Vascular Medicine - Science topic

Purpose Chronic post-thrombotic syndrome (PTS) is a frequent and disabling complication of deep vein thrombosis (DVT) with significant clinical impact. Endovascular stenting (EVS) has established itself as an effective technique but its availability remains limited to expert centers. We sought to identify the key determinants of our learning curve...

Lower-extremity peripheral artery disease (PAD) affects approximately 236 million people worldwide and at least eight million people in the United States (US). Despite availability of new therapies that prevent major adverse cardiovascular events (MACE), these and major adverse limb events (MALE) remain common and occur more frequently in people wi...

Objective The objective is to investigate the association of hyperuricaemia and hyperglycaemia with an increased risk of mortality in acute aortic dissection (AAD). Design Retrospective multicentre cohort study. Setting De-identified information of patients was collected from electronic medical records between 2010 and 2021 across five hospitals...

Background Abdominal aortic aneurysm (AAA) is a life-threatening condition in the elderly population. The insidious nature of AAA onset makes early detection difficult. Currently, there are few studies on changes in laboratory parameters during AAA development. Methods This study included 55 elderly patients with AAA who were admitted to the Depar...

Backgrounds The cardio-ankle vascular index (CAVI) is a new index of arteriosclerosis. The present study investigated the relationship between CAVI value and stroke in hypertension patients, especially the prevalence of stroke in patients with CAVI ≧9. Methods 735 patients (M/F 293/442) with or without hypertension from Department of Vascular Medi...

Isolated distal deep venous thrombosis (iDDVT) is an infra-popliteal DVT without pulmonary embolism (PE). It is a common condition, but its management remains debated. We conducted a survey distributed by email to the members of the French Society of Vascular Medicine, Thrombosis Canada, the Swiss Society of Angiology and INVENT-VTE research networ...

Premature coronary artery disease (CAD) in younger adults often arises from underrecognized risk factors such as elevated lipoprotein(a) (Lp(a)), a genetically determined lipoprotein with atherogenic and prothrombotic properties. We report a 45-year-old male with untreated hypertension, prior ischemic stroke, and significant tobacco use, who presen...

Haemophilia A (HA), defined by factor VIII (FVIII) levels ≤40 IU/dL, is a chronic condition with consequences beyond bleeding complications. Jan Astermark (Professor of Clinical Coagulation Medicine, Senior Consultant, and Head of Department of Translational Medicine, Lund University; and Department of Haematology, Oncology and Radiation Physics, S...

Objectives This systematic review examines prehospital and in-hospital delays in acute stroke care in Indonesia. Design Systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data sources We conducted a thorough search across 11 databases, ClinicalTrials.gov registries and three preprint repos...

Introduction Familial hypercholesterolaemia (FH) is a common genetic condition causing elevated low-density lipoprotein cholesterol levels, which increases the risk of premature atherosclerotic cardiovascular disease. Little is currently known about how persons with FH are counselled by their healthcare professionals regarding pregnancy and breastf...

Atrio-Ventricular Re-entrant Tachycardia (AVNRT) is a relatively uncommon form of supraventricular tachycardia in children under 10 years of age. It is particularly rare in patients with L-Transposition of the Great Arteries (L-TGA), especially within the pediatric demographic. In this report, we describe a case involving a child with concurrent At...

Critical limb ischemia (CLI) poses a substantial and intricate challenge in vascular medicine, necessitating the development of innovative therapeutic strategies to address its multifaceted pathophysiology. Conventional revascularization approaches often fail to adequately address the complexity of CLI, necessitating the identification of alternati...

Objectives: Vascular access (VA) stenoses play a significant role in the morbidity of the haemodialysed population. Classifications for diagnosis, assessment and proposal of treatment strategies can be useful clinical and methodological tools. This review aims to present a comprehensive summary and propose further methodological approaches. Design...

Objective This study aimed to assess the risk, incidence and predictors of venous thromboembolism (VTE) among patients admitted to the emergency department of tertiary hospitals in Addis Ababa city, Ethiopia. Design A multicentre hospital-based prospective follow-up study was conducted. Setting The study was conducted in three tertiary care hospi...

