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Vascular Disease: Etiologic, Diagnostic, Prognostic and Therapeutic Research—2nd Edition

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A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 21 February 2025 | Viewed by 12267

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Special Issue Editors

Prof. Dr. Dan Mircea Olinic

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Guest Editor

1. Internal Medicine Department, Medical Clinic no. 1, Iuliu Hatieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
2. County Emergency Hospital Cluj-Napoca, 400000 Cluj-Napoca, Romania
Interests: vascular medicine; atherothrombosis; cardiology
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Prof. Dr. Agata Stanek

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Department and Clinic of Internal Medicine, Angiology, and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland
Interests: physical medicine; thermal imaging; cryotherapy; cryogenic temperatures; vascular medicine; oxidative stress; rehabilitation; internal medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The Guest Editors are grateful to the many researchers who contributed to the success of the first volume of this Special Issue (https://www.mdpi.com/journal/life/special_issues/vascular_etiology_diagnosis_threapy_prognosis). We are very pleased to now announce the second volume of our Special Issue.

Vascular diseases have an increasing morbidity and mortality impact, as they are related to population aging, socio-economic factors or increasing prevalence of risk factors, such as diabetes. The ongoing COVID-19 pandemic has led to vascular complications, both at the arterial and venous sites. Vascular medicine is not just a field of intense medical research, having also become a distinct medical specialty or subspecialty in many countries. Vascular diseases involve peripheral arteries and veins, aorta and visceral abdominal vessels and cervical vessels, such as carotids and vertebral arteries. Cardiac and cerebral complications are often related to vascular diseases. Coronary, carotid and peripheral arteries have common atherothrombotic etiology and share many clinical diagnostic, prognostic and therapeutic relationships. Microcirculation is a field of increasing fundamental and clinical research interest, both for arterial and venous diseases. The research field in vascular diseases and medicine is broad and opened to contributions from fundamental (genetics, haemostasis, biochemistry, etc.) and clinical medicine. Diagnosis and therapy of vascular diseases are performed by medical, surgical and interventional procedures and specialists. The scope of this Special Issue covers specific arterial and venous diseases, their specific impact on organ diseases and the relationships between vascular diseases at multiple sites. New drugs are developed to control risk factors (dyslipidemia, hypertension, diabetes, etc.) or for antiplatelet and anticoagulant therapy, with a significantly beneficial prognostic impact. Surgical revascularization at different arterial sites improves morbidity and mortality. Interventional procedures gain ground on both arterial and venous sites and have been proven safe and effective. The aim of this Special Issue is to offer an overview of the richness of vascular fundamental and clinical medicine, covering all aspects of etiologic, diagnostic, prognostic and therapeutic research.

Prof. Dr. Dan Mircea Olinic
Prof. Dr. Agata Stanek
Guest Editors

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Keywords

vascular diseases
etiology
diagnosis
prognosis
therapy

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10 pages, 871 KiB

Open AccessArticle

Catheter-Directed Arterial Thrombolysis with a Low-Dose Recombinant Tissue Plasminogen Activator Regimen for Acute Lower Limb Ischemia—Results of the First Regional Registry of Acute Limb Ischemia in Romania

by Sorin Barac, Roxana Ramona Onofrei, Octavian Barbu, Stelian Pantea, Cristina Pleșoianu, Ciprian Gîndac, Bogdan Timar and Andreea Luciana Rață

Life 2024, 14(11), 1516; https://doi.org/10.3390/life14111516 - 20 Nov 2024

Viewed by 626

Abstract

Acute limb ischemia is a limb-threatening condition that is associated with a high degree of mortality and morbidity, with the latter related to acute kidney injury and rhabdomyolysis that can rapidly lead to multiple organ failure. The aim of this study was to assess the efficacy and safety of catheter-directed arterial thrombolysis in acute lower limb ischemia in the Department of Vascular Surgery, Timișoara, Romania. A total of 158 patients (114 males—72.15% and 44 females—27.85%) with symptoms of acute lower limb ischemia were admitted and treated with catheter-directed arterial thrombolysis following our protocol. The amputation-free survival rate at 1 month after the thrombolysis was 82.3%, and at 6 months it was 77.85%. The performance of additional procedures to obtain distal perfusion was predictive of an improved outcome at 30 days. The estimated survival rate at 6 months was 84.81% (SE 0.02). The mean survival time was 158.74 days. We recommend the usage of a thrombolytic regimen in patients with a life expectancy of more than 6 months, even in Rutherford stage IIb patients, if there is no major impairment in the sensorial and mobility function of the ischemic leg. Full article

