Annals of vascular surgery最新文献

{"title":"Pediatric Versus Adult Blunt Cerebrovascular Injuries: Patients Characteristics, Management, and Outcomes","authors":"Sina Asaadi ,&nbsp;Martin G. Rosenthal ,&nbsp;Andrei Radulescu ,&nbsp;Kaushik Mukherjee ,&nbsp;Xian Luo-Owen ,&nbsp;Joseph J. Dubose ,&nbsp;Maryam B. Tabrizi","doi":"10.1016/j.avsg.2025.02.016","DOIUrl":"10.1016/j.avsg.2025.02.016","url":null,"abstract":"<div><h3>Background</h3><div>Blunt cerebrovascular injury (BCVI) management in children currently follows guidelines developed for adults, with limited data on their efficacy in the pediatric population. This study aimed to explore injury features in the pediatric population with BCVIs and compare the clinical manifestations, diagnosis, and treatment of pediatric and adult BCVIs.</div></div><div><h3>Methods</h3><div>A retrospective data analysis of BCVI patients was conducted using the PROspective Observational Vascular Injury Treatment (PROOVIT) registry, covering the period from 2013 to 2022. The clinical manifestation, treatment, and outcome were compared between the adult and pediatric populations (&lt;18 years old).</div></div><div><h3>Results</h3><div>This study included 38 pediatric and 1,310 adult patients with BCVIs. Pediatric patients had a higher median Abbreviated Injury Scale head score (4 vs. 3, <em>P</em> &lt; 0.001) and a lower Glasgow Coma Scale at admission (9 vs. 14, <em>P</em> = 0.005). The 2 groups had no significant differences in Biffl grade injury distribution. Computed tomography angiography was the primary diagnostic method used in both groups (78.9% in pediatrics and 87.8% in adults; <em>P</em> = 0.084). Carotid artery injuries were the most frequently affected vessels in pediatric patients (71%), while vertebral artery injuries were more prevalent in adults (53.4%) (<em>P</em> &lt; 0.001). Treatment methods were similar, with most patients receiving medical treatment (68.4% in pediatrics vs. 77.4% in adults; <em>P</em> = 0.264), although fewer pediatric patients continued medical therapy postdischarge (52.6% vs. 81.1%, <em>P</em> = 0.031). The incidence of BCVI-related stroke was similar between groups (7.9% in pediatrics vs. 6.3% in adults; <em>P</em> = 0.959). In-hospital mortality was not significantly different between the 2 cohorts, but hospital length of stay differed significantly, with pediatric patients having shorter stays than adults (<em>P</em> = 0.047).</div></div><div><h3>Conclusions</h3><div>Our findings suggest that the current management patterns for BCVI in children are not significantly different from those in adults. This similarity may reflect the adoption of care strategies based on adult experience in the absence of pediatric-specific guidelines. Additionally, the outcomes in the pediatric population were comparable to those observed in adults, underscoring the potential effectiveness of these adapted approaches while highlighting the need for further research to develop age-specific guidelines for pediatric BCVI management.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"116 ","pages":"Pages 1-8"},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623320","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 of Targeted Teaching Program on Patients Care in National Health Service Hospitals","authors":"Anwar Al-Kassar,&nbsp;Mohamed Elkawafi,&nbsp;George Ninkovic-Hall,&nbsp;Ragai R. Makar,&nbsp;Tamer Ghatwary Tantawy","doi":"10.1016/j.avsg.2025.02.021","DOIUrl":"10.1016/j.avsg.2025.02.021","url":null,"abstract":"<div><h3>Background</h3><div>Continuous professional development is essential in medical education programs to enhance patient care. Junior doctors in the UK often experience challenges adapting to new specialty-specific standards during their rotations, potentially compromising patient care. A targeted teaching program (TTP) was developed to address this issue. This study evaluates the efficacy of a TTP implemented in a regional vascular surgery unit within the National Health Service on patients' care and safety.