BACKGROUND:Inflammation is pivotal in venous thrombogenesis. Complete blood count (CBC)-derived inflammation indexes are emerging biomarkers, but their value for diagnosing acute deep vein thrombosis (DVT) and stratifying thrombus burden requires further investigation. OBJECTIVE:To evaluate CBC-derived inflammation indexes-neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), lymphocyte-to-monocyte ratio (LMR), and systemic inflammation response index (SIRI)-for diagnosing acute DVT and stratifying thrombus burden. METHODS:In this retrospective study, 360 patients referred for venous Doppler ultrasound were categorized into non-DVT (n = 200), isolated distal DVT (IDDVT, n = 114), and proximal DVT (PDVT, n = 46) groups. Demographic data, comorbidities, and CBC parameters were collected to calculate the indexes. Predictive ability was assessed using receiver operating characteristic (ROC) curve analysis, and group differences were evaluated with the Kruskal-Wallis and Dunn's tests. RESULTS:Acute DVT patients showed significantly elevated NLR, PLR, SII, and SIRI, and reduced LMR. ROC analysis indicated LMR had the highest predictive efficacy for acute DVT (AUC: 0.737) with high specificity (85.5%). For distinguishing IDDVT from PDVT, only NLR and LMR showed significant discriminative value. CONCLUSION:NLR and LMR are valuable biomarkers for diagnosing acute DVT and assessing thrombus burden. Their high specificity supports adjunctive use in risk stratification, but their low sensitivity necessitates integration with comprehensive clinical assessment.

ObjectiveThe rapid identification of pulmonary thromboembolism (PTE) on computed tomography pulmonary angiography (CTPA) is vital but labor-intensive, often leading to diagnostic delays. We aimed to construct and evaluate a YOLOv11 object detection algorithm capable of automatically highlighting intraluminal filling defects to expedite emergency radiological workflows.MethodsA retrospective analysis was conducted on CTPA scans from multiple centers. The dataset was divided into a primary internal cohort (n = 1,368) for model derivation and testing, alongside an independent external cohort (n = 98) to assess generalizability. The diagnostic efficacy of the YOLOv11 architecture was quantified using the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. Additionally, gradient-weighted class activation mapping (Grad-CAM) was applied to map the spatial distribution of the model's focus, ensuring clinical transparency.ResultsDuring internal testing, the proposed framework yielded an AUC of 0.777 [95% confidence interval (CI): 0.765–0.788], corresponding to a sensitivity of 74.53% and a specificity of 64.26%. When applied to the external cohort, the algorithm's discriminative ability remained consistent with an AUC of 0.778 (95% CI: 0.749–0.806). Notably, the external sensitivity reached 86.75% (specificity: 54.46%). Visual assessments via Grad-CAM saliency maps confirmed that the model accurately localized embolic occlusions within the complex pulmonary arterial tree.ConclusionUtilizing the YOLOv11 architecture for automated CTPA analysis yields a highly sensitive and visually interpretable screening mechanism. This artificial intelligence-assisted approach holds substantial promise for reducing missed diagnoses and accelerating patient triage in acute clinical settings.

Background:Paclitaxel-coated devices have been widely used to reduce restenosis in patients with peripheral artery disease (PAD). However, their long-term safety, particularly regarding mortality and amputation risks, remains controversial. Methods:A systematic search of PubMed, Web of Science, the Cochrane Library, and Embase was conducted to identify studies published from the inception of each database through September 2025. Randomized controlled trials (RCTs) comparing paclitaxel-coated devices with noncoated devices in patients with PAD were included with a minimum clinical follow-up duration of 24 months. Primary outcomes were all-cause mortality and limb amputation. Secondary outcomes included target lesion revascularization (TLR) and primary patency. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using fixed- or random-effects models. Heterogeneity was assessed using the I 2 statistic. Risk of bias was evaluated with the Cochrane tool. This PROSPERO-registered review (CRD420251155841) was conducted between September and December 2025. Findings:A total of 15 RCTs involving 5859 patients were included. No significant differences were observed in all-cause mortality between the paclitaxel and control groups at 1 year (RR: 1.04, 95% CI: 0.87-1.24), 2 years (RR: 1.28, 95% CI: 0.95-1.74), or 5 years (RR: 1.13, 95% CI: 0.93-1.38). Similarly, no significant differences in amputation rates were observed at 1 year (RR: 1.07, 95% CI: 0.88-1.31), 2 years (RR: 0.65, 95% CI: 0.34-1.24), or 5 years (RR: 1.03, 95% CI: 0.88-1.20). Paclitaxel-coated devices significantly reduced TLR at 1 year (RR: 0.64, 95% CI: 0.48-0.87) and 2 years (RR: 0.45, 95% CI: 0.38-0.54), but this benefit was not sustained at 5 years (RR: 0.81, 95% CI: 0.64-1.01). Primary patency at 2 years was significantly improved with paclitaxel devices (RR: 1.57, 95% CI: 1.24-1.99). Interpretation:This updated meta-analysis indicates that paclitaxel-coated devices are not associated with increased risks of all-cause mortality or major amputation for up to 5 years. Although these devices offer mid-term benefits in reducing TLR and improving patency, these advantages decrease over the long term. These findings support the continued use of paclitaxel-coated devices in selected patients with symptomatic femoropopliteal disease, while emphasizing the need for individualized decision-making and long-term clinical follow-up. Funding:None.

