Circular RNAs (circRNAs) are believed to play a role in various human diseases, but their involvement in acute myocardial infarction (AMI) remains poorly understood. This study aims to clarify the role of hsa_circ_0081241 in AMI and elucidate its mechanism of action. RT-qPCR and western blotting detected the expression of hsa_circ_0081241, miR-15b-5p, and PHD finger protein 19 (PHF19). A dual-luciferase reporter assay demonstrated their targeting relationships. Cell viability and apoptosis were assessed using CCK-8 and Annexin V-FITC/PI kits. M1 polarization of human bone marrow macrophages (hBMMs) was evaluated by detecting iNOS and CD68/CD86 expression. ELISA kits measured IL-6 and IL-12 secretion levels. Collagen I/III expression was measured to assess fibrosis. Reactive oxygen species (ROS) and superoxide dismutase (SOD) levels were measured to evaluate oxidative stress damage. The clinical value of the hsa_circ_0081241/miR-15b-5p/PHF19 axis was assessed using receiver operating characteristic (ROC) curves and a binary logistic regression model. Hsa_circ_0081241 promoted hypoxia-induced functional impairment in human cardiomyocytes (AC16) and mediated M1 polarization of hBMMs, driving fibrosis progression in human myocardial fibroblasts (hMFs). Pro-inflammatory factors secreted by M1 macrophages further aggravated hMF fibrosis. Hsa_circ_0081241 promoted PHF19 expression by down-regulating miR-15b-5p, mediating oxidative stress injury in hypoxia/reoxygenation (H/R)-damaged AC16 cells and myocardial tissues of the AMI rat model. Hsa_circ_0081241, miR-15b-5p, and PHF19 were independent predictors of AMI, with a combined area under the curve (AUC) of 0.871. The hsa_circ_0081241/miR-15b-5p/PHF19 signaling axis is a potential biomarker for AMI. It may play an important role in myocardial injury caused by hypoxia and inflammatory microenvironments in this disease context.

BACKGROUND:Catheter-directed mechanical thrombectomy for acute pulmonary embolism (PE) has expanded rapidly, yet device-related pulmonary vascular injury has been reported with existing large-bore systems. We evaluated the feasibility and safety of a novel mechanical thrombectomy system incorporating conical nitinol mesh discs. METHODS:This nationwide prospective, single-arm, multicenter study enrolled adults with computed tomography pulmonary angiography (CTPA) confirmed acute PE, symptom duration ≤14 days, systolic blood pressure ≥90 mm Hg, and baseline right ventricular (RV) to left ventricle (LV) diameter ratio ≥0.9. The primary effectiveness endpoint was change in CTPA-derived RV/LV ratio from baseline to 48 hours. The primary safety endpoint was major adverse events (MAEs) within 48 hours. Secondary endpoints included changes in echocardiography-derived systolic pulmonary artery pressure (sPAP) and oxygenation, as well as 30-day outcomes. RESULTS:Among 127 patients treated at 13 centers, device delivery, deployment, and removal were successful in all cases. RV/LV ratio decreased from 1.47 ± 0.37 to 0.83 ± 0.17 at 48 hours (95% CI: -0.69 to -0.59; P < 0.0001). Echocardiography-estimated sPAP decreased from 45.82 ± 14.46 to 36.66 ± 13.18 mm Hg (mean change: -9.69 ± 14.33; P < 0.001). Arterial oxygen partial pressure increased by 17.79 ± 15.50 mm Hg at 48 hours (P < 0.001) under standardized sampling conditions. No MAE occurred within 48 hours. No deaths or symptomatic recurrent PE occurred within 30 days. CONCLUSION:In hemodynamically stable patients with intermediate-risk acute PE and RV dilation, mechanical thrombectomy using a conical mesh-disc system was feasible and associated with early improvements in RV size and echocardiography-estimated pulmonary artery pressures, with no MAE observed within 48 hours. Given the single-arm design, comparative effectiveness versus anticoagulation or other devices cannot be inferred.

