EJVES Vascular Forum最新文献

英文中文

The National Varicose Vein Study: Portuguese Multicentric Prospective Study Regarding Surgical Treatment of Varicose Veins 全国静脉曲张研究：葡萄牙静脉曲张手术治疗多中心前瞻性研究

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.062

Henrique Guedes Da Rocha ∗ , Eduardo Silva , Tiago Ribeiro , Daniela Silva , Marina Dias Neto (Prof) , Joao Rocha Neves (Prof) , Luis Loureiro

引用次数: 0

Carotid Artery Stenting and Improvement of Cognitive Function: Systematic Review and Meta-Analysis 颈动脉支架植入术与认知功能改善：系统回顾与元分析

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.050

Filipa Jácome ∗ , Joel Sousa , Armando Mansilha

引用次数: 0

Outcomes of Acute Limb Ischaemia at a Public Hospital in Brazil During the COVID19 Pandemic COVID19 大流行期间巴西一家公立医院急性肢体缺血的治疗结果

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.042

Inez Torres ∗ , Maria Renata Costa , Ana Beatriz Boffa , Max Wohlauer , Erasmo Silva , Pedro Puech-Leão , Nelson De Luccia

引用次数: 0

Metformin Use and Long Term Outcomes following EVAR for Infrarenal Abdominal Aortic Aneurysm 二甲双胍的使用与肾下腹主动脉瘤 EVAR 术后的长期疗效

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.023

Olivier van Tongeren ∗ , Jorg de Bruin , Vinamr Rastogi , David Vecht , Klaas Ultee , Sanne Hoeks , Hence Verhagen

引用次数: 0

Single Centre Elective Combination of Single Perclose + Angio-Seal Compared With Standard of Care During Percutaneous Endovascular Aortic Aneurysm Repair 经皮血管内主动脉瘤修补术中，单次 Perclose + Angio-Seal 的单中心选择性组合与标准护理的比较

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.035

Paolo Spath ∗ , Filippo Maioli , Sara Pomatto , Michele Leone , Annalisa Perulli , Giacomo Di Iasio , Massimiliano Marini , Silvia Massini , Salvatore Tarantini

引用次数: 0

Critical Limb Ischaemia in Octogenarians: Treatment Outcomes Compared With Younger Patients 八旬老人严重肢体缺血：与年轻患者相比的治疗效果

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2023.12.003

Amaia Ormaechevarria, Melina Vega de Céniga, June Blanco, Laura Yáñez, June Fernández, Luis Estallo

Objective

A growing proportion of patients with chronic limb threatening ischaemia (CLTI) are elderly, the most challenging for management decisions. The aim was to study the patient profile and outcome of CLTI in octogenarian patients, comparing them with younger patients.

Methods

Retrospective cohort of consecutive patients hospitalised for CLTI with infrainguinal disease in a Spanish centre (2013–2020). Data on age, comorbidity, anatomical characteristics, and treatment were gathered. Patients were stratified according to age (<80 and ≥80 years). The primary outcomes were overall survival and limb salvage (LS), analysed using Kaplan–Meier and Cox regression.

Results

: A total of 512 patients were enrolled: 305 were <80 years old with mean age 69.7 ± standard deviation (SD) 8.2 years, and 207 were ≥80 years old with mean age 85.3 ± SD 3.6 years. Smoking and diabetes mellitus were more frequent in younger patients (78.0% vs. 45.4%, p < .001; 68.5% vs. 59.5%, p = .037 respectively). Older patients had a higher prevalence of heart and kidney disease (70.5% vs. 57.0%, p = .002; 39.6% vs. 24.3%, p < .001, respectively). The arterial disease was femoropopliteal or tibial in 68.9% and 31.1% in patients <80 years and 58.9% and 41.1% in patients ≥80 years (p = .021). In younger patients, conservative treatment was indicated in 18.0%, endovascular treatment (ET) in 41.6%, and open or hybrid surgery (OS) in 40.3%; in patients ≥80 years these were 36.9%, 37.4%, and 25.7%, respectively (p <. 001). Mean follow up was 23.3 ± SD 17.4 months. One and two year overall survival was 85.4% and 73.0% in younger patients and 64.1% and 51.3% in patients ≥80 years (p < .001). LS was 83.7% and 79% at the same times in younger patients and 75.3% and 72.1% in older ones (p = .045). In younger patients ET led to worse LS than OS (p = .005) but not in older patients (p = .29).

