Christian-Alexander Behrendt

University Medical Center Hamburg - Eppendorf · Department of Vascular Medicine

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...

Background: Previous epidemiological studies regarding the association between chronic periodontitis (CP) and carotid intima-media thickness (cIMT) and subclinical atherosclerosis have been inconclusive. Objective: The aim of this study was to determine whether CP is associated with subclinical atherosclerosis in a large population-based cohort...

Zusammenfassung Verfahren des maschinellen Lernens (ML) beruhen auf dem Prinzip, dass ein Algorithmus Muster und statistische Zusammenhänge in Datensätzen erkennt, diese in einem Modell abbildet und das Modell anschließend auf andere Datensätze anwenden kann. Neben den großen Chancen, die maschinelle Lernverfahren mit sich bringen, birgt diese Tech...

Purpose: To describe the technical aspects and early results of a new endovascular fenestration method for false lumen occlusion in chronic aortic dissection: the Knickerbocker Technique. Methods: A retrospective observational study including all consecutively treated patients between November 1, 2012, through May 31, 2016, who underwent thoraci...

Summary:Background: Even though nutrition was demonstrated to have an impact on chronic atherosclerotic disease, there is a paucity of corresponding recommendations for patients with peripheral artery disease (PAD). A Mediterranean Diet based on daily intake of fruits and vegetables with high fibre, vegetable oil, and unsalted nuts including fish s...

Objectives Females are at higher mortality risk after endovascular aortic repair. This study aimed to compare the 30-day and 12-month mortality, morbidity and re-intervention rates between sexes, treated with fenestrated or branched endovascular aortic repair (F/BEVAR). Design This meta-analysis was conducted according to PRISMA statement, and its...

Objective: The optimal revascularization modality following complete resection of aortic graft infection (AGI) without enteric involvement remains unclear. The purpose of this investigation is to determine the revascularization approach associated with the lowest morbidity and mortality using real-world data in patients undergoing complete excisio...

The impact of sex on the outcomes of patients with cardiovascular disease is still incompletely understood. The aim of this nationwide multicenter observational study was to investigate the impact of sex on post-operative outcomes in patients undergoing thoracic endovascular aortic repair (TEVAR) for intact thoracic aortic aneurysm (iTAA). The Fren...

Zusammenfassung Maschinelle Lernverfahren finden seit einigen Jahren in immer mehr Bereichen vielfältige Anwendung, wodurch die Relevanz der dabei verwendeten Techniken deutlich wird. Unter dem Begriff des maschinellen Lernens (ML, oft auch „künstliche Intelligenz“) existieren zahlreiche Algorithmen, die unterschiedliche Komplexität und verschieden...

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...

Purpose Currently there is no robust evidence which type of bridging stent graft provides better outcomes after branched endovascular aortic repair (BEVAR). Self-expanding (SESG) and balloon-expandable (BESG) stent grafts are both commonly used to connect branches to their respective target vessels (TV). The aim of the current review was to evaluat...

Zusammenfassung Obwohl Patient:innen mit einer peripheren arteriellen Verschlusskrankheit (PAVK) aufgrund ihres Komorbiditäts- und Risikoprofils ein insgesamt erhöhtes Blutungsrisiko aufweisen, standen bisher keine validierten Werkzeuge zur Vorhersage des Blutungsrisikos zur Verfügung. Erschwerend kommt hinzu, dass viele randomisierte und kontrolli...

Objective The aim was to analyse whether the association between carotid atherosclerosis (CA) and atrial fibrillation (AF), heart function, and renal function is mediated by traditional risk factors. Methods In the prospective, single centre, long term, population based Hamburg City Health Study citizens, between 45 and 74 years of age were studie...

Background Sarcopenia is the loss of muscle mass and strength. It manifests as decreased core muscle area in axial abdominal computed tomography (CT) scans. The predictive value of sarcopenia in outcome research has been widely discussed. A systematic review was conducted to assess sarcopenia as a biomarker in patients undergoing endovascular abdom...

