Vascular最新文献

{"title":"Prevalence of peripheral arterial disease in Nepal: A cross-sectional study.","authors":"Danielle J Wilson, Jaclyn A Gellings, Colleen Flanagan, Swechha Bhatt, Satish Vaidya, Michael Malinowski, Robin Man Karmacharya, Dean E Klinger","doi":"10.1177/17085381251379330","DOIUrl":"10.1177/17085381251379330","url":null,"abstract":"<p><p>BackgroundPeripheral arterial disease (PAD) represents a significant cardiovascular burden in low- and middle-income countries (LMICs), yet its prevalence in Nepal remains unknown. As Nepal undergoes demographic transition with increasing life expectancy and cardiovascular disease burden, understanding PAD prevalence is crucial for healthcare planning. We aimed to determine PAD prevalence among Nepali adults aged ≥45 years using ankle-brachial index (ABI) screening.MethodsThis cross-sectional study was conducted at two sites in Nepal between October 2022 and March 2023. Participants aged ≥45 years without a prior PAD diagnosis were recruited through voluntary screening during routine care visits. We collected demographic data, cardiovascular risk factors, and claudication symptoms. PAD was defined as ABI <0.9, with ABI >1.4 considered non-diagnostic due to incompressible vessels.ResultsAmong 639 participants (median age 60 years, IQR 53-68; 52% male), 638 were included in the analysis. The overall PAD prevalence was 7.4% (95% CI 5.6%-9.7%), increasing to 8.7% (95% CI 6.6%-11.3%) when excluding incompressible ABIs (14.9% of participants). PAD prevalence increased with age, reaching 12.1% in those >75 years. Participants with PAD showed significantly higher rates of cardiac disease (15% vs 4%, <i>p</i> = .002) and claudication symptoms (26% vs 10%, <i>p</i> = .001) compared to those with normal ABIs. Diabetes was more prevalent in those with incompressible ABIs compared to normal ABIs (26% vs 15%, <i>p</i> = .02).ConclusionsThis first systematic assessment of PAD in Nepal reveals a prevalence comparable to other South Asian countries, with significant associations with cardiac disease and claudication symptoms. The findings highlight the need for enhanced vascular disease education in Nepal, where only 25 vascular surgeons serve 31 million people. Future research should include expanded geographic sampling and longitudinal outcomes to inform national screening policies and resource allocation.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"634-640"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041343","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":"Evaluation of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios for stroke predictability in postoperative patients with carotid artery stenosis.","authors":"Aysegul Durmaz, Muhammet Turhan, Ege Dursun, Murat Ugur","doi":"10.1177/17085381261425730","DOIUrl":"10.1177/17085381261425730","url":null,"abstract":"<p><p>Background/ObjectivesPrevious studies have reported that inflammatory biomarkers have prognostic value in various fields, including vascular surgery. Biomarkers such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) help identify patients at higher risk for cerebrovascular events, as well as in the treatment and follow-up of patients. There are studies investigating the usefulness of these biomarkers for carotid artery disease. However, data on whether they help predict neurological complications after carotid artery surgery are limited. This study examined the correlation between preoperative carotid arterial stenosis severity, symptomatic presentation, and PLR and NLR levels as potential biomarkers for predicting postoperative neurological complications.MethodsWe retrospectively analyzed the preoperative and postoperative demographics, physical examination, and laboratory results of patients who underwent carotid endarterectomy for carotid artery stenosis in our clinic between January 2019 and January 2023.ResultsWhile our findings did not demonstrate a statistically significant correlation between NLR and PLR levels and postoperative neurological complications, elevated platelet counts were associated with such complications, underscoring the importance of antiplatelet therapy in managing carotid artery disease.ConclusionsThe study linked high platelet counts to postoperative complications and highlights the importance of antiplatelet therapy in managing carotid artery disease. The differences in findings highlight the complexity of stroke prediction and the need for a multifactorial approach.