Vascular and endovascular surgery最新文献

{"title":"Post-Stent Vein Lumen Shape and Clinical Response in Patients Treated for Iliofemoral Venous Occlusive Disease.","authors":"Paul Gagne, Kayode O Kuku, Robert Mendes, Amy Griggs, Edem Segbefia, Lawrence V Hofmann, Anthony Comerota, Hector M Garcia-Garcia","doi":"10.1177/15385744251321900","DOIUrl":"https://doi.org/10.1177/15385744251321900","url":null,"abstract":"<p><strong>Objective: </strong>Interventionalists have noted significant venous luminal gain with nitinol venous stents although post-placement lumen shape differed from the circular shape observed with elgiloy stents. The goal of this study was to determine the characteristics of a stented vein lumen that correspond with clinical outcomes, and to identify metrics that might be relevant for stent design by assessing aspect ratio (AR), lumen diameter (LD), lumen area (LA), and stent shape (symmetry and eccentricity) post-implant.</p><p><strong>Methods: </strong>This post-hoc analysis evaluated patients from the VIVO US Study (NCT01970007) with pre- and post-stent intravascular ultrasound (IVUS) imaging. Patient characteristics, Venous Clinical Severity Score (VCSS) and Venous Disability Score (VDS) were collected in the study. LD, LA, and stent geometry were measured by the core laboratory. Data were analyzed for linear association between core-laboratory assessed pre and post stent LD, LA, AR, stent eccentricity and symmetry index, and VCSS and VDS change.</p><p><strong>Results: </strong>IVUS imaging was available for 29 patients (2 sites) enrolled in the VIVO US Study (55.2% women; mean age: 59.8 ± 17 years). The cohort had post-thrombotic (48.3%), nonthrombotic iliac vein lesion (44.8%) or acute deep vein thrombotic (6.9%) disease. Mean lesion length was 111.8 ± 60.9 mm. Eleven stents extended below the inguinal ligament. Median minimum LD and LA significantly increased after stent placement (<i>P</i> < 0.001); median lumen AR changed from 2.0 pre-stent to 1.4 post-stent (<i>P</i> < 0.001). Mean VCSS improved from baseline to 12 months (7.6 ± 4.3 to 3.7 ± 2.6). No statistically significant linear relationships were identified between VCSS / VDS change and a specific characteristic of LA, LD, or AR.</p><p><strong>Conclusions: </strong>Measures of lumen change pre and post iliofemoral vein nitinol stent placement reflect disease and stent characteristics. After stent placement, minimum LD and LA increased and AR decreased. Stented lumen shape or size with Zilver Vena did not impact 1-year clinical improvement by VCSS.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251321900"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451359","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":"Disparities in Aortic Aneurysm Mortality Trends: Revealing Sex and Racial Inequalities.","authors":"Masashi Azuma, Andrew Ramirez, G William Moser, Kenny J Oh, Mohammed Abul Kashem, Yoshiya Toyoda, Suyog Mokashi","doi":"10.1177/15385744251321621","DOIUrl":"https://doi.org/10.1177/15385744251321621","url":null,"abstract":"<p><strong>Background: </strong>Abdominal aortic dissection or aneurysm (AAA) is a significant health concern in developed nations often underdiagnosed with poor outcomes. Despite a decline in aortic dissection and aneurysm mortality rates in the US from 1999 to 2020, reported by the CDC, this improvement disproportionately favors males and Caucasians. This study aims to elucidate these disparities.</p><p><strong>Methods: </strong>Data from the CDC Wonder database from 1999 to 2020 on aortic aneurysm, including abdominal, thoracic, and thoracoabdominal aneurysms and rupture related deaths in the US were analyzed. Mortality rates were compared across sex, race, and geographic location separated by state. Mortality was normalized based on population and analyzed with linear regression models with all plots showing goodness of fit.</p><p><strong>Results: </strong>Overall, the mortality gap between male and female cohorts with aortic aneurysm-related deaths widened by 0.57 per 100,000 deaths per year (<i>P</i> < 0.001). Mortality between Caucasians with African American and Asian American cohorts showed reductions of 0.41 per 100,000 per year (<i>P</i> < 0.001). Caucasian and male cohorts started at higher mortality rates when compared to their competitive cohorts.</p><p><strong>Conclusions: </strong>Despite a reduction in mortality rates among individuals with aortic aneurysm in the US from 1999 to 2020, this decline disproportionately benefits males and Caucasians over African American and Asian populations. Although Caucasians and males had higher mortality in 1999, their decline is significantly greater. Following current trends, Caucasian and male mortalities will be lower than minority groups by 2026. Targeted interventions are needed to address these disparities effectively.