Vasa-european Journal of Vascular Medicine最新文献

{"title":"Clinical benefits of paclitaxel-coated balloons in the treatment of infrapopliteal limb-threatening peripheral artery disease.","authors":"Charlott Fuß, Hans Krankenberg, Pawel Aftanski, P Christian Schulze, Marcus Thieme","doi":"10.1024/0301-1526/a001217","DOIUrl":"https://doi.org/10.1024/0301-1526/a001217","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Infrapopliteal lesions account for one-third of peripheral artery disease (PAD) cases; however, its endovascular treatment data are insufficient. Although paclitaxel-coated drug-coated-balloons (DCBs) reduce restenosis and the need for re-interventions in femoropopliteal arteries, their effectiveness in below-the-knee (BTK) vessels is uncertain. This study evaluated the real-world effectiveness and safety of paclitaxel-coated DCBs in BTK vessels. <i>Patients and methods:</i> This retrospective single-centre study included consecutive patients treated with paclitaxel-coated Luminor™ DCB in BTK arteries between August 2017 and March 2022. The follow-up extended to 60 months. Data were retrieved from archives, phone interviews and physician inquiries. <i>Results:</i> Seventy-nine patients (65.5% male; mean age 74.9±9.2 years) underwent 84 interventions with 114 DCBs. The overall and treated lesion lengths averaged 102.1±80.3 and 117.2±75.5 mm, respectively. The median preoperative Rutherford score was 5 [interquartile range (IQR), 5-5; n=80]. The ankle-brachial index (ABI, 0.8±0.4-1.0±0.2, P=.002) and toe-brachial index (TBI, 0.3±0.3-0.6±0.2, P=.039) significantly improved post-intervention. The wound, ischaemia and foot infection score components showed median value reductions from the pre- to the postinterventional assessment: wound, from 1 (IQR, 1-2) to 1 (0-1); ischaemia, from 1 (IQR, 0-2) to 0 (0-1); and foot infection, from 1 (IQR, 0-2) to 0 (0-1). Kaplan-Meier analysis revealed 25 major adverse limb events, 17 re-interventions, 15 major adverse cardiac events, and 8 major amputation events over 5 years. Re-intervention-free survival was lower in men than in women (P=.036). Diabetic status or renal function was not significantly different. The 3-year mortality was 46.4%. <i>Conclusions:</i> This study highlights the clinical benefit of infrapopliteal paclitaxel-coated DCBs in real-world patients. ABI and TBI improvements reflect ischaemia relief. Wound-healing trends suggest reduced ischaemia and infection within 3 days, but requires longer follow-up. High mortality rates emphasise the effect of comorbidities and multidisciplinary care requirements.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785415","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":"Balancing technical success with patient-centered outcomes - Endovascular treatment in nonagenarians with peripheral arterial disease.","authors":"Daniel Raskin, Sasan Partovi","doi":"10.1024/0301-1526/a001219","DOIUrl":"https://doi.org/10.1024/0301-1526/a001219","url":null,"abstract":"","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":"54 5","pages":"289-290"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970875","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":"Intravascular ultrasound in peripheral artery disease - Bridging visualization and precision therapy.","authors":"Christos Rammos, Eric A Secemsky","doi":"10.1024/0301-1526/a001218","DOIUrl":"https://doi.org/10.1024/0301-1526/a001218","url":null,"abstract":"","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":"54 5","pages":"287-288"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970865","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":"Carotid and femoral bifurcation plaques detected by ultrasound as predictors of cardiovascular events.","authors":"Aleš Blinc, Andrew N Nicolaides, Pavel Poredoš, Kosmas I Paraskevas, Christian Heiss, Oliver Müller, Christos Rammos, Agata Stanek, Borut Jug","doi":"10.1024/0301-1526/a001214","DOIUrl":"https://doi.org/10.1024/0301-1526/a001214","url":null,"abstract":"<p><p><b></b> Risk factor-based algorithms give a good estimate of cardiovascular (CV) risk at the population level but are often inaccurate at the individual level. Detecting preclinical atherosclerotic plaques in the carotid and common femoral arterial bifurcations by ultrasound is a simple, non-invasive way of detecting atherosclerosis in the individual and thus more accurately estimating his/her risk of future CV events. The