Annals of vascular surgery最新文献

{"title":"Factors Affecting the Decrease in Psoas Muscle Area 1 Year After Thoracic Aortic Replacement in Older Patients","authors":"Naoya Araki,&nbsp;Kosuke Nakata,&nbsp;Takafumi Hirota,&nbsp;Hideaki Hidaka,&nbsp;Tatsuya Horibe,&nbsp;Jun Takaki,&nbsp;Takashi Yoshinaga,&nbsp;Toshihiro Fukui","doi":"10.1016/j.avsg.2025.06.042","DOIUrl":"10.1016/j.avsg.2025.06.042","url":null,"abstract":"<div><h3>Background</h3><div>To investigate the rate of change in the psoas muscle area (PMA) from the preoperative period to 1 year postoperatively in patients aged ≥65 years undergoing elective thoracic aortic replacement and identify factors influencing PMA decrease at 1 year.</div></div><div><h3>Methods</h3><div>In this single-center retrospective study, PMA was measured in 73 patients (median age, 75 years; 25 women) preoperatively and 1 year postoperatively. Factors affecting PMA decreased after thoracic aortic replacement were identified using univariate and multivariate analyses. Patients were divided into 2 groups based on whether their PMA had decreased 1 year after thoracic aortic replacement compared to the preoperative value.</div></div><div><h3>Results</h3><div>The decrease and nondecrease groups comprised 38 and 35 patients, respectively. From the univariate logistic regression analysis results, male sex (<em>P</em> = 0.004), preoperative body mass index (BMI) (<em>P</em> = 0.020), and failure of postoperative 6-min walk distance (6 MWD) to recover to the preoperative value (<em>P</em> = 0.012) were selected for the multivariate analysis. Multivariate logistic regression analysis identified male sex (odds ratio (OR) = 5.019, 95% confidence interval (CI) = 1.527–16.499, <em>P</em> = 0.008), preoperative BMI (OR = 1.190, 95% CI = 1.004–1.410, <em>P</em> = 0.045), and failure of postoperative 6 MWD to recover to the preoperative value (OR = 9.617, 95% CI = 1.590–58.152, <em>P</em> = 0.014) as independent predictors of PMA decrease.</div></div><div><h3>Conclusion</h3><div>Male sex, preoperative BMI, and failure of postoperative 6 MWD to recover to the preoperative value were independent factors influencing the decrease in PMA 1 year after thoracic aortic replacement.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"121 ","pages":"Pages 333-342"},"PeriodicalIF":1.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615978","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":"Anatomical Factors Influencing Catheterization Time in FEVAR Procedures (KT-FEVAR Study)","authors":"Thibaud Hamelin ,&nbsp;Cindy Vannier ,&nbsp;Jade Hollier-Ben Turkia ,&nbsp;Remy Pascot ,&nbsp;Antoine Lucas ,&nbsp;Adrien Kaladji","doi":"10.1016/j.avsg.2025.07.002","DOIUrl":"10.1016/j.avsg.2025.07.002","url":null,"abstract":"<div><h3>Background</h3><div>Catheterization of the target vessel (TV) during fenestrated endovascular aortic repair (FEVAR) can be challenging and contributes to significant radiation exposure and procedural time. The objective of this study was to investigate the link between the anatomical features of the TVs on celiac trunk (CT) scan and procedural time.</div></div><div><h3>Methods</h3><div>This prospective single-center study included patients who underwent FEVAR procedure between May 2020 and April 2022. Patients with branched, mixed (branched and fenestrated), off-the-shelf, or brachial access were excluded. Variables measured on CT scan (EndoSize, Therenva Inc.) included, for each TV, its diameter, aortic diameter at the TV level, angulations with the aorta, and degree of ostial stenosis (&gt;50%). The catheterization method was the same for all patients: femoral approach, short then long sheath, use of a catheter (no steerable sheath), and a soft then stiff guidewire. Catheterization time was defined as the fluoroscopy time from insertion of the soft guidewire in the short sheath until the placement of the nonexpanded covered stent protected by the introducer. Each anatomical parameter was then correlated with this time interval using both univariate and multivariate analyses.