Ganglioneuroma (GN) is a rare benign tumor arising from sympathetic ganglion cells, often located in the retroperitoneum. We report a case of a 33-year-old woman presenting with intermittent low back pain for 2 months. Imaging revealed a large retroperitoneal mass (24 × 36 × 68 mm) encasing the inferior vena cava (IVC) and right renal vein, with a high suspicion for GN or lymphangioma. Surgical exploration via laparotomy confirmed a tough, adherent mass (5 × 8 × 10 cm) intimately associated with the IVC and renal vessels. Complete resection with vascular repair was performed. Pathology confirmed mature ganglion cells positive for SOX10 and S100, consistent with GN. The patient recovered uneventfully and remained well at 4-month follow-up.

Two-dimensional (2D) computational fluid dynamics (CFD) models have been conventionally adopted for simulating a wide range of fluid flow problems. It is especially useful when the fluid-flow domain is almost 2D, has perfect symmetry (e.g., axial symmetry), or the 3D geometry is too complex and hence too computationally demanding. For the last case, the difference between the "realistic" 3D geometry of the system under investigation and the "surrogate" 3D geometry represented by a 2D model should be fully appreciated in order to rationally predict fluid flow behavior. This article aims at the development of a surrogate 2D CFD model for reliable prediction of gastric emptying, which is critical for understanding the digestion process. The motivation for such development is first justified by the significant overestimation of emptying rate by a conventional 2D model. Respecting the difference between the 3D realistic and surrogate geometries, to achieve equivalent emptying rate, we then develop a mapping approach that can convert measured dynamic data on pyloric diameter to pyloric size evolution in the 2D model. This surrogate model not only has high computational efficiency due to its 2D nature but also achieves emptying rate that is very close to the 3D model. At the same time, it can capture 3D flow behavior, such as retropulsive flow and recirculation eddies. Furthermore, the model demonstrates excellent generality for fluids with different properties, offering a powerful tool for gastric emptying studies.

Snail mucus has shown promise in promoting wound healing; however, its active components and their mechanisms of action are poorly understood. In the present study snail mucus was isolated and hydrolyzed using trypsin to obtain snail mucus active peptides (SMAPs). SMAPs were analyzed using liquid chromatography-mass spectrometry, and bioinformatics screening. Among the screened peptides, an active 12-amino-acid peptide, EK-12 (molecular weight: 1366.2 Da), was identified and synthesized using a solid-phase peptide synthesis approach. In vitro functional verification showed that EK-12 significantly promoted endothelial cell proliferation, migration, and tube formation. An in vivo experiment demonstrated that EK-12 significantly accelerated wound healing in mouse models. Pathological examination revealed a significantly upregulated expression of CD31 and vascular endothelial growth factors in wound tissues, suggesting that this is the mechanism by which the active peptide promotes angiogenesis and wound healing. Thus, snail mucus-derived peptides hold strong potential for development as therapeutic agents for wound healing.

BACKGROUND:To establish a large animal model of deep venous thrombosis (DVT) secondary to chronic iliac vein stenosis (IVS) that can simulate pathophysiologic processes in humans. METHODS:IVS models with degrees of stenosis of approximately 30%, 50%, 70%, and 90% were developed in 4 groups of 12 adult goats using a novel controllable ligation technique. Four weeks later, the stenotic lesion was evaluated by digital subtraction angiography (DSA) and optical coherence tomography (OCT), after which iliac vein thrombosis adjacent to the stenosis was induced by balloon blockade combined with thrombin injection. Three days after thrombosis, the process of clinical thrombus clearance was simulated by a rheolytic thrombectomy catheter, and the IVS was corrected by balloon angioplasty and stent implantation. RESULTS:After controllable ligation, venography revealed IVS degrees of 31.39 ± 3.09%, 48.95 ± 1.24%, 71.34 ± 5.12%, and 89.78 ± 4.66% in the four groups. After 4 weeks, DSA and OCT showed obvious collateral circulation and intimal hyperplasia around stenotic lesions in group 3, which was consistent with the secondary pathological changes in IVS in humans. The iliac veins in groups 1 and 2 remained patent without obvious collateral circulation, while group 4 showed complete iliac vein occlusion with extensive collaterals. Thrombosis was successfully induced in groups 1 and 2, but groups 3 and 4 required repeated thrombin injections and a shortened distance between the two balloons. Clinical thrombus-clearing devices removed most thrombi, and residual stenosis was corrected by balloon angioplasty and stent implantation. OCT confirmed optimal stent apposition. CONCLUSION:This study developed a caprine model of IVS-related thrombosis, which can facilitate research on the IVS-DVT relationship and the evaluation of thrombectomy devices and specialized stents for IVS.

