The International Journal Of Angiology[JOURNAL]
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200 papers
Association of Left and Right Branch Blocks with Clinical Outcomes in Patients with Heart Failure with Preserved Ejection Fraction.
Reddy S, Kattamuri L, Dwivedi A … +2 more , Mukherjee D, Deoker A
Int J Angiol · 2025 Jun · PMID 40365141 · Full text
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 u...
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, < 0.001), SSS (OR = 1.72, < 0.001), CHB (OR = 2.77, < 0.001) and greater hospitalization costs (RR = 1.15, < 0.001) after adjusting for covariates in PS analysis. Similarly, RBBB was associated with AF (OR = 1.30, < 0.001), VF (OR = 1.59, = 0.033), SSS (OR = 1.72, < 0.001), CHB (OR = 2.81, < 0.001), CA (OR = 1.19, < 0.001), and higher hospitalization costs (RR = 1.08, < 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.
Coronary Artery Disease and Loneliness: A Cross-Sectional Analysis using the Revised UCLA Loneliness Scale.
Bhuiya T, Sussman JH, O'Neill F … +5 more , Dussie T, Dichiara G, Abraham J, Zeltser R, Makaryus AN
Int J Angiol · 2026 Jun · PMID 42137765 · Full text
BACKGROUND: Loneliness has been identified as an important psychosocial factor associated with cardiovascular disease, but the relationship has been underexplored using validated measures. MATERIALS AND METHODS: This cro...
BACKGROUND: Loneliness has been identified as an important psychosocial factor associated with cardiovascular disease, but the relationship has been underexplored using validated measures. MATERIALS AND METHODS: This cross-sectional study analyzed 92 patients from 2018 to 2019 using the Revised UCLA Loneliness Scale to evaluate associations between loneliness and coronary artery disease (CAD). Statistical analysis was performed using R v4.4.0. A multivariate logistic regression model assessed the relationship between loneliness scores and CAD, adjusting for age and race/ethnicity. A one-sided Wilcoxon rank-sum test compared loneliness scores between CAD and non-CAD patients. RESULTS: Age was significantly associated with CAD (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.01-1.08, = 0.0084), whereas loneliness score showed a trend toward significance (OR: 1.03, 95% CI: 0.99-1.07, = 0.140). No significant associations were found between race/ethnicity or sex and loneliness. In a subgroup analysis of patients ≥ 55 years, loneliness was significantly associated with CAD (OR: 1.06, 95% CI: 1.00-1.12, = 0.04), whereas age was not ( = 0.378). Patients aged ≥ 55 years with CAD had significantly higher loneliness scores than those without CAD ( = 0.044), whereas no significant difference was observed in patients < 55 years ( = 0.87). CONCLUSION: While loneliness was not independently associated with CAD in the overall cohort, it was significantly associated with CAD in patients aged ≥ 55 years. This suggests that loneliness may be a relevant factor in cardiovascular health among older adults. This emphasizes the need for health care providers to consider loneliness as a potential risk factor for CAD, alongside traditional risk factors.
Diagnosis and Management of Mitral Valve Disease in the Elderly.
Kumar P, Aedma S, Varadarajan P … +1 more , Pai RG
Int J Angiol · 2025 Mar · PMID 39944150 · Full text
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...
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.
Role of Retrograde Tibiopedal Access in Limb Salvage in Patients with Critical Lower Limb Ischemia.
Ghoneim BM, Elhindawy KMA, Fouad FS … +2 more , Ellil MHA, Shaker AA
Int J Angiol · 2025 Mar · PMID 39944149 · Full text
The aim of this study was to assess the efficacy and safety of retrograde tibiopedal access as an alternative approach in cases of critical limb ischemia (CLI) when antegrade access has failed. A prospective study was co...
