Christian-Alexander Behrendt

Asklepios Clinic Wandsbek · Department of Vascular and Endovascular Surgery

Background An increased cardiovascular risk profile in parous women in later life has been related to maternal outcomes of pregnancy such as hypertension, diabetes, excessive weight gain as well as fetal outcomes such as preterm birth or excessive birth weight. Methods Using data from a large, monocenter, prospective, long-term, population-based c...

Background Patients with abdominal aortic aneurysm (AAA) suffer a high risk of ischemic events associated with concomitant atherosclerotic cardiovascular disease, and current clinical practice guidelines recommend antiplatelet therapies to mitigate this risk. However, in patients with AAA and no symptomatic atherosclerosis, the benefit of antiplate...

Background Peripheral arterial disease (PAD) presents a substantial clinical and public health burden. It remains one of the most impactful cardiovascular conditions in terms of both number of affected individuals and its impact on the individual’s survival, functional ability, and quality of life. Nonetheless, comprehensive data on the risk of dev...

Background/Introduction Inflammation is recognized as a residual risk factor and mediator in patients with Atherosclerotic Cardiovascular Disease (ASCVD). High-sensitivity C-Reactive Protein (hsCRP), a marker of systemic inflammation, can be affected by modifiable risk factors (modRF). On the other hand, ASCVD and its extent might modify hsCRP leve...

Importance Patients with abdominal aortic aneurysm have a high risk of ischemic events associated with concomitant atherosclerotic cardiovascular disease, and current clinical practice guidelines recommend antiplatelet therapy to mitigate this risk. However, in patients with aneurysms without symptomatic atherosclerosis, the benefit of antiplatelet...

Background Multispectral optoacoustic tomography (MSOT), a molecular sensitive ultrasound, offers a non-invasive diagnostic approach to image the deep-tissue biomarkers. Objectives The authors aimed to investigate the diagnostic accuracy of MSOT to distinguish between healthy volunteers (HV) and patients with intermittent claudication (IC) by asses...

Diabetes related foot complications have become a major cause of morbidity and are implicated in most major and minor amputations globally. Approximately 50% of people with diabetes and a foot ulcer have peripheral artery disease (PAD) and the presence of PAD significantly increases the risk of adverse limb and cardiovascular events. The Internatio...

Background: Various sequelae have been described after nonsevere coronavirus disease 2019 (COVID-19), but knowledge on postacute effects on blood pressure is limited. Methods: This is a cross-sectional analysis of blood pressure profiles in individuals after nonsevere COVID-19 compared with matched population-based individuals without prior COVI...

Objective: ESVS guidelines endorse a minimum abdominal aortic aneurysm (AAA) repair volume of 20 open (OAR) and/or endovascular (EVAR) AAA repair procedures per year as a proxy for high quality care. In contrast, the SVS espouses 10 exclusively OARs per year. Given the differences in these volume standards and definitions, debate persists regardin...

Introduction: Peripheral artery disease (PAD) is associated with an increased likelihood of delayed or non-healing of a diabetes-related foot ulcer, gangrene, and amputation. The selection of the most effective surgical technique for revascularisation of the lower limb in this population is challenging and there is a lack of conclusive evidence to...

Objective: Peripheral arterial disease (PAD) trends remain unclear because contemporary data are sparse and conflicting. This nationwide cohort study quantified changes in PAD incidence, prevalence, and all-cause mortality, and projected prevalence development through to 2040. Methods: Population based registries covering the entire Danish popul...

Introduction: The presence of peripheral artery disease (PAD) confers a significantly increased risk of failure to heal and major lower limb amputation for people with diabetes-related foot ulcer (DFU). Determining performance of non-invasive bedside tests for predicting likely DFU outcomes is therefore key to effective risk stratification of pati...

As a progressive disease process, early diagnosis and ongoing monitoring and treatment of lower limb peripheral artery disease (PAD) is critical to reduce the risk of diabetes-related foot ulcer (DFU) development, non-healing of wounds, infection and amputation, in addition to cardiovascular complications. There are a variety of non-invasive tests...