Poly(ester amide)s (PEAs) represent promising biomaterials because of their well-balanced mechanical properties, biodegradability, and biocompatibility. However, practical applications of PEAs are still limited by challenges in functional versatility and environmental adaptability. Here, we present the first synthesis of periodic selenium-incorporated PEAs (Se-PEAs) via a rapid, catalyst-free selenol-yne click polymerization process. By harnessing the versatility of selenium, we achieved precise modulation of material properties. The resulting Se-PEAs demonstrated tunable mechanical behavior, spanning rigid plastics to elastomers, alongside exceptional thermal stability and high optical clarity. Programmable degradation profiles ensure long-term stability in physiological environments while facilitating rapid oxidative degradation at the end of the lifecycle. Surface selenoniumization further conferred robust antibacterial efficacy without compromising mechanical integrity. This multifunctionality positions Se-PEAs as transformative materials for biomedical implants, sustainable packaging, and high-refractive-index optics. Our work advanced functional polymer design and underscored the potential of selenium chemistry in addressing global challenges in terms of plastic waste and ecological sustainability.

To assess the feasibility and safety of a novel closure technique, namely the parallel closure technique (Par-CT), in which the sheath is placed parallel to the ProGlide system during veno-arterial extracorporeal membrane oxygenation (VA-ECMO) to enhance the efficiency of percutaneous vascular haemostasis. The abdominal aortas of goats were punctured with a 17F sheath to simulate arterial cannula vascular access for VA-ECMO, and the Par-CT was used to achieve vascular haemostasis. In five goats, the abdominal aorta was punctured with a 17F sheath and then a 6 to 10F vascular sheath was introduced. This resulted in a smaller vascular rupture area and successful closure of the aortic rupture using the Par-CT. If the sheath tube that was introduced was < 8 F, the puncture site could not be closed and would therefore have to be resutured and the Par-CT would have to be repeated. However, the puncture site could be sutured appropriately if the sheath tube that was introduced was ≥ 8F. This study suggested that the Par-CT is both safe and effective for haemostasis after weaning from VA-ECMO.

Chronic venous insufficiency (CVI) is a prevalent lower limb condition among elderly and sedentary individuals, commonly manifested by ankle edema, varicose veins, and superficial venous reflux. Conventional diagnostic techniques, such as palpation and Doppler ultrasound, offer limited quantification and are unsuitable for continuous monitoring. In this study, we present a wearable monitoring system embedded within smart socks, employing flexible capacitive stretch sensors to enable real-time measurement of ankle circumference and dynamic assessment of venous function. A custom-designed capacitance sensing circuit based on an operational amplifier was developed, emphasizing miniaturization, low noise, and extended battery life. The system demonstrated excellent performance, with a linearity of 0.9994, a drift rate of 5.72×10⁻3 %/min, and a signal-to-noise ratio (SNR) of 74.77 dB. Clinical validation involving active ankle dorsiflexion confirmed the system’s ability to accurately track dynamic changes and consistently compute ejection fraction (EF)—a key indicator of venous return—with a coefficient of variation (CV) of 0.011. These results highlight the system’s potential as a reliable, high-precision tool for early detection and ongoing management of CVI in everyday settings.

