Pub Date : 2025-01-23DOI: 10.1016/j.ejvs.2025.01.020
Robert Shahverdyan, Tej Ishaan Mehta, Nicholas Inston, Klaus Konner, Shant Vartanian
Objective: This retrospective, single centre, comparative effectiveness study aimed to compare the long term outcomes of percutaneous arteriovenous fistulae (pAVF) and surgically created arteriovenous fistulae (sAVF) created in the proximal forearm for haemodialysis access.
Methods: Data were reviewed from a prospectively maintained database on patients who underwent pAVF or sAVF creation from September 2017 to September 2023. A total of 217 pAVFs (61 WavelinQ and 156 Ellipsys) and 158 sAVFs were analysed. Outcome measures included technical success, maturation, patency, time to first successful use, re-interventions, and complications.
Results: Technical success was 100% for sAVF and Ellipsys, and 93.4% for WavelinQ (p < .001). Maturation at four weeks was higher in Ellipsys (78.6%) and sAVF (79.7%) groups than in WavelinQ (64.9%) (p = .042). Median time to first cannulation was shortest for Ellipsys (57 days), followed by sAVF (73 days), and longest for WavelinQ (98.6 days) (p = .048). Average follow up was 654 days (interquartile range 164, 1 049 days; range 0 - 2 061 days). Primary patency was higher in sAVF than in pAVFs. The Cox proportional hazard ratio (HR) for loss of primary patency was 1.50 for WavelinQ and 1.42 for Ellipsys compared with sAVF (p = .045). Secondary patency was statistically significantly lower for WavelinQ (HR 2.76; p < .001), but not for Ellipsys (HR 0.74; p = .33). Haemodialysis access induced distal ischaemia (HAIDI) was more common in the sAVF group with nine events (5.7%) compared with one for the Ellipsys (0.64%; p = .008). Re-intervention rates per patient year were comparable across groups (0.60 vs. 0.61 vs. 0.69 for sAVF, WavelinQ, and Ellipsys, respectively).
Conclusion: This study indicates that while all access types can provide long term functional haemodialysis access, sAVFs perform better in some outcome domains and pAVFs (particularly Ellipsys) in others, with sAVF showing higher rates of HAIDI, yet lower rates of juxta-anastomotic stenosis. The findings underscore the importance of personalised vascular access planning, weighing immediate procedural outcomes against long term functionality.
{"title":"Long Term Results of a Comparative Study of Percutaneous and Surgically Created Proximal Forearm Arteriovenous Fistulae.","authors":"Robert Shahverdyan, Tej Ishaan Mehta, Nicholas Inston, Klaus Konner, Shant Vartanian","doi":"10.1016/j.ejvs.2025.01.020","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.01.020","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective, single centre, comparative effectiveness study aimed to compare the long term outcomes of percutaneous arteriovenous fistulae (pAVF) and surgically created arteriovenous fistulae (sAVF) created in the proximal forearm for haemodialysis access.</p><p><strong>Methods: </strong>Data were reviewed from a prospectively maintained database on patients who underwent pAVF or sAVF creation from September 2017 to September 2023. A total of 217 pAVFs (61 WavelinQ and 156 Ellipsys) and 158 sAVFs were analysed. Outcome measures included technical success, maturation, patency, time to first successful use, re-interventions, and complications.</p><p><strong>Results: </strong>Technical success was 100% for sAVF and Ellipsys, and 93.4% for WavelinQ (p < .001). Maturation at four weeks was higher in Ellipsys (78.6%) and sAVF (79.7%) groups than in WavelinQ (64.9%) (p = .042). Median time to first cannulation was shortest for Ellipsys (57 days), followed by sAVF (73 days), and longest for WavelinQ (98.6 days) (p = .048). Average follow up was 654 days (interquartile range 164, 1 049 days; range 0 - 2 061 days). Primary patency was higher in sAVF than in pAVFs. The Cox proportional hazard ratio (HR) for loss of primary patency was 1.50 for WavelinQ and 1.42 for Ellipsys compared with sAVF (p = .045). Secondary patency was statistically significantly lower for WavelinQ (HR 2.76; p < .001), but not for Ellipsys (HR 0.74; p = .33). Haemodialysis access induced distal ischaemia (HAIDI) was more common in the sAVF group with nine events (5.7%) compared with one for the Ellipsys (0.64%; p = .008). Re-intervention rates per patient year were comparable across groups (0.60 vs. 0.61 vs. 0.69 for sAVF, WavelinQ, and Ellipsys, respectively).</p><p><strong>Conclusion: </strong>This study indicates that while all access types can provide long term functional haemodialysis access, sAVFs perform better in some outcome domains and pAVFs (particularly Ellipsys) in others, with sAVF showing higher rates of HAIDI, yet lower rates of juxta-anastomotic stenosis. The findings underscore the importance of personalised vascular access planning, weighing immediate procedural outcomes against long term functionality.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-23DOI: 10.1016/j.ejvs.2025.01.019
