EJVES Vascular Forum最新文献

英文中文

Repair of Contained Rupture of an Infrarenal Aortic Aneurysm Using Autologous Superficial Femoral Vein 利用自体股浅静脉修复肾下主动脉瘤的局限性破裂

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.09.003

Dagim Leykun Berhanu, Benjamin Guarken Chiman, Biruk Woisha Bogale

Introduction

Contained ruptured abdominal aortic aneurysm (CR-AAA) refers to an acute aortic wall disruption leading to expansion of perivascular haematoma that is sealed off by peri-aortic structures. Low and middle income countries have a critical gap in managing abdominal aortic aneurysm (AAA). In Ethiopia, AAA screening is not routine and open surgical repair (OSR) using donated grafts remains the only treatment option. This case shows the first experience at Hawassa University Hospital treating CR-AAA using the superficial femoral vein (SFV) for aortic reconstruction due to lack of prosthetic grafts.

Report

A 40 year old woman presented with three months of abdominal and back pain, vomiting, and a pulsatile abdominal swelling. Imaging showed an 8 cm infrarenal CR-AAA. Due to lack of graft material, a 15 cm SFV was harvested from the left thigh and prepared as a tube graft. OSR via midline laparotomy revealed a 3 cm rupture on the right lateral aortic wall. The reversed SFV graft was anastomosed proximally to the infrarenal aorta, 3 cm below the renal artery, using a 3–0 Prolene suture. Distally, the graft was spatulated for optimal size matching and sewn with a 3–0 Prolene suture at the aortic bifurcation. The procedure lasted 10 hours. Due to the lack of a Cell Saver at the centre, 4 units of whole blood and 4 units of fresh frozen plasma were transfused. Post-operatively, the patient developed bilateral lower extremity swelling, and ultrasound revealed bilateral deep venous thrombosis. Oral anticoagulation was promptly initiated. Follow up imaging confirmed an intact anastomosis with good distal flow. The patient showed clinical improvement in leg swelling at one and three month follow ups. She is scheduled for a six month follow up and will continue regular monitoring.

Discussion

SFV use in ruptured AAA shows promise in resource limited settings. Sub-Saharan Africa's unique AAA patterns highlight specific healthcare needs. Global collaboration is vital to expand vascular care, funding, and research for better AAA treatment.

导言腹主动脉瘤（Contained ruptured abdominal aortic aneurysm，CR-AAA）是指主动脉壁急性破裂导致血管周围血肿扩大，并被主动脉周围结构封闭。中低收入国家在管理腹主动脉瘤（AAA）方面存在严重差距。在埃塞俄比亚，腹主动脉瘤筛查并非常规做法，使用捐赠移植物进行开放手术修复（OSR）仍是唯一的治疗选择。本病例展示了哈瓦萨大学医院因缺乏人工移植物而使用股浅静脉（SFV）进行主动脉重建治疗 CR-AAA 的首次经验。报告一名 40 岁女性因腹部和背部疼痛、呕吐和腹部搏动性肿胀就诊三个月。影像学检查显示其肾下有一条 8 厘米长的 CR-AAA。由于缺乏移植材料，医生从左大腿处采集了一条 15 厘米长的 SFV，并将其准备为管道移植。通过中线开腹手术进行OSR，发现右侧主动脉壁有一处3厘米长的破裂。使用 3-0 Prolene 缝线将反向 SFV 移植物近端与肾动脉下方 3 厘米处的肾下主动脉吻合。在远端，对移植物进行spatulated以获得最佳尺寸匹配，并在主动脉分叉处用 3-0 Prolene 缝线缝合。手术持续了 10 个小时。由于该中心没有细胞保存机，因此输注了 4 个单位的全血和 4 个单位的新鲜冰冻血浆。术后，患者出现双下肢肿胀，超声检查发现双侧深静脉血栓形成。随即开始口服抗凝药。随访造影证实吻合完好，远端血流通畅。在一个月和三个月的随访中，患者腿部肿胀的临床症状有所改善。讨论在资源有限的情况下，SFV 用于治疗破裂的 AAA 显现出了前景。撒哈拉以南非洲独特的 AAA 模式凸显了特殊的医疗保健需求。全球合作对于扩大血管护理、资金和研究范围以改善 AAA 治疗至关重要。

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18F-NAF PET-MRI in Patients Undergoing Carotid Endarterectomy: Correlation With Ex Vivo Imaging and Histology 颈动脉内膜切除术患者的 18F-NAF PET-MRI：与体内外成像和组织学的相关性

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EJVES Vascular Forum

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Use of Natural Language Processing for Identification of Aortic Dissection on Radiology Reports: Petticoat Study. Feasibility Phase 使用自然语言处理技术识别放射报告中的主动脉夹层：Petticoat 研究。可行性阶段

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EJVES Vascular Forum

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Altered Lipidomic Profile of Atheroprotective and Atherogenic Serum Lipoproteins in Patients With Peripheral Artery Disease 外周动脉疾病患者血清中保护动脉粥样硬化和致动脉粥样硬化脂蛋白的脂质组学特征改变

