High-density lipoprotein (HDL) from healthy subjects (HDLhealthy) has anti-inflammatory effects, whereas HDL from patients with coronary artery disease (HDLCAD) is functionally impaired, which may affect atherosclerosis formation differently. We previously demonstrated that HDLhealthy inhibits the expression of the long noncoding RNA high-density lipoprotein-regulated angiogenesis in coronary artery disease (HDRACA), whereas HDLCAD is much less effective. HDRACA is highly expressed in endothelial cells (ECs) of arteriosclerosis obliterans and is associated with the expression of adhesion molecules and chemokines. However, whether HDLhealthy and HDLCAD affect vascular inflammation and atherosclerosis by regulating HDRACA expression remains unclear. Here, we found that HDLhealthy suppressed HDRACA expression in ECs, thereby inhibiting endothelial chemotactic and adhesive effects, whereas HDLCAD had less of an effect. Mechanistically, HDRACA bound to heat shock protein β-1 (HSPB1), an anti-inflammatory protein that underwent liquid-liquid phase separation (LLPS) mediated by its N-terminal domain (NTD) and C-terminal domain (CTD). Overexpression of HDRACA promoted LLPS of HSPB1, inhibited HSPB1-IKKβ interaction, and activated the NF-ĸB pathway, leading to increased expression of adhesion molecules and chemokines. HDLhealthy enhanced the phosphorylation of serine residues 15, 78, and 82 in the NTD of HSPB1 to inhibit its LLPS by suppressing HDRACA expression, whereas HDLCAD was less effective. Delivering HDRACA into mouse aortic ECs also promoted LLPS of HSPB1, leading to enhanced vascular inflammation and accelerated atherosclerosis formation in low-density lipoprotein receptor null mice. Our findings identified HDRACA-induced LLPS of HSPB1 as a novel mechanism linking HDL dysfunction and atherosclerosis development. HDLhealthy suppressed HDRACA-induced LLPS of HSPB1 to inhibit vascular inflammation and exerted anti-atherosclerotic effects, whereas HDLCAD lost its protective role because of its inefficacy in HDRACA inhibition. These findings suggest that improving HDL function, inhibiting HDRACA, and blocking LLPS of HSPB1 may represent promising therapeutic strategies for atherosclerosis.

BACKGROUND:To systematically evaluate the overall clinical outcomes of endovascular treatment in patients with peripheral artery disease (PAD) presenting with moderate-to-severe calcification of the femoropopliteal artery, and to descriptively summarize reported outcomes across different endovascular treatment strategies. METHODS:A systematic search was conducted in PubMed, Scopus, Embase, the Cochrane Central Register, and Web of Science Core Collection from database inception to July 2026 to identify studies related to endovascular treatment in patients with moderate-to-severe calcified PAD of the femoropopliteal artery. The primary outcome measures included the 12-month primary patency rate and freedom from clinically driven target lesion revascularization (f-CD-TLR). RESULTS:A total of 13 studies were finally included. The overall analysis showed that the pooled effect size of the 12-month primary patency rate after endovascular treatment was 83.8%, and the pooled effect size of f-CD-TLR was 90.7%. Sensitivity analysis confirmed the high stability of the conclusions. Subgroup analyses, stratified by treatment strategy and presented in a neutral technology-based order, showed the following descriptive estimates: stent-based strategies (primary patency: 83.0%; f-CD-TLR: 87.12%), atherectomy-based strategies (86.66% and 96.58%), and intravascular lithotripsy-based strategies (82.75% and 89.2%). These subgroup estimates should be interpreted descriptively and should not be considered comparative rankings or evidence of superiority of one treatment strategy over another. No significant publication bias was detected; however, the reliability of these assessments may be limited in subgroups with a small number of studies. CONCLUSION:Endovascular treatment can achieve acceptable short-term outcomes in patients with moderate-to-severe calcified femoropopliteal artery disease. Descriptive subgroup analyses demonstrated variation in reported outcomes across treatment strategies. Given the limited availability of head-to-head comparisons, further high-quality comparative studies between different devices are warranted to better define their relative efficacy.

