Mlačo A, Mlačo N, Begić E
… +2 more, Mekić M, Džubur A
Int J Angiol
· 2023 Dec · PMID 37927846
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D-dimer and fibrinogen are nonspecific diagnostic biomarkers for venous thromboembolism (VTE). The aim of this article was to present the values of D-dimer and fibrinogen in relation to the anatomical localization of dee...D-dimer and fibrinogen are nonspecific diagnostic biomarkers for venous thromboembolism (VTE). The aim of this article was to present the values of D-dimer and fibrinogen in relation to the anatomical localization of deep vein thrombosis (DVT). This was an observational study, which included 1,142 patients hospitalized from 2010 to 2019 at the Department of Angiology, Clinical Center University of Sarajevo. Data on gender, age, and thrombosis location were collected of all patients. Fibrinogen and D-dimer values were available for 983 and 500 patients, respectively. Thrombosis location was classified as iliofemoral (521-45.6% patients), femoral-popliteal (486-42.6% patients), isolated calf DVT (63-5.5% patients), and upper extremity DVT (UEDVT in 72-6.3% patients). A majority, 448 (89.6%), of patients had high D-dimer (the cutoff is 0.55 mg/L) and 662 (67.3%) patients had high fibrinogen (reference range: 1.8-3.8 g/L). The highest D-dimer was detected in patients with iliofemoral DVT (mean: 10.48 mg/L), χ2 = 50.78, = 0.00. The highest fibrinogen was detected in patients with iliofemoral DVT as well (mean 4.87 g/L), χ2 = 11.1, = 0.01. D-dimer and fibrinogen values are significantly higher in patients iliofemoral DVT than femoral-popliteal and isolated calf DVT, and D-dimer values are significantly higher in lower extremity DVT than UEDVT, but these biomarkers cannot be used alone to discriminate between thrombosis locations. Further imaging is required.
Amer M, Annie FH, Adhikari S
… +1 more, Mukherjee D
Int J Angiol
· 2023 Dec · PMID 37927845
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We sought to assess the impact of ablation during index hospitalization (IH) on all-cause mortality (ACM) in patients presenting with newly diagnosed typical atrial flutter (tAFL) as compared with patients without ablat... We sought to assess the impact of ablation during index hospitalization (IH) on all-cause mortality (ACM) in patients presenting with newly diagnosed typical atrial flutter (tAFL) as compared with patients without ablation, irrespective of optimal rate or rhythm control medications. We identified patients with newly diagnosed tAFL in the TriNetX Research Network between January 20, 2010, and January 20, 2021. Using International Classification of Diseases, 10th revision (ICD-10) codes, patients were stratified into those who had undergone ablation during IH and those who did not undergo the procedure. Results were assessed using propensity score matching (PSM) analysis as well as Kaplan-Meier curves. A total of 12,986 (N) patients (aged 35-85 years) met our inclusion criteria. Of those, 3,665 had undergone ablation during IH compared with 9,321 patients who did not. Patients in the ablation group (mean age 64.3 ± 10.1 years) had a higher prevalence of hypertension (80 vs. 78.3%, = 0.02), respectively. PSM created two well-matched groups of 3,652/3,652 patients each with an ACM of ablation of 4.5 versus 7.8% ( = 0.01) at 6 months, 6.6 versus 11.4% ( = 0.01) at 12 months, and 14.5 versus 20.9% ( < 0.001) at 36 months of follow-up. Survival data were confirmed through Kaplan-Meier analysis using a log-rank test. From a large, federated, multicenter population database, we report significant survival benefit of ablation during IH in patients presenting with new tAFL diagnosis. Kaplan-Meier mortality curves confirmed survival advantage with ablation at 6, 12, and 36 months of follow-up in this cohort.
