International Angiology最新文献

{"title":"Endovascular treatment of patients with aortic and iliac aneurysms and congenital pelvic kidney: a systematic review.","authors":"Henrique G Rocha, Carlos Veterano, Carlos Veiga, Carolina Vaz, Rui Machado","doi":"10.23736/S0392-9590.24.05350-1","DOIUrl":"10.23736/S0392-9590.24.05350-1","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital pelvic kidney is a rare condition that complicates the treatment of abdominal aortic aneurysms due to its variable arterial anatomy. Traditionally, most patients were treated with open or hybrid surgery. However, recent advancements in endovascular devices have allowed to manage complex aortic anatomies. Given the limited data, we conducted a systematic review of cases involving congenital pelvic kidneys with non-ruptured aortic and iliac aneurysms treated using endovascular techniques.</p><p><strong>Evidence acquisition: </strong>We performed a literature search in PubMed and Google Scholar using terms such as \"aortic aneurysm,\" \"congenital pelvic kidney,\" \"ectopic,\" \"variation,\" \"anomaly,\" and \"endovascular procedures.\" Only cases of non-ruptured aortic, thoracoabdominal, or isolated iliac aneurysms associated with congenital pelvic kidney treated exclusively with endovascular methods were included.</p><p><strong>Evidence synthesis: </strong>Ten patients (mean age 69.7 years) from three observational studies and six case reports were identified. Half had infrarenal aortic aneurysms, while others presented with iliac or thoracoabdominal aneurysms. Renal arteries most commonly originated from the common iliac artery (N.=4). Various endovascular techniques were employed, including infrarenal endovascular aneurysm repair (EVAR), fenestrated/branched EVAR (F/BEVAR), iliac branched devices (IBD), and chimney EVAR (chEVAR), with a technical success rate of 100%. No postoperative renal function impairment was noted.</p><p><strong>Conclusions: </strong>Endovascular treatment for patients with congenital pelvic kidney and aortic or iliac aneurysms is effective, achieving high technical success and low complication rates. Complex endovascular devices play a crucial role in managing the unique arterial challenges of this condition.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"44 1","pages":"34-40"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763937","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":"Effect of stent shape in areas of high compression on patency rates after venous recanalization in patients with chronic venous obstruction.","authors":"Sharif Elshafei, Karina Schleimer, Alexander Gombert, Houman Jalaie, Mohammad E Barbati","doi":"10.23736/S0392-9590.25.05298-8","DOIUrl":"10.23736/S0392-9590.25.05298-8","url":null,"abstract":"<p><strong>Background: </strong>Venous stenting of the obstructed iliofemoral veins has gained significant popularity over recent years due to its efficacy in restoring venous flow and alleviating symptoms associated with chronic venous obstruction (CVO). The success of venous stenting has been demonstrated through high patency rates, even in cases where stents are implanted in areas of high compression. These stents have been observed to adopt an elliptical shape at areas of high compression, deviating from the expected circular morphology that stents are designed to maintain. This phenomenon raises important questions about its potential impact on stent function and long-term patency rates. The objective of this study was to investigate, through a retrospective analysis, the presence and clinical impact of non-circular-shaped venous stents on patency rates.</p><p><strong>Methods: </strong>From December 2015 to December 2020, a cohort of 115 patients (127 limbs) diagnosed with chronic obstruction of the iliofemoral veins underwent venous angioplasty with stent implantation. Throughout follow-up visits, detailed data were collected, including patient demographics, characteristics, stent types, and ultrasound findings, while especially focusing on the shape and diameter of stents at areas of known external compression, such as the May-Thurner point and under the inguinal ligament.</p><p><strong>Results: </strong>The average follow-up duration was 21.9±8.7 months. The primary patency rate was 79.5%, with an assisted primary patency rate of 92.1% and a secondary patency rate of 96.7%. All the stents implanted were dedicated venous stents, which demonstrated favorable outcomes overall. However, during the follow-up period, 76.56% of the stents were found to have adopted an elliptical shape at areas of high external compression, regardless of the type or structure of the stent. Interestingly, neither the change in stent shape nor a reduction in stent area of less than 25% showed any statistically significant impact on the overall patency rates.</p><p><strong>Conclusions: </strong>This study demonstrates that changes in stent shape are to be expected at points of high external pressure. However, as long as these changes do not lead to a severe reduction in stent lumen (<25% of stent area), they do not negatively impact patency rates.