presence of plaques in these bifurcations is independently associated with increased risk of CV death and myocardial infarction, even after adjusting for traditional risk factors, while ultrasonographic characteristics of vulnerable plaque are mostly associated with increased risk for ipsilateral ischaemic stroke. The predictive value of carotid and femoral plaques for CV events increases in proportion to plaque burden and especially by plaque progression over time. Assessing the burden of carotid and/or common femoral bifurcation plaques enables reclassification of a significant number of individuals with low risk according risk factor-based algorithms into intermediate or high CV risk and intermediate risk individuals into the low- or high CV risk. Ongoing multimodality imaging studies, supplemented by clinical and genetic data, aided by machine learning/ artificial intelligence analysis are expected to advance our understanding of atherosclerosis progression from the asymptomatic into the symptomatic phase and personalize prevention.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709002","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":"Thoracic endovascular aortic repair compared with medical treatment in patients with type B intramural hematoma.","authors":"Shuang Wu, Yan-Min Yang, Juan Wang, Yi-Jing Xin, Jing-Yang Wang, Han-Yang Liang, Li-Hui Zheng, Si-Qi Lyu","doi":"10.1024/0301-1526/a001215","DOIUrl":"https://doi.org/10.1024/0301-1526/a001215","url":null,"abstract":"<p><p><b></b> <i>Background</i>: The benefit-risk profile of thoracic endovascular aortic repair (TEVAR) in patients with type B aortic intramural hematoma (IMH) has not been well established yet. This study aimed to evaluate the outcomes of TEVAR compared with medical management (MM) in this population. <i>Patients and methods:</i> PubMed, EMBASE, the Cochrane Library, and clinicaltrials.gov were searched to identify studies comparing TEVAR with MM in patients with type B IMH. <i>Results:</i> Sixteen studies involving 1528 patients were included in this meta-analysis. Compared with the MM group, the TEVAR group displayed similar incidences of in-hospital death [RR (95%CI): 0.73 (0.32-1.66), p=.45] and aortic-related death [RR (95%CI): 0.70 (0.31-1.58]), p=.39]. The risk of all-cause death was comparable between the two groups [RR (95%CI): 0.62 (0.36-1.07), p=.08]. Meanwhile, TEVAR was superior to MM in promoting IMH regression [RR (95%CI): 1.51(1.26-1.81), p<.001] and reducing IMH progression [RR (95%CI): 0.15 (0.08-0.29), p<.001], dissection [RR (95%CI): 0.26 (0.12-0.60), p=.002], and secondary intervention [RR (95%CI): 0.22 (0.08-0.60), p=.003]. <i>Conclusions:</i> In patients with type B IMH, the incidences of in-hospital death, aortic-related death and all-cause death during follow-up were comparable between the TEVAR group and the MM group. However, TEVAR was superior to MM in promoting IMH regression and reducing IMH progression, dissection, and secondary intervention. Further randomized controlled trials are needed to clarify the role of TEVAR in this population.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699656","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":"Retrograde direct stent puncture for femoropopliteal lesion crossing is safe and effective - results from a multicenter German registry.","authors":"Nikolaos Konstantinou, Grigorios Korosoglou, Andrej Schmidt, Michael Lichtenberg, Martin Andrassy, Erwin Blessing, Nikolaos Tsilimparis, Giovanni Torsello, Konstantinos Stavroulakis","doi":"10.1024/0301-1526/a001212","DOIUrl":"https://doi.org/10.1024/0301-1526/a001212","url":null,"abstract":"<p><p><b></b> <i>Background:</i> To evaluate the safety and efficacy of direct retrograde stent punctures for crossing of chronic total occlusions in patients with symptomatic peripheral arterial disease. <i>Methods:</i> A retrospective registry of consecutive patients treated with retrograde recanalization techniques in five high-volume German centers was performed. Patient cases with attempted retrograde after failed antegrade revascularization were studied. Primary endpoint was technical success. Secondary endpoints were access vessel complications, need for bail-out procedures and major or minor amputation. <i>Results:</i> Of the 1516 retrograde punctures recorded in the registry, 63 (4.2%) were direct stent punctures. Superficial femoral artery stents were punctured in 88.9% (56/63) of the cases, tibial