Vascular Medicine最新文献

{"title":"How to start a vascular diagnostic laboratory - Tips and tricks of the trade.","authors":"Jun-Yang Lou, G Jay Bishop","doi":"10.1177/1358863X251326066","DOIUrl":"https://doi.org/10.1177/1358863X251326066","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":"30 2","pages":"272-274"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016085","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":"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":"124-135"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","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":"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":"205-212"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","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":"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":"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":"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}

{"title":"Identifying peripheral artery disease in persons with and without chronic kidney disease from electronic health records.","authors":"Georgia R Parsons, Gomathy Parvathinathan, Ali Etemadi, Sai Liu, Elsie Ross, W Schuyler Jones, Margaret R Stedman, Tara I Chang","doi":"10.1177/1358863X251322182","DOIUrl":"https://doi.org/10.1177/1358863X251322182","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X251322182"},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543617","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 between guideline-directed medical therapy and reintervention risk following peripheral vascular interventions in patients with peripheral artery disease.","authors":"Santiago Callegari, Gaëlle Romain, Isabella Capuano, Jacob Cleman, Lindsey Scierka, Kim G Smolderen, Carlos Mena-Hurtado","doi":"10.1177/1358863X251320347","DOIUrl":"https://doi.org/10.1177/1358863X251320347","url":null,"abstract":"<p><strong>Introduction: </strong>Reintervention following peripheral vascular intervention (PVI) for peripheral artery disease (PAD) is common. Guideline-directed medical therapy (GDMT) is recommended post-PVI, yet its association with reintervention outcomes remains unclear.</p><p><strong>Methods: </strong>We analyzed Vascular Quality Initiative registry data linked with Medicare outcome for patients undergoing PVI for PAD (2017-2018). GDMT was defined as the receipt of statin, antiplatelet, and angiotensin-converting enzyme or angiotensin receptor blocker (ACE/ARB) therapy if hypertensive at discharge. Competing risk analyses and conditional risk models assessed the reintervention outcome, and the recurrent reintervention outcomes within 2 years, by GDMT receipt, compliance with each GDMT element, the number of elements received, and GDMT rate across sites and operators in a 1:1 propensity score-matched cohort.</p><p><strong>Results: </strong>We included 13,244 patients (mean age 72.0 ± 9.9, women 41.0%). The reintervention outcome did not differ by GDMT receipt (cumulative incidence: 43.0% [95% CI 41.0-44.9%] in no GDMT vs 41.2% [95% CI 39.4- 43.0%] in GDMT; subhazard ratio (sHR): 1.03 [95% CI 0.97-1.10]), compliance with GDMT elements, the number of elements received, or site and operator GDMT rates (sHR per 10% increase: 1.00 [95% CI 0.98-1.03] and 1.00 [95% CI 0.98-1.02]) (all <i>p</i> > 0.05). However, a higher operator GDMT rate reduced the recurrent reintervention risk (HR: 0.98 [95% CI 0.97-1.00], <i>p</i> = 0.026).</p><p><strong>Conclusion: </strong>Around 40% of patients undergoing a PVI experience reintervention within 2 years, but the outcome was not reduced with GDMT receipt, and higher GDMT rates by site and operators were not associated with reintervention risk. Future studies should focus on medication adherence, refills, and more granular GDMT data for PAD care surveillance postrevascularization.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X251320347"},"PeriodicalIF":3.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483781","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":"Relationship between calf muscle pump function and severity of chronic venous disease.","authors":"Atefeh Ghorbanzadeh, David Liedl, Hossam Elbenawi, Thom Rooke, Paul Wennberg, Robert D McBane, Damon E Houghton","doi":"10.1177/1358863X241311254","DOIUrl":"https://doi.org/10.1177/1358863X241311254","url":null,"abstract":"<p><strong>Background: </strong>The calf muscle pump is an understudied contributor to venous return from the lower extremity. This study aimed to determine if calf pump function (CPF) is independently associated with the severity of chronic venous disease classified by CEAP (Clinical-Etiology-Anatomy-Pathophysiology).</p><p><strong>Methods: </strong>The Mayo Clinic Vascular Laboratory database was analyzed from January 2015 through September 2023. Ambulatory adults who underwent venous air plethysmography were included. Venous plethysmography assessed the severity of venous incompetence, and CPF was measured as ejection fraction (EF) per leg. The clinical component (C0 through C6) of the CEAP score was evaluated for each extremity at the time of the study.</p><p><strong>Results: </strong>A total of 7760 limbs from 3733 patients were analyzed. The mean age was 62 years, with 62% women. Venous obstruction was detected in 3.2% of limbs. Venous incompetence severity was categorized as normal (44%), mild (26%), moderate (19%), and severe (10%). A significant trend of reduced CPF was observed with higher CEAP scores (<i>p</i> < 0.001). Multivariable logistic regression, adjusted for age, sex, degree of venous incompetence, and obstruction showed reduced CPF was a significant predictor (odds ratio 1.84, CI: 1.5-2.2) of active/prior ulcer (C5 or C6). In contrast to more severely reduced CPF, mildly reduced CPF (EF 40-49%) was not associated with active/prior ulcers.</p><p><strong>Conclusion: </strong>This large contemporary study demonstrates that decreased CPF is associated with worse chronic venous disease. Importantly, we demonstrate for the first time that CPF is independently associated with active/prior venous ulcers after accounting for other venous physiologic parameters and demographics.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X241311254"},"PeriodicalIF":3.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383324","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}