Endothelial dysfunction is a fundamental pathological process in atherosclerosis (AS), a leading cause of cardiovascular disease worldwide. The present study aimed to explore lncRNA ZEB2-AS1's expression, diagnostic value in AS, and its function on proliferation, inflammation, and potential mechanism in AS-related endothelial dysfunction. ZEB2-AS1 was detected in the specimens of 120 patients with AS and 115 control subjects, and the findings were validated using the GSE120521 dataset. An in vitro model of AS was established by inducing HUVECs with ox-LDL. In this model, ZEB2-AS1 expression was silenced. Assessment of cell viability was carried out with a CCK-8 kit. The secretion profiles of key inflammatory factors (TNF-α, IL-6, IL-1β), along with the chemokine MCP-1 and adhesion molecules (VCAM-1, ICAM-1), were analyzed by ELISA. Potential target miRNAs were predicted through LncRNASNP2 and miEAA databases, and miR-149-5p was verified using rescue experiments. Upregulation of ZEB2-AS1 was observed in the blood and tissues of individuals with AS, consistent with the data on unstable plaques from GSE120521. ZEB2-AS1 knockdown intensified the viability inhibition triggered by ox-LDL and decreased the secretion of inflammatory factors and adhesion molecules. miR-149-5p, a target molecule of ZEB2-AS1, exerted a reversing influence on these alterations. In conclusion, ZEB2-AS1 upregulation in AS promotes ox-LDL-induced endothelial dysfunction via miR-149-5p, acting as a potential AS biomarker/therapeutic target.

In-stent restenosis (ISR), a chronic vascular proliferative disorder, poses significant clinical challenges due to impaired endothelial repair, suboptimal long-term outcomes of interventional therapies, and complications associated with current preventive strategies. Although gene therapy offers a promising approach for ISR management, its clinical translation is hindered by the scarcity of innovative gene-based drugs and the lack of efficient delivery systems. Here, we identify carbonic anhydrase 1 (CA1) as a potential target in regulating endothelial cell survival, regeneration, and inflammatory responses. We then engineered plant-derived exosome-like nanoparticles (CLENs) to encapsulate CA1-siRNA, enabling targeted delivery and enhanced stability. CLENs (siRNA) exhibit prolonged circulation and precise accumulation at aortic lesions, effectively reducing ISR rates. Mechanistically, this therapeutic approach alleviates endothelial inflammatory activation by suppressing the NF-κB and TNF signaling pathways and downregulating PADI2 expression, while also demonstrating favorable biosafety. Our study presents a novel plant-derived nano-delivery system based on purely natural components for early ISR intervention, which demonstrates both therapeutic efficacy and an absence of adverse effects.

Long non-coding RNAs (lncRNAs) play crucial roles in the onset and progression of cardiovascular disease, particularly atherosclerosis. However, the role of PARD3-AS1 in atherosclerosis remains largely uncharacterized. This study therefore aimed to investigate the impact of the PARD3-AS1/miR-668-3p axis on atherosclerosis. The expression levels of PARD3-AS1 and miR-668-3p in human umbilical vein endothelial cells (HUVECs) were quantified by quantitative real-time polymerase chain reaction (RT-qPCR). HUVEC proliferation was assessed using a Cell Counting Kit-8 (CCK-8) assay and 5-ethynyl-2′-deoxyuridine (EdU) incorporation, and migratory and invasive capacities were evaluated using wound healing and Transwell assays. The interaction between PARD3-AS1 and miR-668-3p was confirmed by bioinformatics analysis and dual-luciferase reporter assays. In addition, serum samples were collected from patients diagnosed with atherosclerosis, and ApoE⁻/⁻ C57BL/6 mice were fed a high-fat diet for 8 weeks to establish a model of atherosclerosis. PARD3-AS1 expression was significantly reduced in the serum of patients with atherosclerosis, whereas miR-668-3p levels were markedly elevated, and the two were negatively correlated. Subsequent experiments confirmed that miR-668-3p effectively reversed the promotion effects of PARD3-AS1 on HUVEC proliferation and migration. In vivo, histological staining showed that the PARD3-AS1 overexpression group exhibited improved endothelial repair. Collectively, these findings demonstrate that PARD3-AS1 directly interacts with miR-668-3p to modulate HUVEC proliferation, migration, and invasion, suggesting that PARD3-AS1 may serve as a potential therapeutic target for atherosclerosis.

