Annals of vascular surgery最新文献

{"title":"Palliative Care for End-Stage Vascular Diseases: An Action Strategy","authors":"Aditya Safaya, Ahsan Zil-E-Ali, Ana I. Flores, Kristina Newport, Faisal Aziz","doi":"10.1016/j.avsg.2025.01.005","DOIUrl":"10.1016/j.avsg.2025.01.005","url":null,"abstract":"","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"113 ","pages":"Pages 21-23"},"PeriodicalIF":1.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036109","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":"Endovascular Therapy is Effective in Patients with Post-Thrombotic Syndrome Based on Anatomical Classification: A Multi-Center Experience","authors":"Yulong Huang ,&nbsp;Xinsheng Xie ,&nbsp;Xiaolin Yu ,&nbsp;Xiang Hong ,&nbsp;Tianyue Pan ,&nbsp;Weifeng Lu ,&nbsp;Weiguo Fu ,&nbsp;Lixin Wang","doi":"10.1016/j.avsg.2025.01.009","DOIUrl":"10.1016/j.avsg.2025.01.009","url":null,"abstract":"<div><h3>Background</h3><div>In this study, we aimed to retrospectively review patients with post-thrombotic syndrome (PTS) and investigate its long-term outcomes, and a novel classification were presented across multiple institutions.</div></div><div><h3>Methods</h3><div>We retrospectively evaluated patients with PTS who underwent endovascular therapy at 2 institutions between January 2018 and September 2023. Baseline patient demographics, lesion characteristics, and in-hospital and follow-up outcomes were collected and analyzed retrospectively.</div></div><div><h3>Results</h3><div>83 patients (86 limbs) patients suffered PTS received endovascular related surgery at the 2 institutions. The lesions were summarized into 2 categories: sufficient or insufficient inflow according to digital subtraction angiography (DSA). 77 limbs (89.53%) underwent successful endovascular treatment including 46 limbs receiving percutaneous transluminal angioplasty (PTA) and stent implantation, and 31 limbs undergoing PTA without stent deployment was mainly contributed to insufficient inflow. The mean follow-up time was 23.44 ± 16.91 months (range, 6–60 months) in stent implantation cohort. In-stent restenosis and an occlusive endograft edge were observed in 2 cases, respectively. No other stent-related complications, such as fractures or migration, were noted in any patient during the follow-up period.</div></div><div><h3>Conclusions</h3><div>Endovascular technique was safe and effective for the treatment of PTS and showed promising long-term prognosis. The novel classification of PTS might be feasible for the strategy of endovascular treatment.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"113 ","pages":"Pages 26-34"},"PeriodicalIF":1.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher Rate of Reinterventions after Transfemoral Carotid Artery Stenting in Symptomatic Patients: A Retrospective Stroke Center's Cohort Study Between 2015–2024","authors":"Camila Esquetini-Vernon ,&nbsp;James F. Meschia ,&nbsp;Josephine Huang ,&nbsp;Camilo Polania Sandoval ,&nbsp;Mohamed Rajab ,&nbsp;Kevin M. Barrett ,&nbsp;W. Chris Fox ,&nbsp;David A. Miller ,&nbsp;Rabih G. Tawk ,&nbsp;Gabriela C. Pomales Diaz ,&nbsp;Eniola Oyefeso ,&nbsp;Ranya Benchaaboune ,&nbsp;Gabriel Cruz-Gonzalez ,&nbsp;Janelle R. Hartwell ,&nbsp;Suren Jeevaratnam ,&nbsp;Xindi Chen ,&nbsp;Shalyn M. Fullerton ,&nbsp;Christopher Jacobs ,&nbsp;Richard D. Beegle ,&nbsp;Sukhwinder J.S. Sandhu ,&nbsp;Young Erben","doi":"10.1016/j.avsg.2024.12.074","DOIUrl":"10.1016/j.avsg.2024.12.074","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Carotid artery stenosis is a significant contributor to ischemic strokes, and its surgical management includes carotid artery endarterectomy (CEA), transfemoral carotid artery stenting (TF-CAS), and transcarotid artery revascularization (TCAR). CEA has traditionally been preferred, but TF-CAS and TCAR are also excellent alternative options if the anatomy of the vessels allows them. This study reports our short- and mid-term outcomes after carotid artery revascularization in symptomatic patients at a stroke center.