Daniel Gil-Sala, Julie De Backer, Isabelle Van Herzeele, Gisela Teixidó-Tura, Anders Wanhainen, Sergi Bellmunt-Montoya
{"title":"A European Delphi Consensus on the Management of Abdominal Aortic Aneurysms in Patients with Heritable Aortic Diseases.","authors":"Daniel Gil-Sala, Julie De Backer, Isabelle Van Herzeele, Gisela Teixidó-Tura, Anders Wanhainen, Sergi Bellmunt-Montoya","doi":"10.1016/j.ejvs.2025.01.033","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.01.033","url":null,"abstract":"<p><strong>Objective: </strong>Abdominal aortic aneurysm (AAA) in a patient with an underlying heritable aortic disease (HAD) is rare, and evidence based recommendations for its management are lacking. This study aimed to generate a consensus from multidisciplinary specialists on the diagnosis, treatment, and surveillance of AAA associated with HAD and to define topics of interest for future research.</p><p><strong>Methods: </strong>A Delphi consensus was designed involving European multidisciplinary specialists and reported using the ACcurate COnsensus Reporting Document (ACCORD) reporting guideline. Four rounds were carried out by email: the first two rounds to agree on the content of the questionnaire and the final two rounds to reach an agreement. Questions focused on the composition of the team, imaging, clinical suspicion, genetic testing, medical management, indications for surgical repair, surgical technique, surveillance, exercise, and quality of life. The level of agreement for each question was graded using a Likert type scale and classified into four categories: A (very strong), B (strong), C (fair), and D (no agreement).</p><p><strong>Results: </strong>A total of 35 experts from 18 different hospitals and 10 different countries participated in the study: 19 vascular surgeons, 11 cardiologists, four geneticists, and one cardiac surgeon. Of the 97 statements of the final questionnaire, 16 were graded A (16%), 23 B (24%), five C (5%), and 44 D (45%). The experts highlighted the need to develop personalised therapies for each pathology, as well as international multicentre databases to collect data on the natural course of AAA patients with HAD.</p><p><strong>Conclusion: </strong>This Delphi process led to consensus on several aspects of care for patients with AAA and underlying HAD, providing guidance to manage them in a more standardised fashion. The agreements reached focus on the multidisciplinary aortic teams, imaging and genetic diagnosis, treatment, and follow up. Furthermore, several topics for future research were identified.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047776","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}
Robert Shahverdyan, Tej I Mehta, Nicholas Inston, Klaus Konner, Shant Vartanian
{"title":"Long Term Results of a Comparative Study of Percutaneous and Surgically Created Proximal Forearm Arteriovenous Fistulae.","authors":"Robert Shahverdyan, Tej I Mehta, Nicholas Inston, Klaus Konner, Shant Vartanian","doi":"10.1016/j.ejvs.2025.01.020","DOIUrl":"10.1016/j.ejvs.2025.01.020","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective, single centre, comparative effectiveness study aimed to compare the long term outcomes of percutaneous arteriovenous fistula (pAVF) and surgically created arteriovenous fistula (sAVF) created in the proximal forearm for haemodialysis access.</p><p><strong>Methods: </strong>Data were reviewed from a prospectively maintained database on patients who underwent pAVF or sAVF creation from September 2017 to September 2023. A total of 217 pAVFs (61 WavelinQ and 156 Ellipsys) and 158 sAVFs were analysed. Outcome measures included technical success, maturation, patency, time to first successful use, re-interventions, and complications.</p><p><strong>Results: </strong>Technical success was 100% for sAVF and Ellipsys, and 93.4% for WavelinQ (p < .001). Maturation at four weeks was higher in Ellipsys (78.6%) and sAVF (79.7%) groups than in WavelinQ (64.9%) (p = .042). Median time to first cannulation was shortest for Ellipsys (57 days), followed by sAVF (73 days), and longest for WavelinQ (98.6 days) (p = .048). Mean follow up was 654 days (interquartile range 164, 1049 days; range 0 - 2061 days). Primary patency was higher in sAVFs than in pAVFs. The Cox proportional hazard ratio (HR) for loss of primary patency was 1.50 for WavelinQ and 1.42 for Ellipsys compared with sAVF (p = .045). Secondary patency was statistically significantly lower for WavelinQ (HR 2.76; p < .001), but not for Ellipsys (HR 0.74; p = .33). Haemodialysis access induced distal ischaemia (HAIDI) was more common in the sAVF group with nine events (5.7%) compared with one for the Ellipsys (0.6%; p = .008). Re-intervention rates per patient year were comparable across groups (0.60 vs. 0.61 vs. 0.69 for sAVF, WavelinQ, and Ellipsys, respectively).</p><p><strong>Conclusion: </strong>This study indicates that while all access types can provide long term functional haemodialysis access, sAVFs perform better in some outcome domains and pAVFs (particularly Ellipsys) in others, with sAVFs showing higher rates of HAIDI, yet lower rates of juxta-anastomotic stenosis. The findings underscore the importance of personalised vascular access planning, weighing immediate procedural outcomes against long term functionality.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043343","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":"Health Discrimination or Design Flaw? The Challenge of Iliac Branch Devices for East Asian Aneurysm Patients.","authors":"Enrico Cieri, Andrea M Terpin","doi":"10.1016/j.ejvs.2025.01.031","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.01.031","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042812","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}
Artur Besch, Livia Cotta, Jörg Heckenkamp, Farzin Adili, Markus Steinbauer, Christian-Alexander Behrendt
{"title":"Treatment of Abdominal Aortic Aneurysm in Germany in 2023: A Registry Short Report.","authors":"Artur Besch, Livia Cotta, Jörg Heckenkamp, Farzin Adili, Markus Steinbauer, Christian-Alexander Behrendt","doi":"10.1016/j.ejvs.2025.01.028","DOIUrl":"10.1016/j.ejvs.2025.01.028","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030429","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}
Athanasios Katsargyris, Stephan Haulon, Eric L G Verhoeven
{"title":"Initial Experience with the BeFlared Bridging Covered Stent for Fenestrated Endovascular Aneurysm Repair.","authors":"Athanasios Katsargyris, Stephan Haulon, Eric L G Verhoeven","doi":"10.1016/j.ejvs.2025.01.029","DOIUrl":"10.1016/j.ejvs.2025.01.029","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030426","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":"Commentary on: A Systematic Review and Meta-analysis of 24 Month Patency after Endovenous Stenting of Superior Vena Cava, Subclavian, and Brachiocephalic Vein Stenosis.","authors":"Yi Deng, Wei Cui, Jing Li","doi":"10.1016/j.ejvs.2024.12.042","DOIUrl":"10.1016/j.ejvs.2024.12.042","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016808","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}