Pub Date : 2025-01-01DOI: 10.1016/j.jvssci.2024.100269
Fouzul Kansul , Deborah Vela MD , Judit Csore MD , Bright Benfor MD , Sasha Suarez MD , Anahita Dua MD, MBA, MSC , Trisha L. Roy MD, PhD
Objective
With the growing incidence of peripheral arterial disease (PAD) and the historic under-representation of female patients in cardiovascular trials, a comprehensive evaluation of sex-based variances in PAD presentation and treatment outcomes is needed. This study aims to evaluate sex-based differences in the vessel wall characteristics of patients who underwent amputation owing to critical limb-threatening ischemia to optimize personalized treatment planning and aid in the selection of endovascular devices for PAD patients.
Methods
A total of 35 lower limbs were collected from 34 patients with end-stage PAD undergoing major amputation. We selected, harvested, and cross-sectioned at 3- to 4-mm intervals 163 diseased below-the-knee arterial segments resulting in 1260 arterial rings. Histological analyses were conducted on each individual ring and later summarized by arterial segment.
Results
Male and female patients were remarkably similar across multiple plaque characteristics, including degree of stenosis, calcification severity and localization, and atherosclerotic patterns. A significant sex-based difference was noted in the presence of luminal thrombus, which was more prevalent in females (38.7% vs 25.0%; P = .016). Histopathological differences were noted between popliteal and tibial lesions, with popliteal segments demonstrating increased chronic total occlusion presence and atherosclerosis, whereas severe calcification occurred more often in tibial segments. A sex-based evaluation of the popliteal segments showed increased calcification (60.71% vs 28.0%; P = .003) and atherosclerosis (96.4% vs 73.0%; P = .028) in males compared with females.
Conclusions
Differences in the degree of calcification, incidence of atherosclerosis, and presence of luminal thrombus may pose important clinical implications for antiplatelet and anticoagulation regimen choice and guide treatment options. Further studies are warranted to evaluate the impact of these differences on outcomes of endovascular procedures.
目的：随着外周动脉疾病（PAD）发病率的不断上升，以及女性患者在心血管试验中的代表性历来不足，有必要对PAD表现和治疗结果的性别差异进行全面评估。本研究旨在评估因严重肢体威胁缺血而截肢的患者血管壁特征的性别差异，以优化个性化治疗计划，并帮助PAD患者选择血管内装置。方法：选取34例行大截肢的终末期PAD患者35条下肢。我们选择、采集并以3- 4毫米的间隔对163例膝盖以下病变动脉段进行横切，得到1260个动脉环。对每个环进行组织学分析，然后按动脉段汇总。结果：男性和女性患者在多种斑块特征上非常相似，包括狭窄程度、钙化严重程度和定位以及动脉粥样硬化模式。在管腔血栓的存在方面存在显著的性别差异，女性更普遍(38.7% vs 25.0%；p = .016)。腘窝和胫骨病变之间的组织病理学差异值得注意，腘窝段表现出慢性全闭塞和动脉粥样硬化的增加，而严重的钙化更常发生在胫骨段。基于性别的腘窝段评估显示钙化增加(60.71% vs 28.0%；P = 0.003)和动脉粥样硬化(96.4% vs 73.0%；P = .028)。结论：钙化程度、动脉粥样硬化发生率和腔内血栓存在的差异可能对抗血小板和抗凝治疗方案的选择和指导治疗方案具有重要的临床意义。需要进一步的研究来评估这些差异对血管内手术结果的影响。
{"title":"Evaluation of sex-based differences in below-the-knee plaque histology in patients who underwent amputation for chronic limb-threatening ischemia","authors":"Fouzul Kansul , Deborah Vela MD , Judit Csore MD , Bright Benfor MD , Sasha Suarez MD , Anahita Dua MD, MBA, MSC , Trisha L. Roy MD, PhD","doi":"10.1016/j.jvssci.2024.100269","DOIUrl":"10.1016/j.jvssci.2024.100269","url":null,"abstract":"<div><h3>Objective</h3><div>With the growing incidence of peripheral arterial disease (PAD) and the historic under-representation of female patients in cardiovascular trials, a comprehensive evaluation of sex-based variances in PAD presentation and treatment outcomes is needed. This study aims to evaluate sex-based differences in the vessel wall characteristics of patients who underwent amputation owing to critical limb-threatening ischemia to optimize personalized treatment planning and aid in the selection of endovascular devices for PAD patients.</div></div><div><h3>Methods</h3><div>A total of 35 lower limbs were collected from 34 patients with end-stage PAD undergoing major amputation. We selected, harvested, and cross-sectioned at 3- to 4-mm intervals 163 diseased below-the-knee arterial segments resulting in 1260 arterial rings. Histological analyses were conducted on each individual ring and later summarized by arterial segment.</div></div><div><h3>Results</h3><div>Male and female patients were remarkably similar across multiple plaque characteristics, including degree of stenosis, calcification severity and localization, and atherosclerotic patterns. A significant sex-based difference was noted in the presence of luminal thrombus, which was more prevalent in females (38.7% vs 25.0%; <em>P</em> = .016). Histopathological differences were noted between popliteal and tibial lesions, with popliteal segments demonstrating increased chronic total occlusion presence and atherosclerosis, whereas severe calcification occurred more often in tibial segments. A sex-based evaluation of the popliteal segments showed increased calcification (60.71% vs 28.0%; <em>P</em> = .003) and atherosclerosis (96.4% vs 73.0%; <em>P</em> = .028) in males compared with females.</div></div><div><h3>Conclusions</h3><div>Differences in the degree of calcification, incidence of atherosclerosis, and presence of luminal thrombus may pose important clinical implications for antiplatelet and anticoagulation regimen choice and guide treatment options. Further studies are warranted to evaluate the impact of these differences on outcomes of endovascular procedures.</div></div>","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"6 ","pages":"Article 100269"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jvssci.2025.100284
Adham N. Abou Ali MD , Patrick Cherfan MD , Ashraf G. Taha MD , Michel S. Makaroun MD , Yingze Zhang PhD , Xucai X. Chen PhD , Flordeliza S. Villanueva MD , Rabih A. Chaer MD
Objective
Abdominal aortic aneurysm (AAA) growth is unpredictable. We hypothesize that contrast-enhanced ultrasound (CEUS) imaging and plasma inflammatory biomarkers (PIBs) may detect AAA wall inflammation.
