Vascular Medicine最新文献

{"title":"Systematic review of tracking-based technology for patients with claudication.","authors":"Pavithira Sivagangan, Enrico Mancuso, Isabelle Sanders, Joseph Borucki, Philip W Stather","doi":"10.1177/1358863X251316198","DOIUrl":"https://doi.org/10.1177/1358863X251316198","url":null,"abstract":"<p><strong>Introduction: </strong>Peripheral artery disease (PAD) typically presents with claudication. Although supervised exercise therapy is recommended, many hospitals do not have a program and therefore patients are unable to receive optimal therapy. Tracking-based technology (TBT), including activity monitors and mhealth applications, have stimulated the expansion into PAD management. This systematic review evaluates the effectiveness of TBT for claudication based on walking performance, perceived walking impairment, and quality of life (QoL).</p><p><strong>Methods: </strong>A multidatabase search was undertaken using the terms PAD OR intermittent claudication AND wearable devices OR mobile health applications. This systematic review was conducted according to PRISMA guidelines.ResultsA literature search identified 586 studies, of which 18 were eligible for inclusion. This totaled 1055 patients, with 15 randomized controlled trials and three cohort studies. Patients in the TBT group showed improvements in all walking ability parameters (including 6-minute walking distance, claudication onset time, maximum walking time, maximum walking distance, and claudication distance), QoL, and in the self-reported walking impairment questionnaires.</p><p><strong>Conclusion: </strong>There is evidence for supporting the introduction of TBT into the management of PAD as TBT improves walking performance, functional status, and QoL in patients with PAD. However, further information regarding adherence and compliance rates, as well as long-term outcomes, are imperative in assessing the effectiveness of TBT due to limited existing studies. <b>PROSPERO Registration No.: CRD42022307731</b>.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X251316198"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence patterns and clinical outcomes following paclitaxel-coated balloon angioplasty in femoropopliteal artery disease: Results of the CRESCENT study.","authors":"Naoki Yoshioka, Takahiro Tokuda, Akiko Tanaka, Shunsuke Kojima, Kohei Yamaguchi, Takashi Yanagiuchi, Kenji Ogata, Tatsuro Takei, Yasuhiro Morita, Tatsuya Nakama, Itsuro Morishima","doi":"10.1177/1358863X251322731","DOIUrl":"https://doi.org/10.1177/1358863X251322731","url":null,"abstract":"<p><strong>Background: </strong>Paclitaxel-coated balloons (PCBs) are widely used for femoropopliteal artery (FPA) diseases. However, data on recurrence and recurrence patterns after PCB angioplasty are limited. This study investigated the association between recurrence patterns, baseline characteristics, and clinical outcomes in the cases following PCB angioplasty.</p><p><strong>Methods: </strong>This multicenter, retrospective study included 1159 limbs in 1031 patients treated for de novo FPA lesions using PCBs. Patients were classified into three groups (patency, restenosis, and reocclusion) according to patency or recurrence patterns within 2 years after the index PCB angioplasty. The primary outcome was the incidence of target lesion revascularization (TLR), and the secondary outcome was the pattern of re-recurrence within 2 years following TLR using PCBs.</p><p><strong>Results: </strong>When comparing the three groups, reocclusive cases were characterized by more complex lesions, including chronic total occlusion, at baseline. Following the index PCB angioplasty, approximately 70% of recurrent cases underwent TLR, which was performed more frequently in reocclusive than in restenotic cases (82.1% vs 63.7%). Conversely, a higher percentage of restenotic cases did not require TLR compared to reocclusive cases (10.3% vs 27.8%). In cases where TLR was performed using PCBs, the rate of re-recurrence with occlusive morphology was significantly higher in reocclusive than in restenotic cases (52.3% vs 24.3%).</p><p><strong>Conclusions: </strong>After PCB angioplasty for FPA lesions, symptomatic recurrence and requirement for TLR were more frequent in reocclusive cases. Even after TLR using PCBs, reocclusive cases tend to recur with occlusion.