J. Vasc. Dis., Volume 5, Issue 3 (June 2026) – 8 articles

Background/Objectives: This study examined the association between self-reported walking pace and subclinical hypothyroidism (SCH) in relation to atherosclerotic status, as both walking pace and SCH have been linked to an increased risk of all-cause mortality and cardiovascular disease. The vascular network underlying atherosclerotic processes may help explain this relationship. Methods: This was a cross-sectional study involving 1719 Japanese with normal thyroid function (free triiodothyronine [T3] and free thyroxine [T4] levels within the normal range). Since all individuals who participated in this study had free T3 and free T4 levels within the normal range, those with elevated TSH levels (>4.01 μIU/mL) were classified as having SCH. Self-reported faster walking pace was identified based on the participants’ responses to whether they perceived themselves as walking faster than their peers of the same age and sex. Logistic regression models were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for SCH. Results: Of the study participants, 166 had atherosclerosis and 98 had SCH. Among individuals without atherosclerosis, a self-reported faster walking pace was significantly inversely associated with SCH but not among those with atherosclerosis. The sex and age-adjusted ORs (95% CIs) of SCH for self-reported faster walking pace were 0.58 (0.37, 0.91) for those without atherosclerosis and 2.35 (0.75, 7.36) for those with atherosclerosis. Atherosclerosis showed a significant interaction with the association between SCH and self-reported faster walking pace, with sex- and age-adjusted p-values of 0.027. These associations persisted, even after adjusting for potential confounding factors. Conclusions: Self-reported faster walking pace is inversely associated with SCH in individuals without atherosclerosis but not in those with atherosclerosis. Atherosclerosis status may influence the association between SCH and self-reported faster walking pace. Full article

Objectives: This study investigated the effects of exercise selection and rest interval duration on post-exercise cardiac autonomic modulation following resistance exercise (RE). Methods: Eleven (4 females) resistance-trained individuals performed a single RE session consisting of either a multi-joint exercise (back squat) or a single-joint exercise (leg extension), using rest intervals of 1 or 2 min between sets. Heart rate variability (HRV) was assessed at baseline (pre-exercise) and 30 min following the RE session. RR intervals were recorded for 15 min with participants resting in the supine position on an examination bed in a quiet environment. For HRV analysis, a 5-min artifact-free segment of RR intervals was selected and processed using Kubios HRV software, version 4.3.0 (Kubios Oy, Kuopio, Finland). The HRV metrics analyzed included the root mean square of successive differences (RMSSD), low-frequency normalized (LF), the low-frequency/high-frequency (LF/HF) ratio, and the standard deviation of transverse dispersion (SD1). Results: A significant main effect of time was observed for RMSSD, LF, and the LF/HF ratio. The back squat exercise elicited a significant reduction (p < 0.05) in vagal-related indices (RMSSD and SD1) regardless of interval duration. Longer rest intervals were associated with increased (p < 0.05) sympathetic modulation, as reflected by higher LF and LF/HF values 30 min post-exercise. No significant time × group interactions were observed for most HRV variables. Conclusions: Exercise selection and rest interval duration differentially influence post-exercise cardiac autonomic responses following RE. Multi-joint exercises induce greater vagal withdrawal, whereas longer rest intervals favor sympathetic predominance during recovery. These findings highlight the importance of manipulating RE variables to manage autonomic stress and recovery. Full article

Introduction: Blood viscosity is elevated in diabetes and is inversely related to blood flow. The pathology evidence base associated with blood stasis, namely hematocrit and serum total protein levels, is negatively correlated with age, but affordable pathology tests for blood stasis remain underutilized in clinical medicine practice. This study is intended to evaluate changes in estimated whole blood viscosity (eWBV) with age and gender, as an index of blood stasis and its associated indices of hematocrit and serum total protein levels. Method: This was a clinical laboratory observational retrospective study involving 10 years of pathology data. Three clinical medicine parameters, including eWBV, hematocrit and proteinemia, were compared in stratified age groups. Data were those monitored for HbA1c (N = 21,021). Statistical analysis included univariate (ANOVA) and multivariate (MANOVA) as well as correlation. Results: Average levels of proteinemia, hematocrit and eWBV were different in stratified age groups, and lower in females compared to males. MANOVA analysis shows a significant difference in the three clinical medicine parameters between the younger adults and the elderly (p < 0.001). Age and eWBV are inversely correlated, but this may be negligible with diabetes (r = −0.17). Discussion: There are age-related and gender differences in the pathology evidence base that underpins blood viscosity. The implication of lower blood viscosity in women and the elderly is a higher risk of bleeding. The potentially higher risk of bleeding with increasing age is contrary to the concern for thrombosis, which means that antiplatelet prophylaxis among the elderly may be confounded. Full article

