European Journal of Vascular and Endovascular Surgery最新文献

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Accuracy and Applicability of Motor Evoked Potential Monitoring during Open Thoraco-abdominal Aortic Aneurysm Repair. 开放性胸腹主动脉瘤修复术中运动诱发电位监测的准确性和适用性。

IF 6.8 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2026-01-03 DOI: 10.1016/j.ejvs.2025.12.058

Jelle Frankort, Werner H Mess, Julia Krabbe, Alexander Gombert, Barend M E Mees, Michael J Jacobs

Objective: Spinal cord ischaemia (SCI) is a devastating risk in open thoraco-abdominal aortic aneurysm (TAAA) repair, making the reliable detection and prevention of neurological injury a clinical priority. The objective of this study was to evaluate the accuracy and clinical utility of motor evoked potential (MEP) monitoring in predicting and preventing SCI during open TAAA repair.

Methods: This retrospective case series study analysed 464 patients who underwent elective TAAA repair with MEP monitoring across two academic referral centres between 2000 and 2024. All procedures were performed by the same lead surgeon with an identical neurophysiological protocol. Significant MEP changes were defined as a consistent decrease in leg to arm ratio by more than 50%. Post-operative neurological outcomes were categorised as acute, delayed, or uncertain SCI.

Results: Significant MEP changes occurred in 108 patients (23.3%), with recovery achieved in 99 cases (91.7%) following intra-operative measures to increase spinal cord perfusion. All nine patients without MEP recovery developed acute paraplegia. Among 356 patients with stable MEPs, none developed acute SCI, though 18 (5.1%) experienced delayed paraplegia associated with post-operative haemodynamic instability. The acute SCI rate was 1.9% (9 of 464), and any form of SCI (acute, delayed, or uncertain) occurred in 7.7% of cases (36 of 464). The absence of MEP signals at the end of the operation demonstrated 100% sensitivity, 100% specificity, and 100% negative and positive predictive values for acute SCI.

Conclusion: MEP monitoring is an excellent method, providing a proper execution and a compatible anaesthetic protocol, for detecting acute peri-operative SCI and significantly influences decision making to prevent acute SCI during open TAAA procedures, although delayed SCI remains an important factor that may not be detected by MEP changes alone, largely owing to factors occurring after the index surgery.

目的：脊髓缺血（SCI）是开放性胸腹主动脉瘤（TAAA）修复的一个毁灭性风险，可靠的神经损伤检测和预防是临床的重点。本研究的目的是评估运动诱发电位（MEP）监测在开放性TAAA修复中预测和预防脊髓损伤的准确性和临床应用。方法：本回顾性病例系列研究分析了2000年至2024年间在两个学术转诊中心进行选择性TAAA修复并进行MEP监测的464例患者。所有手术均由同一主治医生按照相同的神经生理学方案进行。显著MEP变化定义为腿臂比持续下降超过50%。术后神经系统预后分为急性、延迟或不确定SCI。结果：108例（23.3%）患者MEP发生明显改变，术中增加脊髓灌注后99例（91.7%）患者恢复。9例MEP未恢复的患者均发生急性截瘫。在356例稳定的mep患者中，没有发生急性脊髓损伤，尽管18例（5.1%）经历了术后血流动力学不稳定相关的迟发性截瘫。急性脊髓损伤发生率为1.9%（464例中有9例），任何形式的脊髓损伤（急性、延迟或不确定）发生率为7.7%（464例中有36例）。手术结束时MEP信号的缺失表现出100%的敏感性、100%的特异性以及100%的急性脊髓损伤阴性和阳性预测值。结论：MEP监测是发现急性围手术期脊髓损伤的一种优秀方法，提供了适当的执行和兼容的麻醉方案，并显著影响开放TAAA手术中预防急性脊髓损伤的决策，尽管迟发性脊髓损伤仍然是一个重要因素，可能仅通过MEP变化无法发现，这主要是由于指数手术后发生的因素。

