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Advances in Vascular and Endovascular Surgery
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Advances in Vascular and Endovascular Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Vascular Medicine".

Deadline for manuscript submissions: closed (10 May 2023) | Viewed by 6905

Special Issue Editors

Dr. Fadi Taher

E-Mail Website
Guest Editor
Department of Vascular and Endovascular Surgery, Klinik Ottakring, Vienna, Austria
Interests: vascular and endovascular surgery; vascular access surgery; carotid surgery; aortic surgery; vascular education
Dr. Afshin Assadian

E-Mail Website
Guest Editor
Department of Vascular and Endovascular Surgery, Klinik Ottakring, Vienna, Austria
Interests: vascular and endovascular surgery; aortic surgery; complex open and endovascular procedures; compression syndromes; carotid and vertebral artery surgery; vascular education; vascular access surgery

Special Issue Information

Dear Colleagues,

Over the last two decades, endovascular treatment options for a myriad of vascular diseases have been increasingly improved and developed. Aortic surgery stands out as a prominent example where endovascular techniques have successfully complimented established open surgical procedures. Ultimately, the popularization of endovascular aortic repair, which itself has developed to a point where highly complex aortic pathologies can be treated using a large repertoire of off-the-shelf and custom-made devices, has undoubtedly contributed to improved patient care. Open and endovascular techniques and their development for peripheral arterial or carotid diseases have been equally important in the vascular surgeon‘s armament, and exciting new developments could spur relevant clinical advances in the treatment of patients requiring hemodialysis access. As patient care has evolved, so has the way we train vascular surgery residents, with exciting open and endovascular training simulators being developed and applied.

This Special Issue of the Journal of Clinical Medicine, entitled “Advances in Vascular and Endovascular Surgery”, provides an opportunity for authors and readers dedicated to improving vascular education and patient care to create and refer to a collection of papers on advances and new insights within our field. The Special Issue aims to highlight exciting developments that could improve how we diagnose and treat patients.

It is our pleasure to invite and welcome you to contribute your manuscripts on advances in vascular and endovascular surgery for peer review. We look forward to a completed collection of high-quality papers that will promote scientific communication of our knowledge with the ultimate goal of positively influencing the decision-making process and care for our patients.

Dr. Fadi Taher
Dr. Afshin Assadian
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • vascular surgery
  • endovascular surgery
  • aortic surgery
  • peripheral arterial disease
  • vascular imaging
  • EVAR
  • FEVAR
  • vascular access
  • vascular education
  • aneurysms

Related Special Issue

Published Papers (5 papers)

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Editorial

Jump to: Research

2 pages, 158 KiB  
Editorial
Precision Medicine in Vascular and Endovascular Surgery
by Fadi Taher, Amun Hofmann and Afshin Assadian
J. Clin. Med. 2023, 12(3), 1031; https://doi.org/10.3390/jcm12031031 - 29 Jan 2023
Viewed by 1102
Abstract
Personalized medicine and precision medicine are terms often used to refer to treatment strategies tailored specifically to individual characteristics of patients, as opposed to a one-size fits all approach [...] Full article
(This article belongs to the Special Issue Advances in Vascular and Endovascular Surgery)

