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Special Issues
Vascular Surgery: Current Challenges and New Perspectives
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Special Issue "Vascular Surgery: Current Challenges and New Perspectives"

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

Deadline for manuscript submissions: 15 February 2024 | Viewed by 1704

Special Issue Editors

Dr. François Saucy

E-Mail Website
Guest Editor
1. Service of Vascular Surgery, Ensemble Hospitalier de la Côte, 1110 Morges, Switzerland
2. Service of Vascular Surgery, Department of Heart and Vessels, University Hospital, 1011 Lausanne, Switzerland
Interests: restenosis; vessel preparation; hostile neck; peripheral arterial disease; drug delivery
Dr. Quentin Pellenc

E-Mail Website
Guest Editor
1. Service of Vascular Surgery, Ensemble Hospitalier de la Côte, 1110 Morges, Switzerland
2. Marfan Syndrome National Referral Center, Bichat University Hospital, 75018 Paris, France
Interests: aortic dissection; false lumen thrombosis; connective tissue disorders; open aortic repair; acute mesenteric ischemia

Special Issue Information

Dear Colleagues,

The development of endovascular approaches has significantly modified the treatment of aortic, peripheral, and carotid diseases with new strategies and complications. Open procedures remain a valuable option in specific situations with recent limited innovations. This Special Issue invites researchers to address current challenges in managing different areas, such as aortic dissection, mesenteric ischemia, and peripheral arterial disease.

The endovascular techniques used in acute and chronic aortic dissection need long-term follow-up to evaluate aortic remodeling and the reduction in the rate of incidence of aortic events. Endovascular management of acute and chronic mesenteric ischemia requires technical skills and dedicated devices to perform complex recanalization and thrombectomy. Vessel preparation and drug-eluting technologies are frequently used in PAD patients. The limitations of paclitaxel when it comes to preventing restenosis and potential side effects has promoted sirolimus-coated balloons and stents, but long-term results are still needed. Nevertheless, the potential clinical benefit of these advanced procedures remains to be defined and compared to the open surgical approach. Artificial intelligence will help decision making in the future, but the perspectives invited should be related to imaging and radioprotection using electromagnetic guidance.

Therefore, the editors will consider original manuscripts, short communications, and reviews relevant to these topics. We look forward to your enthusiastic participation in this Special Issue.

Dr. François Saucy
Dr. Quentin Pellenc
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

  • aortic dissection
  • spinal cord ischemia
  • mesenteric ischemia
  • restenosis
  • vessel preparation
  • hostile neck
  • artificial intelligence
  • radioprotection
  • electromagnetic guidance
  • endoleaks

Published Papers (3 papers)

