Vasa-european Journal of Vascular Medicine最新文献

{"title":"Predictive factors and models for major adverse cardiovascular and limb events in patients with peripheral arterial disease.","authors":"Pan Song, Huarong Xiong, Xiaoyan Quan, Qin Chen, Dan Wang, Xiaoyu Liu, Meihong Shi","doi":"10.1024/0301-1526/a001228","DOIUrl":"10.1024/0301-1526/a001228","url":null,"abstract":"<p><p><i>Background:</i> Peripheral arterial disease (PAD) is associated with an increased risk of major adverse cardiovascular and limb events. However, the factors influencing major adverse cardiovascular events (MACE) and major adverse limb events (MALE) in patients with PAD remain unclear. Additionally, while some predictive models for MACE and MALE in patients with PAD have been developed, their performance is uncertain. This systematic review aims to identify the factors influencing MACE and MALE in patients with PAD and to systematically evaluate existing predictive models. <i>Materials and methods:</i> We conducted a literature search in PubMed, Embase, and the Cochrane Library to identify studies exploring risk factors for MACE and MALE, as well as predictive models for these outcomes. Data extraction focused on study design, patient demographics, reported influencing factors (e.g., clinical, biochemical), and characteristics of predictive models (e.g., variables, validation methods, performance metrics). We specifically evaluated the methodological quality and risk of bias of the identified predictive models using established tools such as PROBAST (Prediction model Risk Of Bias ASsessment Tool). This study aimed to synthesize evidence on determinants of MACE and MALE and critically appraise existing prediction models to inform future research and clinical decision-making. <i>Results:</i> One hundred and sixteen studies reported factors influencing MACE in patients with PAD. Six studies developed or validated predictive models. Three models were rated as having low risk of bias across all domains, while the other three had unclear or high risk of bias in at least one domain. A total of 118 influencing factors associated with MACE were identified. Common factors included: demographic characteristics (age, smoking); (2) comorbidities (diabetes mellitus (DM), coronary artery disease (CAD), prior stroke, heart failure); (3) clinical measures (body mass index (BMI), systolic blood pressure (SBP)); (4) diagnostic indicators (ankle-brachial index (ABI), estimated glomerular filtration rate (eGFR), C-reactive protein (CRP), serum creatinine); (5) medication use (statins); and (6) classification systems (Rutherford classification, Fontaine classification). Fifty-five studies reported factors influencing MALE in patients with PAD. Six studies developed or validated predictive models. Three models were rated as having low risk of bias across all domains, while the other three had unclear or high risk of bias in at least one domain. A total of 88 influencing factors were identified. Common factors across most studies included demographic characteristics (age, smoking, socioeconomic status), comorbid conditions (DM, chronic kidney disease, hypertension, cerebrovascular disease), clinical factors (degree of frailty, BMI), diagnostic indicators (hemoglobin, serum creatinine, serum albumin), medication use (statin), and other factors (Wound, Ischemia, a","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"245-258"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970913","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":"Covered balloon-expandable stents in isolated abdominal aortic stenosis or occlusion in 54 patients, predominantly women.","authors":"Erwin See, Klaus Mathias, Ralf Weser, Sigrid Nikol","doi":"10.1024/0301-1526/a001248","DOIUrl":"10.1024/0301-1526/a001248","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Bilateral symptoms of peripheral artery disease may be rarely caused by isolated atherosclerotic aortic stenosis or short occlusion. Standard therapies have been open surgery, balloon angioplasty and implantation of selfexpanding stents and stentgrafts. <i>Materials and methods:</i> In this retrospective study 54 consecutive patients were treated under local anaesthesia with a balloon-expandable endograft. Endpoints were safety, ankle-brachial and toe-brachial index (ABI, TBI), walking distance, clinical stage and re-interventions at long-term. <i>Results:</i> There were 36 women and 18 men, mean age 68 years; 48 patients suffered from claudication, 6 patients had rest pain with skin lesions in 3 cases. The technical success rate was 100%. There was an immediate average improvement of ABI from 0.76 +/- 0.26 at rest before intervention to 0.88 +/- 0.31 at rest after stentgraft implantation into the aortic stenosis. TBI improved from 0.48 +/- 