International AngiologyPub Date : 2026-04-01Epub Date: 2025-11-13DOI: 10.23736/S0392-9590.25.05472-0
Anne Lejay, Jubran Durbas, Juliette Tabouret, Lena Christ, Nicole Neumann, Salomé Kuntz, Nabil Chakfé
{"title":"Latest vascular devices surveillance news: an overview.","authors":"Anne Lejay, Jubran Durbas, Juliette Tabouret, Lena Christ, Nicole Neumann, Salomé Kuntz, Nabil Chakfé","doi":"10.23736/S0392-9590.25.05472-0","DOIUrl":"10.23736/S0392-9590.25.05472-0","url":null,"abstract":"<p><p>Since the late 1950s, grafts and endografts have been constructed from a variety of materials and have been designed to be implanted in several different ways. However, despite the level of safety, effectiveness and versatility these devices reached, failures still exist. METHODS: Material surveillance through a dedicated explant analysis program is the cornerstone towards improving knowledge about vascular grafts and endografts behavior in humans. Major lessons learned from explant analysis have already been published few years ago, but this review provides an update by summarizing the recent findings of a dedicated explant analysis program over the past five years. Recent findings include vascular grafts degradation, devices calcifications, mechanisms of endografts failure. Two mechanisms of vascular grafts degradation have been reported: a decrease in the density of the meshing and local ruptures of the polyethylene terephthalate fibers. The degradation occurred preferentially in some grafts zones where the textile was weakened during manufacturing process. Calcification of vascular grafts and endografts have also been reported, and may contribute to device failure, as calcification reduces compliance, increases stiffness and generated a compliance mismatch. Concerning mechanisms of endografts failure, it has been shown that the polymer used in the endobags of the Nellix EndoVascular Aneurysm Sealing (EVAS) System could lose weight and volume upon dehydration. Accordingly, the polymer deteriorated and failed to retain its weight, volume and shape, undergoing fragmentation, explaining the high rate of migration observed with this device. Endoleaks have also been investigated and endograft fabric damages responsible for endoleaks have been demonstrated. This review highlights that despite continuous improvement of vascular and endovascular devices, failure still exists. Accordingly, continuous material surveillance is mandatory in order to provide the latest information on the mechanisms responsible for degradation and implement knowledge concerning the biological and mechanical behavior of grafts and endografts.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"143-148"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145503755","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}
International AngiologyPub Date : 2026-04-01Epub Date: 2026-02-02DOI: 10.23736/S0392-9590.26.05497-0
Felipe Coelho, Fernando T Silveira, Paulo R Bignardi, Glenio B Mizubuti, Carlos E Virgini-Magalhães, Douglas Poschinger-Figueiredo, Eduardo de O Rodrigues, Rodrigo G de Oliveira
{"title":"Histopathological evaluation of lower limb reticular veins treated with Nd:YAG 1064 nm laser: a prospective cohort pilot study.","authors":"Felipe Coelho, Fernando T Silveira, Paulo R Bignardi, Glenio B Mizubuti, Carlos E Virgini-Magalhães, Douglas Poschinger-Figueiredo, Eduardo de O Rodrigues, Rodrigo G de Oliveira","doi":"10.23736/S0392-9590.26.05497-0","DOIUrl":"10.23736/S0392-9590.26.05497-0","url":null,"abstract":"<p><strong>Background: </strong>The 1064 nm Nd:YAG transdermal laser is commonly used in the ambulatory treatment of lower limb reticular veins and telangiectasias. However, optimal laser parameters, particularly fluence and pulse duration, remain a subject of debate. In this prospective cohort pilot study, we evaluated the histopathological effects of different Nd:YAG 1064 nm laser settings on reticular veins to identify the parameter combinations most associated with vein wall damage.