EJVES November Headlines

The November 2023 issue opens with an Editorial: Through Knee Amputation: A Neglected Technique that Offers Opportunities for Future Research by Shigong Guo et al. (Read for free) In this editorial the often neglected techniques of through-knee amputation are described. Although all vascular surgeons do not perform amputations themselves, knowledge about these alternatives are crucial for vascular care. Read and learn!

This month’s first Editor’s choice paper is a systematic review: Comparison of the Reproducibility of Ultrasound Calliper Placement Methods in Abdominal Aortic Diameter Measurements: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy Studies by Daniele Bissacco et al. This SR (21 studies) addressed an important issue, which is the best method to measure the aorta with ultrasound: outer to outer (OTO), inner to inner (ITI), and or leading edge to leading edge (LELE) calliper placement? Read and learn! (Read for free)

The second Editor’s choice paper by Cristina Lopez Espada et al is The VASCUNExplanT Project: An international study assessing open surgical conversion of failed non-infected endovascular aortic aneurysm repair. This VASCUNET project identified 348 patients from 17 centres, in 17 countries, who underwent open surgical conversion for non-infected stent grafts. The most common indications were endoleak (with expansion) and rupture. This large cohort supplies a wealth of information for future explant procedures. (Read for free)
This paper comes with an invited commentary by Ciaran O. McDonnell.

The third Editor’s choice paper, by Soroosh Shekarchian et al, is Quality of Life after Stenting for Iliofemoral Venous Obstruction; A Randomized Controlled Trial with 1 Year Follow Up. This paper is also EJVES Open Access. The recruitment to this RCT was severely affected by Covid-19, and in the end only 63 patients were randomised, 2:1. Still stenting was associated with better results. Read the details. (Read for free)
This paper comes with an invited commentary by Stephen Black and Taha Kahn.

This issue also contains three ISSUE HIGHLIGHTS.
The first ISSUE HIGHLIGHT is Epidemiological trends and projections of incidence, prevalence, and disease-related mortality associated with peripheral arterial disease: Observations using nationwide Danish data by Mette Søgaard et al. This paper is also EJVES Open Access. This epidemiological study investigated PAD in 4.8 million inhabitants aged 40-99 in Denmark. Interestingly, the incidence declined but still the prevalence increased, as a result of the ageing population. More work for vascular surgeons despite a healthier population? (Read for free)

A Systematic Review And Meta-Analysis Of Randomized Controlled Trials Comparing Thermal Versus Non-Thermal Endovenous Ablation In Superficial Venous Incompetence by Noman Shahzad et al is also an ISSUE HIGHLIGHT. This SR identified 8 RCTs with 1 956 patients. There was no difference in occlusion rates, but non-thermal ablation was tolerated better (with less pain in the early post-operative period) and had less risk of nerve injury. Improvements in quality of life were similar. (Link)
This paper comes with an invited commentary by Christos Karathanos and Athanasios Giannoukas.

The final ISSUE HIGHLIGHT is Massed training is logistically superior to distributed training in acquiring basic endovascular skills by Gilles Soenes et al. Training in endovascular skills is of strategic importance for the development of modern vascular surgery. This paper compared different ways of training: the “PROficiency based StePwise Endovascular Curricular Training” (PROSPECT) in the originally distributed training format, where trainees learn at their own pace, with a mass training while exempt from clinical duties. The mass training had a lower dropout rate. (Link)
This paper comes with an invited commentary by Alexander Gombert.

The November 2023 issue also features three additional EJVES Open Access papers:

The first EJVES Open Access paper is A retrospective evaluation of intra-prosthetic thrombus formation after endovascular aortic repair in Cook Zenith Alpha and Medtronic Endurant II patients by Håvard Ulsaker et al. This single-centre study from Trondheim, Norway, compared the risk of limb graft occlusion (LGO) and thrombus formation in Zenith Alpha (n=78) and Endurant II (n=86) stent grafts. Zenith Alpha was an independent risk factor for LGO, confirming previous reports, and of importance for patient safety and surveillance. (read for free)
This paper comes with an invited commentary by Marina Dias-Neto and José Oliveira Pinto.