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Article
Preventing Acute Limb Ischemia during VA-ECMO—In Silico Analysis of Physical Parameters Associated with Lower Limb Perfusion
by
Tifanie Brockaert
,
Inês Ferreira
,
Anne Laplante
,
Paul Fogel
,
David Grimbert
and
Pierre Mordant
J. Clin. Med. 2023, 12(18), 6049; https://doi.org/10.3390/jcm12186049 - 19 Sep 2023
Viewed by 177
Abstract
Background: Peripheral femoro-femoral veno-arterial extracorporeal membrane oxygenation is increasingly used in refractory cardiogenic shock. However, the obstruction of the femoral artery by the return cannula could lead to acute limb ischemia, a frequently encountered situation that is inconstantly prevented by the adjunction of [...] Read more.
Background: Peripheral femoro-femoral veno-arterial extracorporeal membrane oxygenation is increasingly used in refractory cardiogenic shock. However, the obstruction of the femoral artery by the return cannula could lead to acute limb ischemia, a frequently encountered situation that is inconstantly prevented by the adjunction of a distal perfusion cannula (DPC). The aim of this study was to investigate the influence of three physical parameters on the perfusion of the cannulated lower limb. Methods: Using patient-specific arterial models and computational fluid dynamic simulations, we studied four diameters of arterial cannula, three diameters of DPC, and two percentages of arterial section limitation. Results: We found that adequate perfusion of the cannulated limb was achieved in only two out of the twenty-one configurations tested, specifically, when the arterial cannula had a diameter of 17 Fr, was considered to limit the section of the artery by 90%, and was associated with an 8 Fr or a 10 Fr DPC. Multivariable analysis revealed that the perfusion of the cannulated lower limb was correlated with the diameter of the DPC, but also with the diameter of the arterial cannula and the percentage of arterial section limitation. Conclusions: In most of the cases simulated here, the current system combining unsized arterial cannula and non-specific DPC was not sufficient to provide adequate perfusion of the cannulated lower limb, urging the need for innovative strategies to efficiently prevent acute limb ischemia during peripheral femoro-femoral veno-arterial extracorporeal membrane oxygenation. Full article
(This article belongs to the Special Issue Vascular Surgery: Current Challenges and New Perspectives)
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Article
Fenestrated Physician-Modified Endografts for Preservation of Main and Accessory Renal Arteries in Juxtarenal Aortic Aneurysms
by
Hon-Lai Chan
,
Dimitrios D. Papazoglou
,
Silvan Jungi
,
Salome Weiss
,
Daniel Becker
,
Drosos Kotelis
and
Vladimir Makaloski
J. Clin. Med. 2023, 12(14), 4708; https://doi.org/10.3390/jcm12144708 - 15 Jul 2023
Viewed by 639
Abstract
Background: There is a paucity of reporting outcomes of complex aortic aneurysm treatment such as juxtarenal abdominal aortic aneurysms, where additional techniques to preserve renal artery perfusion are required. Methods: Retrospective analysis of consecutive patients who underwent emergent and elective aortic repair with [...] Read more.
Background: There is a paucity of reporting outcomes of complex aortic aneurysm treatment such as juxtarenal abdominal aortic aneurysms, where additional techniques to preserve renal artery perfusion are required. Methods: Retrospective analysis of consecutive patients who underwent emergent and elective aortic repair with fenestrated PMEGs between March 2019 and January 2023. Endpoints were technical success, reinterventions, secondary reinterventions and target vessel patency. Results: Forty-seven target vessels in 37 patients (23 male, median age 75 years) were targeted, of which 44 were renal arteries (RAs) with a mean diameter of 5.4 ± 1.0 mm. Thirteen were accessory RAs and six had a diameter ≤ 4 mm. Technical success rate was 87% overall; 97% for main and 62% for accessory RAs respectively. Target vessel patency and freedom from secondary reintervention was 100% and 97% at 30 days and 96% and 91% at one year, respectively. There was no 30-day mortality. Conclusion: Fenestrated physician-modified endografts are safe and effective for the treatment of patients with juxtarenal abdominal aortic aneurysms when incorporating main renal arteries. Limited technical success may be expected when targeting accessory renal arteries, especially when small in diameter. Long-term follow-up is needed to confirm durability of PMEGs for renal artery preservation. Full article
(This article belongs to the Special Issue Vascular Surgery: Current Challenges and New Perspectives)
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Article
Diminishing Endograft Apposition during Follow-Up Is an Important Indicator of Late Type 1a Endoleak after Endovascular Aneurysm Repair
by
Roy Zuidema
,
Anna C. M. Geraedts
,
Willemina A. van Veldhuizen
,
Sana Mulay
,
Jean-Paul P. M. de Vries
,
Richte C. L. Schuurmann
,
Ron Balm
and
J. Clin. Med. 2023, 12(12), 3969; https://doi.org/10.3390/jcm12123969 - 10 Jun 2023
Viewed by 611
Abstract
Late type 1a endoleaks (T1aELs) after endovascular aneurysm repair (EVAR) are hazardous complications which should be avoided. This study investigated the evolution of the shortest apposition length (SAL) post-EVAR and hypothesised that a declining apposition during follow-up may be an indicator of T1aEL [...] Read more.
Late type 1a endoleaks (T1aELs) after endovascular aneurysm repair (EVAR) are hazardous complications which should be avoided. This study investigated the evolution of the shortest apposition length (SAL) post-EVAR and hypothesised that a declining apposition during follow-up may be an indicator of T1aEL development. Patients with a late T1aEL were selected from a consecutive multicentre database. For each T1aEL patient, the preoperative computed tomography angiography (CTA), first postoperative CTA, and pre-endoleak CTA were analysed. T1aEL patients were matched 1:1 to uncomplicated controls, based on endograft type and follow-up duration. Anatomical characteristics and endograft dimensions, including the post-EVAR SAL, were measured. Included were 28 patients with a late T1aEL and 28 matched controls. The SAL decreased from 11.2 mm (5.6–20.6 mm) to 3.9 mm (0.0–11.4 mm) in the T1aEL group (p = 0.006), whereas an increase in SAL was seen in the control group from 21.3 mm (14.1–25.8 mm) to 25.4 mm (19.0–36.2 mm; p = 0.015). On the pre-endoleak CTA, 18 patients (64%) in the T1aEL group had a SAL < 10 mm, and one (4%) patient in the control group had a SAL < 10 mm on the matched CTAs. Moreover, three mechanisms of decreasing sealing zone were identified, which might be used to determine optimal imaging or reintervention strategies. Diminishing SAL < 10 mm is an indicator for T1aEL during follow-up, it is imperative to include apposition analysis during follow-up. Full article
(This article belongs to the Special Issue Vascular Surgery: Current Challenges and New Perspectives)
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