</p><p><strong>Methods: </strong>Patients scheduled for ambulatory phlebectomy received transdermal laser therapy 24 hours prior to surgery, using different combinations of fluence and pulse duration. A total of 15 vein segments were collected during phlebectomy, 12 treated with the laser and 3 untreated controls. All samples were stained with hematoxylin and eosin and independently analyzed by two blinded pathologists for neutrophilic infiltration, luminal thrombosis, and wall fibrosis.</p><p><strong>Results: </strong>Laser parameters of 70 J/cm<sup>2</sup> with pulse durations of 15 ms and 30 ms were significantly associated with the presence of inflammatory infiltrates (P<0.05). No statistically significant differences were found when comparing fixed fluence with variable pulse durations or fixed pulse duration with variable fluences (P>0.05).</p><p><strong>Conclusions: </strong>Nd:YAG 1064 nm transdermal laser induces histopathological inflammation in reticular veins, particularly when using fluence of 70 J/cm<sup>2</sup> combined with pulse durations of 15-30 ms.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"71-76"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105394","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":"Intimal and medial arterial calcification in peripheral arterial disease a systematic review and meta-analysis of imaging and histological evidence.","authors":"Vangelis Bontinis, Argirios Giannopoulos, Georgios A Pitoulias, Konstantinos Kouskouras, Alkis Bontinis, Vasileios Rafailidis, Kiriakos Ktenidis","doi":"10.23736/S0392-9590.25.05517-8","DOIUrl":"10.23736/S0392-9590.25.05517-8","url":null,"abstract":"<p><strong>Introduction: </strong>Vascular calcification (VC) comprises intimal arterial calcification (IAC) and medial arterial calcification (MAC). To date, limited data exist on the prevalence of these calcification types in infrainguinal peripheral arterial disease (PAD).</p><p><strong>Evidence acquisition: </strong>We conducted a systematic review according to PRISMA 2020 guidelines for studies investigating the prevalence of IAC and MAC in PAD.</p><p><strong>Evidence synthesis: </strong>Three CT-based and six histological studies, encompassing 545 patients and 1161 arteries, were included. The pooled prevalence of VC was 96.99% (95% CI: 84.21-99.49) for CT, and 85.75% (95% CI: 74.65-92.48) for histological studies. CT-based assessment displayed IAC predominance over MAC in the femoropopliteal region, OR 6.63 (95% CI: 4.02-10.94), an outcome replicated by histological studies upon sensitivity analysis, OR 4.86 (95% CI: 1.49-15.91). Conversely, pooling of histological studies identified MAC dominance over IAC in the infra-popliteal arteries, OR 0.10 (95% CI: 0.03-0.30). Meta-regression displayed positive associations between male sex and infra-popliteal IAC, type II diabetes mellitus and femoropopliteal IAC, and chronic limb threatening ischemia (CLTI) and infra-popliteal MAC. The pooled prevalence of bone was 14.62% (95% CI: 8.25-24.58), significantly associated with CLTI, chronic kidney disease, and female sex.</p><p><strong>Conclusions: </strong>PAD is characterized by a high prevalence of VC, predominantly IAC in the femoropopliteal arteries and MAC within the infra-popliteal region. The association of IAC, MAC and bone formation with distinct patient characteristics further underscores the clinical relevance and biological complexity of VC. Interpretation of these results should, however, be tempered by the absence of segment-matched CT-histology validation.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"104-114"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105360","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}
International AngiologyPub Date : 2026-04-01Epub Date: 2026-01-16DOI: 10.23736/S0392-9590.25.05487-2
Ryan Gouveia E Melo, Filipa Melo, Carlota Fernández Prendes, Tiago Magalhães, Ruy Fernandes E Fernandes, Luís Mendes Pedro, Daniel Caldeira
