Evidenzbasierte Gefäßchirurgie

Debus, Eike Sebastian; Grundmann, Reinhart T.

doi:10.1007/978-3-662-47167-8

Cited by 10 publications

(5 citation statements)

References 70 publications

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“…3). This distribution reflects the uncertainty in the various guidelines, recommendations of which range from the wide propagation of primary stent angioplasty with nitinol stents, to preference of balloon angioplasty with secondary stenting (bail out) [14]. At the present time a general recommendation does not exist.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous endovascular treatment of infrainguinal PAOD

et al. 2016

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BackgroundThe percutaneous infrainguinal stent (PSI) register study aimed to collate all percutaneous endovascular procedures for infrainguinal peripheral arterial occlusive disease (PAOD) conducted in 74 German vascular centers between September and November 2015 (3 months). In order to obtain representative results all consecutive treatment procedures had to be submitted by the participating trial centers.Material and methodsThis was a prospective, nonrandomized multicenter study design. All patients suffering from intermittent claudication (IC, Fontaine stage II) or critical limb ischemia (CLI, Fontaine stages III and IV) were included. Trial centers with less than 5 cases reported within the 3‑month trial period or centers that could not ensure the submission of all treated patients were excluded.ResultsIn the final assessment 2798 treated cases from 74 trial centers were reported of which 65 (87.8 %) centers were under the leadership of a vascular surgeon. Approximately 33 % of the interventions in centers under the leadership of vascular surgeons were conducted by radiologists. Risk factors, especially chronic renal disease, diabetes and cardiac risk factors were significantly different between patients with IC and CLI. Of the patients with Fontaine stage II PAOD 41.3 % had 3 patent crural vessels compared to only 10.8 % of patients with Fontaine stage IV. With respect to peri-interventional complications, percutaneous endovascular treatment of IC was a safe procedure with severe complications in less than 1 % and no fatalities. Only 4.5 % of the procedures were conducted under ambulatory conditions. In the supragenual region self-expanding bare metal stents, standard percutaneous transluminal angioplasty (PTA) and drug-coated balloons were the most frequently used procedures. For interventions below the knee, standard PTA was the most commonly employed treatment.ConclusionThe main aim of the PSI study was to obtain a realistic picture of percutaneous endovascular techniques used to treat suprapopliteal and infrapopliteal PAOD lesions and to describe the treatment procedures used by vascular specialists in Germany. To investigate the change in trends for treatment over time, this study has to be repeated in the future in order to test how quickly the results of randomized studies can be implemented in practice.Electronic supplementary materialA complete list of the PSI study collaborators is available under doi: 10.1007/s00772-016-0202-2.

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Section: Discussionmentioning

confidence: 99%

Percutaneous endovascular treatment of infrainguinal PAOD

et al. 2016

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“…The chronic pulsatile pressure on the vein leads to endothelial damage, intimal proliferation, and fibrin replacement, resulting in luminal stenosis and fibrosis, and in severe cases, complete occlusion would be expected 6 . The prevalence of this anatomical variation is reported as up to 20% in the general population, 7 and over 25% of the asymptomatic population show more than 50% stenosis of LCIV in their screening CT‐scan 8 . The symptoms could include a range from asymptomatic iliac vein stenosis, to symptoms of chronic vein stasis of the lower limb such as pain, swelling, varicose veins, and pelvic congestion syndrome.…”

Section: Discussionmentioning

confidence: 99%

Hematuria during the right heart catheterization procedure: Renal perforation as a very rare complication

Jenab

Tofighi

Navid

et al. 2023

Clinical Case Reports

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“…With respect to the superiority of the approaches in question, there are currently no randomized trials favoring one approach over the other [1]; however, the literature suggests that older patients in particular benefit from endovascular repair in the elective setting. Given the regular radiological follow-up examinations required following endovascular repair, younger patients should be treated using an open approach where possible.…”

Section: Open or Endovascular Repair?mentioning

confidence: 99%

“…Visceral artery aneurysms are rare with an incidence of approximately 0.01–0.1% in the population [1]. Aneurysms of the splenic artery are the most common, followed by the hepatic artery and the superior and inferior mesenteric arteries [2].…”

Section: Introductionmentioning

confidence: 99%

Visceral artery aneurysms

et al. 2018

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Visceral artery aneurysms are rare with an incidence of only 0.01–0.1% of the population. Open surgical or endovascular elimination should be performed for aneurysms greater than 2 cm in size. The risk of aneurysm rupture is then approximately 25–40%. If the aneurysm ruptures the mortality can be as high as 76%. For mycotic aneurysms or spurious aneurysms there is no lower limit to the diameter size for the need of treatment. Sudden abdominal pain during pregnancy can be caused by visceral artery aneurysms and must be further clarified. The indications for surgery during pregnancy should be made generously. The clinical symptoms (abdominal complaints) of visceral artery aneurysms are manifold. The treatment can be either an open surgical approach or endovascular treatment. In the emergency setting, if endovascular treatment is no longer possible, an open surgical treatment needs to be performed. There are so far no randomized studies which could identify one of the procedures (open surgery vs. endovascular surgery) as clearly being superior. The prognosis after treatment is satisfactory with a 5–10 year survival rate of approximately 90%.

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Evidenzbasierte Gefäßchirurgie

Cited by 10 publications

References 70 publications

Percutaneous endovascular treatment of infrainguinal PAOD

Percutaneous endovascular treatment of infrainguinal PAOD

Hematuria during the right heart catheterization procedure: Renal perforation as a very rare complication

Visceral artery aneurysms

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