The second EJVES Open Access paper is Free tissue transfer in diabetic foot ulcers: A systematic review and meta-analysis by Saiuj Bhat et al. This SR performed by plastic surgeons in Australia, Germany and the USA identified 67 studies (n=1 846 with 1 871 free flaps), 75% underwent revascularisation a median of 8 days between procedures. Ambulation rates were 88%, but most studies had a high risk of bias. Read the details! (read for free)

The third EJVES Open Access paper is Determinants of late venous thromboembolic events after acute isolated superficial vein thrombosis in daily practice: 12-month results of the INSIGHTS-SVT study by Eberhard Rabe et al. This paper reports from a large observational study (n=872). The risk of recurrent TE events remained elevated over 12 months of follow up. Anticoagulation beyond 45 days may be considered in patients with the following risk factors: obesity, history of VTE, and severe systemic infections. (read for free)
This paper comes with an invited commentary by Jay Bakas and Marie Josee van Rijn.

Martin Björck                                                              Jonathan R Boyle
Editor-in-Chief                                                            Senior Editor

AORTA and MAJOR BRANCHES
< Mid-Term Outcomes of Endovascular versus Medical Therapy for Uncomplicated Type B Aortic Dissection: Meta-Analysis of Reconstructed Time-to-Event Data > by Michel Pompeu Sá et al. This Trans-Atlantic collaboration addressed an issue of great clinical importance. They identified 10 studies (8 observational, 2 RCTs). N=2 332 TEVAR and 15 574 medical therapy. TEVAR is associated with better midterm survival, but RCTs with more patients and longer follow up (in progress!) are still needed. (Link)

< A systematic review on endovascular repair outcomes in atherosclerotic chronic mesenteric ischaemia > by Petroula Nana et al. This international collaboration performed a SR (16 retrospective studies, 1 224 patients) to assess outcomes of endovascular repair in patients with CMI. Treatment is safe as first line treatment, but symptom recurrence and re-intervention are not uncommon. (Link)

BASIC RESEARCH and TRANSLATIONAL MEDICINE
< CD93 ameliorates diabetic wound by promoting angiogenesis via p38/MK2/HSP27 axis > by Yuan Xu et al. This translational experiment on mice, studied the effect of the protein CD93 on angiogenesis. It promoted neovascularisation, and CD93 deficiency delayed wound repair. Promising results. Future clinical implications? (Link)

< Poor Below-the-Knee Runoff Impacts Femoropopliteal Stent Failure and Fluoropolymer Antithrombotic Effect in Healthy Swine Model > by Norihito Nakamuraet al. In this healthy swine femoropopliteal artery model, the impact of poor BTK runoff and the antithrombotic effect of Fluoropolymer (FP) coating of the stents were studied. The animals were followed one month after the experiment. Poor BTK runoff was the main cause of in stent restenosis, but FP coating demonstrated the least percent area stenosis. (Link)

RESEARCH LETTERS
< Comparison of Hemodynamic Changes Associated with Two Versus Four Vessel Fenestrated Endovascular Aneurysm Repair Using Patient-Specific Computational Flow Simulation > by Kenneth Tran et al. This two-centre Trans-Atlantic collaboration compared downstream haemodynamics in 2 vs 4 vessel FEVAR in 10+10 patients. This pilot study has thought provoking results, with implications regarding risk of branch and intraluminal thrombus formation. (Link)

< Carotid artery diameter correlates with plaque volume but not with degree of stenosis > by Alison Phair et al. This preliminary study from Manchester studied not only the degree of stenosis, but also the possible importance of carotid plaque volume (CPV) for athero-embolic risk. Thought provoking results regarding carotid haemodynamics, giving inspiration for further research! (Link)

< Endovascular Treatment of Aortic Brucellosis, an Overlooked Cause of Aortic Infection in China > by Siting Li et al. Brucellosis is the most common zoonosis worldwide. In this report 15 Chinese patients with aortic infection treated with endovascular techniques are described, 11 survived. Read the details. (Link)

< Endovascular Treatment for Total Renal Artery Occlusion in Paediatric Patients > by Pengyu Li et al. This is a report on 13 paediatric Chinese patients with renal artery occlusion treated with endovascular techniques. A rare condition. The report is certainly of interest to read next time you encounter such a patient. (Link)