EJVES Vascular Forum最新文献

英文中文

Contemporary Results of EVAR in the Treatment of Ruptured Abdominal Aortic Aneurysms EVAR治疗破裂腹主动脉瘤的当代结果

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.056

Lara Dias ∗ , Leandro Nóbrega , Marina Dias-Neto (Prof.) , Armando Mansilha (Prof.)

引用次数: 0

Single Branch Endovascular Aortic Repair Procedure for an Abdominal Aortic Aneurysm in a Patient With Horseshoe Kidney: A Case Report 马蹄肾患者腹主动脉瘤的单支血管内主动脉修复术：病例报告

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.02.004

Francesco Maiorano , António Duarte , Alice Lopes , Pedro Amorim , Carlos Martins , Luís Mendes Pedro

Introduction

Horseshoe kidney (HK) is an anatomical variant characterised by abnormalities in the position, rotation, and vascular supply of the kidney, with functioning renal masses on both sides of the vertebral column fused together at the isthmus. Due to the altered pattern of kidney vasculature, endovascular aortic repair for aortic abdominal aneurysm (AAA) in the presence of HK requires vascular anatomy specific planning.

Report

A 68 year old male, with multiple comorbidities, presented with an asymptomatic AAA and HK. The kidney vasculature was characterised by the presence of three arteries: two arising laterally at the same level and a third polar artery arising from below. The polar artery was 6 mm in diameter and larger than the other two; therefore, in order to preserve this artery, a custom-made device with a single side branch was implanted below the main renal arteries. A balloon expandable covered stent was used to complete the side branch into the polar renal artery. The follow-up computed tomography angiography revealed a successful outcome, with total aneurysm exclusion, branched graft patency, no endoleak, and unchanged renal function.

Discussion

This case report shows a possible surgical solution for a case of HK with AAA and the importance of accurate endovascular planning. Large polar arteries, if present, need to be preserved, and custom-made devices in the modern endovascular era permit that. This approach could represent the best option for complicated patients.

导言马蹄肾（HK）是一种解剖变异，其特点是肾脏的位置、旋转和血管供应异常，椎体两侧有功能的肾脏肿块在峡部融合在一起。由于肾脏血管模式的改变，在存在 HK 的情况下进行腹主动脉瘤（AAA）的主动脉内血管修复需要根据血管解剖进行具体规划。肾脏血管的特点是有三条动脉：两条横向动脉位于同一水平，第三条极动脉来自下方。极动脉直径为 6 毫米，比其他两条动脉都大；因此，为了保留这条动脉，在主肾动脉下方植入了一个带有单侧分支的定制装置。使用球囊扩张覆盖支架完成了进入极肾动脉的侧支。随访的计算机断层扫描血管造影显示手术成功，动脉瘤完全排除，分支移植物通畅，无内漏，肾功能无变化。讨论本病例报告显示了一种可行的手术解决方案，可用于患有 AAA 的 HK 病例，以及准确的血管内规划的重要性。如果存在大的极动脉，则需要保留，而现代血管内手术时代的定制装置可以做到这一点。这种方法可能是复杂患者的最佳选择。

