International Angiology最新文献

{"title":"Role of carotid plaque analysis in therapeutic decision-making for carotid disease.","authors":"Ivan B Casella, Helio B Neto, Eduardo C Teixeira, José A Tavares Monteiro, Bruno D Constantin, Peter C Françolin, Thiago N Villari, Calógero Presti","doi":"10.23736/S0392-9590.25.05443-4","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05443-4","url":null,"abstract":"<p><p>Carotid atherosclerosis is an important yet declining etiology of embolic stroke and cerebrovascular or retinal ischemic events with an embolic source. The severity of stenosis is the most important anatomic factor for deciding whether to use optimized medical therapy alone or interventional therapy. Recently, specific features of the atherosclerotic plaque have attracted increasing attention; for example, total plaque area, juxtaluminal black area, intraplaque hemorrhage, and mainly echolucent plaques are associated with high risk of late stroke, and these features now influence the therapeutic choices. This review describes the current state of carotid plaque analysis using different image modalities and its effect on current guidelines and clinical practice.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of vasa vasorum in carotid stenosis.","authors":"Alexei V Svetlikov, Aleksandr S Shapovalov, Pyotr V Pigarevsky, Svetlana V Maltseva, Sergei V Lukin, Viktor S Gurevich","doi":"10.23736/S0392-9590.25.05445-8","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05445-8","url":null,"abstract":"<p><p>Carotid stenosis is a significant health concern, characterized by the narrowing of the internal carotid artery due to atherosclerotic plaque formation. It represents a major risk factor for ischemic stroke, which is remaining a leading cause of disability and mortality worldwide. The development and progression of atherosclerosis within the vascular wall involve the intricate interplay of several factors, including, in particular, the role of \"vessels of the vessels\" or \"vasa vasorum.\" Vasa vasorum are small blood vessels that play a crucial role in nourishing the walls of larger blood vessels, including the carotid arteries. Over the years, emerging evidence has suggested that vasa vasorum's involvement in atherosclerosis goes beyond a mere nutritional function. Dysfunctional vasa vasorum have been associated with intraplaque hemorrhage, local inflammation and atherosclerotic plaque destabilization, ultimately leading to stroke. The relationships between vasa vasorum functionality and carotid stenosis is becoming an active area of research in the field of clinical complications of atherosclerosis. This review aims to explore the current state of knowledge regarding the role of vasa vasorum in carotid stenosis and the potential implications for its risk stratification, diagnosis, and treatment.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Female sex and outcomes of symptomatic carotid stenosis revascularization.","authors":"Giulio Accarino, Gaetano Lanza, Umberto M Bracale, Jessica Lanza, Giulia Colonna, Maurizio Taurino, Pasqualino Sirignano","doi":"10.23736/S0392-9590.25.05428-8","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05428-8","url":null,"abstract":"<p><p>Since stroke continues to be a major worldwide cause of death and disability, its prevention and treatment have become increasingly significant to public health. Up to 20% of all strokes are caused by carotid artery disease (CAD). Carotid revascularization techniques such as carotid endarterectomy (CEA) and carotid artery stenting (CAS) are established procedures aimed at reducing stroke risk. Recent studies, while confirming their effectiveness, suggest that women may experience different and sometimes less favorable post-operative outcomes compared to men. These differences stem from factors including anatomy, physiology, hormones, and socioeconomics. Current clinical guidelines rarely include gender-specific recommendations, as women have historically been underrepresented in clinical trials. However, the limited literature on risk assessment for women with CAD highlights significant differences. In this narrative review, we explore the impact of sex-related differences in CAD, outcomes of revascularization, and patterns of diagnosis and referral. We also highlight the gaps hindering personalized medical approaches. We examine the influence of anatomical and physiological variations on procedural risks, analyze hormonal effects on vascular wall physiology, and address metabolic differences between genders. Additionally, we discuss specific perioperative considerations for women and review current guidelines, identifying controversial issues arising from the lack of gender-based evidence. A key objective of this review is to emphasize the importance of research into personalized therapeutic strategies, aiming to improve the understanding of gender-specific influences and ultimately enhance outcomes for women undergoing carotid revascularization.