0.17 to 0.58 +/- 23 at rest. Mean follow-up was 1 to 8 years (mean 4.46) years. Average walking distance improved from 124 m to 612 m. Of the 6 patients with rest pain or skin lesions all except 1 patient improved to at least claudication stage with a painfree walking distance over 200 m. No complications such as aortic rupture, dissection or peripheral embolisation occurred, 2 patients needed surgical revision of their calcified common femoral arteries at the access sites. Three patients developed at long-term recurrent stenosis due to the compression of stentgrafts by the calcified plaque burden which was solved by balloon angioplasty or implantation of an additional aortic stentgraft. <i>Conclusions:</i> Endovascular treatment of aortic stenosis or occlusion is feasible under local anaesthesia with good functional results, very low mortality and morbidity and durable results.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"291-299"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514105","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 to do it - Endovascular solutions for the renovisceral segment in coral reef aortas.","authors":"Sigrid Nikol, Gabriela Marin, Carsten Heintz, Ralf Weser","doi":"10.1024/0301-1526/a001249","DOIUrl":"10.1024/0301-1526/a001249","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Coral reef atherosclerosis of the renovisceral aorta leads to end-organ and extremity malperfusion due to ischaemia and/or embolic events. Those mostly female patients typically present with renovascular hypertension, chronic mesenteric ischaemia, and symmetric peripheral artery disease of all stages, including critical limb ischaemia. Mortality and morbidity are high in open surgery. <i>Materials and methods:</i> Here we describe step by step the individually designed endovascular solutions with multiple arterial accesses using stentgrafts and open stents in 8 consecutive patients. <i>Results:</i> All patients survived, acute renal failure occurred in 1 case, otherwise uneventful inhospital courses. Patients were followed over 25 (7-56) months with durable results. <i>Conclusions:</i> Endovascular treatment of coral reef aorta leading to aortic stenosis or occlusion in the renovisceral segment is feasible in most cases using multiple arterial accesses with good functional results, low mortality and morbidity and durable results.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"300-310"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514148","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":"Beyond function: supervised exercise therapy may target inflammatory gene expression in patients with symptomatic peripheral artery disease.","authors":"Giacomo Buso, Stefano Lanzi, Karima Bouzourène, Christelle Bielmann, Nathalie Rosenblatt-Velin, Lucia Mazzolai","doi":"10.1024/0301-1526/a001230","DOIUrl":"10.1024/0301-1526/a001230","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Supervised exercise therapy (SET) is a first-line treatment for patients with symptomatic peripheral artery disease (PAD). However, its impact on inflammation, as well as the relationship between inflammation and functional improvements, remain poorly understood. <i>Patients and methods:</i> In this prospective, single-arm study, 51 patients with symptomatic PAD underwent a 12-week multimodal SET program. Limb perfusion, walking ability, and estimated muscle power were assessed before and after SET. Inflammatory gene expression in peripheral blood mononuclear cells was evaluated by real-time quantitative PCR. Response to SET was defined as an improvement of >46 m in the six-minute walking distance (6MWD). <i>Results:</i> Following SET, mRNA expression levels significantly decreased for polymorphonuclear (PMN)-elastase (-48%; p=.003) and myeloperoxidase (MPO) (-39%; p=.002). Trends toward reduction were also observed for matrix metalloproteinase-9 (MMP-9) (-42%; p=.070), neutrophil gelatinase-associated lipocalin (NGAL) (-37%; p=.069), and protein-arginine deiminase type 4 (PAD4) (-29%; p=.052). Linear mixed models indicated similar changes between responders and non-responders. After adjusting the model for baseline gene expression levels and clinically relevant covariates, a significant post-SET reduction was observed in both responders and non-responders for PMN-elastase (p=.027 and p<.001, respectively), MMP-9 (both p=.003), and MPO (p=.016 and p=.003, respectively). PAD4 expression significantly decreased only in non-responders (p=.045). Regression analyses revealed no associations between inflammatory gene expression and perfusion, walking ability, or muscle power. <i>Conclusions:</i> SET may reduce the expression of several inflammatory markers in patients with symptomatic PAD, independently of functional gains. Further studies are needed to confirm these findings and to explore whether reducing systemic inflammation translates into improved cardiovascular outcomes in this population.