Impaired Pre-operative Ambulatory Status in Patients Undergoing Elective EVAR Is Associated With Increased Mortality
Objective: Endovascular aneurysm repair (EVAR) has become the dominant surgical treatment for infrarenal abdominal aortic aneurysm (AAA), owing to its minimally invasive approach and lower peri-operative complications and mortality compared with open surgical repair (OSR). Moreover, EVAR has expanded its utility to medically frail patients who would be considered unfit for OSR. However, the benefit in this cohort of patient remains unproven. While ambulatory status is an important determinant of functional status that is readily assessed, its independent association with post-operative outcomes following elective EVAR is n...
Source: EJVES Extra - March 7, 2024 Category: Surgery Authors: Heepeel Chang, Frank Veith, Aiden Lui, Igor Laskowski, Virendra Patel, Sateesh Babu, Romeo Mateo, Min Li Xu, Karan Garg Source Type: research

To Identify Determinants Of Normal Abdominal Aorta Diameter In The Indian Population
Objective: The abdominal aortic diameter must be dilated by at least 50% of the normal abdominal aorta diameter in order to be considered to have abdominal aortic aneurysm (AAA). As a result, the threshold diameter in AAA guidelines should also be determined by the basic diameter in order to accommodate patients with different basic aortic diameters. Studies have demonstrated that the size of the abdominal aorta can be influenced by various factors. Data on the Indian population are scarce. In the present study, the aim was to assess normal and establish any correlations if present. (Source: EJVES Extra)
Source: EJVES Extra - March 7, 2024 Category: Surgery Authors: Vandana Kapoor, Ajay Savlania, Arunanshu Behra, Mandeep Kang, Ujjwal Gorsi, Lileshwar Kaman Source Type: research

Face, Content, and Construct Validity of a Low Cost and Open Source Endovascular Simulator
Objective: Simulation training has been shown to improve subject interest, real world performance, and team based performance in a variety of surgical domains. However, current endovascular simulators are expensive, and have limited availability and limited scope with no ability to modify them. The St Georges Vascular Institute (SGVI) EndoSim is an in house developed open source simulator that leverages low cost computing (a Raspberry pi system of a chip computer), 3D printing (for the internal models), and open source software (which is to be released at the time of publication), costing less than 100 euros and having the...
Source: EJVES Extra - March 7, 2024 Category: Surgery Authors: James Budge, Luis Ribero, Bilal Azhar, Iain Roy, Ian Loftus, Peter Holt Source Type: research

How to Predict TEVAR Early Mortality: Unlocking the Potential of the Modified Five Factor Frailty Index
Objective: Thoracic endovascular aortic repair (TEVAR) has expanded access to descending thoracic aortic repair particularly for elderly and frail patients. This high risk population has limited long term overall survival, so appropriate patient selection is required to optimise patient benefit and resource utilisation.1 The modified five factor frailty index (mFI-5) is a simple, validated score to quantify frailty in surgical patients across multiples sub-specialties, including vascular surgery. (Source: EJVES Extra)
Source: EJVES Extra - March 7, 2024 Category: Surgery Authors: Henrique Guedes Da Rocha, Carlos Veterano, Joao Castro, Andreia Pinelo, Henrique Almeida, Carolina Vaz, Ivone Silva, Rui Almeida Source Type: research

Metformin Use and Long Term Outcomes following EVAR for Infrarenal Abdominal Aortic Aneurysm
Objective: Metformin, widely used for the treatment of diabetes mellitus (DM), has shown potential for inhibiting abdominal aortic aneurysm (AAA) growth by reducing extracellular matrix remodelling and inflammation. However, its influence on clinical outcomes and aneurysm sac dynamics after endovascular aneurysm repair (EVAR) remains uncertain. This retrospective study aims to explore the effects of metformin on long term outcomes following EVAR. (Source: EJVES Extra)
Source: EJVES Extra - March 7, 2024 Category: Surgery Authors: Olivier van Tongeren, Jorg de Bruin, Vinamr Rastogi, David Vecht, Klaas Ultee, Sanne Hoeks, Hence Verhagen Source Type: research

Reducing the Length of Stay Following Carotid Endarterectomy by Implementing a Standardised Post-Operative Pathway
Objective: Carotid endarterectomy (CEA) is a widely practised procedure to prevent ischaemic stroke with, generally, timely recovery and discharge. The unit was an outlier in the length of stay (LoS) after CEA in comparison to published data and the national average of early discharge following the procedure which is recognised as an indicator of the quality of health care and a reportable quantifying outcome.1 Reducing LoS programme was therefore conceived to ensure better outcomes and experiences while preserving capacity. (Source: EJVES Extra)
Source: EJVES Extra - March 7, 2024 Category: Surgery Authors: Mohamed ElKorety, Afifa Naseer, PA Sandeep Kini-bailur, Mohamed Elshaikh, Girish Girish Source Type: research

Transperitoneal vs. Retroperitoneal Approach for Open Conversion after Endovascular Aneurysm Repair
This study aims to evaluate the association between the type of approach and outcomes following open conversion after EVAR. (Source: EJVES Extra)
Source: EJVES Extra - March 7, 2024 Category: Surgery Authors: Sara Allievi, Vinamr Rastogi, Sai Divya Yadavalli, Thomas F.X. O'Donnell, Virendra I. Patel, Hence J.M. Verhagen, Santi Trimarchi, Marc L. Schermerhorn Source Type: research