Conclusion

Patients ≥80 years with CLTI have higher comorbidity and lower life expectancy and receive conservative treatment more frequently than younger patients. ET and OS are associated with similar survival and LS in these older patients.

目的越来越多的慢性肢体缺血（CLTI）患者是老年人，这对治疗决策来说最具挑战性。方法回顾性队列研究西班牙一家中心因胫骨下动脉疾病慢性肢体缺血危象住院的连续患者（2013-2020 年）。收集了有关年龄、合并症、解剖学特征和治疗的数据。根据年龄对患者进行了分层（80岁和≥80岁）。主要结果是总生存率和肢体挽回率（LS），采用卡普兰-梅耶（Kaplan-Meier）和考克斯回归（Cox regression）进行分析：结果：共有 512 名患者入选：305名患者年龄为80岁，平均年龄为（69.7 ± 标准差）8.2岁；207名患者年龄≥80岁，平均年龄为（85.3 ± 标准差）3.6岁。吸烟和糖尿病在年轻患者中更为常见（分别为 78.0% vs. 45.4%，p < .001；68.5% vs. 59.5%，p = .037）。老年患者心脏病和肾病的发病率更高（分别为 70.5% 对 57.0%，p = .002; 39.6% 对 24.3%，p < .001）。在年龄超过 80 岁的患者中，分别有 68.9% 和 31.1% 和 58.9% 和 41.1% 患有股动脉或胫骨动脉疾病（p = .021）。在年轻患者中，18.0%采用保守治疗，41.6%采用血管内治疗（ET），40.3%采用开放或混合手术（OS）；在≥80岁的患者中，这三个比例分别为36.9%、37.4%和25.7%（p = 0.001）。平均随访时间为（23.3 ± SD）17.4个月。年轻患者的一年和两年总生存率分别为 85.4% 和 73.0%，≥80 岁患者的一年和两年总生存率分别为 64.1% 和 51.3%（p <.001）。在同一时期，年轻患者的总生存率分别为 83.7% 和 79%，老年患者的总生存率分别为 75.3% 和 72.1%（p = .045）。结论≥80 岁的 CLTI 患者合并症较多，预期寿命较短，接受保守治疗的频率高于年轻患者。ET和OS与这些老年患者的存活率和LS相似。

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引用次数: 0

Suspected Symptomatic Infected Native Aortic Aneurysm Turns Out To Be Aortic Tumour Originating From Metastatic Cancer of Unknown Primary: A Case Report and Review of Literature 疑似有症状的感染性原发性主动脉瘤竟是源于原发灶不明的转移性癌症的主动脉瘤：病例报告与文献综述

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.06.002

Introduction

The non-specific clinical presentation of a primary aortic tumour may mimic infectious processes. Together with its rarity, this resemblance can complicate timely identification and pose diagnostic challenges.

Report

The case of a 77 year old male patient complaining of abdominal pain radiating to the back, fatigue, and loss of appetite for a month, is presented. Contrast enhanced computed tomography showed a 47 mm infrarenal aortic aneurysm with peripheral enhancement. With suspicion of an infected native aortic aneurysm, open aortic repair was performed using a bovine pericardial Y prosthesis. The intra-operative biopsy revealed a malignant undifferentiated neoplasm, which later turned out to originate from metastatic cancer of unknown primary. The patient died six months later following comprehensive and extensive oncological treatment, which included radiotherapy and chemotherapy.

Discussion

Given the scarcity of literature and challenges in classification, treatment recommendations rely on a multidisciplinary approach, involving surgery, radiotherapy, and chemotherapy. Despite the lack of established guidelines, early intervention, even in metastatic cases, may improve clinical outcomes. Surgical resection, whenever appropriate, is advocated, as it not only alleviates symptoms, but intra-operative histological sampling also aids in obtaining a definitive diagnosis.

