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One Year on: Test Your Knowledge from February 2024
IF 5.7 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.12.019
Stavros Kakkos
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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 Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.08.040
Vangelis Bontinis, Alkis Bontinis, Kiriakos Ktenidis
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引用次数: 0
Sealing Zone Failure Decreases the Long Term Durability of Endovascular Aneurysm Repair 密封区失效会降低血管内动脉瘤修复术的长期耐久性。
IF 5.7 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.09.007
Charlotte Sandström , Mattias B. Andersson , Marko Bogdanovic , Nina Fattahi , Robert Lundqvist , Manne Andersson , Joy Roy , Rebecka Hultgren , Håkan Roos

Objective

Endovascular aneurysm repair (EVAR) has a higher long term aneurysm related mortality rate compared with open surgery, mainly due to aneurysm rupture. Loss of stent graft to vessel apposition at the EVAR sealing zones is a potential cause of post-EVAR rupture. This study aimed to investigate sealing zone failure and its relationship with post-EVAR rupture.

Methods

This was a retrospective structured review of pre- and post-operative computed tomography (CT) scans of 399 consecutive patients treated with standard bifurcated EVAR. The primary outcome was total loss of seal at last post-operative CT. Secondary outcomes were partial loss of seal, standard follow up detection, post-EVAR rupture, aneurysm sac development, and endoleaks.

Results

During a median follow up of 5.3 years, total and partial loss of seal occurred in 85 (21.3%) and 78 (19.5%) patients, respectively. Initial mean sealing zone lengths were within current recommendations but decreased over time, mainly due to vessel dilatation. Mean proximal sealing length at the one month CT was 15.5 ± 10.5 mm (95% confidence interval [CI] 12.6 – 18.5 mm) in the group with total loss of seal, 14.3 ± 6.9 mm (95% CI 12.2 – 16.4 mm) with partial loss of seal, and 23.2 ± 7.4 mm (95% CI 22.3 – 24.0 mm) with preserved seal through follow up (p < .001). Mean iliac sealing lengths were 22.4 ± 12.1 mm (95% CI 18.9 – 25.8 mm) if total loss and 21.8 ± 10.0 mm (95% CI 19.6 – 24.0 mm) if partial loss of seal vs. 34.7 ± 12.4 mm (95% CI 33.8 – 35.7 mm) if preserved seal. Larger vessel diameters were associated with loss of seal in both the proximal and distal sealing zones. During the study period, 13 post-EVAR ruptures occurred, all preceded by CT findings of total (n = 7) or partial (n = 6) loss of seal. Aneurysm sac expansion was seen in 40% of patients with total loss of seal, 18% with partial loss of seal, and 6.6% with preserved seal.