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This single-institution retrospective cohort study was conducted from 2015 to 2024. All patients with focal neurological symptoms attributable to ipsilateral carotid artery stenosis within 6 months before the intervention were included. Primary outcomes were stroke, myocardial infarction (MI), and death within 30 days. Secondary outcomes included mid-term stroke, MI, death, restenosis, and reinterventions. Statistical analyses were performed using R v 4.4.1, and Kaplan-Meier curves were used for sub-group analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 183 interventions on 178 patients were analyzed (TF-CAS = 118, CEA = 55, and TCAR = 10), with a mean age of 71.5 ± 9.6 years. The cohort included 123 male (69.1%) and 55 female (30.9%) patients. Peripheral artery disease (PAD) prevalence was higher in TCAR patients (30.0%) compared to CEA (5.5%) and TF-CAS (5.3%) (&lt;em&gt;P&lt;/em&gt; = 0.04). TF-CAS patients had a higher rate of preoperative stroke (68.6%) compared to CEA (50.9%) (&lt;em&gt;P&lt;/em&gt; = 0.02); though there was no difference in stroke severity (NIHSS in TF-CAS: 6.8 ± 7.2 vs. CEA: 5.7 ± 7.1; &lt;em&gt;P&lt;/em&gt; = 0.86). CEA patients had a higher rate of TIAs (43.6%) than TF-CAS (25.0%) (&lt;em&gt;P&lt;/em&gt; = 0.02); but their ABCD2 score did not differ (CEA 3.6 ± 1.6 vs. TF-CAS 3.4 ± 1.5, &lt;em&gt;P&lt;/em&gt; = 0.92). Preoperative amaurosis fugax rates were similar (TF-CAS:16.4% vs. CEA 14.4% &lt;em&gt;P&lt;/em&gt; = 0.72) among groups. Carotid artery degree of stenosis measured by computed tomography angiography (CTA) was significantly higher in TF-CAS (75.1 ± 17.2) than in CEA (69.6 ± 18.3) (&lt;em&gt;P&lt;/em&gt; = 0.01). A vulnerable plaque was found in 60% of CEA and 50% of TF-CAS patients (&lt;em&gt;P&lt;/em&gt; = 0.42). TF-CAS had longer hospitalizations than CEA patients (TF-CAS median of 14.0 (IQR: 2.0–16.0) days versus CEA median of 9.0 (IQR 2.0–15.0) days; &lt;em&gt;P&lt;/em&gt; &lt; 0.01). Transient cranial nerve injuries occurred in 5.5% of CEA patients but none in TF-CAS patients (&lt;em&gt;P&lt;/em&gt; = 0.03). Thirty-day combined ipsilateral stroke, MI and death were 0.0% for CEA and 5.0% for TF-CAS (&lt;em&gt;P&lt;/em&gt; = 0.18). Two perioperative deaths occurred among TF-CAS patients, who were older than 70 years of age and with NIHSS of 19 and 8 on presentation. Mid-term follow-up was 1.2 ± 1.4 years. Mid-term combined ipsilateral TIA, stroke, MI, and death were 21.8% for CEA and 22.9% for TF-CAS (&lt;em&gt;P&lt;/em&gt; = 0.88). TF-CAS had a higher rate of re","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"113 ","pages":"Pages 64-73"},"PeriodicalIF":1.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035970","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":"Current trends and evidence on post-TEVAR aorto-pulmonary and -bronchial fistula: a narrative review.","authors":"Gemmi Sufali, Constantijn E V B Hazenberg, Joost A van Herwaarden, Mauro Gargiulo, Gianluca Faggioli, Martin Teraa","doi":"10.1016/j.avsg.2024.12.061","DOIUrl":"https://doi.org/10.1016/j.avsg.2024.12.061","url":null,"abstract":"<p><strong>Introduction: </strong>Aorto-bronchial or aorto-pulmonary fistulas (ABPF) are a rare but life-threatening complication following thoracic endovascular aortic repair (TEVAR). This narrative review aims to provide an overview of the current trends and available evidence on ABPF following TEVAR, evaluating risk factors, diagnostic approaches, and possible preventive and therapeutic strategies.</p><p><strong>Methods: </strong>Relevant publications on post-TEVAR ABPF were selected through a literature search on PubMed. Studies providing data on post-TEVAR ABPF concerning pathogenesis, clinical presentation, diagnostic tools, surgical approaches, and outcomes were included.</p><p><strong>Results: </strong>The literature search obtained 169 articles. After selection, 37 studies, published between 2000 and 2024, remained for analysis. The primary symptom of ABPF is typically hemoptysis, which may be recurrent or persistent. The diagnostic pathway for ABPF encompasses medical history, clinical evaluation, blood tests, sputum and blood cultures. CTA is the first-line imaging modality in suspected ABPF, while bronchoscopy is reserved for hemodynamically stable patients. Moreover, 18-fluoro-deoxyglucose positron emission tomography (PET-CT) can aid in the diagnosis of graft infection. Post-TEVAR ABPF are associated with multiple risk factors, mainly patient-specific clinical conditions (i.e. chronic inflammatory conditions, underlying mediastinal oncologic pathologies, and infectious diseases) and anatomical characteristics, mainly large aortic aneurysms, severe aortic tortuosity, and an extensive peri-aortic hematoma. Strategies to minimize the risk of ABPF formation include appropriate device oversizing, long sealing zones, limited extent of aortic coverage, selective hematoma evacuation, and strict adherence to sterility and antibiotic prophylaxis. Radical surgical interventions have shown superior outcomes compared to endovascular approaches, which may be adopted as initial step to stabilize the patient in a staged treatment.