International Angiology最新文献

{"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":"https://doi.org/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":"Clinical evidence of venoactive drugs in diabetic microvascular complications: a scoping review.","authors":"Giacomo Gastaldi, Daniel Zingg, Alessandra Calabrese, Eliete Bouskela, Marie J VAN Rijn, Kursat Bozkurt, Juan Rosas-Saucedo, Eberhard Rabe, Armando Mansilha, Hermann Haller","doi":"10.23736/S0392-9590.25.05389-1","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05389-1","url":null,"abstract":"<p><p>Diabetic microvascular complications (DmVCs) and chronic venous disease (CVD) share common risk factors and pathophysiological features. However, they are often assessed and managed as separate conditions. The study objective was to map the available clinical evidence of venoactive drugs (VADs), beyond their demonstrated effects on sign and symptoms of CVD, in the management of patients with diabetic retinopathy (DR), diabetic nephropathy (DN) and diabetic peripheral neuropathy (DPN). We conducted a Scoping Review to map the clinical evidence on VADs recommended for treating CVD in the management of DR, DN and DPN to address VADs choices in clinics. PubMed and Cochrane Library databases were searched, studies in any language were included with no restriction on publication date. In total, 393 records were identified. Most included studies (N.=42) assessed clinical outcomes in DR (N.=33), followed by DN (N.=7) and DPN (N.=2). The median (range) publication date of the included studies was 2001 (1970-2022). Most studies were randomized trials (57%), followed by case series (17%), and case-control studies/systematic reviews (both 10%). Calcium dobesilate (CaD), was the most assessed VAD in DR (85%), DN (86%), and DPN (50%). CaD has shown significant improvements in DR and DN based on systematic-review data. Our findings suggest that VADs, in particular CaD, may represent a promising therapeutic option for the treatment of patients with both CVD and DmVC. Medical recommendations for VADs prescription should consider patients' microvascular status, evidence about VADs, as well as the multi-modal treatment approach.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"44 2","pages":"94-109"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127456","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":"Endotension following endovascular aortic repair: systematic review and meta-analysis on occurrence rate, treatment approaches and outcomes.","authors":"Nicola Cicala, Claudio Bianchini Massoni, Paola Meroni, Alexandra Catasta, Antonio Freyrie, Paolo Perini","doi":"10.23736/S0392-9590.25.05373-8","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05373-8","url":null,"abstract":"<p><strong>Introduction: </strong>Endotension is still a poorly understood phenomenon in terms of occurrence rate, treatment indications and outcomes. The aim of this study was to report incidence, different treatment approaches and outcomes of patients affected by endotension after EVAR.</p><p><strong>Evidence aquisition: </strong>A systematic review of the literature (database searched: PubMed, Web of Science, Scopus, Cochrane Library) was undertaken until June 2024. Articles reporting data about occurrence rate, strategy of treatment and outcomes of patients affected by endotension, including at least five cases of endotension were included. Meta-analyses of proportions were performed using a random-effects model.</p><p><strong>Evidence synthesis: </strong>Thirteen non-randomized studies published between 2005 and 2024 were examined, with a total of 22,118 patients undergoing EVAR due to abdominal aortic aneurysm. Among them, 209 patients developed endotension during follow-up, resulting in an estimated occurrence rate of 1.6% (95% CI 0.9-2.3). Four approaches to treat endotension were reported in literature. Estimated rates were: open surgical conversion (OSC) in 37.3% (95% CI 10.5-64.0), conservative approach in 25.9% (95% CI -4.4-56.2), endovascular relining in 23.3% (95% CI 11.4-35.2) and semi-conversions in 19.5% (95% CI 4.9-34.2). The technical success (TS) in OSC, relining and semi-conversion subgroups were respectively: 93.4% (95% CI 85.7-101), 80.7% (95% CI 60.5-101) and 94.5% (95% CI 85.2-103.8).</p><p><strong>Conclusions: </strong>OSC is the most used method, achieving high TS rate. OSC and semi-conversion presented a high CS during follow-up, while relining had lower \"durability\" compared to surgical treatments. Data about conservative treatment are scarce but in can be considered for selected cases.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"44 2","pages":"110-119"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127461","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":"Cardiovascular disease risk categories based on SCORE algorithms and age: reclassification based on number of carotid and common femoral bifurcations with plaque.","authors":"Andrew N Nicolaides, Andrie G Panayiotou, Maura B Griffin, Theodosis Tyllis, Efthyvoulos Kyriacou, Costantinos Avraamides, Despo Ierodiakonou, Christiana A Demetriou, Richard M Martin","doi":"10.23736/S0392-9590.25.05386-6","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05386-6","url":null,"abstract":"<p><strong>Background: </strong>The aim was to determine the efficacy of the number of carotid and common femoral bifurcations with plaque (NBP) detected by ultrasound in reclassifying individuals into atherosclerotic cardiovascular disease (ASCVD) risk categories based on SCORE2, SCORE2-OP algorithms and age. Data from the cohort of 908 individuals free from ASCVD and diabetes in the Cyprus Epidemiological Study on Atherosclerosis (CESA) was used.</p><p><strong>Methods: </strong>In each predicted ASCVD risk category (low to moderate, high and very high) the observed 10-year risk of subgroups according to the NBP was used to reclassify participants.</p><p><strong>Results: </strong>There were 183 ASCVD events during a mean follow-up of 15.5±4.6 years. The observed 10-year event rate was 4% in the low to moderate risk category, 7% in the high-risk category and 21% in the very high-risk category. The presence of more than one bifurcation with plaque up-classified 41 (16%) participants from the low to moderate category to a high-risk group (observed 10-year risk of 12%) with adjusted to SCORE2 and SCORE2-OP hazard ratio of 5.21 (95% CI 2.18 to 17.69) and 130 (40%) participants from the high-risk category to a very high-risk group (observed 10-year risk of 17%) with hazard ratio of 4.52 (95% CI 2.35 to 8.69).</p><p><strong>Conclusions: </strong>Because ultrasound is relatively inexpensive, and because ascertaining the presence of plaque in four superficial arterial bifurcations is a much easier and less time-consuming method than measurements of plaque thickness, area, or volume, this method has the potential for a practical clinical application.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"44 2","pages":"120-130"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127447","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}