The aim of this study was to assess the efficacy and safety of retrograde tibiopedal access as an alternative approach in cases of critical limb ischemia (CLI) when antegrade access has failed. A prospective study was conducted that included patients with CLI who underwent tibiopedal access after failed antegrade recanalization from January 2018 to June 2022. Follow-up was conducted at 6, 12, and 24 months. The primary outcomes evaluated were technical success rate and primary patency. Secondary outcomes included complication rate, mortality rate, and limb salvage rate (LSR). Forty-eight patients had CLI and Trans Atlantic Inter-Society Consensus infrainguinal lesions. The retrograde approach was used through the anterior tibial artery in 28 patients (58%), the posterior tibial artery in 18 patients (37.5%), and the peroneal artery in 2 patients (4.5%). Technical success was achieved in 90% of patients (43 patients). There was a significant increase in the anklebrachial index after the procedure with a mean follow-up of 22 months. Twenty-two months primary patency rate was 85.2%, while secondary patency rate was 100% and LSR was 96%, respectively. There was no mortality in the series. Retrograde tibiopedal approach is an alternative option for managing peripheral arterial disease and CLI. This method offers another means of crossing lesions when antegrade access failed, and the intervention can be completed either in an antegrade or retrograde approach. As the retrograde approach does not impact access site, considered a feasible safe treatment alternative which increase the success rate of endovascular treatment.
Jetstream Atherectomy with Paclitaxel-Coated Balloons: 3-Year Outcomes of the Prospective Randomized JET-RANGER Study.
Shammas NW, Shammas G, Jones-Miller S … +1 more , JET-RANGER Investigators
Int J Angiol · 2025 Mar · PMID 39944148 · Full text
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 percu...
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 -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, = 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 ( = 0.7890), 1 year ( = 0.4070), 2 years ( = 0.7410), and 3 years ( = 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 ( = 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 ( = 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.
Venous Thromboembolism Risk Assessment and Thromboprophylaxis Practice in Hospitalized Medical Patients: The Experience of a Singapore Teaching Hospital.
Lee SY, Er C
Int J Angiol · 2025 Mar · PMID 39944146 · Full text
Despite the availability of institutional guidelines, the practice of venous thromboembolism (VTE) risk assessment and thromboprophylaxis remains inadequate in Singapore. With hospital-associated VTE (HA-VTE) being a com...
Despite the availability of institutional guidelines, the practice of venous thromboembolism (VTE) risk assessment and thromboprophylaxis remains inadequate in Singapore. With hospital-associated VTE (HA-VTE) being a common cause of preventable mortality for medical patients, it is vital for prompt, appropriate prescription of thromboprophylaxis after VTE risk assessment. This study aimed to (1) assess the local practice of VTE risk assessment and prophylaxis according to institutional guidelines, (2) study the risk factors of potential preventable HA-VTE among hospitalized medical patients, and (3) improve the quality of care with respect to early prevention of HA-VTE. An audit was performed on daily new admissions to two general medical wards in a teaching hospital in Singapore (total capacity of 76 beds) over 2 weeks. Each new admission's medical records were reviewed to examine whether (1) VTE risk assessment was performed by the managing medical teams, (2) thromboprophylaxis was prescribed during admission in high VTE risk patients, and (3) any contraindications to pharmacological thromboprophylaxis for cases with high VTE risk but no pharmacological thromboprophylaxis prescribed was present. Only 1 out of 52 cases had VTE risk assessment performed. Thirty-one cases (59.1%) were identified to have high VTE risk using the Padua Prediction Score. However, only 1 out of the 31 cases (3.2%) had VTE prophylaxis prescribed. Adherence to local institutional guidelines remains poor despite increasing awareness of the importance of VTE risk assessment and prophylaxis in the prevention of associated morbidity and mortality. Certain patient profiles should prompt clinicians to perform VTE risk assessment.
Association between Skeletal Muscle Characteristics and Arterial Stiffness: Chronic Limb-Threatening Ischemia the Key Element.
Ferreira J, Roque S, Vila I … +2 more , Mansilha A, Cunha P
Int J Angiol · 2025 Mar · PMID 39944145 · Full text
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Acute Kidney Injury after Isolated Coronary Bypass Surgery.
