EJVES Vascular Forum最新文献

英文中文

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 PERIPHERAL VASCULAR DISEASE

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

Salomé Kuntz , Céline Deslarzes , Alexandre Than Vinh Nguyen , Alban Longchamp , Rosalinda D'Amico , Justine Longchamp , Anne Lejay , Nabil Chakfé , Sébastien Déglise

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。

{"title":"Midterm Outcomes With the Nellix Endograft Alone or With Chimneys","authors":"Salomé Kuntz , Céline Deslarzes , Alexandre Than Vinh Nguyen , Alban Longchamp , Rosalinda D'Amico , Justine Longchamp , Anne Lejay , Nabil Chakfé , Sébastien Déglise","doi":"10.1016/j.ejvsvf.2024.06.001","DOIUrl":"10.1016/j.ejvsvf.2024.06.001","url":null,"abstract":"<div><h3>Introduction</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>Fifty patients (male <em>n</em> = 43, female <em>n</em> = 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.</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"62 ","pages":"Pages 8-14"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000923/pdfft?md5=a79271d6e66dd286262de3c000d4bc23&pid=1-s2.0-S2666688X24000923-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142136558","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}

引用次数: 0

Targeting miR29b in a Porcine Model of Aortic Aneurysm Disease: A Novel Endovascular Treatment Option 在猪主动脉瘤模型中靶向 miR29b：一种新的血管内治疗方案

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.07.010

K. Hanft ∗ , S. Metschl , H. Winter , J. Pauli , N. Sachs , R. Boon , S. Dimmeler , C. Knappich , A. Busch , L. Mägdefessel

引用次数: 0

Patient Reported Experience Measures in Vascular Surgery Enhancement Study: The Premiere Study 血管外科强化研究中的患者体验报告措施：首映研究

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.07.020

M. Darwish ∗ , K. Withers , D. Bosanquet

引用次数: 0

A Novel Porcine Thoracic Aortic Aneurysm Model Reveals Persistently Elevated Matrix Metalloproteinase Activity In Aneurysmal Tissues 新型猪胸主动脉瘤模型显示动脉瘤组织中基质金属蛋白酶活性持续升高

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.07.003

J. Stafford , D. Kenawy , D. Campbell , F. Amari , Y. Chun , B. Tillman ∗

引用次数: 0

A Novel Device To Assess the Characteristics of a Vessel Wall for Stent Implantation Purpose 用于评估血管壁特性以达到支架植入目的的新型设备

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.07.029

M.Z. Ghariani ∗ , A. Lejay , N. Chakfe , F. Heim

引用次数: 0

Novel Antithrombotic and Cell Favouring Coating for Vascular Grafts 用于血管移植物的新型抗血栓和细胞保护涂层

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.07.032

P. Reymond ∗ , D. Lagrange , J. Giliberto , R. Marchi , O. Felix , M. Tschopp , P. Fontana , M. Piallat , J. Tille , G. Decher , C. Huber , B. Walpoth

引用次数: 0

Systematic Review of Femoral Artery Stent Fractures 股动脉支架骨折的系统回顾

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.08.001

Arielle Bellissard , Salomé Kuntz , Anne Lejay , Nabil Chakfé

Objective

Primary stenting for long femoropopliteal (FP) lesions remains controversial because of the high risk of stent fracture (SF). This study aimed to summarise current knowledge on SF from randomised control trials about FP stenting.

Methods

A systematic review of the Medline database was performed by a combined strategy of MeSH terms: femoral artery, popliteal artery, stenting, and stent fracture. SF was classified according to a standard classification: 1 = single strut fracture; 2 = ≥ two struts fracture; 3 = type 2 with deformation; 4 = multiple struts fracture with acquired transection; 5, type 4 with gap in the stent body.

Results

The literature search identified 25 publications including covered stents (CSs; n = 3), drug eluting stents (DESs; n = 8), bare metal stents (BMS; n = 17), and bioabsorbable stents (n = 1). Data were extracted from 4 047 patients; mean age ± standard deviation was 68.9 ± 3.0 years and 69% were male. The median lesion length was 87.6 mm (interquartile range [IQR] 70.0, 149) with a median chronic total occlusion proportion of 36.8% (IQR 29.0, 56.5). In 208 patients treated with CS, SF rates ranged from none to 2.6% at 36 months with no clinical correlation. In 1 106 patients treated with DES, SF rates were relatively low in large cohorts, ranging from 0% at 12 months to 1.9% at 60 months. In smaller cohorts (under 100 patients per group), they ranged from 12.5% at six months to 46.7% at 12 months, with no clinical repercussion. In 1 610 patients treated with BMS, SF rates ranged from 2% to 32.7% at 12 months and from 2.9% to 48.9% at 24 months, with no clinical repercussion.

