Vascular and endovascular surgery最新文献_第8页

Axial Ablation versus Terminal Interruption of the Reflux Source (AAVTIRS): A Randomised Controlled Trial. 轴向消融与反流源终端阻断（AAVTIRS）：随机对照试验。

Vascular and endovascular surgery Pub Date : 2024-11-01 Epub Date: 2024-07-21 DOI: 10.1177/15385744241265750

Keohane Cr, Westby D, Twyford M, Aherne T, Tawfick W, Walsh Sr

{"title":"Axial Ablation versus Terminal Interruption of the Reflux Source (AAVTIRS): A Randomised Controlled Trial.","authors":"Keohane Cr, Westby D, Twyford M, Aherne T, Tawfick W, Walsh Sr","doi":"10.1177/15385744241265750","DOIUrl":"10.1177/15385744241265750","url":null,"abstract":"Introduction: Treatment of reflux has been shown to improve time to healing of Venous Leg Ulcers (VLU). Terminal Interruption of the Reflux Source (TIRS) treats reflux within the plexus of veins around an active VLU using foam sclerotherapy. The efficacy of TIRS in managing VLU has never been tested.Methods: We performed a pragmatic, single centre, assessor-blinded, randomised controlled trial comparing endovenous ablation of the axial superficial veins (Axial Ablation-AA) vs TIRS. Patients of any age with VLU of any duration were eligible.Results: 98 Participants were randomised to AA or TIRS. 39/55, 70.9% (95%CI; 57.1-82.37) healed their VLU in the AA group, while 29/39, 74.36% (95%CI; 57.87-86.96) healed their VLU in the TIRS group, P = 0.45.4 were lost to follow-up. Median time to ulcer healing was 84 days (95%CI; 74.67-93.33) in the axial ablation group and 84 days (95%CI; 73.02-94.98) in the TIRS group. Hazard Ratio for ulcer healing with AA vs TIRS was 0.96 (95%CI 0.59-1.56). There were no significant quality of life differences.Conclusion: The AAVTIRS trial did not show that axial ablation was superior to TIRS in the primary outcome of number of VLU healed in 6 months, or time to VLU healing. This trial is not powered to show non-inferiority. TIRS is a viable option for treatment of VLU. Further investigation is necessary before it can be recommended as an alternative to axial ablation.Trial registered at clinicaltrials.gov NCT04484168.","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"805-812"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11425978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736270","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}

引用次数: 0

Vascular and endovascular surgery Pub Date : 2024-11-01 Epub Date: 2024-08-22 DOI: 10.1177/15385744241276688

Sifut Sethi, Jakub Michalski, Rand Moh'd Elayyan Al-Shboul, Frank Carey, Kelvin Tan, Tariq Ali

{"title":"Procedure-Related Complication Rates With the Use of Vascular Closure Devices; Does Size Only Matter? A Large Single Centre Retrospective Study.","authors":"Sifut Sethi, Jakub Michalski, Rand Moh'd Elayyan Al-Shboul, Frank Carey, Kelvin Tan, Tariq Ali","doi":"10.1177/15385744241276688","DOIUrl":"10.1177/15385744241276688","url":null,"abstract":"Introduction: Our retrospective study aimed at assessing safety of vascular closure devices (VCDs) used in a large single-centre Interventional Radiology (IR) department. Complication and deployment failure rates using collagen-based (Angio-seal) and suture-based (ProGlide) devices for common femoral artery haemostasis were compared.Materials and methods: Data from VCDs deployed over a 6-year period were retrospectively analysed for patient age, procedure indication, puncture mode (antegrade/retrograde), sheath size, deployment failure and complications (haematoma, pseudoaneurysm formation, limb occlusion). Numerical and statistical analysis was undertaken.Results: Overall, 1321 common femoral artery punctures in 1217 patients were closed using VCDs. Failure rate using ProGlide was significantly higher when compared with Angio-seal (P=<0.001) in sheath sizes ≤8 Fr. Heparin was not administered in embolisation procedures compared with angioplasty with or without stenting. Therefore, haematoma tended to occur more frequently following angioplasty without stenting (P = 0.003) and angioplasty with stenting (P = 0.001), when compared with embolisation. Deployment failure occurred more frequently when heparin was used during the procedure (P = 0.005).Conclusion: Although complications relating to sheath size are well established in the literature, there remains a paucity of data assessing the impact of procedure specific factors when comparing VCDs. Our study challenges that size is the sole determinant of VCD success and invites a more holistic view of VCD deployment strategies. This study advocates continued research into the nuances of other potential confounding variables to optimise patient outcomes.","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"847-853"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038157","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}

