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Readability of Society for Vascular Surgery patient education flyers does not meet national standards 血管外科学会患者教育传单的可读性不符合国家标准
Pub Date : 2025-01-01 Epub Date: 2025-07-10 DOI: 10.1016/j.jvsvi.2025.100269
Arnav Mahajan MB , Pooja Podugu MD , Ali Mansoor Kara MD , Ariadna Marrero MD , Ramiro Cadena MD , Garietta Falls-Beddies MD

Objective

The Society for Vascular Surgery (SVS) launched the Your Vascular Health microsite to enhance public awareness of vascular disease through educational content. The effectiveness of such materials depends on adherence to national recommendations that patient-facing content be written at a sixth-grade reading level to ensure accessibility for the median United States adult. With evidence suggesting that patient education materials frequently exceed recommended reading levels across medical disciplines, we aimed to assess the readability of all SVS Your Vascular Health patient education flyers.

Methods

We analyzed all publicly available SVS Your Vascular Health flyers using four validated readability metrics: Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), Automated Readability Index (ARI), and Flesch Reading Ease (FRE). FKGL, SMOG, and ARI scores (which correlate with grade level) <6.0 and FRE scores >80 indicate sixth-grade reading level compliance. Estimated reading times were calculated at 200 words per minute, and descriptive statistics were reported.

Results

None of the 15 reviewed flyers met the recommended sixth-grade readability threshold. Mean scores were FKGL 9.9 (standard deviation [SD], 1.7), SMOG 12.1 (SD, 1.5), ARI 9.4 (SD, 1.8), and FRE 43.8 (SD, 10.6). The mean reading time was 3 minutes (range, 2-5 minutes). The most readable flyer was on thoracic outlet syndrome, which ranged from seventh- to eleventh-grade reading level with different measures (FKGL 7.6, SMOG 11.0, ARI 7.4), whereas the least readable was on Cerebrovascular Disease at a fourteenth- to fifteenth-grade reading level (FKGL 13.9, SMOG 15.0, ARI 14.1).

Conclusions

The SVS Your Vascular Health patient education flyers fail to meet established health literacy standards despite their public awareness mission. Materials average nearly a tenth-grade reading level—four grades above national recommendations. These findings raise concerns about accessibility and equity in vascular disease education efforts, particularly for vulnerable populations with limited health literacy. Improving readability should become a central priority in vascular public health outreach, with further research needed to assess whether these materials effectively reach and engage intended audiences.
目的血管外科学会(SVS)推出“你的血管健康”微网站,通过教育内容提高公众对血管疾病的认识。这些材料的有效性取决于是否遵守国家建议,即面向患者的内容应按照六年级的阅读水平编写,以确保美国成年人的中等阅读水平。有证据表明,患者教育材料经常超过医学学科的推荐阅读水平,我们旨在评估所有SVS您的血管健康患者教育传单的可读性。方法我们使用四种经过验证的可读性指标分析了所有公开的SVS Your Vascular Health传单:Flesch- kinkaid Grade Level (FKGL)、Simple Measure of Gobbledygook (SMOG)、Automated readability Index (ARI)和Flesch Reading Ease (FRE)。FKGL、SMOG和ARI得分(与年级水平相关)>; 6.0和FRE得分>;80表示符合六年级阅读水平。估计阅读时间以每分钟200字计算,并报告描述性统计数据。结果15份被审查的传单中没有一份达到推荐的六年级阅读门槛。平均评分为FKGL 9.9(标准差[SD], 1.7), SMOG 12.1(标准差,1.5),ARI 9.4(标准差,1.8),FRE 43.8(标准差,10.6)。平均阅读时间为3分钟(范围2-5分钟)。最易读的传单是关于胸出口综合征的,阅读水平从7年级到11年级不等(FKGL 7.6, SMOG 11.0, ARI 7.4),而最难读的传单是关于脑血管疾病的,阅读水平从14年级到15年级不等(FKGL 13.9, SMOG 15.0, ARI 14.1)。结论SVS“你的血管健康”患者教育传单尽管具有提高公众意识的使命,但未能达到既定的健康素养标准。材料的平均阅读水平比国家推荐的水平高出近10年级的4级。这些发现引起了人们对血管疾病教育工作的可及性和公平性的关注,特别是对健康知识有限的弱势群体。提高可读性应该成为血管公共卫生推广的中心优先事项,需要进一步的研究来评估这些材料是否有效地到达和吸引目标受众。
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引用次数: 0
From coast to coast: Showcasing Canadian innovation in vascular surgery 从东海岸到西海岸:展示加拿大在血管手术方面的创新
Pub Date : 2025-01-01 Epub Date: 2025-09-04 DOI: 10.1016/j.jvsvi.2025.100288
Laura M. Drudi MD , Samuel Jessula MD
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引用次数: 0
Study design of the GORE VIAFORT Vascular Stent trials for the treatment of symptomatic inferior vena cava obstruction with or without iliofemoral obstruction and unilateral iliofemoral obstruction GORE VIAFORT血管支架治疗伴或不伴髂股梗阻及单侧髂股梗阻的症状性下腔静脉梗阻的研究设计
Pub Date : 2025-01-01 Epub Date: 2025-09-23 DOI: 10.1016/j.jvsvi.2025.100295
Kathleen Gibson MD , Kush Desai MD , Gabe Donatell MS , Maryrose Bisagna Smith MPH , Rizwan Afzal MS , Stephen Black MD

