CVIR Endovascular最新文献

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Protrieve sheath utilization for capturing supra-filter thrombus during a retrieval of thrombosed and embedded IVC filter. 在收回血栓形成和嵌入式IVC过滤器期间,利用保护鞘捕获过滤器上血栓。
IF 1.2
CVIR Endovascular Pub Date : 2023-10-26 DOI: 10.1186/s42155-023-00397-4
Annabella Shewarega, Taylor M Powell, Douglas Silin
{"title":"Protrieve sheath utilization for capturing supra-filter thrombus during a retrieval of thrombosed and embedded IVC filter.","authors":"Annabella Shewarega,&nbsp;Taylor M Powell,&nbsp;Douglas Silin","doi":"10.1186/s42155-023-00397-4","DOIUrl":"10.1186/s42155-023-00397-4","url":null,"abstract":"<p><strong>Background: </strong>Inferior vena cava (IVC) filters, while effective in preventing pulmonary embolism, can increase the risk of IVC thrombosis. IVC filter (IVCF) thrombosis can result from emboli getting trapped within the filter, extension of deep vein thrombosis (DVT), or the device's inherent thrombogenicity causing in situ thrombosis. This condition can cause noticeable clinical symptoms and complicate the removal of the filter due to the potential for thromboembolism, often resulting in temporary filters remaining unextracted. This case report highlights a novel approach employed to mitigate the risk of thromboembolism during the procedure by capturing mobilized thrombus proximally to the entrapped IVCF.</p><p><strong>Case presentation: </strong>A 54-year-old woman with a complex medical history including cerebral palsy, Crohn's disease, and transfusion-dependent iron-deficiency anemia experienced a pulmonary embolism. Due to failed anticoagulation therapy resulting in gastrointestinal bleeding and high transfusion requirements, she underwent placement of an IVCF as a preventive measure against recurrent pulmonary embolism. Three years later, the patient presented with lower extremity swelling and a sudden decline in hemoglobin levels. Diagnostic imaging revealed adherent nonocclusive thrombus within and above the indwelling IVCF. Utilizing the novel Protrieve sheath with the self-expandable Nitinol funnel, successful endovascular removal of the embedded IVCF and adherent thrombus was performed, while mitigating the risk of intraprocedural pulmonary embolism.</p><p><strong>Conclusions: </strong>The successful intraprocedural trapping and removal of mobilized thrombus from the IVCF removal was achieved using the Protrieve sheath and Nitinol funnel. This approach provides a promising solution to reduce the risk of embolization during the removal of thrombosed IVCFs, potentially outweighing the complications associated with filter removal.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10602975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50163741","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
Embolization of pseudoaneurysms in the ureteral branch of the renal artery. 肾动脉输尿管支假性动脉瘤的栓塞治疗。
IF 1.2
CVIR Endovascular Pub Date : 2023-10-23 DOI: 10.1186/s42155-023-00400-y
Atsushi Saiga, Takeshi Aramaki, Rui Sato, Kazuhisa Asahara, Hironori Goto
{"title":"Embolization of pseudoaneurysms in the ureteral branch of the renal artery.","authors":"Atsushi Saiga, Takeshi Aramaki, Rui Sato, Kazuhisa Asahara, Hironori Goto","doi":"10.1186/s42155-023-00400-y","DOIUrl":"10.1186/s42155-023-00400-y","url":null,"abstract":"<p><strong>Background: </strong>Although transcatheter arterial embolization for pseudoaneurysms is already well-established, ureteral artery pseudoaneurysm embolization is extremely rare. The present case shows a successful transcatheter arterial embolization for pseudoaneurysms in the ureteral branch of the renal artery due to ureteral invasion from gastric cancer.</p><p><strong>Case presentation: </strong>A 57-year-old female presented with gross hematuria after treatments for poorly differentiated gastric adenocarcinoma. A contrast-enhanced computed tomography revealed pseudoaneurysms around the right ureter with a massive hematoma in the right ureter and bladder. The diagnosis was ureteral branch pseudoaneurysms resulting from possible retroperitoneal invasion due to pelvic lymph node metastasis of gastric cancer. Transcatheter arterial embolization was performed using gelatin particles, successfully controlling her hematuria without complications.</p><p><strong>Conclusions: </strong>Ureteral branch artery embolization, although extremely rare, may be an effective and safe treatment option.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10593685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693812","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