Background and Aim: Accurate preoperative identification of clinically significant prostate cancer (csPCa) remains challenging due to the limited specificity of prostate-specific antigen (PSA) and the experience-dependent inter-reader variability of PI-RADS scoring. Large language models (LLMs) have shown potential in medical decision support, but their comparative performance against radiologists of varying experience and their independent predictive value in csPCa diagnosis are poorly understood. Methods: This multicenter retrospective cohort study included 1,709 patients who underwent prostate biopsy across three tertiary hospitals. Four LLMs (DeepSeek-V4 Flash, GPT-5.4, Claude Opus 4.6, and Gemini 3.1 Flash) generated csPCa probabilities and PI-RADS scores from anonymized MRI reports combined with clinical variables. Three radiologists (junior, intermediate, senior) independently assigned PI-RADS v2.1 scores. Diagnostic performance was evaluated using the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, calibration metrics, and decision curve analysis. Logistic regression and incremental value analyses were performed. Subgroup analysis was conducted in the PSA gray zone (tPSA 4–10 μg/L). Results: Claude Opus 4.6 achieved the highest AUC among LLMs (0.840, 95% CI: 0.821–0.859), comparable to GPT-5.4 (0.839) and Gemini 3.1 Flash (0.835), and significantly outperformed DeepSeek-V4 Flash (0.777, P < 0.001). Claude Opus 4.6 showed similar discriminative ability to the senior radiologist (AUC 0.840 vs. 0.842, P = 0.866) and significantly outperformed junior (0.704) and intermediate (0.747) radiologists. PI-RADS agreement was fair with the senior radiologist (κ = 0.383) but slight with junior/intermediate radiologists. In multivariable analysis, adding Claude Opus 4.6 probability to clinical variables improved AUC from 0.851 to 0.867, but after including the senior radiologist’s PI-RADS score, the LLM probability provided no incremental value (ΔAUC = −0.0002, P = 0.616). In the PSA gray zone (n = 803, csPCa prevalence 27.0%), all evaluators showed decreased performance; the best LLM (Gemini 3.1 Flash, AUC = 0.755) performed comparably to intermediate radiologists but remained inferior to the senior radiologist (0.826). Conclusion: Claude Opus 4.6, GPT-5.4, and Gemini 3.1 Flash achieved diagnostic accuracy for csPCa comparable to that of a senior radiologist and significantly better than junior and intermediate radiologists. However, LLMs probability did not provide incremental predictive value beyond the senior radiologist’s PI-RADS score. In the challenging PSA gray zone, LLM performance dropped to the level of an intermediate radiologist. LLMs may serve as useful decision-support tools, especially in resource-limited settings, but are unlikely to replace expert human interpretation.

To evaluate the efficacy and safety of renal artery embolization (RAE) for the management of blunt traumatic renal hemorrhage. Patients with blunt traumatic renal hemorrhage treated with RAE across four hospitals from January 2018 to December 2024 were included in the study. Technical and clinical success rates, renal function preservation, side effects and complication were analyzed. In the 71 study patients, the technical success rate of RAE was 100

[This corrects the article DOI: 10.3389/fphar.2025.1529343.].