{"title":"Single Branch Endovascular Aortic Repair Procedure for an Abdominal Aortic Aneurysm in a Patient With Horseshoe Kidney: A Case Report","authors":"Francesco Maiorano , António Duarte , Alice Lopes , Pedro Amorim , Carlos Martins , Luís Mendes Pedro","doi":"10.1016/j.ejvsvf.2024.02.004","DOIUrl":"https://doi.org/10.1016/j.ejvsvf.2024.02.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Horseshoe kidney (HK) is an anatomical variant characterised by abnormalities in the position, rotation, and vascular supply of the kidney, with functioning renal masses on both sides of the vertebral column fused together at the isthmus. Due to the altered pattern of kidney vasculature, endovascular aortic repair for aortic abdominal aneurysm (AAA) in the presence of HK requires vascular anatomy specific planning.</p></div><div><h3>Report</h3><p>A 68 year old male, with multiple comorbidities, presented with an asymptomatic AAA and HK. The kidney vasculature was characterised by the presence of three arteries: two arising laterally at the same level and a third polar artery arising from below. The polar artery was 6 mm in diameter and larger than the other two; therefore, in order to preserve this artery, a custom-made device with a single side branch was implanted below the main renal arteries. A balloon expandable covered stent was used to complete the side branch into the polar renal artery. The follow-up computed tomography angiography revealed a successful outcome, with total aneurysm exclusion, branched graft patency, no endoleak, and unchanged renal function.</p></div><div><h3>Discussion</h3><p>This case report shows a possible surgical solution for a case of HK with AAA and the importance of accurate endovascular planning. Large polar arteries, if present, need to be preserved, and custom-made devices in the modern endovascular era permit that. This approach could represent the best option for complicated patients.</p></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000753/pdfft?md5=dedb7a3a06ce03243313aaef7612f097&pid=1-s2.0-S2666688X24000753-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195624","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

A Tubular Vena Cava Conduit Used to Lengthen a Kidney Transplant Renal Artery Injured During Organ Procurement 用于延长器官移植过程中损伤的肾动脉的管化腔静脉导管

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.052

Bogdan Bratu , Salomé Kuntz , Sophie Caillard , Nabil Chakfe , Anne Lejay

Introduction

Organ transplantation is limited by the supply of transplantable organs, and the supply of organs cannot meet the needs of patients on the waiting list. Ensuring transplantation of any procured organ is therefore mandatory. Organ injury, mostly to the organ's vasculature, can occur during multi-organ procurement, preventing subsequent transplantation. In such a context, vascular reconstructions of arterial or venous organ injuries can be useful.

Report

This report describes the case of an obese 64 year old female with a history of diabetic nephropathy who underwent a cadaveric kidney transplant (right kidney with one main renal artery, one inferior polar artery, one vein, and one ureter). The ex situ preparation of the graft revealed that the main renal artery was injured and cut close to the renal hilum (0.8 cm length, 6 mm diameter), not allowing graft implantation. In order to increase the length of the main renal artery, the donor inferior vena cava was used to create a tubular conduit, allowing subsequent graft implantation. Cold and warm ischaemic times were respectively 12 hours and 36 minutes, with immediate graft function. The patient was discharged on day 8 (serum creatinine level was 95 μmol/L). Twelve month follow up was uneventful (serum creatinine level was 108 μmol/L and duplex ultrasonography showed homogeneous blood flow throughout the graft).

Discussion

This case report highlights the possibility of overcoming an injured kidney graft artery by creating a tubular vena cava conduit in order to allow subsequent transplantation. Vascular reconstructions of organs injured during procurement should be considered.

导言器官移植受到可移植器官供应的限制，器官供应无法满足候选名单上患者的需求。因此，必须确保所购器官的移植。在多器官获取过程中，可能会出现器官损伤，主要是器官的血管损伤，从而阻碍随后的移植。本报告描述了一例肥胖的 64 岁女性病例，她有糖尿病肾病史，接受了尸体肾移植（右肾，含一条肾主动脉、一条肾下极动脉、一条静脉和一条输尿管）。原位制备移植物时发现，肾主动脉受伤，在靠近肾门的位置被切断（长 0.8 厘米，直径 6 毫米），无法植入移植物。为了增加主肾动脉的长度，利用供体下腔静脉创建了一个管状导管，以便随后植入移植物。冷缺血和暖缺血时间分别为 12 小时和 36 分钟，移植物立即发挥作用。患者于第 8 天出院（血清肌酐水平为 95 μmol/L）。12 个月的随访顺利（血清肌酐水平为 108 μmol/L，双相超声波检查显示整个移植物血流均匀）。应考虑对移植过程中受伤的器官进行血管重建。

