International Journal of Vascular Medicine最新文献

Purpose: Our study is aimed at exploring the association between peripheral artery disease (PAD) and metabolic syndrome (MetS) across different age and gender groups among patients with Type 2 diabetes mellitus (T2DM). Patients and Methods: A total of 3638 patients with T2DM were enrolled in the study, including 281 patients with PAD and 3357 patients without PAD. Demographic data and anthropometric measurements, such as height, weight, and waist circumference, were collected. Laboratory tests and ankle-brachial index (ABI) assessment were also conducted. Multiple logistic regression was used to evaluate the relationship between PAD and the number of MetS components across different age and gender groups. Results: After adjusting for potential confounding factors, our results indicated that the ORs for the presence of PAD increased progressively with the number of MetS components. Stratified analysis showed that this effect was particularly pronounced in younger patients (aged < 40 years) and older patients (aged ≥ 60 years), where the risk of PAD rose with an increasing number of MetS components. Furthermore, the positive association between the number of MetS components and PAD presence was significantly stronger in females. Conclusions: In summary, our findings suggest that the risk of PAD is positively correlated with the number of MetS components in patients with T2DM, especially among younger patients and older patients. Additionally, the positive association between the number of MetS components and the presence of PAD was significantly more evident in female patients.

Background: One of the main challenges in managing lymphedema and lipedema is the lack of valid and reliable objective measures for diagnosis and follow-up. This study was aimed at gathering evidence regarding the objective measures of cardiorespiratory fitness (CRF) among these populations. Methods: Scopus, PubMed, and Embase were searched for observational studies investigating the objective measures of CRF among individuals with lipedema and lymphedema. Both primary and secondary lymphedema were included. Different CRF measures reported by the included articles were determined, and the main outcomes regarding these measurements were extracted. The meta-analysis was performed to compare the pooled mean 6-min walk test (6MWT) between individuals with lower limb lymphedema and lipedema using STATA software (Version 17.0). Results: Eight articles were included, and the majority of participants were female. Four distinct objective measures of CRF were reported among the included articles, including hemodynamic indices, spirometry indices, VO₂ peak, and 6MWT. The mean VO₂ peak was significantly lower among women with breast cancer-related lymphedema; however, there was no correlation between affected limb volumes and the VO₂ peak. The meta-analysis revealed a lower mean 6MWT among individuals with lipedema compared to lymphedema (pooled difference: 37.71 [confidence interval (CI): 5.19-70.22], p value: 0.02, I ²: 0%). Also, there was a significant relationship between 6MWT and subjective measures of CRF, such as the Short Form 36 (SF-36) physical function score, in one included article. Conclusion: While limited evidence exists on the objective measures of CRF among individuals with lymphedema and lipedema, there might be a significant difference in 6MWT between these two groups.

Introduction: The progression of aneurysmal disease in the common iliac arteries (CIAs) after EVAR remains an insufficiently investigated field. The purpose of this study is to investigate the long-term outcomes of standard elective EVAR with a variety of last-generation bifurcated aortic endografts in relation with the progression of aneurysmal disease in the CIAs. Methods: This is a prospective cohort study of 168 patients, who were treated with six different endografts between 2013 and 2018 and completed the 5-year computed tomography aortoangiography (CTA) follow-up. Postoperative CTA analysis included CIA measurements at four diameters' points and two length levels in three postoperative time spots: first, 24th, and 60th months. All EVAR-related adverse events were recorded, including migrations, endoleaks, limb occlusions, reinterventions, ruptures, and mortality. Results: At both time intervals, a significant and nearly linear dilatation and elongation of CIAs was evident. The mean percent increase, among all diameter points measured, was 11.7% at 24 months and 22.8% at 60 months (p < 0.001) with a nearly constant mean increase rate by 0.07 mm per month. The corresponding monthly elongation rate of total CIA length was 0.26 mm at 24 months and 0.34 mm at 5 years (p < 0.001). The respective monthly lengthening of CIAs' uncovered (from stent graft) segment was 0.10 and 0.15 mm, and the overall increase rate at 60 months was up to 53.9% (p < 0.001). A total of 20 EVAR-related events were recorded, and multivariate analysis revealed that CIA dilatation served as a significant and independent predictor of long-term EVAR failures, increasing the likelihood of adverse events by 2.8-fold. Conclusions: Analysis of long-term geometric CIA remodeling after a standard EVAR revealed a significant progression of aneurysmal disease in CIAs, which was associated with worsening EVAR outcomes and emphasizes the importance of a rigorous and extensive follow-up protocol to maintain the long-term EVAR effectiveness.