</div></div><div><h3>Results</h3><div>Forty patients were included, and 132 TVs were catheterized. All procedures were guided by image fusion. The median catheterization time for renal arteries was 7 ± 6.9 min, 4.5 ± 3.1 min for the superior mesenteric artery, and 13 ± 13.9 min for the CT. There was 16% of TV with ostial stenosis. Of the 24 stented CTs, 5 had an arcuate ligament. The 2 variables significantly correlated with catheterization time in univariate analysis were the angulation of the TV (the more the artery is oriented downwards, the longer the time, <em>P</em> = 0.01) and the presence of ostial stenosis in the TV (<em>P</em> &lt; 0.0001). In multivariate analysis, these 2 parameters remained significantly correlated (<em>P</em> = 0.04 for angulation and <em>P</em> = 0.0001 for the presence of ostial stenosis).</div></div><div><h3>Conclusion</h3><div>The presence of ostial stenosis and/or a very downward orientation of the TVs are independently correlated with catheterization time and should be considered when planning FEVAR procedures, either by proposing a brachial approach or using a steerable sheath.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"120 ","pages":"Pages 354-360"},"PeriodicalIF":1.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615976","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":"Preliminary Experience of Protocol for Digital Subtraction Angiography Using Diluted Contrast Medium during Endovascular Aneurysm Repair","authors":"Ayaka Yu ,&nbsp;Naoki Fujimura ,&nbsp;Kyosuke Hosokawa ,&nbsp;Takahiro Shoji ,&nbsp;Kenji Suzuki ,&nbsp;Kentaro Matsubara ,&nbsp;Hirohisa Harada","doi":"10.1016/j.avsg.2025.06.038","DOIUrl":"10.1016/j.avsg.2025.06.038","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the efficacy of digital subtraction angiography (DSA) using low-concentration contrast medium (LC-DSA) during endovascular aneurysm repair (EVAR).</div></div><div><h3>Methods</h3><div>An LC-DSA protocol for EVAR using the Infinix Celeve-i angiography system (Canon Medical Systems Corporation, Tochigi, Japan) was developed through an ex vivo experiment. Seventeen patients undergoing EVAR using the LC-DSA protocol between October 2018 and November 2019 were prospectively analyzed. A historical cohort that underwent EVAR using a normal contrast medium between November 2017 and May 2018 was included as the control group (<em>n</em> = 11).</div></div><div><h3>Results</h3><div>Contrast medium use was significantly lower in the LC-DSA group (15.8 mL vs. 64.6 mL, <em>P</em> &lt; 0.001). There were no significant differences between the groups in clinical outcomes, including technical success (<em>P</em> = 0.44) and perioperative complications (<em>P</em> = 0.35). However, the quality of the DSA image was significantly inferior in the LC-DSA group (contrast noise ratio; 35.2 vs. 53.8, <em>P</em> = 0.01), and the radiation dose was significantly higher in the LC-DSA group (1290.0 mGy vs. 393.7 mGy, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The LC-DSA protocol for EVAR can reduce the amount of contrast medium used without affecting the clinical outcomes. However, this is associated with inferior image quality and a significant increase in radiation exposure, warranting further improvements.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"120 ","pages":"Pages 311-319"},"PeriodicalIF":1.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615957","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":"Risk factors and consequences of bleeding complications after transcarotid artery revascularization in the Vascular Quality Initiative.","authors":"Christina L Cui, Laura B Pride, Lauren N West-Livingston, Daemar Jones, Young Kim","doi":"10.1016/j.avsg.2025.07.008","DOIUrl":"https://doi.org/10.1016/j.avsg.2025.07.008","url":null,"abstract":"<p><strong>Background: </strong>Previous case series on post-operative bleeding complications after transcarotid artery revascularization (TCAR) have primarily been through case series. The purpose of this study is to evaluate risk factors and consequences of bleeding complications after TCAR on a national level.