Objective: There is a paucity of observational data including long term outcomes after invasive treatment for carotid artery stenosis. Methods: This retrospective study utilised nationwide insurance claims from the third largest provider in Germany, DAK-Gesundheit. Patients who underwent inpatient carotid endarterectomy (CEA) or carotid artery s...

Objective: The need for open surgical conversion (OSC) after failed endovascular aortic aneurysm repair (EVAR) persists, despite expanding endovascular means for secondary intervention. The VASCUNExplanT project collected international data in order to identify risk factors for failed EVAR, as well as OSC outcomes. This retrospective cross-section...

The field of vascular registry-based research has rapidly developed during the last few decades. Increasingly more and continuously growing data sources are becoming available for heterogeneous projects of quality improvement and health services research. Innovative methods of data analysis in the field of big data and machine learning open up new...

Purpose: Sarcopenia has been identified as an independent predictor of mortality in patients with infrarenal abdominal aortic aneurysm and may also affect outcomes in patients with complex aortic pathologies. The aim of this study was to assess sarcopenia, combined with the American Society of Anesthesiologists (ASA) score, as predictors for spina...

Introduction: Female sex is a risk factor of post-operative mortality and morbidity after abdominal aortic aneurysm (AAA) repair. The aim of this systematic review is to assess the sex-specific early mortality following both elective and urgent AAA repair. Evidence acquisition: The Preferred Reporting Items for Systematic Reviews and Meta-analys...

Background: Guidelines recommend comprehensive lifestyle change in patients with peripheral arterial disease (PAD) to prevent cardiovascular events and death. When compared with other populations, patients with PAD are less likely to receive best medical therapies (BMT). The aim of this pilot study was to integrate all aspects of BMT in an interven...

Background: To determine the physician's perspective and perception on walking exercise as well as barriers in guideline-directed best medical treatment of patients with lower extremity peripheral arterial disease (PAD). Patients and methods: All members of the German Society for Vascular Surgery and Vascular Medicine and of the German Society for...

The diagnosis of peripheral arterial disease (PAD) is not always evident as symptoms and signs may show great variation. As all grades of PAD are linked to both an increased risk for cardiovascular complications and adverse limb events, awareness of the condition and knowledge about diagnostic measures, prevention and treatment is crucial. This art...

Objective: It has been suggested that peri-operative complications after carotid surgery may be higher in women than in men. This assumption may affect the treatment patterns, and it is thus possible that carotid endarterectomy (CEA) is provided to women less often. The aim of the current VASCUNET study was to determine sex related differences in...

Objective: Antithrombotic strategies are currently recommended for the treatment of lower extremity artery disease (LEAD) but specific scores to assess the risk of bleeding in these patients are scarce. To fill the gap, the OAC3-PAD bleeding score was recently developed and validated in German cohorts. The aim of this study was to determine whethe...

Coffee, next to water the most widespread beverage, is attributed both harmful and protective characteristics concerning cardiovascular health. This study aimed to evaluate associations of coffee consumption with cardiac biomarkers, echocardiographic, electrocardiographic parameters and major cardiovascular diseases. We performed a cross-sectional...

The evidence-based guideline-compliant antithrombotic treatment of patients with peripheral arterial occlusive disease (PAOD) has for a long time been a challenge in the routine clinical practice of vascular specialists. For the first time in 2023 clinical practice guidelines of the European Society for Vascular Surgery (ESVS) that explicitly deal...

This population-based cross-sectional cohort study investigated the association of the Mediterranean and DASH (Dietary Approach to Stop Hypertension) diet as well as supplement intake with gray-scale median (GSM) and the presence of carotid plaques comparing women and men. Low GSM is associated with plaque vulnerability. Ten thousand participants o...

Background: Endovascular peripheral vascular intervention (PVI) has become the primary revascularization technique used for peripheral artery disease (PAD). Yet, there is limited understanding of long-term outcomes of PVI among women versus men. In this study, our objective was to investigate sex differences in the long-term outcomes of patients u...

Background: To report technical success as well as perioperative outcomes of patients who underwent endovascular aortic repair (EVAR) of penetrating abdominal aortic ulcers ≤35 mm in diameter (PAU). Patients and methods: The abdominal aortic aneurysm (AAA) quality registry of the German institute for vascular research (DIGG) was used to identify pa...

