EJVES Vascular Forum最新文献

英文中文

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

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。

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引用次数: 0

Exploring the Differences in Skeletal Muscle Between Patients with Chronic Limb-Threatening Ischemia and Claudication 探索慢性肢体缺血和跛行患者骨骼肌的差异

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.068

Joana Ferreira ∗ , Adhemar Longatto-Filho (Prof) , Julieta Afonso (Prof) , Susana Roque (Prof) , Alexandre Carneiro , Isabel Vila , Pedro Cunha (Prof) , Armando Mansilha (Prof)

引用次数: 0

Influence of Clinical Status and Dissection Morphology on Transfusion Volume in Acute Aortic Dissection Surgery 急性主动脉夹层手术中临床状态和夹层形态对输血量的影响

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.011

Yohnosuke Wada ∗ , Naoyuki Kimura , Mitsunori Nakano , Yohei Nomura , Daijiro Hori , Manabu Shiraishi , Atsushi Yamaguchi

引用次数: 0

Area Based Analysis of Long Term Aortic Remodelling After Endovascular Repair for Type B Aortic Dissection B 型主动脉夹层血管内修复术后主动脉长期重塑的区域分析

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.037

Kun Fang ∗ , Jiawei Zhao , Zhongze Cao , Mingyao Luo , Hui Wang , Tun Wang , Chang Shu

引用次数: 0

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.038

Eugenio Martelli ∗ , Matilde Zamboni , Giovanni Sotgiu , Laura Saderi , Massimo Federici , Giuseppe Sangiorgi , Mariangela Valentina Puci , Allegra Rosa Martelli , Teresa Messina , Paolo Frigatti , Maria Pia Borrelli , Carlo Ruotolo , Ilaria Ficarelli , Paolo Rubino , Francesco Pezzo , Luciano Carbonari , Andrea Angelini , Edoardo Galeazzi , Luca Calia di Pinto , Franco Michelino Fiore , Alberto Maria Settembrini

引用次数: 0

Optical Coherence Tomography as Therapeutic Imaging Modality in Intravascular Lithotripsy of Human Peripheral Vasculature 将光学相干断层成像技术作为人体外周血管血管内碎石术的治疗成像模式

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.014

Rohit Mehra ∗ , Vikram Patra , Rishi Dhillan

引用次数: 0

Bilateral Focal Venous Malformations of the Breasts 双侧乳房局灶性静脉畸形

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.05.004

Yara Bachour, Sandra C. Donkervoort

引用次数: 0

Salvage Aneurysmorrhaphy as an Adaptable and Still Pertinent Technique in the Management of Challenging True Aneurysms of Arteriovenous Fistulas: A Case Series of Different Variations, With Illustrative Surgical Pictures 动脉瘤夹闭术是治疗动静脉瘘真性动脉瘤的一种灵活而又实用的技术：不同变异的病例系列，附手术插图

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.05.002

Homa Pourriyahi , Homayoun Pourriahi , Hossein Najd Sepas

Introduction

Aneurysmorrhaphy, described as reduction aneurysmoplasty, partial aneurysmectomy, or vessel wall recalibration, can be considered a suitable surgical plan for true aneurysms of arteriovenous fistulas (AVFs), allowing for a dynamic approach to reconstruction of aneurysmal AVFs of different severities, ensuring salvage of the native access.

Report

Six challenging cases of AVF aneurysms are presented, some with extremely dilated and tortuous megafistulas, for which three surgical technique variations were performed. The patients had a mean age of 59.2 years, 50% were female, with brachiocephalic (n = 5, 83.3%) or brachiobasilic (n = 1, 16.7%) AVFs. The fistulas were created an average of 4.67 years previously, and the aneurysms had an average maximum diameter of 37.5 mm (range 25–60 mm). Surgical indications were rupture risk, thrombosis, or outflow stenosis compromising haemodialysis, infections, and concerns for quality of life (affected by post-puncture bleedings, disfiguring aesthetics, pain, and discomfort). The surgical techniques were simple aneurysmorrhaphy (n = 3, 50%), aneurysmorrhaphy with partial excision of aneurysmal segment with end to end anastomosis of venous ends (n = 2, 33.3%), and aneurysmorrhaphy with establishment of new venous outflow (n = 1, 16.7%). All AVFs were patent post-operatively and at follow up (mean 5.6 months, median one month). Haemodialysis was resumed through the AVFs at a mean of 2.17 weeks post-operatively, with placement of an alternative route for haemodialysis in the meantime. No patients experienced post-operative complications.

Discussion

Experience with the more challenging cases shows that aneurysmorrhaphy can still be considered an acceptable, flexible, and pertinent method for salvage of megafistulas, giving the surgeon the much needed versatility to adapt to anatomical and pathological variations, with high patency rates and minimal complications, especially when other treatment options are not possible in complicated cases. AVF salvage through aneurysmorrhaphy allows for a dynamic approach to the reconstruction of severely tortuous, dilated veins, ensuring patency of the native AVF.