{"title":"A Tubular Vena Cava Conduit Used to Lengthen a Kidney Transplant Renal Artery Injured During Organ Procurement","authors":"Bogdan Bratu , Salomé Kuntz , Sophie Caillard , Nabil Chakfe , Anne Lejay","doi":"10.1016/j.ejvsvf.2024.01.052","DOIUrl":"10.1016/j.ejvsvf.2024.01.052","url":null,"abstract":"<div><h3>Introduction</h3><p>Organ transplantation is limited by the supply of transplantable organs, and the supply of organs cannot meet the needs of patients on the waiting list. Ensuring transplantation of any procured organ is therefore mandatory. Organ injury, mostly to the organ's vasculature, can occur during multi-organ procurement, preventing subsequent transplantation. In such a context, vascular reconstructions of arterial or venous organ injuries can be useful.</p></div><div><h3>Report</h3><p>This report describes the case of an obese 64 year old female with a history of diabetic nephropathy who underwent a cadaveric kidney transplant (right kidney with one main renal artery, one inferior polar artery, one vein, and one ureter). The <em>ex situ</em> preparation of the graft revealed that the main renal artery was injured and cut close to the renal hilum (0.8 cm length, 6 mm diameter), not allowing graft implantation. In order to increase the length of the main renal artery, the donor inferior vena cava was used to create a tubular conduit, allowing subsequent graft implantation. Cold and warm ischaemic times were respectively 12 hours and 36 minutes, with immediate graft function. The patient was discharged on day 8 (serum creatinine level was 95 μmol/L). Twelve month follow up was uneventful (serum creatinine level was 108 μmol/L and duplex ultrasonography showed homogeneous blood flow throughout the graft).</p></div><div><h3>Discussion</h3><p>This case report highlights the possibility of overcoming an injured kidney graft artery by creating a tubular vena cava conduit in order to allow subsequent transplantation. Vascular reconstructions of organs injured during procurement should be considered.</p></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000534/pdfft?md5=03c0bb56a0de6b1c12c730a97ee4a3cd&pid=1-s2.0-S2666688X24000534-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139539551","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

Fibula Erosion Due to Popliteal Artery False Aneurysm 腘动脉假性动脉瘤导致腓骨侵蚀

IF 1.4 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.05.001

Aude Gatinot, Simon Rinckenbach

引用次数: 0

Magnetic Resonance Imaging and Histological Insights Into Deep Venous Arterialisation 磁共振成像和组织学对深静脉动脉化的启示

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.04.003

Bright Benfor , Judit Csore , Deborah C. Vela , Miguel Montero-Baker , Trisha L. Roy

Introduction

Percutaneous deep venous arterialisation (DVA) is emerging as a promising alternative for limb salvage in chronic limb threatening ischaemia (CLTI) patients without any reasonable anatomical option for conventional revascularisation techniques. However, its mechanism of action remains incompletely understood. This report aimed to find some of the histological alterations occurring in the limb following DVA.

Report

This short report presents the case of a 53 year old female who underwent DVA for Rutherford 5 CLTI. Although the intervention was successful and showed evidence of improved blood flow to the foot, the post-operative course was notable due to worsening infection leading to a below knee amputation four weeks later. The blood vessels were harvested for histological analysis, which found features of venous arterialisation such as smooth muscle cell proliferation and neointimal hyperplasia, even in the paired posterior tibial vein that did not undergo DVA.

Discussion

This case demonstrated unexpected histological changes occurring in the paired posterior tibial vein that did not undergo DVA. This warrants further investigations to fully understand the mechanisms at play in DVA and to explore the role of the paired vein in sustaining arterialised flow to the foot.

