Vascular and endovascular surgery最新文献

{"title":"Iliac Artery Occlusion Following Iliac Vein Recanalization and Stenting in Two Patients.","authors":"Thomas Pennix, Zayed Metwalli, Peiman Habibollahi","doi":"10.1177/15385744251327018","DOIUrl":"https://doi.org/10.1177/15385744251327018","url":null,"abstract":"<p><p>Ileocaval venous thrombosis and outflow obstruction is a condition with many possible causes that typically presents with symptoms related to venous congestion or insufficiency. Recent device development and availability of endovascular stenting and venoplasty for lifestyle-limiting symptoms refractory to conservative management has led to increased interest in these procedures. While several common complications of venous stent placement have been well-described, 1 uncommon and emergent complication is nearby arterial compression or occlusion. Here we present 2 cases of iliac artery occlusion occurring after iliac venous recanalization and stenting, and discuss possible factors that may contribute to this uncommon complication.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251327018"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675137","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":"Single Center Experience of Isolated Mechanical Thrombectomy and Thromboaspiration in Cancer-Related Acute Iliofemoral Deep Vein Thrombosis.","authors":"Görkem Yiğit","doi":"10.1177/15385744251329735","DOIUrl":"https://doi.org/10.1177/15385744251329735","url":null,"abstract":"<p><p>IntroductionIliofemoral deep vein thrombosis (IFDVT) and subsequent pulmonary embolism (PE) are an crucial cause of mortality in cancer patients. There is a lack of evidence on the results of mechanical thrombectomy and thromboaspiration (MTT) procedures performed on cancer patients. The aim of this research was to assess safety, efficacy, and clinical outcomes following MTT for cancer-related IFDVT patients.MethodsFrom July 2020 and April 2022, a total of 14 active cancer patients with symptomatic acute IFDVT were managed with MTT with Mantis device. Primary outcomes included overall survival, venous patency, major bleeding and minor bleeding. Secondary outcomes included duration in intensive care unit and hospital stay, complications, bleeding events, reocclusion and reintervention rates.ResultsIn twelve patients (85.7%), a significant early clinical improvement was found. Median intensive care unit (ICU) stay was 1 (range, 1-4) days, while the median hospital stay was 4 (range, 3-10) days. Recurrence of IFDVT was observed in 14.3% of cases (n = 2) in the study group. No re-intervention was performed in these patients. The overall survival for the study cohort was 85.7% at 6 months, and 71.4% at 12 months. Venous patency rate at 12-month follow-up control was 64.3%. There was a significant decrease in Villalta scores following the procedures (<i>P</i> < 0.0001). The overall procedural complication rate was 28.6%.ConclusionIn cancer patients, MTT promises to be a reliable and successful treatment for IFDVT considering the dramatic early symptomatic improvement, low reocclusion rates, acceptable procedure-related major complications, satisfactory patency rates, and improved patient quality of life.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251329735"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672160","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":"The Use of Intravascular Ultrasound During Deep Venous Interventions in a Tertiary Care Center.","authors":"Sahar H Ali, Paula Pinto Rodriguez, Ehsan Abualanain, Ying Li, Mostafa S Khalil, Hesham Aboloyoun, Juan Carlos Perez Lozada, Edouard Aboian, Robert Attaran, Cassius Iyad Ochoa Chaar","doi":"10.1177/15385744251326989","DOIUrl":"https://doi.org/10.1177/15385744251326989","url":null,"abstract":"<p><p>ObjectiveIntravascular ultrasound (IVUS) is the gold standard for diagnosing venous stenosis and sizing venous stents, yet its impact on thrombosis after deep venous interventions is not well-studied. This study evaluates the impact of IVUS on outcomes of lower extremity deep venous interventions, hypothesizing improved results with its use.MethodsThis retrospective study analyzed consecutive patients undergoing deep venous lower extremity interventions, dividing them into two groups based on IVUS use. Patient characteristics and outcomes, including primary patency and symptomatic improvement, were compared.ResultsAmong 185 patients (75.7% with IVUS), those without IVUS had higher rates of COPD (16% vs 5%; <i>P</i> = 0.045), chronic kidney disease (27% vs 5%; <i>P</i> < 0.001), and hypercoagulable state (47% vs 19%; <i>P</i> = 0.001). Non-IVUS patients more frequently presented with thrombotic disease (78% vs 40%; <i>P</i> < 0.001), while IVUS patients were more likely to have edema (41% vs 31%; <i>P</i> = 0.04) and receive stenting (92% vs 44%; <i>P</i> < 0.001). Wallstent was the most commonly