</div></div><div><h3>Methods</h3><div>This observational study was designed to gather data about patients' management in the vascular department at the Countess of Chester National Health Service Foundation trust in the period between 2019 and 2023. Various clinical audits were completed to assess the impact of TTP on clinical outcomes and to gauge the improvement in health-care delivery standards and adherence to national guidelines.</div></div><div><h3>Results</h3><div>The TTP significantly improved patient care metrics in our vascular surgery service between 2019 and 2023. Key improvements included antiplatelet medication prescriptions increasing from 86% to 100%, lipid modification therapy from 82.9% to 98%, postamputation pain management from 25% to 92%, and diabetes screening using HbA1c from 32% to 100%. These enhancements demonstrate a marked advancement patient care standards following TTP introduction.</div></div><div><h3>Conclusion</h3><div>Introduction of regular TTP has led to significant improvements in the standard of care for patients by implementing evidence-based practices. Furthermore, it enhanced doctors’ knowledge, reduced the adaptation period to new specialties, and positively impacted the national trainee survey. Expanding targeted teaching to other clinical and nonclinical areas is recommended to enhance patient care across various settings.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"115 ","pages":"Pages 69-73"},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623317","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 Implications of Oxygen-Dependent Chronic Obstructive Pulmonary Disease on Sac Growth and Mortality Following Endovascular Aneurysm Repair","authors":"Kirthi S. Bellamkonda ,&nbsp;Bjoern D. Suckow ,&nbsp;Jesse A. Columbo ,&nbsp;Gilbert R. Upchurch Jr. ,&nbsp;Benjamin Jacobs ,&nbsp;Cassius I. Ochoa Chaar ,&nbsp;Rebecca E. Scully ,&nbsp;Philip P. Goodney ,&nbsp;Salvatore T. Scali ,&nbsp;David H. Stone","doi":"10.1016/j.avsg.2025.02.019","DOIUrl":"10.1016/j.avsg.2025.02.019","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD) is a known risk factor for abdominal aortic aneurysm (AAA) growth and rupture. The impact of COPD on AAA sac behavior following endovascular aneurysm repair (EVAR) is poorly understood. This study aimed to determine the association between COPD and sac remodeling after EVAR.</div></div><div><h3>Methods</h3><div>We identified all EVAR patients (2010–2021) in the Society for Vascular Surgery-Vascular Quality Initiative database. COPD severity (none, medication-treated, oxygen (O₂)-dependent) was the primary exposure variable. The primary end point was 1-year sac growth post-EVAR. Mixed effects linear and logistic regression were used to assess the effects of COPD severity on sac remodeling, controlling for covariates. Cox proportional hazards regression and competing risks regression identified predictors of mortality and reintervention.</div></div><div><h3>Results</h3><div>30,686 patients met inclusion criteria. COPD was present in 24% of patients (no COPD, 75.8% [<em>n</em> = 23,260], medication-treated COPD, 19.7% [<em>n</em> = 6,057], O₂-dependent COPD, 4.5% [<em>n</em> = 1,369]). O₂-dependent COPD was associated with persistent sac growth (mean difference: +0.55 mm, 95% confidence interval [CI] [0.05–1.05], <em>P</em> = 0.03) following EVAR implantation; however, medication-treated COPD was not (mean difference: −0.06 mm, 95% CI [−0.32 to 0.19]; <em>P</em> = 0.64). O₂-dependent COPD patients did not experience increased reintervention rates (hazard ratio [HR] 0.82, 95% CI [0.65–1.02], <em>P</em> = 0.07) but were identified to have significantly increased mortality (HR 1.8, 95% CI [1.52–2.22], <em>P</em> &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>O₂-dependent COPD was significantly associated with increased sac growth after EVAR. O₂-dependent COPD did not correlate with increased reintervention, likely due to the disproportionately elevated mortality rates in this group. These findings highlight that patients with O₂-dependent COPD have limited life expectancy and potentially less favorable sac remodeling, and elective EVAR should thus be reserved for only those at greatest risk for AAA-related mortality.