Annals of vascular surgery最新文献

{"title":"Outcomes Associated with Non-standard Configuration of Renal Branches in Aortic Endografts.","authors":"Anastasia Dean, Summer Hassan, William Yoon, Kevin Mani, Anders Wanhainen, David Lindström","doi":"10.1016/j.avsg.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.avsg.2025.03.014","url":null,"abstract":"<p><strong>Background: </strong>Endovascular repair of thoracoabdominal and pararenal aortic aneurysms (TAAAs and PAAAs) involves the use of branched stent grafts to perfuse visceral arteries. Non-standard renal branch configuration, such as \"ballerina,\" may be required as a bailout technique in challenging anatomical or technical situations. This configuration may result in altered hemodynamic stress, increasing the risk of branch-related complications.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study analyzed outcomes of renal branches in standard and non-standard configurations (outside IFU) following endovascular repair of TAAAs and PAAAs. Renal branches were categorized as standard or ballerina (branch connected to the contralateral renal artery, ≥90° radial deviation from the cuff to the arterial orifice) based on postoperative imaging. Adverse outcomes, including branch occlusion, thrombus formation, and the need for re-intervention, were recorded. Kaplan-Meier analysis was used to assess complication-free survival.</p><p><strong>Results: </strong>A total of 97 renal branches in 56 patients were analyzed and followed for a median of 25 months. Non-standard configuration (11 branches) had significantly higher adverse event rates (45%) compared to standard configurations (16%, p = 0.04). Complications among the eleven ballerina branches included two occlusions, one thrombus, and two compressions requiring re-lining. In standard configurations, branch occlusions were the most common complication (14%). Kaplan-Meier analysis demonstrated significantly reduced complication-free survival in non-standard configurations compared to standard configurations (median 54 vs 594 days, p = 0.02).</p><p><strong>Conclusion: </strong>Bailout non-standard renal branch configurations are associated with a high rate of serious adverse events. Intensified postoperative imaging surveillance with readiness for re-intervention and optimized antithrombotic therapy should be considered in these cases.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Advancements in Endovascular Aortic Repair with Off-the-Shelf Solutions.","authors":"Tilo Kölbel, Jose I Torrealba","doi":"10.1016/j.avsg.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.avsg.2025.03.016","url":null,"abstract":"","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ankle Peak Systolic Velocity Correlates with Toe Pressure in Patients with Peripheral Artery Disease","authors":"Tedy Sawma ,&nbsp;Hassan Chamseddine ,&nbsp;Sarah Wehbe ,&nbsp;Karim Kanbar ,&nbsp;Sami Cheaib ,&nbsp;Fady Haddad ,&nbsp;Jamal J. Hoballah","doi":"10.1016/j.avsg.2025.03.013","DOIUrl":"10.1016/j.avsg.2025.03.013","url":null,"abstract":"<div><h3>Background</h3><div>Conventional screening of Peripheral Artery Disease (PAD) with Ankle Brachial Index may be limited in diabetic patients due to arterial calcification. Alternatively, ankle peak systolic velocity (APSV) may be a more accurate measure of limb perfusion in those patients. This study aims to assess the correlation between APSV and toe pressure (TP) in patients evaluated for PAD.</div></div><div><h3>Methods</h3><div>This is a single-center retrospective study examining the correlation between APSV and TP in patients evaluated for PAD at a tertiary medical center between January 2019 and August 2020. Spearman Correlation and multivariate linear regression were used to assess the association between APSV and TP. The optimal cutoffs for APSV corresponding to TP of 30 mm Hg and 50 mm Hg were generated using the Youden index.</div></div><div><h3>Results</h3><div>A total of 224 patients with median age of 72 years were included in this study. 61% of patients were females and 54% were diabetic. The mean APSV of the overall population was 62 cm/s. APSV was significantly correlated with TP (R = 0.6, <em>P</em> &lt; 0.001) in both diabetic and nondiabetic patients. On multivariate analysis, TP was significantly associated with APSV (estimate B 0.41, 95% confidence interval 0.29–0.53, <em>P</em> &lt; 0.001). The optimal cutoffs of APSV to detect a TP ≤ 30 mm Hg and TP ≥ 50 mm Hg were 35 cm/s and 44 cm/s, respectively.