Michael K W Lichtenberg, Stefan Stahlhoff, Simone Mueller, Egor Nazarov, Leonardo Romano, Konstantinos Stavroulakis
{"title":"Long-term efficacy Safety analysis of a woven nitinol venous stent for iliac vein obstruction.","authors":"Michael K W Lichtenberg, Stefan Stahlhoff, Simone Mueller, Egor Nazarov, Leonardo Romano, Konstantinos Stavroulakis","doi":"10.1024/0301-1526/a001191","DOIUrl":"https://doi.org/10.1024/0301-1526/a001191","url":null,"abstract":"<p><p><b></b> <i>Background:</i> To assess long-term patency rates, clinical outcomes, and device-related adverse events associated with the use of a dedicated woven nitinol venous stent following venoplasty to treat patients with symptomatic iliac and femoral vein obstruction. <i>Material and methods:</i> This single-center, single-arm, observational study consisted of 25 patients with iliofemoral vein obstructions caused by residual thrombosis, non-thrombotic compression, or post-thrombotic stenosis. Lesions were treated with the blueflow Venous Stent, a closed-cell stent made of woven strands of Nitinol wire. Primary outcome measures were primary patency and sustained clinical success at 3 months while secondary clinical measures included the revised Venous Clinical Severity Score (rVCSS), Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) classification, and the number of device-related adverse events through 60 months. <i>Results:</i> Primary patency was 94.7% and sustained clinical success was 76.5% at 3 months. Primary patency was 95.2% and 70% while sustained clinical success was 76.2% and 70% at 12 and 60 months. The mean rVCSS was 7.4 ± 4.0 at baseline, 5.3 ± 1.8 at 3 months, 4.6 ± 1.4 at 12 months, and 2.6 ± 0.9 at 60 months. CEAP classifications at baseline were predominantly C3 (52%) while 36%, 52%, and 40% of scores were C1-C2 at 3, 12, and 60 months. One device-related adverse event (i.e., in-stent restenosis) was reported resulting in reintervention. There were three patient deaths: two from the progression of metastatic cancer and one from a bicycle accident. <i>Conclusions:</i> This exploratory study demonstrated a primary patency rate of 94.7% and a clinical success rate of 76.2% at 3 months. Patency was 70% with a 65% reduction in the mean rVCSS score from baseline at 5 years (-5.2). The blueflow Venous Stent performed adequately with no safety concerns when used for its intended indication.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711175","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}
Sabine Sieber, Albert Busch, Angelos Karlas, Christoph Knappich, Shamsun Naher, Ilaria Puttini, Matthias Trenner
{"title":"Temporal trends and outcomes for the treatment of acute aortic occlusion from 2009 to 2020 in Germany.","authors":"Sabine Sieber, Albert Busch, Angelos Karlas, Christoph Knappich, Shamsun Naher, Ilaria Puttini, Matthias Trenner","doi":"10.1024/0301-1526/a001189","DOIUrl":"https://doi.org/10.1024/0301-1526/a001189","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Acute abdominal aortic occlusion is a rare vascular emergency associated with high morbidity and mortality. To date, the topic has hardly been addressed scientifically. Most case series are afflicted with small cohort numbers. The aim of this study was to identify risk factors after invasive treatment of acute abdominal aortic occlusion and changes over time. <i>Patients and methods:</i> Using case-based nationwide hospital statistics (diagnosis-related group [DRG] statistics) from 2009 to 2020, all cases with ICD-10 codes for embolism and thrombosis of the abdominal aorta in conjunction with acute limb ischaemia and consecutive invasive treatment (endovascular or open surgery) were included. The analysis included patient characteristics, treatment, mortality, amputation, and complications. The primary outcome was in-hospital death. A multivariable regression model was applied to detect risk factors. <i>Results:</i> A total of 1160 cases (66% male) with acute abdominal aortic occlusion were identified (941 open; 219 endovascular). Between 2009 and 2020, the rate of endovascular treatments (2010: 6%; 2020: 29%; p<.001) increased significantly over the years. Older patients (odds ratio [OR] 0.76; 95% confidence interval [CI] 0.64-0.9, p=.002) and women (OR 0.65; 95% CI 0.48-0.88, p=.006) were more likely to receive endovascular care. In-hospital mortality was 13% after open surgery and 14% after endovascular treatment, with no significant change in open surgery, but high variability in endovascular treatment during the observation period (2009-2011: open 14%; endovascular 25%; 2018-2020: 10%; 11%). In-hospital mortality increased significantly with higher age (OR 2.19 per 10-year increase; 95% CI 1.79-2.7, p<.001) and comorbidities (OR 1.1 per Elixhauser point; 95% 1.07-1.11, p<.001). <i>Conclusions:</i> Acute aortic occlusion remains a rare but life-threatening emergency. Use of endovascular revascularization techniques is increasing, while in-hospital mortality rates remain high, specifically for older and morbid patients.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606488","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}
Nigel A Callender, Lars Øivind Høiseth, Iacob Mathiesen, Jonny Hisdal