Conclusion

SF rates in large cohorts were low in CF and DES, and quite common in BMS, although none of them had clinical consequences. However, longer follow up and detailed, accurate reports are needed to assess eventual real clinical outcomes.

目的由于支架断裂（SF）的高风险，对股骨腘动脉（FP）长病变进行初级支架植入术仍存在争议。本研究旨在总结有关股腘动脉支架置入术的随机对照试验中有关 SF 的现有知识。方法采用 MeSH 术语：股动脉、腘动脉、支架置入术和支架骨折，对 Medline 数据库进行了系统性回顾。SF 按照标准分类法进行分类：结果文献检索发现了25篇文献，包括覆盖支架（CS；n = 3）、药物洗脱支架（DES；n = 8）、裸金属支架（BMS；n = 17）和生物可吸收支架（n = 1）。从 4 047 名患者中提取了数据；平均年龄（标准差）为 68.9 ± 3.0 岁，69% 为男性。病变长度中位数为 87.6 毫米（四分位数间距 [IQR] 70.0，149），慢性全闭塞比例中位数为 36.8%（IQR 29.0，56.5）。在208名接受CS治疗的患者中，36个月时的SF率从无到2.6%不等，且无临床相关性。在1 106例接受DES治疗的患者中，大样本队列的SF率相对较低，从12个月时的0%到60个月时的1.9%不等。在较小的队列中（每组不足100人），SF率从6个月时的12.5%到12个月时的46.7%不等，没有临床反响。在1610名接受BMS治疗的患者中，12个月时的SF率从2%到32.7%不等，24个月时的SF率从2.9%到48.9%不等，没有临床反响。然而，要评估最终的实际临床结果，还需要更长时间的随访和详细准确的报告。

{"title":"Systematic Review of Femoral Artery Stent Fractures","authors":"Arielle Bellissard , Salomé Kuntz , Anne Lejay , Nabil Chakfé","doi":"10.1016/j.ejvsvf.2024.08.001","DOIUrl":"10.1016/j.ejvsvf.2024.08.001","url":null,"abstract":"<div><h3>Objective</h3><p>Primary stenting for long femoropopliteal (FP) lesions remains controversial because of the high risk of stent fracture (SF). This study aimed to summarise current knowledge on SF from randomised control trials about FP stenting.</p></div><div><h3>Methods</h3><p>A systematic review of the Medline database was performed by a combined strategy of MeSH terms: femoral artery, popliteal artery, stenting, and stent fracture. SF was classified according to a standard classification: 1 = single strut fracture; 2 = ≥ two struts fracture; 3 = type 2 with deformation; 4 = multiple struts fracture with acquired transection; 5, type 4 with gap in the stent body.</p></div><div><h3>Results</h3><p>The literature search identified 25 publications including covered stents (CSs; <em>n</em> = 3), drug eluting stents (DESs; <em>n</em> = 8), bare metal stents (BMS; <em>n</em> = 17), and bioabsorbable stents (<em>n</em> = 1). Data were extracted from 4 047 patients; mean age ± standard deviation was 68.9 ± 3.0 years and 69% were male. The median lesion length was 87.6 mm (interquartile range [IQR] 70.0, 149) with a median chronic total occlusion proportion of 36.8% (IQR 29.0, 56.5). In 208 patients treated with CS, SF rates ranged from none to 2.6% at 36 months with no clinical correlation. In 1 106 patients treated with DES, SF rates were relatively low in large cohorts, ranging from 0% at 12 months to 1.9% at 60 months. In smaller cohorts (under 100 patients per group), they ranged from 12.5% at six months to 46.7% at 12 months, with no clinical repercussion. In 1 610 patients treated with BMS, SF rates ranged from 2% to 32.7% at 12 months and from 2.9% to 48.9% at 24 months, with no clinical repercussion.</p></div><div><h3>Conclusion</h3><p>SF rates in large cohorts were low in CF and DES, and quite common in BMS, although none of them had clinical consequences. However, longer follow up and detailed, accurate reports are needed to assess eventual real clinical outcomes.</p></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"62 ","pages":"Pages 48-56"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24001382/pdfft?md5=32f3b60fece57fb23a506c1d930b4df9&pid=1-s2.0-S2666688X24001382-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240668","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}