BACKGROUND:Intermediate-high risk acute pulmonary embolism (PE) carries a significant long-term burden of post-thrombotic syndrome (PTS) and chronic thromboembolic pulmonary hypertension (CTEPH). Standard anticoagulation does not actively resolve obstructive thrombi, and systemic thrombolysis is limited by high bleeding risk. While percutaneous mechanical thrombectomy (PMT) offers rapid thrombus removal, robust multicenter evidence regarding its efficacy in preventing long-term complications is scarce, leading to its current class IIb recommendation in major international guidelines (2022 ESC, 2024 AHA). AIMS:To compare the long-term complications, right heart function, and quality of life between patients with intermediate-high risk acute pulmonary embolism treated with 8 F catheter percutaneous mechanical thrombectomy plus anticoagulation versus anticoagulation alone. OBJECTIVES:This study sought to evaluate whether 8 F catheter simple aspiration PMT combined with standard anticoagulation, compared to anticoagulation alone, improves long-term outcomes-including PTS, CTEPH, right heart function, and quality of life-in patients with intermediate-high risk acute PE. METHODS:In this multicenter, retrospective cohort study, we enrolled 426 patients with intermediate-high risk acute PE from 10 regional tertiary centers (2019-2023). After 1:1 propensity score matching (PSM) to balance baseline characteristics, patients were allocated into a PMT plus anticoagulation group (n = 182) and an anticoagulation-alone group (n = 244). Primary endpoints were the incidence of PTS at 12 months (diagnosed via modified Villalta scale) and CTEPH at 24 months (confirmed by right heart catheterization). Secondary endpoints included right ventricular ejection fraction (RVEF), SF-36 quality of life scores, and adverse events (all-cause mortality, PE recurrence, major bleeding) at 24 months. RESULTS:After a median follow-up of 24 months, the PMT group demonstrated significantly lower incidences of 12-month PTS (15.2% vs. 34.8%; adjusted HR = 0.32, 95% CI: 0.19-0.54; p < 0.001) and 24-month CTEPH (1.3% vs. 5.6%; adjusted HR = 0.25, 95% CI: 0.11-0.57; p = 0.001). The PMT group also exhibited superior improvement in RVEF at 24 months (from baseline 36.2% ± 5.7% to 58.2% ± 6.3% in the PMT group vs. from baseline 35.8% ± 6.1% to 46.3% ± 6.1% in the control group; between-group p < 0.001) and all core domains of the SF-36 at 24 months (all p < 0.001). Critically, the two groups had comparable rates of all-cause mortality (2.7% vs. 3.7%, p = 0.518), PE recurrence (2.2% vs. 2.9%, p = 0.632), and major bleeding (3.3% vs. 2.9%, p = 0.806). CONCLUSION:In patients with intermediate-high risk acute PE, 8 F catheter PMT combined with anticoagulation significantly reduces the risks of PTS and CTEPH, enhances right ventricular recovery, and improves quality of life, without increasing adverse events. These compelling real-world findings challenge the current guideline positioning (e.g., 2022 ESC, 2024 AHA) that classifies PMT as a class IIb rescue therapy and strongly support its consideration as a first-line treatment strategy for this patient population.

Transjugular intrahepatic portosystemic shunt (TIPS) is an effective method for reducing portal hypertension in patients with decompensated cirrhosis. However, portal vein puncture is associated with a steep learning curve. Conventional “blind” puncture methods are often imprecise, carry a high risk of complications, and require significant radiation exposure. To increase puncture accuracy, we developed an intravascular navigational ultrasound (IVNU) system. This study aimed to evaluate the feasibility, efficacy, and safety of IVNU for portal vein puncture during TIPS procedures. In the in vitro experiment, we performed punctures using IVNU in four isolated porcine livers. Subsequently, in the in vivo animal study, eight Bama swine (Sus scrofa) were randomly assigned to undergo TIPS using either IVNU (experimental group) or conventional “blind” puncture with the RUPS100 COOK kit (control group). In our in vitro experiment, the IVNU system successfully punctured each lobe. In our in vivo study, all the procedures successfully established portosystemic shunts. The IVNU group exhibited significantly fewer punctures (1.8 ± 0.4 vs. 4.2 ± 1.1), shorter procedure times (32.5 ± 4.2 min vs. 58.7 ± 6.5 min), shorter fluoroscopy times (8.1 ± 1.3 min vs. 20.4 ± 2.1 min), and lower radiation doses (579.5 ± 45.9 mGy vs. 1305.7 ± 50.4 mGy) than the control group (all P < 0.01). Puncture-related complications were also significantly reduced in the IVNU group. These findings indicate that IVNU significantly improves portal vein targeting success, reduces the risk of puncture-related complications and radiation exposure, and decreases procedure time, offering clinicians an optimized solution for TIPS creation.