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"269-280"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030618","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":"Adjunct medical therapy and its impact on survival and reintervention rates in patients with common femoral artery disease undergoing endovascular revascularization or open repair.","authors":"Solon Antoniades, Konstantinos P Donas, Jason T Lee, Martin Andrassy, Drosos Kotelis, Marco V Usai, Konstantinos Avranas, Mario D'Oria, Raphael Coscas, Nicola Troisi, Bahaa Nasr, Athanasios Saratzis, Hany Zayed, Grigorios Korosoglou","doi":"10.1024/0301-1526/a001246","DOIUrl":"10.1024/0301-1526/a001246","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Optimal pharmacotherapy is a cornerstone for the treatment of patients with symptomatic peripheral artery disease (PAD). Our aim was to evaluate the impact of adjunct medical therapy, including lipid-lowering and antiplatelet treatment in patients undergoing open or endovascular revascularization due to common femoral artery occlusive disease (CFAOD). <i>Patients and methods:</i> Consecutive patients undergoing either endovascular or open revascularization due to CFAOD were analyzed. Pharmacotherapy before and after treatment was registered and its impact on the following post-procedural outcomes: (i) all-cause mortality and (ii) major adverse limb events (MALE), including major amputation and clinically driven target lesion revascularization (CD-TLR), were systematically analyzed. <i>Results:</i> Patients undergoing endovascular therapy (n=225) were older and exhibited more comorbidities such as diabetes mellitus and heart failure and had more frequently chronic limb threatening ischemia (CLTI) compared to those undergoing open repair (n=662). During 1.73 (0.9-3.3) years of follow-up, 96 (10.8%) deaths and 118 (13.3%) MALE occurred. After endovascular therapy, more patients received clopidogrel (70.2% versus 41.5%) and statins (92.0% versus 74.9%), (p<.001 for both). By multivariable analysis, statin prescription was associated with lower death rates (Odds Ratio (OR)= 0.43, 95%CI=0.25-0.73, p<.002), whereas clopidogrel was associated with lower MALE rates (OR=0.65, 95%CI=0.43-0.97, p=.04). These effects were primarily driven by patients undergoing open repair (effect of statins) and by patients with chronic limb threatening ischemia (effect of clopidogrel). <i>Conclusions:</i> Statin and clopidogrel treatment are important components of the post-procedural treatment of patients with PAD undergoing revascularisation due to CFAOD. Especially statins need to be prescribed based on current national and international guidelines independent of the revascularization type in every patient to reduce death rates.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"281-290"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145393359","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":"Dependencies of vein diameters and venous valve function on patient positioning during duplex ultrasound examination.","authors":"Charline Diessner, Norbert Weiss, Sebastian Werth","doi":"10.1024/0301-1526/a001256","DOIUrl":"10.1024/0301-1526/a001256","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Duplex ultrasound assessment with the patient standing is standard for diagnosing chronic venous insufficiency (CVI). However, assessments are often performed with patients in tilted or supine positions due to age or physical limitations. This study aimed to evaluate the influence of the patient's positioning on venous diameters and venous valve function. <i>Patients and Methods:</i> Monocentric, prospective cohort study in 30 patients with CVI of the great saphenous vein (GSV). 18 contralateral limbs without GSV insufficiency were defined as the control group. With duplex ultrasound, we measured GSV diameters at different anatomic points. Moreover, we analyzed the occurrence of venous reflux (>0.5s) with the patient in a lying position (0°), on the tilting table in 30° and 70° positions, and with the patient standing (90°). <i>Results:</i> A linear relationship was found between patient inclination and diameters in varicose GSVs. Average diameters in limbs with CVI increased from lying to standing by 39-42%, while average diameters in healthy GSVs increased by 20-23%. In ≥97% of the patients, pathological venous reflux findings observed in the standing position were also detected in the 70° tilted position, with no statistically significant differences between these two positions. <i>Conclusions:</i> For duplex ultrasound examination of the GSV in cases of suspected CVI, it can be recommended to position the patient on a table tilted at 70°. This position provides results comparable to those obtained in the standing position while enhancing patient safety and examiner comfort.