European Journal of Vascular and Endovascular Surgery最新文献

{"title":"Popliteal Vein Aneurysm with Thrombosis.","authors":"Wenfei Guan, Yongpan Cui","doi":"10.1016/j.ejvs.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.04.006","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising Secondary Prevention in Patients Undergoing Carotid Surgery: A Cohort Study Assessing Lipid Lowering Therapy and Antithrombotic Therapy Odd page running title: Cardiovascular Prevention Medications in Carotid Surgery Patients.","authors":"Jing Yi Kwan, Alex Harper, Mehak Sood, Eleanor Carney, Ciara Doyle, Fabio Stocco, Henry Davies, David Julian Ashbridge Scott, Marc Aaron Bailey, Patrick A Coughlin","doi":"10.1016/j.ejvs.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.04.007","url":null,"abstract":"<p><strong>Objective: </strong>UK and European guidelines recommend that patients with atherosclerotic carotid artery disease should be commenced on optimal cardioprotective medical therapy, specifically antiplatelet agents and lipid lowering therapy (LLT). This single centre cohort study explored the peri-operative prescription and titration of guideline directed medical therapy (GDMT) alongside low density lipoprotein cholesterol (LDL-C) levels in patients undergoing carotid intervention.</p><p><strong>Methods: </strong>This study included 260 patients who underwent carotid intervention from 1 January 2017 to 31 December 2021. Electronic hospital records were checked for data on demographics, comorbidities, antiplatelet and LLT prescriptions, and cholesterol results. Data from four time points were obtained: prior to the index event; at the time of admission for carotid intervention; at discharge following intervention; and at one year.</p><p><strong>Results: </strong>Antiplatelet therapy was indicated in one fifth and high intensity LLT in 39% of patients who were not on cardioprotective medications prior to the index event. From the time of admission for carotid intervention to discharge, the proportion of patients who were prescribed antithrombotic therapy (82% vs. 100%; p < .001) and LLT (88% vs. 94%; p = .004) increased statistically significantly. Mean LDL-C levels reduced statistically significantly from 2.2 mmol/L at pre-admission to 1.8 mmol/L at one year follow up (p = .026). However, only 53% of patients achieved an LDL-C target of < 1.8 mmol/L at one year following intervention. All patients who did not achieve the LDL-C target had scope for uptitration of statin or co-prescription of adjuvant LLT agents, including ezetimibe, inclisiran, and PCSK9i.</p><p><strong>Conclusion: </strong>Underutilisation of LLT prior to incident stroke was identified as a key tractable problem. Admission for carotid intervention is associated with an increase in GDMT and reduction in LDL-C levels. There is scope for improvement and a need for long term community based management of cardiovascular risk, specifically risk assessment, initiation and ongoing uptitration of LLT, and regular monitoring of LDL-C levels.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Strategy for Chronic Mesenteric Ischaemia.","authors":"Eshan T Affan, Timothy P Shiraev","doi":"10.1016/j.ejvs.2025.03.038","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.03.038","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"If You're Not on the Inside, You're on the Outside: Navigating Target Vessels and Limited Information in a Complex World.","authors":"Timothy Andrew Resch","doi":"10.1016/j.ejvs.2025.03.037","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.03.037","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Core Outcome Set for Clinical Studies on Chronic Venous Disease Involving the Deep Veins.","authors":"George Hudson, Maia Osborne-Grinter, Aleksandra Staniszewska, Eleanor McNally, Stephen Black, Efthymios Avgerinos, Domenico Baccellieri, Olivier Hartung, Beverley J Hunt, Houman Jalaie, Marie Josee van Rijn, Peter Mezes, Gerry O'Sullivan, Marta Ramírez Ortega, Paolo Prandoni, Robert Hinchliffe, Baris A Ozdemir","doi":"10.1016/j.ejvs.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.04.005","url":null,"abstract":"<p><strong>Objective: </strong>Chronic venous disease (CVD) is a debilitating disease that results in significant morbidity and costs. A lack of standardised outcome reporting has made it difficult to evaluate the impact of interventions for CVD involving the deep veins. This study aimed to develop a core outcome set (COS) for studies evaluating interventions for this subset of CVD.</p><p><strong>Methods: </strong>The COS was developed using the Core Outcome Measures in Effectiveness Trials (COMET) methodology. A systematic review and interviews with 19 patients experiencing post-thrombotic syndrome after deep vein thrombosis generated a longlist of outcomes, which was then refined by a steering group. Each outcome was rated on importance by patients and healthcare practitioners using a 9 point Likert scale within a Delphi survey. Outcomes not meeting consensus criteria in the first round were reprioritised in a second round. Outcomes meeting the criteria for being critically important were discussed in a final meeting between patients and international experts to develop the COS.</p><p><strong>Results: </strong>The review and interviews generated 80 outcomes, which entered the Delphi process. In total, 233 stakeholders responded in the first round and 143 in the second round. Consensus was reached on 29 outcomes deemed critically important. These outcomes were discussed in the final meeting to yield seven general outcomes and six procedure specific outcomes, since some outcomes were not relevant to all patients with CVD. The general outcomes were death, lower limb ulceration, venous thromboembolism, bleeding, quality of life, limb pain, and oedema or limb swelling. The procedure specific outcomes were device migration, device mechanical failure, patency, technical and or procedural success, re-intervention, and vascular complications.</p><p><strong>Conclusion: </strong>A COS was developed for studies evaluating interventions for CVD involving the deep veins, comprising seven general outcomes and six procedure specific outcomes. Reporting these outcomes will promote comparison of interventions for CVD involving the deep veins.