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Prognostication of Patients with Pulmonary Thromboembolism with and without Residual Deep Vein Thrombosis: A Subanalysis of the J'xactly Study. 伴有和不伴有残余深静脉血栓形成的肺血栓栓塞患者的预后:J’xactly研究的亚分析。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-09-25 DOI: 10.3400/avd.oa.22-00111
Norikazu Yamada, Ikuo Fukuda, Mashio Nakamura, Morimasa Takayama, Hideaki Maeda, Takeshi Yamashita, Takanori Ikeda, Makoto Mo, Tsutomu Yamazaki, Yasuo Okumura, Atsushi Hirayama

Objectives: It is unclear whether patients with acute pulmonary thromboembolism (PE) with and without residual deep vein thrombosis (DVT) have different prognoses, and there is debate over whether inferior vena cava filters (IVCFs) should be used in conjunction with oral anticoagulants in patients with venous thromboembolism (VTE). Materials and Methods: The J'xactly involved 1,016 patients and was a multicenter, prospective, observational research. In this subanalysis, 419 patients with PE with or without residual DVT who received rivaroxaban with or without IVCFs between February 2016 and April 2018 in Japan were examined. Results: Of 419 patients with PE, 320 had residual DVT. There was no difference between the groups with and without DVT in terms of the percentage of patients who experienced symptomatic PE recurrence (2.8% [9/320] vs. 3.0% [3/99]) or who died from VTE-related complications (0.9% [3/320] vs. 1.0% [1/99]). The percentages of patients with symptomatic PE recurrence were 0% and 3.2%, and the percentages of patients who died from VTE-related causes were 0% and 1.1%, respectively, in the groups with (n=39) and without (n=281) IVCF, albeit not being statistically different. Conclusion: Patients with PE with and without residual DVT did not have a different incidence of symptomatic PE recurrence. These results require additional study to be confirmed.

目的:目前尚不清楚伴有和不伴有残余深静脉血栓形成(DVT)的急性肺血栓栓塞症(PE)患者是否有不同的预后,也存在下腔静脉滤器(IVCF)是否应与静脉血栓栓塞症患者的口服抗凝剂联合使用的争论。材料和方法:J’xact涉及1016名患者,是一项多中心、前瞻性、观察性研究。在这项亚分析中,对2016年2月至2018年4月期间在日本接受利伐沙班(含或不含IVCF)治疗的419名PE伴或不伴残余DVT的患者进行了检查。结果:419例PE患者中,320例存在残余DVT。有DVT组和无DVT组的PE症状复发(2.8%[9/320]对3.0%[3/99])或死于VTE相关并发症(0.9%[3/320]对1.0%[1/99])的患者百分比没有差异。在有(n=39)和没有(n=281)IVCF的组中,症状性PE复发的患者百分比分别为0%和3.2%,死于VTE相关原因的患者百分比为0%和1.1%,尽管没有统计学差异。结论:伴有和不伴有残余DVT的PE患者症状性PE复发的发生率没有差异。这些结果需要进一步的研究来确认。
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引用次数: 0
Improvement in Quality of Life Following Celiprolol Hydrochloride Administration in a Patient with Vascular Ehlers-Danlos Syndrome: A Case Report. 盐酸塞利洛尔对血管性埃勒-丹洛斯综合征患者生活质量的改善:1例报告。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-06-25 DOI: 10.3400/avd.cr.22-00130
Kanichiro Shimizu, Yoshihiko Kameoka, Kenji Motohashi, Yohei Munetomo, Naoki Kurata, Shunichi Sadaoka

A 40-year-old female, who underwent transcatheter arterial embolization due to acute bleeding from an iliolumbar artery, was subsequently genetically diagnosed with vascular Ehlers-Danlos syndrome. She experienced chronic anemia for many years due to the easy bruising of her whole body. The bruising improved with oral administration of celiprolol hydrochloride. There were no cardiac or vascular events during the 7 years following the transcatheter arterial embolization. Vascular Ehlers-Danlos syndrome requires specialized treatment that is scientifically proven to prevent a major vascular event. Proactive genetic diagnosis is recommended in patients suspected of having vascular Ehlers-Danlos syndrome after careful patient interview.

