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Vascular Surgery: Recent Developments and Emerging Trends
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Vascular Surgery: Recent Developments and Emerging Trends

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

Deadline for manuscript submissions: closed (25 November 2024) | Viewed by 3984

Special Issue Editors

Dr. Evangelia Samara

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Guest Editor
Department of Anaesthesia and Postoperative Intensive Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, 455 00 Ioannina, Greece
Interests: cardiothoracic and vascular anaesthesia; perioperative thrombosis and haemostasis; emergency medicine
Dr. Petros G. Tzimas

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Guest Editor
Department of Anaesthesia and Postoperative Intensive Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, 455 00 Ioannina, Greece
Interests: anaesthesia for HPB; cardiothoracic surgery; perioperative antithrombotic monitoring
Dr. Georgios I. Karaolanis

E-Mail Website
Guest Editor
Vascular Unit, Department of Surgery, University Hospital of Ioannina and School of Medicine, 455 00 Ioannina, Greece
Interests: vascular surgery; endovascular surgery; open surgery; thoracic aneurysms; thoraco-abdominal aortic aneurysms; abdominal aneurysms; aortic diseases; carotid diseases

Special Issue Information

Dear Colleagues,

Treatment for vascular disease varies depends on the type and severity. Open and endovascular techniques represent the cornerstone of vascular surgery, treating a plethora of diseases in various vascular “beds” or target vessels.

Open surgical repair represents the traditional approach in various vascular territories, while endovascular techniques have caused a dramatic change in vascular surgery over the last years, characterized as “endovascular evolution” due to their rapid introduction, acceptance and development.

Both techniques are equally important in the vascular surgeon’s arsenal; however, considering open vs endovascular procedures, a variety of factors should be reviewed, including but not limited to the disease itself, the patient, the skill and experience of the treating physician, and the urgency of the procedure.       

This Special Issue of the Journal of Clinical Medicine, "Vascular Surgery: Recent Developments and Emerging Trends", offers authors and readers a collection of advances in our field and new insights.

We are pleased to invite and welcome your peer-reviewed manuscripts on advances in vascular and endovascular surgery. We are seeking high-quality papers that will advance the scientific exchange of our knowledge, with the ultimate goal of positively influencing the decision-making process of our patients.

Dr. Evangelia Samara
Dr. Petros G. Tzimas
Dr. Georgios I. Karaolanis
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

  • vascular surgery
  • endovascular surgery
  • cardiothoracic surgery
  • perioperative antithrombotic monitoring
  • anaesthesia
  • emergency medicine

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Published Papers (4 papers)