Objectives: This study is aimed at comparing the effectiveness of ulnar compression and brachial compression in inducing radial artery dilatation. Methods: This randomized crossover study included 30 patients undergoing elective diagnostic transradial coronary angiography. Ulnar compression and brachial compression maneuvers were performed in two groups. Radial artery diameter and cross-sectional area were measured at baseline and remeasured every 30 s (up to 2 min) after the interventions. Results: Both ulnar compression and brachial compression maneuvers successfully increased radial artery diameter for up to 60 s following the interventions. There were no statistically significant differences between the two groups after adjusting for baseline measurements. However, each treatment group showed a significant increase in indicators up to 60 s, followed by a subsequent decrease. The maximum radial artery diameter occurred at 60 s after the removal of compression in both groups. Conclusion: Ulnar compression and brachial compression maneuvers demonstrated effectiveness in inducing radial artery dilation for a limited duration. These maneuvers may reduce the occurrence of access failure during radial artery cannulation. No significant differences were observed between the two maneuvers, indicating that they can be used interchangeably based on clinician preference. So, because the ulnar compression is simpler and more feasible for the patients, it can be considered instead of brachial compression. Trial Registration: IRCT20230209057372N1.

Background: Cardiovascular diseases (CVDs) remain the leading cause of mortality, especially in low- and middle-income countries, many of which are in the Arab region. We aimed to conduct a bibliometric analysis to assess the scientific output concerning CVDs in the Arab region and the Middle East over the past decade. Methods: A bibliometric search was conducted on PubMed and Scopus between 2012 and 2022. The study analyzed the number of publications, countries, institutional sources, authors, journals, and keywords. Visualization analysis was executed using various software tools, including R, VOSviewer, and CiteSpace. Results: PubMed and Scopus yielded 5340 documents related to CVDs at the time of data collection. A total of 1263 documents were retrieved after screening based on specific inclusion criteria that guarantee the inclusion only for Arab region studies and authors. There has been a consistent increase in annual publications in recent years. The countries that contributed the most to research in this field were Egypt, Saudi Arabia, and the UAE. Although Egypt stood out as the most productive country, the institute with the highest number of documents was in Qatar. In addition, the Top 3 authors hailed from Qatar. Saudi Medical Journal leads the field as the most productive journal, followed closely by PLoS One and Angiology. Research topics of significant interest in the realm of CVDs include specific diseases such as heart failure, risk factors related to CVDs, genetic aspects of CVDs, and congenital disorders in infant's cardiac health. Conclusion: This study provides a comprehensive overview of the current status of CVD research in the Arab region. It includes research hotspots that can guide authors in determining the necessary future investigations within this field. There is a clear call for further exploration of various aspects of CVDs in the Arab world. Strengthening cooperation between countries and institutes is needed.

Introduction: This study investigates the long-term effectiveness and safety of endovenous laser treatment (EVLT) for chronic venous insufficiency (CVI), a condition commonly caused by dysfunctional valves in the venous circulation system.

Materials and methods: In this retrospective cohort study, patients underwent EVLT and were followed up for successive short intervals and one last time after a median duration of 9-year postprocedural. Pre- and postprocedure duplex ultrasound was used to assess changes in the great saphenous vein (GSV) diameter, reflux, and saphenofemoral junction incompetence. Quality of life was evaluated using the SF-36 and Aberdeen Varicose Vein Questionnaire (AVVQ).

