European Journal of Vascular and Endovascular Surgery最新文献

英文中文

1H Nuclear Magnetic Resonance Spectroscopy Reveals Changes in Metabolic Phenotype Associated with Disease Stage in Patients with Chronic Venous Disease 1H 核磁共振波谱显示慢性静脉疾病患者的代谢表型变化与疾病分期有关。

IF 5.7 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.09.019

Sarah Onida , Hannah J. Lees , Richmond Bergner , Joseph Shalhoub , Elaine Holmes , Alun H. Davies

Objective

Chronic venous disease (CVD) is a condition presenting a great burden to patients and society, with poorly characterised pathophysiology. Metabolic phenotyping can elucidate mechanisms of disease and identify candidate biomarkers. The aim of this study was to determine differences in the metabolic signature between symptomatic patients with CVD and asymptomatic volunteers using proton nuclear magnetic resonance spectroscopy (¹H-NMR).

Methods

This was a prospective case control study of consecutive patients with symptomatic CVD and asymptomatic volunteers recruited from a single centre. Participants underwent clinical assessment, venous duplex ultrasound, and blood and urine sampling. Disease stage was defined according to the Clinical–Etiology–Anatomy–Pathophysiology (CEAP) classification. ¹H-NMR experiments were performed, with data analysed via multivariable statistical techniques.

Results

A total of 622 participants were recruited, including 517 symptomatic patients with CVD (telangiectasia [C1] 0.6%, varicose veins [C2] 48.5%, swelling [C3] 12.0%, skin changes [C4] 27.7%, healed or active ulceration [C5/6] 11.2%) and 105 asymptomatic participants (no disease [C0] 69.5%, telangiectasia [C1] 29.6%). Multivariable analysis revealed differences between the metabolic profile of the symptomatic CVD and asymptomatic groups, and between CEAP clinical classes in the CVD group. Serum aromatic amino acids positively correlated with increasing CEAP clinical class (p < .001). Urinary formate, creatinine, glycine, citrate, succinate, pyruvate, and 2-hydroxyisobutyrate negatively correlated with increasing CEAP clinical class (p < .001). These metabolites are involved in the tricarboxylic acid cycle, hypoxia inducible factor pathway, and one carbon metabolism.

Conclusion

Untargeted biofluid analysis via ¹H-NMR has detected metabolites associated with the presence and severity of CVD, highlighting biological pathways of relevance and providing candidate biomarkers to explore in future research.

目的：慢性静脉疾病（CVD）是一种给患者和社会带来巨大负担的疾病，其病理生理学特征不甚明了。代谢表型分析可以阐明疾病机制并确定候选生物标记物。本研究的目的是利用质子核磁共振波谱（1H-NMR）确定有症状的心血管疾病患者与无症状志愿者之间代谢特征的差异：这是一项前瞻性病例对照研究，研究对象是从一个中心连续招募的无症状心血管疾病患者和无症状志愿者。参与者接受了临床评估、静脉双相超声检查以及血液和尿液采样。疾病分期根据临床-病因-解剖-病理生理学（CEAP）分类法进行定义。进行了 1H-NMR 实验，并通过多元统计技术对数据进行了分析：共招募了 622 名参与者，包括 517 名有症状的心血管疾病患者（毛细血管扩张 [C1] 0.6%、静脉曲张 [C2] 48.5%、肿胀 [C3] 12.0%、皮肤变化 [C4] 27.7%、愈合或活动性溃疡 [C5/6] 11.2%）和 105 名无症状参与者（无疾病 [C0] 69.5%、毛细血管扩张 [C1] 29.6%）。多变量分析显示，有症状的心血管疾病组和无症状组之间的代谢概况存在差异，心血管疾病组的 CEAP 临床分级也存在差异。血清芳香族氨基酸与 CEAP 临床分级的增加呈正相关（p < .001）。尿甲酸盐、肌酐、甘氨酸、柠檬酸盐、琥珀酸盐、丙酮酸盐和 2-羟基异丁酸盐与 CEAP 临床分级的增加呈负相关（p < .001）。这些代谢物参与了三羧酸循环、缺氧诱导因子途径和一碳代谢：结论：通过 1H-NMR 进行的非靶向生物流体分析检测出了与心血管疾病的存在和严重程度相关的代谢物，突出了相关的生物通路，并为今后的研究提供了候选生物标记物。

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引用次数: 0

Measuring perianastomotic pressure to identify patients at high risk for dialysis-associated steal syndrome

IF 5.7 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2025.01.010

Gina M. Biagetti MD, Matthew F. Carpiniello MD, Matthew J. Dougherty MD, Douglas A. Troutman MD, Keith D. Calligaro MD