In the endovascular treatment of femoropopliteal peripheral arterial disease (PAD), bare metal stents (BMS) are frequently employed as a bailout option. However, in-stent restenosis (ISR) and subsequent reintervention remain a challenge. With the increasing adoption of drug-eluting devices, drug-coated balloons (DCBs) have garnered much attention as an adjunctive strategy. This study aims to evaluate whether the addition of DCBs to bailout stenting improves clinical outcomes. Patients who underwent endovascular procedures with bailout stenting for femoropopliteal artery (FPA) lesions from January 2019 to September 2023 were retrospectively investigated. The primary endpoints were freedom from clinically driven target lesion revascularization (CD-TLR) and survival rates. Inverse probability of treatment weighting (IPTW) was employed to balance the baseline characteristics, thereby ensuring comparability between the two groups. The study cohort included 148 consecutive patients with FPA lesions requiring bailout stenting after plain old balloon angioplasty (POBA). Among them, 118 patients received POBA followed by BMS (POBA + BMS group), and 30 patients received POBA and DCB prior to BMS (POBA + DCB + BMS group). At 1-year follow-up, the POBA + DCB + BMS group demonstrated a significantly higher freedom from CD-TLR (log-rank P = 0.03) compared to the POBA + BMS group, with fewer events (2 vs. 29). However, IPTW-adjusted Cox analysis showed a non-significant trend toward reduced CD-TLR risk (HR 0.43, 95

Background 2-Methoxybenzoic acid (2MOA) is a natural compound with potential salicylate-like effects; however, its impact on arterial thrombosis remains unclear. Objectives This study aimed to investigate the effects of 2MOA on thrombogenesis and its underlying mechanisms. Methods FeCl3-induced carotid artery injury and laser-induced cremaster artery injury thrombosis assays were used to explore the effect of 2MOA on thrombogenesis in vivo. Various ex vivo platelet function assays were conducted to evaluate the impacts of 2MOA on platelet activity. In addition, untargeted metabolomics analysis was performed to identify the alterations in intraplatelet metabolites following 2MOA treatment. Results We found that 2MOA significantly ameliorated thrombosis in a dose-dependent manner, without affecting the normal hemostasis in C57BL/6J mice. 2MOA suppressed platelet reactivity as indicated by decreased spreading, retraction, and aggregation in both mouse and human platelets. Metabolomics analysis revealed significantly alterations in purine metabolism following 2MOA treatment, which increased cyclic guanosine monophosphate production in platelets. Mechanistically, 2MOA inhibited the activity of carbonic anhydrase, leading to elevated intraplatelet cGMP level, and subsequent suppression of cytosolic phospholipase A2 phosphorylation. Conclusion Our study illustrates that 2MOA efficaciously inhibits platelet reactivity and alleviates thrombogenesis via suppressing carbonic anhydrase activity, which should be a promising reagent in the prevention and treatment of arterial thrombotic events.

BACKGROUND:Aortic arch pathologies are complex to treat. Alternatives include open surgery, hybrid surgery (endovascular aortic stent-grafting and open surgical debranching procedures) and total endovascular solutions with branched stent-grafts. Branched stent-grafts are the mainstream approach for endovascular repair, but they are primarily available only as dedicated custom-made devices. The aim of this study was to evaluate the safety and effectiveness of a non-customized modular aortic arch stent-graft. METHOD:This trial was led by the Chinese PLA General Hospital and 16 additional aortic centres in China. All included patients were treated with a non-customized modular inner branched stent-graft (Endonom Medtech, Hangzhou, China). The study endpoints were 30-day death and stroke, technical success, clinical success, early and late complications, reintervention, and death during follow-up. Follow-up via clinical examination and CT angiography scan were scheduled post surgery at 1, 6, and 12 months, and annually thereafter. RESULTS:From June 2021 to December 2024, a total of 88 patients were enrolled in this study. Technical success rate was 100%. The mean follow-up was 28.6 ± 11.7 months. The overall 30-day mortality rate was 3%, and the 30-day stroke rate was 9%. Overall survival was 91% ± 3%, 86% ± 4%, and 81% ± 4% at 12, 24, and 36 months respectively. A total of 10 patients developed endoleaks, none of which required reintervention. CONCLUSION:Modular branched stent-graft repair for aortic arch disease is feasible and with comparative rates of safety with custom made branched endovascular stent-grafts, hybrid techniques and open surgery. Long-term comparative effectiveness studies are required to establish whether it is superior to alternative interventions.

