J. Vasc. Dis., Volume 1, Issue 1 (September 2022) – 8 articles

Background: To evaluate the technical results of an arterial repair, a variety of intraoperative imaging and assessment techniques can be used during carotid endarterectomy (CEA). The aim of the study was to evaluate the usefulness of intraoperative ultrasound flow measurement as a quality control after primary CEA in a teaching hospital setting. Methods: Over 36 months, 107 consecutive CEAs were performed at our institution. Retrospectively acquired demographics, intraoperative flow measurements, duplex results, revisions, and surgical outcomes were reviewed. Postoperative 30-day transient ischemic attack (TIA), stroke, and death rates were analyzed. Results were compared with ultrasound flow measurement and duplex ultrasonography. Results: From March 2012 to March 2015, 107 primary consecutive CEAs were performed in 107 patients (71% male, 29% female), whose age ranged from 51 to 81 years with a mean age of 68 ± 4 years. Associated risk factors included diabetes for 89 (83%), smoking for 92 (86%), hypertension for 94 (87.8%), chronic renal insufficiency for 71 (66%), and coronary artery disease for 57 (53%) of the patients. Early postoperative duplex scans in all 107 patients showed no significant changes from intraoperative findings. The ipsilateral stroke and death rate in this study was 0 (0/107) and the 30-day death and stroke rate was also 0 (0/107), with no significant difference between trainees and senior surgeons. Three patients (2.8%) had flow < 100 mL/Min and two of them were revised after completion of contrast angiography. Conclusions: The findings of this study indicate that the intraoperative flow measurement is an alternative method for detecting technical errors and a tool for quality-control imaging. Especially for trainees, it makes sense to ensure effectiveness of the procedure upon its completion and to assess the technical adequacy of CEA. Full article

Background: Atherosclerosis (AS) is an important pathological basis of many cardiovascular diseases. Canagliflozin and dapagliflozin have yielded impressive results in the treatment of cardiovascular disease in both diabetic and non-diabetic patients. In this study, we investigated their targets and mechanism involved in the treatment of atherosclerosis using network pharmacology. Methods: The potential targets of canagliflozin and dapagliflozin were gathered from the database PharmMapper. Targets associated with AS were derived from the GeneCards, Drugbank, DisGeNet, and therapeutic target databases (TTD) by searching for keywords on atherosclerosis and coronary artery disease. Overlap targets were collected by uploading drug and disease targets into jvenn. The cross-targets of the Venny plots were uploaded to the STRING database, and a protein–protein interaction (PPI) was constructed with their calculated features, aiming to reveal several key targets. Key targets were selected by using a plug-in of the Cytoscape software. Gene ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed using the database Metascape. Cytoscape was used to set up the pathways-genes network. Molecular docking with core targets and drugs was performed with AutoDock. Results: A total of 288 canagliflozin targets, 287 dapagliflozin targets and 4939 AS-related targets were obtained. A total of 191 overlapping targets were found after intersecting. Five core targets, including protein kinase B (Akt1), Mitogen-activated protein kinase 1 (MAPK1), Mitogen-activated protein kinase 14 (MAPK14), Proto-oncogene tyrosine-protein kinase SRC (SRC) and Epidermal growth factor receptor (EGFR) were collected. Pathways, biological processes, molecular functions and cellular components of canagliflozin and dapagliflozin were found. Conclusion: Canagliflozin and dapagliflozin play a role in atherosclerosis by regulating Akt1, MAPK1, MAPK14, SRC and EGFR. Our research provides further insights into the use of canagliflozin and dapagliflozin in the treatment of atherosclerosis. Full article

Background: We aimed to compare the macular sensitivity after one initial intravitreal injection of an anti-vascular endothelial growth factor (VEGF) agent followed by pro re nata (PRN) dosing with that after three initial monthly injections followed by PRN dosing in patients with central retinal vein occlusion (CRVO) and macular edema. Methods: We included 20 eyes of 20 patients with treatment-naïve macular edema in CRVO and followed them for 12 months after intravitreal ranibizumab injection (IRI). Before and 1, 3, 6, and 12 months after IRI, macular sensitivity within the central 1 mm, 3 mm, and 6 mm fields was measured with an MP3 microperimeter and best-corrected visual acuity (BCVA) was assessed. Eleven eyes received one initial IRI (1 + PRN group), and nine received three initial monthly IRIs (3 + PRN group). PRN injections were performed when fovea exudative changes were evident. Results: Mean macular sensitivity within the central 1 mm, 3 mm, and 6 mm fields significantly improved from baseline to month 12 in all treated eyes. We found no significant differences in macular sensitivity in the central 1 mm, 3 mm, or 6 mm fields between the two groups at month 1, 3, 6, or 12. The choice of treatment regimen (1 + PRN or 3 + PRN) showed no association with either macular sensitivity in the central 1 mm, 3 mm, and 6 mm fields or BCVA at month 12. Conclusions: These findings suggest that a 1 + PRN regimen improves macular sensitivity to a similar extent as a 3 + PRN regimen. Full article

