Vascular and endovascular surgery最新文献

{"title":"Functional Outcomes and Complications of Carotid Tandem Lesions After Mechanical Thrombectomy for Treatment of Large-Vessel Occlusion Stroke.","authors":"Colin Scott, Lena Abdulrahman, Mackenzie Snyder, Lidia Castillo, Jeffrey Lu, Eleanor Dunlap, Khanjan Nagarsheth","doi":"10.1177/15385744241301494","DOIUrl":"10.1177/15385744241301494","url":null,"abstract":"<p><p>BackgroundLarge Vessel Occlusion (LVO) stroke patients with tandem lesions (TLs) have been observed to have worse outcomes when compared to patients with simple isolated intracranial occlusions.ObjectiveTo examine the difference in post-operative functional status at discharge for patients treated with mechanical thrombectomy for an acute LVO stroke based on the presence of a tandem carotid lesion.MethodsThis is a retrospective cohort study of 589 patients presenting within the first 24 hours of stroke onset who underwent mechanical thrombectomy. The primary outcome was functional status quantified by modified Rankin Score (mRS) at time of discharge. The secondary outcomes were presence of hemorrhagic conversion, midline shift >5 cm, malignant cerebral edema, reocclusion, Thrombolysis in Cerebral Infarction Scale (TICI), and discharge location.ResultsPatients with tandem occlusions and those with isolated intracranial lesions had similar baseline demographics. However, in patients with TLs, there was a significantly higher NIH stroke scale at admission and a longer time to recanalization. Modified Rankin Score prior to admission was similar for both groups, but was significantly higher in patients with TLs at discharge. The secondary outcomes were similar for hemorrhagic conversion, discharge to hospice, and a TICI scale of 0, but were significantly worse for patients with TLs for in-hospital mortality, midline shift >5 mm, and malignant cerebral edema. The presence of a tandem lesion predicted a higher modified Rankin Score at discharge in univariate regression modeling (β = .45; <i>P</i>-value = .006).ConclusionThe two groups were similar in baseline characteristics and cardiovascular risk factors, yet patients with tandem carotid lesions experienced more complications during their hospitalization and had greater functional disability at discharge. Patients with a TL had a longer mean time to recanalization, representing a potential explanation for these differences in outcomes.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"396-400"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insurance and Structural Access Quality and Effects on AAA Mortality: A National Healthcare Quality and Disparities Report Analysis.","authors":"Andrew Ramirez, Masashi Azuma, Aron Frederik Popov, Jan D Schmitto, G William Moser, Suyog Mokashi","doi":"10.1177/15385744241296933","DOIUrl":"10.1177/15385744241296933","url":null,"abstract":"<p><p>BackgroundThe National Health care Quality and Disparities Report (NHDQR) presents trends for measures related to access to care, affordable care, care coordination, effective treatment, healthy living, patient safety, and person-centered care. This study aims to determine the significance of insurance quality and access to care on AAA repair outcomes.MethodsData was obtained through the Agency for Health care Research and Quality database from 2016-2020. AAA repair mortality rates per 1000 persons, insurance quality, and structural access were compared between the 31 reportable U.S. states in which data was analyzed using linear regression models and ANOVA. Insurance quality and structural access groups were categorized as weak, average, and strong, based on NHDQR Reports measures.ResultsNo association was found between access to care and AAA mortality at specific time points (2016 and 2020; <i>P</i>-value = .90 and .29 respectively) and when comparing states that showed improvement from 2016 to 2020 (weak categorization to strong; <i>P</i> value = .27). An association was found between private insurance quality and AAA repair mortality at baseline (2016; <i>P</i>-value = .022) and in those that showed improvement or worsening in private insurance quality over the study period (<i>P</i>-value = .042).ConclusionsOur findings suggest that there is no association between structural access quality and AAA mortality although an association exists between AAA mortality and private insurance quality.