Vascular Medicine最新文献

{"title":"Sex differences in treatment strategies for pulmonary embolism in older adults: The SERIOUS-PE study of RIETE participants and US Medicare beneficiaries.","authors":"Behnood Bikdeli, Hannah Leyva, Alfonso Muriel, Zhenqiu Lin, Gregory Piazza, Candrika D Khairani, Rachel P Rosovsky, Ghazaleh Mehdipour, Michelle L O'Donoghue, Olga Madridano, Juan Bosco Lopez-Saez, Meritxell Mellado, Ana Maria Diaz Brasero, Elvira Grandone, Primavera A Spagnolo, Yuan Lu, Laurent Bertoletti, Luciano López-Jiménez, Manuel Jesús Núñez, Ángeles Blanco-Molina, Marie Gerhard-Herman, Samuel Z Goldhaber, Shannon M Bates, David Jimenez, Harlan M Krumholz, Manuel Monreal","doi":"10.1177/1358863X241292023","DOIUrl":"10.1177/1358863X241292023","url":null,"abstract":"<p><strong>Introduction: </strong>Sex differences exist in risk factors and comorbidities of older adults (aged ⩾ 65 years) with pulmonary embolism (PE). Clinically relevant sex-based treatment disparities for PE have not been adequately addressed. The few existing show conflicting results due to small sample size (type II error) and suboptimal methods (overreliance on <i>p</i>-value, which may detect differences of small clinical relevance).</p><p><strong>Methods: </strong>We assessed sex differences in anticoagulation and advanced therapies for PE in older adults, utilizing data from Registro Informatizado Enfermedad TromboEmbolica (RIETE), a large PE registry with predominant participation from Europe, and data from US Medicare beneficiaries. We prespecified a standardized difference (SRD) > 10% as clinically relevant. RIETE included 33,462 (57.7% female) and Medicare included 102,391 (55.0% female) older adults with PE.</p><p><strong>Results: </strong>In RIETE, there were no overall sex differences in the use of anticoagulation (median: 181 vs 180 days, SRD < 1%), fibrinolysis (SRD < 3%), thrombectomy (SRD < 2%), or inferior vena cava (IVC) filters (SRD: 4.4%). However, fibrinolytic therapy (systemic or catheter-based) was less often used in female than male patients with intermediate-risk PE (8.0% vs 12.1%, SRD: 13.6%). No sex differences were noted with advanced PE therapies in Medicare beneficiaries. In unadjusted analyses, fibrinolysis and IVC filter placement were more frequent in Medicare than RIETE participants regardless of sex (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>In a predominantly European PE registry and a US study of older adults, there were no overall sex differences in anticoagulation patterns or advanced therapy utilization. Future studies should determine if sex disparities in fibrinolytic therapy for intermediate-risk PE and greater use of advanced therapies in US older adults correlate with clinical outcomes.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"58-66"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717203","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":"Death certificate documentation is inaccurate for most patients with acute pulmonary embolism.","authors":"Firas Hentati, Milan Kaushik, Shantum Misra, Brett J Carroll, William B Earle, Eric A Secemsky","doi":"10.1177/1358863X241287691","DOIUrl":"10.1177/1358863X241287691","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"79-81"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476008","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":"Early combination lipid-lowering therapy is associated with greater achievement of goal LDL-C: Insights from the OPTIMIZE PAD-1 trial.","authors":"Connie N Hess, Ashley Daffron, Mark R Nehler, Michael Szarek, Christopher P Cannon, Judith Hsia, Joseph J Saseen, Marc P Bonaca","doi":"10.1177/1358863X241309839","DOIUrl":"https://doi.org/10.1177/1358863X241309839","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X241309839"},"PeriodicalIF":3.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048179","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":"https://doi.org/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":"1358863X241309326"},"PeriodicalIF":3.