European Journal of Vascular and Endovascular Surgery最新文献

{"title":"Cilostazol and Risk of Major Adverse Limb and Cardiovascular Events after Revascularisation for Peripheral Artery Disease.","authors":"Donna Shu-Han Lin, Hsu-Ping Wu, Wen-Jung Chung, Shu-Kai Hsueh, Po-Chao Hsu, Jen-Kuang Lee, Chun-Chi Chen, Hsuan-Li Huang","doi":"10.1016/j.ejvs.2026.10.012","DOIUrl":"https://doi.org/10.1016/j.ejvs.2026.10.012","url":null,"abstract":"<p><strong>Objective: </strong>Patients with peripheral artery disease (PAD) remain at high risk of major adverse limb events (MALE) and cardiovascular events (MACE) after revascularisation. Cilostazol, a phosphodiesterase-3 inhibitor with antiplatelet and antiproliferative effects, reduces re-stenosis but its real world impact on clinical outcomes is uncertain. This retrospective, nationwide, propensity score matched cohort study evaluated the effectiveness and safety of cilostazol on MALE, MACE, and all cause mortality after lower limb revascularisation for PAD.</p><p><strong>Methods: </strong>Using the Taiwan National Health Insurance Research Database, patients who underwent lower limb revascularisation for PAD from 2010 - 2023, with follow up through 2024 were identified. Patients with prior cilostazol use were excluded. 1:1 propensity score matching (n = 5 464 per group) adjusted for baseline differences. Cox regression and Fine-Gray competing risk models were used to evaluate outcomes. The comparison reflects cilostazol used with or without background antithrombotic therapy.</p><p><strong>Results: </strong>Cilostazol use was associated with significantly lower risks of MALE (78.7 vs. 154.0 events/1 000 person-years; subdistribution hazard ratio [SHR] 0.50; 95% confidence interval [CI] 0.46 - 0.53) and MACE (97.9 vs. 117.1 events/1 000 person-years; hazard ratio [HR] 0.84; 95% CI 0.79 - 0.89). All cause mortality was also reduced (116.0 vs. 127.6 events/1 000 person-years; HR 0.91; 95% CI 0.86 - 0.96). Major bleeding did not differ significantly between groups (SHR 0.90; 95% CI 0.81 - 1.00), although the absolute rate was high in both groups (12.1% vs. 13.1%). Subgroup analysis showed greater limb benefit in patients not on other antiplatelet agents.</p><p><strong>Conclusion: </strong>Cilostazol after PAD revascularisation was associated with lower risks of limb and cardiovascular events and mortality. These effects were observed without any increase in the rate of major bleeding, although this rate was high in both groups. Randomised trials focused on cardiovascular events are needed.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207472","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":"Differences in Clinical Presentation of Chronic Pelvic Pain Caused by Iliac Vein Obstruction Impacts Referral Pathway, Time to Diagnosis, and Post-stenting Pain Resolution.","authors":"Theresa A Larkin, Morgan Neasey, Bronte Horsley, Tyler Keys, Laurencia M Villalba","doi":"10.1016/j.ejvs.2026.10.013","DOIUrl":"https://doi.org/10.1016/j.ejvs.2026.10.013","url":null,"abstract":"<p><strong>Objective: </strong>Iliac venous stenting improves chronic pelvic pain (CPP) caused by iliac vein obstruction (IVO). Signs and symptoms vary, but this pain is reproducible and easily identifiable. However, patients can experience significant delays in diagnosis and treatment. This study aimed to determine associations between the referral history, clinical presentation, pain characteristics, and stenting outcomes among women with CPP due to IVO.</p><p><strong>Methods: </strong>This was a retrospective analysis of prospectively collected data of women who were referred to a vascular surgeon with signs and symptoms of IVO, including CPP, and who underwent iliac venous stenting. Associations between clinical presentation (signs, symptoms, pain severity), medical and referral history, and stenting outcomes were compared between three patient groups based on number of other specialist consultations prior to stenting (none, one, or at least two).</p><p><strong>Results: </strong>Data were for 113 women (46.5 ± 15.7 years) who had CPP for 6.3 ± 6.6 years with initial severity of 6.7 ± 2.3 (out of 10). CPP was reproducible for all women, with exercise, standing, and intercourse being the most common triggers. More than two thirds had lower limb pain, oedema, and varicose veins. At a median of 7 years post-stenting, the latest pain score was 0.8 ± 1.6, and approximately 80% had full pain resolution. Women who had seen at least two other specialists had the worst initial pelvic pain, the most prescription pain medication, back pain, other abdominopelvic signs and symptoms, and previous interventions, and the fewest varicose veins. These women had 8.5 ± 7.9 years to diagnosis, but 99% still had significant improvement in, and 66% had full resolution of, their pelvic pain.</p><p><strong>Conclusion: </strong>All patients had a reproducible pattern of venous origin pelvic pain, but those with worse CPP, more abdominopelvic symptoms, and less varicose veins had a more complex and delayed referral pathway and the lowest pain resolution.