Background The spectrum of metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent, affecting 30% of the world’s population, with a significant risk of hepatic and cardiometabolic complications. Different stages of MASLD are accompanied by distinct gut microbial profiles, and several microbial components have been impli...

Ice cooling exposure (ICE) is an interesting, but little explored, technique used to examine human peripheral microcirculatory adaptive mechanisms. In this study, we compare in vivo perfusion changes assessed by laser Doppler flowmetry (LDF) during post-occlusive reactive hyperemia (POHR) and ICE procedures. Eleven healthy women, 29.3±7.3 years old...

### Abstract This chapter provides an in-depth overview of advanced diagnostic tools in vascular medicine, referred to as *Propedêutica Arterial Armada*. It emphasizes the integration of modern technologies, such as ultrasonography, angiography, and tomography, with traditional methodologies to enhance diagnostic accuracy for arterial pathologies....

Background: The most common cause of death in patients with peripheral artery disease (PAD) are major adverse cardiovascular events (MACEs), including myocardial infarction (MI) and stroke. However, data on biomarkers that could be used to help predict MACEs in patients with PAD to guide clinical decision making is limited. Angiogenesis-related pro...

Background/Objectives: The leading cause of death for people with peripheral artery disease (PAD) is major adverse cardiovascular events (MACE), including heart attacks and strokes. However, research into biomarkers that could help predict MACE in patients with PAD has been limited. Immunomodulatory proteins are known to significantly influence sys...

Background Previous studies have reported a protective effect of type 2 diabetes on the incidence and progression of aortic aneurysms. We investigated whether this protective effect extends to aortic dissections. Methods Data from the US Nationwide Readmission Database (2016–2019) were analyzed. Patients admitted for open surgery repair of acute t...

Zusammenfassung Die im September 2024 veröffentlichten Leitlinien der European Society of Cardiology (ESC) zur peripheren arteriellen Verschlusskrankheit (pAVK) und zu aortalen Erkrankungen bilden erstmals Empfehlungen für beide Krankheitsbilder in einem gemeinsamen Leitliniendokument ab. Die Zusammenführung von pAVK- und Aortenleitlinien folgt ein...

Hemodialysis vascular access profoundly impacts the quality of care for chronic kidney disease (CKD) patients worldwide, with arteriovenous fistulas (AVFs) preferred for superior outcomes. Despite global guidelines, Sub-Saharan Africa, including Tanzania, faces challenges, by still relying on non-tunneled central venous catheters (CVCs) due to acce...

Zusammenfassung Hintergrund Bereits vor Jahren wurde von der interdisziplinär besetzten Arbeitsgruppe des Universitätsklinikums Magdeburg A. ö. R. eine „Standard Operating Procedure“ (SOP) zur postoperativen Schmerztherapie in der Allgemeinchirurgie veröffentlicht. Ziel Es wurde erweiternd eine Anpassung der „SOP – postoperative Schmerztherapie“...

La ecografía como herramienta diagnóstica económica, oportuna y de provecho en contextos de resucitación y emergencias se ha convertido en una herramienta no solo útil, sino necesaria tal y como lo ha sido un fonendoscopio. La Trombosis venosa profunda (TVP) y la embolia pulmonar (EP) son patologías susceptibles de ser evaluadas con ultrasonido. La...

Background Endovascular procedures are the preferred method for treating peripheral arterial disease. However, limited imaging options during these procedures, such as X‐rays and contrast media, expose patients and healthcare professionals to potentially harmful radiation. This study introduces a robotic ultrasound system (RUSS) for navigating endo...

Purpose of Review Peripheral Artery Disease (PAD), a condition affecting millions of patients, is often underdiagnosed due to a lack of symptoms in the early stages and management can be complex given differences in genetic and phenotypic characteristics. This review aims to provide readers with an update on the utility of machine learning (ML) in...