Methods
Patients with an AAA diameter ≥4 cm had CEUS and PIB testing at enrollment and every 6 months. Microbubble replenishment was analyzed via manually drawn regions of the aortic wall. Aneurysm growth, rupture, and repair were recorded. PIB testing was analyzed using biomarker panels. Independent and paired t-tests were used to detect differences in PIB levels. Logistic regression was used to study the association between PIBs, microbubble uptake, and AAA growth.
Results
A total of 59 patients were enrolled (mean age, 68.8 ± 8.6 years; 13.6% female; 93.2% White). Mean AAA size on presentation was 41.6 ± 6.7 mm. Microbubble uptake was seen in 36 patients (61%). Patients with AAA had high baseline levels of Cystatin C and interferon-γ and low levels of macrophage migration inhibitory factor. Microbubble uptake was seen in 59% of patients with ≥5 mm AAA growth but was not predictive of growth on logistic regression.
Conclusions
We have demonstrated that microbubble uptake with CEUS is seen in the aortic wall/intraluminal thrombus of patients with AAA. CEUS and PIBs could provide insight into aneurysm behavior in newly diagnosed AAA.
{"title":"Contrast-enhanced ultrasound microbubble uptake and abnormal plasma biomarkers are seen in patients with abdominal aortic aneurysms","authors":"Adham N. Abou Ali MD , Patrick Cherfan MD , Ashraf G. Taha MD , Michel S. Makaroun MD , Yingze Zhang PhD , Xucai X. Chen PhD , Flordeliza S. Villanueva MD , Rabih A. Chaer MD","doi":"10.1016/j.jvssci.2025.100284","DOIUrl":"10.1016/j.jvssci.2025.100284","url":null,"abstract":"<div><h3>Objective</h3><div>Abdominal aortic aneurysm (AAA) growth is unpredictable. We hypothesize that contrast-enhanced ultrasound (CEUS) imaging and plasma inflammatory biomarkers (PIBs) may detect AAA wall inflammation.</div></div><div><h3>Methods</h3><div>Patients with an AAA diameter ≥4 cm had CEUS and PIB testing at enrollment and every 6 months. Microbubble replenishment was analyzed via manually drawn regions of the aortic wall. Aneurysm growth, rupture, and repair were recorded. PIB testing was analyzed using biomarker panels. Independent and paired <em>t</em>-tests were used to detect differences in PIB levels. Logistic regression was used to study the association between PIBs, microbubble uptake, and AAA growth.</div></div><div><h3>Results</h3><div>A total of 59 patients were enrolled (mean age, 68.8 ± 8.6 years; 13.6% female; 93.2% White). Mean AAA size on presentation was 41.6 ± 6.7 mm. Microbubble uptake was seen in 36 patients (61%). Patients with AAA had high baseline levels of Cystatin C and interferon-γ and low levels of macrophage migration inhibitory factor. Microbubble uptake was seen in 59% of patients with ≥5 mm AAA growth but was not predictive of growth on logistic regression.</div></div><div><h3>Conclusions</h3><div>We have demonstrated that microbubble uptake with CEUS is seen in the aortic wall/intraluminal thrombus of patients with AAA. CEUS and PIBs could provide insight into aneurysm behavior in newly diagnosed AAA.</div></div>","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"6 ","pages":"Article 100284"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838131","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}
Pub Date : 2025-01-01DOI: 10.1016/j.jvssci.2025.100287
Baqir Kedwai BHSc , Joshua Geiger MD , Sam Najjar BS , Joel Kruger MD , Michael Richards PhD , Chung Yeh BS , Mary Dennehy BS , Michael Stoner MD , Doran Mix MD
<div><h3>Background</h3><div>This study aimed to quantify the nonbiologic effects of Shape Memory IMPEDE-FX embolization plug deployment rate and packing volume on pressure-normalized wall strain (<span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP) of an idealized 3D-printed abdominal aortic aneurysm model.</div></div><div><h3>Methods</h3><div>An endograft was deployed into an abdominal aortic aneurysm model and connected to an industry-validated hemodynamic simulator. Plugs were deployed into the excluded sac to packing volumes of 100%, 200%, 300%, and 400% under two conditions: (1) sequential and (2) immediate deployment. Axial ultrasound images were taken for each packing volume. Frame-to-frame displacements of the aneurysm wall were measured with ultrasound elastography over one cardiac cycle and normalized to the circuit's pulse pressure to calculate the mean principal strain (<span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP).</div></div><div><h3>Results</h3><div>In the 100% packing condition, <span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP was +113% above baseline at 15 minutes. After sequential deployment to 400%, the <span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP trended down to +43% above baseline. Immediate packing was associated with a greater <span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP reduction than sequential packing. When packed immediately to 400%, the <span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP was −6.7% below baseline.</div></div><div><h3>Conclusions</h3><div>These modeling data suggest that an immediate deployment strategy and higher plug packing volumes are associated with lower <span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP, which has been associated with decreased sac growth rates.</div></div><div><h3>Clinical Relevance</h3><div>The present findings suggest that rapid, high-volume filling of IMPEDE-FX embolization plugs results in a reduction in wall <span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP, independent of thrombus formation. Fully expanded embolization plugs in aggregate limit pulsatile aortic sac displacement likely contribute to a greater reduction in overall wall strain compared with low packing volumes. These findings may inform clinical application for this device, supporting a rapid and high-volume deployment strategy for greater reduction in <span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo>