Objective

Ambulatory venous hypertension secondary to chronic inferior vena cava (IVC) and iliofemoral obstruction can have considerable impact on patient quality of life, including pain, edema, venous ulceration, and exercise intolerance. To date, there are no venous stents available in the United States specifically designed to treat iliocaval obstruction. The GORE VIAFORT Vascular Stent clinical trials investigate the safety and effectiveness of a novel venous stent developed for the treatment of symptomatic IVC obstruction, with or without iliofemoral obstruction, as well as unilateral symptomatic iliofemoral venous obstruction.

Methods

Two prospective, nonrandomized, multicenter, single-armed clinical studies are being conducted at 34 clinical sites. The iliocaval study enrolled 89 patients in the United States, Europe, Australia, and New Zealand, with an additional 23 patients enrolled globally for regulatory purposes, for a total of 112 patients. Its primary end point is a composite measure that includes primary patency and freedom from stent embolization/migration at 12 months, as well as 30-day freedom from clinically significant pulmonary embolism and device- or procedure-related events (eg, death, major bleeding, or vascular injury requiring surgical or endovascular intervention). The iliofemoral study aims to enroll up to 165 patients in the United States. Its primary composite safety end point consists of freedom from stent embolization/migration at 12 months, as well as 30-day freedom from clinically significant pulmonary embolism and device- or procedure-related events (eg, death, major bleeding, and vascular injury requiring surgical or endovascular intervention). The distinct primary efficacy end point is primary patency through 12 months. Secondary end points for both studies include technical, lesion, and procedural success; primary and secondary patency; clinically driven target lesion revascularization; and device fractures through the 60-month follow-up, stent embolization through 12-month follow-up, and individual device- or procedure-related events through 30 days. Quality of life scores assessed through 60 months include revised Venous Clinical Severity Scale (rVCSS), rVCSS pain score, VEINES, Villalta, and EQ-5D-5L. The primary end points and the secondary end point of improvement in rVCSS pain score at 12 months will undergo formal hypothesis testing in both studies. All additional secondary end points will be summarized descriptively.

Conclusions

The GORE VIAFORT Vascular Stent clinical trials are designed to evaluate the safety and efficacy of the unique GORE VIABAHN Venous Stent for the treatment of IVC and iliofemoral occlusive disease.
目的继发于慢性下腔静脉(IVC)和髂股梗阻的动态静脉高压会对患者的生活质量产生相当大的影响,包括疼痛、水肿、静脉溃疡和运动耐受不良。到目前为止,在美国还没有专门设计用于治疗髂腔梗阻的静脉支架。GORE VIAFORT血管支架临床试验研究了一种新型静脉支架用于治疗伴有或不伴有髂股梗阻的症状性下腔静脉梗阻以及单侧症状性髂股静脉梗阻的安全性和有效性。方法在34个临床地点进行了两项前瞻性、非随机、多中心、单臂临床研究。髂腔研究在美国、欧洲、澳大利亚和新西兰招募了89名患者,另外在全球招募了23名患者,总计112名患者。其主要终点是一个复合指标,包括12个月时原发性通畅和无支架栓塞/移位,以及30天无临床显著肺栓塞和设备或手术相关事件(如死亡、大出血或需要手术或血管内干预的血管损伤)。髂股研究的目标是在美国招募165名患者。其主要复合安全性终点包括12个月时无支架栓塞/移位,以及30天无临床显著肺栓塞和设备或手术相关事件(如死亡、大出血和需要手术或血管内干预的血管损伤)。不同的主要疗效终点是12个月的原发性通畅。两项研究的次要终点包括技术、病变和手术成功;原发性和继发性通畅;临床驱动靶病变血运重建术;器械骨折随访60个月,支架栓塞随访12个月,单个器械或手术相关事件随访30天。60个月的生活质量评分包括修订的静脉临床严重程度量表(rVCSS)、rVCSS疼痛评分、VEINES、Villalta和EQ-5D-5L。两项研究将对12个月时rVCSS疼痛评分改善的主要终点和次要终点进行正式的假设检验。所有附加的次要终点将进行描述性总结。结论GORE VIAFORT血管支架临床试验旨在评估GORE VIABAHN静脉支架治疗IVC和髂股闭塞性疾病的安全性和有效性。
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引用次数: 0
A narrative review exploring the association between hypothyroidism and thoracic aortic diseases 探讨甲状腺功能减退与胸主动脉疾病之间的关系
Pub Date : 2025-01-01 Epub Date: 2025-05-06 DOI: 10.1016/j.jvsvi.2025.100246
Mohammad Hamzah BS , Fatima Al-Maaz BS , Ahmad Chalhoub BS , Rita Nemr MD