Results: Sixty-eight patients with a mean age of 52.4 ± 12.4 years were enrolled in the study. The mean follow-up time was 8.9 ± 2.1 years, ranging from 5 to 12 years. The mean GSV diameter significantly decreased in all patients (whole group) across proximal (from 5.8 ± 2.3 mm to 4.2 ± 2.1 mm), middle (from 4.7 ± 1.6 mm to 2.8 ± 2.2 mm), and distal (from 4.5 ± 2.3 mm to 2.2 ± 2.2 mm) segments, with P < 0.001. A disease recurrence rate of 33.8% was noted, predominantly in male patients and those with larger middle GSV diameters (OR = 5.2 (95%CI = 1.3-20.4) and OR = 1.5 (95%CI = 1-2.1), respectively). The average follow-up time for patients without recurrence was 8.8 ± 2.1 years. Almost half of the patients without recurrence were followed up for 10 years or more (49%).

Conclusion: The efficacy of EVLT in managing varicose veins is demonstrated by its relatively low recurrence rate over a 10-year follow-up period, highlighting EVLT as a viable long-term treatment strategy.

Objective: Impaired angiogenesis, measured as serum levels of angiogenic growth factors, may be among the mechanisms underlining aortic stiffness in diabetes patients. We studied the association between aortic stiffness and circulating angiogenic growth factors in type 2 diabetes (T2DM) patients without any organ damage.

Methods: In a case-control design, aortic pulse wave velocity (PWV), augmentation index (AIx), and aortic blood pressures (BPs) were measured in 140 T2DM patients and 110 nondiabetic controls. Fasting blood samples were collected to measure the levels of angiopoietin- (Ang-) 1, Ang-2, and vascular endothelial growth factor-A (VEGF).

Results: Compared to nondiabetes participants, T2DM patients had increased PWV (8.7 ± 1.5 vs. 7.6 ± 1.3, p = 0.031), aortic pulse BP (58 ± 20 vs. 49 ± 17, p = 0.011), Ang-2 (838 (473-1241) vs. 597 (274-1005), p = 0.018), and VEGF (72.2 (28-201.8) vs. 48.4 (17.4-110.1), p = 0.025) but reduced levels of AIx (21.7 ± 13.8 vs. 34 ± 12.9, p < 0.001) and Ang-1 (33.1 (24.7-42.1) vs. 41.1 (30-57.3), p = 0.01). In all study participants, compared to those in the lower tertile, participants in the upper tertile of Ang-2 had increased odds of PWV (2.01 (1.17-3.84), p = 0.004), aortic systolic BP (1.24 (1.04-1.97), p = 0.011), and aortic pulse BP (1.19 (1.04-1.82), p = 0.041) but reduced odds of AIx (0.84 (0.71-0.96), p = 0.014) in multivariable-adjusted models.

Conclusion: In our study population, increased circulating Ang-2 was associated with increased levels of aortic stiffness parameters.