(This article belongs to the Special Issue Vascular Disease: Etiologic, Diagnostic, Prognostic and Therapeutic Research—2nd Edition)

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13 pages, 1747 KiB

Open AccessArticle

The Effect of Arterial Elongation on Isolated Common Iliac Artery Pathologies

by Ádám Szőnyi, Balázs Bence Nyárády, Márton Philippovich, Adrienn Dobai, Ekrem Anil Sari, András Szőnyi, Anikó Ilona Nagy and Edit Dósa

Life 2024, 14(11), 1440; https://doi.org/10.3390/life14111440 - 7 Nov 2024

Viewed by 695

Abstract

Purpose: to investigate the effects of vessel geometry on steno-occlusive and dilatative common iliac artery (CIA) pathologies. Methods: this single-center, retrospective study included 100 participants, namely 60 participants with a unilateral, isolated CIA pathology who were divided into three pathology-based groups (a stenosis group, n = 20, an occlusion group, n = 20, and an aneurysm group, n = 20) and 40 participants without a CIA pathology (control group). All participants underwent abdominal and pelvic computed tomography angiography. The aortoiliac region of the participants was reconstructed into three-dimensional models. Elongation parameters (tortuosity index (TI) and absolute average curvature (AAC)) and bifurcation parameters (iliac take-off angle, iliac planarity angle, and bifurcation angle) were determined using an in-house-written piece of software. Demographic data, anthropometric data, cardiovascular risk factor data, and medical history data were obtained from participants’ electronic health records. The following statistical methods were used: one-way ANOVA, chi-square test, t-tests, Wilcoxon test, Kruskal–Wallis test, and multivariate linear regression. Results: in the occlusion group, both TI and AAC values were significantly higher on the contralateral side than on the ipsilateral side (both p < 0.001), whereas in the aneurysm group the AAC values were significantly higher on the ipsilateral side than on the contralateral side (p = 0.001). The ipsilateral and contralateral TI and AAC values of the iliac arteries were significantly higher in the aneurysm group than in the other three groups (all p < 0.001). Age significantly affected all of the elongation parameters except for the TI of the infrarenal aorta (all p < 0.010 except the TI of the infrarenal aorta). In addition, the AAC values for the iliac arteries were significantly associated with obesity (ipsilateral iliac artery, p = 0.045; contralateral iliac artery, p = 0.047). Aortic bifurcation parameters did not differ significantly either within each group (ipsilateral versus contralateral side) or between the individual groups. Conclusions: occlusions tend to develop in relatively straight iliac arteries, whereas unilateral, isolated CIA aneurysms are more likely to occur in elongated aortoiliac systems. Full article

(This article belongs to the Special Issue Vascular Disease: Etiologic, Diagnostic, Prognostic and Therapeutic Research—2nd Edition)

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8 pages, 1995 KiB

Open AccessArticle

Left Ventricular Strains and Right Ventricular Longitudinal Shortening Are Associated in Healthy Adults—A Detailed Analysis from the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Healthy Study

by Attila Nemes, Árpád Kormányos, Nóra Ambrus and Csaba Lengyel

Life 2024, 14(11), 1422; https://doi.org/10.3390/life14111422 - 4 Nov 2024

Viewed by 613

Abstract

Introduction: The right ventricle (RV) lies on the left ventricle (LV), and their shapes and movements are characteristic and significantly different. The aim of the present study was to investigate the relationship between three-dimensional speckle-tracking echocardiography (3DSTE)-derived LV strains, which represent LV contractility as quantitative features, and tricuspid annular plane systolic excursion (TAPSE) as determined by M-mode echocardiography, which represents the longitudinal movement of the RV, in healthy adults. Methods: A total of 79 healthy adults (mean age: 28.1 ± 6.3 years; 33 men) were enrolled in the present study. After two-dimensional Doppler echocardiography, 3DSTE-derived data acquisition was carried out in all cases, and detailed 3DSTE-based analysis was performed offline at a later date. Results: Reduced TAPSE was associated with increased global and basal LV radial strain (RS). Increased TAPSE was also associated not only with increased global and basal LV-RS but also with global LV longitudinal strain (LS). An increase in global LV-RS and global LV circumferential strain (CS) showed associations with other strains except for global LV-LS. An increase in global LV-LS did not show associations with other strains. Increased global LV-RS was associated with reduced TAPSE, while the degree of global LV-LS and global LV-CS did not show associations with TAPSE. Conclusions: Three-dimensional speckle-tracking echocardiography-derived LV-RS and LV-LS are associated with the longitudinal shortening of the RV represented by TAPSE in healthy adults. Full article