BACKGROUND:Current guidelines recommend retrievable inferior vena cava filters (RIVCFs) placement prior to endovascular intervention (EI) for deep vein thrombosis (DVT), yet the impact of EI on RIVCF-related thrombosis/trapped embolus (T/TE) remains controversial. METHODS:In this prospective registry-based study (ChiCTR1800014252), 2,773 patients undergoing RIVCF placement across 103 Chinese centers (2018-2019) were stratified into EI (n = 1,472) and no-EI (n = 1,301) groups. Propensity score matching (1:1) balanced 23 baseline variables (e.g., DVT acuity and anticoagulation). The primary end point was RIVCF T/TE (defined as inferior vena cava obstruction or thrombus >5 cm above the filter), validated by core-lab adjudicated imaging (computed tomography/angiography). All treating physicians from the 103 participating centers received unified standardized training on the clinical selection criteria for EI and non-EI therapy prior to the study initiation, ensuring consistent intercenter decision-making. The selection of therapeutic modalities was further based on individualized clinical characteristics, including the anatomical location of DVT, thrombus burden, presence of procedural contraindications, and patient's informed consent after full risk-benefit explanation. RESULTS:After matching (n = 1,007 per group), EI was associated with a 46% lower risk of RIVCF T/TE (8.9% vs. 14.0%, P < 0.001; odds ratio = 0.54, 95% confidence interval: 0.41-0.71). Symptomatic pulmonary embolism rates were comparable (1.2% vs. 2.8%, P = 0.07). No brand-specific differences in T/TE incidence were observed (P = 0.32). CONCLUSION:This study challenges the necessity of routine RIVCF placement before EI, demonstrating that EI itself reduces thrombosis risk. These findings advocate for selective filter use, potentially sparing patients from device-related complications.

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.

This study aimed to explore the role of long non-coding RNA cancer Susceptibility 15 (CASC15) and microRNA (miR)-940 in atherosclerosis (AS) and to elucidate their potential mechanisms of action using an in vitro cell model of AS. Human umbilical vein endothelial cells (HUVECs) were subjected to oxidized low-density lipoproteins (ox-LDL) induction to establish an atherosclerotic cell model, and the expression levels of CASC15 and miR-940 in this model were evaluated. Cell viability and apoptosis were detected using the Cell Count Kit (CCK)-8 assay and flow cytometry, respectively. Quantitative real-time PCR was employed to quantify gene expression levels of CASC15, miR-940, and cell adhesion molecules intercellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1, while Enzyme-linked immunosorbent assay was used to measure the protein levels of interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α. Bioinformatics analysis was utilized to explore the target genes of miR-940 and their functional implications. The expression of CASC15 and miR-940 in ox-LDL-induced HUVECs showed an increase in CASC15 and a decrease in miR-940. Notably, miR-940 is a downstream target gene of CASC15. CASC15 knockdown mitigated ox-LDL-induced autophagy flux impairment, thereby promoting autophagy, whereas decreased levels of miR-940 significantly inhibit autophagy. Inhibition of CASC15 alleviates endothelial dysfunction caused by ox-LDL primarily through promoting activity and reducing apoptosis and inflammation. Conversely, a decrease in miR-940 exacerbates endothelial dysfunction. The addition of an autophagy activator relieved endothelial dysfunction, highlighting the involvement of the CASC15/miR-940 axis in regulating autophagy, and its role in modulating endothelial function impairment through autophagy regulation. Inhibition of CASC15 alleviates ox-LDL-induced endothelial dysfunction, potentially through the activation of autophagy via the modulation of miR-940.

Objective:To evaluate the feasibility and short-term clinical outcomes of the Kabedon technique-based endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAA) with severe infrarenal neck angulation (angle >60°). Methods:This retrospective cohort study was based on a single-center database. Between January 2019 and May 2023, 120 patients with AAA of hostile neck angulation underwent endovascular procedures using the Kabedon technique for abdominal aortic remodeling. A standardized protocol was followed to calculate the serial changes in the aneurysmal neck angle. The primary endpoints were proximal type Ia endoleak and stent-graft migration. The secondary endpoints were all-cause and aneurysm-related mortality, proximal neck dilatation, and re-intervention. Results:The mean age was 71.40 ± 10.69 years, and 95 (79.17%) were male. The mean AAA sac diameter and proximal neck angle were 63.71 ± 17.32 mm and 83.67 ± 18.45°, respectively. All patients underwent the Kabedon-based EVAR, with a technical success rate of 94.17% (113/120). During the operation, 7 cases of endoleak and 2 cases of endograft migration were observed, which were resolved by corresponding measures such as coil embolization and proximal cuff stent salvage. No complications were observed within 30 days. In addition, neck calcification, funnel-shaped aneurysm, intraoperative complications and corresponding treatments may be potential negative factors for technical success, but there was no statistical difference. Conclusions:Kabedon-based EVAR for AAA with a severely angulated neck provided high technical success, low mortality and complication rates during short-term follow-up. Further studies with larger sample sizes and longer follow-up periods are warranted.

