Vascular and endovascular surgery最新文献

{"title":"Genetic Diagnosis and Combinational Treatment With Pharmacomechanical Thrombectomy and Transjugular Intrahepatic Portosystemic Shunt for Non-cirrhotic and Non-malignant Portal Vein Thrombosis.","authors":"Feng Chen, Qing Gen Xiong, Fei Lu, Zhi Jian Luo, Wei Luo, Wei Zhou","doi":"10.1177/15385744251334793","DOIUrl":"https://doi.org/10.1177/15385744251334793","url":null,"abstract":"<p><p>ObjectiveThis study aimed to evaluate the potential role of the whole-exome sequencing (WES) technique in screening pathogenic genes of non-cirrhotic and non-malignant portal vein thrombosis (PVT) and the clinical efficacy of AngioJet-assisted pharmacomechanical thrombectomy (PMT) with transjugular intrahepatic portosystemic stent shunt (TIPS) to treat this disease.Methods16 patients with acute non-cirrhotic and non-malignant PVT were retrospectively analyzed. 14 patients received genetically diagnosed using the WES technique, ten patients received PMT with or without TIPS and 6 cases received anticoagulation alone. Changes in clinical symptoms, and recanalization of the portal vein (PV) were also recorded.Results4 patients (28.6%) had JAK2 V617 F mutation, 4 patients (28.6%) had PROC mutations, 3 patients (21.4%) had SERPINC1mutations. Among patients treated with anticoagulation alone, 5 patients (83.3%, 5/6) developed cavernous transformation of PV and one patient with JAK2 V617 F mutation achieved complete recanalization of PV. One patient treated with PMT without TIPS developed PV cavernous transformation, eight patients (80%) treated with PMT and TIPS achieved complete or partial recanalization of PV. Three patients who developed intestinal necrosis all had SERPINC1 mutations and one of them died of intestinal necrosis. No recurrence was found during follow-up (1-36 months).ConclusionsThe WES technique offers a promising way to screen for thrombophilia in patients with non-cirrhotic and non-malignant PVT. Patients with SERPINC1 mutations are more inclined to develop intestinal necrosis than others. PMT combined with TIPS provides a safe and effective therapeutic alternative.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251334793"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048316","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":"Sapheno-Femoral Junction Aneurysm: Single Centre Experience With Technical Notes and Histological Analysis.","authors":"Matteo Bucalossi, Alberto Caggiati, Simone Carotti, Lorenzo Nevi, Fabrizio Mariani, Daniele Bissacco, Stefano Mancini","doi":"10.1177/15385744251334794","DOIUrl":"https://doi.org/10.1177/15385744251334794","url":null,"abstract":"<p><p>ObjectiveAn aneurysm is a localized dilation of a blood vessel, commonly referring to the arterial system, but venous aneurysms, especially in the lower limbs, are significant and often underreported vascular conditions. This study focuses on superficial venous aneurysms at the sapheno-femoral junction (SFJ), categorized as Type IA and IB.Materials and MethodsEleven patients (5 females, 6 males; mean age 50 years) with venous masses were identified after negative hernia evaluations. Diagnosis was established through clinical examination and duplex ultrasound, confirming SFJ dilation with specific inclusion criteria. Surgical excision was performed, followed by follow-up assessments up to 5 years.ResultsAll patients underwent successful surgical excision. No major complications occurred, and all patients ambulated immediately post-surgery. Five years post-operation, there were no inguinal recurrences, and residual great saphenous vein remained patent and continent. Histopathological analysis revealed wall thinning, reduced smooth muscle and elastic fibers, and fibrous connective tissue predominance.ConclusionSuperficial venous aneurysms at the SFJ are rare but can be effectively managed through surgical excision. With appropriate diagnosis and intervention, the risk of complications is minimal, supporting the need for awareness and accurate classification in clinical practice.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251334794"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004515","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":"Complete Recovery After Thoracic Endovascular Aortic Repair for Type a Aortic Dissection With Cerebral Malperfusion: A Case Report.","authors":"Feifei Wang, Xiaojun Shu","doi":"10.1177/15385744241290414","DOIUrl":"10.1177/15385744241290414","url":null,"abstract":"<p><p>A 52-year-old woman presented with chest pain, shortness of breath and loss of sensation in her left limbs. Computed tomography angiography revealed an type A aortic dissection involving the brachiocephalic trunk and right common carotid artery. Endovascular therapy successfully managed the condition by reconstructing the artery and occluding the false lumen.