{"title":"Effect of smoking cessation on abdominal aortic aneurysm growth: a systematic review and network meta-analysis.","authors":"Ryan Gouveia E Melo, Filipa Melo, Carlota Fernández Prendes, Tiago Magalhães, Ruy Fernandes E Fernandes, Luís Mendes Pedro, Daniel Caldeira","doi":"10.23736/S0392-9590.25.05487-2","DOIUrl":"10.23736/S0392-9590.25.05487-2","url":null,"abstract":"<p><strong>Introduction: </strong>To compare the effect of smoking cessation in abdominal aortic aneurysm growth compared to active smokers and non-smokers.</p><p><strong>Evidence acquisition: </strong>A systematic review and Network Meta-Analysis was performed following the PRISMA guidelines using a registered protocol (CRD42021295315). We searched MEDLINE, CENTRAL, PsycInfo, Web of Science Core Collection and OpenGrey databases from inception to January 2022 for comparative studies reporting on abdominal aortic aneurysm growth according to smoking habits. AAA was defined as an infra-renal aortic diameter >3 cm. The main outcome was to estimate the mean difference of abdominal aortic aneurysms growth between smokers, former smokers, and nonsmokers. The estimates were pooled through a random-effects model network meta-analysis and heterogeneity assessed through the I<sup>2</sup> statistic.</p><p><strong>Evidence synthesis: </strong>After 567 abstracts reviewed and 17 full text studies, six studies were included in the review and meta-analysis. Studies reported data from 1987-2017, encompassing a population of 2960 people with diagnosis of AAA, which 972 were active smokers, 1254 were former smokers and 679 were nonsmokers. Based on the network estimates, we did not find a statistically significant difference between AAA growth rate differences between former smokers and non-smokers (MD 0.05, 95% CI: -0.36 to 0.47). However, we found statistically significant differences between former smokers and active smokers (MD -0.45, 95% CI: -0.83 to -0.06) and active smokers versus non-smokers (MD 0.50, 95% CI: 0.16 to 0.85).</p><p><strong>Conclusions: </strong>Smoking cessation seems to reduce the growth rate of AAA to rates similar to non-smokers, being a potential therapeutic target. These findings should lead to a higher awareness of the importance of smoking eviction in AAA patients and to future studies on this matter.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"95-103"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989028","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}
International AngiologyPub Date : 2026-04-01Epub Date: 2025-09-24DOI: 10.23736/S0392-9590.25.05377-5
Manisha Siriwardene, Nikita Naidu, Sewon Kim, Christopher Rogan, Karen Cheung, Steven Kossard, Alison Potter, David E Connor, Kurosh Parsi
{"title":"Radiology or histopathology: the misdiagnosis of benign and malignant tumors as vascular anomalies.","authors":"Manisha Siriwardene, Nikita Naidu, Sewon Kim, Christopher Rogan, Karen Cheung, Steven Kossard, Alison Potter, David E Connor, Kurosh Parsi","doi":"10.23736/S0392-9590.25.05377-5","DOIUrl":"10.23736/S0392-9590.25.05377-5","url":null,"abstract":"<p><strong>Background: </strong>Benign and malignant soft tissue tumors with a prominent vascular architecture may be misdiagnosed as vascular anomalies on imaging. The aim of this paper is to highlight the limitations of diagnostic imaging and emphasize the importance of histological analysis in obtaining the correct diagnosis.</p><p><strong>Methods: </strong>We report three cases of non-vascular tumors initially misdiagnosed as vascular malformations despite investigations using a range of imaging modalities including Duplex ultrasound (DUS), computed tomography, magnetic resonance imaging and angiography.</p><p><strong>Results: </strong>In all three cases, DUS performed in-house demonstrated features suggestive of soft tissue tumors rather than vascular malformations highlighting the operator-dependent nature of DUS. All other imaging modalities including computed-tomography and MR angiography failed to diagnose the lesions correctly. Following biopsy, two patients were diagnosed with malignant tumors, a follicular B-cell lymphoma and an extremely rare plasmacytoid/rhabdoid sarcoma of unknown histogenesis. The third patient had a benign eccrine angiomatous hamartoma (EAH). The patient with the B-cell lymphoma had a history of trauma to the site, causing a delay in diagnosis. There are only a few reports of similar cases documented in the literature.</p><p><strong>Conclusions: </strong>Diagnostic imaging modalities play an important role in the diagnosis and management of lesions thought to be vascular but as shown in cases presented here, reliance on imaging may result in misdiagnosis. Histological diagnosis of soft tissue lesions should be deemed mandatory where the diagnosis is in doubt.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"135-142"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130674","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}
