JVS-vascular insights最新文献

{"title":"The use of artificial intelligence in three-dimensional imaging modalities and diabetic foot disease – a systematic review","authors":"Manal Ahmad, Matthew Tan, Henry Bergman, J. Shalhoub, Alun H Davies","doi":"10.1016/j.jvsvi.2024.100057","DOIUrl":"https://doi.org/10.1016/j.jvsvi.2024.100057","url":null,"abstract":"","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"34 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139827515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regarding “Intravascular Ultrasound Use in Peripheral Arterial and Deep Venous Interventions: Multidisciplinary Expert Opinion from SCAI/AVF/AVLS/SIR/SVM/SVS”","authors":"B. Tonnessen, Bernadette Aulivola","doi":"10.1016/j.jvsvi.2024.100055","DOIUrl":"https://doi.org/10.1016/j.jvsvi.2024.100055","url":null,"abstract":"","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"18 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139811823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Assessment of Racial Diversity in Vascular Surgery Educational Resources","authors":"Aman A. Kankaria, Natalie T. Chao, Rana O. Afifi, Sarasijhaa K. Desikan","doi":"10.1016/j.jvsvi.2024.100056","DOIUrl":"https://doi.org/10.1016/j.jvsvi.2024.100056","url":null,"abstract":"","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139813681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality improvement efforts to address racial and ethnic disparities in patients with peripheral vascular disease and chronic limb-threatening ischemia","authors":"","doi":"10.1016/j.jvsvi.2024.100093","DOIUrl":"10.1016/j.jvsvi.2024.100093","url":null,"abstract":"<div><h3>Introduction</h3><div>Racial and ethnic disparities in care have been documented among patients who present with chronic limb-threatening ischemia (CLTI), the most severe form of peripheral artery disease (PAD). This scoping review was designed to explore the different types of quality improvement (QI) initiatives that have been set up to address disparities in access to care and treatment outcomes for this vulnerable patient population.</div></div><div><h3>Methods</h3><div>A systematic search of the MEDLINE, Embase, and CINAHL databases was performed to identify articles that evaluated QI programs, care processes, or outcomes established to address disparities in access and treatment among non-White and ethnic minority patients with PAD and/or CLTI. This search was limited to studies published in the English language after 1990, and abstracts were screened and abstracted by the authors. The review was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines for scoping reviews.</div></div><div><h3>Results</h3><div>Our search yielded six articles published between 1990 and 2023 that reported on QI initiatives designed to address some aspect of differential care among non-White patients with different types of PAD including CLTI. QI protocols were primarily focused on addressing disparities in the care of non-White patients with diabetic foot infections and/or adherence to guidelines for patients with CLTI. Findings from these studies identified potential for improvement through multidisciplinary care teams and algorithm-based treatment protocols that emphasize the importance of medication compliance, timely revascularization, and frequent follow-up. Nevertheless, data between studies were heterogeneous, and there were limited protocols that specifically focused on measures to mitigate differential access for non-White patients with PAD or CLTI.</div></div><div><h3>Conclusions</h3><div>There has been a paucity of QI initiatives and processes established to address disparities in access to care and treatment outcomes for non-White and ethnic minority patients with PAD and/or CLTI. More hospital and community-based programs are needed to improve access to vascular surgery care for this vulnerable patient population.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100093"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141137588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"European Carotid Surgical Trial-based diameter measurement using B-mode ultrasound imaging to quantify low-grade carotid artery stenosis: the QUAMUS study","authors":"Frédéric Giauffret MD ,&nbsp;Fabien Hocq MD ,&nbsp;Sophie Lafond PhD ,&nbsp;Aurélie Autret MS ,&nbsp;Antoine Elias MD","doi":"10.1016/j.jvsvi.2024.100061","DOIUrl":"10.1016/j.jvsvi.2024.100061","url":null,"abstract":"<div><h3>Background</h3><p>Identification of carotid atherosclerotic lesions with no hemodynamic effect on Doppler ultrasound examination is a common situation. Although the use of B-mode ultrasound examination has been recommended to assess this type of lesion, there is no validated examination procedure to date for quantifying low-grade carotid stenosis.