BACKGROUND:Traditional percutaneous transluminal angioplasty is insufficient for treating lower limb arterial disease. More evidence is needed to support the short-term safety and efficacy of chocolate balloon. METHODS:Retrospective study was conducted on 113 consecutive cases treated with chocolate balloon catheter for lower limb arterial disease between September 2020 and September 2022. Primary end point is primary patency (PP) at 30 days and 12 months. Secondary end points are secondary patency, freedom from clinically-driven target lesion revascularization (CD-TLR), major target limb amputation, all-cause mortality at 30 days and 12 months. RESULTS:A total of 110 patients and 113 limbs were treated. PP was 77.8% and freedom from CD-TLR was 87.0% at 12 months. Drug-coated balloon (P = 0.014) and poor tibial vessel outflow (P = 0.032) can affect the results. Rutherford clinical category showed significant improvement between baseline and 12 months (P < 0.001). CONCLUSION:Chocolate balloon is safe and effective in treating lower limb arterial stenosis or occlusion, with results consistent with expectations in the early stages and after 12 months of treatment.

Abstract Objective To evaluate the safety and efficacy of chocolate balloons in patients with chronic limb-threatening ischemia (CLTI) and infrapopliteal artery disease, and compare them with conventional balloons. Methods This single-center retrospective study included 167 patients with CLTI and infrapopliteal who underwent endovascular intervention with or without chocolate balloons from September 1, 2019 to June 30, 2023. The primary endpoint was amputation-free survival (AFS). Secondary endpoints included major amputation, the absence of clinically driven target lesion revascularization (CD-TLR), the incidence of flow-limiting dissection, below-the-knee (BTK) stent implantation, change in Rutherford clinical grade, procedural success, and major adverse cardiovascular events (MACEs). Patients were followed at 30 days, 6 months, and 12 months to assess symptom improvement, vascular patency as determined by dual-function ultrasound or angiography, and survival. Results At 12 months, AFS was noted in 78.1% of patients in chocolate balloon group and 70.7% of those in conventional balloon group (p = 0.37). The chocolate balloon group demonstrated a significantly higher rate of CD-TLR absence, with 84.0% compared to 69.4% in the conventional balloon group (p = 0.04). The chocolate balloon group had a major amputation-free rate of 92.8%, slightly better than the 89.5% in the conventional balloon group (p = 0.58). Notably, the chocolate balloon group significantly reduced flow-limiting dissection (p = 0.02) and BTK stent implantation (p = 0.03) compared to the conventional balloon group. Conclusion Chocolate balloon reduces the incidence of flow-limiting dissection and BTK stent implantation in patients with CLTI and infrapopliteal. Compared with conventional balloons, there was less lesion revascularization at 12 months, but no significant benefit was found in improving ASF and reducing major amputation of the affected limb.