(This article belongs to the Special Issue Vascular Disease: Etiologic, Diagnostic, Prognostic and Therapeutic Research—2nd Edition)

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13 pages, 2206 KiB

Open AccessArticle

Regimens and Response Assessment in Minimally Invasive Image-Guided Therapies for Vascular Malformations: Insights from a Large Cohort Study at a Tertiary-Care Hospital

by Gesa Doreen Savic, Giovanni F. Torsello, Anne Frisch, Gero Wieners, Uli Fehrenbach, Timo Alexander Auer, Willie Magnus Lüdemann, Bernhard Gebauer and Lynn Jeanette Savic

Life 2024, 14(10), 1270; https://doi.org/10.3390/life14101270 - 5 Oct 2024

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This retrospective study was aimed at characterizing vascular malformations (VMFs) presenting for minimally invasive image-guided therapies (MIT) at a tertiary-care center and evaluating treatment regimens and image-based outcomes using MRI. We analyzed demographic, disease-related, and radiologic features of VMFs presenting to interventional radiology between May 2008 and August 2020 using compendium vascular anomaly (Compva) criteria. MIT and specific agents were evaluated, and treatment effects were assessed through volumetry and mean signal intensity (MSI) on multiparametric longitudinal MRI. The statistics included the paired t-test, ANOVA, and Fisher’s exact test. The cohort included 217 patients (mean age 30 ± 18.4 years; 134 female). Venous malformations were most common (47%). VMFs were frequently located in the head-neck region (23.5%), legs (23.04%), and arms (13.8%). Among 112 treatments, sclerotherapy was performed most frequently (63.9%), followed by embolization (19.3%). MRI showed a significant reduction in T2 MSI for venous (1107.95 vs. 465.26; p = 0.028) and decreased contrast media uptake for lymphatic malformations (557.33 vs. 285.33; p = 0.029) after sclerotherapy, while the lesion volumes did not change significantly (p = 0.8). These findings propose MRI-derived MSI as a potential non-invasive biomarker for assessing the response of VMF to MIT. By leveraging MRI, this study addresses challenges in managing rare diseases like VMFs, while advocating for standardized approaches and prospective studies to better link imaging findings with clinical outcomes. Full article

(This article belongs to the Special Issue Vascular Disease: Etiologic, Diagnostic, Prognostic and Therapeutic Research—2nd Edition)

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12 pages, 7449 KiB

Open AccessArticle

Optimizing Femoral Access in Emergency EVAR with a Decision-Making Algorithm

by Domenico Mirabella, Salvatore Bruno, Manfredi Agostino La Marca, Ettore Dinoto, Edoardo Rodriquenz, Andrea Miccichè and Felice Pecoraro

Life 2024, 14(9), 1113; https://doi.org/10.3390/life14091113 - 4 Sep 2024

Viewed by 850

Abstract

Endovascular aneurysm repair (EVAR) has become the preferred approach over open repair for abdominal aortic aneurysms (AAAs) due to its minimally invasive nature. The common femoral artery (CFA) is the main access vessel for EVAR, with both surgical exposure and percutaneous access being utilized. However, in emergent cases, percutaneous access can be challenging and may result in complications such as bleeding or dissection thrombosis, leading to the need for surgical conversion. This study aimed to share experiences in implementing a decision-making algorithm to reduce surgical conversions due to percutaneous access failures. A total of 74 aortic patients treated with EVAR in emergency settings were included in this retrospective study. This study focused on various outcomes such as perioperative mortality, morbidity, procedure time, surgical exposure time, and surgical conversion rate. After the implementation of the decision-making algorithm, decreases in surgical conversions and operating time were observed. Percutaneous access was found to be more challenging in cases with specific anatomical characteristics of the CFA, such as severe atherosclerosis or smaller vessel diameter. This study highlighted the importance of carefully assessing patient anatomical features and utilizing a decision-making algorithm to optimize outcomes in EVAR procedures. Further research is needed to continue improving practices for managing aortic aneurysms and reducing complications in femoral artery access approaches. Full article

