Nikolaos Konstantinou, Tomasz Jakimowicz, Stephan Haulon, Maximilian Pichlmaier, Said Abisi, Luis Mendes Pedro, Adib Khanafer, Nikolaos Tsilimparis
{"title":"Outcomes after Endovascular Arch Repair in Patients with a Mechanical Aortic Valve: Results from a Multicentre Study.","authors":"Nikolaos Konstantinou, Tomasz Jakimowicz, Stephan Haulon, Maximilian Pichlmaier, Said Abisi, Luis Mendes Pedro, Adib Khanafer, Nikolaos Tsilimparis","doi":"10.1016/j.ejvs.2024.09.029","DOIUrl":"https://doi.org/10.1016/j.ejvs.2024.09.029","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate outcomes after endovascular aortic arch repair in patients with a mechanical aortic valve where the valve needs to be crossed.</p><p><strong>Methods: </strong>An international, multicentre, retrospective observational study was undertaken including all consecutive patients who underwent endovascular arch repair with mechanical aortic valve crossing.</p><p><strong>Results: </strong>From March 2020 to August 2023, 12 patients were included in the study (median age 55 years, interquartile range 45, 67 years; 58% male). Five patients (42%) had a genetically confirmed connective tissue disorder (CTD) and three more had a high clinical suspicion of CTD. Most patients had a bileaflet valve (11/12; 92%) and one patient had a monoleaflet one. All patients had previously undergone surgical ascending aortic repair. Technical success was 100% with successful completion of the procedure with no valve damage. Two deaths (17%) were observed in the first 30 days post-operatively with no signs of valve malfunction: one patient died of major stroke due to excessive wire and sheath manipulation in the arch; and another due to cardiac arrest of unknown cause, with no valve damage being detected in the autopsy. No intra-operative technical difficulties regarding valve cannulation were observed. During a median follow up of eight months, one patient died fifteen months after the procedure owing to non-aortic related causes, and four endoleaks were present on the latest computed tomography angiography, none type I or III.</p><p><strong>Conclusion: </strong>Endovascular aortic arch repair in a selected group of patients with a mechanical aortic valve treated in experienced, high volume aortic centres seems technically feasible and reasonably safe. These preliminary results underline the complexity of the procedure and should be validated by larger cohort studies. With careful patient selection and adequate physician experience, the presence of a mechanical aortic valve could potentially no longer pose a major contraindication for endovascular arch repair in the future.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309171","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":"Anatomical Suitability of Iliac Branch Devices for East Asian Patients With Abdominal Aortic Aneurysm.","authors":"Mingwei Wu, Luxia Ren, Haibo Wang, Jiang Xiong","doi":"10.1016/j.ejvs.2024.09.024","DOIUrl":"https://doi.org/10.1016/j.ejvs.2024.09.024","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify iliac artery characteristics of East Asian patients with abdominal aortic aneurysms (AAAs) and to evaluate the anatomical suitability rates with current iliac branch devices (IBDs).</p><p><strong>Methods: </strong>This was a single centre, retrospective, cross-sectional study. Patients diagnosed with AAA between 2008 and 2023 were enrolled. Morphological parameters of iliac arteries were measured, and their eligibility for four IBDs (Cook ZBIS, Gore IBE, E-Liac IBD, and G-Iliac IBD) was evaluated according to the manufacturer's latest instructions for use (IFU).</p><p><strong>Results: </strong>Among 1 144 AAAs observed in the study, 45.5% (n = 521) presented with concurrent common iliac artery aneurysm (CIAA). In total, 304 patients (26.6%) and 371 iliac arteries necessitated internal iliac artery (IIA) reconstruction. The anatomical suitability rates for the Cook ZBIS, Gore IBE, E-Liac IBD, and G-Iliac IBD were 18.9%, 21.8%, 11.9%, and 22.6%, respectively. The E-Liac IBD exhibited a significantly lower anatomical suitability rate compared with the other three devices (p < .001). The primary exclusion criteria of IBDs were: a common iliac artery (CIA) length of < 50 mm for Cook ZBIS (n = 211, 56.9%); an IIA diameter of < 6.5 mm or > 13.5 mm for Gore IBE (n = 177, 47.7%); and a CIA bifurcation diameter of < 18 mm both for E-Liac IBD and G-Iliac IBD (n = 244, 65.8%). A total of 171 patients (46.1%) failed to meet the anatomical criteria for any device, while 120 (32.4%) qualified for one device, 34 (9.2%) for two devices, 36 (9.7%) for three devices, and 10 (2.7%) for all four devices.</p><p><strong>Conclusion: </strong>A significant proportion of East Asian patients with AAA present with concurrent CIAA, necessitating substantial IIA reconstruction. The IBD techniques show low anatomical suitability rates among the East Asian population, with 46.1% of patients failing to meet anatomical criteria for any IBD based on the manufacturer's IFU.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301414","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}
