EJVES Vascular Forum最新文献

英文中文

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

Alberto M. Settembrini , Leonardo Foresti , Paolo Verlato , Gianluca Buongiovanni , Daniele Bissacco , Chiara Lomazzi , Marco Maggioni , Santi Trimarchi

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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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

Roberto Sánchez

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

Assessing the Growth Rate of Abdominal Aortic Aneurysms Greater than 5 cm 评估大于 5 厘米的腹主动脉瘤的生长速度

IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.064

Sinead Gormley ∗ , Calum Barton , Chelsea Tong , Andy Kindon , Oliver Bernau , Manar Khashram

引用次数: 0

Percutaneous vs. Cutdown Access for Endovascular Aortic Repair 血管内主动脉修复的经皮入路与切口入路

IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.026

Tariq Alanezi ∗ , Sultan Alsheikh , Badr Aljabri , Mohammed Aldossary , Kaisor Iqbal , Abdulmajeed Altoijry

引用次数: 0

The Role of Gender in Perceived Vascular Surgical and Cardiovascular Residency Training Experience 性别在感知血管外科和心血管住院医师培训经历中的作用

IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.016

Shaidah Deghan Manshadi ∗ , Sneha Raju , Harsukh Benipal , Nader Chaya , Jean Jacob-Brassard , Thomas Forbes , Elisa Greco

引用次数: 0

Careers in Vascular and Endovascular Surgery in a Country Lacking an Integrated Vascular Residency Program 在缺乏综合血管住院医师培训计划的国家开展血管和血管内外科工作

IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.059

Tariq Alanezi ∗ , Hesham AlGhofili , Abdulmajeed Altoijry (Prof.) , Kaisor Iqbal , Sultan Alsheikh

引用次数: 0

The Diversity of the Relay Stent Graft Custom Made Platform in the Treatment of Different Aortic Arch Pathology Relay 支架移植定制平台在治疗不同主动脉弓病变中的多样性

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.07.012

V. Dabravolskaite ∗ , H. Hakovirta , F. Schoenhoff , D. Kotelis , V. Makaloski , M. Lescan

引用次数: 0

Closure Device Migration: An Unusual Cause of Acute Limb Ischaemia Following a Simple Endovascular Procedure 闭合装置移位：简单血管内手术后急性肢体缺血的一个不寻常原因

IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.05.006

Alexandre Oliny , Côme Bosse , Philippe Charbonneau , Stephan Haulon , Dominique Fabre

Introduction

Acute limb ischaemia resulting from foreign body embolisation is an infrequent yet critical complication associated with vascular closure devices (VCDs). Despite the widespread use of VCDs, rare complications such as fragment emboli pose unique challenges, necessitating heightened clinical awareness. This case report presents a case of acute limb ischaemia caused by a VCD malfunction following an endovascular procedure.

Report

A 70 year old male who was diagnosed with a severe claudication of the lower extremity (Rutherford III) due to right common iliac stenosis, underwent angioplasty using a FemoSeal (Terumo Ltd., Surrey, UK) to close the right femoral artery access. Two weeks later, the patient presented with acute lower limb ischaemia due to a right popliteal–tibial occlusion. Emergency surgical thrombo-embolectomy was successfully performed from a medial popliteal approach, and the thrombus, which contained a polymer disc from the VCD at its distal end, was completely removed.

Discussion

Despite VCDs being proven safe and efficient, rare complications such as fragment emboli can occur, and physicians should be aware of the possible delayed onset of symptoms. Moreover, the radiolucent nature of the polymer disc in a FemoSeal complicates diagnostic imaging. While endovascular approaches exist, open surgery is a safe and effective strategy for retrieving fragments and treating the patient in acute limb ischaemia cases.

Conclusion

Physicians should remain vigilant for embolic risks associated with vascular closure devices, even with suitable anatomy and following guidelines, especially considering the trend toward early ambulation and discharge.