Background

Thoracic aortic aneurysms (TAA) and aortic dissections (AD) are recognized as one of the leading causes of death in developed countries. Although mortality decreases if at-risk individuals are diagnosed early, on thorough screening, many fail to seek the proper preventive interventions timely. Genetic predisposition, smoking, and hypertension are well-known risk factors for highly lethal aortic aneurysmal rupture or dissection. Hypothyroidism has also been described extensively in the literature as a possible risk factor directly related to the origin of TAA and dissection. Numerous studies have proposed a pathophysiological role for hypothyroidism in the development of TAA and AD, although this role is still not fully understood. This scoping review sought human and animal studies to examine the relationship between hypothyroidism and thoracic aortic diseases.

Methods

A search in PubMed, Web of Science, and Scopus using the terms “aortic dissection,” “aorta,” “aortic aneurysm,” and “hypothyroidism” yielded 907 articles, although only 9 were relevant to this study topic and criteria.

Results

The included articles discuss thoracic aortic diseases as potential risk factors for TAA and dissection. A low thyroid hormone level might be a negative prognostic indicator after acute AD.

Conclusions

Establishing a link between hypothyroidism and thoracic aortic diseases could improve clinical practice through the development of screening strategies for thyroid function in patients with thoracic aortic diseases, thereby reducing postoperative mortality rates.
背景胸主动脉瘤(TAA)和主动脉夹层(AD)是发达国家公认的主要死亡原因之一。尽管在进行彻底筛查的情况下,如果高危人群得到早期诊断,死亡率会降低,但许多人未能及时寻求适当的预防干预措施。众所周知,遗传易感性、吸烟和高血压是导致高致命性主动脉瘤破裂或夹层的危险因素。甲状腺功能减退在文献中也被广泛描述为与TAA和夹层的起源直接相关的可能的危险因素。许多研究已经提出了甲状腺功能减退在TAA和AD发展中的病理生理作用,尽管这种作用仍未完全了解。本综述通过人类和动物研究来研究甲状腺功能减退和胸主动脉疾病之间的关系。方法在PubMed、Web of Science和Scopus中搜索“主动脉夹层”、“主动脉”、“主动脉瘤”和“甲状腺功能减退”,得到907篇文章,尽管只有9篇与本研究主题和标准相关。结果纳入的文章讨论了胸主动脉疾病是TAA和夹层的潜在危险因素。低甲状腺激素水平可能是急性AD后的一个阴性预后指标。结论通过制定胸主动脉疾病患者甲状腺功能筛查策略,建立甲状腺功能减退与胸主动脉疾病之间的联系,可以改善临床实践,从而降低术后死亡率。
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引用次数: 0
Artificial intelligence-powered remote monitoring for lower extremity wound management: A randomized controlled trial protocol 人工智能远程监测下肢伤口管理:一项随机对照试验方案。
Pub Date : 2025-01-01 Epub Date: 2025-08-08 DOI: 10.1016/j.jvsvi.2025.100279
Y.H. Andrew Wu MD , Alana C. Keegan MD , Midori P. Starks White MD , Sanuja Bose MD, MPH , Sherry G. Leung BA , Ronald Sherman DPM , Christopher J. Abularrage MD , Elizabeth Selvin PhD, MPH , Caitlin W. Hicks MD, MS

Background

Lower extremity wounds associated with diabetes are a serious global health issue, with diabetic foot ulcers affecting 12% to 25% of adults with diabetes and accounting for 80% to 90% of all lower extremity amputations in the United States. Comprehensive in-person care for lower extremity wounds is important but can be burdensome for patients and costly for health care systems. A cost-effective telehealth model using a smartphone-integrated digital application that remotely analyzes wound status with machine learning algorithms in real time could make lower extremity wounds care more accessible to patients. This trial aims to determine if artificial intelligence (AI)-powered digital remote monitoring is a feasible, patient-centered solution for remote wound monitoring and management compared with standard in-person visits.