Abdominal aortic aneurysm (AAA) treatment relies on covered stents, yet thrombosis, restenosis, and delayed endothelialization remain challenges. This study developed a bifunctional heparin/zwitterionic polymer (CBMA) coating on dopamine-modified stents via surface-initiated atom transfer radical polymerization (SI-ATRP). The coating integrates CBMA's antifouling properties (98.5% reduction in BSA adsorption) with heparin's sustained anticoagulation (37% APTT prolongation, 17 s TT increase) and endothelialization promotion (194.97% endothelial cell activity after 5 days). Animal trials confirmed reduced TNF-α expression (75% decrease), enhanced collagen deposition, neovascularization post-28 days, and preserved mechanical strength (diametral tensile strength >57 MPa) with 25% lower permeability. This dual-functional coating offers a novel synergistic strategy for antithrombosis and endothelial repair in clinical applications.

PURPOSE:To assess whether paclitaxel-drug-eluting stent (Paclitaxel-DES) can inhibit in-stent restenosis (ISR) in the iliac vein after thrombectomy. MATERIALS AND METHODS:A bilateral iliac vein thrombosis model was established in 12 goats. Three days after thrombosis induction, percutaneous mechanical thrombectomy was performed for bilateral iliac vein thrombosis. A Paclitaxel-DES was placed in 1 iliac vein, whereas a bare-metal stent (BMS) was placed in the contralateral vein as a control. ISR and intimal hyperplasia were evaluated using angiography, optical coherence tomography, and histopathological examination at 1, 2, and 6 months after stent implantation. RESULTS:Compared with the BMS group, the Paclitaxel-DES group showed significantly reduced intimal hyperplasia at 1 and 2 months postoperatively and exhibited a lower percent area stenosis (P < .01). Fluorescence staining revealed lower smooth muscle cell expression and higher inflammation scores in the Paclitaxel-DES group at 1 month (P < .05). However, no significant differences in the percent area stenosis or lumen loss rate were observed between the 2 groups at 6 months after implantation (P > .05). CONCLUSIONS:Paclitaxel-DES significantly inhibited intimal hyperplasia and reduced ISR during the early stages after iliac vein thrombectomy. No significant difference in lumen loss was observed between the Paclitaxel-DES and BMS groups after 6 months, suggesting a potential late catch-up effect in the Paclitaxel-DES group.

Cardiovascular disease (CVD) is a major global health challenge, which causes significant illness and death worldwide. These include a range of conditions that affect the heart and blood vessels, including coronary artery disease, stroke, peripheral artery disease, and heart failure. Despite advances in medicine and healthcare delivery, CVD continues to have a serious impact on individuals, families, and the healthcare system. This review begins by delineating the merits and demerits of commonly employed synthetic and natural materials for artificial blood vessels. It delves into various techniques commonly employed in the fabrication of artificial blood vessels, encompassing traditional textile technologies, electrospinning, thermally induced phase separation, and 3D printing. The review critically analyzes the attributes of different preparation methodologies alongside the latest advancements in research. The review also outlines the requisite performance requirements for artificial blood vessels, which encompass robust mechanical properties, appropriate porosity, exceptional compatibility, and antibacterial attributes. It provides a succinct overview of ongoing efforts in vascular functionalization, particularly emphasizing thrombus mitigation, promotion of endothelialization, and enhancement of nitric oxide production. The review finally encapsulates the primary challenges confronting vascular grafts and prospective avenues for future research.

The dialysis catheter indwelling in human bodies has a high risk of inducing thrombus and stenosis. Biomechanical research showed that such physiological complications are triggered by the wall shear stress of the vascular vessel. This study aimed to assess the impact of CVC implantation on central venous haemodynamics and the potential alterations in the haemodynamic environment related to thrombus development. The SVC structure was built from the images from computed tomography. The blood flow was calculated using the Carreau model, and the fluid domain was determined by CFD. The vascular wall and the CVC were computed using FEA. The elastic interaction between the vessel wall and the flow field was considered using FSI simulation. With consideration of the effect of coupling, it was shown that the catheter vibrated in the vascular systems due to the periodic variation of blood pressure, with an amplitude of up to 10% of the vessel width. Spiral flow was observed along the catheter after CVC indwelling, and recirculation flow appeared near the catheter tip. High OSI and WSS regions occurred at the catheter tip and the vascular junction. The arterial lumen tip had a larger effect on the WSS and OSI values on the vascular wall. Considering FSI simulation, the movement of the catheter inside the blood flow was simulated in the deformable vessel. After CVC indwelling, spiral flow and recirculation flow were observed near the regions with high WSS and OSI values.