BACKGROUND:To compare the midterm clinical outcomes of endovascular repair (ER) versus open surgical repair (OR), including different conduits used to treat popliteal artery aneurysms (PAAs) and popliteal artery pseudoaneurysms (PAPAs) in a single medical center. METHODS:The clinical data of PAAs and PAPAs from a single medical center were collected between January 2003 and September 2020. The outcomes of the patients treated with OR or ER were retrospectively reviewed. Notably, 26 PAAs and PAPAs with computed tomographic angiography images were grouped as Ⅰ-Ⅲ based on the anatomical segments of the involved popliteal artery. RESULTS:Overall, 42 patients with 42 limbs (19 PAAs and 23 PAPAs) were included. Notably, 35 patients underwent OR and seven patients underwent ER. OR was associated with an increased operative time (OR: 265; interquartile range: 160 min vs ER: 90; interquartile range: 70 min, P = 0.003) and postoperative length of stay (OR: 14.1 ± 9.3 days vs ER: 5.3 ± 4.2 days; P = 0.001). OR demonstrated a better primary patency rate (OR: 64.2% vs ER: 21.4%; P < 0.05), but a similar secondary patency rate (OR: 64.0% vs ER: 71.4%; P > 0.05) compared with ER at 3 years. Among 26 patients with computed tomographic angiography, four patients were classified as group I, 10 patients as group II, and 12 patients as group III. In group I (P = 1.000) and group II (P = 0.524), ER showed an equivalent primary patency to OR. In group III, which includes lesions involving P3 popliteal segments, ER has a higher incidence of restenosis than OR with prosthetic grafts and great saphenous vein grafts (P = 0.01). There is a trend showing that the saphenous vein graft has better patency compared with prosthesis graft (saphenous vein graft: 100% vs prosthesis graft: 75%). CONCLUSION:There is similar midterm secondary patency between the ER and OR methods despite more frequent reinterventions in ER. However, for popliteal aneurysms involving the below-knee segment, ER demonstrates poorer patency compared with OR.

BACKGROUND:The use of off-the-shelf multi-branched endografts for thoracoabdominal aortic aneurysm (TAAA) is increasing; however, these commercially available devices have limited anatomical feasibility for treating TAAA. This study aimed to assess the safety and efficacy of a novel G-branch off-the-shelf endograft for TAAA. MATERIALS AND METHODS:A total of 73 patients with TAAA were treated using the G-branch endograft at 14 sites across China. The primary endpoints were the 30-day technical success and major adverse events rates. The secondary endpoints were all-cause mortality, secondary intervention, endoleaks, target vessel patency, and freedom from renal function deterioration during a 1-year follow-up. RESULTS:The technical success rate was 95.9% (70/73). Renovisceral artery reconstruction was successful in 99.7% (291/292) of patients. Within 30 days, six patients (8.2%) experienced major adverse events, namely paraplegia (n = 2), acute kidney injury (n = 2), acute myocardial infarction (n = 1), and cerebral infarction (n = 1). During the 1-year follow-up, one patient died from aortic dissection, giving an overall survival rate of 98.6%. Four patients (5.5%) underwent secondary interventions, giving a freedom from secondary intervention rate of 92.8%. Endoleaks occurred in 12 patients (10 type II, 2 type III). The primary patency rate of the target vessels was 95.7%, and three bridged stent grafts were successfully recanalized, resulting in a secondary patency rate of 96.7%. Renal function deterioration occurred in six patients (8.2%), giving a freedom from renal function deterioration rate of 94.6%. CONCLUSIONS:The off-the-shelf G-Branch endograft appears safe, with favorable 30-day and 1-year mortality and morbidity rates for both elective and urgent TAAA treatment.

Objective: For abdominal aortic disease with complex anatomical features or renal insufficiency, endovascular aneurysm repair (EVAR) may not always be an appropriate option. The combination of open surgical repair (OSR) with renal autotransplantation (RAT) has demonstrated a promising efficacy, albeit with limited reported cases. This study presents our experience with RAT in conjunction with traditional OSR or EVAR for managing complex abdominal aortic disease. Methods: A retrospective review was conducted on 10 patients with complex abdominal aortic disease, mainly juxtarenal abdominal aortic aneurysm, who underwent RAT between 2012 and 2022 in our center. Data including demographic, clinical, imaging, and surgical details were collected and assessed meticulously. Results: The average age of the patients was 59.5 +/- 21.8 years. Among them, six patients were diagnosed with juxtarenal abdominal aortic aneurysm, two with endoleak after EVAR, one with aortitis, and one with aortic intimal sarcoma. Eight patients underwent OSR combined with RAT, and two underwent endovascular repair in conjunction with RAT. One patient required temporary hemodialysis postoperatively. The mean serum creatinine and blood urea nitrogen at discharge were 123.2 +/- 72.6 mmol/L and 8.67 +/- 10.14 mmol/L, respectively, showing no significant variance from the preoperative levels (P = .19 and P = .52). One patient died perioperatively owing to cerebral hemorrhage, and another was lost to follow-up after discharge. Follow-up computed tomography angiography confirmed excellent patency of arterial reconstruction in eight patients, without persistent renal impairment. Conclusions: OSR or EVAR combined with RAT represents a potentially feasible and effective treatment approach for complex abdominal aortic disease. (JVS-Vascular Insights 2025;3:100206.)