</p></div><div><h3>Methods</h3><p>We conducted a single-center prospective study (QUAntification Morphologique en UltraSonographie [QUAMUS] study) to assess the reproducibility of B-mode ultrasound quantification of low-grade internal carotid artery stenosis using the European Carotid Surgical Trial (ECST) measurement method. We included consecutive patients with &lt;50% North American Symptomatic Carotid Endarterectomy Trial carotid stenosis identified by the University of Washington duplex criteria (ie, maximum systolic velocity of &lt;125 cm/second at a Doppler angle of 50°-60°). The examination was carried out and interpreted independently, blindly, and successively by two operators according to a precise methodology based on the measurement of cross-sectional diameter in B-mode and calculation of the stenosis percentage according to the ECST method. The primary objective was to assess the measurement concordance of the stenosis percentage for a difference not exceeding 10% between the two operators. The secondary objective was to assess concordance in relation to examination quality.</p></div><div><h3>Results</h3><p>Among the 86 patients included, 159 atherosclerotic carotid arteries were eligible and 157 could be explored (feasibility of 98.74%). The conditions were considered as good by the two operators in 69.43% of cases and poor in 2.55%. The concordance of the stenosis percentage measurement for a maximum difference of 10% between the two operators was 89.17% (95% confidence interval, 83.23-93.56) with a Lin concordance correlation coefficient of 0.87 (95% confidence interval, 0.82-0.90). Under examination conditions estimated as good, average, and poor, the concordance was 95.37%, 78.95%, and 60.00%, respectively.</p></div><div><h3>Conclusions</h3><p>Our study shows that ECST-based B-mode ultrasound measurement of low-grade carotid stenosis is reliable and can be performed in routine practice in most patients with a measurement variation of &lt;10% using a simple standardized examination procedure.</p></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100061"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949912724000096/pdfft?md5=c33a930ab9bc17ff41a721a8db91c422&pid=1-s2.0-S2949912724000096-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139966842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical and ethical challenges of maintaining vascular access in chronic kidney disease: A qualitative interview study","authors":"Farhad R. Udwadia MBE, MD ,&nbsp;Danielle Cohen BSc ,&nbsp;Ningzhi Gu MD ,&nbsp;Alexa Mordhorst MD ,&nbsp;Tomas Skala RN ,&nbsp;York N. Hsiang MBChB, MHSc, FRCSC ,&nbsp;Jonathan Misskey MD, MHPE, FRCSC","doi":"10.1016/j.jvsvi.2023.100050","DOIUrl":"10.1016/j.jvsvi.2023.100050","url":null,"abstract":"<div><h3>Objective</h3><p>Chronic kidney disease affects 16.8% of adults in the United States, for which hemodialysis is most commonly used for renal replacement therapy. Although emphasis with the Fistula First Initiative has historically focused on the prioritization of autogenous arteriovenous access, higher rates of maturation failure and access dysfunction have prompted a reappraisal of this approach in the literature and clinical practice. Oftentimes, frail or medically complex patients with dysfunctional access are subjected to a large number of surgical procedures to maintain or reestablish patency. The influence of arteriovenous fistula (AVF) dysfunction and repetitive reintervention on patient experience and quality of life remains largely unexplored in contemporary literature.</p></div><div><h3>Methods</h3><p>Using a provincial database of renal failure patients (Patient-Reported Outcomes Measurement Information System [PROMIS]), we selected patients who had undergone five or more interventional procedures (open or endovascular) to maintain vascular access within a 20-year period from a single institution. Semistructured interviews were conducted with these patients and analyzed qualitatively using the constant comparative approach.</p></div><div><h3>Results</h3><p>Seventeen patients who met the inclusion criteria were recruited from across British Columbia. The cohort included patients from both genders (10 male, 7 female) between the ages of 52 and 87 years old. Four major thematic categories were identified; treatment values, impact of disorder, disposition toward AVF and impact of repeated interventions. Survival was the primary theme in the treatment values category (11/17), with reduction in dialysis frequency being secondary. Within impact of disorder, loss of independence was the primary theme (14/17), with psychological impact being secondary. Displeasure with the high rates of failure emerged as the primary theme (15/17) in disposition toward AVF, with pain with use (8/17) and inadequate informed consent (8/17) as secondary themes. Finally, for impact of repeated interventions, the primary theme was interruption to daily life (12/17). Overall, only 8 of 17 patients expressed satisfaction with their AVF.</p></div><div><h3>Conclusions</h3><p>These findings highlight that repeated interventions to maintain fistula patency pose significant disruption to patient's quality of life. Rates and impacts of fistula failure need to be explained thoroughly to patients during their informed consent process, moving toward a more patient-centered, individualized and holistic approach to vascular access over a ubiquitous fistula-first approach in all cases.