</p><p><strong>Conclusions: </strong>Post-TEVAR ABPF is a rare and life-threatening condition. Literature is scarce and a deeper understanding of risk factors, diagnostic pathways, and therapeutic strategies is essential for the prevention and management of ABPF secondary to TEVAR.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036045","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":"Development of a clinical and ultrasonic parameter-based nomogram model to predict restenosis after superficial femoral artery stenting.","authors":"Yiwei Wang, Mingjie Gao, Xinyu Zhao, Peng Han, Libo Zhang, Alan Dardik","doi":"10.1016/j.avsg.2024.12.068","DOIUrl":"https://doi.org/10.1016/j.avsg.2024.12.068","url":null,"abstract":"<p><strong>Objectives: </strong>Prediction of in-stent restenosis (ISR) is clinically important for patients with peripheral artery disease in their superficial femoral arteries (SFA) who have been treated with stenting. The aim of this study was to construct and validate a predictive model for ISR after SFA stenting based on a series of clinical and ultrasonic parameters.</p><p><strong>Methods: </strong>This retrospective study included 381 patients who were treated with self-expanding bare nitinol stents in their SFA at our hospital between January 1, 2018, and January 1, 2022. These patients were randomly allocated to a training cohort (266 patients) or a validation cohort (115). Clinical and ultrasonic parameters related to ISR (>50%) in the SFA at 12 months were derived by univariable and multivariable logistic regression analyses to create a nomogram model predictive of risk of ISR. Receiver operating characteristic (ROC) curve analyses were used to assess the recognition ability of the model. A calibration curve was used to evaluate the model's calibration ability, and decision curve analysis was used to validate the nomogram's clinical utility.</p><p><strong>Results: </strong>Logistic regression analyses showed that sex, echogenicity of the target plaque, preoperative arterial runoff score, preoperative popliteal artery flow rate, lesion length, and residual diameter were risk factors for ISR; these parameters were used to construct the nomogram model. Internal and external validation showed that the areas under the ROC curves were 0.82 (95%CI: 0.77-0.87) and 0.70 (95%CI: 0.60-0.79), respectively, suggesting good recognition ability of the model. Additionally, calibration curves for the predictive model indicated good calibration, and decision curve analysis demonstrated clinical utility of the model.</p><p><strong>Conclusions: </strong>This novel nomogram that predicts ISR after SFA stenting demonstrated excellent discriminatory power, calibration capacity, and clinical usefulness.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035982","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":"Lipidomic Expression Analysis In Carotid Atherosclerotic Disease: A Systematic Review.","authors":"Camilo Polania-Sandoval, Seul Kee Byeon, Janelle Hartwell, Mercedes Prudencio, Leonard Petrucelli, Tara Brigham, James F Meschia, Akhilesh Pandey, Young Erben","doi":"10.1016/j.avsg.2024.12.063","DOIUrl":"https://doi.org/10.1016/j.avsg.2024.12.063","url":null,"abstract":"<p><strong>Objective: </strong>Lipids are key molecules for atherosclerosis, with tight regulation mechanisms, making them potential biomarkers for disease-specific diagnostics and therapeutics. Therefore, we aim to perform a systematic literature review on lipidomic analysis in serum/plasma and plaque samples of patients with carotid atherosclerosis.</p><p><strong>Methods: </strong>We performed a systematic review following the PRISMA guidelines on the lipidomic profile in serum/plasma and carotid artery plaques from patients with significant carotid disease by degree of stenosis in preoperative imaging and clinical presentation (symptomatic, asymptomatic, radiation-induced carotid disease). Main outcome was the differential lipidomic expression of serum/plasma, and plaque lipids of patients with carotid artery atherosclerosis. Studies were screened using the Newcastle-Ottawa Scale to determine the quality of the design and content of the selected manuscripts.