International Angiology最新文献

{"title":"Comparison of angiography and ultrasound for femoropopliteal angioplasty: decision-making and 12-month outcomes.","authors":"Yuchi Zou,&nbsp;Qiang Tong,&nbsp;Xuehu Wang,&nbsp;Chuli Jiang,&nbsp;Zheng Qin,&nbsp;Yu Zhao,&nbsp;Jun Cheng","doi":"10.23736/S0392-9590.23.05064-2","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05064-2","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate whether intravascular ultrasound (IVUS) combined with angiography during percutaneous transluminal angioplasty impacts treatment strategies and the 12-month patency of the femoropopliteal artery, compared to angiography alone.</p><p><strong>Methods: </strong>This retrospective, single-center study enrolled 137 patients who underwent a femoropopliteal endovascular intervention between February 2020 and May 2021. Among these interventions, 43 were guided by IVUS combined with angiography and the remaining 94 were guided by angiography only. Treatment strategies and 12-month patency were analyzed in both groups. Multivariable analysis was performed to clarify the predictors of restenosis within 12 months.</p><p><strong>Results: </strong>Primary patency at 12 months was significantly higher in the IVUS group than in the angiography group (56.4% vs. 76.7%, P=0.047). The reference diameter on IVUS images was greater than that on angiography images. Therefore, the IVUS group presented a higher balloon-to-vessel ratio [1.0 (0.97, 1.01) vs. 1.06 (1.0.1.25)]. More adjunctive stents were required in the angiography group. However, more dissections were performed in the IVUS group, with no difference in flow-limiting dissections between groups. Target disease length (odds ratio 1.02, P=0.021) and balloon-to-vessel ratio (odds ratio 0.01, P=0.021) were independent predictors of restenosis.</p><p><strong>Conclusions: </strong>Compared with angiography guidance alone, IVUS guidance for femoropopliteal artery-related treatment can significantly increase primary patency. This finding may be explained by the selection of larger balloons in IVUS and the resulting sufficient plaque compression and elastic membrane stretch. Moreover, IVUS was shown to detect more non-flow-limiting dissections than angiography.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"327-336"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10335450","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":"International Union of Angiology consensus document on vascular compression syndromes.","authors":"Mario D'Oria,&nbsp;Petar Zlatanovic,&nbsp;Anthony Anthony,&nbsp;Anahita Dua,&nbsp;Alyssa M Flores,&nbsp;Adam Tanious,&nbsp;Alejandro Rodríguez Morata,&nbsp;Alba Scerrati,&nbsp;Domenico Baccellieri,&nbsp;Federico Biscetti,&nbsp;Giulia Baldazzi,&nbsp;Giorgio Mantovani,&nbsp;Indrani Sen,&nbsp;Javier Peinado Cebrian,&nbsp;Joao Rocha-Neves,&nbsp;Joel Sousa,&nbsp;Lazar Davidovic,&nbsp;Michal Juszynski,&nbsp;Miroslav Markovic,&nbsp;Mar Oller Grau,&nbsp;Mirko Tessari,&nbsp;Niamh Hynes,&nbsp;Peter Gloviczki,&nbsp;Palma Shaw,&nbsp;Paolo Zamboni,&nbsp;Robert Hinchliffe,&nbsp;Roberta Ricci,&nbsp;Sherif Sultan,&nbsp;Yogesh Acharya,&nbsp;Nicola Troisi,&nbsp;Pier Luigi Antignani,&nbsp;Armando Mansilha,&nbsp;Pedro P Komlos","doi":"10.23736/S0392-9590.23.05100-3","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05100-3","url":null,"abstract":"<p><p>Vascular compression syndromes (VCS) are rare diseases, but they may cause significant symptoms interfering with the quality of life (QoL) of patients who are often in their younger age. Given their infrequent occurrence, multiform clinical and anatomical presentation, and absence of dedicated guidelines from scientific societies, further knowledge of these conditions is required to investigate and treat them using modern imaging and surgical (open or endovascular) techniques. This consensus document will focus on known VCS, affecting the arterial and venous system. The position paper, written by members of International Union of Angiology (IUA) Youth Committee and senior experts, will show an overview of pathophysiology, diagnostic, and therapeutical approaches for patients with VCS. Furthermore, this document will provide also unresolved issues that require more research that need to be addressed in the future.