Any stroke event is compared in both groups.

<p>Graphical representation of the results. <i>M-H:</i> Mantel-Haenszel.</p

Systematic Review of Randomized Controlled Trials of Different Types of Patch Materials during Carotid Endarterectomy

<div><h3>Background and Purpose</h3><p>Carotid endarterectomy (CEA) with patch angioplasty produces greater results than with primary closure; however, there remains uncertainty on the optimal patch material in CEA. A systematic review of randomized controlled trials (RCTs) was performed to evaluate the effect of angioplasty using venous patch versus synthetic patch material, and Dacron patch versus polytetrafluoroethelene (PTFE) patch material during CEA.</p> <h3>Methods</h3><p>A multiple electronic health database screening was performed including the Cochrane library, Pubmed, Ovid, EMBASE and Google Scholar on all randomized controlled trials (RCTs) published before November 2012 that compared the outcomes of patients undergoing CEA with venous patch versus synthetic patch. RCTs were included if they compared carotid patch angioplasty with autologus venous patch versus synthetic patch material, or compared one type of synthetic patch with another.</p> <h3>Results</h3><p>Thirteen RCTs were identified. Ten trials, involving 1946 CEAs, compared venous patch with synthetic patch materials. Two trials, involving 400 CEAs in 380 patients, compared Dacron patch with PTFE patch. The hemostasis time in CEA with PTFE patch was significantly longer than with venous patch (<em>P</em><0.0001), and longer than with Dacron patch (<em>P</em><0.0001). There was no significant difference of mortality rate, stroke rate, restenosis, and operative time in CEA with venous patch versus synthetic patch material, or in CEA with Dacron patch versus PTFE patch (all <em>P</em>>0.05). One RCT of 95 CEAs in 92 patients compared bovine pericardium with Dacron patch, and demonstrated a statistically significant decrease in intraoperative suture line bleeding with bovine pericardium compared with Dacron patch (<em>P</em><0.001).</p> <h3>Conclusions</h3><p>The hemostasis time in CEA with PTFE patch was longer than with venous patch or Dacron patch. The overall perioperative and long-term mortality rate, stroke rate, restenosis, and operative time were similar when using venous patch versus synthetic patch material or Dacron patch versus PTFE patch material during CEA. More data are required to clarify differences between different patch materials.</p> </div

Mortality in both groups.

<p>Graphical representation of the results. <i>M-H</i> : Mantel-Haenszel.</p

Reoperation for wound hematoma compared in both groups.

<p>Graphical representation of the results. <i>M-H:</i> Mantel-Haenszel.</p

Meta-analysis of hemostasis time (a), and operative time (b) in minutes during carotid endarterectomy, comparing Dacron and PTFE during CEA in two randomized controlled trials.

<p><i>CEA:</i> carotid endarterectomy; <i>PTFE:</i> polytetrafluoroethelene.</p

Details of randomized controlled trials.

<p>ASV ankle saphenous vein, <i>BP</i> bovine pericardium, <i>EJV</i> external jugular vein, <i>FU</i> follow up, <i>PTFE</i> polytetrafluoroethylene patch, <i>SV</i> saphenous vein, <i>VPC</i> vein patch closure, <i>Y</i> year, <i>Mon</i> month.</p

Postoperative wound infection events in both groups.

<p>Graphical representation of the results. <i>M-H</i> : Mantel-Haenszel.</p

Restenosis of carotid artery in both groups.

<p>Graphical representation of the results. <i>M-H:</i> Mantel-Haenszel.</p

Flow diagram showing different steps of the systematic review.

<p><i>RCTs:</i> randomized controlled trials.</p

DataSheet1_Potential biomarkers and immune cell infiltration involved in aortic valve calcification identified through integrated bioinformatics analysis.PDF

Background: Calcific aortic valve disease (CAVD) is the most common valvular heart disease in the aging population, resulting in a significant health and economic burden worldwide, but its underlying diagnostic biomarkers and pathophysiological mechanisms are not fully understood.Methods: Three publicly available gene expression profiles (GSE12644, GSE51472, and GSE77287) from human Calcific aortic valve disease (CAVD) and normal aortic valve samples were downloaded from the Gene Expression Omnibus database for combined analysis. R software was used to identify differentially expressed genes (DEGs) and conduct functional investigations. Two machine learning algorithms, least absolute shrinkage and selection operator (LASSO) and support vector machine-recursive feature elimination (SVM-RFE), were applied to identify key feature genes as potential biomarkers for Calcific aortic valve disease (CAVD). Receiver operating characteristic (ROC) curves were used to evaluate the discriminatory ability of key genes. The CIBERSORT deconvolution algorithm was used to determine differential immune cell infiltration and the relationship between key genes and immune cell types. Finally, the Expression level and diagnostic ability of the identified biomarkers were further validated in an external dataset (GSE83453), a single-cell sequencing dataset (SRP222100), and immunohistochemical staining of human clinical tissue samples, respectively.Results: In total, 34 identified DEGs included 21 upregulated and 13 downregulated genes. DEGs were mainly involved in immune-related pathways such as leukocyte migration, granulocyte chemotaxis, cytokine activity, and IL-17 signaling. The machine learning algorithm identified SCG2 and CCL19 as key feature genes [area under the ROC curve (AUC) = 0.940 and 0.913, respectively; validation AUC = 0.917 and 0.903, respectively]. CIBERSORT analysis indicated that the proportion of immune cells in Calcific aortic valve disease (CAVD) was different from that in normal aortic valve tissues, specifically M2 and M0 macrophages. Key genes SCG2 and CCL19 were significantly positively correlated with M0 macrophages. Single-cell sequencing analysis and immunohistochemical staining of human aortic valve tissue samples showed that SCG2 and CCL19 were increased in Calcific aortic valve disease (CAVD) valves.Conclusion: SCG2 and CCL19 are potential novel biomarkers of Calcific aortic valve disease (CAVD) and may play important roles in the biological process of Calcific aortic valve disease (CAVD). Our findings advance understanding of the underlying mechanisms of Calcific aortic valve disease (CAVD) pathogenesis and provide valuable information for future research into novel diagnostic and immunotherapeutic targets for Calcific aortic valve disease (CAVD).</p