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Diagnostics
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Recent Advances in the Diagnosis and Treatment of Vascular Diseases
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Recent Advances in the Diagnosis and Treatment of Vascular Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 4775

Special Issue Editor

Dr. Guillaume Goudot

E-Mail Website
Guest Editor
Hôpital Européen Georges-Pompidou, Paris, France
Interests: arteries; vascular diseases; carotid arteries; peripheral vascular diseases; arterial stiffness
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Vascular diseases are highly heterogeneous conditions in which the blood vessels are affected. These are dominated by atherosclerosis and its complications, and are at the origin of cardiovascular morbidity/mortality. In addition to arterial wall disorders, vascular diseases include microcirculatory, venous, and lymphatic disorders. Recent advances in diagnosing and treating arterial diseases have led to better patient outcomes.

One of the key developments in vascular disease diagnosis is the use of non-invasive imaging techniques such as ultrasound, computed tomography angiography (CTA), and magnetic resonance angiography (MRA). These techniques provide detailed images of the blood vessels, with new imaging markers of disease progression.

From a therapeutic point of view, vascular diseases call for a wide variety of treatments: drug treatment, interventional management, but also, and above all, lifestyle modification and vascular rehabilitation.

This Special Issue invites manuscript submissions dedicated to diagnosing and treating vascular pathologies, with a particular emphasis on the coupling of imaging markers to guide innovative therapeutic approaches.

Dr. Guillaume Goudot
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • artery
  • theranostics
  • imaging
  • endothelial cells
  • atherosclerosis
  • vascular surgery
  • microcirculation
  • thrombosis
  • vasculitis
  • arterial wall

Published Papers (6 papers)