Background: The radial artery deviation and reimplantation (RADAR) technique uses an artery-to-vein (end-to-side) configuration. We have developed a modified RADAR (M-RADAR) technique. This new technique enables a side-to-side anastomosis between the vessels, and furthermore, the distal cephalic vein is ligated. The VAC Study (Paradigm Shift in Vascular Access Creation) is a multicenter randomized controlled trial comparing the clinical outcomes of radiocephalic fistula created using the conventional technique (CT group) versus the modified RADAR method (M-RADAR group).Methods: Prospective, multicenter, randomized study starting in December 2024. Participant recruitment has commenced. All data are collected via paper-based Case Report Forms (CRFs). The primary clinical endpoints include the 1-year primary patency rate of AVF and the incidence of venous juxta-anastomotic stenosis. Secondary endpoints include the 1-year access-assisted primary patency, access cumulative patency, hospitalization rates, mortality, and an analysis of the economic costs associated with maintaining vascular access. An estimated 408 participants will be recruited from approximately 29 dialysis units across China.Discussion: A high-quality, adequately powered multicenter randomized controlled trial (RCT) is still needed to provide clear guidance for clinicians on selecting optimal treatment strategies for the cephalic vein during AVF surgery.Trial registration: Registration number: ChiCTR2400093537, Registered on 2024-12-06.

BACKGROUND:The value of color doppler ultrasound (CDU) for perioperative evaluation and follow-up outcomes of carotid body tumor (CBT) remains elusive. This study aimed to investigate the role of CDU in CBT in our center. METHODS:From January 2015 to December 2020, 75, patients with CBT were included in the study. Computed tomography angiography (CTA) and CDU data of patients were collected and analyzed. The postoperative recovery and follow-up outcomes were summarized. RESULTS:A total of 91 CBTs in 75 patients were included in the study. 73.3% of the patients had unilateral lesions, while 26.7% had bilateral lesions. Lesions were categorized as Shamblin I (4.4%), Shamblin II (52.7%), and Shamblin III (42.9%). 79.5% lesions were treated by surgical resection, 12.3% were treated by surgical resection with internal carotid artery reconstructed by artificial vessel, while 8.2% were treated by surgical resection with internal carotid artery reconstructed by autogenous great saphenous vein. Compared with CTA, the sensitivity of CDU for the detection of CBT was 96.7%, the sensitivity and specificity of CDU for the detection of Shamblin I lesions were both 100%, the sensitivity and specificity for Shamblin II were 100% and 72.1%, respectively, while the sensitivity and specificity for Shamblin III were 69.2% and 100%, respectively. There were no statistically significant differences between CTA and CDU for the detection of the maximal diameter, volume of CBT, distance between the end of the tumor, and the mastoid process. 79.7% of the patients were followed up with CDU. The eecurrence of CBT occurred in 1 patient. CDU showed that stenosis and occlusion of artificial vessel occurred in 1 and 6 patients, respectively. The occlusion of autogenous great saphenous vein was found in 2 cases. CONCLUSIONS:CDU can accurately diagnose Shamblin I CBT, have high sensitivity for Shamblin II, and high specificity for Shamblin III CBT. It plays an important role in diagnosis, perioperative evaluation, and follow-up analysis of CBT.

