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The effect of diabetes on abdominal aortic aneurysm growth - updated systematic review and meta-analysis. 糖尿病对腹主动脉瘤生长的影响--最新系统综述和荟萃分析。
IF 4.6 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-08-29 DOI: 10.1024/0301-1526/a001143
Lakna Harindi Alawattegama, Mariam Gaddah, Linda Kimani, George A Antoniou

Studies have shown that diabetes mellitus is associated with a reduced prevalence and growth of abdominal aortic aneurysms (AAA). Establishing the factors that influence AAA growth will enable us to risk stratify patients and potentially optimise management. We aimed to provide an updated systematic review and meta-analysis that would inform more targeted screening practices based on patient demographics. MEDLINE, EMBASE, and DARE were searched using the Ovid interface and PubMed search engine. Studies were deemed eligible if they compared the growth rate of AAA between diabetic and non-diabetic populations. The mean difference (MD) and 95% confidence internal (CI) was used for data synthesis. Twenty-four studies from 20 articles with a total of 10,121 participants were included in our meta-analysis. An overall negative effect was shown between AAA growth and diabetes, with an annual mean effect of -0.25 mm/year (95% CI -0.35, -0.15; I2 = 73%). Our meta-analysis, which is larger and scientifically more robust compared to previous analyses, has confirmed that diabetes reduces the growth of AAA by approximately 0.25 mm a year compared to non-diabetic populations. This could have significant implications for AAA screening practices.

研究表明,糖尿病与腹主动脉瘤(AAA)的发病率降低和生长有关。确定影响 AAA 生长的因素将使我们能够对患者进行风险分层,并有可能优化管理。我们旨在提供最新的系统综述和荟萃分析,以便根据患者的人口统计学特征提供更有针对性的筛查方法。我们使用 Ovid 界面和 PubMed 搜索引擎检索了 MEDLINE、EMBASE 和 DARE。如果研究比较了糖尿病和非糖尿病人群中 AAA 的生长率,则被认为符合条件。数据综合采用平均差(MD)和 95% 置信度(CI)。我们的荟萃分析纳入了 20 篇文章中的 24 项研究,共有 10,121 人参与。AAA的生长与糖尿病之间存在总体负效应,年平均效应为-0.25毫米/年(95% CI -0.35,-0.15;I2 = 73%)。与之前的分析相比,我们的荟萃分析规模更大、科学性更强,证实了与非糖尿病人群相比,糖尿病会使 AAA 的生长速度每年降低约 0.25 毫米。这可能会对 AAA 筛查实践产生重大影响。
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引用次数: 0
Clinical evolution of patients with lower extremity peripheral artery disease during the COVID-19 pandemic (the COVID-PAD study). COVID-19 大流行期间下肢外周动脉疾病患者的临床演变(COVID-PAD 研究)。
IF 2.1 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-07-24 DOI: 10.1024/0301-1526/a001139
Giacomo Buso, Stefano Lanzi, André Berchtold, Sébastien Deglise, Adriano Alatri, Luca Calanca, Lucia Mazzolai

Background: The COVID-19 pandemic has led to significant disruptions in chronic disease care and forced people to stay at home. The effects of such issues on outpatients with lower extremity peripheral artery disease (PAD) remain unknown. Patients and methods: Single-centre, retrospective-prospective study conducted in a Swiss University Hospital. Patients with PAD were included between May 1 and July 31, 2020, with a follow-up visit at 12 months. Upon both visits, the Leriche-Fontaine PAD stage was recorded, and study participants underwent ankle-brachial index (ABI) calculation to assess limb perfusion. Functional capacities were assessed through the 6-minute walking and treadmill tests. Major adverse cardiovascular (MACE) and limb events (MALE) were recorded. Data collected during the pandemic were compared with the pre-pandemic period (January 1, 2019-April 30, 2020). Results: Overall, 259 patients were included. Mean age was 69 years and male sex was prevalent (69.1%). Odds of experiencing a degradation in PAD stage were lower during the pandemic than before (odds ratio [OR]: 0.43; 95% confidence interval [CI]: 0.21-0.87; p = 0.018). No significant difference was found between periods in terms of ABI trends. Both pain-free walking time at treadmill test (p = 0.003) and maximal pain intensity at 6-minute walking test (p = 0.001) significantly improved during the pandemic. Compared with the pre-pandemic period, during the pandemic patients were hospitalized less frequently (p = 0.028) and were less likely to undergo elective limb revascularization (p<0.001). No significant difference was found between periods in terms of MALE (p = 0.311), whereas non-fatal strokes were less frequently reported during the pandemic (p = 0.043). Conclusion: In a cohort of outpatients with PAD, we found no evidence of clinical deterioration during the pandemic compared with the pre-pandemic period, though rates of adverse events were nonnegligible in both periods. In case of future pandemics, patients with PAD should be encouraged to maintain an active lifestyle while being closely monitored to avoid clinical worsening.