(This article belongs to the Special Issue Vascular Disease: Etiologic, Diagnostic, Prognostic and Therapeutic Research—2nd Edition)

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10 pages, 3203 KiB

Open AccessArticle

Hydrogen Gas Inhalation Treatment for Coronary Artery Lesions in a Kawasaki Disease Mouse Model

by Wen-Ling Shih, Tsung-Ming Yeh, Kuang-Den Chen, Steve Leu, Shih-Feng Liu, Ying-Hsien Huang and Ho-Chang Kuo

Life 2024, 14(7), 796; https://doi.org/10.3390/life14070796 - 24 Jun 2024

Viewed by 1241

Abstract

Background: Kawasaki disease (KD) is a syndrome primarily affecting young children, typically under the age of five, and is characterized by the development of acute vasculitis. Through extensive research conducted on both murine and human subjects, it has been demonstrated that heightened levels of reactive oxygen species (ROS) play a pivotal role in the development of KD, especial coronary artery lesions (CALs). Hydrogen gas exhibits potent antioxidant properties that effectively regulate ROS production and the inflammatory response. Methods: We used Lactobacillus casei cell wall extract (LCWE)-induced vasculitis in mice as an animal model of KD and treated the mice with hydrogen gas inhalation. Results: We observed significant dilatation and higher Z scores in the left coronary artery (LCA) in D21 and D28 in mice after LCWE treatment compared to the control group (p < 0.001) and a significant resolution of LCA diameters (p < 0.01) and Z scores (p < 0.01) after treatment with inhaled hydrogen gas. We further demonstrated that serum IL-6 expression was higher in mice after LCWE treatment (p < 0.01) and IL-6 significantly decreased after inhaled hydrogen gas therapy (p < 0.001). Conclusion: According to our literature review, this is the first report where hydrogen gas inhalation has been demonstrated to be effective for the treatment of coronary artery dilatation in a KD murine model. Full article

(This article belongs to the Special Issue Vascular Disease: Etiologic, Diagnostic, Prognostic and Therapeutic Research—2nd Edition)

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12 pages, 681 KiB

Open AccessArticle

The Clinical Impact of Access Site Selection for Successful Thrombolysis and Intervention in Acute Critical Lower Limb Ischaemia (RAD-ALI Registry)

by Adam Csavajda, Karoly Toth, Nandor Kovacs, Szilard Rona, Zoltan Vamosi, Balazs Berta, Flora Zsofia Kulcsar, Olivier F. Bertrand, Istvan Hizoh and Zoltan Ruzsa

Life 2024, 14(6), 666; https://doi.org/10.3390/life14060666 - 23 May 2024

Viewed by 1091

Abstract

Background: Acute limb ischaemia (ALI) is of great clinical importance due to its consequent serious complications and high comorbidity and mortality rates. The purpose of this study was to compare the acute success and complication rates of CDT performed via transradial, transbrachial, and transfemoral access sites in patients with acute lower limb vascular occlusion and to investigate the 1-year outcomes of CDT and MT for ALI. Methods: Between 2008 and 2019, 84 consecutive patients with ALI were treated with CDT in a large community hospital. Data were collected and retrospectively analysed. The primary (“safety”) endpoints encompassed major adverse events (MAEs), major adverse limb events (MALEs), and the occurrence of complications related to the access site. Secondary (“efficacy”) endpoints included both technical and clinical achievements, treatment success, fluoroscopy time, radiation dose, procedure time, and the crossover rate to an alternative puncture site. Results: CDT was started with radial (n = 17), brachial (n = 9), or femoral (n = 58) access. CDT was technically successful in 74/84 patients (88%), but additional MT and angioplasty and/or stent implantation was necessary in 17 (20.2%) and 45 cases (53.6%), respectively. Clinical success was achieved in 74/84 cases (88%). The mortality rate at 1 year was 14.3%. The cumulative incidence of MAEs and MALEs at 12 months was 50% and 40.5%, respectively. After conducting multivariate analysis, history of Rutherford stage IIB (hazard ratio [HR], 3.64; 95% confidence interval [CI], 1.58–8.41; p = 0.0025), occlusion of the external iliac artery (HR, 27.52; 95% CI, 2.83–267.33; p = 0.0043), being a case of clinically unsuccessful thrombolysis (HR, 7.72; 95% CI, 2.48–23.10; p = 0.0004), and the presence of diabetes mellitus (HR, 2.18; 95% CI, 1.01–4.71; p = 0.047) were independent predictors of a high MAE mortality rate at 12 months. For MALEs, statistically significant differences were detected with the variables history of Rutherford stage IIB (HR, 4.30; 95% CI, 1.99–9.31; p = 0.0002) and external iliac artery occlusion (HR, 31.27; 95% CI, 3.47–282.23; p = 0.0022). Conclusions: Based on the short-term results of CDT, acute limb ischaemia can be successfully, safely, and effectively treated with catheter-directed thrombolytic therapy with radial, brachial, or femoral access. However, radial access is associated with fewer access site complications. A history of Rutherford stage IIB, occlusion of external iliac artery, unsuccessful thrombolysis, and the presence of diabetes mellitus were independently associated with an increased risk of MAEs. A history of Rutherford stage IIB and external iliac artery occlusion are independent predictors of MALEs. Full article