Slaughter JC, Davenport DL, Saha SP
Int J Angiol · 2025 Mar · PMID 39944144 · Full text
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 exa...
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.
Association of and Genes Polymorphism with Coronary Artery Disease.
Raza ST, Eba A, Wani IA … +2 more , Srivastava S, Mahdi F
Int J Angiol · 2025 Mar · PMID 39944143 · Full text
Coronary artery disease (CAD) is one of the most common cardiovascular diseases (CVDs), being the foremost reason for mortality and disability globally. It is a cascade of polygenic architecture of various disorders as a...
Coronary artery disease (CAD) is one of the most common cardiovascular diseases (CVDs), being the foremost reason for mortality and disability globally. It is a cascade of polygenic architecture of various disorders as a resultant of complexities between various genetic factors and environmental factors. The aim of the present study was to investigate whether the and gene polymorphism is associated with the susceptibility to CAD. This study was approved by the Ethical Review Committee of Era Medical College and Hospital. Three milliliters of venous blood sample was collected in ethylenediaminetetraacetic acid-coated vials, and genomic DNA was isolated by using the standard phenol-chloroform extraction method for restriction fragment length polymorphism-polymerase chain reaction study. The gene AA, AG, GG, and AG + GG genotypes frequencies were 13.91, 40.87, 45.22, and 86.99% in CAD cases and 13, 50, 37, and 87% in controls, respectively. The gene GG, GT, TT, GT + TT genotypes frequencies were 6.67, 37.5, 55.8, and 93.34% in CAD cases and 6.67, 25.33, 68, and 93.34% in controls. The and gene polymorphisms were not significantly associated with the risk of CAD.
Major Delay in Door-to-Ballon Time for Primary Percutaneous Coronary Intervention is Not Related to Interventional Cardiologist's Late Arrival.
Movahed MR, Irilouzadian R
Int J Angiol · 2025 Mar · PMID 39944142 · Full text
Interventional cardiologists are held accountable for delay in the door-to-balloon time (DBT) for patients undergoing primary percutaneous coronary intervention in the setting of ST-elevation myocardial infarction (STEMI...
Interventional cardiologists are held accountable for delay in the door-to-balloon time (DBT) for patients undergoing primary percutaneous coronary intervention in the setting of ST-elevation myocardial infarction (STEMI) even though in the chain of STEMI activation, the interventional cardiologist is the last person that needs to be available to start angiography. The goal of our study is to conduct a thorough analysis of the DBT data to assess time delays by randomly evaluating two consecutive years at the University of Arizona Medical Center (UAMC). We evaluated all available DBT data for STEMIs occurring in the fiscal years of 2011 and 2012 at the UAMC and calculated the time needed for the cardiologist to start the procedure after the patient was ready in the cardiac catheterization laboratory called time to start the procedure (TSP) in addition to other time intervals. Mean TSP time was 4 minutes and 24 seconds, one of the shortest time delays in the chain of STEMI activation and DBT. The median TSP delay was 3 minutes. The longest delay interval was the STEMI team's arrival to with a mean of 17 minutes and 38 seconds. Our data are the first to evaluate delays related to DBT revealing the least delay occurring due to the late arrival of Interventional cardiologists. Our data emphasizes the importance of performing a detailed time analysis of the DBT.
Preventable Hospital Admission-associated VTE: Thoughts on Thromboprophylaxis as Asians.
D Maran ES, Er C, Gohar S … +1 more , Adamjee T
Int J Angiol · 2025 Mar · PMID 39944141 · Full text
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 audi...
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.
The Year in Cardiology-Practice Changing Trials from European Society of Cardiology Congress 2023.
Pradhan A, Tripathi U, Singh A
Int J Angiol · 2025 Mar · PMID 39944140 · Full text
The European Society of Cardiology annual congress is the premier global platform for dissemination and unraveling major scientific advances in the field of cardiology. Each year a myriad number of scientific ideas are e...
