Manuel Miralles

Hospital Universitari i Politècnic la Fe

This study addresses the translation and linguistic validation of two questionnaires on quality of life (AneurysmDQoL) and treatment satisfaction (AneurysmTSQ) for Catalan and Spanish-speaking patients with abdominal aortic aneurysms. The translation and cross-cultural adaptation process involved several phases, including forward translations, back...

One of the most significant complications of diabetes mellitus is diabetic sensory neuropathy. A reduction in pain perception increases the risk of diabetic patients developing foot ulcers and requiring amputation, which in turn results in impaired mobility and a diminished quality of life. Despite recent advances in our understanding of the aetiol...

In diabetic foot injury prevention, no studies relate physical activity with the inflammatory response of the plantar tissues, evaluated by thermography and pressure distribution. These measurements are easy to be implemented in diabetic foot follow-up. The objective of this study was to analyze whether the plantar skin response, evaluated with the...

In this article, we explore the potential of artificial intelligence (AI) tools to improve doctor-patient communication, particularly in the reinterpretation of medical reports. We explore the use of chatbots, such as ChatGPT, to adapt and simplify complex medical texts for patients. We highlight the benefits of AI in improving the readability of r...

Introduction Abdominal aortic aneurysm (AAA) is a relevant clinical problem due to the risk of rupture of progressively dilated infrarenal aorta. It is characterized by degradation of elastic fibers, extracellular matrix, and inflammation of the arterial wall. Though neutrophil infiltration is a known feature of AAA, markers of neutrophil activatio...

Foot lesions are among the most frequent causes of morbidity and disability in the diabetic population. Thus, the exploration of preventive control measures is vital for detecting early signs and symptoms of this disease. Infrared thermography is one of the complementary diagnostic tools available that has proven to be effective in the control of d...

Globally, a leg is amputated approximately every 30 seconds, with an estimated 85 percent of these amputations being attributed to complications arising from diabetic foot ulcers (DFU), as stated by the American Diabetes Association. Peripheral arterial disease (PAD) is a risk factor resulting in DFU and can, either independently or in conjunction...

Foot lesions are among the most frequent causes of morbidity and disability in the diabetic population. Thus, exploration of means of preventive control are vital for detecting early signs and symptoms of this disease, Infrared thermography has been proven effective in the control of diabetic foot is among the complementary diagnostic tools availab...

Introduction: Our objective was to compare the in vitro efficacy of electrothermal bipolar [EB] vessel sealing and ultrasonic harmonic scalpel [HS] versus mechanical interruption, with conventional ties or surgical clips (SC), in sealing saphenous vein (SV) collaterals, during its eventual preparation for bypass surgery. Methods: Experimental in...

Purpose: The aim of this study was to assess the agreement of multiplanar reconstruction (MPR) and semiautomated central lumen line (CLL) analysis of abdominal aortic aneurysms (AAA), with 3 different software workstations (WS1, WS2, WS3) and 2 experienced practitioners as well as to analyze its eventual impact in graft selection. Materials and m...

Introduction Marfan syndrome (MS) most often shows as thoracic aortic aneurysm (TAA) or aortic dissection, but it may also involve other vascular territories. Objective To identify those extra-thoracic vascular manifestations most frequently associated with MS. Methodology Systematic review of the literature with PRISMA criteria. The following da...

Background: Calcification and progression of atheromatous disease (AD) both have been independently related with the risk of stroke. However, the link between the two phenomena is still unclear. The main objective of this study was to analyze the temporal evolution of Ca content of carotid atheromatous plaques and its relation with the progression...

Thrombospondins are a family of matricellular proteins with a multimeric structure that is known to be involved in several biological and pathological processes. Their relationship with vascular disorders has raised special interest recently. Aortic aneurysms are related to the impairment of vascular remodeling, in which extracellular matrix protei...

Purpose: We present a hybrid technique for the treatment of chronic limb-threatening ischemia (CLTI) due to complex, multilevel infrainguinal disease. It consists of an open distal endarterectomy combined with endovascular proximal treatment (the DEEP technique). Materials and Methods: This was a prospective cohort study. Thirty-three limbs (30 pat...

Use of the term endotension in the treatment of aortic aneurysm is currently controversial. Initially it was proposed to define the circumstance in which there is an enlargement of the aneurysm sac after endovascular repair without a demonstrable endoleak. The term was established with the aim of transmitting the possibility of causes other than pr...

Objectives Chronic limb-threatening ischemia (CLTI) is frequently due to multilevel, heavily calcified lesions, and it is often associated with desert foot. Effective revascularization currently presents an additional challenge due to the increasing age, comorbidities, and frailty related to these patients. Pure endovascular treatment often fails t...