引用次数: 0

Outcomes Following Vascular and Endovascular Procedures Performed During the First COVID-19 Pandemic Wave 第一次 COVID-19 大流行期间进行的血管和血管内手术的结果

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.08.002

Panagiota Birmpili , Ruth A. Benson , Brenig Gwilym , Sandip Nandhra , Nina Al-Saadi , Graeme K. Ambler , Robert Blair , David Bosanquet , Nikesh Dattani , Louise Hitchman , Katherine Hurndall , Matthew Machin , Sarah Onida , Athanasios Saratzis , Joseph Shalhoub , Lauren Shelmerdine , Aminder A. Singh

Objective

The first COVID-19 pandemic wave was a period of reduced surgical activity and redistribution of resources to only those with late stage or critical presentations. This Vascular and Endovascular Research Network COVID-19 Vascular Service (COVER) study aimed to describe the six-month outcomes of patients who underwent open surgery and or endovascular interventions for major vascular conditions during this period.

Methods

In this international, multicentre, prospective, observational study, centres recruited consecutive patients undergoing vascular procedures over a 12-week period. The study opened in March 2020 and closed to recruitment in August 2020. Patient demographics, procedure details, and post-operative outcomes were collected on a secure online database. The reported outcomes at 30 days and six months were post-operative complications, re-interventions, and all cause in-hospital mortality rate. Multivariable logistic regression was used to assess factors associated with six-month mortality rate.

Results

Data were collected on 3 150 vascular procedures, including 1 380 lower limb revascularisations, 609 amputations, 403 aortic, 289 carotid, and 469 other vascular interventions. The median age was 68 years (interquartile range 59, 76), 73.5% were men, and 1.7% had confirmed COVID-19 disease. The cumulative all cause in-hospital, 30-day, and six-month mortality rates were 9.1%, 10.4%, and 12.8%, respectively. The six-month mortality rate was 32.1% (95% CI 24.2–40.8%) in patients with confirmed COVID-19 compared with 12.0% (95% CI 10.8–13.2%) in those without. After adjustment, confirmed COVID-19 was associated with a three times higher odds of six-month death (adjusted OR 3.25, 95% CI 2.18–4.83). Increasing ASA grade (3–5 vs. 1–2), frailty scores 4–9, diabetes mellitus, and urgent and or immediate procedures were also independently associated with increased odds of death by six months, while statin use had a protective effect.

Conclusion

During the first wave of the pandemic, the six-month mortality rate after vascular and endovascular procedures was higher compared with historic pre-pandemic studies and associated with COVID-19 disease.

目的COVID-19大流行的第一波期间，外科手术活动减少，资源仅重新分配给晚期或危重病人。这项血管和血管内研究网络COVID-19血管服务（COVER）研究旨在描述在此期间接受开放手术和血管内介入治疗的主要血管疾病患者的6个月预后。研究于 2020 年 3 月开始，2020 年 8 月结束招募。患者的人口统计学资料、手术细节和术后结果都收集在一个安全的在线数据库中。报告的 30 天和 6 个月的结果包括术后并发症、再次介入治疗和所有原因的院内死亡率。结果收集到了 3 150 例血管手术的数据，包括 1 380 例下肢血管再通手术、609 例截肢手术、403 例主动脉手术、289 例颈动脉手术和 469 例其他血管介入手术。中位年龄为68岁（四分位数范围为59-76岁），73.5%为男性，1.7%确诊患有COVID-19疾病。所有病因的累计住院死亡率、30天死亡率和6个月死亡率分别为9.1%、10.4%和12.8%。确诊COVID-19患者的6个月死亡率为32.1%（95% CI 24.2-40.8%），而未确诊COVID-19患者的6个月死亡率为12.0%（95% CI 10.8-13.2%）。经调整后，确诊的 COVID-19 与六个月内死亡几率增加三倍有关（调整后 OR 3.25，95% CI 2.18-4.83）。ASA等级的提高（3-5级与1-2级）、虚弱评分4-9分、糖尿病以及紧急或立即手术也与6个月内死亡几率的增加独立相关，而他汀类药物的使用则具有保护作用。