used stent in both groups. IVUS patients achieved higher technical success (99% vs 82%; <i>P</i> < 0.001) and had fewer 30-day complications (7% vs 20%; <i>P</i> = 0.022). Over a mean follow-up of 3.5 years, IVUS use was associated with greater symptom relief (50% vs 41%; <i>P</i> < 0.001) and higher primary patency rates (83% vs 53%; <i>P</i> < 0.001). Regression analysis showed that age, prior anticoagulant use, and thrombolysis were significantly associated with loss of patency, while IVUS showed a trend toward decreased loss of patency (HR = 0.6; <i>P</i> = 0.244).ConclusionIVUS use during deep venous interventions is associated with fewer complications and improved primary patency rates, suggesting its utility in enhancing patient outcomes when complementing multiplanar venography.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251326989"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653036","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":"The Alpha to Omega of Dialysis Access: Evaluation, Interventions, Innovations (Part 2).","authors":"Mohammad Ghasemi-Rad, Kelly Trinh, Mohadese Ahmadzade, Kevin Agahi, Xavier Jefferson, Carleigh Klusman, David Leon, David Wynne, Jie Cui","doi":"10.1177/15385744251326325","DOIUrl":"https://doi.org/10.1177/15385744251326325","url":null,"abstract":"<p><p><b>Background:</b> End-stage kidney disease (ESKD) is a growing global health concern, significantly impacting patient morbidity and mortality, particularly among patients on hemodialysis. Vascular access remains a major challenge, often limiting the effectiveness of hemodialysis and requiring strategic planning to optimize outcomes. <b>Purpose:</b> This review examines the current evidence on vascular access for dialysis, with a focus on pre- and post-operative assessments, necessary interventions for complications, and innovations in vascular access materials and techniques. <b>Research Design:</b> This is a literature review analyzing existing studies, clinical trials and guidelines to evaluate the different vascular access options, interventions, and emerging technologies in dialysis access. <b>Results:</b> Findings highlight the importance of thorough preoperative assessment, including vascular imaging and patient-specific considerations, to optimize access placement. Postoperative assessments and early interventions are crucial in ensuring access longevity. Innovations such as drug-coated balloons, stent technologies, and biologically engineered grafts have improved patient outcomes and reduced complications. <b>Conclusion:</b> Strategic planning and advancements in vascular access technology play a critical role in improving dialysis efficiency and patient outcomes. Continued research and innovation are needed to refine vascular access techniques and address challenges associated with ESKD management.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251326325"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635050","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":"Endovenous Treatment for Great Saphenous Vein Insufficiency: A Comparative Study of Segmental Radiofrequency and 1470-nm Endovenous Laser.","authors":"Márcio Gomes Filippo, Leonardo de Oliveira Harduin, Thiago Almeida Barroso, Leonardo Cortizo de Almeida, Alberto Schanaider, Gaudencio Espinosa","doi":"10.1177/15385744251327014","DOIUrl":"https://doi.org/10.1177/15385744251327014","url":null,"abstract":"<p><p>PurposeThis study aims to evaluate recovery time, patient-centric postoperative outcomes, and the efficacy of endovenous laser ablation (LA) and radiofrequency ablation (RFA) in treating venous insufficiency associated with great saphenous vein (GSV) reflux.MethodsIn this single-center, self-paired, randomized trial, 16 limbs from 8 patients with symptomatic bilateral GSV insufficiency were treated. LA was performed on one lower limb, and after 40 days, the contralateral limb was treated with RFA. For LA, we used a 1470-nm endolaser with radial fiber, and for RFA, the VNUS ClosureFast™ system. All patients were followed with clinical, radiological, and laboratory evaluations for 6 months postoperatively.ResultsBoth techniques showed similar postoperative pain scores, number of complications, time to return to work, and patient satisfaction scores. LA and RFA decreased the mean Venous Clinical Severity Score by the end of the study and achieved a 100% vein occlusion rate, along with a reduction in GSV size. Procedure time was significantly shorter with LA.ConclusionLA and RFA demonstrated similar recovery profiles, pain levels, and patient satisfaction outcomes, maintaining high efficacy in resolving venous insufficiency associated with GSV reflux.