一名40岁女性,因髂腰动脉急性出血接受经导管动脉栓塞治疗,随后被基因诊断为血管性埃勒斯-丹洛斯综合征。由于全身容易瘀伤,她经历了多年的慢性贫血。口服盐酸塞利洛尔后,瘀伤改善。经导管动脉栓塞后7年内无心脏或血管事件发生。血管埃勒-丹洛斯综合征需要专门的治疗,科学证明可以预防主要的血管事件。在仔细的患者访谈后,建议对怀疑患有血管性埃勒-丹洛斯综合征的患者进行积极的遗传诊断。
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引用次数: 0
Iliofemoral Aneurysm in Patients with Type 1 Neurofibromatosis: A Case Report and a Literature Review. 1型神经纤维瘤病伴髂股动脉瘤1例并文献复习。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-06-25 DOI: 10.3400/avd.cr.23-00007
Takeshi Uzuka, Riko Umeta, Hiroki Uchiyama, Ayaka Arihara, Hitoki Hashiguchi, Akihiko Sasaki

Vascular involvement, especially in the iliofemoral segment, is rare in type 1 neurofibromatosis. We herein report a case involving a 49-year-old male diagnosed with type 1 neurofibromatosis who presented with right inguinal pain and swelling. CT angiography revealed a 50-mm aneurysm extending from the right external artery to the common femoral artery. Although surgical reconstruction was performed successfully, the patient required an additional operation 6 years later for aneurysm enlargement in the deep femoral artery. Histopathological examination confirmed the proliferation of neurofibromatosis cells in the aneurysm wall.

血管受累,尤其是髂股段,在1型神经纤维瘤病中是罕见的。我们在此报告一例49岁男性,诊断为1型神经纤维瘤病,表现为右侧腹股沟疼痛和肿胀。CT血管造影显示一50毫米动脉瘤,从右外动脉延伸至股总动脉。虽然手术重建成功,但患者在6年后因股深动脉动脉瘤扩大而需要进行额外的手术。组织病理学检查证实动脉瘤壁神经纤维瘤细胞增生。
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引用次数: 0
Coil Embolization of Recurrent Internal Iliac Artery Aneurysm via the Superior Gluteal Artery. 经臀上动脉栓塞治疗复发性髂内动脉瘤。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-06-25 DOI: 10.3400/avd.cr.22-00116
Takuro Fukumoto, Yukihisa Ogawa, Kiyoshi Chiba, Shintaro Nawata, Shojiro Morikawa, Takeshi Miyairi, Hidefumi Mimura, Hiroshi Nishimaki

We report a case of recurrent internal iliac artery aneurysm previously treated with a combination of stent graft placement and coil embolization in an 85 year-old male patient. The patient was scheduled for the direct puncture embolization of the superior gluteal artery. The patient was placed in a prone position under general anesthesia. An 18G-PTC needle was inserted into the superior gluteal artery under ultrasonographic guidance. A 2.2F microcatheter was inserted through an outer needle and advanced to the aneurysmal sac. Coil embolization was successfully performed without endoleaks. This approach is technically feasible when other treatment options fail or are deemed unsuitable.

我们报告一例复发性髂内动脉瘤先前治疗联合支架植入和线圈栓塞在一个85岁的男性患者。患者计划直接穿刺臀上动脉栓塞。病人在全身麻醉下取俯卧位。超声引导下将18G-PTC针插入臀上动脉。2.2F微导管通过外针插入至动脉瘤囊。线圈栓塞成功,无内漏。当其他治疗方案失败或被认为不合适时,这种方法在技术上是可行的。
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引用次数: 0
Prognostic Value of Nutritional Markers for Long-Term Mortality in Patients Undergoing Endovascular Aortic Repair. 营养指标对接受血管内主动脉修复术患者长期死亡率的预后价值
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-06-25 DOI: 10.3400/avd.oa.22-00118
Toshiya Nishibe, Masaki Kano, Ryumon Matsumoto, Hitoshi Ogino, Jun Koizumi, Alan Dardik

Objective: The relationship between nutritional status and morbidity and death in a number of diseases and disorders has garnered considerable attension. In patients having endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAA), we assessed the prognostic value of nutritional markers of albumin (ALB), body mass index (BMI), and geriatric nutritional risk index (GNRI) for long-term mortality. Materials and Methods: Retrospective data analysis was done on patients who had undergone elective EVAR for AAA more than 5 years earlier. Results: A total of 176 patients underwent EVAR for AAA between March 2012 and April 2016. The optimal cutoff value of ALB, BMI, and GNRI for predicting long-term mortality was calculated as 3.75 g/dL (area under the curve [AUC] 0.64), 21.4 kg/m2 (AUC 0.65), and 101.4 (AUC 0.70), respectively. Low ALB, low BMI, and low GNRI as well as age ≥75 years, chronic obstructive pulmonary disease, chronic kidney disease, and active cancer were independent risk factors for long-term mortality. Conclusion: Malnutrition, which is measured by ALB, BMI, and GNRI, is an independent risk factor for long-term mortality in patients receiving EVAR for AAA. Of the nutritional markers, the GNRI can be the most reliable nutritional indicator to identify a potentially high-risk group of mortality after EVAR.