Objective: The objective of this study was to develop and evaluate the effectiveness of machine learning (ML) models in predicting carotid plaque instability. Methods:A retrospective analysis was conducted on data from 449 patients with carotid plaques treated at The Affiliated Hospital of Qingdao University between July 2022 and November 2024. Patients were randomly divided into a training set and a testing set at a 7:3 ratio. Five ML algorithms were utilized to establish prediction models. The predictive performance of each model was assessed using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity on the testing set. Results: Among the five ML algorithms, the light gradient boosting machine (LightGBM) demonstrated the best performance with an AUC of 0.921 (95% confidence interval [CI]: 0.887–0.956) and an accuracy of 0.837 in the training set, and an AUC of 0.864 (95% CI: 0.784–0.944) and an accuracy of 0.811 in the testing set. The feature importance results showed that C-reactive protein (CRP), leukocytes, high-density lipoprotein (HDL), and platelets were the four most significant contributors to carotid plaque instability. Conclusion:We developed and validated the ML models for predicting carotid plaque instability, and identified that LightGBM model with 9 relevant factors had the best performance and high levels of clinical applicability.

Postinjury restenosis is a common complication of peripheral arterial disease treated via endovascular techniques. Its pathogenesis mainly involves neointimal hyperplasia and persistent inflammation. Although antiproliferative drugs used clinically can temporarily slow restenosis, their effects are limited by short action duration and lack of precise regulation. In this investigation, tRF-49:69-chrM.Trp-TCA (tRF-Trp-TCA) was identified through sequencing data from an animal restenosis model, and its regulatory effects on endothelial cell migration and inflammation were confirmed. Additionally, we discovered that cabbage exosome-like nanoparticles (CELNs) could precisely target injured blood vessels in vivo, enhance the stability of nucleic acid therapeutics, and more effectively inhibit neointimal hyperplasia in a carotid artery balloon injury model. Our results demonstrated that tRF-Trp-TCA is crucial in restenosis induced by arterial injury and CELNs loaded with tRF-Trp-TCA effectively inhibit neointimal hyperplasia following carotid artery injury in rats, showing good biocompatibility. This study has, for the first time, identified the target tRF-Trp-TCA for treating restenosis after vascular injury and has also, for the first time, used CELNs as the delivery system. This discovery could provide new insights for noninvasive treatments or mitigation of restenosis post-endovascular therapy.

