European Journal of Vascular and Endovascular Surgery最新文献

{"title":"Factors Affecting the Analysis of the Outcomes of Elective Endovascular Popliteal Artery Aneurysm Repair.","authors":"Tsai Ling Ting, Ming-Chih Chou, Shiuan-Chih Chen","doi":"10.1016/j.ejvs.2025.05.060","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.060","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295403","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":"Sac Shrinkage after Endovascular Aneurysm Repair: Multicentre Comparative Data from Three Stent Grafts.","authors":"Koichi Morisaki, Daisuke Matsuda, Ken Nakayama, Atsushi Guntani, Kazuomi Iwasa, Shinichiro Yoshino, Kentaro Inoue, Masazumi Kume, Terutoshi Yamaoka, Tomoharu Yoshizumi","doi":"10.1016/j.ejvs.2025.06.005","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.06.005","url":null,"abstract":"<p><strong>Objective: </strong>Abdominal aortic aneurysm (AAA) sac shrinkage has been reported as a surrogate marker of treatment success after endovascular aneurysm repair (EVAR). This study aimed to compare sac shrinkage after treatment with the Aorfix stent graft with that of Endurant and Excluder devices.</p><p><strong>Methods: </strong>This retrospective, multicentre cohort study analysed data for 444 patients with AAA after EVAR who were treated with Aorfix, Endurant, or Excluder devices between 2014 and 2021. Sac shrinkage was defined as a decrease in the maximum aneurysm diameter of ≥ 5 mm. Primary endpoints included sac shrinkage and factors related to sac shrinkage within one year after EVAR. Secondary endpoints included re-intervention, type Ia endoleak (T1aEL), aneurysm related death (ARD), and overall survival.</p><p><strong>Results: </strong>Of the 444 patients, 88 were treated with Aorfix, 191 with Endurant, and 165 with the Excluder. Sac shrinkage rates within one year in the Aorfix, Endurant, and Excluder groups were 52.1%, 32.8%, and 34.0%, respectively (p = .003). Multivariate analysis revealed that Aorfix device (ref. Endurant, p < .001; ref. Excluder, p = .010), smaller proximal neck diameter (p = .004), and number of patent lumbar arteries less than four (p = .033) were positive factors for sac shrinkage within one year. Rates of re-intervention and T1aEL were lower in the sac shrinkage group within one year than in the group without sac shrinkage within one year. The ARD rate at ten years was 3.8% in the no shrinkage group and 0.7% in the shrinkage group (p= .29).</p><p><strong>Conclusion: </strong>Sac shrinkage within one year was better in patients treated with the Aorfix device than in those treated with Endurant or Excluder devices, and sac shrinkage was a good surrogate marker for freedom from re-intervention and T1aEL after EVAR. However, the retrospective study design may introduce bias.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295405","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":"Concave Triple Branched Stent Graft System for Aortic Arch Pathologies: A First in Man Prospective Cohort Study.","authors":"Chang Shu, Tun Wang, Kun Fang, Quanming Li, Mingyao Luo, Hao He, Xin Li, Yuanyuan Guo, Ming Li","doi":"10.1016/j.ejvs.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.06.009","url":null,"abstract":"<p><strong>Objective: </strong>Endovascular aortic arch repair with supra-aortic trunk (SAT) reconstruction is an alternative to surgical replacement, but the ideal stent graft is still under investigation. This study describes the first experience and one year results of a novel, off the shelf, concave supra-arch triple branched stent graft system (CS system) for aortic arch diseases.</p><p><strong>Methods: </strong>This was a prospective cohort study conducted in three hospitals, enrolling patients from March 2022 to June 2023, to evaluate use of the CS system for aortic arch pathologies. An interdisciplinary board assessed patients pre-operatively. All patients were treated using the CS system to cover the aortic arch pathologies and reconstruct all SATs. Follow up assessments were conducted with computed tomography scans at two weeks and six and 12 months.</p><p><strong>Results: </strong>Ten patients (eight men) were treated using the CS system. The mean age was 65.3 years. Conditions included thoracic aortic aneurysm, non-A-non-B aortic dissection, and penetrating aortic arch ulcer. Technical success was achieved in all patients, with one type III endoleak during the procedure. The mean procedure time was 160 ± 23 minutes and the mean fluoroscopy time was 63 ± 20 minutes. The in hospital mortality and stroke rates were both 0%. The mean follow up duration was 456.9 ± 93.6 days. All patients recovered well without complications. The CS system completely covered the aortic pathologies, and all reconstructed branches remained patent. The single endoleak sealed spontaneously within six months. Mild to moderate in stent stenosis was observed in three left common carotid arteries. No other morphological abnormalities were observed, and secondary interventions were unnecessary.