(1) Background: While tibial bypass surgery still plays a role in the treatment of patients with chronic limb-threatening ischemia and diabetic foot syndrome; only a few centers have recorded considerable numbers of these conditions. The current study aimed to determine contemporary practice with special focus on the performance of extra-anatomic g...

Background Due to an increasing life expectancy, more and more patients experience the failure of peripheral arterial revascularization. This study aims to investigate patients treated for the failure of infra-inguinal bypass grafts, and to investigate the interaction of different bypass materials [great saphenous vein (GSV) and polytetrafluoroethy...

Eine Läsion der A. brachialis im Rahmen der suprakondylären Humerusfraktur (SKHF) ist eine der häufigsten Gefäßverletzungen beim Kind. Da nicht jede Klinik, die diese kindliche Fraktur behandelt, über eine Gefäßchirurgie verfügt, stellt sich im Alltag oft die Frage, wie man bei Verdacht auf Gefäßläsion vorgeht. In der (nicht mehr gültigen) S1 Leitl...

Objective There is a paucity of evidence concerning the risk of bleeding after hospitalisation for symptomatic peripheral artery disease (PAD) in everyday clinical practice, as randomised clinical trials commonly exclude patients with heightened risk. The current study aimed to develop a pragmatic risk score that enables prediction of major bleedin...

Background: Broadly available digital and mobile health applications (also known as mHealth) have recently gained increasing attention by the vascular community, but very little is known about the dissemination and acceptance of such technologies in certain target populations. The current study aimed to determine the user behaviour and acceptance...

Aims Long-term sequelae may occur after SARS-CoV-2 infection. We comprehensively assessed organ-specific functions in individuals after mild to moderate SARS-CoV-2 infection compared with controls from the general population. Methods and results Four hundred and forty-three mainly non-hospitalized individuals were examined in median 9.6 months aft...

Zusammenfassung Die periphere arterielle Verschlusskrankheit (PAVK) gilt als Volkskrankheit mit weltweit mehr als 230 Mio. Betroffenen und schlechter Prognose. Durch den systemischen und progressiven Charakter der Atherosklerose sowie den Befall vieler Gefäßbereiche ist neben dem Risiko für gefäßbedingte Amputationen auch die generelle Lebenserwart...

Extracorporeal membrane oxygenation (ECMO) is potentially lifesaving for patients with acute respiratory distress syndrome (ARDS) but may be accompanied by serious adverse events, including intracranial hemorrhage (ICRH). We hypothesized that ICRH occurs more frequently in patients with COVID-19 than in patients with ARDS of other etiologies. We pe...

Background: Ascending aorta and aortic arch diseases have an increasing interest among cardiovascular specialists regarding diagnosis and management. Innovations in endovascular surgery and evolution of open surgery have extended the indications for treatment in patients previously considered unfit for surgery. The aim of this systematic review of...

Objective To assess the association between long term risk of hospitalisation for heart failure (HHF) and lower extremity minor and major amputation (LEA) in patients initiating sodium glucose cotransporter 2 inhibitors (SGLT2i) suffering from type 2 diabetes and peripheral arterial disease (PAD). Outcomes were compared with patients without PAD an...

Background This systematic review sought to identify and summarize existing evidence for the impact of nutrition on the development, progression, and outcomes of peripheral artery disease (PAD). Methods We performed a systematic literature search of available studies published between January 1974 and December 2019. Randomized controlled trials (R...

Objective There is growing evidence of a female patient disadvantage in complex endovascular aortic repair using fenestrated and branched endografts (FB-EVAR) primarily related to peri-procedural events including ischaemic and access vessel complications. This study aimed to determine the impact of sex differences on treatment patterns, and in hosp...

There are increasing data prompting that SARS-CoV-2 infection and the COVID-19 pandemic are directly or indirectly associated with acute thromboembolic events. While the incidence of acutely ischaemic limb events in heterogeneous cohorts varied widely in the available literature, multiple studies revealed that deep vein thrombosis (DVT) and pulmona...

Purpose To compare outcomes between the elective, urgent, and emergent treatment of thoracoabdominal aortic aneurysms (TAAAs) with the t-branch off-the-shelf multibranched stent-graft. Methods All consecutive patients treated for TAAA using the t-Branch between September 2012 and June 2019 were included in the study. Patients were divided into thr...