International AngiologyPub Date : 2026-04-01Epub Date: 2025-12-18DOI: 10.23736/S0392-9590.25.05433-1
Gabriele Pagliariccio, Mario D'Oria, Laura Capoccia, Aldo Musilli, Sara Schiavon, Elena Giacomelli, Paolo Ottavi, Marco Leopardi, Francesco Squizzato, Ilenia DI Sario
{"title":"Safety and effectiveness of carotid endarterectomy for symptomatic high-risk mild extracranial carotid stenosis: preliminary results from an Italian multicentric study.","authors":"Gabriele Pagliariccio, Mario D'Oria, Laura Capoccia, Aldo Musilli, Sara Schiavon, Elena Giacomelli, Paolo Ottavi, Marco Leopardi, Francesco Squizzato, Ilenia DI Sario","doi":"10.23736/S0392-9590.25.05433-1","DOIUrl":"10.23736/S0392-9590.25.05433-1","url":null,"abstract":"<p><strong>Background: </strong>The impact of carotid endarterectomy (CEA) on symptomatic patients with mild high-risk carotid stenosis has not been really investigated and it is not well-defined. This multicenter retrospective study aims to assess the safety and effectiveness of CEA in patients with 50% or less stenosis with symptoms despite best medical therapy.</p><p><strong>Methods: </strong>Between January 2018 and December 2024, all consecutive patients presenting with carotid-related neurological symptoms and a ≤50% high risk carotid stenosis submitted to CEA in eight high-volume vascular centers were included in the present study. All patients underwent duplex ultrasonography and computed tomography angiography to identify plaque morphological features. All patients were checked for alternative possible source of brain embolism.</p><p><strong>Results: </strong>Twenty-nine patients with high-risk embolic plaques determining ≤50% stenosis and carotid-related neurological symptoms underwent CEA. The majority of plaques were Gray-Weale 1 or 2 (79.3%) and with ulcerated cap (79.3%). Symptoms reported at onset and during hospitalization up to CEA were 8 (27.5%) TIA, 8 (27.5%) crescendo TIA, 10 (34.4%) minor strokes, 3 (34.4%) strokes in evolution. Ischemic brain lesions of less of 25 mm were detected in 12 patients (41.3%). No perioperative stroke, death, myocardial infarction or cerebral hemorrhage occurred in this series. Only one TIA was detected due to a surgical defect that was promptly corrected. No patient experienced recurrent neurologic events related to the revascularized hemisphere during follow-up (mean 35.6 months).</p><p><strong>Conclusions: </strong>Despite the limited number of patients included in the study, CEA has been shown to be safe and effective in preventing recurrent neurological ischemic events in highly selected patients with mild carotid high-embolic-risk plaque stenosis treated at high-volume institutions. Further studies are required to identify the most appropriate diagnostic tools and the precise carotid plaque features associated with high-embolic risk.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"87-94"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774639","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}
International AngiologyPub Date : 2025-12-01Epub Date: 2025-11-20DOI: 10.23736/S0392-9590.25.05492-6
Maoping Zhang, Shuoyi Ma, Guodong Chen
{"title":"Vascular plug in the treatment of high-flow type I endoleak after endovascular repair of abdominal aortic aneurysm.","authors":"Maoping Zhang, Shuoyi Ma, Guodong Chen","doi":"10.23736/S0392-9590.25.05492-6","DOIUrl":"10.23736/S0392-9590.25.05492-6","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate the feasibility, safety, and radiographic outcomes of vascular plug embolization for high-flow type I endoleaks after endovascular repair of abdominal aortic aneurysms.</p><p><strong>Methods: </strong>This single-center retrospective case series included 10 patients who underwent endovascular repair of abdominal aortic aneurysms. These patients were subsequently diagnosed with high-flow type I endoleaks, either during the index endovascular repair of abdominal aortic aneurysms at completion angiography or during a staged procedure prompted by the evidence of a persistent type I endoleak on follow-up contrast-enhanced computed tomography. Each patient received endovascular embolization using vascular plugs. The collected data comprised patient demographics, clinical characteristics, complications, device number and size, and procedural details. Contrast-enhanced computed tomography was scheduled at 1, 3, 6, and 12 months and annually thereafter for up to 5 years.