events after carotid interventions, but that asymptomatic patients do not.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 4","pages":"Pages 476-486"},"PeriodicalIF":2.5,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134977688","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}

{"title":"Thoracic outlet syndrome in females: A systematic review","authors":"Lauren E. Cralle ,&nbsp;Linda M. Harris ,&nbsp;Ying Wei Lum ,&nbsp;Sarah E. Deery ,&nbsp;Misty D. Humphries","doi":"10.1053/j.semvascsurg.2023.09.003","DOIUrl":"10.1053/j.semvascsurg.2023.09.003","url":null,"abstract":"<div><p><span><span>Thoracic outlet syndrome (TOS) is a rare anatomic condition caused by compression of neurovascular structures as they traverse the thoracic outlet. Depending on the </span>primary structure affected by this spatial narrowing, patients present with one of three types of TOS—venous TOS, arterial TOS, or neurogenic TOS. Compression of the </span>subclavian vein<span><span>, subclavian artery, or </span>brachial plexus<span> leads to a constellation of symptoms, including venous thrombosis<span><span>, with associated discomfort and swelling; upper extremity ischemia; and chronic pain due to brachial </span>plexopathy<span>. Standard textbooks have reported a predominance of females patients in the TOS population, with females comprising 70%. However, there have been few comparative studies of sex differences in presentation, treatment, and outcomes for the various types of TOS.</span></span></span></span></p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 4","pages":"Pages 487-491"},"PeriodicalIF":2.5,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434206","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}

{"title":"Sex disparities in patients with acute aortic dissection: A scoping review","authors":"Amanda C. Filiberto ,&nbsp;Omar I. Ramadan ,&nbsp;Grace J. Wang ,&nbsp;Michol A. Cooper","doi":"10.1053/j.semvascsurg.2023.09.002","DOIUrl":"10.1053/j.semvascsurg.2023.09.002","url":null,"abstract":"<div><p><span><span>Disparities in outcomes for patients with cardiovascular disease and those undergoing cardiac or vascular operations are well-established. These disparities often span several dimensions and persist despite advancements in medical and surgical care; sex is among the most pervasive. Specifically, females sex has been implicated as a predictor of poor outcomes in both patients with acute type A </span>aortic dissections<span> (ATAADs) and type B aortic dissections (TBADs). For instance, one study, using the International Registry of Acute Aortic Dissection database, found that females with acute aortic dissection—including ATAAD and TBAD that were either medically or surgically managed—had 40% higher odds of in-hospital mortality than men. Notably, both types of acute aortic dissections affect men more commonly than females and can be life-threatening without prompt, appropriate treatment. The underlying mechanisms for these disparities are unclear but are thought to be multifactorial. The association of sex with patterns of disease and outcomes </span></span>in patients with ATAAD or TBAD remains unclear, with conflicting reports from different studies. Thus, we sought to review the literature regarding sex disparities in patients with ATAAD and TBAD.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 4","pages":"Pages 492-500"},"PeriodicalIF":2.5,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135205161","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}

{"title":"Bias in artificial intelligence in vascular surgery","authors":"Zachary Tran ,&nbsp;Julianne Byun ,&nbsp;Ha Yeon Lee ,&nbsp;Hans Boggs ,&nbsp;Emma Y. Tomihama ,&nbsp;Sharon C. Kiang","doi":"10.1053/j.semvascsurg.2023.07.003","DOIUrl":"10.1053/j.semvascsurg.2023.07.003","url":null,"abstract":"<div><p><span>Application of artificial intelligence (AI) has revolutionized the utilization of big data, especially in patient care. The potential of deep learning models to learn without </span><em>a priori</em><span> assumption, or without prior learning, to connect seemingly unrelated information mixes excitement alongside hesitation to fully understand AI's limitations. Bias, ranging from data collection and input to algorithm development to finally human review of algorithm output affects AI's application to clinical patient presents unique challenges that differ significantly from biases in traditional analyses. Algorithm fairness, a new field of research within AI, aims to mitigate bias by evaluating the data at the preprocessing stage, optimizing during algorithm development, and evaluating algorithm output at the postprocessing stage. As the field continues to develop, being cognizant of the inherent biases and limitations related to black box decision making, biased data sets agnostic to patient-level disparities, wide variation of present methodologies, and lack of common reporting standards will require ongoing research to provide transparency to AI and its applications.</span></p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 3","pages":"Pages 430-434"},"PeriodicalIF":2.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48099709","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}

{"title":"Considerations for the application of artificial intelligence in vascular surgical education","authors":"David A. Rigberg ,&nbsp;Jeffrey Jim","doi":"10.1053/j.semvascsurg.2023.07.004","DOIUrl":"10.1053/j.semvascsurg.2023.07.004","url":null,"abstract":"<div><p>The rapid adoption of artificial intelligence (AI) into everyday use has presented multiple issues for surgical educators to consider. In this article, the authors discuss some of the ethical aspects of academic integrity and the use of AI. These issues include the importance of understanding the current limits of AI and the inherent biases of the technology. The authors further discuss the ethical considerations of the use of AI in surgical training and in clinical use, with an emphasis on vascular surgery.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 3","pages":"Pages 471-474"},"PeriodicalIF":2.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684759","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}

{"title":"FORWARD","authors":"Sharon C. Kiang MD, RPVI, FSVS, FACS","doi":"10.1053/j.semvascsurg.2023.07.005","DOIUrl":"10.1053/j.semvascsurg.2023.07.005","url":null,"abstract":"","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 3","pages":"Page 393"},"PeriodicalIF":2.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684760","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}

{"title":"Machine learning and image analysis in vascular surgery","authors":"Roger T. Tomihama ,&nbsp;Saharsh Dass ,&nbsp;Sally Chen ,&nbsp;Sharon C. Kiang","doi":"10.1053/j.semvascsurg.2023.07.001","DOIUrl":"10.1053/j.semvascsurg.2023.07.001","url":null,"abstract":"<div><p><span>Deep learning, a subset of machine learning within artificial intelligence, has been successful in medical image analysis<span> in vascular surgery. Unlike traditional computer-based segmentation methods that manually extract features from input images, deep learning methods learn image features and classify data without making prior assumptions. Convolutional neural networks, the main type of deep learning for computer vision processing, are neural networks with multilevel architecture and weighted connections between nodes that can “auto-learn” through repeated exposure to training data without manual input or supervision. These networks have numerous applications in vascular surgery imaging analysis, particularly in </span></span>disease classification, object identification, semantic segmentation, and instance segmentation. The purpose of this review article was to review the relevant concepts of machine learning image analysis and its application to the field of vascular surgery.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 3","pages":"Pages 413-418"},"PeriodicalIF":2.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47752934","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}