BACKGROUND:This study was performed to evaluate the early outcomes of the WeFlow-JAAA off-the-shelf (OTS) endograft system for the treatment of juxtarenal and pararenal abdominal aortic aneurysms (JR/PR-AAAs). METHODS:We conducted a prospective, multicenter study involving 115 patients diagnosed with JR/PR-AAAs. The inclusion criteria were a distance of ≥4 mm from the inferior edge of the superior mesenteric artery (SMA) to the aneurysm and a proximal landing zone angulation of <60°. All participants underwent endovascular repair using the WeFlow-JAAA system. The primary end points were clinical success and major adverse events (MAEs) within 30 days postprocedure. The secondary end points were all-cause mortality, secondary interventions, endoleaks, target vessel patency, and preservation of renal function during the first 30 days. RESULTS:The patients' mean age was 69.1 years, and 94.8% were male. The average maximum aneurysm diameter was 62.7 mm. The mean proximal neck length below the SMA was 20.3 ± 8.3 mm (range: 5-50 mm). Technical success was achieved in 99.1% of patients, with a target vessel patency rate of 99.4% within 30 days. One patient (0.9%) developed an early type I endoleak. MAEs occurred in 3.5% of patients, including 1 all-cause death due to cardiac arrest and three cases of minor ischemic stroke, all of which resolved. No significant aneurysm growth or stent migration was observed. CONCLUSION:The WeFlow-JAAA OTS endograft system demonstrated high technical success and low complication rates in the early treatment of JR/PR-AAAs. The occurrence of type II endoleaks and minor adverse events highlights areas for improvement. Future studies should focus on reducing type II endoleak risk and assessing long-term durability.

OBJECTIVE:The optimal treatment for retrograde ascending aortic dissection (rAAD) remains unclear. In this study, the long term clinical outcomes of endovascular treatment for rAAD were investigated retrospectively, and haemodynamic remodelling of the ascending aorta was analysed. METHODS:This retrospective, single centre study analysed clinical data of rAAD cases treated endovascularly from 2001 - 2020. Endpoints included aortic related death and re-intervention. Computational fluid dynamics (CFD) models were established to compare haemodynamic changes after endovascular repair. RESULTS:A total of 85 patients with rAAD (mean age 52.8 ± 11.4 years, range 29.0 - 79.0 years) underwent thoracic endovascular aortic repair (TEVAR). Technical success was achieved in 73 patients (86%). In hospital death occurred in one patient (1%). During the 75 month median follow up (interquartile range 54, 101 months), all cause mortality was 7% (6/84, including two aortic related deaths). Overall survival rates for one, five, and ten years were 98.8%, 92.7%, and 88.6%, respectively. Sixteen aortic related adverse events were observed in 15 patients during follow up, including two proximal stent graft induced new entries (SINEs), two distal SINEs, and 12 primary endoleaks into the false lumen. Secondary endoleak was not observed. The free from aortic related event rates for one, five, and ten years were 77.3%, 74.3%, and 71.5%, respectively. Complete thrombosis or disappearance of the false lumen in the ascending aorta was observed in all cases. The true lumen diameter of the ascending aorta increased statistically significantly from 31.8 ± 5.2 mm (range 15.8 - 40.8 mm) to 35.4 ± 3.5 mm (range 28.3 - 44.0 mm) (p < .001) at the last follow up. CFD analysis showed that the median wall shear stress in the ascending aorta statistically significantly decreased from 16.4 Pa to 12.4 Pa (p = .006). CONCLUSION:Encouraging short and long term outcomes were demonstrated using TEVAR for rAAD, suggesting that it may represent a treatment alternative to open repair in selected cases.