</p></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100050"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949912723000478/pdfft?md5=41d72600b41a0ce9ebb22c4b8785c4de&pid=1-s2.0-S2949912723000478-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139129142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative analysis of the significance of ergonomics among vascular surgeons","authors":"Abdul Wasay Paracha BS ,&nbsp;Billal Alamarie BS ,&nbsp;Ahsan Zil-E-Ali MBBS ,&nbsp;Fadi Samaan BS ,&nbsp;Faisal Aziz MD, FACS, DFSVS","doi":"10.1016/j.jvsvi.2024.100054","DOIUrl":"10.1016/j.jvsvi.2024.100054","url":null,"abstract":"<div><h3>Objective</h3><p>Surgical ergonomics has become an increasingly recognized topic of discussion in surgical literature. Vascular surgery is a high-stress field with long operating hours, which can become physically challenging for surgeons. The study aims to investigate the ergonomic challenges experienced by vascular surgeons and identify current habits and rituals used for optimal ergonomics.</p></div><div><h3>Methods</h3><p>The qualitative assessment of vascular surgeons ergonomics was assessed using semistructured interviews. These interviews were conducted with six academic vascular surgeons who often performed open abdominal aortic aneurysm operations at a tertiary care academic medical center. The interview targeted several domains, such as preoperative habits, postoperative habits, and operating room practices. A research team member conducted all interviews, recorded, and later transcribed them. Two independent research team members cross-referenced the interview transcriptions. Thematic analysis using NVivo was performed to identify patterns and themes among the interviews given by the study participants. Differing opinions on the themes were reconciled via discussion between four researchers.</p></div><div><h3>Results</h3><p>The participants included three female and three male academic vascular surgeons with a mean age of 40 ± 5 years and an average of 6 ± 5 years in practice. In total, five major themes were identified in all six interviews. The themes were perception of ergonomics, preprocedural habits, postprocedural habits, the impact of surgeries on ergonomic health, and advice to future trainees. Within these five themes, there were a multitude of subthemes between the six participants. Of the six participants, two (33%) mentioned the importance of preoperative and postoperative exercise and stretching, including targeting core muscles and legs to cope with the lengthy procedural demands. Some of the comments were alarming and eye opening, for example “Oh, I think it's actually horrible. It's horrible. I know. It's killing me slow.” All six of the participants (100%) emphasized the need for optimizing the height of the surgical table, and four participants (66%) mentioned ensuring the need for proper equipment, such as loupes, during the procedure to prevent neck and back pain postoperatively. Finally, four of the participants (66%) agreed that incoming trainees must develop healthy habits, such as proper sleep hygiene, stretching, and hydration. Three participants (50%) discussed the importance of exercise to overcome the physical demands of vascular surgery and maintaining hobbies during training as coping mechanisms against mental burnout.</p></div><div><h3>Conclusions</h3><p>Vascular surgeons face unique ergonomic challenges daily. The findings from this qualitative study emphasize the importance of preoperative and postoperative habits, such as regular exercise and manipulation of the height of the surgical table, t","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100054"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949912724000023/pdfft?md5=7be0081fa8b9305b9e6b661b1ad9e075&pid=1-s2.0-S2949912724000023-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139538196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Society for Vascular Surgery Patient Safety Organization Quality Fellowship in Training (FIT) program, training the next-generation quality-focused vascular surgeons","authors":"Betsy Wymer DNP, RN, CV-BC ,&nbsp;Adam Johnson MD, MPH ,&nbsp;James Wadzinski ,&nbsp;Gary Lemmon MD","doi":"10.1016/j.jvsvi.2024.100071","DOIUrl":"10.1016/j.jvsvi.2024.100071","url":null,"abstract":"","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100071"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949912724000199/pdfft?md5=fe157d600e15a6077c512a9526eee361&pid=1-s2.0-S2949912724000199-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140271138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrative review of the role of endoscopically assisted in situ bypass in the modern era of limb salvage vascular bypass","authors":"Mufaddal Baghdadwala MD, PhD ,&nbsp;Alison Michels MD, PhD ,&nbsp;Peter Brown MD, FRCSC ,&nbsp;David Zelt MD, MSc, FRCSC ,&nbsp;Michael Yacob MD, MEd, RPVI, FRCSC","doi":"10.1016/j.jvsvi.2024.100078","DOIUrl":"10.1016/j.jvsvi.2024.100078","url":null,"abstract":"<div><h3>Objective</h3><p>In this narrative review, we seek to summarize key literature describing nontraditional minimally invasive in situ lower extremity bypass techniques. We describe the various historical and newer attempts and their known outcomes to date. We particularly focused on the sparsely used endoscopic-assisted in situ bypass technique.