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation in compressive mechanical properties between subacute and chronic venous thrombosis in a novel unilateral iliac thrombosis model.","authors":"Nathaniel J Parchment, Christian Argenti, Sriganesh B Sharma, Oscar Moreno, David Gordon, Laura Durham, Veronica Forsythe, David M Williams, Thomas W Wakefield, Nathan Weidenhamer, Daniel Durant Myers, Minhaj S Khaja, Peter K Henke, Albert J Shih, Andrea Tara Obi","doi":"10.1177/1358863X241308481","DOIUrl":"https://doi.org/10.1177/1358863X241308481","url":null,"abstract":"<p><p><b>Background:</b> Interventional therapies to relieve chronic deep vein thrombosis (DVT) fail through inability to penetrate, cross, and remove the occlusion. Development of suitable tools requires fundamental understanding of chronic DVT mechanical properties and a reliable model for testing. <b>Methods:</b> Female farm swine underwent a novel, endovenous generation of long-segment unilateral iliac vein thrombosis. Thrombus was confirmed via venogram, intravascular ultrasound, and transabdominal duplex for 14 days. Thrombus components were quantified via histology. Thrombus mechanical properties were assessed via uniaxial compression. <b>Results:</b> Among seven swine, technical success was 100%. Compared to subacute thrombi (7-day), chronic thrombi (14-day) showed organizing thrombus with diffuse myointimal thickening and collagen matrix formation on histology. The thrombi collagen content was 41% versus 55% (<i>p</i> = 0.17) and the thrombus erythrocyte percentage was 4.3% versus 2.2%, <i>p</i> = 0.21 in 7- versus 14-day thrombi, respectively. The onset point (compression required to load the thrombus fiber network) was 66.6% versus 35.3% (<i>p</i> = 0.004), the secant modulus (resistance to deformation) measured at the onset point was 153.8 versus 275.99 kPa (<i>p</i> = 0.18), and the average shear constant (resistance to shearing), as defined by the Yeoh hyperelastic model, was 1.85 kPa versus 2.85 kPa in 7- versus 14-day thrombi. <b>Conclusions:</b> This study demonstrates the feasibility of an endovenous model generating chronic unilateral venous thrombi in 2 weeks with similar anatomy to humans and provides critical mechanical properties of thrombi for future research.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X241308481"},"PeriodicalIF":3.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011334","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":"Is lipedema a progressive disease?","authors":"Isabel Forner-Cordero, José Muñoz-Langa","doi":"10.1177/1358863X241306415","DOIUrl":"https://doi.org/10.1177/1358863X241306415","url":null,"abstract":"<p><strong>Background: </strong>It is not yet known whether lipedema is a progressive chronic disease or not. The aim of this paper is to describe the long-term changes in the volume of the lower limbs.</p><p><strong>Methods: </strong>The primary endpoint of this prospective cohort study of patients with lipedema was the percentage of volume change (PVC) during follow up. Progression was defined as when the PVC was > 10% from the baseline, whereas improvement was defined as when the PVC was < -10%, and stability as PVC -10% to 10%.</p><p><strong>Results: </strong>A cohort of 100 patients with lipedema were included in the study. The average follow-up period from the start of this study was 4.6 years. The average PVC was 2.8%. Stability was observed in 62% of the patients, progression in 28%, and improvement in 10%. In the univariate analysis, a significant positive association was observed between PVC and both BMI-change and waist-to-height ratio (WHtR)-change. The more the BMI increased, the more the lipedema progressed (<i>p</i> < 0.0001), as did the WHtR (<i>p</i> < 0.0001). In the adjusted regression analysis, age was not seen to be an influencing factor for PVC. Regarding maintenance therapies, no associations were observed.</p><p><strong>Conclusion: </strong>Lipedema was seen to be stable in two-thirds of the patients. Age was not related to progression. Progression was related to WHtR increase, which is an indicator of abdominal fat gain. This demonstrates the relationship between fat gain and lipedema progression.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X241306415"},"PeriodicalIF":3.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012701","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: Severe acrocyanosis with capillaroscopic findings.","authors":"Angelo Nigro","doi":"10.1177/1358863X241309834","DOIUrl":"https://doi.org/10.1177/1358863X241309834","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X241309834"},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","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":"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":"1358863X241306406"},"PeriodicalIF":3.0,"publicationDate":"2025-01-06","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":"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":"https://doi.org/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":"1358863X241305097"},"PeriodicalIF":3.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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":"https://doi.org/10.1177/1358863X241308208","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X241308208"},"PeriodicalIF":3.0,"publicationDate":"2025-01-06","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}