Christian-Alexander Behrendt

Asklepios Clinic Wandsbek · Department of Vascular and Endovascular Surgery

Background Mitral regurgitation (MR) is the most common valvular heart disease in adults and is associated with increased morbidity and mortality. Treatment recommendations of degenerative MR have been liberalized, however, the role of asymptomatic patients is still insufficiently defined. Purpose The purpose of this study were to evaluate the pre...

Background Despite evidence-based guidelines recommending secondary prevention with antithrombotics and lipid-lowering therapies, adherence to optimal pharmacological therapies remains suboptimal in patients with symptomatic lower extremity peripheral arterial disease (PAD), potentially contributing to excess morbidity and mortality. However, the b...

Objective: The impact of sex on outcomes following carotid endarterectomy (CEA) and carotid artery stenting (CAS) is not fully elucidated. The aim of this study was to analyze the association between sex and outcomes of asymptomatic patients who underwent primary carotid interventions in France. Methods: This nationwide retrospective study was perf...

Background: Transfemoral access (TFA) is a valuable alternative to upper extremity access (UEA) for branched endovascular aortic repair (bEVAR). However, TFA requires large introducer sheaths, which can reduce blood flow to lower limbs and the pelvis. This study aimed to evaluate the efficacy of sheath downsizing to maintain lower limb perfusion du...

Background/Objective: To investigate the prevalence and effects of genetic variants (GVs) in survivors of thoracic aortic dissection/aneurysm repair. Methods: Patients aged 18–80 years who survived follow-up after cardiosurgical or endovascular repair of thoracic aortic aneurysm or dissection at a single tertiary center between 2008 and 2019 and un...

Background and aims The impact of mitral regurgitation (MR) in asymptomatic patients is not well defined. We aimed to determine the prevalence of MR-related complications and their association with 10-year survival in a large unselected asymptomatic MR cohort. Methods Health insurance claims data from Germany’s second largest health insurance fund...

Introduction Although major amputations can often be avoided due to evolving methods of endovascular and surgical revascularizations techniques, in patients with chronic limb-threatening ischemia, it is still necessary in some cases. Aim of this study was the detection of wound healing disorders through intraoperative microcirculation measurements...

Approximately 500 hospitals in Germany carry out the elective and emergency treatment of people with abdominal aortic aneurysms (AAA). A proportion of these hospitals are connected to a quality network under the umbrella of the German Society for Vascular Surgery and Vascular Medicine (DGG) to improve the quality of outcomes through rigorous benchm...

Background. Marfan syndrome (MFS) guidelines recommend optimal pharmacological therapy (OPT) and replacement of the ascending aorta (RAA) at 5.0cm diameters to prevent acute type A aortic dissection (ATAAD) and death. The effect of early MFS diagnosis and initiation of therapy on outcomes is not known. Objective. To evaluate the effect of age at MF...

Scientists had already considered several constructs of artificial intelligence (AI) in the first half of the last century. Due to the recent widespread popularity of chatbots and generative AI, these AI-based techniques have rapidly developed in both medical research and clinical use. The majority of cases of application in vascular surgery includ...

Background: Heritable connective tissue disorders are often accompanied by an increased risk for thoracic aortic aneurysm and dissection (TAAD). Profound knowledge of the underlying pathology may have an impact on individual treatment, systematic follow-up, and early detection by the screening of offspring. The aim of this study, based in a single...

Zusammenfassung Einleitung Die medizinischen Weiterentwicklungen in den vergangenen 15 Jahren und die veränderte Versorgungsrealität bei der flächendeckenden elektiven Behandlung des Bauchaortenaneurysmas machen eine Reevaluation der Qualitätssicherungsrichtlinie des Gemeinsamen Bundesausschuss in Deutschland (QBAA-RL) erforderlich. Diese fordert...

Body mass index (BMI) is seen as a predictor of cardiovascular disease (CVD) in lipedema patients. A valid predictor of CVD is increased aortic stiffness (IAS), and previous research described IAS in lipedema. However, it is not known if this applies to all patients. In this cross-sectional single-center cohort study, peripheral pulse wave velocity...

The heterogeneous clinical manifestations of peripheral arterial occlusive disease (PAOD) necessitate a systematic stepwise diagnostic procedure as well as a stage-related and realistic target-oriented treatment. Although preventive medical aspects in all stages of the disease are currently considered the foundations of complementary treatment befo...

Purpose Blunt thoracic aortic injury (BTAI) represents a potentially life-threatening condition and thoracic endovascular aortic repair (TEVAR) is recommended as the first-line treatment (Class I level of evidence C) by the current guidelines. The aim of this systematic review was to determine the perioperative and mid-term follow-up outcomes of pa...

Background: Smoking represents the well-known enemy of vascular well-being. Numerous previous studies emphasised the important role of smoking on the development and progression of atherosclerotic cardiovascular disease. The current study aimed to identify hurdles and barriers for an insufficient implementation of secondary prevention in the treatm...

Background: There is a paucity of evidence on people with thoracic aortic aneurysm and dissection. We aimed to determine the prevalence of genetic variants and their associations with phenotypes. Methods: In this cross-sectional single-centre cohort study of consecutive patients who underwent endovascular or open-surgical repair of thoracic aortic...

Diabetes mellitus is one of the cardiovascular risk factors for which the prevalence and incidence have increased worldwide in recent years. There are currently some 537 million people worldwide who suffer from diabetes mellitus. This disease with the diabetic foot syndrome also represents a challenge for the treating vascular surgeon. The diagnost...

Decreasing prevalences have been reported for abdominal aortic aneurysms for many years, whereby the median case number especially for open surgical treatment of aneurysms in decentralized healthcare systems was recently still only approximately 7 per year. Against the background of the dynamic developments over more than two decades with respect t...

Objectives: Predictive models for reintervention may guide clinicians to optimize selection, education and follow-up of patients undergoing endovascular iliac revascularization. While the impact of lesion- and device-related characteristics on iliac restenosis and reintervention risk is well-defined, data on patient-specific risk factors are scarce...

Background: There is a paucity of evidence on people with thoracic aortic aneurysm and dissection. We aimed to determine the prevalence of genetic variants and associations with phenotypes. Methods: In the current cross-sectional single centre cohort study of consecutive patients who underwent endovascular or open-surgical repair of thoracic aortic...

The inflammatory burden as measured by high-sensitivity C-reactive Protein (hsCRP) is recognized as a cardiovascular risk factor, which can however be affected by lifestyle-related risk factors (LRF). Up-to-date the interplay between hsCRP, LRF and presence and extent of atherosclerotic disease is still largely unknown, which we therefore sought to...

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...