Vascular Medicine (London, England)最新文献

{"title":"Images in Vascular Medicine: Trapped thrombus underneath a recently placed inferior vena cava filter.","authors":"Stanislav Henkin, Eric S Rothstein, Michael N Young","doi":"10.1177/1358863X20967432","DOIUrl":"https://doi.org/10.1177/1358863X20967432","url":null,"abstract":"","PeriodicalId":151049,"journal":{"name":"Vascular Medicine (London, England)","volume":" ","pages":"346-347"},"PeriodicalIF":3.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1358863X20967432","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38589850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interactions between vitamin D levels, cardiovascular risk factors, and atherothrombosis markers in patients with symptomatic peripheral artery disease.","authors":"Andrea Da Porto, Alessandro Cavarape, Cristiana Catena, Gianluca Colussi, Viviana Casarsa, Leonardo Alberto Sechi","doi":"10.1177/1358863X20979360","DOIUrl":"https://doi.org/10.1177/1358863X20979360","url":null,"abstract":"Peripheral artery disease (PAD) affects approximately 200 million patients worldwide, with a prevalence of 30% in individuals aged over 70 years. The clinical spectrum of disease is wide and includes individuals who are asymptomatic as well as those with intermittent claudication or critical limb ischemia (CLI). It is well known that patients with PAD have an increased risk of death from cardiovascular (CV) disease.1 In addition to traditional CV risk factors,2 vitamin D deficiency was shown to be independently associated with PAD,3,4 as confirmed in two recent meta-analyses.5,6 Moreover, low vitamin D levels were associated with faster decline in functional performance among individuals with PAD.7 Vitamin D is involved in several phases of the atherosclerotic process, with direct effects on endothelial cells forming the vascular wall8 and indirect effects through its association with proatherogenic risk factors such as hypertension,9 insulin resistance,10 and unfavorable lipid profile.11 We evaluate the association between vitamin D status, clinical severity of PAD, and CV risk factors in 190 patients with symptomatic PAD. Demographics and clinical aspects were extracted from electronic medical reports. PAD was confirmed by angiographic evidence of stenosis > 50% in the iliac and femoral-popliteal arteries of infrapopliteal vessels. The study was performed in accordance with the current legislation on Observational Studies and the Helsinki Declaration. Patients have given consent to the processing of personal data. Study design was approved by the local ethics committee (Internal Board DAME, University of Udine, Italy). Values of normally distributed variables are expressed as mean ± SD. The normality of distribution was assessed by the Kolmogorov–Smirnov test, and variables with a skewed distribution were analyzed after logarithmic transformation. Pearson’s chi-squared test was used to compare frequency distributions. ANOVA tests were used to examine differences in variables through 25(OH) vitamin D tertiles. Relationships between continuously distributed variables were examined by linear regression analysis, and the correlation was expressed by Pearson’s correlation coefficient. Stepwise multivariate linear regression analysis was used to ascertain which variables were independently related. A two-tailed probability value of less than 5% was considered to indicate statistical significance. Data analyses were performed using XLSTAT 2020 (Addinsoft, New York, NY, USA). Most patients had a history of hypertension (82.6%), diabetes (44.5%), and coronary or cerebrovascular disease (31.6% and 60.5%, respectively). A total of 19.4% of patients were current smokers. Almost all patients were treated with an antiplatelet drug or statin (89.5% and 81.5%, respectively). Other demographics and clinical aspects are summarized in online supplement 1. Among our population, 54.3% of patients had serum 25(OH)D levels below 30 ng/ml. Patients with more severe PA","PeriodicalId":151049,"journal":{"name":"Vascular Medicine (London, England)","volume":" ","pages":"315-316"},"PeriodicalIF":3.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1358863X20979360","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38823560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging modalities for cardiovascular phenotyping in asymptomatic people living with HIV.","authors":"Maria Bonou,&nbsp;Chris J Kapelios,&nbsp;Eleni Athanasiadi,&nbsp;Sophie I Mavrogeni,&nbsp;Mina Psichogiou,&nbsp;John Barbetseas","doi":"10.1177/1358863X20978702","DOIUrl":"https://doi.org/10.1177/1358863X20978702","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) has emerged as a leading cause of non-HIV-related mortality among people living with HIV (PLWH). Despite the growing CVD burden in PLWH, there is concern that general population risk score models may underestimate CVD risk in these patients. Imaging modalities have received mounting attention lately to better understand the pathophysiology of subclinical CVD and provide improved risk assessment in this population. To date, traditional and well-established techniques such as echocardiography, pulse wave velocity, and carotid intima thickness continue to be the basis for the diagnosis and subsequent monitoring of vascular atherosclerosis and heart failure. Furthermore, novel imaging tools such as cardiac computed tomography (CT) and cardiac CT angiography (CCTA), positron emission tomography/CT (PET/CT), and cardiac magnetic resonance (CMR) have provided new insights into accelerated cardiovascular abnormalities in PLWH and are currently evaluated with regards to their potential to improve risk stratification.