(This article belongs to the Special Issue Vascular Disease: Etiologic, Diagnostic, Prognostic and Therapeutic Research—2nd Edition)

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12 pages, 773 KiB

Open AccessArticle

The Protective Effect of the Crosstalk between Zinc Hair Concentration and Lymphocyte Count—Preliminary Report

by Tomasz Urbanowicz, Anetta Hanć, Jolanta Tomczak, Michał Michalak, Anna Olasińska-Wiśniewska, Patrycja Rzesoś, Mateusz Szot, Krzysztof J. Filipiak, Beata Krasińska, Zbigniew Krasiński, Andrzej Tykarski and Marek Jemielity

Life 2024, 14(5), 571; https://doi.org/10.3390/life14050571 - 29 Apr 2024

Viewed by 1378

Abstract

Background: An imbalance between pro- and anti-inflammatory mechanisms is indicated in the pathophysiology of atherosclerotic plaque. The coronary artery and carotid disease, despite sharing similar risk factors, are developed separately. The aim of this study was to analyze possible mechanisms between trace element hair–scalp concentrations and whole blood counts that favor atherosclerotic plaque progression in certain locations. Methods: There were 65 (36 (55%) males and 29 (45%) females) patients with a median age of 68 (61–73) years enrolled in a prospective, preliminary, multicenter analysis. The study group was composed of 13 patients with stable coronary artery disease (CAD group) referred for surgical revascularization due to multivessel coronary disease, 34 patients with carotid artery disease (carotid group) admitted for vascular procedure, and 18 patients in a control group (control group). Results: There was a significant difference between the CAD and carotid groups regarding lymphocyte (p = 0.004) counts. The biochemical comparison between the coronary and carotid groups revealed significant differences regarding chromium (Cr) (p = 0.002), copper (Cu) (p < 0.001), and zinc (Zn) (p < 0.001) concentrations. Spearman Rank Order Correlations between lymphocyte counts and trace elements in the analyzed groups were performed, revealing a strong correlation with zinc (R = 0.733, p < 0.001) in the control group (non-CAD, non-carotid). Conclusion: Significant differences in hair–scalp concentrations related to atherosclerosis location were observed in our analysis. The interplay between zinc concentration and lymphocyte count may play a pivotal role in cardiovascular disease development. Full article

(This article belongs to the Special Issue Vascular Disease: Etiologic, Diagnostic, Prognostic and Therapeutic Research—2nd Edition)

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12 pages, 920 KiB

Open AccessArticle

ADAMTS13, von Willebrand Factor, Platelet Microparticles, Factor VIII, and Impact of Somatic Mutations in the Pathogenesis of Splanchnic Vein Thrombosis Associated with BCR-ABL-Negative Myeloproliferative Neoplasms

by Roberto Castelli, Alessandra Berzuini, Roberto Manetti, Alessandro Palmerio Delitala, Dante Castro, Giuseppe Sanna, Marta Chiara Sircana, Nicia Isabella Profili, Arianna Bartoli, Leyla La Cava, Giorgio Lambertenghi Deliliers, Mattia Donadoni and Antonio Gidaro