Research

Jump to: Editorial

12 pages, 2222 KiB  
Article
Single-Center Retrospective Subgroup Analysis of “Primary Aortic” (Aneurysm, Aortic Dissection, PAU) and “Secondary Aortic” (Iatrogenic, Trauma, Aortoesophageal Fistula) Indications for Emergency TEVAR
by Artur Rebelo, Jumber Partsakhashvili, Ulrich Ronellenfitsch, Endres John, Jörg Kleeff and Jörg Ukkat
J. Clin. Med. 2023, 12(12), 4037; https://doi.org/10.3390/jcm12124037 - 13 Jun 2023
Viewed by 1113
Abstract
Background: The aim of this study was to analyze the outcome of emergency thoracic endovascular aortic repair (TEVAR) in the treatment of “primary aortic” (aneurysm, aortic dissection, penetrating aortic ulcer (PAU)) and “secondary aortic” (iatrogenic, trauma, and aortoesophageal fistula) pathologies. Methods: Retrospective review [...] Read more.
Background: The aim of this study was to analyze the outcome of emergency thoracic endovascular aortic repair (TEVAR) in the treatment of “primary aortic” (aneurysm, aortic dissection, penetrating aortic ulcer (PAU)) and “secondary aortic” (iatrogenic, trauma, and aortoesophageal fistula) pathologies. Methods: Retrospective review of a cohort of patients treated at a single tertiary referral center from 2015 to 2021. The primary end point was postoperative in-hospital mortality. Secondary end points were the duration of the procedure, duration of postoperative intensive care treatment, length of hospital stay, and the nature and severity of postoperative complications according to the Dindo–Clavien classification. Results: A total of 34 patients underwent TEVAR for emergency indications. Twenty-two patients were treated for primary and twelve patients for secondary aortic pathologies. Concerning in-hospital mortality, no statistically significant difference could be observed between the primary and secondary aortic groups (27.3% vs. 33.3%, p = 0.711). Patients with an aortoesophageal fistula had a mortality rate of 66.7%. Postoperative morbidity (Dindo–Clavien > 3) was also not statistically significantly different between the primary and secondary aortic groups (36.4% vs. 33.3%, p = 0.86). Preoperative hemoglobin level (p < 0.001 for mortality, p = 0.002 for morbidity), hemoglobin level difference (p = 0.022, p = 0.032), postoperative creatinine level (p = 0.009, p = 0.035), and pre- and postoperative lactate levels (p < 0.001 for both mortality and morbidity) were found to be independent factors associated with postoperative mortality and morbidity (Dindo–Clavien > 3), respectively. The preoperative creatinine level was found to be associated with mortality (p = 0.024) but not morbidity. Conclusions: Morbidity and in-hospital mortality are still considerable after emergency TEVAR for both primary and secondary aortic indications. Pre- and postoperative levels of hemoglobin, creatinine, and lactate may be valuable to predict patient outcomes. Full article
(This article belongs to the Special Issue Advances in Vascular and Endovascular Surgery)
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10 pages, 2072 KiB  
Article
Endoleak Detection after Endovascular Aortic Repair via Coded-Excitation Ultrasound—A Feasibility Study
by Amun G. Hofmann, Fabian R. Klosz, Irene Mlekusch, Georg Wickenhauser, Corinna Walter, Afshin Assadian and Fadi Taher
J. Clin. Med. 2023, 12(11), 3775; https://doi.org/10.3390/jcm12113775 - 31 May 2023
Cited by 2 | Viewed by 985
Abstract
Endoleaks are the most common complication after endovascular aortic repair (EVAR). Their correct identification is one of the main objectives of surveillance protocols after EVAR. So far, computed tomography angiography (CTA), contrast-enhanced (CEUS) and Duplex ultrasound (DUS), as well as magnetic resonance angiography, [...] Read more.
Endoleaks are the most common complication after endovascular aortic repair (EVAR). Their correct identification is one of the main objectives of surveillance protocols after EVAR. So far, computed tomography angiography (CTA), contrast-enhanced (CEUS) and Duplex ultrasound (DUS), as well as magnetic resonance angiography, have been investigated for their ability to detect endoleaks. In general, all technologies have distinct benefits and disadvantages, with CTA and CEUS emerging as the reference standard for surveillance after EVAR. However, they are both contrast-enhancer-dependent, and CTA additionally exposes patients to ionizing radiation. In the present study, we investigated B-Flow, a type of coded-excitation ultrasound that was specifically designed to optimize the visualization of blood flow, for its ability to detect endoleaks, and compared its performance to CEUS, CTA, and DUS. In total, 34 patients were included in the analysis that accumulated in 43 distinct B-Flow investigations. They underwent a total of 132 imaging investigations. Agreement between B-Flow and other imaging modalities was high (>80.0%), while inter-method reliability can be interpreted as good. However, with B-Flow, six and one endoleaks would have been missed compared to CEUS and CTA, respectively. Regarding endoleak classification, all metrics were lower but retained an adequate level of comparison. In a subset of patients requiring intervention, B-Flow had 100% accuracy regarding both endoleak detection and classification. Ultrasonography enables endoleak detection and classification without the need for pharmaceutical contrast enhancement or radiation. Ultrasound coded-excitation imaging in the application of B-Flow could further simplify surveillance after EVAR by offering adequate accuracy without requiring intravenous contrast enhancement. Our findings may promote subsequent investigations of coded-excitation imaging for endoleak detection and classification in the surveillance after EVAR. Full article
