International Angiology最新文献

{"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}

{"title":"Transcarotid artery revascularization in symptomatic carotid stenosis: a systematic review.","authors":"Francisco Garcia, Filipa Jácome, Joel Sousa, Armando Mansilha","doi":"10.23736/S0392-9590.24.05275-1","DOIUrl":"10.23736/S0392-9590.24.05275-1","url":null,"abstract":"<p><strong>Introduction: </strong>Carotid endarterectomy is currently the gold standard treatment option for significant symptomatic carotid stenosis. Carotid artery stenting can be an alternative in selected patients, although with inferior results when compared with its open counterpart. Transcarotid artery revascularization (TCAR) emerged as a new option, with promising results. This study aims to systematically review current evidence of the safety of TCAR in patients with symptomatic carotid artery stenosis.</p><p><strong>Evidence acquisition: </strong>A systematic review of the literature was performed, according to PRISMA guidelines. Literature search was performed on the PubMed and Web of Science databases, which returned 178 studies. Eleven studies were selected. Data were extracted using predefined forms.</p><p><strong>Evidence synthesis: </strong>A total of 28326 symptomatic patients undergoing TCAR were included for analysis. Reported TIA/stroke rates after TCAR ranged between 2.3-3.3% in-hospital and 1.2-4.3% at 30-days. Similarly, in-hospital post-operative mortality was reported in 0.5-0.7% of the cases, and 1-4.9% at 30 days. After 1 year, TIA/Stroke and death rates ranged between 3.5-3.7% and 2.5-13%, respectively. Postoperative cardiovascular events were observed in up to 2.9% of the patients among the included studies. Cranial nerve injuries were reported in up to 0.7% of the cases, while surgical and vascular access complications ranged between 1.2-6.1%.</p><p><strong>Conclusions: </strong>TCAR has shown promising results for significant symptomatic carotid stenosis treatment, and may be a relevant alternative to carotid endarterectomy, especially in high-risk patients. Further studies are required to assess the effectiveness of TCAR and its comparability with carotid endarterectomy.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"131-140"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566568","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":"Use of microcirculatory parameters to evaluate foam sclerotherapy treatment of superficial chronic venous disease, associated or not with venotonic drug: randomized, double-blind trial.","authors":"Juliana M Vieira, Carmen L Porto, Walkyria Y Hara, Beatriz F Oliveira, Eliete Bouskela","doi":"10.23736/S0392-9590.25.05223-X","DOIUrl":"10.23736/S0392-9590.25.05223-X","url":null,"abstract":"<p><strong>Background: </strong>Chronic venous disease (CVD) is a pathology with unfavorable outcome when treated and/or followed up incorrectly. In addition to macroscopic venous changes, CVD also causes changes in microcirculation. Based on these hypotheses, a non-invasive test to quantify the evolution of microangiopathy may be useful to assess the effects and benefits of treatment.</p><p><strong>Methods: </strong>Fifty female patients with varicose veins classified by clinical class C2 or C3 of the CEAP classification were selected and allocated randomly in two groups: foam sclerotherapy (FS) + micronized purified flavonoid fraction (MPFF) or FS + placebo, double-blind. Microcirculation was evaluated using Sidestream Dark Field techniques. The revised VCSS score was performed pre and post FS.</p><p><strong>Results: </strong>It was found an improvement on VCSS and all microcirculation parameters, in both groups, except on the number of pathological capillaries. When comparing the results between groups, a greater reduction in the diameters of dermal papilla was observed in the MPFF group (P=0.053), which, despite not being statistically significant, had an effect size of 0.55 (-0.01-1.10). In addition, capillary bulk and capillary limb also had a higher decrease in the MPFF group.</p><p><strong>Conclusions: </strong>FS treatment of the trunk veins reduced distal venous hypertension, improving microcirculation in all patients, helping to control the venous disease. All patients got therapeutic success (total occlusion or partial occlusion with improvement in venous reflux or reduction in venous caliber).