</p><p><strong>Methods: </strong>The Vascular Quality Initiative (VQI) database was retrospectively queried for all patients undergoing TCAR between 2017 to 2023. The primary outcome of interest was postoperative bleeding complications, which included all neck hematomas, surgical bleeding, and pseudoaneurysms. Univariate tests and multivariable logistic regression analyses were utilized.</p><p><strong>Results: </strong>A total of 50,909 TCAR procedures were included. The overall incidence of bleeding complications was 1.9%. The strongest risk factor for postoperative bleeding complications was lack of intraoperative protamine (adjusted odds ratio [aOR] 3.91 [95% CI, 3.41-4.47], p<0.0001). Other risk factors included prior carotid endarterectomy (aOR 1.44 [95% CI, 1.18-1.75], p=0.0004), neck radiation (aOR 1.42 [95% CI, 1.08-1.85], p=0.01), and symptomatic stenosis (aOR 1.19 [95% CI, 1.04-1.35], p=0.009). Preoperative and discharge anticoagulation (AC) were not associated with bleeding complications. Patients suffering postoperative bleeding complications had a longer index hospitalization and more unplanned reoperations for bleeding (p<0.0001 both). Non-bleeding complications were also more common among patients suffering bleeding complications, including cranial nerve injury, postoperative stroke, reperfusion injury, myocardial infarction, dysrhythmia, carotid stenosis or occlusion, CHF exacerbation and wound infection (p<0.0001 each).</p><p><strong>Conclusions: </strong>Postoperative bleeding complications are rare after TCAR and may be associated with adverse outcomes, including systemic and neurologic sequelae. Bleeding complications are not associated with AC or antiplatelet regimen. However, intraoperative protamine is associated with reduced risk of surgical bleeding complications, and should be considered during TCAR operations.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615959","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":"Impact of Early Ambulation on Recovery Following Open Abdominal Aortic Aneurysm Repair","authors":"Shusuke Nojiri ,&nbsp;Naohiro Akita ,&nbsp;Yohei Kawai ,&nbsp;Daichi Takagi ,&nbsp;Shinya Tanaka ,&nbsp;Kiyonori Kobayashi ,&nbsp;Tomohiro Sato ,&nbsp;Shuta Ikeda ,&nbsp;Masayuki Sugimoto ,&nbsp;Kiyoaki Niimi ,&nbsp;Hiroshi Banno","doi":"10.1016/j.avsg.2025.06.040","DOIUrl":"10.1016/j.avsg.2025.06.040","url":null,"abstract":"<div><h3>Background</h3><div>The importance of early ambulation after various types of surgeries has been highlighted; however, the impact of early ambulation on the clinical course after open abdominal aortic aneurysm (AAA) repair remains unclear. The aim of this study was to investigate the associations of early ambulation with functional recovery and the length of hospital stay. Moreover, the preoperative factors predicting early ambulation after surgery were evaluated.</div></div><div><h3>Methods</h3><div>Three hundred sixteen patients who underwent elective open AAA repair at a university hospital between 2012 and 2018 were included in this retrospective study. Spearman's rank correlation coefficient and multiple regression analysis were used to investigate the association between early ambulation and functional recovery, as determined by the completion of a 100-m walk, and length of stay. Multiple regression analysis was performed to identify the preoperative factors associated with early ambulation.</div></div><div><h3>Results</h3><div>Early ambulation was correlated with functional recovery and length of hospital stay (ρ = 0.730 and 0.473, respectively). After adjusting for age, sex, and juxtarenal AAA, early ambulation was independently associated with functional recovery and length of stay (B = 1.318 and 2.253, respectively). Multiple regression analysis revealed that none of the 11 preoperative factors, including functional exercise capacity, were associated with early ambulation.</div></div><div><h3>Conclusion</h3><div>Early ambulation after open abdominal aortic aneurysm repair is strongly associated with the clinical course, such as functional recovery and length of stay, with a more than 2-fold impact. None of the preoperative factors were associated with early ambulation after surgery. The preoperative prediction of delayed ambulation remains challenging, emphasizing the need for strategies that promote early mobilization after surgery.