Vascular Medicine最新文献

{"title":"Cerebral arteriopathies of childhood and stroke - A focus on systemic arteriopathies and pediatric fibromuscular dysplasia (FMD).","authors":"Moran Hausman-Kedem, Pradeep Krishnan, Nomazulu Dlamini","doi":"10.1177/1358863X241254796","DOIUrl":"10.1177/1358863X241254796","url":null,"abstract":"<p><p>Systemic vascular involvement in children with cerebral arteriopathies is increasingly recognized and often highly morbid. Fibromuscular dysplasia (FMD) represents a cerebral arteriopathy with systemic involvement, commonly affecting the renal and carotid arteries. In adults, FMD diagnosis and classification typically relies on angiographic features, like the 'string-of-beads' appearance, following exclusion of other diseases. Pediatric FMD (pFMD) is considered equivalent to adult FMD although robust evidence for similarities is lacking. We conducted a comprehensive literature review on pFMD and revealed inherent differences between pediatric and adult-onset FMD across various domains including epidemiology, natural history, histopathophysiology, clinical, and radiological features. Although focal arterial lesions are often described in children with FMD, the radiological appearance of 'string-of-beads' is highly nonspecific in children. Furthermore, children predominantly exhibit intimal-type fibroplasia, common in other childhood monogenic arteriopathies. Our findings lend support to the notion that pFMD broadly reflects an undefined heterogenous group of monogenic systemic medium-or-large vessel steno-occlusive arteriopathies rather than a single entity. Recognizing the challenges in categorizing complex morphologies of cerebral arteriopathy using current classifications, we propose a novel term for describing children with cerebral and systemic vascular involvement: 'cerebral and systemic arteriopathy of childhood' (CSA-c). This term aims to streamline patient categorization and, when coupled with advanced vascular imaging and high-throughput genomics, will enhance our comprehension of etiology, and accelerate mechanism-targeted therapeutic developments. Lastly, in light of the high morbidity in children with cerebral and systemic arteriopathies, we suggest that investigating for systemic vascular involvement is important in children with cerebral arteriopathies.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":"29 3","pages":"328-341"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11188572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427757","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":"Migraine headache in patients with spontaneous coronary artery dissection: A report of the iSCAD Registry.","authors":"Bryan J Wells, Malissa J Wood, Anne E O'Duffy, Jennifer A Sumner, Gerald Chi, Anna Grodzinsky, Heather L Gornik, Daniella Kadian-Dodov, Angela Taylor, Connie N Hess, Monika Sanghavi, Stanislav Henkin, Gretchen Wells, Lori Tam, James Orford, Kathryn Lindley, Dharam J Kumbhani, Clara Vitarello, Fahad Alkhalfan, C Michael Gibson, Katherine K Leon, Sahar Naderi, Esther Sh Kim","doi":"10.1177/1358863X241252444","DOIUrl":"10.1177/1358863X241252444","url":null,"abstract":"<p><strong>Introduction: </strong>Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic cause of myocardial infarction. Migraine headache has been reported to be common among patients with SCAD, but the degree of migraine-related disability has not been quantified.</p><p><strong>Methods: </strong>Clinical data and headache variables were obtained from the baseline assessment of the prospective, multicenter iSCAD Registry. Migraine-related disability was quantified using the self-reported Migraine Disability Assessment (MIDAS). Demographic, clinical, psychosocial, and medical characteristics from data entry forms were compared between patients with and without migraine.</p><p><strong>Results: </strong>Of the 773 patients with available data, 46% reported previous or current migraines. Those with migraines were more likely to be women (96.9% vs 90.3%, <i>p</i> = 0.0003). The presence of underlying carotid fibromuscular dysplasia was associated with migraine (35% vs 27%, <i>p</i> = 0.0175). There was not a significant association with carotid artery dissection and migraine. Current migraine frequency was less than monthly (58%), monthly (24%), weekly (16%), and daily (3%). Triptan use was reported in 32.5% of patients, and 17.5% used daily migraine prophylactic medications. Using the MIDAS to quantify disability related to migraine, 60.2% reported little or no disability, 14.4% mild, 12.7% moderate, and 12.7% severe. The mean MIDAS score was 9.9 (mild to moderate disability). Patients with SCAD had higher rates of depression and anxiety (28.2% vs 17.7% [<i>p</i> = 0.0004] and 35.3% vs 26.7% [<i>p</i> = 0.0099], respectively).</p><p><strong>Conclusions: </strong>Migraines are common, frequent, and a source of disability in patients with SCAD. The association between female sex, anxiety, and depression may provide some insight for potential treatment modalities.