Objective Current risk stratification for lower extremity deep vein thrombosis remains limited, often failing to identify high-risk patients for impending pulmonary embolism (PE) and leading to non-guideline-concordant overtreatment. We aimed to develop and validate a novel artificial intelligence (AI) system that processes dynamic digital subtraction angiography (DSA) radiomics, with the potential to guide precision therapy during endovascular intervention. Methods In a retrospective cohort study of 168 patients treated at a single vascular surgery center (2019-2023), we developed a hybrid deep learning model integrating a transformer-UNet for spatial feature extraction and a long short-term memory (LSTM) network for temporal hemodynamic analysis. This model processed intraprocedural dynamic DSA sequences to quantify novel thrombus kinematic parameters (eg, displacement velocity, oscillation angle θ) and hemodynamic parameters venous (quantitative flow ratio). The model's performance for predicting subsequent PE was compared against the Wells score. Its impact on clinical decision-making and 12-month outcomes was evaluated rigorously. Results The AI model demonstrated significantly superior discriminative performance for predicting PE compared with the Wells score (area under the curve, 0.88; 95% confidence interval [CI], 0.85-0.92 vs 0.76; 95% CI, 0.70-0.83; P = .026). Implementation of the AI-guided strategy was associated with markedly improved clinical outcomes at the 12-month follow-up: a 54% lower incidence of PE (3.4% vs 11.1%; relative risk [RR], 0.46; 95% CI, 0.08-0.82; P = .005), a 62% lower incidence of severe post-thrombotic syndrome (Villalta score ≥10; 8.0% vs 21.0%; RR, 0.38; 95% CI, 0.17-0.86; P = .008), and a lower prevalence of preexisting inferior vena cava filters in the AI-stratified high-risk group (25.3% vs 44.4%; RR, 0.57; 95% CI, 0.36-0.89; P < .001), without a significant increase in major bleeding events (2.3% vs 7.4%; P = .096). Conclusions An AI-guided risk stratification system based on dynamic DSA radiomics accurately identifies thrombus instability and hemodynamic impairment in real time and suggests its potential to help enable more personalized therapeutic decisions during intervention. In this retrospective analysis, AI-based risk stratification was associated with a significantly lower incidence of PE and severe post-thrombotic syndrome while safely curbing the overuse of inferior vena cava filters, representing a transformative advancement in the precision management of acute deep vein thrombosis.

The triglyceride–glucose (TyG) index, a reliable surrogate marker of insulin resistance, has been established as a predictor for various cardiovascular diseases. This study aimed to investigate its previously unexplored association with the incidence of abdominal aortic aneurysm (AAA). In this multicenter retrospective study, we analyzed data from 2513 patients (mean age 71.5 ± 6.9 years) who underwent surgical treatment for AAA between January 2018 and June 2023 (open surgery, 504 cases; endovascular aneurysm repair, 2009 cases). A control group of 6290 age-matched healthy individuals was included. Propensity score matching (1:1) yielded 1998 pairs for analysis. Patient survival was assessed through telephone interviews or outpatient visits, with a median follow-up duration of 36.4 months (interquartile range: 24.1–52.8 months). Multivariable regression was used to identify risk factors. After matching, the AAA group had a significantly higher TyG index compared to controls (7.570 ± 0.31 vs. 6.803 ± 0.28, P < 0.001). Multivariable analysis identified a high TyG index as an independent risk factor for AAA (HR = 3.344, 95

OBJECTIVE:To identify risk factors for deep vein thrombosis (DVT) following total knee arthroplasty (TKA) and to develop a predictive nomogram model. STUDY DESIGN:An observational study. Place and Duration of the Study: Department of Orthopaedics, Nanjing Pukou People's Hospital, Liangjiang Hospital, Southeast University, Nanjing, China, from March 2018 to March 2022. METHODOLOGY:Among the 1,015 eligible TKA patients, 457 developed postoperative DVT (DVT group), and 558 served as controls (non-DVT group). Risk factors were identified through univariate analysis and multivariate logistic regression. RESULTS:The DVT group showed significantly higher proportions of patients aged age ≥65 years, BMI ≥28 kg/m2, female gender, history of diabetes, cemented prosthesis, operation duration ≥90 minutes, bed rest duration ≥72 hours, no mechanical thromboprophylaxis, D-dimer levels >0.545 mg/L, and von Willebrand factor (vWF) level >178.55 ng/mL (all p <0.05) vs. the non-DVT group. Independent risk factors for DVT included age ≥65 years, BMI ≥28 kg/m2, female gender, history of diabetes, cemented prosthesis, operation duration ≥90 minutes, bed rest duration ≥72 hours, no mechanical thromboprophylaxis, D-dimer >0.545 mg/L, and vWF >178.55 ng/mL. A predictive nomogram incorporated these variables using regression coefficients (e.g., age × 1.128 ... vWF × 6.225; intercept = 4.545). CONCLUSION:Key modifiable and non-modifiable factors influence the risk of DVT following TKA. The predictive validated nomogram demonstrates clinical utility for individualised risk stratification and prevention strategies. KEY WORDS:Total knee arthroplasty, Deep vein thrombosis, Risk factors, Predictive model.