Perfusion asymmetries have been associated with vascular pathology. Physical activity is a component of vascular health. Here, we investigate the impact of a thirty-day regular home-based physical activity program in older individuals with multiple age-related comorbidities. Eleven participants of both sexes were included. Skin perfusion was assess...

May-Thurner syndrome (MTS) involves the compression of the left iliac vein between the right iliac artery anteriorly and the lumbar vertebrae posteriorly. Patients may remain asymptomatic throughout their lives or experience unilateral lower limb swelling and symptoms of deep vein thrombosis (DVT), such as redness and pain in the limb, or features...

Background We previously reported that in women with symptomatic pelvic venous insufficiency secondary to combined iliac vein stenosis (IVS) and ovarian vein reflux (OVR), treated with iliac vein stenting alone that 78% reported complete symptom resolution up to 6 months. The purpose of this investigation was to determine the long-term effectivenes...

Arterial disorders such as atherosclerosis, thrombosis, and aneurysm pose significant health risks, necessitating advanced interventions. Despite progress in artificial blood vessels and animal models aimed at understanding pathogenesis and developing therapies, limitations in graft functionality and species discrepancies restrict their clinical an...

A 19-year-old female presented with intermittent claudication without anatomical abnormality in the popliteal fossa on magnetic resonance imaging and computed tomography. However, duplex ultrasound (DUS) showed compression of the popliteal artery (PA) and vein during plantarflexion and dorsiflexion. She was diagnosed with functional PA entrapment s...

The field of vascular medicine has undergone a profound transformation in the 21 st century, transforming our approach to assessment and treatment. Athero-sclerosis, a complex inflammatory disease that affects medium and large arteries, presents a major challenge for researchers and healthcare professionals. This condition, characterized by arteria...

Abdominal aortic aneurysm (AAA) is a large-vessel disease with high mortality, characterized by complex pathogenic mechanisms. Current therapeutic approaches remain insufficient to halt its progression. Fungi are important members of the gut microbiota. However, their characteristic alterations and roles in AAA remain unclear. This study investigat...

Acute limb ischemia (ALI) due to arterial thromboembolic occlusion is a critical emergency in vascular medicine, requiring attention for rapid diagnosis and intervention, to prevent limb loss and major amputation, which is associated with patient disability in the long term. Traditionally, surgical embolectomy has been used for the treatment of ALI...

Background The decline in the mental well-being of young adults following an episode of venous thromboembolism may be related to the uncertainty of long-term health and fear of recurrence. In recent years, post-pulmonary embolism syndrome has gained acceptance, however, less attention has been given to the psychological impact on young patients aft...

La Dra. Diana Noemí García nació en la ciudad de Mar de Plata el 25 de septiembre de 1945, en el seno de una familia de padres argentinos de primera generación y de abuelos españoles, afincados en esa ciudad. Realizo sus estudios primarios (Escuela de estudios primarios Nro 31) y secundarios (Escuela San Vicente de Paul), ambos también en Mar del P...

Misdiagnosed and inadequately treated vasculogenic sexual dysfunction affects millions of females worldwide, highlighting the importance of a mostly overlooked pathology. Organic female sexual dysfunction, such as vaginal engorgement and clitoral erectile insufficiency, may be associated with hypogastric atherosclerosis. In the author’s vascular me...

Background The evolution of medical students population and their choices of medical residency is poorly documented in France. The objective of this study was to perform a retrospective analysis of medical students residency choices at their national ranking exam (NRE) once they have completed six years of theoretical and practical medical training...

Atherosclerotic cardiovascular disease (ASCVD) is the most important cause of morbidity and mortality worldwide. While it is traditionally attributed to lipid accumulation in the vascular endothelium, recent research has shown that plaque inflammation is an important additional driver of atherogenesis. Though clinical outcome trials utilizing anti-...

Purpose Robot-assisted systems offer an opportunity to support the diagnostic and therapeutic treatment of vascular diseases to reduce radiation exposure and support the limited medical staff in vascular medicine. In the diagnosis and follow-up care of vascular pathologies, Doppler ultrasound has become the preferred diagnostic tool. The study pres...