Carotid patch infection is a rare but dreaded complication after endarterectomy. About 160 cases can be found in literature, but presentation in a patient with post-endarterectomy stenting has not been reported. Most frequent clinical manifestations include the occurrence of a sinus, a pseudoaneurysm, or neck swelling, but in severe cases it may pr...

Background Chronic lower limb ischemia develops earlier and more frequently in patients with type 2 diabetes mellitus. Diabetes remains the main cause of lower-extremity non-traumatic amputations. Current medical treatment, based on antiplatelet therapy and statins, has demonstrated deficient improvement of the disease. In recent years, research ha...

Background: Red cell distribution width (RDW) reflecting impaired erythropoyesis, has been associated with poor prognosis and mortality in several conditions. The aim of this study was to determine the relationship between RDW and the 5-year survival after the endovascular repair of abdominal aortic aneurysms (EVAR) and its ability to improve the...

During the last years, several kinds of Embolic Protection Devices (EPD) have been developed, with the aim of minimizing complication caused by thrombi generated during Carotid Artery Stenting (CAS). These devices are capable of capturing small particles generated during the intervention, avoiding cerebral stroke and improving the outcomes of the s...

Background Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disab...

Objective Endovascular techniques have become an essential tool for the treatment of descending thoracic aortic disease (thoracic endovascular aneurysm repair [TEVAR]). The aim is to analyze the indications and outcomes of emergency TEVAR at national level in relation to elective surgery. Study design and scope A retrospective multicenter registry...

Background: To analyze the appropriateness of the type of repair (open or endovascular) performed for abdominal aortic aneurysm (AAA) in five university hospitals in Spain, according to evidence-based recommendations. Methods: A multicenter, retrospective cross-sectional study of patients with AAA who underwent elective open surgical repair (OSR...

Background: Chronic lower limb ischemia develops earlier and more frequently in patients with type 2 diabetes mellitus. Diabetes remains the main cause of lower-extremity non-traumatic amputations. Current medical treatment, based on antiplatelet therapy and statins, has demonstrated deficient improvement of the disease. In recent years, research h...

Marfan syndrome (MFS) is a systemic connective tissue disorder caused by mutations in the fibrillin‐1 (FBN1) gene, and cardiovascular involvement is the leading cause of mortality. We sought to examine the genotype/phenotype realtionship in 61 consecutive patients with a phenotype and genotype compatible with MFS. The FBN1 gene was analyzed by mass...

Objectives We present the technical description and preliminary results of a hybrid approach for the treatment of chronic total occlusions of superficial femoral artery in the setting of critical limb-threatening ischemia (CLTI). Methods A retrospective analysis of selected case series was performed. A trans-popliteal hybrid technique was carried...

[This corrects the article DOI: 10.3389/fimmu.2019.01151.].

Introducción: los dispositivos de protección embólica tipo red para procedimientos endovasculares carotídeos (DPEr) son de uso habitual. Su objetivo es disminuir el riesgo de embolia cerebral secundaria a la manipulación y rotura de placa. Sus diferentes características hacen sospechar un distinto comportamiento que puede afectar a su eficacia. Ob...

Paciente que presentaba una lesión en la región aquílea del miembro inferior derecho con exposición tendinosa y esfacelos, secundaria a decúbito tras inmovilización prolongada. Se evidenció oclusión femoropoplítea con Índice tobillo brazo de 0.36. Dada la complejidad de las lesiones, la no opción de revascularización y el alto riesgo de la paciente...

Abdominal aortic aneurysm (AAA) is a vascular disorder caused by a dilatation of the aortic diameter that can be potentially lethal in case of rupture. Molecular mechanisms underlying the development of AAA are complex and not completely understood. However, inflammation plays a pivotal role in AAA development. Infiltration of inflammatory cells, e...

microRNAs (miRNAs) are small RNAs that regulate different biological processes. Our objective was to identify miRNAs dysregulated in plasma and tissue of patients with abdominal aortic aneurysm (AAA) and explore new potential targets involved in AAA. Fifty-seven subjects were recruited for a plasma study (30 AAA patients, 16 healthy volunteers and...

Background Endovascular techniques have become an essential tool for treatment of thoracic aortic pathology (TEVAR). The objetive of this study is to analyze indications and results of TEVAR in Vascular Surgery Units, through a retrospective and multicentric national registry called Regis-TEVAR. Methods From 2012 to 2016, a total of 287 patients f...