Indriani S, Amshar M, Nugraha RA
… +2 more, Siddiq T, Adiarto S
Int J Angiol
· 2023 Dec · PMID 37927841
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Numerous studies have reported cases of acute limb ischemia (ALI) in coronavirus disease 2019 (COVID-19), along with a sharp increase of ALI incidence during the COVID-19 pandemic. The objective of this study was to anal...Numerous studies have reported cases of acute limb ischemia (ALI) in coronavirus disease 2019 (COVID-19), along with a sharp increase of ALI incidence during the COVID-19 pandemic. The objective of this study was to analyze the clinical features, treatment strategies, and outcomes in COVID-19 patients who developed ALI. A systematic search was performed in PubMed, ScienceDirect, and Cochrane to identify relevant articles. Variables of interest included ALI location, ALI and COVID-19 severity, concomitant thrombosis, comorbidities/risk factors, coagulation and inflammatory parameters, therapy, outcome, and cause of death. Data extraction and pooling were conducted by two reviewers. Fifty-six articles with a total of 191 subjects were included in the analysis; 78.5% of the subjects were male; mean age was 64.2 years; 94.2% of cases were ALI de novo; 41.1% of the subjects had ALI stage IIB; 82.7% of ALI occurred in the lower limb. The popliteal artery was the most commonly affected artery (48.2% of subjects); 38.1% of the subjects had severe COVID-19; 11.1% had asymptomatic COVID-19, and 15.9% were post-COVID-19; 50.7% of the subjects had hypertension; 12.0% of the subjects had concomitant thrombosis; 98.1% of the subjects had elevated D-dimer, and 83.3% of the subjects had elevated C-reactive protein; 61.9% of the subjects underwent surgical thromboembolectomy, 21.3% underwent conservative treatment, and 8.1% underwent amputation initially. The overall mortality rate and limb amputation rate were 39.3 and 22.4%, respectively; 67.6% of deaths were due to respiratory failure. Our study supports that COVID-19 is associated with hypercoagulability that may trigger the development of ALI, and that ALI is a possible predictor of poor outcome in COVID-19 patients.
Int J Angiol
· 2023 Dec · PMID 37927836
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Coral reef aorta is a rare type of atherosclerotic disease that causes severe calcification in the abdominal aorta. We present a case of coral reef aorta with hemodynamically significant symptomatic aortic stenosis causi...Coral reef aorta is a rare type of atherosclerotic disease that causes severe calcification in the abdominal aorta. We present a case of coral reef aorta with hemodynamically significant symptomatic aortic stenosis causing intermittent claudication and bilateral cyanosis of the toes. Despite the challenging anatomy for endovascular treatment, the patient underwent successful transfemoral endovascular stent-graft placement. The endovascular intervention with stents is a viable alternative method and, in many cases, constitutes the first choice for the treatment of coral reef aorta.
Khedija S, Nadia A, Houcine H
… +2 more, Mouna B, Amine J
Int J Angiol
· 2023 Dec · PMID 37927832
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Coronavirus disease causes a hypercoagulable state with endothelial inflammation. These conditions can produce embolic complications. Thrombosis can occur in different locations and may lead to ischemic stroke and ischem...Coronavirus disease causes a hypercoagulable state with endothelial inflammation. These conditions can produce embolic complications. Thrombosis can occur in different locations and may lead to ischemic stroke and ischemic limb. We report the case of a 64-year-old woman with recent severe acute respiratory syndrome coronavirus 2 pneumonia who was admitted to the hospital due to a giant floating thrombus in the ascending aorta with multiple ischemic events. Aortic computed tomography angiogram revealed an aberrant right subclavian artery associated with bicarotid trunk that might have protected carotid arteries from embol migration. Thrombosis is a rare clinical presentation in coronavirus disease 2019 infection but with serious complications that must be kept in mind to detect and avoid morbidities like ischemic stroke.