Methods

We will conduct a nonblinded randomized control trial of 120 patients with active lower extremity wounds treated in the Johns Hopkins Hospital Multidisciplinary Diabetic Foot and Wound Clinic in Baltimore, Maryland (ClinicalTrials.gov: NCT05579743). Participants will be randomly assigned 1:1 to receive wound care monitoring using AI-powered remote wound monitoring technology (Healthy.io) or standard in-person monitoring for 12 weeks. The primary aim is to establish the feasibility of a novel remote patient-centered monitoring program for the surveillance and monitoring of lower extremity wounds. Secondary aims include evaluating patient and provider satisfaction with remote wound monitoring technology compared with standard in-person monitoring and generating pilot data on wound healing times and major amputation rates in patients who are monitored remotely compared with patients treated with the standard of care.

Conclusions

This trial will determine whether AI-powered remote digital monitoring is feasible and acceptable as an alternative to standard in-person monitoring for the monitoring and management of patients with active lower extremity wounds.
背景:与糖尿病相关的下肢伤口是一个严重的全球健康问题,糖尿病足溃疡影响了12%至25%的成人糖尿病患者,占美国所有下肢截肢的80-90%。下肢伤口的全面亲自护理很重要,但对患者来说可能是负担,对卫生保健系统来说也是昂贵的。一种具有成本效益的远程医疗模型,使用集成智能手机的数字应用程序,通过机器学习算法实时远程分析伤口状态,可以使患者更容易获得下肢伤口护理。该试验旨在确定与标准的亲自就诊相比,人工智能(AI)驱动的数字远程监测是否是一种可行的、以患者为中心的远程伤口监测和管理解决方案。方法:我们将在马里兰州巴尔的摩市约翰霍普金斯医院多学科糖尿病足和伤口诊所(ClinicalTrials.gov: NCT05579743)对120例下肢活动性伤口患者进行非盲随机对照试验。参与者将被随机分配为1:1,接受使用人工智能驱动的远程伤口监测技术的伤口护理监测。)或标准的现场监测,为期12周。主要目的是建立一种以患者为中心的新型远程监测方案的可行性,用于监测和监测下肢伤口。次要目标包括与标准的现场监测相比,评估患者和提供者对远程伤口监测技术的满意度;并生成关于伤口愈合时间和主要截肢率的试点数据,这些数据是由远程监控的患者与接受标准治疗的患者进行比较的。结论:本试验将确定人工智能驱动的远程数字监测是否可行和可接受,作为标准现场监测的替代方案,用于监测和管理活动性下肢伤口患者。
{"title":"Artificial intelligence-powered remote monitoring for lower extremity wound management: A randomized controlled trial protocol","authors":"Y.H. Andrew Wu MD ,&nbsp;Alana C. Keegan MD ,&nbsp;Midori P. Starks White MD ,&nbsp;Sanuja Bose MD, MPH ,&nbsp;Sherry G. Leung BA ,&nbsp;Ronald Sherman DPM ,&nbsp;Christopher J. Abularrage MD ,&nbsp;Elizabeth Selvin PhD, MPH ,&nbsp;Caitlin W. Hicks MD, MS","doi":"10.1016/j.jvsvi.2025.100279","DOIUrl":"10.1016/j.jvsvi.2025.100279","url":null,"abstract":"<div><h3>Background</h3><div>Lower extremity wounds associated with diabetes are a serious global health issue, with diabetic foot ulcers affecting 12% to 25% of adults with diabetes and accounting for 80% to 90% of all lower extremity amputations in the United States. Comprehensive in-person care for lower extremity wounds is important but can be burdensome for patients and costly for health care systems. A cost-effective telehealth model using a smartphone-integrated digital application that remotely analyzes wound status with machine learning algorithms in real time could make lower extremity wounds care more accessible to patients. This trial aims to determine if artificial intelligence (AI)-powered digital remote monitoring is a feasible, patient-centered solution for remote wound monitoring and management compared with standard in-person visits.</div></div><div><h3>Methods</h3><div>We will conduct a nonblinded randomized control trial of 120 patients with active lower extremity wounds treated in the Johns Hopkins Hospital Multidisciplinary Diabetic Foot and Wound Clinic in Baltimore, Maryland (ClinicalTrials.gov: <span><span>NCT05579743</span><svg><path></path></svg></span>). Participants will be randomly assigned 1:1 to receive wound care monitoring using AI-powered remote wound monitoring technology (Healthy.io) or standard in-person monitoring for 12 weeks. The primary aim is to establish the feasibility of a novel remote patient-centered monitoring program for the surveillance and monitoring of lower extremity wounds. Secondary aims include evaluating patient and provider satisfaction with remote wound monitoring technology compared with standard in-person monitoring and generating pilot data on wound healing times and major amputation rates in patients who are monitored remotely compared with patients treated with the standard of care.</div></div><div><h3>Conclusions</h3><div>This trial will determine whether AI-powered remote digital monitoring is feasible and acceptable as an alternative to standard in-person monitoring for the monitoring and management of patients with active lower extremity wounds.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100279"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
New horizons in abdominal aortic aneurysm management through customized endografts 腹主动脉瘤定制内移植物治疗的新视野
Pub Date : 2025-01-01 Epub Date: 2025-06-02 DOI: 10.1016/j.jvsvi.2025.100256
Christian Tague MD
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引用次数: 0
A qualitative study exploring the acceptability of the TEXTPAD telehealth and virtual supervised exercise intervention and trial for patients with peripheral arterial disease living in socioeconomically disadvantaged areas 一项质性研究,探讨TEXTPAD远程医疗和虚拟监督运动干预的可接受性,并对生活在社会经济弱势地区的外周动脉疾病患者进行试验
Pub Date : 2025-01-01 Epub Date: 2024-12-19 DOI: 10.1016/j.jvsvi.2024.100175
Maddey Patterson MPH , Letitia Sermin-Reed MSc , James Prentis MBBS , Arathi Radhakrishnan MBBS , Eileen Kaner PhD , Sandip Nandhra MBBS , Maisie Rowland BSc , Gabriel Cucato PhD , Mackenzie Fong PhD