Thirty years after the transition period, starting from 1989, Central and Eastern European countries (CEECs), representing one-fifth of the entire European population, share many historical, societal, political, economic, and cultural characteristics. Although accumulating data on coronary heart diseases and cerebrovascular diseases support these o...

INTRODUCTION Aortic graft infection remains a considerable clinical challenge, and it is unclear which variables are associated with adverse outcomes among patients undergoing partial resection. METHODS A retrospective, multi-institutional study of patients who underwent partial resection of infected aortic grafts from 2002-2014 was performed usin...

Background Post carotid blood pressure fluctuation and hypertension (PEH) are associated with increased risk for adverse outcome; there is limited evidence on the impact of eversion endarterectomy (E-CEA) versus conventional endarterectomy with patch closure (C-CEA) on postoperative blood pressure course. Patients and Methods In this retrospective...

Vor mehr als zwei Jahren, im Dezember 2018, löste eine Metaanalyse zu industriegesponserten randomisierten kontrollierten Studien (RCT) eine Welle von Diskussionen aus, die trotz einer gewissen Paclitaxel-Fatique bis heute anhalten. Mit einer zunehmenden Anzahl an Publikationen und Meinungen zum Thema ist es mittlerweile herausfordernd, eine qualif...

Background: Previous observational studies reported a wide variation and possible room for improvement in the treatment of patients suffering from symptomatic peripheral artery disease (PAD). Yet, systematic assessment of everyday clinical practice is lacking. A General Data Protection Regulation (GDPR) compliant registry was developed and used to...

Objective: To investigate the association between hospital volume and failure to rescue (FtR), after open (OAR) and endovascular (EVAR) repair of intact abdominal aortic aneurysms (AAA) among centers participating in the VASCUNET and International Consortium of Vascular Registries (ICVR). Summary background data: FtR (i.e., in-hospital death fol...

Background and aims We aimed to determine the association of carotid intima media thickness (CIMT), carotid plaques, and heart function with peak systolic velocity (PSV) of the common (CCA) and internal carotid artery (ICA) in a cross-sectional study. Methods In the population-based Hamburg-City-Health-Study participants between 45 and 74 years we...

Objective Outcomes for intact abdominal aortic aneurysm (AAA) repair vary over time and by healthcare system, country, and surgeon. The aim of this study was to analyse peri-operative mortality for intact AAA repair in 11 countries over time and compare outcomes by gender, age, and geographical location. Methods Prospective data on primary repair...

Objective The t-Branch, a standardized off-the-shelf multibranched stent-graft has been used for the treatment of elective and urgent cases in aortic disease. The aim of this study was to assess the early outcomes in terms of technical success, mortality and morbidity in >500 patients being treated with the t-branch device. Methods A two-center ret...

Introduction: The aim of this systematic review and meta-analysis is to assess the impact of accessory renal artery (ARA) coverage on renal function in terms of acute kidney injury (AKI), renal infarcts, chronic renal failure (CRF), and mortality in patients undergoing standard endovascular aortic aneurysm repair (EVAR) or endovascular repair of c...

Objectives: Peripheral arterial occlusive disease (PAOD) and periodontitis are common chronic diseases, which together affect almost 1 billion people worldwide. There is growing evidence suggesting a relationship between chronic inflammatory conditions such as periodontitis and PAOD. This study aims to determine an association between both entitie...

Quality improvement programs and clinical trial research experienced disruption due to the COVID-19 pandemic. Vascular registries showed an immediate impact with significant declines in second quarter vascular procedure volumes witnessed across Europe and the United States. To better understand the magnitude and impact of the pandemic, organization...

[Article in German] Although there is a paucity of valid population-based data concerning the prevalence and incidence of abdominal aortic aneurysms (AAA) in Germany, national screening studies in Sweden, the USA, and England suggest a prevalence of AAA of 1.5–3.6% among males over 65 years old. The treatment of patients with AAA in Germany is prov...