Objective: The goal of this study was to compare clinical outcomes in patients with peripheral arterial occlusive disease undergoing revascularisation by peripheral endovascular intervention (EVI), bypass surgery, endarterectomy (EA), and hybrid surgery in an unselected real world setting. Methods: This was a German, prospective, multicentre, co...

Background: To determine the adherence to supervised exercise training and underlying reasons for non-adherence amongst patients with inpatient treatment of symptomatic lower extremity peripheral arterial disease (PAD). Patients: This was a prospective questionnaire-based survey study of all consecutively treated inpatients with treatment for eithe...

Aims: Optimal endovascular management of intermittent claudication (IC) remains disputed. This systematic review and meta-analysis compares efficacy and safety outcomes for balloon angioplasty (BA), bare-metal stents (BMS), drug-coated balloons (DCB), drug-eluting stents (DES), covered stents, and atherectomy. Methods and results: Electronic dat...

Background: Extended downstream endovascular management has been applied in acute complicated type B aortic dissection (acTBAD), distally to standard thoracic endovascular aortic repair (TEVAR), using bare metal stents, with or without lamina disruption, using balloon inflation. The aim of this systematic review was to assess technical success, 30-...

Objective: To investigate the clinical characteristics, risk factors, and outcomes of inpatients with peripheral arterial disease (PAD) including lower extremity PAD, abdominal aortic aneurysm (AAA), and carotid artery disease in a large cohort of critically ill patients aged ≥ 90 years. Methods: A retrospective analysis was conducted of all adu...

Introduction There is a paucity of current figures on the prevalence of carotid and lower extremity peripheral arterial disease (PAD) and abdominal aortic aneurysm (AAA) as well as associated cardiovascular risk factors to support considerations on screening programmes. Methods In the population-based Hamburg City Health Study participants between...

Zusammenfassung Das Gehtraining gehört zu den wichtigsten Säulen der Behandlung der peripheren arteriellen Verschlusskrankheit (pAVK). Das Gehtraining in Gruppen unter Anleitung ist dabei besonders effektiv. In Deutschland ist ein flächendeckendes Angebot von Gehtrainingsgruppen nicht verfügbar. Von der Deutschen Gesellschaft für Gefäßchirurgie und...

Peripheral arterial disease (PAD) is one of the most common diseases in vascular medicine and is also considered an important risk marker for cardiovascular events and mortality. In addition to improving functionality and leg preservation, increasing health-related quality of life is also a primary treatment goal. Continuous measurement of patient-...

Hypertension is a global public health concern and an important contributor to cardiovascular disease. It remains disputed how important life circumstances are for the etiology of hypertension. Thus, the aim of this study is to assess the spatial variation of hypertension within an urban population and to investigate the association with the qualit...

The age pyramid in Germany is upside down. According to the Federal Statistical Office this development will continue in the coming years, which presents a challenge for surgeons to surgically treat increasingly more and increasingly older people. Particularly in vascular surgery, which is a surgery of old people, this fact represents a special cha...

Introduction There is a paucity of data on the relationship between hospital procedural volume and outcomes after inpatient treatment of symptomatic peripheral arterial disease (PAD). This study aimed to generate meaningful hypotheses to support the ongoing discussion. Methods Data derived from Germanys second largest insurance provider, BARMER, w...

Background Aortocaval fistula (ACF) secondary to an abdominal aortic aneurysm (AAA) is a rare complication, inadvertently caused by a rupture into the inferior vena cava. Different treatment modalities have been applied towards the repair of such lesions, including open surgical and endovascular repair. The aim of this study was to report on ACF tr...

Objective: To examine long-term outcomes after endovascular (EVAR) and open repairs (OAR) for intact abdominal aortic aneurysms (AAA) in Australia, Germany, and the US, using a unified study design. Summary background data: Similarities and differences in long-term outcomes after EVAR versus OAR across countries remain unclear, given differences...