{"title":"Intermittent negative pressure influences popliteal artery shear rate during supine and sitting postures.","authors":"Nigel A Callender, Lars Øivind Høiseth, Iacob Mathiesen, Jonny Hisdal","doi":"10.1024/0301-1526/a001172","DOIUrl":"10.1024/0301-1526/a001172","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Intermittent negative pressure is an emerging treatment for lower limb vascular disease but the specific physiological effects, particularly upon large artery haemodynamics are unclear. This study examined the influence of intermittent negative pressure upon popliteal artery shear rate during both supine and sitting postures. <i>Participants and methods:</i> Eleven healthy participants (5 female; age: 28.3 ± 5.8 y; weight: 69.6 ± 9.8 kg, height: 1.75 ± 0.07 m) received intermittent negative pressure (-37 mmHg; 9.5-sec on, 7.5-sec off), upon the lower leg during both supine and sitting postures. Popliteal artery blood flow and shear rate were recorded (duplex ultrasound), accompanied by heart rate (3-lead ECG) and blood pressure (volume clamp method). <i>Results:</i> Compared to sitting, a supine posture led to greater mean shear rate during baseline (supine: 21[9]; sitting: 17[13] sec<sup>-1</sup>; all median [IQR]) and negative pressure phases (supine: 24[15]; sitting: 17[14] sec<sup>-1</sup>; both p<0.05). While supine, negative pressure raised mean shear rate above baseline levels (p<0.05) and reduced it upon return to atmospheric pressure (p < 0.05). In sitting, mean shear rate only differed from baseline at the points of peak and minimum shear (peak:18[17]; minimum: 10[9] sec<sup>-1</sup>; both p<0.05). Shear pattern (oscillatory shear index) showed changes from baseline during both postures (p<0.05), but was not different between postures. Conclusions: Intermittent negative pressure influenced lower limb popliteal artery shear rate during both the supine and sitting postures, the effect was greater while supine. Fluctuation in shear pattern seen during both positions may account for positive clinical effects observed following intermittent negative pressure treatment. These findings are framed against previous work investigating clinical populations. Future work should investigate any differences in lower limb haemodynamics and markers of endothelial function among patients with vascular disease.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"113-123"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955627","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}
Torsten Schulz, Mary Lee Warg, Olga Kurow, Stefan Langer, Rima Nuwayhid
{"title":"The burden of lymphedema on quality of life.","authors":"Torsten Schulz, Mary Lee Warg, Olga Kurow, Stefan Langer, Rima Nuwayhid","doi":"10.1024/0301-1526/a001173","DOIUrl":"10.1024/0301-1526/a001173","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Due to a lack of validated methodologies, this study aimed to evaluate the quality of life (QoL) among individuals affected by lymphedema and to compare them with the general population and common diseases. <i>Patients and methods:</i> Patients were recruited from October 2023 till March 2024. The SF-36 and LYMQOL questionnaires were administered. The Robert Koch Institute provided data from the survey for secondary evaluations of the DEGS1 study. Descriptive analysis of the patient's data was conducted, followed by an analysis of risk factors, a comparison with common diseases and a pairs matched analyses with the general population based on the parameters sex, age and Body Mass Index (BMI). A p-value below 0.05 was considered significant. <i>Results:</i> Among the 273 patients, 18 had primary lymphedema and 255 had secondary lymphedema due to cancer history. Staging revealed 28 patients in stage I, 137 in stage II, and 75 in stage III. The majority of patients (83%) were female and mostly the lower extremity was affected. Age, International Society of Lymphology (ISL)-stage, and BMI were significantly correlated with reduced QoL in seven, six, and eleven out of thirteen subscales of the respective scores. The LYMQOL analysis revealed, that patients with upper limb lymphedema (ULL) demonstrated higher QoL compared to those with lower limb lymphedema (LLL). When compared to the general population, individuals with ULL exhibited reduced QoL in five out of eight SF-36 domains (p<0.05). Conversely, LLL patients showed decreased QoL across all eight SF-36 subscales (p<0.01). In comparison to diseases like myocardial infarction or malignant diseases, patients with lymphedema experience a significant, diminished QoL. <i>Conclusions:</i> By 2024, lymphedema patients continue to experience significantly lower QoL compared to the general population or common diseases in Germany. LLL patients exhibit a reduced QoL compared to individuals with ULL.