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"736-740"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182469","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":"Pediatric idiopathic iliac artery aneurysm repair with limited conduit options.","authors":"David N DeVaro, Alexander S Fairman","doi":"10.1177/17085381251379286","DOIUrl":"10.1177/17085381251379286","url":null,"abstract":"<p><p>ObjectivesPediatric arterial aneurysms are very uncommon. Those without an underlying identifiable etiology such as infection or autoimmune disease are even rarer. In young children, options for repair are limited. We report the case of a pediatric common iliac artery aneurysm that was surgically repaired.MethodsA 27-month-old male presenting for an evaluation of persistent hypertension underwent an abdominal CT scan and was incidentally found to have a large right common iliac artery aneurysm along with a thrombosed, proximal right internal iliac artery aneurysm. Given the size, the aneurysm was repaired with a bypass constructed from cryopreserved femoral artery allograft.ResultsThe procedure was uncomplicated, with continued patency of the graft determined via ultrasound at 7 months.ConclusionA pediatric iliac artery aneurysm was successfully repaired with a cadaveric femoral artery graft in the setting of limited conduit options.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"549-552"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between global limb anatomic staging system (GLASS) and short- and mid-term endovascular treatment outcomes in chronic limb-threatening ischemia (CLTI) patients with infra-inguinal lesions.","authors":"Mohammed Shahat, Haitham Ali Hassan Ali, Abdelrahman Ahmed Shawki, Mohamed Mahmoud","doi":"10.1177/17085381251379297","DOIUrl":"10.1177/17085381251379297","url":null,"abstract":"<p><p>BackgroundChronic limb-threatening ischemia (CLTI), a severe form of peripheral artery disease (PAD), results in significant morbidity and mortality. The Global Limb Anatomic Staging System (GLASS) is a new tool designed to predict outcomes in CLTI patients undergoing endovascular treatments, yet its relationship with short-term outcomes requires further investigation.ObjectiveThis study evaluates the correlation between GLASS staging and short-term outcomes in CLTI patients treated with endovascular procedures for infrainguinal lesions.MethodsProspective cohort of 160 CLTI patients who received endovascular treatment for infrainguinal lesions was analyzed. GLASS staging was assigned based on angiographic data, and short-term outcomes, including immediate technical failure (ITF), limb-based patency (LBP) at 1 year, and amputation-free survival (AFS) at 1 year, were measured.ResultsIn the cohort of patients, a significant association was found between GLASS staging and short-term outcomes. Higher GLASS stages correlated with increased ITF rates, lower 1-year LBP rates, and reduced 1-year AFS rates. Specific GLASS parameters, such as femoropopliteal and infrapopliteal scores, independently predicted short-term outcomes.ConclusionThis study indicates that GLASS staging is a useful prognostic tool for assessing short-term outcomes in CLTI patients undergoing endovascular treatment for infrainguinal lesions. Utilizing GLASS staging in clinical settings may enhance treatment planning and patient prognoses.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"620-628"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034209","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":"Impact of internal iliac interventions on mortality and intestinal ischemia in ruptured abdominal aortic aneurysm endovascular repair.","authors":"Jose Oyama Leite, Sung H Yang, Amit Jain, Joseph S Giglia, Jiarong Ouyang, Xuan Cao","doi":"10.1177/17085381251379846","DOIUrl":"10.1177/17085381251379846","url":null,"abstract":"<p><p>ObjectivesRuptured abdominal aortic aneurysm (RAAA) is a life-threatening vascular emergency with high mortality rate despite advances in surgical and endovascular techniques. This study evaluates the impact of internal iliac artery interventions on short-term (30-day) and long-term (up to 6564 days) mortality and intestinal ischemia in patients undergoing endovascular aneurysm repair (EVAR) for RAAA.MethodsA retrospective analysis of 4274 patients who underwent emergent EVAR for RAAA between 2004 and 2022 was conducted using the Vascular Quality Initiative (VQI) database. Patients were stratified into four groups based on the type of internal iliac intervention: no intervention, revascularization of at least one internal iliac artery, occlusion of both internal iliac arteries, and occlusion of one internal iliac artery. Mortality and intestinal ischemic outcomes were compared using chi-square tests, and logistic regression