Clinical Advances and Challenges in Vascular and Endovascular Medicine

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

Deadline for manuscript submissions: 31 July 2024 | Viewed by 588

Special Issue Editor


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Guest Editor
Division of Vascular Surgery, Department of Clinical and Experimental Sciences, ASST Spedali Civili of Brescia, 25123 Brescia, Italy
Interests: vascular surgery; vascular medicine; stents; aortic diseases; vascular diseases; medical and biomedical image processing; angiography; atherosclerosis

Special Issue Information

Dear Colleagues,

Vascular and endovascular medicine are specialized fields of medicine that focus on the diagnosis, treatment, and management of diseases affecting the blood vessels. Endovascular treatments such as angioplasty, stenting, and embolization have revolutionized the treatment of vascular diseases, reducing the need for open surgery and improving patient recovery times. Recent clinical advances in vascular imaging technologies, such as CT angiography and magnetic resonance imaging (MRI), have improved the accuracy of diagnosis, allowing for earlier detection and treatment of vascular disease. However, these advances have also brought challenges, include the development of better preventative measures and more effective treatments for vascular diseases such as arterial aneurysms, peripheral artery disease, and venous thromboembolism.

In conclusion, while recent clinical advances in vascular and endovascular medicine have greatly improved patient outcomes, they have also introduced new challenges that will require ongoing attention from the medical community. Addressing these challenges will require continued innovation, research, and collaboration among practitioners in these fields. We look forward to your enthusiastic participation in this Special Issue that will promote scientific communication of our knowledge with the ultimate goal of positively influencing treatment and care for our patients.

Dr. Luca Bertoglio
Guest Editor

Manuscript Submission Information

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Keywords

  • vascular and endovascular medicine
  • minimally invasive cardiovascular surgery
  • vascular diseases
  • endovascular technologies
  • endovascular surgery
  • aortic dissection

Published Papers (1 paper)

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Research

15 pages, 2161 KiB  
Article
Analysis of Target Vessel Instability in Fenestrated Endovascular Repair (f-EVAR) in Thoraco-Abdominal Aortic Pathologies
by Daniel Becker, Laura Sikman, Ahmed Ali, Selim Mosbahi, Carlota F. Prendes, Jan Stana and Nikolaos Tsilimparis
J. Clin. Med. 2024, 13(10), 2898; https://doi.org/10.3390/jcm13102898 - 14 May 2024
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Abstract
Objective: The aim of this study was to evaluate the influence of target vessel anatomy and post-stenting geometry on the outcome of fenestrated endovascular aortic repair (f-EVAR). Methods: A retrospective review of data from a single center was conducted, including all consecutive fenestrated [...] Read more.
Objective: The aim of this study was to evaluate the influence of target vessel anatomy and post-stenting geometry on the outcome of fenestrated endovascular aortic repair (f-EVAR). Methods: A retrospective review of data from a single center was conducted, including all consecutive fenestrated endovascular aortic repairs (f-EVARs) performed between September 2018 and December 2023 for thoraco-abdominal aortic aneurysms (TAAAs) and complex abdominal aortic aneurysms (cAAAs). The analysis focused on the correlation of target vessel instability to target vessel anatomy and geometry after stenting. The primary endpoint was the cumulative incidence of target vessel instability. Secondary endpoints were the 30-day and follow-up re-interventions. Results: A total of 136 patients underwent f-EVAR with 481 stented target vessels. A total of ten target vessel instabilities occurred including three in visceral and seven instabilities in renal vessels. The cumulative incidence of target vessel instability with death as the competing risk was 1.4%, 1.8% and 3.4% at 1, 2 and 3 years, respectively. In renal target vessels (260/481), a diameter ≤ 4 mm (OR 1.21, 95% CI 1.035–1.274, p = 0.009) and an aortic protrusion ≥ 5.75 mm (OR 8.21, 95% CI 3.150–12-23, p = 0.027) was associated with an increased target vessel instability. In visceral target vessels (221/481), instability was significantly associated with a preoperative tortuosity index ≥ 1.25 (HR 15.19, CI 95% 2.50–17.47, p = 0.045) and an oversizing ratio of ≥1.25 (HR 7.739, CI % 4.756–12.878, p = 0.049). Conclusions: f-EVAR showed favorable mid-term results concerning target vessel instability in the current cohort. A diameter of ≤4 mm and an aortic protrusion of ≥5.75 mm in the renal target vessels as well as a preoperative tortuosity index and an oversizing of the bridging stent of ≥1.25 in the visceral target vessels should be avoided. Full article
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