Vascular Medicine最新文献

{"title":"Cumulative impact of procedural and anatomical factors on in-hospital bleeding complications in endovascular therapy for lower-extremity artery disease: A nationwide registry study in Japan.","authors":"Takuya Nakahashi, Mitsuyoshi Takahara, Osamu Iida, Shun Kohsaka, Yoshimitsu Soga, Kazunori Horie, Kenji Sakata, Masayuki Takamura, Tetsuya Amano, Ken Kozuma","doi":"10.1177/1358863X251320113","DOIUrl":"10.1177/1358863X251320113","url":null,"abstract":"<p><p><b>Background:</b> Although bleeding is a common procedure-related adverse event following endovascular therapy (EVT), limited data exist regarding the procedural and anatomical factors associated with its complications in patients with lower-extremity artery disease (LEAD) undergoing EVT. <b>Methods:</b> Data were extracted from a nationwide Japanese EVT registry of 73,990 patients who underwent EVT for symptomatic LEAD between January 2021 and December 2022. The primary outcome measure was in-hospital bleeding complications, including access site bleeding, nonaccess site bleeding, and hemorrhagic stroke. <b>Results:</b> The mean age of the patients was 75 ± 9 years, and 69% were men. In-hospital bleeding complications were observed in 613 (0.8%) patients. Logistic regression analysis demonstrated significant associations between bleeding complications and the following procedural, anatomical, and pharmacological variables: emergent revascularization (odds ratio [OR]: 1.90, 95% CI: 1.29-2.79), multiple approach sites (OR: 2.46, 95% CI: 2.00-3.01), bilateral arterial calcification (OR: 1.46, 95% CI: 1.19-1.79), chronic occlusion (OR: 1.53, 95% CI: 1.28-1.83), dual antiplatelet therapy (OR: 1.70, 95% CI: 1.27-2.28), and oral anticoagulant (OR: 1.63, 95% CI: 1.31-2.03). The adjusted incidence of in-hospital bleeding was 0.59% (95% CI: 0.51-0.68%) in patients with one of the identified procedural and anatomical risk factors, 0.96% (95% CI: 0.82-1.13%) in patients with two factors, and 2.40% (95% CI: 1.88-3.05%) in patients with three or four factors. <b>Conclusions:</b> Procedural and anatomical factors as well as antithrombotic strategies were significantly associated with an increased risk of in-hospital bleeding in patients with LEAD who underwent EVT.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"155-161"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483919","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":"Interaction of anxiety symptoms with peripheral artery disease treatment strategies and health status outcomes.","authors":"Toluwani Odu, Gaëlle Romain, Lindsey Scierka, Jacob Cleman, Santiago Callegari, Francky Jacque, Carlos Mena-Hurtado, Kim G Smolderen","doi":"10.1177/1358863X241306406","DOIUrl":"10.1177/1358863X241306406","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"216-217"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932716","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":"Vascular Disease Patient Information Page: Visceral artery aneurysms.","authors":"Tabitha N Lobo, Alexandra Solomon, Christopher J Abularrage, Elizabeth V Ratchford","doi":"10.1177/1358863X251326568","DOIUrl":"https://doi.org/10.1177/1358863X251326568","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":"30 2","pages":"265-271"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001822","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":"Association of oxidized LDL with carotid wall layers in hypertensive patients.","authors":"Saturne Barthold, Eduarda Oz Minin, Luís Frs Carvalho-Romano, Edmilson R Marques, Layde R Paim, Elisangela Cp Lopes, Camila Fl Vegian, José A Pio-Magalhães, José R Matos-Souza, Otavio R Coelho-Filho, Andrei C Sposito, Wilson Nadruz, Roberto Schreiber","doi":"10.1177/1358863X251323516","DOIUrl":"10.1177/1358863X251323516","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"213-215"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543613","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":"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":"Prognostic performance of bedside tests for predicting ulcer healing and wound healing after minor amputation in patients prone to medial arterial calcification: A systematic review.","authors":"Siem A Willems, Jelle A Nieuwstraten, Abbey Schepers, Jan van Schaik, Pim van den Hoven, Joost R van der Vorst, Jaap F Hamming, Jeroen Jwm Brouwers","doi":"10.1177/1358863X241309326","DOIUrl":"10.1177/1358863X241309326","url":null,"abstract":"<p><p>Foot ulceration is a significant and growing health problem worldwide, particularly due to rises in diabetes mellitus (DM) and peripheral artery disease. The prediction of ulcer healing remains a major challenge. In patients with foot ulcers, medial arterial