(This article belongs to the Special Issue Advances in Vascular and Endovascular Surgery)
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11 pages, 760 KiB  
Article
Abdominal Aortic Aneurysm Detection in Bioelectrical Impedance Cardiovascular Screenings—A Pilot Study
by Amun G. Hofmann, Tarik Shoumariyeh, Christoph Domenig, Falko Skrabal and Johannes J. Kovarik
J. Clin. Med. 2023, 12(11), 3726; https://doi.org/10.3390/jcm12113726 - 28 May 2023
Viewed by 1318
Abstract
Screening and diagnosing abdominal aortic aneurysms (AAA) are currently dependent on imaging studies such as ultrasound or computed tomography angiography. All imaging studies offer distinct advantages but also suffer from inherent limitations such as examiner dependency or ionizing radiation. Bioelectrical impedance analysis has [...] Read more.
Screening and diagnosing abdominal aortic aneurysms (AAA) are currently dependent on imaging studies such as ultrasound or computed tomography angiography. All imaging studies offer distinct advantages but also suffer from inherent limitations such as examiner dependency or ionizing radiation. Bioelectrical impedance analysis has previously been investigated with respect to its use in the detection of several cardiovascular and renal pathologies. The present pilot study assessed the feasibility of AAA detection based on bioimpedance analysis. In this single-center exploratory pilot study, measurements were conducted among three different cohorts: patients with AAA, end-stage renal disease patients without AAA, and healthy controls. The device used in the study, CombynECG, is an open-market accessible device for segmental bioelectrical impedance analysis. The data was preprocessed and used to train four different machine learning models on a randomized training sample (80% of the full dataset). Each model was then evaluated on a test set (20% of the full dataset). The total sample included 22 patients with AAA, 16 chronic kidney disease patients, and 23 healthy controls. All four models showed strong predictive performance in the test partitions. Specificity ranged from 71.4 to 100%, while sensitivity ranged from 66.7 to 100%. The best-performing model had 100% accuracy for classification when applied to the test sample. Additionally, an exploratory analysis to approximate the maximum AAA diameter was conducted. An association analysis revealed several impedance parameters that might possess predictive ability with respect to aneurysm size. AAA detection via bioelectrical impedance analysis is technically feasible and appears to be a promising technology for large-scale clinical studies and routine clinical screening assessments. Full article
(This article belongs to the Special Issue Advances in Vascular and Endovascular Surgery)
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11 pages, 1465 KiB  
Article
Long-Term Outcome of Bypass Surgery versus Endovascular Revascularization in Long Femoropopliteal Lesions
by Michaela Kluckner, Leonhard Gruber, David Wippel, Daniela Lobenwein, Werner Westreicher, Manuela Pilz and Florian K. Enzmann
J. Clin. Med. 2023, 12(10), 3507; https://doi.org/10.3390/jcm12103507 - 17 May 2023
Cited by 1 | Viewed by 1508
Abstract
Long-term follow-up data comparing surgical and endovascular revascularization of femoropopliteal lesions is rarely reported. This study presents 4-year results of revascularization for long femoropopliteal lesions (Trans-Atlantic Inter-Society Consensus Types C and D) with vein bypass (VBP), polytetrafluorethylene bypass (PTFE), and endovascular intervention with [...] Read more.
Long-term follow-up data comparing surgical and endovascular revascularization of femoropopliteal lesions is rarely reported. This study presents 4-year results of revascularization for long femoropopliteal lesions (Trans-Atlantic Inter-Society Consensus Types C and D) with vein bypass (VBP), polytetrafluorethylene bypass (PTFE), and endovascular intervention with a nitinol stent (NS). Data from a randomized-controlled trial on VBP and NS was compared with a retrospective patient cohort using PTFE with the same inclusion and exclusion criteria. Primary, primary assisted, and secondary patency, as well as changes in Rutherford categories and limb salvage rates, are reported. Between 2016 and 2020, 332 femoropopliteal lesions underwent revascularization. The lesion lengths and basic patient characteristics were similar between the groups. 49% of the patients presented with chronic limb threatening ischemia at the time of revascularization. During the four-year follow-up, primary patency was comparable for all three groups. Primary assisted and secondary patency were significantly higher after VBP, while PTFE and NS had similar results. Clinical improvement was also significantly superior after VBP. After four years of follow-up, patency rates as well as the clinical outcome clearly favor VBP. If no vein is available, NS is as effective as PTFE bypass with regard to patency and clinical outcome. Full article
(This article belongs to the Special Issue Advances in Vascular and Endovascular Surgery)
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