Vascular MedicinePub Date : 2025-04-01Epub Date: 2025-03-13DOI: 10.1177/1358863X251319243
Raghu Kolluri, Eri Fukaya, Surith Krishna, Steven Dean
{"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":"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":"218-237"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","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}
Vascular MedicinePub Date : 2025-04-01Epub Date: 2025-03-24DOI: 10.1177/1358863X251328645
Maxime Dubosq-Lebaz, Eric A Secemsky
{"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":"10.1177/1358863X251328645","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"183-185"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","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}
Vascular MedicinePub Date : 2025-04-01Epub Date: 2025-04-23DOI: 10.1177/1358863X251326066
Jun-Yang Lou, G Jay Bishop
{"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}
Vascular MedicinePub Date : 2025-04-01Epub Date: 2025-01-20DOI: 10.1177/1358863X241306415
Isabel Forner-Cordero, José Muñoz-Langa
{"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":3.3,"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}
Vascular MedicinePub Date : 2025-04-01Epub Date: 2025-01-21DOI: 10.1177/1358863X241308481
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
{"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":3.3,"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}
Vascular MedicinePub Date : 2025-02-01Epub Date: 2025-01-01DOI: 10.1177/1358863X241309832
Anu Aggarwal, A Phillip Owens, Scott J Cameron
{"title":"Platelet pals: How blood cells shape the future of the aorta.","authors":"Anu Aggarwal, A Phillip Owens, Scott J Cameron","doi":"10.1177/1358863X241309832","DOIUrl":"10.1177/1358863X241309832","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"48-49"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915668","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}
Vascular MedicinePub Date : 2025-02-01Epub Date: 2024-12-03DOI: 10.1177/1358863X241298926
Muhammad Yogi Pratama, Benjamin King, Katherine A Teter, Christina Bi, Natalie Presedo, Keerthi B Harish, Catarina Santos Giardinetto, Sheehan Belleca, Ethan Chervonski, Thomas S Maldonado, Bhama Ramkhelawon
{"title":"Altered platelet phenotype in patients with type II endoleaks following abdominal aortic aneurysm repair.","authors":"Muhammad Yogi Pratama, Benjamin King, Katherine A Teter, Christina Bi, Natalie Presedo, Keerthi B Harish, Catarina Santos Giardinetto, Sheehan Belleca, Ethan Chervonski, Thomas S Maldonado, Bhama Ramkhelawon","doi":"10.1177/1358863X241298926","DOIUrl":"10.1177/1358863X241298926","url":null,"abstract":"<p><strong>Background: </strong>Endovascular abdominal aortic aneurysm repair (EVAR) is a preferred surgery to prevent aneurysm sac enlargement and minimize the risk of life-threatening rupture in patients with AAA. Serious complications of type II endoleaks following EVAR can cause sac expansion and increase rupture risk. This study focused on evaluating clinical and blood characteristics in patients with type II endoleaks to refine our understanding of systemic fluctuations associated with unsuccessful EVAR.</p><p><strong>Methods: </strong>This retrospective study included 146 patients with AAA who underwent primary elective endovascular procedures (EVAR/fEVAR) between 2013 and 2021. Clinical characteristics, complete blood count (CBC) and imaging data were analyzed from patients who did and did not develop type II endoleaks.</p><p><strong>Results: </strong>Mean platelet volume (MPV) was significantly increased in patients who developed type II endoleaks after EVAR. Receiver operating characteristic analysis showed that MPV has a satisfactory discriminatory performance in distinguishing post-EVAR patients who developed type II endoleaks, yielding an area under the curve (AUC) value of 0.64. A risk stratification panel incorporating MPV, type II diabetes history, and administration of dual antiplatelet therapies yielded an AUC of 0.70 and predicted an endoleak-free survival rate with a hazard ratio of 2.94. A nomogram revealed that MPV had the highest scoring weight among all significant variables.</p><p><strong>Conclusion: </strong>Patients with type II endoleaks following EVAR have elevated MPV indicative of different phenotypes of circulating platelets. MPV presents an attractive predictive criteria for assessing the occurrence of type II endoleaks in patients with AAA.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"38-47"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772776","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}
Vascular MedicinePub Date : 2025-02-01Epub Date: 2024-10-17DOI: 10.1177/1358863X241288139
Daniel K Sweet, P Daniel Patterson, Steven Reis, Dave Hostler
{"title":"Changes in the reactive hyperemia index after continuous and interval exercise.","authors":"Daniel K Sweet, P Daniel Patterson, Steven Reis, Dave Hostler","doi":"10.1177/1358863X241288139","DOIUrl":"10.1177/1358863X241288139","url":null,"abstract":"<p><strong>Introduction: </strong>High-intensity interval exercise (HIIE) is more effective than moderate-intensity interval exercise (MICE) for improving macrovascular function (e.g., flow-mediated dilation), but less is known regarding the effect of HIIE on microvascular function. We used peripheral artery tonometry to measure the reactive hyperemia index (RHI) and examine the acute effects of HIIE and MICE on microvascular function.</p><p><strong>Methods: </strong>Ten healthy participants (50% men, age: 26 ± 5 years, mass: 75.6 ± 15.1 kg, height: 170 ± 10 cm, body mass index: 26.0 ± 3.1 kg∙m<sup>-2</sup>) performed single bouts of HIIE and MICE cycling on separate occasions. The MICE protocol was 20 min at 60% of maximum power output. The HIIE protocol was a 12-min warm up at 50% of maximum power output immediately followed by an 8-min Tabata protocol where participants alternated between cycling at ⩾ 100% max power (20 sec) and rest (10 sec). The RHI was measured before, immediately after, and 1 h after exercise and compared by two-way repeated measures analysis of variance (condition [MICE, HIIE] and time [pre-, post-, and 1-h postexercise]).</p><p><strong>Results: </strong>Compared to baseline, RHI increased 1 h after MICE only (<i>p</i> = 0.02). Heart rate was higher during MICE at 5 and 10 min (<i>p</i> = 0.02) and higher during HIIE at min 20 (<i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>Within a sample of healthy adults, the RHI was improved 1 h after a single session of MICE but not HIIE. Future research is needed to determine the significance of the differential effects of exercise regimens on the macro- and microvasculature.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"3-9"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475944","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}