Zemlyanskiy V, Zemlyanskaya N, Sultanaliev T
… +3 more, Dautov T, Kozhahmetov S, Openko V
Int J Angiol
· 2023 Dec · PMID 37927829
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The aim of this study was to evaluate the effectiveness of the proposed method of preventive embolization of the internal iliac arteries using a liquid tantalum-containing ethylene vinyl alcohol copolymer. In this non... The aim of this study was to evaluate the effectiveness of the proposed method of preventive embolization of the internal iliac arteries using a liquid tantalum-containing ethylene vinyl alcohol copolymer. In this nonrandomized clinical study with a retrospective control group, 55 patients with aneurysmal lesions of the infrarenal abdominal aorta participated. In the course of this study, we developed and implemented a method of preventive embolization of the ostia of the internal iliac artery using a liquid tantalum containing ethylene-vinyl alcohol copolymer having viscosity of 34 centipoise. The method was applied in 27 cases in patients with aneurysmal lesions of the infrarenal abdominal aorta with unilateral involvement of the common iliac artery. The maximum follow-up period at the stage of publication of the results was 24 months. The proposed method of embolization of the internal iliac artery is accompanied by an absolute risk of developing type II endoleak 0.393 (95% confidence interval: 0.2120-0.5738, = 0.029); therefore, when using the new technique, there is a decrease in the absolute risk of developing type II endoleak by 39.3%. The proposed method of preventive embolization allows to perform reliable occlusion of the internal iliac artery as proximally as possible, which makes it possible to maintain distal blood flow in the internal iliac artery and minimizes the risks of ischemic events.
Int J Angiol
· 2023 Dec · PMID 37927825
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Chronic thromboembolic pulmonary hypertension is rare, underdiagnosed form of pulmonary hypertension. It is caused by intravascular obstruction of pulmonary arteries due to fibrotic transformation of thromboembolic mater...Chronic thromboembolic pulmonary hypertension is rare, underdiagnosed form of pulmonary hypertension. It is caused by intravascular obstruction of pulmonary arteries due to fibrotic transformation of thromboembolic material and microvasculopathy. It is important to diagnose this variant as potentially curative treatment in the form of pulmonary endarterectomy is available. Last two decades have seen rapid advances in targeted medical management and refinement in balloon pulmonary angioplasty technique, which have provided a viable therapeutic option for patients who deemed to be inoperable.
Karaca S, Yalic İ, Bulut B
… +2 more, Engin Y, Posacıoğlu H
Int J Angiol
· 2025 Jun · PMID 40365142
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Thoracic endovascular aortic repair (TEVAR) has been performed in the treatment of thoracic aortic disease since the mid-1990s. Complications associated with TEVAR are increasing rapidly due to its widespread use. One of...Thoracic endovascular aortic repair (TEVAR) has been performed in the treatment of thoracic aortic disease since the mid-1990s. Complications associated with TEVAR are increasing rapidly due to its widespread use. One of these complications is late lethal aortoesophageal fistula (AEF). The aim of this study was to describe the diagnosis of AEF in a 64-year-old woman 8 months after TEVAR. The AEF was diagnosed on a computed tomography angiography with oral and intravenous contrast. The patient underwent open surgical repair and died of sepsis 12 days after surgery.