Objectives This study is to establish a nomination graph model for individualised early prediction of the 3-month prognosis of patients who had an acute ischaemic stroke (AIS) receiving intravenous thrombolysis with recombinant tissue plasminogen activator. Design For the period from January 2016 through August 2022, 991 patients who had an acute...

Engineered biomaterials are materials specifically designed to interact with biological systems for biomedical applications. This paper offers the comprehensive analysis of global clinical trial trends involving such materials. We surveyed 834 studies in the ClinicalTrials.gov database and explored biomaterial types, their initiation points, and du...

Introduction Peripheral vasodilation causes a redistribution of body temperature from the core to the periphery, resulting in shivering and hypothermia. These are normal pathological and physiological processes during spinal anaesthesia. Two drugs, norepinephrine and phenylephrine, have peripheral vasoconstrictive effects. It is unclear the effects...

Background Non-small cell lung cancer (NSCLC) has a poor prognosis. Transvascular intervention is an important approach for treating NSCLC. Drug-eluting bead bronchial artery chemoembolisation (DEB-BACE) is a technique of using DEBs loaded with chemotherapeutic drugs for BACE. This study aims to conduct a meta-analysis to comprehensively assess the...

This S2k guideline on venous leg ulcers was created on the initiative and under the leadership of the German Society of Phlebology and Lymphology (DGPL). The guideline group also consisted of representatives from the German Society for Phlebology and Lymphology, German Dermatological Society, German Society for General Medicine, German Society for...

Venous thromboembolism, commonly presented as pulmonary embolism and deep-vein thrombosis, is a paramount and potentially fatal condition with variable clinical presentation. Diagnosis is key to providing appropriate treatment in a safe and timely fashion. Clinical judgment and assessment using clinical scoring systems should guide diagnostic testi...

Background: Intermittent Claudication symptomatic peripheral arterial disease (ICSPAD) is associated with reduced mobility, functional capacity, and quality of life. Physical exercise is an effective non-pharmacological intervention for the management of ICSPAD. Adherence to exercise programs is challenging, due to the nature of the disease and the...

Background This study explores the comparison between Doppler ultrasound and multidetector CT angiography (MDCTA) in diagnosing peripheral arterial disease (PAD), emphasizing the urgent need for precise and minimally invasive methodologies in vascular medicine. PAD, stemming from atherosclerosis, manifests as reduced blood flow and symptoms, such a...

A 2002 óta működő Érsebészeti Regiszter kezdetben verőérműtétek adatainak gyűjtéséből és a beavatkozások eredményeinek elemzéséből állt. Nagy előrelépést jelentett 2006-ban az Európai Érsebész Társaság VASCUNET Munkacsoportjához történő csatlakozás, mely szervezet azóta globális nemzetközi tudományos együttműködéssé fejlődött. A hazai regiszter ada...

The healing of bone fractures is a well-known physiological process involving various cell types and signaling molecules interacting at the defect site to repair lost bone tissue. However, large bone defects meaning large tissue loss are a complicated problem in orthopedic surgery. In this chapter, we first present the bone treatment procedure and...

Objectives To compare catheter-related outcomes of individuals who received a tunnelled femorally inserted central catheter (tFICC) with those who received a peripherally inserted central catheter (PICC) in the upper extremities. Design A propensity-score matched cohort study. Setting A 980-bed tertiary referral hospital in South West Sydney, Aus...

Introduction Lymphoedema is a chronic condition caused by lymphatic insufficiency. It leads to swelling of the limb/midline region and an increased risk of infection. Lymphoedema is often associated with mental and physical problems limiting quality of life. The first choice of treatment is a conservative treatment, consisting of exercises, skin ca...

People living with HIV (PLWH) face a growing burden of chronic diseases, owing to the combinations of aging, environmental triggers, lifestyle choices, and virus-induced chronic inflammation. The rising incidence of pulmonary vascular diseases represents a major concern for PLWH. The study of HIV-associated pulmonary vascular complications ideally...