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207954","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":"Nordic Multicentre Experience on the Thoracic Branch Endoprosthesis in Aortic Arch Pathologies: A Leakage of Trust.","authors":"Petroula Nana, Tilo Kölbel","doi":"10.1016/j.ejvs.2026.10.016","DOIUrl":"https://doi.org/10.1016/j.ejvs.2026.10.016","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208053","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":"Midterm Outcomes of the Minos Ultralow Profile Endograft: Results from the Multicentre MINER Registry.","authors":"Michele Antonello, Marco J Bilato, Diego Cognolato, Francesco Talarico, Roberto Silingardi, Roberto Chiappa, Stefano Bonvini, Enrico Maria Marone, Sonia Ronchey, Franco Grego, Michele Piazza, Francesco Squizzato","doi":"10.1016/j.ejvs.2026.10.011","DOIUrl":"https://doi.org/10.1016/j.ejvs.2026.10.011","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to assess midterm outcomes of the ultralow profile Minos endograft in a physician initiated registry.</p><p><strong>Methods: </strong>A non-sponsored registry collected consecutive patients treated with the Minos device in 20 Italian centres (2021 - 2025). Elective patients (the primary analysis population) were stratified by access quality (hostile vs. standard access); hostile iliac-femoral access was defined by a narrowest iliac diameter < 7 mm, iliac artery tortuosity index > 1.6, aortic bifurcation diameter < 16 mm, or severe circumferential calcification. Proximal neck features were covariates only; urgent and emergent procedures were analysed separately. Outcomes were thirty day technical success, mortality, and major adverse events (MAEs), and midterm freedom from rupture, limb occlusion, type I or III endoleak, and re-intervention.</p><p><strong>Results: </strong>Of 310 patients (mean aneurysm diameter 54.8 ± 10.0 mm), 288 (92.9%) were elective. Among these, 154 (53.5%) had a standard access and 134 (46.5%) a hostile access. The latter were more frequently women (16.4% vs. 6.0%; p = .009) and more frequently had peripheral arterial disease (31.6% vs. 16.8%; p = .006). Elective technical success was 100%, with no thirty day deaths. The thirty day MAE rate was higher with hostile access (8.2% vs. 1.3%; p = .032), mainly from access related events and blood loss > 1 000 mL (3.7% vs. 0.0%; p = .021), as was early re-intervention (3.7% vs. 0.0%; p = .021). At 3 years there were no aneurysm related deaths; freedom from limb occlusion was 97% vs. 100% (p = .025) and from type I OR III endoleak was 98% vs. 100% (p = .18) in the standard and hostile access groups, respectively.</p><p><strong>Conclusion: </strong>The Minos ultralow profile endograft was safe and effective for the treatment of elective abdominal aortic aneurysms. Peri-operative morbidity was higher when the iliac-femoral access was hostile, and limb occlusion, type I - III endoleak, and re-intervention were more evident compared with standard access anatomy. An ultralow profile platform can extend endovascular repair to unfavourable access vessels without affecting midterm device performance.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208064","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 Giant, Tortuous Hepatic Artery.","authors":"Long Cao, Jianping Bai","doi":"10.1016/j.ejvs.2026.10.015","DOIUrl":"https://doi.org/10.1016/j.ejvs.2026.10.015","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207460","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":"Invited Editorial Commentary to accompany the European Society for Vascular Surgery (ESVS) 2027 Clinical Practice Guidelines on Major Limb Amputation (Bosanquet DC, Twine CP, Geertzen JHB, et al.).","authors":"George Smith, Willemien van de Water","doi":"10.1016/j.ejvs.2026.10.018","DOIUrl":"https://doi.org/10.1016/j.ejvs.2026.10.018","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207929","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":"Core Descriptor Set for Studies Evaluating Interventions for Chronic Deep Venous Diseases.","authors":"George Antoniou, Jonathan Boyle, Stavros Kakkos, Fabien Lareyre, Mario D'Oria, Arun Pherwani, Athanasios Saratzis, Matthias Trenner, Maarit Venermo, Sandip Nandhra, Martin Terra","doi":"10.1016/j.ejvs.2026.10.003","DOIUrl":"https://doi.org/10.1016/j.ejvs.2026.10.003","url":null,"abstract":"<p><strong>Objective: </strong>Chronic deep venous disease (CDVD) is a common and debilitating disease resulting in significant morbidity and costs. However, inconsistent reporting of patient characteristics in CDVD hinders study comparability and limits opportunities for data synthesis. This study aimed to develop a core descriptor set (CDS) for studies evaluating interventions for CDVD of the lower limbs.