导言经皮深静脉动脉化（DVA）正在成为慢性肢体威胁性缺血（CLTI）患者肢体抢救的一种有前途的替代方法，因为传统的血管重建技术没有任何合理的解剖选择。然而，人们对它的作用机制仍不完全了解。本报告旨在发现 DVA 术后肢体发生的一些组织学改变。本简短报告介绍了一例 53 岁女性因卢瑟福 5 型 CLTI 而接受 DVA 术的病例。虽然干预手术很成功，并有证据表明足部血流得到改善，但术后感染恶化导致膝下截肢，四周后截肢。采集血管进行组织学分析后发现了静脉动脉化的特征，如平滑肌细胞增生和新内膜增生，甚至在未进行 DVA 的成对胫后静脉也是如此。这需要进一步研究，以充分了解 DVA 的作用机制，并探索成对静脉在维持足部动脉血流中的作用。

{"title":"Magnetic Resonance Imaging and Histological Insights Into Deep Venous Arterialisation","authors":"Bright Benfor , Judit Csore , Deborah C. Vela , Miguel Montero-Baker , Trisha L. Roy","doi":"10.1016/j.ejvsvf.2024.04.003","DOIUrl":"https://doi.org/10.1016/j.ejvsvf.2024.04.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Percutaneous deep venous arterialisation (DVA) is emerging as a promising alternative for limb salvage in chronic limb threatening ischaemia (CLTI) patients without any reasonable anatomical option for conventional revascularisation techniques. However, its mechanism of action remains incompletely understood. This report aimed to find some of the histological alterations occurring in the limb following DVA.</p></div><div><h3>Report</h3><p>This short report presents the case of a 53 year old female who underwent DVA for Rutherford 5 CLTI. Although the intervention was successful and showed evidence of improved blood flow to the foot, the post-operative course was notable due to worsening infection leading to a below knee amputation four weeks later. The blood vessels were harvested for histological analysis, which found features of venous arterialisation such as smooth muscle cell proliferation and neointimal hyperplasia, even in the paired posterior tibial vein that did not undergo DVA.</p></div><div><h3>Discussion</h3><p>This case demonstrated unexpected histological changes occurring in the paired posterior tibial vein that did not undergo DVA. This warrants further investigations to fully understand the mechanisms at play in DVA and to explore the role of the paired vein in sustaining arterialised flow to the foot.</p></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000790/pdfft?md5=a2714844df8c391acde105d34cf0220c&pid=1-s2.0-S2666688X24000790-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141240853","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

Got a New Complication? Treat it With an Old Technique! 有新的并发症？用老方法治疗

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.06.003

引用次数: 0

Intestinal Fatty Acid Binding Protein as a Predictor of Early Mesenteric Injury Preceding Clinical Presentation: A Case Report 肠脂肪酸结合蛋白是临床表现前肠系膜早期损伤的预测因子：病例报告

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.04.004

Annet A.M. Duivenvoorden , Flores M. Metz , Robin Wijenbergh , Hanne C.R. Verberght , Annemarie A.J.H.M. van Bijnen , Steven W.M. Olde Damink , Robert H. Geelkerken , Kaatje Lenaerts , Tim Lubbers

Introduction

Diagnosing non-occlusive mesenteric ischaemia (NOMI) in patients is complicated, due to poor signs and symptoms and non-specific laboratory tests, leading to a high mortality rate. This case study presents the rare case of a patient who developed mesenteric ischaemia after an emergency thoracic endovascular aneurysm repair (TEVAR) for a type B aortic dissection (TBAD) and peri-operative cardiogenic shock. Study outcomes revealed that intestinal fatty acid binding protein (I-FABP) identified early mucosal damage two days before the clinical presentation.