Afandy JE, Taofan T, Indriani S
… +2 more, Batubara EAD, Adiarto S
Int J Angiol
· 2025 Jun · PMID 40365144
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Chronic limb-threatening ischemia represents the end stage of peripheral artery disease (PAD), primarily affecting individuals over 60 years old. While quite rare, nephrotic syndrome (NS) is recognized for increasing the...Chronic limb-threatening ischemia represents the end stage of peripheral artery disease (PAD), primarily affecting individuals over 60 years old. While quite rare, nephrotic syndrome (NS) is recognized for increasing the susceptibility to arterial thromboembolism (ATE). A 32-year-old male complained of resting pain in his left leg and pain after walking 50 meters with his right leg. He had a 9-year history of NS confirmed through biopsy and was on a daily regimen of 2 × 360 mg mycophenolic acid and 1 × 8 mg methylprednisolone. He had no history of hypertension, diabetes, or smoking. Atrophy and ulcers were observed on his left leg. Laboratory tests revealed elevated D-dimer and borderline high cholesterol levels. The right ankle-brachial index was 0.5, and for the left, it was 0.33. Computed tomography angiography identified occlusion in the left external iliac artery and right superficial femoral artery (SFA). The patient underwent percutaneous transluminal angioplasty with a plain balloon on both legs and an additional drug-eluting stent on the left SFA. He was discharged on rivaroxaban, clopidogrel, aspirin, simvastatin, mycophenolic acid, and methylprednisolone, with no complaints. The mechanism behind NS-caused ATE remains unclear, although it is associated with the loss of anticoagulants in urine, increased procoagulant activity, altered fibrinolytic systems, thrombocytosis, and enhanced platelet activation. Prolonged corticosteroid therapy in NS management also amplifies the risk of thromboembolism by promoting a hypercoagulable state. We suspected NS and the prolonged use of corticosteroids as risk factors for ATE, manifested as PAD in our patient. While optimal NS therapy may reduce the risk of PAD, prolonged corticosteroid use should be closely monitored.
Int J Angiol
· 2023 Sep · PMID 37576537
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Many components of required skills and competencies exist, and are felt to contribute to the successful completion of training for independent practice in the medical field as a physician. These requirements are document...Many components of required skills and competencies exist, and are felt to contribute to the successful completion of training for independent practice in the medical field as a physician. These requirements are documented and detailed in a temporal fashion during the training period and used for advancement during training as well as documentation of successful completion of that training. While clinical skill development that allows optimal care and treatment of patients is of utmost importance during this training, other components of the training are important and contribute to the ideal development of a well-rounded and credentialed physician. One of these other components which is very important and needs to be recognized is the engagement of medical trainees across disciplines in academic and research scholarly activity. This engagement is an important component of medical training, and the development of skills and didactics geared toward efficient and accurate performance of research is essential.
Shibata Y, Kobayashi N, Shirakabe A
… +2 more, Miyauchi Y, Asai K
Int J Angiol
· 2023 Sep · PMID 37576535
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We aimed to examine the relationship of living arrangements (i.e., living alone or living with others) with background, clinical severity, preintervention culprit lesion plaque morphology, and clinical outcomes in patien...We aimed to examine the relationship of living arrangements (i.e., living alone or living with others) with background, clinical severity, preintervention culprit lesion plaque morphology, and clinical outcomes in patients with acute coronary syndrome (ACS). Among 1,683 consecutive patients with ACS, we retrospectively compared patients living alone ( = 318) versus living with others ( = 1,362). Optical coherence tomography (OCT) findings, which are high-resolution intracoronary imaging devices, were analyzed in patients with preintervention OCT and compared between patients living alone ( = 174) versus those living with others ( = 665). Older (median; 69 vs. 67 y, = 0.046) and female (31 vs. 17%, < 0.001) patients more frequently lived alone. Frequency of achieving a time interval of 6 hours or less from ACS onset to admission was lower in patients living alone (56 vs. 63%, = 0.022). Clinical presentation was more severe in patients living alone (Killip II/III/IV; 27 vs. 22%, = 0.029). Plaque morphology evaluated by OCT was similar between groups (plaque rapture; 48 vs. 48%, = 0.171). Kaplan-Meier analyses revealed higher rates of cardiac mortality during 2-year follow-up period in patients living alone [13.9 vs. 8.5%, hazard ratio (HR) 1.604, 95% confidence interval (CI) 1.112-2.313, = 0.010]. After traditional cardiovascular risk factors and clinical severity upon admission had been adjusted, living alone was an independent predictor of cardiac mortality in ACS patients (HR 1.582, 95% CI 1.056-2.371, = 0.026). Living alone was independently associated with 2-year cardiacmortality in ACS patients after adjusting for background and presentation and might be unrelated to the development of atherosclerosis.