目的:营养状况与多种疾病和失调的发病率和死亡率之间的关系受到广泛关注。在腹主动脉瘤(AAA)血管内动脉瘤修补术(EVAR)患者中,我们评估了白蛋白(ALB)、体重指数(BMI)和老年营养风险指数(GNRI)等营养指标对长期死亡率的预后价值。材料与方法:对 5 年前接受 AAA 选择性 EVAR 的患者进行回顾性数据分析。结果:2012年3月至2016年4月期间,共有176名患者因AAA接受了EVAR手术。计算得出预测长期死亡率的最佳ALB、BMI和GNRI临界值分别为3.75 g/dL(曲线下面积 [AUC] 0.64)、21.4 kg/m2(AUC 0.65)和101.4(AUC 0.70)。低 ALB、低 BMI 和低 GNRI 以及年龄≥75 岁、慢性阻塞性肺病、慢性肾病和活动性癌症是长期死亡率的独立风险因素。结论以ALB、BMI和GNRI衡量的营养不良是AAA EVAR患者长期死亡的独立风险因素。在营养指标中,GNRI 是最可靠的营养指标,可用于识别 EVAR 术后死亡的潜在高危人群。
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引用次数: 0
Preceding Aortic Bare Stenting for Visceral and Limb Malperfusion before Proximal Surgical Repair of Stanford Type A Aortic Dissection. 斯坦福A型主动脉夹层近端手术修复前的内脏和肢体灌注不良的主动脉支架置入术。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-06-25 DOI: 10.3400/avd.cr.22-00075
Kunitaka Kumagai, Arudo Hiraoka, Genta Chikazawa, Hidenori Yoshitaka

Mesenteric malperfusion is a fatal complication of acute aortic dissection, which should rapidly be repaired. However, the optimal treatment strategy remains controversial in patients with type A aortic dissection. We report on a case with aortic bare stenting for visceral and lower limb malperfusion prior to the proximal repair. The visceral and limb reperfusion was obtained after aortic bare stenting and proximal repair was successfully performed. This technique can be an alternative option for visceral malperfusion due to type A aortic dissection. However, careful patient selection is required considering the risk of new dissection and rupture.

肠系膜灌注不良是急性主动脉夹层的致命并发症,应迅速修复。然而,对于A型主动脉夹层患者的最佳治疗策略仍存在争议。我们报告一例在近端修复前采用主动脉裸支架治疗内脏和下肢灌注不良的病例。主动脉裸支架置入术后获得内脏和肢体再灌注,近端修复成功。该技术可作为A型主动脉夹层引起的内脏灌注不良的另一种选择。然而,考虑到新的剥离和破裂的风险,需要仔细选择患者。
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引用次数: 0
Renal Vein Thrombosis Occurring in Association with Oral Contraceptives: A Case Report. 口服避孕药引起肾静脉血栓:1例报告。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-06-25 DOI: 10.3400/avd.cr.22-00129
Takuya Miyahara, Yoshifumi Nishino, Masahiko Ozaki, Masanori Ogiwara

Peripheral venous thromboembolism is a well-known complication of hormonal contraception, but reports on its association with visceral vein thrombosis is limited. We report the case of left renal vein thrombosis (RVT) associated with oral contraceptives (OCs) and concurrent smoking. The clinical presentation of this patient was acute left flank pain. Computed tomography revealed left RVT. The OC was discontinued, and we initiated anticoagulation with heparin and switched to edoxaban. Computed tomography 6 months later showed complete resolution of the thrombosis. This report alerts us regarding the importance of OCs as a risk factor for RVT.