</p></div><div><h3>Methods</h3><p>A list of search terms and keywords relevant to novel in situ bypass techniques was identified. A retrospective review of the literature was conducted screening PubMed/MEDLINE and Scopus with a search period from January 1, 1959, to August 1, 2023.</p></div><div><h3>Results</h3><p>Our search yielded six previous studies that used various permutations of the novel in situ bypass techniques. Despite the relative paucity of high-quality data, the studies demonstrate that the endoscopic technique results in lower wound complications rates, shorter hospital stays, and no significant differences in outcomes compared with the traditional in situ bypass technique.</p></div><div><h3>Conclusions</h3><p>The endoscopic in situ bypass technique demonstrates important wound-related benefits compared with the traditional in situ technique. This minimally invasive approach is certainly in keeping with the current technical knowledge and skillset in vascular surgery. Future studies are needed to systematically compare the long-term outcomes.</p></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100078"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949912724000266/pdfft?md5=68b8f264edfe0fd5beea63e2284c3c0d&pid=1-s2.0-S2949912724000266-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140780254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapted chicken model for training percutaneous arterial access","authors":"Julie M. Clanahan MD, MHPE ,&nbsp;Gayan S. De Silva MD ,&nbsp;J. Westley Ohman MD, FACS","doi":"10.1016/j.jvsvi.2024.100100","DOIUrl":"10.1016/j.jvsvi.2024.100100","url":null,"abstract":"<div><h3>Objective</h3><p>Endovascular approaches within vascular surgery have grown substantially over the past two decades. As general surgery trainees gain exposure to these approaches, innovative simulation methods to train basic endovascular skills are needed. The purpose of this study was to pilot an existing low-cost model for percutaneous femoral arterial access and examine its effect on resident simulation performance and procedural interest.</p></div><div><h3>Methods</h3><p>A percutaneous arterial access simulation was designed using an adapted chicken breast model. Exiting postgraduate year 1 and 2 general surgery residents participated in sessions with these models for ultrasound-guided arterial access simulation using 5F micropuncture kits. Vascular surgery faculty and fellows provided didactic introductions and proctoring during sessions. Residents also completed skill self-assessments before and after participating in the simulation and rated the model and simulation as a whole. Paired <em>t</em> tests and descriptive statistics were applied in analyses.</p></div><div><h3>Results</h3><p>Twenty-six residents participated in the simulation in May 2022. Mean resident confidence in overall ability to complete steps required for percutaneous femoral arterial access increased from 3.1 ± 1.0 to 4.4 ± 0.6 (<em>P</em> &lt; .001) when assessed on a 5-point rating scale. Most improved individual steps were identification of arterial cannulation sites using ultrasound (mean difference, +1.4; 95% confidence interval, 1.0-1.8; <em>P</em> &lt; .001) and advancement of hemostatic sheaths over the guidewire into position (mean difference, +1.5; 95% confidence interval, 1.0, 1.9; <em>P</em> &lt; .001). Residents also reported increased comfort level asking to vascular surgery fellows and faculty to participate in subsequent percutaneous access procedures (mean before, 2.7 ± 1.0; mean after, 3.2 ± 0.7; <em>P</em> = .015). On session evaluations, the majority of residents (n = 19 [86%]) strongly agreed that the model was realistic for training purposes and could be used for future skill assessments (n = 16 [73%]). The average material cost required for creation of one chicken model was estimated at $10.32.</p></div><div><h3>Conclusions</h3><p>General surgery trainees require opportunities for low-stakes, independent practice of basic endovascular skills, particularly those with applicability beyond vascular surgery. In this study, use of a simple, a low-cost chicken model promoted increases in procedural confidence and was sufficiently realistic for further training with residents. In the future, this model will be incorporated into standardized assessments to ensure translation of simulated skills to live operative settings.</p></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100100"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949912724000485/pdfft?md5=9426496873be33ef413861c8f4d0dc8f&pid=1-s2.0-S2949912724000485-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141389508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}