Locoregional therapies play a fundamental role in the treatment of patients with early and intermediate and locally advanced hepatocellular carcinomas. With encouraging recent advances in immunotherapy-based systemic therapies, locoregional therapies are being both promoted and challenged by new systemic therapy options. Combined locoregional and systemic therapies might enhance treatment outcomes compared with either option alone. This Series paper summarises the existing data on locoregional and systemic therapies for hepatocellular carcinoma, and discusses evidence from studies investigating their combination with a focus on their synergistic efficacy and safety.

Intestinal ischemia reperfusion (I/R) injury is a severe condition characterized by inflammation, oxidative stress, and compromised intestinal barrier function, which can lead to death. This study investigated the effects of paricalcitol, a synthetic vitamin D receptor (VDR) agonist, on intestinal I/R injury, focusing on the activating transcription factor 4 (ATF4)-C/EBP homologous protein (CHOP) signaling pathway and the modulation of endoplasmic reticulum stress (ERS). This study consists of both in vivo and in vitro experiments. In vivo experiment, a mouse model of intestinal I/R injury was established by clamping the superior mesenteric artery, and followed by 24 or 72 h of reperfusion. 6-week-old male C57BL/6 J mice were randomly assigned to six groups: sham, I/R 24h, I/R 72 h, and their respective paricalcitol-treated counterparts. VDR knockout mice and wild-type mice were assigned to WT, VDR-KO, WT + I/R and VDR-KO + I/R groups. The paricalcitol-treated groups received oral gavage of paricalcitol (0.3 μg/kg) once daily for 5 days before I/R. In vitro, IEC-6 cells were incubated in a microaerophilic system (5% CO2, 1% O2, 94% N2) for 6 h to induce hypoxia. The cells were then transferred to complete medium with or without paricalcitol (200 nM) and cultured under normoxic conditions for 24 h to establish the hypoxia/re-oxygenation (H/R) model and investigate the protective effects of paricalcitol on H/R-induced injury in cells. We further utilized VDR- and ATF4-silenced cells to examine how paricalcitol regulates the expression of VDR, ATF4, and CHOP. We demonstrated that protective paricalcitol treatment reduces ERS and apoptosis by activating VDR and inhibiting the ATF4-CHOP pathway, thereby alleviating intestinal I/R injury in vivo and H/R injury in vitro. Furthermore, experiments with VDR knockout mice demonstrated that the absence of VDR exacerbated I/R injury, underscoring the protective role of VDR in intestinal epithelial cells. These findings suggest that the protective effects of paricalcitol may offer a promising therapeutic strategy for managing intestinal I/R injury.

Neutrophil extracellular traps (NETs) act as a vital first line of defence against tissue damage and pathogens, playing a significant role in improving diseases such as intestinal ischemia reperfusion injury (IRI). However, we observed that after intestinal injury, intestinal bacteria and lipopolysaccharides (LPS) can enter the circulatory system, leading to a significant secondary increase in NETs production and the subsequent activation of a coagulation cascade. This phenomenon contributes to a pathological process known as the 'second strike' of NETs, which exaggerates intestinal damage and microcirculation disturbance. Selectively mitigating the detrimental effects associated with this second strike presents a promising therapeutic strategy. We developed an innovative conjugate of stroke-homing peptide (SHp) and DNase1 (SHp-DNase1) to enhance the stability of DNase in the bloodstream while selectively targeting NETs in thromboembolic events. The effects of SHp-DNase1 on blood flow, ischemia, and vascular leakage were evaluated in a mouse model using laser Doppler flowmetry and an in vivo imaging system. Levels of LPS and NETs were elevated in patients with IRI. Similarly, the expression of NETs and LPS was upregulated in mice with intestinal IRI. In vivo imaging revealed disturbances in intestinal microcirculation, accompanied by intestinal leakage, which were effectively reversed by the administration of SHp-DNase1. Almost all of the SHp-DNase1 localised to the gastrointestinal tract, demonstrating the effective targeting of DNase1 to the site of intestinal injury via SHp guidance. Furthermore, the combination of SHp-DNase1 and CRO significantly reduced the expression of ischemia-inducible factors, leading to a marked decrease in mortality in the mouse model. These findings suggest that intestinal LPS leakage correlated with NETs exacerbation plays a critical role in IRI. The combination of SHp-DNase1 and CRO is an effective treatment strategy by simultaneously controlling inflammation and addressing microcirculatory disorders induced by NETs in the therapy of IRI.