</p>","PeriodicalId":151049,"journal":{"name":"Vascular Medicine (London, England)","volume":" ","pages":"326-337"},"PeriodicalIF":3.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1358863X20978702","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38843006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait changes after supervised exercise training in patients with symptomatic lower extremity peripheral artery disease.","authors":"Stefano Lanzi,&nbsp;Joël Boichat,&nbsp;Luca Calanca,&nbsp;Pauline Aubertin,&nbsp;Davide Malatesta,&nbsp;Lucia Mazzolai","doi":"10.1177/1358863X20984831","DOIUrl":"https://doi.org/10.1177/1358863X20984831","url":null,"abstract":"<p><p>This study aimed to investigate the effects of supervised exercise training (SET) on walking performance and spatiotemporal gait changes in patients with symptomatic lower extremity peripheral artery disease (PAD). In this single-arm prospective nonrandomized cohort study, patients with Fontaine stage II PAD following a 3-month SET program were included. Before and after SET, a constant-load treadmill test was performed to determine the pain-free and maximal walking distances (PFWD and MWD, respectively). During this test, spatiotemporal gait parameters were assessed. The ankle-brachial index (ABI) and toe-brachial index (TBI) were also measured. Twenty-seven patients with PAD (64.0 ± 1.9 y, 74% men) were included. Following SET, the PFWD (+68%; <i>p</i> = 0.001) and MWD (+79%; <i>p</i> ⩽ 0.001) significantly increased. The ABI and TBI did not change significantly. Following SET, the stride duration, stride frequency, stride length, and double support phase duration did not change significantly. In contrast, subphases of stance showed significant changes: the loading response (+8%; <i>p</i> = 0.03) and foot-flat (+2%; <i>p</i> = 0.01) phases were significantly longer, whereas the push-off phase (-7%; <i>p</i> = 0.002) was significantly shorter. A significant positive correlation was found between changes in the foot-flat phase and changes in PFWD (<i>r</i> = 0.43, <i>p</i> = 0.03). A significant negative correlation was found between changes in the push-off phase and changes in PFWD (<i>r</i> = -0.39, <i>p</i> = 0.05). No significant correlations were found between changes in relative durations of the subphases of stance and MWD. These results indicate that changes in temporal gait parameters during the foot contact phase potentially constitute an underlying mechanism of delayed claudication distance in patients with symptomatic PAD.</p>","PeriodicalId":151049,"journal":{"name":"Vascular Medicine (London, England)","volume":" ","pages":"259-266"},"PeriodicalIF":3.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1358863X20984831","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25359661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Images in Vascular Medicine: Rare vascular infection in spondylodiscitis.","authors":"Daniela Gabrielli,&nbsp;Paolo Pagano,&nbsp;Maria Virginia Boni,&nbsp;Carlo Marinucci,&nbsp;Brunella Rossi,&nbsp;Ivan Santi,&nbsp;Fabio D'Emidio","doi":"10.1177/1358863X20988349","DOIUrl":"https://doi.org/10.1177/1358863X20988349","url":null,"abstract":"Aortic infections may be the result of hematogenous dissemination from a remote focal infection or direct invasion from an adjacent septic focus such as infection involving the intervertebral disc and the nearest vertebrae of the spine (spondylodiscitis). They are so rare that the exact incidence is unknown1; however, the mortality rate is still 20% to 40%.2 Diagnosis is challenging because clinical features are nonspecific. Radiological imaging is mandatory in the early detection of infective vascular complications and to plan the treatment strategy. We describe a rare case of penetrating aortic ulcer (PAU) of the descending thoracic aorta that arose during the hospitalization of a patient with spondylodiscitis. A 67-year-old man, with arterial hypertension and immunoglobulin G lambda monoclonal gammopathy, was admitted to our emergency department with a diagnosis of spondylodiscitis involving D11 and D12 vertebral bones following recently performed dorso-lumbar computed tomography (CT) (Panel A-1, arrow) and magnetic resonance imaging (MRI) (Panels A-2– A-4, arrows). On clinical examination, he had suffered severe back pain for 2 months, as well as fever and difficulty walking. Initial laboratory analysis revealed a