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引用次数: 0

Embolic Acute Mesenteric Ischaemia: Closing the Evidence Gap One Cohort at a Time. 栓塞性急性肠系膜缺血：一次缩小一个队列的证据差距。

IF 6.8 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2026-01-02 DOI: 10.1016/j.ejvs.2025.12.059

Natasha Hasemaki, Konstantinos Stavroulakis

引用次数: 0

Post-exercise Ankle brachial Index Increases the Detection of Peripheral Artery Disease in Patients with Exertional Limb Symptoms. 运动后踝肱指数可提高有肢体运动症状患者外周动脉疾病的检出率。

IF 6.8 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2026-01-02 DOI: 10.1016/j.ejvs.2025.12.056

A Guezais, M Talbot, N Senouci, A Le Faucheur, J E Trihan, G Mahé

引用次数: 0

Median Arcuate Ligament Release for Abdominal Pain is Still Experimental Surgery. 正中弓状韧带松解术治疗腹痛仍是实验性手术。

IF 6.8 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2026-01-02 DOI: 10.1016/j.ejvs.2025.12.057

Jussi M Kärkkäinen, Elina Lietzen

引用次数: 0

Effects of Repeated Remote Ischaemic Preconditioning on Arterial Stiffness, Organ Damage, and Oxidative Stress in Patients with Intermittent Claudication: A Sham Controlled Randomised Trial 反复远程缺血预处理对间歇性跛行患者动脉僵硬、器官损伤和氧化应激的影响：一项假对照随机试验

IF 6.8 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2026-01-01 DOI: 10.1016/j.ejvs.2025.06.046

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

Objective

The clinical efficacy of remote ischaemic preconditioning (RIPC) remains unclear. This pilot study, a substudy of a randomised controlled trial, tested whether repeated RIPC reduces arterial stiffness, end organ damage, and oxidative stress in patients with intermittent claudication (IC).

Methods

In a single centre, randomised, sham controlled, double blind trial, 42 males with Fontaine stage IIa or IIb IC were allocated at a ratio of 1:1 to receive RIPC or sham using an automated device for 28 days in an outpatient setting (ClinicalTrials.gov ID NCT05084066). Secondary outcomes included changes in augmentation index (AIx), heart rate corrected AIx, carotid–femoral pulse wave velocity (cf-PWV), and biomarkers for cardiac (high sensitivity troponin T [hs-TnT], N-terminal pro B-type natriuretic peptide [NT-proBNP]), renal (creatinine, urea, cystatin C, β2 microglobulin, neutrophil gelatinase associated lipocalin, kidney injury molecule 1), and oxidative stress (high sensitivity C reactive protein, interleukin-6, interleukin-18, myeloperoxidase, adiponectin, oxidised low density lipoprotein).

Results

Data from 41 patients (RIPC n = 23, sham n = 18) aged 64.9 ± 7.4 years were analysed. The median change in cf-PWV was 0.2 m/s (interquartile range [IQR] –0.6, 0.6) in the RIPC group vs. 0.2 m/s (IQR –0.3, 0.8) in the sham group (p = .54). The median change in hs-TnT was 0 ng/L (IQR –1, 2) in the RIPC group vs. 1 ng/L (IQR –1, 2) in the sham group (p = .54). NT-proBNP showed a median change of –7 ng/L (IQR –32, 18) in the RIPC group vs. 6 ng/L (IQR –14, 35) in the sham group (p = .14). No statistically significant differences were observed between groups for arterial stiffness, oxidative stress, or renal biomarkers.

Conclusion

Repeated RIPC did not significantly alter arterial stiffness, end organ damage, or oxidative stress biomarkers compared with sham treatment. It is possible that patients with IC already experience repeated RIPC from their ischaemic legs, thereby attenuating any additional effects from arm induced RIPC.