Aim: This study aimed to develop a TensorFlow Lite algorithm for angiography classification and to deploy it on a basic mobile smartphone device, thereby verifying the proof of concept for creating a comprehensive end-to-end mobile computer vision application for vascular medicine. Materials and Methods: After ethical approval by the local ethics c...

Introduction Intracranial aneurysm (IA) is a common cerebrovascular disease. Considering the risks and benefits of surgery, a significant proportion of patients with unruptured IA (UIA) choose conservative observation. Previous studies suggest that inflammation of aneurysm wall is a high-risk factor of rupture. Dimethyl fumarate (DMF) acts as an an...

Ischaemic diseases such as critical limb ischaemia and myocardial infarction affect millions of people worldwide¹. Transplanting endothelial cells (ECs) is a promising therapy in vascular medicine, but engrafting ECs typically necessitates co-transplanting perivascular supporting cells such as mesenchymal stromal cells (MSCs), which makes clinical...

Peripheral artery disease (PAD) continues to increase in prevalence worldwide due to risk factors such as advanced age, diabetes mellitus, and obesity. Critical limb ischemia (CLTI) is the advanced form of PAD that can result in a lack of healing and limb loss as the most devastating consequence. Patients with PAD, especially CLTI, benefit from mul...

Endovascular interventions and diagnostic examinations using iodinated contrast media (ICM) are standard of care in current vascular medicine. Although ICM use is generally considered safe, it may be associated with adverse reactions, vary from minor disturbances to rare, but severe life-threatening complications. This position paper of European So...

Background and Objectives: The clinical relevance of “corona phlebectatica” and the management of risk factors for recurrence of venous ulcers in patients with chronic venous disease may be variable based on vascular specialists in different geographical areas of Italy. The aim of the present survey is to evaluate the management of patients with ch...

Background: In vascular medicine, peripheral arterial disease (PAD) and diabetic foot syndrome (DFS) are often considered synonymous with respect to the need for revascularization. In PAD patients, clinical symptoms reflect the degree of atherosclerotic disease, since peripheral innervation, including pain sensation, is not usually compromised. In...

Objectives This study aimed to evaluate the predictive value of admission D-dimer levels for in-hospital mortality in patients with COVID-19 and acute ischaemic stroke. Design Cohort (prospective). Setting Tertiary referral hospital in the capital city of Indonesia conducted from June to December 2021. Participants 60 patients with acute ischaem...

Introduction International guidelines recommend that adults with peripheral artery disease (PAD) be prescribed antiplatelet, statin and antihypertensive medications. However, it is unclear how often people with PAD are underprescribed these drugs, which characteristics predict clinician underprescription of and patient non-adherence to guideline-re...

Spontaneous coronary artery dissection (SCAD) is an uncommon condition which is increasingly recognized as a cause of significant morbidity. SCAD can cause acute coronary syndrome and myocardial infarction (MI), as well as sudden cardiac death. It presents similarly to atherosclerotic MI although typically in patients with few or no atherosclerotic...

Background: Telemedicine is increasingly used in several fields of healthcare, including vascular medicine. This study aimed to investigate the views of experts and propose clinical practice recommendations on the possible applications of telemedicine in vascular medicine. Methods: A clinical guidance group proposed a set of 67 clinical practice re...

Cilostazol is a quinolinone-derivative selective phosphodiesterase inhibitor and is a platelet-aggregation inhibitor and arterial vasodilator for the symptomatic treatment of intermittent claudication (IC). Cilostazol has been shown to improve walking distance for patients with moderate to severe disabling intermittent claudication who do not respo...

Objectives To describe opportunities and challenges experienced from the four pharmacoepidemiological database studies included in the rivaroxaban post authorisation safety study (PASS) programme and propose ways to maximise the value of population-based observational research when addressing regulatory requirements. Design PASS programme of rivar...

Background Pythiosis is a rare disease with high mortality, with over 94% of cases reported from Thailand and India. Prompt diagnosis and surgery improves patient outcomes. Therefore, continuing professional development (CPD) is essential for early recognition. However, a needs assessment related to a pythiosis CPD program has not been performed....