Endovascular coil-embolization of an unruptured, true UAA during early pregnancy- a case report. 妊娠早期未破裂的真正UAA的血管内线圈栓塞——一例报告。
IF 1.2
CVIR Endovascular Pub Date : 2023-10-23 DOI: 10.1186/s42155-023-00398-3
Kai Jannusch, Andrea Steuwe, Lars Schimmöller, Frederic Dietzel, Lena M Wilms, Daniel Weiss, Farid Ziayee, Tanja Natascha Fehm, Charlotte Schlimgen, Vanessa Poth, Reinhold Thomas Ziegler, Peter Minko
{"title":"Endovascular coil-embolization of an unruptured, true UAA during early pregnancy- a case report.","authors":"Kai Jannusch, Andrea Steuwe, Lars Schimmöller, Frederic Dietzel, Lena M Wilms, Daniel Weiss, Farid Ziayee, Tanja Natascha Fehm, Charlotte Schlimgen, Vanessa Poth, Reinhold Thomas Ziegler, Peter Minko","doi":"10.1186/s42155-023-00398-3","DOIUrl":"10.1186/s42155-023-00398-3","url":null,"abstract":"<p><strong>Background: </strong>True uterine artery aneurysms, especially during pregnancy, are a rare entity and not well understood. Clinical symptoms are unspecific pelvic pain and pressure. Diagnosis can be confirmed by transvaginal color-coded-sonography and/or magnetic resonance imaging. Because of potential risk of rupture, immediate interdisciplinary discussion and treatment planning in the best interests of both mother and child is crucial.</p><p><strong>Case presentation: </strong>We present a 31-year-old pregnant woman with increasing pelvic pain and pressure. Diagnosis of an unruptured uterine artery aneurysm was confirmed by color-coded-sonography and magnetic resonance angiography. After interdisciplinary consultation, successful endovascular super-selective coil-embolization was performed by using X-ray fluoroscopy. Thus, fetal radiation dose during treatment with 4.33 mGy (VirtualDoseTM) was as low as possible with no immediate harm to the fetus.</p><p><strong>Conclusions: </strong>Unruptured true uterine artery aneurysms can be successfully treated by endovascular super-selective coil-embolization during early pregnancy with no immediate harm to the fetus.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10593720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693813","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
Neointimal dissection - a rare complication to endovascular treatment in grafts and stent grafts. 内膜夹层-移植物和支架移植物血管内治疗的罕见并发症。
IF 1.2
CVIR Endovascular Pub Date : 2023-10-23 DOI: 10.1186/s42155-023-00401-x
Anne Sofie F Larsen, Shakil Aslam, Lars Olaf Holmen
{"title":"Neointimal dissection - a rare complication to endovascular treatment in grafts and stent grafts.","authors":"Anne Sofie F Larsen, Shakil Aslam, Lars Olaf Holmen","doi":"10.1186/s42155-023-00401-x","DOIUrl":"10.1186/s42155-023-00401-x","url":null,"abstract":"<p><strong>Background: </strong>Neointima formation and hyperplasia in vascular grafts may lead to graft complications threatening the patency of the vascular reconstruction. A rare complication to endovascular treatment of grafts and stent grafts is dissection inside the graft.</p><p><strong>Case report: </strong>We present here a case of a 69-year-old female with acute occlusion of the limb of an aorto-bifemoral graft for the third time, 16 years after the primary operation. As at the first two occasions, catheter-based intra-arterial thrombolysis was performed, but with residual stenosis inside the graft. During stent placement, dissection of the neointima or fibrin sheet occluded the inflow to the stent. The complication was resolved with placement of kissing stents.</p><p><strong>Conclusions: </strong>It is important to recognize iatrogenic neointima dissection inside graft and stent grafts, as continued thrombolysis will not solve this, but increase the risk of hemorrhagic complications.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10593731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693814","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