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

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K. Batzalexis ∗ , C. Kostara , G. Kouvelos , C. Karathanos , G. Volakakis , K. Spanos , E. Bairaktari , A. Giannoukas

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The Impact of the Inflammatory Ratios Neutrophil To Lymphocyte Ratio, Monocyte To Lymphocyte Ratio, Platelet To Lymphocyte Ratio on Abdominal Aortic Aneurysm Growth 炎症比率中性粒细胞与淋巴细胞比率、单核细胞与淋巴细胞比率、血小板与淋巴细胞比率对腹主动脉瘤生长的影响

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.07.031

M. Stevanov ∗ , P. Konstantiniuk , T. Cohnert , R.H. Portugaller

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IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.07.007

B. Ravindhran ∗ , J. Prosser , A. Lim , B. Mishra , R. Lathan , L. Hitchman , G. Smith , D. Carradice , D. Thakker , S. Pymer , I. Chetter

引用次数: 0

Relationship Between Intraluminal Thrombus Volume and Circulating ADAMTS-13 Activity in Abdominal Aortic Aneurysms 腹主动脉瘤腔内血栓体积与循环 ADAMTS-13 活性之间的关系

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.07.040

Qasam M. Ghulam , Jens P. Goetze , Nikolaj Eldrup , Jonas P. Eiberg

Introduction

Abdominal aortic aneurysms (AAAs) with intraluminal thrombus (ILT) are suggested to be more prone to rupture than AAAs without. Prior studies indicate that the von Willebrand factor (vWf) plays a role in the formation of ILT since a positive correlation between ILT volume and vWf has been shown. vWf mediates the tethering of platelets at sites of endothelial injury, and the protease ADAMTS-13 cleaves larger forms of vWf, thus counteracting the thrombosis cascade and maintaining haemostatic balance. When investigating the largest quantifiable thrombus in the human body, it was hypothesised that circulating ADAMTS-13 activity may be associated with ILT size in patients with AAA and the aim was to explore this potential relationship using 3D contrast enhanced ultrasound (3D-CEUS) for ILT volume determination.

Report

In this retrospective, exploratory study, 60 patients with AAA were evaluated, and the association between ILT volume and thickness and ADAMTS-13 was estimated using 3D-CEUS. ADAMTS-13 activity was measured in plasma samples obtained the same day. No association between ILT volume (r = −0.03, p = 0.84) or ILT thickness (r = 0.02, p = 0.87) and ADAMTS-13 activity was found. Likewise, when subdividing the group into lowest and highest 50% of ADAMTS-13 activity, the half with the lowest ADAMTS-13 activity (mean ILT volume ±standard deviation [SD]: 32 ± 34 mL) did not differ from the half with the highest ADAMTS-13 activity (43 ± 24 mL) when comparing ILT volume (p = 0.172, F = 2.95) and thickness (p = 0.070).

Discussion

After evaluating the largest quantifiable intraluminal thrombus in the vasculature, it was concluded that, surprisingly, circulating ADAMTS-13 activity seems unrelated to ILT formation in AAA.

导言有腔内血栓（ILT）的腹主动脉瘤（AAA）比无腔内血栓的腹主动脉瘤（AAA）更容易破裂。先前的研究表明，von Willebrand因子（vWf）在ILT的形成中起作用，因为ILT的体积与vWf呈正相关。vWf在内皮损伤部位介导血小板的系留，蛋白酶ADAMTS-13可裂解较大形式的vWf，从而抵消血栓形成级联反应并维持止血平衡。在研究人体内最大的可量化血栓时，有人假设循环中的 ADAMTS-13 活性可能与 AAA 患者的 ILT 大小有关，目的是利用三维对比增强超声波（3D-CEUS）测定 ILT 体积，探索这种潜在的关系。报告在这项回顾性、探索性研究中，对 60 名 AAA 患者进行了评估，并利用 3D-CEUS 估计了 ILT 体积和厚度与 ADAMTS-13 之间的关系。对当天获得的血浆样本中的 ADAMTS-13 活性进行了测定。未发现ILT体积（r = -0.03，p = 0.84）或ILT厚度（r = 0.02，p = 0.87）与ADAMTS-13活性之间存在关联。同样，当将该组细分为 ADAMTS-13 活性最低和最高的 50% 时，在比较 ILT 体积时，ADAMTS-13 活性最低的一半（平均 ILT 体积 ± 标准差 [SD]：32 ± 34 mL）与 ADAMTS-13 活性最高的一半（43 ± 24 mL）没有差异（P = 0.讨论在对血管中最大的可量化腔内血栓进行评估后得出的结论是，令人惊讶的是，循环中的 ADAMTS-13 活性似乎与 AAA 中 ILT 的形成无关。

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引用次数: 0

The European Society for Vascular Surgery Translational Spring Meeting 2024 Selected Abstracts

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/S2666-688X(24)00154-0

引用次数: 0

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IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

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

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IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

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

引用次数: 0

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