The European Society of Cardiology annual congress is the premier global platform for dissemination and unraveling major scientific advances in the field of cardiology. Each year a myriad number of scientific ideas are exchanged at this meeting and many major path-breaking clinical trials are presented that have the potential to alter our practice. Last year was not different and more than 30 clinical trials spanning various facets of cardiology were unveiled and discussed-heart failure, lipid lowering, coronary intervention, intracoronary imaging, cardiomyopathies, anticoagulation, atrial fibrillation, antiplatelet therapy, etc. We present a brief summary of 10 major trials which in the view of authors have the potential for impacting daily cardiology practice. In each study, we also attempt to provide a contemporary perspective and the way forward. We aim to provide a glimpse on the major advances in the field of cardiology in the past year.
A Snapshot on Clinical Trials on Zotarolimus DES: A Repurposing Drug against Myocardial Infarction.
Undale VR, Lembhe SK, Satone SD … +1 more , Hase P
Int J Angiol · 2025 Mar · PMID 39944137 · Full text
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 4...
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.
Afraid of the Cold: Mitral Valve Replacement in a Patient with Cold Agglutinins.
Sokolowski C, Newman JS, Lambert D … +2 more , Pupovac SS, Manetta F
Int J Angiol · 2026 Jun · PMID 42137761 · Full text
A 40-year-old male presented with symptomatic severe mitral stenosis and moderate mitral insufficiency and was recommended to undergo mitral valve replacement. While undergoing preoperative workup, the patient was found...
A 40-year-old male presented with symptomatic severe mitral stenosis and moderate mitral insufficiency and was recommended to undergo mitral valve replacement. While undergoing preoperative workup, the patient was found to have positive cold agglutinin (CA) autoantibodies. The patient underwent a successful mechanical mitral valve replacement with maintenance of systemic normothermia and myocardial hypothermia. Postoperatively, no neurologic or thrombotic sequelae were observed and the patient was discharged home with no complications. We propose a management approach to patients with CAs that affords myocardial hypothermia in patients requiring cardiac surgery.
Challenges in the Management of Dislodged Coronary Stent Embolization: A Case Report.
Bekler O
Int J Angiol · 2026 Jun · PMID 42137759 · Full text
Although device embolization is a rare complication in percutaneous coronary interventions (PCI), its mortality and morbidity are serious complications. With the increasing prevalence of complicated procedures, invasive...
Although device embolization is a rare complication in percutaneous coronary interventions (PCI), its mortality and morbidity are serious complications. With the increasing prevalence of complicated procedures, invasive cardiologists encounter device embolization daily. Different devices and techniques are utilized to retrieve these devices. Most devices used during PCIs are infection stents. More infrequently, the tip of diverting wires, angioplasty balloons, or balloon holders may break and embolize distally into the arteries. A 51-year-old man with non-ST elevation myocardial infarction was presented for restoration of the ring of the stent, which was stripped in the first diagonal ostium, with snare communication. The patient had an anterior myocardial infarction and underwent stent implantation in the left anterior descending artery (LAD) 1 month ago. While the stripped stent was being retracted, the LAD stent had been inserted, causing the stent implanted a month ago to be retracted. Additionally, the dissection was observed in the proximal LAD, and the procedure was terminated by stenting the LAD-Diagonal bifurcation lesion using the mini-crush technique. This case report highlights the importance of constant vigilance that invasive cardiologists must show when removing the embolized device. The maturity of the technique depends on the operator's experience with the methods of use and the material possibilities in the laboratory.
High Success Rate in Sealing Distal Coronary Artery Perforations Using Absorbable Gelatin Sponge.
Hashemi A, Serati A, Ahmadieh A … +2 more , Ghaffari L, Movahed MR
Int J Angiol · 2026 Jun · PMID 42137757 · Full text
Coronary artery perforation (CAP) is a major complication of percutaneous coronary intervention (PCI). The management of CAP can be challenging, requiring tailored approaches based on specific clinical scenarios. We are...