背景:COVID-19 大流行导致慢性病护理受到严重干扰,人们不得不呆在家里。这些问题对下肢外周动脉疾病(PAD)门诊患者的影响尚不清楚。患者和方法:在瑞士一所大学医院进行的单中心回顾性研究。研究纳入了 2020 年 5 月 1 日至 7 月 31 日期间的 PAD 患者,并进行了 12 个月的随访。在两次就诊时,研究人员都记录了莱里什-方丹 PAD 分期,并进行了踝肱指数(ABI)计算,以评估肢体灌注情况。功能能力通过 6 分钟步行和跑步机测试进行评估。记录了主要不良心血管事件(MACE)和肢体事件(MALE)。将大流行期间收集的数据与大流行前(2019 年 1 月 1 日至 2020 年 4 月 30 日)的数据进行比较。结果:共纳入 259 名患者。平均年龄为 69 岁,男性占多数(69.1%)。在大流行期间,PAD 阶段退化的几率低于大流行之前(几率比 [OR]:0.43;95% 置信区间 [CI]:0.21-0.87;P = 0.018)。不同时期的 ABI 变化趋势无明显差异。大流行期间,跑步机测试的无痛行走时间(p = 0.003)和 6 分钟行走测试的最大疼痛强度(p = 0.001)均有明显改善。与大流行前相比,大流行期间患者的住院次数减少了(p = 0.028),接受选择性肢体血管重建手术的可能性也降低了(p):在一组门诊 PAD 患者中,我们没有发现大流行期间与大流行前相比临床病情恶化的证据,尽管两个时期的不良事件发生率都不可忽略。在未来的大流行中,应鼓励 PAD 患者保持积极的生活方式,同时密切监测以避免临床症状恶化。
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引用次数: 0
Crossing by or effective BYCROSSing in long & calcified peripheral lesions with a New Kid on the Block? 使用 "新生力量 "对长而钙化的外周病变进行交叉或有效的 BYCROSSing?
IF 2.1 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 DOI: 10.1024/0301-1526/a001150
Grigorios Korosoglou, Christos Rammos, Erwin Blessing
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引用次数: 0
Peripheral arterial disease in women. 女性外周动脉疾病。
IF 2.1 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-07-17 DOI: 10.1024/0301-1526/a001137
Matija Kozak, Pavel Poredoš, Aleš Blinc, Mateja Kaja Ježovnik, Peter Poredoš

Peripheral arterial disease (PAD) represents one of the most frequent manifestations of atherosclerosis in men and women. In both sexes, PAD is related to classical risk factors of atherosclerosis, which are similarly distributed, but some additional factors determine differences between men and women. More frequent asymptomatic disease in women than in men and less frequent screening in women may result in a false underestimation of the prevalence of PAD in women. All these factors may cause delayed diagnosis and treatment of PAD in women. Estrogen hormones have vasoprotective properties that lower the prevalence of atherosclerosis in women of younger age. However, estrogen probably does not have a protective role against the development of cardiovascular disease in women of an older age. Hormone replacement therapy (HRT) of less than one year does not appear to reduce the odds of developing PAD in postmenopausal women. It may even increase the risk of morbidity from vascular interventions. However, some studies indicated that HRT for more than one year significantly decreases the risk of PAD if administered early after the last menstruation. Also, treatment of PAD in women differs to some extent from men.