artery stents in 6 patients (9.5%) and a stent in an occluded femoropopliteal bypass in one case (1.6%). Mean lesion length was 322±125 mm. Stent puncture was successful in 62 cases (98.4%) and the procedural success rate was 96.8% (61/63) with one technical failure despite successful puncture. A sheathless approach was performed in 79.4% (50/63) of cases. Drug-coated balloon angioplasty was applied in 63.5% (40/63) and new stenting (bare-metal or drug-eluting) in 55.6% (35/63) of lesions. One minor and no major amputations were recorded in the first 30 days after the procedure. A sheathless retrograde approach was associated with significantly higher procedural technical success (p = .04). <i>Conclusion:</i> Retrograde femoral or tibial direct stent puncture seems to be safe and effective for the recanalization of chronic total occlusions of the femoropopliteal segment in cases where antegrade recanalization is deemed unsuccessful.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675832","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":"State-of-the-art lesion preparation in femoropopliteal lesions - a case-based systematic approach.","authors":"Grigorios Korosoglou, Andrej Schmidt, Michael Lichtenberg, Nasser Malyar, Konstantinos Stavroulakis, Holger Reinecke, Gerd Grözinger, Dittmar Böckler, Christian A Behrendt, Erwin Blessing, Ralf Langhoff, Thomas Zeller, Christos Rammos","doi":"10.1024/0301-1526/a001213","DOIUrl":"10.1024/0301-1526/a001213","url":null,"abstract":"<p><p><b></b> Vessel preparation has emerged as a key feature in endovascular treatment strategies as treated lesions are increasingly complex. While treatment algorithms have been presented, a practical systematic case-based approach, entailing contemporary vessel preparation tools, would provide assistance for vascular specialists in the daily routine. Based on patient characteristics, including clinical presentation, age and comorbidities and lesion specific parameters, team-based and patient-centered decisions are necessary for successful treatment. In addition, pre- and procedural imaging, lesion specific characteristics, such as the presence of chronic total occlusions, lesion length and calcification or the presence of thrombus are evaluated. Furthermore, run-off vessels serving as potential conduits for retrograde puncture in case of failed antegrade crossing need to be considered. Based on lesion-specific variables and the type of crossing (intraluminal versus subintimal), options for lesion preparation techniques, including plain-old-balloon angioplasty (POBA), specialty balloons, atherectomy, intravascular lithotripsy and/or thrombectomy are selected prior to the definitive treatment of the lesion. The selection of such vessel preparation strategies depends on the current scientific evidence, guidelines and expert opinion statements. Treatment of patients with intermittent claudication or chronic limb threatening ischemia (CLTI) are now discussed, where a recently published lesion preparation algorithm is applied. By the establishment of this algorithm in daily practice, harmonization of endovascular practice and further improvements in vessel and patient specific outcomes are anticipated.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555088","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":"Intraluminal thrombus volume correlates with the crural vessel runoff in popliteal artery aneurysms upon initial presentation.","authors":"Hans-Christian Arne Stroth, Floris Berg, Hannah Emilia Freytag, Christian Reeps, Steffen Wolk, Ralf-Thorsten Hoffmann, Heiner Nebelung, Jens-Peter Kühn, Albert Busch, Marvin Kapalla","doi":"10.1024/0301-1526/a001198","DOIUrl":"10.1024/0301-1526/a001198","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Patients having emergency surgery due to ischemia caused by a popliteal artery aneurysm (PAA) have worse outcomes in all endpoints (operation time, major adverse limb events (MALE), amputation-free survival) than after elective treatment, mostly due to a limited crural vessel runoff. This study investigates the relationship between PAA diameter, volume, and luminal thrombus load in relation to the preoperative crural runoff. <i>Patients and methods:</i> Retrospective single-centre evaluation of surgically treated patients with PAA and semi-automated quantitative CT analysis of PAA morphologies (diameter, volume and intraluminal thrombus volume). Primary endpoints