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"311-316"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557805","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 new era in carotid prevention - critical appraisal of the CREST-2 results.","authors":"Christian-Alexander Behrendt, Farzin Adili, Erwin Blessing, Ralf Langhoff, Oliver J Müller, Christos Rammos, Barbara Rantner, Grigorios Korosoglou","doi":"10.1024/0301-1526/a001274","DOIUrl":"https://doi.org/10.1024/0301-1526/a001274","url":null,"abstract":"","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":"55 4","pages":"241-244"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346542","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":"Trametinib for the treatment of advanced stage patients with arterio-venous malformations.","authors":"Beatrix Cucuruz, Andreas Deistung, Oleksandr Bidakov, Octavian Andercou, Thomas Schmitz-Rixen, Julius Loeser, Celia Inselmann, Michael Koller, Walter Alexander Wohlgemuth","doi":"10.1024/0301-1526/a001286","DOIUrl":"https://doi.org/10.1024/0301-1526/a001286","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Arterio-venous malformations (AVMs) may lead to vessel aneurysms and thus to life-threatening bleeding or malperfusion of the extremities, causing recurrent ulceration. Possible therapies are embolisation and/or resection. This study investigates treatment options for patients with AVM Schobinger stage III and IV for whom embolisation and resection are no longer possible and medical treatment with trametinib, a mitogen-activated protein kinase inhibitor (MEK) was performed. <i>Patients and methods:</i> As part of the German guideline development process for the diagnosis and treatment of vascular malformations (AWMF register number 003-007), a systematic literature search was performed using a professional service provider, followed by a retrospective, exploratory analysis based on a consecutive local registry at an interdisciplinary tertiary care center for vascular anomalies. All patients with AVM Schobinger stage IIII - IV were included. <i>Results:</i> Of the 559 reports on specific medications for vascular malformations, only 4 (0.7%) included treatment with trametinib, and only 2 (0.4%) of them addressed its use in AVMs showing reduced blood inflow in the malformation or volume reduction. In our case series of 99 consecutive patients with AVM Schobinger stage III-IV, nine were treated with trametinib. Out of them, 6/9 (66%) had ulceration. 1/6 (20% of the patients with ulceration died, one patient required major amputation, and 4 (60%) were healed without recurrence through treatment. Three patients with chronic pain showed reduced symptoms without requiring additional analgesics. <i>Conclusions:</i> The single cases found in the literature and our small case series suggest that MEK1-inhibitors, such as trametinib, are an option for treating AVM Schobinger stage III - IV. Further large-scale studies are required to confirm these initial observations and to fully explore the potential of MEK1-inhibitors.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975873","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":"Drug coated balloon angioplasty for femoropopliteal lesions: \"keep it safe and effective\".","authors":"Grigorios Korosoglou, Erwin Blessing, Christos Rammos","doi":"10.1024/0301-1526/a001293","DOIUrl":"10.1024/0301-1526/a001293","url":null,"abstract":"","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869713","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":"Chronic venous disease - an update on pathophysiology, diagnosis and management.","authors":"Bernhard Zierfuss, Christof Zerweck, Markus Theurl, Marco Fresa, Sabine Steiner, Oliver Schlager","doi":"10.1024/0301-1526/a001291","DOIUrl":"https://doi.org/10.1024/0301-1526/a001291","url":null,"abstract":"<p><p><b></b> Chronic venous disease (CVD) is a common disease, affecting up to 20% of the general population. In later clinical stages of venous refluxive disease dwelling oedema, skin changes and leg ulcers can occur. Therapeutic options comprise compression therapy and several minimal-invasive as well as open surgery treatments. Venous leg ulcers, as well as mixed arterial-venous leg ulcers inflict high socioeconomic and health care system burden. Despite both the high prevalence as well as the high cost, timely and effective treatment are often delayed. Thus, this review summarizes all of these mentioned aspects of CVD.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843466","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}