</p><p><strong>Results: </strong>Seven patients (70.0%) had type Ia endoleaks and three (30.0%) had type Ib endoleaks. Twelve vascular plugs were implanted with 100% technical success and complete occlusion of all type I endoleaks. Imaging follow-up was available in eight patients; during 6-52 months of observation, no recurrent type I endoleak was detected on contrast-enhanced computed tomography.</p><p><strong>Conclusions: </strong>Vascular plug embolization of high-flow type I endoleaks after endovascular repair of abdominal aortic aneurysm is feasible and safe. The technical success rate is high with durable radiographic exclusion on early to mid-term follow-up.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"503-507"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563972","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":"Effectiveness of micronized purified flavonoid fraction on venous symptoms and signs in patients at all stages of chronic venous disease: A systematic review and meta-analysis. Part II: signs.","authors":"Andrew Nicolaides, Kirill Lobastov, Armando Mansilha, Alejandro J Gonzalez-Ochoa, Vanessa Blanc-Guillemaud, Marie-Blanche Onselaer, Soumeya Serifou, Hurrem P Yaltirik, Narayanan Sriram, Lianrui Guo, Stavros Kakkos","doi":"10.23736/S0392-9590.25.05463-X","DOIUrl":"10.23736/S0392-9590.25.05463-X","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic venous disease (CVD) is a widespread disease characterized by various clinical manifestations. This manuscript is Part II of a systematic literature review and meta-analysis assessing the effects of micronized purified flavonoid fraction (MPFF) on lower limb symptoms and signs in patients with CVD at all stages of the disease. Part I examined symptoms and Part II presented herein focused on signs.</p><p><strong>Evidence acquisition: </strong>A systematic literature review was conducted in November 2023 to identify studies investigating the efficacy of MPFF oral treatment (1000 mg daily for at least 1 month) on venous symptoms and signs in patients with CVD at all stages (C0s-C6). Databases searched included Medline, Embase, and Cochrane. Eligible studies included randomized controlled trials (RCTs) and non-RCTs (non-randomized comparative, single-arm, and observational studies) evaluating venous signs: edema, redness, ulcer healing and disease severity assessed by venous clinical severity score (VCSS). A single-group random-effects meta-analysis was used to estimate the mean change in sign intensity and the proportion of sign improvement or complete resolution from baseline to the final assessment.</p><p><strong>Evidence synthesis: </strong>Out of 387 identified articles, 56 studies were included in the analysis, among which 33 reported CVD signs in 24,617 MPFF-treated patients. Included participants were mainly females (84.1%) with a mean age (±SD) of 48.6 (±8.8) years, and overweight with a mean BMI of 26.3 (±4.5) kg/m<sup>2</sup>. Significant reductions were observed in mean [95% confidence interval] ankle and calf circumferences (-7.6 mm [-9.1 to -6.2] and -8.0 mm [-11.2 to -4.8], respectively, P<0.001). Venous ulcers were healed in 48.9% [30.3% to 67.8%] or regressed in 73.4% [63.3% to 82.3%] of the patients (P<0.001). Significant improvements were also shown in redness and VCSS score (P<0.001). Twelve studies had a high risk of bias, while sensitivity analyses did not change the study results. Heterogeneity level was frequently high among studies.</p><p><strong>Conclusions: </strong>This comprehensive meta-analysis provides additional evidence supporting the effectiveness of MPFF in improving clinical signs of CVD across all stages of the disease.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"469-485"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707954","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}