Latest Research in Peripheral Artery Diseases

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

Deadline for manuscript submissions: 10 October 2024 | Viewed by 2431

Special Issue Editor


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Guest Editor
Department of General Surgery (Vascular Surgery), Sengkang General Hospital, Singapore
Interests: diabetic foot disease; peripheral arterial disease; acute and chronic aortic dissections; aortic aneurysms (thoracic, thoracoabdominal, and abdominal); arteriovenous malformation (AVM); carotid aneurysms; carotid atherosclerotic disease and stroke prevention; carotid body tumors; deep vein thrombosis; dialysis access for hemodialysis and peritoneal dialysis; May–Thurner syndrome; mesenteric and renovascular disease; peripheral and visceral aneurysms; popliteal artery entrapment syndrome (PAES); thoracic outlet syndrome; varicose veins; vascular graft infections; vascular trauma; vena caval filters; venous ulcers

Special Issue Information

Dear Colleagues,

The treatment of peripheral arterial disease (PAD) today is substantially different compared to just 10 to 15 years ago. The collective research endeavours in the past two decades have led to major changes and improvements in the endovascular treatment of PAD by vascular specialists. Technological advancements in endovascular techniques have enabled the crossing of PAD lesions which may previously have been considered “uncrossable” and allowed vascular specialists to reach lesions previously considered too distal and risky. Furthermore, innovations in the delivery of various drugs (paclitaxel and sirolimus), in the form of drug-coated balloons and drug-eluting stents, have improved the durability of PAD treatment, so that lesions stay patent for longer. The scope of endovascular treatment has also expanded to include options for atherectomies, intravascular lithotripsy, and specialty balloons (e.g., scoring balloons or balloons with spurs); therefore, there are now more ways to open the arteries other than just plain balloon angioplasties. Advancements in intravascular imaging with intravascular ultrasound (IVUS) has allowed for the more accurate sizing of lesions so that treatments are more precise. Finally, one must not forget open surgery. Two recent major randomizsed trials (BEST CLI and BASIL 2) have ignited debate on open bypass surgery versus endovascular treatment for PAD. 

Dr. Edward Choke
Guest Editor

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Keywords

  • chronic limb-threatening ischemia
  • intermittent claudication
  • peripheral arterial disease
  • diabetic foot ulcer
  • drug-coated balloons
  • paclitaxel
  • sirolimus
  • stents
  • atherectomy
  • lithotripsy
  • intravascular ultrasound

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Published Papers (2 papers)

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13 pages, 1924 KiB  
Article
Ghrelin Expression in Atherosclerotic Plaques and Perivascular Adipose Tissue: Implications for Vascular Inflammation in Peripheral Artery Disease
by Sorin Nicolae Peiu, Diana Gabriela Iosep, Mihai Danciu, Veronica Scripcaru, Victor Ianole and Veronica Mocanu
J. Clin. Med. 2024, 13(13), 3737; https://doi.org/10.3390/jcm13133737 - 26 Jun 2024
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Abstract
Atherosclerosis, a leading cause of peripheral artery disease (PAD), is driven by lipid accumulation and chronic inflammation within arterial walls. Objectives: This study investigates the expression of ghrelin, an anti-inflammatory peptide hormone, in plaque morphology and inflammation in patients with PAD, highlighting [...] Read more.
Atherosclerosis, a leading cause of peripheral artery disease (PAD), is driven by lipid accumulation and chronic inflammation within arterial walls. Objectives: This study investigates the expression of ghrelin, an anti-inflammatory peptide hormone, in plaque morphology and inflammation in patients with PAD, highlighting its potential role in age-related vascular diseases and metabolic syndrome. Methods: The analysis specifically focused on the immunohistochemical expression of ghrelin in atherosclerotic plaques and perivascular adipose tissue (PVAT) from 28 PAD patients. Detailed immunohistochemical staining was performed to identify ghrelin within these tissues, comparing its presence in various plaque types and assessing its association with markers of inflammation and macrophage polarization. Results: Significant results showed a higher prevalence of calcification in fibro-lipid plaques (63.1%) compared to fibrous plaques, with a notable difference in inflammatory infiltration between the two plaque types (p = 0.027). Complicated plaques exhibited increased ghrelin expression, suggesting a modulatory effect on inflammatory processes, although this did not reach statistical significance. The correlation between ghrelin levels and macrophage presence, especially the pro-inflammatory M1 phenotype, indicates ghrelin’s involvement in the inflammatory dynamics of atherosclerosis. Conclusions: The findings propose that ghrelin may influence plaque stability and vascular inflammation, pointing to its therapeutic potential in managing atherosclerosis. The study underlines the necessity for further research to clarify ghrelin’s impact on vascular health, particularly in the context of metabolic syndrome and age-related vascular alterations. Full article
(This article belongs to the Special Issue Latest Research in Peripheral Artery Diseases)
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16 pages, 4786 KiB  
Article
Five-Year Trends of Vascular Disease-Related Amputations in Romania: A Retrospective Database Study
by Horațiu F. Coman, Bogdan Stancu, Octavian A. Andercou, Razvan Ciocan, Claudia D. Gherman, Adriana Rusu, Norina A. Gavan, Cosmina I. Bondor, Alexandru D. Gavan, Cornelia G. Bala, Alexandru Necula, Trif Ana, Trif Tatiana and Peter L. Haldenwang
J. Clin. Med. 2024, 13(9), 2549; https://doi.org/10.3390/jcm13092549 - 26 Apr 2024
Cited by 1 | Viewed by 1014
Abstract
Background/Objectives: Lower extremity amputations (LEAs) are a burdensome complication of peripheral artery disease (PAD) and/or arterial embolism and thrombosis (AET). We assessed the trends in PAD- and/or AET-related LEAs in Romania. Methods: This retrospective study (2015–2019) analyzed data on minor and major LEAs [...] Read more.
Background/Objectives: Lower extremity amputations (LEAs) are a burdensome complication of peripheral artery disease (PAD) and/or arterial embolism and thrombosis (AET). We assessed the trends in PAD- and/or AET-related LEAs in Romania. Methods: This retrospective study (2015–2019) analyzed data on minor and major LEAs in hospitalized patients recorded in the National School for Public Health, Management, and Health Education database. The absolute numbers and incidences of LEAs were analyzed by diagnosis type, year, age, sex, and amputation level. Results: Of 38,590 vascular disease-related amputations recorded nationwide, 36,162 were in PAD and 2428 in AET patients. The average LEA incidence in the general population was 34.73 (minimum: 31.96 in 2015; maximum: 36.57 in 2019). The average incidence of major amputations, amputations above the knee, hip amputations, amputations below the knee, and minor amputations was 16.21 (15.62 in 2015; 16.84 in 2018), 13.76 (13.33 in 2015; 14.28 in 2018), 0.29 (0.22 in 2017; 0.35 in 2019), 2.15 (2.00 in 2015; 2.28 in 2019), and 18.52 (16.34 in 2015; 20.12 in 2019), respectively. Yearly PAD- and/or AET-related amputations were significantly higher in men versus women. The overall number of LEAs increased with age, particularly in patients ≥ 70 years. The increase in the total number of amputations was mainly due to a constant rise in minor amputations for both groups, regardless of gender. Conclusions: PAD- and/or AET-related LEAs in Romania increased from 2015 to 2019, with men having a greater incidence than women. Raising awareness and effective management strategies are needed to prevent LEAs. Full article
(This article belongs to the Special Issue Latest Research in Peripheral Artery Diseases)
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