Objective:The aim of this study was to perform patient-specific hemodynamic simulations of thoracoabdominal aortic aneurysm (TAAA) models and evaluate the potential for intraluminal thrombus (ILT) formation. Methods:Computed Tomography Angiography data from 12 TAAA patients were reconstructed into patient-specific models, which were grouped according to the presence or absence of ILT accumulation. Old blood volume fraction (OBVF) and convergence time were proposed to reveal the association between thrombotic potential and blood stasis in TAAA. Results:The aneurysm exhibited high blood stasis compared with other parts. In the ILT group, normalized OBVF and convergence time (a passive-tracer washout time, not a physiological thrombosis timescale) were 76.66% ± 12.38% and 42.58 ± 13.29 s, respectively, whereas in the non-ILT group, they were 21.42% ± 3.39% and 10.93 ± 5.96 s. The OBVF and convergence time were significantly greater in the ILT group than in the non-ILT group (P-values were <0.0001, <0.01), indicating pronounced blood stasis. Conclusion:The blood stasis model provides a new and intuitive approach for clinicians to diagnose and treat ILT in TAAA, offering clearer insights than parameters related to WSS. This model can provide useful guidance for operative planning and postoperative evaluation.

BACKGROUND:To assess perioperative safety and mid-term durability of open surgical repair (OSR) as a salvage therapy for endoleaks after failed endovascular aneurysm repair. METHODS:A single-center retrospective analysis was performed on 23 consecutive patients (21 males, 2 females; mean age 65.6 ± 10.6 years) undergoing OSR for persistent endoleaks at Nanjing Drum Tower Hospital between May 2018 and July 2023. Endoleak subtypes included type I (n = 7), type II (n = 14), type III (n = 1), and type IV (n = 1). Primary end points were 30-day mortality and major adverse events, with secondary end points encompassing 3-year survival and reintervention rate. RESULTS:The 30-day mortality of the cohort reached 13.0% (3/23), attributed to pulmonary infection (n = 1), circulatory collapse (n = 1), and septic shock (n = 1). Notably, 34.8% (8/23) developed pulmonary complications, whereas 21.7% (5/23) experienced acute kidney injury. At a median follow-up of 30.6 months (interquartile range 25.4-38.9), the 3-year overall survival rate was 86.9%. No aorta-related deaths occurred during the follow-up; only 1 patient (4.3%) required secondary intervention for distal iliac artery redilation. CONCLUSION:OSR constitutes a definitive solution for endoleak management postendovascular aneurysm repair , demonstrating acceptable perioperative risk and durable mid-term outcomes. Although pulmonary and renal complications remain noteworthy short-term concerns, the technique offers low reintervention rates and stable survival trajectories, particularly in the absence of aorta-related mortality.

Deep vein thrombosis (DVT) remains a therapeutic challenge, primarily driven by pathological platelet adhesion at sites of vascular injury mediated by endothelial adhesion molecule overexpression. However, the molecular mechanisms underlying endothelial-dependent pathological platelet adhesion remain elusive. Here, integrating single-cell RNA sequencing (scRNA-seq) and functional validation, we identified aberrant activation of the stimulator of interferon genes (STING) as a critical driver of endothelial dysfunction and pathological platelet adhesion. Using STING knockout mice, we confirmed its central role in promoting a prothrombotic microenvironment via the NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome. Targeting this pathway, we identified forsythoside A (FA) as a potent STING inhibitor and constructed artificial platelets (Pm@Fng) via photopolymerization-membrane extrusion technology. Pm@Fng, consisting of FA-loaded nanogels cloaked with activated platelet membrane vesicles (APMVs), exhibited enhanced glycoprotein Ib alpha (GPIbα) -mediated binding affinity to von Willebrand factor (vWF), competitively blocking pathological platelet adhesion. Under thrombotic microenvironment (acidic pH and high reactive oxygen species), FA was released to modulate the STING - NLRP3 pathway, suppressing adhesion molecule expression. In a mouse DVT model, Pm@Fng rapidly targeted the endothelium, noticeably reducing thrombosis by 30% (p < 0.001) and preserving endothelial integrity. By exploiting competitive adhesion principles, this study presents a novel therapeutic strategy for DVT and other endothelial injury-related diseases.