Daniel Thompson, Oliver T Lyons
{"title":"Heritable Aortic Disease: Uncertainty in the Absence of Evidence.","authors":"Daniel Thompson, Oliver T Lyons","doi":"10.1016/j.ejvs.2025.01.019","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.01.019","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-23DOI: 10.1016/j.ejvs.2025.01.031
Enrico Cieri, Andrea M Terpin
{"title":"Health Discrimination or Design Flaw? The Challenge of Iliac Branch Devices for East Asian Aneurysm Patients.","authors":"Enrico Cieri, Andrea M Terpin","doi":"10.1016/j.ejvs.2025.01.031","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.01.031","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-21DOI: 10.1016/j.ejvs.2025.01.028
Artur Besch, Livia Cotta, Jörg Heckenkamp, Farzin Adili, Markus Steinbauer, Christian-Alexander Behrendt
{"title":"Treatment of Abdominal Aortic Aneurysm in Germany in 2023: A Registry Short Report.","authors":"Artur Besch, Livia Cotta, Jörg Heckenkamp, Farzin Adili, Markus Steinbauer, Christian-Alexander Behrendt","doi":"10.1016/j.ejvs.2025.01.028","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.01.028","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-21DOI: 10.1016/j.ejvs.2025.01.029
Athanasios Katsargyris, Stephan Haulon, Eric L G Verhoeven
{"title":"Initial Experience with the BeFlared Bridging Covered Stent for Fenestrated Endovascular Aneurysm Repair.","authors":"Athanasios Katsargyris, Stephan Haulon, Eric L G Verhoeven","doi":"10.1016/j.ejvs.2025.01.029","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.01.029","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-17DOI: 10.1016/j.ejvs.2024.12.042
Yi Deng, Wei Cui, Jing Li
{"title":"Commentary on: A Systematic Review and Meta-analysis of 24 Month Patency after Endovenous Stenting of Superior Vena Cava, Subclavian, and Brachiocephalic Vein Stenosis.","authors":"Yi Deng, Wei Cui, Jing Li","doi":"10.1016/j.ejvs.2024.12.042","DOIUrl":"https://doi.org/10.1016/j.ejvs.2024.12.042","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-16DOI: 10.1016/j.ejvs.2025.01.014
Tamana Alozai, Sharon Oud, Céline A M Eggen, Renee Pullens, Michiel A Schreve, Çağdaş Ünlü, Michael C Mooij, Clarissa J van Vlijmen
Objective: The aim of this study was to compare anterior accessory saphenous vein (AASV) reflux after standard endovenous laser ablation (EVLA) vs. flush EVLA (fEVLA) of the great saphenous vein (GSV).
Methods: This was as randomised, single blind, controlled trial (Dutch Trial Register, NL5283). Patients with GSV and saphenofemoral junction incompetence and competent AASV were randomised to standard EVLA or fEVLA using a 1 470 nm radial fibre. Treatment was blinded both for patients and phlebologists. The primary outcome was AASV reflux assessed at one week and six, twelve, and twenty four months. Secondary outcomes included GSV occlusion, stump length, endovenous heat induced thrombus (EHIT), complications, pain, time to return to daily activities, Venous Clinical Severity Score (VCSS), Aberdeen Varicose Vein Questionnaire (AVVQ) score, cosmetic results, and re-interventions.
Results: In total, 52 patients were randomised to standard EVLA and 49 to fEVLA. After twenty four months, AASV reflux occurred in 21% after standard EVLA and 30% after fEVLA (risk ratio 1.53, 95% confidence interval 0.64 - 3.66; p = .34). Freedom from AASV reflux was 81% after standard EVLA vs. 74% after fEVLA (log rank test, χ2 = 0.68, 1 df, p = .41). The GSV occlusion rate was 98% vs. 100%, respectively (p = .33). Mean stump length ± standard deviation was longer after standard EVLA (8 ± 4 mm vs. 4 ± 4 mm; p < .001). EHIT 1 occurred more frequently after fEVLA (57% vs. 17%; p < .001). EHIT 2 was seen in 2% vs. 6%, respectively (p = .34). The superficial vein thrombosis rate was 2% after standard EVLA (p = .33) and the paraesthesia rate was 4% after fEVLA (p = .23). Pain levels, time to return to daily activities, and cosmetic results were comparable, as were VCSS and AVVQ scores.
Conclusion: FEVLA of the GSV using a radial two ring laser does not reduce AASV reflux at twenty four months compared with standard EVLA.