引用次数: 0

Open Survey on Barriers to International Research in Vascular Surgery and Potential Role of the European Society for Vascular Surgery 关于血管外科国际研究障碍和欧洲血管外科协会潜在作用的公开调查。

IF 5.7 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.09.012

Fabien Lareyre , Matthias Trenner , Juliette Raffort , Robert J. Hinchliffe , Athanasios Saratzis

引用次数: 0

Editor's Choice – Daily Remote Ischaemic Preconditioning for Intermittent Claudication: A Sham Controlled Randomised Trial 间歇性跛行的每日远程缺血预处理：虚假对照随机试验

IF 5.7 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.10.047

Kadri Eerik , Teele Kasepalu , Holger Post , Jaan Eha , Mart Kals , Jaak Kals

Objective

Remote ischaemic preconditioning (RIPC) is a promising non-invasive strategy in which brief episodes of ischaemia and reperfusion can increase skeletal muscle resistance to ischaemia and improve mobility. This study aimed to determine whether 28 consecutive days of RIPC improved intermittent claudication (IC) symptoms compared with sham intervention.

Methods

This single centre, parallel, randomised, sham controlled, double blind trial was conducted from January 2022 to April 2023 in outpatient settings. Forty two patients with stable IC Fontaine stage IIa or IIb were randomised to RIPC or sham for 28 days. The pre-specified primary outcome was a change in the maximum walking distance (MWD) after 28 days measured with a treadmill test. A > 10% change in MWD was considered clinically significant. Change in intermittent claudication distance (ICD), time to relief from claudication (TRC), and health related quality of life (HRQoL) measured with the VascuQoL-6 questionnaire were the secondary outcomes (ClinicalTrials.gov ID: NCT05084066).

Results

Forty one men (RIPC = 23, sham = 18) aged 64.9 ± 7.4 years were analysed. A change of > 10% in MWD occurred in 14 patients in the RIPC group vs. eight patients in the sham group (relative risk 1.37, 95% confidence interval 0.74 – 2.25; p = .35). Changes in ICD, TRC, and HRQoL between the groups were not statistically significant.

Conclusion

In this trial, RIPC did not significantly improve MWD, ICD, or TRC compared with treatment with a sham device.

目的：远程缺血预处理（RIPC）是一种很有前景的非侵入性策略，通过短暂的缺血和再灌注可以增强骨骼肌对缺血的抵抗力，改善活动能力。本研究旨在确定与假干预相比，连续 28 天的 RIPC 是否能改善间歇性跛行（IC）症状：这项单中心、平行、随机、假对照、双盲试验于 2022 年 1 月至 2023 年 4 月在门诊环境中进行。42名方丹氏 IIa 期或 IIb 期稳定型 IC 患者被随机分配到 RIPC 或假干预中，为期 28 天。预设的主要结果是28天后通过跑步机测试测量的最大步行距离（MWD）的变化。MWD变化大于10%被认为具有临床意义。间歇性跛行距离（ICD）的变化、跛行缓解时间（TRC）以及用 VascuQoL-6 问卷测量的健康相关生活质量（HRQoL）是次要结果（ClinicalTrials.gov ID：NCT05084066）：对 41 名男性（RIPC = 23，假体 = 18）进行了分析，他们的年龄为 64.9 ± 7.4 岁。RIPC组有14名患者的MWD变化大于10%，而假体组有8名患者的MWD变化大于10%（相对风险1.37，95%置信区间0.74 - 2.25；P = .35）。两组间ICD、TRC和HRQoL的变化无统计学意义：在这项试验中，与使用假设备治疗相比，RIPC 对 MWD、ICD 或 TRC 没有明显改善。

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引用次数: 0

Remote Ischaemic Preconditioning for Claudication May Not Be Worthwhile 针对跛行的远程缺血预处理可能没有价值

IF 5.7 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.11.020

Marijn M.L. van den Houten , Marc R.M. Scheltinga

引用次数: 0

Prognostic Value of a Classification System for Iliofemoral Stenting in Patients with Chronic Venous Obstruction 慢性静脉阻塞患者髂股动脉支架植入术分类系统的预后价值

IF 5.7 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.10.002

Houman Jalaie , Mohammad E. Barbati , Long Piao , Suat Doganci , Nils Kucher , Mert Dumantepe , Olivier Hartung , Michael Lichtenberg , Stephen Black , Gerard O’Sullivan , Efthymios D. Avgerinos , Alun H. Davies , Mahmood K. Razavi

Objective

This retrospective, multicentre study aimed to assess the prognostic value of a proposed classification system for chronic venous obstruction (CVO) patients undergoing successful interventional procedures.