外周静脉血栓栓塞是众所周知的激素避孕并发症,但报道其与内脏静脉血栓形成的关系是有限的。我们报告左肾静脉血栓形成(RVT)与口服避孕药(OCs)和同时吸烟。该患者的临床表现为急性左侧疼痛。计算机断层扫描显示左侧RVT。停用OC,我们开始用肝素抗凝,然后改用依多沙班。6个月后的计算机断层扫描显示血栓完全消退。该报告提醒我们,OCs作为RVT的危险因素的重要性。
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引用次数: 0
Safety of SARS-CoV-2 Vaccination in Patients with Vascular Malformations: Patient-Reported Adverse Vaccine Reactions. 血管畸形患者接种SARS-CoV-2疫苗的安全性:患者报告的疫苗不良反应
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-06-25 DOI: 10.3400/avd.oa.22-00126
Makoto Shiraishi, Mitsunaga Narushima, Chihena Hansini Banda, Kohei Mitsui, Kanako Danno, Ryohei Ishiura, Masakazu Kurita, Shunsuke Yuzuriha, Mutsumi Okazaki

Objectives: Concerns among susceptible individuals, especially those with vascular malformations, have been raised by reports of thromboembolism following the administration of the SARS-CoV-2 vaccination against coronavirus disease 2019 (COVID-19). This study's goal was to assess any negative side effects that patients with vascular malformations who received the SARS-CoV-2 vaccine reported after receiving it. Materials and Methods: Through the three patient groups for vascular malformations in Japan in November 2021, a questionnaire was distributed to patients with vascular malformations who were 12 years of age or older. Multiple regression analysis was used to find relevant variables. Results: A total of 128 patients responded, representing a response rate of 58.8%. Ninety-six participants (75.0%) had received at least one dose of SARS-CoV-2 vaccine. In total, 84 (87.5%) and 84 (89.4%) subjects experienced at least 1 general adverse response following dose 1 and dose 2, respectively. Adverse reactions related to vascular malformations were reported by 15 participants (16.0%) after the 1st dose and 17 (17.7%) after the 2nd dose. Notably, no case of thromboembolism following vaccination was reported. Conclusion: The rate of vaccine-related adverse reactions in patients with vascular malformations is not different from that reported in the general population. There is no report of life-threatening responses in the research population.

目的:在接种针对2019冠状病毒病(COVID-19)的SARS-CoV-2疫苗后发生血栓栓塞的报道引起了易感人群,特别是血管畸形人群的关注。这项研究的目的是评估接受SARS-CoV-2疫苗的血管畸形患者在接受疫苗后报告的任何负面副作用。材料与方法:通过2021年11月日本三个血管畸形患者组,对12岁及以上的血管畸形患者发放调查问卷。采用多元回归分析寻找相关变量。结果:共有128例患者应答,有效率为58.8%。96名参与者(75.0%)至少接种了一剂SARS-CoV-2疫苗。总共有84名(87.5%)和84名(89.4%)受试者分别在剂量1和剂量2后经历了至少1次一般不良反应。第一次给药后出现血管畸形不良反应15例(16.0%),第二次给药后出现血管畸形不良反应17例(17.7%)。值得注意的是,没有接种疫苗后发生血栓栓塞的病例报告。结论:血管畸形患者的疫苗相关不良反应发生率与一般人群无明显差异。在研究人群中没有危及生命的反应报告。
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引用次数: 0
Abdominal Aortic Aneurysm with Essential Thrombocythemia: A Case Report Describing Perioperative Management in Open Surgery. 腹主动脉瘤合并原发性血小板增多症:1例开放手术围手术期处理报告。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-06-25 DOI: 10.3400/avd.cr.23-00010
Naoki Yamamoto, Koji Onoda

We report perioperative management and open surgery to treat a case of infrarenal abdominal aortic aneurysm with essential thrombocythemia (ET), a chronic myeloproliferative disorder associated with arterial or venous thrombosis, idiopathic bleeding, and heparin-resistant diathesis. Following careful preoperative management, including assessment of heparin resistance, open surgery was successfully performed to treat the aortic aneurysm of our patient. This report shows that optimal preparation for surgery is important to safely perform abdominal aortic aneurysm repair and prevent perioperative thrombosis and bleeding in patients with abdominal aortic aneurysm with ET.

我们报告一例伴有原发性血小板增多症(ET)的肾下腹主动脉瘤患者的围手术期管理和开放手术治疗,ET是一种慢性骨髓增殖性疾病,伴有动脉或静脉血栓形成、特发性出血和肝素抵抗性特质。经过仔细的术前管理,包括评估肝素耐药性,我们成功地进行了开放手术治疗我们的病人的主动脉瘤。本报告显示,最佳的手术准备对于腹主动脉瘤合并ET患者安全进行腹主动脉瘤修复和预防围术期血栓形成及出血至关重要。
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引用次数: 0
Experience of Balloon Aortic Valvuloplasty for Severe Aortic Stenosis in Patients Scheduled for Open Surgery for Chronic Limb-Threatening Ischemia. 球囊主动脉瓣成形术治疗严重主动脉狭窄患者因慢性肢体缺血而行开放手术的经验。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-06-25 DOI: 10.3400/avd.oa.22-00131
Kiyoshi Tanaka, Shinsuke Mii, Masaru Ishida, Atsushi Guntani, Sho Yamashita, Shun Kurose, Jin Okazaki, Eisuke Kawakubo

