Adenomyosis (AM), a common benign gynecological disorder in reproductive-aged women, is characterized by menorrhagia, dysmenorrhea, and infertility. Epidemiological studies indicate that approximately 12.2% of AM patients exhibit an elevated risk for venous thromboembolism (VTE). Although the precise pathophysiological interplay between AM and VTE remains unelucidated, current evidence implicates hyperestrogenism, abnormal uterine bleeding, anemia, uterine enlargement, and elevated tumor marker carbohydrate antigen 125 levels (Ca-125) as potential contributors to VTE development. This article systematically reviews the latest research advances in recent years, synthesizes key risk factors, and analyzes current therapeutic strategies, with the aim of improving patients’ quality of life, reducing the incidence of VTE, and providing evidence-based guidance for clinical practice.
Lower extremity arterial calcification remains a major challenge in vascular surgery. Its treatment has evolved from conventional balloon angioplasty and stent implantation into an era of individualized therapy centered on calcium debulking technologies, including atherectomy and intravascular lithotripsy (IVL). Building on the systematic framework proposed by Ma and Wu regarding calcification grading systems and device selection, and integrating our team’s clinical experience with the latest evidence, this article provides a systematic review of imaging-guided precise assessment and classification of calcified lesions, as well as the application strategies and synergistic use of calcium debulking techniques such as atherectomy and IVL. In addition, it explores future directions in individualized treatment, including artificial intelligence-assisted decision-making and biomaterial-mediated vascular microenvironment restoration, with the aim of informing clinical decision-making and guiding future research on complex lower extremity arterial calcification.
BACKGROUND: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism, is a major cause of cardiovascular morbidity and mortality in the United States. This study examined long-term trends in VTE-related mortality from 1999 to 2024, with a focus on demographic and geographic disparities. METHODS: We conducted a nationwide population-based study using mortality data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database (1999–2024). Adults aged ≥ 25 years with VTE (ICD-10 codes I26, I80, and I82) listed as the underlying cause of death were included. Age-adjusted mortality rates (AAMRs) were calculated, and temporal trends were assessed using Joinpoint regression. Analyses were stratified by age, sex, race/ethnicity, and US Census region. RESULTS: A total of 283,805 VTE-related deaths were identified during the study period. The overall AAMR declined from 6.46 to 4.59 per 100,000 population, corresponding to an average annual percent change of − 1.43% (95% confidence interval: −2.35 to − 0.50). Despite this overall decline, important subgroup disparities persisted. Mortality increased among adults aged 25–44 years, whereas older adults consistently exhibited the highest absolute mortality rates. Non-Hispanic Black individuals and residents of the Southern United States also experienced persistently elevated mortality throughout the study period. CONCLUSION: Although VTE-related mortality in the United States declined between 1999 and 2024, substantial disparities persisted across age, race/ethnicity, and geographic regions. These findings underscore the need for targeted prevention strategies and equitable access to timely diagnosis and evidence-based VTE care.
OBJECTIVES: Current hind limb peripheral artery disease (PAD) animal models, which claim to mimic chronic limb ischemia, are examples of acute limb ischemia because of total ligation of the femoral artery. In this study, we have created a novel animal model using partial femoral artery occlusion to mimic chronic limb ischemia with decreased blood flow but not total occlusion. We hypothesize that this model will help us better understand chronic PAD with decreased, but not completely obstructed, blood perfusion and facilitate future investigation of therapeutic strategies for chronic obstructive vascular disease. MATERIALS AND METHODS: Male C57BL/6J mice, 10–12 weeks old, were anesthetized using intraperitoneal injections of ketamine (150 mg/kg)/xylazine (10 mg/kg). In the partial hind limb ischemia model (PHLI) ( n = 16), the lumen of the Femoral artery was narrowed by applying a 10-0 nylon suture through the mid-diameter and ligating half of the lumen. In the complete hind limb ischemia model ( n = 16), the femoral artery was completely tied off. Daily laser Doppler blood flow measurements were employed to follow changes in limb perfusion up to 25 days postexperiments. The perfusion difference between the ischemic and the control limbs was measured. Six mice from each group were randomly euthanized on day 7, and their calf muscles underwent microscopic evaluations by a board-certified histopathologist blinded to the specimen groups. The amount of cell necrosis, inflammatory cell infiltration, and interstitial fibroblast proliferation in each specimen was averaged and scored from 0 to 5 based on the severity of the histological changes. RESULTS: Following surgery, the mice in both the PHLI and CHLI groups presented with persistent limping, and the involved hind limbs were found to be pale and cool to the touch. Comparison of the laser Doppler perfusion between the experimental and control hind limbs with both PHLI and CHLI showed that there was a significant reduction in blood flow in the experimental hind limb following the procedures. During the 1 st week of the experiment, mice in the PHLI group had significantly higher blood flow to their experimental hind limbs compared with the CHLI group (day 3, P < 0.05; day 7, P < 0.05). This difference gradually disappeared, and after 15 days, there was no difference in the hind limb perfusion of the mice between PHLI and CHLI. The histological evaluation of the experimental hind limbs in both groups showed evidence of ischemia-related coagulative necrosis of the gastrocnemius samples but the difference in histological scoring did not reach statistical significance. CONCLUSION: A partial hind limb ischemia mouse model mimicking chronic limb ischemia with partially decreased blood flow was successfully established. This new model was successful in the creation of a low-flow state during the experiments in the partial ischemia group. The partial ischemia model presented here more closely mimics human PAD with a reduced perfusion instead of acute total occlusion.