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251321621"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417129","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":"Is There a \"Weekend Effect\" on In-Hospital Outcomes of Type a Aortic Dissection Repair? A Population-Based Analysis of National Inpatient Sample From 2015-2020.","authors":"Renxi Li, Stephen J Huddleston","doi":"10.1177/15385744251321293","DOIUrl":"https://doi.org/10.1177/15385744251321293","url":null,"abstract":"<p><strong>Background: </strong>\"Weekend effect\" in type A aortic dissection (TAAD) repair has been identified in several countries where weekend admission is associated with higher mortality rates. However, in the US, findings have been mixed regarding the \"weekend effect\" on TAAD outcomes. This study aimed to conduct a comprehensive, population-based analysis of the association between weekend admission and the in-hospital outcomes of TAAD repair using a large-scale national registry.</p><p><strong>Methods: </strong>Patients who underwent TAAD repair were identified in National Inpatient Sample from Q4 2015-2020. Multivariable logistic regressions were used to compare in-hospital outcomes between patients admitted on the weekend vs weekday, where demographics, comorbidities, hospital characteristics, primary payer status, and transfer-in status were adjusted.</p><p><strong>Results: </strong>There were 1007 and 3275 patients who underwent TAAD repair under weekend and weekday admission, respectively. Patients admitted on the weekend were more likely to get transferred in from a different acute care hospital and have renal malperfusion. After multivariable analysis, patients admitted on the weekend and weekday had comparable times from admission to operation (0.88 ± 2.64 vs 0.92 ± 2.99 days, <i>P</i> = 0.64) and in-hospital mortality (15.99% vs 14.84%, aOR = 1.119, 95 CI = 0.914-1.37, <i>P</i> = 0.28). All other in-hospital outcomes, hospital length of stay, and total hospital charge were similar between the 2 cohorts.</p><p><strong>Conclusion: </strong>Patients admitted on weekends and weekdays had comparable times from admission to operation, as well as similar in-hospital mortality and morbidities. These findings suggest the effectiveness of weekend emergency care protocols for TAAD patients and the lack of a \"weekend effect\" on TAAD repair in the United States.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251321293"},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416607","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":"Surgical Treatment of Superior Vena Cava Syndrome in a Preterm Neonate.","authors":"Safak Alpat, Melih Alma","doi":"10.1177/15385744241284881","DOIUrl":"10.1177/15385744241284881","url":null,"abstract":"<p><p>Superior vena cava syndrome is rare and challenging clinical entity in neonates. Medical treatment options are usually effective. However, when failed, surgery is warranted. Herein, we present a preterm neonate with SVC syndrome and associated chylothorax. When 2 weeks old, he underwent successful open thrombectomy and SVC reconstruction under cardiopulmonary bypass. Immediately after the operation findings of SVC syndrome and chylotorax were completely resolved. To our knowledge, this patient is the smallest baby underwent open SVC reconstruction with cardiopulmonary bypass.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"187-190"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305369","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 Open Repair of a Thoracoabdominal Aortic Aneurysm After Multiple Failed Endovascular Treatments in a 22-Years-Old Individual With Loeys-Dietz Syndrome.","authors":"Annarita Santoro, Mohamed Rizk, Laura Inga Tavara, Moh'd Shafiq Ramadan, Germano Melissano","doi":"10.1177/15385744241285112","DOIUrl":"10.1177/15385744241285112","url":null,"abstract":"<p><p>Loeys-Dietz syndrome is a rare genetically triggered disease characterized by aortic involvement, predisposing individuals to aneurysm and dissection at young age. Open repair is considered the treatment of choice despite the fact that it is associated with significant morbidity and mortality rates. On the other hand, endovascular treatment may be also considered an acceptable option in specific cases such as emergency or in patients unfit for open surgery or when landing zones are within surgical grafts. We report the case of a thoracoabdominal aortic aneurysm (TAAA) open surgical repair (OSR) in a 22-year-old male patient diagnosed with type 2 Loeys-Dietz syndrome, treated by means of a TAAA replacement with a 30-mm multi-branched \"Coselli\" aortic graft (Vascutek, Renfrewshire, Scotland, UK) after multiple previously interventions, including a thoracic endovascular aortic repair (TEVAR) and a custom made endograft for the visceral aorta.