Vascular and endovascular surgery最新文献

{"title":"TRIple moDality: Extraction, Aspiration and Thrombolysis in Pulmonary Embolism. Preliminary Results of the TRIDENT-PE Study.","authors":"Carlos Torres-Herrera, Ruvistay Gutierrez-Arias, Ruben Lamich, Anibal Zamorano, Gastón Dusaillant, Fabian Adasme, Carlos Goset, Emiliano Borques, Pablo Potthoff, Javiera Zamorano, Fernanda Pedreros, Marlon Ponce Orellana, Pablo Pedreros","doi":"10.1177/15385744261441952","DOIUrl":"10.1177/15385744261441952","url":null,"abstract":"<p><p>ObjectiveTo evaluate the clinical outcomes and safety of a triple percutaneous treatment protocol involving mechanical thrombolysis, direct thromboaspiration, and low-dose tPA thrombolysis in patients with moderate to high or high-risk pulmonary embolism (PE).DesignSingle-center retrospective cohort study.MethodsWe included patients aged 18 years or older with moderate to high or high-risk PE, as determined by a chest vascular scan. The primary outcome was survival. Secondary outcomes included functional capacity (FC), systolic pulmonary artery pressure (sPAP), right ventricle (RV) dilation, and tricuspid annular plane systolic excursion (TAPSE). All outcomes were assessed at 48-h post-procedure and at the 6-month follow-up. Additionally, the incidence of adverse events was evaluated during the 48-h following the procedure.ResultsThirty-five patients were included, comprising 51.43% males, with a mean age of 55 years (SD 18). Survival at 48-h post-procedure was 97%. Of the 19 patients who followed up for 6 months, 95% survived. Eight patients (23%) had FC I-II at admission, which increased to 91% at 48-h post-procedure and 100% at 6 months of follow-up. At admission, 25 patients (71%) had moderate to severe RV dilation. In contrast, 33 patients (94%) had a normal or slightly dilated RV at 48-h post-procedure, and 100% (n/N 19/19) at 6 months of follow-up. In addition, there was a significant reduction in mean baseline sPAP to 36 mmHg (SD 10.3) at 48-h post-procedure and to 29 mmHg (SD 4.9) at 6-month follow-up (<i>P</i> < .001). TAPSE increased significantly to 20.8 mm (SD 4.8) at 48-h post-procedure and to 22.3 mm (SD 2.8) at 6-month follow-up (<i>P</i> < .001). No adverse events occurred.ConclusionIn patients with moderate to high or high-risk PE, the triple percutaneous treatment protocol appears to be an effective and safe intervention. This strategy achieves high survival and adequate FC, normalizing pulmonary vascular pressures and RV function.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"486-491"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655579","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 Endovascular Management of Gastroduodenal Artery Pseudoaneurysm Following Acute Pancreatitis, Case Report and Literature Review.","authors":"Qais Alnjoom, Dana Salahat, Mohammed Maraqa, Nisreen Khalifa, Ahmad G Hammouri, Ali Hamad, Alhusseini Rajai, Ibraheem AbuAlrub","doi":"10.1177/15385744261442200","DOIUrl":"10.1177/15385744261442200","url":null,"abstract":"<p><p>Gastroduodenal artery (GDA) pseudoaneurysm is a rare but potentially life-threatening vascular condition due to its risk of rupture. The exact mechanisms underlying GDA pseudoaneurysm formation remain unclear. A 47-year-old female with a history of laparoscopic cholecystectomy developed post-surgical complications, including necrotizing pancreatitis, portal vein thrombosis, and superior mesenteric vein (SMV) thrombosis. After 4 months she presented with severe abdominal pain and recurrent vomiting. Contrast-enhanced computed tomography (CT) imaging revealed the presence of a gastroduodenal artery pseudoaneurysm. Additionally, a walled-off pancreatic necrosis was identified, necessitating drainage via gastrocystostomy. Diagnostic angiography confirmed the presence of a GDA pseudoaneurysm, which was successfully treated via endovascular coil embolization. The patient's history of laparoscopic cholecystectomy, necrotizing pancreatitis, and walled-off pancreatic necrosis highlighted the significant risk factors for developing a GDA pseudoaneurysm. Early diagnosis and intervention, such as embolization, are crucial for optimal outcomes.