C-reactive protein (CRP) level of 5.8 mg/L, a white cell count of 7.300/mm3, a hemoglobin level of 12.1 g/dL, and a creatinine level of 1.4 mg/dL. Blood culture isolated Streptococcus agalactiae and after infectious disease consultation the patient was started on appropriate intravenous antibiotic therapy – first with amoxicillin and clavulanic acid and then with cephalosporins. He became afebrile and resumed walking without aids after rehabilitation therapy. A 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT was performed a week later; it showed radiotracer uptake in the septic focus of the spine (SUVmax 9.1) and in the middle of the descending thoracic aorta (SUVmax 13.3) (Panel B, arrows). CT angiography (CTA) showed a PAU of the descending aorta (Type B) of 12 mm in depth – an additional finding and as a result of infective vascular damage that arose during the hospitalization (Panel C, arrows). Antibiotic therapy was continued until CRP level normalization was achieved for 2 consecutive weeks. According to general consensus, medical therapy with careful clinical follow-up and imaging surveillance are the treatment strategy of choice Images in Vascular Medicine: Rare vascular infection in spondylodiscitis","PeriodicalId":151049,"journal":{"name":"Vascular Medicine (London, England)","volume":" ","pages":"348-349"},"PeriodicalIF":3.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1358863X20988349","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25379913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SVM Communications: Message from the Scientific Program Committee Chair.","authors":"Herbert D Aronow","doi":"10.1177/1358863X211007200","DOIUrl":"https://doi.org/10.1177/1358863X211007200","url":null,"abstract":"","PeriodicalId":151049,"journal":{"name":"Vascular Medicine (London, England)","volume":" ","pages":"356"},"PeriodicalIF":3.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1358863X211007200","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25565261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular Disease Patient Information Page: Compression therapy.","authors":"Natalie S Evans,&nbsp;Elizabeth V Ratchford","doi":"10.1177/1358863X211002263","DOIUrl":"https://doi.org/10.1177/1358863X211002263","url":null,"abstract":"","PeriodicalId":151049,"journal":{"name":"Vascular Medicine (London, England)","volume":" ","pages":"352-355"},"PeriodicalIF":3.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1358863X211002263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25572689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and prognostic impact of post-discharge bleeding after endovascular therapy for peripheral artery disease.","authors":"Keiichi Hishikari,&nbsp;Hiroyuki Hikita,&nbsp;Fumichika Abe,&nbsp;Naruhiko Ito,&nbsp;Yoshinori Kanno,&nbsp;Munehiro Iiya,&nbsp;Tadashi Murai,&nbsp;Atsushi Takahashi,&nbsp;Taishi Yonetsu,&nbsp;Tetsuo Sasano","doi":"10.1177/1358863X21992863","DOIUrl":"https://doi.org/10.1177/1358863X21992863","url":null,"abstract":"<p><p>This study evaluated the incidence, predictors, and impact of bleeding requiring hospitalization following successful endovascular therapy (EVT) for peripheral artery disease. Platelet inhibition after EVT reduces the risk of major adverse limb events but increases the risk of bleeding. The incidence of post-discharge bleeding after EVT, its independent predictors, and its prognostic importance in clinical practice have not been fully addressed. We evaluated 779 consecutive patients who underwent EVT. We found that 77 patients (9.9%) were hospitalized for major bleeding during follow-up after EVT (median 39 months, range 22-66 months), with almost half (48.1%) of the bleeding categorized as gastrointestinal bleeding. Significant predictors of post-discharge bleeding were hemodialysis (hazard ratio (HR), 3.12; 95% CI: 1.93 to 5.05; <i>p</i> < 0.001) and dual antiplatelet therapy (DAPT) use (HR, 1.87; 95% CI: 1.03 to 3.41; <i>p</i> = 0.041). During follow-up, the all-cause mortality-free survival rate was significantly worse in patients who had experienced major bleeding than in those who had not (log-rank test χ² = 54.6; <i>p</i> < 0.001). Cox proportional hazards analysis showed that major bleeding (HR, 2.78; 95% CI: 1.90 to 4.06; <i>p</i> < 0.001) was an independent predictor of all-cause death after EVT. Hospitalization for post-discharge bleeding after EVT is associated with a substantially increased risk of death, even after successful EVT. We concluded that patients' predicted bleeding risk should be considered when selecting patients likely to benefit from EVT, and that the risk should be considered especially thoroughly in hemodialysis patients.</p>","PeriodicalId":151049,"journal":{"name":"Vascular Medicine (London, England)","volume":" ","pages":"281-287"},"PeriodicalIF":3.