Conclusion

Loss of seal after EVAR is frequent and associated with post-EVAR rupture. Increased recommended sealing zones lengths and focus on sealing zones in surveillance may reduce post-EVAR ruptures and aneurysm related death.
目的与开放手术相比,血管内动脉瘤修补术(EVAR)与动脉瘤相关的长期死亡率较高,主要原因是动脉瘤破裂。EVAR密封区支架移植物与血管贴合的丧失是导致EVAR术后破裂的潜在原因。本研究旨在调查密封区失效及其与EVAR术后破裂的关系。方法这是一项回顾性结构化研究,对399例连续接受标准分叉EVAR治疗的患者的术前和术后计算机断层扫描(CT)进行回顾性分析。主要结果是术后最后一次 CT 检查时完全失封。结果在中位 5.3 年的随访期间,分别有 85 例(21.3%)和 78 例(19.5%)患者出现完全和部分失封。最初的平均密封区长度符合目前的建议,但随着时间的推移有所减少,这主要是由于血管扩张造成的。在一个月的CT检查中,完全丧失密封性组的近端平均密封长度为15.5 ± 10.5 mm(95% 置信区间 [CI] 12.6 - 18.5 mm),部分丧失密封性组的近端平均密封长度为14.3 ± 6.9 mm(95% 置信区间 [CI] 12.2 - 16.4 mm),通过随访保留密封性组的近端平均密封长度为23.2 ± 7.4 mm(95% 置信区间 [CI] 22.3 - 24.0 mm)(p < .001)。如果完全丧失密封性,平均髂骨密封长度为 22.4 ± 12.1 毫米(95% CI 18.9 - 25.8 毫米);如果部分丧失密封性,平均髂骨密封长度为 21.8 ± 10.0 毫米(95% CI 19.6 - 24.0 毫米);如果保留密封性,平均髂骨密封长度为 34.7 ± 12.4 毫米(95% CI 33.8 - 35.7 毫米)。血管直径越大,近端和远端密封区的密封性越差。在研究期间,共发生了 13 例 EVAR 术后破裂,所有破裂前的 CT 检查结果均为完全(7 例)或部分(6 例)失去密封性。在完全丧失密封的患者中,有 40% 出现动脉瘤囊扩张;在部分丧失密封的患者中,有 18% 出现动脉瘤囊扩张;在保留密封的患者中,有 6.6% 出现动脉瘤囊扩张。增加推荐的密封区长度并在监测中重点关注密封区,可减少EVAR术后破裂和动脉瘤相关死亡率。
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引用次数: 0
Short Term Outcomes of a Prospective Registry of Popliteal and Infrapopliteal Endovascular Interventions for Chronic Limb Threatening Ischaemia 腘窝和腘下血管内介入治疗慢性肢体缺血的前瞻性登记的短期效果。
IF 5.7 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.09.033
Michael J. Nugteren , Constantijn E.V.B. Hazenberg , Olaf J. Bakker , Maarten K. Dinkelman , Bram Fioole , Jan-Willem Hinnen , Maurice Pierie , Gert J. de Borst , Çağdaş Ünlü

Objective

The prevalence of chronic limb threatening ischaemia (CLTI) is increasing worldwide, resulting in the need for more patients to undergo revascularisation, especially for below the knee pathology. Nevertheless, prospective data on below the knee endovascular interventions are lacking. The aim of the study was to provide large scale, real world data on procedural and short term outcomes of popliteal and infrapopliteal endovascular interventions in patients with CLTI.

Methods

This study is an analysis of the first 1 000 interventions of the Dutch Chronic Lower Limb Threatening Ischaemia Registry (THRILLER). It includes all patients with CLTI undergoing popliteal or infrapopliteal endovascular revascularisation in seven hospitals in the Netherlands. The primary outcomes were limb salvage and amputation free survival (AFS) at three months estimated by the Kaplan–Meier method. Secondary outcomes were procedural complications and primary patency.

Results

Between February 2021 and July 2023, 1 000 endovascular procedures were performed in 840 patients (947 limbs), treating 486 popliteal and 1 209 tibial lesions. Wound, Ischaemia, and foot Infection (WIfI) stages 1 – 4 were present in 16.8%, 17.2%, 25.4%, and 40.6% of the limbs, respectively. Technical success was hampered by arterial perforation, acute thrombosis, and distal embolisation in 8.7%, 1.0%, and 2.3% of the interventions, respectively. Limb salvage was 100.0%, 96.9%, 94.9%, and 86.1% (p < .001), whereas AFS was 96.9%, 93.2%, 86.6%, and 76.4% for WIfI stages 1 – 4 at three months (p < .001), respectively. Primary patency at the 6 – 8 week visit was 86.4% for popliteal and 74.3% for tibial lesions, respectively.