were the correlations these characteristics with the number of patent crural vessels. <i>Results:</i> A total of 89 PAAs (61 patients, median age 75, IQR 12; 94.4% male) were identified, of which 47.2% were symptomatic with 18 acute limb ischemia (ALI). The diameter at surgery was 33.8 ± 12.1mm and the volume 68.5 ± 13.6mm³. A median of two lower leg vessels were patent (elective 3 [1, 2, 3] vs. emergency 1 [1, 2], p=0.1) upon preoperative CTA. 77 PAAs underwent elective surgery, five PAAs (5.6%) received endovascular treatment. The surgical complication rate was 23.6% without immediate or early occlusion. The follow-up was 42.5 [39-45] months. The overall mortality rate was 11.2% and the primary patency rate 73.9%. While the total aneurysm volume correlated well with the diameter (r=0.77, p<0.01), the intraluminal thrombus volume (ILT) showed the clearest correlation with the crural runoff (r=-0.34, p=0.01). No correlation between the diameter and crural runoff was observed (r=-0.17, p=0.1). A reduced crural run-off was significantly associated with impaired amputation-free survival (p=0.01). A subgroup analysis (n=21) with sequential CTs showed a tendency towards greater increase of thrombus volume compared to plain diameter during PAA growth. The thrombus volume index (=ILT/total PAA volume) was significantly higher in emergency patients (p=0.01), while diameters tended to be smaller (p=0.57). <i>Conclusions:</i> The increasing intraluminal thrombus volume correlates most distinctly with a reduced crural runoff in PAAs and should therefore be considered prognostically important, especially in the presence of an increased growth rate compared to the diameter.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"242-252"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999345","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":"Cardiovascular outcomes in kidney transplant patients with pre-existing peripheral arterial disease and diabetes mellitus.","authors":"Mohinder R Vindhyal, Sahith Mandala, Wan-Chi Chan, Rhythm Vasudeva, Suveenkrishna Pothuru, Harsh Mehta, Sania Jiwani, Kamal Gupta","doi":"10.1024/0301-1526/a001201","DOIUrl":"10.1024/0301-1526/a001201","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Kidney transplantation (KT) has been shown to enhance the quality of life, be more cost-effective, and reduce mortality in dialysis patients. We aimed to study the impact of pre-existing diabetes mellitus (DM) and peripheral arterial disease (PAD) on cardiovascular outcomes and mortality after kidney transplantation (KT). <i>Materials and methods:</i> A secondary USRDS (United States Renal Data System) analysis was performed from 2006 to 2017 in adult patients who underwent KT. The primary outcome was 3-year all-cause mortality, and secondary outcomes were myocardial infarction (MI), cerebrovascular accident, gangrene/limb ischemia, and graft failure. Adjusted hazard ratios were computed, and multivariate analysis was conducted. All p-values were 2-sided, and a value of <0.05 was deemed to be statistically significant. Statistical analyses were performed using the SAS 9.4 software. <i>Results:</i> A total of 51,009 patients with kidney transplants met the study inclusion/ exclusion criterion. Patients with both DM and PAD had the highest risk of mortality (15.3%, aHR 1.8, 1.6-2.0), followed by patients with PAD without DM (14.1%, aHR 1.6, 1.4-1.9), DM without PAD (9.9%, aHR 1.4, 1.3-2.6), and those without either DM or PAD (5.5%). MI was also higher in patients with DM and PAD (7.3%, aHR 1.8, 1.5-2.2), followed by DM alone (4.6%, aHR 1.58, 1.4-1.7), PAD alone (4.3%, aHR 1.14, 0.8-1.6), and no diabetes nor PAD (2.2%). <i>Conclusions:</i> In patients undergoing KT, those with pre-existing DM and/ or PAD have a significantly higher all-cause mortality and risk of MI.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"235-241"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161175","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":"Time to apply guidelines and work together to win the battle against peripheral artery disease.","authors":"Adelaïde Guézais, Guillaume Mahé","doi":"10.1024/0301-1526/a001192","DOIUrl":"https://doi.org/10.1024/0301-1526/a001192","url":null,"abstract":"","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":"54 4","pages":"223-224"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529764","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}