European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
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Eur J Vasc Endovasc Surg · Oct 2021
Meta AnalysisEditor's Choice - Paclitaxel Coated Balloon Angioplasty vs. Plain Balloon Angioplasty for Haemodialysis Arteriovenous Access Stenosis: A Systematic Review and a Time to Event Meta-Analysis of Randomised Controlled Trials.
A systematic review and meta-analysis of randomised controlled trials (RCTs) was performed to determine the effectiveness and safety of drug coated balloon (DCB) angioplasty compared with uncoated plain balloon (PB) angioplasty in treating arteriovenous access stenosis. ⋯ Paclitaxel coated DCBs reduced the risk of loss of target lesion patency and circuit patency in arteriovenous access stenosis compared with PBs. Considering the heterogeneity of the included trials, there is a need to investigate optimal treatment regimens regarding drug dose and agent of the DCB and the treatment procedure.
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Eur J Vasc Endovasc Surg · Sep 2021
Comparative Study Observational StudyRegional Anaesthesia for Lower Extremity Amputation is Associated with Reduced Post-operative Complications Compared with General Anaesthesia.
Primary and secondary lower extremity amputation, performed for patients with lower extremity arterial disease, is associated with increased post-operative morbidity. The aim of the study was to assess the impact of regional anaesthesia vs. general anaesthesia on post-operative pulmonary complications. ⋯ A statistically significant reduction in pulmonary complications was observed in patients who received RA for lower extremity amputation compared with GA.
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Eur J Vasc Endovasc Surg · Jul 2021
Comparative StudyHow Does SARS-CoV-2 Infection Affect Survival of Emergency Cardiovascular Patients? A Cohort Study From a German Insurance Claims Database.
A previous study revealed a preliminary trend towards higher in hospital mortality in patients admitted as an emergency with acute stroke during the COVID-19 pandemic in Germany. The current study aimed to further examine the possible impact of a confirmed SARS-CoV-2 infection on in hospital mortality. ⋯ This retrospective analysis of claims data has provided hints of an association between the COVID-19 pandemic and increased in hospital mortality in patients with acute stroke. Furthermore, confirmed SARS-CoV-2 infection was associated with increased mortality in patients with stroke, TIA, and ALI. Future studies are urgently needed to better understand the underlying mechanism and relationship between the new coronavirus and acute stroke.
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Eur J Vasc Endovasc Surg · May 2021
The Use of Near Infrared Spectroscopy to Evaluate the Effect of Exercise on Peripheral Muscle Oxygenation in Patients with Lower Extremity Artery Disease: A Systematic Review.
Near infrared spectroscopy (NIRS) has been suggested as a new diagnostic tool in patients with lower extremity artery disease (LEAD). The aim of this systematic review was to summarise the impact of exercise therapy on lower limb muscle oxygenation, evaluated by NIRS, in patients with LEAD, and to give an overview on NIRS instruments and methodology. ⋯ The available data suggest that exercise training improves de-oxygenation and re-oxygenation patterns, as measured with NIRS, in patients with LEAD. Whereas NIRS is a promising tool in the evaluation of LEAD, the low number of randomised controlled trials, as well as large heterogeneity in NIRS assessment methods, outcome measures, and instrumentation, warrants more research to better understand the role of muscle oxygenation associated with exercise induced improvements in walking capacity.
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Eur J Vasc Endovasc Surg · Apr 2021
COVID-19 Infection in Critically Ill Patients Carries a High Risk of Venous Thrombo-embolism.
The coronavirus disease of 2019 (COVID-19) due to SARS-CoV-2 infection has been found to cause an increased risk of venous thrombo-embolism (VTE). The aims of the study were to determine the frequency of VTE in critically ill patients with COVID-19 and its correlation with D dimer levels and pharmacological prophylaxis. ⋯ Patients with severe COVID-19 infection are at high risk of VTE, and further new symptomatic VTE events and recurrence can occur despite anticoagulation. The prophylactic anticoagulant dose may need to be increased in patients with a low risk of bleeding.