Joakim Nordansti, Willemien van de Water, Sergi Bellmunt
{"title":"Intervention for Intermittent Claudication: \"Primum Non Nocere\".","authors":"Joakim Nordansti, Willemien van de Water, Sergi Bellmunt","doi":"10.1016/j.ejvs.2024.09.028","DOIUrl":"https://doi.org/10.1016/j.ejvs.2024.09.028","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301418","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":"Open Survey on Barriers for International Research in Vascular Surgery and Potential Role of the European Society for Vascular Surgery.","authors":"Fabien Lareyre, Matthias Trenner, Juliette Raffort, Robert J Hinchliffe, Athanasios Saratzis","doi":"10.1016/j.ejvs.2024.09.012","DOIUrl":"https://doi.org/10.1016/j.ejvs.2024.09.012","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301420","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":"Is Going Radial Too Radical?","authors":"Jos C van den Berg","doi":"10.1016/j.ejvs.2024.09.020","DOIUrl":"https://doi.org/10.1016/j.ejvs.2024.09.020","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301419","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":"3D Aortic Dissection Luminal Navigation: A Radiation Free Alternative or Complement to Intravascular Ultrasound?","authors":"Behzad S Farivar","doi":"10.1016/j.ejvs.2024.09.021","DOIUrl":"https://doi.org/10.1016/j.ejvs.2024.09.021","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301411","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}
Sarah Onida, Hannah J Lees, Richmond Bergner, Joseph Shalhoub, Elaine Holmes, Alun H Davies
{"title":"1H Nuclear Magnetic Resonance Spectroscopy Reveals Changes in Metabolic Phenotype Associated with Disease Stage in Patients with Chronic Venous Disease.","authors":"Sarah Onida, Hannah J Lees, Richmond Bergner, Joseph Shalhoub, Elaine Holmes, Alun H Davies","doi":"10.1016/j.ejvs.2024.09.019","DOIUrl":"https://doi.org/10.1016/j.ejvs.2024.09.019","url":null,"abstract":"<p><strong>Objective: </strong>Chronic venous disease (CVD) is a condition presenting a great burden to patients and society, with poorly characterised pathophysiology. Metabolic phenotyping can elucidate mechanisms of disease and identify candidate biomarkers. The aim of this study was to determine differences in the metabolic signature between symptomatic patients with CVD and asymptomatic volunteers using proton nuclear magnetic resonance spectroscopy (1H-NMR).</p><p><strong>Methods: </strong>This was a prospective case-control study of consecutive patients with symptomatic CVD and asymptomatic volunteers recruited from a single centre. Participants underwent clinical assessment, venous duplex ultrasound, and blood and urine sampling. Disease stage was defined according to the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification. 1H-NMR experiments were performed, with data analysed via multivariate statistical techniques.</p><p><strong>Results: </strong>A total of 622 participants were recruited, including 517 symptomatic patients with CVD (telangiectasia [C1] 0.6%, varicose veins [C2] 48.5%, swelling [C3] 12.0%, skin changes [C4] 27.7%, healed or active ulceration [C5/6] 11.2%) and 105 asymptomatic participants (no disease [C0] 69.5%, telangiectasia [C1] 29.6%). Multivariate analysis revealed differences between the metabolic profile of the symptomatic CVD and asymptomatic groups, and between CEAP clinical classes in the CVD group. Serum aromatic amino acids positively correlated with increasing CEAP clinical class (p < .001). Urinary formate, creatinine, glycine, citrate, succinate, pyruvate, and 2-hydroxyisobutyrate negatively correlated with increasing CEAP clinical class (p < .001). These metabolites are involved in the tricarboxylic acid cycle, hypoxia inducible factor pathway, and one carbon metabolism.</p><p><strong>Conclusion: </strong>Untargeted biofluid analysis via 1H-NMR has detected metabolites associated with the presence and severity of CVD, highlighting biological pathways of relevance and providing candidate biomarkers to explore in future research.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301410","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":"Are You in the State of Mind for Multistate Models?","authors":"Lorenz Meuli, Christoph Kuemmerli","doi":"10.1016/j.ejvs.2024.09.023","DOIUrl":"https://doi.org/10.1016/j.ejvs.2024.09.023","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301415","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":"Conservative Therapy for Patients with Intermittent Claudication: What we See Might Depend Mainly on What we are Looking For.","authors":"Joakim Nordanstig, Karin Ludwigs, Vishal Amlani","doi":"10.1016/j.ejvs.2024.09.025","DOIUrl":"https://doi.org/10.1016/j.ejvs.2024.09.025","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301417","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}