{"title":"Quantifying the effect of IMPEDE-FX packing rate and volume on pressure-normalized principal wall strain in an idealized 3D-printed aneurysm model","authors":"Baqir Kedwai BHSc , Joshua Geiger MD , Sam Najjar BS , Joel Kruger MD , Michael Richards PhD , Chung Yeh BS , Mary Dennehy BS , Michael Stoner MD , Doran Mix MD","doi":"10.1016/j.jvssci.2025.100287","DOIUrl":"10.1016/j.jvssci.2025.100287","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to quantify the nonbiologic effects of Shape Memory IMPEDE-FX embolization plug deployment rate and packing volume on pressure-normalized wall strain (<span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP) of an idealized 3D-printed abdominal aortic aneurysm model.</div></div><div><h3>Methods</h3><div>An endograft was deployed into an abdominal aortic aneurysm model and connected to an industry-validated hemodynamic simulator. Plugs were deployed into the excluded sac to packing volumes of 100%, 200%, 300%, and 400% under two conditions: (1) sequential and (2) immediate deployment. Axial ultrasound images were taken for each packing volume. Frame-to-frame displacements of the aneurysm wall were measured with ultrasound elastography over one cardiac cycle and normalized to the circuit's pulse pressure to calculate the mean principal strain (<span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP).</div></div><div><h3>Results</h3><div>In the 100% packing condition, <span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP was +113% above baseline at 15 minutes. After sequential deployment to 400%, the <span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP trended down to +43% above baseline. Immediate packing was associated with a greater <span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP reduction than sequential packing. When packed immediately to 400%, the <span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP was −6.7% below baseline.</div></div><div><h3>Conclusions</h3><div>These modeling data suggest that an immediate deployment strategy and higher plug packing volumes are associated with lower <span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP, which has been associated with decreased sac growth rates.</div></div><div><h3>Clinical Relevance</h3><div>The present findings suggest that rapid, high-volume filling of IMPEDE-FX embolization plugs results in a reduction in wall <span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo></mrow></msub><mo>¯</mo></mover></mrow></math></span>/PP, independent of thrombus formation. Fully expanded embolization plugs in aggregate limit pulsatile aortic sac displacement likely contribute to a greater reduction in overall wall strain compared with low packing volumes. These findings may inform clinical application for this device, supporting a rapid and high-volume deployment strategy for greater reduction in <span><math><mrow><mover><msub><mi>ε</mi><mrow><mi>ρ</mi><mo>+</mo>","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"6 ","pages":"Article 100287"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937846","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}
Pub Date : 2025-01-01DOI: 10.1016/j.jvssci.2025.100286
Karin Lindén MD , Philipp Seeger MD , Samira Weisselberg PhD , Eike Sebastian Debus MD
Objective
This in vitro study aims to evaluate any additional antimicrobial efficacy by impregnating nanocolloidal silver on commercially available vascular grafts, to compare the results with precoated silver grafts, and to test the feasibility of the procedure.
Methods
Vascular grafts from a prosthetic graft material of polyester (polyethylene terephthalate, Dacron) and from a xenograft (bovine pericardium) were sprayed with a nanocolloidal silver solution on both sides of the grafts and left to vaporize for 10 minutes. Thereafter, the grafts were cut into 1 × 1 cm2 graft units (GUs) and incubated at 37°C for 1 or 24 hours, respectively, with a 106 bacteria/mL solution from four bacterial strains: Pseudomonas aeruginosa, Staphylococcus epidermidis, Escherichia coli, and methicillin-sensitive Staphylococcus aureus. In addition, the untreated grafts from polyester and bovine pericardium, as well as the precoated silver grafts, were cut and incubated analogously, resulting in 5 groups of 80 GUs each (n = 400). After incubation, each GU was washed and sonicated and samples from each sonication fluid were plated on separate Müller-Hinton Agar (MH) plates. These were incubated at 37°C and CFU were counted after 24 hours.
Results
Grafts impregnated with nanocolloidal silver spray demonstrated a statistically significant decrease in detected adhering bacteria compared to their controls, both after 1 hour and 24 hours of incubation (Padj < .001 to .006). The only nonsignificant result was recorded for polyester after 1 hour of incubation with Pseudomonas aeruginosa (Padj = .721). In addition, no significant difference between the impregnated grafts and the precoated silver graft was demonstrated after 24 hours of incubation.
Conclusions
Impregnating vascular grafts from polyester and bovine pericardium with a nanocolloidal silver spray, before inoculation with a bacterial suspension, significantly reduced bacterial colonization on the grafts. The procedure proved feasible and should be tested further in in vitro and in vivo trials.
{"title":"Enhanced antimicrobial efficacy by impregnation of vascular grafts with nanocolloidal silver","authors":"Karin Lindén MD , Philipp Seeger MD , Samira Weisselberg PhD , Eike Sebastian Debus MD","doi":"10.1016/j.jvssci.2025.100286","DOIUrl":"10.1016/j.jvssci.2025.100286","url":null,"abstract":"<div><h3>Objective</h3><div>This in vitro study aims to evaluate any additional antimicrobial efficacy by impregnating nanocolloidal silver on commercially available vascular grafts, to compare the results with precoated silver grafts, and to test the feasibility of the procedure.</div></div><div><h3>Methods</h3><div>Vascular grafts from a prosthetic graft material of polyester (polyethylene terephthalate, Dacron) and from a xenograft (bovine pericardium) were sprayed with a nanocolloidal silver solution on both sides of the grafts and left to vaporize for 10 minutes. Thereafter, the grafts were cut into 1 × 1 cm<sup>2</sup> graft units (GUs) and incubated at 37°C for 1 or 24 hours, respectively, with a 10<sup>6</sup> bacteria/mL solution from four bacterial strains: <em>Pseudomonas aeruginosa</em>, <em>Staphylococcus epidermidis</em>, <em>Escherichia coli</em>, and methicillin-sensitive <em>Staphylococcus aureus.</em> In addition, the untreated grafts from polyester and bovine pericardium, as well as the precoated silver grafts, were cut and incubated analogously, resulting in 5 groups of 80 GUs each (n = 400). After incubation, each GU was washed and sonicated and samples from each sonication fluid were plated on separate Müller-Hinton Agar (MH) plates. These were incubated at 37°C and CFU were counted after 24 hours.</div></div><div><h3>Results</h3><div>Grafts impregnated with nanocolloidal silver spray demonstrated a statistically significant decrease in detected adhering bacteria compared to their controls, both after 1 hour and 24 hours of incubation (<em>P</em><sub>adj</sub> < .001 to .006). The only nonsignificant result was recorded for polyester after 1 hour of incubation with <em>Pseudomonas aeruginosa</em> (<em>P</em><sub>adj</sub> = .721). In addition, no significant difference between the impregnated grafts and the precoated silver graft was demonstrated after 24 hours of incubation.</div></div><div><h3>Conclusions</h3><div>Impregnating vascular grafts from polyester and bovine pericardium with a nanocolloidal silver spray, before inoculation with a bacterial suspension, significantly reduced bacterial colonization on the grafts. The procedure proved feasible and should be tested further in in vitro and in vivo trials.</div></div>","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"6 ","pages":"Article 100286"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138836","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}