Recent advances in therapy and the promulgation of multidisciplinary pulmonary embolism teams (PERTs) show great promise to improve management and outcomes of acute pulmonary embolism (PE). However, the absence of randomized evidence and lack of consensus leads to tremendous variations in treatment and compromises the wide implementation of new inn...

Statement of the Problem: Impairment of the blood coagulation system remains a relevant issue in clinical practice. A striking example of this is the fact that despite the administration of anticoagulant therapy, up to 35% of COVID-19 patients were hospitalized in the intensive care unit with thromboembolic complications. Prophylactic and therapeut...

Introduction Low-density lipoprotein cholesterol (LDL) is a known contributing factor to atherosclerotic cardiovascular disease (ASCVD) and a primary therapeutic target for medical management of ASCVD. Non-high-density lipoprotein cholesterol (non-HDL) has recently been identified as a secondary therapeutic target but is not yet widely used in vasc...

Embolization of de novo pulmonary arteriovenous malformations (PAVMs) using high-volume detachable non-fibered (HVDNF) coils was compared to traditional non-HVDNF coils. Persistent-occlusion rates were evaluated. A total of 272 de novo (previously untreated) PAVM treatments were retrospectively stratified into those treated with non-HVDNF coils onl...

Objective This meta-analysis aimed to demonstrate the effect of methylene blue (MB) in patients with distributive shock. Design Meta-analysis. Methods According to the Prospective International Register of Systematic Reviews (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched the relevant randomised contro...

Diabetes mellitus and related metabolic and vascular impairments are notable health problems. Fruits and vegetables contain phenolics that are beneficial to metabolic and oxidative health and useful in preventing associated disease. Scientific evidence has shown that some bioactive phenolics are more abundant in the non-edible parts (especially the...

Background Ethnobotanical research in Southeast Europe—one of the most important European hotspots for biocultural diversity—is significant for the acquisition of Traditional Ecological Knowledge related to plants as well as for encouraging the development of local environments. The current ethnobotanical research was conducted in the region of Mt...

Introduction Individuals with sickle cell disease (SCD) and central venous catheters (CVC) are at high risk for venous thromboembolism (VTE). Minimal data exist regarding the use of anticoagulation as thromboprophylaxis of VTE in this demographic, and as a result, clinical equipoise exists. Prophylactic dose rivaroxaban, a direct oral anticoagulant...

Angiology is an important and dynamic medical discipline that educates physicians to be well prepared to translate knowledge about vascular biology into management of patients with vascular diseases in clinical practice. Vascular diseases that are the subject of angiology include: atherosclerosis, thromboembolism, hypertension, vasculitis, vasospas...

Erythromelalgia (EM) is a rare disease, which is still poorly characterized. In the present paper, we compared the hand perfusion of one female EM patient, under challenges, with a healthy control group. Using a laser Doppler flowmeter (LDF) with an integrated thermal probe, measurements were taken in both hands at rest (Phase I) and after two sepa...

Cardiovascular medicine and practice in recent times have evolved as complex procedures are performed to manage difficult cases. The majority of these interventions are done percutaneously in order to minimize patient risk. Additionally, training specialist in handling these interventions require a lot of exposure to them; as such, patients are at...

Introduction. As of today, acute cerebrovascular accident is still the most important medical and social challenge in the modern society, due to its high growth rates of morbidity, disability, and mortality. A highly proven method of ischemic stroke treatment is reperfusion therapy, including intravenous thrombolytic therapy and mechanical thrombus...

Objectives Today, the involvement of patients in their care is essential. As the population ages increases, the number of patients with chronic diseases is increasing. In the vascular medicine and surgery departments, patients are polymedicated and mostly suffer from several chronic diseases. Approximately 50% of patients with a chronic disease are...

Background The German Society for Vascular Surgery and Vascular Medicine ( Deutsche Gesellschaft für Gefäßchirurgie und Gefäßmedizin , DGG) represents over 3100 members. In addition to continuing education and professional policy positioning, an important area is the promotion of research and science as well as their visibility. The DGG has set up...