EJVES Vascular Forum最新文献

英文中文

Type III Arch Angulation Increases Aortic Pulse Wave Velocity in an Ex Vivo Porcine Model 在猪体内模型中，Ⅲ型弓成角可提高主动脉脉搏波速度

IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.034

Tim Mandigers ∗ , Ariel Pascaner , Michele Conti , Martina Schembri , Sonja Jelic , Daniele Bissacco , Maurizio Domanin , Joost Van Herwaarden , Ferdinando Auricchio , Santi Trimarchia

引用次数: 0

A Rare Case of Upper Limb Phlegmasia Cerulea Dolens 一个罕见的多发性上肢痰症病例

IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.049

Leandro Nóbrega ∗ , Lara Dias , José Almeida Lopes , Pedro Paz Dias , Sofia Silva , Armando Mansilha

引用次数: 0

Open E-survey on the Use and Perception of Chatbots in Vascular Surgery 关于聊天机器人在血管外科中的使用和认知的公开电子调查

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.07.037

Fabien Lareyre , Mario D'Oria , Caroline Caradu , Vincent Jongkind , Gilles Di Lorenzo , Matthew R. Smeds , Bahaa Nasr , Juliette Raffort

Objective

Large language models and artificial intelligence (AI) based chatbots have brought new insights in healthcare, but they also raise major concerns. Their applications in vascular surgery have scarcely been investigated to date. This international survey aimed to evaluate the perceptions and feedback from vascular surgeons on the use of AI chatbots in vascular surgery.

Methods

This international open e-survey comprised 50 items that covered participant characteristics, their perceptions on the use of AI chatbots in vascular surgery, and their user experience. The study was designed in accordance with the Checklist for reporting Results of Internet E-Surveys and was critically reviewed and approved by international members of the European Vascular Research Collaborative (EVRC) prior to distribution. Participation was open to self reported health professionals specialised (or specialising) in vascular surgery, including residents or fellows.

Results

Of the 342 individuals who visited the survey page, 318 (93%) agreed to participate; 262 (82.4%) finished the survey and were included in the analysis. Most were consultants or attending physicians (64.1%), most declared not having any training or education related to AI in healthcare (221; 84.4%), and 198 (75.6%) rated their knowledge about the abilities of AI chatbots between average to very poor. Interestingly, 95 participants (36.3%) found that AI chatbots were very useful or somewhat useful in clinical practice at this stage and 229 (87.4%) agreed that they should be systematically validated prior to being used. Eighty participants (30.5%) had specifically tested it for questions related to clinical practice and 59 (73.8%) of them experienced issues or limitations.

Conclusion

This international survey provides an overview of perceptions of AI chatbots by vascular surgeons and highlights the need to improve knowledge and training of health professionals to better evaluate, define, and implement their use in vascular surgery.

目标基于大型语言模型和人工智能（AI）的聊天机器人为医疗保健领域带来了新的见解，但也引发了重大问题。迄今为止，对其在血管外科中的应用还很少进行调查。这项国际调查旨在评估血管外科医生对人工智能聊天机器人在血管外科中应用的看法和反馈。方法这项国际开放式电子调查包括 50 个项目，涵盖参与者的特征、他们对人工智能聊天机器人在血管外科中应用的看法以及他们的用户体验。本研究根据互联网电子调查结果报告核对表进行设计，并在发布前经过欧洲血管研究合作组织 (EVRC) 国际成员的严格审核和批准。在访问调查页面的 342 人中，318 人（93%）同意参与调查；262 人（82.4%）完成了调查并被纳入分析。大多数人是顾问或主治医师（64.1%），大多数人声称没有接受过任何与医疗保健领域人工智能相关的培训或教育（221 人，84.4%），198 人（75.6%）将自己对人工智能聊天机器人能力的了解评为一般到很差。有趣的是，95 位参与者（36.3%）认为人工智能聊天机器人在现阶段的临床实践中非常有用或有点用，229 位参与者（87.4%）同意在使用前应对其进行系统验证。80名参与者（30.5%）专门针对与临床实践相关的问题进行了测试，其中59名参与者（73.8%）遇到了问题或限制。

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引用次数: 0

Exploring the Differences in Skeletal Muscle Between Patients with Chronic Limb-Threatening Ischemia and Claudication 探索慢性肢体缺血和跛行患者骨骼肌的差异

IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.068

Joana Ferreira ∗ , Adhemar Longatto-Filho (Prof) , Julieta Afonso (Prof) , Susana Roque (Prof) , Alexandre Carneiro , Isabel Vila , Pedro Cunha (Prof) , Armando Mansilha (Prof)

引用次数: 0

Optical Coherence Tomography as Therapeutic Imaging Modality in Intravascular Lithotripsy of Human Peripheral Vasculature 将光学相干断层成像技术作为人体外周血管血管内碎石术的治疗成像模式

IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.014

Rohit Mehra ∗ , Vikram Patra , Rishi Dhillan

引用次数: 0

Influence of Clinical Status and Dissection Morphology on Transfusion Volume in Acute Aortic Dissection Surgery 急性主动脉夹层手术中临床状态和夹层形态对输血量的影响

IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.011

Yohnosuke Wada ∗ , Naoyuki Kimura , Mitsunori Nakano , Yohei Nomura , Daijiro Hori , Manabu Shiraishi , Atsushi Yamaguchi

引用次数: 0

Area Based Analysis of Long Term Aortic Remodelling After Endovascular Repair for Type B Aortic Dissection B 型主动脉夹层血管内修复术后主动脉长期重塑的区域分析

IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.037

Kun Fang ∗ , Jiawei Zhao , Zhongze Cao , Mingyao Luo , Hui Wang , Tun Wang , Chang Shu

引用次数: 0

IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.038

Eugenio Martelli ∗ , Matilde Zamboni , Giovanni Sotgiu , Laura Saderi , Massimo Federici , Giuseppe Sangiorgi , Mariangela Valentina Puci , Allegra Rosa Martelli , Teresa Messina , Paolo Frigatti , Maria Pia Borrelli , Carlo Ruotolo , Ilaria Ficarelli , Paolo Rubino , Francesco Pezzo , Luciano Carbonari , Andrea Angelini , Edoardo Galeazzi , Luca Calia di Pinto , Franco Michelino Fiore , Alberto Maria Settembrini

引用次数: 0

Primary Aorto-Enteric Fistula With a Subsequent Secondary Aorto-Enteric Fistula 原发性肠主动脉瘘伴继发性肠主动脉瘘

IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.05.005

Iris Kärjä , Venla Soini , Olli Hautero , Maarit Venermo

Objective

Primary aorto-enteral fistula (PAEF) is a connection between the gastrointestinal tract and the aorta that occurs without previous aortic surgery. The aetiological factors include, but are not limited to, aneurysm, infection, and tumours. It is a life threatening condition if untreated and requires emergency vascular surgical repair. A secondary aorto-enteric fistula (AEF) can occur to a previously reconstructed aorta. This case report presents a unique case of a male patient who developed a primary AEF and subsequent secondary AEF with successful surgical outcomes, suggested to be due to tuberculous aortitis.

Report

The patient was diagnosed and treated for tuberculosis and developed a saccular aneurysm within six months. The PAEF was surgically corrected with a tube graft using a bovine pericardial patch, the defect in duodenum was sutured, and a retrocolic omental flap was created between the duodenum and aorta. He developed a small stable pseudoaneurysm during follow up, and then a secondary AEF two and a half years later, in which a connection between the pseudoaneurysm and duodenum was corrected using a new bovine aorto–aortic interposition graft using a bovine pericardium patch. The defect in the duodenum was also sutured in two layers and a new omental flap was created.

Discussion

The mortality rate of AEF is high and it is very unlikely that a patient will survive two AEFs without major complications. It is believed that there are extremely few double AEF cases described in the literature. The aetiological factor in the development of PAEF in this case was most likely the patient's aortic aneurysm, which was most likely of mycotic origin due to tuberculosis. The patient developed a pseudoaneurysm during follow up and it is uncertain whether the pulsatile pressure of the pseudoaneurysm led to the recurrence of the AEF.

目的原发性主动脉-肠瘘（PAEF）是指胃肠道与主动脉之间的连接，这种连接以前未做过主动脉手术。致病因素包括但不限于动脉瘤、感染和肿瘤。如果不及时治疗，会危及生命，需要进行紧急血管手术修复。继发性主动脉-肠瘘（AEF）可能发生在之前重建的主动脉上。本病例报告介绍了一例独特的男性患者病例，该患者被诊断为结核性大动脉炎，并接受了结核性大动脉炎的治疗，在六个月内出现了囊状动脉瘤。手术用牛心包补片管状移植矫正了 PAEF，缝合了十二指肠缺损，并在十二指肠和主动脉之间制作了结肠网膜瓣。在随访期间，他出现了一个稳定的小假性动脉瘤，两年半后又出现了继发性 AEF，在这种情况下，使用了一个新的牛主动脉插管移植，并使用牛心包补片矫正了假性动脉瘤和十二指肠之间的连接。十二指肠的缺损也被缝合成两层，并制作了一个新的网膜瓣。讨论AEF的死亡率很高，患者不太可能在两次AEF中都存活下来而不出现重大并发症。据信，文献中描述的双 AEF 病例极少。该病例发生 PAEF 的病因很可能是患者的主动脉瘤，而主动脉瘤很可能是结核引起的霉菌性动脉瘤。患者在随访期间出现了假性动脉瘤，目前还不能确定假性动脉瘤的搏动压力是否导致了 PAEF 的复发。