Foam cell formation has traditionally been attributed to macrophages; however, emerging evidence highlights vascular smooth muscle cells (VSMCs) as another significant contributor. Here, we found that TMEM41B is significantly upregulated in VSMCs of both human atherosclerotic (AS) lesions and murine models. Silencing TMEM41B in VSMCs of apolipoprotein E-deficient (ApoE-/-) mice markedly reduced plaque size and macrophage infiltration. Overexpressing TMEM41B in cultured VSMCs altered intracellular lipid profiles by stabilizing fatty acid synthase (FASN), a crucial enzyme in fatty acid synthesis, via inhibiting its ubiquitination and degradation. The TMEM41B-FASN axis drove lipid synthesis, promoted intracellular lipid storage, and facilitated the release of pro-inflammatory cytokines. Further, in cultured VSMCs, herpes simplex virus (HSV) infection amplified TMEM41B expression via OCT-1-mediated transcriptional activation, linking viral infection to lipid metabolic reprogramming in vitro. These findings expand the current understanding of VSMC-derived foam cell formation and suggest that targeting the TMEM41B-FASN axis may represent a promising therapeutic strategy for AS, particularly in the context of HSV infection.

OBJECTIVES:This study aimed to assess the midterm outcomes of a novel embedded modular single-branched stent-graft (EMSBSG) designed to preserve the left subclavian artery (LSA) of type B aortic dissection (TBAD). METHODS:From December 2020 to November 2021, a total of 120 patients with TBAD treated with an EMSBSG were enrolled in a multicenter prospective clinical trial at 18 Chinese tertiary hospitals. Follow-up computed tomography angiography scanning was conducted at 1, 6, and 12 months postprocedure. RESULTS:The technical success rate was 99.17% (n = 119/120), with only 1 technical failure attributed to aortic intimo-intimal intussusception. The 30-day mortality rate was 0.83% (n = 1). Thirty-day major complications included 2 cases (1.67%) of retrograde type A aortic dissection (RTAD), 3 cases (2.50%) of stroke, and 6 cases (5.22%) of Type Ia endoleaks. The median follow-up time was 12.84 (range, 11-16) months. The 1-year mortality rate was 4.17% (n = 5/120), and the follow-up patency rate of the branch section was 99.09% (n = 109/110). The overall 12-month reintervention rate was 4.17% (n = 5), including 3 RTAD cases, 2 Type I endoleaks, and 1 stent-induced new entry. CONCLUSION:For patients with TBAD involving the LSA, the midterm outcomes are encouraging for EMSBSG as a relatively safe, effective, and noncustomized endovascular option. However, long-term outcomes warrant attention and further investigation.Clinical ImpactThe midterm outcomes indicate that EMSBSG offers a safe, and effective endovascular option for preserving the LSA in patients with TBAD. The EMSBSG achieves LSA preservation through a non-customized endovascular solution, making it particularly suitable for emergency procedures. The core innovation of EMSBSG lies in its flexible, modular Embedded design, which adapts to the anatomical characteristics of TBAD in patients.

Aims: Abnormal migration and proliferation of vascular smooth muscle cells (VSMCs) are considered early events in the onset of thoracic aortic dissection (TAD). Endogenous sulfur dioxide (SO2), primarily produced by aspartate aminotransferase (AAT1) in mammals, has been reported to inhibit the migration and proliferation of VSMCs. However, the role of SO2 in the development of TAD remains unclear. Results: Endogenous SO2 production was decreased in aortic samples from patients with TAD. Supplementation with SO2 ameliorated β-aminopropionitrile-induced vascular injury in mice. Increasing the expression of SO2 pathway might reverse the abnormal migration, proliferation, and phenotypic switching in VSMCs. MicroRNA sequencing revealed miR-184-3p as the miRNA with the most significant increased expression level after AAT1 knockdown, and Cyp26b1 was predicted to be its potential target. A decrease in the SO2 pathway resulted in reduced Cyp26b1 expression, impairing VSMCs function, while restoring Cyp26b1 expression with miR-184-3p inhibitors could improve the VSMCs function. Innovation: This research extends the application of endogenous SO2 to the aortic diseases and elucidates the role of miRNA in endogenous SO2 regulatory network, highlighting its potential as a target for clinical practice. Conclusion: Endogenous SO2 inhibits the migration and proliferation of VSMCs in TAD progression via the miR-184-3p/Cyp26b1 axis. Antioxid. Redox Signal. 42, 672-686.