</div></div><div><h3>Conclusion</h3><div>APSV is a reliable measure for evaluating perfusion in PAD patients. Its adoption in the clinical setting can significantly improve the accuracy of PAD diagnosis, allowing earlier detection and treatment.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"116 ","pages":"Pages 55-60"},"PeriodicalIF":1.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Greener Vascular Surgery: A Survey of Current Green Practices","authors":"Nina Al-Saadi","doi":"10.1016/j.avsg.2025.03.012","DOIUrl":"10.1016/j.avsg.2025.03.012","url":null,"abstract":"<div><h3>Background</h3><div>Climate change is an environmental emergency. With health care systems contributing to 5% of carbon emissions globally, environmental sustainability is an important consideration when delivering surgical services. This survey aimed to understand current green practices across vascular centers.</div></div><div><h3>Methods</h3><div>A survey on routine sustainable practices and the feasibility of implementing greener practices was developed between the Vascular and Endovascular Research Network and the Vascular Society of Great Britain and Ireland. The survey was delivered using the Qualtrics online survey tool and distributed through mailing lists and social media. The survey was open to completion by all vascular health care professionals internationally. Responses were collected between June 2, 2023, and September 15, 2023.</div></div><div><h3>Results</h3><div>A total of 115 vascular health care professionals across 14 different countries responded. Disposable theater materials were used in 85% (98/115) of respondents' centers. Most centers used electronic patient records (investigation requests [76%, 85/112], observation charts [81%; 91/112], prescriptions [74%; 83/112]). Paper recycling policies were available in 52% (58/112) of respondents' centers. All the respondents agreed that vascular surgery can be greener. 80% (92/115) of respondents reported environmental sustainability was never discussed in departmental meetings and 24% (28/115) reported their department engaged with management to implement more sustainable practices. Barriers to change included finance (77%, 89/115), competing priorities (84%, 97/115), and lack of engagement (82%, 94/115).</div></div><div><h3>Conclusion</h3><div>This survey identified areas where vascular services could be more environmentally friendly, including reducing the use of disposable materials and improving recycling. Vascular health professionals are largely supportive of implementing changes to reduce the carbon footprint.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"116 ","pages":"Pages 73-80"},"PeriodicalIF":1.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 tranexamic acid in non-cardiac arterial procedures: a systematic review and meta-analysis.","authors":"T A H Steunenberg, N C Bakker, A M Wiersema, E Tournoij, K K Yeung, V Jongkind","doi":"10.1016/j.avsg.2025.03.015","DOIUrl":"https://doi.org/10.1016/j.avsg.2025.03.015","url":null,"abstract":"<p><strong>Objectives: </strong>Non-cardiac arterial procedures (NCAP) are associated with a high risk of bleeding. Tranexamic acid (TXA) is used among surgical disciplines to reduce blood loss, however its effectiveness and safety in NCAP remain unclear. This review evaluates the efficacy and safety of TXA during NCAP.</p><p><strong>Methods: </strong>Systematic review and meta-analysis was performed in accordance with PRISMA guidelines. Literature searches in PubMed, EMBASE, and Cochrane databases (October 2023 and October 2024) identified studies investigating TXA in open and endovascular NCAP. Meta-analyses were conducted using Cochrane's Review Manager.