5 research outputs found
Editor's Choice – Focused Update on Patients Treated with the Nellix EndoVascular Aneurysm Sealing (EVAS) System from the European Society for Vascular Surgery (ESVS) Abdominal Aortic Aneurysm Clinical Practice Guidelines
No full textObjective: After alerts on EndoVascular Aneurysm Seal (EVAS) failure were raised, the European Society for Vascular Surgery (ESVS) Abdominal Aortic Aneurysm (AAA) Clinical Practice Guidelines Writing Committee (WC) initiated a task force with the aim to provide guidance on surveillance and management of patients with implanted EVAS devices. Methods: Based on a scoping review of risk for late serious aortic-related adverse events in patients treated with EVAS for AAA, the ESVS AAA Guidelines WC agreed on recommendations graded according to the European Society of Cardiology (ESC) grading system. Results: EVAS has a very high incidence of late endograft migration resulting in proximal type 1 endoleak with risk of rupture, requiring open conversion with device explantation. The reported mortality rate for elective explantation varies between 0% and 14%, while acute conversion for rupture has a very dismal prognosis with a 67 – 75% mortality rate. Conclusion: It is recommended that all patients in whom a Nellix device has been implanted should be identified, properly informed, and enrolled in enhanced surveillance. If device failure is detected, early elective device explantation should be considered in surgically fit patients.Peer reviewe
Editor's choice : focused update on patients treated with the Nellix EndoVascular Aneurysm Sealing (EVAS) System from the European Society for Vascular Surgery (ESVS) Abdominal Aortic Aneurysm Clinical Practice Guidelines
No full textObjective: After alerts on EndoVascular Aneurysm Seal (EVAS) failure were raised, the European Society for Vascular Surgery (ESVS) Abdominal Aortic Aneurysm (AAA) Clinical Practice Guidelines Writing Committee (WC) initiated a task force with the aim to provide guidance on surveillance and management of patients with implanted EVAS devices.Methods: Based on a scoping review of risk for late serious aortic-related adverse events in patients treated with EVAS for AAA, the ESVS AAA Guidelines WC agreed on recommendations graded according to the European Society of Cardiology (ESC) grading system.Results: EVAS has a very high incidence of late endograft migration resulting in proximal type 1 endoleak with risk of rupture, requiring open conversion with device explantation. The reported mortality rate for elective explantation varies between 0% and 14%, while acute conversion for rupture has a very dismal prognosis with a 67 -75% mortality rate.Conclusion: It is recommended that all patients in whom a Nellix device has been implanted should be identified, properly informed, and enrolled in enhanced surveillance. If device failure is detected, early elective device explantation should be considered in surgically fit patients
Focused update on patients treated with the nellix endovascular aneurysm sealing (EVAS) system from the european society for vascular surgery (ESVS) abdominal aortic aneurysm clinical practice guidelines
No full textObjective: After alerts on Endovascular Aneurysm Seal (EVAS) failure were raised, the European Society for Vascular Surgery (ESVS) Abdominal Aortic Aneurysm (AAA) Clinical Practice Guidelines Writing Committee (WC) initiated a task force with the aim to provide guidance on surveillance and management of patients with implanted EVAS devices. Methods: Based on a scoping review of risk for late serious aortic-related adverse events in patients treated with EVAS for AAA, the ESVS AAA Guidelines WC agreed on recommendations graded according to the European Society of Cardiology (ESC) grading system. Results: EVAS has a very high incidence of late endograft migration resulting in proximal type 1 endoleak with risk of rupture, requiring open conversion with device explantation. The reported mortality rate for elective explantation varies between 0% and 14%, while acute conversion for rupture has a very dismal prognosis with a 67 – 75% mortality rate. Conclusion: It is recommended that all patients in whom a Nellix device has been implanted should be identified, properly informed, and enrolled in enhanced surveillance. If device failure is detected, early elective device explantation should be considered in surgically fit patients.On behalf of the ESVS AAA Guidelines Writing Committee, the ESVS Guidelines Steering Committee.</p
Editor's Choice – European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on Antithrombotic Therapy for Vascular Diseases
No full textPeer reviewe
Современные представления о месте ацетилсалициловой кислоты в лечении больных с различными проявлениями атеротромбоза
No full textThe review is devoted to the analysis of the significance of acetylsalicylic acid (ASA) in the primary and secondary prevention of various manifestations of atherothrombosis. The results of the ARRIVE, ASPREE and ASCEND studies are considered, based on which the evidence base for the use of reduced low-dose ASA (75-100 mg) for primary prevention of cardiovascular diseases (CVD), including patients with diabetes mellitus is formed. Nevertheless, the question of the significance of ASA in primary prevention of CVDs has not been finally resolved, because the results of the latest TIPS-3 study, published in 2020, showed that the combination of enteric-coated ASA with a polypill consisting of a statin and three hypotensive drugs, compared with placebo, reduces the frequency of cardiovascular episodes (CVEs) in individuals without CVDs but with average cardiovascular risk. ASA is an immutable component of dual antiplatelet therapy (DAPT) in patients with acute coronary syndromes (ACS), in patients with coronary heart disease, subjected to planned stenting. Recently, evidence has been obtained about the impact of bleeding on prognostic outcomes, so there is a clear trend to reduce the duration of aspirin therapy in patients with atrial fibrillation and ACS or undergoing planned stenting. A new trend is enhancement of ASA therapy with a second antithrombotic drug in patients with stable manifestations of atherothrombosis with high risk of thrombotic complications. Thus, modern recommendations suggest to enhance ASA therapy with a vascular dose of rivaroxaban (2.5 mg 2 p/day) or a P2Y12-receptor platelet inhibitor. ASA appears to be a classic antiaggregant and an essential partner for new antithrombotic drugs.Обзор посвящен анализу значимости ацетилсалициловой кислоты (АСК) в первичной и вторичной профилактике различных проявлений атеротромбоза. Рассмотрены результаты исследований последних лет: ARRIVE, ASPREE, ASCEND, на основании которых сформирована доказательная база применения сниженных малых доз АСК (75–100 мг) с целью первичной профилактики сердечнососудистых заболеваний (ССЗ), включая пациентов с сахарным диабетом. Тем не менее вопрос о значимости АСК в первичной профилактике ССЗ окончательно не решен, так как результаты последнего исследования TIPS-3, опубликованного в 2020 г., показали, что комбинация кишечнорастворимой АСК с полипилюлей, состоящий из статина и трех гипотензивных препаратов, по сравнению с плацебо снижает частоту сердечно-сосудистых эпизодов (ССЭ) у лиц без ССЗ, но имеющих средний сердечно-сосудистый риск. АСК является незыблемым компонентом двойной антитромбоцитарной терапии (ДАТТ) у больных острыми коронарными синдромами (ОКС), у пациентов с коронарной болезнью сердца, подвергнутых плановому стентированию. В последнее время получены доказательства о влиянии кровотечений на определяющие прогноз исходы, поэтому наметилась отчетливая тенденция к сокращению длительности периода лечения аспирином у пациентов с фибрилляцией предсердий и ОКС или подвергнутых плановому стентированию. Новое направление – усиление терапии АСК с помощью второго антитромботического препарата у больных со стабильными проявлениями атеротромбоза, имеющими высокий риск тромботических осложнений. Так, современные рекомендации предлагают усилить терапию АСК с помощью сосудистой дозы ривароксабана (2,5 мг 2 р/день) или ингибитора P2 Y12-рецепторов тромбоцитов. АСК представляется классическим антиагрегантом и важнейшим партнером для новых антитромботических препаратов