导言异物栓塞导致的急性肢体缺血是血管闭合器（VCD）的一种不常见但却很严重的并发症。尽管血管闭合器已被广泛使用，但碎片栓塞等罕见并发症仍构成了独特的挑战，因此有必要提高临床认识。本病例报告介绍了一例血管内手术后因 VCD 故障导致急性肢体缺血的病例。报告一名 70 岁的男性因右髂总动脉狭窄而被诊断为下肢严重跛行（卢瑟福 III 型），他接受了血管成形术，使用 FemoSeal（泰尔茂有限公司，英国萨里郡）封闭了右股动脉通路。两周后，患者因右侧腘胫动脉闭塞而出现急性下肢缺血。从腘窝内侧入路成功实施了紧急血栓栓塞切除术，血栓被完全清除，血栓远端含有一个来自 VCD 的聚合物圆盘。此外，FemoSeal 聚合物椎间盘的放射性透明特性使影像诊断变得复杂。结论即使有合适的解剖结构并遵循指南，特别是考虑到早期活动和出院的趋势，医生仍应警惕与血管闭合装置相关的栓塞风险。

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引用次数: 0

YouTube as a Source of Patient and Trainee Education in Vascular Surgery: A Systematic Review YouTube 作为血管外科患者和受训人员教育的来源：系统回顾

IF 0.6 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.054

Arshia Javidan , Muralie Vignarajah , Matthew W. Nelms , Fangwen Zhou , Yung Lee , Faysal Naji , Ahmed Kayssi

Objective

Due to its video based approach, YouTube has become a widely accessed educational resource for patients and trainees. This systematic review characterised and evaluated the peer reviewed literature investigating YouTube as a source of patient or trainee education in vascular surgery.

Data sources

A comprehensive literature search was conducted using EMBASE, MEDLINE, and Ovid HealthStar from inception until 19 January 2023. All primary studies and conference abstracts evaluating YouTube as a source of vascular surgery education were included.

Review methods

Video educational quality was analysed across several factors, including pathology, video audience, and length.

Results

Overall, 24 studies were identified examining 3 221 videos with 123.1 hours of content and 37.1 million views. Studies primarily examined YouTube videos on diabetic foot care (7/24, 29%), peripheral arterial disease (3/24, 13%), carotid artery stenosis (3/24, 13%), varicose veins (3/24, 13%), and abdominal aortic aneurysm (2/24, 8%). Video educational quality was analysed using standardised assessment tools, author generated scoring systems, or global author reported assessment of quality. Six studies assessed videos for trainee education, while 18 studies evaluated videos for patient education. Among the 20 studies which reported on the overall quality of educational content, 10/20 studies deemed it poor, and 10/20 studies considered it fair, with 53% of studies noting poor educational quality for videos intended for patients and 40% of studies noting poor educational quality in videos intended for trainees. Poor quality videos had more views than fair quality videos (mean 27 348, 95% CI 15 154–39 543 views vs. 11 372, 95% CI 3 115–19 629 views, p = .030).

Conclusion

The overall educational quality of YouTube videos for vascular surgery patient and trainee education is suboptimal. There is significant heterogeneity in the quality assessment tools used in their evaluation. A standardised approach to online education with a consistent quality assessment tool is required to better support online patient and trainee education in vascular surgery.