models were used to identify significant predictors.ResultsNo statistically significant differences in short-term (<i>p</i> = .5638) or long-term mortality (<i>p</i> = .5776) were observed between groups. Group 3 (occlusion of both internal iliac arteries) had the highest rates of intestinal ischemia (11.36%) and 30-day mortality (31.11%), though these differences were not statistically significant. Intestinal ischemia increased the odds of long-term mortality by 2.82 times (<i>p</i> < .001). Advanced age and preoperative creatinine levels were strong predictors of mortality: each additional year of age increased the odds of death by 7% (<i>p</i> < .0001), and the presence of COPD raised the odds of long-term mortality by 51% (<i>p</i> < .001). Prolonged procedure time and blood loss were also associated with higher risks of both long-term mortality and intestinal ischemia.ConclusionsThe type of internal iliac intervention did not significantly affect short-term or long-term mortality, but mitigating intraoperative factors such as prolonged procedure time and excessive blood loss is critical for improving short-term survival and reducing the risk of intestinal ischemia. Managing chronic conditions like COPD and optimizing renal function are essential to improving long-term outcomes, especially in high-risk patients with advanced age and systemic disease.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"553-560"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041490","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":"The role of doxycycline in reducing MMP-9 and acute-phase reactants to limit abdominal aortic aneurysm growth: A systematic review.","authors":"Luis Morales-Ojeda, Stefania Montero-Arcila, Leetha Paul, Victor Nunes, Emily A Malgor, Donald L Jacobs, Rafael D Malgor","doi":"10.1177/17085381251379296","DOIUrl":"10.1177/17085381251379296","url":null,"abstract":"<p><p>BackgroundAbdominal aortic aneurysms (AAAs) are a significant vascular disease characterized by the degradation of medial elastic lamellae, neovascularization, and inflammatory responses. While surgical intervention remains the standard treatment for large or rapidly expanding AAAs, there is no universally accepted pharmacological therapy to prevent aneurysm progression. Matrix metalloproteinases (MMPs), particularly MMP-9, and inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP) are implicated in AAA pathogenesis, making them potential therapeutic targets. Doxycycline, a broad-spectrum tetracycline antibiotic, has demonstrated inhibitory effects on MMP-9 and anti-inflammatory properties. However, its efficacy in slowing AAA progression remains unclear.MethodsA systematic review was conducted following PRISMA guidelines. Electronic searches were performed in PubMed, MEDLINE, EMBASE, and ClinicalTrials.gov. Inclusion criteria encompassed randomized controlled trials (RCTs), cohort studies, in vitro studies, and systematic reviews evaluating the effects of doxycycline on AAA growth. Data extraction was performed using Covidence software, and study quality was assessed using the Cochrane Risk of Bias Tool 2.0 (RoB2) for RCTs, the QUIN tool for in vitro studies, and the SYRCLE tool for animal experiments. Statistical analysis employed a random-effects model to evaluate heterogeneity among studies.ResultsThe initial search identified 1313 references, of which 10 studies met inclusion criteria: two RCTs, two systematic reviews, three in vitro studies, one in vivo study, one methodological study, and one experimental study. The two RCTs, involving 515 patients with an average age of 71 years, reported minimal to no significant reductions in AAA growth following doxycycline administration. In contrast, in vitro and in vivo studies demonstrated inhibition of MMP-9 and inflammatory markers, supporting doxycycline's potential therapeutic role. Meta-analysis was not performed due to high heterogeneity (I² = 75%). Risk of bias assessment indicated a low risk for RCTs, whereas in vitro and in vivo studies showed a moderate risk of bias.ConclusionWhile doxycycline exhibits promising biochemical effects in AAA pathophysiology, its clinical efficacy remains uncertain. Current evidence does not support its routine use in AAA management outside clinical trials. Future research should focus on targeted pharmacotherapy integrating patient-specific biomarkers to enhance therapeutic outcomes.