Circulating biomarkers are not associated wtih endoleaks after endovascular repair of abdominal aortic aneurysms

Objective: Endoleak is a common complication of endovascular repair (EVAR) for abdominal aortic aneurysm (AAA), but can only be detected through prolonged follow-up with repeated aortic imaging. This study examined the potential for circulating matrix metalloproteinase-9 (MMP9), osteoprotegerin (OPG), D-dimer, homocysteine (HCY) and C-reactive protein (CRP) to act as diagnostic markers for endoleak in AAA patients undergoing elective EVAR. Methods: Linear mixed effects models were constructed to assess differences in AAA diameter after EVAR, between groups of patients who did, and did not develop endoleak during follow-up, adjusting for potential confounders. Circulating MMP9, OPG, D-dimer, HCY and CRP concentrations were measured in pre- and post-operative plasma samples. The association of these markers with endoleak diagnosis was assessed using linear mixed effects adjusted as above. The potential for each marker to diagnose endoleak was assessed using receiver operator characteristic (ROC) curves. Results: Seventy-five patients were included in the current study, 24 of whom developed an endoleak during follow-up. Patients with an endoleak had significantly large AAA sac diameters than those that did not have an endoleak. None of the assessed markers showed a significant association with endoleak. This was confirmed through ROC curve analyses indicating poor diagnostic ability for all markers. Conclusions: Circulating concentrations of MMP9, OPG, D-dimer, HCY and CRP were not associated with endoleak in patients undergoing EVAR in this study

Editor's choice : European Society for Vascular Surgery (ESVS) 2020 clinical practice guidelines on the management of acute limb ischaemia

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Editor's Choice – European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Asymptomatic Lower Limb Peripheral Arterial Disease and Intermittent Claudication

peer reviewe

Aneurysma spurium der infrarenalen aorta

© EMH Schweizerischer ArzterlugW.G. Mouton, K.T. Otten and R.A. Fitridg

Additional file 1 of Gap analysis of diabetes-related foot disease management systems in Pacific Islands Countries and Territories

Supplementary Material

Microvascular basal lamina antigens disappear during cerebral ischemia and reperfusion

Background and Purpose Changes in vascular permeability are well-known and important consequences of cerebral ischemia. The development of edema and of petechial hemorrhage is connected to altered vascular integrity. A major part in microvascular integrity is played by the basal lamina. Methods The fates of the basal lamina components laminin, fibronectin, and type IV collagen during middle cerebral artery occlusion (2 hours, n=3) and occlusion (3 hours) with reperfusion (1 hour, n=3; 4 hours, n=3; and 24 hours, n=4) were evaluated in the nonhuman primate. Specific monoclonal antibodies against these components were used. The number and size distribution of the microvessels in each specimen were determined by video-imaging microscopy, and the relative fluorescence intensity of laminin was semiquantified by laser confocal microscopy. Basal lamina antigen presentations were compared by double-stain immunofluorescence histochemistry. Results The number of microvascular structures defined by the presence of each basal lamina antigen decreased significantly up to 24 hours of reperfusion (P<.0001). The ratio of laminin-containing vessels between the ischemic and nonischemic territories decreased significantly from control (0.98±0.04) to 2 hours of ischemia (0.83±0.09) and 1 hour (0.79±0.08), 4 hours (0.77±0.06), and 24 hours of reperfusion (0.55±0.07). The ratio of fibronectin (cellular) and of collagen (IV)-containing vessels decreased from 0.98±0.04 to 0.75±0.1 and from 1.02±0.03 to 0.57±0.1, respectively. Mean laminin fluorescence intensity decreased from 76.1±6.0 U (controls) to 52.0±14.6 U (24 hours of reperfusion; P<.001). Conclusions The significant parallel losses of three basal lamina components, both in number and intensity, contribute to loss of microvascular integrity. These phenomena may be important for understanding cell extravasation and the hemorrhagic consequences of acute stroke.Gerhard F. Hamann, Yasushi Okada, Robert Fitridge and Gregory J. del Zopp