International Journal of Angiology最新文献

Interleukin-8 (IL-8) is a neutrophil chemotactic factor produced by vascular endothelial cells. This study aimed to evaluate whether the serum IL-8 level can be the biomarker for postoperative intimal hyperplasia in the rat model. Sixteen male Lewis rats (mean weight: 501 ± 44 g) were subjected in this study. The right epigastric vein graft is interposed into the common femoral artery with 10-0 interrupted sutures, as previously described. Vein grafts from each group were stained with hematoxylin and eosin and Elastica Verhoeff's van Gieson's at 2 and 4 weeks postoperatively. Unoperated right epigastric veins were also examined as a Sham. In Group edaravone, free-radical scavenger, edaravone (Radicut ^® , Mitsubishi Tanabe Pharma Corp., Osaka Japan) was administered, instead of saline. The initial areas of vein grafts were measured using computerized planimetry (NIH Image Ver. 1.61). Serum IL-8 levels were measured and compared using an unpaired t -test. This study was approved by the Hyogo College of Medicine Animal Research Committee (No. 235). The average intimal area at 4 weeks in Control group was significantly increased compared with that of Sham group (0.43 ± 0.11 vs. 0.00 ± 0.00 mm ² , p  < 0.01). The average serum IL-8 levels at 4 weeks were also significantly increased, compared with that of Sham group (148 ± 6 vs. 53 ± 14 pg/mL, p  < 0.05). The serum IL-8 levels in Group edaravone were appeared to be suppressed but not significant (132 ± 24 pg/mL, p  = 0.72). It is very important to detect the biomarker such as the serum IL-8, before the establishment of postoperative intimal hyperplasia.

The associations of left bundle branch block (LBBB) and right bundle branch block (RBBB) with cardiovascular (CV) outcomes compared with normal QRS in heart failure patients with preserved ejection fraction (HFpEF) are unclear. We sought to determine CV morbidity, mortality, and total costs associated with LBBB and RBBB in acute HFpEF compared with those without BBB. A cross-sectional study using the 2019 NIS database analyzed adult HFpEF hospitalizations for acute heart failure, categorizing patients by LBBB, RBBB, or normal QRS. Clinical outcomes included atrial fibrillation (AF), ventricular fibrillation (VF), complete heart block (CHB), sick sinus syndrome (SSS), cardiac arrest (CA), hospitalization costs, and in-hospital mortality. Associations between BBB types and outcomes were assessed using logistic and relative risk (RR) models with propensity score weighting, validated by sensitivity analyses. A total of 334,511 hospitalizations with HFpEF including LBBB (6,818, 2%) and RBBB (7,948, 2.4%) were analyzed. Compared with normal QRS duration, LBBB was associated with VF (odds ratio [OR] = 2.47, p  < 0.001), SSS (OR = 1.72, p  < 0.001), CHB (OR = 2.77, p  < 0.001) and greater hospitalization costs (RR = 1.15, p  < 0.001) after adjusting for covariates in PS analysis. Similarly, RBBB was associated with AF (OR = 1.30, p  < 0.001), VF (OR = 1.59, p  = 0.033), SSS (OR = 1.72, p  < 0.001), CHB (OR = 2.81, p  < 0.001), CA (OR = 1.19, p  < 0.001), and higher hospitalization costs (RR = 1.08, p  < 0.001). These associations remained unchanged in multiple validation analyses even after additionally adjusting for obesity, hypertension, and diabetes. The length of stay was shorter in HFpEF with RBBB and LBBB subgroups compared with normal QRS. In hospitalizations of acute decompensated HFpEF, BBB was associated with an increased risk of CV outcomes and hospitalization costs.

Since the 1980s, extracorporeal shock wave lithotripsy (ESWL) has been the treatment of choice for most urinary calculi. It is generally considered a safe method with a few complications involving the vascular system, among others. There are only a few literature reports of aortic rupture after ESWL and these mainly concern abdominal aortic aneurysms and rarely, severe atherosclerotic aorta. We report the case of a 67-year-old man with a rupture of a longitudinally and circumferentially calcified abdominal aorta and pseudoaneurysm formation following ESWL which he underwent a few days before the symptoms started. He reported urgently to our department after a recurrence of severe abdominal and lumbar pain. An endovascular treatment attempt with stent graft implantation was made initially but since the perforation did not seal, open surgery with stent removal, hematoma excision, and an aortobifemoral bypass was decided. He died 23 days later because of acute myocardial infarction. We believe that it is possible for severely calcified vessels to rupture through ESWL, and great care should be taken in these patients for symptoms or signs of retroperitoneal hematoma after the procedure.