ObjectiveThe aim of study is to investigate the safety and efficacy of preserving bilateral internal iliac arteries (IIAs) in patients with aortoiliac aneurysms using iliac branch stent grafts (IBSG).MethodsFrom June 2019 to February 2024, a total of 265 patients with aortoiliac aneurysm from four tertiary hospitals in China were included. They were divided into 110 patients with bilateral iliac artery aneurysms and 155 patients with unilateral aneurysm. Based on whether the IIA were occluded, the patients with bilateral aneurysms were further divided into Group BB (bilateral aneurysms with bilateral IBSG) and Group BU (bilateral aneurysms with unilateral IBSG and contralateral IIA embolization), and the patients with unilateral aneurysm into Group UB (unilateral aneurysm and preserve bilateral IIA) and Group UU (unilateral aneurysm and preserve unilateral IIA). Group BB and Group BU, as well as Group UB and Group UU, were compared after propensity score matching. The primary endpoint was major adverse events, and the secondary endpoint was pelvic ischemia.ResultsAfter matching, there were 76 patients in the Group BB (38 patients) and the Group BU (38 patients), with an average follow-up of 24.0 ± 7.0 months. Among these patients, 3 patients (7.9%) in the Group BB and 2 patients (5.3%) in the Group BU experienced IBSG occlusion. In the Group BB, 1 patient (2.6%) had type IB endoleak, 1 patient (2.6%) had type III endoleak due to IBSG migration, and 1 patient (2.6%) in the Group BU had type I endoleak. The rate of IBSG-related interventions was similar between the two groups (13.2% vs. 7.9%, p > 0.05). Compared with the Group BB, patients with buttock claudication (1 vs. 10, p < 0.05) and decreased erection function (2 vs. 12, p < 0.05) were more common in the Group BU, and the Group BU also reported more new cases of erectile dysfunction (1 vs. 6, p < 0.05). After matching, there were 55 patients in the Group UB and 55 patients in the Group UU, with an average follow-up of 23.0 ± 6.0 months. One patient (1.8%) in the Group UB and 1 patient (1.8%) in the Group UU experienced type I endoleak. Four patients (7.3%) in the Group UB and 1 patient (1.8%) in the Group UU underwent reintervention (p > 0.05). One patient (1.8%) in the Group UB and 13 patients (23.6%) in the Group UU complained of buttock claudication, and more patients in the Group UU had decreased erection function (2 vs. 14, p < 0.05). Among these, 9 patients (16.4%) had newly developed erectile dysfunction (p < 0.05). During the study period, no patients experienced aneurysm-related mortality.ConclusionThe complete preservation of bilateral IIAs using IBSG has shown satisfactory midterm results, which are associated with lower rates of occlusion and reintervention. Additionally, the strategy may effectively preserve the ambulation and sexual function of patients.

Restenosis is the primary complication following stenting for coronary and peripheral arterial disease, posing an ongoing clinical challenge. Metabolic syndrome (MetS), characterized by metabolic disturbances, has been identified as an independent predictor for postoperative restenosis in coronary and carotid arteries, potentially due to endothelial dysfunction and augmented oxidative stress in cells, while its specific regulatory mechanism is still largely unknown. Lysine 2-hydroxyisobutyrylation (Khib), a recently identified posttranslational modification, plays a crucial role in transcriptional regulation and cellular metabolism. However, there is a lack of comprehensive analysis of the proteome and Khib modifications within restenotic vessels in the context of MetS, as well as in the understanding of the associated pathophysiology. In this study, we observed a significant upregulation of Khib in restenotic arteries induced by MetS, confirmed by animal and cellular experiments. Further, using high-throughput liquid chromatography-mass spectrometry, we catalogued 15,558 Khib sites across 2568 proteins, implicating a multitude of biological functions. Analysis revealed 2007 Khib sites on 1002 proteins with considerable differential modifications which are present within the cytoplasm and nucleus. Interestingly, proteins located in the mitochondria, endoplasmic reticulum, and cell membrane also exhibit distinct expression and modification profiles to varying extents that related to vascular smooth muscle contraction, platelet activation, and the PI3K-Akt signaling pathway. Notably, the level of COL1A1 protein detected in the protein-protein interaction pathway network and the level of Khib modification are diametrically opposed, suggesting a significant role in the disease's pathogenesis. This study provides the first comprehensive proteomic and Khib modification overview of MetS-related in-stent restenosis vasculature, offering key insights to inform novel therapeutic approaches for restenosis mitigation.

Background: The objective of this study is to document our experience using low-profile endografts for the endovascular repair of abdominal aortic aneurysms (AAAs) in cases where access arteries are challenging, commonly referred to as hostile access arteries. Methods: Data regarding patients with narrow or tortuous access arteries who underwent endovascular aortic repair (EVAR) using low-profile endografts at 3 tertiary medical centers between January 2020 and December 2022 were retrospectively collected and analyzed. A total of 76 patients were enrolled in the study. The primary endpoints included technical success, occurrence of endoleaks, endograft occlusion, and any device- or procedure-related major adverse events. Secondary endpoints were assessed for endograft migration, endograft fracture, access site complications, and aneurismal sac shrinkage. Results: The mean follow-up duration was 28.1 +/- 9.0 months (range, 14.0e54.0). Among the patients, 32 (42.1%) had narrow artery access (diameter <6.0 mm), 29 (38.2%) had access arteries characterized by tortuosity, and 15 (19.7%) patients presented with both narrow and tortuous access arteries. Technical success was achieved in 73 (96.1%) cases. A total of 4 (5.2%) patients received reintervention due to endograft occlusion. During follow-up, a total of 8 (10.5%) type II endoleaks were observed during follow-up without intervention, and the endoleak disappeared in the follow-up period. Abdominal aortic aneurysm-sac shrinkage and stability were observed in 25 (32.9%) and 51 (67.1%) cases, respectively. The overall survival rate was 98.7%. The perioperative and follow-up outcomes for the groups categorized by 'Narrow arteries', 'Tortuous arteries', and 'Narrow and Tortuous arteries' did not show statistically significant differences when compared to each other. Conclusions: This preliminary investigation indicates that the use of low-profile endografts is associated with safety and effectiveness within the observed period.