外周动脉疾病(PAD)是男性和女性动脉粥样硬化最常见的表现之一。在男女两性中,PAD 都与动脉粥样硬化的传统风险因素有关,这些因素的分布情况相似,但一些额外的因素决定了男女之间的差异。与男性相比,女性无症状疾病的发生率更高,女性筛查的频率更低,这些都可能导致女性 PAD 患病率被错误低估。所有这些因素都可能导致女性 PAD 诊断和治疗的延误。雌激素荷尔蒙具有血管保护作用,可降低年轻女性动脉粥样硬化的发病率。但是,雌激素对老年妇女心血管疾病的发生可能没有保护作用。少于一年的激素替代疗法(HRT)似乎不会降低绝经后妇女罹患 PAD 的几率。它甚至可能增加血管介入治疗的发病风险。然而,一些研究表明,如果在末次月经后尽早进行一年以上的人工流产治疗,则可显著降低 PAD 的风险。此外,女性 PAD 的治疗在一定程度上也与男性不同。
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引用次数: 0
The right lymphatic duct: basic anatomy and clinical relevance. 右淋巴管:基本解剖和临床意义。
IF 2.1 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-08-29 DOI: 10.1024/0301-1526/a001146
Panagiotis Kanavaros, Georgios Karatzias, Alexandra Papoudou-Bai, Alexandra Barbouti, Theodoros Troupis

The anatomical variability of the thoracic duct and the right lymphatic duct predisposes them to inadvertent damage following head and neck surgery thereby leading to chyle leak which is an uncommon complication with potentially significant associated morbidity. Although chyle leak is predominately associated with left-sided neck surgery, it also occurs as a complication of the right-sided neck dissection. Variable figures concerning chyle leakage after right-sided neck dissections were reported, ranging from 0 per cent to higher prevalences such as 14%, 24%, 33% and 60% of total cases of chyle leakages associated with neck surgery. The right-sided complications may implicate the right lymphatic duct and right-sided terminations of the thoracic duct into the venous system which occur in about 1-6% of humans. Other clinically relevant conditions involving the right-sided major lymphatic vessels include chyle leaks following right anterior cervical spine surgery, cysts of the right lymphatic duct and dilatation of the right lymphatic duct in the setting of recurrent cervical swelling. This article presents a review of the literature concerning the basic anatomy and the clinical relevance of the right lymphatic duct and the right-sided terminations of the thoracic duct into the venous circulation.

由于胸导管和右淋巴管的解剖结构多变,在头颈部手术后容易发生意外损伤,从而导致糜烂性渗漏,这是一种不常见的并发症,可能会造成严重的相关并发症。虽然糜烂性渗漏主要与左侧颈部手术有关,但它也是右侧颈部切除术的并发症之一。有关右侧颈部切除术后糜烂渗漏的报告数字不一,从 0% 到更高的发生率不等,如占颈部手术糜烂渗漏病例总数的 14%、24%、33% 和 60%。右侧并发症可能与右侧淋巴管和胸导管进入静脉系统的右侧末端有关,发生率约为 1-6%。其他涉及右侧主要淋巴管的临床相关病症包括右侧颈椎前路手术后的糜烂渗漏、右侧淋巴管囊肿以及复发性颈椎肿胀时的右侧淋巴管扩张。本文对有关右淋巴管和胸导管进入静脉循环的右侧终端的基本解剖和临床意义的文献进行了综述。
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引用次数: 0
Determination of digital biomarkers of disease progression for digital phenotyping of patients with arterial hypertension. 为动脉高血压患者的数字表型确定疾病进展的数字生物标志物。
IF 2.1 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-10-11 DOI: 10.1024/0301-1526/a001155
Nataliya Kasimovskaya, Elena Fomina, Maria Krivetskaya, Ekaterina Diatlova, Elena Egorova, Dmitry Pavlov

Background: To compare the effectiveness of digital phenotyping of patients diagnosed with arterial hypertension with traditional monitoring methods over a three-year period. Patients and methods: The study was conducted from January 2021 to January 2024 among 800 patients diagnosed with arterial hypertension at 6 clinics in Moscow, Russia, evenly divided into experimental (identification of digital biomarkers of disease progression for digital phenotyping) and control (standard monitoring methods) groups. The intervention included lifestyle changes focused on increasing physical activity, improving sleep quality, reducing stress, and modifying diet. Significant improvements were observed in the experimental group compared to the control group. Systolic blood pressure decreased by 10 mmHg (p<0.001), pulse by 5 beats per minute (p<0.001), and stress level by 2 points (p<0.001) in the experimental group. Additionally, physical activity increased by 15 minutes per day (p<0.001), and sleep quality improved by 2 points on a scale from 1 to 10 (p<0.001). Results: Multiple regression analysis showed a decrease in the significance of digital biomarkers over the study period, indicating a positive response to the intervention. Conclusions: The obtained results emphasize the importance of comprehensive interventions in managing arterial hypertension and its related conditions. Implementing comprehensive lifestyle changes can lead to significant health improvements and serve as an effective preventive strategy. Further research is needed to explore optimal intervention strategies for promoting societal health.