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15 pages, 2015 KiB  
Article
Quantification of the Survival Disadvantage Associated with Major Amputation in Patients with Peripheral Arterial Disease
by Maria Elisabeth Leinweber, Emanuel Greistorfer, Julia Rettig, Fadi Taher, Miriam Kliewer, Afshin Assadian and Amun Georg Hofmann
J. Clin. Med. 2025, 14(1), 104; https://doi.org/10.3390/jcm14010104 - 27 Dec 2024
Viewed by 437
Abstract
Objective: Despite advancements in vascular surgery, the mortality among peripheral arterial disease (PAD) patients undergoing major amputations remains high. While a large body of evidence has previously covered survival rates after major amputation, there is less evidence regarding the associated survival penalty [...] Read more.
Objective: Despite advancements in vascular surgery, the mortality among peripheral arterial disease (PAD) patients undergoing major amputations remains high. While a large body of evidence has previously covered survival rates after major amputation, there is less evidence regarding the associated survival penalty from an epidemiological perspective. The present analysis aimed at quantifying the survival disadvantage after major lower limb amputation while investigating which factors are associated with mortality in this patient cohort. Methods: Data from 246 PAD patients undergoing major amputations were retrospectively collected and matched with mortality records from the Austrian National Death Registry. Life expectancy was estimated using population-based life tables, and differences between observed and expected survival were analyzed across subgroups. Results: The median follow-up was 492 days (Q1–Q3: 73–1438), and 82.5% (n = 203) of patients died, with cardiovascular events being the leading cause (41%). A profound discrepancy between estimated (4697 days, Q1–Q3: 2962–6236) and observed survival (457 days, Q1–Q3: 73–1438, p < 0.001) was seen. In men, an associated median survival penalty of 11.2 years was observed, equivalent to a proportionate reduction in life expectancy of over 90%, while the difference in women was 8.7 years, equaling a reduction of 84.6%. In a multiple regression model, 1 year in life expectancy was associated with a survival penalty of −0.96 years, thereby affecting younger patients with the highest life expectancies the most. Conclusions: Major amputation in PAD patients is associated with a significant reduction in survival compared to standardized mortality rates in the general population. The survival disadvantage exceeds 70% of estimated survival times in over 70% of patients. Elevated mortality rates after major amputation in PAD patients should not be interpreted as a causal relationship but as a surrogate for impaired systemic cardiovascular health. Full article
(This article belongs to the Special Issue Vascular Surgery: Recent Developments and Emerging Trends)
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15 pages, 1166 KiB  
Article
Assessment of Facial Pain After Internal Carotid Artery Stenting: The Role of External Carotid Artery Overstenting
by Dorota Łyko-Morawska, Łukasz Szkółka, Michał Serafin, Emila Senderek, Paweł Kiczmer, Magdalena Górska and Wacław Kuczmik
J. Clin. Med. 2024, 13(24), 7666; https://doi.org/10.3390/jcm13247666 - 16 Dec 2024
Viewed by 317
Abstract
Background: The external carotid artery (ECA) supplies blood to various facial and neck regions and may contribute to collateral cerebral perfusion. With the rise in carotid artery stenting (CAS) as a treatment for carotid stenosis, ECA overstenting has become a common procedure [...] Read more.
Background: The external carotid artery (ECA) supplies blood to various facial and neck regions and may contribute to collateral cerebral perfusion. With the rise in carotid artery stenting (CAS) as a treatment for carotid stenosis, ECA overstenting has become a common procedure feature. This study aimed to assess the incidence, characteristics, and duration of facial pain following CAS, hypothesizing that ECA overstenting may contribute to facial pain. Materials and Methods: This prospective study included 55 patients treated with CAS for internal carotid artery (ICA) stenosis at a single center. Patients’ facial pain was evaluated using a numeric rating scale (NRS) before, immediately after, and 24 h post-CAS. Patient data, including demographics, comorbidities, and procedural details, were analyzed to assess the relationship between ICA stenosis degree, ECA diameter changes, and facial pain incidence. Results: CAS was associated with intraoperative facial pain in 27.27% of patients, with 7.28% reporting residual pain 24 h post-procedure. Pain occurrence was significantly higher in patients with lower ICA stenosis (p = 0.04). The median ECA diameter decreased from 4.11 mm to 3.16 mm (p < 0.001) after CAS, with ECA overstenting observed in 96.4% of cases. No significant relationship was found between pain severity and stent width or length. Conclusions: This study highlights that CAS significantly decreases the diameter of ECA. Additionally, ECA overstenting might be associated with perioperative and postoperative facial pain, emphasizing the need for careful monitoring of ECA patency following CAS. Full article
(This article belongs to the Special Issue Vascular Surgery: Recent Developments and Emerging Trends)
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13 pages, 1987 KiB  
Article
Endovascular Repair of Ruptured Abdominal Aortic Aneurysms Using the Endurant™ Endograft
