Peripheral artery disease (PAD) of the lower extremities, which poses a major challenge in the field of global public health, has seen a rising trend in its incidence and disability rate year by year. With the continuous innovation of new diagnostic techniques, imaging evaluation methods, and treatment strategies, profound changes have taken place in the diagnosis and treatment paradigm in this field. Based on the “European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Asymptomatic Lower Limb Peripheral Arterial Disease and Intermittent Claudication” issued by the European Society for Vascular Surgery in 2024, we systematically reviewed the relevant international guidelines in recent years and conducted horizontal comparisons. Combining with the latest clinical research evidence, we conducted an in-depth analysis from the perspective of evidence-based medicine on the strategic evolution, technical key point updates, and clinical evidence levels of endovascular treatment for lower extremity PAD. The aim is to provide an evidence-based medical basis for clinical decision-making.
Objective To review the progress of the robotic applications in vascular surgery. Methods Recent literature about the robotic applications in vascular surgery was reviewed and analyzed. Results Robotic system is composed of surgery robotic system and endovascular interventional robotic system. The time of aortic clamping and anastomosis is reduced considerably during the robotic-assisted aorta bypass surgery, and the dissection of aorta is completed successfully in totally robotic approach. Endovascular interventional robotic system has good performance in navigation and stability, and shows apparent advantages in passing special anatomical segment and complicated lesion. However, the robotic systems are still limited in application for high cost. The problem of tactile feedback should also be solved quickly. Conclusion Robotic systems have apparent advantages and good prospect in vascular surgery. Nevertheless, it still require many clinical trials to formulate the indication and contraindication, to establish standard procedure, to assess the long-term effectiveness of the robotic systems and so on.
In the late-breaking trials session of the American Heart Association’s Scientific Sessions 2021, which took place in November 2021, six clinical trials in cardiac surgery published their primary results. This review will look into three of them including the management of patients with moderate or less-than-moderate tricuspid regurgitation at the time of surgery for degenerative mitral regurgitation, timing of ticagrelor cessation before coronary artery bypass grafting, and long-term outcomes of ticagrelor-based antiplatelet therapy for secondary prevention of coronary artery bypass grafting.
Since 1979, vascularized iliac bone graft based on the deep circumflex iliac vessels (DCIV) or the deep superior branches of superior gluteal vassels (SGV) was used to the treatment of bone defect, non-union of fracture, and aseptic necrosis of the femoral head in Ⅱ4 cases. Of these Ⅱ4 graftings, 68 were pedicled, 46 were microvascular free transfer. Early callus formation developed 6 weeks after surgery. Solid bony union was obtained in 3 months. Among 32 patients with aseptic necrosis of femoral head followed more tha 1 years, dior relief of pain and omprovement of X-ray findings were obtained in 31. The advantages of using vascularized iliac bone graft, especially based on the DCIV and SGV, are discussed. The author has a good opinion of vascularized iliac bone graft based on the SGV.
Committee of Minimally Invasive Cardiovascular Surgery (CMICS) annually investigates the minimally invasive cardiovascular surgery performed by departments of cardiovascular surgery of all hospitals in China of last year, and makes classification and summary according to the operation amount of minimally invasive surgery, regional and hospital distribution, and publishes it on the theme report of China Minimally Invasive Cardiovascular Surgery Conference (CMC). In 2021, CMICS published the 2018-2019 annual data of Chinese cardiovascular surgery in the form of a white paper for the first time in the Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, which attracted great attention from peers. In this statistical report, CMICS will focus on the volume of minimally invasive cardiovascular surgery, regional and hospital distribution in China (excluding Hong Kong Special Administrative Region, Macao Special Administrative Region, and Taiwan Province) in the 2020—2021 for your reference.
The cardiovascular surgery in China has reached a stable platform, with notable progress been achieved in the past several decades. However, significant divergency regarding the healthcare quality was also observed, which requiring effective intervention to start the transition from the focus on "quantity" to the pursuit of "quality". Quality improvement program, including the establishment of a national cardiovascular surgery database, the conformation of a standard key quality evaluation indicator system, and the conduction of quality intervention and improvement initiatives, are promising to consolidate and expand the advantages of cardiac surgery and lead to better patient outcomes.
ObjectiveTo investigate the clinical application of fresh autologous pericardial patch transplantation in cardiovascular surgery. MethodFrom January 2008 to December 2014, we used fresh autologous pericardial patch as a repair material in surgical treatment of congenital heart disease, valvular and vascular malformation. A total of 239 patients were included (130 males, 109 females), with a mean age of 0.40±13.80 years ranging from 0.25-69.00 years, including 180 infants. ResultThe time of intensive care unit (ICU) stay was 3-15 days and the time of ventilator-assisted breathing was 4-100 hours. Postoperative atelectasis and pleural effusion occured in 8 patients and was cured successfully by closed thoracic drainage and anti-infection therapy. Nine patients died within 30 days after surgery, including 3 deaths caused by low cardiac output syndrome and acute renal failure, 5 deaths caused by multiple organ failure, and 1 death caused by malignant arrhythmia. All patients had no infective endocarditis, thrombosis, hemolysis, blood vessel stenosis, or calcification of pericardial patch. The cause of death was associated with the primary lesion, but not with transplanted pericardium. We followed up 198 patients for 3-64 months. During follow-up, echocardiography showed no patch graft vegetation, thrombosis, perforation or calcification. ConclusionThe fresh autologous pericardium is a good material for repairing cardiac defects.
ObjectiveTo summarize the research progress of mixed reality (MR) technology in the field of vascular surgery.MethodWe retrieved the literatures about the application of MR technology in vascular surgery, and summarized and analyzed them.ResultsThe application of MR technology in vascular surgery could greatly improve the standardization of medical education, shorten the learning cycle, effectively shorten the operation time, and increase the benefit of patients. The application of MR in vascular surgery was still in its infancy, and it showed some attractive prospects as well as some shortcomings.ConclusionsThe application of MR technology in vascular surgery is still at the exploratory stage, but it has an attractive prospect. With the continuous improvement of registration technology and the continuous improvement of accuracy, MR technology will be more and more widely used in vascular surgery.
The minimally invasive cardiovascular surgery developed rapidly in last decades. In order to promote the development of minimally invasive cardiovascular surgery in China, the Chinese Minimally Invasive Cardiovascular Surgery Committee (CMICS) has gradually standardized the collection and report of the data of Chinese minimally invasive cardiovascular surgery since its establishment. The total operation volume of minimally invasive cardiovascular surgery in China has achieved substantial growth with a remarkable popularization of concepts of minimally invasive medicine in 2019. The data of Chinese minimally invasive cardiovascular surgery in 2019 was reported as a paper for the first time, which may provide reference to cardiovascular surgeons and related professionals.
bjective To study the effectiveness of subfascial endoscopic communicating branch vein ablation in treating communicating branch vein insufficiency.MethodsFiftyseven cases of primary lower extremity vein valve insufficiency complicated by communicating vein insufficiency diagnosed by venography and color duplex were treated with subfascial endoscopic communicating branch vein ablation, and their information was analyzed retrospectively.ResultsSwelling was observed in leg of 7 cases after operation, and disappeared within one week spontaneously. Incision infection occurred in 2 cases and skin ambustion happened in 2 cases. Superficial vein varicosis disappeared in all case, skin pigmentatin declined significantly and ulcers healed in 2-3 weeks.Conclusion Subfascial endoscopic communicating branch vein ablation is an excellent choice in treating communicating branch vein insufficiency.