背景:比较对确诊为动脉高血压患者的数字表型与传统监测方法在三年内的效果。患者和方法:该研究于 2021 年 1 月至 2024 年 1 月在俄罗斯莫斯科 6 家诊所的 800 名确诊为动脉高血压的患者中进行,平均分为实验组(识别疾病进展的数字生物标志物,进行数字表型)和对照组(标准监测方法)。干预措施包括改变生活方式,重点是增加体育锻炼、提高睡眠质量、减轻压力和调整饮食。与对照组相比,实验组的情况有了显著改善。收缩压降低了 10 毫米汞柱(pppppp结果:多元回归分析表明,在研究期间,数字生物标志物的重要性有所下降,这表明干预措施产生了积极的效果。结论研究结果强调了综合干预对控制动脉高血压及其相关疾病的重要性。全面改变生活方式可显著改善健康状况,是一种有效的预防策略。需要进一步开展研究,探索促进社会健康的最佳干预策略。
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引用次数: 0
Arterial stiffness is associated with new-onset chronic kidney disease. 动脉僵化与新发慢性肾病有关。
IF 2.1 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-09-11 DOI: 10.1024/0301-1526/a001142
Kangbo Li, Qi Qi, Xinyi Li, Liying Tian, Liyan Wang, Shouling Wu, Quanle Han

Background: A potential independent association between arterial stiffness (AS) and the development of new-onset chronic kidney disease (CKD) has not been thoroughly examined. Patients and methods: A total of 6929 participants were collected from the Kailuan study. All participants were free of CKD at the baseline. The participants were divided into four groups based on their brachial-ankle pulse wave velocity (baPWV) values. Cox regression models were used to analyze the relationship between baPWV values and the risk of new-onset CKD. Results: Over the course of a 10.06-year follow-up period, a total of 962 cases of new-onset CKD were documented. Cox proportional hazards analyses showed that a higher baPWV quartile was linked to an increased risk of new-onset CKD. Conclusions: Brachial-ankle pulse wave velocity has a strong correlation with the development of new-onset CKD. Therefore, baPWV can be considered an innovative indicator for predicting the occurrence of new-onset CKD.

背景:动脉僵化(AS)与新发慢性肾脏病(CKD)发病之间的潜在独立关联尚未得到深入研究。患者和方法:开滦研究共收集了 6929 名参与者。所有参与者在基线时均无慢性肾脏病。根据肱踝关节脉搏波速度(baPWV)值将参与者分为四组。采用 Cox 回归模型分析了 baPWV 值与新发 CKD 风险之间的关系。结果显示在长达 10.06 年的随访期间,共记录了 962 例新发 CKD 病例。Cox 比例危险度分析表明,baPWV 四分位数越高,新发 CKD 的风险越高。结论是肱踝关节脉搏波速度与新发慢性肾脏病的发生密切相关。因此,baPWV 可被视为预测新发 CKD 的创新指标。
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引用次数: 0
Epidemiology of deep vein thrombosis. 深静脉血栓的流行病学。
IF 2.1 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-01 Epub Date: 2024-08-29 DOI: 10.1024/0301-1526/a001145
Simon Wolf, Stefano Barco, Marcello Di Nisio, Charles E Mahan, Konstantinos C Christodoulou, Sophie Ter Haar, Stavros Konstantinides, Nils Kucher, Frederikus A Klok, Suzanne C Cannegieter, Luca Valerio

Deep vein thrombosis (DVT) is a cause of considerable morbidity worldwide. It is a common clinical disease in the daily practice of several medical disciplines including general medicine, angiology, and internal medicine, as well as of interest to public health because of its preventability and its sensitivity to secular changes in the distribution of population risk factors. In this review we present a comprehensive overview of the epidemiological features of DVT, including incidence and risk factors. Additionally, we give an overview of the burden that DVT poses on modern health care systems.