Transarterial chemoembolization (TACE) plays a critical role in the treatment of hepatocellular carcinoma (HCC), yet variability in its performance leads to inconsistent prognostic outcomes, with objective response rates (ORRs) ranging from below 10% to over 60% for intermediate HCC. Published evidence and recommendations emphasize that TACE should be executed with precise targeting and accessibility to superselective catheterization. To enhance quality control and standardize TACE procedures, the concept of "precision TACE" is introduced by an international expert panel of International Society of Multidisciplinary Interventional Oncology (ISMIO), emphasizing the inclusion of standardized angiography, superselective catheterization and embolization, appropriate selection of embolic agents, determination of optimal embolization endpoints, and evaluation for efficacy immediately post-TACE. Precision TACE is divided into superior precision TACE (SP-TACE) and moderate precision TACE (MP-TACE). SP-TACE aims at achieving complete response (CR) or close to CR for all treated intrahepatic lesions in one session, while minimizing damage to normal liver tissue as much as possible. For SP-TACE, ideal candidates are intermediate HCCs with moderate intrahepatic tumor burden (maximum diameters of lesions no more than 5 cm, possibly up to 7 cm, with less than 5 intrahepatic lesions) and early HCCs who are unable or unwilling to receive curative approaches. MP-TACE aims at achieving partial response (PR) or stable disease (SD) for treated intrahepatic lesions with one or repeated sessions of TACE. For MP-TACE, ideal candidates are intermediate HCCs with high intrahepatic tumor burden and locally-advanced HCCs (with vascular invasion). Besides, precision TACE combined with other therapies such as ablation, systemic therapies, and hepatic resection, is discussed. Lastly, a scoring system for quantifying the precision of TACE is proposed to evaluate its effectiveness.

To develop and validate a novel prediction model for venous thromboembolism (VTE) after hematoma evacuation in spontaneous intracerebral hemorrhage (sICH) patients.sICH patients who underwent hematoma evacuation from January 2022 to December 2024 were retrospectively analyzed in two tertiary hospitals. The cohort was divided into a development cohort and a validation cohort. Clinical data and laboratory test results were collected. Multivariate logistic regression was used to identify independent predictors of VTE at 30 days after surgery and Nomogram was constructed. The model performance was tested with the validation cohort and assessed using the C-index, calibration curve, Hosmer-Lemeshow test, decision curve analysis (DCA), and clinical impact curve (CIC).A total of 456 patients were enrolled in the study, 346 of whom were used in the training cohort and 110 in the validation cohort. The C-index and Brier score of the nomogram in the training set were 0.902 and 0.072, respectively, and the correction values after internal verification were 0.805 and 0.026, respectively. The calibration curve showed favorable consistency between the prediction of the nomogram and actual observations in both the training and validation cohorts. In addition, DCA and CIC confirmed the clinical utility of the nomogram constructed to predict postoperative VTE in sICH patients.This first surgery-specific nomogram integrates five perioperative variables to accurately predict VTE risk post-evacuation in sICH patients. It enables early targeted prophylaxis, potentially reducing preventable morbidity.

Hemoptysis is defined as bleeding originating from the respiratory tract distal to the larynx and is associated with a wide spectrum of underlying conditions,including bronchiectasis,pulmonary malignancies,tuberculosis,aspergillosis,and vascular malformations.[1-3]A meta-analysis involving patients with massive hemoptysis reported a mortality rate of 3.5％.[4]This underscores the critical importance of prompt and effective embolization of the responsible artery to improve outcomes,particularly in patients presenting with life-threatening hemoptysis.