引用次数: 0

The Unique Case of Acute Limb Ischemia in a Patient With a Patent Foramen Ovale. 卵圆孔未闭患者急性肢体缺血的独特病例。

Vascular and endovascular surgery Pub Date : 2024-11-01 Epub Date: 2024-08-22 DOI: 10.1177/15385744241276615

George Elzawy, Paul Petrasek, Ali Fatehi Hassanabad

{"title":"The Unique Case of Acute Limb Ischemia in a Patient With a Patent Foramen Ovale.","authors":"George Elzawy, Paul Petrasek, Ali Fatehi Hassanabad","doi":"10.1177/15385744241276615","DOIUrl":"10.1177/15385744241276615","url":null,"abstract":"Acute limb ischemia (ALI) is the sudden onset of decreased blood supply to the extremities and carries a poor prognosis for the affected limb and survival. A rare but well-recognized embolic etiology is a paradoxical embolism, the translocation of a thrombus from venous to arterial circulation through an intracardiac communication, most commonly a patent foramen ovale. The presentation of ALI secondary to a PFO-mediated paradoxical embolism is most often accompanied by combinations of deep vein thrombosis (DVT), pulmonary embolism (PE), and an acute cerebral or visceral ischemia. We present the first documented case of a Rutherford class I ALI secondary to a PFO-mediated paradoxical embolism, ipsilateral DVT, and PE in a 29-year-old female who was surgically managed for her disabling claudication rather than limb salvage. The overlapping presentation of a viable ALI and ipsilateral DVT created a challenging clinical diagnosis. Our review of the literature on PFO-mediated paradoxical emboli involved 43 reports including 51 patients with various arterial thromboses; 19 of these cases involved lower extremity ALI. This case report is the first case to date that demonstrates a paradoxical embolism causing acute lower extremity ischemia with ipsilateral DVT and no additional limb/visceral ischemia to suggest the diagnosis of ALI. We also highlight the role that quality of life plays in vascular surgical decision-making, extending ALI management goals to not only reducing mortality and major amputations, but also improving quality of life.","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"894-899"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038158","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}

引用次数: 0

Anatomical Feasibility of Percutaneous Arteriovenous Fistula Formation in Korea. 韩国经皮动静脉瘘形成的解剖可行性。

Vascular and endovascular surgery Pub Date : 2024-11-01 Epub Date: 2024-08-22 DOI: 10.1177/15385744241274267

Ki Yoon Moon, Eun Ju Jang, Seung Hoon Lee, Hong Suk Han, Sun Cheol Park, Jang Yong Kim, Sang Seob Yun

{"title":"Anatomical Feasibility of Percutaneous Arteriovenous Fistula Formation in Korea.","authors":"Ki Yoon Moon, Eun Ju Jang, Seung Hoon Lee, Hong Suk Han, Sun Cheol Park, Jang Yong Kim, Sang Seob Yun","doi":"10.1177/15385744241274267","DOIUrl":"10.1177/15385744241274267","url":null,"abstract":"Introduction: Currently, there are two types of percutaneous arteriovenous fistula (pAVF) formation systems approved by the FDA: Ellipsys and WavelinQ. Although these systems are already in use in Europe or the United States, they have not been approved for use in Korea yet. For this reason, this study aimed to check anatomical feasibility of these systems for Korean population prior to their actual use.Methods: Consecutive patients who received ultrasound vein mapping for arteriovenous fistula formation from June 2021 to June 2022 were included. The anatomical feasibility of each system was confirmed according to the manufacturer's instructions for use (IFU).Results: Upper extremity ultrasonography was performed for a total of 83 patients to determine their feasibility for pAVF formation. Of these patients, 65.1% were feasible for pAVF formation with appropriate deep communicating vein (DCV) and outflow. Among them, 57.8% were feasible for the Ellipsys system and 54.2% were feasible for the WavelinQ system. Most patients who were infeasible for pAVF formation had a DCV of small size. Ulnar vessels were more suitable than radial vessel for WavelinQ (54.2% vs 33.7%, P-value = .012). The most common reason for not meeting the criteria was a small vein size at the access site.Conclusions: More than half of all patients were feasible for pAVF formation in this study. Ellipsys had a higher feasibility than WavelinQ, although they showed no significant difference in the feasibility. If these devices are imported into Korea, it will be a good opportunity for many patients to reduce the surgical burden and create AVFs more easily through these procedures.","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"841-846"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038155","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}