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251327014"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617943","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":"Three-Year Outcomes of Chronic Total Occlusion (CTO) versus Non-CTO Femoropopliteal Lesions Treated With Atherectomy Followed by Drug-Coated Balloon Angioplasty.","authors":"Haroon Kamran, Rohit Gokhale, Michael Halista, Anna Telegina, Zulfiya Bakirova, Anvar Babaev","doi":"10.1177/15385744251326976","DOIUrl":"https://doi.org/10.1177/15385744251326976","url":null,"abstract":"<p><p>BackgroundEndovascular intervention of the femoropopliteal chronic total occlusions (CTOs) is technically challenging and associated with increased rates of treatment failure and complications. The long-term patency of CTOs of the femoropopliteal segment treated with contemporary tools, such as atherectomy and drug-eluting technology, is not well studied.MethodsWe performed a prospective, single-center analysis of 60 consecutive patients with femoropopliteal disease successfully treated with either directional or orbital atherectomy followed by paclitaxel drug-coated balloon (DCB). Endpoints of interest were freedom from restenosis and revascularization following atherectomy and DCB angioplasty. All patients underwent clinical and imaging evaluation for 3 years to identify evidence of target lesion restenosis (RS) and revascularization (TLR).ResultsThere were 26 patients with CTO and 34 patients with non-CTO lesions. Baseline demographic and clinical characteristics were similar between the CTO and non-CTO groups other than ankle-brachial indices (ABI, 0.73 ± 0.11 vs 0.88 ± 0.14, <i>P</i> < 0.001). Kaplan Meier (KM) analysis for freedom from RS and TLR at 3 years was similar among the 2 groups (log rank p; 0.42, 0.69 respectively). Post-procedure, all patients had improvement of claudication, normalization of ABI indexes and duplex ultrasound velocities.ConclusionFreedom from target lesion restenosis and revascularization at 3 years were similar between CTO and non-CTO lesions treated with atherectomy followed by DCB angioplasty. These findings underscore the importance of optimal vessel preparation to achieve improved patency regardless of lesion morphology.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251326976"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627302","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":"Median Arcuate Ligament Syndrome Without Static Image Findings of Celiac Artery Compression: The Potential Existence of a Pure Neurogenic Subtype.","authors":"Atsushi Okita, Nobuji Yokoyama","doi":"10.1177/15385744251326980","DOIUrl":"https://doi.org/10.1177/15385744251326980","url":null,"abstract":"<p><p>Symptomatic median arcuate ligament syndrome (MALS) is considered to be a diagnosis of exclusion, and there is no consensus about its diagnostic criteria. We present the case of a 39-year-old woman, who presented with persistent epigastric pain. A computed tomography scan did not show external celiac artery (CA) stenosis. Ultrasonography showed that the peak systolic blood flow velocity of the CA in inspiration and expiration position was 1.13 m/sec and 2.16 m/sec, respectively. The difference in the angle between the aorta and CA between maximum inspiration and maximum expiration was >50°. Only the patient's physical findings were suggestive of MALS, as the ultrasonographic findings demonstrated normal flow without compression through the celiac axis. The patient underwent laparoscopic division of the median arcuate ligament (MAL), and her symptoms disappeared postoperatively. The pathophysiology of MALS remains unclear, and our case suggests the potential existence of a neurogenic subtype in which MAL compresses the celiac plexus, but not the CA.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251326980"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627300","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":"Stent Graft Intervention in a Lumbar Artery Pseudoaneurysm Improved Cauda Equina Syndrome: A Case Report of Combined Embolization Strategy.","authors":"Yuta Murai, Kouki Nakashima, Yukio Tamura, Kagami Miyaji","doi":"10.1177/15385744251326336","DOIUrl":"https://doi.org/10.1177/15385744251326336","url":null,"abstract":"<p><p>A lumbar artery pseudoaneurysm following a lumbar vertebral compression fraction is rare. Cauda equina syndrome due to spinal canal compression is a rarer complication of this pseudoaneurysm. Endovascular treatment, which involves embolization of the inflow and outflow vessels, is the first-line treatment for lumbar artery pseudoaneurysms. We report a case of a lumbar artery pseudoaneurysm with spinal canal compression that was treated with coil embolization of the outflow vessel and stent graft placement to occlude the inflow vessel. After treatment, the symptoms of cauda equina syndrome improved. Using a stent graft is particularly effective when the inflow vessel to be occluded is short and, combined with other endovascular therapies such as coil embolization, increases the potential for complete exclusion of a lumbar artery pseudoaneurysm.