Background: Thoracoabdominal aortic pathologies involving visceral arteries pose complex challenges for endovascular repair. This study aimed to evaluate the clinical outcomes and identify risk factors for adverse events in patients with complex thoracoabdominal aortic aneurysms (CTAAA) who underwent fenestrated-branched endovascular aortic repair (f/b EVAR) using physician-modified endografts (PMEG). Methods: In this single-center retrospective case-control study, 105 patients undergoing f/b EVAR with at least one visceral artery reconstruction between January 2018 and December 2019 were analyzed. Follow-up was conducted for a median of 36 months. Baseline clinical and imaging characteristics, procedural details, and long-term follow-up data were collected. The primary outcome was patient mortality. Secondary outcomes included technical success, complications, and reinterventions. Results: The technical success rate was 94.3%, with a 30-day mortality rate of 2.86%. During follow-up, 11 patients (10.5%) died, and 15 (14.3%) required reintervention. Analysis of prognostic factors revealed that visceral artery dissection was an independent factor affecting patient survival and positive aortic remodeling, while preoperative renal failure was closely associated with reintervention. Patient age, aortic calcification, and maximum aortic diameter were significant factors influencing endoleak development. Conclusions: f/b EVAR with PMEG is a safe and effective treatment for CTAAA, with low perioperative mortality and acceptable mid- to long-term outcomes. Preoperative renal function and visceral artery dissection are important predictors of prognosis. Larger studies are needed to further validate these findings.

Aortic aneurysm is a high-risk cardiovascular disease without an effective cure. Vascular smooth muscle cell (VSMC) phenotypic switching is a key step in the pathogenesis of aortic aneurysm. Here, we revealed the role of histidine triad nucleotide-binding protein 1 (HINT1) in aortic aneurysm. HINT1 was upregulated both in aortic tissue from patients with aortic aneurysm and angiotensin II-induced aortic aneurysm mice. VSMC-specific HINT1 deletion alleviated aortic aneurysm via preventing VSMC phenotypic switching. With the stimulation of pathological factors, the increased nuclear translocation of HINT1 mediated by nucleoporin 98 promoted the interaction between HINT1 and transcription factor AP-2 α (TFAP2A), further triggered the transcription of integrin α6 (ITGA6) mediated by TFAP2A, and consequently activated the downstream focal adhesion kinase (FAK)/STAT3 signal pathway, leading to aggravation of VSMC phenotypic switching and aortic aneurysm. Importantly, defactinib treatment was demonstrated to limit aortic aneurysm development by inhibiting the FAK signal pathway. Thus, the HINT1/ITGA6/FAK axis emerges as a potential therapeutic strategy in aortic aneurysm.

To retrospectivly investigate the short-term clinical outcomes of one-stop and two-staged endovenous laser ablation (EVLA) procedures for treatment of varicose veins (VVs) and iliac vein compression syndrome (IVCS). In this study, 424 patients were treated for VVs and IVCS from June 2017 to June 2020, 91 underwent one-stop stent angioplasty (SA) and EVLA, 132 underwent two-staged SA and EVLA, 104 underwent one-stop balloon angioplasty (BA) and EVLA, and 97 underwent two-staged BA and EVLA. Clinical outcomes and complications were recorded at 3 and 12 months post-intervention. Quality of life (QoL) was assessed with the venous clinical severity score (VCSS) and Villalta scale. Patients in the SA groups were older (p < 0.05) with higher BMI values (p < 0.05). The incidences of iliac vein stenosis (p < 0.001) and recurrent VVs (p < 0.01) were lower in the one-stop SA group. The VCSS was significantly improved (p < 0.05) at 12 months after the one-stop SA procedure. The one-stop SA procedure effectively relieved symptoms, decreased symptom recurrence, and improved the QoL of patients with VVs and severe IVCS. The two-staged BA procedure is recommended for patients with longer life expectancy.