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for asymptomatic carotid stenosis: routine or selective?","authors":"Bruce A Perler","doi":"10.23736/S0392-9590.25.05400-8","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05400-8","url":null,"abstract":"<p><p>The current review discusses the advantages and disadvantages of routine vs. selective screening for asymptomatic carotid artery stenosis. The cost-effectiveness of screening programs is discussed. Furthermore, the rationale of offering selective screening, as well as the current recommendations regarding screening for asymptomatic carotid stenosis are presented. A selective screening strategy would identify individuals at high cardiovascular disease (CVD) risk early and would allow the timely initiation of conservative lifestyle measures and best medical therapy to prevent both stroke and CVD morbidity and mortality.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future in the management of patients with asymptomatic carotid artery stenosis.","authors":"Kosmas I Paraskevas, Sherif A Sultan, Ali F Aburahma, Wesley S Moore, Matthew Blecha, Piotr Myrcha, Clark J Zeebregts, Ales Blinc, Alun H Davies, Mario D'Oria, Mauro Gargiulo, Pavel Poredos, Alexei Svetlikov, Bruce A Perler, Seemant Chaturvedi, Gemmi Sufali, Luca Saba, Jens Eldrup-Jorgensen, Sean P Lyden, Carlo Setacci, Vincenzo DI Lazzaro, Tilman Reiff, Agnieszka Sawicka, Christos D Liapis, Gaetano Lanza, Gaia Spinetti, Antonino Bruno, Andrew N Nicolaides, Ankur Thapar, Maarten Uyttenboogaart, Arkadiusz Jawien, Dimitri P Mikhailidis, Francesco Spinelli, Francesco Stilo, Piotr Musialek, Victor Gurevich, Mauro Silvestrini, Young M Erben, Peter A Schneider, Gregory Y Lip, Christopher J White, Alan Dardik, James F Meschia, Mahmoud B Malas, Peter Gloviczki, Marc L Schermerhorn, Armando Mansilha","doi":"10.23736/S0392-9590.25.05401-X","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05401-X","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal management of patients with asymptomatic (AsxCS) and symptomatic carotid stenosis (SxCS) is still debatable. The present article will discuss emerging technological advances for the diagnosis and management of patients with AsxCS.</p><p><strong>Evidence acquisition: </strong>PubMed/MedLine was searched until December 31, 2024 for studies in English discussing emerging technological advances in the diagnosis and management of patients with AsxCS.</p><p><strong>Evidence synthesis: </strong>Several technological advances have recently been reported, among others, nanoplastics and microplastics, artificial intelligence and machine learning in predictive analytics for stroke prevention, digital twins for personalized monitoring, electronic tattoos for continuous non-invasive monitoring, stroke risk prediction through plaque morphology and late-phase contrast-enhanced ultrasound. A brief overview of each technological advance is presented and discussed.</p><p><strong>Conclusions: </strong>The technological advances discussed in the present article will aid the early diagnosis of AsxCS as well as the individualized optimal management of patients with AsxCS.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for asymptomatic carotid stenosis: routine or selective?","authors":"Bruce A Perler","doi":"10.23736/S0392-9590.25.05372-6","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05372-6","url":null,"abstract":"<p><p>Stroke is one of the most serious health care conditions in the western world. In the USA nearly 800,000 strokes occur annually and in the EU more than 1.1 million strokes occur each year. It has been estimated that in the United States, 66,000 of 600,000 first-time strokes, and in the UK 16,500 of 150,000 new strokes annually, occur secondary to thromboembolism from extracranial carotid disease, and many of these strokes occur in individuals who were completely asymptomatic until that stroke occurred. A simple diagnostic test, Duplex ultrasound, can identify significant internal carotid stenoses in patients with asymptomatic disease. However, routine screening of individuals is controversial. Tis commentary will discuss the pros and cons of routine screening for asymptomatic carotid disease.