</p><p><strong>Results: </strong>Five studies (n=4304) were identified. One randomized controlled trial of TXA in non-cardiac surgery (n=9535), including a vascular cohort (14.8%; n=699 TXA, n=700 placebo), showed lower composite bleeding outcomes in the overall cohort receiving TXA (9.5% vs 11.7%; p<0.001), but not in the vascular cohort (HR 0.85; 95%CI 0.64-1.13). Another trial found no difference in blood loss or transfusion rates in 100 patients undergoing open abdominal aortic aneurysm surgery. Both trials reported no increased cardiovascular or thrombo-embolic complications (TEC) or 30-day mortality. A prospective study showed similar thrombosis-related technical failure rates in traumatic vascular injury patients (TXA 6.3% vs 3.8%, p=0.14) and no significant differences in bleeding or hematoma (TXA 11.4% vs 4.3%, p=0.13). In 297 carotid endarterectomy (CEA) patients, TXA significantly reduced postoperative hematoma (7.9% vs 1.3%; p=0.01) without increasing TEC or stroke. TXA during an intraoperative hemostasis protocol during CEA (TXA n=8) reported similar results. Meta-analysis showed no significant differences in TEC (RR 1.10; 95%CI 0.71-1.70) or reoperation rates (RR 0.55; 95%CI 0.19-1.63).</p><p><strong>Conclusion: </strong>TXA does not increase the risk of TEC in NCAP. However, there is currently insufficient evidence that TXA reduces bleeding complications.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete Endovascular Repair of Entire Aorta for Extensive Pathologies -A set of China Strategies.","authors":"Wei Guo, Yang Yang Ge, Dan Rong, Hong Peng Zhang, Jiang Xiong, Xin Jia, Xiao Hui Ma, Li Jun Wang, Yong Le Xu, Min Hong Zhang, Feng Liu","doi":"10.1016/j.avsg.2025.03.017","DOIUrl":"https://doi.org/10.1016/j.avsg.2025.03.017","url":null,"abstract":"<p><p>Endovascular aortic repair was first clinically applied in China in 1997. In subsequent years, this technique was rapidly adopted across the country and has since evolved with ongoing device development. Domestically produced endovascular devices began to emerge after 2000 and have been continuously growing, benefiting from advancements of materials and manufacturing processes. Nonetheless, the availability of devices for complex aortic pathologies remains limited in China, leading to prevalent use of physician-modified devices by vascular surgeons. For nearly two decades, our center has been committed to advancing endovascular technologies for the treatment of aortic diseases. We have designed innovative devices for reconstructing aortic arch branches, visceral arteries and internal iliac arteries, specifically the devices for post-dissection thoracoabdominal aortic aneurysms. Now we have developed a stent graft system which can be used for complete endovascular repair of the entire aorta in the high-risk patients with expansive aortic diseases. This article aims to discuss the design principles of these novel devices, the progress of clinical trials or applications, and the technical challenges encountered during development.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Revascularization for Peripheral Artery Disease in Aboriginal and Torres Strait Islander Peoples and Non-Indigenous Australians","authors":"Kevin Tian ,&nbsp;David Sun ,&nbsp;Maarisha Kumar ,&nbsp;Dylan Morris ,&nbsp;Kate Gibson ,&nbsp;James Charles ,&nbsp;Justin Cain ,&nbsp;Jonathan Golledge","doi":"10.1016/j.avsg.2025.03.004","DOIUrl":"10.1016/j.avsg.2025.03.004","url":null,"abstract":"<div><h3>Background</h3><div>Australia's Aboriginal and Torres Strait Islander Peoples are at high risk of peripheral arterial disease (PAD), but outcomes of revascularization are unknown. Revascularization outcomes were compared among Aboriginal and Torres Strait Islander and non-Indigenous Australians.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted of patients who underwent lower limb revascularization between January 2015 and July 2023. PAD severity was defined using the Rutherford classification and angiographic scoring systems (ANGIO score, Global Limb Anatomic Staging System [GLASS], Trans-Atlantic Inter-Society Consensus). The primary outcome was major adverse limb events (MALE), that is, major amputation or repeat revascularization. The secondary outcomes were major adverse cardiovascular events (MACE), major amputation, and repeat revascularization alone.