Pub Date : 2025-01-01DOI: 10.1016/j.jvssci.2025.100392
Yukihiko Aoyagi MD , Andrew W. Schwartz BS , Zhuo Li MD, PhD , Hualong Bai MD, PhD , Bryan Ho MD , Cayetana Lazcano-Etchebarne BS , Luis Gonzalez PhD , Yuichi Ohashi MD , Masaki Kano MD , Bogdan Yatsula PhD , Cassius Iyad Ochoa Chaar MD, MPH, MS , Kathleen Martin PhD , Roberto Vazquez-Padron PhD , Guohao Dai PhD , Alan Dardik MD, PhD
<div><h3>Objective</h3><div>Mature arteriovenous fistulae (AVF) are the gold standard vascular access allowing hemodialysis for patients with end-stage kidney disease. The rate of AVF failure remains high, reflecting an incomplete understanding of the biology of AVF maturation and failure. Sox17 is a transcription factor indispensable for the acquisition and maintenance of endothelial arterial identity. Because endothelial cells (EC) acquire dual arteriovenous identity after AVF creation, we determined whether Sox17 mediates venous remodeling in AVF.</div></div><div><h3>Methods</h3><div>Human preaccess vein, failed AVF, and mature AVF from second stage basilic vein transpositions were analyzed using immunofluorescence and single cell sequencing to determine Sox17 expression. Aortocaval AVF created in 9- to 11-week-old C57BL/6J mice were harvested on day 7 or 21 for analysis with Western blot, quantitative polymerase chain reaction, histology, or immunofluorescence to assess Sox17 immunoreactivity in EC. Doppler ultrasound examination confirmed AVF patency and measured inferior vena cava and aortic flow velocity and diameter. Sox17 knockdown was performed using short hairpin RNA lentivirus delivered perivascularly immediately after AVF creation. Analysis of variance and <em>t</em> tests were used for statistical analyses.</div></div><div><h3>Results</h3><div>Sox17 was significantly elevated in mature human AVF compared with control veins (<em>P</em> = .02) and in mature human AVF compared with failed human AVF (<em>P</em> = .04). In the mouse AVF, Sox17 expression was also significantly upregulated compared with sham-operated mice (<em>P</em> = .0012 in male mice; <em>P</em> = .0062 in female mice). Sox17 immunoreactivity was highest on days 7 and 21 and returned to near sham levels at day 42. In both human and mouse AVF, Sox17 expression was localized to the nucleus of EC. Sox17 knockdown mice had impaired venous remodeling, characterized by a smaller inferior vena cava diameter (<em>P</em> = .001) and thinner intima-media layers relative to control AVF (<em>P</em> = .015). Sox17 knockdown mice had decreased JAG1 expression (<em>P</em> = .008) and decreased smooth muscle cell proliferation (<em>P</em> = .03) on day 7.</div></div><div><h3>Conclusions</h3><div>Sox17 is a novel mediator of venous remodeling during AVF maturation. Sox17 is upregulated in the venous outflow of AVF, and Sox17 knockdown causes impaired outward remodeling and wall thickening. Manipulation of endothelial vascular identity may be a translational approach to regulate venous remodeling and improve AVF patency.</div></div><div><h3>Clinical Relevance</h3><div>Arteriovenous fistula (AVF) failure remains a major barrier to long-term hemodialysis access in patients with end-stage kidney disease. This study identifies Sox17 as a key transcription factor mediating venous remodeling after AVF creation. Sox17 expression is elevated in mature human AVF and affects outward remodeling,
{"title":"Sox17 mediates venous adaptive remodeling after arteriovenous fistula creation","authors":"Yukihiko Aoyagi MD , Andrew W. Schwartz BS , Zhuo Li MD, PhD , Hualong Bai MD, PhD , Bryan Ho MD , Cayetana Lazcano-Etchebarne BS , Luis Gonzalez PhD , Yuichi Ohashi MD , Masaki Kano MD , Bogdan Yatsula PhD , Cassius Iyad Ochoa Chaar MD, MPH, MS , Kathleen Martin PhD , Roberto Vazquez-Padron PhD , Guohao Dai PhD , Alan Dardik MD, PhD","doi":"10.1016/j.jvssci.2025.100392","DOIUrl":"10.1016/j.jvssci.2025.100392","url":null,"abstract":"<div><h3>Objective</h3><div>Mature arteriovenous fistulae (AVF) are the gold standard vascular access allowing hemodialysis for patients with end-stage kidney disease. The rate of AVF failure remains high, reflecting an incomplete understanding of the biology of AVF maturation and failure. Sox17 is a transcription factor indispensable for the acquisition and maintenance of endothelial arterial identity. Because endothelial cells (EC) acquire dual arteriovenous identity after AVF creation, we determined whether Sox17 mediates venous remodeling in AVF.</div></div><div><h3>Methods</h3><div>Human preaccess vein, failed AVF, and mature AVF from second stage basilic vein transpositions were analyzed using immunofluorescence and single cell sequencing to determine Sox17 expression. Aortocaval AVF created in 9- to 11-week-old C57BL/6J mice were harvested on day 7 or 21 for analysis with Western blot, quantitative polymerase chain reaction, histology, or immunofluorescence to assess Sox17 immunoreactivity in EC. Doppler ultrasound examination confirmed AVF patency and measured inferior vena cava and aortic flow velocity and diameter. Sox17 knockdown was performed using short hairpin RNA lentivirus delivered perivascularly immediately after AVF creation. Analysis of variance and <em>t</em> tests were used for statistical analyses.</div></div><div><h3>Results</h3><div>Sox17 was significantly elevated in mature human AVF compared with control veins (<em>P</em> = .02) and in mature human AVF compared with failed human AVF (<em>P</em> = .04). In the mouse AVF, Sox17 expression was also significantly upregulated compared with sham-operated mice (<em>P</em> = .0012 in male mice; <em>P</em> = .0062 in female mice). Sox17 immunoreactivity was highest on days 7 and 21 and returned to near sham levels at day 42. In both human and mouse AVF, Sox17 expression was localized to the nucleus of EC. Sox17 knockdown mice had impaired venous remodeling, characterized by a smaller inferior vena cava diameter (<em>P</em> = .001) and thinner intima-media layers relative to control AVF (<em>P</em> = .015). Sox17 knockdown mice had decreased JAG1 expression (<em>P</em> = .008) and decreased smooth muscle cell proliferation (<em>P</em> = .03) on day 7.