目的：本研究的目的是比较大隐静脉（GSV）标准静脉内激光消融（EVLA）与冲洗EVLA （fEVLA）后的前副隐静脉（AASV）反流。方法：随机、单盲、对照试验（荷兰试验登记，NL5283）。GSV、隐股连接处不全和正常AASV患者随机分为标准EVLA或使用1470 nm径向纤维的fEVLA。对患者和血液学家进行盲法治疗。主要结局是在1周、6个月、12个月和24个月时评估AASV反流。次要结果包括GSV阻塞、残端长度、静脉内热致血栓（EHIT）、并发症、疼痛、恢复日常活动时间、静脉临床严重程度评分（VCSS）、阿伯丁静脉曲张问卷（AVVQ）评分、美容结果和再干预。结果：52例患者随机分为标准EVLA组，49例患者随机分为fEVLA组。24个月后，标准EVLA后出现AASV反流的比例为21%，fEVLA后出现AASV反流的比例为30%(风险比1.53,95%可信区间0.64 - 3.66；P = .34)。标准EVLA后的AASV返流自由度为81%，而fEVLA后为74%（对数秩检验，χ2 = 0.68, 1 df, p = 0.41）。GSV闭塞率分别为98%和100% （p = 0.33）。标准EVLA后残肢平均长度±标准差更长（8±4 mm vs. 4±4 mm）；P < 0.001)。EHIT 1在fEVLA后发生的频率更高(57% vs. 17%；P < 0.001)。EHIT 2分别为2%和6% （p = .34）。标准EVLA术后浅静脉血栓形成率为2% (p = 0.33)， fEVLA术后感觉异常率为4% （p = 0.23）。疼痛程度、恢复日常活动的时间和美容结果具有可比性，VCSS和AVVQ评分也具有可比性。结论：与标准EVLA相比，径向双环激光对GSV的FEVLA在24个月时不能减少AASV反流。
{"title":"A Randomised, Single Blind, Controlled Trial Comparing Flush Endovenous Laser Ablation with Standard Endovenous Laser Ablation of the Great Saphenous Vein.","authors":"Tamana Alozai, Sharon Oud, Céline A M Eggen, Renee Pullens, Michiel A Schreve, Çağdaş Ünlü, Michael C Mooij, Clarissa J van Vlijmen","doi":"10.1016/j.ejvs.2025.01.014","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.01.014","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to compare anterior accessory saphenous vein (AASV) reflux after standard endovenous laser ablation (EVLA) vs. flush EVLA (fEVLA) of the great saphenous vein (GSV).</p><p><strong>Methods: </strong>This was as randomised, single blind, controlled trial (Dutch Trial Register, NL5283). Patients with GSV and saphenofemoral junction incompetence and competent AASV were randomised to standard EVLA or fEVLA using a 1 470 nm radial fibre. Treatment was blinded both for patients and phlebologists. The primary outcome was AASV reflux assessed at one week and six, twelve, and twenty four months. Secondary outcomes included GSV occlusion, stump length, endovenous heat induced thrombus (EHIT), complications, pain, time to return to daily activities, Venous Clinical Severity Score (VCSS), Aberdeen Varicose Vein Questionnaire (AVVQ) score, cosmetic results, and re-interventions.</p><p><strong>Results: </strong>In total, 52 patients were randomised to standard EVLA and 49 to fEVLA. After twenty four months, AASV reflux occurred in 21% after standard EVLA and 30% after fEVLA (risk ratio 1.53, 95% confidence interval 0.64 - 3.66; p = .34). Freedom from AASV reflux was 81% after standard EVLA vs. 74% after fEVLA (log rank test, χ<sup>2</sup> = 0.68, 1 df, p = .41). The GSV occlusion rate was 98% vs. 100%, respectively (p = .33). Mean stump length ± standard deviation was longer after standard EVLA (8 ± 4 mm vs. 4 ± 4 mm; p < .001). EHIT 1 occurred more frequently after fEVLA (57% vs. 17%; p < .001). EHIT 2 was seen in 2% vs. 6%, respectively (p = .34). The superficial vein thrombosis rate was 2% after standard EVLA (p = .33) and the paraesthesia rate was 4% after fEVLA (p = .23). Pain levels, time to return to daily activities, and cosmetic results were comparable, as were VCSS and AVVQ scores.</p><p><strong>Conclusion: </strong>FEVLA of the GSV using a radial two ring laser does not reduce AASV reflux at twenty four months compared with standard EVLA.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-15DOI: 10.1016/j.ejvs.2025.01.015
Adam M Gwozdz, Shreya Chawla, Stephen Black
{"title":"Response to Letter by Deng and Colleagues on \"A Systematic Review of Meta-analysis of 24 Month Patency after Endovenous Stenting of Superior Vena Cava, Subclavian, and Brachiocephalic Vein Stenosis\".","authors":"Adam M Gwozdz, Shreya Chawla, Stephen Black","doi":"10.1016/j.ejvs.2025.01.015","DOIUrl":"https://doi.org/10.1016/j.ejvs.2025.01.015","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号