Conclusion

THRILLER presents a large prospective database on outcomes of endovascular CLTI interventions. Popliteal and infrapopliteal endovascular revascularisation for CLTI is safe. Interventions with initial technical success have high rates of limb salvage and survival at three months. The WIfI classification provides a reliable instrument to predict limb salvage and AFS independently at three months.
目的:慢性肢体缺血(CLTI)的发病率在全球范围内不断上升,因此需要对更多患者进行血管重建,尤其是膝下病变患者。然而,目前还缺乏膝下血管内介入治疗的前瞻性数据。该研究旨在提供大规模的真实数据,说明腘动脉和膝下动脉血管内介入治疗CLTI患者的程序和短期疗效:本研究是对荷兰慢性下肢危重缺血登记处(THRILLER)前 1000 例介入治疗的分析。研究对象包括在荷兰七家医院接受腘部或腘下血管内再通术的所有慢性下肢危重缺血患者。主要结果是三个月后的肢体挽救率和无截肢存活率(AFS),采用 Kaplan-Meier 法进行估算。次要结果为手术并发症和主要通畅率:结果:2021 年 2 月至 2023 年 7 月期间,为 840 名患者(947 条肢体)实施了 1000 例血管内手术,治疗了 486 例腘动脉病变和 1 209 例胫骨病变。分别有16.8%、17.2%、25.4%和40.6%的肢体出现伤口、缺血和足部感染(WIfI)1-4期。分别有8.7%、1.0%和2.3%的介入手术因动脉穿孔、急性血栓形成和远端栓塞而影响了技术成功率。三个月后,肢体挽救率分别为 100.0%、96.9%、94.9% 和 86.1%(P < .001),而 WIfI 1 - 4 期的 AFS 分别为 96.9%、93.2%、86.6% 和 76.4%(P < .001)。腘窝和胫骨病变在6-8周就诊时的初次通畅率分别为86.4%和74.3%:THRILLER提供了一个大型前瞻性数据库,用于研究CLTI血管内介入治疗的效果。腘窝和胫骨下血管内血运重建治疗CLTI是安全的。最初技术成功的介入治疗具有较高的肢体挽救率和三个月的存活率。WIfI分类法是独立预测三个月后肢体挽救率和AFS的可靠工具。
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引用次数: 0
Conservative Therapy for Patients with Intermittent Claudication: What we See Might Depend Mainly on What we are Looking For 间歇性跛行患者的保守疗法:我们所看到的可能主要取决于我们在寻找什么。
IF 5.7 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.09.025
Joakim Nordanstig, Karin Ludwigs, Vishal Amlani
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引用次数: 0
Dual Antiplatelet Therapy Following Branched or Fenestrated Endovascular Aneurysm Repair Might Be the Best Option 分支或瘘管血管内动脉瘤修复术后的双重抗血小板疗法可能是最佳选择。
IF 5.7 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.10.027
José Oliveira-Pinto , Christopher P. Twine
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引用次数: 0
A Randomised Controlled Trial is Needed to Prove the Efficacy of Venous Arterialisation in Patients with Chronic Limb Threatening Ischaemia 需要进行随机对照试验,以证明静脉动脉化对慢性肢体缺血患者的疗效。
IF 5.7 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.11.023
Maarit A. Venermo
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引用次数: 0
A South African View of the New European Society for Vascular Surgery Vascular Trauma Guidelines 南非对新欧洲血管外科学会血管创伤指南的看法。
IF 5.7 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2024.12.034
Pradeep Pravinkumar Mistry, Dirk Andries Le Roux, Ian Roy Grant
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引用次数: 0
Employing magnetic resonance histology for precision chronic limb-threatening ischemia treatment planning
IF 5.7 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-02-01 DOI: 10.1016/j.ejvs.2025.01.008
Judit Csore MD, PhD , Madeline Drake MD , Christof Karmonik PhD , Bright Benfor MD , Peter Osztrogonacz MD , Alan B. Lumsden MD , Trisha L. Roy MD, PhD
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引用次数: 0
EJVES vol. 69, issue 2 (February 2025) - Spanish Translated Abstracts
IF 5.7 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-02-01 DOI: 10.1016/S1078-5884(25)00038-3
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引用次数: 0
期刊
European Journal of Vascular and Endovascular Surgery
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