Background: Gemcitabine/nab-paclitaxel therapy (GnP) is widely used to treat pancreatic cancer (PC), but chemotherapy-induced peripheral neuropathy (CIPN) is common. The CIPN is also reported to be related by microvascular damage as the basis for toxic neuropathy. However, no sufficient treatment options are available for CIPN. Mirogabalin is a novel drug for treating peripheral neuropathy. We investigated the effects of mirogabalin on CIPN due to GnP. Methods: Patients who had received GnP for PC and had taken mirogabalin for CIPN, were included. Patients completed a questionnaire about their symptoms before and after taking mirogabalin. The outcome was the change in numbness and tingling scores on the patient-reported outcomes version of the Common Terminology Criteria for Adverse Events, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Chemotherapy-Induced Peripheral Neuropathy (EORTC-QLQ-CIPN20), numerical rating scale, and adverse events (AEs). Results: Increased numbness and tingling severity (1.84 vs. 1.76; p = 0.63) and interference (1.42 vs. 1.44; p = 0.80) were not seen in any of the 25 enrolled patients. The scores on the sensory subscale of the EORTC-QLQ-CIPN improved significantly after treatment (17.5 vs. 15.7; p = 0.02). Adverse events occurred in 22 patients (88%), but there were no serious AEs (≥grade 3). Conclusions: Mirogabalin may control the progression of CIPN caused by GnP and significantly improved sensory neuropathy. However, as the incidence of AEs is high, mirogabalin should be used with caution. (UMIN:R000044039). Full article

Background: Although an association between lung function and subclinical atherosclerosis has been reported, it remains unclear whether this association is only driven by tobacco smoking. We aimed to assess this in a population with at least one cardiovascular risk factor. Methods: We recruited 6209 subjects aged between 45 and 70 years with at least one cardiovascular risk factor (excluding diabetes mellitus) participating in the ILERVAS project 2015–2018. Lung function was determined by spirometry. Subclinical atherosclerosis was assessed with the ankle–brachial index (ABI) and the presence of carotid and femoral plaques measured by ultrasound. Results: A total of 5927 subjects were included: 49% male, median (p25–p75) age 57 years (52–62). Plaques were found in 4337 (73.2%) of the subjects. The patients with atherosclerosis showed worse lung function: median forced expiratory volume in one second (FEV₁) 95% and forced vital capacity (FVC) 94% in the patients with plaques vs. 99% and 98% in the other patients (p < 0.001). Adjusted models stratified by smoking status showed that being in the lower quartiles of FEV₁ % was associated with carotid and femoral plaques (OR 1.599, p = 0.005; and OR 1.654, p = 0.006), whereas FVC % was inversely associated with carotid plaques (OR 0.967, p = 0.041). A pathological ABI was associated with worse FEV₁ (OR 1.971, p = 0.038) and the presence of airway obstruction (OR 1.658, p = 0.015). However, these differences were restricted to current smokers. Conclusions: Lung function impairment was correlated with subclinical atherosclerosis only in current smokers. This highlights the unique role of smoking-related vascular and pulmonary dysfunction in early stages of pulmonary and cardiovascular afflictions. Full article

Early detection of type 2 diabetes mellitus (T2DM) complications is essential to prevent disability and death. Risk prediction models are tools to estimate the probability that an individual with specific risk factors will develop a future condition within a certain time period. A predictive model that incorporates time to quantify the risk of T2DM complications such as cardiovascular diseases (CVD) event is still lacking. Well-established and validated predictive models of T2DM complications are vital to stratify patients based on their risks; thus, individualization therapy could be optimized. New approaches (e.g., the parametric approach) are needed in developing predictive models of T2DM complications by incorporating new and time-varying predictors that may improve the existing models’ predictive ability. This review aimed (1) to summarize the reported predictors for the five main complications of T2DM, which include cardiovascular diseases, ischemic stroke, diabetic nephropathy, diabetic neuropathy, and diabetic retinopathy, and (2) to highlight the persistent need for future risk score models as screening tools for the early prevention of T2DM complications. Full article

Background: The use of mini electrodes with a small surface and narrow electrode-to-electrode spacing is believed to lead to a higher electrical resolution. Until now, the effects of tip-to-tissue contact, angulation, and irrigation on signal quality and morphology are unknown. Methods: The beating heart of an open-chest pig was examined while controlling the angulation and contact between the catheter tip and myocardial tissue, as well as the irrigation of the catheter tip. The mini electrodes were mounted onto commercially available 8 mm non-irrigated and 4 mm irrigated tip catheters. Different electrode interconnections, angulations, contact forces, and irrigation flow were analyzed and compared to signals recorded from conventional electrodes. Results: A total of 63 electrode samples of 21 defined, stable settings, each lasting 30 s, were analyzed. (1) Tissue contact of mini electrodes was given as soon as the conventional tip electrode showed tissue contact. (2) Angulation of the tip-to-tissue contact showed a trend towards changes in the integral of signals derived from mini electrodes, and no significant changes were seen in signals derived from conventional or mini electrodes. (3) Irrigation flow surrounding the mini electrodes did not influence signals derived from mini electrodes, whereas conventional electrodes showed signals with a longer duration under higher irrigation. Conclusion: Mini electrodes are robust to contact force and irrigation flow regarding signal quality, whereas signals of conventional electrodes are affected by irrigation flow, leading to substantial changes in signal duration and kurtosis. Signals of mini electrodes are sensitive to local electrical changes because of a high local resolution. Full article