Clinical feasibility of endovascular recanalization with intravascular ultrasound-guided wiring for chronic total occlusion of below-the-knee arteries. 血管内超声引导下导线血管内再通治疗膝下动脉慢性完全闭塞的临床可行性。
IF 1.2
CVIR Endovascular Pub Date : 2023-10-19 DOI: 10.1186/s42155-023-00399-2
Naoki Hayakawa, Satoshi Kodera, Hiromi Miwa, Shinya Ichihara, Satoshi Hirano, Masataka Arakawa, Yasunori Inoguchi, Shunichi Kushida
{"title":"Clinical feasibility of endovascular recanalization with intravascular ultrasound-guided wiring for chronic total occlusion of below-the-knee arteries.","authors":"Naoki Hayakawa, Satoshi Kodera, Hiromi Miwa, Shinya Ichihara, Satoshi Hirano, Masataka Arakawa, Yasunori Inoguchi, Shunichi Kushida","doi":"10.1186/s42155-023-00399-2","DOIUrl":"10.1186/s42155-023-00399-2","url":null,"abstract":"<p><strong>Background: </strong>Revascularization with endovascular therapy (EVT) for complex below-the-knee (BTK) chronic total occlusion (CTO) remains a challenging problem. The Japanese-BTK (J-BTK) CTO score is reported as an indicator of the difficulty of BTK CTO, with the guidewire (GW) passage success rate decreasing as the grade increases. We previously reported an effective GW crossing method for the intravascular ultrasound (IVUS)-guided parallel wiring of complex BTK CTO. In this study, we investigated the feasibility of EVT using IVUS-guided wiring for BTK CTO.</p><p><strong>Materials and methods: </strong>This single center, retrospective study analyzed 65 consecutive BTK CTO vessels in which IVUS-guided wiring was attempted after the failure of a conventional antegrade wiring approach from November 2020 to November 2022. The primary endpoint was the clinical success of the target CTO vessel. The secondary endpoints were the GW success rate per grade based on the J-BTK CTO score, number of GW used for CTO crossing, fluoroscopy time, and complications.</p><p><strong>Results: </strong>Target vessels were the anterior tibial artery (66.2% of cases), peroneal artery (9.2%), and posterior tibial artery (24.6%). Blunt type CTO entry was performed in 55.4% of cases, calcification of entry was observed in 24.6% of cases, the mean occlusion length was 228.2 ± 93.7 mm, mean reference vessel diameter was 2.1 ± 0.71 mm, and outflow was absent in 38.5% of cases. J-BTK CTO scores of 0/1 (grade A), 2/3 (grade B), 4/5 (grade C), and 6 (grade D) were seen in 18.5%, 43.1%, 36.3%, and 1.5% of cases, respectively. The clinical success rate was 95.4%. The GW success rate by J-BTK CTO grade was as follows: grade A (100%), B (100%), C (91.7%), and D (0%). The mean number of GW used was 3.4 ± 1.4, the mean fluoroscopy time was 72.3 ± 32.5 min, and complications occurred in 7.7% of cases.</p><p><strong>Conclusion: </strong>This study showed a very high clinical success rate despite the difficulty of BTK CTO. IVUS-guided EVT might be a feasible strategy for complex BTK CTO.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10587042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684902","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
Transarterial interventions in civilian gunshot wound injury: experience from a level-1 trauma center. 经动脉介入治疗平民枪伤:一级创伤中心的经验。
IF 1.2
CVIR Endovascular Pub Date : 2023-10-16 DOI: 10.1186/s42155-023-00396-5
Qian Yu, Alex Lionberg, Kylie Zane, Ethan Ungchusri, Jonathan Du, Karan Nijhawan, Austin Clarey, Rakesh Navuluri, Osman Ahmed, Priya Prakash, Jeffrey Leef, Brian Funaki
