EJVES Vascular Forum最新文献

英文中文

Bilateral Transankle Intervention as a Critical Determinant of Successful Revascularisation in Complex Peripheral Arterial Disease 双侧经踝介入是复杂外周动脉疾病血管重建成功的关键因素

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.07.038

Introduction

Establishing optimal vascular access sites is important for the procedural success of endovascular treatment (EVT) and the patient's comfort afterwards. Among the variety of vascular access sites, the transankle intervention (TAI) has been used more recently; however, there have been no reports of complex lower extremity arterial disease lesions treated with the TAI manoeuvre.

Report

An 82 year old man with chronic limb threatening ischaemia in both lower extremities underwent EVT for bilateral long segment occlusion from the iliac arteries to the superficial femoral artery (SFA). The right posterior tibial artery was punctured under extravascular ultrasound guidance and a Parent Select 5082 guide sheath was inserted. The guidewire was manipulated under intravascular ultrasound (IVUS) guidance. When the first guidewire entered the subintimal space, the second guidewire was manipulated to advance through the intraplaque route, while monitoring it using IVUS. The intraluminal space of the right common iliac artery was reached by repeating these procedures. A self expandable stent was deployed in the external iliac artery and drug coated balloons were inflated from the common femoral artery to the SFA; good vascular patency and favourable blood flow were confirmed. Subsequently, a similar TAI procedure was performed from the left dorsalis pedis artery, and successful revascularisation was achieved from the left common iliac artery to the SFA. After revascularisation, the persistent pain disappeared in the right lower limb and the wound healed favourably in the left lower limb.

Conclusion

In this case of complex chronic limb threatening ischaemia, the TAI strategy worked favourably for successful revascularisation. Transankle intervention can provide various advantages for successful EVT.

导言建立最佳的血管通路对于血管内治疗（EVT）的手术成功和患者术后的舒适度非常重要。在各种血管入路部位中，经踝介入（TAI）最近得到了较多的应用；然而，目前还没有关于用TAI手法治疗复杂的下肢动脉疾病病变的报道。报告一名82岁的男性患者因双下肢慢性肢体缺血而接受了EVT治疗，该患者双侧髂动脉至股浅动脉（SFA）长段闭塞。在血管外超声引导下穿刺右侧胫后动脉，插入 Parent Select 5082 导丝鞘。在血管内超声（IVUS）引导下操作导丝。当第一根导丝进入内膜下间隙时，操纵第二根导丝通过斑块内路径前进，同时使用 IVUS 进行监测。重复这些步骤后，右侧髂总动脉的腔内空间就到达了。在髂外动脉部署了自膨胀支架，并从股总动脉向SFA充气，确认了良好的血管通畅性和良好的血流。随后，又从左脚背动脉进行了类似的 TAI 手术，并成功实现了从左髂总动脉到 SFA 的血管再通。结论在这例复杂的慢性肢体威胁性缺血病例中，经踝关节置换术（TAI）成功实现了血管再通。经踝介入可为成功的 EVT 提供各种优势。

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引用次数: 0

Concave Margin Sign on Doppler Ultrasound 多普勒超声显示凹缘征象

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.002

Rémy Hamdan, Mélanie Leboffe

引用次数: 0

Reducing the Length of Stay Following Carotid Endarterectomy by Implementing a Standardised Post-Operative Pathway 通过实施标准化术后路径缩短颈动脉内膜切除术后的住院时间

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.024

Mohamed ElKorety , Afifa Naseer , PA Sandeep Kini-bailur , Mohamed Elshaikh ∗ , Girish Girish

引用次数: 0

SVS/AAVS Grading for Pulmonary Status and Contemporary Outcomes of Elective Endovascular Aortic Aneurysm Repair SVS/AAVS 肺部状态分级和选择性血管内主动脉瘤修复术的当代疗效

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.067

Lara Dias ∗ , Leandro Nóbrega , José Oliveira-Pinto (Prof.) , Armando Mansilha (Prof.)