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"115 ","pages":"Pages 98-106"},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623324","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":"Rupture of a Non-Infected, Non-Anastomotic False Aneurysm in a Patient with Prior Femorofemoral Bypass","authors":"Margaret P. Johnson MD,&nbsp;Benjamin J. Pearce MD","doi":"10.1016/j.avsg.2024.12.031","DOIUrl":"10.1016/j.avsg.2024.12.031","url":null,"abstract":"","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"113 ","pages":"Pages 441-442"},"PeriodicalIF":1.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593934","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":"Association of Central Venous Stenosis with Arterio-Venous Graft Outcomes in Patients with End-Stage Renal Disease on Hemodialysis","authors":"Ankit Dhiman MBBS, MS,&nbsp;Ji Young Baik BA,&nbsp;Danielle Frischmann MSN, ACNPC-AG,&nbsp;Andrew J. Soo Hoo MD,&nbsp;Gautam Agarwal MD","doi":"10.1016/j.avsg.2024.12.020","DOIUrl":"10.1016/j.avsg.2024.12.020","url":null,"abstract":"","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"113 ","pages":"Page 435"},"PeriodicalIF":1.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594240","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":"Retrograde Common Carotid Artery Stenting in Isolated Carotid Disease","authors":"Vishaal Motla BS,&nbsp;Andrew Soo Hoo MD,&nbsp;Gautam Agarwal MD,&nbsp;William D. Jordan Jr. MD","doi":"10.1016/j.avsg.2024.12.026","DOIUrl":"10.1016/j.avsg.2024.12.026","url":null,"abstract":"","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"113 ","pages":"Pages 438-439"},"PeriodicalIF":1.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591972","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":"Open Surgical Repair in a Highly Comorbid Patient with Loeys-Dietz Syndrome and Extensive Vascular Compromise: A Case Report and Literature Review","authors":"Camilo A. Polania MD,&nbsp;Houssam Farres MD,&nbsp;Santh P. Lanka MD,&nbsp;Christopher Jacobs MD,&nbsp;Young Erben MD","doi":"10.1016/j.avsg.2024.12.059","DOIUrl":"10.1016/j.avsg.2024.12.059","url":null,"abstract":"","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"113 ","pages":"Pages 442-443"},"PeriodicalIF":1.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593936","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":"Beyond Academic Centers: Insights from TCAR in a Community Hospital Environment","authors":"Daniel J. Whitson MD,&nbsp;Mena Louis DO,&nbsp;Lucas Canaan DO,&nbsp;Robert T. Harvell MD,&nbsp;Ryan Anderson MD,&nbsp;Niraj Parikh MD","doi":"10.1016/j.avsg.2024.12.019","DOIUrl":"10.1016/j.avsg.2024.12.019","url":null,"abstract":"","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"113 ","pages":"Pages 434-435"},"PeriodicalIF":1.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594239","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":"Can ChatGPT Write My Vascular Surgery Case Report?","authors":"Phil H. Moon BS,&nbsp;Maurice Solis MD","doi":"10.1016/j.avsg.2024.12.024","DOIUrl":"10.1016/j.avsg.2024.12.024","url":null,"abstract":"","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"113 ","pages":"Pages 437-438"},"PeriodicalIF":1.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591970","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":"Sacrilege Or Innovation? Common Femoral Atherectomy Yields Safe Results and Low Morbidity in the Outpatient Setting","authors":"Jarred Napier MD ,&nbsp;Abdulhameed Aziz MD ,&nbsp;Michael Heidenreich MD ,&nbsp;Patrick Kato MD ,&nbsp;Vikram Sundararaghavan MD","doi":"10.1016/j.avsg.2024.12.030","DOIUrl":"10.1016/j.avsg.2024.12.030","url":null,"abstract":"","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"113 ","pages":"Pages 440-441"},"PeriodicalIF":1.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593933","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}