Methods

This study analysed data from 13 vascular centres, including 1 033 patients with CVO treated between 2015 – 2019. The patients were classified into five category types: 1 – non-thrombotic iliac vein lesion; 2 – CVO of iliac segment; 3 – CVO of iliofemoral segment above common femoral vein confluence; 4 – CVO of iliofemoral segment extending into the femoral vein (FV) or deep femoral vein (DFV); and 5 – CVO of iliofemoral segment involving both DFV and FV. Stent deployment, complications, and follow ups were evaluated. Uni- and multivariable analyses were performed to identify predictors of primary patency loss.

Results

The mean age of the patients was 44.0 ± 14.7 years, with 59.9% being women. A median of two stents was used for unilateral cases and five stents for bilateral cases. At twelve months follow up, primary patency rates for types 1 – 5 were 94.9%, 90.3%, 80.8%, 60.6%, and 39.4%, respectively. These rates were strongly correlated with the extent of CVO and showed significant differences between each type. Univariable analysis identified predictors of primary patency loss as the type of CVO, history of deep vein thrombosis, and the total number of stents. In the multivariable analysis, the significant independent predictors of primary patency loss were the type of CVO and the total number of stents.

Conclusion

The proposed anatomical classification of iliofemoral CVO will help to predict intervention outcomes and facilitate comparison of stent outcomes in future studies. However, further evaluation and validation in prospective studies are needed to confirm the utility of this classification.

目的这项多中心回顾性研究旨在评估针对成功接受介入手术的慢性静脉阻塞（CVO）患者提出的分类系统的预后价值：本研究分析了来自13个血管中心的数据，包括2015-2019年间接受治疗的1 033名CVO患者。患者被分为五类：1-非血栓性髂静脉病变；2-髂段CVO；3-股总静脉汇合处以上的髂股段CVO；4-延伸至股静脉（FV）或股深静脉（DFV）的髂股段CVO；5-同时涉及DFV和FV的髂股段CVO。对支架部署、并发症和随访进行了评估。进行了单变量和多变量分析，以确定主要通畅损失的预测因素：患者的平均年龄为（44.0 ± 14.7）岁，59.9%为女性。单侧病例使用的支架中位数为两个，双侧病例使用的支架中位数为五个。在 12 个月的随访中，1-5 型支架的初次通畅率分别为 94.9%、90.3%、80.8%、60.6% 和 39.4%。这些比率与 CVO 的扩展密切相关，并且每种类型之间存在显著差异。单变量分析发现，CVO 类型、深静脉血栓病史和支架总数是主要通畅损失的预测因素。在多变量分析中，CVO类型和支架总数是主要通畅损失的重要独立预测因素：结论：所提出的髂股动脉CVO解剖学分类有助于预测介入治疗的结果，并便于在未来的研究中比较支架的效果。然而，还需要在前瞻性研究中进行进一步评估和验证，以确认该分类的实用性。

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引用次数: 0

Go With the Flow 顺其自然。

IF 5.7 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.11.354

Marie Josee E. van Rijn , Mark A.F. de Wolf

引用次数: 0

Spontaneous Inferior Mesenteric Artery Occlusion after Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm and its Impact on Clinical Outcomes 腹主动脉瘤血管内动脉瘤修补术后自发性肠系膜下动脉闭塞及其对临床疗效的影响

IF 5.7 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.09.036

Shinichiro Yoshino, Koichi Morisaki, Takehiko Aoyagi, Go Kinoshita, Kentaro Inoue, Tomoharu Yoshizumi

Objective

The incidence and related factors of spontaneous occlusion of a patent inferior mesenteric artery (IMA) after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) without pre-emptive embolisation remain unclear. This study aimed to elucidate the incidence, clinical implications, and predictors of spontaneous IMA occlusion after EVAR.

Methods

This was a single centre, retrospective cohort study. Patients who underwent elective EVAR between 2007 and 2022 were categorised into three groups (group 1, spontaneous IMA occlusion; group 2, patent IMA with no type II endoleak [T2EL] from IMA; group 3, T2EL from IMA). Endpoints were the incidence of spontaneous IMA occlusion, sac enlargement, freedom from re-intervention, and overall survival after EVAR.

Results

Of 372 cases of elective EVAR for AAA, 230 who had patent IMA pre-operatively were analysed, after excluding 127 with pre-occluded IMA and 15 who underwent pre-emptive IMA embolisation. Spontaneous IMA occlusion occurred in 101 patients (43.9%). The sac enlargement rate was lower in group 1 than in groups 2 and 3. The freedom from re-intervention rate was higher in group 1 than in group 3 but did not differ between groups 1 and 2. Multivariable analysis revealed the absence of antiplatelet therapy, pre-operative higher haematocrit, absence of concomitant iliac artery aneurysm, posterior thrombus in the sac, and use of Endurant as predictors associated with spontaneous IMA occlusion. Spontaneous IMA occlusion was observed in 7.1% and 77.5% of patients with zero and four or five predictors, respectively.

