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Vascular Medicine

Prakash Krishnan, Pedro R Moreno, Irene C Turnbull, Meerarani Purushothaman, Urooj Zafar, Arthur Tarricone, Sandeep Singla, Annapoorna Kini, Samin Sharma, Jagat Narula, Juan J Badimon, K-Raman Purushothaman
Diabetes mellitus (DM) and chronic kidney disease (CKD) separately are known to facilitate the progression of medial arterial calcification (MAC) in patients with symptomatic peripheral artery disease (PAD), but their combined effect on MAC and associated mediators of calcification is not well studied. The association of MAC and calcification inducer bone morphogenetic protein (BMP-2) and inhibitor fetuin-A, with PAD, is well known. Our aim was to investigate the association of MAC with alterations in BMP-2 and fetuin-A protein expression in patients with PAD with DM and/or CKD...
May 15, 2019: Vascular Medicine
Hemanshu Patel, Cissy Yong, Ali Navi, Sidney G Shaw, Xu Shiwen, David Abraham, Daryll M Baker, Janice Cs Tsui
Critical limb ischemia (CLI) is associated with skeletal muscle damage. However, the pathophysiology of the muscle damage is poorly understood. Toll-like receptors (TLR) have been attributed to play a role in ischemia-induced tissue damage but their role in skeletal muscle damage in CLI is unknown. TLR2 and TLR6 expression was found to be upregulated in skeletal muscle of patients with CLI. In vitro, ischemia led to upregulation of TLR2 and TLR6 by myotubes, and activation of the downstream TLR signaling pathway...
May 14, 2019: Vascular Medicine
Brenton Jennewine, Derek de Grijs, Aditya Sharma, Carlin Williams
No abstract text is available yet for this article.
April 26, 2019: Vascular Medicine
Joseph F Polak, David Herrington, Daniel H O'Leary
Common carotid artery (CCA) intima-media thickness (IMT) is associated with coronary heart disease and can be measured on ultrasound images either by hand or with an automated edge detector. The association of CCA IMT with incident peripheral artery disease (PAD) is poorly studied. We studied 5467 participants of the Multi-Ethnic Study of Atherosclerosis composed of non-Hispanic white, Chinese, Hispanic, and African American participants with a mean age of 61.9 years (47.8% men). Framingham Risk Factors, manual-traced IMT (mt-IMT), and edge-detected IMT (ed-IMT) were entered into multivariable Cox proportional hazards models with incident PAD as the outcome...
April 26, 2019: Vascular Medicine
Michael Megaly, Bishoy Abraham, Marwan Saad, Andrew Mekaiel, Peter Soukas, Subhash Banerjee, Mehdi H Shishehbor
The role of cilostazol after endovascular therapy (EVT) of peripheral artery disease (PAD) remains unclear. We conducted a meta-analysis for all studies reporting the outcomes of cilostazol after EVT of PAD from January 2000 through November 2018 with the outcomes of interest including primary patency, major adverse limb events (MALE), target lesion revascularization (TLR), and major amputation. We included eight studies (three randomized controlled trials (RCTs) and five observational studies) with a total of 3846 patients (4713 lesions)...
April 26, 2019: Vascular Medicine
Michael J Blaha, Elizabeth V Ratchford
No abstract text is available yet for this article.
April 1, 2019: Vascular Medicine
Ryan J Mays, Ashley A Mays, Ryan L Mizner
Calf claudication is a significant cause of walking limitation for patients with peripheral artery disease (PAD). Ankle-foot orthoses (AFO) are leg devices that can reduce the physical demands on the calf muscles during ambulation. The purpose of this study was to determine the efficacy of AFO on walking ability in patients with PAD. This was an open-label, interventional trial including 15 patients with calf claudication who were fit with AFO. Patients completed graded treadmill testing, followed by 12 weeks of unstructured community-based walking using the AFO ad libitum...
March 29, 2019: Vascular Medicine
Andrew Jp Klein, Mehdi H Shishehbor
No abstract text is available yet for this article.
March 27, 2019: Vascular Medicine
Gaurav Rao, Hai Xu, Jason J Wang, Andrew Galmer, Jay Giri, Michael R Jaff, Raghu Kholluri, Joe F Lau, Samy Selim, Ido Weinberg, Mitchell D Weinberg
Both catheter-directed thrombolysis (CDT) and ultrasound-assisted thrombolysis (USAT) are novel treatment modalities for patients presenting with acute pulmonary embolism (PE). The objective of this study was to compare clinical and quality-of-life (QOL) outcomes for patients undergoing either treatment modality. We retrospectively studied 70 consecutive patients treated with either CDT or USAT over 3 years at a multicenter health system. The primary clinical efficacy endpoint was right ventricular systolic pressure (RVSP) reduction post-procedurally...
March 27, 2019: Vascular Medicine
Ahmed Al-Ogaili, Ali Ayoub, Luis Diaz Quintero, Christian Torres, Harry E Fuentes, Setri Fugar, Ahmed A Kolkailah, Wael Dakkak, Alfonso J Tafur, Neha Yadav
Venous thromboembolism (VTE) and coronary artery disease are major health issues that cause substantial morbidity and mortality. New data have emerged suggesting that these two conditions could have a close relationship. Thus, we sought to determine the trends in annual rate of VTE occurrence in patients with ST-segment elevation myocardial infarction (STEMI) and measure its impact on in-hospital mortality, bleeding complications, and cost and length of hospitalization. We queried the 2003-2013 Nationwide Inpatient Sample databases to identify adults with primary diagnosis of STEMI...
