European Journal of Vascular and Endovascular Surgery最新文献

{"title":"Leriche Syndrome Presenting as Hypertensive Urgency.","authors":"Ying-Lan Tang, Ya-Qiong He","doi":"10.1016/j.ejvs.2025.05.021","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.021","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":"144082127","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":"Systematic Review and Meta-analysis of Occurrence Rate, Treatments, and Outcomes of Vascular Graft and Stent Infections in the Supra-aortic Trunks.","authors":"Paolo Perini, Marjan Wouthuyzen-Bakker, Oliver T Lyons, Ivika Heinola, Alexandra Catasta, Anne Lejay","doi":"10.1016/j.ejvs.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.006","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to systematically review and synthesise the available evidence on the management of vascular graft and stent infections in the supra-aortic trunks (SATs).</p><p><strong>Data sources: </strong>MEDLINE, Scopus, Cochrane databases, and citation searching.</p><p><strong>Review methods: </strong>All study designs (case reports and series, cohort studies, and trials) addressing treatments for post-operative infections of prosthetic vascular grafts and stents in the SAT were included. GRADE methodology was used to assess the certainty of evidence.</p><p><strong>Results: </strong>Seventy one studies were included in this systematic review. Fifty four were case reports and case series (215 patients) describing SAT infections following surgery. Among these, 11 studies with 149 patients who initially underwent carotid endarterectomy (CEA) with patch closure were included in the meta-analysis. The estimated infection rate after CEA with patch closure was 0.7% (95% confidence interval [CI] 0.4 - 0.9%). Surgical treatment was mostly based on complete removal of the infected material and in situ arterial reconstruction (82.2%, 95% CI 71.4 - 92.9%). Post-operative complications occurred in 25.9% (95% CI 16 - 35.9%). Cranial nerve injury occurred in 12.5% (95% CI 5.7 - 19.4%), with 28.4% (95% CI 5.2 - 57.4%) of these being permanent. Re-infections during a mean follow up of 37.7 months occurred in 3.4% of patients. Seventeen studies were case reports documenting SAT infections in 21 patients following endovascular treatment. Stent explantation was performed in 18 of 21 cases. A reconstruction to restore SAT flow was performed in 11 of 18 cases. GRADE analysis determined the certainty of evidence for all outcomes to be very low.</p><p><strong>Conclusion: </strong>Vascular graft and stent infections in the SAT are uncommon. The preferred treatment was removal of the infected graft and autologous reconstruction. Alternatives included drainage, stent relining, and antibiotics. Cranial nerve injuries were common, with one third resulting in permanent damage.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060573","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":"Endovascular Treatment of Abdominal Aortic Aneurysm and Impact of Yearly Caseload in the Quality Registry of the German Society for Vascular Surgery and Vascular Medicine (DGG).","authors":"Artur Besch, Jörg Heckenkamp, Farzin Adili, Markus Steinbauer, Livia Cotta, Christian-Alexander Behrendt","doi":"10.1016/j.ejvs.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.012","url":null,"abstract":"<p><strong>Objective: </strong>While the impact of yearly caseload on short term outcomes after abdominal aortic aneurysm (AAA) repair is still under debate, current data from the most decentralised healthcare system in Europe may offer valuable insights into an area that has changed considerably due to the widespread use of endovascular aortic aneurysm repair (EVAR).</p><p><strong>Methods: </strong>This was a retrospective observational study of multicentric quality registry data from Germany on EVAR for intact and ruptured AAA between January 2017 and December 2023. The impact of yearly caseload and risk factors on in hospital mortality, complication rates, and failure to rescue after intact AAA repair was determined using multivariable logistic regression models.</p><p><strong>Results: </strong>A total of 19 641 individuals (n = 2 576 females [13.1%]; median age 74 years, interquartile range [IQR] 68, 80) who underwent EVAR for intact (n = 18 763) or ruptured (n = 878) AAA were included at 194 centres. Among these, 44.3% of males were selected for treatment with maximum diameter < 55 mm (31.8% of females < 50 mm). After a median length of hospital stay of 6 days (IQR 5, 8) and 10 days (IQR 6, 17) for intact and ruptured cases, 1.0% and 19.7% died, respectively. The rate of any post-interventional complication was 8.2% and 31.4%, respectively. An endoleak was apparent in the completion angiography in 17.6% of intact cases (14.5% type II) and 18.2% of ruptured cases (11.0% type II). The median yearly EVAR caseload per centre was 34.7 (IQR 22.1, 58.4), and 25.1% of patients were treated at centres above the 75th percentile. An American Society of Anesthesiologists (ASA) score ≥ 4, juxtarenal aneurysm extent, severe heart failure, female sex, larger aneurysm diameter, older age, and history of cancer, chronic obstructive pulmonary disease, and stroke were associated with in hospital death after intact AAA repair, but not yearly caseload or severe chronic kidney failure. Sensitivity analyses including different outcomes were confirmative, except for a statistically significant impact of yearly caseload on the composite endpoint of any post-interventional complication (p = .008).