</div></div><div><h3>Conclusions</h3><div>Sox17 is a novel mediator of venous remodeling during AVF maturation. Sox17 is upregulated in the venous outflow of AVF, and Sox17 knockdown causes impaired outward remodeling and wall thickening. Manipulation of endothelial vascular identity may be a translational approach to regulate venous remodeling and improve AVF patency.</div></div><div><h3>Clinical Relevance</h3><div>Arteriovenous fistula (AVF) failure remains a major barrier to long-term hemodialysis access in patients with end-stage kidney disease. This study identifies Sox17 as a key transcription factor mediating venous remodeling after AVF creation. Sox17 expression is elevated in mature human AVF and affects outward remodeling, ","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"6 ","pages":"Article 100392"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145264952","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}
Pub Date : 2025-01-01DOI: 10.1016/j.jvssci.2025.100285
Sean M. Carr PhD, Ottis Scrivner PhD, Katherine Elizabeth Hekman MD, PhD
Objective
Several decades of medical research have shown an intricate and definitive connection between dysfunctional endothelium and cardiovascular disorders, including atherosclerosis and peripheral artery disease (PAD). Initial investigations into endothelial cell (EC) physiology highlighted excretion of protein-based growth factors and their signaling pathways with highly specific targets. However, more recent research has focused on nonprotein metabolic signaling.
Methods
A narrative review methodology was used. The review involved keyword searches of electronic databases, including Medline and ScienceDirect, conducted in March through October 2022. Review search terms included “endothelial cell metabolism,” “peripheral artery disease metabolism,” “angiogenesis metabolism,” and “endothelial cell metabolic regulation.” The search included primary research articles and subject matter narrative reviews. Abstracts were reviewed for English-language articles published between 2003 and 2022 and supplemented with targeted reference tracing.
Results
Small-molecular-weight metabolites have been found to regulate key EC functions such as angiogenesis directly. More specifically, they impact EC behavior through control of energy production, de novo biomass synthesis, redox homeostasis, and production of gases like nitric oxide and hydrogen sulfide. Recent investigations targeting these metabolic pathways have yielded preliminary success in correcting undesirable endothelial dysfunction in atherosclerosis and PAD.
Conclusions
Further investigations into therapeutic targeting of EC metabolism may yield novel approaches for treating PAD.
{"title":"Narrative review of endothelial cell metabolism and aberrations in atherosclerosis and peripheral artery disease","authors":"Sean M. Carr PhD, Ottis Scrivner PhD, Katherine Elizabeth Hekman MD, PhD","doi":"10.1016/j.jvssci.2025.100285","DOIUrl":"10.1016/j.jvssci.2025.100285","url":null,"abstract":"<div><h3>Objective</h3><div>Several decades of medical research have shown an intricate and definitive connection between dysfunctional endothelium and cardiovascular disorders, including atherosclerosis and peripheral artery disease (PAD). Initial investigations into endothelial cell (EC) physiology highlighted excretion of protein-based growth factors and their signaling pathways with highly specific targets. However, more recent research has focused on nonprotein metabolic signaling.</div></div><div><h3>Methods</h3><div>A narrative review methodology was used. The review involved keyword searches of electronic databases, including Medline and ScienceDirect, conducted in March through October 2022. Review search terms included “endothelial cell metabolism,” “peripheral artery disease metabolism,” “angiogenesis metabolism,” and “endothelial cell metabolic regulation.” The search included primary research articles and subject matter narrative reviews. Abstracts were reviewed for English-language articles published between 2003 and 2022 and supplemented with targeted reference tracing.</div></div><div><h3>Results</h3><div>Small-molecular-weight metabolites have been found to regulate key EC functions such as angiogenesis directly. More specifically, they impact EC behavior through control of energy production, de novo biomass synthesis, redox homeostasis, and production of gases like nitric oxide and hydrogen sulfide. Recent investigations targeting these metabolic pathways have yielded preliminary success in correcting undesirable endothelial dysfunction in atherosclerosis and PAD.</div></div><div><h3>Conclusions</h3><div>Further investigations into therapeutic targeting of EC metabolism may yield novel approaches for treating PAD.</div></div>","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"6 ","pages":"Article 100285"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927449","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}
Pub Date : 2025-01-01DOI: 10.1016/j.jvssci.2025.100393
Pierce L. Massie MD , Marcus A. Garcia PharmD , Daniel Gallego MD , Christopher Schlosser PA , Aerlin Decker BSPS , Rui Liu PhD , Milad MazloumiBakhshayesh MPharm , Deepali Kulkarni MD , Matthew P. Justus MS , Carolyn Pace BS , Rowza T. Rumma MD , Matthew J. Campen PhD , Ross M. Clark MD, MBA, FSVS
Objective
As plastic production continues to accelerate, the byproducts increasingly fill the environment. Once degraded into micronanoplastics (MNPs), particles may circulate into food, drinking water, or air. Nascent literature has demonstrated MNP bioaccumulation within human tissues, such as the blood, brain, and solid organs. Only recently have MNPs been identified within thrombi and atherosclerotic plaques of diseased blood vessels, and these findings have been associated with adverse clinical outcomes. Data on MNP content in infrainguinal arterial occlusive disease is currently lacking, however. We investigated MNP presence within femoral artery plaques and examined patient clinical variables to characterize their associations in a territory commonly affected by peripheral arterial disease.