导言：动脉瘤切除术被描述为缩小动脉瘤成形术、部分动脉瘤切除术或血管壁重新校准术，可被视为治疗动静脉瘘（AVF）真性动脉瘤的合适手术方案，可采用动态方法重建不同严重程度的动脉瘤性动静脉瘘，确保挽救原生通路。报告介绍了六例具有挑战性的动静脉瘘动脉瘤病例，其中一些病例的巨瘘管极度扩张和迂曲，对这些病例采用了三种不同的手术技巧。患者的平均年龄为 59.2 岁，50% 为女性，患有肱动脉（5 例，83.3%）或肱动脉（1 例，16.7%）。瘘管平均创建于 4.67 年前，动脉瘤的平均最大直径为 37.5 毫米（范围为 25-60 毫米）。手术适应症包括破裂风险、血栓形成或流出道狭窄，从而影响血液透析、感染和生活质量（受穿刺后出血、影响美观、疼痛和不适的影响）。手术方法包括单纯动脉瘤夹闭术（3 例，50%）、动脉瘤夹闭术，部分切除动脉瘤段，静脉端端吻合（2 例，33.3%），以及动脉瘤夹闭术，建立新的静脉流出（1 例，16.7%）。术后和随访期间（平均 5.6 个月，中位一个月），所有动静脉瘘均通畅。在术后平均 2.17 周时，通过动静脉瘘恢复了血液透析，并在此期间安置了血液透析的替代途径。讨论从较具挑战性的病例中获得的经验表明，动脉瘤夹闭术仍可被视为一种可接受的、灵活的和相关的巨瘘抢救方法，为外科医生提供了所需的多功能性，以适应解剖和病理上的变化，同时具有较高的通畅率和最低的并发症，尤其是在复杂病例中无法采用其他治疗方案时。通过动脉瘤切除术挽救动静脉瘘，可以对严重迂曲、扩张的静脉进行动态重建，确保原生动静脉瘘的通畅。

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引用次数: 0

Primary Aorto-Enteric Fistula With a Subsequent Secondary Aorto-Enteric Fistula 原发性肠主动脉瘘伴继发性肠主动脉瘘

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.05.005

Iris Kärjä , Venla Soini , Olli Hautero , Maarit Venermo

Objective

Primary aorto-enteral fistula (PAEF) is a connection between the gastrointestinal tract and the aorta that occurs without previous aortic surgery. The aetiological factors include, but are not limited to, aneurysm, infection, and tumours. It is a life threatening condition if untreated and requires emergency vascular surgical repair. A secondary aorto-enteric fistula (AEF) can occur to a previously reconstructed aorta. This case report presents a unique case of a male patient who developed a primary AEF and subsequent secondary AEF with successful surgical outcomes, suggested to be due to tuberculous aortitis.

Report

The patient was diagnosed and treated for tuberculosis and developed a saccular aneurysm within six months. The PAEF was surgically corrected with a tube graft using a bovine pericardial patch, the defect in duodenum was sutured, and a retrocolic omental flap was created between the duodenum and aorta. He developed a small stable pseudoaneurysm during follow up, and then a secondary AEF two and a half years later, in which a connection between the pseudoaneurysm and duodenum was corrected using a new bovine aorto–aortic interposition graft using a bovine pericardium patch. The defect in the duodenum was also sutured in two layers and a new omental flap was created.

Discussion

The mortality rate of AEF is high and it is very unlikely that a patient will survive two AEFs without major complications. It is believed that there are extremely few double AEF cases described in the literature. The aetiological factor in the development of PAEF in this case was most likely the patient's aortic aneurysm, which was most likely of mycotic origin due to tuberculosis. The patient developed a pseudoaneurysm during follow up and it is uncertain whether the pulsatile pressure of the pseudoaneurysm led to the recurrence of the AEF.

目的原发性主动脉-肠瘘（PAEF）是指胃肠道与主动脉之间的连接，这种连接以前未做过主动脉手术。致病因素包括但不限于动脉瘤、感染和肿瘤。如果不及时治疗，会危及生命，需要进行紧急血管手术修复。继发性主动脉-肠瘘（AEF）可能发生在之前重建的主动脉上。本病例报告介绍了一例独特的男性患者病例，该患者被诊断为结核性大动脉炎，并接受了结核性大动脉炎的治疗，在六个月内出现了囊状动脉瘤。手术用牛心包补片管状移植矫正了 PAEF，缝合了十二指肠缺损，并在十二指肠和主动脉之间制作了结肠网膜瓣。在随访期间，他出现了一个稳定的小假性动脉瘤，两年半后又出现了继发性 AEF，在这种情况下，使用了一个新的牛主动脉插管移植，并使用牛心包补片矫正了假性动脉瘤和十二指肠之间的连接。十二指肠的缺损也被缝合成两层，并制作了一个新的网膜瓣。讨论AEF的死亡率很高，患者不太可能在两次AEF中都存活下来而不出现重大并发症。据信，文献中描述的双 AEF 病例极少。该病例发生 PAEF 的病因很可能是患者的主动脉瘤，而主动脉瘤很可能是结核引起的霉菌性动脉瘤。患者在随访期间出现了假性动脉瘤，目前还不能确定假性动脉瘤的搏动压力是否导致了 PAEF 的复发。

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引用次数: 0

Treatment Of Brachial Artery Aneurysms Associated With Arteriovenous Fistulas: Institutional Experience 治疗伴有动静脉瘘的肱动脉动脉瘤：机构经验

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.047

Carlos Veterano ∗ , Sérgio Teixeira , Ivone Silva , Pedro Sá Pinto , Rui Almeida

引用次数: 0

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