目的：远程缺血预处理（RIPC）的临床疗效尚不清楚。这项试点研究是一项随机对照试验的一项亚研究，旨在测试反复RIPC是否能降低间歇性跛行（IC）患者的动脉僵硬、终末器官损伤和氧化应激。方法：在一项单中心、随机、假对照、双盲试验中，42名Fontaine期IIa或IIb期IC患者按1:1的比例在门诊环境中使用自动装置接受RIPC或假药治疗28天（ClinicalTrials.gov ID NCT05084066）。次要结局包括增强指数（AIx）、心率校正AIx、颈动脉-股动脉脉波速度（cf-PWV）、心脏生物标志物（高敏肌钙蛋白T [hs-TnT]、n端前b型利钠肽[NT-proBNP]）、肾脏生物标志物（肌酐、尿素、胱抑制素C、β2微球蛋白、中性粒细胞明胶质酶相关脂钙蛋白、肾损伤分子1）和氧化应激(高敏C反应蛋白、白细胞介素-6、白细胞介素-18、髓过氧化物酶、脂联素，氧化低密度脂蛋白)。结果：41例患者（RIPC n= 23, sham n= 18），年龄64.9±7.4岁。RIPC组cf-PWV的中位变化为0.2 m/s（四分位数范围[IQR] -0.6, 0.6），而sham组为0.2 m/s (IQR -0.3, 0.8) （p= 0.54）。RIPC组hs-TnT变化中位数为0 ng/L (IQR - 1,2)， sham组为1 ng/L (IQR - 1,2)，差异有统计学意义（p = 0.54）。RIPC组NT-proBNP的中位数变化为-7 ng/L (IQR为- 32,18)，而sham组为6 ng/L (IQR为- 14,35)（p = .14）。在动脉僵硬、氧化应激或肾脏生物标志物方面，两组之间没有统计学上的显著差异。结论：与假治疗相比，重复RIPC没有显著改变动脉僵硬、终末器官损伤或氧化应激生物标志物。IC患者可能已经从其缺血的腿部经历了反复的RIPC，从而减弱了手臂诱导的RIPC的任何额外影响。

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引用次数: 0

Shrink to Survive: Graft Design Influences Aneurysm Remodelling after Endovascular Aneurysm Repair 收缩生存：血管内动脉瘤修复后移植物设计影响动脉瘤重塑。

IF 6.8 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2026-01-01 DOI: 10.1016/j.ejvs.2025.07.035

François Saucy

引用次数: 0

Pursuit of Fabulous Outcomes in Complicated Type B Aortic Dissection: New Wine into an Old Bottle? 复杂的B型主动脉夹层：旧瓶新酒？

IF 6.8 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2026-01-01 DOI: 10.1016/j.ejvs.2025.06.068

Hai-Lei Li, Stephen W.K. Cheng

引用次数: 0

Risk Stratification of Patients with a Symptomatic Carotid Stenosis 症状性颈动脉狭窄患者的风险分层。

IF 6.8 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2026-01-01 DOI: 10.1016/j.ejvs.2025.08.049

Stavros K. Kakkos , Luca Saba

引用次数: 0

Will Endovascular Techniques Change the Meaning of “C” for “Complex” Abdominal Aortic Aneurysms to “Common”? 血管内技术是否会将“复杂”腹主动脉瘤的“C”改为“普通”？

IF 6.8 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2026-01-01 DOI: 10.1016/j.ejvs.2025.09.003

Nabil Chakfe , Salomé Kuntz

引用次数: 0

SAVVE US pivotal study of patients with severe chronic insufficiency due to deep valvular venous reflux: One-year results after VenoValve implantation SAVVE美国对深瓣膜静脉回流引起的严重慢性功能不全患者的关键研究：静脉瓣膜植入后一年的结果

IF 6.8 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

European Journal of Vascular and Endovascular Surgery

Pub Date : 2026-01-01 DOI: 10.1016/j.ejvs.2025.12.034

Cassius Iyad Ochoa Chaar MD, MPH, MS , Eric S. Hager MD , Claire L. Griffin MD , Matthew R. Smeds MD , SAVVE Trial Investigators

引用次数: 0

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