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"44 1","pages":"6-13"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763932","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":"Target vein volume and sclerotherapy outcomes: all a pre-injection issue?","authors":"Daniele Bissacco, Mario Salerno","doi":"10.23736/S0392-9590.25.05349-0","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05349-0","url":null,"abstract":"","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"44 1","pages":"80-81"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763943","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":"Lower extremity arterial disease perspective: IUA consensus document on \"LEAD management\". Part 2.","authors":"Pier Luigi Antignani, Pavel Poredoš, Giacomo Gastaldi, Ana Spirkoska, Armando Mansilha","doi":"10.23736/S0392-9590.25.05344-1","DOIUrl":"10.23736/S0392-9590.25.05344-1","url":null,"abstract":"","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"61-70"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390591","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":"Building evidence for diagnosis of lipedema: using a classification and regression tree (CART) algorithm to differentiate lipedema from lymphedema patients.","authors":"Isabel Forner-Cordero, José Muñoz-Langa, Lola Morilla-Bellido","doi":"10.23736/S0392-9590.25.05207-1","DOIUrl":"10.23736/S0392-9590.25.05207-1","url":null,"abstract":"<p><strong>Background: </strong>Discriminating lipedema from lymphedema becomes challenging in the absence of a pathognomonic test. The objective was to find the best manifestations that discriminate between lipedema and lymphedema and to build a diagnosis algorithm.</p><p><strong>Methods: </strong>Prospective cohort study of two cohorts of patients, one with lipedema and another with lymphedema. Inclusion criteria for lipedema cohort involved bilateral lower limbs (LL) enlargement and at least three symptoms: pain/tenderness, bruising, familial history, no Stemmer's sign, symmetrical involvement, and non-swollen feet. The lymphedema cohort included female patients with LL lymphedema. A univariate analysis was performed to determine which clinical features were different between both samples. We used a TREE procedure to create a tree-based classification model using the CART (Classification And Regression Tree) algorithm, in order to discriminate lipedema from lymphedema patients.</p><p><strong>Results: </strong>Currently, 138 lipedema and 111 lymphedema patients were included. After univariate analysis, symmetrical involvement, disproportion between upper and lower parts of the body, spare feet, bruising, spider veins, family history, and pain were significantly more present in lipedema than in lymphedema (P<0.0001). Stemmer's sign, lymphangitis bouts, pitting and fibrosis were more representative of lymphedema (P<0.0001). The most important variables for discrimination were: disproportion (100%), spare feet (92.6%), bruising (92.3%) and symmetrical involvement (90.3%). After CART analysis, only three variables were retained in the final model: bruising, disproportion and spare feet. The model's accuracy was 100% with a probability error of 0.0% (SE: 0.00).</p><p><strong>Conclusions: </strong>A simple clinical tree can be used to classify patients between lymphedema and lipedema.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"71-79"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500951","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":"A review of clinical efficacy, safety, and quality of life of ClosureFast™ radiofrequency ablation of saphenous vein insufficiency.","authors":"Rodrigo Rial, Megha Garg, Nick Pooley, Guillermo M Ducaju, Alissa Doth, Ines Joaquim","doi":"10.23736/S0392-9590.25.05284-8","DOIUrl":"10.23736/S0392-9590.25.05284-8","url":null,"abstract":"<p><strong>Introduction: </strong>This review aimed to systematically identify the efficacy, safety, and quality of life of ClosureFast^™ radio frequency ablation (RFA) compared with other treatments for saphenous vein insufficiency.</p><p><strong>Evidence acquisition: </strong>A systematic literature search was conducted using MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, World Health Organization-International Clinical Trials Registry Platform, and ClinicalTrials.gov from the time of their inception to June 2021. Randomised controlled trials (RCTs) comparing ClosureFast^™ to surgery, endovenous laser ablation (EVLA), mechanochemical ablation (MOCA), foam sclerotherapy, or cyanoacrylate closure (CAC) were eligible for inclusion.