{"title":"Outcomes Following Vascular and Endovascular Procedures Performed During the First COVID-19 Pandemic Wave","authors":"Panagiota Birmpili , Ruth A. Benson , Brenig Gwilym , Sandip Nandhra , Nina Al-Saadi , Graeme K. Ambler , Robert Blair , David Bosanquet , Nikesh Dattani , Louise Hitchman , Katherine Hurndall , Matthew Machin , Sarah Onida , Athanasios Saratzis , Joseph Shalhoub , Lauren Shelmerdine , Aminder A. Singh","doi":"10.1016/j.ejvsvf.2024.08.002","DOIUrl":"10.1016/j.ejvsvf.2024.08.002","url":null,"abstract":"<div><h3>Objective</h3><div>The first COVID-19 pandemic wave was a period of reduced surgical activity and redistribution of resources to only those with late stage or critical presentations. This Vascular and Endovascular Research Network COVID-19 Vascular Service (COVER) study aimed to describe the six-month outcomes of patients who underwent open surgery and or endovascular interventions for major vascular conditions during this period.</div></div><div><h3>Methods</h3><div>In this international, multicentre, prospective, observational study, centres recruited consecutive patients undergoing vascular procedures over a 12-week period. The study opened in March 2020 and closed to recruitment in August 2020. Patient demographics, procedure details, and post-operative outcomes were collected on a secure online database. The reported outcomes at 30 days and six months were post-operative complications, re-interventions, and all cause in-hospital mortality rate. Multivariable logistic regression was used to assess factors associated with six-month mortality rate.</div></div><div><h3>Results</h3><div>Data were collected on 3 150 vascular procedures, including 1 380 lower limb revascularisations, 609 amputations, 403 aortic, 289 carotid, and 469 other vascular interventions. The median age was 68 years (interquartile range 59, 76), 73.5% were men, and 1.7% had confirmed COVID-19 disease. The cumulative all cause in-hospital, 30-day, and six-month mortality rates were 9.1%, 10.4%, and 12.8%, respectively. The six-month mortality rate was 32.1% (95% CI 24.2–40.8%) in patients with confirmed COVID-19 compared with 12.0% (95% CI 10.8–13.2%) in those without. After adjustment, confirmed COVID-19 was associated with a three times higher odds of six-month death (adjusted OR 3.25, 95% CI 2.18–4.83). Increasing ASA grade (3–5 <em>vs</em>. 1–2), frailty scores 4–9, diabetes mellitus, and urgent and or immediate procedures were also independently associated with increased odds of death by six months, while statin use had a protective effect.</div></div><div><h3>Conclusion</h3><div>During the first wave of the pandemic, the six-month mortality rate after vascular and endovascular procedures was higher compared with historic pre-pandemic studies and associated with COVID-19 disease.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"62 ","pages":"Pages 64-71"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142318695","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}

引用次数: 0

Integrating Intravascular Lithotripsy to Overcome Severe Aorto-Iliac Atherosclerosis in Standard Endovascular Aortic Repair: A Case Report 在标准血管内主动脉修复术中结合血管内碎石术克服严重的主动脉-髂动脉粥样硬化：病例报告

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.09.005

Giuseppe Mastropaolo, Andrea Cumino, Fabiana Zandrino, Sara Pomatto, Vittorio Pasta, Ilaria Ambrogio, Alberto Pecchio

Introduction

Endovascular aneurysm repair (EVAR) is a safe and widespread treatment option for abdominal aortic aneurysm (AAA). Unfavourable anatomy, such as hostile neck and aorto-iliac atherosclerosis, can lead to many complications and compromise the long term reliability of the endograft, resulting in a high rate of EVAR failure. Intravascular lithotripsy (IVL) has emerged as an alternative treatment to address severe iliofemoral atherosclerosis, aiding trackability of devices in EVAR. However, the use of IVL to address severe calcification in hostile necks has not yet been described.

Report

A 74 year old man with multiple comorbidities was referred for definitive treatment of an asymptomatic infrarenal AAA with severe aorto-iliac atherosclerosis. Kissing lithotripsy was firstly performed to treat the calcified stenosis of the aortic bifurcation and iliac axes. To prevent infolding and type Ia endoleak (ELIa), IVL was also performed through simultaneous inflation of two IVL balloon catheters and a compliant aortic balloon on a conical shape neck with an eccentric calcified plaque. The procedure was completed with standard EVAR. The three month follow up computed tomography angiography confirmed a successful outcome with shrinkage of the excluded aneurysmal sac, patent iliac axes, and complete disruption of the severe eccentric calcification of the aortic neck with no signs of infolding or endoleak.