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1358863X21992863","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25422902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of the paclitaxel-eluting Eluvia stent for long femoropopliteal lesions in Asian patients with predominantly chronic limb-threatening ischemia.","authors":"Steven Kum,&nbsp;Jetty Ipema,&nbsp;Eline Huizing,&nbsp;Yih K Tan,&nbsp;Darryl Lim,&nbsp;Ian Yh Lok,&nbsp;Constantijn Evb Hazenberg,&nbsp;Çağdaş Ünlü","doi":"10.1177/1358863X20987894","DOIUrl":"https://doi.org/10.1177/1358863X20987894","url":null,"abstract":"<p><p>The fluoropolymer-coated, paclitaxel-eluting Eluvia stent has shown promising results for the endovascular treatment of femoropopliteal artery lesions in patients with claudication. The aim of the current study was to evaluate efficacy and safety outcomes of the Eluvia stent for the treatment of long femoropopliteal lesions in Asian patients. This is a single-center, retrospective study. The primary endpoint was primary patency at 1 year. Secondary outcomes were 30-days complication rate, technical success, 1-year freedom from clinically driven target lesion revascularization (CD-TLR), limb salvage, survival, amputation-free survival (AFS), wound healing, and clinical improvement. A total of 64 patients with 67 femoropopliteal lesions were included; 78% suffered from diabetes and 84% had chronic limb-threatening ischemia (CLTI). Of those with ischemic wounds, 79% did not have run-off to the foot. Mean lesion length was 193 ± 128 mm and 52% were severely calcified. Primary patency at 1 year was 84% in the overall cohort and 91% in patients with complete lesion coverage with the Eluvia stent. Technical success was achieved in 100% of the cases and 30-day complications occurred in six patients. Twelve-month freedom from CD-TLR, limb salvage, survival, and AFS were 92%, 93%, 85%, and 80%, respectively. In 80% of patients, complete wound healing was experienced and 84% had clinical improvement after 1 year. The Eluvia stent showed promising 12-month patency and clinical results for femoropopliteal treatment in this CLTI-dominant patient population with severely calcified, long lesions. Patient numbers were, however, small; larger trials are required to validate these findings. Aneurysmal change seen in some cases also needs further investigation.</p>","PeriodicalId":151049,"journal":{"name":"Vascular Medicine (London, England)","volume":" ","pages":"267-272"},"PeriodicalIF":3.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1358863X20987894","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25490532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of the Wells score in predicting deep vein thrombosis in medical and surgical hospitalized patients with or without thromboprophylaxis: The R-WITT study.","authors":"Jean-Eudes Trihan,&nbsp;Michael Adam,&nbsp;Sara Jidal,&nbsp;Isabelle Aichoun,&nbsp;Sarah Coudray,&nbsp;Jeremy Laurent,&nbsp;Laurent Chaussavoine,&nbsp;Sebastien Chausserie,&nbsp;Jerome Guillaumat,&nbsp;Damien Lanéelle,&nbsp;Antonia Perez-Martin","doi":"10.1177/1358863X21994672","DOIUrl":"https://doi.org/10.1177/1358863X21994672","url":null,"abstract":"<p><p>The Wells score had shown weak performance to determine pre-test probability of deep vein thrombosis (DVT) for inpatients. So, we evaluated the impact of thromboprophylaxis on the utility of the Wells score for risk stratification of inpatients with suspected DVT. This bicentric cross-sectional study from February 1, 2018 to January 31, 2019 included consecutive medical and surgical inpatients who underwent lower limb ultrasound study for suspected DVT. Wells score clinical predictors were assessed by both ordering and vascular physicians within 24 h after clinical suspicion of DVT. Primary outcome was the Wells score's accuracy for pre-test risk stratification of suspected DVT, accounting for anticoagulation (AC) treatment (thromboprophylaxis for ⩾ 72 hours or long-term anticoagulation). We compared prevalence of proximal DVT among the low, moderate and high pre-test probability groups. The discrimination accuracy was defined as area under the receiver operating characteristics (ROC) curve. Of the 415 included patients, 30 (7.2%) had proximal DVT. Prevalence of proximal DVT was lower than expected in all pre-test probability groups. The prevalence in low, moderate and high pre-test probability groups was 0.0%, 3.1% and 8.2% (<i>p</i> = 0.22) and 1.7%, 4.2% and 25.8% (<i>p</i> < 0.001) for inpatients with or without AC, respectively. Area under ROC curves for discriminatory accuracy of the Wells score, for risk of proximal DVT with or without AC, was 0.72 and 0.88, respectively. The Wells score performed poorly for discrimination of risk for proximal DVT in hospitalized patients with AC but performed reasonably well among patients without AC; and showed low inter-rater reliability between physicians. <b>ClinicalTrials.gov Identifier: NCT03784937.</b></p>","PeriodicalId":151049,"journal":{"name":"Vascular Medicine (London, England)","volume":" ","pages":"288-296"},"PeriodicalIF":3.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1358863X21994672","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25514806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}