Vascular diseases (Paris, France)最新文献

{"title":"Aspirin for primary prevention in patients with high lipoprotein(a): A promising therapeutic option while awaiting future therapies?","authors":"Francesca Vittone, Giuliana Autiero, Sara Angela Malerba, Elisabetta Grolla, Michele Dalla Vestra","doi":"10.1016/j.vasdi.2026.09.001","DOIUrl":"https://doi.org/10.1016/j.vasdi.2026.09.001","url":null,"abstract":"<p><p>Elevated lipoprotein(a) [Lp(a)] is a genetically determined cardiovascular risk factor, linked to both atherosclerotic cardiovascular disease and aortic valve stenosis. Plasma Lp(a) levels between 30-50mg/dL suggest a moderate risk, while levels of 51-180mg/dL indicate high risk, and concentrations exceeding 180mg/dL are linked to a very high cardiovascular risk. Currently, there are no approved therapies specifically indicated to lower Lp(a). Recent evidences indicate a role of aspirin in reducing cardiovascular events in primary prevention in patients with high Lp(a). In this review, we discuss the results of the studies that explored the impact of aspirin in reducing cardiovascular events in primary prevention in patients with increased Lp(a) while waiting for the results from large-scale research initiative exploring the impact of RNA-targeting Lp(a)-lowering therapies in reducing cardiovascular risk. In conclusion, waiting for the ongoing trials on emerging RNA-based therapies, the use of aspirin in a subgroup of patients with high atherosclerotic cardiovascular risk, with very high Lp(a) levels and without important bleeding risk could be an interesting strategy. Emerging RNA-targeted therapies might offer in future increased protection against the occurrence of major atherosclerotic cardiovascular events compared to standard lipid management agents in these patients.</p>","PeriodicalId":520901,"journal":{"name":"Vascular diseases (Paris, France)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing pharmacologic thromboprophylaxis in medical inpatients using sequential IMPROVE risk assessment models: Clinical, economic and environmental implications.","authors":"Théo Bourny, Salomé Bougerolle, Ygal Benhamou, Sébastien Miranda","doi":"10.1016/j.vasdi.2026.09.002","DOIUrl":"https://doi.org/10.1016/j.vasdi.2026.09.002","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) is a major preventable cause of morbidity and mortality in hospitalized medical patients. Current recommendations support broad pharmacologic thromboprophylaxis, while individualized risk assessment may help refine prescribing. The IMPROVE VTE and IMPROVE Bleeding scores provide standardized risk assessment tools but should complement, rather than replace, clinical judgment.</p><p><strong>Objective: </strong>To evaluate the discrepancy between real-world thromboprophylaxis prescribing and a prespecified sequential IMPROVE-based strategy and assess its economic and environmental implications.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort study in internal medicine over one month. Adults hospitalized for>48h were included, excluding those receiving therapeutic anticoagulation. IMPROVE VTE and Bleeding scores were calculated retrospectively. Pharmacologic prophylaxis was supported by the strategy for patients with an IMPROVE Bleeding score<7 and IMPROVE VTE score≥2. Observed prescriptions were compared with the prespecified strategy using contingency analysis and Fisher's exact test.</p><p><strong>Results: </strong>Among 99 patients, 79.8% received pharmacologic thromboprophylaxis, whereas 46.5% met the strategy criteria. Among treated patients, 46.8% did not meet these criteria. Strict application of the strategy would theoretically result in 292 fewer doses over one month, corresponding to €233.60 in estimated savings and approximately 405kg CO₂eq.</p><p><strong>Conclusion: </strong>Real-world prescribing differed substantially from the prespecified strategy. Strict application would theoretically reduce anticoagulant use, costs, and carbon emissions. However, clinical outcomes were not assessed, and RAMs should complement rather than replace clinical judgment. Prospective studies incorporating VTE and bleeding outcomes are required to assess the safety of this approach.