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Research

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10 pages, 215 KiB  
Article
Clinical and Radiological Outcomes of Accessory Renal Artery Exclusion during Endovascular Repair of Abdominal Aortic Aneurysms
by Alessia Di Girolamo, Marta Ascione, Francesca Miceli, Alireza Mohseni, Chiara Pranteda, Pasqualino Sirignano, Maurizio Taurino, Luca di Marzo and Wassim Mansour
Diagnostics 2024, 14(9), 864; https://doi.org/10.3390/diagnostics14090864 - 23 Apr 2024
Viewed by 344
Abstract
Background: Accessory renal arteries (ARAs) frequently coexist with abdominal aortic aneurysms (AAA) and can influence treatment. This study aimed to retrospectively analyze the ARA’s exclusion effect on patients undergoing standard endovascular aneurysm repair for AAA. Methods: The study focused on medium- and long-term [...] Read more.
Background: Accessory renal arteries (ARAs) frequently coexist with abdominal aortic aneurysms (AAA) and can influence treatment. This study aimed to retrospectively analyze the ARA’s exclusion effect on patients undergoing standard endovascular aneurysm repair for AAA. Methods: The study focused on medium- and long-term outcomes, including type II endoleak, aneurysmal sac changes, mortality, reoperation rates, renal function, and infarction post-operatively. Results: 76 patients treated with EVAR for AAA were included. One hundred and two ARAs were identified: 69 originated from the neck, 30 from the sac, and 3 from the iliac arteries. The ARA treatment was embolization in 15 patients and coverage in 72. Technical success was 100%. One-month post-operative computed tomography angiography (CTA) revealed that 76 ARAs (74.51%) were excluded. Thirty-day complications included renal deterioration in 7 patients (9.21%) and a blood pressure increase in 15 (19.73%). During follow-up, 16 patients (21.05%) died, with three aneurysm-related deaths (3.94%). ARA-related type II endoleak (T2EL) was significantly associated with the ARA’s origin in the aneurysmatic sac. Despite reinterventions were not significantly linked to any factor, post-operative renal infarction was correlated with an ARA diameter greater than 3 mm and ARA embolization. Conclusion: ARAs can influence EVAR outcomes, with anatomical and procedural factors associated with T2EL and renal infarction. Further studies are needed to optimize the management of ARAs during EVAR. Full article
(This article belongs to the Special Issue Recent Advances in the Diagnosis and Treatment of Vascular Diseases)
13 pages, 2965 KiB  
Article
The Impact of Sarcopenia in the Long-Term Survival of Patients following Complex Endovascular Aortic Surgery for Thoracoabdominal Aortic Aneurysms
by Georgios Sachsamanis, Judith Stahl, Karin Pfister, Wilma Schierling, Thomas Betz and Simon Jage
Diagnostics 2024, 14(7), 751; https://doi.org/10.3390/diagnostics14070751 - 1 Apr 2024
Viewed by 542
Abstract
Objectives: Image-based sarcopenia has been the subject of recent studies, hypothesized as a prognostic factor for patients with thoracoabdominal aortic aneurysms. Methods and Materials: We conducted a single-center retrospective analysis of patients who underwent complex endovascular repair for thoracoabdominal aortic aneurysms between 2008 [...] Read more.
Objectives: Image-based sarcopenia has been the subject of recent studies, hypothesized as a prognostic factor for patients with thoracoabdominal aortic aneurysms. Methods and Materials: We conducted a single-center retrospective analysis of patients who underwent complex endovascular repair for thoracoabdominal aortic aneurysms between 2008 and 2016. CT image assessment was performed and patients were classified as sarcopenic and non-sarcopenic using two stratification methods: skeletal mass index (SMI) and total psoas muscle index (TPMI). According to sex, each patient was defined as sarcopenic if their SMI or TPMI was in the lowest third of the study group. The primary endpoint was impact of sarcopenia on perioperative mortality and long-term survival. Secondary endpoints were perioperative complications. Results: From a total of 155 patients, 135 were eligible for study. Overall, in-hospital mortality was 5.9% (8/135). The 30-day, 1-year, 3-year and 5-year mortality was 10.4% (14/135), 20% (27/135), 28.1% (38/135) and 31.1% (42/135), respectively. There was no difference in the long-term mortality rates between sarcopenic and non-sarcopenic patients regardless of the stratification method used (p = 0.4 for SMI and p = 0.2 for TPMI). According to SMI, 30-day mortality of sarcopenic patients was significantly lower in comparison to non-sarcopenic patients (1/45, 2.2% vs. 13/90, 14.4%, p = 0.028). Based on the total psoas muscle index, sarcopenic patients were at higher risk for development of pulmonary complications in comparison to non-sarcopenic patients postoperatively (p = 0.03). Conclusion: Using SMI and TPMI, sarcopenia was not associated with reduced long-term survival in patients undergoing complex endovascular repair for thoracoabdominal aortic aneurysms. Full article
(This article belongs to the Special Issue Recent Advances in the Diagnosis and Treatment of Vascular Diseases)
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12 pages, 3144 KiB  
Article
Feasibility of Encord Artificial Intelligence Annotation of Arterial Duplex Ultrasound Images
by Tiffany R. Bellomo, Guillaume Goudot, Srihari K. Lella, Eric Landau, Natalie Sumetsky, Nikolaos Zacharias, Chanel Fischetti and Anahita Dua
Diagnostics 2024, 14(1), 46; https://doi.org/10.3390/diagnostics14010046 - 25 Dec 2023
Viewed by 958
Abstract
DUS measurements for popliteal artery aneurysms (PAAs) specifically can be time-consuming, error-prone, and operator-dependent. To eliminate this subjectivity and provide efficient segmentation, we applied artificial intelligence (AI) to accurately delineate inner and outer lumen on DUS. DUS images were selected from a cohort [...] Read more.
DUS measurements for popliteal artery aneurysms (PAAs) specifically can be time-consuming, error-prone, and operator-dependent. To eliminate this subjectivity and provide efficient segmentation, we applied artificial intelligence (AI) to accurately delineate inner and outer lumen on DUS. DUS images were selected from a cohort of patients with PAAs from a multi-institutional platform. Encord is an easy-to-use, readily available online AI platform that was used to segment both the inner lumen and outer lumen of the PAA on DUS images. A model trained on 20 images and tested on 80 images had a mean Average Precision of 0.85 for the outer polygon and 0.23 for the inner polygon. The outer polygon had a higher recall score than precision score at 0.90 and 0.85, respectively. The inner polygon had a score of 0.25 for both precision and recall. The outer polygon false-negative rate was the lowest in images with the least amount of blur. This study demonstrates the feasibility of using the widely available Encord AI platform to identify standard features of PAAs that are critical for operative decision making. Full article
(This article belongs to the Special Issue Recent Advances in the Diagnosis and Treatment of Vascular Diseases)
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Review