Objectives: To estimate the effectiveness of balloon aortic valvuloplasty (BAV) for severe aortic stenosis (SAS) in patients scheduled for open surgery for chronic limb-threatening ischemia. Materials and Methods: Clinical data of patients from 2012 to 2018 were retrieved and summarized. The early outcomes and survival after BAV and open bypass were retrospectively investigated. Results: BAV was performed on seven dialysis patients. One patient died of mesenteric infarction 3 days after BAV; however, six patients were able to undergo open bypass at an average of 10 days (7-19 days) after BAV. One patient died of hemorrhagic shock before the wound healed; five patients underwent limb salvage. Four of these five patients could not undergo surgical aortic open valve replacement owing to advanced age or poor cardiac function and died within 2 years. Only one patient who underwent radical surgery after a bypass survived more than 4 years. Conclusion: BAV enabled open surgery and limb salvage in patients with SAS. Although BAV alone cannot ensure long-term survival, the procedure will continue to be important as a bridge technique to radical surgery, such as transcatheter aortic valve implantation and aortic valve repair, which are often avoided owing to infection.

目的:评价球囊主动脉瓣成形术(BAV)治疗重度主动脉瓣狭窄(SAS)的有效性。材料与方法:检索我院2012 ~ 2018年患者的临床资料并进行汇总。回顾性研究BAV和开放旁路术后的早期预后和生存率。结果:7例透析患者行BAV治疗。1例BAV后3天死于肠系膜梗死;然而,6例患者在BAV后平均10天(7-19天)能够进行开放旁路手术。1例患者在伤口愈合前死于失血性休克;5例患者行肢体保留术。5例患者中有4例因年事已高或心功能不佳而不能行主动脉瓣置换术,并在2年内死亡。只有一名患者在搭桥手术后接受了根治性手术,存活超过4年。结论:BAV可用于SAS患者的开放手术和肢体保留。虽然单靠BAV不能保证长期存活,但作为根治性手术(如经导管主动脉瓣植入术和主动脉瓣修复术)的桥梁技术,BAV将继续发挥重要作用,而根治性手术通常因感染而无法进行。
{"title":"Experience of Balloon Aortic Valvuloplasty for Severe Aortic Stenosis in Patients Scheduled for Open Surgery for Chronic Limb-Threatening Ischemia.","authors":"Kiyoshi Tanaka,&nbsp;Shinsuke Mii,&nbsp;Masaru Ishida,&nbsp;Atsushi Guntani,&nbsp;Sho Yamashita,&nbsp;Shun Kurose,&nbsp;Jin Okazaki,&nbsp;Eisuke Kawakubo","doi":"10.3400/avd.oa.22-00131","DOIUrl":"https://doi.org/10.3400/avd.oa.22-00131","url":null,"abstract":"<p><p><b>Objectives:</b> To estimate the effectiveness of balloon aortic valvuloplasty (BAV) for severe aortic stenosis (SAS) in patients scheduled for open surgery for chronic limb-threatening ischemia. <b>Materials and Methods:</b> Clinical data of patients from 2012 to 2018 were retrieved and summarized. The early outcomes and survival after BAV and open bypass were retrospectively investigated. <b>Results:</b> BAV was performed on seven dialysis patients. One patient died of mesenteric infarction 3 days after BAV; however, six patients were able to undergo open bypass at an average of 10 days (7-19 days) after BAV. One patient died of hemorrhagic shock before the wound healed; five patients underwent limb salvage. Four of these five patients could not undergo surgical aortic open valve replacement owing to advanced age or poor cardiac function and died within 2 years. Only one patient who underwent radical surgery after a bypass survived more than 4 years. <b>Conclusion:</b> BAV enabled open surgery and limb salvage in patients with SAS. Although BAV alone cannot ensure long-term survival, the procedure will continue to be important as a bridge technique to radical surgery, such as transcatheter aortic valve implantation and aortic valve repair, which are often avoided owing to infection.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"16 2","pages":"108-114"},"PeriodicalIF":0.8,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/51/7e/avd-16-2-oa.22-00131.PMC10288117.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10090795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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Annals of vascular diseases
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