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"555-561"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679762","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":"External Iliac Artery Endofibrosis: A Rare Condition With Distinct Presentations.","authors":"Safa Riahi, Yassine Khadhar, Bilel Derbel, Serge Haupert, Malek Ben Mrad, Raouf Denguir","doi":"10.1177/15385744261442202","DOIUrl":"10.1177/15385744261442202","url":null,"abstract":"<p><p><b>Backgroung:</b> External iliac artery (EIA) endofibrosis is a rare, non-atherosclerotic condition affecting endurance athletes, commonly presenting as exercise-induced claudication. It is typically underdiagnosed and misattributed to musculoskeletal or neurological causes. <b>Case Summary:</b> We present our management of 3 cases of EIA endofibrosis in endurance athletes. The first patient, a 55-year-old male cyclist, underwent surgical revascularization for right EIA stenosis. The second case involved a 43-year-old female physical education teacher, who was treated with a prosthetic bypass graft for a loop configuration of the EIA. The third case, an amateur triathlete, presented with acute ischemia and underwent urgent revascularization using an interposition graft. All patients experienced complete resolution of symptoms and successfully resumed their athletic activities. <b>Conclusion:</b> EIA endofibrosis is an important consideration in athletes with exertional leg symptoms. Surgical treatment, including venous or prosthetic bypass grafts, is effective in relieving symptoms and ensuring long-term recovery. Early diagnosis is crucial to avoid complications, particularly in cases involving acute ischemia.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"562-565"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679784","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":"Cystic Artery Pseudoaneurysm Bleed With Gallbladder Perforation - A Challenging Clinical Problem.","authors":"Kaushal Singh Rathore, Ankit Rai, Balakrishnan Selvakumar, Subhash Chandra Soni, Vaibhav Kumar Varshney, Peeyush Varshney, Lokesh Agarwal, Tushar Suvra Ghosh","doi":"10.1177/15385744261441943","DOIUrl":"10.1177/15385744261441943","url":null,"abstract":"<p><p>Cystic artery pseudoaneurysm bleed is rare which becomes potentially fatal when associated with gallbladder perforation. We report two cases of elderly men who presented with acute onset abdominal pain, shock, metabolic acidosis, low haemoglobin and deranged renal functions. The first patient was resuscitated and with a clinical diagnosis of gallbladder perforation, a percutaneous drain was inserted. However, due to its haemorrhagic output and slow fall in Hb, a computed tomography abdominal angiography was done later which diagnosed cystic artery pseudoaneurysm, which was coil embolized and he underwent elective cholecystectomy. The second patient was hemodynamically unstable and underwent an emergency laparotomy, ligation of the cystic artery pseudoaneurysm and open cholecystectomy. We discuss the diagnostic and management challenges faced in both these cases.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"545-549"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655585","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":"Non-Surgical Pneumoperitoneum After Fenestrated Endovascular Aortic Repair- Case Report.","authors":"George Apostolidis, Giuseppe Panuccio, Petroula Nana, José I Torrealba, Daour Yousef Al Sarhan, Tilo Kölbel","doi":"10.1177/15385744261428751","DOIUrl":"10.1177/15385744261428751","url":null,"abstract":"<p><p>ObjectivePost-operative pneumoperitoneum is mainly related to gastrointestinal perforation, although non-surgical pneumoperitoneum may also be present, with mechanical ventilation being the leading cause. Herein, we report a case of non-surgical pneumoperitoneum after percutaneous fenestrated endovascular aortic repair (fEVAR).Case reportA 79-year-old female presented with a 58 mm asymptomatic juxtarenal abdominal aortic aneurysm. The preoperative computed tomography angiography (CTA) detected also a diaphragmatic hernia. According to the latest guidelines, an indication for fEVAR was set. The successful implantation of a four-fenestrated custom-made endograft was performed using bilateral percutaneous femoral access. Even though the immediate postoperative period was uneventful, the predischarge CTA revealed a high-volume pneumoperitoneum and pneumomediastinum. The patient developed mild tenderness of the lower abdomen during palpation, and a postoperative elevation of the C-reactive protein (CRP = 205 mg/L) was identified. After general surgery consultation, an exploratory laparoscopy with intraoperative gastro-duodenoscopy were performed, which revealed no evidence of gastrointestinal perforation. The patient was discharged in good general condition on the sixth postoperative day.ConclusionPost-operative pneumoperitoneum may be related to mechanical ventilation due to alveolar injury after fEVAR. Laboratory and imaging findings should be judged in the influence of clinical image. An initial watch and wait approach may be justified.