Treatment of aneurysms of the descending thoracic aorta has made significant progress in recent years. Endovascular therapy (TEVAR) is currently regarded as the gold standard for this aortic segment and enables the treatment even of older and sicker patient groups. There are currently five international guidelines covering the treatment of aneurysm...

More than half a century ago, pioneers from interventional radiology invented a new minimally invasive approach to treat atherosclerotic lesions of the lower extremity arteries. In 1964, an elderly lady suffering from ischaemic foot ulcers ineligible for bypass surgery understandably declined a primary amputation. Charles T. Dotter and his assistan...

Objective A previous study revealed a preliminary trend towards higher in-hospital mortality in patients emergently admitted with acute stroke during the COVID-19 pandemic in Germany. The current study aims to further examine the possible impact of a confirmed SARS-CoV-2 infection on in-hospital mortality. Methods This was a retrospective analysis...

Ein Erratum zu dieser Publikation wurde veröffentlicht: https://doi.org/10.1007/s00772-021-00752-6

Since first being detected in December 2019 in the City of Wuhan, China, a rapidly disseminating pandemic keeps the world in suspense. While observational data on coronavirus disease 2019 (COVID-19) is still limited by its low validity and remarkable differences in screening and treatment patterns, COVID-19 vaccines are currently being divided up b...

Introduction 3D printing has a wide range of applications in medicine. In surgery, this technique can be used for preoperative planning of complex procedures, production of patient specific implants, as well as training. However, accuracy evaluations of 3D vascular models are rare. Objectives Aim of this study was to investigate the accuracy of pa...

Currently, we are all living in dire straits not only because a global pandemic threw the world into turmoil. There is evidence for collateral damage particularly affecting patients with cardiovascular and cerebrovascular conditions. Certainly, another major health problem affected the same target population, and most of us might have forgotten tha...

Objective As open abdominal aortic aneurysm (AAA) repair (OAR) rates decline in the endovascular era, the endorsement of minimum volume thresholds for OAR is increasingly controversial, as this may affect credentialing and training. The purpose of this analysis was to identify an optimal centre volume threshold that is associated with the most sign...

Objective There are several reports addressing sex disparities in peripheral arterial occlusive disease (PAOD) treatment with inconclusive or even conflicting results. However, most previous studies have neither been sufficiently stratified nor used matching or weighting methods to address severe confounding. This study aims to determine disparitie...

Peripheral arterial occlusive disease (PAOD) is the manifestation of atherosclerosis as a systemic vascular disease. Worldwide there is an increasing prevalence of up to 10%, which increases with the aging of the population to 20% in patients over 70 years of age. Only 25% of patients with PAOD are symptomatic. Women tend to be diagnosed at an olde...

Vascular surgery patients older than 80 years have been seen more frequently in the clinical routine over the last years. This demographic change poses a challenge to medicine and will accompany us in the future. Many studies in recent years have provided evidence of a positive impact of revascularization in chronic critical limb ischemia; however,...

Zusammenfassung Die IDOMENEO-Studie wurde für vier Jahre durch den Gemeinsamen Bundesausschuss gefördert und hat sich intensiv mit der validen Nutzung von Routinedaten und Registerdaten zur Behandlung der peripheren arteriellen Verschlusserkrankung beschäftigt. Neben der Identifikation von geeigneten Qualitätsindikatoren war auch die Entwicklung un...

Cardiovascular societies have developed recommendations regarding the management of thoracic aortic diseases. While improvements in treatment have been observed during the past decade in regard to patient selection, thoracic endovascular aortic repair (TEVAR) and associated techniques, and high-volume centralization, the broad expansion of TEVAR ha...

Background: Randomized controlled trials have reported excess mortality in patients treated with paclitaxel-coated devices versus uncoated devices, while observational studies have reported the opposite. This study aims to determine the underlying factors and cohort differences that may explain these opposite results, with specific focus on sex dif...

Objective: Previous studies have showed a potential disadvantage of female patients who underwent abdominal aortic aneurysm (AAA) repair. The current study aims to determine sex-specific perioperative and long-term outcomes using propensity score matched unselected nationwide health insurance claims data. Methods: Insurance claims from a large G...