Report

A 43 year old male patient was admitted to the emergency department with an acute TBAD and a dissection of the superior mesenteric artery (SMA), for which TEVAR was performed with additional stent placement in the SMA. Peri-operatively, the patient went into cardiogenic shock with a sustained period of hypotension. Post-operatively, the plasma I-FABP levels were measured prospectively, revealing an initial increase on post-operative day five (551.1 pg/mL), which continued beyond day six (610.3 pg/mL). On post-operative day seven, the patient developed a fever and demonstrated signs of peritonitis and bowel perforation. He underwent an emergency laparotomy, followed by an ileocaecal resection (<100 cm) with a transverse ileostomy. Pathological analysis confirmed the diagnosis of mesenteric ischaemia.

Discussion

The diagnosis of NOMI in critically ill patients is often complicated, and the currently available diagnostic markers lack the specificity and sensitivity to detect early intestinal injury. This case report highlights that elevated I-FABP in plasma levels may indicate the presence of early mesenteric injury. Further research needs to be conducted before I-FABP can be applied in daily practice.

导言由于症状和体征不明显、实验室检查不特异，患者非闭塞性肠系膜缺血（NOMI）的诊断非常复杂，导致死亡率很高。本病例研究介绍了一例罕见病例，该患者因 B 型主动脉夹层（TBAD）和围手术期心源性休克而接受紧急胸腔内血管动脉瘤修补术（TEVAR），术后出现肠系膜缺血。研究结果显示，肠道脂肪酸结合蛋白（I-FABP）可在临床表现前两天发现早期粘膜损伤。报告一名 43 岁的男性患者因急性 TBAD 和肠系膜上动脉（SMA）夹层而被送入急诊科，医生为其实施了 TEVAR，并在 SMA 中放置了额外的支架。围手术期，患者出现心源性休克，并持续低血压。术后对血浆 I-FABP 水平进行了前瞻性测量，结果显示术后第五天血浆 I-FABP 水平开始上升（551.1 pg/mL），并持续到术后第六天（610.3 pg/mL）。术后第七天，患者出现发烧，并表现出腹膜炎和肠穿孔的迹象。他接受了急诊开腹手术，随后进行了回盲肠切除术（100 厘米）和横向回肠造口术。病理分析证实了肠系膜缺血的诊断。讨论危重病人NOMI的诊断通常比较复杂，目前可用的诊断指标缺乏检测早期肠道损伤的特异性和敏感性。本病例报告强调，血浆中 I-FABP 水平升高可能表明存在早期肠系膜损伤。在将 I-FABP 应用于日常实践之前，还需要开展进一步的研究。

{"title":"Intestinal Fatty Acid Binding Protein as a Predictor of Early Mesenteric Injury Preceding Clinical Presentation: A Case Report","authors":"Annet A.M. Duivenvoorden , Flores M. Metz , Robin Wijenbergh , Hanne C.R. Verberght , Annemarie A.J.H.M. van Bijnen , Steven W.M. Olde Damink , Robert H. Geelkerken , Kaatje Lenaerts , Tim Lubbers","doi":"10.1016/j.ejvsvf.2024.04.004","DOIUrl":"https://doi.org/10.1016/j.ejvsvf.2024.04.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Diagnosing non-occlusive mesenteric ischaemia (NOMI) in patients is complicated, due to poor signs and symptoms and non-specific laboratory tests, leading to a high mortality rate. This case study presents the rare case of a patient who developed mesenteric ischaemia after an emergency thoracic endovascular aneurysm repair (TEVAR) for a type B aortic dissection (TBAD) and peri-operative cardiogenic shock. Study outcomes revealed that intestinal fatty acid binding protein (I-FABP) identified early mucosal damage two days before the clinical presentation.</p></div><div><h3>Report</h3><p>A 43 year old male patient was admitted to the emergency department with an acute TBAD and a dissection of the superior mesenteric artery (SMA), for which TEVAR was performed with additional stent placement in the SMA. Peri-operatively, the patient went into cardiogenic shock with a sustained period of hypotension. Post-operatively, the plasma I-FABP levels were measured prospectively, revealing an initial increase on post-operative day five (551.1 pg/mL), which continued beyond day six (610.3 pg/mL). On post-operative day seven, the patient developed a fever and demonstrated signs of peritonitis and bowel perforation. He underwent an emergency laparotomy, followed by an ileocaecal resection (<100 cm) with a transverse ileostomy. Pathological analysis confirmed the diagnosis of mesenteric ischaemia.</p></div><div><h3>Discussion</h3><p>The diagnosis of NOMI in critically ill patients is often complicated, and the currently available diagnostic markers lack the specificity and sensitivity to detect early intestinal injury. This case report highlights that elevated I-FABP in plasma levels may indicate the presence of early mesenteric injury. Further research needs to be conducted before I-FABP can be applied in daily practice.</p></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000807/pdfft?md5=eeb854be3acb4fa56764d5e30c2e256d&pid=1-s2.0-S2666688X24000807-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141243689","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