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"524-528"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286988","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":"Median Arcuate Ligament Compressing Multiple Arteries in a Young Man Treated by Surgical Release.","authors":"Eswaravaka Saikrishana, Balakrishnan Selvakumar, Taruna Yadav, Subhash Chandra Soni, Peeyush Varshney, Lokesh Agarwal, Chhagan Lal Birda, Ankit Rai","doi":"10.1177/15385744261428768","DOIUrl":"10.1177/15385744261428768","url":null,"abstract":"<p><p><b>Background:</b> Asymptomatic compression of celiac artery (CA) by median arcuate ligament (MAL) is quite common, but simultaneous compression of other arteries by MAL is very rare. <b>Case details:</b> A 20-year-old man presented with post-prandial epigastric pain for the past 1 year and a 5 kg weight loss. On examination, he had a body mass index of 17.2 kg/m² and was normotensive. Blood tests were unremarkable except for a mildly raised serum creatinine. A CT angiography (CTA) showed MAL-related 60% proximal CA narrowing and 40% proximal right renal artery (RRA) narrowing with a small right kidney. After multi-disciplinary team discussion, surgical MAL release at both sites was planned. The surgery was started laparoscopically to identify CA origin by a 'top to down' approach. The CA origin could not be visualised as it was looping behind the pancreatic neck caudally; hence the procedure was converted to open. CA origin was identified and overlying MAL divided. After kocherisation, RRA origin was found compressed by right limb of MAL and was divided. The operative duration was 200 mins with 50 mL blood loss. <b>Results:</b> The patient had an uneventful recovery. At 12-month, he is asymptomatic with serum creatinine normalised and gained 8 kg weight. A follow-up CTA at 2 months showed a normal CA and RRA. In this report, we discuss briefly about the current presentation, diagnosis and treatment of MAL compression of CA and other upper abdominal arteries. <b>Conclusions:</b> The learning point from this case is that one should carefully inspect all upper abdominal arteries in CTA for MAL-related compression as they may be asymptomatic, and this enables simultaneous treatment at these sites too in a single surgery.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"535-539"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260601","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":"Vascular Injuries Secondary to Penetrating Neck Trauma.","authors":"Anish M Patel, Kyle Bui, Andrea Alonso, Sophia M Smith, Emmanuel C Nwachuku, Elizabeth King, Alik Farber, Sabrina E Sanchez, Crisanto Torres, Noelle N Saillant, Jeffrey J Siracuse","doi":"10.1177/15385744261441751","DOIUrl":"10.1177/15385744261441751","url":null,"abstract":"<p><p>ObjectivesPenetrating neck trauma with vascular injury can have significant morbidity. Our goal was to examine the management and outcomes of vascular injuries secondary to penetrating neck trauma.MethodsA single-center retrospective study identified patients with penetrating neck trauma with vascular injury (2014-2024). Injury characteristics, management, and subsequent morbidity were analyzed.ResultsThere were 47 patients with penetrating neck trauma and associated vascular injury. The average age was 37.5 years, 80.9% were male, and 57% were of Black race. Mechanisms were stabbing (57.4%), firearm (34%), and other causes, including dog bites (8.5%). Vascular injuries were arterial (23.4%), venous (51.1%), and combined arterial/venous. Concurrent aerodigestive injuries occurred in 23.4% of cases. Median time from injury to emergency department (ED) presentation was 20 minutes, with 48.9% intubated enroute or on arrival. There were 72.3% that had an emergency intervention with median time to operating room of 35-minutes. Open arterial repairs included 10% carotid artery bypass, 35% carotid artery repair, and 55% arterial ligation of neck arteries. Open venous repair included 93.1% ligation and 13.8% primary vein repair. Endovascular interventions were vertebral (67%) and inferior thyroid artery (33%) embolizations. There were 12.8% of patients who died soon after presentation (67% trauma bay and 33% in the operating room), and 12.8% suffered a stroke. There were no 30-days or 1-year deaths after discharge, but 25% of patients had at least one 30-days ED visit. Follow-up imaging was received by 66% of discharged patients with an arterial repair.ConclusionsPenetrating neck trauma with vascular injuries require prompt operative repair and are associated with high initial mortality and stroke rate. Combined arterial and venous injuries are common, and aerodigestive injuries should be considered during initial presentation. High rates of ED utilization post-discharge suggest the need for improved follow-up in this patient population.