Background

UK clinical guidelines recommend supervised exercise training and support for health behavior change for patients with peripheral arterial disease (PAD). Despite this, supervised exercise programs are largely unavailable and unfunded across the UK. Remote, virtual support may overcome some barriers to attending facilities in person experienced by PAD patients, such as poor mobility and financial cost. The TEXTPAD pilot randomized controlled trial investigated the impact of the 12-week TEXTPAD intervention that involved weekly phone calls for behavioral counselling and twice-weekly virtual, supervised exercise sessions. Both TEXTPAD and control group participants were encouraged to engage in an unsupervised walking program and were provided with an activity tracker. This qualitative study aimed to explore participants' acceptance of the TEXTPAD and unsupervised walking programs and trial procedures.

Methods

Participants were recruited from the vascular department of Newcastle-upon-Tyne Hospitals Trust. Eligibility for the pilot randomized controlled trial included age ≥40 years, a diagnosis of PAD, and living in an area in the lowest 30% of super output area based on the Office for National Statistics. Interview participants were sampled purposively based on study group allocation. A focus group was conducted with three health improvement practitioners who delivered the TEXTPAD intervention. Interview and focus group audio recordings were transcribed verbatim and thematic analysis was applied to data.

Results

A total of 18 participants were interviewed, comprising 9 participants each in the TEXTPAD and control groups (mean age, 66.2 years). Fifteen patients were male and three were female. Overall, the TEXTPAD and walking programs were highly acceptable to and positively perceived by participants. Some participants were not confident in using the various aspects of technology needed to engage in the TEXTPAD and walking programs and sought support from family, friends, or practitioners. TEXTPAD participants wanted more interaction with other participants to share experiences, advice, and information (theme 1). Participants in both groups perceived a range of benefits to their health and well-being (theme 2) and considered the study procedures to be acceptable and not overly burdensome (theme 3).

