EJVES Vascular Forum最新文献

英文中文

Higher Amount of Perivascular Adipose Tissue Ipsilateral to an “Acute Culprit” Carotid Stenosis 颈动脉狭窄 "急性病因 "的同侧血管周围脂肪组织较多

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.017

Joana Ferreira ∗ , Cristina Cunha , Teresa Medeiros , Adhemar Longatto-Filho , Jorge Cotter , Margarida Correia-Neves , Pedro Cunha , Armando Mansilha

引用次数: 0

A Multi-Professional Clinic for AAA (MPC-AAA): Does It benefit patients? AAA 多专业诊所（MPC-AAA）：它对患者有益吗？

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.012

Camilla Davies ∗ , Tom Hewitt , Saima Ehsan

引用次数: 0

Management of Isolated Internal Iliac Artery Aneurysm: Two Case Reports And Systematic Review 孤立的髂内动脉瘤的治疗：两个病例报告和系统回顾

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.004

Baker Ghoneim ∗ , Prakash Madhavan , Sean O’Neill , Adrian O’Callaghan , Zenia Martin , Catriona Canning , Mary Colgan

引用次数: 0

Collaborative Vascular Research in Europe to Improve Care for Patients With Vascular Diseases: What Is Out There, and How to Participate? 欧洲合作开展血管研究，改善对血管疾病患者的护理：有哪些研究，如何参与？

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.05.009

Fabien Lareyre, Matthias Trenner

引用次数: 0

Midterm Outcomes With the Nellix Endograft Alone or With Chimneys Nellix 内移植物单独使用或与烟囱一起使用的中期效果

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.06.001

Introduction

Endovascular aneurysm sealing (EVAS) appeared to be an innovative alternative to conventional endovascular abdominal aortic aneurysm repair. However, high rates of midterm failure of EVAS led to withdrawal of the device from the market. The study aim was to report midterm outcomes of patients treated with EVAS alone or associated with chimneys (Ch-EVAS) and the management of their complications.

Methods

In this single centre study, all consecutive Nellix implants between 2013 and 2016 were included. The primary endpoint was device failure: (1) a triad of caudal migration of the Nellix stents >5 mm, separation of the endobags (>5 mm), and sac enlargement (>5 mm), with or without visible endoleak, (2) secondary aneurysm rupture, (3) surgical explant of the graft, or (4) any intervention for a type I endoleak. Overall mortality, aneurysm related mortality, and re-intervention rates were analysed.

Results

Fifty patients (male n = 43, female n = 7) were included. Median follow-up was 3.05 years (interquartile range [IQR] 0.52, 4.63) and follow up index was 0.51 (IQR 0.10, 0.88). Device failures occurred in 17 patients (34%). Overall and aneurysm related mortality rates during the follow up period were 30% and 13%. Fourteen (28%) patients required re-interventions. Five EVAS patients (17%) presented with complications. Type Ia endoleaks were managed by device explantation for three patients, and endovascular aneurysm repair in Nellix for two patients. Type Ib endoleaks were managed with an iliac branched device and limb extension. Nine Ch-EVAS patients (42.9%) presented with complications. Type Ia endoleaks were was managed by Nellix stent prolongation and renal extension, two multibranched thoraco-abdominal devices, and two device explantations. Type Ib endoleaks were managed by limb extension and stent complications by stent angioplasty and iliorenal bypass.

Conclusion

The midterm outcome of EVAS is poor. All patients who underwent EVAS implantation must be informed and should undergo frequent surveillance. Open repair and device explantation should be considered as the primary treatment.

导言血管内动脉瘤封堵术（EVAS）似乎是传统血管内腹主动脉瘤修补术的创新替代方案。然而，EVAS的中期失败率较高，导致该设备退出市场。这项研究旨在报告单独使用EVAS或与烟囱（Ch-EVAS）联合使用EVAS的患者的中期疗效及其并发症的处理情况。方法在这项单中心研究中，纳入了2013年至2016年期间所有连续植入Nellix的患者。主要终点是设备故障：（1）Nellix支架尾部移位（>5 mm）、内袋分离（>5 mm）和囊肿增大（>5 mm）三联征，伴有或不伴有可见内漏；（2）继发性动脉瘤破裂；（3）手术切除移植物；或（4）对I型内漏进行任何干预。对总死亡率、动脉瘤相关死亡率和再次介入率进行了分析。中位随访时间为 3.05 年（四分位数间距 [IQR] 0.52，4.63），随访指数为 0.51（IQR 0.10，0.88）。17名患者（34%）发生了设备故障。随访期间，总死亡率和动脉瘤相关死亡率分别为 30% 和 13%。14名患者（28%）需要再次介入治疗。五名 EVAS 患者（17%）出现并发症。有 3 名患者的 Ia 型内漏通过设备拆卸得到了处理，有 2 名患者通过 Nellix 进行了血管内动脉瘤修复。Ib 型内漏通过髂支器械和肢体延伸进行了处理。九名 Ch-EVAS 患者（42.9%）出现了并发症。Ia 型内漏是通过 Nellix 支架延长和肾脏延伸、两个胸腹多分支装置和两个装置拆卸来处理的。Ib型内漏通过肢体延长术处理，支架并发症通过支架血管成形术和髂肾旁路手术处理。所有接受 EVAS 植入术的患者都必须知情，并应经常接受监测。应考虑将开放式修复和装置拆卸作为主要治疗方法。