引用次数: 0

Transcarotid Artery Revascularization for Symptomatic Retropharyngeal Internal Carotid Artery Stenosis. 经颈动脉血管重建术治疗症状性咽后颈内动脉狭窄。

Vascular and endovascular surgery Pub Date : 2024-11-01 Epub Date: 2024-08-20 DOI: 10.1177/15385744241276644

Ari Ettleson, Justin Robbins, Enrico Ascher, Anil Hingorani

引用次数: 0

Comprehensive Management of Thrombosed Lower Extremity Venous Aneurysms: A Single-Center Retrospective Analysis and Insights Into Clinical Strategies. 血栓性下肢静脉动脉瘤的综合治疗：单中心回顾性分析及临床策略启示。

Vascular and endovascular surgery Pub Date : 2024-11-01 Epub Date: 2024-08-22 DOI: 10.1177/15385744241276695

Sameh Alagha, Meral Ekim

{"title":"Comprehensive Management of Thrombosed Lower Extremity Venous Aneurysms: A Single-Center Retrospective Analysis and Insights Into Clinical Strategies.","authors":"Sameh Alagha, Meral Ekim","doi":"10.1177/15385744241276695","DOIUrl":"10.1177/15385744241276695","url":null,"abstract":"Objective: Venous aneurysms are rare vascular abnormalities associated with venous thromboembolism. In this study, we presented our experience in managing thrombosed lower extremity venous aneurysms and evaluate the impact of vitamin D deficiency and genetic thrombophilic risk factors on patient management and outcomes.Methods: A single-center retrospective observational analysis was conducted on ten patients with thrombosed lower limb venous aneurysms who underwent surgical procedures at our hospital from July 2014 to February 2023. Collected data included venous duplex ultrasonographic imaging and laboratory tests including genetic thrombophilic risk factors and assessments of vitamin D levels.Results: There were 5 males and 5 females. The mean age was 46.6 ± 12.1 years. The aneurysms were located in the popliteal vein in three patients, the great saphenous vein in six, and the small saphenous vein in one. Venous duplex imaging revealed saccular aneurysms in eight patients and fusiform aneurysms in two, with a mean diameter of 37.2 ± 10.6 mm, ranging from 23 to 52 mm. Laboratory tests indicated vitamin D deficiency in all of the patients, and genetic thrombophilic risk factors were identified in two cases. Surgical interventions consisted of tangential excision with lateral venorrhaphy in three patients and total excision and ligation in seven patients. The postoperative period was favorable for all patients.Conclusions: Surgical treatment of thrombosed venous aneurysms in the lower extremities is essential to prevent complications such as thromboembolism. A comprehensive approach, including knowledge of genetic risk factors and vitamin D levels, may improve patient outcomes.","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"854-861"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038156","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}

引用次数: 0

Factors that Influence Growth Rates of Abdominal Aortic Aneurysms. Analysis of a Mexican Cohort. 影响腹主动脉瘤生长速度的因素。墨西哥队列分析

Vascular and endovascular surgery Pub Date : 2024-11-01 Epub Date: 2024-07-21 DOI: 10.1177/15385744241265758

Luis O Bobadilla-Rosado, Javier E Anaya-Ayala, Eros Santos-Chavez, Julio Navarro, Ignacio Martinez-Quesada, Hugo Laparra-Escareno, Nina Mendez-Dominguez, Carlos A Hinojosa