Pipolo DO, Guevara S, Vasiljevic L
… +20 more, Pietrantonio AED, Brennan W, Asmus H, McCann-Molmenti A, Cho YM, Shinozaki K, Hayashida K, Okuma Y, Shoaib M, Becker LB, Decker ME, Worku HA, Majdak P, Donzelli G, Patel A, Davoud S, Vaca-Zorrilla A, Beutler SS, Molmenti EP, Miyara SJ
Int J Angiol
· 2023 Sep · PMID 37576534
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In this case study, we describe a 25-year-old male who was admitted due to a severe traumatic brain injury, requiring invasive intracranial pressure monitoring. At 48 hours posttrauma, he developed intracranial hypertens...In this case study, we describe a 25-year-old male who was admitted due to a severe traumatic brain injury, requiring invasive intracranial pressure monitoring. At 48 hours posttrauma, he developed intracranial hypertension refractory to medical treatment without tomographic changes in the brain. Subsequently, intra-abdominal hypertension and tomographic signs of abdominal surgical pathology were observed. An exploratory laparotomy was performed with an intraoperative diagnosis of acute mesenteric ischemia. After surgical intervention for the abdominal pathology, intracranial pressure was restored to physiological values with a favorable recovery of the patient. In this report, the relationship between intracranial pressure and intra-abdominal pressure is discussed, highlighting the delicate association between the brain, abdomen, and thorax. Measures should be taken to avoid increases in intra-abdominal pressure in neurocritical patients. When treating intracranial hypertension refractory to conventional measures, abdominal causes and multiple compartment syndrome must be considered. The cranial compartment has physiological interdependence with other body compartments, where one can be modified by variations from another, giving rise to the concept of multiple compartment syndrome. Understanding this relationship is fundamental for a comprehensive approach of the neurocritical patient. To the best of our knowledge, this is the first report of a comatose patient post-traumatic brain injury, who developed medically unresponsive intracranial hypertension secondary to acute mesenteric ischemia, in which surgical resolution of intra-abdominal pathology resulted in intracranial pressure normalization and restitutio ad integrum of neurological status.
Int J Angiol
· 2023 Sep · PMID 37576533
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Plasma level of chemokine CXCL12 can predict adverse cardiovascular outcomes in patients with coronary artery disease, but data on its relationship with severity of coronary stenosis in cases of severe myocardial infarct...Plasma level of chemokine CXCL12 can predict adverse cardiovascular outcomes in patients with coronary artery disease, but data on its relationship with severity of coronary stenosis in cases of severe myocardial infarction (MI) are scarce and conflicting. The objective of this study was to investigate link between plasma CXCL12 levels and different grades of left ventricular ejection fraction (LVEF) in statin-treated and -untreated patients with severe MI. A total of 198 consecutive patients with first-time severe MI (ST-elevated myocardial infarction [STEMI], = 121 and non-ST-elevated myocardial infarction [NSTEMI], = 77) were recruited from Coronary Care Unit, King Abdulaziz University Hospital. They have one to two coronary arteries blocked ≥50%, or three arteries blocked 30 to 49%. Demographic and clinical criteria were collected and plasma CXCL12 level was measured. No correlations were detected between demographic and clinical criteria and CXCL12 level. While troponin peaks and LVEF significantly differed between STEMI and NSTEMI patients, CXCL12 level showed nonsignificant changes. Plasma CXCL12 levels decreased significantly in statin-treated patients compared with those untreated. From receiver operating characteristic (ROC) analysis, high CXCL12 levels were associated with no statin therapy. For STEMI and NSTEMI patients, area under the receiver operating characteristic curve for CXCL12 test were 0.685 and 0.820, while sensitivity and specificity values were 75.9 and 54.8%, and 73.1 and 84%, respectively. Plasma CXCL12 levels showed nonsignificant changes with different ranges of LVEF and troponin peaks. In patients with severe MI, irrespective of statin therapy, plasma CXCL12 showed no correlation with different ranges of LVEF suggesting that it cannot predict left ventricular dysfunction in these cases. However, cross-sectional design of this study is a limitation.