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"218-223"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335649","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 Recanalization in Patients With Vertebral Artery Stump Syndrome: A Single-Center Experience.","authors":"Renjie Ji, Hanfeng Chen, Ziqi Xu, Benyan Luo","doi":"10.1177/15385744241286603","DOIUrl":"10.1177/15385744241286603","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the feasibility, success rate, and safety of endovascular revascularization of patients with vertebral artery stump syndrome (VASS).</p><p><strong>Methods: </strong>This single-center retrospective study analyzed clinical and imaging data from consecutive patients with VASS who underwent endovascular recanalization from January 2020 until June 2023.</p><p><strong>Results: </strong>Our study enrolled 30 patients [mean age 69 (range 51-84) years; 26 men]. The rate of successful technical revascularization was 96.7% (n = 29), and the rate of complications was 3.3% (n = 1). At the 6-month follow-up, the patients with successful endovascular revascularization of VASS did not have any neurological symptoms, and computed tomography angiography showed 3/29 (10.3%) re-occlusions and 4/29 (13.8%) restenosis of the stent, which was confirmed by digital subtraction angiography.</p><p><strong>Conclusions: </strong>Endovascular recanalization in patients with VASS is feasible in selected patients and has a high procedural success rate and low rate of complications. A large, multicenter, randomized study is warranted to confirm these findings.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"126-132"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305366","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 Embolization of Aneurysmal Renal Arteriovenous Malformation.","authors":"Jacob S Ghahremani, Michael A Chapek, S Shamtej Singh Rana, John Lee, Brent A Safran, David L Lau, Michael B Brewer","doi":"10.1177/15385744241286675","DOIUrl":"10.1177/15385744241286675","url":null,"abstract":"<p><p>Renal arteriovenous malformations (AVM) represent an uncommon vascular condition characterized by an abnormal direct communication between an intrarenal artery and vein. Though asymptomatic in many individuals, treatment is often indicated if the AVM causes flank pain, hematuria, or medically refractory hypertension, or if there is an associated renal artery aneurysm. We present a case of a large right renal AVM with associated renal artery aneurysm and large varix which was incidentally found on magnetic resonance imaging of the spine. Endovascular and open surgical options were considered, including ex-vivo renal vascular reconstruction and nephrectomy. The patient was successfully treated with endovascular embolization of the AVM with coil packing of the arterial aneurysm and inflow artery. The patient recovered uneventfully with well-maintained renal function and blood pressure control. We review and discuss the literature on the etiology and treatment options for renal AVM.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"198-203"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305365","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":"Axillary to Lateral Above Knee Popliteal Artery Bypass: An Alternative Approach to Lower Extremity Revascularization.","authors":"Trung Nguyen, Paul Tenewitz, Murry Shames, Rajavi Parikh","doi":"10.1177/15385744241285240","DOIUrl":"10.1177/15385744241285240","url":null,"abstract":"<p><strong>Objective: </strong>Management of limb ischemia in the setting of malignancy with history of resection and/or radiation presents a unique challenge. Radiation arteritis contributing to limb ischemia may not respond to endovascular intervention. Furthermore, significant tissue scarring from extensive resection and/or radiation can increase the risk of complications with open intervention and limit revascularization options. Utilization of an axillary to popliteal artery bypass using a lateral approach to the popliteal artery has been described as a reasonable alternative in these challenging cases.