Editor's Choice -- European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Asymptomatic Lower Limb Peripheral Arterial Disease and Intermittent Claudication

Nordanstig, Joakim; Behrendt, Christian-Alexander; Baumgartner, Iris; Belch, Jill; Bäck, Maria; Fitridge, Robert; Hinchliffe, Robert; Lejay, Anne; Mills, Joseph L.; Rother, Ulrich; Sigvant, Birgitta; Spanos, Konstantinos; Szeberin, Zoltán; van de Water, Willemien; Antoniou, George A.; Björck, Martin; Gonçalves, Frederico Bastos; Coscas, Raphael; Dias, Nuno V.; Van Herzeele, Isabelle; Lepidi, Sandro; Mees, Barend M.E.; Resch, Timothy A.; Ricco, Jean-Baptiste; Trimarchi, Santi; Twine, Christopher P.; Tulamo, Riikka; Wanhainen, Anders; Boyle, Jonathan R.; Brodmann, Marianne; Dardik, Alan; Dick, Florian; Goëffic, Yann; Holden, Andrew; Kakkos, Stavros K.; Kolh, Phillipe; McDermott, Mary M.

doi:10.1016/j.ejvs.2023.08.067

Cited by 105 publications

(16 citation statements)

References 634 publications

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“…Variabilidades nas definições utilizadas para diagnosticar DAP e AVC e na qualidade dos dados coletados são fatores adicionais que podem comprometer a fiabilidade dos estudos. Essa heterogeneidade sugere a necessidade de diretrizes padronizadas para o diagnóstico e relato de resultados em futuros estudos sobre o tema (Nordanstig et al, 2024).…”

Section: Limitações Dos Estudos Incluídosunclassified

Avaliação sistemática dos preditores de acidente vascular cerebral em pacientes com doença arterial periférica

Avanci Júnior,

Silva,

Finamore

et al. 2024

SHS

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A revisão sistemática focou na associação entre a doença arterial periférica (DAP) e o acidente vascular cerebral (AVC), detalhando a prevalência e os impactos dessas condições na saúde global. As doenças cardiovasculares, incluindo a DAP, são marcantes por suas graves consequências, como o AVC, que resultam em altas taxas de mortalidade e incapacidade prolongada. Este estudo utilizou uma metodologia qualitativa e descritiva de revisão integrativa da literatura, com uma abordagem sistemática para analisar as publicações selecionadas das bases de dados como PubMed, LILACS e Scopus. Foi observada uma forte correlação entre a DAP e o risco elevado de AVC, mediada por fatores de risco tradicionais como hipertensão, diabetes, tabagismo, e hiperlipidemia, e também por marcadores emergentes como inflamatórios e genéticos. A revisão destacou a necessidade de uma gestão integrada desses fatores de risco e sugeriu uma direção para futuras pesquisas focadas em biomarcadores específicos e intervenções preventivas personalizadas. Conclui-se que, apesar do conhecimento substancial dos fatores de risco associados à DAP e ao AVC, muitas estratégias de prevenção e tratamento permanecem subutilizadas, ressaltando a importância de estratégias de saúde pública mais efetivas e direcionadas para mitigar esses riscos. As implicações desta revisão são vastas, sugerindo que a integração de estratégias preventivas personalizadas, que considerem tanto fatores de risco tradicionais quanto emergentes, pode melhorar significativamente os resultados de saúde. Isso ressalta a necessidade urgente de políticas de saúde pública mais robustas e abrangentes que não apenas promovam a conscientização sobre a DAP e o AVC, mas também incentivem abordagens multidisciplinares para o manejo dessas condições. O estudo conclui que uma abordagem mais direcionada e personalizada é essencial para fechar a lacuna entre o conhecimento existente e a aplicação prática nas estratégias de prevenção e tratamento da DAP e do AVC.