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20 pages, 5248 KiB  
Review
Multi-Modality Imaging in Vasculitis
by Mohamed N. Allam, Nima Baba Ali, Ahmed K. Mahmoud, Isabel G. Scalia, Juan M. Farina, Mohammed Tiseer Abbas, Milagros Pereyra, Moaz A. Kamel, Kamal A. Awad, Yuxiang Wang, Timothy Barry, Steve S. Huang, Ba D. Nguyen, Ming Yang, Clinton E. Jokerst, Felipe Martinez, Chadi Ayoub and Reza Arsanjani
Diagnostics 2024, 14(8), 838; https://doi.org/10.3390/diagnostics14080838 - 18 Apr 2024
Viewed by 605
Abstract
Systemic vasculitides are a rare and complex group of diseases that can affect multiple organ systems. Clinically, presentation may be vague and non-specific and as such, diagnosis and subsequent management are challenging. These entities are typically classified by the size of vessel involved, [...] Read more.
Systemic vasculitides are a rare and complex group of diseases that can affect multiple organ systems. Clinically, presentation may be vague and non-specific and as such, diagnosis and subsequent management are challenging. These entities are typically classified by the size of vessel involved, including large-vessel vasculitis (giant cell arteritis, Takayasu’s arteritis, and clinically isolated aortitis), medium-vessel vasculitis (including polyarteritis nodosa and Kawasaki disease), and small-vessel vasculitis (granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis). There are also other systemic vasculitides that do not fit in to these categories, such as Behcet’s disease, Cogan syndrome, and IgG4-related disease. Advances in medical imaging modalities have revolutionized the approach to diagnosis of these diseases. Specifically, color Doppler ultrasound, computed tomography and angiography, magnetic resonance imaging, positron emission tomography, or invasive catheterization as indicated have become fundamental in the work up of any patient with suspected systemic or localized vasculitis. This review presents the key diagnostic imaging modalities and their clinical utility in the evaluation of systemic vasculitis. Full article
(This article belongs to the Special Issue Recent Advances in the Diagnosis and Treatment of Vascular Diseases)
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11 pages, 548 KiB  
Review
Nailfold Capillaroscopy Analysis Can Add a New Perspective to Biomarker Research in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis
by Gianluca Screm, Lucrezia Mondini, Paola Confalonieri, Francesco Salton, Liliana Trotta, Mariangela Barbieri, Marco Mari, Nicolò Reccardini, Rossana Della Porta, Metka Kodric, Giulia Bandini, Michael Hughes, Mattia Bellan, Selene Lerda, Marco Confalonieri and Barbara Ruaro
Diagnostics 2024, 14(3), 254; https://doi.org/10.3390/diagnostics14030254 - 24 Jan 2024
Viewed by 990
Abstract
Background: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) includes granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA), all of which are characterised by inflammation of small–medium-sized vessels. Progressive understanding of these diseases has allowed researchers and clinicians to start [...] Read more.
Background: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) includes granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA), all of which are characterised by inflammation of small–medium-sized vessels. Progressive understanding of these diseases has allowed researchers and clinicians to start discussing nailfold video capillaroscopy (NVC) as a future tool for many applications in daily practice. Today, NVC plays a well-established and validated role in differentiating primary from secondary Raynaud’s phenomenon correlated with scleroderma. Nevertheless, there has not been sufficient attention paid to its real potential in the ANCA-associated vasculitis. In fact, the role of NVC in vasculitis has never been defined and studied in a multicentre and multinational study. In this review, we carried out a literature analysis to identify and synthesise the possible role of capillaroscopy for patients with ANCA-associated vasculitis. Methods: Critical research was performed in the electronic archive (PUBMED, UpToDate, Google Scholar, ResearchGate), supplemented with manual research. We searched in these databases for articles published until November 2023. The following search words were searched in the databases in all possible combinations: capillaroscopy, video capillaroscopy, nailfold-video capillaroscopy, ANCA-associated vasculitis, vasculitis, granulomatosis with polyangiitis, EGPA, and microscopic polyangiitis. Results: The search identified 102 unique search results. After the evaluation, eight articles were selected for further study. The literature reported that capillaroscopy investigations documented non-specific abnormalities in 70–80% of AAV patients. Several patients showed neoangiogenesis, capillary loss, microhaemorrhages, and bushy and enlarged capillaries as the most frequent findings. Furthermore, the difference between active phase and non-active phase in AAV patients was clearly discernible. The non-active phase showed similar rates of capillaroscopy alterations compared to the healthy subjects, but the active phase had higher rates in almost all common abnormalities instead. Conclusions: Microvascular nailfold changes, observed in patients affected by vasculitis, may correlate with the outcome of these patients. However, these non-specific abnormalities may help in the diagnosis of vasculitis. As such, new analysis analyses are necessary to confirm our results. Full article
(This article belongs to the Special Issue Recent Advances in the Diagnosis and Treatment of Vascular Diseases)
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Other