引用次数: 0

Delay to CEA 延迟至 CEA

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.015

Christopher Nwatuzor ∗ , Syed Maaz

引用次数: 0

Evolution of the Inflammatory Markers in Patients with Chronic Limb Threatening Ischemia 慢性肢体缺血患者炎症标志物的变化

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.058

Joana Ferreira ∗ , Alexandre Carneiro , Isabel Vila , Adhemar Longatto-Filho (Prof) , Jorge Cotter (Prof.) , Margarida Correia-Neves (Prof.) , Pedro Cunha (Prof.) , Armando Mansilha (Prof.)

引用次数: 0

Accessory Renal Arteries Role In Endovascular Treatment Of Abdominal Aorta Aneurysms 附属肾动脉在腹主动脉瘤血管内治疗中的作用

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.045

Alessia Di Girolamo ∗ , Wassim Mansour , Chiara Pranteda , Pasqualino Sirignano , Maurizio Taurino , Luca di Marzo

引用次数: 0

First Rib Resection Using Videothoracoscopy in Patients With Vascular Thoracic Outlet Syndrome 使用视频胸腔镜为血管性胸廓出口综合征患者进行第一肋骨切除术

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.06.004

Objective

Thoracic outlet syndrome (TOS) comprises a series of signs and symptoms produced by compression of neurovascular structures in any of the anatomical spaces of the thoracic outlet. First rib resection is a therapeutic alternative to decompress the structures of the thoracic outlet at the costoclavicular space. Traditional surgical approaches include transaxillary, supraclavicular, and infraclavicular access. The objective was to describe the surgical experience and follow up results of first rib resection using video assisted thoracoscopic surgery (VATS) in patients with vascular TOS.

Methods

Observational descriptive study based on a retrospective single centre analysis of a prospective database. Patients diagnosed with vascular TOS who underwent VATS first rib resection from January 2017 to December 2023 were included. The diagnosis for each subtype was based on the criteria defined in the standards of the American Society for Vascular Surgery in TOS. Among other things, the response to initial anticoagulation, peri-operative data, complications, symptom improvement, duration of post-operative anticoagulation, and symptom recurrence were investigated.

Results

Twenty nine patients diagnosed with vascular TOS who underwent VATS first rib resection, three of whom had bilateral procedures, were included. The total number of costal rib resections performed was 32 (31 venous TOS and one arterial TOS). The mean age was 29.1 ± 10.4 years and mean hospital stay was 2.7 ± 1.2 days. There were neither conversions to open surgery nor intra-operative complications, but there were two major post-operative complications (6.25%). No recurrences were detected during midterm follow up (median of 17.9 months, interquartile range 7.3, 45).

Conclusion

VATS first rib resection is a safe and feasible procedure. Unlike traditional approaches, this procedure allows physicians to make the resection under complete vision of the anatomical structures of the thoracic outlet reducing intra-operative complications and, if necessary, entire rib resection can be performed.

目的胸廓出口综合征（TOS）由胸廓出口解剖空间内的神经血管结构受压所产生的一系列体征和症状组成。第一肋骨切除术是对肋锁间隙的胸廓出口结构进行减压的一种治疗方法。传统的手术方法包括经腋窝、锁骨上和锁骨下入路。目的是描述血管性 TOS 患者使用视频辅助胸腔镜手术（VATS）进行第一肋骨切除的手术经验和随访结果。方法基于前瞻性数据库的单中心回顾性分析进行观察描述性研究。纳入2017年1月至2023年12月期间接受VATS第一肋骨切除术的确诊为血管性TOS的患者。每种亚型的诊断均基于美国血管外科学会 TOS 标准中定义的标准。除其他外，还调查了患者对初始抗凝的反应、围手术期数据、并发症、症状改善情况、术后抗凝持续时间以及症状复发情况。肋骨切除术总数为 32 例（31 例静脉 TOS 和 1 例动脉 TOS）。平均年龄为（29.1±10.4）岁，平均住院时间为（2.7±1.2）天。患者既没有转为开放手术，也没有出现术中并发症，但术后出现了两种主要并发症（6.25%）。结论VATS第一肋骨切除术是一种安全可行的手术。与传统方法不同，该手术允许医生在胸廓出口解剖结构的完整视野下进行切除，减少了术中并发症，如有必要，还可进行整条肋骨切除。