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"367-373"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preservation of Blood Flow to the Internal Iliac Artery Using a Custom-Made Single Fenestrated Endograft: A Case Report.","authors":"Sara Shakery, Denise Nio, Maarten Truijers","doi":"10.1177/15385744251315998","DOIUrl":"10.1177/15385744251315998","url":null,"abstract":"<p><p>PurposeThis report describes the use of a custom-made single-fenestrated endograft to preserve blood flow to the internal iliac artery (IIA) in a patient with an aorto-iliac aneurysm with unsuitable anatomy for a standard iliac branch device (IBD).Case ReportA 56-year-old man presented with an abdominal aortic aneurysm (AAA) of 56 mm involving the right common iliac artery (CIA). Use of a standard IBD for preservation of the IIA was deemed impossible due to narrow arrow anatomy of the right CIA. To preserve IIA flow, a custom-made Terumo endograft with an additional single-fenestration for the IIA was designed. The repair was successful and flow to the right IIA was preserved.ConclusionUsing a custom-made single-fenestrated endograft for the IIA in case of unsuitable anatomy for off-the-shelf IBDs prevents exclusion of the IIA and might prevent complications like buttock claudication and erectile dysfunction in patients with an aorto-iliac aneurysm. This report describes the use of a custom-made single fenestrated endograft to preserve blood flow to the IIA as a valuable alternative to standard iliac branched repair in patients with anatomical challenges.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"442-446"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Skirt Reconstruction of Aortoiliac Bifurcation Using Bare-nitinol Stents: ESCORT Technique.","authors":"Takenobu Shimada, Yoshihisa Shimada, Daisuke Tonomura, Kazunori Terashita, Yuki Yamanaka, Daiju Fukuda","doi":"10.1177/15385744251339967","DOIUrl":"https://doi.org/10.1177/15385744251339967","url":null,"abstract":"<p><p>BackgroundEndovascular treatment for aortoiliac occlusive disease (AIOD) is still challenging. We propose a stent deployment technique for AIOD using only bare-nitinol stents (BNSs) in a form that is ultimately similar to the normal aortoiliac bifurcation structure.Methods and case seriesThe Endovascular Skirt reCOnstruction of aoRToiliac bifurcation using bare-nitinol stents (ESCORT) technique involves primary implantation of a large BNS, with its distal edge being placed just at the edge of the carina by mounting onto 2 pull-through guidewires from the side of an upper extremity followed by V-stenting using BNSs into the pre-implanted BNS at the terminal aorta. The results of experiments showed that this technique can be achieved by the unique structural characteristic of an E-Luminexx Vascular stent (BD, Tempe, AZ, USA) as a main body in which the stent edge can be advanced beyond the catheter tip. This technique without using stent grafts can avoid recrossing of the jailed guidewire and can reduce the procedural and long-term care that is necessary when using stent grafts, and a future cross-over approach may be established also after treatment. Between 2017 and 2021, the ESCORT technique was performed in 7 consecutive cases of AIOD at our institute. The procedural success rate was 100%, and no complication occurred in any of the patients. Symptom resolution was obtained in all patients. Target lesion revascularization (TLR) was performed in 1 patient with extremely severe calcified lesions. Except for the 1 case requiring TLR, at least 2-year patency was confirmed in patients who were followed up. The establishment of a cross-over system was tried in 2 patients after the procedure, and it was successful in both cases.ConclusionThe ESCORT technique for AIOD is a feasible and beneficial stenting strategy.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251339967"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Depression is Associated With a Higher Risk of Bleeding in Type a Aortic Dissection Repair: A Population Study of National Inpatient Sample From 2015-2020.","authors":"Renxi Li, Qianyun Luo, Stephen J Huddleston","doi":"10.1177/15385744241296218","DOIUrl":"10.1177/15385744241296218","url":null,"abstract":"<p><p>BackgroundDepression is highly prevalent in patients with aortic diseases. While depression has been shown to predispose patients to adverse outcomes after surgery, its impact on postoperative outcomes in Stanford Type A Aortic Dissection (TAAD) has not been established. This study aimed to conduct a population-based examination of the effect of preoperative depression on in-hospital outcomes after TAAD using the National/Nationwide Inpatient Sample (NIS) database, the largest all-layer database in the US.MethodsPatients undergoing TAAD repair were identified in NIS from the last quarter of 2015-2020. Multivariable logistic regressions were used to compare in-hospital outcomes between patients with and without preoperative depression, adjusted for demographics, comorbidities, hospital characteristics, primary payer status, and transfer status.ResultsThere were 321 (7.50%) patients with depression and 3961 (92.50%) non-depressive patients who underwent TAAD repair. Patients with and without depression had comparable in-hospital mortality (11.84% vs 15.37%, <i>P</i> = 0.35). However, Patients with depression had a higher risk of