Conclusions

Providing exercise training and behavioral counselling virtually using digital technologies to people with PAD from lower socioeconomic backgrounds can be considered as an acceptable way to deliver care. However, people who have poorer digital skills must be provided with adequate support to use the technologies needed to engage with these virtual interventions. Enabling intervention participants to interact with each other would help to nurture social support which was perceived to be lacking in the current program.
背景:duk临床指南推荐外周动脉疾病(PAD)患者有监督的运动训练和健康行为改变支持。尽管如此,有监督的锻炼项目在英国基本上是没有的,也没有资金支持。远程、虚拟支持可以克服PAD患者亲自就诊的一些障碍,例如移动性差和财务成本。TEXTPAD试点随机对照试验调查了为期12周的TEXTPAD干预的影响,包括每周打电话进行行为咨询和每周两次有监督的虚拟锻炼。TEXTPAD组和对照组的参与者都被鼓励参加一个无人监督的步行项目,并配备了活动追踪器。本定性研究旨在探讨参与者对文本pad和无监督步行计划和试验程序的接受程度。方法研究对象来自泰恩河畔纽卡斯尔医院信托医院血管科。该试点随机对照试验的入选条件为:年龄≥40岁,诊断为PAD,居住在英国国家统计局统计的超级产出区最低30%的地区。根据研究组的分配,有目的地对访谈参与者进行抽样。一个焦点小组由三位提供TEXTPAD干预的健康改善从业人员组成。访谈和焦点小组录音逐字转录,并对数据进行专题分析。结果共采访了18名参与者,其中TEXTPAD组和对照组各9名,平均年龄66.2岁。男性15例,女性3例。总的来说,文本pad和步行项目被参与者高度接受和积极感知。一些参与者对使用文本pad和步行项目所需的各种技术没有信心,并向家人、朋友或从业者寻求支持。TEXTPAD的参与者希望与其他参与者进行更多的互动,分享经验、建议、和信息(主题1)。两组参与者都认为对他们的健康和福祉有一系列好处(主题2),并认为研究程序是可接受的,不会过于繁重(主题3)。结论:使用虚拟数字技术向社会经济背景较低的PAD患者提供运动训练和行为咨询可以被认为是一种可接受的提供护理的方式。然而,必须为数字技能较差的人提供充分的支持,使他们能够使用参与这些虚拟干预所需的技术。使干预参与者能够相互交流,将有助于培养社会支持,这在当前的项目中被认为是缺乏的。
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引用次数: 0
Protocol for a randomized controlled trial of transdermal continuous oxygen therapy for surgical site wound healing after lower extremity revascularization 经皮持续氧疗治疗下肢血运重建术后手术部位伤口愈合的随机对照试验方案
Pub Date : 2025-01-01 Epub Date: 2025-04-12 DOI: 10.1016/j.jvsvi.2025.100236
Khanjan Nagarsheth MD , Georges Jreij MD , Eleanor Dunlap DNP , Shannon Hawkins DNP , Rachel White BSN , Areck Ucuzian MD, PhD , Brajesh K. Lal MD

Objective

Patients undergoing vascular surgery are at increased risk of poor wound healing due to ischemia and their underlying comorbidities. Following lower extremity revascularization, 40% to 50% of patients experience non-healing wounds that persist for months despite functional bypass grafts. Additionally, surgical site infections (SSIs) in these patients can lead to sepsis, disability, and limb loss. SSI rates are reported between 5% and 10% and as high as 32% for infrainguinal incisions. Supplemental systemic oxygen therapy has shown promise in improving wound healing and reducing SSIs. An emerging alternative is transdermal continuous oxygen therapy (TCOT), which delivers oxygen directly to the wound, thereby avoiding systemic effects of oxygen and simplifying the logistics of oxygen delivery. TCOT has demonstrated faster wound healing and lower infection rates compared with standard of care wound therapy in preliminary studies. We propose a randomized trial to provide level one evidence on the effectiveness of TCOT in improving incisional healing and reducing SSI rates in vascular surgery patients.

Methods

This randomized controlled trial will enroll 100 participants aged 18 to 90 years undergoing elective lower extremity arterial revascularization at the University of Maryland Medical Center and Baltimore VA Medical Center. Participants will be randomized 1:1 to receive either TCOT with control dressing, or control dressing alone. The investigational device, EPIFLO, will be used to deliver continuous oxygen to the wound via a semi-occlusive dressing for up to 28 days. The primary endpoint is the percent wound closure rate at 4 weeks, assessed using the Bates-Jensen Wound Assessment Tool. The secondary endpoint is SSI incidence at 90 days, evaluated with the Szilagyi classification. Participants will attend five follow-up visits, during which wound healing, SSIs, and adverse events will be recorded. A centralized randomization system will ensure balanced allocation, and blinded evaluators will assess wound images to reduce bias. Statistical analysis will include mixed models for repeated measures and Barnard’s test for SSI rates.