</p>","PeriodicalId":520901,"journal":{"name":"Vascular diseases (Paris, France)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity and cardiovascular risk factors in familial hypercholesterolemia: A scoping review.","authors":"Alyssa Dolwick, Kristen Heitman, Brooke Starkoff","doi":"10.1016/j.vasdi.2026.08.002","DOIUrl":"https://doi.org/10.1016/j.vasdi.2026.08.002","url":null,"abstract":"<p><strong>Objectives: </strong>Familial hypercholesterolemia (FH) is an inherited disorder characterized by lifelong elevations in low-density lipoprotein cholesterol (LDL-C) and increased cardiovascular risk. While statins are the primary treatment, physical activity (PA) may improve cardiovascular health in FH, though its effects remain unclear. This scoping review mapped existing evidence on PA and cardiovascular risk factors across the lifespan in individuals with FH.</p><p><strong>Methods: </strong>PubMed, Embase, and CINAHL were searched through September 27, 2025. Eligible studies included participants with FH, assessed PA exposure or interventions, reported cardiovascular risk factors, and included a comparison group. Data from eligible studies were descriptively synthesized. A scoping review methodology was selected because the available evidence examining PA and cardiovascular biomarkers in FH is limited and heterogeneous with respect to study design, participant age, intervention characteristics, PA assessment methods, and reported outcomes. The objective was to map the existing evidence and identify where the gaps in knowledge are, instead of estimating the treatment effects.</p><p><strong>Results: </strong>Four studies met the inclusion criteria, spanning pediatric and adult populations. PA findings were heterogeneous. One intervention increased moderate-to-vigorous PA (MVPA) in adults but decreased MVPA in children, with no between-group differences. Observational data indicated that youth consistently exhibited low and declining PA. Cardiovascular risk factors were mixed, with only one study reporting significant LDL-C reductions.</p><p><strong>Conclusion: </strong>Evidence linking PA to cardiovascular risk factors in FH is limited and inconsistent, highlighting the need for more rigorous, standardized, and longitudinal research.</p>","PeriodicalId":520901,"journal":{"name":"Vascular diseases (Paris, France)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced practice nursing in vascular medicine in France: Implementation, roles, and patient outcomes.","authors":"G Dubois, G Dumas, A Danjou, R Spear, M Joly, S Blaise","doi":"10.1016/j.vasdi.2026.08.001","DOIUrl":"https://doi.org/10.1016/j.vasdi.2026.08.001","url":null,"abstract":"<p><strong>Background: </strong>Advanced Practice Nurses (APNs) were introduced in France in 2019 to address chronic disease burden, healthcare access inequalities, and medical workforce shortages. By the end of 2024, 751 APNs had graduated in France, with Stabilized Chronic Diseases (PCS) representing the predominant specialty (54-57%). APNs specialized in Stabilized Chronic Diseases are expected to collaborate with vascular physicians, although their role continues to evolve following recent authorization of direct patient access and independent prescribing rights. This study aimed to assess the implementation of APNs in vascular medicine in France.</p><p><strong>Methods: </strong>An online survey was conducted between December 2025 and February 2026 among French vascular physicians through the mailing list of the Collège des enseignants en médecine vasculaire. Separate questionnaires were distributed to APNs and vascular physicians to evaluate referral pathways, clinical activities, delegated tasks, and prescribing practices.</p><p><strong>Results: </strong>Four hospital-based APNs and 40 vascular physicians participated in the survey. APN activities mainly included therapeutic education, chronic wound management, thromboembolic disease follow-up, and technical vascular assessments such as ankle-brachial index measurements and walking tests. Thirty-three physicians reported active collaboration with APNs, mainly for follow-up consultations and to reduce delays in specialist care. However, cardiovascular risk factor management remained limited, and only 61.8% of physicians supported independent prescribing authority for APNs.