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Section: Limitações Dos Estudos Incluídosunclassified

Avaliação sistemática dos preditores de acidente vascular cerebral em pacientes com doença arterial periférica

Avanci Júnior,

Silva,

Finamore

et al. 2024

SHS

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“…Endarterectomy has historically been the treatment modality of choice for atherosclerotic lesions of the CFA. This has been justified by a perceived low risk of morbidity combined with high patency rates [ 1 , 2 , 3 ]. Upon closer inspection, OSR may not be as innocuous as originally believed, with postoperative complications delineated in up to one-quarter of treated patients.…”

Section: Narrative Reviewmentioning

confidence: 99%

“…More recently, the 2024 ESVS guidelines on the management of intermittent claudication have supported EVT for extensive lesions affecting the CFA bifurcation in patients with a hostile groin or morbid obesity (Class IIb, Level C). For CFA stenosis or occlusion that does not affect the femoral bifurcation, EVT has been outlined as a viable alternative to OSR owing to similar mid-term patency rates in non-complex lesions (Class IIb, Level B) [ 2 ].…”

Section: Narrative Reviewmentioning

confidence: 99%

Percutaneous Endovascular Reconstruction of the Common Femoral Artery and Its Bifurcation

Rassam,

Coscas

2024

JCM

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Occlusive lesions of the common femoral artery (CFA) and its bifurcation have traditionally been treated with open surgery. Although long-term patency rates after open surgery are excellent, such repairs are associated with substantial local and general morbidity. In recent years, different treatment options have emerged within percutaneous endovascular repair. We hereby present a narrative review on endovascular treatment modalities and a treatment algorithm for endovascular revascularisation of the CFA and its bifurcation. Lesion analysis, access issues, vessel preparation tools, and types of repairs with or without the involvement of the bifurcation are described. Based on current data, an interventional approach can result in high technical success and acceptable mid-term patency rates. Further comparative evidence with open surgery and/or between the different types of endovascular repairs is required to improve the current treatment algorithm.

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“…Following endovascular lower limb revascularisation, patients who are not at high risk of bleeding are commonly treated with dual antiplatelet therapy for at least one month before continuing monotherapy long-term to reduce the risk of secondary cardiovascular and major adverse limb events. High-quality evidence on the optimum antithrombotic regimen post-lower limb revascularisation has yet to be published [ 2 , 15 , 16 ]. These recommendations should be offered in conjunction with counselling for lifestyle modifications including smoking cessation and preventative foot care, particularly in the context of diabetic neuropathy.…”

Section: Introductionmentioning

confidence: 99%

Current Status of and Future Prospects for Drug-Eluting Stents and Scaffolds in Infrapopliteal Arteries

Lim,

Varcoe

2024

JCM

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Background: Chronic limb-threatening ischaemia can be a debilitating disease and may result in limb amputation if untreated. Atherosclerotic disease of the infra-popliteal arteries is particularly challenging to treat due to the small caliber of the vessels and the heavy burden of atherosclerotic plaque. Percutaneous transluminal angioplasty is the conventional first-line approach and is advantageous due to its minimal invasiveness, repeatability, and cost-effectiveness but is limited by high rates of elastic recoil, dissection, and short- to mid-term re-stenosis. Methods: This review analyses the growing body of published and presented clinical data from multiple randomised controlled trials that have investigated the role of coronary drug-eluting stents in the treatment of infrapopliteal disease. Results: Coronary drug-eluting stents demonstrate superior primary patency compared with angioplasty and/or bare metal stenting alone but are limited to application in short-segment disease and have not been widely adopted due to the nature of the permanent implant. Conclusions: Newer devices like drug-eluting resorbable scaffolds are promising as they allow the restoration of vessel wall vasomotion without a residual foreign body and can be used to treat longer, complex lesions.

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Editor's Choice -- European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Asymptomatic Lower Limb Peripheral Arterial Disease and Intermittent Claudication

Cited by 105 publications

References 634 publications

Avaliação sistemática dos preditores de acidente vascular cerebral em pacientes com doença arterial periférica

Avaliação sistemática dos preditores de acidente vascular cerebral em pacientes com doença arterial periférica

Percutaneous Endovascular Reconstruction of the Common Femoral Artery and Its Bifurcation

Current Status of and Future Prospects for Drug-Eluting Stents and Scaffolds in Infrapopliteal Arteries

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