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Medicina
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New Perspectives in Vascular and Endovascular Surgery
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New Perspectives in Vascular and Endovascular Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 7158

Special Issue Editor

Dr. Piotr Duchnowski

E-Mail Website
Guest Editor
Cardinal Wyszynski National Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland
Interests: cardiology; valve disease; hypertension; heart failure; cardiac surgery; postoperative complications
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent years, there has been a significant development of therapeutic methods in angiology and vascular surgery. Compelling evidence shows the reproducibility, safety, and effectiveness of such endovascular procedures.

Endovascular techniques are playing a rapidly growing role in the treatment of patients with atherosclerotic lesions, aneurysms, and dissections of both peripheral and aortic vessels, in many cases replacing surgical treatment. Nevertheless, both the surgical and endovascular treatment of arterial diseases, including thoracoabdominal aortic aneurysms, present many difficulties.

Original research articles, meta-analyses, and case reports are welcome to be submitted to this Special Issue. Research areas may include (but are not limited to) the following:

  • Surgical and endovascular treatment of aortic diseases;
  • Surgical and endovascular treatment of peripheral vessels;
  • Innovative techniques for treating the aorta and peripheral vessels;
  • Challenges in the perioperative, anesthetic, and ICU management of patients with aortic and peripheral vascular diseases.

Dr. Piotr Duchnowski
Guest Editor

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. Medicina is an international peer-reviewed open access monthly 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 1800 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

  • complex aortic surgery and endovascular techniques
  • aortic valve disease
  • aortic valve inervention
  • comprehensive surgery of peripheral arteries
  • endovascular techniques of peripheral arteries
  • risk of vascular procedures and qualification for vascular treatments
  • complications of classic and endovascular procedures
  • vascular treatments in the elderly
  • intensive therapy in patients after vascular surgery

Published Papers (6 papers)