</p><p><strong>Conclusion: </strong>This large registry analysis was unable to confirm an impact of caseload on short term results after EVAR for intact AAA. Future studies should address long term outcomes after EVAR as well as the underlying reasons for the considerably large proportion of small AAA treatment.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010193","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 There Magic in the Oldest Diabetes Drug If You Have an Abdominal Aortic Aneurysm.","authors":"Jonathan Golledge","doi":"10.1016/j.ejvs.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.001","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019415","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":"Takayasu's Arteritis: Is This the Eureka Moment?","authors":"Prem C Gupta, Laxmi Gupta","doi":"10.1016/j.ejvs.2025.04.050","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.04.050","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058667","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":"Changes in Ascending Aorta and Aortic Arch Secondary Flow Patterns Following Endovascular Repair of the Descending Thoracic Aorta.","authors":"Alexandra Hauguel, Kianosh Kasani, Virgile Chevance, Xingjian Zhang, Abdul I Barakat, Stephan Haulon, Arshid Azarine","doi":"10.1016/j.ejvs.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.005","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess modifications of aortic secondary flow patterns following thoracic endovascular aortic repair (T-EVAR) using four dimensional flow magnetic resonance imaging (4D flow MRI).</p><p><strong>Methods: </strong>FASCAT is a French, prospective, observational, single centre study. All included patients underwent cardiac MRI, including aortic magnetic resonance angiography and 4D flow MRI acquisition, before and three months after T-EVAR. Visual and quantitative aortic flow patterns were assessed using Tempus Pixel Cardio and cvi42 software. Basic 4D flow MRI metrics such as aortic forward flow (AFF), aortic reverse flow (ARF), aortic net flow (ANF), and peak and mean velocities were initially assessed. 4D flow MRI derived advanced metrics such as pulse wave velocity (PWV) related to aortic stiffness, flow ejection angle, flow eccentricity (ECC), and mean systolic fraction of reverse flow (FRF) and their duration over systole (FRFd_sys and ECCd_sys, respectively) were also measured on pre- and post-operative MRIs.</p><p><strong>Results: </strong>The analysis was conducted on 15 T-EVAR procedures in 14 patients (seven aneurysms and seven dissections). The median time between pre- and post-operative MRI was 122.8 ± 71.4 days. PWV statistically significantly increased within the stented segment (17.8 ± 12.1 cm/s vs. 9.4 ± 8.5 cm/s; p = .005), while it statistically significantly decreased upstream of the graft (8.8 ± 9.1 cm/s vs. 4.9 ± 6.2 cm/s; p = .035) post T-EVAR. No statistically significant changes were found in terms of mean AFF, ANF, velocities, or flow ejection angle pre to post T-EVAR. Mean systolic FRF statistically significantly decreased post T-EVAR (37%, 26%, and 48% at the sinotubular junction, mid ascending aorta, and T-EVAR inlet, respectively). FRFd_sys and ECCd_sys also statistically significantly decreased post T-EVAR.</p><p><strong>Conclusion: </strong>This pre to post T-EVAR 4D flow MRI study found a statistically significant decrease in ARF and ECC upstream of the graft, suggesting improved upstream aortic flow fields post T-EVAR.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010189","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 Second European Carotid Surgery Trial (ECST-2): Clinical Implications and Future Directions.","authors":"Paul J Nederkoorn, Gert J de Borst","doi":"10.1016/j.ejvs.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.003","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060791","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 European Society for Vascular Surgery 2025 Guidelines on the Management of Diseases of the Mesenteric and Renal Arteries and Veins. Known Knowns and Known Unknowns: A Call For Collaboration.","authors":"Anastasia Dean, Meg Beaumont, Manar Khashram","doi":"10.1016/j.ejvs.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.007","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043106","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":"Additional Considerations in Assessing Mesenteric Artery Stenosis as a Risk Factor for Anastomotic Leakage.","authors":"Wenhan Wu","doi":"10.1016/j.ejvs.2025.03.039","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.03.039","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013594","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":"Navigating Uncharted Waters in Supra-aortic Trunk Infections.","authors":"Kitty Wong, Sergi Bellmunt-Montoya","doi":"10.1016/j.ejvs.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.05.002","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060572","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}