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"479-485"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648015","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 Influence of Procedure Setting on Femoral-Popliteal Endovascular Arterial Intervention Practice Patterns in the Medicare Population.","authors":"Vamsi Potluri, Paula Pinto Rodriguez, Karen Yuan, Haroon Dossani, Shaunak Patel, Mihir Patel, Khuong Nguyen, Michael B Silva, Matthew Blecha","doi":"10.1177/15385744261441993","DOIUrl":"10.1177/15385744261441993","url":null,"abstract":"<p><p>ObjectiveThe purpose of this study is to investigate the influence of practice location on the type of femoral-popliteal endovascular arterial intervention performed in the Medicare population. Additionally, the study investigates the distribution of each intervention type among the primary subspecialty stakeholders in endovascular lower extremity care.MethodsA retrospective analysis of claims data from the Centers for Medicare and Medicaid Services (CMS) Physician/Supplier Procedure Summary files for each year between 2011 and 2022 was performed. Physicians were divided into four categories: radiologists, cardiologists, vascular surgeons, or others. Claims data were collected for all Current Procedural Terminology (CPT) codes corresponding to endovascular therapy in the femoral-popliteal arterial segment. These CPT codes include interventions such as angioplasty alone, atherectomy with or without angioplasty, stent placement with or without angioplasty, and atherectomy combined with stent placement. Chi-squared testing was used for univariable comparisons.ResultsA total of 292 453 femoral-popliteal segment procedures were included in the study. 16.7% (<i>N</i> = 48 705) of procedures were performed in an Office-based Laboratory or stand-alone outpatient ambulatory surgical centers (OBL) setting, while 83.3% (<i>N</i> = 243 401) took place in a hospital-based setting. Cardiologists performed 31.8% (<i>N</i> = 92 969), interventional radiologists 16.8% (<i>N</i> = 49 200), other specialties 4% (<i>N</i> = 11 730), and vascular surgeons 48.7% (<i>N</i> = 142 480) of all CMS-insured femoral-popliteal segment endovascular interventions during the study period. By 2016, atherectomy-based procedures surpassed angioplasty and stent-alone procedures within the CMS population. Cardiologists performed the highest number of atherectomy procedures, with or without stenting, in the femoral-popliteal segment (<i>P</i> < .001). However, the overall rate of atherectomy performed by cardiology compared to other subdisciplines was within 3 percentage points and not significantly different. Vascular surgeons performed atherectomy at the lowest rate, but within 4% of cardiologists. Atherectomy procedures were performed nearly twice as often in outpatient-based facilities compared to hospital-based facilities (57.3% vs 31.6%, OR 1.81, <i>P</i> < .0001). Vascular surgery (44.2%) and cardiology (29.2%) performed the most OBL-based cases, while interventional radiology accounted for 20.0% and other specialties 6.6% (<i>P</i> < .001).ConclusionsThere was a substantial increase in the use of atherectomy in the femoral-popliteal segment in the OBL setting for the CMS population between 2011 and 2022. The rate of atherectomy use is nearly two-fold higher in the OBL setting compared to hospital-based facilities.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"510-516"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655574","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":"Perioperative and Long-Term Outcomes of Lower Extremity Revascularization in Patients With Malignancy.","authors":"Lily Cormier, Annie Cherner, Mitchell W Cox","doi":"10.1177/15385744261441009","DOIUrl":"10.1177/15385744261441009","url":null,"abstract":"<p><p>ObjectiveCancer patients in general are thought to be poor candidates for lower extremity revascularization procedures due to hypercoagulability, potential need for chemotherapy, or multiple other cancer-related co-morbidities. While vascular surgeons may shy away from these patients, only one previous study we found has assessed the effect of this relationship on lower extremity bypass patency, and substantially worse outcomes were documented. Our study aims to quantify the risk of poor outcomes for lower extremity revascularization in a large sample of cancer patients, utilizing the TriNetX database.MethodsWithin the US cohort of 55 healthcare organizations in the TriNetX database, we identified 1419 patients diagnosed with either breast, prostate, colon, or non-small cell lung cancer of any stage and 60 609 patients without diagnosis of those cancers who had