</div></div><div><h3>Results</h3><div>A total of 504 patients were included. Fifty-seven (11.3%) were Aboriginal and Torres Strait Islander People, who were more likely to present with chronic limb-threatening ischemia (74% vs. 65%; <em>P</em> = 0.01) and have infrapopliteal disease (GLASS: odds ratio [OR] 1.93, 95% confidence interval 1.15–3.24; <em>P</em> = 0.013; ANGIO score: OR 1.97, 1.18–3.29; <em>P</em> = 0.01) compared to non-Indigenous Australians. Risk of MALE (rate ratio [RR] 1.39; 0.91–2.13; <em>P</em> = 0.126) and repeat revascularization (RR 1.18, 0.74–1.88; <em>P</em> = 0.493) were similar, but Aboriginal and Torres Strait Islander People had a higher risk of major amputation (RR 3.35; 1.66–6.75; <em>P</em> = 0.001) and MACE (RR 1.88, 1.17–3.03; <em>P</em> = 0.009) than non-Indigenous participants. Adjusted analyses suggested the increased risk of major amputation was due to Aboriginal and Torres Strait Islander People presenting with more severe PAD and tissue loss compared to non-Indigenous patients.</div></div><div><h3>Conclusion</h3><div>Aboriginal and Torres Strait Islander Peoples present with more severe PAD and have greater risk of major amputation. Culturally appropriate programs are needed to raise awareness and promote secondary prevention.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"116 ","pages":"Pages 34-44"},"PeriodicalIF":1.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical Thrombectomy for the Management of Acute Branch Occlusions in Patients who Previously Underwent Fenestrated/Branched Endovascular Repair for Thoracoabdominal Aneurysm","authors":"Chase R. Nelson ,&nbsp;Nallely Saldana-Ruiz ,&nbsp;Reginald Nkansah ,&nbsp;Kirsten D. Dansey ,&nbsp;Matthew P. Sweet ,&nbsp;Sara L. Zettervall","doi":"10.1016/j.avsg.2025.03.005","DOIUrl":"10.1016/j.avsg.2025.03.005","url":null,"abstract":"<div><h3>Background</h3><div>Acute thrombosis of visceral artery branch stents represents a rare but potentially devastating complication among patients who have undergone fenestrated and branched endovascular repair (F/BEVAR) for the treatment of thoracoabdominal aortic aneurysm (TAAA). There is limited data regarding the optimal management strategy in these patients. In this study, we describe the management and outcomes of patients who presented with this complication and were subsequently treated with the use of percutaneous mechanical thrombectomy.</div></div><div><h3>Methods</h3><div>A retrospective review of all patients enrolled in a single-institution, physician-sponsored investigational device exemption trial for endovascular repair of thoracoabdominal aneurysms (F/BEVAR) from 2012 to 2024 was performed. Patients who presented during the long-term follow-up period with acute graft thrombosis and treated with percutaneous mechanical thrombectomy were identified, and their preoperative course, hospital management, and long-term follow-up are described.</div></div><div><h3>Results</h3><div>3 patients (1.3%) were identified with acute mesenteric ischemia or acute kidney injury due to branch graft occlusion and were subsequently treated with percutaneous mechanical thrombectomy. All patients were on a statin and an antiplatelet agent at the time of presentation, and the time from symptom onset to presentation was between 11 hr and 1 week. Patient 1 had complete occlusion of all 4 visceral artery branches. Patient 2 had occlusion of the celiac and superior mesenteric arteries (SMA), and patient 3 had occlusion of the right renal artery. All had successful return of vessel patency following mechanical thrombectomy, with an average fluoroscopy time of 15.5 min. All were spared bowel resection or permanent need for dialysis, and in each of the 7 affected vessels, patency was intact on long-term follow-up.</div></div><div><h3>Conclusion</h3><div>Percutaneous mechanical thrombectomy represents a viable treatment modality for patients with acute thrombosis of branch stents following F/BEVAR, including those who present in extremis or with multivessel involvement. Given the rapid rate of flow restoration, this technique may represent the optimal treatment modality for this patient population.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"116 ","pages":"Pages 27-33"},"PeriodicalIF":1.