Coronary artery perforation (CAP) is a major complication of percutaneous coronary intervention (PCI). The management of CAP can be challenging, requiring tailored approaches based on specific clinical scenarios. We are reporting outcome data on six patients who experienced distal CAP during PCI and were 100% successfully treated using absorbable gelatin sponge embolization without procedural or immediate postprocedural complications.
Endovascular Repair of Large Iliac Artery Pseudoaneurysm after Remote Transplant Nephrectomy.
Monastiriotis S, Brezinka TL, Franz RW
Int J Angiol · 2026 Jun · PMID 42137758 · Full text
This case study focuses on a 49-year-old woman several years after a right transplant nephrectomy for delayed renal hemorrhage. The patient had an incidental finding of a right external iliac artery pseudoaneurysm measur...
This case study focuses on a 49-year-old woman several years after a right transplant nephrectomy for delayed renal hemorrhage. The patient had an incidental finding of a right external iliac artery pseudoaneurysm measuring 8.1 cm at its largest dimension. Of note, the patient had undergone cardiac catheterization several months prior with right common femoral artery access. This study aimed to implement endovascular repair of posttransplant nephrectomy iliac artery pseudoaneurysms as a less invasive treatment option as compared with open repair in suitable candidates. Percutaneous access of the right common femoral artery with the deployment of a 9 × 50 mm covered stent within the right external iliac artery with the successful exclusion of the pseudoaneurysm. Postoperative course was uncomplicated, and the patient was discharged home on dual antiplatelet therapy. The patient's symptoms completely resolved after the intervention. She underwent follow-up surveillance scans, which redemonstrated a patent external iliac stent and excluded pseudoaneurysm. Endovascular repair with a covered stent for posttransplant nephrectomy iliac artery pseudoaneurysms is a safe, minimally invasive, and valuable treatment option in the absence of underlying infection.
Venous Thromboembolism: Current Insights and Future Directions.
Mahani S, DiCaro MV, Tak N … +3 more , Hartnett S, Cyrus T, Tak T
Int J Angiol · 2024 Dec · PMID 39502354 · Full text
Venous thromboembolism (VTE) is the third most common cause of death worldwide even though incidence rates differ globally. Western nations report 1 to 2 cases per 1,000 person-years, while Eastern countries exhibit lowe...
Venous thromboembolism (VTE) is the third most common cause of death worldwide even though incidence rates differ globally. Western nations report 1 to 2 cases per 1,000 person-years, while Eastern countries exhibit lower rates (<1 per 1,000 person-years). This comprehensive review delves into diverse VTE risk factors including gender, diabetes, obesity, smoking, genetic mutations, hormonal influences, travel, infections, trauma, and cancer. Notably, VTE incidence is highest in certain cancers (such as pancreatic, liver, and non-small-cell lung cancers) and lowest in others (such as breast, melanoma, and prostate cancers). The extensive review provides essential information about prevalent factors and explores potential molecular mechanism contributing to VTE.
Endothelial-Derived Microparticles Associate with Hospital Major Adverse Cardiovascular Events but not with Long-Term Adverse Events in Acute Myocardial Infarction.
Hartopo AB, Mayasari DS, Puspitawati I … +2 more , Putri AK, Setianto BY
Int J Angiol · 2024 Dec · PMID 39502353 · Full text
Endothelial-derived microparticles (EDMP) are markers of vascular function and convey roles in coagulation, inflammation, vasoactivity, angiogenesis, and cellular apoptosis, which implicate acute myocardial infarction (A...