PURPOSE:To compare the sensitivity of measuring iliac vein stenosis using two-dimensional digital subtraction angiography (2D-DSA) and three-dimensional digital subtraction angiography (3D-DSA), with multidetector computed tomography venography (MDCTV) as the reference standard. METHODS:Between January 2020 and January 2023, a total of 103 patients suffered from chronic venous insufficiency symptoms categorized as CEAP Level 3 or above were included from three centers. These patients were admitted to our hospital after abdominal vascular ultrasound and MDCTV positivity. During hospitalization, all patients underwent both 2D-DSA and 3D-DSA procedures simultaneously. Ensure double-blind and rigorous evaluation process when evaluating images. All patients were categorized into two groups based on the degree of CTV stenosis: Group A (50%-70%) and Group B (>70%). Considering the morphology of iliac vein compression, all patients were categorized into three groups: central, lateral, and partial obstruction. Subsequently, the effectiveness analysis was performed for each diagnostic method based on the aforementioned classification. RESULTS:With MDCTV as the reference standard, in Group A, the sensitivity of 2D-DSA and 3D-DSA is 78.69% and 90.48%, respectively. In Group B, the sensitivity of 2D-DSA and 3D-DSA is 93.44% and 97.62%, respectively. In Group A, the accuracy of 3D-DSA is significantly higher than that of 2D-DSA (p = 0.019). However, there is no statistically significant difference in Group B (p = 0.360). The accuracy rates for central, lateral, and partial obstruction using 2D-DSA are, respectively, 77.55%, 69.70%, and 95.24%. The accuracy rates for central, lateral, and partial obstruction using 3D-DSA are, respectively, 93.88%, 93.94%, and 100%. In central group, the accuracy of 3D-DSA is significantly higher than that of 2D-DSA (p = 0.021). In lateral group, no significant difference was observed between the accuracy obtained by both methods (p = 0.011). Similarly, no significant difference was found in partial obstruction group (p = 1.000). During the angiography procedure using 3D-DSA, a significant reduction was observed in both contrast agent quantity and exposure time (p < 0.05) without any apparent effects on renal function. CONCLUSION:Regardless of the degree or type of iliac vein stenosis, 3D-DSA exhibits superior sensitivity compared to 2D-DSA for the diagnosis and evaluation of stenosis. Particularly in instances of noncentral stenosis, 3D-DSA outperforms 2D-DSA.Clinical ImpactThis will provide new insights for the clinical diagnosis and treatment of iliac vein compression syndrome (IVCS), significantly enhancing the diagnostic accuracy of IVCS. For clinicians, three-dimensional digital subtraction angiography (3D-DSA)offers a more comprehensive and detailed assessment in clinical practice, leading to more precise diagnosis and treatment of the disease. The efficacy of two-dimensional digital subtraction angiography (2D-DSA) in treating IVCS is significantly compromised without the guidance from computed tomography venography (CTV). We consider that 3D-DSA can replace CTV in both diagnosis and treatment, providing a new diagnostic and therapeutic strategy.