Smoking is related to vascular aging. However, the hazardous effect of e-cigarette is often debatable, with limited studies available. In contrast, moderate-intensity aerobic exercise is well known to decrease aortic stiffness. We provide novel research to determine the effect of e-cigarette and aerobic moderate-intensity exercise on the aortic structure of Wistar rats. A total of 26 male Wistar rats (Rattus norvegicus) 8 weeks aged, 200-250 g b.w., were randomly divided into 4 groups, namely, K0 (normal rats), K1 (rats were given moderate-intensity aerobic exercise by animal treadmill 20 m/30 min), K2 (rats were given e-cigarette with 6 mg nicotine, 40% propylene glycol, and 60% vegetable glycerine 30 min for 5 days/week), and K3 (rats were given e-cigarette and moderate-intensity aerobic exercise). After exposure for 6 weeks, all animals were sacrificed to isolate the aorta for histopathological analysis with hematoxylin-eosin stain to evaluate the elastic fiber layer and intimal-medial thickness. The Verhoeff-Van Gieson staining was done for quantification elastic lamina fragmentation. Our study found that the e-cigarette group had the highest elastic lamina fragmentation among groups (8.14 ± 2.85). The exercise only group showed the lowest elastic lamina fragmentation (2.50 ± 1.87). Fragmentation in the e-cigarette and exercise group was higher than in the exercise only group (5.83 ± 0.753 vs. 2.50 ± 1.87, p = 0.002). There is a significant difference of NO serum between four groups. The result of post hoc analysis using LSD showed that there is a significant difference of NO serum between K0 and K2, K0 and K3, K1 and K2, and K1 and K3. Therefore, our research demonstrated that the most injury of aorta elastic lamina was in the group that was exposed to e-cigarette that leads to vascular aging while exercise is not yet proven to reverse this effect.

Background: Many of the therapeutic proposals for COVID-19 have been associated with adverse effects, including the risk of QT interval prolongation and torsades de pointes (TdP). The objective was to determine the use of drugs with a risk of QT interval prolongation in 21 clinics/hospitals in Colombia from January to December 2020.

Methods: This cross-sectional study identified drug use according to pharmacological groups with potential risk of QT interval prolongation according to a risk classification: conditional, possible, and known risk of TdP. Descriptive analyses were performed.

Results: A total of 355,574 patients who received QT-prolonging drugs were identified (equivalent to 51.4% of all inpatients treated during the study period). Of the group of patients on QT drugs, 54.4% used at least one drug with conditional risk, 52.6% with possible risk, and 40.3% with known risk. The most commonly used belonged to the group of drugs for the nervous system (63.0%), alimentary tract and metabolism (56.8%), anti-infectives for systemic use (13.0%), and the cardiovascular system (11.7%). On average, patients received 2.0 ± 1.5 risk drugs. Regarding drugs initially considered against COVID-19, 2,120 patients (0.6%) received azithromycin, 802 (0.2%) received chloroquine, 517 received hydroxychloroquine (0.1%), and 265 received lopinavir/ritonavir (0.1%).

Conclusion: The high proportion of patients treated at the hospital level who receive drugs with risk of prolonging the QT interval should alert those responsible for their care to avoid fatal outcomes, especially during the COVID-19 epidemic, when some QT drugs are being used more frequently.

Background: Vascular malformations are structural abnormalities which are formed by progressively enlarging aberrant and ecstatic vessels without endothelial cell proliferation and composed of the type of vessel involved, i.e., capillary, veins, and arteriovenous. Treatment of vascular malformations may involve many techniques like sclerotherapy, embolization, surgical resection, cryotherapy, laser treatment, or medical therapy. This observational prospective study is aimed at evaluating and comparing the effects and efficacy of diode laser and sclerotherapy in the treatment of oral vascular malformation.

Materials and methods: 40 patients presenting with oral vascular malformation were included in the present study. The patients were divided equally (20 in each) into two groups, i.e., the laser group and sclerotherapy group. Sclerotherapy was performed with 3% sodium tetradecyl sulfate while the laser group was treated with diode laser 980 nm with transmucosal thermophotocoagulation. The patients were assessed for the response, remission, and side effects. The results obtained were tabulated and compared with the chi-square test.

Results: Side effects were found significantly lesser in the laser group compared to the sclerotherapy group (p < 0.05). Statistically significant difference was seen for postoperative pain between two groups. The laser group had mild to moderate pain compared to severe pain in the sclerotherapy group. Recurrence was observed more in the laser group compared to the sclerotherapy group.

Conclusions: Laser and sclerotherapy with 3% sodium tetradecyl sulfate both are effective in the treatment of vascular malformations. Diode laser seems to be better than sclerotherapy given lesser side effects and comfort to the patients while sclerotherapy seems to be better in respect to recurrences.