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Innovations in Vascular Medicine: Optimizing Patient Care through Peripheral Interventions

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Vascular Medicine".

Deadline for manuscript submissions: closed (15 October 2024) | Viewed by 6743

Special Issue Editor


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Guest Editor
Department of Interventional Cardiology, Institute of Cardiology, The John Paul II Hospital, Jagiellonian University Medical College, 80 Prądnicka St, 31-202 Krakow, Poland
Interests: cardiovascular disease; inflammatory cytokines and microRNAs in atherosclerosis and aortic valve stenosis; athero-sclerosis prevention and treatment; interventions on carotid and renal arteries; renovascular disease; monitoring of ath-erosclerosis progression; carotid intima-media; arterial stiffness; vascular age
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Special Issue Information

Dear Colleagues,

This Special Issue is dedicated to outlining the recent advancements in clinical vascular medicine. It focuses on improving the treatment and prognosis of vascular diseases and enhancing quality of life for patients through the use of innovative peripheral interventions, such as minimally invasive procedures and surgeries.

The optimization of the management of and interventions in an individual patient should be tailored to specific clinical scenarios that may be challenging. Whether in patients of advanced age or in young adults, the risk and benefit of intervention, together with post-intervention well-being and outcomes, should be strongly considered.

Therefore, the launching of this Special Issue is a call for submissions focused on current updates and perspectives on non-coronary interventions in all age categories, including very young patients, child-bearing females, very elderly patients, etc.

Observational, review, research, or meta-analysis papers examining patterns of care, outcomes, and comparative effectiveness of percutaneous or surgical interventions are invited. The future of clinical vascular medicine holds promising prospects. Continued research efforts are expected to refine the existing procedures, improve patient outcomes, and minimize risks. Additionally, advancements in interventional devices are being explored to optimize treatment options.

We welcome researchers, clinicians, and experts in this field to contribute their original research articles and reviews. The goal of this Special Issue is to promote knowledge exchange, collaboration, and advance the field towards optimal patient care.

This Special Issue aims to bring together recent research and review articles, particularly focused on the following topics:

  • Carotid artery interventions in stable and vulnerable plaque;
  • Challenges in the management of chronic and acute limb ischemia in patients with and without diabetes;
  • Minimally invasive interventions in very elderly patients;
  • Clinical and invasive approaches to manage vascular complications in pregnancy;
  • Optimization of care and risk stratification to individualize patient treatment;
  • Non-coronary interventions in various subsets of patients;
  • Interventions on atherosclerotic lesions and non-atherosclerotic arterial disease, including arterial embolization and inflammatory or congenital vascular disease;
  • Arterial complications in heart diseases.

Prof. Dr. Anna Kabłak-Ziembicka
Guest Editor

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Keywords

  • vascular medicine
  • peripheral interventions
  • interventional devices
  • clinical research
  • elderly patients
  • specific patients' populations
  • child-bearing
  • pregnancy
  • young patients
  • diabetes
  • limb ischemia
  • carotid interventions
  • atherosclerotic lesions
  • non-atherosclerotic vascular disease

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Published Papers (5 papers)