OBJECTIVE:Acute aortic dissection (AD) is a life threatening condition that poses considerable challenges for timely diagnosis. Non-contrast computed tomography (CT) is frequently used to diagnose AD in certain clinical settings, but its diagnostic accuracy can vary among radiologists. This study aimed to develop and validate an interpretable You only look once version 8 (YOLOv8) deep learning model based on non-contrast CT to detect AD. METHODS:This retrospective study included patients from five institutions, divided into training, internal validation, and external validation cohorts. The YOLOv8 deep learning model was trained on annotated non-contrast CT images. Its performance was evaluated using area under the curve (AUC), sensitivity, specificity, and inference time compared with findings from vascular interventional radiologists, general radiologists, and radiology residents. In addition, gradient weighted class activation mapping (Grad-CAM) saliency map analysis was performed. RESULTS:A total of 1 138 CT scans were assessed (569 with AD, 569 controls). The YOLOv8s submodel achieved an AUC of 0.964 (95% confidence interval [CI] 0.939 - 0.988) in the internal validation cohort and 0.970 (95% CI 0.946 - 0.990) in the external validation cohort. In the external validation cohort, the performance of the three groups of radiologists in detecting AD was inferior to that of the YOLOv8s model. The model's sensitivity (0.976) was slightly higher than that of vascular interventional specialists (0.965; p = .18), and its specificity (0.935) was superior to that of general radiologists (0.835; p < .001). The model's inference time was 3.47 seconds, statistically significantly shorter than the radiologists' mean interpretation time of 25.32 seconds (p < .001). Grad-CAM analysis confirmed that the model focused on anatomically and clinically relevant regions, supporting its interpretability. CONCLUSION:The YOLOv8s deep learning model reliably detected AD on non-contrast CT and outperformed radiologists, particularly in time efficiency and diagnostic accuracy. Its implementation could enhance AD screening in specific settings, support clinical decision making, and improve diagnostic quality.

OBJECTIVE:The goal of this study was to evaluate the incidence, predictors, and clinical outcomes of thrombus propagation in patients with isolated calf muscle venous thrombosis (CMVT). METHODS:This retrospective observational study included all consecutive hospitalized patients who were diagnosed with isolated CMVT between January 1, 2022, and August 1, 2024. Data on demographics, comorbidities, laboratory biomarkers, and management strategies were collected. The primary end point was the incidence of thrombus propagation (defined as either a previously localized thrombi within the muscular calf veins that was found to extend to the axis calf veins or proximal veins of the ipsilateral extremity or as a thrombus that had clearly extended but remained confined to the muscular calf veins) during follow-up. Secondary end points included the incidence of venous thromboembolism (VTE) recurrence (defined as the formation of a new thrombus [ipsilateral or contralateral deep vein thrombosis or pulmonary embolism] confirmed by imaging during follow-up after complete resolution of the original CMVT), bleeding events, rehospitalization, and death. RESULTS:Among the 459 patients included in this study, the incidence of CMVT propagation was 8.7% (n = 40). Independent predictors of thrombus propagation were immobilization (odds ratio [OR]; 3.06 [95% confidence interval, 1.04-8.99]; P = .042), history of VTE (OR, 4.31 [95% CI, 1.42-13.05]; P = .010), and elevated D-dimer level (OR, 1.06 [95% CI, 1.02-1.09]; P = .003). The mean time to propagation was 9.3 ± 5.2 days. VTE recurrence rates were 2.5% (n = 1) in patients with propagation and 1.7% (n = 7) in patients without propagation (P = .702). Major bleeding events occurred in 5.0% of patients (n = 2) with propagation and in 3.1% of patients (n = 13) without propagation (P = .519). During the follow-up period, no patients were rehospitalized or died owing to VTE events. CONCLUSIONS:Thrombus propagation in patients with isolated CMVT is uncommon and generally not fatal. Predictors of CMVT propagation include immobilization, history of VTE, and elevated D-dimer level. These findings may help to identify patients with a significant risk of CMVT propagation.

To assess the clinical presentation of aortic penetration by inferior vena cava (IVC) filters, as well as common management strategies and clinical outcomes. A systematic search of the literature was conducted to identify studies pertaining to aortic penetration by IVC filters published between January 1967 and April 2025. A total of 35 reports regarding aortic penetration by IVC filters were identified, including a total of 53 patients and 11 types of IVC filters. The median time from filter placement to the diagnosis of aortic penetration was 5.0 years (interquartile range: 1.7, 8.0 years). Of the 53 patients, 28 (52.8