{"title":"Factors that Influence Growth Rates of Abdominal Aortic Aneurysms. Analysis of a Mexican Cohort.","authors":"Luis O Bobadilla-Rosado, Javier E Anaya-Ayala, Eros Santos-Chavez, Julio Navarro, Ignacio Martinez-Quesada, Hugo Laparra-Escareno, Nina Mendez-Dominguez, Carlos A Hinojosa","doi":"10.1177/15385744241265758","DOIUrl":"10.1177/15385744241265758","url":null,"abstract":"Objective: Abdominal Aortic Aneurysms (AAA) growth remains a process not fully understood. The objective of this study was to analyze risk factors associated with changes in AAA diameter in a Mexican cohort.Methods: An observational study in which we analyzed the entirely of patients in which an AAA was reported in a Computed Tomography (CT) study from 2014 to 2021 who had a follow-up CT. We divided them by groups depending on the diagnosis of type 2 diabetic mellitus and pharmacological history (diabetic vs non-diabetic, metformin vs non-metformin intake and statin vs non-statin intake). We compared pre and post follow-up AAA diameters using paired t-tests. A multivariate analysis was performed in order to identify independent variables associated with an increased growth rate. Statistical analysis was performed on Stata 17.Results: During the studied period 72 (39.77%) patients had a follow-up CT. Mean age was 75 years (±9.05) and 52 (72.22%) were men. When comparing infra-renal largest diameter through time based on metformin intake, a significant difference was found only in the metformin non-intake group (42.05 ± 12.54 vs45.34 ± 12.06 [P = 0.02]), in contrast the metformin intake group measures were non-significantly different (36.13 ± 7.04 vs 37.00 ± 4.51; P = 0.57) through follow-up. In the multivariate analysis AAA largest diameter at diagnosis correlated with significantly increased growth rate (coeff = 0.06, P < 0.05).Conclusions: AAA diameters appear to change through time in a non-linear pattern influenced by different epidemiological and clinical factors. Metformin intake appears to promote a stability in AAA diameter growth in our studied population.","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"813-817"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736272","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}

引用次数: 0

Physician Modified Endograft for Ruptured Dissecting Aortic Arch Aneurysm. 治疗破裂的主动脉弓夹层动脉瘤的医生改良内移植术。

Vascular and endovascular surgery Pub Date : 2024-11-01 Epub Date: 2024-08-20 DOI: 10.1177/15385744241276599

Antonio Solano, Melissa R Keller, Jesus Porras Colon, Rhusheet Patel, Carlos H Timaran, Melissa L Kirkwood, M Shadman Baig

{"title":"Physician Modified Endograft for Ruptured Dissecting Aortic Arch Aneurysm.","authors":"Antonio Solano, Melissa R Keller, Jesus Porras Colon, Rhusheet Patel, Carlos H Timaran, Melissa L Kirkwood, M Shadman Baig","doi":"10.1177/15385744241276599","DOIUrl":"10.1177/15385744241276599","url":null,"abstract":"Background: Endovascular repair of thoracic aortic aneurysms (TAA) in elective settings has demonstrated successful clinical outcomes. However, life-threatening conditions such as rupture are more often managed with open surgical repair due to the high complexity of arch endovascular repair, lack of available off-the-shelf devices, and limited long-term data.Case summary: A 49-year-old female with a recent history of prior ascending aortic repair for Type A10 aortic dissection presented with chest pain and dyspnea. Chest computed tomography angiogram (CTA) revealed acute bilateral pulmonary emboli and a 6.2 cm post dissection aneurysm of the posterior aortic arch with the dissection extending to the right iliac artery. She was treated with thrombolysis and subsequently became hemodynamically unstable. Repeat CTA revealed a massive left hemithorax with concern for aortic arch rupture. Given significant cardiorespiratory compromise and recent open repair, she was considered unfit for redo open repair. Thoracic endovascular aortic repair (TEVAR) with a physician-modified endograft (PMEG) was planned. An Alpha Zenith endograft was modified adding an internal branch for the innominate artery and a fenestration for the left common carotid artery. The left subclavian artery was occluded with a microvascular plug and coil embolization up to the level of the vertebral artery. TEVAR PMEG extension to the celiac artery was performed followed by deployment of a Zenith dissection stent to the aortic bifurcation. Completion angiogram demonstrated successful aneurysm exclusion and patency of target vessels.Conclusion: Endovascular treatment of ruptured TAA with PMEGs is feasible. This approach may be an alternative for unfit patients for open repair in emergent settings.","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"876-883"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010178","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}

引用次数: 0

Optimizing Surgical Choices of Renal Artery Aneurysm With Sequential Use of "Two-Click AVA" Technique and FlightPlan for Embolization: A Report of Two Cases. 使用 "双击 AVA "技术和 FlightPlan 进行栓塞，优化肾动脉动脉瘤的手术选择：两个病例的报告。