by Petroula Nana, George Volakakis, Konstantinos Spanos, George Kouvelos, Metaxia Bareka, Eleni Arnaoutoglou, Athanasios Giannoukas and Miltiadis Matsagkas
J. Clin. Med. 2024, 13(17), 5282; https://doi.org/10.3390/jcm13175282 - 6 Sep 2024
Viewed by 837
Abstract
Background: Endovascular aortic aneurysm repair (EVAR) represents a valid treatment modality for ruptured abdominal aortic aneurysms (rAAAs). This study aimed to present rAAA outcomes treated by EVAR using the Endurant endograft. Methods: A single-center retrospective analysis of consecutive patients treated with standard EVAR [...] Read more.
Background: Endovascular aortic aneurysm repair (EVAR) represents a valid treatment modality for ruptured abdominal aortic aneurysms (rAAAs). This study aimed to present rAAA outcomes treated by EVAR using the Endurant endograft. Methods: A single-center retrospective analysis of consecutive patients treated with standard EVAR (sEVAR) or parallel graft (PG)-EVAR for infra- or juxta/para-renal rAAA using the Endurant endograft (1 January 2008–31 December 2023) was undertaken. The primary outcomes were technical success, mortality, and reintervention. Follow-up outcomes, including survival and freedom from reintervention, were assessed using Kaplan–Meier estimates. Results: Eighty-eight patients were included (87.5% sEVAR and 12.5% PG-EVAR). The mean aneurysm diameter was 73.3 ± 19.3 mm (71.4 ± 22.2 mm sEVAR and 81.7 ± 33.0 mm PG-EVAR). Among 77 patients receiving sEVAR, 26 (33.8%) received an aorto-uni-iliac device. All PG-EVAR patients were managed with bifurcated devices, one receiving a single PG, seven double PGS, and three triple PGs. Technical success was 98.8% (100.0% sEVAR and 90.9% PG-EVAR). The 30-day mortality was 47.2% (50.7% sEVAR and 27.3% PG-EVAR), with nine (10.2%) deaths recorded on the table. The mean time of follow-up was 13 ± 9 months. After excluding 30-day deaths, the estimated survival was 75.5% (standard error (SE) 6.9%) at 24 months. The estimated freedom from reintervention was 89.7% (SE 5.7%) at 24 months. Only one endoleak type Ia event was recorded during follow-up. Conclusions: Endurant showed high technical success rates and low rates of endoleak type Ia events and reinterventions, despite the emergent setting of repair. rAAA is still a highly fatal condition within 30 days, with an acceptable mid-term survival of 30-day survivors at 75.5%. Full article
(This article belongs to the Special Issue Vascular Surgery: Recent Developments and Emerging Trends)
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11 pages, 580 KiB  
Systematic Review
Laparoscopic Ligation of the Inferior Mesenteric Artery: A Systematic Review of an Emerging Trend for Addressing Type II Endoleak Following Endovascular Aortic Aneurysm Repair
by Konstantinos Roditis, Paraskevi Tsiantoula, Nikolaos-Nektarios Giannakopoulos, Afroditi Antoniou, Vasileios Papaioannou, Sofia Tzamtzidou, Dimitra Manou, Konstantinos G. Seretis, Theofanis T. Papas and Nikolaos Bessias
J. Clin. Med. 2024, 13(9), 2584; https://doi.org/10.3390/jcm13092584 - 27 Apr 2024
Viewed by 1399
Abstract
Background/Objectives: this systematic review aims to explore the efficacy and safety of the laparoscopic ligation of the inferior mesenteric artery (IMA) as an emerging trend for addressing a type II endoleak following endovascular aortic aneurysm repair (EVAR). Methods: A comprehensive literature [...] Read more.
Background/Objectives: this systematic review aims to explore the efficacy and safety of the laparoscopic ligation of the inferior mesenteric artery (IMA) as an emerging trend for addressing a type II endoleak following endovascular aortic aneurysm repair (EVAR). Methods: A comprehensive literature search was conducted across several databases including Medline, Scopus, and the Cochrane Central Register of Controlled Trials, adhering to the PRISMA guidelines. The search focused on articles reporting on the laparoscopic ligation of the IMA for the treatment of a type II endoleak post-EVAR. Data were extracted regarding study characteristics, patient demographics, technical success rates, postoperative outcomes, and follow-up results. Results: Our analysis included ten case studies and two retrospective cohort studies, comprising a total of 26 patients who underwent a laparoscopic ligation of the IMA between 2000 and 2023. The mean age of the cohort was 72.3 years, with a male predominance (92.3%). The mean AAA diameter at the time of intervention was 69.7 mm. The technique demonstrated a high technical success rate of 92.3%, with a mean procedure time of 118.4 min and minimal blood loss. The average follow-up duration was 19.9 months, with 73% of patients experiencing regression of the aneurysmal sac, and no reports of an IMA-related type II endoleak during the follow-up period. Conclusions: The laparoscopic ligation of the IMA for a type II endoleak following EVAR presents a promising, minimally invasive alternative with high technical success rates and favorable postoperative outcomes. Despite its potential advantages, including reduced contrast agent use and radiation exposure, its application remains limited to specialized centers. The findings suggest the need for further research in larger prospective studies to validate the effectiveness of this procedure and potentially broaden its clinical adoption. Full article
(This article belongs to the Special Issue Vascular Surgery: Recent Developments and Emerging Trends)
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