Revistas
Revista:
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
ISSN:
1078-5884
Año:
2022
Vol.:
63
N°:
1
Págs.:
163 - 164
Autores:
Kashyap, V. S. (Autor de correspondencia); So, K. L.; Schneider, P. A.; et al.
Revista:
JOURNAL OF VASCULAR SURGERY
ISSN:
0741-5214
Año:
2022
Vol.:
76
N°:
2
Págs.:
466 - 473.e1
Objectives: Transcarotid artery revascularization (TCAR) is a carotid stenting technique that utilizes reversal of cerebral arterial flow to confer cerebral protection. Although carotid endarterectomy (CEA) remains the standard for treatment of symptomatic and asymptomatic carotid stenosis, the search for the optimal minimally invasive option for the high-risk surgical patient continues. The goal of the current study is to evaluate the 1-year safety and efficacy of TCAR in a prospective clinical trial.
Methods: ROADSTER 2 is a prospective, open-label, single-arm, multicenter, post-approval registry for patients undergoing TCAR. All patients were considered high risk for CEA and underwent independent neurological assessments preoperatively, postoperatively, and had long-term clinical follow-up. The primary end point was incidence of ipsilateral stroke after treatment with the ENROUTE Transcarotid Stent System. Secondary end points included individual/composite rates of stroke, death, and perioperative myocardial infarction.
Results: Between June 2016 and November 2018, 155 patients at 21 centers in the United States and one in the European Union were enrolled and represented a subset of the overall trial. Asymptomatic (n = 119; 77%) and symptomatic patients (n = 36; 23%) with high-risk anatomic (ie, high lesion, restenosis, radiation injury; 43%), physiologic (32%), or combined factors (25%) were enrolled. No patient suffered a perioperative myocardial infarction or stroke. Over the year, no patient had an ipsilateral stroke, but four patients died (2.6%), all from non-neurological causes. Additionally, a technical success rate of 98.7% with a low cranial nerve deficit rate of 1.3% was achieved.
Conclusions: In patients with high risk factors, TCAR yields high technical success with a low stroke and death rate at 1 year. Further comparative studies with CEA are warranted.
Revista:
ACTA OTO-LARYNGOLOGICA
ISSN:
0001-6489
Año:
2020
Vol.:
140
N°:
11
Págs.:
883-888
Background The main sequences used to assess degree of endolymphatic hydrops (EH) are the 3D- inversion-recovery (IR) with real reconstruction and the 3D- fluid-attenuated inversion recovery (FLAIR). Objectives The purpose of this study is to describe and compare both sequences. Material and methods Forty-two consecutive patients diagnosed with probable or definite Menier ' s disease were referred for hydrops MR examination. Vestibular and cochlear EH in both sequences were read by two independent radiologists, unaware of the patient's clinical status. The primary study endpoint was the concordance in the hydrops detection and severity with both imaging sequences. This was assessed using the Cohen's kappa Kappa statistic for disease grading and Pearson X(2)test to test the difference in detection rates of hydrops. Statistical significance was defined as two-sidedp < .05. Results We obtained an excellent overall concordance, with a kappa of 0.821, (p < .001) when comparing hydrops detection. The degree of concordance is higher in vestibular hydrops than in cochlear hydrops. The 3D-IR sequence detected more hydrops than the 3D FLAIR, (62 vs. 39.5%,p < .03). Conclusion The 3D-IR sequence seems to be superior to the 3D-FLAIR for the assessment of EH. Significance:The 3D-IR sequence should be considered as a standalone parameter for a shorter and optimized EH magnetic resonance imaging protocol.
Autores:
Nayahangan, L. J. (Autor de correspondencia); Vila, R.; Lawaetz, J.; et al.