{"title":"Transarterial interventions in civilian gunshot wound injury: experience from a level-1 trauma center.","authors":"Qian Yu, Alex Lionberg, Kylie Zane, Ethan Ungchusri, Jonathan Du, Karan Nijhawan, Austin Clarey, Rakesh Navuluri, Osman Ahmed, Priya Prakash, Jeffrey Leef, Brian Funaki","doi":"10.1186/s42155-023-00396-5","DOIUrl":"10.1186/s42155-023-00396-5","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the effectiveness of trans-arterial vascular interventions in treatment of civilian gunshot wounds (GSW).</p><p><strong>Materials and methods: </strong>A retrospective review was performed at a level-1 trauma center to include 46 consecutive adults admitted due to GSW related hemorrhage and treated with endovascular interventions from July 2018 to July 2022. Patient demographics and procedural metrics were retrieved. Primary outcomes of interest include technical success and in-hospital mortality. Factors of mortality were assessed using a logistic regression model.</p><p><strong>Results: </strong>Twenty-one patients were brought to the endovascular suite directly (endovascular group) from the trauma bay and 25 patients after treatment in the operating room (OR group). The OR group had higher hemodynamic instability (48.0% vs 19.0%, p = 0.040), lower hemoglobin (12.9 vs 10.1, p = 0.001) and platelet counts (235.2 vs 155.1, p = 0.003), and worse Acute Physiology and Chronic Health Evaluation (APACHE) score (4.1 vs 10.2, p < 0.0001) at the time of initial presentation. Technical success was achieved in all 40 cases in which targeted embolization was attempted (100%). Empiric embolization was performed in 6/46 (13.0%) patients based on computed tomographic angiogram (CTA) and operative findings. Stent-grafts were placed in 3 patients for subclavian artery injuries. Availability of pre-intervention CTA was associated with shorter fluoroscopy time (19.8 ± 12.1 vs 30.7 ± 18.6 min, p = 0.030). A total of 41 patients were discharged in stable condition (89.1%). Hollow organ injury was associated with mortality (p = 0.039).</p><p><strong>Conclusion: </strong>Endovascular embolization and stenting were effective in managing hemorrhage due to GSW in a carefully selected population. Hollow organ injury was a statistically significant predictor of mortality. Pre-intervention CTA enabled targeted, shorter and equally effective procedures.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10579195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240808","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 technical review of percutaneous sclerotherapy with bleomycin for giant hepatic venous malformation. 博来霉素经皮硬化治疗巨大肝静脉畸形的技术回顾。
IF 1.2
CVIR Endovascular Pub Date : 2023-09-27 DOI: 10.1186/s42155-023-00394-7
Omid Ghaemi, Mohammad-Mehdi Mehrabi Nejad, Mohammad Reza Rouhezamin, Niloofar Ayoobi Yazdi, Ramin Pourghorban, Hadi Rokni Yazdi
{"title":"A technical review of percutaneous sclerotherapy with bleomycin for giant hepatic venous malformation.","authors":"Omid Ghaemi, Mohammad-Mehdi Mehrabi Nejad, Mohammad Reza Rouhezamin, Niloofar Ayoobi Yazdi, Ramin Pourghorban, Hadi Rokni Yazdi","doi":"10.1186/s42155-023-00394-7","DOIUrl":"10.1186/s42155-023-00394-7","url":null,"abstract":"<p><strong>Background: </strong>Hepatic venous malformation (HVM), traditionally called liver haemangioma, is considered the most common benign hepatic lesion. Treatment might be indicated in large and symptomatic HVMs. We aim to describe stepwise technical aspects of trans-hepatic percutaneous sclerotherapy of hepatic venous malformation (HVM).</p><p><strong>Main text: </strong>Patients with symptomatic HVM larger than 5 cm are selected after discussion in hepatobiliary multidisciplinary team. After prophylactic antibiotic and corticosteroid administration, local anaesthesia and conscious sedation are applied. A 22-gauge spinal or Chiba needle is used to obtain percutaneous access to the HVM through normal liver parenchyma under ultrasound guidance. To ensure proper needle placement and to prevent accidental delivery of sclerosant into unintended areas, about 5-10 mL iodine contrast is injected under fluoroscopy. Then, 45-60 IU bleomycin is mixed with 10 mL distilled water and 10 mL lipiodol and is slowly injected under fluoroscopy over a period of 20-30 s. After the needle is removed, manual pressure is applied over the puncture site for a period of 5 min followed by placement of a sandbag. Patients are monitored for 6-8 h post-procedure.</p><p><strong>Conclusion: </strong>In this technical review, we described our institutional technique of percutaneous sclerotherapy, which could be regarded as an alternative to TAE in the management of HVM.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10533756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41120255","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
