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 · Dec 2019
Magnetic Resonance Imaging Identified Brain Ischaemia in Symptomatic Patients Undergoing Carotid Endarterectomy Is Related to Histologically Apparent Intraplaque Haemorrhage.
Intraplaque haemorrhage (IPH) has been independently associated with a higher risk of future ipsilateral stroke in patients with carotid artery stenosis. Evaluation of plaque characteristics may contribute to risk assessment of recurrent (silent) cerebrovascular events in order to prioritise patients for timing of treatment. It is unknown if patients showing histologically apparent IPH also have increased risk of silent ischaemic brain lesions in the waiting period between index event and revascularisation. ⋯ Symptomatic patients with ipsilateral carotid stenosis and silent brain ischaemia on pre-operative MR-DWI, more often showed pathological evidence of IPH compared with those without ischaemic lesions. This identifies carotid IPH as a marker for patients at risk of silent brain ischaemia and possibly for future stroke and other arterial disease complications. Such patients may be more likely to benefit from CEA than those without evidence of ipsilateral carotid IPH.
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Frailty is a state of increased vulnerability and is a stronger predictor for post-operative outcome than age alone. The aim of this study was to determine whether frailty is associated with adverse 30 day outcome in vascular surgery patients. ⋯ Frailty is associated with a higher risk of post-operative complications and discharge to a nursing home after vascular surgery. Some frailty domains (mobility, nutrition, cognition and psychosocial condition) appear to have a more pronounced impact.
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Eur J Vasc Endovasc Surg · Oct 2019
Multicenter Study Comparative StudyInternational Validation of the Danish Vascular Registry Karbase: A Vascunet Report.
Vascunet has previously published an international comparison of registry data within vascular surgery. Data validity and completeness in participating registries is essential for a meaningful interpretation of differences between countries. The Vascunet collaboration has therefore developed a methodology for validation of international vascular registry data, previously used for validation of two national registries. This study aimed to assess the internal and external validity of the Danish vascular registry, Karbase, by independent Vascunet validators. ⋯ This study used the Vascunet template for international validation of registry data and demonstrated that Karbase is a reliable system of quality data collection for Danish vascular surgery, especially regarding endpoints. Data quality in the Karbase registry was clearly superior to local administrative data.
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Eur J Vasc Endovasc Surg · Sep 2019
Review Multicenter StudyPenetrating Neck Injury in Two Dutch Level 1 Trauma Centres: the Non-Existent Problem.
Penetrating neck injuries (PNIs) have a low incidence in European trauma populations. Selective non-operative management of PNI has been suggested as a safe alternative to standard surgical neck exploration, but evidence is lacking. This clinical scenario evaluates institutional PNI management, specifically the associated carotid artery injury, and compares it with current guidelines. ⋯ This clinical scenario evaluates institutional management in two trauma centres for PNI and associated carotid artery injury, and compares it to current guidelines. In comparison with guideline recommendations, CTA scanning and the so called "No zone" approach appears to have assumed a more prominent role in management of PNI.
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Eur J Vasc Endovasc Surg · Aug 2019
Achieving Consensus to Define Curricular Content for Simulation Based Education in Vascular Surgery: A Europe Wide Needs Assessment Initiative.
To gather consensus among European educators about technical procedures that should be included in a future simulation based curriculum in vascular surgery. ⋯ The prioritised list of technical procedures from this ESVS supported project could be used to guide planning and development of future SBE programs to meet the needs of vascular surgeons across Europe.