</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"83-93"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657304","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":"Pregnancy as a possible reason for recurrent varicosity after laser crossectomy.","authors":"Imre Bihari, Anna Bihari, Sara Lovasz, James Doherty, Péter Bihari","doi":"10.23736/S0392-9590.25.05295-2","DOIUrl":"10.23736/S0392-9590.25.05295-2","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy is one of the most important factors which promote the development and recurrence of varicose veins.</p><p><strong>Methods: </strong>Altogether 38 limbs of 33 women were evaluated who underwent laser crossectomy following childbirth and after that received US follow-up. Surgery was performed between October 2008 and October 2019. Timespan between surgery and pregnancy was 22.7±20.49 months. In 34 cases GSV, 2 SSV and in 2 cases GSV and perforator veins were treated. Diameter of treated veins was 6.26±3.25 mm. In most cases 1550 nm diode laser equipment and radial fiber was used (70%). Tip of the laser fiber was 1.0 later 0.5 cm to the femoral vein. Mean delivered energy was 100 J/cm along the saphenous veins and approximately double that near the SFJ.</p><p><strong>Results: </strong>Before gravidity there were flush closures of the SFJ with the femoral vein in 26 cases (EHIT1). In 12 cases there were stumps whose length was mean 7.5±3.73 mm. Between surgery and pregnancy none of them had any recurrency clinically nor with US. After delivery there were recurrent C2 varicosities in 18 cases (47.4%). Pathology of them were as follows: neo vascularization - 6; acc. ant. varicosity -5; perforator vein insufficiency -4 and recanalization -3 cases. This means that in 14/38 cases (36.8%) the SFJ became insufficient which contributed to recurrency. Few results are available about the impact of pregnancy on recurrency after varicose vein surgery.</p><p><strong>Conclusions: </strong>Our results suggest that recurrent varicosity results are acceptable using laser crossectomy. We couldn't judge if any of the used techniques could influence those very strong factors which cause recurrent varicosity during pregnancy.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"1-5"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440798","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":"How much volume of iodinated contrast medium leads to acute kidney injury in endovascular aortic repair?","authors":"Andrea Vacirca, Gianluca Faggioli, Antonino DI Leo, Sara Fronterrè, Rodolfo Pini, Enrico Gallitto, Chiara Mascoli, Stefania Caputo, Mauro Gargiulo","doi":"10.23736/S0392-9590.25.05286-1","DOIUrl":"10.23736/S0392-9590.25.05286-1","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a significant complication of endovascular aortic repair (EVAR), often related to iodinated contrast medium (ICM) exposure. This study aimed to analyze AKI incidence after EVAR in a monocentric case series and define a cutoff value for contrast volume (VIC) predictive of AKI.</p><p><strong>Methods: </strong>All elective EVARs performed on patients with abdominal aortic aneurysms (AAA) from 2012-2020 were analyzed for AKI incidence. AKI was defined by serum creatinine criteria (≥0.3 mg/dL within 48 hours, ≥1.5x baseline within a week) or urine output criteria (≤0.5 mL/kg/hour for 6 hours). Statistical analysis included Chi-square, Student's t-test, log-rank, ROC curve, and multivariate regression.</p><p><strong>Results: </strong>Among 732 patients undergoing EVAR, 27 (3.6%) developed AKI, with 21 (77.8%) cases identified as Contrast-Induced AKI (CI-AKI). AKI patients received significantly higher ICM (AKI 153±100 vs. 89±57 mL No-AKI, P=0.015). Independent predictors of AKI included preoperative CKD stage (OR1.72, 95% CI: 1.00-2.96, P=0.046) and intraoperative VIC ≥90 mL (OR=2.77, 95% CI: 1.11-6.89, P=0.025). AKI was associated with higher postoperative mortality (AKI 7.4% vs. 0.4% No-AKI, P=0.013) and prolonged hospitalization (AKI 7±6 vs. 5±5 days No-AKI, P=0.017). Survival at 24±21 months was significantly reduced in the AKI group (80±8% vs. 89±2%, P=0.026). A VIC-to-preoperative-eGFR ratio (VIC/pre-eGFR) ≥2.91 was predictive of CI-AKI (42.9% sensitivity, 93.7% specificity).</p><p><strong>Conclusions: </strong>While infrequent, AKI after elective EVAR significantly impacts short- and long-term outcomes. Preoperative CKD stage and intraoperative VIC are key predictors. Procedures should aim for a VIC/pre-eGFR ratio <2.91 to mitigate CI-AKI risk.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"24-33"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440762","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":"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}