Una endofuga se define como la persistencia de flujo sanguíneo en el saco aneurismático. Su incidencia es aproximadamente del 25% y aunque la mayoría cursan de forma “benigna”, en otros casos pueden provocar la presurización del aneurisma, aumentando su tamaño e incrementando el riesgo de ruptura. El objetivo de este estudio fue analizar la validez...

Objective: Endovascular techniques have become an essential tool for the treatment of descending thoracic aortic disease (thoracic endovascular aneurysm repair [TEVAR]). The aim is to analyze the indications and outcomes of emergency TEVAR at national level in relation to elective surgery. Study design and scope: A retrospective multicenter regi...

Activated protein C (APC) acts as an "on demand" anticoagulant, reducing thrombin formation. Reduced plasma levels of APC or protein C (PC) are associated with an increased risk of venous thromboembolism. APC also displays cytoprotective functions and its therapeutic use has been evaluated in severe sepsis and is under evaluation in several disease...

Background: To assess potential variability in the clinical characteristics and treatment of patients undergoing elective surgery for abdominal aortic aneurysm (AAA) across five hospitals in Spain. Methods: Multicenter, retrospective cohort study of patients diagnosed with AAA and treated with open surgical repair (OSR) or endovascular aneurysm...

Cell therapy is a progressively growing field that is rapidly moving from preclinical model development to clinical application. Outcomes obtained from clinical trials reveal the therapeutic potential of stem cell-based therapy to deal with unmet medical treatment needs for several disorders with no therapeutic options. Among adult stem cells, mese...

Neoplasias affecting the aorta are usually due to a variety of thoracic and abdominal tumors, which are more common than primary tumors of the aortic wall. Those tumors that can invade the abdominal aorta are usually sarcomas, which are able to mimic, both clinically and radiologically, an aortic disease such as an aneurysm or a dissection. There a...

Resumen Introducción Los microRNA (miR) son RNA de pequeño tamaño involucrados en la regulación de numerosos procesos biológicos. Debido a su estabilidad y a su capacidad para detectarse en fluidos, se han convertido en objeto de estudio como posibles biomarcadores de diferentes patologías. Objetivo Seleccionar un número reducido de miR candidato...

Available assays for circulating levels of activated protein C (APC) are either time-consuming or difficult to use in a routine laboratory, or have a detection limit above normal levels. We have developed a simplified assay that measures both the in vivo free APC and the in vivo APC complexed to PC inhibitor (PCI). We measured APC levels, with both...

Resumen Introducción La anemia es muy frecuente en los pacientes sometidos a cirugía vascular y puede influir en los resultados postoperatorios. Objetivos Evaluar la prevalencia de anemia en los pacientes intervenidos de cirugía arterial aortoilíaca e infrainguinal. Analizar la influencia de la anemia en la aparición de complicaciones postoperato...

Access for endovascular treatment of the superficial femoral artery (SFA) is usually gained through an antegrade approach from the ipsilateral common femoral artery (CFA), or by crossing over from the contralateral CFA. In this technical note, an alternative method, based on retrograde access of the ipsilateral iliac artery (IA), and conversion int...

The relationship between arterial calcification and osteoporosis has been referred to in several studies. However, its temporal relationship has scarcely been analyzed. Hypothesis: We assessed the hypothesis that temporal evolution of Ca content in the carotid bifurcation is related with densitometric variation in bone calcium mass, in order to ass...

1. To design a volumetric method for the assessment of carotid atheromatosis (CA) based on CT angiography and three-dimensional (3D) reconstructions. 2. To analyze the accuracy and optimal threshold values to differentiate between equivalent degrees of severity by duplex scanning and CT-angiography (MIP 2D) (internal carotid artery stenosis (ICS) <...

Introduction Carotid surgery on asymptomatic patients is still controversial. Its cost-effectiveness has been questioned due to the number of patients needed to treat to prevent a stroke, especially when compared with surgery on symptomatic patients. Objectives To analyse a series of patients, in a single centre, subjected to surgery due to asympt...

Introduction 1. To analyze the risk of death, complications and in-hospital stay in patients undergoing endovascular aneurysm repair (EVAR) and open repair (OR) of ruptured abdominal aortic aneurysms (RAAA). 2. To compare the accuracy of several risk-scoring models. 3. To identify predictors of outcomes. Material and methods A multicenter and retr...

The aim of this paper was to determine prevalence, cardiovascular risk factors and association with coronary heart disease (CHD) of isolated infrapopliteal arterial disease in old-adult men. Design: cross-sectional; participants: population-based sample of 699 men aged 55 to 74 years, measurements: cardiovascular history and risk factors, electroca...