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"121 ","pages":"Pages 325-332"},"PeriodicalIF":1.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615980","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":"Secondary open surgery for type A aortic dissection following thoracic endovascular aortic repair.","authors":"Wenliu Xu, Chaojie Wang, Ge Wang, Zengxiao Zou, Songtao Tan, Changjiang Yu, Xiaoping Fan","doi":"10.1016/j.avsg.2025.06.043","DOIUrl":"https://doi.org/10.1016/j.avsg.2025.06.043","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the clinical features, surgical techniques, and outcomes of patients who developed type A aortic dissection (TAAD) after undergoing thoracic endovascular aortic repair (TEVAR).</p><p><strong>Methods: </strong>From January 2018 to April 2024, 31 consecutive patients who developed ascending aortic dissection following TEVAR underwent secondary open arch surgery. Postoperative mortality and morbidity were analyzed to evaluate the immediate and mid-term results. Survival analysis during the follow-up was evaluated using a Kaplan-Meier survival curve.</p><p><strong>Results: </strong>The patients had a mean age of 52.1 ± 10.7 years, and the median interval between TEVAR and TAAD repair was 3 months. All patients underwent aortic arch reconstruction using the frozen elephant trunk (FET) technique, with 25 patients receiving separate grafts and 6 undergoing the modified island technique. The mean durations of the operation, cardiopulmonary bypass, aortic cross-clamp, and hypothermic circulatory arrest were 475.5 ± 95.9 minutes, 252.3 ± 55.2 minutes, 132.9 ± 34.7 minutes, and 21.4 ± 8.8 minutes, respectively. The in-hospital mortality rate was 6.5% (2 of 31 patients). No cases of reoperation for bleeding, spinal cord injury, or cerebral complications were observed. Three patients required hemodialysis due to elevated serum creatinine. Follow-up data were available for 29 survivors, with a mean follow-up period of 43.3 ± 19.2 months (range, 3 to 79 months). Three patients were lost to follow-up, and one patient died during the follow-up period.</p><p><strong>Conclusion: </strong>Aortic arch reconstruction using the FET technique is a safe and effective treatment option for patients with TAAD following TEVAR, offering acceptable early and mid-term outcomes.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615960","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":"Comparative Outcomes of Paclitaxel-Coated Balloons and Simple Plain Balloon Angioplasty in the Treatment of Infrainguinal Bypass Anastomotic Stenosis","authors":"Mariana Videira ,&nbsp;Daniel Mendes ,&nbsp;Andreia Pinelo ,&nbsp;Rui Machado","doi":"10.1016/j.avsg.2025.06.048","DOIUrl":"10.1016/j.avsg.2025.06.048","url":null,"abstract":"<div><h3>Background</h3><div>Paclitaxel-coated balloons (PCBs) have shown increasing efficacy in the treatment of stenosis across different vascular territories. However, their specific role in the management of bypass graft stenosis remains poorly defined. This study aimed to compare clinical outcomes of PCBs versus simple plain balloon angioplasty (PBA) in treating infrainguinal bypass graft anastomotic stenosis.</div></div><div><h3>Methods</h3><div>A retrospective single-center cohort study was conducted including all interventions for infrainguinal prosthetic and vein bypass graft anastomotic stenosis between 2014 and 2023. Demographic characteristics, clinical, interventional, and follow-up data were obtained from medical records. The primary end point was reintervention-free survival at 24 months. Secondary end points included freedom from target lesion revascularization, major amputation, and mortality rates. Multivariate analyses were performed, along with secondary analyses based on the graft type (venous or prosthetic) and graft status (thrombosed or failing).