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X251322731"},"PeriodicalIF":3.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking common femoral artery disease treatment: When and how to choose endovascular over open surgery?","authors":"Maxime Dubosq-Lebaz, Eric A Secemsky","doi":"10.1177/1358863X251328645","DOIUrl":"https://doi.org/10.1177/1358863X251328645","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X251328645"},"PeriodicalIF":3.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicomponent interventions designed to support adherence to guideline-recommended therapy in patients with peripheral artery disease: A scoping review.","authors":"Smaragda Lampridou, Tania Domun, Javiera Rosenberg, Rachael Lear, Alun Huw Davies, Mary Wells, Gaby Judah","doi":"10.1177/1358863X251315071","DOIUrl":"https://doi.org/10.1177/1358863X251315071","url":null,"abstract":"<p><p>Adherence to guideline-recommended therapies for peripheral artery disease (PAD), including pharmacotherapy (antiplatelet, lipid-lowering, and antihypertensive agents) and lifestyle modifications (smoking cessation, diet, weight management, and physical activity) remains low. Though single-component interventions targeting smoking cessation, exercise, or medication adherence show some efficacy, comprehensive multicomponent interventions are vital for addressing the complexity of PAD management. This review systematically synthesized multicomponent interventions for patients with PAD. A systematic search was conducted in Embase, MEDLINE, Cochrane Library, APA PsycINFO, CINAHL, Web of Science Core Collection, ProQuest, and Google Scholar to identify primary research describing multicomponent interventions supporting PAD treatment adherence, published between 2007 and 2024. A narrative synthesis was reported using the Template for Intervention Description and Replication (TIDieR) checklist and the behavioral change techniques (BCT) taxonomy. Out of 15 studies (2462 patients, 60.4% men) included in this review, only two addressed all guideline-recommended treatment aspects. Key intervention components included structured exercise (12/15) and education programs (10/15). Most interventions were delivered by multidisciplinary teams in hospital settings over 3 months. Only one study employed behavioral theory in its development, and most interventions (13/15) focused on the BCT 'instructions on how to perform a behavior' rather than diverse BCTs. No interventions significantly increased adherence to all PAD therapies. Few studies measured the intervention's impact on adherence, making it difficult to determine effective intervention characteristics. Most interventions lacked behavioral science approaches and were not designed to address specific adherence determinants. Future interventions should incorporate these elements to effectively address patients' needs. <b>Open Science Framework Registry ID:</b> osf.io/7xqzj.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X251315071"},"PeriodicalIF":3.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atherectomy-assisted endovascular therapy versus open repair for atherosclerotic common femoral artery disease: The multicenter ARISTON study.","authors":"Grigorios Korosoglou, Jason T Lee, Martin Andrassy, Drosos Kotelis, Marco V Usai, Mario D'Oria, Raphael Coscas, Nicola Troisi, Bahaa Nasr, Athanasios Saratzis, Solon Antoniades, Konstantinos P Donas","doi":"10.1177/1358863X251323508","DOIUrl":"https://doi.org/10.1177/1358863X251323508","url":null,"abstract":"<p><strong>Background: </strong>Endarterectomy (open repair) represents the gold-standard for common femoral atherosclerotic disease (CFAD) treatment. However, with developments like atherectomy, endovascular therapy (endovascular revascularization) may offer an alternative option. The aim of the present study was to evaluate the safety and effectiveness of endovascular versus open therapy for the CFAD.</p><p><strong>Methods: </strong>The ARISTON (AtheRectomy-assIsted endovaScular Therapy versus OpeN) study was an 11-center research collaborative in which data from consecutive patients with symptomatic CFAD were analyzed. Retrospective matching was performed for patient-specific characteristics, including age, cardiovascular risk factors and comorbidities, and lesion-specific variables, including lesion calcification and complexity. Primary endpoints were all-cause mortality and freedom from clinically driven target lesion revascularization (CD-TLR). Amputation-free survival (AFS) was a secondary endpoint.