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.

Primary deep venous valve insufficiency (PDVVI) is a common lower extremity venous disease in vascular surgery, distinguished from simple lower extremity varicose veins and lower extremity thrombotic diseases, and requires clinical management as a separate disease. Surgical procedures alone in the superficial venous system cannot completely correct valve reflux and venous hypertension and require surgical valve repair. In addition, the development of non-autologous prosthetic valve transplantation provides a new breakthrough point. This article summarizes the diagnostic and therapeutic advances in PDVVI for discussion.

(1) Background: Renal artery occlusion after F/B EVAR for abdominal aortic aneurysm is a serious complication that may require re-intervention, and understanding the hemodynamic mechanisms by which it occurs is essential to optimize the surgical procedure. (2) Methods: We used computational fluid dynamics (CFD) to analyze the impact of various parameters on blood flow. Theoretical vascular models were constructed based on the common dimensions and angles of aortic stents and branch arteries in clinical practice. Actual case models were constructed from CT image data of six patients treated with F/B-EVAR. Data were collected for analysis after simulation and calculation by FLUENT software. (3) Results: Theoretical model simulations showed that a larger tilt angle of the branch stent, smaller branch entry depth, and larger branch stent diameter were beneficial for blood flow. In the case models, a significant difference in the tilt angle of the renal artery stents was observed between the high- and low-flow groups, while the differences in entry depth and branch stent diameter were not significant. Occluded renal arteries had lower WSS values than patent ones. (4) Conclusions: This study offers valuable guidance for optimizing stent placement in F/B EVAR to mitigate renal artery occlusion risk.

Background Physician-modified fenestrated and branched endografts (PMEGs) have emerged as an endovascular solution for managing thoracoabdominal aortic aneurysms (TAAAs) in the past decade. This study evaluated the outcomes and experience of 3 high-volume centers. Methods Patient data from 3 academic centers in China, spanning from 2017 and 2021, were retrospectively collected and analyzed. Early outcomes were assessed through perioperative morbidity and mortality. Follow-up outcomes included survival, freedom from reintervention, and patency of target vessels. Results PMEG procedures were performed in 186 patients (156 men; mean age, 68.4 ± 13.4 years) with TAAAs. Fenestrations or branches were used to incorporate 618 target vessels. Postoperative all-cause mortality was 6.5%, with aneurysm-related deaths accounting for 1.6%. Morbidity included acute kidney injury (5.9%), stroke (1.1%), myocardial infarction (2.7%), and limb ischemia, respiratory failure, and bowel ischemia requiring resection (each 1.6%). Transient spinal cord injury developed in 1 patient. With a mean follow-up of 3.4 ± 1.3 years, survival rates were 96% at 1 year and 94% 3 years. The secondary patency rates of target vessels at 1 and 3 years were 99% and 98%, and freedom from reintervention was 95% and 91%, respectively. Conclusions Fenestrated and branched endovascular aneurysm repair with PMEGs appears to be a safe and effective treatment for complex aortic aneurysms. Although early and midterm outcomes are promising and comparable to those of custom-made devices, further follow-up is essential to confirm long-term efficacy.

OBJECTIVE:Physician-modified stent grafts (PMEGs) are widely used to treat complex pathologies in the aortic arch, but featured by varied preparation methods. This study was conducted to investigate the differences in operative characteristics and postoperative outcomes of PMEGs prepared using 2 methods: 3D printed models (Group A) and traditional measurement (Group B). METHODS:This retrospective study included 201 patients treated with multiple fenestrated/branched endovascular repair in the aortic arch at 3 vascular centers in China. This study was designed to establish 2 groups based on different preparation methods, including Group A (3D printed models) and Group B (traditional measurement). Both groups matched (1:3) using propensity scoring for subsequent analysis based on age, history of aortic surgery, type of aortic lesion, number of stent fenestrations, and brand of aortic stent. This study further clarified differences in demographic characteristics, procedure characteristics, 30-day outcomes, and 1-year outcomes between 2 groups. RESULTS:A total of 143 patients were enrolled and matched from February 2018 to February 2024, with 91 in Group A and 52 in Group B. Group A had significantly shorter duration of intervention, less contrast use, and lower rate of postoperative renal dysfunction than those in Group B. In addition, no significant differences were observed in the rest of the operative characteristics and postoperative outcomes. CONCLUSION:The use of 3D-printed models may contribute to reducing endovascular intervention time and contrast use, and decreasing the incidence of postoperative renal dysfunction. However, traditional measurement remains a necessary skill for surgeons in case of emergency procedures with short preparation time.Clinical ImpactThis study demonstrates that 3D-printed model-assisted PMEGs preparation significantly reduces endovascular operating time and contrast volume compared to traditional measurement, particularly in triple-fenestrated aortic arch repairs. For clinicians, it provides a validated approach to minimize renal impairment risk and enhance procedural efficiency in elective cases. The innovation lies in leveraging patient-specific 3D anatomy to optimize fenestration positioning. While traditional methods remain essential for emergencies, this technique standardizes complex endovascular reconstruction, potentially reducing reintervention rates.