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251326336"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627301","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":"Management of Popliteal Artery Interposition Graft Infection by Extra-anatomic Bypass.","authors":"Daanish Sheikh, Shri Timbalia, Maham Rahimi","doi":"10.1177/15385744251327013","DOIUrl":"https://doi.org/10.1177/15385744251327013","url":null,"abstract":"<p><p>ObjectivesInfection of peripheral interposition grafts is a rare but devastating complication following aneurysm repair. Typically, graft infection necessitates explantation and, if possible, revascularization of the limb. However, treatment complexity varies substantially depending on the location and extent of infection. This case describes the management of a popliteal artery interposition graft infection.MethodsWe describe an 84 year old male with a history of left popliteal artery aneurysm repair with PTFE interposition graft (found on workup a year prior for a gangrenous great toe) who presented with four days of night sweats, chills, and a painful posterior left knee. Laboratory findings indicated leukocytosis, while ultrasound and CT imaging revealed complex fluid surrounding the graft without evidence of pseudo-aneurysm. Surgical management was conducted in two stages, the first with the patient supine for bypass from the superficial femoral artery to the posterior tibial artery using ipsilateral reversed great saphenous vein. The patient was then repositioned prone for the second stage of the procedure, and the infected popliteal fossa was entered posteriorly for debridement with caution to avoid injury to the tibial nerve and popliteal vein. The infected graft was removed, and antibiotic beads were placed in the infected region.ResultsFollowing this procedure and serial washouts one week later, the patient retained motor function, sensation, and palpable posterior tibial and dorsal pedal pulses. The patient was placed on IV cefazolin for 6 weeks following the procedure and discharged with 6 months of oral suppression to achieve long-term prevention of further infection.ConclusionsWhen managing popliteal artery graft infection, the presence of purulent material in the popliteal fossa can make anatomic bypasses high-risk for recurrent infection, and caution must be taken to avoid the nearby popliteal vein and tibial nerve during irrigation and debridement.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251327013"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617944","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":"Asymptomatic Carotid Stenosis is Associated With Mobility Dysfunction: Results From the InChianti Study.","authors":"Sarasijhaa K Desikan, James Borrelli, Vicki L Gray, Aman A Kankaria, Michael Terrin, Brajesh K Lal","doi":"10.1177/15385744251323434","DOIUrl":"https://doi.org/10.1177/15385744251323434","url":null,"abstract":"<p><strong>Background: </strong>Older adults with mobility dysfunction are at risk for falls, hospitalization, and death. In an earlier pilot study, individuals with asymptomatic carotid artery stenosis (ACAS) demonstrated mobility dysfunction when compared to individuals without ACAS. We tested whether carotid stenosis affected mobility function in a larger community-dwelling cohort using the Invecchaire in Chianti (InCHIANTI) database.</p><p><strong>Methods: </strong>We analyzed data from participants in the InCHIANTI study who completed a medical history, carotid duplex testing, and mobility function testing (Short Physical Performance Battery- SPPB). Participants with a history of stroke, transient ischemic attack, or carotid endarterectomy were excluded. 709 participants met inclusion criteria (116 ACAS, 593 no ACAS). Our analytic approach sought to evaluate the impact of stenosis on mobility after accounting for age, sex and cardiovascular risk factors. Age was stratified into 2 age-groups (65-74 and 75-84 years). Two-way ANOVA was used to test the effect of stenosis-group, age-group, and their interactions on SPPB score with sex as a covariate.</p><p><strong>Results: </strong>Stenosis-group (<i>P</i> = 0.0002), age-group (<i>P</i> < 0.0001), and the interaction between stenosis-group and age-group (<i>P</i> = 0.0008) significantly affected SPPB. Post-hoc testing showed that participants with ACAS demonstrated worse performance on the SPPB (9.81 ± 0.37) compared to those with no ACAS (11.10 ± 0.11) in the 65-74 years age-group (<i>P <</i> 0.0001).</p><p><strong>Conclusions: </strong>65-74-year-old adults with ACAS performed significantly worse on the SPPB than those without ACAS. These results lend further support that ACAS may be associated with mobility dysfunction in older adults.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251323434"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525658","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}