European Journal of Vascular and Endovascular Surgery最新文献

{"title":"Optimising the Classification System for Iliofemoral Stenting in Patients with Chronic Venous Obstruction.","authors":"Maofeng Gong, Jianping Gu","doi":"10.1016/j.ejvs.2025.04.072","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.04.072","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087086","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 Results of Antegrade Laser Fenestrations Using Image Fusion Guidance in Complex Aortic Aneurysm Repair.","authors":"Jean Sénémaud, Jennifer Canonge, Joseph Touma, Adrien Glomaud, Marek Majewski, Vania Tacher, Hicham Kobeiter, Pascal Desgranges","doi":"10.1016/j.ejvs.2025.04.071","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.04.071","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective, observational, single centre study aimed to describe midterm results of physician modified stent grafts using antegrade laser fenestrations and image fusion guidance (LEVAR) for the treatment of complex abdominal aortic aneurysms, thoraco-abdominal aortic aneurysms, and type I endoleaks.</p><p><strong>Methods: </strong>All LEVAR procedures between 1 September 2016 and 1 January 2022 were reviewed. Endpoints included intra-operative adverse events (IOAEs), in hospital mortality, re-interventions, and target vessel patency. Midterm outcomes were estimated using the Kaplan-Meier time to event method and 95% confidence intervals (95% CI).</p><p><strong>Results: </strong>Sixty patients underwent LEVAR procedures during the study period. All patients were deemed unfit for open repair. The LEVAR cases included 12 symptomatic aneurysms, 33 enlarging aneurysms > 65 mm, 14 anatomical constraints and/or presence of previous renal stents, and one rupture. The median diameter of aortic aneurysms was 65.5 mm (IQR 13). One hundred seventy antegrade laser fenestrations were performed (mean 2.8/patient). IOAEs were recorded in 21 cases (35%). Technical success was recorded in 98% of cases. The in hospital mortality rate was 5% (n = 3). The median follow up duration was 35.7 months. The estimates of overall survival and freedom from re-intervention at three years were 81% (95% CI 68.3 - 89) and 60.2% (95% CI 43.4 - 73.4), respectively. Six target vessels occluded during follow up, giving a three year target vessel patency rate of 90.1% (95% CI 77.5 - 95.8). Two LEVAR explantations were recorded during follow up, either for infection or persistent endoleak. The three year freedom from aortic death estimate was 98% (95% CI 86.9 - 99.7).</p><p><strong>Conclusion: </strong>In high risk patients deemed unfit for open repair, LEVAR may provide satisfactory midterm overall survival and target vessel patency rates, although re-intervention rates were high in this study, requiring close and extensive follow up.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082140","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":"Mesenteric Artery Stenosis and Anastomotic Leakage: A Complex, Clinically Significant, and Multifactorial Complication.","authors":"Koen J Vree Egberts, Flores M Metz, Desiree van Noord","doi":"10.1016/j.ejvs.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.009","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082136","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":"Pilot Study of Radiomic Analysis for Assessment of the Proximal Neck in Abdominal Aortic Aneurysms.","authors":"Vasco Trigo, Fábio Sousa-Nunes, Ana Filipa Campos Jácome, Sandra Magalhães, António S Barros, Marina Dias Neto","doi":"10.1016/j.ejvs.2025.05.015","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.015","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082142","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":"Preservation of the Internal Iliac Artery Bifurcation May Maintain Pelvic Arterial Volume after Endovascular Aneurysm Repair.","authors":"Kazuyoshi Matsubara, Ryosuke Taniguchi, Masaru Kimura, Takuro Shirasu, Toshio Takayama, Katsuyuki Hoshina","doi":"10.1016/j.ejvs.2025.05.016","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.016","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082144","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 Feasibility of a Thoracic Branched Endograft for Aortic Pathology Requiring Proximal Sealing in Zone 2.","authors":"Andrea Vacirca, Gianluca Faggioli, Stefania Caputo, Antonino Di Leo, Enrico Gallitto, Mauro Gargiulo","doi":"10.1016/j.ejvs.2025.05.013","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.013","url":null,"abstract":"<p><strong>Objective: </strong>Type B acute aortic syndrome (AAS) and thoracic or thoraco-abdominal aortic aneurysm (TAA/TAAA) requiring proximal sealing in Ishimaru zone 2 have traditionally been managed with thoracic endovascular aortic repair (T-EVAR), often combined with carotid-subclavian bypass. The new Gore Thoracic Branch Endograft (TBE) facilitates the treatment of distal aortic arch lesions by including the left subclavian artery yet maintaining its patency. This study aimed to assess the anatomical feasibility of TBE in patients treated or awaiting treatment for AAS or TAA/TAAA requiring proximal seal in zone 2.