目的YouTube以视频为基础，已成为患者和受训者广泛访问的教育资源。本系统性综述对研究 YouTube 作为血管外科患者或受训者教育资源的同行评议文献进行了特征描述和评估。数据来源使用 EMBASE、MEDLINE 和 Ovid HealthStar 对从开始到 2023 年 1 月 19 日的文献进行了全面检索。所有评估 YouTube 作为血管外科教育来源的主要研究和会议摘要均被纳入其中。综述方法根据病理学、视频受众和视频长度等多个因素对视频教育质量进行分析。结果总计确定了 24 项研究，共审查了 3 221 个视频，内容长达 123.1 小时，浏览次数达 3710 万次。研究主要考察了 YouTube 上有关糖尿病足护理（7/24，29%）、外周动脉疾病（3/24，13%）、颈动脉狭窄（3/24，13%）、静脉曲张（3/24，13%）和腹主动脉瘤（2/24，8%）的视频。视频教学质量采用标准化评估工具、作者生成的评分系统或作者报告的总体质量评估进行分析。有 6 项研究对受训者教育视频进行了评估，有 18 项研究对患者教育视频进行了评估。在报告了教育内容总体质量的 20 项研究中，10/20 的研究认为教育内容质量较差，10/20 的研究认为教育内容质量尚可，其中 53% 的研究指出面向患者的视频教育质量较差，40% 的研究指出面向学员的视频教育质量较差。质量差的视频比质量一般的视频有更多的浏览量（平均 27 348 次，95% CI 15 154-39 543 次 vs. 11 372 次，95% CI 3 115-19 629 次，p = .030）。结论YouTube视频用于血管外科患者和受训者教育的总体教育质量不尽如人意，其评估中使用的质量评估工具也存在明显的异质性。为了更好地支持血管外科患者和受训人员的在线教育，需要一种标准化的在线教育方法和一致的质量评估工具。

{"title":"YouTube as a Source of Patient and Trainee Education in Vascular Surgery: A Systematic Review","authors":"Arshia Javidan , Muralie Vignarajah , Matthew W. Nelms , Fangwen Zhou , Yung Lee , Faysal Naji , Ahmed Kayssi","doi":"10.1016/j.ejvsvf.2024.01.054","DOIUrl":"10.1016/j.ejvsvf.2024.01.054","url":null,"abstract":"<div><h3>Objective</h3><p>Due to its video based approach, YouTube has become a widely accessed educational resource for patients and trainees. This systematic review characterised and evaluated the peer reviewed literature investigating YouTube as a source of patient or trainee education in vascular surgery.</p></div><div><h3>Data sources</h3><p>A comprehensive literature search was conducted using EMBASE, MEDLINE, and Ovid HealthStar from inception until 19 January 2023. All primary studies and conference abstracts evaluating YouTube as a source of vascular surgery education were included.</p></div><div><h3>Review methods</h3><p>Video educational quality was analysed across several factors, including pathology, video audience, and length.</p></div><div><h3>Results</h3><p>Overall, 24 studies were identified examining 3 221 videos with 123.1 hours of content and 37.1 million views. Studies primarily examined YouTube videos on diabetic foot care (7/24, 29%), peripheral arterial disease (3/24, 13%), carotid artery stenosis (3/24, 13%), varicose veins (3/24, 13%), and abdominal aortic aneurysm (2/24, 8%). Video educational quality was analysed using standardised assessment tools, author generated scoring systems, or global author reported assessment of quality. Six studies assessed videos for trainee education, while 18 studies evaluated videos for patient education. Among the 20 studies which reported on the overall quality of educational content, 10/20 studies deemed it poor, and 10/20 studies considered it fair, with 53% of studies noting poor educational quality for videos intended for patients and 40% of studies noting poor educational quality in videos intended for trainees. Poor quality videos had more views than fair quality videos (mean 27 348, 95% CI 15 154–39 543 views <em>vs.</em> 11 372, 95% CI 3 115–19 629 views, <em>p</em> = .030).</p></div><div><h3>Conclusion</h3><p>The overall educational quality of YouTube videos for vascular surgery patient and trainee education is suboptimal. There is significant heterogeneity in the quality assessment tools used in their evaluation. A standardised approach to online education with a consistent quality assessment tool is required to better support online patient and trainee education in vascular surgery.</p></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"61 ","pages":"Pages 62-76"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000558/pdfft?md5=cf93b94fb75ababa525384f5cd25e1f5&pid=1-s2.0-S2666688X24000558-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139636778","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}

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