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"124-132"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955647","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":"Relationship between LE8 score and peripheral arterial disease from NHANES perspective.","authors":"Zhixian Liu, Zhibo Zhang, Tianhua Li","doi":"10.1024/0301-1526/a001169","DOIUrl":"10.1024/0301-1526/a001169","url":null,"abstract":"<p><p><b></b> <i>Background:</i> This study examined the link between the Life's Essential 8 (LE8) metric and peripheral artery disease (PAD) prevalence in the U.S. <i>Patients and methods:</i> This population-based prospective cohort study analyzed data from 6,076 participants aged 20 years and older from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2004. LE8 scores were categorized into low, moderate, and high cardiovascular health (CVH) levels. Multivariable weighted logistic regression and subgroup analyses were performed to examine the relationship between CVH and PAD, adjusting for demographic and clinical variables. <i>Results:</i> In final analysis, a total of 6,076 individuals were included, with a mean age of 59.41±12.80 years and 51.3% (n=3,115) being male. The prevalence of PAD was 6.9% (n=418). After adjusting for confounding factors, compared to participants with low CVH, those with moderate CVH had a 34% lower risk of PAD (OR: 0.66, 95% CI: 0.53-0.82), and those with high CVH had a 62% lower risk of PAD (OR: 0.38, 95% CI: 0.25-0.58). <i>Conclusions:</i> In conclusion, we report that lower CVH scores are associated with higher PAD risk among U.S. adults. These findings may contribute to the prevention strategies for PAD.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"99-105"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979999","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":"Caffeine and nicotine acutely inhibit flow-mediated vasodilation, but not both are necessarily harmful in the long term.","authors":"Martin Storck, Knut Kröger, Christos Rammos","doi":"10.1024/0301-1526/a001167","DOIUrl":"10.1024/0301-1526/a001167","url":null,"abstract":"<p><p><b></b> Today, flow-mediated dilation (FMD) is a standardized test for the non-invasive assessment of vascular endothelial function in humans. The test is often used to assess the influence of various living conditions on the vascular system. Many factors have a short-term effect on FMD and reduce it. However, not every short-term FMD-reducing effect also signals long-term vascular damage with repeated exposure. The comparison between coffee consumption and smoking will be used to discuss that although both stimulants lead to comparable acute changes in vascular function, they differ in their long-term effects on the vascular system. Therefore, acute FMD effects cannot always be equated with long-term damaging effects.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"85-90"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012601","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}
Grigorios Korosoglou, Christos Rammos, Eric Secemsky
{"title":"A call for interdisciplinary and guideline-recommended PAD treatment.","authors":"Grigorios Korosoglou, Christos Rammos, Eric Secemsky","doi":"10.1024/0301-1526/a001161","DOIUrl":"10.1024/0301-1526/a001161","url":null,"abstract":"","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"81-84"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682926","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}
Moritz Wegner, Reinier R Smeets, Leo F Veenstra, Wael Ahmad, Amelie L Behrens, Florian Kursch, Hendrik Wienemann, Bernhard Dorweiler, Stephan Baldus, Matti Adam, Barend M E Mees, Max M Meertens
{"title":"Comparison of patients with occlusive or hemorrhagic access site complications requiring reintervention after percutaneous transfemoral transcatheter aortic valve implantation.","authors":"Moritz Wegner, Reinier R Smeets, Leo F Veenstra, Wael Ahmad, Amelie L Behrens, Florian Kursch, Hendrik Wienemann, Bernhard Dorweiler, Stephan Baldus, Matti Adam, Barend M E Mees, Max M Meertens","doi":"10.1024/0301-1526/a001154","DOIUrl":"10.1024/0301-1526/a001154","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Transcatheter aortic valve implantation (TAVI) via transfemoral (TF) access is increasingly integral to aortic valve disease treatment, expanding beyond high-risk patients. Despite technical advancements, access-related vascular complications, occurring in approximately 10% of TAVI procedures, remain a substantial challenge. <i>Objective:</i> This study investigated the clinical and morphological characteristics of percutaneous TF-TAVI patients experiencing occlusive (OC) and hemorrhagic (HC) complications managed with surgical or endovascular reintervention. <i>Methods:</i> The cohort included patients from a Dutch and a German tertiary referral hospital, managed with TF-TAVI procedures between 2017 and 2021 that required reintervention for OC or HC. Demographics, comorbidities, procedural details, and preoperative imaging data were collected and compared between groups. <i>Results:</i> Among 109 TF-TAVI patients, 32 with OC and 77 with HC required reintervention. The OC group presented significantly smaller access arterial diameters (common femoral artery: OC 6.7 mm vs. HC 8.9 mm, <i>p</i><.001; external iliac artery: OC 7.2 mm vs. HC 8.3 mm, <i>p</i><.001; common iliac artery: OC 9.4 mm vs. HC 10.5 mm, <i>p</i>=.012) while the HC group presented higher tortuosity index (TI) (OC 1.24 vs. HC 1.30; <i>p</i>=.017). No differences were observed regarding baseline characteristics, vessel calcification or vascular closure device use. <i>Conclusions:</i> In patients requiring reintervention following TF-TAVI, smaller arterial diameters were associated with OC, while higher TI was linked to HC. These findings emphasize the importance of preoperative imaging in developing individualized prevention strategies.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"133-141"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547777","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}