</p><p><strong>Results: </strong>We included fourteen studies, from which ten included plaque analysis. The lipidomic analysis revealed that sterols and hydroxycholesterols were consistently found in both blood and plaque across studies. Triacylglycerols were present in both sample types, with specific forms linked to radiation-induced carotid artery disease. Symptomatic patients exhibited esterified hydroxyeicosatetraenoic acids and arachidonic acid precursors exclusively in plaque with an inflammatory profile of the disease. In contrast, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) were associated with plaque stability. Diabetics showed nonesterified fatty acids and specific phospholipids only in plaque, indicating localized lipid changes. Other pathways relevant to disease progression include the sphingolipids and ceramide pathways with inflammatory profiling.</p><p><strong>Conclusion: </strong>Lipidomic provides an innovative approach to stratify carotid atherosclerotic disease. Integrating lipidomic data with other -omics approaches may further enhance our understanding of disease mechanisms and aid in the development of precision medicine approaches, specifically in those patients at risk for early carotid atherosclerotic disease.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036092","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":"Wound Healing in Older Adults after Major Lower Extremity Amputation","authors":"Maja Wichhart Donzo ,&nbsp;Nathaniel Forrester ,&nbsp;Chengcheng Hu ,&nbsp;Brandi M. Mize ,&nbsp;Yazan Duwayri ,&nbsp;Camille P. Vaughan ,&nbsp;Olamide Alabi","doi":"10.1016/j.avsg.2024.12.066","DOIUrl":"10.1016/j.avsg.2024.12.066","url":null,"abstract":"<div><h3>Background</h3><div>The higher prevalence of multiple chronic conditions and frailty among older adults may increase the physiologic demand required for wound healing after a major lower extremity amputation (LEA). After below knee amputations (BKA), patients generally have improved prosthetic fitting rates, postoperative ambulation, and quality of life compared to an above knee amputation (AKA). However, the benefit of a BKA must be weighed against the risk of wound complications. The purpose of this study is to examine the association between advanced age and wound healing in our contemporary cohort of patients who underwent LEA.</div></div><div><h3>Methods</h3><div>Our study reviewed all patients who received LEA at 2 major academic healthcare systems between January 2015 and December 2022. Patients with prior ipsilateral LEA were excluded. The exposure of interest was advanced age, defined as age over 80 years old, and the primary outcome was time to wound healing (defined as clinical documentation of a healed amputation incision). Chi-squared test was used to evaluate advanced age and prosthetic fitting after LEA and Cox proportional hazard models were fit to examine the relationship between advanced age and time to wound healing after a LEA.</div></div><div><h3>Results</h3><div>Among 597 patients who underwent LEA, 8.9% (<em>n</em> = 53) were over the age of 80. Over one-third of all patients underwent AKA (<em>n</em> = 235, 39.4%) and patients with advanced age represented 12.3% of this group. There was no statistically significant difference detected between the proportion of those with advanced age who were fit for prosthetic compared to those under age 79 who were fit for prosthetic (47.1% vs 58.5%, <em>P</em> = 0.11). The median time to wound healing was faster among those with advanced age, even when stratified by level of LEA (Table 1). Advanced age was associated with faster wound healing (hazard ratio [HR] 1.42; 95% CI, 1.06–1.87).</div></div><div><h3>Conclusions</h3><div>In our cohort of patients, those with advanced age healed faster than their younger counterparts at both levels of LEA and were equally likely to receive a prosthetic after LEA. Age alone should not be used as a factor in determining eligibility to undergo LEA or receipt of prosthetic. Future studies will evaluate other clinical characteristics that are associated with successful wound healing among adults 80 and older.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"113 ","pages":"Pages 13-20"},"PeriodicalIF":1.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027752","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":"Commentary on “Complications and Technical Success on Upper Limb Vascular Access for Endovascular Repair of Complex Abdominal and Thoraco-Abdominal Aortic Aneurysms: A Systematic Review and Meta-analysis”","authors":"Mehrab Neyazi,&nbsp;Rachana Mehta,&nbsp;Shubham Kumar,&nbsp;Ranjana Sah","doi":"10.1016/j.avsg.2025.01.006","DOIUrl":"10.1016/j.avsg.2025.01.006","url":null,"abstract":"","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"113 ","pages":"Pages 24-25"},"PeriodicalIF":1.