</p><p><strong>Methods: </strong>This was a retrospective cohort analysis of all patients with AAS or TAA/TAAA referred to a single centre (January 2018 to March 2025) requiring proximal seal in zone 2 and with an indication for endovascular repair. Pre-operative computed tomography scans were reviewed. Anatomical feasibility (AF) was defined according to the TBE instructions for use. Iliac feasibility (IF) was determined based on iliofemoral diameters and calcification. True feasibility (TF) was the combination of AF and IF.</p><p><strong>Results: </strong>During the study period, 93 patients (78% male; median age at presentation 72 years [interquartile range 16]) were enrolled, of whom 65 (70%) had AAS and 28 (30%) had TAA/TAAA. T-EVAR with CSB was performed in 53% (49/93), T-EVAR with LSA coverage in 26% (24/93), and TBE in 5% (5/93); 16% (15/93) were awaiting endovascular repair. The overall AF for TBE was 92%, while TF was 85%, with seven patients showing hostile iliofemoral axes. There were no statistically significant differences in TBE AF (AAS 91% vs. TAA/TAAA 96%; p = .67) and TF (AAS 85% vs. TAA/TAAA 86%; p = 1.0) among patients with AAS and TAA/TAAA.</p><p><strong>Conclusion: </strong>TBE showed high AF in both AAS and TAA/TAAAs requiring proximal sealing in zone 2. However, the elevated profile of the endograft may be considered a concern in patients with hostile iliofemoral axes.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082203","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 Optimising the Classification System for Iliofemoral Stenting in Patients with Chronic Venous Obstruction.","authors":"Mohammad E Barbati, Efthymios D Avgerinos, Houman Jalaie","doi":"10.1016/j.ejvs.2025.05.018","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.018","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082147","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":"Time To Move Beyond Traditional Risk Scores.","authors":"Çağdaş Ünlü, Hence J M Verhagen","doi":"10.1016/j.ejvs.2025.05.019","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.019","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082211","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":"Merits of Puncture and Drainage of Perigraft Material in Patients with Vascular and Endovascular Prosthetic Graft Infection.","authors":"Giulia Colonna, Reinoud P H Bokkers, Marjan Wouthuyzen Bakker, Barzi Gareb, Maurizio Taurino, Clark J Zeebregts, Ben R Saleem","doi":"10.1016/j.ejvs.2025.04.059","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.04.059","url":null,"abstract":"<p><strong>Objective: </strong>Vascular graft or endograft infections (VGEIs) pose significant challenges due to their rarity and potential for severe complications. Direct identification of micro-organisms is highly recommended by the European Society for Vascular Surgery guidelines, yet standardised approaches are limited to the literature. Percutaneous drainage followed by lifelong suppressive antimicrobial therapy offers a viable alternative for high risk patients. This study evaluated the diagnostic and therapeutic implications of percutaneous cultures in abdominal and peripheral VGEIs and assessed the efficacy of conservative treatment when surgery is unfeasible.</p><p><strong>Methods: </strong>This was a retrospective cohort study of all patients admitted to a tertiary referral centre with suspected abdominal or peripheral VGEI, according to Management of Aortic Graft Infection Collaboration (MAGIC) criteria, and who underwent percutaneous procedures between 2017 and 2023. The diagnostic accuracy of percutaneous cultures was evaluated by comparing their results with the final diagnosis of VGEI based on MAGIC criteria, and analysing the sensitivity, specificity, positive predictive value, and negative predictive value. Additionally, the influence of percutaneous cultures on antibiotic therapy adjustment and conservative treatment choice was investigated. Survival outcomes were compared between patients who were conservatively treated and those who underwent total or partial surgical graft removal.</p><p><strong>Results: </strong>The study included 69 patients: 45 with suspected abdominal VGEI and 24 with suspected peripheral VGEI. Percutaneous culture results statistically significantly correlated with VGEI diagnosis (p = .023 and p = .048, respectively), with a sensitivity and specificity of 50% and 70% in abdominal infections and 80% and 68% in peripheral infections, respectively. Percutaneous procedures statistically significantly impacted the choice of antibiotic therapy (p < .001 and p = .011). Overall survival for conservative treatment was comparable with surgical graft extraction (p= .63 and p = .25).</p><p><strong>Conclusion: </strong>Percutaneous cultures offer high specificity for VGEI diagnosis and can be used to guide effective personalised antibiotic therapy. For inoperable patients, drainage with lifelong antimicrobial treatment is a valuable conservative option.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082132","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 It's Now or Never for Popliteal Artery Stenting: The Latter May Be King.","authors":"Alexander Gombert","doi":"10.1016/j.ejvs.2025.05.020","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.020","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082208","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}