Background: Mechanical thrombectomy is effective and safe for treating pulmonary embolism (PE). Although the Tendvia mechanical thrombectomy system has been validated in pigs, further evidence supporting its use in PE treatment is needed. Objectives: This study was aimed at evaluating the safety and efficacy of the Tendvia system for intermediate-risk acute PE. Methods: This prospective, single-arm, multicenter study included symptomatic patients with acute PE ≥18 years of age, with a right ventricular (RV)/left ventricular (LV) diameter ratio ≥0.9. The primary efficacy endpoint was the change in RV/LV diameter ratio from baseline to 48 hours postprocedure. The primary safety endpoint was the incidence of major adverse events (AEs), device-related death, 48-hour postprocedure major bleeding, pulmonary vascular injury, and cardiac injury. The secondary efficacy endpoint was the systolic pulmonary arterial pressure (PAP) change from pre- to postprocedure. Secondary safety endpoints included 48-hour postprocedure clinical deterioration, device-related AEs, and symptomatic PE recurrence within 30 days. Results: Of 127 patients at 15 centers with intermediate-risk acute PE who underwent mechanical thrombectomy with the Tendvia system (September 2021 to December 2022), 123 underwent analysis. The mean RV/LV diameter ratio decrease was 0.42 ± 0.28; 95% CI: 0.37–0.47; P < 0.001. The bleeding risk was low, and the hospitalization duration was short. One patient experienced clinical deterioration within 48 hours, and none experienced major AEs, device-related pulmonary vascular injury, cardiac injury, or major bleeding within 48 hours. Seven patients had 11 serious AEs within 30 days. The mean systolic PAP decrease was 7.10 mmHg (P < 0.001). Conclusion: The Tendvia system for mechanical thrombectomy is safe and effective for intermediate-risk acute PE, in agreement with the safety profiles in other studies.

IntroductionRuptured abdominal aortic aneurysm (rAAA) represents a critically urgent vascular surgical condition, and endovascular aneurysm repair (EVAR) is a clinically effective treatment option. This study aims to investigate whether the type of intravascular graft used for ruptured abdominal aortic aneurysms has an impact on perioperative outcomes of EVAR.MethodsA retrospective analysis was conducted on patients who underwent EVAR for ruptured abdominal aortic aneurysm at a single medical center from 2019 to 2022. Patients who required simultaneous stent implantation in the renal arteries or visceral arteries, as well as those with ruptured aneurysms located in the para-renal, supra-renal, or thoracoabdominal regions, were excluded from the analysis. Additionally, patients who underwent open surgery during the initial procedure or converted to open repair were excluded. The primary endpoint was perioperative mortality rate. Other study outcomes included perioperative complications, reoperation rates, and length of hospital stay. Characteristics and corresponding outcomes of patients receiving different endovascular stent treatments were compared using SPSS software.ResultsA total of 58 patients received treatment with two types of endovascular stents: Gore Excluder (n = 29) and Microport Hercules (n = 29). The number of other endografts was too small for statistical analysis. Compared to patients treated with Hercules, those treated with Excluder had a significantly increased likelihood of concomitant coronary atherosclerosis (P = 0.009) and potentially higher creatinine levels (P = 0.014). Additionally, Excluder was more commonly used in patients with shorter aneurysm necks (P < 0.001). There was a statistically significant difference in overall mortality between the two groups (Hercules 27.6%, Excluder 6.9%, P = 0.037). Furthermore, patients who received Excluder treatment had lower mortality rates in subgroups of non-alcohol users (P = 0.028), non-diabetic patients (P = 0.027), and patients with dispersed thrombosis at the proximal neck (P = 0.046). In the multivariate analysis, the type of stent used (OR 0.06, 95% CI 0.00–1.31) and the occurrence of intraoperative complications (OR 20.70, 95% CI 1.14–76.70) in patients with rAAA was identified as an independent risk factor for perioperative mortality.ConclusionOur study suggests that the management of intraoperative complications may be a modifiable factor that can improve outcomes. Patients receiving Excluder treatment demonstrated better performance in EVAR for single-center rAAA patients compared to other endovascular stents, and this difference warrants further investigation.

