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Article ; Online: Double dosing or one extra drop? In response to

Chan, Yiu Che

2022 Volume 37, Issue 8, Page(s) 618

MeSH term(s)	Cyanoacrylates ; Femoral Vein ; Humans ; Saphenous Vein/diagnostic imaging ; Saphenous Vein/surgery ; Treatment Outcome ; Varicose Veins/therapy ; Venous Insufficiency
Chemical Substances	Cyanoacrylates
Language	English
Publishing date	2022-07-06
Publishing country	England
Document type	Letter
ZDB-ID	645172-x
ISSN	1758-1125 ; 0268-3555
ISSN (online)	1758-1125
ISSN	0268-3555
DOI	10.1177/02683555221112732
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Article ; Online: Reply.

Li, Hai-Lei / Chan, Yiu Che / Cheng, Stephen W

Journal of vascular surgery. Venous and lymphatic disorders

2024 Volume 12, Issue 3, Page(s) 101821

Language	English
Publishing date	2024-03-19
Publishing country	United States
Document type	Letter
ISSN	2213-3348
ISSN (online)	2213-3348
DOI	10.1016/j.jvsv.2024.101821
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Article ; Online: Efficacy and Durability of Percutaneous Deep Vein Arterialization: A Systematic Review.

So, Samuel E / Chan, Yiu Che / Cheng, Stephen W

Annals of vascular surgery

2024 Volume 105, Page(s) 89–98

Abstract: Background: Endovascular deep vein arteriaization (DVA) is a novel technique aimed at salvaging peripheral arterial disease unamenable to conventional surgical intervention. This study aims to review contemporary literature on the efficacy, safety, and ... ...

Abstract	Background: Endovascular deep vein arteriaization (DVA) is a novel technique aimed at salvaging peripheral arterial disease unamenable to conventional surgical intervention. This study aims to review contemporary literature on the efficacy, safety, and durability of DVA on patients with no-option critical limb ischemia (NO-CLI). Methods: The study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, using predefined search terms of "percutaneous deep vein arterialization" or "percutaneous deep venous arterialization" in PubMed, Web of Sciences, OvidSP, and Embase. Only studies with 5 or more patients were included, and studies involving open or hybrid DVA were excluded. The primary outcomes included technical success and primary amputation rates. Secondary outcomes included rates of wound healing, complication, reintervention, and all-cause mortality. Results: Ten studies encompassing a total of 233 patients were included. Patients were primarily those deemed to have NO-CLI. The median follow-up period was 12 months (range 1-63 months). The technical success rate was 97% (95% confidence interval [CI] 96.2%-97.9%) and the major amputation rate was 21.8% (95% 21.1%-22.4%). The wound healing rate was 69.5% (95% CI 67.9-71.0%), complication rate was 13.8% (95% CI 11.7%-15.9%), reintervention rate was 37.4% (95% CI 34.9%-39.9%), and all-cause mortality rate was 15.7% (95% CI 14.1%-17.2%). Conclusions: Our study showed that endovascular DVA is safe for patients with NO-CLI. Nonetheless, studies were small with follow-up period of less than 1 year. There is currently lack of level 1 evidence to recommend routine use in patients with NO-CLI.
Language	English
Publishing date	2024-04-03
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2024.01.008
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Article ; Online: COVID-19 related thrombosis: A mini-review.

Cheng, Nicole M / Chan, Yiu Che / Cheng, Stephen W

Phlebology

2022 Volume 37, Issue 5, Page(s) 326–337

Abstract: Introduction: COVID-19 associated VTE is a new disease entity with high morbidity and mortality. The aim of this paper is to review contemporary emerging literature on the incidence, pathophysiology, predictive prognostic indicators, and management ... ...