</p><p><strong>Discussion: </strong>APNs are progressively being integrated into vascular medicine teams in France, particularly in hospital settings. Although international evidence supports the safety and effectiveness of APN-led care, clearer role definition and broader integration into chronic vascular disease management remain necessary within the French healthcare system.</p>","PeriodicalId":520901,"journal":{"name":"Vascular diseases (Paris, France)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148836172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosage of lipoproteins for risk management according to guidelines.","authors":"Christophe Bonnin, Caroline Fourgeaud, Guillaume Mahé, Khalil Ezzaki, Marc Gras, François Xavier Himpens, Romain Jacquet, Lina Khider, Tristan Mirault, Jean Noël Poggi, Stéphane Zuily, Judith Catella-Chatron, Michel Farnier","doi":"10.1016/j.vasdi.2026.05.001","DOIUrl":"10.1016/j.vasdi.2026.05.001","url":null,"abstract":"<p><p>LDL cholesterol (LDL-C) measurement is a key component in assessing cardiovascular disease risk and managing dyslipidemia. Despite irrefutable evidence that LDL-C-targeted strategies effectively reduce the risk of cardiovascular events, there is considerable variability among individuals in response to lipid-lowering therapies and in the resulting reduction of cardiovascular risk. Focusing solely on LDL-C assessment and management is no longer an optimal strategy for all patients. A major concern also lies in the potential for substantial errors in risk estimation, given the recognized measurement or calculation inaccuracies of LDL-C in patients with hypertriglyceridemia. Furthermore, the imprecision of calculated or measured LDL-C is less acceptable in the era of new lipid-lowering therapies that achieve very low LDL-C levels. This text, through existing recommendations, highlights the reasons why it has become necessary to use biomarkers beyond LDL-C to identify and treat patients at high cardiovascular risk.</p>","PeriodicalId":520901,"journal":{"name":"Vascular diseases (Paris, France)","volume":" ","pages":"179-188"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic challenge of an asymptomatic carotid stenosis suggestive of a carotid web in an older patient: A case report.","authors":"Jean Bréro, Adélaïde Guézais, Mathieu Léderlin, Rémy Pascot, Marjolaine Talbot, Guillaume Mahé","doi":"10.1016/j.vasdi.2026.06.002","DOIUrl":"10.1016/j.vasdi.2026.06.002","url":null,"abstract":"","PeriodicalId":520901,"journal":{"name":"Vascular diseases (Paris, France)","volume":" ","pages":"201-204"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148428647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardized definitions and imaging protocols for peripheral arterial abnormalities in heritable thoracic aortic disease: A French national Delphi consensus.","authors":"Dominique Stephan, Maxime Mongault, Elena-Mihaela Cordeanu, Amer Hamade, Laurence Bal, Sophie Skopinski, Guillaume Jondeau","doi":"10.1016/j.vasdi.2026.05.004","DOIUrl":"10.1016/j.vasdi.2026.05.004","url":null,"abstract":"<p><strong>Background: </strong>Peripheral arterial abnormalities (PAA) are increasingly recognized in heritable thoracic aortic disease (HTAD), yet no standardized definitions or imaging protocols exist. This heterogeneity limits clinical interpretation, longitudinal follow-up, and comparability across studies. We conducted a French national Delphi consensus to establish uniform criteria for the identification, classification, and measurement of PAA in Marfan syndrome (MFS) and related HTAD.</p><p><strong>Methods: </strong>A two-round modified Delphi process was completed by national experts in vascular medicine, radiology, and cardiology. Round 1 addressed definitions, reference diameter selection, tortuosity assessment, and imaging methodology. Round 2 refined key items based on qualitative feedback. Strong consensus was predefined as ≥85% agreement.