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Research

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9 pages, 450 KiB  
Article
Usefulness of the N-Terminal of the Prohormone Brain Natriuretic Peptide in Predicting Acute Kidney Injury Requiring Renal Replacement Therapy in Patients Undergoing Heart Valve Surgery
by Piotr Duchnowski and Witold Śmigielski
Medicina 2023, 59(12), 2083; https://doi.org/10.3390/medicina59122083 - 27 Nov 2023
Cited by 1 | Viewed by 688
Abstract
Background and Objectives: By definition, acute kidney injury (AKI) is a clinical syndrome diagnosed when the increase in serum creatinine concentration is >0.3 mg/dL in 48 h or >1.5-fold in the last seven days or when diuresis < 0.5 mL/kg/h for a [...] Read more.
Background and Objectives: By definition, acute kidney injury (AKI) is a clinical syndrome diagnosed when the increase in serum creatinine concentration is >0.3 mg/dL in 48 h or >1.5-fold in the last seven days or when diuresis < 0.5 mL/kg/h for a consecutive 6 h. AKI is one of the severe complications that may occur in the early postoperative period in patients undergoing heart valve surgery, significantly increasing the risk of death. Early implementation of renal replacement therapy increases the chances of improving treatment results in patients with postoperative AKI. The study assessed the predictive ability of selected preoperative and perioperative parameters for the occurrence of postoperative AKI requiring renal replacement therapy in the early postoperative period in a group of patients with severe valvular heart disease. Materials and Methods: A prospective study was conducted on a group of patients undergoing consecutive heart valve surgeries. The primary endpoint was postoperative AKI requiring renal replacement therapy. AKI was diagnosed with an increase in serum creatinine > 0.3 mg/dL in 48 h or >1.5-fold in the previous 7 days and/or a decrease in diuresis < 0.5 mL/kg/h for 6 h. The observation period was until the patient was discharged home or death occurred. Logistic regression analysis was used to assess which variables were predictive of primary endpoint, and odds ratios (OR) were calculated with a 95% confidence interval (CI). Multivariate analysis was based on the result of single factor logistic regression, i.e., to further steps, all statistically significant variables were taken into consideration. Results: A total of 607 patients were included in the study. The primary endpoint occurred in 50 patients. At multivariate analysis: NT-proBNP (OR 1.406; 95% CI 1.015–1.949; p = 0.04), CRP (OR 1.523; 95% CI 1.171–1.980; p = 0.001), EuroSCORE II (OR 1.090; 95% CI 1.014–1.172; p = 0.01), age (OR 1.037; 95% CI 1.001–1.075; p = 0.04) and if they stayed in the intensive care unit longer than 2 days (OR 9.077; 95% CI 2.026–40.663; p = 0.004) remained the independent predictors of the primary endpoint. The mean preoperative NT-proBNP level was 2063 pg/mL (±1751). Thirty-eight patients with AKI requiring renal replacement therapy died in intrahospital follow-up. Conclusions: The results of the presented study indicate that a high preoperative level of NT-proBNP and postoperative hemodynamic instability may be associated with a significant risk of a postoperative AKI requiring renal replacement therapy. The results of the study may also suggest that qualifying for heart valve surgery earlier may be associated with improved prognosis in this group of patients. Full article
(This article belongs to the Special Issue New Perspectives in Vascular and Endovascular Surgery)
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8 pages, 300 KiB  
Article
Risk Factors of Postoperative Hospital-Acquired Pneumonia in Patients Undergoing Cardiac Surgery
by Piotr Duchnowski and Witold Śmigielski
Medicina 2023, 59(11), 1993; https://doi.org/10.3390/medicina59111993 - 13 Nov 2023
Viewed by 954
Abstract
Background and Objectives. Hospital-acquired pneumonia is one of the complications that may occur in the postoperative period in patients undergoing heart valve surgery, which may result in prolonged hospitalization, development of respiratory failure requiring mechanical ventilation or even death. This study investigated [...] Read more.
Background and Objectives. Hospital-acquired pneumonia is one of the complications that may occur in the postoperative period in patients undergoing heart valve surgery, which may result in prolonged hospitalization, development of respiratory failure requiring mechanical ventilation or even death. This study investigated the preoperative risk factors of postoperative pneumonia after heart valve surgery. Materials and Methods: This was a prospective study in a group of consecutive patients with hemodynamically significant valvular heart disease undergoing valve surgery. The primary endpoint at the in-hospital follow-up was hospital-acquired pneumonia after heart valve surgery. Logistic regression analysis was used to assess which variables were predictive of the primary endpoint, and odds ratios (ORdis) were calculated with a 95% confidence interval (CI). Multivariate analysis was based on the results of single-factor logistic regression, i.e., in further steps all statistically significant variables were taken into consideration. Results: The present study included 505 patients. Postoperative pneumonia occurred in 23 patients. The mean time to diagnosis of pneumonia was approximately 3 days after heart valve surgery (±2 days). In multivariate analysis, preoperative level of high-sensitivity Troponin T (hs-TnT) (OR 2.086; 95% CI 1.211–3.593; p = 0.008) and right ventricular systolic pressure (RVSP) (OR 1.043; 95% CI 1.018–1.067; p 0.004) remained independent predictors of the postoperative pneumonia. Of the patients with postoperative pneumonia, 3 patients died due to the development of multiple organ dysfunction syndrome (MODS). Conclusions: Preoperative determination of serum hs-TnT concentration and echocardiographic measurement of the RVSP parameter may be useful in predicting postoperative pneumonia in patients undergoing heart valve surgery. Full article
(This article belongs to the Special Issue New Perspectives in Vascular and Endovascular Surgery)
10 pages, 1567 KiB  
Article
Three-Year Patency Results following Endovascular Transvenous Femoropopliteal Bypass
by Roberts Rumba, Dainis Krievins, Janis Savlovskis, Natalija Ezite, Aigars Lacis, Eva Petrosina, Ludovic Mouttet, Janis Gardovskis and Christopher K. Zarins
Medicina 2023, 59(3), 462; https://doi.org/10.3390/medicina59030462 - 25 Feb 2023
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Abstract
Background and Objectives: Peripheral artery disease is one of the most common vascular pathologies. There is an ongoing debate among specialists on whether open or endovascular revascularization is preferred in cases of complex superficial femoral artery (SFA) lesions. The purpose of this [...] Read more.
Background and Objectives: Peripheral artery disease is one of the most common vascular pathologies. There is an ongoing debate among specialists on whether open or endovascular revascularization is preferred in cases of complex superficial femoral artery (SFA) lesions. The purpose of this study was to assess patency results of a relatively new transvenous endovascular bypass device. This could add to existing evidence and aid in comparison between open and endovascular bypass. Materials and Methods: Patients with complex TASC-C and D SFA lesions who had indications for revascularization were identified. Prospective analysis of stent graft patency from 54 transvenous femoropopliteal bypass procedures was performed. Patency was assessed by Duplex ultrasound every six months. Kaplan–Meier analysis was performed to assess primary, primary-assisted, and secondary patency of transvenous bypass. Results: Following endovascular transvenous femoropopliteal bypass, 3-year graft primary, primary-assisted, and secondary patency was 43.8%, 66.3%, and 73.9%, respectively. Conclusions: Transvenous endovascular femoropopliteal bypass is a viable option for selected patients who lack adequate saphenous vein or have comorbidities that increase the risk of open femoropopliteal bypass. Strict post-operative follow-up is necessary to improve patency rates. Full article
(This article belongs to the Special Issue New Perspectives in Vascular and Endovascular Surgery)
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Review