</p><p><strong>Conclusion: </strong>The CS system for endovascular treatment of aortic arch pathologies demonstrated promising safety and efficacy in this study with no occurrences of death, stroke, retrograde type A aortic dissection, re-intervention, or significant endoleak during one year follow up. Stenosis of the reconstructed SATs should be closely monitored.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295400","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":"Reply to: Factors Affecting the Analysis of the Outcomes of Elective Endovascular Popliteal Artery Aneurysm Repair.","authors":"Goudje L van Leeuwen, Ignace Tielliu, Jean-Paul P M de Vries","doi":"10.1016/j.ejvs.2025.06.006","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.06.006","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295404","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":"Extending the Certification of Basic Skills Paradigm to Open Infrarenal Abdominal Aortic Aneurysm Repair.","authors":"Joseph Shalhoub","doi":"10.1016/j.ejvs.2025.06.008","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.06.008","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295402","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":"European Society for Vascular Surgery (ESVS) 2025 Clinical Practice Guidelines on the Management of Diseases of the Mesenteric and Renal Arteries and Veins.","authors":"Mark J Koelemay, Robert H Geelkerken, Jussi Kärkkäinen, Nicola Leone, Elena Iborra, George Antoniou, Jorg de Bruin, Alexander Gombert, Anders Gottsäter, Sonia Ronchey, Konstantinos Spanos, Jos C van den Berg, Sabine Wipper, Frederico Bastos Gonçalves, Martin Björck, Raphael Coscas, Sandro Lepidi, Timothy A Resch, Jean-Baptiste Ricco, Riikka Tulamo, Anders Wanhainen, Thomas S Huber, Annika Reintam Blaser, Olivier Corcos, Alexander Oberhuber, Matti Tolonen","doi":"10.1016/j.ejvs.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.06.010","url":null,"abstract":"<p><strong>Objective: </strong>The European Society for Vascular Surgery (ESVS) has developed clinical practice guidelines for the care of patients with diseases of the mesenteric and renal arteries and veins, in succession to the first 2017 guidelines, with the aim of assisting physicians and patients in selecting the best management strategy.</p><p><strong>Methods: </strong>These guidelines are based on scientific evidence and expert opinion. By summarising and evaluating the best available evidence, recommendations for the diagnosis and treatment of patients have been formulated. The recommendations are graded according to the new ESVS clinical practice guidelines class of recommendation grading system, where the strength (class) of each recommendation is graded from I to III, and the letter A to C marks the level of evidence.</p><p><strong>Results: </strong>A total of 102 recommendations have been issued on the management of chronic arterial mesenteric ischaemia, median arcuate ligament syndrome, acute arterial mesenteric ischaemia, non-occlusive mesenteric ischaemia, venous mesenteric thrombosis and ischaemia, occlusive disease of the renal arteries and veins, visceral artery aneurysms, and spontaneous isolated dissection of the visceral arteries.</p><p><strong>Conclusion: </strong>These 2025 ESVS clinical practice guidelines provide comprehensive and up to date advice to physicians and patients on the management of diseases of the mesenteric and renal arteries and veins.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295401","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":"Data Driven Models Merging Geometric, Biomechanical, and Clinical Data to Assess the Rupture of Abdominal Aortic Aneurysms.","authors":"Marta Alloisio, Antti Siika, Joy Roy, Sebastian Zerwes, Alexander Hyhlik-Duerr, T Christian Gasser","doi":"10.1016/j.ejvs.2025.06.002","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.06.002","url":null,"abstract":"<p><strong>Objective: </strong>Despite elective repair of a large portion of stable abdominal aortic aneurysms (AAAs), the diameter criterion cannot prevent all small AAA ruptures. Since rupture depends on many factors, this study explored whether machine learning (ML) models (logistic regression [LogR], linear and non-linear support vector machine [SVM-Lin and SVM-Nlin], and Gaussian Naïve Bayes [GNB]) might improve the diameter based risk assessment by comparing already ruptured (diameter 52.8 - 174.5 mm) with asymptomatic (diameter 40.4 - 95.5 mm) aortas.