In the clinical application of intravascular optical coherence tomography (IVOCT), it is necessary to flush opaque blood during image acquisition. However, there are no specific standards for how to perform low-dose but effective flushing. In this study, computational fluid dynamics (CFD) and optical models were integrated to numerically simulate the complete process of IVOCT, which includes blood flushing with normal saline followed by image acquisition. Moreover, an intermittent injection scheme was proposed, and its advantages over the conventionally adopted scheme of continuous injection were verified. The results show that intermittent injection can significantly reduce the dosage of normal saline (reduced by 44.4%) with only a slight sacrifice of image quality (reduced by 8.7%, but still acceptable). The developed model and key findings in this work can help surgeons practice optimized IVOCT operations and potentially lead to improved designs of the IVOCT equipment.

Background: This study aimed to evaluate the safety and efficacy of performing diagnostic cerebral angiography using a 5-Fr guiding catheter with a 0.035-inch guidewire in place. Methods: Actual flow rates at different pressures using the 5-Fr guiding catheter with a 0.035-inch guidewire in place were measured in vitro. Integrity of the guidewire surface after high-pressure injection was determined by examination under a light microscope and scanning electron microscope. Injected and unused contrast medium were collected and analyzed using a particle detector. Furthermore, a prospective randomized controlled study was conducted to compare safety and efficacy between the guided (guidewire in place) and conventional methods. Results: The maximum injection pressure at a flow rate of 5 mL/s for the various types of commonly used contrast medium was approximately 350 psi, which is below the pressure limit for cerebral angiography. The guidewire surface remained relatively intact after multiple high-pressure injections. Procedure success and primary success rates did not significantly differ between the guided and conventional methods. However, procedure time (25.93 ± 4.07 vs 31.55 ± 5.49 minutes) and radiation exposure time (12.16 ± 3.82 vs 17.27 ± 6.12 minutes) were significantly shorter in the guided method group. Conclusion: The guided catheterization method is safe and feasible for cerebral angiography and has several advantages over the conventional method.

Purpose: To establish an animal model for in-stent restenosis (ISR) after postthrombotic iliac vein stent placement and characterize histopathological changes in tissue within the stented vein. Materials and Methods: Iliac vein thrombosis was induced using balloon occlusion and thrombin injection in 8 male Boer goats. Mechanical thrombectomy and iliac vein stent placement were performed 3 days after thrombosis induction. Restenosis was evaluated by venography and optical coherence tomography (OCT) at 1 and 8 weeks after stent placement, and stent specimens were taken for pathological examination after the animals were euthanized. Results: Thrombosis induction was successful in all 8 goats, with >80% iliac vein occlusion. After thrombus removal, OCT revealed considerable venous intimal thickening and a small number of mural thrombi. Neointimal hyperplasia with thrombus formation was observed in all goats 1 week after stent implantation; the degree of ISR was 15%-33%. At 8 weeks, the degree of ISR was 21%-32% in 3 goats, and stent occlusion was observed in 1 goat. At 1 week, the neointima predominantly consisted of fresh thrombi. At 8 weeks, proliferplastic fibrotic tissue and smooth muscle cells (SMCs) were predominant, and the stent surfaces were endothelialized in 2 of 3 goats and partially endothelialized in 1 goat. Conclusions: In the goat model, postthrombotic neointimal hyperplasia in the venous stent may result from timedependent thrombus formation and organization, accompanied by migration and proliferation of SMCs, causing ISR. These results provide a basis to further explore the mechanism of venous ISR and promote the development of venous stents that reduce neointimal hyperplasia.