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引用次数: 0

A Low Cost Emergency Laparotomy Task Trainer for Major Abdominal Bleeding: An Option for Surgical Residents to Learn Lifesaving Basic Surgical Skills 针对腹部大出血的低成本紧急腹腔手术任务训练器：外科住院医师学习救生基本外科技能的一种选择

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.04.002

Tiia Kukkonen , Eerika Rosqvist , Marika Ylönen , Annika Mäkeläinen , Juha Paloneva , Teuvo Antikainen

Objective

To instantly stop life threatening abdominal bleeding (e.g., a ruptured abdominal aneurysm), every surgeon should be familiar with the principles of emergency laparotomy (EL) and aortic clamping. Simulation training in a safe environment can be used to rehearse these situations like other medical emergencies. Owing to the lack of a suitable commercial simulator, a homemade task trainer was constructed. This study aimed to evaluate the feasibility of an EL simulation training course among surgical residents using this low cost task trainer.

Methods

To enable simulation training for massive abdominal bleeding with subsequent EL and aortic clamping, a multiprofessional team developed an EL task trainer. A structured evaluation of the trainer and its applicability was performed by external consultants, who tested the trainer themselves. Instructions for constructing the trainer were created and costs were calculated. During the EL simulation course targeted for surgical trainees early in their careers, 34 participants familiarised themselves with EL. Their experiences of the feasibility of the course and increase in self assessed clinical competence in managing the situation were studied using a questionnaire. In a subgroup of trainees, the simulation was compared with a real life EL subsequent to the course.

Results

Participants found that the trainer was fit for its purpose (mean score, 4.7 out of 5). Their self assessed clinical competence increased in several domains: EL as a procedure (p < 0.01), handling of intra-abdominal tissues and organs during EL (p = 0.008), and emergency procedures in intra-abdominal haemorrhage (p < 0.001). The cost for the body of the trainer was €108 and there was an additional €42 for the disposables for one training scenario.

Conclusion

A low cost task trainer with pulsatile flow enabling surgical residents to rehearse EL with aortic clamping can be constructed from commonly available materials. Preliminary experience of its feasibility and effects on learning in a simulation training course have been positive.

目的为了立即止住危及生命的腹腔出血（如腹部动脉瘤破裂），每位外科医生都应熟悉紧急开腹手术（EL）和主动脉夹闭的原理。可以在安全的环境中进行模拟训练，像演练其他医疗紧急情况一样演练这些情况。由于缺乏合适的商业模拟器，我们自制了一个任务训练器。本研究旨在评估使用这种低成本任务训练器在外科住院医师中开展 EL 模拟培训课程的可行性。方法为了能够对大量腹腔出血及随后的 EL 和主动脉夹闭进行模拟培训，一个多专业团队开发了 EL 任务训练器。外部顾问对训练器及其适用性进行了结构化评估，并亲自对训练器进行了测试。此外，还制作了培训器械的构造说明，并计算了成本。在针对初入职场的外科学员开设的 EL 模拟课程中，34 名学员熟悉了 EL。通过问卷调查，研究了他们对课程可行性的体验以及自我评估的临床处理能力的提高情况。结果学员们认为培训师符合其目的（平均分 4.7 分，满分 5 分）。他们自我评估的临床能力在多个领域都有所提高：EL作为一种程序（p < 0.01）、EL过程中腹腔内组织和器官的处理（p = 0.008）以及腹腔内出血的急救程序（p < 0.001）。训练器主体的成本为 108 欧元，一个训练场景的一次性耗材成本为 42 欧元。其在模拟培训课程中的可行性和学习效果的初步经验是积极的。

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引用次数: 0

Endovascular Repair of Infective Aortic Pathology 血管内修复感染性主动脉病变

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.007

Baker Ghoneim ∗ , Giulia Bertagna , Andrew Woodhouse , Darryl Braganza , Martin Claridge , Maciej Juszczak , Donald Adam

引用次数: 0

Impaired Pre-operative Ambulatory Status in Patients Undergoing Elective EVAR Is Associated With Increased Mortality 接受择期 EVAR 患者术前活动能力受损与死亡率升高有关

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.019

Heepeel Chang ∗ , Frank Veith , Aiden Lui , Igor Laskowski , Virendra Patel , Sateesh Babu , Romeo Mateo , Min Li Xu , Karan Garg

引用次数: 0

To Identify Determinants Of Normal Abdominal Aorta Diameter In The Indian Population 确定印度人正常腹主动脉直径的决定因素

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.020

Vandana Kapoor ∗ , Ajay Savlania , Arunanshu Behra , Mandeep Kang , Ujjwal Gorsi , Lileshwar Kaman

引用次数: 0

Frailty Predicts Prognosis After Thoracic Endovascular Aortic Repair 虚弱程度可预测胸腔内血管主动脉修复术后的预后

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.008

Shingo Tsushima ∗ , Tsuyoshi Shibata , Yutaka Iba , Tomohiro Nakajima , Junji Nakazawa , Akihito Ohkawa , Itaru Hosaka , Nobuyoshi Kawaharada

引用次数: 0

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