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Assessment of Risk Score Performance in Ruptured Abdominal Aortic Aneurysm Repair Risk Stratification.","authors":"Andrew S Warren, Jake F Hemingway, Elina Quiroga, Thomas F X O'Donnell, Marc L Schermerhorn, Sara L Zettervall, Kirsten Dansey","doi":"10.1016/j.ejvs.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.04.002","url":null,"abstract":"<p><strong>Objective: </strong>Several risk scores are available to stratify mortality risk for ruptured abdominal aortic aneurysm (rAAA) repair. This study compared the performance of seven risk scores found in the literature using the National Surgical Quality Improvement Program (NSQIP) and Vascular Quality Initiative (VQI) registries.</p><p><strong>Methods: </strong>All patients who underwent open or endovascular rAAA repair in NSQIP (2011 - 2018) and VQI (2003 - 2021) were included. The following risk scores were calculated: Dutch Aneurysm Score (DAS); Glasgow Aneurysm Score (GAS); modified Harborview Risk Score (mHRS); Hardman index (HI); Leiden score; Medicare risk score; and Vascular Surgery Group of New England (VSGNE) risk score. Discrimination was assessed for all patients (combined open and endovascular) using receiver operating characteristic (ROC) curves, with area under the curve (AUC) values compared within datasets using the DeLong test. Calibration was evaluated using graphical calibration curves and was quantified via the integrated calibration index (ICI).</p><p><strong>Results: </strong>A total of 2 134 NSQIP patients and 6 458 VQI patients were included. In NSQIP, the GAS had the highest discrimination ability (AUC 0.687; p < .010 vs. all); while in VQI, the DAS performed best (AUC 0.688; p < .050 vs. all). The Medicare risk score exhibited the best calibration with an ICI of 0.007 in NSQIP and 0.003 in VQI. The DAS tended to underestimate risk, while all other scores overestimated mortality.</p><p><strong>Conclusion: </strong>Risk scores serve as valuable tools to augment, but not replace, clinical decision making in patients with rAAA. The GAS and DAS demonstrated superior discrimination, rendering them best for distinguishing between low and high risk patients. Meanwhile, the Medicare risk score offers the most accurate risk prediction. The mHRS and HI offered a balance of adequate discrimination and calibration while remaining simple and easily calculable, making them practical for urgent clinical settings.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients with Abdominal Aortic Aneurysm: Are We Missing Something?","authors":"Jean-Baptiste Ricco, Aurélien Hostalrich","doi":"10.1016/j.ejvs.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.04.003","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bypass After Failed Endovascular Intervention Is Associated with an Increased Risk of Above Ankle Amputation Among Patients with Chronic Limb Threatening Ischaemia in a Randomised Trial Population.","authors":"Alik Farber, Matthew T Menard, Michael S Conte, Kenneth Rosenfield, Caitlin W Hicks, Gheorge Doros, Michael B Strong, Kim Houlind, Philippe Kolh, Jeffrey J Siracuse","doi":"10.1016/j.ejvs.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.04.001","url":null,"abstract":"<p><strong>Objective: </strong>One concern about the endovascular-first (ENDO) approach for chronic limb threatening ischaemia (CLTI) is whether bridges are burned for a secondary bypass (SB) if required in the future. This secondary analysis of a prospective randomised trial aimed to compare above ankle amputation rates in patients with CLTI treated with primary bypass (PB) compared with those treated with SB after an initial ENDO approach.</p><p><strong>Methods: </strong>Data from the randomised unblinded Best Endovascular versus Best Surgical Therapy of Patients with CLTI (BEST-CLI) trial were analysed. Patients were included if they had CLTI and were considered as candidates for open or ENDO revascularisation with the primary outcomes being major adverse limb free event survival. There were two parallel cohorts based on whether single segment great saphenous vein (SSGSV) was (cohort 1) or was not (cohort 2) available. Primary bypass was compared with SB after index ENDO using the primary outcome of above ankle amputation with death as a competing risk. Multivariable and propensity matched analyses were performed.</p><p><strong>Results: </strong>There were 665 PB and 158 SB in cohort 1 and 192 PB and 45 SB in cohort 2. Time to SB after ENDO occurred at a median of 28 days in all patients and median of 210 days in those who had a successful initial ENDO procedure. Unadjusted one year analysis showed SB to be associated with increased above ankle amputation (14% vs. 8.1%; p = .002) overall. Secondary bypass was associated with increased above ankle amputation in cohort 1 (13.5% vs. 7.4%; p = .003), whereas this was not statistically significant in cohort 2 (15.9% vs. 10.9%; p = .28). These findings were confirmed on multivariable analysis (adjusting for age, gender, wound ischaemia foot infection stage, randomisation strata, diabetes mellitus, end stage kidney disease, previous index infrainguinal reconstruction, and smoking history) for cohort 1, with SB associated with increased above ankle amputation (HR 1.72, 95% CI 1.08 - 2.73; p = .02), remaining true when restricting to SB after a technically successful ENDO (HR 2.21, 95% CI 1.26 - 3.86; p =.005). Results were similar on propensity matched analyses.</p><p><strong>Conclusion: </strong>In patients with CLTI deemed suitable for either open or ENDO, SB was associated with worse limb salvage compared with PB, particularly in patients with available SSGSV.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Risk and Medication in Abdominal Aortic Aneurysm Across Three Decades: The End of the Beginning?","authors":"Anders Gottsäter","doi":"10.1016/j.ejvs.2025.03.035","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.03.035","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bypass after Failed Endovascular Intervention is Associated with an Increased Risk for Above Ankle Amputation: Do It Right, Do It Once?","authors":"Alexander Gombert","doi":"10.1016/j.ejvs.2025.03.029","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.03.029","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}