Abstract	Introduction: COVID-19 associated VTE is a new disease entity with high morbidity and mortality. The aim of this paper is to review contemporary emerging literature on the incidence, pathophysiology, predictive prognostic indicators, and management consensus for Covid-19 related thrombotic complications, in particular DVT and PE. Methods: A literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. All searches were done via PubMed. References of review articles were further screened according to the exclusion criteria. Results: In total, 154 records were identified and 20 duplicates were removed. A final 68 articles were included in the qualitative analysis. COVID-19 related thrombosis can affect multiple organs of the body, presenting in the form of arterial or venous thrombosis such as ischemic stroke, myocardial infarction, mesenteric ischemia, limb ischemia, DVT, or PE. DVT and PE has an overall incidence of 6-26%, and severely ill COVID-19 patients have even higher incidence of thromboembolism. On the other hand, incidence of arterial thromboembolism is much lower with incidence of 0.7%-3.7%. D-dimer is found to be an independent risk factor, and IMPROVE score, Caprini score, and Padua score have all been used as predictors. International guidelines suggest the use of low molecular weight heparin (LMWH) or fondaparinux for prophylaxis of VTE, and therapeutic dosage of weight adjusted LMWH for treatment if confirmed diagnosis. Conclusions: Contemporary rapidly evolving evidence shows that COVID-19 associated thrombosis was a novel clinical entity, especially in severely ill COVID-19 patients. There are multiple society-driven guidelines only, but without any level 1 evidence for management regimen. The ideal dose for prophylaxis is not established and may vary depending on balance of bleeding and thrombosis risk. The risk of bleeding may be increased in patients in intensive care unit.
MeSH term(s)	Anticoagulants ; COVID-19/complications ; Hemorrhage/chemically induced ; Heparin, Low-Molecular-Weight ; Humans ; Pulmonary Embolism/epidemiology ; Thrombosis/epidemiology ; Thrombosis/etiology ; Venous Thromboembolism/prevention & control
Chemical Substances	Anticoagulants ; Heparin, Low-Molecular-Weight
Language	English
Publishing date	2022-04-10
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	645172-x
ISSN	1758-1125 ; 0268-3555
ISSN (online)	1758-1125
ISSN	0268-3555
DOI	10.1177/02683555211052170
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Zs.A 2538: Show issues

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Article ; Online: Trans-Cervical Endovascular Management of Saccular Aneurysm of the Extracranial Internal Carotid Artery Using a Self-Expanding Nitinol Base ePTFE Covered Stent.

Lai, Wai Yin / Chan, Yiu Che / Cheng, Stephen W

Vascular and endovascular surgery

2022 Volume 57, Issue 3, Page(s) 272–275

Abstract: Saccular aneurysm of the extracranial internal carotid artery is rare. We present a 56-year-old lady presented with a progressively enlarging pulsatile swelling over the right neck, and the right internal carotid artery aneurysm was successfully treated ... ...

Abstract	Saccular aneurysm of the extracranial internal carotid artery is rare. We present a 56-year-old lady presented with a progressively enlarging pulsatile swelling over the right neck, and the right internal carotid artery aneurysm was successfully treated with trans-carotid endovascular stenting of right common to right carotid artery using a self-expanding nitinol base ePTFE covered stent (COVERA Plus™ stent, Bard, Tempe, USA). The external carotid artery was prophylactically embolised to prevent back bleeding. New generation covered stents have consistently improved flexibility and conformability, and this is to our knowledge the first reported case in the world's literature of using this type of self-expanding nitinol base ePTFE covered stent in endovascular stenting of carotid artery aneurysms, with excellent short-term results.
MeSH term(s)	Female ; Humans ; Middle Aged ; Carotid Artery, Internal ; Treatment Outcome ; Aneurysm/therapy ; Stents ; Carotid Artery Diseases/therapy ; Endovascular Procedures
Chemical Substances	nitinol (2EWL73IJ7F)
Language	English
Publishing date	2022-11-18
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2076272-0
ISSN	1938-9116 ; 1538-5744
ISSN (online)	1938-9116
ISSN	1538-5744
DOI	10.1177/15385744221141216
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Zs.A 622: Show issues

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Article ; Online: Risk Factor Analysis and Long-Term Outcomes in Patients with Endovascular Revascularization for Intermittent Claudication or Chronic Limb-Threatening Ischemia.

Fung, Victor / Chan, Yiu Che / Cheung, Grace C / Cheng, Stephen W

Annals of vascular surgery

2022 Volume 89, Page(s) 261–268

Abstract: Background: The aim of this study is to review long-term outcome and identify risk factors for patients with peripheral arterial disease (PAD) with percutaneous transluminal angioplasty/stent as a primary treatment strategy for intermittent claudication ...