Chronic limb-threatening ischemia (CLTI) represents poses a substantial threat with escalating mortality and amputation rates. Despite the existence of various clinical techniques for diagnosing CLTI, the role of microRNAs (miRNAs) in arteriogenesis remains ambiguous. Comprehensive knowledge on miRNAs may facilitate the advancement of targeted therapy pertaining to the enhancement of collateral blood flow in obstructed vessels. Therefore, this study aimed at analyzing arteriogenesis-associated plasma miRNA profiles in patients with CLTI using gene expression. Samples were acquired from the collateral arteries (CA group, n  = 3) and the contralateral healthy limb (healthy artery; HA group, n  = 3) of a single set of patients with CLTI. The RNA extracted from the samples was assessed for concentration and purity. A normalization factor was used to address variations in analyte abundance and/or quality across the samples. Subsequently, individual RNA molecules were directly quantified and subjected to comparative analysis between the CA and HA groups to identify the miRNAs involved in arteriogenesis. The five arteriogenesis-related miRNAs exhibiting maximum upregulation were miR-301b-3p, miR-221-5p, miR-639, miR-34a-5p, and let-7a-5p, while the five most downregulated miRNAs included miR-151a-5p, miR-371a-5p, miR-651-5p, miR-510-5p, and miR-660-5p. Summarily, this study documented marked upregulation and downregulation of miRNAs associated with arteriogenesis in the collateral arteries of patients with CLTI as compared with their contralateral healthy limbs. Possible mechanisms involved, including the regulation of YAP/TAZ pathway, TGFBR3 mRNA, SIRT1 expression, and other processes have shown to be modulated by miRNAs fluctuations.

Calcific mitral stenosis, commonly seen in the elderly in developed countries, occurs primarily due to mitral annular calcification, and its prevalence is increasing secondary to an aging population. Mitral regurgitation, commonly seen across all age groups, occurs primarily due to anatomical or functional impairment of one or more components of the mitral apparatus or the left ventricle that are necessary for normal valve function, and its prevalence is increasing secondary to an increasing number of patients with heart failure. The current review discusses the diagnosis of and treatment options (medical, surgical, and transcatheter) for mitral valve disease, including the associated challenges, specifically in the elderly.

Myocardial infarction is the permanent death (necrosis) of heart muscle caused by a lack of oxygen for an extended period of time (ischemia). Since the very first percutaneous transluminal coronary angioplasty was done 40 years ago, the science of interventional cardiology has advanced dramatically. The above progression began with a balloon catheter attached to a fixed wire, advancing to bare-metal stents, first-generation drug-eluting stents (DES), second- and third-generation biodegradable polymer-based DES. Ultimately, bioabsorbable stents are still in development. Zotarolimus is a new pharmacologic therapy with a similar reprint address; for example, the antirestenosis agent sirolimus has recently been investigated as part of a stent platform combined with a biomimetic phosphorylcholine and BioLINX polymer for its biological activity, as well as its usefulness as an antiproliferative agent. Several clinical trials have been conducted to assess the safety and efficacy of the zotarolimus drug-eluting stent (Z-DES). Medtronic Medical Devices, a global leader in medical technology (United States), and Abbot Global Health Care and Research began clinical trials on the Z-DES in 2002 and will continue through 2021 (INDIA). Endeavor (E-Zes), Resolute (R-Zes), Resolute Integrity (I-Zes), and Resolute Onyx are the different forms of Z-DES that Medtronic has tested in clinical trials. In comparison to other DES, Z-DES was found to be safe in these clinical trials done across multiple nations and in a diverse demographic. This review helps understand the overall clinical trial of Z-DES.