Revista:
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
ISSN:
1078-5884
Año:
2020
Vol.:
60
N°:
6
Págs.:
933 - 941
Objective: The aim of this study was to gather validity evidence for the Assessment of basic Vascular Ultrasound Expertise (AVAUSE) tool, and to establish a pass/fail score for each component, to support decisions for certification. Methods: A cross sectional validation study performed during the European Society for Vascular Surgery's annual meeting. Validity evidence was sought for the theoretical test and two practical tests based on Messick's framework. The participants were vascular surgeons, vascular surgical trainees, sonographers, and nurses with varying experience levels. Five vascular ultrasound experts developed the theoretical and two practical test components of the AVAUSE tool for each test component. Two stations were set up for carotid examinations and two for superficial venous incompetence (SVI) examinations. Eight raters were assigned in pairs to each station. Three methods were used to set pass/fail scores: contrasting groups' method; rater consensus; and extended Angoff. Results: Nineteen participants were enrolled. Acceptable internal consistency reliability (Cronbach's alpha) for the AVAUSE theoretical (0.93), carotid (0.84), and SVI (0.65) practical test were shown. In the carotid examination, inter-rater reliability (IRR) for the two rater pairs was good: 0.68 and 0.78, respectively. The carotid scores correlated significantly with years of experience (Pearson's r = 0.56, p = .013) but not with number of examinations in the last five years. For SVI, IRR was excellent at 0.81 and 0.87. SVI performance scores did not correlate with years of experience and number of examinations. The pass/fail score set by the contrasting groups' method was 29 points out of 50. The rater set pass/fail scores were 3.0 points for both carotid and SVI examinations and were used to determine successful participants. Ten of 19 participants passed the tests and were certified. Conclusion: Validity evidence was sought and established for the AVAUSE comprehensive tool, including pass/fail standards. AVAUSE can be used to assess competences in basic vascular ultrasound, allowing operators to progress towards independent practice.
Revista:
JOURNAL OF VASCULAR SURGERY
ISSN:
0741-5214
Año:
2019
Vol.:
69
N°:
6
Págs.:
1786-1796
Revista:
DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY
ISSN:
1305-3825
Año:
2019
Vol.:
25
N°:
2
Págs.:
166 - 168
Aneurysms of the portal vein and its branches have been rarely described. Their natural history is unknown although large ones (>3 cm in diameter) have been reported to cause rupture, thrombosis, duodenal or biliary obstruction, inferior vena cava compression and/or portal hypertension. We report the case of an incidentally diagnosed 4.5 cm splenic vein aneurysm repaired by endovascular treatment through a transhepatic route. The aneurysm was successfully excluded using a covered stent (Viabahn, Gore). The transhepatic route opens the possibility of offering a minimally invasive approach to vascular lesions of the portal vein system.
Revista:
ENDOVASCULAR TODAY
ISSN:
1551-1944
Año:
2018
Vol.:
17
N°:
8
Págs.:
11-13
Revista:
JOURNAL OF VASCULAR SURGERY
ISSN:
0741-5214
Año:
2017
Vol.:
65
N°:
3
Págs.:
916-920
Autores:
Peinado Cebrián, J.; Flores Herrero, Á.; Salgado Lopetegui, C.L.; et al.
Revista:
ANNALS OF VASCULAR SURGERY
ISSN:
0890-5096
Año:
2015
Vol.:
29
N°:
7
Págs.:
1353-62
Revista:
ANGIOLOGIA
ISSN:
0003-3170
Año:
2015
Vol.:
67
N°:
4
Págs.:
291-296
Revista:
JOURNAL OF VASCULAR SURGERY
ISSN:
0741-5214
Año:
2015
Vol.:
62
N°:
5
Págs.:
1227-34
Revista:
JOURNAL OF VASCULAR SURGERY
ISSN:
0741-5214
Año:
2012
Vol.:
56
N°:
6
Págs.:
1585-90
Autores:
Gil-Sales, J.; Vicente, S.; Martínez, N.; et al.
Revista:
ANNALS OF VASCULAR SURGERY
ISSN:
0890-5096
Año:
2012
Vol.:
26
N°:
7
Págs.:
1013.e1-4
Revista:
ANGIOLOGIA
ISSN:
0003-3170
Año:
2011
Vol.:
63
N°:
2
Págs.:
65-74
Revista:
ANNALS OF VASCULAR SURGERY
ISSN:
0890-5096
Año:
2011
Vol.:
25
N°:
2
Págs.:
222-8
Revista:
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
ISSN:
1078-5884
Año:
2010
Vol.:
39
N°:
6
Págs.:
661-6