BACKGROUND:This study aimed to evaluate the safety and efficacy of Venastent for the patients with iliac vein compression syndrome (IVCS). METHODS:A multicenter retrospective clinical trial enrolling 199 IVCS patients was conducted by the department of vascular surgery of 3 hospitals from October 2021 to January 2023. Among them, 91 were treated with a new type of iliac vein stent and defined as the experimental group, and 108 cases in the control group were using Zilver Vena venous stent (Cook Medical). Twelve-month follow-up was performed for the following primary end points: the patency rate, the venous clinical severity score (VCSS), and the Clinical, Etiology, Anatomy, and Pathology (CEAP) classification. RESULTS:To validate the role of Venastent in the prevention of thrombosis, 91 patients with Venastent versus 108 patients with control stent were compared. No difference was found in the demographic data or accompanying symptoms or disease severity scores between the 2 groups of patients. The patency rates of the contralateral deep vein at 24 months after the surgery were 100.00% vs. 94.5%, respectively (P = 0.043). Moreover, no difference was found on the VCSS score and CEAP classification of the both groups. CONCLUSION:Venastent with a large corolla-like mesh and an adequate radial force shows a good patency in the ipsilateral iliac vein and could prevent thrombosis in the contralateral iliac vein.

OBJECTIVE:This study aimed to evaluate the peri-operative and follow up results of multicentre 3D printing assisted fenestrated thoracic endovascular repair for aortic arch diseases in zones 0 and 1. METHODS:A multicentre retrospective study of patients undergoing 3D printing assisted multi-fenestrated endovascular arch repair was conducted. The primary endpoints included death, complications, and technical success. Statistical analysis was performed using SPSS version 26, and Kaplan-Meier survival analysis was employed to calculate mid to long term outcomes. RESULTS:The study included 149 patients (mean age 62 ± 13 years; 87.9% men). Diagnoses included thoracic aortic dissection (50.3%, n = 75), aortic aneurysm (46.3%, n = 69), and penetrating aortic ulcer (3.4%, n = 5). The technical success rate was 94.0% (n = 140). Two patients died during the operation. The thirty day post-operative mortality rate was 2.7% (n = 4), while the incidence of cerebral infarction was 8.8% (n = 13), and spinal ischaemia occurred in 2.7% (n = 4). The median follow up was 28 months, during which nine died, two of which were aortic related. The overall endoleak rate was 7.0% (n = 10), comprising four type Ia, four type Ic, and two type IIIa endoleaks; nine underwent re-intervention. The one, two, and three year survival rates were 93.5% (standard error [SE] 2.1%), 90.0% (SE 2.7%), and 87.5% (SE 3.1%), respectively. CONCLUSION:For patients with complex aortic arch disease unfit for open surgery, 3D printing assisted fenestrated thoracic endovascular repair in zones 0 or 1 demonstrated a technically feasible solution with high success and acceptable 30 day mortality and complication rates. Broader validation with larger cohorts and extended follow up is required to establish the durability and safety of this technique as a viable alternative for aortic arch repair.