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12 pages, 1878 KiB  
Review
Paragangliomas and Anemia: Literature Review and Case Report
by Maria-Daniela Tănăsescu, Ștefan Popescu, Alexandru Mincă, Teodora Isac, Emel Suliman, Maria Mihaela Grigorie, Emine Suliman, Daniel Stăniloaie, Delia Timofte and Dorin Ionescu
Medicina 2023, 59(11), 1925; https://doi.org/10.3390/medicina59111925 - 30 Oct 2023
Viewed by 1117
Abstract
Paragangliomas are rare neuroendocrine tumors that arise from the extra-adrenal autonomic paraganglia, i.e., small organs consisting mainly of neuroendocrine cells that are derived from the embryonic neural crest and have the ability to secrete catecholamines. Paragangliomas can derive from either parasympathetic or sympathetic [...] Read more.
Paragangliomas are rare neuroendocrine tumors that arise from the extra-adrenal autonomic paraganglia, i.e., small organs consisting mainly of neuroendocrine cells that are derived from the embryonic neural crest and have the ability to secrete catecholamines. Paragangliomas can derive from either parasympathetic or sympathetic paraganglia. Most of the parasympathetic ganglia-derived paragangliomas are nonfunctional, and symptoms result from mass effect. Conversely, the sympathetic paragangliomas are functional and produce catecholamine. Although such patients could have symptoms similar to pheochromocytoma, mass effect symptoms, or non-specific symptoms, being benign tumors, they can also present with anemia, specifically iron-deficiency anemia. Considering that neoplastic pathology is chronically accompanied by moderate, normochromic, normocytic anemia, association between paragangliomas that are mostly benign but with a potential degree of malignancy and anemia is not as frequent as expected, with only 12 cases reported in the literature. We report a case of a 54-year-old female patient diagnosed with a paraganglioma of the carotid glomus accompanied by severe normochromic, normocytic anemia, which reached normal limits after excision of the paraganglioma. Full article
(This article belongs to the Special Issue New Perspectives in Vascular and Endovascular Surgery)
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Other

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7 pages, 1951 KiB  
Case Report
Successful Hybrid Approach Treatment of a Large Persistent Sciatic Artery Aneurysm—A Case Report
by Vladimir Cvetic, Marko Miletic, Borivoje Lukic, Dragoslav Nestorovic, Ognjen Kostic, Milos Sladojevic, Petar Zlatanovic and Nenad Jakovljevic
Medicina 2023, 59(7), 1328; https://doi.org/10.3390/medicina59071328 - 19 Jul 2023
Viewed by 988
Abstract
Background and Objectives: Persistent sciatic artery (PSA) is a rare congenital vascular anomaly that is often asymptomatic, but can be associated with aneurysm formation and potential complications, such as thromboembolism or aneurysm rupture in some cases. We present a case of a [...] Read more.
Background and Objectives: Persistent sciatic artery (PSA) is a rare congenital vascular anomaly that is often asymptomatic, but can be associated with aneurysm formation and potential complications, such as thromboembolism or aneurysm rupture in some cases. We present a case of a 75-year-old woman with a symptomatic thrombus-containing aneurysm of the left PSA. Materials and Methods: The treatment of the PSA aneurysm involved a successful hybrid approach, which included open surgical bypass and endovascular embolization. The open surgical bypass was performed from the left common femoral artery to the left above-the-knee popliteal artery using a synthetic graft, while the aneurysm exclusion was achieved through endovascular plug embolization. Results: Control angiography revealed complete exclusion of the PSA aneurysm. At the 1-month follow-up, there were no palpable pulsatile masses in the left gluteal region, and the patient reported no symptoms. Conclusions: Given the high incidence of limb- and life-threatening complications associated with a PSA aneurysm, accurate diagnosis and appropriate treatment are crucial. In this case, a combination of open surgical and endovascular techniques resulted in a favorable outcome for the patient, highlighting the effectiveness of the hybrid approach in managing PSA aneurysms. Further studies are warranted to explore and refine treatment strategies for these complex vascular anomalies. Full article
(This article belongs to the Special Issue New Perspectives in Vascular and Endovascular Surgery)
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11 pages, 473 KiB  
Hypothesis
Dynamic Loading—A New Marker for Abdominal Aneurysm Growth?
by John Friesen, Lucas Stein, Farzin Adili and Peter F. Pelz
Medicina 2023, 59(2), 404; https://doi.org/10.3390/medicina59020404 - 19 Feb 2023
Viewed by 1241
Abstract
The growing possibilities of non-invasive heart rate and blood pressure measurement with mobile devices allow vital data to be continuously collected and used to assess patients’ health status. When it comes to the risk assessment of abdominal aortic aneurysms (AAA), the continuous tracking [...] Read more.
The growing possibilities of non-invasive heart rate and blood pressure measurement with mobile devices allow vital data to be continuously collected and used to assess patients’ health status. When it comes to the risk assessment of abdominal aortic aneurysms (AAA), the continuous tracking of blood pressure and heart rate could enable a more patient-specific approach. The use of a load function and an energy function, with continuous blood pressure, heart rate, and aneurysm stiffness as input parameters, can quantify dynamic load on AAA. We hypothesise that these load functions correlate with aneurysm growth and outline a possible study procedure in which the hypothesis could be tested for validity. Subsequently, uncertainty quantification of input quantities and derived quantities is performed. Full article
(This article belongs to the Special Issue New Perspectives in Vascular and Endovascular Surgery)
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