Acute kidney injury (AKI) is among the most serious of the common postoperative complications of cardiac surgeries, which can increase the short- and long-term morbidity and mortality of patients. This study aimed to examine possible risk factors that lead to AKI. We sought to compare our AKI rates to national averages in coronary artery bypass grafting (CABG) reported by the Society of Thoracic Surgeons (STS). We reviewed our institution's data for renal failure in CABG procedures performed between January 1, 2020, and June 30, 2023. From the database, we identified 1,068 CABG patients and reviewed demographics, nonmodifiable conditions, and modifiable risk factors. The STS database uses the Risk, Injury, Failure, Loss, and End-stage renal disease definition for renal failure. Of our patient sample, 14 (1.3%) experienced renal failure. The national rate for AKI after isolated CABG was 1.9% in 2023. Chronic lung disease was a risk factor for AKI development. The mean perfusion, cross-clamp, ventilator times, and hospital stay increased in AKI patients. All patients who suffered from AKI had undergone perioperative blood transfusion. Our single-center experience with renal failure is slightly better than the national average. In our population, chronic lung disease and lower preoperative ejection fractions were associated with increased rates of AKI. Modifiable risk factors in our population included perioperative blood transfusion and increased perfusion/cross-clamp times. Lastly, AKI patients spent longer time on ventilators, increased lengths of stay, and increased postoperative mortality.

The JET-RANGER study (NCT03206762) was a multicenter (11 U.S. centers), randomized trial, core-lab adjudicated and designed to demonstrate the superiority of Jetstream + paclitaxel-coated balloon (JET + PCB) versus percutaneous transluminal angioplasty (PTA) + PCB in treating femoropopliteal arterial disease. The 1- and 2-year outcomes have been recently published. The 3-year outcome data are presented in this report. The JET-RANGER trial initially had 47 patients with 48 lesions. Thirty-one in the JET-PCB arm and 16 in the PTA + PCB arm (2:1 randomization). At 3-year follow-ups, there were 20 patients in the JET-PCB arm and 14 patients in the PTA + PCB arm. Kaplan-Meier survival analysis was performed to estimate the freedom from target lesion revascularization (TLR) at 3 years. Bailout stenting was not considered a TLR in this analysis. Statistical significance was determined by a p -value < 0.05. Freedom from TLR was statistically similar between the two groups at 3 years between JET + PCB and PTA + PCB (freedom from TLR was 88.0 vs. 67.8%, respectively, p  = 0.1380). There was also no significant difference in the change of ankle-brachial index (ABI) between the PTA + PCB and JET + PCB from baseline at 6 months ( p  = 0.7890), 1 year ( p  = 0.4070), 2 years ( p  = 0.7410), and 3 years ( p  = 0.8010). There was also no statistical difference between the JET + PCB and PTA + PCB arms for RCC improvement by one or more categories from baseline to 3 years ( p  = 0.8949). There were no minor or major amputations for either arm throughout the 3-year follow-up. Five JET + PCB patients died before the 3-year specified window and none in the PTA + PCB arm ( p  = 0.137). Two of the deaths were due to cancer and three due to cardiac causes. None were deemed related to the device or procedure. JET + PCB had similar freedom from TLR and improvement in ABI and RCC at 3-year follow-up with no difference in amputation or mortality between the 2 arms. A trend toward less TLR was seen in the JET + PCB arm.

Previous studies surveying senior and junior doctors have shown that thromboprophylaxis was not commonly practiced in hospitalized medical patients in three public hospitals in Singapore. We, therefore, conducted an audit of our hospital's venous thromboembolism (VTE) clinic cases to study the proportion of preventable hospital admission-associated VTE (HAAVTE). All newly diagnosed VTE cases referred to our VTE clinic from March 2023 to December 2023 were reviewed, to identify those potentially associated with recent hospital admissions. We then reviewed the medical records of those cases to see if thromboprophylaxis was prescribed if indicated. HAAVTEs that had high VTE risk and did not receive appropriate thromboprophylaxis (pharmacological or mechanical) were considered preventable HAAVTE. Thirteen cases of HAAVTEs were identified, out of which only one was given the appropriate thromboprophylaxis. The proportion of preventable HAAVTE was 92.3%. Thromboprophylaxis is not widely practiced in our hospital. More effort is required to improve local thromboprophylaxis practice for hospitalized patients to reduce the burden of preventable HAAVTE.