</div></div><div><h3>Results</h3><div>Eighty-three patients who underwent a total of 116 interventions (46 PCBs and 70 PBA procedures) were included. Reintervention-free survival at 24 months was significantly higher in the PCB group compared to the PBA group (64.1% vs. 43.6%; <em>P</em> = 0.007). Multivariate analysis identified adequate runoff (hazard ratio [HR] = 0.56; 95% confidence interval [CI]: 0.32–0.99; <em>P</em> = 0.046) and the use of drug-eluting balloons (HR = 0.48; 95% CI: 0.26–0.88; <em>P</em> = 0.017) as independent predictors of improved reintervention-free survival. Freedom from target lesion revascularization was also significantly higher in the PCB group (67.8% vs. 51.5%; <em>P</em> = 0.024). There were no significant differences in the rates of major amputation (22.8% vs. 25.0%; <em>P</em> = 1) or mortality (5.7% vs. 10.4%; <em>P</em> = 0.567) between patients treated with or without PCBs, respectively.</div></div><div><h3>Conclusions</h3><div>The use of PCBs in the treatment of infrainguinal bypass graft anastomotic stenosis appears to be associated with improved freedom from the composite end point of reintervention, amputation, or death, compared to PBA alone.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"120 ","pages":"Pages 320-330"},"PeriodicalIF":1.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615977","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":"Management of Complex Aortic Endograft Infection by a Multidisciplinary Team.","authors":"Marco Campolmi, Mathilde Puges, Karl Sörelius, Walter Dorigo, Eric Ducasse, Caroline Caradu, Xavier Berard","doi":"10.1016/j.avsg.2025.07.003","DOIUrl":"https://doi.org/10.1016/j.avsg.2025.07.003","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the outcomes of a multidisciplinary team approach managing infections of complex aortic endografts, focusing on conservative treatment as an alternative to surgical explantation in selected cases.</p><p><strong>Design: </strong>This was a retrospective, monocentric study conducted at Bordeaux University Hospital.</p><p><strong>Methods: </strong>From January 2018 to July 2024, we reviewed cases of complex aortic endografts (ChEVAR, BEVAR, FEVAR) infections, managed by our Multidisciplinary Vascular Infection Team (MDVIT). The primary endpoints were in-hospital mortality and overall survival. Secondary endpoints included complications during hospitalization and follow-up.</p><p><strong>Results: </strong>All 11 cases of complex endografts infections managed by our MDVIT were scrutinized, infected FEVARS n=10 and infected ChEVAR n= 1. The mean age was 72 years. The patients were divided into two groups: Group A (7 patients) managed with conservative treatment with antimicrobial therapy ± percutaneous drainage, and Group B (4 patients) undergoing surgical treatment due to complications. Group A demonstrated infection remission in 6/7 patients (86%) with antimicrobial therapy. One patient from Group A required emergent surgery due to sepsis, and was reassigned to Group B. All patients in Group B presented with complications such as aorto-duodenal fistulas n=3 and pseudoaneurysms n=1; three underwent graft explantations, and one underwent sacotomy and duodenal fistula repair without graft removal. The overall in-hospital mortality was 9%, and the mean follow-up was 15 months (range 3-37). The overall survival was 82% at one year. Long-term vascular complications were limited, and suppressive antimicrobial therapy was effective with high rate of remission of infection.</p><p><strong>Conclusion: </strong>Multidisciplinary team management enables a tailored approach to complex aortic endograft infections. Conservative treatment was first line treatment, but for cases complicated by fistula or pseudoaneurysm surgical explantation was performed. Antimicrobial grafts and visceral debranching played a pivotal role in the surgical cases. This study highlights the importance of multidisciplinary decision-making and follow-up to optimize patient outcomes and inform future multicenter research.