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"326-330"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383152","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":"Rupture of an Aneurysmal Pulmonary Sequestration Artery.","authors":"Marjolijn Hordijk, Mathijs G Buimer","doi":"10.1177/15385744241292114","DOIUrl":"10.1177/15385744241292114","url":null,"abstract":"<p><p>Pulmonary sequestration (PS) is a rare lung malformation seldomly accompanied by aneurysmal deformation of its arterial vasculature. This is a first report of aneurysmal PS presenting with acute aneurysmal rupture. The ruptured aneurysm was treated uneventfully by emergency endovascular coiling, and thoracoscopic hemothorax drainage.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"338-341"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396536","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":"Meta-Analysis of Randomised Controlled Trials Comparing Bypass and Endovascular Revascularisation for Peripheral Artery Disease.","authors":"Angus H Pegler, Shivshankar Thanigaimani, Siddharth S Pai, Dylan Morris, Jonathan Golledge","doi":"10.1177/15385744241292123","DOIUrl":"10.1177/15385744241292123","url":null,"abstract":"<p><strong>Objective: </strong>Peripheral artery disease affects approximately 250 million people globally. Multiple randomised controlled trials have compared bypass and endovascular interventions but the optimum revascularisation approach remains unclear. The recently published BEST-CLI and BASIL-2 trials provide current and robust data addressing this question, however their findings are not concordant. This systematic review and meta-analysis provides an overview of the worldwide randomised evidence comparing bypass surgery and endovascular revascularisation in lower limb peripheral artery disease.</p><p><strong>Methods: </strong>A comprehensive literature search of MEDLINE, Embase and CENTRAL databases was performed of all time periods up to 7 May 2023 to identify randomised controlled trials comparing bypass and endovascular revascularisation for treating lower limb peripheral artery disease. The primary outcome was major amputation. Secondary outcomes were mortality, re-intervention, 30-day adverse events and 30-day mortality. Odds ratios were calculated and pooled using the random-effects model. Risk of bias was assessed using the Cochrane risk of bias 2 tool.</p><p><strong>Results: </strong>Fourteen cohorts were identified across thirteen studies, enrolling 3840 patients. There was no significant difference in major amputation (OR 1.12; 95% CI 0.80-1.57) or mortality (OR 0.96; 95% CI 0.79-1.17) between the bypass and endovascular groups. Bypass was associated with a significant reduction in re-intervention compared with endovascular treatment (OR 0.57, 95% CI 0.40-0.82).</p><p><strong>Conclusions: </strong>These findings suggest that rates of major amputation and mortality are similar following bypass and endovascular interventions. Patients who undergo bypass surgery have a significantly lower re-intervention rate post-operatively.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"277-287"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484815","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":"The Role of Intravascular Ultrasound in Limb Salvage: A Systematic Review and Meta-Analysis.","authors":"Allen Gee, Arthur Tarricone, Lawrence A Lavery, Karlo A Wiley, Noell Palmieri, Samin Sharma, Prakash Krishnan","doi":"10.1177/15385744241292861","DOIUrl":"10.1177/15385744241292861","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to review the current literature of intravascular ultrasound (IVUS) use in real world cohorts inclusive of chronic limb threatening ischemia (CLTI) patients and compare the outcomes to patients imaged by angiography alone.</p><p><strong>Methods: </strong>The systematic review was registered in Research Registry. A literature search was performed across 4 databases: PubMed, Medline/Embase, Cochrane Review, and Web of Science for eligible comparative studies. The primary outcomes examined were clinically driven target lesion revascularization (CD-TLR), amputation (including minor below the ankle and major above the ankle), all-cause mortality, limb salvage and mean balloon dilation. A random effects model was used when pooling outcomes to account for heterogeneity. Publication bias was determined using eggers test and illustrated on a funnel plot.