</p><p><strong>Methods: </strong>A retrospective case-control observational study included ruptured AAAs from two centres (2010 - 2012) with computed tomography angiography images for finite element analysis. Clinical patient data and geometric and biomechanical AAA properties were fed into ML models, whose output was compared with the results from intact cases. Classifications were explored for all cases and those having diameters below 70 mm. All data trained and validated the ML models, with a five fold cross-validation. SHapley Additive exPlanations (SHAP) analysis ranked the factors for rupture identification.</p><p><strong>Results: </strong>One hundred and seven ruptured (20% female, mean age 77 years, mean diameter 86.3 mm) and 200 non-ruptured aneurysmal infrarenal aortas (22% female, mean age 74 years, mean diameter 57 mm) were investigated through cross-validation methods. Given the entire dataset, the diameter threshold of 55 mm in men and 50 mm in women provided a 58% accurate rupture classification. It was 99% sensitive (AAA rupture identified correctly) and 36% specific (intact AAAs identified correctly). ML models improved accuracy (LogR 90.2%, SVM-Lin 89.48%, SVM-Nlin 88.7%, and GNB 86.4%); accuracy decreased when trained on the ≤ 70 mm group (55/50 mm diameter threshold 44.2%, LogR 82.5%, SVM-Lin 83.6%, SVM-Nlin 65.9%, and GNB: 84.7%). SHAP ranked biomechanical parameters other than the diameter as the most relevant.</p><p><strong>Conclusion: </strong>A multiparameter estimate enhanced the purely diameter based approach. The proposed predictability method should be further tested in longitudinal studies.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250888","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 New S.PH.E.RE. of Influence in the World of Physician-Modified Endografts.","authors":"Claire M Motyl, Adam W Beck","doi":"10.1016/j.ejvs.2025.05.025","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.025","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250884","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":"Aortogastric Fistula After Bovine Thoracoabdominal Repair for Mid-Aortic Syndrome.","authors":"Francesco Maiorano, Lorenzo Gibello","doi":"10.1016/j.ejvs.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.06.003","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250885","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":"Certification of Basic Skills in Open Repair of Infrarenal Abdominal Aortic Aneurysms Through a Modular Simulation Course with Real Time Performance Assessment.","authors":"Rebecca A C Skov, Jonathan Lawaetz, Cecilie M Møller, Kim K Bredahl, Igor Koncar, Jonas P Eiberg","doi":"10.1016/j.ejvs.2025.05.059","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.059","url":null,"abstract":"<p><strong>Objective: </strong>Training opportunities in open surgical repair (OSR) of abdominal aortic aneurysms (AAAs) have declined in parallel with the growing use of endovascular aortic aneurysm repair. Consequently, simulation based education (SBE) in OSR is recommended in the European Society for Vascular Surgery (ESVS) 2024 clinical practice guidelines on the management of abdominal aorto-iliac artery aneurysms. This study aimed to assess whether and how novices can reach proficiency in basic OSR skills when following a fixed duration and certifying SBE programme and to evaluate the reliability and inter-rater variability of the assessment tool in this setting.</p><p><strong>Methods: </strong>The ESVS and Copenhagen Certification Programme in OSR (ENHANCE-OPEN) was tested prospectively among OSR novices from 2023 to 2024. This programme includes pre-course e-learning and 21 hours of hands on SBE in a realistic pulsatile AAA model supervised by an experienced OSR instructor. Participant performance was rated four to five times with the OPERATE assessment tool. A previously validated pass limit of 27.7 points defined proficiency and certification.</p><p><strong>Results: </strong>Twenty four OSR novices were included, of whom 21 (88%) passed the programme. The median baseline performance score was 23 points (interquartile range [IQR] 12, 29), which improved to a median score of 32 points (IQR 27, 39) in the final test. Participants required a median of three test attempts (IQR 1, 5) to reach the pass limit. The internal consistency of OPERATE was excellent, with a Cronbach's α coefficient of 0.93. Instructor ratings varied significantly (range -5.4 to +4.9 points; p < .001). To minimise individual instructor bias, a system was implemented whereby instructors rotated between participants.</p><p><strong>Conclusion: </strong>Most novices reached proficiency and certification in basic OSR when following the ENHANCE-OPEN programme. OPERATE assessment was reliable for evaluating OSR skills; however, variations between instructor ratings were high, underlining the necessity of instructor training.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250887","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}