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Journal of Vascular Diseases

Journal of Vascular Diseases is an international, peer-reviewed, open access journal on all aspects of cardiovascular, cerebrovascular, and peripheral vascular diseases, published bimonthly online by MDPI.

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All Articles (178)

  • Review
  • Open Access

Giant Cell Arteritis: Cardiac and Aortic Complications at the Cardio-Rheumatology Interface

  • Jay Gohri,
  • Tanisha Jindal and
  • Shivaram P. Arunachalam
  • + 18 authors

Giant cell arteritis (GCA) is the most common primary systemic vasculitis of older adults and has traditionally been framed as an ophthalmologic emergency. Its most serious consequences, however, occur in the cardiovascular system, often years after inflammatory markers have normalized. In contemporary matched population cohorts, patients with GCA carry an approximately two-fold excess risk of aortic aneurysm; the historical Olmsted County cohort reported a 17-fold excess of thoracic aortic aneurysm with wide confidence limits, and the characteristic latency to aneurysm is five to ten years. Patients also face elevated risks of aortic dissection, myocardial infarction, stroke, venous thromboembolism, and heart failure that cluster within the first year of diagnosis, when vascular inflammation is most active. This narrative review, based on a structured search of PubMed/MEDLINE and Google Scholar through September 2026 with independent verification of every cited estimate, synthesizes current evidence on the full spectrum of cardiac and aortic complications of GCA, including aortitis, aneurysm and dissection, coronary arteritis, valvular disease, pericarditis, myocarditis, and conduction disease. We trace their common origin to the immunopathology of the arterial wall, where dendritic cell activation, Th1/Th17 polarization, and maladaptive vascular remodeling produce occlusion in medium-sized arteries and dilation in the aorta. We examine current diagnostic modalities, from the ultrasound-based fast-track clinic, which has reduced permanent visual loss by half or more in observational cohorts, to FDG-PET/CT, in which aortic uptake at diagnosis is associated with subsequent aortic dilation. We review treatment after the GiACTA and SELECT-GCA trials in the light of the 2025 European Alliance of Associations for Rheumatology (EULAR) recommendations, the unresolved role of antiplatelet and statin therapy, and the surgical and endovascular management of GCA-related aortopathy. We suggest that the organization of care, as well as the limitations of drug therapy, may contribute to the residual mortality of GCA, a hypothesis that has not been tested; distinguish recommendations that are supported by current guidelines from those that are our own proposals; and outline a cardio-rheumatology pathway in which baseline vascular phenotyping informs individualized aortic surveillance. GCA is a disease whose natural history often begins in the rheumatology clinic and ends in the cardiac operating room without prior surveillance.

J. Vasc. Dis.

30 September 2026

Immunopathogenesis of giant cell arteritis, from the adventitia to the vessel wall.
  • Editorial
  • Open Access

Peripheral vascular diseases encompass an extraordinarily heterogeneous spectrum of disorders, ranging from highly prevalent atherosclerotic and venous conditions to uncommon vascular syndromes, anatomical variants, and vascular tumors [...]

J. Vasc. Dis.

3 October 2026

  • Case Report
  • Open Access

Background: The facial artery exhibits considerable anatomical variability in its course, branching pattern, caliber, and terminal distribution. Facial arterial tortuosity has also been reported to increase with age, making it important to distinguish unusual vascular configurations from morphological changes potentially associated with ageing. The present anatomical case describes a markedly tortuous unilateral facial artery associated with multiple consecutive cervical and facial loops, a prominent ascending arterial branch, an unusual double arterial pattern supplying the lower-lip region, and preservation of the lateral nasal–angular continuation. Case Presentation: Anatomical dissection was performed in an 82-year-old female body donor after injection of approximately 100 mL of red-pigmented liquid latex through the common carotid arterial system. The right facial artery exhibited two large cervical loops before crossing the inferior border of the mandible and five additional loops or marked curvatures along its facial course. After careful mechanical unfolding, the cervical segment measured approximately 58 mm and the facial–angular segment approximately 70 mm. A prominent ascending arterial branch arose from the facial artery near the level of the oral commissure and followed an independent superior course for approximately 30 mm before dividing into secondary branches. Two independently arising arterial branches coursed toward the lower-lip region. The more cranial vessel followed a course compatible with an inferior labial artery, whereas the second vessel followed a deeper, more caudal, and predominantly horizontal trajectory, raising the possibility of a horizontal labiomental artery. Distally, the facial artery continued through the lateral nasal and angular territories and established an anastomotic communication with the dorsal nasal artery. The contralateral facial artery followed a substantially more direct course without a comparable multi-loop configuration. Conclusions: This case documents a complex unilateral facial arterial configuration characterized by marked tortuosity involving both cervical and facial segments and associated with additional branching variations. The advanced age of the donor must be considered as a potential contributing factor to the observed arterial tortuosity, and the present anatomical observation does not establish a specific developmental or pathological mechanism. Likewise, the coexistence of multiple arterial features should be interpreted as a morphological association rather than evidence of a common embryological origin. Such individualized arterial configurations may have potential relevance for surgical dissection, reconstructive procedures, and image-guided facial interventions and reinforce the value of patient-specific vascular assessment whenever technically feasible.

J. Vasc. Dis.

28 September 2026

  • Review
  • Open Access

Background/Objectives: Artificial intelligence (AI) has emerged as a promising adjunct in intracranial aneurysm (IA) care, with potential applications in diagnosis, rupture risk assessment, treatment planning, and outcome prediction. This review summarizes current AI-based approaches in the management and prognostication of IAs. Methods: A structured search of PubMed, Embase, and Scopus was conducted for English-language studies published from January 2001 to 14 April 2026, evaluating machine learning (ML), deep learning, or large language model (LLM) applications in IA diagnosis, treatment, or prognosis. After screening and full-text review, 45 studies were included. Results: AI models demonstrated utility across several domains of aneurysm care. Deep learning approaches supported aneurysm detection and morphological segmentation, while traditional ML models were applied to rupture status classification, aneurysm stability, treatment selection, occlusion prediction, and post-treatment outcomes. Emerging LLMs showed early promise in treatment recommendation and prognostication, although evidence remains limited. Conclusions: AI may improve individualized aneurysm management from initial diagnosis to long-term outcome prediction by integrating clinical, radiographic, procedural, and hemodynamic data beyond conventional scoring systems. However, current models are limited by retrospective designs, heterogeneous outcomes, limited external validation, and concerns regarding interpretability, bias, and clinical implementation. Prospective multicenter validation and standardized reporting are needed before AI tools can be reliably incorporated into routine aneurysm care.

J. Vasc. Dis.

24 September 2026

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J. Vasc. Dis. - ISSN 2813-2475