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking and lower extremity artery disease.","authors":"Pier L Antignani, Pavel Poredoš, Aleš Blinc, Matija Cevc, Agata Stanek, Arkadiusz Jawien, Armando Mansilha","doi":"10.23736/S0392-9590.25.05302-7","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05302-7","url":null,"abstract":"<p><p>Cigarette smoking is a major preventable risk factor for lower extremity arterial disease (LEAD) and is strongly associated with a higher risk of disease progression, worse post-procedural outcomes, and increased healthcare utilization. Smoking provokes the development of atherosclerotic through different mechanisms. Endothelial cell dysfunction, oxidative stress, inflammation, and arterial stiffness are among the key factors related to the development of atherogenesis due to smoking. Smoking cessation among patients with LEAD and the use of smoking cessation methods, including pharmacological treatment, are mandatory. Given that smoking cessation interventions remain underutilized. Therefore, in this narrative review we highlight the importance of incorporating smoking cessation treatments as part of the medical management of LEAD. Regulatory approaches to reduce tobacco use and support smoking cessation have the potential to reduce the burden of LEAD.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medium-term results of stenting with Hunter's canal fasciotomy for long femoropopliteal occlusions.","authors":"Alexey V Cheban, Olesya S Osipova, Pavel V Ignatenko, Alexandr A Gostev, Shoraan B Saaya, Andrey A Karpenko","doi":"10.23736/S0392-9590.25.05272-1","DOIUrl":"10.23736/S0392-9590.25.05272-1","url":null,"abstract":"<p><strong>Background: </strong>The present study investigates the hypothesis that fasciotomy of the Hunter's canal increases the mobility of the superficial femoral artery and reduces the risk of stent fracture. The objective of this study was to compare the long-term success of drug-eluting nitinol stents with and without a fasciotomy for patients with total femoropopliteal occlusion. The hypothesis is that fasciotomy of Hunter's canal can increase the mobility of the superficial femoral artery and reduce the incidence of stent breakage. The objective of this study was to compare the long-term patency of drug-eluting nitinol stents with and without fasciotomy in patients with total femoropopliteal occlusions.</p><p><strong>Methods: </strong>A randomized clinical trial was conducted in patients with femoral-popliteal stenococclusive lesions longer than 200 mm. Patients in group 1 (Zilver) underwent recanalization of the femoropopliteal artery occlusion with stenting. In the second group (ZilverFas), recanalization of the femoropopliteal occlusion with stenting and fasciotomy of Hunter's canal was performed. The follow-up evaluation of patency was conducted at 24 months.</p><p><strong>Results: </strong>The present study involved a total of 60 subjects. The primary patency at 24 months was 33% and 60% in the Zilver and ZilverFas groups, respectively (P=0.03). The freedom from target revascularization (TLR) in the Zilver and ZilverFas groups was 40% and 64%, respectively (P=0.1). The primary assisted patency at 24 months was 46.7% in the Zilver group versus 66.5% in the ZilverFas group (log-rank P=0.14) versus 46.7% in the Zilver group (log-rank P=0.14), while the 2-year secondary patency was 53.3% in the Zilver group compared to 69% in the ZilverFas group (log-rank P=0.24) compared to 53.3% in the Zilver group (log-rank P=0.24). In the Zilver and ZilverFas groups, the number of patients with stent failures was 14 and 7, respectively (P=0.05). In the Zilver and ZilverFas groups, the number of stents that fractured was 14 and 7, respectively (P=0.05). Multivariable Cox regression analysis revealed that fasciotomy significantly reduced the risk of reocclusion and restenosis by 2.1 times.</p><p><strong>Conclusions: </strong>The present study has demonstrated that decompression of the stented segment of the superficial femoral artery (SFA) with fasciotomy leads to a significant improvement in patency of the femoropopliteal segment and a substantial reduction in the number and severity of stent fractures.