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引用次数: 0

Video Assisted Thoracoscopic Surgery: A Tool to Consider in Vascular Thoracic Outlet Syndrome Treatment 视频辅助胸腔镜手术：血管性胸廓出口综合征治疗中应考虑的工具

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.07.039

引用次数: 0

Acute Lower Limb Ischaemia as a Presenting Sign of Atrial Myxoma: Case Report and Scoping Review of the Literature 急性下肢缺血是心房肌瘤的先兆：病例报告和文献综述

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.07.036

Objective

Cardiac myxomas (CMs) are the most common primary cardiac tumour in adults. They are a rare cause of peripheral embolisation and may present as acute lower limb ischaemia (ALI). A scoping review was undertaken and a case of ALI due to CM embolisation is presented in this paper.

Methods

MEDLINE, Scopus, and Embase were systematically searched for studies reporting data on ALI as a presentation of CM embolisation. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) was followed.

Results

A healthy 26 year old female presented to the emergency department with bilateral ALI. Urgent bilateral aorto-iliac embolectomy and distal embolectomy of the left femoropopliteal axis were performed. The retrieved embolic material exhibited a yellowish appearance and jelly like consistency, and histological analysis provided a diagnosis of a myxomatous embolus. Transoesophageal echocardiography confirmed the left atrial origin of a myxomatous tumour, but the residual mass was considered too small for further excision. At a two year clinical follow up, the patient was alive and well without recurrence. Between 1989 and 2023, 59 patients with ALI due to CM embolisation were identified in the literature. An in hospital mortality rate of 12.1% (n = 7) was reported, while the in hospital complication and re-intervention rates were 34.5% (n = 20) and 27.6% (n = 16), respectively. No post-discharge deaths, complications, or re-interventions were reported; fasciotomies were the most reported (n = 10). Post-discharge follow up was reported in 22 (37.3%) patients. Mean follow up was 18.0 ± 18.8 months (range 1–120), and 86.4% of patients (n = 19) were alive and well at last follow up.

Conclusion

This review and the associated case report underline that CM embolisation should be considered in healthy young patients presenting with cryptogenic ALI. Early transoesophageal echocardiography and histological analysis of the retrieved embolus are recommended to minimise misdiagnosis in these populations.

目的心脏肌瘤（CMs）是成人最常见的原发性心脏肿瘤。它们是外周栓塞的罕见原因，可能表现为急性下肢缺血（ALI）。本文对该病例进行了范围审查，并介绍了一例因CM栓塞引起的ALI病例。方法：系统检索了MEDLINE、Scopus和Embase，以查找报告因CM栓塞引起ALI的研究数据。结果一名26岁的健康女性因双侧ALI到急诊科就诊。急诊科为她进行了双侧髂主动脉栓子切除术和左股骨盆轴远端栓子切除术。取出的栓塞物外观呈淡黄色，呈果冻状，组织学分析诊断为肌瘤性栓塞。经食道超声心动图证实肌瘤起源于左心房，但认为残留肿块太小，无法进一步切除。在两年的临床随访中，患者生存良好，没有复发。1989 年至 2023 年间，文献中发现了 59 例因 CM 栓塞导致 ALI 的患者。据报道，住院死亡率为 12.1%（7 例），住院并发症和再次介入率分别为 34.5%（20 例）和 27.6%（16 例）。没有出院后死亡、并发症或再次干预的报告；筋膜切开术的报告最多（10 例）。22例（37.3%）患者接受了出院后随访。平均随访时间为 18.0 ± 18.8 个月（1-120 个月），86.4% 的患者（19 人）在最后一次随访时仍健在。建议尽早进行经食道超声心动图检查和对取出的栓子进行组织学分析，以尽量减少对这些人群的误诊。

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