Conclusion

Spontaneous IMA occlusion occurred in nearly half of cases and was associated with positive clinical outcomes. In patients with a high prediction of spontaneous IMA occlusion, pre-emptive IMA embolisation may be omitted.

目的：腹主动脉瘤（AAA）血管内动脉瘤修补术（EVAR）后，在没有预先栓塞的情况下，肠系膜下动脉（IMA）自发闭塞的发生率和相关因素仍不清楚。本研究旨在阐明EVAR术后IMA自发性闭塞的发生率、临床影响和预测因素：这是一项单中心、回顾性队列研究。2007年至2022年间接受择期EVAR的患者分为三组（第1组，自发性IMA闭塞；第2组，IMA通畅且IMA无II型内漏（T2EL）；第3组，IMA有T2EL）。终点是自发性IMA闭塞的发生率、囊肿增大、免于再次介入以及EVAR后的总存活率：在372例AAA择期EVAR病例中，有230例术前IMA通畅，在排除127例术前IMA闭塞和15例术前IMA栓塞后，对这些病例进行了分析。101例患者（43.9%）发生了自发性IMA闭塞。第一组的囊肿扩大率低于第二组和第三组。第 1 组的免于再次介入率高于第 3 组，但第 1 组和第 2 组之间没有差异。多变量分析显示，未接受抗血小板治疗、术前血细胞比容较高、未合并髂动脉瘤、囊后血栓和使用 Endurant 是与自发性 IMA 闭塞相关的预测因素。在预测因素为零、预测因素为四或五的患者中，分别有 7.1% 和 77.5% 出现自发性 IMA 闭塞：结论：自发性 IMA 闭塞发生在近一半的病例中，并与积极的临床结果相关。对于自发性 IMA 闭塞预测较高的患者，可以省略先发制人的 IMA 栓塞治疗。

{"title":"Spontaneous Inferior Mesenteric Artery Occlusion after Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm and its Impact on Clinical Outcomes","authors":"Shinichiro Yoshino, Koichi Morisaki, Takehiko Aoyagi, Go Kinoshita, Kentaro Inoue, Tomoharu Yoshizumi","doi":"10.1016/j.ejvs.2024.09.036","DOIUrl":"10.1016/j.ejvs.2024.09.036","url":null,"abstract":"<div><h3>Objective</h3><div>The incidence and related factors of spontaneous occlusion of a patent inferior mesenteric artery (IMA) after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) without pre-emptive embolisation remain unclear. This study aimed to elucidate the incidence, clinical implications, and predictors of spontaneous IMA occlusion after EVAR.</div></div><div><h3>Methods</h3><div>This was a single centre, retrospective cohort study. Patients who underwent elective EVAR between 2007 and 2022 were categorised into three groups (group 1, spontaneous IMA occlusion; group 2, patent IMA with no type II endoleak [T2EL] from IMA; group 3, T2EL from IMA). Endpoints were the incidence of spontaneous IMA occlusion, sac enlargement, freedom from re-intervention, and overall survival after EVAR.</div></div><div><h3>Results</h3><div>Of 372 cases of elective EVAR for AAA, 230 who had patent IMA pre-operatively were analysed, after excluding 127 with pre-occluded IMA and 15 who underwent pre-emptive IMA embolisation. Spontaneous IMA occlusion occurred in 101 patients (43.9%). The sac enlargement rate was lower in group 1 than in groups 2 and 3. The freedom from re-intervention rate was higher in group 1 than in group 3 but did not differ between groups 1 and 2. Multivariable analysis revealed the absence of antiplatelet therapy, pre-operative higher haematocrit, absence of concomitant iliac artery aneurysm, posterior thrombus in the sac, and use of Endurant as predictors associated with spontaneous IMA occlusion. Spontaneous IMA occlusion was observed in 7.1% and 77.5% of patients with zero and four or five predictors, respectively.</div></div><div><h3>Conclusion</h3><div>Spontaneous IMA occlusion occurred in nearly half of cases and was associated with positive clinical outcomes. In patients with a high prediction of spontaneous IMA occlusion, pre-emptive IMA embolisation may be omitted.</div></div>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"69 2","pages":"Pages 250-258"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373611","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}

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One Year on: Test Your Knowledge from February 2024

IF 5.7 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.12.019

Stavros Kakkos

引用次数: 0

The Miracles of Turning Water into Wine and Kaplan–Meier Analysis Estimates into Dichotomous Outcomes 化水为酒的奇迹和二分法结果的 Kaplan-Meier 分析估计。

IF 5.7 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.08.040

Vangelis Bontinis, Alkis Bontinis, Kiriakos Ktenidis

引用次数: 0

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