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"44 2","pages":"150-158"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Portal vein dilation in Klippel-Trenaunay and CLOVES syndromes.","authors":"Asma Maqsood, Jaime Alonso Sanchez, Gary Peiser, Aisling Carroll-Downey, Maria F Dien Equivel, Joao Amaral, Laura Willis, Manuel Carcao, Alessandro Gasparetto","doi":"10.23736/S0392-9590.25.05416-1","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05416-1","url":null,"abstract":"<p><strong>Background: </strong>Klippel-Trenaunay Syndrome (KTS) and congenital lipomatous overgrowth, vascular anomalies, epidermal nevi and skeletal abnormalities (CLOVES) syndrome are rare conditions associated with overgrowth and vascular anomalies more frequently involving the lower extremities. Although uncommon, these syndromes can be associated with portal vein (PV) abnormalities, including PV thrombosis, and PV hypertension. In this study, we describe additional findings of PV dilation in five patients with KTS or CLOVES.</p><p><strong>Methods: </strong>A single institution 20 year retrospective review was performed to evaluate PV findings in patients with vascular anomalies and overgrowth of the lower extremities. Two radiologists reviewed the imaging examinations (US, CT and MRI) and recorded type and location of vascular alterations.</p><p><strong>Results: </strong>Of 35 patients (25 females, 24 KTS, 7 CLOVES and 4 other, median age: 8.5 years) with available abdominal imaging, 5 patients had PV dilation and one PV thrombosis. All patients presented additional abdominal vascular anomalies in association.</p><p><strong>Conclusions: </strong>Systematic evaluation of the abdominopelvic region in patients with KTS and CLOVES can identify vascular anomalies, including PV dilation, which may indicate a prethrombotic state. Early detection and monitoring of these findings could have clinical implications for preventing complications such as portal hypertension and thrombosis.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"44 2","pages":"159-163"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute limb ischemia after occluded femoro-popliteal stents: a comparative analysis between endovascular revascularization vs. open bypass (FOCUS Study).","authors":"Giulia Bertagna, Nicola Troisi, Mario D'Oria, Mauro Gargiulo, Michele Antonello, Giovanni Pratesi, Stefano Michelagnoli, Roberto Silingardi, Giacomo Isernia, Gian Franco Veraldi, Giovanni Tinelli, Rocco Giudice, Arnaldo Ippoliti, Pierluigi Cappiello, Massimiliano Martelli, Sandro Lepidi, Raffaella Berchiolli","doi":"10.23736/S0392-9590.25.05366-0","DOIUrl":"10.23736/S0392-9590.25.05366-0","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to compare the early and medium-term outcomes of endovascular revascularization versus bypass for the treatment of occluded femoro-popliteal stents in patients with acute limb ischemia (ALI) (insights of the OUT-STEPP multicentric registry).</p><p><strong>Methods: </strong>Between January 2016 and December 2021, 317 patients in 14 centers underwent treatment for symptomatic femoro-popliteal In-Stent Occlusion (ISO). Sixty patients with ALI were included into the present study: 42 (70%) underwent endovascular revascularization (Group ENDO), and 18 (30%) underwent open bypass surgery (Group OPEN). Early (30 days) results were assessed and compared between the two groups. Estimated 5-year outcomes were evaluated and compared with the log-rank test.</p><p><strong>Results: </strong>At 30 days no differences were found in terms of Major Adverse Cardiovascular Events (MACEs), acute kidney injury, reintervention(s), major amputation, and all-cause mortality between the two groups. The need for blood transfusions was similar in both groups (Group OPEN 7, 38.9% vs. Group ENDO 13, 30.1%; P=0.14). The mean length of hospital stay was higher for patients in Group OPEN (11.3±6.5 vs. 4.4±1.9 days; P<0.001). The overall median duration of follow-up was 35 (IQR 13-55.75) months. At 5 years there were no differences between the two groups in terms of survival (69.8% Group OPEN vs. 64.6% Group ENDO; P=0.76, log-rank 0.09), overall patency (71.4% Group OPEN vs. 72.8% Group ENDO; P=0.56, log-rank 0.34), freedom from reintervention(s) (76% Group OPEN vs. 63.4% Group ENDO; P=0.32, log-rank 0.99), and amputation-free survival (88.1% Group OPEN vs. 83.4% Group ENDO; P=0.76, log-rank 0.09).</p><p><strong>Conclusions: </strong>Endovascular revascularization and bypass seem to provide effective flow restoration in patients with ALI due to femoro-popliteal ISO. Open surgery was associated with longer hospital stay. At 5 years, no significant differences were found between the two groups in terms of overall patency, need for reintervention(s), and amputation-free survival, even though further studies on a larger sample size and potentially prospective will be necessary to validate these preliminary findings.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"141-149"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}