</p><p><strong>Main findings: </strong>Six studies were included in this review, with a total of 1883 subjects with Rutherford 1-6. Among the 1883 subjects, 940 had Rutherford 4-6. IVUS was used in 1294 subjects and angiography alone was used in 589 subjects. Pooled analysis determined no significant association in IVUS + angiography with CD-TLR (O.R = 1.43 [CI: 0.80, 2.58]), all-cause amputation (O.R = 0.63 [CI: 0.34, 1.17]), and all-cause mortality (O.R = 0.63 [CI: 0.34, 1.17]). Sub analysis of subjects with CLTI, Rutherford classes 4-6 showed an association between IVUS + angiography use with limb salvage at 1 year, O.R = 2.22 [1.24, 3.97].</p><p><strong>Conclusion: </strong>The use of IVUS + angiography compared to angiography alone showed larger reference vessel diameter in both all-inclusive Rutherford classifications and the CLTI subset. The use of IVUS + angiography compared to angiography alone showed no difference in CD-TLR at 12 months, lower extremity amputation, and all-cause mortality for Rutherford 1-6. The use of IVUS + angiography compared to angiography alone in the CLTI subset analysis improved limb salvage.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"288-297"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484819","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":"Does the Combined Arteritis Damage Score (CARDS) in the Diagnosis of Takayasu Arteritis Predict Prognosis and Need for Biologic Therapy?","authors":"Rabia Deniz, Tevfik Güzelbey, Merve Tanrıkulu, Cemal Bes","doi":"10.1177/15385744241292104","DOIUrl":"10.1177/15385744241292104","url":null,"abstract":"<p><strong>Background: </strong>We aimed to investigate the prognostic value of the combined arteritis damage score (CARDS) in Takayasu arteritis (TAK) patients to predict the need for biologic treatment at diagnosis and the possible contribution of wall thickness (WT).</p><p><strong>Materials and methods: </strong>Blind evaluation of MRA/CTA at the time of diagnosis was performed by a reader rheumatologist (RR) and an interventional radiologist (RIR). The CARDS damage score for 21 arterial regions was assessed as normal, mild or moderate/severe stenosis, occclusion or aneursym/dilatation. Additionally, WT was scored for all regions as present or absent. A modified CARDS (mCARDS) was calculated as the sum of CARDS and the number of WT areas.</p><p><strong>Results: </strong>According to follow-up treatment, 10 patients with non-biologic treatment (non-BT) (F/M:8/2, median age 37.5 years) and 15 patients with biologic treatment (BT) (F/M:13/2, median age 30 years) were included. Indian Takatasu Arteritis Score (ITAS), CRP, and ESR levels were similar in both groups. CARDS (1.4 (0-7.2) vs 4.5 (.6-19), <i>P</i>: .003), WT (1.5 (0-8) vs 7 (1-21), <i>P</i> < .001), and mCARDS (4 (0-14.2) vs 11.4 (1.6-40), <i>P</i> < .001) scores were significantly higher in the BT group compared to nonBT group. Cohen's kappa coefficient between RR and RIR for WT was .99 with 99.6% aggrement, and CARDS was .98 with 99.6% agreement. The AUC values for CARDS, WT, and mCARDS scores were .748 (.605-.892), .837 (.723-.950), and .847 (.735-.958), respectively, and <i>P</i> value was <.0001.</p><p><strong>Conclusions: </strong>The prediction of prognosis and biologic treatment need at TAK diagnosis using non-invasive angiographic images can improve outcomes and prompt closer follow-up. The combination of CARDS and WT as mCARDS achieved the highest sensitivity and specificity, and all scores appear useful for predicting prognosis.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"250-256"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396535","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":"Clinical Outcomes After Distal Bypass in Patients With Chronic Limb-Threatening Ischemia due to Connective Tissue Disease.","authors":"Taira Kobayashi, Masaki Hamamoto, Takanobu Okazaki, Ryo Okusako, Hironori Shimoda, Misa Hasegawa, Shinya Takahashi","doi":"10.1177/15385744241290012","DOIUrl":"10.1177/15385744241290012","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic limb-threatening ischemia (CLTI) is mostly caused by arteriosclerosis, but is sometimes due to connective tissue disease. However, there is a limited knowledge of clinical outcomes of patients with CLTI with connective tissue disease. The objective of the study was to assess outcomes after distal bypass in these patients using global vascular guidelines.</p><p><strong>Material and methods: </strong>Data from distal bypasses performed for CLTI at a single center from 2014 to 2023 were evaluated retrospectively. Clinical outcomes after distal bypass were compared for patients with CLTI with arteriosclerosis (AS group) and those with connective tissue disease (CD group). The primary endpoints were limb salvage and wound healing.