Conclusions

This study will provide level one evidence on the efficacy of TCOT in improving wound healing and preventing SSIs in vascular surgery patients.
目的接受血管手术的患者由于缺血及其潜在的合并症导致伤口愈合不良的风险增加。在下肢血管重建术后,40% - 50%的患者经历了持续数月的不愈合伤口,尽管有功能的旁路移植。此外,这些患者的手术部位感染(ssi)可导致败血症、残疾和肢体丧失。据报道,SSI发生率在5%至10%之间,腹股沟下切口高达32%。补充全身氧治疗已显示出改善伤口愈合和减少ssi的希望。一种新兴的替代方案是透皮持续氧疗(TCOT),它直接将氧气输送到伤口,从而避免了氧气的全身影响,简化了氧气输送的物流。初步研究表明,与标准护理伤口治疗相比,TCOT伤口愈合更快,感染率更低。我们提出了一项随机试验,为TCOT在改善血管手术患者切口愈合和降低SSI发生率方面的有效性提供一级证据。方法:本随机对照试验将在马里兰大学医学中心和巴尔的摩VA医学中心招募100名年龄在18至90岁之间接受选择性下肢动脉重建术的参与者。参与者将以1:1的比例随机接受TCOT和对照敷料,或单独接受对照敷料。研究设备EPIFLO将通过半封闭敷料向伤口输送连续氧气长达28天。主要终点是4周时伤口愈合率的百分比,使用Bates-Jensen伤口评估工具进行评估。次要终点是90天的SSI发生率,用Szilagyi分级进行评估。参与者将参加五次随访,在此期间将记录伤口愈合,ssi和不良事件。集中随机化系统将确保平衡分配,盲法评估人员将评估伤口图像以减少偏差。统计分析将包括重复测量的混合模型和巴纳德SSI率测试。结论本研究为TCOT在促进血管外科患者创面愈合和预防ssi的疗效提供了一级证据。
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引用次数: 0
Global trends and insights in vascular surgery research from 2000 to 2023 从2000年到2023年血管外科研究的全球趋势和见解
Pub Date : 2025-01-01 Epub Date: 2025-01-16 DOI: 10.1016/j.jvsvi.2025.100184
Arshia P. Javidan MD, MSc , Polycronis P. Akouris BMSc, MSc , Kaan Y. Balta BHSC, MBDc , Wafa Baqri BSc , Leslie Summers DeLuca PhD , Ahmed Kayssi MD, MSC, MPH

Objectives

This study aimed to provide a comprehensive bibliometric analysis of vascular surgery research from 2000 to 2023, examining trends in publications, key research themes, and international collaboration networks.

Methods

A literature search was conducted via Scopus, including English-language articles, reviews, and conference papers published between 2000 and 2023 in 16 key vascular surgery journals. Multiple parameters of the retrieved publications were analyzed, including annual growth, key themes identified through author keyword co-occurrence analysis, productivity and impact of countries, institutions, journals, and authors through citation analysis, and collaborative networks through co-authorship analysis.

Results

Our search yielded 43,483 documents with a mean of 23.5 citations per document and an overall h-index of 242. There was a steady increase in annual publications, rising from 1257 documents in 2000 to 2974 in 2023. The predominant research themes identified were abdominal aortic aneurysm (1559 occurrences), peripheral artery/arterial disease (1222 occurrences), and endovascular aneurysm repair (752 occurrences), with additional focus areas including carotid endarterectomy (511 occurrences), and varicose veins (310 occurrences). The Journal of Vascular Surgery emerged as the most prolific journal, publishing 10,760 documents (24.7%) with 430,306 citations (42.1%), followed by the Annals of Vascular Surgery (7464 documents, 17.2%) and the Journal of Vascular and Interventional Radiology (5613 documents, 12.9%). The United States led in research productivity, producing 20,324 documents with 554,038 citations, followed by the United Kingdom (3743 documents and 118,370 citations) and the Netherlands (2220 documents and 71,016 citations). Institutionally, the Department of Vascular Surgery at the Cleveland Clinic Foundation led with 238 documents and 12,784 citations. Furthermore, 14 of the top 20 most productive institutions and all 10 of the top 10 authors with the highest total citation counts were American.