Abstract	Background: The aim of this study is to review long-term outcome and identify risk factors for patients with peripheral arterial disease (PAD) with percutaneous transluminal angioplasty/stent as a primary treatment strategy for intermittent claudication (IC) or chronic limb-threatening ischemia (CLTI). Methods: A retrospective cohort study with data collected prospectively from Clinical Data Analysis and Reporting System, departmental database, and Clinical Management System. All patients who underwent endovascular procedures for PAD between January 2011 and December 2020 were identified. The primary outcomes are overall survival and amputation-free survival. Predictive factors for OS and AFS were determined using Cox Model. Results: A total number of 640 patients with PAD (IC, n = 243; CLTI, n = 377) underwent endovascular percutaneous transluminal angioplasty/stenting for PAD from January 2011 to December 2020. Patients with CLTI had a significantly higher 30 days readmission rate (18.8% vs. 6.5%, P < 0.001), emergency reoperation within 30 days (3.4% vs. 0%, P = 0.002), and death within same admission (2.7% vs. 0%, P = 0.008) compared to IC patients. The overall survival and amputation-free survival rates were significantly lower in CLTI patients (P < 0.0001 and P < 0.0001, respectively). On Cox multivariate analysis, CLTI was strongly predictive of all-cause mortality and amputation (hazard ratio [HR] 2.33 and HR 14.92, respectively). In patients with CLTI, chronic kidney disease was an independent predictor of mortality and amputation (HR 1.66 and HR 2.36, respectively). Smoking and ischemic heart disease were also independent predictors of mortality in this subgroup (HR 2.06 and HR 2.43, respectively). Conclusions: Although patients with IC and CLTI both manifest from atherosclerotic occlusive disease of the lower limb arteries, these patients may have different clinical outcomes with significant mortality occurred in both IC and CLTI groups. In patients with IC, the risk of amputation was less than 1% at 5 years following revascularization.
MeSH term(s)	Humans ; Intermittent Claudication/diagnostic imaging ; Intermittent Claudication/therapy ; Chronic Limb-Threatening Ischemia ; Retrospective Studies ; Limb Salvage ; Ischemia/diagnostic imaging ; Ischemia/surgery ; Treatment Outcome ; Peripheral Arterial Disease/diagnostic imaging ; Peripheral Arterial Disease/therapy ; Risk Factors ; Endovascular Procedures ; Chronic Disease
Language	English
Publishing date	2022-09-24
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2022.09.038
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Zs.A 2882: Show issues

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Article ; Online: Methods and Outcomes of Endovascular False Lumen Embolization for Thoracic Aortic Dissection.

Li, Hai-Lei / Chan, Yiu Che / Jia, He-Yue / Cheng, Stephan W

Annals of vascular surgery

2022 Volume 85, Page(s) 371–382

Abstract: Background: To provide a contemporary review on endovascular false lumen (FL) embolization for thoracic aortic dissection (AD) and evaluate its early outcome.: Methods: A systematic literature review on FL embolization for thoracic AD from January ... ...

Abstract	Background: To provide a contemporary review on endovascular false lumen (FL) embolization for thoracic aortic dissection (AD) and evaluate its early outcome. Methods: A systematic literature review on FL embolization for thoracic AD from January 2003 to December 2020 was performed under the instruction of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Each article was analyzed using a standardized protocol including predefined demographic characteristics, perioperative mortality, and major complications. Results: A total of 29 papers with 229 patients were included into the analysis. The methods of FL occlusion used were the candy-plug technique, the knickerbocker technique, the "cork in the bottleneck" technique, and direct FL embolization with a combination of stent-grafts, coils, onyx, plugs, and glue. FL embolization procedure was performed in 79 patients (34.5%) with type A AD and 150 (65.5%) with type B AD. FL direct embolization was the most frequently used technique and it was applied in 198 (86.5%) patients. Candy-plug, knickerbocker, and "cork in the bottleneck" techniques were used in 26 (11.4%), 3 (1.3%), and 2 (0.9%) patients, respectively. Technical success was achieved in all patients except one (228/229, 99.6%) in which implantation of a stent to celiac trunk was not possible. There were 4 hospital deaths (1.7%). Neurological complications occurred in 6 patients (2.6%), including 4 (1.7%) spinal cord ischemia and 2 (0.9%) ischemic stroke. There were 1 (0.4%) iatrogenic retrograde dissection and 2 (0.9%) renal failure reported. The mean duration of follow-up was 16.5 months. There were 21 deaths (9.3%) during follow-up and 8 (3.6%) were aorta-related. Thirty three (14.7%) secondary interventions were performed. Five patients (2.2%) required an open completion thoracoabdominal procedure incorporating the stent-graft into the repair. Complete FL thrombosis was observed in 181 (80.4%) patients, 34 (15.1%) had partial thrombosis, and 10 (4.4%) had FL progression. Conclusions: FL embolization of the distal thoracic aorta is a promising technique in a group of patients to promote FL thrombosis and aortic remodeling in thoracic aorta.
MeSH term(s)	Aneurysm, Dissecting/diagnostic imaging ; Aneurysm, Dissecting/surgery ; Aortic Aneurysm, Thoracic/diagnostic imaging ; Aortic Aneurysm, Thoracic/surgery ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; Endovascular Procedures ; Humans ; Retrospective Studies ; Stents ; Thrombosis/surgery ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2022-03-24
Publishing country	Netherlands
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2022.03.020
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Zs.A 2882: Show issues

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Article ; Online: Risk factor analysis and treatment outcome of patients with spontaneous isolated celiac axis or superior mesenteric artery dissection.