</p><p><strong>Results: </strong>Of the 282 distal bypasses performed for 222 patients with CLTI, 22 were conducted for 21 patients with connective tissue disease (CD group). The connective tissue disease was progressive systemic scleroderma (n = 11 patients), pemphigoid diseases (n = 2), polyarteritis nodosa (n = 2), rheumatoid arthritis (n = 2), and others (n = 4). Compared with the AS group, the CD group included more females (<i>P</i> = .007) and had greater oral steroid use (<i>P</i> < .001) and a higher Global Limb Anatomical Staging System (GLASS) inframalleolar (IM) modifier P2 (<i>P</i> < .001). The mean follow-up period of the whole cohort was 27 ± 22 months with no significant difference between the groups (<i>P</i> = .25), and 22 limbs required major amputation during this period. The 2-year limb salvage rate was significantly lower in the CD group compared to the AS group (75% vs 94%, <i>P</i> = .020). Wound healing was achieved in 220 (78%) limbs, and the 12-month wound healing rate was significantly lower in the CD group (52% vs 86%, <i>P</i> = .006).</p><p><strong>Conclusion: </strong>The low 2-year limb salvage and 12-month wound healing rates in patients with CLTI with connective tissue disease indicate that distal bypass may be challenging in these patients.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"243-249"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373975","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":"Drug-Coated Balloon Angioplasty for In-Stent Restenosis in the Vertebral Artery Ostium: Experiences From a Single Center.","authors":"Wendeng Xu, Yi Shen, Ye Wang, Bin Liang, Jian Wu, Xiaofeng Zhang","doi":"10.1177/15385744241292115","DOIUrl":"10.1177/15385744241292115","url":null,"abstract":"<p><p><b>Background and purpose:</b> Stenting appears to be a safe treatment for vertebral artery ostial stenosis (VAOS) with low complication rates and positive long-term effects. However, in-stent restenosis (ISR) after stenting is common. Drug-coated balloons (DCBs) are an effective management strategy for ISR in patients with coronary or carotid disease. In this study, we investigated the feasibility, safety, and effectiveness of DCB-assisted angioplasty for the treatment of ISR after treatment of VAOS. <b>Research Design:</b> The study included patients in the Department of Neurology at Beijing Tsinghua Changgung Hospital who underwent DCB-assisted angioplasty for ISR after previously undergoing stenting for VAOS. We retrospectively analyzed the clinical and functional outcomes in these patients. <b>Results:</b> Fourteen patients were enrolled in the study between January 2018 and April 2022. Five of the patients were female, and the mean age was 69.4 ± 7.5 years. The technical success rate was 100% and the mean operation time was 57.1 ± 29.2 minutes. No perioperative complications were reported. There were no new cases of cerebral infarction or transient ischemic attacks in hospital or during 6 months of follow-up. There were only 2 reports of ISR in the vertebral artery ostium in the 6 months following DCB-assisted angioplasty. The median modified Rankin scale score was 0. <b>Conclusion:</b> DCB-assisted angioplasty may be feasible for treatment of ISR after stenting of the vertebral artery ostium. However, more research is needed to confirm our findings.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"266-270"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484811","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":"Successful Percutaneous Rescue Treatment of Acute Carotid Stent Thrombosis Utilizing a Modified Embolic Protection Device.","authors":"Alessandro Di Giorgio, Alessandro Mazzapicchi, Carla Rochira, Salvatore Azzarelli, Francesco Scardaci, Davide Salvatore Tomasello, Vincenzo Argentino, Francesco Amico","doi":"10.1177/15385744241290006","DOIUrl":"10.1177/15385744241290006","url":null,"abstract":"<p><p>Acute Carotid Stent Thrombosis (ACST) is a rare complication of Carotid Artery Stenting (CAS) with a potentially fatal outcome. We report a case of ACST occurring five minutes after the end of a successful CAS procedure that was promptly treated by carotid stent-in-stent implantation using a new percutaneous strategy based on the creation of a modified embolic protection device. Following the procedure, we did not observe brain lesions suggestive of acute cerebral ischemic events at the CT scan performed at 48 hours, as well as no neurological deficits in the following days.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"320-325"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373976","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}