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"282-309"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9902989","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":"Transformational features of the vein wall during a long-term period of endovenous laser ablation using 1910 nm laser radiation. Results of in-vivo experiments.","authors":"Sergey A Artemov,&nbsp;Alexander N Belyaev,&nbsp;Olga S Bushukina,&nbsp;Vasiliy I Davydkin,&nbsp;Svetlana A Khrushchalina,&nbsp;Sergey V Kostin,&nbsp;Polina A Ryabochkina,&nbsp;Alina D Taratynova","doi":"10.23736/S0392-9590.23.05013-7","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05013-7","url":null,"abstract":"<p><strong>Background: </strong>In this paper, results of in-vivo experiments on the animals of endovenous laser ablation (EVLA) using laser radiation with the wavelength 1910 nm are reported. The results of histological studies of the vein segments removed immediately after the procedure and in a long-term period (30 days and 3 months) are presented. Their structural transformation and the obliteration degree of the vein lumen using different values of the linear energy density of laser radiation (LEED=7.5; 15; 20 J/cm) are estimated.</p><p><strong>Methods: </strong>Edilbay breed of sheep (males) were used as experimental animals. Laser radiation with a wavelength of λ=1910 nm and power of Р<inf>rad</inf> = 1.5, 3, 4 W was used for EVLA experiments, and speed of fiber traction (v) was 2 mm/s. 8 days after EVLA stitches and an elastic bandage were removed. Animals were observed for 3 months in the vivarium. Animals have duplex ultrasound scanning of coagulation veins under anesthesia, after analysis vein segments were excised for histological examination. As a result, the damage degree to the vein wall tissues (intima, media, adventitia) and peri-venous tissues was revealed.</p><p><strong>Results: </strong>It is shown that in the long-time period, the intima and partial muscle layer transformed to connective tissue. EVLA using laser radiation with a higher value of LEED led to the growth of connective tissue, oedema of all vein layers and peri-venous tissue. The lumen closure occurred due to clot and the vein wall transformation, a maximum value was 25% using LEED=20 J/cm.</p><p><strong>Conclusions: </strong>The connective-tissue transformation of the coagulated vein occurs in a long-term period and more pronounced for higher LEED. However, features of vein hemodynamics of animals and differences between the clot formation process of human varicose veins and healthy animal veins lead to incomplete occlusion. These features should be taken into account during extrapolation results of experiments on animals in clinical practice.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"362-370"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9905286","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":"Implications of abdominal aortic aneurysm rupture at a lower diameter than the recommended threshold for AAA repair.","authors":"Kosmas I Paraskevas,&nbsp;Armando Mansilha","doi":"10.23736/S0392-9590.23.05076-9","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05076-9","url":null,"abstract":"","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"279-281"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10225664","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":"Randomized controlled trial on occupational graduated compression clinical and cost-effectiveness.","authors":"Sergio Gianesini,&nbsp;Emidia Vagnoni,&nbsp;Caterina Cavicchi,&nbsp;Yung-Wei Chi,&nbsp;Anselmo Pagani,&nbsp;Mirko Tessari,&nbsp;Paolo Zamboni,&nbsp;Erica Menegatti","doi":"10.23736/S0392-9590.23.05030-7","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05030-7","url":null,"abstract":"<p><strong>Background: </strong>Subjects exposed to occupational standing are at risk of developing chronic venous disease. Graduated compression stockings (GCS) counteract venous hypertension. Aim of the present investigation was to assess GCS clinical and cost effectiveness in prolonged standing up workers.</p><p><strong>Methods: </strong>Randomized controlled trial involving 75 healthy healthcare professionals working in 6 hours standing up shifts without or with GCS (group A and B, respectively). Outcome measures were performed before and after the shift, at baseline (T0), at 1 (T1), 6 (T6) and 12 (T12) months and included lower limb volume, air plethysmography (APG), quality of life, and dedicated cost-effectiveness questionnaires.</p><p><strong>Results: </strong>Seventy-two subjects completed the data collection. Leg volume increased in group A and decreased in B at all assessment points (T0, 1, 6, 12) (P<0.0001). Venous filling index did not change within the 12 months, but, after every shift, its value was lower in B compared to A (P<0.0001). At 12 months, VVSymQ worsened in A and improved in B (P<0.0001) and CIVIQ significantly worsened in A (P<0.0001), while in B it significantly improved (P<0.0001). Perceived disability was higher in A at 12 months (P<0.001) and the cost calculation revealed a saving of 1510 euro per year in B.