Conclusions

This study provides a comprehensive bibliometric analysis of vascular surgery research spanning from 2000 to 2023, revealing substantial growth in publication output and identifying key research themes. The findings underscore the dominant role of the United States in shaping global research collaboration within vascular surgery, as evidenced by its significant contributions in publication volume and citations across national, institutional, and individual authorship domains. These insights provide valuable guidance for future research endeavors aimed at advancing understanding and enhancing the effectiveness of vascular surgery research globally.
本研究旨在提供2000年至2023年血管外科研究的综合文献计量学分析,检查出版物趋势,关键研究主题和国际合作网络。方法通过Scopus检索16种血管外科重点期刊2000 ~ 2023年间发表的英文文章、综述和会议论文。对检索到的出版物的多个参数进行了分析,包括年增长率、作者关键词共现分析确定的关键主题、引用分析得出的国家、机构、期刊和作者的生产力和影响,以及共同作者分析得出的合作网络。结果共检索到文献43483篇,平均被引23.5次,总h指数为242。年度出版物稳步增长,从2000年的1257份增加到2023年的2974份。确定的主要研究主题是腹主动脉瘤(1559例)、外周动脉/动脉疾病(1222例)和血管内动脉瘤修复(752例),其他重点领域包括颈动脉内膜切除术(511例)和静脉曲张(310例)。《血管外科杂志》(Journal of Vascular Surgery)是最多产的期刊,发表了10760篇论文(24.7%),引用次数为430306次(42.1%),其次是《血管外科年鉴》(7464篇,17.2%)和《血管与介入放射学杂志》(5613篇,12.9%)。美国以2.0324万篇论文(554038次)位居首位,其次是英国(3743篇论文、11.8370万次)、荷兰(2220篇论文、7.1016万次)。在制度上,克利夫兰诊所基金会的血管外科部门以238份文件和12,784次引用领先。此外,前20个最多产的机构中有14个是美国人,总引用数最高的前10位作者中有10位都是美国人。本研究对2000年至2023年血管外科研究进行了全面的文献计量分析,揭示了出版物产量的大幅增长,并确定了关键的研究主题。研究结果强调了美国在塑造血管外科全球研究合作方面的主导作用,其在国家、机构和个人作者领域的出版物数量和引用方面的重大贡献证明了这一点。这些见解为未来的研究工作提供了有价值的指导,旨在促进对血管外科研究的理解和提高全球研究的有效性。
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引用次数: 0
Where eagles dare 雄鹰敢去的地方
Pub Date : 2025-01-01 Epub Date: 2025-04-11 DOI: 10.1016/j.jvsvi.2025.100228
Nivedita Mitta MBBS, MS, MCh, MRCS, Raghvinder Pal Singh Gambhir MS, DNB, FRCSEd, FFSTEd, FACS, FEBS, Abhilash Sudarsanam MBChB (Hons), MSc, FRCS, Domenico Valenti MBChB (Hons), FRCS(Eng), FRCS(Ed), FEBVS
Eagle syndrome is a rare clinical condition that presents with multitude of symptoms, owing to an abnormally elongated/misshapen styloid process. The patients often present to other specialties like otorhinology, oromaxillofacial surgeons, or neurologists rather than vascular surgeons. Our case and the literature review, focuses on the stylocarotid syndrome. Styloidectomy along with corrective carotid surgery, after multidisciplinary consultation, led to resolution of long-standing symptoms in a young patient.
鹰综合征是一种罕见的临床病症,表现为多种症状,由于茎突异常延长/畸形。患者通常会到其他专科就诊,如耳鼻喉科、口腔颌面外科医生或神经科医生,而不是血管外科医生。我们的病例和文献回顾,集中在茎突颈动脉综合征。茎突切除术和颈动脉矫正手术,多学科咨询后,导致解决长期症状的年轻患者。
{"title":"Where eagles dare","authors":"Nivedita Mitta MBBS, MS, MCh, MRCS,&nbsp;Raghvinder Pal Singh Gambhir MS, DNB, FRCSEd, FFSTEd, FACS, FEBS,&nbsp;Abhilash Sudarsanam MBChB (Hons), MSc, FRCS,&nbsp;Domenico Valenti MBChB (Hons), FRCS(Eng), FRCS(Ed), FEBVS","doi":"10.1016/j.jvsvi.2025.100228","DOIUrl":"10.1016/j.jvsvi.2025.100228","url":null,"abstract":"<div><div>Eagle syndrome is a rare clinical condition that presents with multitude of symptoms, owing to an abnormally elongated/misshapen styloid process. The patients often present to other specialties like otorhinology, oromaxillofacial surgeons, or neurologists rather than vascular surgeons. Our case and the literature review, focuses on the stylocarotid syndrome. Styloidectomy along with corrective carotid surgery, after multidisciplinary consultation, led to resolution of long-standing symptoms in a young patient.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100228"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
JVS-vascular insights
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