hemorrhage/hematoma (83.49% vs 76.6%, aOR 1.593, 95 CI 1.161-2.184, <i>P</i> < 0.01) and a higher rate of transfer out (40.81% vs 32.62%, aOR 1.396, 95 CI 1.077-1.81, <i>P</i> = 0.01). All other in-hospital complications, hospital length of stay (LOS), and total hospital charge were comparable between patients with and without depression.ConclusionPreoperative depression is associated with a higher risk of bleeding after TAAD repair. This may be due to anti-depression treatment, such as Selective Serotonin Reuptake Inhibitors (SSRIs), that can disrupt platelet function and lead to abnormal bleeding. While depression is not associated with other major outcomes, preoperative depression screening, as well as hemostatic monitoring and appropriate blood management in patients with depression may be crucial in preventing bleeding complications in TAAD repair.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"353-359"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Treatment of Primary Bilateral Racemose Hemangioma With Multiple Bilateral Bronchial Artery Aneurysms: A Case Report and Review of Literature.","authors":"Mohammad Reza Rouhezamin, Sara Haseli, Jafar Golzarian, Hadi Rokni","doi":"10.1177/15385744251339962","DOIUrl":"https://doi.org/10.1177/15385744251339962","url":null,"abstract":"<p><p>A 36-year-old man was presented with hemoptysis. The contrast enhanced chest computed tomography and bronchial angiography revealed multiple bilateral ostial and intraparenchymal bronchial artery aneurysms (BAA) and bilateral primary Racemose hemangioma (PRH). Endovascular embolization with polyvinyl alcohol and n-butyl-2-cyanoacrylate was preferred to occlude the BAAs. Five days after the procedure, the patient was discharged and remained stable without recurrence over the 6 month follow up. To the best of our knowledge, this is the first case of PRH with multiple bilateral BAAs and the second published case of bilateral BAAs. This study aims to describe the successful treatment method employed for management of this rare condition and review the published articles relating to BBA and PRH.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251339962"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Results of a Single-Center Prospective Clinical Trial: In Situ Fenestration System for Aortic Dissection.","authors":"Yingxin Tan, Weijian Chen, Zhengfei Li, Helong Xu, Yufeng Zhao, Dan Zhou, Yubo Bai, Xiaojie Wang, Tao Xu, Yulin Zhang, Jun Xu, Xiaojun Shu","doi":"10.1177/15385744251330013","DOIUrl":"https://doi.org/10.1177/15385744251330013","url":null,"abstract":"<p><p>Objectivestudy aims to assess the clinical efficacy, technical features, and early follow-up outcomes of aortic arch dissection (AD) requiring left subclavian artery (LSA) reconstruction using the aorta arch stent-graft system combined with the endovascular needle system for in situ fenestration.Methods and ResultsEight patients with AD were enrolled in this clinical trial after rigorous screening between July 2021 and August 2022. The 8 patients who participated in this trial were male, with a mean age of 62.0 ± 8.3 years. The total operative time was 148.38 ± 35.06 minutes, and the mean hospitalization time was 11.4 ± 4.4 days. A total of 12 aortic stents were implanted in the 8 patients, and branching stents were implanted in the LSA in all patients. No cases of delayed endoleak occurred. There were no stent- or aorta-related deaths. The 2 deaths that did occur were confirmed to have been due to causes outside of the aorta and were unrelated to the thoracic endovascular aortic repair procedure, with a 1-year stent patency rate of 100%.ConclusionsWe believe that this trial of in situ fenestration achieved satisfactory early results, with reasonable postprocedural stent patency and patient survival, and there were no endoleaks requiring intervention during follow-up. However, long-term follow-up is needed to validate the findings of this trial.Trial registrationClinicalTrials.gov PRS Protocol Registration and Results System (URL: Home - ClinicalTrials.gov, NCT05126446).</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251330013"},"PeriodicalIF":0.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Treatment of Common Iliac Aneurysm After Aortobifemoral Bypass: Banana Technique and Shape Memory Polymer Plug Embolization.","authors":"Sergio Asensio, Jose Antonio Brizuela, Alvaro Revilla, Sergio Fernández-Bello, James Henry Taylor, Enrique Maria San Norberto","doi":"10.1177/15385744251326310","DOIUrl":"https://doi.org/10.1177/15385744251326310","url":null,"abstract":"<p><p><b>Objective:</b> This case report aims to present a new endovascular technique for arterial embolization using a relatively recently developed endovascular device, Shape Memory Polymer (SMP) Embolization Plug (IMPEDE, Shape Memory Medical). <b>Methods:</b> A 66-year-old man presented an asymptomatic common iliac aneurysm with a maximun diameter of 4.4 cm and a previous aorto-bifemoral bypass. <b>Results:</b> An embolization of the common iliac artery aneurysm with 5 units of IMPEDE-FX Rapid Fill (12 mm, Shape Memory Medical) and revascularization from external iliac artery to internal iliac artery through a banana technique with an auto-expandable covered stent (Viabahn 10 × 100 mm, Gore) was performed. <b>Conclusion:</b> The experience obtained after the use of this device has allowed us to increase the therapeutic arsenal for high volume aneurysm embolization.