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"587-597"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410236","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":"Long-term impact of dyslipidemia on sac dynamics after endovascular aortic repair for abdominal aortic aneurysms in the GREAT registry: An insight in dyslipidemia using propensity matched controls.","authors":"Bibombe P Mwipatayi, James E Dodd, Shannon D Thomas, Elizabeth L Chou, Ross Milner, Ali Azizzadeh, Santi Trimarchi, Jan Mm Heyligers, Dittmar Böckler, Markus P Schlaich","doi":"10.1177/17085381251377316","DOIUrl":"10.1177/17085381251377316","url":null,"abstract":"&lt;p&gt;&lt;p&gt;ObjectivesTo investigate the differences in aneurysmal sac regression after endovascular aortic repair (EVAR) of abdominal aortic aneurysms (AAAs) in patients with and without dyslipidemia.MethodsThis was a retrospective analysis of 3453 patients from an international prospective registry (Europe, United States of America, Brazil, Australia, and New Zealand) of patients treated with the GORE® EXCLUDER® endograft. All scheduled EVARs for infrarenal AAAs between 2014 and 2016 with complete 6-year follow-up imaging data were included. Logistic regression analysis was performed to assess changes in aneurysm diameter based on dyslipidemia after adjusting for sex, age, body mass index, tobacco use, hypertension, coronary artery disease, aneurysm diameter, aneurysm neck length, and aneurysm neck angle. The secondary outcomes included all-cause mortality, stroke/transient ischemic attack (TIA), paraplegia/paraparesis/spinal cord ischemia, reintervention, endoleaks, and aortic rupture. A control group of patients without dyslipidemia with similar age and comorbidities was selected using propensity scores and matched using a 1:1 scheme.ResultsOf the 3453 patients, 85.3% in the non-dyslipidemia group and 85.5% in the dyslipidemia group were men. The mean age was 73.5 ± 8.8 years for the non-dyslipidemia group and 73.4 ± 8.2 years for the dyslipidemia group (&lt;i&gt;p&lt;/i&gt; &lt; .001). The mean body mass index was 26.7 ± 4.9 kg/m&lt;sup&gt;2&lt;/sup&gt; for the non-dyslipidemia group, whereas it was 28.0 ± 5.2 kg/m&lt;sup&gt;2&lt;/sup&gt; for the dyslipidemia group (&lt;i&gt;p&lt;/i&gt; &lt; .001). Overall, 2269 patients (64.0%) were identified as having dyslipidemia. After propensity score matching (PSM), the dyslipidemia group had higher rates of hypertension (&lt;i&gt;p&lt;/i&gt; &lt; .001), TIA (&lt;i&gt;p&lt;/i&gt; = .006), carotid disease (&lt;i&gt;p&lt;/i&gt; = .002), coronary artery bypass grafting (&lt;i&gt;p&lt;/i&gt; = .005), congestive cardiac failure (&lt;i&gt;p&lt;/i&gt; = .018), and peripheral artery disease (&lt;i&gt;p&lt;/i&gt; &lt; .001). The indications for device placement were similar between the groups. After PSM, the non-dyslipidemia group was more likely to be treated off-label (&lt;i&gt;p&lt;/i&gt; = .030) and to have an aneurysm neck length of &lt;15 mm (&lt;i&gt;p&lt;/i&gt; = .035). There was no significant difference in the sac size changes within 1 year (&lt;i&gt;p&lt;/i&gt; = .7) or 6 years (&lt;i&gt;p&lt;/i&gt; = .14) between the groups. After PSM, all-cause mortality was 6.7% in individuals with dyslipidemia and 10.6% in those without (p = .018). However, there were no significant differences in aortic-related mortality between the overall (&lt;i&gt;p&lt;/i&gt; = .571) and the matched (&lt;i&gt;p&lt;/i&gt; = .662) populations. The rates of reintervention, stroke/transient ischemic attack, and spinal cord ischemia were not significantly different. Among patients with dyslipidemia, larger aneurysm size at 1 year (&lt;i&gt;p&lt;/i&gt; = .037) and increased age at 6 years (&lt;i&gt;p&lt;/i&gt; &lt; .001) were associated with sac expansion.ConclusionIn this comprehensive real-world study of patients who underwent EVAR with the GORE® EXCLUDER endopros","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"525-537"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of true dorsalis pedis aneurysm.","authors":"Elizabeth Christophel, Zachary Matthay, Jordan R Stern","doi":"10.1177/17085381251379917","DOIUrl":"10.1177/17085381251379917","url":null,"abstract":"<p><p><b>Background:</b> True aneurysms of the dorsalis pedis artery (DPA) are a rare vascular condition. The pathophysiology of DPA aneurysms remains poorly understood, and there is no established consensus on indications for intervention or the optimal treatment approach. <b>Methods:</b> A review of the existing literature highlights a variety of treatment strategies. In this report, we describe the management of a 78-year-old woman who presented with a pulsatile mass on the dorsum of her left foot. <b>Results:</b> Diagnostic imaging and surgical exploration confirmed a true DPA aneurysm with mural thrombus, and she underwent a successful resection with end-to-end anastomosis that resulted in excellent distal perfusion. This case and review of the literature underscore the importance of individualized surgical decision making based on anatomical and functional considerations. <b>Conclusion:</b> The key takeaway is that early surgical intervention, including reconstruction when appropriate, is recommended for DPA aneurysms to prevent potential complications such as distal embolization and ischemia.