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Research

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19 pages, 1028 KiB  
Article
Identifying Risk Factors for Lower Extremity Artery Disease (LEAD) in Cardiology Patients: The Role of Ankle-Brachial Index Measurement
by Bartosz Zambrzycki, Michał Łuczaj, Marlena Dubatówka, Karolina Dańkowska, Katarzyna Nowicka, Małgorzata Knapp, Anna Szpakowicz, Karol Kamiński and Anna Lisowska
J. Clin. Med. 2024, 13(24), 7858; https://doi.org/10.3390/jcm13247858 - 23 Dec 2024
Viewed by 692
Abstract
Background and aims: Lower Extremity Artery Disease (LEAD) is a predictor of atherosclerotic plaques in other locations and significantly increases the risk of death from cardiovascular events. This study aimed to identify cardiology patient subpopulations that should undergo Ankle-Brachial Index (ABI) measurement. Methods: [...] Read more.
Background and aims: Lower Extremity Artery Disease (LEAD) is a predictor of atherosclerotic plaques in other locations and significantly increases the risk of death from cardiovascular events. This study aimed to identify cardiology patient subpopulations that should undergo Ankle-Brachial Index (ABI) measurement. Methods: A total of 800 patients hospitalized in the Department of Cardiology were included. Inclusion criteria were age over 40 years for men and over 45 years for women, with the ability to measure ABI. Results: The study group was divided into two subgroups based on ABI values, with LEAD (ABI ≤ 0.9) detected in 61 patients (7.6%). Among these, 45% exhibited symptoms of intermittent claudication. LEAD was significantly more common in patients with a lower ejection fraction, a history of myocardial infarction, coronary artery disease, coronary atherosclerosis, heart failure, hypercholesterolemia, diabetes, and in those with a past diagnosis of atherosclerosis. There was no statistical association with the incidence of ischemic stroke, renal failure, hypertension or a family history of cardiovascular disease. Average living conditions and financial status increased LEAD likelihood (p = 0.029; p = 0.018), while physical activity reduced it (p < 0.001). LEAD occurred more often in both current and former smokers. Patients with LEAD were more likely to be on statin therapy (p = 0.002). Higher hemoglobin A1c levels significantly increased the risk of LEAD. Conclusions: Identifying patients with risk factors for LEAD suggests that ABI measurement should be performed to detect LEAD early and implement appropriate diagnostic and therapeutic strategies. Full article
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20 pages, 1837 KiB  
Article
Depression in Cardiac Patients Is a Major Cardiovascular Event Risk Factor: A 12-Month Observational Study
by Jakub Podolec, Paweł Kleczyński, Marcin Piechocki, Michał Okarski, Katarzyna Lizończyk, Kornelia Szkodoń, Andrzej Silczuk, Tadeusz Przewłocki, Jacek Legutko and Anna Kabłak-Ziembicka
J. Clin. Med. 2024, 13(22), 6911; https://doi.org/10.3390/jcm13226911 - 16 Nov 2024
Viewed by 1226
Abstract
Background: Depression is a known factor in poor cardiovascular outcomes but is often underassessed in cardiac units. This study evaluates the impact of depression on cardiovascular outcomes in patients undergoing cardiac interventions. Methods: The study included 133 patients who underwent uncomplicated procedures [...] Read more.
Background: Depression is a known factor in poor cardiovascular outcomes but is often underassessed in cardiac units. This study evaluates the impact of depression on cardiovascular outcomes in patients undergoing cardiac interventions. Methods: The study included 133 patients who underwent uncomplicated procedures for degenerative aortic valve stenosis (n = 40), acute coronary syndrome (n = 29), or chronic coronary artery disease (n = 64). Depression was assessed using the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HAM-D). The primary endpoint was a major adverse cardiac and cerebrovascular event (MACCE). Patients were followed up for 12 months. Cox proportional hazards analysis was used to identify MACCE risk factors. Results: Depression was more frequently screened by HAM-D than BDI (42.9% vs. 30.8%, p < 0.001). During follow-up, 26 (19.5%) MACCEs occurred. In univariate analysis, risk factors included BDI score ≥ 11, HAM-D score ≥ 8, diabetes on insulin, anticoagulant use, atrial fibrillation, and serum creatinine level ≥ 130 µmol/L. Depression in the BDI increased the risk of the MACCE 3.6-fold (95%CI: 1.64–8.0, p = 0.001), whereas in the HAM-D, it increased the risk 4.9-fold (95%CI: 1.97–12.24, p < 0.001). Multivariate analysis showed HAM-D score ≥ 8 as the strongest predictor of MACCE (HR: 3.08, 95%CI: 1.18–8.08). Conclusions: Depression is a common finding in cardiovascular patients, and it is a strong risk factor for one-year cardiovascular mortality and adverse event risk. Therefore, we believe that common guidelines should be elaborated between relevant psychiatry and cardiology scientific societies. Full article
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15 pages, 1328 KiB  
Article
Outcomes of Revascularisation for Treating Lifestyle-Limiting Intermittent Claudication in Aboriginal and Torres Strait Islander People and Non-Indigenous Patients from North Queensland: A Retrospective Cohort Study
by Shannon Wong, Shivshankar Thanigaimani, James Charles, Donald Whaleboat and Jonathan Golledge
J. Clin. Med. 2024, 13(11), 3339; https://doi.org/10.3390/jcm13113339 - 5 Jun 2024
Viewed by 892
Abstract
Background: This retrospective analysis of an ongoing prospective cohort study aimed to assess the outcome of revascularisation for treating lifestyle-limiting intermittent claudication caused by peripheral artery disease (PAD) in Aboriginal and Torres Strait Islander Peoples and non-Indigenous North Queenslanders. Methods: Consenting patients with [...] Read more.