Observational Study on the Risk of Surgical Site Infection in Patients Undergoing Common Femoral Endarterectomy in Conjunction With an Endovascular Procedure Compared With Common Femoral Endarterectomy Alone 股总动脉内膜切除术与单纯股总动脉内膜切除术患者手术部位感染风险的观察性研究

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.05.003

Hamish Walker, Manik S. Chana, Kavisha Mandalia, Sachin R. Kulkarni, Sharath C.V. Paravastu

Objective

A hybrid approach is being employed increasingly in the management of peripheral arterial disease. This study aimed to assess the surgical site infection (SSI) incidence of hybrid revascularisation (HR) compared with common femoral endarterectomy (CFEA) alone.

Methods

This was a retrospective review of consecutive patients who underwent CFEA or HR alongside CFEA between 2017 and 2021 including one year of follow up. The primary outcome was SSI incidence. Secondary outcomes included length of surgery, duration of admission, further revascularisation surgery, limb salvage, and death. Differences in outcomes were assessed with the Student's unpaired t test, chi square test, and Fisher's exact test.

Results

A total of 157 groin incisions from 155 patients were included: 78 had CFEA procedures and 79 had HR procedures. No statistical difference was found between groups for age, sex, and indication for surgery. Surgical site infection occurred in five of the CFEA patients (6%) compared with seven of the HR patients (9%) (p = 0.77). The HR procedures took significantly longer, with an average of 299 minutes compared with 220 minutes for CFEA (p < 0.001). No statistically significant difference was identified for length of admission: median stay five days for CFEA vs. four days for HR (p = 0.44). Major amputation was performed within one year in five of the CFEA procedures (6%) and five of the HR procedures (6%) (p = 1.0). Further revascularisation surgery was attempted in two patients in the HR group and six patients in the CFEA group (p =. 17). No statistically significant difference was found in the one year mortality rate: eight CFEA (10%) and seven HR (9%) (p = 0.77).

Conclusion

Patients who underwent HR alongside CFEA did not have a statistically significantly increased incidence of SSI, despite increased surgical time. Using HR techniques enabled patients to have multilevel disease treated in one stage without an increased incidence of SSI.

目的在外周动脉疾病的治疗中，越来越多地采用混合方法。本研究旨在评估混合血管重建术（HR）与单纯股总动脉内膜剥脱术（CFEA）相比的手术部位感染（SSI）发生率。方法这是对2017年至2021年间接受CFEA或与CFEA同时接受HR的连续患者进行的回顾性研究，包括一年的随访。主要结果是SSI发生率。次要结局包括手术时间、入院时间、进一步血管重建手术、肢体挽救和死亡。结果共纳入了 155 名患者的 157 个腹股沟切口：其中 78 人进行了 CFEA 手术，79 人进行了 HR 手术。两组患者在年龄、性别和手术指征方面均无统计学差异。5 名 CFEA 患者（6%）发生了手术部位感染，而 7 名 HR 患者（9%）发生了手术部位感染（P = 0.77）。HR手术耗时明显更长，平均为299分钟，而CFEA为220分钟（P = 0.001）。入院时间的差异无统计学意义：CFEA的中位住院时间为5天，而HR为4天（p = 0.44）。CFEA手术中有5例（6%）和HR手术中有5例（6%）在一年内进行了大截肢手术（p = 1.0）。HR组中有两名患者尝试了进一步的血管重建手术，CFEA组中有六名患者尝试了进一步的血管重建手术（P = 17）。结论尽管手术时间增加，但同时接受HR和CFEA手术的患者的SSI发生率并没有明显增加。使用HR技术可使患者的多层次疾病在一个阶段内得到治疗，而不会增加SSI的发生率。