Background: A controversy on bridging covered stent (BCS) choice, between self-expanding (SECS) and balloon-expandable (BECS) stents, still exists in branched endovascular repair. This study aimed to determine the primary target vessel (TV) patency in patients treated with the t-Branch device and identify factors impairing the outcomes. Methods:...

Background Proximal seal extension, after previously failed standard endovascular aneurysm repair (EVAR), has been described using various endovascular techniques. The aim of this systematic review was to assess technical success, 30-day mortality and mortality and re-intervention rates during the available follow-up, in patients managed with endov...

Background: Telemedicine has the potential to revolutionize healthcare. While the development of digital health technologies for the management of patients with cardiovascular diseases has been increasingly reported, applications in vascular surgery have been far less specifically investigated. The aim of this review is to summarize applications r...

Background Peripheral arterial disease (PAD) is a critical clinical and public health issue with a prevalence of >10% worldwide among adults ≥50 years. Whether this occurrence has been increasing, decreasing or stable over time remains a matter of debate as contemporary population data are sparse and conflicting. Purpose To quantify changes in PAD...

Background Coffee, next to water the most widespread beverage, is attributed both harmful and protective characteristics concerning cardiovascular health. This study aimed to evaluate associations of coffee consumption with cardiac biomarkers, echocardiographic, and electrocardiographic parameters as well as major cardiovascular diseases. Methods...

Objective To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. Methods An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services du...

We have all learned a great deal from the ongoing pandemic that has already taken more than five million lives in less than three years [...]

Background and Objectives It is uncertain whether there is an association of carotid plaques (CP) and flow velocities with peak-width mean diffusivity (PSMD) and white matter hyperintensities (WMH) independent of shared risk factors. We aimed to study this association controlling for biomarkers of inflammation and cardiac dysfunction as well as typ...

Aim: Aim of this study was to investigate the association between periodontitis and arterial hypertension, both of which show correlations with classical cardiovascular risk factors and inflammatory activity. Materials and methods: A cross-sectional analysis of data from a large population-based health survey (the Hamburg City Health Study, HCHS...

Objectives: Patients with peripheral arterial occlusive disease (PAOD) are at risk of worsening limb symptoms, major adverse cardiovascular events and exhibit an impaired life expectancy. There is a lack of evidence on the extent of pharmacological secondary prevention in PAOD patients. This study assesses treatment patterns of antithrombotic agen...

Vor etwa 40 Jahren, als nur etwa 1 % aller weltweit verfügbaren Informationen in digitaler Form gespeichert wurden, war an den Bedarf für ein gemeinsames europäisches Datenschutzrecht oder die strengere Reglementierung der Medizinproduktezulassung noch nicht zu denken [1]. Obwohl die interventionell-endovaskuläre Therapie der peripheren arteriellen...

Healthcare systems are confronted with major challenges [...]

Objective: The current study aimed to determine the relationship between chronic kidney disease (CKD) and major 12-month outcomes for patients with in-hospital treatment for symptomatic peripheral arterial occlusive disease (PAOD). Methods: An analysis of the prospective longitudinal multicentric cohort study with 12-month follow-up was conducte...

Objective This study aimed to develop a core set of patient-reported outcome quality indicators (QIs) for the treatment of patients with intermittent claudication (IC), that allow a broad international implementation across different vascular registries and within trials. Methods We utilized a rigorous modified two-stage Delphi technique to promot...

Fifty articles comprising 18 randomized controlled trials (RCTs), 16 observational studies, and 16 meta-analyses on the safety and effectiveness of sodium-glucose cotransporter 2 inhibitors were evaluated in the current review. Only one-fourth of the cohorts of recent trials had peripheral arterial disease (PAD), whereas this subgroup was at high r...

Objective Applications of artificial intelligence (AI) have been reported in several cardiovascular diseases but its interest in patients with peripheral artery disease (PAD) has been so far less reported. The aim of this review was to summarize current knowledge on applications of AI in patients with PAD, to discuss current limits and highlight pe...

Background Valvular heart diseases are frequent and increasing in prevalence. Minimally invasive heart valve surgery embedded in an interdisciplinary enhanced recovery after surgery (ERAS) program may have potential benefits with regard to reduced length of stay and improved patient reported outcomes. However, no prospective randomized data exist r...