</p><p><strong>Evidence synthesis: </strong>Thirty-two publications, representing 21 RCTs were included. Clinical efficacy (procedure success/failure) for ClosureFast^™ was significantly better compared to Foam, MOCA, and other RFA devices, significantly poorer than CAC; and similar to high ligation and division, stripping, and EVLA. Symptom alleviation was similar between therapies; however, one study reported significantly worse symptom scores for ClosureFast^™ compared to CAC. Compared with ClosureFast^™, patients receiving EVLA treatment exhibited significantly higher pain scores, whereas CAC, MOCA, and other RFA groups reported lower pain scores. ClosureFast^™ showed significantly lower rates of minor complications compared with EVLA in three studies, with rates of complication comparable with other treatments. ClosureFast^™ patients returned to work or normal activity faster than surgical but slower than CAC patients. There was no difference in health-related quality of life and patient satisfaction between treatments.</p><p><strong>Conclusions: </strong>ClosureFast^™ has overall higher safety than EVLA and surgery, with better clinical efficacy than Foam, MOCA, and other RFA devices. Efficacy and safety of ClosureFast^™ is comparable to or lower than CAC.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"44 1","pages":"14-23"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763753","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":"Comparing arm-ergometry and treadmill exercise training on cardiovascular risk factors in peripheral artery disease: secondary analysis of the ARMEX trial.","authors":"Sandra Magalhães, Mário Santos, Sofia Viamonte, Joana Martins, Cristine Schmidt, Fernando Ribeiro, Henrique Cyrne-Carvalho","doi":"10.23736/S0392-9590.25.05364-7","DOIUrl":"10.23736/S0392-9590.25.05364-7","url":null,"abstract":"<p><strong>Background: </strong>Peripheral artery disease (PAD), usually caused by atherosclerosis, is linked to high cardiovascular mortality. In this setting, a multidimensional cardiovascular rehabilitation program (CRP) comprising supervised exercise training can improve cardiovascular risk factors (CRF) control. This study compares the effects of an arm-ergometry supervised exercise training (AEx) with a standard treadmill protocol (TEx) on CRF.</p><p><strong>Methods: </strong>The ARMEX trial (ISRCTN54908548) was a single-center, single-blinded, parallel groups, noninferiority randomized clinical trial enrolling symptomatic PAD patients referred to a CRP. Participants were randomized (1:1) either to a 12-week AEx or TEx. Changes in blood pressure, lipid profile, glycated hemoglobin, body composition, physical activity levels, sedentary time and number of cigarettes smoked after the CRP were assessed.</p><p><strong>Results: </strong>Fifty-six patients (66±8.4 years; 87.5% male) were included: AEx (N.=28) and TEx (N.=28). Systolic and diastolic blood pressure decreased in both groups without significant between-group differences. Total cholesterol and low-density lipoprotein cholesterol decreased significantly only in the AEx group, without significant between-group differences. Weight, body mass index, waist circumference, waist/hip ratio and physical activity levels improved in both groups, without significant between-group differences. Smoking reduction was also similar between groups.</p><p><strong>Conclusions: </strong>A multidimensional CRP, whether involving arm-ergometry or treadmill exercise, improved CRF control in symptomatic PAD patients. Both exercise modalities were equally effective, supporting their use as part of a comprehensive approach in this complex population.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"51-60"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390663","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":"Medical treatment versus endarterectomy for symptomatic carotid stenosis: systematic review and meta-analysis.","authors":"José R Rodrigues, Andreia Coelho, Armando Mansilha","doi":"10.23736/S0392-9590.25.05308-8","DOIUrl":"10.23736/S0392-9590.25.05308-8","url":null,"abstract":"<p><strong>Introduction: </strong>The treatment of symptomatic carotid stenosis traditionally relies on revascularization procedures. However, evolution of medical treatment over the last decades, prompted the possibility to consider a best medical treatment approach as viable for the management of low-risk symptomatic patients. Nevertheless, there is limited evidence on the long-term outcomes of symptomatic patients treated medically, being critical to reassess the risk-benefit balance of invasive procedures in addition to best medical treatment. This study aims to review evidence on long-term outcomes of symptomatic carotid stenosis patients treated with best medical treatment alone and assess whether additional revascularization offers any beneficial effects.</p><p><strong>Evidence acquisition: </strong>A systematic review was performed according to the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-analysis statement and guidelines.</p><p><strong>Evidence synthesis: </strong>There was a trend for a higher risk of stroke (pooled risk of 6.96% [95% confidence interval (CI): 4.76-9.15%]), death (pooled risk of 3.14% [95% CI: 1.64-4.64%]), and the combined outcome of stroke or death (pooled risk of 8.91% [95% CI: 6.49-11.33%]) in the medical group compared to patients undergoing revascularization procedures: 4.51% (95% CI: 2.67-6.35%), 2.65% (95% CI: 1.23-4.08%), and 6.56% (95% CI: 4.37-8.76%), respectively.