导言原发性主动脉肿瘤的非特异性临床表现可能与感染过程相似。该病例是一名 77 岁的男性患者，主诉腹痛放射至背部、乏力和食欲不振一个月。对比增强型计算机断层扫描显示，肾下主动脉瘤直径为 47 毫米，周边增强。由于怀疑是受感染的原发性主动脉瘤，医生使用牛心包Y型假体进行了主动脉开放修补术。术中活检发现了恶性未分化肿瘤，后来证实是原发灶不明的转移癌。讨论鉴于文献资料的匮乏和分类方面的挑战，治疗建议依赖于多学科方法，包括手术、放疗和化疗。尽管缺乏既定的指南，但早期干预，即使是转移性病例，也可改善临床预后。在适当的情况下，主张进行手术切除，因为这不仅能缓解症状，而且术中组织学取样也有助于获得明确诊断。

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引用次数: 0

Surgical Treatment of Multiple Venous and Arterial Aneurysms Due to Arteriovenous Malformations of the Arm 手臂动静脉畸形引起的多发性静脉和动脉动脉瘤的手术治疗

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.02.002

Killian Fontaine, Louis Magnus, Gwenaël John, Tristan Leterrier, Mathilde Burgaud, Olivier Rouyer, Fabien Thaveau

Introduction

Arteriovenous malformations (AVMs) are rare, especially in elderly patients. Occasionally, AVM can produce aneurysmal degenerations, which can lead to bleeding or rupture. The aim of this case report was to describe the surgical treatment of large arterial and venous aneurysms in the arm associated with an AVM.

Report

An 83 year old woman of White ethnicity who was a non-smoker presented with a large pulsatile aneurysm at the left elbow with paresis of the first three fingers. The diagnosis was made by duplex ultrasonography (DUS), computed tomography angiography (CTA), and arteriography. Additional tests confirmed aneurysms of the brachial artery and the outflow veins, with the largest more than 7 cm in diameter. A very proximal brachial artery bifurcation and increased venous flow were noted. DUS confirmed the AVM by showing continuous flow in the axillary vein. The decision for surgical resection involved vascular surgeons, radiologists, angiologists, and anaesthetists. Treatment involved opening and excision of multiple venous aneurysms and AVMs. A short segment of the aneurysmal brachial artery was also resected and repaired with end to end anastomosis. The deep brachial artery which supplied AVMs and venous aneurysms was ligated and excision of these lesions was performed. At one year follow up, there were no complications and the revascularisation was patent.

Discussion

Arterial and venous aneurysms occurring together with AVMs are rare and not well documented in the medical literature. In this case, surgical intervention, including resection with direct anastomosis of the arterial aneurysm coupled with excision of venous aneurysms and AVM, proved to be effective, as evidenced by stable post-operative outcomes after one year.

导言动静脉畸形（AVM）很少见，尤其是在老年患者中。偶尔，动静脉畸形会产生动脉瘤变性，导致出血或破裂。本病例报告旨在描述手臂大的动静脉畸形动脉瘤的手术治疗方法。报告一位 83 岁的白种女性，不吸烟，左肘处有一个大的搏动性动脉瘤，前三指瘫痪。经双相超声波检查（DUS）、计算机断层扫描血管造影术（CTA）和动脉造影术确诊。其他检查证实了肱动脉和流出静脉的动脉瘤，最大的直径超过 7 厘米。患者的肱动脉分叉很近，静脉流量增加。DUS 显示腋静脉血流连续不断，证实了 AVM 的存在。血管外科医生、放射科医生、血管科医生和麻醉师共同决定进行手术切除。治疗包括打开并切除多个静脉动脉瘤和 AVM。动脉瘤肱动脉的一小段也被切除，并进行了端对端吻合修复。结扎了供应动静脉畸形和静脉动脉瘤的肱深动脉，并切除了这些病变。在一年的随访中，没有出现并发症，血管再通效果良好。在本病例中，手术干预（包括切除动脉瘤并直接吻合，同时切除静脉瘤和 AVM）被证明是有效的，一年后稳定的术后结果也证明了这一点。

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引用次数: 0

Volumetric vs. Diametric Measurement in the Follow Up of Abdominal Aortic Aneurysm After Endovascular Repair 腹主动脉瘤血管内修复术后随访中的体积测量与直径测量比较

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.009

Joel Soriano Iniesta ∗ , Maria Lourdes Del Río Solá , Manuel Díez Martínez , Joan Francisco Roedan Oliver , Sergio Asensio Rodríguez

引用次数: 0

Aortic Mural Thrombus Progression Under Full Dose Anticoagulation 全剂量抗凝治疗下的主动脉壁血栓进展

IF 0.6 Q3 Medicine

EJVES Vascular Forum

Pub Date : 2024-01-01 DOI: 10.1016/j.ejvsvf.2024.01.033

Armanda Duarte ∗ , Tony Soares , Tiago Costa , Gonçalo Cabral , José Tiago , José Gimenez , Diogo Cunha e Sá

引用次数: 0

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