calcification (MAC) can be present as a result of concomitant DM or chronic kidney disease and is a prognostic factor for unfavorable outcome. This systematic review aimed to evaluate the prognostic reliability of bedside tests to predict ulcer healing and wound healing after minor amputation in patients prone to MAC, following PRISMA guidelines. Primary endpoints were the positive and negative likelihood ratios for ulcer healing. Methodological quality and risk of bias were assessed using the QUIPS-tool. A total of 35 studies were included, predominantly investigating transcutaneous oxygen pressure (TcPO₂), followed by ankle-brachial index and toe pressure. None of these bedside tests effectively provided an acceptable trade-off between predicting healing and nonhealing. A TcPO₂ below 30 mmHg was most closely associated with nonhealing of an ulcer. The same applied to wound healing after minor amputation, in which none of the bedside tests was able to sufficiently predict healing or nonhealing. To conclude, currently used bedside tests lack acceptable prognostic performance for ulcer healing and healing after minor amputation in patients prone to MAC. Future prospective studies should establish a clear definition of ulcer healing, utilize a standardized wound classification system, and minimize patient heterogeneity. A combined assessment of microvascular and macrovascular perfusion status could improve the prediction of wound healing.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"250-260"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare resource utilization and costs after initiating direct-acting oral anticoagulants or low molecular weight heparins in patients with venous thromboembolism.","authors":"Godwin Okoye, Kenechukwu C Ben-Umeh, Anton Lv Avanceña, Eberechukwu Onukwugha","doi":"10.1177/1358863X241305097","DOIUrl":"10.1177/1358863X241305097","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) can lead to significant healthcare resource utilization (HcRU) and costs. First-line treatments such as direct-acting oral anticoagulants (DOAC) and low molecular weight heparin (LMWH) are utilized for VTE management. There are limited observational studies to determine which first-line drug for VTE is associated with lower HcRU and cost. Therefore, we sought to compare HcRU and costs of commercially insured patients with VTE who initiated DOAC or LMWH in the US.</p><p><strong>Methods: </strong>We utilized Merative MarketScan Research Database (2016-2021) to identify adults initiating DOAC or LMWH for VTE. Baseline measures were assessed 12 months prior to the index date of drug initiation. Inverse probability of treatment weighting was used to control confounding. For HcRU, logistic regression was used to model emergency room and inpatient visits and the negative binomial count model was used for outpatient visits. The average marginal effect for total healthcare cost comparing DOAC with LMWH users was estimated using a generalized linear model. HcRU and costs were evaluated for 12 months posttreatment initiation.</p><p><strong>Results: </strong>DOAC users had lower odds of inpatient visits (adjusted odds ratio [aOR] 0.53, 95% CI 0.46 to 0.59), emergency room visits (aOR 0.86, 95% CI 0.73 to 0.99), and outpatient visits (adjusted incident rate ratio 0.52, 95% CI 0.50 to 0.54) in comparison to LMWH users. DOAC users had lower total healthcare costs of -$9573 (95% CI -$11,149 to -$7997) (US dollars).</p><p><strong>Conclusion: </strong>This cohort study suggests that DOAC use is associated with fewer inpatient, outpatient, and emergency room visits, and lower healthcare costs compared to LMWH use for VTE management.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"197-204"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Images in Vascular Medicine: Severe acrocyanosis with capillaroscopic findings.","authors":"Angelo Nigro","doi":"10.1177/1358863X241309834","DOIUrl":"10.1177/1358863X241309834","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"263-264"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012697","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":"Images in Vascular Medicine: Naked and clothed right coronary artery in aortic intramural hematoma.","authors":"Hisato Takagi","doi":"10.1177/1358863X241308208","DOIUrl":"10.1177/1358863X241308208","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"261-262"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932697","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":"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 chronic 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":"170-182"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","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}