</p><p><strong>Methods: </strong>Candidate descriptors were identified from published literature and stakeholder recommendations. Vascular surgeons, haematologists, interventional radiologists, and nurse specialists took part in two rounds of an international modified Delphi process using a nine point Likert scale to rank descriptor importance. Descriptors not meeting consensus criteria in the first round were re-evaluated in round two. Descriptors meeting the criteria for critical importance were discussed in a final meeting between international specialists to finalise the CDS.</p><p><strong>Results: </strong>One hundred and thirty-eight Delphi participants were recruited from 29 countries. Ninety-eight descriptors were longlisted from the literature, refined to 84 by the steering group. After round one, 23 descriptors achieved consensus and were removed from subsequent rounds. Seven newly proposed descriptors were then added, resulting in a total of 68 descriptors in round two. Following round two, a further 13 descriptors achieved consensus with eight considered borderline. Following two Delphi survey rounds and a consensus meeting, 84 candidate descriptors were systematically evaluated and narrowed down to a final set of 21 core descriptors across the domains of demographics, thrombotic risk, venous history, anatomy, symptoms, and clinical findings.</p><p><strong>Conclusion: </strong>This study defined the CDS for CDVD, facilitating more consistent, robust, and meaningful reporting across studies and enabling reliable synthesis.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197891","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":"Efficacy and Safety of No Thromboprophylaxis after Endovenous Radiofrequency Ablation for Incompetent Saphenous VeiNs: the TRAIN Non-inferiority Randomised Controlled Trial.","authors":"Yuhan Qi, Jiarong Wang, Chengxin Weng, Leihan Cao, Jinting Ge, Biao Jing, Huawei Zhang, Bin Huang, Ding Yuan, Tiehao Wang","doi":"10.1016/j.ejvs.2026.10.005","DOIUrl":"https://doi.org/10.1016/j.ejvs.2026.10.005","url":null,"abstract":"<p><strong>Objective: </strong>The benefit of post-operative pharmacological thromboprophylaxis after endovenous radiofrequency ablation (RFA) for incompetent saphenous veins in patients without previous deep vein thrombosis (DVT) of the lower limbs is unclear. This trial compared no extended thromboprophylaxis with extended anticoagulation after RFA.</p><p><strong>Methods: </strong>TRAIN (Thromboprophylaxis after endovenous Radiofrequency Ablation for Incompetent saphenous veiNs) was a multicentre, evaluator blinded, non-inferiority randomised controlled trial. Adults with primary great saphenous vein incompetence undergoing RFA, with concomitant tributary phlebectomy and or ultrasound guided foam sclerotherapy when clinically indicated, were enrolled. Patients with previous DVT of the lower limbs were excluded. All participants received a single intra-operative intravenous dose of unfractionated heparin and were randomised to either no extended pharmacological thromboprophylaxis or rivaroxaban 10 mg once daily for fourteen days post-operatively. The primary outcome was thrombosis related events within thirty days.</p><p><strong>Results: </strong>Of 406 patients screened, 354 were included in the intention to treat analysis and 304 in the per protocol analysis. The no extended thromboprophylaxis strategy was non-inferior to fourteen days of rivaroxaban 10 mg once daily for thrombosis related events (risk difference -1.34%, 95% confidence interval -7.53 - 4.84%; p = .022 for non-inferiority). One participant in the anticoagulation group (one of 177; 0.6%) experienced clinically relevant non-major bleeding on post-operative day 10. No bleeding event occurred in the no anticoagulation group (0 of 177; p = 1.0).</p><p><strong>Conclusion: </strong>Omitting extended post-operative rivaroxaban thromboprophylaxis after RFA with concomitant phlebectomy and sclerotherapy in patients without previous DVT was non-inferior to fourteen days of rivaroxaban 10 mg once daily for thrombosis related events. Prophylactic rivaroxaban was not associated with an increased risk of bleeding.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197994","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":"The Right Operation or No Operation: Using Comprehensive Geriatric Assessment and Optimisation (CGA) to Deliver Realistic Choice, Shared Decision Making, and Value Based Care for Patients with Aortic Aneurysms.","authors":"Athanasios Saratzis, Jugdeep K Dhesi, Judith S L Partridge","doi":"10.1016/j.ejvs.2026.10.010","DOIUrl":"https://doi.org/10.1016/j.ejvs.2026.10.010","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197669","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":"The Long Run Favours Heat: Seven Year Data Reaffirm Thermal Ablation's Durability Edge Over Mechanochemical Ablation.","authors":"Christos Karathanos, Vangelis Bontinis","doi":"10.1016/j.ejvs.2026.10.002","DOIUrl":"10.1016/j.ejvs.2026.10.002","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197631","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}