深静脉血栓(DVT)是全球发病率相当高的一种疾病。它是包括全科医学、血管病学和内科医学在内的多个医学学科日常临床实践中的常见疾病,同时也因其可预防性和对人群风险因素分布的长期变化的敏感性而备受公共卫生关注。在这篇综述中,我们全面概述了深静脉血栓形成的流行病学特征,包括发病率和风险因素。此外,我们还概述了深静脉血栓对现代医疗保健系统造成的负担。
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引用次数: 0
Anticoagulation and compression therapy for proximal acute deep vein thrombosis. 针对近端急性深静脉血栓形成的抗凝和加压疗法。
IF 2.1 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-01 Epub Date: 2024-07-17 DOI: 10.1024/0301-1526/a001138
Gualtiero Palareti, Davide Santagata, Chiara De Ponti, Walter Ageno, Paolo Prandoni

The treatment of proximal deep vein thrombosis (DVT) of the lower limbs includes an initial management phase, covering the first 1 to 3 weeks, a primary treatment phase, lasting a minimum of 3 months, and a secondary treatment phase for those patients requiring continuing anticoagulation beyond the first 3 to 6 months. During the initial phase most patients with DVT can be managed as outpatients. Exclusion criteria for home treatment include high risk of bleeding, limb threatening DVT or other conditions requiring hospitalisation. Anticoagulant drugs represent the mainstay of treatment and include parenteral drugs such as unfractionated heparin or low molecular weight heparin, and oral drugs such as the vitamin K antagonists and the direct oral anticoagulants (DOACs). DOACs are currently recommended as the first line of treatment for proximal DVT of the lower limbs, with no preference for one DOAC over another. Factors to consider when choosing the anticoagulant strategy include, among others, renal and liver function, underlying diseases such as cancer or the antiphospholipid syndrome, and patient preferences. Indefinite duration of anticoagulation beyond the first 3 to 6 months is recommended for patients with unprovoked DVT and patients with permanent, chronic risk factors. Two DOACs, namely apixaban and rivaroxaban, can be administered at low doses for the secondary prevention of DVT. Elastic compression stockings (ECS) have been used for decades in patients with proximal DVT with the aim of counteracting the venous hypertension generated by the vascular disorder and reducing leg edema and to prevent the post-thrombotic syndrome.

下肢近端深静脉血栓形成(DVT)的治疗包括初始管理阶段(最初 1 到 3 周)、初级治疗阶段(至少持续 3 个月)和二级治疗阶段(针对需要在最初 3 到 6 个月后继续抗凝的患者)。在初始治疗阶段,大多数深静脉血栓患者可在门诊接受治疗。排除在家治疗的标准包括高出血风险、危及肢体的深静脉血栓或其他需要住院治疗的情况。抗凝药物是治疗的主要手段,包括非静脉注射药物(如非分数肝素或低分子量肝素)和口服药物(如维生素 K 拮抗剂和直接口服抗凝剂 (DOAC))。目前推荐将 DOACs 作为治疗下肢近端深静脉血栓的一线药物,但并不偏爱哪一种 DOAC。选择抗凝策略时需要考虑的因素包括肝肾功能、癌症或抗磷脂综合征等基础疾病以及患者的偏好。对于无诱因的深静脉血栓患者和具有永久性慢性风险因素的患者,建议在最初的 3 至 6 个月后无限期地进行抗凝治疗。两种 DOAC(阿哌沙班和利伐沙班)可以小剂量使用,用于深静脉血栓的二级预防。几十年来,弹性弹力袜(ECS)一直被用于近端深静脉血栓患者,目的是对抗血管疾病引起的静脉高压,减轻腿部水肿,预防血栓后综合征。
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引用次数: 0
Endothelial function in peripheral artery disease - diagnosis and risk stratification. 外周动脉疾病的内皮功能--诊断和风险分层。
IF 2.1 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-01 DOI: 10.1024/0301-1526/a001132
Olga Petrikhovich, Tienush Rassaf, Christos Rammos
{"title":"Endothelial function in peripheral artery disease - diagnosis and risk stratification.","authors":"Olga Petrikhovich, Tienush Rassaf, Christos Rammos","doi":"10.1024/0301-1526/a001132","DOIUrl":"10.1024/0301-1526/a001132","url":null,"abstract":"","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":"53 5","pages":"287-288"},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Vasa-european Journal of Vascular Medicine
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