Background: While cardiovascular diseases (CVD) manifest in adulthood, vascular changes may begin in childhood. Early markers of CVD, such as carotid intima-media thickness (CIMT), have not been well studied in children in the African setting. The potential influence of environmental and genetic factors on the CIMT of African children is not well understood. Objective: This study assessed the cardiovascular risk profiles of Ghanaian children and adolescents in rural and urban settings using carotid intima-media thickness (CIMT) and ultrasound-measured adiposity. Methods: A cross-sectional study was conducted involving 343 asymptomatic, healthy school children (10–16 years) from the Ashanti region of Ghana. Participants were recruited from one urban and one rural school. Data collected included height, weight, blood pressure, and ultrasound measurements of CIMT, subcutaneous, preperitoneal, and Visceral fat. Results: The mean CIMT for the cohort was 0.60 ± 0.07 mm. Urban children had significantly higher BMI (p < 0.001), subcutaneous fat (p = 0.005), and preperitoneal fat (p < 0.001) compared to rural children, yet there was no significant difference in CIMT between the two sites (p = 0.497). Multiple linear regression revealed that peritoneal fat thickness (p = 0.029) and male gender (p < 0.001) were significant predictors of CIMT, whereas BMI and blood pressure were not. Conclusions: Ghanaian children exhibit elevated CIMT values compared to Western pediatric cohorts despite having lower BMI and normal blood pressure. The significant correlation between peritoneal (visceral) adiposity and CIMT suggests that fat distribution is a more sensitive indicator of early vascular remodeling than BMI in this population. This highlights the need for population-specific screening strategies that move beyond BMI. Full article

Transgender individuals face unique challenges in vascular health due to the complex interactions between gender identity, psychosocial determinants of health, and medical interventions such as gender-affirming hormone therapy (GAHT). Growing evidence indicates that transgender populations may exhibit distinct patterns of vascular disease risk compared with cisgender individuals; however, available data remain limited and heterogeneous. A narrative review of the literature was conducted using major biomedical databases to identify studies examining the vascular and cardiovascular effects of gender-affirming hormone therapy in transgender individuals. This review provides a comprehensive overview of vascular health in transgender people, with particular attention to both venous and arterial disease. We summarize current epidemiological evidence on vascular outcomes and explore biological mechanisms through which exogenous sex hormones, including estrogens, anti-androgens, and testosterone, may influence endothelial function, vascular remodeling, inflammation, and coagulation pathways. Specific emphasis is placed on venous disorders, such as thromboembolic disease and chronic venous disease (CVD), as well as arterial conditions, including chronic peripheral arterial disease (PAD). In addition, we discuss the contribution of traditional vascular risk factors, minority stress, disparities in healthcare access, and social determinants of health in shaping vascular risk profiles. Clinical implications for vascular risk assessment, prevention strategies, and long-term monitoring in transgender individuals receiving GAHT are addressed. Finally, key knowledge gaps and priorities for future research are identified, underscoring the need for robust, longitudinal studies to support personalized and evidence-based vascular care in transgender populations. Full article