</p><p><strong>Case report: </strong>The patient is a 68-year-old male with history of liposarcoma of the left groin, scrotum, and medial thigh for which he underwent multiple resections, flap reconstruction, and skin graft. He had a recurrence 2 years later and underwent repeat resection, placement of brachytherapy catheters, vertical rectus abdominal flap, and external beam radiation. He now presents with Rutherford 2B acute limb ischemia with associated left foot drop. Computed tomography angiography was performed and revealed an occluded left common femoral artery stent, proximal left superficial and deep femoral artery occlusion, and thrombosis of the left femoral vein. An attempt was made at endovascular recanalization without success. He subsequently underwent left axillary-to-lateral above knee popliteal artery bypass with a 6 mm ringed polytetrafluoroethylene graft, tibial thrombectomy, and 4 compartment fasciotomy.</p><p><strong>Results: </strong>Post-operatively, his pain resolved. He continued to have left foot drop but recovered his ability to ambulate with a walker. He was ultimately discharged on post-operative day 11 to an inpatient rehabilitation facility on aspirin and apixaban.</p><p><strong>Conclusion: </strong>Hostile groin secondary to infection, malignancy requiring resection/radiation presents a unique challenge for revascularization. When endovascular revascularization or obturator bypass are not feasible options, axillary-to-lateral above knee popliteal artery bypass is a described, feasible alternative approach to restore blood flow in this challenging patient population.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"191-197"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305364","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":"Trash Feet and Mesenteric Ischemia as a Rare Manifestation of a Complicated Abdominal Aortic Aneurysm: A Case Report.","authors":"Elisa Bignamini, Alexandra Catasta, Luca Giovannacci, Alessandro Robaldo, Giorgio Prouse","doi":"10.1177/15385744241286198","DOIUrl":"10.1177/15385744241286198","url":null,"abstract":"<p><strong>Background: </strong>Abdominal aortic aneurysms and atheromatous plaques are well-established potential culprits in the development of cholesterol embolization. This embolic phenomenon can result in the occlusion of peripheral arteries in the forefoot or toes, commonly referred to as \"trash foot\".</p><p><strong>Case: </strong>A 61-year old patient exhibited severe symptoms and signs of lower limb and mesenteric ischemia, represented clinically by abdominal pain, hematochezia, and bilateral plantar necrotic lesions, attributed to embolization from a previously unknown large infrarenal abdominal aortic aneurysm. Diagnosis was confirmed by performing angio-CT of the abdomen, an angiologic examination, as well as colonoscopy. The patient underwent open surgical repair of the aortic aneurysm and received intravenous prostanoids, resulting in a successful outcome with resolution of bowel ischemia and complete recovery of bilateral foot lesions with no tissue loss.</p><p><strong>Conclusion: </strong>Cholesterol embolization syndrome seldom manifests with its complete clinical spectrum. Identifying and addressing the underlying cause is crucial, with a focus on potential abdominal aortic aneurysms. A combined approach involving surgical repair and prostanoid therapy may offer a viable option for patients experiencing severe manifestations.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"228-232"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335650","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":"Pulmonary Aneurysmal Arteriovenous Malformation Treated With a Vascular Plug.","authors":"Mauricio Gonzalez-Urquijo, Michelle Marchesini, Leopoldo Marine, Jose Francisco Vargas, Michel Bergoeing, Renato Mertens, Francisco Valdes","doi":"10.1177/15385744241287617","DOIUrl":"10.1177/15385744241287617","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of an asymptomatic patient with a pulmonary aneurysmal arterio-venous malformation successfully treated with a vascular plug.</p><p><strong>Case report: </strong>An active 30-year-old male patient, residing at 3000 ft above sea level was referred due to an incidental finding on a CT scan of a 37 mm vascular mass localized in the lower lobe of the right lung, which corresponded to a pulmonary arteriovenous malformation with a single feeding artery. The patient was treated with an Amplatzer vascular plug, which effectively excluded the afferent vessel. An angio CT at 19 months follow-up revealed a hypodense residual mass of 9.0 mm in diameter with no arterial filling or venous drainage. The patient is fully active and remains asymptomatic at 24 months follow-up.</p><p><strong>Conclusion: </strong>An unusual case of a pulmonary aneurysmal arteriovenous malformation successfully treated with a vascular plug is presented, highlighting the efficiency of this procedure.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"224-227"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305367","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}