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251326310"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Transcarotid Approach for Endovascular Aortic Repair in Treating Aortic Disease.","authors":"Haofan Shi, Xingyou Guo, Chengkai Su, Haoyue Huang, Yihuan Chen, Jinlong Zhang, Bowen Zhang, Xiang Feng, Zhenya Shen","doi":"10.1177/15385744251335775","DOIUrl":"https://doi.org/10.1177/15385744251335775","url":null,"abstract":"<p><p>PurposeThe purpose of this study is to evaluate the feasibility, efficacy, and safety of transcarotid approach endovascular aortic repair (EVAR) in patients where conventional femoral access is not possible.Materials and MethodsA systematic review of all articles discussing transcarotid approach EVAR published in the PubMed, Embase, Ovid, Web of Science, and Cochrane Library databases were conducted. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsIn accordance with the inclusion criteria, 17 articles discussing transcarotid approach EVAR were retrieved, encompassing 18 patients. Among these patients, 6 patients were related to ascending aortic disease, including 4 cases of pseudoaneurysms, 1 case of penetrating ulcer, and 1 case of dissection. 9 patients had descending aortic disease, comprising 6 aneurysms, 2 penetrating ulcers, and 1 pseudoaneurysm. There were 3 cases of abdominal aortic disease, including 2 aneurysms and 1 endoleak. Among these patients, 10 cases had access through the left common carotid artery, and 8 cases had access through the right common carotid artery. One patient experienced spinal cord ischemia and subsequently died of multi-organ failure caused by acute pancreatitis. Additionally, there was one case of minor embolization in the nonsurgical carotid supply area. No cerebral infarctions were observed in the vascular territory of the ipsilateral carotid artery at the surgical approach site.ConclusionsResearch on transcarotid approach EVAR is limited and predominantly consists of case reports, with a notable absence of randomized controlled trials. This systematic review suggests that transcarotid approach EVAR may be a viable alternative for selecting patient groups when the conventional femoral artery approach is not feasible. These findings indicate that this method is associated with a relatively manageable perioperative complications and mortality rates.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251335775"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suspected Paclitaxel Allergy Following Angioplasty With a Drug-Coated Balloon.","authors":"Zach Haffler, Eric Endean","doi":"10.1177/15385744251326259","DOIUrl":"https://doi.org/10.1177/15385744251326259","url":null,"abstract":"<p><p>PurposePaclitaxel is a chemotherapeutic agent which may be administered locally to an arterial lesion via a drug-coated balloon or drug-eluting stent. We report an allergic reaction to locally administered paclitaxel.Case SummaryA 75 year-old woman underwent a right external iliac to superior mesenteric artery bypass and presented a year later with evidence of iliac artery stenosis, which was repaired via angioplasty and stenting. Two years later, the patient presented again with restenosis. She underwent balloon angioplasty of affected vessels with an IN.PACT Admiral® 6 × 40 drug-coated (Paclitaxel) balloon. The patient presented to her local hospital a week later with severe pruritis and a rash, for which she received a dose of parenteral steroid. Despite the patient's denial of changes in medication or environmental changes, she continued to experience hypersensitivity symptoms which required recurrent courses of oral prednisone, diphenhydramine, and cetirizine before finally resolving.ConclusionTo our knowledge, a severe allergic reaction to paclitaxel has not been reported when administered locally using either a drug-coated balloon or a drug-eluting stent. This case emphasizes that severe allergic reactions can occur. Because the drug is embedded in the arterial tissue, it cannot be easily removed, and such allergic reactions should be treated with systemic corticosteroids and antihistamines. The allergic reaction should be self-limited as the drug is eliminated over time.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251326259"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}