March 27, 2019: Vascular Medicine
Daniel P Rothschild, James A Goldstein, Joseph Ciacci, Terry R Bowers
Ultrasound-accelerated thrombolysis (USAT) is advocated in pulmonary embolism (PE) based on the hypothesis that adjunctive ultrasound provides superior clinical efficacy compared to standard catheter-directed thrombolysis (CDT). This retrospective study was designed to compare outcomes between the two modalities. We analyzed patients with computed tomography-diagnosed PE at our institution treated with either USAT or standard CDT. Efficacy parameters assessed included invasive pulmonary artery systolic pressure (PASP; pre- and 24 hours post-treatment), non-invasive right-to-left ventricle (RV/LV) ratio (pre- and post-treatment), and general clinical outcomes (length-of-stay, significant bleeding, and mortality)...
March 27, 2019: Vascular Medicine
Joseph L McDevitt, Ravi N Srinivasa, Anthony N Hage, Jacob J Bundy, Joseph J Gemmete, Rajiv N Srinivasa, Jeffrey Forris Beecham Chick
The aim of this study was to report the technical success, adverse events, clinical outcomes, and long-term stent patency of iliocaval stent reconstruction for naïve, non-inferior vena cava (IVC) filter-related, chronic iliocaval thrombosis. A total of 69 patients, including 47 (68%) men, with a mean age of 36 years (range: 8-71 years), underwent first-time iliocaval stent reconstruction for non-IVC filter-associated iliocaval thrombosis. The mean number of prothrombotic risk factors was 2.2 (range: 0-5), including 30 (43%) patients with IVC atresia...
March 25, 2019: Vascular Medicine
Caroline Galliano, Sumit Gupta, Michael L Steigner, Ayaz Aghayev
No abstract text is available yet for this article.
March 21, 2019: Vascular Medicine
Abayomi O Oyenuga, Aaron R Folsom, Pamela L Lutsey, Weihong Tang
To optimize cardiovascular health, the American Heart Association (AHA) has recommended 'Life's Simple 7 (LS7)'. We tested the hypothesis that greater adherence to the LS7 cardiovascular risk metric is associated with reduced risk of developing abdominal aortic aneurysm (AAA). A total of 14,375 black and white participants aged 45-64 years at the baseline visit of the Atherosclerosis Risk in Communities (ARIC) study cohort were included in this analysis. A 14-point summary score for LS7 was calculated, and participants were classified as having poor (0-4), average (5-9), or ideal (10-14) cardiovascular health...
March 21, 2019: Vascular Medicine
Siddharth M Patel, David A Morrow, Stephen K Kidd, Erica L Goodrich, Benjamin M Scirica, Marc P Bonaca
No abstract text is available yet for this article.
March 14, 2019: Vascular Medicine
Ayman Elbadawi, Amgad Mentias, Islam Y Elgendy, Ahmed H Mohamed, Mohammed Hz Syed, Gbolahan O Ogunbayo, Odunayo Olorunfemi, Igor Gosev, Sunil Prasad, Scott J Cameron
Little is known about the temporal trends and outcomes for extra-corporeal membrane oxygenation (ECMO) in patients with high-risk pulmonary embolism (PE) in the United States. We queried the National Inpatient Sample (NIS) database from 2005 to 2013 to identify patients admitted with high-risk PE. Our objective was to determine trends for ECMO use in patients with high-risk PE. We also assessed in-hospital outcomes among patients with high-risk PE receiving ECMO. We evaluated 77,809 hospitalizations for high-risk PE...
March 5, 2019: Vascular Medicine
Nkiruka V Arinze, Andrew Gregory, Jean M Francis, Alik Farber, Vipul C Chitalia
Peripheral artery disease (PAD) represents a major health care burden. Despite the advent of screening and interventional procedures, the long-term clinical outcomes remain suboptimal, especially in patients with chronic kidney disease (CKD). While CKD and PAD share common predisposing factors, emerging studies indicate that their co-existence is not merely an association; instead, CKD represents a strong, independent risk factor for PAD. These findings implicate CKD-specific mediators of PAD that remain incompletely understood...
March 1, 2019: Vascular Medicine
Weijuan Li, Alexandra Moran, Esther Sh Kim
No abstract text is available yet for this article.
February 27, 2019: Vascular Medicine
Eric Kaplovitch, Luke Rannelli, Sonia S Anand
Patients with peripheral artery disease (PAD) are at high risk for ischemic cardiovascular complications. While single antiplatelet therapy (SAPT), predominantly aspirin, has long been the standard antithrombotic treatment in stable PAD, there have now been greater than 40,000 PAD patients randomized to varying antiplatelet and/or anticoagulant regimens. In this review, we provide a summary of the current evidence for antithrombotics in stable PAD, focusing on the rates of major adverse cardiovascular events (MACE), major adverse limb events (MALE), and major bleeding...
February 24, 2019: Vascular Medicine
Elke Bouwens, Sanne Klaphake, Karin J Weststrate, Joep Aw Teijink, Hence Jm Verhagen, Sanne E Hoeks, Ellen V Rouwet
Guidelines recommend supervised exercise therapy (SET) as first-line treatment for intermittent claudication. However, the use of revascularization is widespread. We addressed the effectiveness of preventing (additional) invasive revascularization after primary SET or revascularization based on lesion and patient characteristics. In this single-center, retrospective, cohort study, 474 patients with intermittent claudication were included. Patients with occlusive disease of the aortoiliac tract and/or common femoral artery (inflow) were primarily considered for revascularization, while patients with more distal disease (outflow) were primarily considered for SET...
February 22, 2019: Vascular Medicine
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