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"598-603"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056023","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":"Lessons learned from a single-center vascular quality improvement audit for thoracic and complex endovascular aortic repair.","authors":"Siwei Dong, Ahmed A Sorour, Donna Fleming, Ali Khalifeh, Ravi N Ambani, Francis J Caputo, Levester Kirksey, Sean P Lyden, Jon G Quatromoni","doi":"10.1177/17085381251379288","DOIUrl":"10.1177/17085381251379288","url":null,"abstract":"<p><p>IntroductionThe Vascular Quality Initiative (VQI) of the Society for Vascular Surgery (SVS) is a collection of 14 registries that collects data on over 1,000,000 vascular procedures performed in North America. These registries exist in order to improve the quality, safety, and cost of vascular healthcare. Centers participating in the VQI are subject to routine audits to ensure accurate and comprehensive data entry. The aim of the study is to describe a single-institution experience with the VQI audit of the thoracic endovascular aortic repair (TEVAR)/complex endovascular aneurysm repair (EVAR) registry, highlighting the benefits and lessons learned from participating in the audit.MethodsIn 2022, our institution received a VQI audit notification to review all TEVAR/complex EVAR procedures performed between January 1^st, 2021 and December 31^st, 2021. The institutional financial department obtained claims validation data for all procedures billed under corresponding CPT codes for the listed dates. This was matched against the procedures entered manually into the VQI database by institutional data managers and abstracters. Mismatches between claims validation data and VQI entries were identified and sent to a coding specialist for review and possible revision.ResultsBetween January 1, 2021 and December 31, 2021, there were 125 unique TEVAR/complex EVAR patients identified by either the claims validation data or manually entered VQI registry data. Sixteen patients were listed in the VQI registry only and one patient was identified by claims validation data only, leaving 108 patients that were identified by both the registry and claims data, for an 86% (108/125) match rate. The audit revealed that 13 patients were incorrectly billed, of which 12/13 patients were incorrectly billed as TEVAR extensions (CPT 33886) instead of new TEVAR procedures (CPT 33880). Recoding and rebilling these patients had significant financial implications to the institution.ConclusionThis audit highlighted the importance of meticulous coding and manual review to maintain registry accuracy and optimize financial outcomes. Our findings underscore the necessity of ongoing education for coding and billing personnel and the value of VQI participation in identifying coding discrepancies and improving institutional practices.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"572-580"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081882","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":"Three-stage extensive aortic substitution in a young man with a variant of uncertain significance in myosin heavy chain 11 gene.","authors":"Federico Pascucci, Tommaso Donati, Albino Vallabini, Mauro Cassese, Yamume Tshomba","doi":"10.1177/17085381251359315","DOIUrl":"10.1177/17085381251359315","url":null,"abstract":"<p><p>BackgroundNon-syndromic hereditary aortic diseases are caused by mutations in genes encoding for connective tissue components, involving structural integrity of aortic tissue. Amongst them, MYH11 gene mutation is a known causative factor for aortic diseases, especially in young patients.Research DesignWe report the case of a 37 years-old male which came to our attention for an acute DeBakey type I aortic dissection. In three different operations he was submitted to a total aortic substitution with a Bentall operation, a Frozen Elephant Trunk and a Thoracoabdominal Aortic open repair. During the last two operations particular technical tips, which are reported in this work, have been adopted to optimize surgical strategy.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"538-542"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}