Percutaneous vs. Cutdown Access for Endovascular Aortic Repair
Objective: The management of aortic pathologies has fundamentally changed over the years, with endovascular approaches being more and more utilised. Both endovascular aneurysm repair (EVAR) and thoracic endovascular aortic repair (TEVAR) procedures involve the deployment of endografts to treat an underlying aortic pathology. Two techniques are utilised to deliver such grafts, percutaneous and cutdown, both of which are frequently done through the common femoral artery (CFA). In the present study, the aim is to compare these approaches in both EVAR and TEVAR surgeries, while also evaluating the factors that predict the risk...
Source: EJVES Extra - March 7, 2024 Category: Surgery Authors: Tariq Alanezi, Sultan Alsheikh, Badr Aljabri, Mohammed Aldossary, Kaisor Iqbal, Abdulmajeed Altoijry Source Type: research

Mid-term Outcomes of Hybrid and Endovascular Aortic Arch Surgery
Objective: Aortic arch surgery is still a challenge. The ESC guidelines recommend a sufficient proximal and distal landing zone of at least 2 cm for the safe deployment and fixation of TEVAR.1 Sometimes, previous surgeries are required (as ascending aorta replacement or debranching of the supra-aortic branches) to secure that safe deployment of the thoracic graft.2 It is also important to work in an aortic multidisciplinary committee to assess the patients and offer them the best treatment option. (Source: EJVES Extra)
Source: EJVES Extra - March 7, 2024 Category: Surgery Authors: Miquel Gil, Carlos Esteban, Marc Masana, Anna Llorens, Cl àudia Riera, Pere Altes, Víctor Martínez, Christian Muñoz, Secundino Llagostera Source Type: research

The Role of Socioeconomic Status in PAD: The Role of Health Literacy
Objective: The association between peripheral arterial disease (PAD) and socioeconomic status (SES) is well established. This association is highly complex, but detailed exploration of this relationship and its aetiology is lacking. (Source: EJVES Extra)
Source: EJVES Extra - March 7, 2024 Category: Surgery Authors: Katerina Dangas, Dominic Howard Source Type: research

Renal Outcomes in Octogenarians and Nonagenarians Undergoing Endovascular Femoro-Popliteal Intervention
Objective: Endovascular therapy has emerged as the treatment of choice for peripheral arterial disease due to its minimally invasive nature. Acute kidney injury (AKI) is a recognised complication of endovascular therapy, particularly in the elderly, where frailty, pre-existing chronic kidney disease, and cardiovascular comorbidity may predispose to its development. There is a paucity of data on the incidence of acute kidney injury in the elderly undergoing endovascular treatment for disease of the femoro-popliteal segment. (Source: EJVES Extra)
Source: EJVES Extra - March 7, 2024 Category: Surgery Authors: Chee Yee Hew, Emmanuel Katsogridakis, Prakash Saha, Athanasios Diamantopoulos, Hany Zayed, Matthew Bown, Athanasios Saratzis Source Type: research

Iatrogenic Aorta-Iliac laparoscopic Injuries
Objective: Laparoscopic surgery has developed over the years, as an alternative to open surgery, as it has been instrumental in improving patient safety and outcomes for many life threatening diseases. Iatrogenic laparoscopic vascular injuries are uncommon and have been reported to occur in 0.3 – 1.0% of all procedures. When such injuries do occur, aside from medical litigation concerns, they are a cause of significant morbidity and in some cases mortality. Two patients with vascular injuries during elective laparoscopic surgery are described. (Source: EJVES Extra)
Source: EJVES Extra - March 7, 2024 Category: Surgery Authors: Asiyah Shafi, Taohid Oshodi Source Type: research

Aortic Seat Belt Injuries: Analysis of 52 Cases Published in the Last 60 Years
Objective: Seat belt aorta is a rare but often severe complication arising from blunt trauma with compression of the abdominal aorta against vertebrae. Seat belt sign is often present as an ecchymosis across the abdomen. The association with abdominal wall disruption and hollow viscus injury has been named seat belt triad; the presence of Chance fracture is sometimes considered a fourth component. (Source: EJVES Extra)
Source: EJVES Extra - March 7, 2024 Category: Surgery Authors: Eduardo Silva, V ânia Constâncio, Celso Nunes, Leonor Baldaia, Miguel Silva, Luís Orelhas, Manuel Fonseca Source Type: research

Pedal Acceleration Time a New Method to Assess Peripheral Arterial Disease
Objective: The use of ankle –brachial index (ABI) in the diagnosis and evaluation of the severity of peripheral arterial disease (PAD) is well established. Due to its limitations, diagnostic alternatives have been developed to assess the severity of the disease, namely the use of toe–brachial index (TBI) or transcutaneous partial pressure of oxygen (TcPO2), yet these are not as widely available as ABI. Measuring pedal acceleration time (PAT) at the arteries in the foot constitutes a new tool in the evaluation of PAD, requiring only the use of ultrasound. (Source: EJVES Extra)
Source: EJVES Extra - March 7, 2024 Category: Surgery Authors: Eduardo Silva, Pedro Lima, Joana Igl ésias, Vânia Constâncio, Celso Nunes, Leonor Baldaia, Miguel Silva, Luís Orelhas, Manuel Fonseca Source Type: research

Aortic Mural Thrombus Progression Under Full Dose Anticoagulation
Objective: Non-aneurysmal, non-atherosclerotic aortic mural thrombus is a rare entity and an unusual source of embolisation.1 Aortic thrombus formation can be associated with malignant disease, hypercoagulable disorders, primary endothelial disorders, or even iatrogenic causes.2 The biggest concern with these thrombi is the potential of embolisation to the visceral arteries or lower limbs.3 Treatment of these conditions is not well established.1 (Source: EJVES Extra)
Source: EJVES Extra - March 7, 2024 Category: Surgery Authors: Armanda Duarte, Tony Soares, Tiago Costa, Gon çalo Cabral, José Tiago, José Gimenez, Diogo Cunha e Sá Source Type: research