Background: Restenosis (RS) poses a significant concern, leading to recurrent ischemia and the potential for amputation following intraluminal angioplasty in the treatment of Peripheral Artery Disease (PAD). Through microRNA microarray analysis, the study detected a significant downregulation of miR-199a-5p within arterial smooth muscle cells (ASMCs) associated with RS. Objective: This research aims to explore the possible function and the underlying mechanisms of miR-199a-5p in the context of RS. Methods: Primary ASMCs were extracted from the femoral arteries of both healthy individuals and patients with PAD or RS. The expression levels of miR-199a-5p were assessed using both qRT-PCR and in situ hybridization techniques. To examine the impacts of miR-199a-5p, a series of experiments were performed, including flow cytometry, TUNEL assay, EdU assay, CCK8 assay, Transwell assay, and wound closure assay. A rat carotid balloon injury model was employed to elucidate the mechanism through which miR-199a-5p mitigated neointimal hyperplasia. Results: MiR-199a-5p exhibited downregulation in RS patients and was predominantly expressed within ASMCs. Elevated the expression of miR-199a-5p resulted in an inhibitory effect of proliferation and migration in ASMCs. Immunohistochemistry and a dual-luciferase reporter assay uncovered that RS exhibited elevated expression levels of both HIF-1α and E2F3, and they were identified as target genes regulated by miR-199a-5p. The co-transfection of lentiviruses carrying HIF-1α and E2F3 alongside miR-199a-5p further elucidated their role in the cellular responses mediated by miR-199a-5p. In vivo, the delivery of miR-199a-5p via lentivirus led to the mitigation of neointimal formation following angioplasty, achieved by targeting HIF-1α and E2F3. Conclusion: MiR-199a-5p exhibits promise as a prospective therapeutic target for RS since it alleviates the condition by inhibiting the proliferation and migration of ASMCs via its regulation of HIF-1α and E2F3.

Arteriosclerosis obliterans (ASO) is characterized by arterial narrowing and blockage due to atherosclerosis, influenced by endothelial dysfunction and inflammation. This research focuses on exploring the role of MAGOH-DT, a long noncoding RNA, in mediating endothelial cell dysfunction through endothelial-mesenchymal transition (EndMT) under inflammatory and hyperglycemic stimuli, aiming to uncover potential therapeutic targets for ASO. Differential expression of lncRNAs, including MAGOH-DT, was initially identified in arterial tissues from ASO patients compared to healthy controls through lncRNA microarray analysis. Validation of MAGOH-DT expression in response to tumor necrosis factor-alpha (TNF-alpha) and high glucose (HG) was performed in human umbilical vein endothelial cells (HUVECs) using RT-qPCR. The effects of MAGOH-DT and HNRPC knockdown on EndMT were assessed by evaluating EndMT markers and TGF-13 2 protein expression with Western blot analysis. RNA-immunoprecipitation assays were used to explore the interaction between MAGOH-DT and HNRPC, focusing on their role in regulating TGF-132 translation. In the results, MAGOH-DT expression is found to be upregulated in ASO and further induced in HUVECs under TNF-alpha/HG conditions, contributing to the facilitation of EndMT. Silencing MAGOH-DT or HNRPC is shown to inhibit the TNF-alpha/HG-induced increase in TGF-13 2 protein expression, effectively attenuating EndMT processes without altering TGF-13 2 mRNA levels. In conclusion, MAGOH-DT is identified as a key mediator in the process of TNF-alpha/HG-induced EndMT in ASO, offering a promising therapeutic target. Inhibition of MAGOH-DT presents a novel therapeutic strategy for ASO management, especially in cases complicated by diabetes mellitus. Further exploration into the therapeutic implications of MAGOH-DT modulation in ASO treatment is warranted.