Background: Acute aortic dissection compresses diagnosis, transfer, and operative readiness into a narrow time window in which hospital capability may influence survival. Yet U.S. studies define specialized or high-volume care inconsistently, limiting translation of the literature into actionable regionalization criteria. We reviewed U.S. evidence comparing outcomes for acute aortic dissection across hospitals categorized by procedural volume or center specialization. Methods: We performed a PRISMA-aligned systematic review with narrative synthesis. We searched PubMed, Embase, Scopus, Web of Science, and CINAHL for English-language, peer-reviewed studies published from January 2000 through July 2025. Eligible studies included adult U.S. cohorts with acute aortic dissection and reported outcomes stratified by hospital volume tier or center designation. Two reviewers independently screened studies and extracted study characteristics, exposure definitions, analytic approach, and outcomes. We assessed quality to inform interpretation. Results: Searches identified 457 records, and 7 observational U.S. studies met eligibility criteria. Across most studies, higher-volume or specialized-center care was associated with lower in-hospital or 30-day mortality. Two studies showed no meaningful difference. Hospital length of stay was often longer in higher-volume strata. Neurologic complications were inconsistently associated with the center category. Definitions and thresholds used to denote “high volume” or “aortic center” varied substantially across studies. Conclusions: In U.S. observational data, higher-volume or specialized-center care for acute aortic dissection is most consistently associated with improved short-term survival, whereas secondary outcomes are heterogeneous. A major barrier to implementation is definitional inconsistency. Future work should pair transparent volume thresholds with explicit, measurable system capabilities. Full article

Background: Acute portal vein thrombosis (aPVT) is a severe complication of the splanchnic venous system, often associated with portal hypertension, intestinal ischemia, and hepatic dysfunction. Anticoagulation is the first-line therapy but is frequently insufficient in advanced Yerdel grade III–IV cases, where recanalization rates remain low. Endovascular interventions have emerged as alternative therapeutic strategies in selected patients. Methods: We present three cases of patients with Yerdel grade III–IV aPVT who underwent endovascular management. The techniques included: (1) transhepatic aspiration thrombectomy combined with intra-thrombus thrombolysis using alteplase (Actilyse); (2) combined aspiration thrombectomy, intra-thrombus thrombolysis with alteplase, portal vein stenting, and transjugular intrahepatic portosystemic shunt (TIPS) creation; and (3) transsplenic aspiration thrombectomy followed by angioplasty, stent placement, and TIPS creation in a post-liver transplant patient. Results: All procedures were technically successful, achieving complete or near-complete recanalization of the portal venous system. Restoration of patency in the extrahepatic portal circulation was confirmed, and portal pressures were reduced in the TIPS-assisted case. No major periprocedural complications occurred. Clinical outcomes included preservation of transplant candidacy and graft salvage. Conclusions: Endovascular therapy may be an option in selected patients with acute portal vein thrombosis. Careful patient selection and an individualized technical approach are essential. Full article

Objective: The AXS Vecta 46 intermediate catheter (Stryker) features a large inner diameter, enabling effective aspiration, combined with a small outer diameter and soft distal-tip flexibility, which allows for safe tracking through more tortuous and smaller arterial segments to target medium vessel occlusions non-traumatically. The efficacy of the Vecta 46 in the spectrum of large and medium vessel occlusions has not been well elucidated in the literature. Methods: This retrospective cohort study included patients who underwent MT for acute ischemic stroke at our institution between July 2022 and June 2024. The outcomes of patients treated with Vecta 46 were compared to those of all other catheters used at the institution. Results: The distribution of aspiration and stent retriever attempts in Vecta 46 procedures versus non-Vecta 46 procedures was significantly different (p = 0.00325). Aspiration was attempted 1.66 ± 0.936 times in the Vecta 46 group and 1.12 ± 0.650 times in the non-Vecta 46 group (p = 0.00135). More mechanical thrombectomies with the Vecta 46 included aspiration of a secondary thrombus (p = 0.0314), despite no difference in the distribution of the primary or secondary occlusion location. There were no statistically significant differences in recanalization success (p = 0.800), recanalization time (p = 0.245), procedure duration (p = 0.580), discharge modified Rankin Score (p = 0.875), or intracranial hemorrhage rate (p = 0.720) between non-Vecta 46 and Vecta 46 procedures. Conclusions: Vecta 46 has similar safety and functional outcomes compared to other endovascular treatment options despite procedural differences. Full article