Vascular and endovascular surgery Pub Date : 2024-11-01 Epub Date: 2024-08-22 DOI: 10.1177/15385744241276704

Siting Li, Fangda Li, Rong Zeng, Xiaolong Liu, Zhili Liu, Yuehong Zheng

{"title":"Optimizing Surgical Choices of Renal Artery Aneurysm With Sequential Use of \"Two-Click AVA\" Technique and FlightPlan for Embolization: A Report of Two Cases.","authors":"Siting Li, Fangda Li, Rong Zeng, Xiaolong Liu, Zhili Liu, Yuehong Zheng","doi":"10.1177/15385744241276704","DOIUrl":"10.1177/15385744241276704","url":null,"abstract":"Background: Selecting intervention strategies for renal artery aneurysms (RAAs) is challenging especially for those located at the vessel bifurcation. The relationship between the aneurysm and renal branches could not always be accurately viewed from traditional computed tomography angiography (CTA) images.Case presentation: This study proposed a new method to investigate the anatomy and affected vessel branches of RAAs using automated software. Two patients with RAAs located at the renal artery bifurcation underwent Cone beam CTA (CBCTA) analysis. We sequentially coupled the \"two-click AVA\" function of Vessel IQ Xpress (GE Healthcare) with the \"vascular tree extraction\" function from FlightPlan for Embolization (GE Healthcare) to evaluate the relationship among the main renal artery, vessel branches, and aneurysms. The results showed that one patient had 1 out of 3 branches affected by the aneurysm, whereas the other's branches were all affected. Endovascular repair and open surgery were performed respectively based on the image analysis. Both patients recovered well at follow-up examination.Conclusions: Based on CBCTA analysis, the combination use of the \"two-click AVA\" function of VesselIQ Xpress and FlightPlan for Embolization software could assist in aneurysm assessment and intervention choices for RAAs.","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"888-893"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142020077","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}

引用次数: 0

A Comparison of Outcome in Patient With and Without Undergoing Cardiopulmonary Exercise Testing (CPET). 接受和未接受心肺运动测试 (CPET) 患者的结果比较。

Vascular and endovascular surgery Pub Date : 2024-11-01 Epub Date: 2024-08-22 DOI: 10.1177/15385744241277053

Pushpa Veeralakshmanan, Maciej Juszczak, Alok Tiwari

{"title":"A Comparison of Outcome in Patient With and Without Undergoing Cardiopulmonary Exercise Testing (CPET).","authors":"Pushpa Veeralakshmanan, Maciej Juszczak, Alok Tiwari","doi":"10.1177/15385744241277053","DOIUrl":"10.1177/15385744241277053","url":null,"abstract":"Background: Cardiopulmonary exercise testing (CPET) is a preoperative risk stratification tool providing an objective measure of fitness and functional capacity. There is however little evidence on the use of this compared to non-physiological test in vascular surgery despite its current use. This study investigates whether CPET perioperatively has value alongside non-physiological testing for patients undergoing elective open abdominal aortic aneurysm (AAA) repair.Method: Retrospective data was collected at 2 vascular centres between 2015-2019 in a CPET centre vs non-CPET centre in patients undergoing elective AAA repair. Outcomes measured included: length of stay in an intensive care unit (ICU); total length of stay; post-operative complications and acute kidney injury (AKI). Statistical analysis was performed using IBM SPSS software.Results: There were 38 patients at each centre. The mean duration of stay in ICU for patients in CPET centre was 2.5 ± 2.13 days whilst in non-CPET centre it was 3.68 ± 4.08 days (P = 0.05). The mean duration of stay in ICU and total length of stay was significantly shorter in CPET centre (P = 0.05 and P = 0.015 respectively). Mortality in CPET centre was 2.63% and 5.26% in non-CPET centre (not significant). The number of patients developing AKI post-operatively was 13.61% in CPET vs 28.95% in non-CPET centre.Conclusion: CPET tested patients have statistically significant lower length of total and ICU stay compared to non-CPET patients. CPET is therefore a useful adjunct in selecting patients for open surgery compared to non-physiological testing. This study provides some evidence on the use of this routinely but not validated assessment tool in aortic aneurysm repair.","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"862-865"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142020055","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}

引用次数: 0