</p><p><strong>Conclusions: </strong>GCS counteracted occupational oedema and positively influenced venous filling index, while improving vein specific quality of life measurements in addition to cost savings.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"344-351"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9899231","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":"Varicose veins are associated with an increased risk of mitral valve regurgitation: a nationwide population-based cohort study.","authors":"Meng-Lin Lee,&nbsp;Wan-Yun Chou,&nbsp;Yi-Wei Kao,&nbsp;Ming-Chih Chen,&nbsp;Ben-Chang Shia,&nbsp;Pei-Shyuan Lee,&nbsp;Thay-Hsiung Chen,&nbsp;Ting-Yuan Lin,&nbsp;Shih-Yu Huang,&nbsp;Yen-Bo Su,&nbsp;Wei-Che Chiu","doi":"10.23736/S0392-9590.23.05053-8","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05053-8","url":null,"abstract":"<p><strong>Background: </strong>Varicose veins (VV) and mitral valve regurgitation (MR) are both common diseases. The aim was to investigate whether VV are associated with an increased risk of MR.</p><p><strong>Methods: </strong>We conducted a nationwide cohort study to assess the association between VV and risk of developing MR. Drawn from the Taiwan National Health Insurance Research Database (NHIRD), the records of 56,898 patients with VV (the VV cohort) and 56,898 propensity score-matched patients without VV (the non-VV cohort) in the years 2007 to 2015 were identified. Follow-up duration was calculated from the date of entry in the cohort until the occurrence of a first MR diagnosis, death, or the end of the observation period (December 31, 2015), whichever occurred first. Hazard ratios (HRs) and accompanying 95% confidence intervals (CIs) derived from the Cox proportional hazards model were used to estimate the association between VV and MR risks.</p><p><strong>Results: </strong>After multivariable adjustment, VV was associated with an increased risk of MR (adjusted HR, 1.63; 95% CI: 1.52-1.74). Notably, significant associations between VV and MR risk were evident in both genders and in all age groups. A trend of significant increase of MR risk was also observed with increasing frequency of annual clinical visits for VV. Within the VV cohort, the subgroup of MR presence had higher incidences of atrial fibrillation, heart failure, valve-related surgeries, and mortality (P<0.001).</p><p><strong>Conclusions: </strong>This population-based cohort study revealed that VV was associated with an increased risk of MR in a Taiwanese population. Vigilance of MR existence should be emphasized in patients of VV due to its potentially poor long-term outcomes.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"352-361"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10275085","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":"Preoperative factors affecting long-term mortality in patients survived to ruptured abdominal aortic aneurysm repair.","authors":"Nicola Troisi,&nbsp;Giacomo Isernia,&nbsp;Giulia Bertagna,&nbsp;Daniele Adami,&nbsp;Luigi Baccani,&nbsp;Gianbattista Parlani,&nbsp;Raffaella Berchiolli,&nbsp;Gioele Simonte","doi":"10.23736/S0392-9590.23.05058-7","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05058-7","url":null,"abstract":"<p><strong>Background: </strong>Aim of this study was to retrospectively evaluate preoperative factors affecting long-term mortality in patients survived to surgical repair for ruptured abdominal aortic aneurysms (rAAAs).</p><p><strong>Methods: </strong>From January 2007 to December 2021, 444 patients have been treated for symptomatic or ruptured aortoiliac aneurysms in two tertiary referral centers. Only 405 with diagnosis of rAAA at computed tomography were included in the present study. Initial outcome measures were assessed during at 30 and 90 days post-treatment. Estimated 10-year survival of patients survived after 90 days from the index procedure was evaluated with Kaplan-Meier Test. Uni- and multivariate analyses of the preoperative factors affecting 10-year survival in survivor patients was performed by means of log-rank and multivariate Cox regression analysis.</p><p><strong>Results: </strong>Among included patients, 94 (23.3%) underwent endovascular aortic repair (EVAR) and 311 (76.8%) open surgical repair (OSR). Intraoperative death occurred in 29 patients (7.2%). At 30 days, overall death rate was 24.2% (98/405 cases). Hemorrhagic shock (HR 15.5, 95% CI 3.5 to 41.1, P<0.001) was an independent predictor for 30-day mortality. The overall rate of 90-day mortality was 32.6%. In survivors estimated survival rates at 1, 5, and 10 years were 84.2%, 58.2%, and 33.3%, respectively. Type of treatment (OSR vs. EVAR) did not affect long-term freedom from AAA-related death (HR 0.6, P=0.42). In survivor patients, multivariate analysis confirmed the association between late mortality and female sex (HR 4.7, 95% CI 3.8 to 5.9, P=0.03), age >80 years (HR 28.5, 95% CI 25.1 to 32.3, P<0.001), and chronic obstructive pulmonary disease (HR 5.2, 95% CI 4.3 to 6.3, P=0.02).