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引用次数: 0

Salvage Aneurysmorrhaphy as an Adaptable and Still Pertinent Technique in the Management of Challenging True Aneurysms of Arteriovenous Fistulas: A Case Series of Different Variations, With Illustrative Surgical Pictures 动脉瘤夹闭术是治疗动静脉瘘真性动脉瘤的一种灵活而又实用的技术：不同变异的病例系列，附手术插图

IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.05.002

Homa Pourriyahi , Homayoun Pourriahi , Hossein Najd Sepas

Introduction

Aneurysmorrhaphy, described as reduction aneurysmoplasty, partial aneurysmectomy, or vessel wall recalibration, can be considered a suitable surgical plan for true aneurysms of arteriovenous fistulas (AVFs), allowing for a dynamic approach to reconstruction of aneurysmal AVFs of different severities, ensuring salvage of the native access.

Report

Six challenging cases of AVF aneurysms are presented, some with extremely dilated and tortuous megafistulas, for which three surgical technique variations were performed. The patients had a mean age of 59.2 years, 50% were female, with brachiocephalic (n = 5, 83.3%) or brachiobasilic (n = 1, 16.7%) AVFs. The fistulas were created an average of 4.67 years previously, and the aneurysms had an average maximum diameter of 37.5 mm (range 25–60 mm). Surgical indications were rupture risk, thrombosis, or outflow stenosis compromising haemodialysis, infections, and concerns for quality of life (affected by post-puncture bleedings, disfiguring aesthetics, pain, and discomfort). The surgical techniques were simple aneurysmorrhaphy (n = 3, 50%), aneurysmorrhaphy with partial excision of aneurysmal segment with end to end anastomosis of venous ends (n = 2, 33.3%), and aneurysmorrhaphy with establishment of new venous outflow (n = 1, 16.7%). All AVFs were patent post-operatively and at follow up (mean 5.6 months, median one month). Haemodialysis was resumed through the AVFs at a mean of 2.17 weeks post-operatively, with placement of an alternative route for haemodialysis in the meantime. No patients experienced post-operative complications.

Discussion

Experience with the more challenging cases shows that aneurysmorrhaphy can still be considered an acceptable, flexible, and pertinent method for salvage of megafistulas, giving the surgeon the much needed versatility to adapt to anatomical and pathological variations, with high patency rates and minimal complications, especially when other treatment options are not possible in complicated cases. AVF salvage through aneurysmorrhaphy allows for a dynamic approach to the reconstruction of severely tortuous, dilated veins, ensuring patency of the native AVF.

导言：动脉瘤切除术被描述为缩小动脉瘤成形术、部分动脉瘤切除术或血管壁重新校准术，可被视为治疗动静脉瘘（AVF）真性动脉瘤的合适手术方案，可采用动态方法重建不同严重程度的动脉瘤性动静脉瘘，确保挽救原生通路。报告介绍了六例具有挑战性的动静脉瘘动脉瘤病例，其中一些病例的巨瘘管极度扩张和迂曲，对这些病例采用了三种不同的手术技巧。患者的平均年龄为 59.2 岁，50% 为女性，患有肱动脉（5 例，83.3%）或肱动脉（1 例，16.7%）。瘘管平均创建于 4.67 年前，动脉瘤的平均最大直径为 37.5 毫米（范围为 25-60 毫米）。手术适应症包括破裂风险、血栓形成或流出道狭窄，从而影响血液透析、感染和生活质量（受穿刺后出血、影响美观、疼痛和不适的影响）。手术方法包括单纯动脉瘤夹闭术（3 例，50%）、动脉瘤夹闭术，部分切除动脉瘤段，静脉端端吻合（2 例，33.3%），以及动脉瘤夹闭术，建立新的静脉流出（1 例，16.7%）。术后和随访期间（平均 5.6 个月，中位一个月），所有动静脉瘘均通畅。在术后平均 2.17 周时，通过动静脉瘘恢复了血液透析，并在此期间安置了血液透析的替代途径。讨论从较具挑战性的病例中获得的经验表明，动脉瘤夹闭术仍可被视为一种可接受的、灵活的和相关的巨瘘抢救方法，为外科医生提供了所需的多功能性，以适应解剖和病理上的变化，同时具有较高的通畅率和最低的并发症，尤其是在复杂病例中无法采用其他治疗方案时。通过动脉瘤切除术挽救动静脉瘘，可以对严重迂曲、扩张的静脉进行动态重建，确保原生动静脉瘘的通畅。

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引用次数: 0

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