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615954","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":"WavelinQ EndoAVF Long Term Patency–A Follow-Up from a Prospective Stud","authors":"Gavin Christy,&nbsp;Elizabeth D'sa,&nbsp;David P. Ebertz,&nbsp;Matthew R. Smeds","doi":"10.1016/j.avsg.2025.07.009","DOIUrl":"10.1016/j.avsg.2025.07.009","url":null,"abstract":"<div><h3>Background</h3><div>The WavelinQ EndoAVF system has been used in the United States since 2018 to create minimally invasive arteriovenous fistulas (AVFs) in the upper extremity. Our group previously published promising early short-term results of initial patients using this system, with a patency of 88% at 2 months. With several years of follow-up, we sought to examine the long-term success of WavelinQ.</div></div><div><h3>Methods</h3><div>A retrospective cohort study conducted at a single tertiary center followed 32 patients who underwent WavelinQ creation from October 2018 to July 2019. Kaplan–Meier univariate analysis was used to compare primary and secondary patency at 6 months, 1 year, and 3 years. Secondary outcomes of flow volume, surgical site infection, steal syndrome, and intraoperative complications were tracked and compared using χ² analysis.</div></div><div><h3>Results</h3><div>Thirty-two patients were followed out to an average of 960.8 days following WavelinQ placement. Sixty-five point six percent of patients required interventions before successful cannulation. Primary patency at 6 months was 53.3%, 30.0% at 1 year, and 7.6% at 3 years. Secondary patency at 6 months was 83.3%, 73.3% at 1 year, and 46.5% at 3 years. There was only one surgical site infection and no instances of steal syndrome.</div></div><div><h3>Conclusion</h3><div>WavelinQ EndoAVF access has inferior patency compared to surgical fistulas.</div><div>Despite lower rates of steal syndrome and infection compared to surgical fistulas, the high reintervention rates and poor long-term patency suggest that traditional surgical fistula creation may still be the preferred approach.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"122 ","pages":"Pages 225-230"},"PeriodicalIF":1.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607230","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":"Brachial Artery Entrapment in a Professional Athlete","authors":"Branson Taheri ,&nbsp;Shawn Fortin ,&nbsp;Alex Ebinger ,&nbsp;Fraser J. Leversedge ,&nbsp;Max Wohlauer","doi":"10.1016/j.avsg.2025.07.004","DOIUrl":"10.1016/j.avsg.2025.07.004","url":null,"abstract":"<div><h3>Background</h3><div>Pathologic compression of the median nerve at the elbow by the bicipital aponeurosis, or lacertus fibrosus, in athletes has been described well; however arterial compression at this level has been rarely described. We describe the evaluation and surgical treatment of a case of distal brachial artery and proximal radial artery compression by the lacertus fibrosus in a professional baseball pitcher.</div></div><div><h3>Methods</h3><div>We received verbal consent from the patient involved to prepare a published report of this case.</div></div><div><h3>Results</h3><div>A professional baseball pitcher presented with an acute brachial artery thrombus. The patient had been treated at multiple institutions for recurrent right upper extremity arterial occlusions and had undergone a right first rib resection for arterial thoracic outlet syndrome. The patient underwent thrombectomy of the brachial thrombus. Subsequent outpatient imaging included an unremarkable computed tomagraphy angiogram with provocative thoracic outlet syndrome maneuvers, an inconclusive dynamic magnetic resonance imaging scan, and a right upper extremity arterial duplex with an increase in radial artery velocities with the arm abducted to 90°. Right brachial and radial artery exploration and decompression was performed. Preprocedure angiography demonstrated disruption of flow distal to the brachial bifurcation with the shoulder abducted and externally rotated with elbow flexed in the “pitching” or cocking position. Following lacertus fibrosus decompression, repeat angiography demonstrated normal brachial artery blood flow in all arm positions.</div></div><div><h3>Conclusion</h3><div>The patient did well postoperatively without additional episodes of arterial occlusion after nearly 3 years of follow-up.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"121 ","pages":"Pages 319-324"},"PeriodicalIF":1.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607224","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}