Methods
Common femoral artery plaques were collected from patients undergoing common femoral endarterectomy for medically refractory lower extremity peripheral arterial disease. These samples were then sectioned, frozen, and analyzed using pyrolysis gas chromatography/mass spectrometry for MNP content by polymer. A total of 12 polymers were investigated in triplicate. A group of decedent patients without clinical atherosclerosis served as control with whole carotid artery tissue used for a similar analysis.
Results
A total of 10 plaques from 8 patients were collected for the plaque group, and 30 whole carotids were gathered from decedents and age matched to the plaque group. The total MNP concentration was 80-fold higher in femoral plaque compared with the control group 3234 μg/g tissue vs 40.68 μg/g tissue for control arteries (P = .0001). By polymer, polyethylene, polystyrene, acrylonitrile butadiene styrene, styrene-butadiene, polyvinylchloride, polyethylene terephthalate, poly(methyl methacrylate), polycarbonate, nylon 66, and nylon 6 were all significantly elevated compared with control tissue. No differences in sex were detected in either group. Polypropylene content was positively correlated with age (P = .011). Within the plaque group, patients undergoing revascularization for chronic limb-threatening ischemia had a greater than three-fold concentration of PP (247 ± 113.6 μg/g vs 71.9 ± 73.5 μg/g) and 10-fold concentration of polyurethane (17.4 ± 12.1 μg/g vs 1.69 ± 2.9 μg/g) compared with those with claudication (P = .0381 and P = .0238, respectively).
Conclusions
This study demonstrates a greater accumulation of MNPs in common femoral artery plaques compared with nonatherosclerotic artery tissue. This finding further supports the premise that, despite similarities in age between groups, MNPs tend to be represented heavily in atherosclerotic tissues. Patients with chronic limb-threatening ischemia showed a greater concentration of some polymers compared with those with claudication, raising the question of
随着塑料生产的不断加速，其副产品越来越多地填满环境。一旦降解为微塑料（MNPs），颗粒可能会循环进入食物、饮用水或空气中。早期文献已经证明MNP在人体组织（如血液、大脑和实体器官）中具有生物蓄积性。直到最近才在病变血管的血栓和动脉粥样硬化斑块中发现MNPs，这些发现与不良临床结果有关。然而，腹股沟下动脉闭塞性疾病中MNP含量的数据目前缺乏。我们研究了MNP在股动脉斑块中的存在，并检查了患者的临床变量，以表征它们在通常受外周动脉疾病影响的区域中的关联。方法对难治性下肢外周动脉疾病行股总动脉内膜切除术的患者收集股总动脉斑块。然后对这些样品进行切片、冷冻，并使用热解气相色谱/质谱法分析聚合物的MNP含量。共研究了12种聚合物，一式三次。一组没有临床动脉粥样硬化的死亡患者作为对照组，用整个颈动脉组织进行类似的分析。结果斑块组共收集了8例患者的10个斑块，斑块组收集了与斑块组年龄匹配的死者的30个完整的颈动脉。与对照组相比，股骨斑块中MNP总浓度高80倍（3234 μg/g），对照组为40.68 μg/g （P = 0.0001）。经聚合物处理后，聚乙烯、聚苯乙烯、丙烯腈-丁二烯、苯乙烯-丁二烯、聚氯乙烯、聚对苯二甲酸乙二醇酯、聚甲基丙烯酸甲酯、聚碳酸酯、尼龙66和尼龙6均显著高于对照组织。在两组中均未发现性别差异。聚丙烯含量与年龄呈正相关（P = 0.011）。在斑块组中，慢性肢体缺血血运重建患者的PP浓度（247±113.6 μg/g vs 71.9±73.5 μg/g）和聚氨酯浓度（17.4±12.1 μg vs 1.69±2.9 μg/g）分别是跛行组的3倍和10倍（P = 0.0381和0.0238）。结论：本研究表明，与非动脉粥样硬化组织相比，MNPs在股动脉总斑块中的积累更多。这一发现进一步支持了一个前提，即尽管组间年龄相似，但MNPs往往在动脉粥样硬化组织中大量存在。与跛行患者相比，慢性肢体威胁缺血患者的某些聚合物浓度更高，这就提出了不同个体聚合物与不同疾病严重程度相关的问题。这项研究表明，与健康的、未患病的人颈动脉相比，人股动脉粥样硬化斑块中微塑料（MNPs）水平较高。在肢体缺血或对照患者中，年龄和MNP水平之间没有明显的关联。与跛行相比，一些单独的聚合物与晚期动脉粥样硬化疾病（慢性肢体威胁缺血）有关。这些数据增加了越来越多的文献，表明MNP颗粒在动脉粥样硬化病变中积聚。未来的工作应该研究MNPs在血管粥样硬化疾病的病理生理中可能发挥的机制作用，如果有的话。
{"title":"Micro- and nanoplastics are elevated in femoral atherosclerotic plaques compared with undiseased arteries","authors":"Pierce L. Massie MD , Marcus A. Garcia PharmD , Daniel Gallego MD , Christopher Schlosser PA , Aerlin Decker BSPS , Rui Liu PhD , Milad MazloumiBakhshayesh MPharm , Deepali Kulkarni MD , Matthew P. Justus MS , Carolyn Pace BS , Rowza T. Rumma MD , Matthew J. Campen PhD , Ross M. Clark MD, MBA, FSVS","doi":"10.1016/j.jvssci.2025.100393","DOIUrl":"10.1016/j.jvssci.2025.100393","url":null,"abstract":"<div><h3>Objective</h3><div>As plastic production continues to accelerate, the byproducts increasingly fill the environment. Once degraded into micronanoplastics (MNPs), particles may circulate into food, drinking water, or air. Nascent literature has demonstrated MNP bioaccumulation within human tissues, such as the blood, brain, and solid organs. Only recently have MNPs been identified within thrombi and atherosclerotic plaques of diseased blood vessels, and these findings have been associated with adverse clinical outcomes. Data on MNP content in infrainguinal arterial occlusive disease is currently lacking, however. We investigated MNP presence within femoral artery plaques and examined patient clinical variables to characterize their associations in a territory commonly affected by peripheral arterial disease.