D-dimer is widely used in the diagnosis of deep vein thrombosis (DVT), but the specificity is low. The study examined the diagnostic value of long non-coding RNA (lncRNA) SNHG12 in DVT, and preliminarily discussed its mechanism. SNHG12 levels were detected in 200 elderly fracture patients via RT-qPCR, including 38 DVTs. Logistic regression analysis and receiver operating characteristic (ROC) curve were applied for diagnostic value evaluation. HUVECs were used for function study. Cell proliferation, migration, apoptosis, release of inflammatory cytokines, and adhesion factors were detected. Student's t test and one-way ANOVA were applied for data comparison between two or among three or more groups. Correlation analysis of indicators was completed via Pearson's correlation analysis. Bioinformatics analysis predicted the target miRNAs and genes of SNHG12, with GO and KEGG for the function enrichment. It was found that SNHG12 was at low expression in DVT patients, and negatively correlated with D-dimer concentration (r = -0.535). SNHG12 and D-dimer were independent influence factors related to the development of DVT. SNHG12 and D-dimer combination had the best performance in DVT diagnosis. In HUVECs, SNHG12 promoted cell proliferation and migration and restricted the release of inflammatory cytokines and adhesion factors, but these influences were counteracted by miR-424-5p. A total of 208 overlapping target genes of miR-424-5p were identified, and their function was enriched in cellular cycle and senescence. PI3K-Akt signaling pathway was the most significant pathway based on KEGG results. In conclusion, SNHG12 had good diagnostic potential for DVT combined with D-dimer. SNHG12 maintains vascular endothelial cell function by acting as a competitive endogenous RNA (ceRNA) for miR-424-5p.

BACKGROUND AND AIMS:Endothelial-to-mesenchymal transition (EndMT) is an important reason for restenosis but the underlying mechanisms need to be further explored. Therefore, the purpose of this study is to screen significantly different microRNAs (miRNAs) and assess their functions and downstream pathways. METHODS:This study screened several miRNAs with significant differences between human arterial segments from restenosis patients and healthy volunteers using whole transcriptome resequencing and real-time quantitative reverse transcription PCR (qRT-PCR). We explored the correlation between miR-1290 and EndMT using Western blot, qRT-PCR, Pearson correlation analysis and further functional gain and loss experiments. Subsequently, we identified the direct downstream target of miR-1290 by bioinformatics analysis, RNA pull-down, double Luciferase reporter gene and other functional experiments. Finally, rat carotid artery balloon injury model demonstrated the therapeutic potential of miR-1290 regulator. RESULTS:We screened 129 differentially expressed miRNAs. Among them, miR-1290 levels were significantly higher in restenosis arteries than in healthy arteries, and as expected, EndMT was functionally enhanced with miR-1290 overexpression and comparatively weakened when miR-1290 was knocked down. In addition, fibroblast growth factor-2 (FGF2) was established as the downstream target of miR-1290. Finally, we utilized an animal model and found that low miR-1290 levels could alleviate EndMT and the progression of restenosis. CONCLUSIONS:Our study demonstrated the strong regulatory effects of miR-1290 on EndMT, endometrial hyperplasia and restenosis, which could be useful as biomarker and therapeutic target for stent implantation in patients with arterial occlusive disease of the lower extremities.

PurposeTo compare the long-term efficacy of the parallel stent graft (PSG), fenestrated stent graft (FSG), and branched stent graft (BSG) techniques to treat thoracoabdominal aortic pathologies.Materials and methodsIn total, 291 patients with thoracic aortic aneurysm (TAA) and dissection (TAD) involving visceral arteries who underwent PSG (n = 85; 15 TAA and 70 TAD), FSG (n = 107; 47 TAD and 60 TAA), or BSG (n = 99; 37 TAD and 62 TAA) were included from multiple centers from January 2015 to December 2022, and a total of 1,108 visceral aortic branches were reconstructed.ResultsThe average reconstruction time of each visceral aortic branch for FSG, BSG, and PSG is 27.5 ± 12.1, 23.2 ± 11.9, and 18.8 ± 11.8 min, respectively (P < 0.01). The free-from-endoleak rate at the last follow-up for FSG, BSG, and PSG was 86.9%, 91.9%, and 60.0%, respectively. The last follow-up patency rate for FSG, BSG, and PSG was 85.0%, 91.9%, and 94.1%, respectively. The average reconstruction price of each visceral aortic branch for FSG, BSG, and PSG was 41.40 ± 3.22 thousand RMB, 41.84 ± 3.86 thousand RMB, and 42.35 ± 4.52 thousand RMB, respectively (P = 0.24).ConclusionTo treat the aortic pathologies involving the visceral segment, BSG had a lower endoleak rate and higher branch patency rate when compared with the FSG and PSG techniques. The expense of BSG was comparable to the other two techniques.