J. Vasc. Dis., Volume 4, Issue 1 (March 2025) – 5 articles

Abdominal aortic aneurysm (AAA) is a prevalent vascular disease with high mortality rates upon rupture. AAA features a distinct sexual dimorphism, with a prevalence three times higher in males than in females. Interestingly, females are faced with a greater risk of rupture and a worse prognosis following surgical repairs. Nevertheless, stratified approaches for managing and predicting outcomes of AAA in male and female patients remain limited, largely hindered by our incomplete understanding of the mechanisms underlying this sex dimorphism. In this article, we will summarize the recent clinical and preclinical efforts aimed at understanding the therapeutic and mechanistic implications of sex-specific factors shaping AAA. Full article

Background: People with HIV (PWH) are at increased risk of vascular dysfunction and cardiovascular disease (CVD). SARS-CoV-2 infection has been associated with acute CVD complications. The aim of the study was to as-sess macrovascular function as an early indicator of CVD risk in PWH after mild SARS-CoV-2 infection. Methods: PWH aged 20–60 years, with undetectable viral load (RNA < 20 copies/mL), on stable anti-retroviral therapy (≥6 months) and history of mild COVID-19 (≥30 days) without any CVD manifestations prior to enrollment were recruited. Participants were excluded if they had history of diabetes mellitus, end-stage renal disease, heart or respiratory disease. Participants were matched 1:1 to pre-pandemic PWH. A health survey, surrogate measures of CVD risk, and macrovascular function (brachial artery flow-mediated vasodilation and arterial stiffness assessments via applanation tonometry) were compared between group. Results: A total of 17 PWH and history of COVID-19 (PWH/COV+) were matched with 17 PWH without COVID-19 (PWH/COV−) pre-pandemic. Mean age (45.5 years), sex (76.5% male), body mass index (27.3), and duration of HIV infection (12.2 years) were not different between groups. Both groups had comparable CVD risk factors (total cholesterol, LDL, HDL, systolic and diastolic blood pressure). There were no differences in measures of flow mediated arterial dilatation or arterial stiffness after 30 days of SARS-CoV-2 infection. Conclusions: After recent SARS-CoV-2 infection, PWH did not demonstrate evidence of macrovascular dysfunction and increased CVD risk. Results suggest that CVD risk may not be increased in people with well-controlled HIV who did not manifest CVD complications SARS-CoV-2 infection. Full article

Background: Central venous access devices (CVADs) are crucial for various medical conditions, but pose risks, including catheter-related bloodstream infections (CRBSI). CRBSI increases comorbidity, mortality, and healthcare costs. Surveillance and evidence-based guidelines have successfully reduced CRBSI rates, although the COVID-19 pandemic has led to increased infection rates. Main body: This review explores strategies for reducing the incidence of CRBSI and examines factors contributing to variations in reported rates across developed countries. Highlighting the significant morbidity, mortality, and healthcare resource burden associated with CRBSI, the analysis delves into evidence-backed preventive measures. It discusses the impact of the COVID-19 pandemic on infection rates and proposes resilient strategies in response to these challenges. The review emphasises the importance of understanding CRBSI pathogenesis, patient, procedure, and device-related risk factors, and the implementation of evidence-guided algorithms and surveillance measures. Recommendations include the use of all-inclusive procedure packs, ultrasound-guided placement, daily dressing changes with antimicrobial treatment, and the use of antimicrobial locks. Conclusions: The review underscores the need for clear, concise algorithms adaptable to various healthcare settings and the scalability of infection prevention systems to ensure resilience. Full article

Endovascular revascularization is a critical strategy in managing total occlusions of the femoropopliteal artery, a significant challenge in patients with peripheral artery disease (PAD). This review provides a comprehensive analysis of procedural strategies, highlighting the role of drug-coated balloons, atherectomy devices, and advanced crossing techniques like subintimal recanalization and re-entry methods. It discusses the importance of lesion-specific considerations, such as the use of atherectomy devices for un-crossable or un-dilatable lesions and the effectiveness of drug-coated balloons in reducing restenosis. Emerging techniques, including the PIERCE needle-cracking method and intravascular lithotripsy, offer novel approaches for treating heavily calcified plaques. Moreover, the review compares endovascular interventions with surgical bypass, noting that while minimally invasive techniques are preferred for high-risk patients, a hybrid approach may be optimal for selected cases. Despite advances, challenges remain regarding long-term outcomes and the management of complex calcified lesions, emphasizing the need for ongoing research and innovation in this field. Full article

Background: The influence of health literacy on PAD outcomes remains poorly understood, particularly in minoritized communities. The objective of this study is to examine the understanding of PAD within San Francisco’s Chinese-speaking population while discerning preferences regarding learning methods. Materials and Methods: An anonymous 14-question survey in Mandarin and English was conducted in two San Francisco Chinatown health fairs. Results: About one-third of the respondents (29/91) reported prior knowledge about PAD and that arthritis was the leading symptom related to PAD (32/65). Half of respondents (44/88) preferred consulting a family doctor for foot wounds, followed by a podiatrist (27/88) and a general surgeon (19/88). The top three methods to receive health information were radio, television and newspaper. Those who were 65 years old and above (OR 0.124, 95% CI [0.021–0.0728]) and participants who were proficient in English (OR 0.078; 95% CI [0.012–0.52]) less preferred using radio to receive health information. Male gender preferred newspapers to receive health information (p = 0.003, OR 5.26; 95% CI [1.76–15.69]). Discussion: Our findings may suggest a community-specific campaign to increase the awareness of PAD given that age, education level, gender and English proficiency may influence the media of choice to receive health information. Conclusions: The two cohorts that were surveyed had similar and suboptimal understanding of PAD, and a community-specific strategy is needed to address such inequity, which may improve awareness of PAD and health outcomes. Full article