Endothelial-derived microparticles (EDMP) are markers of vascular function and convey roles in coagulation, inflammation, vasoactivity, angiogenesis, and cellular apoptosis, which implicate acute myocardial infarction (AMI). This study aimed to investigate whether, among AMI, on-admission EDMP counts affect hospital major adverse cardiovascular events (MACE) and whether the change of EDMP in 30-day posthospital discharge affects long-term follow-up MACE. The research design was a prospective cohort study. The subjects were 119 patients diagnosed and hospitalized with AMI, who were enrolled consecutively. The EDMP was measured on hospital admission and repeated 30-day posthospital discharge. The outcomes were in the hospital MACE comprised of cardiac mortality, heart failure, cardiogenic shock, reinfarction, and resuscitated ventricular arrhythmia. Furthermore, long-term follow-up were performed on 30-day, 90-day, and 1-year posthospital AMI discharge. The on-admission EDMP counts were significantly higher in subjects with hospital MACE compared with those without (median [interquartile range]: 27,421.0 [6,956.5-53,184.0] vs. 11,617.5 [4,599.0-23,336.7] counts/µL, = 0.028). The EDMP counts cutoff value of >26,810.0 counts/µL (52.4% sensitivity, 81.6% specificity) had significantly increased hospital MACE occurrence (adjusted odd ratio: 4.45, 95% confidence interval: 1.47-13.53, = 0.008). The EDMP counts were significantly increased after 30-day posthospital discharge. Both on-admission and 30-day EDMP counts and the changes in EDMP counts did not impact MACE on the long-term follow-up. In conclusion, higher on-admission EDMP counts were independently associated with hospital MACE among AMI. However, on-admission and 30-day postdischarge EDMP and their changes did not impact long-term follow-up MACE.
Atherogenic Effect of Homocysteine, a Biomarker of Inflammation and Its Treatment.
Prasad K
Int J Angiol · 2024 Dec · PMID 39502352 · Full text
Hyperhomocysteinemia (HHcy) is an independent risk factor for atherosclerosis. Ischemic stroke and heart disease, coronary heart disease, and cardiovascular disease are events resulting from long-lasting and silent ather...
Hyperhomocysteinemia (HHcy) is an independent risk factor for atherosclerosis. Ischemic stroke and heart disease, coronary heart disease, and cardiovascular disease are events resulting from long-lasting and silent atherosclerosis. This paper deals with the synthesis of homocysteine (Hcy), causes of HHcy, mechanism of HHcy-induced atherosclerosis, and treatment of HHcy. Synthesis and metabolism of Hcy involves demethylation, transmethylation, and transsulfuration, and these processes require vitamin B and vitamin B folic acid (vitamin B ). Causes of HHcy include deficiency of vitamins B , B , and B , genetic defects, use of smokeless tobacco, cigarette smoking, alcohol consumption, diabetes, rheumatoid arthritis, low thyroid hormone, consumption of caffeine, folic acid antagonist, cholesterol-lowering drugs (niacin), folic acid antagonist (phenytoin), prolonged use of proton pump inhibitors, metformin, and hypertension. HHcy-induced atherosclerosis may be mediated through oxidative stress, decreased availability of nitric oxide (NO), increased expression of monocyte chemoattractant protein-1, smooth muscle cell proliferation, increased thrombogenicity, and induction of arterial connective tissue. HHcy increases the generation of atherogenic biomolecules such as nuclear factor-kappa B, proinflammatory cytokines (IL-1β, IL-6, and IL-8), cell adhesion molecules (intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and E-selection), growth factors (IGF-1 and TGF-β), and monocyte colony-stimulating factor which lead to the development of atherosclerosis. NO which is protective against the development of atherosclerosis is reduced by HHcy. Therapy with folic acid, vitamin B , and vitamin B lowers the levels of Hcy, with folic acid being the most effective. Dietary sources of folic acid, vitamin B , vitamin B , omega-3 fatty acid, and green coffee extract reduce Hcy. Abstaining from drinking coffee and alcohol, and smoking also reduces blood levels of Hcy. In conclusion, HHcy induces atherosclerosis by generating atherogenic biomolecules, and treatment of atherosclerosis-induced diseases may be by reducing the levels of Hcy.
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