The accurate and timely diagnosis of acute aortic syndrome (AAS) in patients presenting with acute chest pain remains a clinical challenge. Aortic computed tomography (CT) angiography is the imaging protocol of choice in patients with suspected AAS. However, due to economic and workflow constraints in China, the majority of suspected patients initially undergo noncontrast CT as the initial imaging testing, and CT angiography is reserved for those at higher risk. Although noncontrast CT can reveal specific signs indicative of AAS, its diagnostic efficacy when used alone has not been well characterized. Here we present an artificial intelligence-based warning system, iAorta, using noncontrast CT for AAS identification in China, which demonstrates remarkably high accuracy and provides clinicians with interpretable warnings. iAorta was evaluated through a comprehensive step-wise study. In the multicenter retrospective study (n = 20,750), iAorta achieved a mean area under the receiver operating curve of 0.958 (95% confidence interval 0.950-0.967). In the large-scale real-world study (n = 137,525), iAorta demonstrated consistently high performance across various noncontrast CT protocols, achieving a sensitivity of 0.913-0.942 and a specificity of 0.991-0.993. In the prospective comparative study (n = 13,846), iAorta demonstrated the capability to significantly shorten the time to correct diagnostic pathway for patients with initial false suspicion from an average of 219.7 (115-325) min to 61.6 (43-89) min. Furthermore, for the prospective pilot deployment that we conducted, iAorta correctly identified 21 out of 22 patients with AAS among 15,584 consecutive patients presenting with acute chest pain and under noncontrast CT protocol in the emergency department. For these 21 AAS-positive patients, the average time to diagnosis was 102.1 (75-133) min. Finally, iAorta may help prevent delayed or missed diagnoses of AAS in settings where noncontrast CT remains the only feasible initial imaging modality-such as in resource-limited regions or in patients who cannot receive, or did not receive, intravenous contrast.

Background Exosomes (Exos) generated from bone mesenchymal stem cells (BMSCs) are elucidated to enhance cutaneous wound healing in mice models of diabetes mellitus (DM). While underlying mechanisms remain unknown. Methods Next-generation sequencing (NGS) was used to examine changes in circRNA expression levels following Exo treatment. Luciferase assays were used to determine the interactions between RNAs. Immunofluorescence staining was used to examine reactive oxygen species (ROS) in endothelial progenitor cells (EPCs) cultured in high glucose (HG) conditions. Therapeutic effects regarding Exos were also examined by immunofluorescence. Results We found that Exo treatment enhanced cutaneous wound healing significantly. NGS indicated that circ-Snhg11 was involved in Exo-mediated tissue repairing. Downregulation of circ-Snhg11 decreased Exo-mediated therapy responses during wound healing in diabetic mouse. Our luciferase reporter data confirmed that SLC7A11 and miR-144-3p were circ-Snhg11 downstream targets. miR-144-3p overexpression or SLC7A11 knockdown altered the protective effects of circ-Snhg11 upon EPCs exposed to HG conditions. Upregulation of circ-Snhg11 incremented therapy effects of Exo treatment during wound healing in DM mice through enhanced angiogenesis along with a reduction in GPX4-mediated ferroptosis. Conclusions circ-Snhg11 in BMSC-Exos enhanced SLC7A11/GPX4-mediated anti-ferroptosis signals via miR-144-3p sponging resulting in enhanced diabetic wound healing and improved angiopoiesis.

Iliac vein stenting for the treatment of iliac vein compression syndrome (IVCS) has been gradually developed. This article investigated the long-term patency and improvement of clinical symptoms after endovascular stenting for iliac vein obstruction patients. From 2020 to 2022, 83 patients at a single institution with IVCS underwent venous stent implantation and were divided into two groups: non-thrombotic IVCS ( n = 55) and thrombotic IVCS ( n = 28). The main stent-related outcomes include technical success, long-term patency, and thrombotic events. The technical success rate of all stent implantation was 100%. The mean length of hospital stay and cost were higher in the thrombotic IVCS group than in the non-thrombotic ICVS group, as well as the length of diseased vessel segment and the number of stents implanted were higher than in the control non-thrombotic group. The 1-, 2-, and 3-year patency rates were 85.4%, 80% and 66.7% in the thrombosis group, which were lower than 93.6%, 88.7%, and 87.5% in the control group ( P = .0135, hazard ratio = 2.644). In addition, patients in both groups had a foreign body sensation after stent implantation, which resolved spontaneously within 1 year after surgery. Overall, there were statistically significant differences in long-term patency rate outcome between patients with thrombotic and non-thrombotic IVCS, the 1-, 2-, and 3-year patency rates in non-thrombotic IVCS patients were higher than those in thrombotic IVCS patients.