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":"29 3","pages":"286-295"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11188565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427758","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":"Cardiovascular manifestations of Erdheim-Chester disease: A narrative review with two cases.","authors":"Alan Wong, Aditya Sharma, Randy Ramcharitar","doi":"10.1177/1358863X241228271","DOIUrl":"10.1177/1358863X241228271","url":null,"abstract":"<p><p>Erdheim-Chester disease (ECD) is a rare 'L' (Langerhans) group histiocytic neoplasm that affects a multitude of organ systems, causing osteosclerotic bone lesions, periaortic encasement ('coated' aorta), retroperitoneal fibrosis involving kidneys and ureters ('hairy kidney'), and infiltration of the central nervous system. Cardiovascular involvement can occur in up to 70% of patients and is usually found during computed tomography/magnetic resonance imaging evaluation. When present, cardiovascular symptoms can have wide variability in presentation from asymptomatic to pericarditis, fatal cardiac tamponade, myocardial infarction, conduction abnormalities, heart failure, renal artery stenosis, and claudication. Cardiac involvement found on imaging includes right atrial pseudotumor, right atrioventricular groove infiltration, and pericardial effusions. ECD can involve the large- and medium-sized arteries, often seen as periarterial thickening (commonly coating the aorta) with stenosis/occlusion. Although more cardiovascular ECD cases have begun to be published in the literature, more data are needed on the outcomes of these patients, as well as how cardiovascular manifestations respond to treatment of ECD.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"313-319"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140102514","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":"Support and resources for patients with aortic disease.","authors":"April D Shinske, Ellen Hostetler, Catherine Fowler, Gareth Owens, Chrisanne Campos, Victoria Hilton, Gretchen MacCarrick","doi":"10.1177/1358863X241237185","DOIUrl":"10.1177/1358863X241237185","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"362-366"},"PeriodicalIF":3.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307094","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":"Factors associated with false lumen changes in patients with superior mesenteric artery dissection.","authors":"Junhao Mei, Yuan Yuan, Hui Yan, Xi Zhao, Tongqing Xue, Haobo Su, Zhongzhi Jia","doi":"10.1177/1358863X231220624","DOIUrl":"10.1177/1358863X231220624","url":null,"abstract":"<p><strong>Background: </strong>False lumen changes (FLCs) are the main reference for the prognosis judgment and treatment plan selection for type IIa superior mesenteric artery dissection (SMAD).</p><p><strong>Methods: </strong>For this retrospective study, 55 patients with symptomatic type IIa SMAD were included. Computational fluid dynamics (CFD) analysis was used to explore the hemodynamic basis of FLCs. Correlation and multiple linear regression analyses were performed to identify clinical, morphological and hemodynamic factors associated with FLCs.</p><p><strong>Results: </strong>The FLCs of patients with successful conservative treatment (<i>n</i> = 29) are significantly higher than those with failed conservative treatment (<i>n</i> = 26) (58.5 ± 21.1% vs 10.9 ± 17.4%, <i>p</i> < 0.0001). Positive correlations were seen between FLCs and the morphological parameters false lumen length (FLL)/dissection entrance length (DEL) and FLL. In terms of hemodynamic parameters, negative correlations were seen between FLCs and time-averaged wall shear stress (TAWSS), vorticity, and high areas of TAWSS and vorticity, whereas positive correlations were seen between FLCs and oscillatory shear index (OSI), relative residence time (RRT), and high areas of OSI and RRT. Multiple linear regression analysis identified symptom duration (odds ratio [OR], 0.93; 95% CI, 0.91-0.96; <i>p</i> < 0.0001), FLL/DEL (OR, 1.30; 95% CI, 1.01-1.67; <i>p</i> = 0.044), and high RRT area (OR, 2.03; 95% CI, 1.48-2.78; <i>p</i> < 0.0001) as predictors of FLCs.</p><p><strong>Conclusion: </strong>The clinical predictor symptom duration, morphological factor FLL/DEL, and the hemodynamic factor high RRT area can serve as predictors of FLCs in patients with symptomatic type IIa SMAD.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"274-285"},"PeriodicalIF":3.