European Journal of Vascular and Endovascular Surgery

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Lightweight Lead Aprons: The Emperor's New Clothes in the Angiography Suite?

18 April 2019 - 12:00am
The aim was to determine whether lead containing and lead free composite garments in current use provide the level of radiation protection stated by manufacturers.

Outcome Differences in Critical Limb Ischaemia: Does Sex Matter?

17 April 2019 - 12:00am
In this volume, Benson and colleagues1 extrapolate data from the randomised BASIL-1 trial, where a bypass first strategy was compared with a percutaneous transluminal angioplasty (PTA) first strategy in patients with critical limb ischaemia (CLI).2 They found that women had better overall survival (OS), amputation free survival (AFS), and fewer major adverse limb events (MALE) after three years follow up while re-intervention rates were similar.1 Management of CLI is an important part of most vascular surgeons' practices and gender related differences in presentation and outcome for peripheral arterial disease (PAD) are well appreciated.

Endovascular Aneurysm Repair (EVAR) or Endovascular Aneurysm Control (EVAC)?

17 April 2019 - 12:00am
In this latest addition to the EVAR literature, Väärämäki et al.1 report their single institution experience of 282 patients treated by infrarenal EVAR using a single commercially available stent graft in the elective setting. At first glance, the data appear similar to many reports demonstrating EVAR is effective, yet not absolute, in the prevention of AAA related mortality. However on closer inspection there are one or two interesting details that add weight to the uncertainty relating to the widespread acceptance of EVAR as the default treatment option for patients with infrarenal AAA.

Psoas Muscle Area and Sarcopenia - Bridging the Gap

17 April 2019 - 12:00am
In this issue, Antoniou et al. report on the prognostic role of low psoas muscle area (PMA) in overall survival of patients with asymptomatic abdominal aortic aneurysms (AAAs) undergoing open and endovascular aneurysm repair.1 Their meta-analysis of seven cohort studies concluded that patients with low PMA had a significantly higher odds of mortality compared with patients with more PMA. Therefore, the authors postulate that PMA may be used as a prognostic tool in the pre-operative risk management and stratification of patients, even considering some of the methodological challenges identified in this review.

A Wearable Compression Device to Normalise Calf Muscle Pump Function in Chronic Venous Insufficiency for Each Postural Position

17 April 2019 - 12:00am
For the currently used compression therapy, the applied compression pressure is usually inadequate to exert an effective impact on the veins in different body positions. The aim was to assess the venous ejection fraction achieved by a new compression device which automatically adjusts the interface pressure to body position in an acute experimental setting.

Elective Fenestrated and Branched Endovascular Thoraco-abdominal Aortic Repair with Supracoeliac Sealing Zones and without Prophylactic Cerebrospinal Fluid Drainage: Early and Medium-term Outcomes

17 April 2019 - 12:00am
To report the outcome of elective fenestrated and branch (FEVAR–BEVAR) endovascular aortic repair with supracoeliac (SC) sealing zones and the impact of staged repair without prophylactic cerebrospinal fluid (CSF) drainage on the incidence of spinal cord ischaemia (SCI).

Catheter Directed Thrombolysis Protocols for Peripheral Arterial Occlusions: a Systematic Review

17 April 2019 - 12:00am
Catheter directed thrombolysis (CDT) for peripheral arterial occlusions is a well established alternative to thrombo-embolectomy in patients with (sub)acute limb ischaemia. However, protocols are heterogeneous and need optimisation to improve results and lower bleeding risks. The objective was to review the results and outcomes of different CDT protocols for patients with peripheral arterial occlusions.

Haemodynamics in Different Flow Lumen Configurations of Customised Aortic Repair for Infrarenal Aortic Aneurysms

15 April 2019 - 12:00am
Customised aortic repair (CAR) is a new and minimally invasive technique for the endovascular treatment of abdominal aortic aneurysms (AAAs). The aneurysm is completely sealed with a non-contained, non-cross linked polymer, while a new flow lumen is created with balloons. For CAR, the haemodynamically most favourable balloon and flow lumen configuration has not been established before; therefore, four flow parameters were assessed in an in vitro model.

ROTEM and Propensity: Two Strategies to Save Blood and Empower Papers

13 April 2019 - 12:00am
“Life is endless battle and conflict, and you cannot fight effectively unless you can identify your enemies.”1

Long-Term Outcome of Symptomatic Patients Undergoing Hybrid Revascularisation for Extracranial Carotid Artery Tandem Stenosis

12 April 2019 - 12:00am
Carotid tandem lesions are a multilevel significant (>50%) atherosclerotic disease involving both the internal carotid artery (ICA) and either the ipsilateral common carotid artery (CCA) or the innominate artery (IA). These lesions may be challenging to treat. Current guidelines offer no definitive recommendation on the optimal treatment algorithm. The aim of this analysis was to assess the long-term outcome of patients undergoing surgical revascularisation for tandem lesions.

The ATTRACT Trial Becomes More Attractive

11 April 2019 - 12:00am
Results from the large scale and long awaited ATTRACT trial were published at the beginning of 2017.1 The analysis of the femoropopliteal and iliofemoral cohorts as a single group has been one of the major reasons that the trial was heavily criticised. It has been known for many years that post-thrombotic syndrome (PTS) is more frequent and serious with iliac and common femoral vein involvement than with more distally thrombosed vein segments.2 Equally, it has been “old wisdom” that there is a 4–5 fold higher rate of recanalisation of the femoral vein than the iliac vein in patients managed with medical measures alone, particularly on the left side.

Treadmill Measured vs. Questionnaire Estimated Changes in Walking Ability in Patients With Peripheral Artery Disease

11 April 2019 - 12:00am
Determining the maximum walking time (MWT) using the treadmill test is the gold standard method for evaluating walking capacity and treatment effect in patients with peripheral arterial disease (PAD). However, self reported functional disability is important when assessing quality of life. Changes in the Walking Estimated Limitation Calculated by History (WELCH) questionnaire scores were compared with the MWT.

Haemangioma of the Thumb

8 April 2019 - 12:00am

Great Power Brings Great Responsibility: Some Thoughts About a Promising Approach to Standardised Data Assessment in Registry Studies

5 April 2019 - 11:00pm
Behrendt et al. have generated a lucid core set of items specific for acute limb ischaemia (ALI), which could enable standardised data collection in vascular surgical registries.1 This cooperation is a promising approach towards creating a comparable framework for the assessment of “big data” gained from prospective registries, leading to more reliable and valid results. Furthermore, these criteria may be used as an objective benchmark to evaluate each registry in which they are used.

What's in a Name?… Ten Years After Publication of the VEIN-TERM Document

5 April 2019 - 11:00pm
Exactly 10 years ago, a transatlantic interdisciplinary faculty of experts developed a consensus document about venous terminology, under the auspices of the American Venous Forum, the European Venous Forum, the International Union of Phlebology, the American College of Phlebology (nowadays the American Vein and Lymphatic Society), and the International Union of Angiology.1 The aim of this consensus document was to promote the use of a common scientific language for future articles dealing with the investigation and management of chronic venous disorders, obviously to be published in the English language.

Isolated Hepatic Aneurysm

4 April 2019 - 11:00pm