{"title":"Observational Study on the Risk of Surgical Site Infection in Patients Undergoing Common Femoral Endarterectomy in Conjunction With an Endovascular Procedure Compared With Common Femoral Endarterectomy Alone","authors":"Hamish Walker, Manik S. Chana, Kavisha Mandalia, Sachin R. Kulkarni, Sharath C.V. Paravastu","doi":"10.1016/j.ejvsvf.2024.05.003","DOIUrl":"10.1016/j.ejvsvf.2024.05.003","url":null,"abstract":"<div><h3>Objective</h3><p>A hybrid approach is being employed increasingly in the management of peripheral arterial disease. This study aimed to assess the surgical site infection (SSI) incidence of hybrid revascularisation (HR) compared with common femoral endarterectomy (CFEA) alone.</p></div><div><h3>Methods</h3><p>This was a retrospective review of consecutive patients who underwent CFEA or HR alongside CFEA between 2017 and 2021 including one year of follow up. The primary outcome was SSI incidence. Secondary outcomes included length of surgery, duration of admission, further revascularisation surgery, limb salvage, and death. Differences in outcomes were assessed with the Student's unpaired <em>t</em> test, chi square test, and Fisher's exact test.</p></div><div><h3>Results</h3><p>A total of 157 groin incisions from 155 patients were included: 78 had CFEA procedures and 79 had HR procedures. No statistical difference was found between groups for age, sex, and indication for surgery. Surgical site infection occurred in five of the CFEA patients (6%) compared with seven of the HR patients (9%) (<em>p</em> = 0.77). The HR procedures took significantly longer, with an average of 299 minutes compared with 220 minutes for CFEA (<em>p</em> < 0.001). No statistically significant difference was identified for length of admission: median stay five days for CFEA <em>vs.</em> four days for HR (<em>p</em> = 0.44). Major amputation was performed within one year in five of the CFEA procedures (6%) and five of the HR procedures (6%) (<em>p</em> = 1.0). Further revascularisation surgery was attempted in two patients in the HR group and six patients in the CFEA group (<em>p</em> =. 17). No statistically significant difference was found in the one year mortality rate: eight CFEA (10%) and seven HR (9%) (<em>p</em> = 0.77).</p></div><div><h3>Conclusion</h3><p>Patients who underwent HR alongside CFEA did not have a statistically significantly increased incidence of SSI, despite increased surgical time. Using HR techniques enabled patients to have multilevel disease treated in one stage without an increased incidence of SSI.</p></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000832/pdfft?md5=64d7d2128a3de74847f51bebb85edcc8&pid=1-s2.0-S2666688X24000832-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141046762","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

A for Aneurysm! A 代表动脉瘤！

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.001

Carlos Martínez-Rico, Elena Iborra-Ortega

引用次数: 0

Prospective Evaluation of Effects of Neutrophil to Lymphocyte Ratio on Mortality after Elective Vascular Procedures 前瞻性评估中性粒细胞与淋巴细胞比率对择期血管手术后死亡率的影响

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.018

Ayman Alrazim , Avkash Patel ∗ , Anuja Sarode , Tania Jarc , William Yoon , Mehdi Shishehbor , Alvin Schmaier , Jae Cho

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.

﹀