</p><p><strong>Conclusions: </strong>While best medical treatment has undergone significant advancements in recent decades, there is scarce data regarding the long-term outcomes of symptomatic patients receiving such treatment. Future research investigating the treatment of symptomatic carotid stenosis by surgery or endovascular methods should incorporate medical treatment arms to accurately assess the incidence of recurrent events in patients undergoing best medical treatment in the long-term.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"44 1","pages":"41-50"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763941","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":"Saphenous vein versus synthetic graft in arteriovenous fistula for hemodialysis in patient with inaccessible veins.","authors":"Ali M Galal, Mohamed A Ismail, Marco S Abdrabo, Ahmed K Mahmoud","doi":"10.23736/S0392-9590.24.05287-8","DOIUrl":"10.23736/S0392-9590.24.05287-8","url":null,"abstract":"<p><strong>Background: </strong>An autologous arteriovenous fistula (AVF) provides an optimal and secure way for managing the condition. An optimal blood supply to hemodialysis is linked to decreased incidence of complications and mortality, as well as reduced expenses. The objective of this research was to evaluate the outcome of people with suboptimal superficial venous system quality or who had exhausted all available arteriovenous fistula options, who received either autologous saphenous vein graft or polytetrafluoroethylene (PTFE) interposition graft as an access for effective hemodialysis.</p><p><strong>Methods: </strong>This prospective randomized controlled trail was carried out on fifty cases with chronic renal failure on hemodialysis and inaccessible superficial veins of both upper limbs for AVF. Cases were separated into two equal groups: Group A: cases performed saphenous vein reposition graft for hemodialysis access. Group B: cases who underwent PTFE interposition graft for prosthetic hemodialysis access.</p><p><strong>Results: </strong>Time for maturation and time for graft maturation, operative time, hospital stay, and postoperative HB were significant increase in group A in contrast to group B (P<0.05). Blood loss was significant decrease in group A in contrast to group B (P<0.001).</p><p><strong>Conclusions: </strong>Patients underwent saphenous vein repositioning graft for hemodialysis access required prolonged operative time and hospital stay. Cases that underwent PTFE interposition graft for prosthetic hemodialysis access were less in time for maturation and time for graft maturation.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"615-620"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813031","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":"Glycocalyx disruption, endothelial dysfunction and vascular remodeling as underlying mechanisms and treatment targets of chronic venous disease.","authors":"Jose A Diaz, Sergio Gianesini, Raouf A Khalil","doi":"10.23736/S0392-9590.24.05339-2","DOIUrl":"10.23736/S0392-9590.24.05339-2","url":null,"abstract":"<p><p>The glycocalyx is an essential structural and functional component of endothelial cells. Extensive hemodynamic changes cause endothelial glycocalyx disruption and vascular dysfunction, leading to multiple arterial and venous disorders. Chronic venous disease (CVD) is a common disorder of the lower extremities with major health and socio-economic implications, but complex pathophysiology. Genetic aberrations accentuated by environmental factors, behavioral tendencies, and hormonal disturbances promote venous reflux, valve incompetence, and venous blood stasis. Increased venous hydrostatic pressure and changes in shear-stress cause glycocalyx injury, endothelial dysfunction, secretion of adhesion molecules, leukocyte recruitment/activation, and release of cytokines, chemokines, and hypoxia-inducible factor, causing smooth muscle cell switch from contractile to synthetic proliferative phenotype, imbalance in matrix metalloproteinases (MMPs), degradation of collagen and elastin, and venous tissue remodeling, leading to venous dilation and varicose veins. In the advanced stages of CVD, leukocyte infiltration of the vein wall causes progressive inflammation, fibrosis, disruption of junctional proteins, accumulation of tissue metabolites and reactive oxygen and nitrogen species, and iron deposition, leading to skin changes and venous leg ulcer (VLU). CVD management includes compression stockings, venotonics, and surgical intervention. In addition to its antithrombotic and fibrinolytic properties, literature suggests sulodexide benefits in reducing inflammation, promoting VLU healing, improving endothelial function, exhibiting venotonic properties, and inhibiting MMP-9. Understanding the role of glycocalyx, endothelial dysfunction, and vascular remodeling should help delineate the underlying mechanisms and develop improved biomarkers and targeted therapy for CVD and VLU.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"43 6","pages":"563-590"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}