</p><p><strong>Results: </strong>From 2015 to 2022, 826 patients undergoing endovascular (<i>n</i> = 213 [25.8%]) versus open therapy (<i>n</i> = 613 [74.2%]) were analyzed. The total number of procedural complications was higher with open therapy, whereas hospital stay was shorter with endovascular therapy (<i>p</i> < 0.0001 for both). Major adverse cardiac and limb events at 30-day outcomes were, however, not statistically different (<i>p</i> = 0.06). Bail-out stent rates with atherectomy-assisted endovascular therapy were 5.1%. After matching and during 1.72 (0.9-3.3) years of follow up, all-cause mortality, AFS, and CD-TLR were not statistically different in endovascular versus open therapy (HR = 0.68, 95% CI 0.36-1.29; HR = 1.5, 95% CI 0.59-3.77; and HR = 1.46, 95% CI 0.61-3.49, <i>p</i> = NS for all).</p><p><strong>Conclusion: </strong>Endovascular and open therapy exhibit comparable outcomes for the treatment of patients with symptomatic CFAD, including similar CD-TLR in patients with claudication and AFS in patients with critical limb-threatening ischemia, during short-term follow up. Atherectomy-assisted endovascular therapy may therefore provide a useful alternative for patients who are unfit for surgery.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X251323508"},"PeriodicalIF":3.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of the Hospital Frailty Risk Score (HFRS) and outcomes in peripheral artery disease and end-stage kidney disease.","authors":"Monil Majmundar, Chan Wan-Chi, Kunal N Patel, Vidit Majmundar, Rhythm Vasudeva, Kirk A Hance, Adam Ali, George Hajj, Axel Thors, Jinxiang Hu, Kamal Gupta","doi":"10.1177/1358863X251316837","DOIUrl":"https://doi.org/10.1177/1358863X251316837","url":null,"abstract":"<p><strong>Background: </strong>Peripheral artery disease (PAD) and end-stage kidney disease (ESKD) are independent risk factors affecting outcomes like in-hospital mortality. The role of a frailty index in prognosticating outcomes in patients with ESKD and PAD is unknown. We aim to assess the prognostic value of the Hospital Frailty Risk Score (HFRS) and its association with outcomes in these patients.</p><p><strong>Methods: </strong>We identified patients with PAD using data from the United States Renal Data System (USRDS) for the years 2015-2018. These patients were stratified into three categories of frailty risk based on their HFRS, a validated frailty assessment tool using ICD-10 codes: low (< 5), intermediate (5-10), and high risk (> 10) and based on revascularization or not. Primary outcomes included in-hospital mortality and composite of mortality or major amputation. Secondary outcomes encompassed postdischarge mortality and composite of mortality or major amputation at 1 year.</p><p><strong>Results: </strong>Out of 122,649 patients with PAD and ESKD, 4118 underwent revascularization and 118,531 did not. In-hospital outcomes demonstrated a nonlinear relationship and postdischarge outcomes displayed a nearly linear relationship with HFRS, regardless of revascularization status. In both cohorts, the high-risk group was associated with a significantly higher risk of in-hospital mortality/amputation (revascularization: odds ratio [OR] 4.6, 95% CI 3.3-6.2, <i>p</i> < 0.001; no revascularization: OR 3.1, 95% CI 2.8-3.3, <i>p</i> < 0.001) and mortality (revascularization: OR 5.5, 95% CI 3.4-8.7, <i>p</i> < 0.001; no revascularization: OR 5.1, 95% CI 4.6-5.6, <i>p</i> < 0.001) compared with the low-risk group.</p><p><strong>Conclusion: </strong>In patients with ESKD and PAD, the HFRS serves as a valuable predictor of mortality and amputation irrespective of revascularization. This information can support informed decision-making.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X251316837"},"PeriodicalIF":3.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel swine model of chronic deep vein thrombosis (DVT) suitable for endovascular device assessment.","authors":"Wenzhu Li, Farouc A Jaffer","doi":"10.1177/1358863X251324911","DOIUrl":"https://doi.org/10.1177/1358863X251324911","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X251324911"},"PeriodicalIF":3.