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036038","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":"Correlation Between Osteal Kneading and Carotid Artery Atherosclerotic Plaque.","authors":"Yusuo Bai, Sibo Liu, Qian Wang, Bohan Wang, Guangyang Xu, Chang Hu, Feng Tang, Yongjiu Yang, Lei Li","doi":"10.1016/j.avsg.2025.01.010","DOIUrl":"https://doi.org/10.1016/j.avsg.2025.01.010","url":null,"abstract":"<p><strong>Background: </strong>Adjacent bony structures may directly rub the carotid artery during swallowing or head and/neck movement. Long-term repeated stimulation might be considered to be a potential risk factor for carotid atherosclerotic plaque formation, development, and hazard. we defined the process as \"Osteal Kneading\".</p><p><strong>Methods: </strong>A total of 192 consecutive (384 carotid arteries) neck CT angiography (CTAs) and cerebral MRIs performed within 1 month were analysed. The ipsilateral bones (thyroid cartilage and hyoid bone), carotid arteries, and plaque were characterised using the CTA images. Cerebral ischemic lesions were analysed using the MRI images. According to the relationship between the position of the plaque and the bony structures, the vessels were divided into the osteal kneading positive group (OK+) and the osteal kneading negative group (OK-). The effects of osteal kneading on plaque formation, development, and hazard were then explored.</p><p><strong>Results: </strong>95.7% of the OK+ plaques were located in the common carotid artery. The thyroid cartilage and hyoid bone were significantly closer to the carotid artery wall (p<0.001) and the vascular radius was significantly larger (p<0.001) in the OK+ group. The distance from the thyroid cartilage and hyoid bone to the ipsilateral carotid arteries was negatively correlated with plaque thickness, carotid artery stenosis rate, and calcified plaque occurrence (p<0.05).</p><p><strong>Conclusion: </strong>This pilot study provides preliminary evidence for the hypothesis of \"osteal kneading\" of the carotid artery, and also suggests that osteal kneading may play some role in carotid artery plaque formation and development. Further research is required to provide more concrete evidence for the hypothesis, such as the inclusion of samples from multiple centres, precise outcome observation, artificial intelligence assisted image analysis, and dynamic evaluation methods.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036041","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":"Critical Review of Guidelines for Type B Aortic Dissection.","authors":"Mario D'Oria, Jacob Budtz-Lilly, Kevin Mani, Peter Legeza, Gabriele Piffaretti, Mohamad Bashir, Matti Jubouri, Giovanni Tinelli, Salvatore Scali","doi":"10.1016/j.avsg.2025.01.002","DOIUrl":"https://doi.org/10.1016/j.avsg.2025.01.002","url":null,"abstract":"<p><p>The management of type B aortic dissection is one of the most challenging and debated topics in contemporary cardiovascular surgery practice. Patients with acute or chronic dissection-related complications, face high morbidity and mortality if not treated promptly. For most patients requiring intervention, thoracic endovascular aortic repair (TEVAR) is considered the gold standard. However, both early and late TEVAR-related complications make decision-making complex, even for experienced clinicians. In many cases, optimal medical management with longitudinal imaging surveillance may be preferred. In response to these challenges, several societal guidelines have recently been published^1-5 to provide evidence-based or expert consensus 'best practice' recommendations. Although these guidelines share many commonalities, they also highlight key unresolved clinical questions. For example, debates persist over the appropriate use of TEVAR for 'uncomplicated' TBAD, defining 'high-risk' criteria for uncomplicated presentations, and management of the false lumen, among other topics. Despite recent updates, a critical evaluation of the nuanced differences between these guidelines is lacking. Therefore, the purpose of this review is to compare current clinical practice guidelines, highlight their similarities and differences, and offer a comprehensive evaluation of the evidence surrounding management of TBAD. Moreover, this analysis will provide recommendations to address important knowledge gaps.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036044","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}