Background: To identify risk factors for loss to follow-up after inferior vena cava (IVC) filter placement in inpatients of other departments (IODs) and to determine whether a quality improvement project launched at our institution in April 2022 improved follow-up and filter retrieval rates in these patients. Methods: Consecutive patients who underwent retrievable filter placement at our institution between March 2021 and March 2023 were included in this study. Patients were divided into preimprovement (before April 2022; n = 81) and postimprovement (after April 2022; n = 77) groups. Risk factors for loss to follow-up were assessed in the preimprovement group, and filter retrieval rates were compared between groups. Results: Acute cerebral hemorrhage (OR = 5.745; 95% CI: 1.471-22.434) and lack of requirement for follow-up by the referring department (OR = 3.435; 95% CI: 1.035-11.398) were identified as independent risk factors for loss to follow-up. The filter retrieval rate was higher in the postimprovement group (94.8%) than in the preimprovement group (69.1%; P < 0.001). The rate of loss to follow-up was lower in the postimprovement group (5.2%) than in the preimprovement group (30.9%; P < 0.001). The preimprovement group had a higher incidence of IVC perforation (9.6%) than the postimprovement group (0; P = 0.019) at the time of filter retrieval. Conclusion: Acute cerebral hemorrhage and lack of requirement for follow-up by the referring department are independent risk factors for loss to follow-up among IODs. The quality improvement project at our institution improved follow-up and IVC filter retrieval rates in IODs.

Background: The prevention and management of venous thromboembolism (VTE) represent crucial issues within healthcare, as they are linked to patient safety and quality of care. As such, healthcare workers are expected to demonstrate certain levels of knowledge, attitudes, and practices (KAP) regarding VTE. This study evaluated the efficacy of an existing 5-year blended interprofessional education program (BIEP) designed to improve KAP regarding VTE at a university-affiliated hospital. Objective: To evaluate the BIEP's effectiveness on enhancing KAP regarding VTE prevention and management. Methods: This single-center observational study was designed to assess changes in KAP regarding VTE before and after the implementation of a BIEP. These changes were evaluated via an expert-developed electronic questionnaire distributed to healthcare workers participating in the BIEP. Knowledge items were assessed in terms of accuracy, whereas attitude and practice items were assessed using a 5-point Likert scale, with higher scores indicating improvements in attitudes and practices. Results: Of 1817 questionnaires distributed, a total of 1145 healthcare workers completed the pre-training and post-training surveys. The average accuracy rate for knowledge-based questions increased from 36.9% before training to 50.4% after training (P < 0.001). Attitude scores improved modestly (from 18.68 +/- 5.76 to 19.41 +/- 4.97; P = 0.011), as did practice scores (from 19.86 +/- 3.88 to 20.37 +/- 3.89; P = 0.003). Conclusions: The BIEP improved the KAP of healthcare workers regarding VTE. These findings emphasize the importance of continuous education in enhancing the quality of VTE management and provide a scientific basis for future educational interventions.

Background: False lumen changes (FLCs) are the main reference for the prognosis judgment and treatment plan selection for type IIa superior mesenteric artery dissection (SMAD). Methods: For this retrospective study, 55 patients with symptomatic type IIa SMAD were included. Computational fluid dynamics (CFD) analysis was used to explore the hemodynamic basis of FLCs. Correlation and multiple linear regression analyses were performed to identify clinical, morphological and hemodynamic factors associated with FLCs. Results: The FLCs of patients with successful conservative treatment ( n = 29) are significantly higher than those with failed conservative treatment ( n = 26) (58.5 ± 21.1% vs 10.9 ± 17.4%, p < 0.0001). Positive correlations were seen between FLCs and the morphological parameters false lumen length (FLL)/dissection entrance length (DEL) and FLL. In terms of hemodynamic parameters, negative correlations were seen between FLCs and time-averaged wall shear stress (TAWSS), vorticity, and high areas of TAWSS and vorticity, whereas positive correlations were seen between FLCs and oscillatory shear index (OSI), relative residence time (RRT), and high areas of OSI and RRT. Multiple linear regression analysis identified symptom duration (odds ratio [OR], 0.93; 95% CI, 0.91–0.96; p < 0.0001), FLL/DEL (OR, 1.30; 95% CI, 1.01–1.67; p = 0.044), and high RRT area (OR, 2.03; 95% CI, 1.48–2.78; p < 0.0001) as predictors of FLCs. Conclusion: The clinical predictor symptom duration, morphological factor FLL/DEL, and the hemodynamic factor high RRT area can serve as predictors of FLCs in patients with symptomatic type IIa SMAD.