Int J Angiol
· 2023 Sep · PMID 37576530
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Chronic venous disease (CVD) associated with great saphenous vein (GSV) reflux has a higher prevalence of pain in the lower limbs. This study evaluates the impact of ultrasound-guided foam sclerotherapy (UGFS) for GSV an...Chronic venous disease (CVD) associated with great saphenous vein (GSV) reflux has a higher prevalence of pain in the lower limbs. This study evaluates the impact of ultrasound-guided foam sclerotherapy (UGFS) for GSV and symptom control, accessed by the visual analogue scale (VAS). Patients with CVD who underwent GSV-UGFS were included in this retrospective cohort (417 limbs). The pain was measured before and after the treatment. The scale alteration was assessed as a function of age, sex, Clinical Etiologic Anatomic Pathophysiologic (CEAP) classes, total of sclerotherapy sessions, GSV occlusion patterns, and ulcer healing. Majority of patients were female (59.2%), and the mean age was 56 ± 11.5 years. In the total sample, 78.2% of the GSVs were fully occluded, 19.7% had partial occlusion, 2.2% remained open, and 3.2 ± 1.9 (median = 3.0) sessions were performed. The reduction of symptoms occurred in 88.3% of participants (VAS drop median = 4.8). Patients younger than 50 years and females had the greatest VAS decreases. When comparing the outcomes of complete occlusion versus partial occlusion, there was no significant difference in VAS pain reduction ( = 0.14). The comparison between CEAP clinical classes also did not show statistically significant differences in delta VAS ( = 0.71). GSV-UGFS was effective for pain control. However, this improvement does not appear to be related to the pattern of occlusion, indicating that in the short term, the outcomes of total and partial occlusion suggest successful management of symptoms. Other aspects such as gender, age, pretreatment pain intensity, and CEAP classes seem to play a role in the clinical outcome.
Indriani S, Dewangga R, Adiarto S
… +4 more, Siddiq T, Dakota I, Andriantoro H, Vuylsteke M
Int J Angiol
· 2023 Sep · PMID 37576529
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Acute limb ischemia (ALI) is a predictor of high morbidity and mortality. Previous studies showed that ALI developed after cardiac surgery may increase mortality. This study aimed to elucidate the clinical course and ide...Acute limb ischemia (ALI) is a predictor of high morbidity and mortality. Previous studies showed that ALI developed after cardiac surgery may increase mortality. This study aimed to elucidate the clinical course and identify risk factors contributing to mortality in patients with ALI after cardiovascular surgery. This is a single-center retrospective cohort study. We analyzed data from 52 patients with ALI after cardiovascular surgery between 2016 and 2020. We evaluated the risk factors for 1-year mortality using Cox proportional hazards regression analysis. Most of the patients with ALI were male and the median age was 56 years (23-72 years). Most of the patients with ALI had coronary artery diseases. The 1-year mortality rate was 55.8% ( = 29 patients). Multivariable analysis revealed that cardiopulmonary bypass (CPB) time ≥ 100 minutes (hazard ratio [HR]: 3.067, 95% confidence interval [CI]: 1.158-8.120) and postoperative acute kidney injury (HR: 2.927, 95% CI: 1.358-6.305) were significantly increasing the risk of mortality in patients with ALI after an operation. ALI after cardiovascular surgery was associated with high 1-year mortality in our study and long CPB time and postoperative acute kidney injury contributed to the mortality.