undergone either an open infra-inguinal bypass of any graft type or endovascular intervention on the infra-inguinal arteries from September 3, 2004 to September 3, 2024. Propensity score matching was conducted, which yielded 1413 patients analyzed in each group, and incidence of arterial thrombectomy, bypass revision, amputation, and arteriogram were recorded for each group at 30-day and 1-year time points. Secondary subgroup analyses were conducted within the cancer cohort to determine whether rates of the same outcomes listed above varied between open versus endovascular interventions.ResultsIn the primary analysis, there was no significant difference in any of the 4 outcomes between cancer patients and non-cancer patients. In the subgroup analysis, open bypass was found to have a significantly lower incidence of repeat arteriogram within 30 days as compared to endovascular intervention (3.62% vs 7.97%; risk ratio [RR], 0.455, <i>P</i> = 0.029) and 1 year (18.84% vs 28.62%; risk ratio [RR], 0.658, <i>P</i> = 0.007). All other outcomes in both the 30-day and 1-year follow-up periods for the subgroup analysis did not vary significantly between the 2 groups.ConclusionIt is possible that patients with a recent diagnosis of cancer may not have worse outcomes for lower extremity bypass compared to patients without a cancer diagnosis. Cancer patients undergoing endovascular interventions, in contrast, did require more repeat interventions which may suggest that open interventions are preferable in this population. We would, however, caution that overall limb salvage was reasonable in this patient population and results were not markedly worse with any intervention strategy. Cancer diagnosis should not necessarily be seen as a contraindication to a lower extremity revascularization and should be considered on a case-by-case basis.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"473-478"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635619","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":"A Systematic Review of Interventions Designed to Reduce Surgical Site Infection in Patients Who Undergo Transmetatarsal Amputation.","authors":"Rebecca Jess, Kieran Das, Lakna Harindi Alawattegama, Nina Al-Saadi, David Bosanquet, Ian Chetter, Ismay Fabre, Andrew Garnham, Brenig Gwilym, Louise Hitchman, Terry Hughes, Judith Long, Laura Magill, Thomas Pinkney, Matthew Popplewell, Michael Wall","doi":"10.1177/15385744261421787","DOIUrl":"10.1177/15385744261421787","url":null,"abstract":"<p><p>IntroductionSurgical site infection (SSI) following transmetatarsal amputation (TMA) is thought to be common. In patients who have peripheral arterial disease (PAD) or diabetes related foot complications, little is known regarding the effectiveness of interventions designed to reduce SSI following TMA. Our aim was to perform a systematic review of the literature to inform practice and highlight areas that warrant further research to reduce SSI post TMA.MethodsThis review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance and was prospectively registered with the International Prospective Register of Systematic Reviews (CRD4202454958). MEDLINE, EMBASE and Cochrane databases were searched using a predefined search strategy, without date restriction. All randomised controlled trials (RCTs) and observational studies including patients that underwent TMA due to PAD or complications of diabetes related foot disease, with at least 1 intervention designed to promote wound healing or reduce SSI were included. Bias was assessed using the Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale.ResultsThe initial search identified 445 papers. Two RCTs and three observational studies, reporting on 378 TMAs and four interventions, were included. The effect of post-operative antibiotic use on the incidence of SSI differed between the studies. The use of antibiotic-impregnated beads embedded within the soft tissues prior to wound closure were associated with a reduction in SSI rate. The use of Negative Pressure Wound Therapy (NPWT) was associated with a reduction in SSI incidence and faster wound healing. No significant difference was identified in the incidence of SSI between different skin preparations.ConclusionData regarding interventions to prevent SSI following TMA are sparse in the current literature. Prolonged post-operative antibiotic use could reduce SSI, while NPWT and antibiotic beads may be beneficial to wound healing. However, larger more robust RCTs are required to confirm these findings.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"411-419"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146095433","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}