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11 pages, 1212 KiB  
Case Report
Isolated Intramural Hematoma of Superior Mesenteric Artery: Case Reports and a Review of Literature
by Marta Ascione, Rocco Cangiano, Alireza Mohseni, Andrea Molinari, Antonio Marzano, Alessia Di Girolamo, Luca Di Marzo and Wassim Mansour
Diagnostics 2023, 13(23), 3581; https://doi.org/10.3390/diagnostics13233581 - 1 Dec 2023
Viewed by 881
Abstract
(1) Background: Spontaneous isolated intramural hematoma of the superior mesenteric artery (SIHSMA) is a rare entity often considered as a subset of spontaneous isolated dissection of the superior mesenteric artery (SIDSMA). It is characterized by a completely thrombosed false lumen with or without [...] Read more.
(1) Background: Spontaneous isolated intramural hematoma of the superior mesenteric artery (SIHSMA) is a rare entity often considered as a subset of spontaneous isolated dissection of the superior mesenteric artery (SIDSMA). It is characterized by a completely thrombosed false lumen with or without an ulcer-like projection with computed tomography (CT) imaging. The recent literature describes few reports with a relatively short-term follow-up. The natural course, prognosis, and treatment options for SIHSMA still lack consensus. We present two cases of acute abdominal pain in a young man due to IMH of the superior mesenteric artery with an extensive literature review. (2) Case report: A 46-year-old male patient was submitted to an urgent CTA for acute abdominal pain, showing the presence of an isolated dissection of the superior mesenteric artery, determining significant stenosis of the vessel with collateral vessel patency. The patient referred to a recent COVID-19 infection, whose course was paucisymptomatic. He was conservatively treated with antiplatelet therapy and corticosteroid treatments, and, after a few days, the symptomatology completely regressed; also, the 2-month-control CTA showed complete IMH regression and the absence of any signs of residual stenosis. The second patient was a 61-year-old male patient who was submitted to an urgent CTA for acute abdominal pain, showing the presence of an isolated dissection of the superior mesenteric artery, not determining significant vessel stenosis. He was conservatively treated with antiplatelet therapy and corticosteroid treatment, and after a few days, the symptomatology completely regressed and the radiological control showed complete dissection regression. (3) Conclusion: SISHSMA is a rare entity of vascular pathology, and conservative management represents the best medical strategy. We propose corticosteroid treatment as one of the most appropriate tools in the conservative treatment of SISHSMA. Full article
(This article belongs to the Special Issue Recent Advances in the Diagnosis and Treatment of Vascular Diseases)
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