Unmet Needs and Opportunities for Australian Innovation and Clinical Research to Improve Quality of Life and Outcomes in Patients With Peripheral Artery Disease

Heart Lung and Circulation, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Peripheral arterial disease (PAD) is characterised by atherosclerotic stenosis or occlusion of arteries that leads to reduced blood flow the limbs. PAD associated with a very high rate cardiovascular morbidity and mortality making health economic burden substantial. Despite high-quality evidence international guidelines recommending conservative medical management risk factors, exercise lifestyle interventions, surgical revascularisation (open endovascular) remains main treatment for PAD. Alarmingly, up one-third patients do not receive best therapy after surgery despite supporting this reduces events. Due considerable presents, manuscript aims identify gaps in care clinical research across Australia proposes potential collaborative solutions. In Australia, there significant disparity between rural/regional metropolitan communities. These are exacerbated inequitable access services particularly First Nation Australians, culturally linguistically diverse groups those living regional remote areas. This review identifies unmet needs multifaceted, spanning from improved understanding mechanisms, diagnostic tools stratification personalised therapy, paucity rehabilitation therapies symptoms prevention complications. Furthermore, opportunities national registries optimise trial quality outcomes. Strategies should be applied improve implementation optimal which will life, reduce costs, prevent secondary complications, limb loss, Australia's population.

Language: Английский

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Aortic Dissection: An Unexpected Complication of Transcatheter Aortic Valve Implantation

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 6, 2025

A 53-year-old female with a medical history of multiple cardiovascular risk factors, alcoholic chronic hepatic disease (Child-Pugh B) thrombocytopenia, and severe calcified aortic stenosis was admitted for an elective transcatheter valve implantation (TAVI). After the procedure, patient hypotensive unresponsive to fluid challenge, there significant difference in blood pressure between two arms. The echocardiogram confirmed normal position function prosthetic but suggestive dissection. thoracic angiotomography urgently done revealed flap intima layer aorta at arch level, false lumen beginning proximal left subclavian artery without extension ascending or descending aorta. multidisciplinary team opted conservative management dissection, treatment only. discharged later remains clinically stable one-year follow-up.

Language: Английский

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Endovaskuläre Therapie der aortoiliakalen Verschlusskrankheit

Deleted Journal, Journal Year: 2025, Volume and Issue: 66(3), P. 249 - 257

Published: Feb. 14, 2025

Arterial occlusive disease of the central arteries involving abdominal aorta and iliac leads to multiple symptoms such as intermittent claudication, including gluteus muscle, erectile dysfunction. A description indications, technique clinical outcomes endovascular therapy aorto-iliac artery disease. Due new techniques improved stents stent grafts developed over last two decades, obstructions has become standard method for treatment claudication in experienced centers. Open surgical bypass revascularisation is mainly indicated after a failed attempt or case unfavourable anatomy therapy, flush occlusions distal renal origins. less frequently used technique, hybrid revascularisation, combines open thromboendarterectomy common femoral implantation ipsilateral aorta. Obstructions internal resulting in, among other things, dysfunction hip are ever more treated with either drug-eluting balloons. In appropriate operator experience suitable anatomy, first-line strategy artery.

Language: Английский

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Hospital frailty risk and CHA2DS2-VA scores in the mortality assessment of older patients with peripheral artery disease

VASA, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 17, 2025

Summary: Background: Older patients with peripheral artery disease (PAD) encounter an increased risk of in-hospital mortality. Accurate scoring methods are crucial for assessing the likelihood cardiovascular events in these patients. However, a comprehensive comparison predicting mortality PAD has not yet been conducted. Patients and methods: This study analyzed 173,075 hospitalized year 2020 from German nationwide registry. We assessed five scores: Elixhauser Comorbidity Index, Charlson CHA 2 DS -VA Score, EuroSCORE, Hospital Frailty Risk Score (HFRS). The average patient age was 72 ± 10.94 years, 36.82% female 35.27% also diagnosed diabetes mellitus. overall rate 2.68%. Mean scores were 7.12±6.55 2.66±1.72 3.85±1.43 8.96%±8.85% 3.53±5 HFRS. HFRS showed highest predictive potential area under curve (AUC) 0.86 (95% confidence interval (CI): 0.86–0.87) but had worst calibration high-risk lowest AUC 0.69 CI: 0.68–0.70) most consistent prediction model regarding calibration. Conclusions: effective predictor mortality, did detect those very high robust increasing score points sensitivity. Therefore, use combined application appears to be appropriate identifying older at

Language: Английский

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Infrared monitoring-based optimization of interventional lumbar sympathectomy outcomes evaluation in peripheral vascular disease patients: Experimental trial thermovision-guided lumbar sympathectomy

Medicine, Journal Year: 2025, Volume and Issue: 104(7), P. e41524 - e41524

Published: Feb. 14, 2025

Chronic limb-threatening ischemia (CLTI) is associated with significant mortality and limb loss. The interventional lumbar sympathectomy (LS) one of the supportive treatment options for CLTI patients, reducing pain intensity peripheral arterial resistance. use LS has gradually declined despite its positive effects. contradictory results studies dealing evidence tissue perfusion improvement after are possible explanations. We describe a new approach evaluation efficacy in 2 patients below-the-knee arteries pathology our observational cohort experimental trial. utilized angiosome concept foot. Angiography identified angiosomes occluded source artery. relationship between corresponding surface areas angiosomes-dermatomes was identified. infrared thermography used measurement thermal changes dermatomes before LS. Based on their dermatomes, we estimated procedure. found that clinically relevant increase temperature (>1°C) presented only to hypothesize opens up anastomoses angiosomes, resulting redistribution blood flow an

Language: Английский

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