</div></div><div><h3>Methods</h3><div>Common femoral artery plaques were collected from patients undergoing common femoral endarterectomy for medically refractory lower extremity peripheral arterial disease. These samples were then sectioned, frozen, and analyzed using pyrolysis gas chromatography/mass spectrometry for MNP content by polymer. A total of 12 polymers were investigated in triplicate. A group of decedent patients without clinical atherosclerosis served as control with whole carotid artery tissue used for a similar analysis.</div></div><div><h3>Results</h3><div>A total of 10 plaques from 8 patients were collected for the plaque group, and 30 whole carotids were gathered from decedents and age matched to the plaque group. The total MNP concentration was 80-fold higher in femoral plaque compared with the control group 3234 μg/g tissue vs 40.68 μg/g tissue for control arteries (<em>P</em> = .0001). By polymer, polyethylene, polystyrene, acrylonitrile butadiene styrene, styrene-butadiene, polyvinylchloride, polyethylene terephthalate, poly(methyl methacrylate), polycarbonate, nylon 66, and nylon 6 were all significantly elevated compared with control tissue. No differences in sex were detected in either group. Polypropylene content was positively correlated with age (<em>P</em> = .011). Within the plaque group, patients undergoing revascularization for chronic limb-threatening ischemia had a greater than three-fold concentration of PP (247 ± 113.6 μg/g vs 71.9 ± 73.5 μg/g) and 10-fold concentration of polyurethane (17.4 ± 12.1 μg/g vs 1.69 ± 2.9 μg/g) compared with those with claudication (<em>P</em> = .0381 and <em>P</em> = .0238, respectively).</div></div><div><h3>Conclusions</h3><div>This study demonstrates a greater accumulation of MNPs in common femoral artery plaques compared with nonatherosclerotic artery tissue. This finding further supports the premise that, despite similarities in age between groups, MNPs tend to be represented heavily in atherosclerotic tissues. Patients with chronic limb-threatening ischemia showed a greater concentration of some polymers compared with those with claudication, raising the question of","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"6 ","pages":"Article 100393"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157272","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}
Pub Date : 2025-01-01DOI: 10.1016/j.jvssci.2024.100279
Marcos Vinícius Melo de Oliveira MD, PhD , Alexandre Malta Brandão MD, PhD , Gina Camillo Rocha Silvestre BS , Alexandre Queiroz Silva BS , Michele Alberto Marques BS , Marcia Martins Reis PhD , Maria de Lourdes Higuchi MD, PhD , Erasmo Simão da Silva MD, PhD
Objective
Infrarenal abdominal aortic aneurysm (AAA) and popliteal artery aneurysm (PAA) are localized arterial dilatations with distinct clinical outcomes. This study aimed to comprehensively compare these two types of aneurysms' biomechanical, histological, and immunohistochemical characteristics.
Methods
This study included 180 patients with AAA and 18 with PAA. Medical history and imaging data were collected. Biomechanical testing assessed arterial wall mechanical strength and elasticity, and histological and immunohistochemical analyses examined tissue composition and inflammatory markers.
Results
PAA wall fragments demonstrate higher failure strain energy (13.36 N/m2 vs 9.95 N/m2; P = .023), a measure of mechanical strength. Regarding immunohistochemical markers, AAA exhibited more B lymphocyte cells in the adventitia (CD20 1475.50 vs 320; P = .003) compared with PAA. Additionally, AAA demonstrated more adipogenic differentiation in the adventitia (PPARgamma 4854.50 vs 778; P = .009), whereas PAA showed more adipogenic differentiation in the intima (KLF5 283.50 vs 77.50; P = .039).
Conclusions
PAA wall fragments demonstrate greater mechanical strength compared with AAA wall fragments. In contrast, AAA walls contain a greater number of B lymphocytes within the adventitia compared with PAA walls. Adipogenic differentiation is more pronounced in the adventitia of AAA than in PAA, whereas in PAA, it is more prominent in the intima compared with AAA.
Clinical Relevance
The clinical significance of this study lies in its potential to enhance our understanding of the distinct pathophysiological mechanisms underlying abdominal aortic aneurysms, which is often associated with rupture, and popliteal artery aneurysms, which are more prone to thrombosis and distal embolization. By comprehensively comparing the biomechanical, histological, and immunohistochemical aspects of these two aneurysm types, the study aims to illuminate the factors contributing to their differing clinical presentations and outcomes.