Background: This retrospective analysis of an ongoing prospective cohort study aimed to assess the outcome of revascularisation for treating lifestyle-limiting intermittent claudication caused by peripheral artery disease (PAD) in Aboriginal and Torres Strait Islander Peoples and non-Indigenous North Queenslanders. Methods: Consenting patients with PAD who underwent endovascular or open revascularisation procedures for treating lifestyle-limiting intermittent claudication were included. The primary outcome measure was major adverse limb events (MALEs), defined as major amputation or the requirement for repeat open or endovascular revascularisation. Results: Of the 378 included patients, 18 (4.8%) identified as Aboriginal and/or Torres Strait Islander Peoples. During a mean follow-up (standard deviation) of 6.0 (3.9) years, the incidence of MALE was similar in the Aboriginal and Torres Strait Islander People and non-Indigenous Australians (absolute percentage: 50.0% vs. 40.6%, log rank p = 0.59). In both unadjusted and adjusted analyses, Aboriginal and Torres Strait Islander Peoples and non-Indigenous Australians had similar risks of MALE (unadjusted hazard ratio, HR, 1.20, 95% confidence interval, CI, 0.61, 2.36; adjusted HR 1.02, 95%CI 0.50, 2.06). Conclusions: This study suggests that Aboriginal and Torres Strait Islander People are under-represented in the population of patients undergoing revascularisation to treat intermittent claudication. Due to small numbers it cannot be reliably concluded that Aboriginal and Torres Strait Islander People and non-Indigenous Australians have similar rates of MALE. Full article
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10 pages, 647 KiB  
Article
Relationship between Pulse Pressure and Handgrip Strength in the Korean Population: A Nationwide Cross-Sectional Study
by Ryuk Jun Kwon, Young Hye Cho, Eun-Ju Park, Youngin Lee, Sang Yeoup Lee, Jung-In Choi, Sae Rom Lee and Soo Min Son
J. Clin. Med. 2024, 13(5), 1515; https://doi.org/10.3390/jcm13051515 - 6 Mar 2024
Cited by 2 | Viewed by 1716
Abstract
Background: Sarcopenia is defined as the loss of muscle mass and strength and low physical performance, and it is closely related to the risk of cardiovascular disease and mortality. Pulse pressure (PP) is a biomarker of arterial stiffness and compliance. Elevated PP levels [...] Read more.
Background: Sarcopenia is defined as the loss of muscle mass and strength and low physical performance, and it is closely related to the risk of cardiovascular disease and mortality. Pulse pressure (PP) is a biomarker of arterial stiffness and compliance. Elevated PP levels increase the risk of cardiovascular diseases and all-cause mortality. Nevertheless, the association between PP and sarcopenia has not yet been clearly established. Methods: Participant data were extracted from the Korea National Health and Nutrition Examination Survey conducted from 2014 to 2020. The study population was classified into three groups (PP < 40 mmHg, 40 mmHg ≤ PP < 60 mmHg, and PP ≥ 60 mmHg). PP was calculated by deducting the diastolic blood pressure from the systolic blood pressure. For handgrip strength, the maximum value measured with a grip dynamometer was adopted (weak handgrip strength: <28 kg for men, <18 kg for woman; normal handgrip strength: ≥28 kg for men, ≥18 kg for women). To determine the relationship between PP and the prevalence of weak handgrip strength, multiple logistic regression analysis was performed after adjusting for possible confounding factors. Results: The higher PP group had a higher age, body mass index; systolic blood pressure, prevalence of hypertension, diabetes, hyperlipidemia, and metabolic syndrome, and maximum handgrip strength. In all models, the prevalence of weak handgrip strength was significantly higher in the group with PP ≥ 60 mmHg compared to the control group (PP < 40 mmHg). Conclusions: Elevated PP was significantly associated with a higher prevalence of weak muscle strength. Thus, PP monitoring may be used to identify individuals at risk of sarcopenia and is helpful in improving health outcomes. Full article
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18 pages, 2735 KiB  
Systematic Review
The Utility of Three-Dimensional Printing in Physician-Modified Stent Grafts for Aortic Lesions Repair
by Wiktoria Antonina Zasada, Hubert Stępak, Magdalena Węglewska, Łukasz Świątek, Jerzy Kluba and Zbigniew Krasiński
J. Clin. Med. 2024, 13(10), 2977; https://doi.org/10.3390/jcm13102977 - 18 May 2024
Cited by 1 | Viewed by 1448
Abstract
Background: Three-dimensional (3D) printing is becoming increasingly popular around the world not only in engineering but also in the medical industry. This trend is visible, especially in aortic modeling for both training and treatment purposes. As a result of advancements in 3D [...] Read more.
Background: Three-dimensional (3D) printing is becoming increasingly popular around the world not only in engineering but also in the medical industry. This trend is visible, especially in aortic modeling for both training and treatment purposes. As a result of advancements in 3D technology, patients can be offered personalized treatment of aortic lesions via physician-modified stent grafts (PMSG), which can be tailored to the specific vascular conditions of the patient. The objective of this systematic review was to investigate the utility of 3D printing in PMSG in aortic lesion repair by examining procedure time and complications. Methods: The systematic review has been performed using the PRISMA 2020 Checklist and PRISMA 2020 flow diagram and following the Cochrane Handbook. The systematic review has been registered in the International Prospective Register of Systematic Reviews: CRD42024526950. Results: Five studies with a total number of 172 patients were included in the final review. The mean operation time was 249.95± 70.03 min, and the mean modification time was 65.38 ± 10.59 min. The analysis of the results indicated I2 of 99% and 100% indicating high heterogeneity among studies. The bias assessment indicated the moderate quality of the included research. Conclusions: The noticeable variance in the reviewed studies’ results marks the need for larger randomized trials as clinical results of 3D printing in PMSG have great potential for patients with aortic lesions in both elective and urgent procedures. Full article
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