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708047","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: String of pearls and skydancer in fibromuscular dysplasia (FMD) with abdominal aortic aneurysm (AAA).","authors":"Beth Western, Toby Richards","doi":"10.1177/1358863X231219001","DOIUrl":"10.1177/1358863X231219001","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"345-346"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378255","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: Idiopathic internal mammary artery aneurysms.","authors":"Jing Yi Kwan, Henry Davies, Sapna Puppala, Marc A Bailey","doi":"10.1177/1358863X231210294","DOIUrl":"10.1177/1358863X231210294","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"347-348"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138831718","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: The large PANeurysm - A rare case of hepatic artery aneurysm in a 25-year-old woman with polyarteritis nodosa.","authors":"Patrick Vera Cruz, Emilita Lapuz, Jenelle Faustino, Francisco Dalangin","doi":"10.1177/1358863X231213362","DOIUrl":"10.1177/1358863X231213362","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"349-351"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730625","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":"Vasa vasorum interna in the carotid wall of active forms of Takayasu arteritis evidenced by ultrasound localization microscopy.","authors":"Guillaume Goudot, Anatole Jimenez, Nassim Mohamedi, Jonas Sitruk, Louise Z Wang, Lina Khider, Patrick Bruneval, Emmanuel Messas, Mathieu Pernot, Tristan Mirault","doi":"10.1177/1358863X241228262","DOIUrl":"10.1177/1358863X241228262","url":null,"abstract":"<p><p><b>Introduction:</b> Takayasu arteritis (TA) is associated with microvascularization of the wall of large arteries and is related to inflammation. Ultrasound localization microscopy (ULM), combining ultrafast ultrasound imaging with microbubble (MB) injection, can track the path of MBs within the arterial wall and thus provide imaging of the vasa vasorum. From the analysis of MB tracks in the common carotid arteries of patients with active TA, we report the presence of microvessels in connection with the carotid lumen (i.e., vasa vasorum interna [VVI]). <b>Methods:</b> ULM maps were obtained on five patients with active disease in the observational single-center series of the TAK-UF study. MB tracks connected to the carotid lumen were automatically identified, allowing the reconstruction of VVI. <b>Results:</b> MB tracking allows us to observe a microvascular network on the inner part of the wall, with some vessels in communication with the carotid lumen. This type of vessel was identified in all patients with active TA (<i>n</i> = 5) with a median of 2.2 [1.1-3.0] vessels per acquisition (2D longitudinal view of 3 cm of the common carotid artery). The blood flow within these vessels is mainly centrifugal; that is, toward the adventitia (88% [54-100] of MB tracks with flow directed to the outer part of the wall). <b>Conclusion:</b> VVI are present in humans in the case of active TA and emphasize the involvement of the intima in the pathological process. <b>ClinicalTrials.gov Identifier: NCT03956394</b>.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"296-301"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132704","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":"Despite celiprolol therapy, patients with vascular Ehlers-Danlos syndrome remain at risk of vascular events: A 12-year experience in an Italian referral center.","authors":"Giacomo Buso, Anna Paini, Claudia Agabiti-Rosei, Carolina De Ciuceis, Fabio Bertacchini, Deborah Stassaldi, Massimo Salvetti, Marco Ritelli, Marina Venturini, Marina Colombi, Maria Lorenza Muiesan","doi":"10.1177/1358863X231215330","DOIUrl":"10.1177/1358863X231215330","url":null,"abstract":"<p><strong>Background: </strong>Vascular Ehlers-Danlos syndrome (vEDS) is an inherited connective tissue disorder characterized by arterial fragility. Celiprolol has been suggested to significantly reduce rates of vascular events in this setting, though real-world evidence is limited. The aim of this study was to report our experience with celiprolol therapy in vEDS management.</p><p><strong>Methods: </strong>Patients with a genetically confirmed diagnosis of vEDS who were referred for outpatient consultation at the Brescia University Hospital between January 2011 and July 2023 were included. At each visit, patients' medical history, results of vascular imaging, and office blood pressure measurements were recorded. Celiprolol therapy was progressively titrated to the maximum tolerated dose of up to 400 mg daily, according to the patients' tolerance.</p><p><strong>Results: </strong>Overall, 26 patients were included. Female sex was prevalent (62%). Mean (SD) age was 37 (16) years. Follow-up duration was 72 (41) months. At the last follow-up visit, all patients were on celiprolol therapy, 80% of whom were taking the maximum recommended dose. The yearly risk of symptomatic vascular events was 8.8%, the majority of which occurred after reaching the maximum recommended dose of celiprolol. No significant predictor of symptomatic vascular events was identified among patients' clinical characteristics.</p><p><strong>Conclusion: </strong>In our cohort, rates of celiprolol use were high and the drug was well tolerated overall. Nonetheless, the risk of symptomatic vascular events remained nonnegligible. Future studies should identify reliable predictors of major adverse events and explore additional therapeutic strategies that could further lower the risk of life-threatening events in this population.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"265-273"},"PeriodicalIF":3.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810538","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}