Early stent fractures in superficial femoral artery resulting multiple pseudoaneurysm formation within one year: a case report. 股浅动脉早期支架骨折一年内形成多发假性动脉瘤1例。
IF 1.2
CVIR Endovascular Pub Date : 2023-09-09 DOI: 10.1186/s42155-023-00391-w
Taylor Benedict, Esraa Hassan, Mikael Mir, Sydney Boike, Jidi Gao, Syed Anjum Khan
{"title":"Early stent fractures in superficial femoral artery resulting multiple pseudoaneurysm formation within one year: a case report.","authors":"Taylor Benedict, Esraa Hassan, Mikael Mir, Sydney Boike, Jidi Gao, Syed Anjum Khan","doi":"10.1186/s42155-023-00391-w","DOIUrl":"10.1186/s42155-023-00391-w","url":null,"abstract":"<p><strong>Background: </strong>Though fracture is known complication of stenting, pseudoaneurysm asscoiated with stent fracture is an extremely rare complication. This has previoulsy been described to occur at least one or more years following initial stent placement. Here we present a case of multi-site stent fracture leading to two separate SFA pseudoaneurysms within one year of placement, successfully treated with covered stents.</p><p><strong>Case presentation: </strong>A 72-year-old male presented with severe claudication of his left lower extremity (Rutherford 3), found to have long segment SFA chronic total occlusion (CTO). Patient successfully underwent endovascular revascularization. Follow-up duplex ultrasound (US) at one year demonstrated a focus of severe in-stent restenosis (ISR). During repeat angiogram for treatment of the stenosis, stent fracture and pseudoaneurysm was seen in the distal SFA, which was treated successfully with a self-expanding covered stent. Additional stent fractures and pseudoanerusyms were subseuqently identified on follow-up, necessitating a third angiogram, and these were successfully repaired using overlapping covered stents, without further recurrence.</p><p><strong>Conclusions: </strong>Superficial femoral artery stent fractures leading to pseudoaneurysms are extremely rare, particularly within first year of stent placement. Endovascular repair with covered stents has proven to be an effective treatment option with decreased procedural morbidity compared to surgical repair.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10212319","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
German nation-wide in-patient treatment of abdominal aortic aneurysm-trends between 2005 and 2019 and impact of the SARS-CoV-2 pandemic. 德国全国腹主动脉瘤住院治疗——2005年至2019年的趋势和SARS-CoV-2大流行的影响
IF 1.2
CVIR Endovascular Pub Date : 2023-08-29 DOI: 10.1186/s42155-023-00389-4
Stefanie Bette, Josua A Decker, Sebastian Zerwes, Yvonne Gosslau, Dominik Liebetrau, Alexander Hyhlik-Duerr, Florian Schwarz, Thomas J Kroencke, Christian Scheurig-Muenkler
{"title":"German nation-wide in-patient treatment of abdominal aortic aneurysm-trends between 2005 and 2019 and impact of the SARS-CoV-2 pandemic.","authors":"Stefanie Bette, Josua A Decker, Sebastian Zerwes, Yvonne Gosslau, Dominik Liebetrau, Alexander Hyhlik-Duerr, Florian Schwarz, Thomas J Kroencke, Christian Scheurig-Muenkler","doi":"10.1186/s42155-023-00389-4","DOIUrl":"10.1186/s42155-023-00389-4","url":null,"abstract":"<p><strong>Purpose: </strong>Aim of this study was to analyze hospitalizations due to ruptured and non-ruptured abdominal aortic aneurysms (rAAA, nrAAA) in Germany between 2005 and 2021 to determine long-term trends in treatment and the impact of the SARS-CoV-2 pandemic.</p><p><strong>Materials and methods: </strong>Fully anonymized data were available from the research data center (RDC) of the German Federal Statistical Office (Destatis). All German hospitalizations with the ICD-10 code \"I71.3, rAAA\" and \"I71.4, nrAAA\" in 2005 and 2010-2021 were analyzed.