目的：肾下腹主动脉瘤（AAA）和腘动脉动脉瘤（PAA）是两种具有不同临床结局的局限性动脉扩张。本研究旨在全面比较这两种动脉瘤的生物力学、组织学和免疫组织化学特征。方法本研究纳入AAA患者180例，PAA患者18例。收集病史和影像学资料。生物力学测试评估了动脉壁的机械强度和弹性，组织学和免疫组织化学分析检查了组织成分和炎症标志物。结果spaa壁片具有较高的破坏应变能（13.36 N/m2 vs 9.95 N/m2）；P = .023)，是机械强度的量度。在免疫组织化学标志物方面，AAA在外膜中显示更多的B淋巴细胞(CD20 1475.50 vs 320；P = .003)。此外，AAA表现出更多的外膜脂肪分化(PPARgamma 4854.50 vs 778；P = 0.009)，而PAA在内膜中显示更多的脂肪分化(KLF5 283.50 vs 77.50；p = .039)。结论spaa壁片比AAA壁片具有更高的机械强度。相反，与PAA壁相比，AAA壁在外膜内含有更多的B淋巴细胞。AAA的外膜比PAA的脂肪分化更明显，而PAA的内膜比AAA的脂肪分化更突出。临床意义本研究的临床意义在于，它有可能加深我们对腹主动脉瘤不同的病理生理机制的理解，腹主动脉瘤常伴有破裂，腘动脉动脉瘤更容易形成血栓和远端栓塞。通过全面比较这两种动脉瘤类型的生物力学、组织学和免疫组织化学方面，本研究旨在阐明导致其不同临床表现和结果的因素。
{"title":"Comparative analysis between abdominal aortic aneurysm and popliteal artery aneurysm","authors":"Marcos Vinícius Melo de Oliveira MD, PhD , Alexandre Malta Brandão MD, PhD , Gina Camillo Rocha Silvestre BS , Alexandre Queiroz Silva BS , Michele Alberto Marques BS , Marcia Martins Reis PhD , Maria de Lourdes Higuchi MD, PhD , Erasmo Simão da Silva MD, PhD","doi":"10.1016/j.jvssci.2024.100279","DOIUrl":"10.1016/j.jvssci.2024.100279","url":null,"abstract":"<div><h3>Objective</h3><div>Infrarenal abdominal aortic aneurysm (AAA) and popliteal artery aneurysm (PAA) are localized arterial dilatations with distinct clinical outcomes. This study aimed to comprehensively compare these two types of aneurysms' biomechanical, histological, and immunohistochemical characteristics.</div></div><div><h3>Methods</h3><div>This study included 180 patients with AAA and 18 with PAA. Medical history and imaging data were collected. Biomechanical testing assessed arterial wall mechanical strength and elasticity, and histological and immunohistochemical analyses examined tissue composition and inflammatory markers.</div></div><div><h3>Results</h3><div>PAA wall fragments demonstrate higher failure strain energy (13.36 N/m<sup>2</sup> vs 9.95 N/m<sup>2</sup>; <em>P</em> = .023), a measure of mechanical strength. Regarding immunohistochemical markers, AAA exhibited more B lymphocyte cells in the adventitia (CD20 1475.50 vs 320; <em>P</em> = .003) compared with PAA. Additionally, AAA demonstrated more adipogenic differentiation in the adventitia (PPARgamma 4854.50 vs 778; <em>P</em> = .009), whereas PAA showed more adipogenic differentiation in the intima (KLF5 283.50 vs 77.50; <em>P</em> = .039).</div></div><div><h3>Conclusions</h3><div>PAA wall fragments demonstrate greater mechanical strength compared with AAA wall fragments. In contrast, AAA walls contain a greater number of B lymphocytes within the adventitia compared with PAA walls. Adipogenic differentiation is more pronounced in the adventitia of AAA than in PAA, whereas in PAA, it is more prominent in the intima compared with AAA.</div></div><div><h3>Clinical Relevance</h3><div>The clinical significance of this study lies in its potential to enhance our understanding of the distinct pathophysiological mechanisms underlying abdominal aortic aneurysms, which is often associated with rupture, and popliteal artery aneurysms, which are more prone to thrombosis and distal embolization. By comprehensively comparing the biomechanical, histological, and immunohistochemical aspects of these two aneurysm types, the study aims to illuminate the factors contributing to their differing clinical presentations and outcomes.</div></div>","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"6 ","pages":"Article 100279"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jvssci.2024.100277
Blair E. Warren MD, MSCS , Kong-Teng Tan MD , Dheeraj K. Rajan MD , Miranda Witheford MD, PhD , Sean Crawford MD, MSc , Arash Jaberi MD, MEd , Sebastian Mafeld MBBS
Background
Peripheral arterial disease (PAD) is a common source of morbidity and mortality globally and is expected to raise increase in prevalence. Many endovascular techniques exist to manage PAD; however, there remains room for improvement, especially as it relates to below-the-knee vessels. Recent evidence and devices are leading to a resurgence of interest in bioresorbable vascular scaffolds and the -limus family of antiproliferative drugs in the PAD treatment space.
Methods
This nonsystematic review examines emerging technology for treatment of PAD with a specific focus on below-the-knee vessels and bioresorbable vascular scaffolds. Additional emerging and early technology such as novel delivery platforms are also briefly discussed with directions of future research highlighted.
Results
Bioresorbable vascular scaffold biomechanics and history are highlighted. Foundational knowledge of antiproliferative agents and evolving agents in peripheral vascular disease are also described.
Conclusions
Bioresorbable vascular scaffolds are an additional endovascular tool for the treatment of peripheral vascular disease. The integration with an antiproliferative agent may result in improved patency and performance; however, there is a paucity of data in the literature at present.
{"title":"Moving away from metal: Step toward the future with bioresorbable vascular scaffolds and novel antiproliferative agents","authors":"Blair E. Warren MD, MSCS , Kong-Teng Tan MD , Dheeraj K. Rajan MD , Miranda Witheford MD, PhD , Sean Crawford MD, MSc , Arash Jaberi MD, MEd , Sebastian Mafeld MBBS","doi":"10.1016/j.jvssci.2024.100277","DOIUrl":"10.1016/j.jvssci.2024.100277","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral arterial disease (PAD) is a common source of morbidity and mortality globally and is expected to raise increase in prevalence. Many endovascular techniques exist to manage PAD; however, there remains room for improvement, especially as it relates to below-the-knee vessels. Recent evidence and devices are leading to a resurgence of interest in bioresorbable vascular scaffolds and the -limus family of antiproliferative drugs in the PAD treatment space.</div></div><div><h3>Methods</h3><div>This nonsystematic review examines emerging technology for treatment of PAD with a specific focus on below-the-knee vessels and bioresorbable vascular scaffolds. Additional emerging and early technology such as novel delivery platforms are also briefly discussed with directions of future research highlighted.</div></div><div><h3>Results</h3><div>Bioresorbable vascular scaffold biomechanics and history are highlighted. Foundational knowledge of antiproliferative agents and evolving agents in peripheral vascular disease are also described.</div></div><div><h3>Conclusions</h3><div>Bioresorbable vascular scaffolds are an additional endovascular tool for the treatment of peripheral vascular disease. The integration with an antiproliferative agent may result in improved patency and performance; however, there is a paucity of data in the literature at present.</div></div>","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"6 ","pages":"Article 100277"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号