Hau, Siew Fung / Chan, Yiu Che / Cheung, Grace C / Cheng, Stephen W

Journal of vascular surgery

2022 Volume 77, Issue 1, Page(s) 150–157

Abstract: Background: Spontaneous isolated mesenteric artery (celiac axis or superior mesenteric artery [SMA]) dissection (IMAD) is a rare clinical entity. The aim of the present study was to examine the patient demographics, comorbidities, clinical and ... ...

Abstract	Background: Spontaneous isolated mesenteric artery (celiac axis or superior mesenteric artery [SMA]) dissection (IMAD) is a rare clinical entity. The aim of the present study was to examine the patient demographics, comorbidities, clinical and radiologic features, management, and prognosis and to identify the risk factors predictive of symptoms. Methods: We performed a single-center, retrospective review from November 2005 to November 2021 of prospectively collected data from patients with a diagnosis of IMAD. The clinical data and radiologic images were reviewed, and statistical analysis was performed to compare the symptomatic and asymptomatic groups. Results: A total of 78 patients were identified. Of the 78 patients, 24 (31%) had had celiac dissections, 51 (65%) had had SMA dissections, and 3 (4%) had had both celiac and SMA dissections. The mean age was 57.7 years (range, 36-84 years), with a male predominance (86%). More than one half (55%) of the patients had had hypertension. In addition, 29 patients (37%) were symptomatic, and 24 (31%) had been admitted to the hospital. The symptomatic patients with celiac axis dissections were more likely to have thrombosis (P = .02), significant stenosis (P = .01) or branch extension (P = .02). The symptomatic patients with SMA dissections were more likely to have a smaller artery diameter (P = .07), a longer dissection length (P = .05), thrombosis (P < .001), significant stenosis (P < .001), or branch extension (P = .003). The symptomatic patients were more likely to have been treated with antiplatelet or anticoagulant therapy (P < .001). Only three patients had undergone an intervention. Seven patients (9%) had died of unrelated causes. The Kaplan-Meier survival analysis showed a 5-year survival rate of 96% and 10-year survival rate of 91%. Conclusions: IMAD is an uncommon disease entity with a risk of visceral ischemia. Nonetheless, most of these patients can be treated conservatively with medication, with only a small minority requiring emergency surgery.
MeSH term(s)	Humans ; Male ; Middle Aged ; Female ; Mesenteric Artery, Superior/diagnostic imaging ; Mesenteric Artery, Superior/surgery ; Constriction, Pathologic ; Risk Factors ; Treatment Outcome ; Thrombosis ; Celiac Artery/diagnostic imaging ; Celiac Artery/surgery ; Retrospective Studies
Language	English
Publishing date	2022-09-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	605700-7
ISSN	1097-6809 ; 0741-5214
ISSN (online)	1097-6809
ISSN	0741-5214
DOI	10.1016/j.jvs.2022.08.036
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Zs.A 1933: Show issues

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Article ; Online: Modification of protocol with one extra drop of endovascular cyanoacrylate improved closure rates in incompetent great saphenous veins.

Chan, Yiu Che / Cheung, Grace C / Ting, Albert C / Cheng, Stephen W

Phlebology

2022 Volume 37, Issue 6, Page(s) 425–431

Abstract: Introduction: Great saphenous vein diameter (GSV) of >8 mm was predictor of recanalization following Venaseal cyanoacrylate treatment. The aim of this study was to report our modified protocol with a single extra-drop for treatment for GSV>8 mm, and ... ...