</p><p><strong>Conclusions: </strong>Late freedom from AAA-related death was not affected by the type of treatment (EVAR vs. OSR) in patients undergoing urgent repair for rAAA. In survivors, female gender, elderly age, and chronic obstructive pulmonary disease negatively affected long-term survival.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 4","pages":"318-326"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10277750","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":"Aorto-iliac and infrainguinal artery occlusive disease: different revascularization options according to the critical limb threatening ischemia category.","authors":"Rodolfo Pini,&nbsp;Gianluca Faggioli,&nbsp;Cecilia Angherà,&nbsp;Antonio Cappiello,&nbsp;Mohammad Abualhin,&nbsp;Sara Pomatto,&nbsp;Enrico Gallitto,&nbsp;Mauro Gargiulo","doi":"10.23736/S0392-9590.23.04992-1","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.04992-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Critical limb threatening-ischemia (CLTI) can be due to an extensive involvement of both the aorto-iliac (AI) and the infra-inguinal (II) districts and the efficacy of and extensive AI+II vs. only AI revascularization is still matter of debate. The aim of the present study was to evaluate the outcome in CLTI patients with concomitant AI and II peripheral artery disease (PAD) after revascularization limited to the AI or extended also to the II segment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients with CLTI and concomitant AI (TransAtlantic InterSociety Consensus: C-D) and II PAD (Global-Anatomic-Staging-System: II-III) from 2016 to 2021 were retrospectively evaluated. Patients were compared according to type of revascularization: limited to AI vs. AI+II. Common femoral and profunda artery endarterectomy (C/P-TEA) was considered in both groups. Perioperative mortality, limb salvage, foot healing (within 6 months after surgery), necessity of adjunctive revascularization and survival were analyzed and the follow-up performed with clinical and duplex assessment every six months. The primary endpoint was to evaluate the composite event of limb salvage, wound healing and necessity of adjunctive revascularization during follow-up in AI vs. AI+II groups, through Kaplan Meier and Cox regression analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Over a total of 1105 peripheral revascularizations for CLTI, 96 (8.7%) patients met the inclusion criteria for the study. AI revascularization was performed in 38 (40%) and AI+II in 58 (60%). AI and AI+II groups were similar for preoperative risk factors and extension of PAD with the exception of American Society of Anesthesiology (ASA) Classification (ASA IV: 50% vs. 25%, P=0.02, respectively). The AI group was treated with angioplasty/stenting in all cases and with C/P-TEA in 20 (52%) cases. In the AI+II group, the AI district was treated by angioplasty/stenting in 55 (95%) and by aorto-bifemoral bypass in 3 (5%) and C/P-TEA in 20 (34%). The II revascularization was performed by femoro-popliteal/tibial bypass in 27 (47%); and endovascular revascularization in 31 (53%) patients. Minor amputation rate was similar between AI and AI+II revascularization (39% vs. 48%, P=1.0); length of stay, blood transfusion units, were significantly higher in AI+II group: 7±4 days vs. 12±5 days, P=0.04 and 2±2 vs. 4±2, P=0.02. The 30-day mortality was 7% with no differences according to the type of treatment. At a mean follow-up of 28±10 months, the overall limb salvage was 87±4% with similar results in AI vs. AI+II revascularization (95±5% vs. 86±6%; P=0.56). AI had a higher necessity of adjunctive revascularization and lower wound healing compared to AI+II (18±9% vs. 0%, P=0.02; 72% vs. 100%, P=0.001, respectively). AI+II was associated with a better primary endpoint compared to AI (87±5% vs. 53±9%, P=0.01), and it was confirmed in Rutherford 5 and 6 patients (100% vs. 54±14%, P=0.01; 78±9 vs. 50±13%, P=0.04), an","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 3","pages":"209-215"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9891221","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":"Machine learning models for diabetic neuropathy diagnosis using microcirculatory parameters in type 2 diabetes patients.","authors":"Xiaoyu Zhang,&nbsp;Yining Sun,&nbsp;Zuchang Ma,&nbsp;Liang Lu,&nbsp;Mengyuan Li,&nbsp;Xueya Ma","doi":"10.23736/S0392-9590.23.05008-3","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.05008-3","url":null,"abstract":"<p><strong>Background: </strong>Diabetic peripheral neuropathy (DPN) is a primary cause of diabetic foot, early detection of DPN is essential. This study aimed to construct a machine learning model for DPN diagnosis based on microcirculatory parameters, and identify the most predictive parameters for DPN.