Discussion

This case report highlights the potential of IVL to improve the proximal sealing zone, prevent infolding and ELIa, enhance trackability of devices, reduce major complications, and extend the application of standard EVAR in patients with challenging anatomy. However, further studies and long term follow up are needed to define the efficacy and safety of integrating IVL in standard EVAR.

导言血管内动脉瘤修补术（EVAR）是治疗腹主动脉瘤（AAA）的一种安全而广泛的方法。不利的解剖结构，如敌对的颈部和主动脉-髂动脉粥样硬化，可导致许多并发症，并损害血管内移植物的长期可靠性，导致 EVAR 失败率很高。血管内碎石术（IVL）已成为解决严重髂股动脉粥样硬化的替代治疗方法，有助于EVAR中设备的可追踪性。报告称，一名 74 岁的男性患者患有多种并发症，因无症状的肾下 AAA 和严重的主动脉-髂动脉粥样硬化而转诊接受最终治疗。首先进行了吻合碎石术，治疗主动脉分叉和髂轴的钙化狭窄。为了防止内折和Ia型内漏（ELIa），还通过在有偏心钙化斑块的锥形颈部同时充气两个IVL球囊导管和一个顺应性主动脉球囊来进行IVL。手术以标准的 EVAR 完成。随访三个月的计算机断层扫描血管造影证实了手术的成功，排除的动脉瘤囊缩小，髂轴通畅，主动脉颈部严重偏心钙化完全被破坏，没有任何折叠或内漏的迹象。讨论该病例报告强调了 IVL 在改善近端密封区、防止折叠和 ELIa、提高设备的可追踪性、减少主要并发症以及扩大标准 EVAR 在具有挑战性解剖的患者中的应用范围方面的潜力。不过，还需要进一步研究和长期随访，以确定将 IVL 纳入标准 EVAR 的有效性和安全性。

{"title":"Integrating Intravascular Lithotripsy to Overcome Severe Aorto-Iliac Atherosclerosis in Standard Endovascular Aortic Repair: A Case Report","authors":"Giuseppe Mastropaolo, Andrea Cumino, Fabiana Zandrino, Sara Pomatto, Vittorio Pasta, Ilaria Ambrogio, Alberto Pecchio","doi":"10.1016/j.ejvsvf.2024.09.005","DOIUrl":"10.1016/j.ejvsvf.2024.09.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Endovascular aneurysm repair (EVAR) is a safe and widespread treatment option for abdominal aortic aneurysm (AAA). Unfavourable anatomy, such as hostile neck and aorto-iliac atherosclerosis, can lead to many complications and compromise the long term reliability of the endograft, resulting in a high rate of EVAR failure. Intravascular lithotripsy (IVL) has emerged as an alternative treatment to address severe iliofemoral atherosclerosis, aiding trackability of devices in EVAR. However, the use of IVL to address severe calcification in hostile necks has not yet been described.</div></div><div><h3>Report</h3><div>A 74 year old man with multiple comorbidities was referred for definitive treatment of an asymptomatic infrarenal AAA with severe aorto-iliac atherosclerosis. Kissing lithotripsy was firstly performed to treat the calcified stenosis of the aortic bifurcation and iliac axes. To prevent infolding and type Ia endoleak (ELIa), IVL was also performed through simultaneous inflation of two IVL balloon catheters and a compliant aortic balloon on a conical shape neck with an eccentric calcified plaque. The procedure was completed with standard EVAR. The three month follow up computed tomography angiography confirmed a successful outcome with shrinkage of the excluded aneurysmal sac, patent iliac axes, and complete disruption of the severe eccentric calcification of the aortic neck with no signs of infolding or endoleak.</div></div><div><h3>Discussion</h3><div>This case report highlights the potential of IVL to improve the proximal sealing zone, prevent infolding and ELIa, enhance trackability of devices, reduce major complications, and extend the application of standard EVAR in patients with challenging anatomy. However, further studies and long term follow up are needed to define the efficacy and safety of integrating IVL in standard EVAR.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"62 ","pages":"Pages 78-82"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526917","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}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

EJVES Vascular Forum

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