Objective: We retrospectively investigated the association between the imaging features of spontaneous isolated superior mesenteric artery dissection (SISMAD) accompanied by total true lumen occlusion and the clinical symptoms to identify the patients at high risk and establish personalized therapeutic options. Methods: Among 261 patients with SISMAD, we selected 37 with Yun's type III dissection; 35 patients underwent successful conservative management and 2 patients underwent exploratory laparotomy. After discharge, all patients were periodically followed up on an outpatient basis. We recorded patients' general condition, symptoms, time until symptom relief, imaging findings and follow-up results. Results: All patients experienced acute abdominal pain prior to admission, with an onset time of 29.95 +/- 24.66 hours. The mean time until relief of abdominal pain in patients who received conservative treatment was 42.17 +/- 38.09 hours. Correlation analysis revealed no correlation between the length of dissection or of the occluded segment and abdominal pain intensity. Pain scores were lower and time until pain relief was shorter in patients with a definite arc of Riolan (AOR) on admission than in those without an AOR. No collateral circulation was observed in the two patients who underwent exploratory laparotomy, and distal intestinal perfusion was poor in these cases. Complete and partial remodeling of the superior mesenteric artery (SMA) was observed in 6 and 16 patients, respectively at the 12-month follow-up. Although the SMA remained occluded in 12 patients, abundant collateral circulation was detected. Three patients were lost to follow-up. Conclusion: This study highlights that conservative treatment should be attempted as first-line therapy in most patients with Yun's type III SISMAD. Complete AOR can contribute to remission of clinical symptoms during the acute stage. Poor distal blood flow of occluded vessels may serve as an important indicator for identification of patients at high risk of ischemic intestinal necrosis.

BACKGROUND:Phlegmasia cerulea dolens (PCD) is a rare and serious complication of deep venous thrombosis and iliac vein lesions (IVLs) are the most common cause of PCD. The purpose of this study was to explore the safety and efficacy of single-stage endovascular thrombus removal and stenting to treat PCD caused by IVLs.METHODS:Clinical data of 13 patients with PCD secondary to IVL were retrospectively analyzed. They underwent endovascular thrombus removal, including rheolytic thrombectomy, manual aspiration thrombectomy, and simultaneous iliac vein stenting after thrombus removal. The safety and efficacy of single-stage endovascular thrombectomy and stenting in the treatment of PCD were evaluated.RESULTS:The technical success rate was 100% (13/13). Postoperative symptoms were significantly relieved in all patients. There were no perioperative major bleeding complications or other critical adverse events. Two (15.4%) patients had slightly elevated serum creatinine concentration after surgery, which returned to normal before discharge. At the 12-month follow-up, the stent primary patency rate was 81.8% and there were no cases of severe post-thrombotic syndrome.CONCLUSIONS:Single-stage endovascular thrombectomy and stenting in PCD due to IVLs was minimally invasive, safe, and effective; it is recommended as a first-line treatment for PCD caused by IVLs.

目的 为髂静脉狭窄继发深静脉血栓形成的发病机制研究以及实验性器具研发提供良好的动物模型.方法 将12只波尔山羊编号后采用随机目数表法分为A、B、C 3组(每组4只),建立50％、70％、90％髂静脉狭窄模型.采用球囊阻断髂静脉、注射凝血酶诱导血栓形成.血栓形成后采用机械血栓清除系统(AngioJet)清除血栓,并通过数字减影血管造影(DSA)及光学相干断层扫描(OCT)观察静脉管腔及内膜变化,多组数据之间采用单因素方差分析,两组数据之间采用独立样本t检验.结果 A组和B组山羊凝血酶诱导技术成功率均为100％(8/8),所有山羊经凝血酶诱导后均发生髂静脉血栓形成.C组1只山羊出现髂静脉闭塞,另2只山羊单独用凝血酶诱导血栓失败,辅助球囊损伤内膜后成功诱导血栓形成.A、B两组取栓后管腔通畅、显影良好,术后髂静脉内膜较术前增厚(t=-9.21,P＜0.01).结论 本研究结果显示在50％～70％的慢性髂静脉狭窄中,采用球囊阻断联合凝血酶注射具有更高的建模成功率.

近年来,光学相干层析成像(optical coherence tomography,OCT)发展迅速. 它使用近红外光代替声波,利用类似超声波脉冲回波成像的方式[1, 2],通过干涉法测量光在不同深度组织的折射率,从而生成高分辨的组织内部横截面图像[3].目前OCT已被应用于临床多个领域,包括视神经病变[4, 5]、皮肤癌[6]、牙科[7]和血管等.