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Predictive Value of the CHA2DS2-VASc Score in the Development of Contrast-Induced Nephropathy after Endovascular Intervention in Peripheral Artery Disease","authors":"Ali Evsen ,&nbsp;Adem Aktan ,&nbsp;Raif Kılıç ,&nbsp;Mehmet Ali Işık ,&nbsp;Abdulaziz Yalçın ,&nbsp;Tuncay Güzel ,&nbsp;Recep Gülmez ,&nbsp;Mehmet Altunova ,&nbsp;Mehmet Özbek","doi":"10.1016/j.avsg.2025.03.009","DOIUrl":"10.1016/j.avsg.2025.03.009","url":null,"abstract":"<div><h3>Background</h3><div>Contrast-induced nephropathy (CIN) is a frequent complication of endovascular interventions for peripheral artery disease (PAD). It is linked to renal dysfunction, extended hospital stays, increased cardiovascular events, and higher mortality rates. The CHA₂DS₂-VASc score, widely utilized for assessing cardioembolic risk and guiding anticoagulation therapy in nonvalvular atrial fibrillation, encompasses risk factors that overlap with those of CIN. This study investigates whether the CHA₂DS₂-VASc score can predict CIN in PAD patients undergoing endovascular interventions.</div></div><div><h3>Methods</h3><div>The study included 754 consecutive PAD patients who underwent endovascular procedures at 2 centers. Each patient's CHA₂DS₂-VASc score was calculated and categorized into low (&lt;3) and high (≥3) groups. Patients were retrospectively monitored for CIN development and divided into CIN-positive (CIN+) and CIN-negative (CIN−) groups. Univariate and multivariate regression analyses were performed to identify independent predictors of CIN, and a significance level of <em>P</em> &lt; 0.05 was used for all statistical analyses.</div></div><div><h3>Results</h3><div>Of the 754 patients, 178 (23.6%) developed CIN, with 151 (84.8%) occurring in the high CHA₂DS₂-VASc score group (<em>P</em> &lt; 0.001). The CHA₂DS₂-VASc score was significantly higher in the CIN(+) group compared to the CIN(−) group (<em>P</em> &lt; 0.001). Regression analysis identified the CHA₂DS₂-VASc score (odds ratio [OR]: 1.574, 95% confidence interval [CI]: 1.298–1.907, <em>P</em> &lt; 0.001), baseline creatinine (OR: 2.296, 95% CI: 1.580–3.335, <em>P</em> &lt; 0.001), and hemoglobin (OR: 0.915, 95% CI: 0.844–0.992, <em>P</em> &lt; 0.001) as independent risk factors. A CHA₂DS₂-VASc score cutoff of 2.5 predicted CIN with 85% sensitivity and 42% specificity.</div></div><div><h3>Conclusion</h3><div>The CHA₂DS₂-VASc score is an independent predictor of the development of CIN in patients with PAD undergoing endovascular intervention.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"116 ","pages":"Pages 17-26"},"PeriodicalIF":1.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calf Muscle-Venous Pump Dysfunction in Patients with Pelvic Venous Disorder","authors":"Sergey G. Gavrilov,&nbsp;Anatoly V. Karalkin,&nbsp;Ekaterina P. Moskalenko,&nbsp;Anastasiya S. Grishenkova","doi":"10.1016/j.avsg.2025.03.008","DOIUrl":"10.1016/j.avsg.2025.03.008","url":null,"abstract":"<div><h3>Background</h3><div>To study the evacuation function of calf muscle-venous pump (CMP) in patients with pelvic venous disorder (PeVD).</div></div><div><h3>Methods</h3><div>This single-center cross-sectional study included 170 female patients (120 with PeVD ± chronic venous disease (CVD) and 50 with CVD without PeVD) and 20 healthy volunteers. All subjects underwent duplex ultrasound (DUS) of the pelvic and lower extremity veins, radionuclide venography (RV) of the lower extremities, and single-photon emission computed tomography (SPECT) of the pelvic veins (PVs) with in vivo labeled red blood cells (RBCs). The pelvic venous congestion (PVC) signs were deposition of labeled RBCs in the PVs and the PVC coefficient (C_PVC) &gt; 0.5. The CMP evacuation dysfunction was identified during RV as an increase in the average isotope transit time (T_ave) in the tendon (T_t) and muscle (T_m) parts of CMP and in the popliteal vein (T_pv).</div></div><div><h3>Results</h3><div>The CMP dysfunction was detected in 81.6% and 78.3% of patients with symptomatic and asymptomatic PeVD, accordingly, and in 92% of patients with CVD. This condition was characterized by a significant increase in the isotope transit time (T_t 18–30 s, T_m 27–45 s, and T_pv 20–40 s).</div></div><div><h3>Conclusion</h3><div>The CMP dysfunction is present in about 80% of patients with PeVD, regardless of the clinical c<em>o</em>urse of PeVD and the presence of CVD of the lower extremities.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"116 ","pages":"Pages 61-72"},"PeriodicalIF":1.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}