Abstract	Introduction: Great saphenous vein diameter (GSV) of >8 mm was predictor of recanalization following Venaseal cyanoacrylate treatment. The aim of this study was to report our modified protocol with a single extra-drop for treatment for GSV>8 mm, and comparative duplex results in closure rates. Methods: Patients in our single-centre registry treated with Venaseal were followed up by serial duplex examinations at week 1 and month(s)- 1, 6, 12, 18, 24, and then annually. The primary endpoint was successful obliteration of the GSV, secondary endpoints were closure distance from Saphenofemoral junction (SFJ), presence of endovenous glue-induced thrombosis (EGIT) or deep vein thrombosis. Results: A total of 243 legs in 123 consecutive patients with duplex-proven SFJ/GSV incompetence were included in this study between September 2014 and October 2020. The median duplex follow-up period of this cohort of patients was 24 (range 0.2-58) months. Comparing closure rates in GSV diameter ≥8 mm treated with normal protocol, the 'extra-drop protocol' significantly improved closure rates ( Conclusion: Our experience showed that VenaSeal cyanoacrylate worked best in GSV<8 mm diameter. Even in GSV diameter of ≥8 mm which has a higher recanalization rate on follow-up duplex, our modified extra-drop protocol significantly improved the closure rates, and did not predispose to development of EGIT.
MeSH term(s)	Cyanoacrylates ; Femoral Vein ; Humans ; Saphenous Vein/diagnostic imaging ; Saphenous Vein/surgery ; Treatment Outcome ; Varicose Veins/diagnostic imaging ; Varicose Veins/therapy ; Venous Insufficiency/diagnostic imaging ; Venous Insufficiency/therapy
Chemical Substances	Cyanoacrylates
Language	English
Publishing date	2022-03-26
Publishing country	England
Document type	Journal Article
ZDB-ID	645172-x
ISSN	1758-1125 ; 0268-3555
ISSN (online)	1758-1125
ISSN	0268-3555
DOI	10.1177/02683555221082358
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Zs.A 2538: Show issues

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Article ; Online: Effectiveness and Safety of Endoanchors in Abdominal and Thoracic Endovascular Aneurysm Repair: A Systematic Review and Meta-analysis.

Tang, Esther Wai Chi / Lau, Arthur Chak Kai / Cheng, Joshua Cheuk Hei / Wong, Joseph Chi-Yeung / Chan, Yiu Che

Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists

2024 , Page(s) 15266028241245911

Abstract: Purpose: This systematic review aimed to summarize the effectiveness and safety of endoanchor, a stabilizing device for the proximal endograft designed to prevent endoleak and stent migration in endovascular aneurysm repair (EVAR) and thoracic ... ...

Abstract	Purpose: This systematic review aimed to summarize the effectiveness and safety of endoanchor, a stabilizing device for the proximal endograft designed to prevent endoleak and stent migration in endovascular aneurysm repair (EVAR) and thoracic endovascular aneurysm repair (TEVAR). Materials and methods: A systematic review and meta-analysis was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. Literature up to May 31, 2023 was searched and independently screened from 4 databases. Data were pooled for meta-analysis. Primary outcomes included intraoperative and follow-up endoleak, stent migration, and reintervention rates; sac regression; and 30-day all-cause mortality. Results: Sixteen EVAR (n=1145) and 6 TEVAR studies (n=163) using the Heli-Fx EndoAnchor system were included from 2225 retrieved records. For EVAR patients (mean follow-up=11.9 months), the endoleak, graft migration, and reintervention rates were 3.97% (95% confidence interval [CI]=0.36%-1.99%), 0.004% (95% CI=0.00%-0.76%), and 5.43% (95% CI=0.86%-12.54%), respectively. The endoleak rates for primary and revision EVAR were 0.16% (95% CI=0.00%-1.65%) and 3.60% (95% CI=0.14%-9.72%), respectively. Only 4 cases of 30-day mortality (n=4) were reported in the literature. For TEVAR patients, the endoleak, stent migration, and reintervention rates were 7.4% (95% CI=0.03%-0.13%), 0.2% (95% CI=0.00%-0.06%), and 17.1% (95% CI=0.01%-0.45%), respectively. The 30-day mortality was 0.9% (95% CI=0%-0.12%). Conclusions: Endoanchor fixation in EVAR and TEVAR is effective and safe in preventing and treating endoleak and stent migration. The mortality is minimal in EVAR but higher in TEVAR. Clinical impact: Endoleak, graft migration, and reintervention in EVAR and TEVAR with endoanchor use were rare. Mortality in EVAR was low. The adjunctive deployment of endoanchors is an effective and safe means to prevent and treat endoleak and stent migration in EVAR and TEVAR. Yet, long-term efficacy and safety data and randomized controlled trials would be required to definitively recommend endoanchor use in routine clinical practice.
Language	English
Publishing date	2024-04-16
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2006618-1
ISSN	1545-1550 ; 1526-6028
ISSN (online)	1545-1550
ISSN	1526-6028
DOI	10.1177/15266028241245911
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