</p><p><strong>Methods: </strong>Our study involved 261 subjects, including 102 diabetics with neuropathy (DMN), 73 diabetics without neuropathy (DM), and 86 healthy controls (HC). DPN was confirmed by nerve conduction velocity and clinical sensory tests. Microvascular function was measured by postocclusion reactive hyperemia (PORH), local thermal hyperemia (LTH), and transcutaneous oxygen pressure (TcPO<inf>2</inf>). Other physiological information was also investigated. Logistic regression (LR) and other machine learning (ML) algorithms were used to develop the model for DPN diagnosis. Kruskal-Wallis Test (non-parametric) were performed for multiple comparisons. Several performance measures, such as accuracy, sensitivity and specificity, were used to access the efficacy of the developed model. All the features were ranked based on the importance score to find features with higher DPN predictions.</p><p><strong>Results: </strong>There was an overall decrease in microcirculatory parameters in response to PORH and LTH, as well as TcPO<inf>2</inf>, in DMN group compared to DM group and HC group. Random forest (RF) was found to be the best model, and achieved 84.6% accuracy along with 90.2% sensitivity and 76.7% specificity. RF_PF% of PORH was the main predictor of DPN. In addition, diabetic duration was also an important risk factor.</p><p><strong>Conclusions: </strong>PORH Test is a reliable screening tool for DPN, which can accurately distinguish DPN from diabetics using RF.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 3","pages":"191-200"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892787","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":"Management and outcomes of calf deep vein thrombosis in patients with contraindication to full anticoagulation due to bleeding.","authors":"Giovanna Elmi,&nbsp;Davide Allegri,&nbsp;Leonardo Aluigi,&nbsp;Pier L Antignani,&nbsp;Raffaele Aspide,&nbsp;Valeria Camaggi,&nbsp;Rosella DI Giulio,&nbsp;Andrea Domanico,&nbsp;Elisa R Rinaldi,&nbsp;Alberto Martignani,&nbsp;Gualtiero Palareti","doi":"10.23736/S0392-9590.23.04947-7","DOIUrl":"https://doi.org/10.23736/S0392-9590.23.04947-7","url":null,"abstract":"<p><strong>Background: </strong>This prospective observational study was aimed at assessing early outcomes of inpatients with isolated distal deep vein thrombosis (IDDVT) and coexisting bleeding.</p><p><strong>Methods: </strong>Patients received enoxaparin 4000 units daily or intermediate doses, and ultrasound surveillance (US). Primary outcomes were extension to the popliteal vein (PDVT) or symptomatic pulmonary embolism (PE), bleeding complications during the treatment and the composite of PDVT and bleeding complications. Secondary outcomes were recurrent IDDVTs and death.</p><p><strong>Results: </strong>90/95 patients completed the study period (30 days). PDVT occurred in 2/41 (4.9%) and in 3/45 (6.7%) subjects receiving enoxaparin 4000 units and intermediate doses respectively (OR 1.39; 95% CI: 0.22-11; P=0.72). PE occurred in only one of the 4 untreated subjects (25% vs. 0 patients taking enoxaparin 4000 units or intermediate doses; P=1.0). Recurrent IDDVTs occurred in 29 subjects (32.2%), more frequently during enoxaparin 4000 (19/29, 65.5%). Four patients died (4.4%). Bleeding complications occurred in 8 subjects (8.9%), all treated with intermediate doses (0 vs. 17.8%; P=1.0). Enoxaparin 4000 units significantly reduced the risk of the composite outcome compared with higher doses (4.9% vs. 24.4%; OR 6.31; 95% CI: 1.56-42.65; P=0.02). Major trauma significantly increased the risk of PDVT (OR 20.92; 95% CI: 2.82-427.51, P=0.01; logistic regression P=0.01). Patients with major trauma are also at increased bleeding risk (OR 5; 95% CI: 1.06-23.76, P=0.04; logistic regression P=0.03).</p><p><strong>Conclusions: </strong>Enoxaparin 4000 units daily, supported by US, may be an option for selected patients.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"42 3","pages":"229-238"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9524084","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}