</p><p><strong>Results: </strong>We report data of a total of 202,951 hospitalizations. The number of hospitalizations increased from 2005 to 2019 (14,075 to 16,051, + 14.0%). The rate of open repair (OR) constantly decreased, whereas the rate of endovascular aortic repair (EVAR) increased until 2019. During the pandemic, the number of hospitalizations due to nrAAA dropped from 13,887 (86.5%) in 2019 to 11,278 (85.0%) in 2021. The strongest decrease of hospitalizations for AAA was observed during the first wave of the SARS-CoV-2-pandemic in spring 2020 (-25.5%).</p><p><strong>Conclusion: </strong>Over the past decades, we observed an increasing number of hospitalizations due to AAA accompanied by a shift from OR to EVAR especially for nrAAA. During the lockdown measures due to the SARS-CoV-2-pandemic, a decrease in hospitalizations for nrAAA (but not for rAAA) was shown in 2020 and furthermore in 2021 with no rebound of treatment of nrAAA suggesting an accumulation of untreated AAA with a potentially increased risk of rupture.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10465413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10127739","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
Safety and efficacy of interventional treatment of acute limb ischemia in Germany 2021. 2021年德国急性肢体缺血介入治疗的安全性和有效性。
IF 1.2
CVIR Endovascular Pub Date : 2023-08-26 DOI: 10.1186/s42155-023-00393-8
Moritz B Bastian, Jonathan Nadjiri, Joel Wessendorf, Michael Scheschenja, Alexander M König, Jarmila Jedelska, Andreas H Mahnken
{"title":"Safety and efficacy of interventional treatment of acute limb ischemia in Germany 2021.","authors":"Moritz B Bastian, Jonathan Nadjiri, Joel Wessendorf, Michael Scheschenja, Alexander M König, Jarmila Jedelska, Andreas H Mahnken","doi":"10.1186/s42155-023-00393-8","DOIUrl":"10.1186/s42155-023-00393-8","url":null,"abstract":"<p><strong>Purpose: </strong>Interventional procedures have become a mainstay in the therapy of acute limb ischemia caused by embolism or arterial thrombosis. Treatment options include pharmacological thrombolysis (PT) and mechanical thrombectomy (MT). The aim of this study was to evaluate success and major complication rates of interventional radiological treatments of arterial embolism and thrombosis in Germany in 2021 and to compare their results with accepted international quality standards.</p><p><strong>Materials and methods: </strong>Data for PT and MT for 2021 was obtained from the quality management system of the German interventional radiological society (DeGIR). 2431 PT and 1582 MT procedures were documented for 2021, with 459 combinations of PT and MT. Data was analysed for technical and clinical success rates, as well as major complication rates such as intracranial bleeding, major bleeding, distal embolization, aneurysm formation, organ-failure and cardiac-decompensation.</p><p><strong>Results: </strong>PT alone had technical and clinical success rate of 90.21% and 81.08%, respectively. MT alone had technical and clinical success rates of 97.41% and 95.39%, respectively. MT&PT had technical and clinical success rates of 91.07% and 84.75%, respectively. Major complications were: distal embolization (PT:2.02%; MT:1.74%; PT&MT:2.61%), major bleeding (PT:0.94%; MT:1.14%; PT&MT:0.87%), aneurysm formation (PT:0.33%;MT: 1.14%;PT&MT: 0%), intracranial bleeding (PT:0.16%;MT:0%;PT&MT:0.22%), cardiac-decompensation (PT:0.21%;MT: 0.06%;PT&MT:0%) and organ-failure (PT:0%;MT:0.06%;PT&MT:0.22%). Technical and clinical success rates were higher, while complication rates were lower than the corresponding threshold recommended by the Society of Interventional Radiology for percutaneous management of acute lower-extremity ischemia.</p><p><strong>Conclusion: </strong>Treatment of arterial embolism and thrombosis performed by interventional radiologists in Germany is effective and safe with outcomes exceeding internationally accepted standards.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10481332","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}
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