Background and objectivesCritical leg ischemia (CLI) is a medical emergency with a high morbidity and mortality. Although its prognosis has improved during the last years, there are no data on its clinical characteristics, treatment and in-hospital prognosis in our country.Patients and method671 patients (81% males, mean age 71.2 years) with athero...

Critical leg ischemia (CLI) is a medical emergency with a high morbidity and mortality. Although its prognosis has improved during the last years, there are no data on its clinical characteristics, treatment and in-hospital prognosis in our country. 671 patients (81% males, mean age 71.2 years) with atherosclerotic CLI, attended in 46 departments o...

Upper limb arterial disease is less common that of lower limb, although the reason is not known exactly. Antiphospholipid Sindrome (AFLS) characterized by thrombotic complications, counts as one of the possible etiologies. A case is reported of a 35-years-old woman with an atypical AFLS debut and the thrombotic complications including postoperative...

La thrombo-angéite oblitérante (également connue sous le nom de maladie de Buerger) est une vasculopathie inflammatoire qui affecte les artères de petit et moyen calibre et les veines des extrémités. Il n’existe pas de traitement spécifique et la seule intervention efficace consiste en l’arrêt absolu de l’intoxication tabagique. Une dysfonction end...

Thromboangiitis obliterans (also known as Buerger's disease) is an inflammatory vascular disorder that affects small and medium-sized arteries and veins in the extremities. There is no specific treatment and the only effective intervention is absolute cessation of tobacco use. Endothelial dysfunction appears to be of relevance to this condition and...

The aim of this study was to assess the accuracy of CT-angiography for identification and measurement of calcification of carotid atherosclerotic plaques and to characterise the content and distribution pattern of mineral calcium (hydroxyapatite, Ca) in carotid bifurcations and investigate its relationship with neurological symptoms. Twenty-six pat...

Introdução A trombocitopenia induzida pela heparina (TIH) é uma complicação pouco frequente, mediada por imunoglobulinas e não dose-dependente. A suspeita de TIH secundária a profilaxia com heparinas raramente é considerada, embora as suas complicações possam ser igualmente graves. Caso clínico Homem de 52 anos de idade submetido electivamente a t...

Introduction. Heparin-induced thrombocytopenia (HIT) is an infrequent complication mediated by immunoglobulins and is not dosage dependent. Suspecting HIT to be secondary to prophylaxis with heparins is rarely considered, although its complications can be just as serious. Case report. A 52-year-old male who was electively submitted to a transpositi...

Introdução A descoberta de uma patologia subjacente da artéria renal, como consequência do desenvolvimento de explorações morfológicas pouco invasivas, pode supor no futuro um aumento da incidência da cirurgia extra-corpórea renovascular. Objectivo Revisão da nossa casuística em cirurgia ex-vivo em aneurismas da artéria renal (AAR) e avaliação det...

Introduction. The discovery of an underlying pathology affecting the renal artery, as a consequence of the development of non-invasive morphological explorations, may, in the future, lead to an increase in the incidence of extracorporeal renovascular surgery. Aims. The purpose of this study was to conduct a survey of our case mix of patients submit...

Endoluminal procedures are not particularly aggressive and, despite their lower permeability rates, can be used as an alternative to revascularisation with bypass techniques. Nevertheless, two basic issues must be addressed of both options are to be evaluated from a reasonable viewpoint. First, what immediate and long-term permeability from the pro...

Introdução. Os paragangliomas são tumores neuroectodérmicos poum frequentes, de carácter neurosecretor em 5% dos casos, que se associam a outras tumefacções endócrinas múltiplas. Mostram tendência para se tornarem malignos em 10% dos casos e possuem marcada apresentação familiar. Apresentamos um caso de paraganglioma localizado no corpo carotídeo (...

To assess the reporting quality variation of the abstracts accepted for oral presentation at the National Meetings of the SEACV (Sociedad Española de Angiologíay Cirugía Vascular, Spanish Society for Angiology and Vascular Surgery) during the last 10 years.Material and methods150 abstract forms were randomly selectedfrom the 1991-2000 period. All t...

Introduction. The paragangliomas are uncommon neuroectodermal tumours which are neurosecretory in 5% of cases, and associated with other multiple endocrine tumours. In 10% of the cases they become malignant, with a marked familial tendency. We report a case of paragangliomas of the carotid body (chemodectoma) associated with a paraganglioma in the...

Objectives. To assess the reporting quality variation of the abstracts accepted for oral presentation at the National Meetings of the SEACV (Sociedad Española de Angiología y Cirugía Vascular, Spanish Society for Angiology and Vascular Surgery) during the last 10 years. Material and methods. 150 abstract forms were randomly selected from the 1991-2...