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous leg ulcers: A review of clinical variability and differential diagnosis.","authors":"Raghu Kolluri, Eri Fukaya, Surith Krishna, Steven Dean","doi":"10.1177/1358863X251319243","DOIUrl":"https://doi.org/10.1177/1358863X251319243","url":null,"abstract":"<p><p>Venous hypertension due to anatomical venous insufficiency (superficial or deep venous valvular reflux and venous obstruction) and/or functional venous insufficiency (calf dysfunction, dependent edema, lymphatic dysfunction, elevated central venous pressures, etc.) leads to chronic venous insufficiency (CVI) and its sequelae. The most severe clinical manifestation of CVI is venous leg ulcer (VLU), which leads to substantial morbidity and disability. VLUs can present in both typical and atypical forms. However, several other types of leg ulcers can mimic VLUs. Therefore, vascular and wound care specialists must recognize the variability in VLU presentation and understand the differential diagnoses to deliver an accurate diagnosis and optimal care of atypical VLUs and conditions that resemble VLUs. Herein, we review and discuss the broad differential diagnosis of VLUs, supported by illustrative examples.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X251319243"},"PeriodicalIF":3.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathological and clinical findings of calcified nodules in carotid artery stenosis: A study of 508 consecutive carotid endarterectomies.","authors":"Kiyofumi Yamada, Kinta Hatakeyama, Kisaki Amemiya, Masanori Kawasaki, Soichiro Abe, Hirotoshi Imamura, Hisae Mori, Manabu Shirakawa, Shinichi Yoshimura, Koji Iihara, Hiroharu Kataoka","doi":"10.1177/1358863X251324159","DOIUrl":"https://doi.org/10.1177/1358863X251324159","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X251324159"},"PeriodicalIF":3.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient factors associated with activation level in peripheral artery disease.","authors":"Margaret A Reilly, Megan E Alagna, Cassandra Iroz, Emily Ho, Alexander Lundberg, Andrew W Hoel, Ashley K Vavra, Julie K Johnson, Karen J Ho","doi":"10.1177/1358863X251318652","DOIUrl":"10.1177/1358863X251318652","url":null,"abstract":"<p><strong>Introduction: </strong>As a chronic and incurable condition, lower extremity peripheral artery disease (PAD) and its optimal self-management requires patient participation in treatment. Patient activation (knowledge, skills, and confidence to manage one's health) is known to improve chronic disease outcomes. We aimed to identify factors associated with activation in patients with PAD.</p><p><strong>Methods: </strong>In this single-center study, participants with PAD completed a survey assessing demographics, activation, PAD knowledge, and functional health literacy (FHL). The primary outcome, activation, was measured by the Patient Activation Measure (PAM-13). The PAD knowledge score was the percentage of correct responses, and FHL was assessed using the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Bivariable analysis and logistic regression identified factors associated with activation.</p><p><strong>Results: </strong>Of the 91 participants (49.5% women, mean ± SD age: 68.6 ± 11.9 years, 29.7% Black), 72.6% were activated, 78.7% demonstrated adequate FHL, and the mean knowledge score ± SD was 79.1% ± 13.3%. White race (<i>p</i> = 0.025), higher income (<i>p</i> = 0.015), ability to ambulate (<i>p</i> = 0.023), and increased knowledge score (<i>p</i> = 0.002) were associated with activation in bivariable analyses. In a logistic regression model, younger age (<i>p</i> = 0.029), higher income (<i>p</i> = 0.016), and higher knowledge score (<i>p</i> = 0.012) independently correlated with odds of greater activation.</p><p><strong>Conclusions: </strong>Many participants were activated, demonstrated adequate FHL, and scored well on the PAD knowledge test. The remaining 27.5% were inactivated, which was associated with poor PAD knowledge and certain demographic characteristics. Future studies should focus on developing and implementing patient-centric educational interventions for inactivated patients and strategies to increase activation.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X251318652"},"PeriodicalIF":3.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}