</p><p><strong>Results: </strong>Of 45 invited experts, 22 responded to round 1 (49% response rate) and 18 completed round 2 (82% retention). Strong consensus was reached for standardized definitions of aneurysm (focal dilatation ≥150% of reference diameter), ectasia (125-149%), mega-artery (diffuse non-focal dilatation ≥150% of reference diameter), and arterial tortuosity (≥2 inflexions). A hierarchical reference diameter approach was validated, prioritizing the adjacent non-pathological segment, followed by the contralateral artery and population-based norms. Perpendicular measurement to the vessel axis achieved unanimous agreement (100%). The term tortuosity was preferred over dolichoartery (89%). Divergent opinions persisted regarding ultrasound measurement technique, leading to pragmatic recommendations aligned with existing aortic imaging practices.</p><p><strong>Conclusions: </strong>This French national Delphi consensus provides a standardized framework for defining and assessing PAA in MFS and related HTAD. The harmonized terminology and imaging recommendations will enhance diagnostic consistency, facilitate multicentre research, and support integration of PAA into comprehensive vascular evaluation within specialized HTAD care networks.</p>","PeriodicalId":520901,"journal":{"name":"Vascular diseases (Paris, France)","volume":" ","pages":"172-178"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceleration time and maximal acceleration in lower extremity peripheral artery disease: Measurements and application.","authors":"Jean-Eudes Trihan, Guillaume Mahé, Damien Lanéelle, Jeanne Hersant","doi":"10.1016/j.vasdi.2026.05.003","DOIUrl":"10.1016/j.vasdi.2026.05.003","url":null,"abstract":"<p><p>Acceleration time (AT) is a pulsed-wave Doppler ultrasound parameter reflecting the time interval between the onset of systolic flow and peak systolic velocity. Although described several decades ago, AT has remained underutilized in routine practice. Recent evidence, however, has highlighted its diagnostic and clinical value in lower extremity peripheral artery disease (PAD), particularly in situations where the ankle-brachial index is unreliable. This manuscript provides a comprehensive and practical overview of AT, focusing on its physiological basis, technical requirements for accurate measurement, and clinical applications in PAD. We detail standardized measurement conditions, emphasize common pitfalls, and underline the importance of adequate Doppler acquisition parameters to ensure reproducibility. The diagnostic performance of AT is reviewed across different arterial levels, showing its ability to detect significant upstream stenoses and to exclude hemodynamically relevant disease with high sensitivity and specificity. In advanced PAD, particularly chronic limb-threatening ischemia, the concept of maximal acceleration time (ATmax), defined as the highest AT measured in distal pedal arteries, is discussed as a reliable marker of severe hypoperfusion. ATmax shows strong correlation with toe pressure and has demonstrated prognostic value following revascularization. In addition, maximal systolic acceleration (ACCmax) is complementary Doppler-derived parameter, reflecting the rate of systolic flow acceleration and providing further hemodynamic insight although with higher technical demands. Overall, AT, ATmax and ACCmax are simple, reproducible, and non-invasive markers that enhance vascular ultrasound assessment of PAD. Their systematic integration into clinical practice may improve diagnostic accuracy, disease severity evaluation, and patient management.</p>","PeriodicalId":520901,"journal":{"name":"Vascular diseases (Paris, France)","volume":" ","pages":"189-193"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare cause of acute abdominal pain in pregnancy: Right adrenal vein thrombosis with unilateral adrenal infarction.","authors":"Olivier Varennes, Simon Soudet, Marie-Antoinette Sevestre-Pietri, Arthur Foulon, Cédric Renard, Lise Guerdoux","doi":"10.1016/j.vasdi.2026.04.003","DOIUrl":"10.1016/j.vasdi.2026.04.003","url":null,"abstract":"","PeriodicalId":520901,"journal":{"name":"Vascular diseases (Paris, France)","volume":" ","pages":"194-196"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Absence of myeloproliferative neoplasm-associated mutations in patients with recurrent venous thrombosis on anticoagulation: A molecular diagnostic audit.","authors":"Stephen E Langabeer","doi":"10.1016/j.vasdi.2026.04.004","DOIUrl":"10.1016/j.vasdi.2026.04.004","url":null,"abstract":"","PeriodicalId":520901,"journal":{"name":"Vascular diseases (Paris, France)","volume":" ","pages":"197-198"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}