Int J Angiol
· 2024 Dec · PMID 39502348
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Thoracoabdominal aortic aneurysms (TAAAs) are complex and if untreated have high mortality and morbidity rates. Open surgical repair is the historical treatment approach; however, postoperative complications remain high...Thoracoabdominal aortic aneurysms (TAAAs) are complex and if untreated have high mortality and morbidity rates. Open surgical repair is the historical treatment approach; however, postoperative complications remain high with spinal cord ischemia notably one of the more serious and common complications. The avoidance of thoracotomy or laparotomy with the advent of endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR) have decreased the morbidity and mortality with TAAA repair, especially in patients with significant comorbidities such as a history of aortic surgery, underlying cardiac disease, and chronic obstructive pulmonary disease. Endovascular treatment options have grown to include fenestrated EVAR, multibranched EVAR, and physician-modified fenestration stent grafts. These techniques have achieved lower mortality rates than traditional open repair, but complications such as limb ischemia, spinal cord ischemia, and long-term durability must be considered. This review provides an overview of the most common endovascular techniques for TAAAs as well as short- and midterm outcomes.
Monzio-Compagnoni N, Zuccon G, Barbosa F
… +2 more, Rampoldi AG, Tolva VS
Int J Angiol
· 2024 Dec · PMID 39502347
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Type 2 endoleak has been proved not to significantly increase the risk of aneurysm rupture. However, it is associated with aneurysm enlargement and may require secondary interventions. Its role has been widely investigat...Type 2 endoleak has been proved not to significantly increase the risk of aneurysm rupture. However, it is associated with aneurysm enlargement and may require secondary interventions. Its role has been widely investigated, but a definitive consensus about its management has still not been obtained. We performed a retrospective, single-center observational study that investigates the incidence of type 2 endoleak and its implications in the long-term follow-up in all the patients who underwent endovascular aortic repair (EVAR) for abdominal aortic aneurysm from 2011 to 2016 at our institution. A total of 216 patients who underwent EVAR during the specified time period were enrolled, and 85 of them (39%) developed type 2 endoleak in their follow-up. Thirty-one of the patients who developed type 2 endoleak faced an aneurysm sac growth > 10 mm and required secondary intervention. Only nine of them showed resolution of the leak. In the long-term follow-up, patients who developed type 2 endoleak after EVAR did not show a significantly increased mortality compared with those who did not, but some of them required late open conversion due to aneurysm sac enlargement and some other developed a secondary type 1 endoleak which required correction. The management of type 2 endoleak remains debated, despite consensus exist regarding the need for intervention when a > 10-mm aneurysm sac growth is observed. Further studies are necessary to better define which are the "high-risk" type 2 endoleaks and identify the patients who would benefit more from correction.
Shaker AA, Shehata AH, Alhindawy KM
… +1 more, El Daly W
Int J Angiol
· 2023 Jun · PMID 37207014
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Common femoral artery (CFA) atherosclerotic lesions currently remain one of the last limitations for adoption of endovascular repair as the first-line treatment, easy surgical accessibility, and, last but not least, favo...Common femoral artery (CFA) atherosclerotic lesions currently remain one of the last limitations for adoption of endovascular repair as the first-line treatment, easy surgical accessibility, and, last but not least, favorable long-term outcomes, still making CFA disease treatment part of the surgical domain. In the last 5 years, improvement of the endovascular equipment and technical skills of the operators have led to an increase in percutaneous CFA procedures. A single-center randomized prospective study of 36 symptomatic (Rutherford 2-4) CFA stenotic or occlusive lesions were included, and patients were randomized over two groups based on the management approach SUPERA versus hybrid technique. Patients had a mean age 60.8 ± 8.2 years. Thirty-two (88.9%) patients reported improvement of the clinical symptoms, 28 (87.5%) patients had intact pulse postoperatively, and 28 (87.5%) had patent vessels. Follow-up showed that none developed reocclusion or restenosis during the period of follow-up. Comparison of difference in peak systolic velocity ratio (PSVR) among study groups showed that the hybrid technique had more reduction of PSVR postintervention compared to the SUPERA group with a -value of < 0.0001. Safety and feasibility of endovascular approach with the SUPERA stent to the CFA (no stent zone) has low incidence of postoperative morbidity and mortality in well experienced surgical hands.