Life 2024, 14(4), 486; https://doi.org/10.3390/life14040486 - 9 Apr 2024

Cited by 1 | Viewed by 1390

Abstract

Background: Myeloproliferative neoplasms (MPNs) are often associated with splanchnic vein thrombosis (SVT). Not all the factors involved in the thrombotic tendency are currently known. Objectives: This study aims to evaluate a possible association between ADAMTS13, von Willebrand factor (VWF), platelet microvesicles (MV), and factor VIII activity (FVIII:C) with thrombotic events in MPN patients. Materials and methods: In total, 36 consecutive MPN patients with SVT were enrolled. The MPNs were diagnosed based on clinical characteristics and one or more gene mutations among JAK-2, CALR, and MPL. As controls, 50 randomly selected patients with MPN without thrombosis, 50 patients with deep vein thrombosis without MPNs, and 50 healthy blood donors were evaluated. Complete blood count, ADAMTS13, VWF, MV, and FVIII:C in plasma were measured in all the subjects. Results: The JAK-2 mutation was found in 94% of the patients with SVT, but none were triple-negative for genetic mutations (JAK2 V617F, CALR, MPL, and exon 12). Compared to the normal subjects, in all the MPN patients (with or without SVT), the levels of ADAMTS13 were found to be significantly lower (p < 0.001) and the MV concentrations were significantly higher (p < 0.001). Among the MPN patients, the VWF and FVIII:C levels were significantly higher in the patients with SVT than those without thrombosis (p = 0.007 and p = 0.04, respectively). Splenomegaly was present in 78% of MPN patients with SVT and in 30% of those without SVT (p < 0.001). The ADAMTS13/VWF ratio was reduced in all the patients, but not in the healthy blood donors (p < 0.001). Conclusions: The significant increase in circulating MV, VWF, and FVIII:C in the MPN patients and in the patients with thrombosis supports the role of endothelium damage in promoting thrombotic events. In particular, a significant increase in VWF and FVIII:C levels was found in the MPN patients with SVT. Full article

(This article belongs to the Special Issue Vascular Disease: Etiologic, Diagnostic, Prognostic and Therapeutic Research—2nd Edition)

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13 pages, 2802 KiB

Open AccessReview

Peripheral Artery Disease Ultrasound Assessment in Predicting the Severity of Coronary Artery Disease

by Maria Olinic, Florin-Leontin Lazar, Horea-Laurentiu Onea, Calin Homorodean, Mihai Ober, Dan Tataru, Mihail Spinu, Alexandru Achim and Dan-Mircea Olinic

Life 2024, 14(3), 333; https://doi.org/10.3390/life14030333 - 1 Mar 2024

Cited by 2 | Viewed by 2000

Abstract

Atherosclerosis in a progressive disease that is systemic in nature, and hence the simultaneous presentation of coronary artery disease (CAD) and peripheral artery disease (PAD) is not uncommon. As clinically manifested PAD is associated with worse cardiovascular outcomes, the timely identification of subclinical atherosclerosis seems of utmost importance. Ultrasonography (US) is an ideal imaging modality for assessing PAD that is easy to use, accurate, widely available and avoids unnecessary exposure to radiation. Several US parameters have been proposed in the assessment of PAD, with varying prognostic usefulness, depending on disease location. The aim of this review is to summarize the most important evidence available on the association between US-detected atherosclerosis in different vascular sites and the presence and severity of CAD, as well as the impact of the early detection of PAD on the outcomes of patients presenting with CAD. Full article

(This article belongs to the Special Issue Vascular Disease: Etiologic, Diagnostic, Prognostic and Therapeutic Research—2nd Edition)

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10 pages, 1558 KiB

Open AccessCase Report

Significant Calcification of an Entire Aortic Tree with Renal Artery Subocclusion: Acute Kidney Injury, Ischemic Kidney Disease, and the Tissue Viability Question—A Case Report

by Marko Baralić, Selena Gajić, Aleksandra Kezić, Ana Bontić, Jelena Pavlović, Voin Brković, Vidna Karadžić Ristanović, Danka Bjelić, Maja Životić, Sanja Radojević-Škodrić, Želimir Antonić, Nenad Ilijevski and Milan Radović

Life 2025, 15(1), 82; https://doi.org/10.3390/life15010082 - 11 Jan 2025

Viewed by 280

Abstract

Background: Undiagnosed and untreated atherosclerotic renal artery stenosis (ARAS) can result in end-stage kidney disease (ESKD). To obtain an accurate diagnosis, it is crucial to recognize the symptoms and signs suggesting renal artery stenosis (RAS) and perform appropriate diagnostic and treatment procedures afterward. Case Presentation: We present a case of a 60-year-old female patient with hypertensive crisis, acute heart failure (HF), and pulmonary edema as the initial signs of acute kidney injury (AKI) caused by right RAS and left renal artery occlusion in the presence of severe aortic atherosclerosis revealed on computed tomography angiography (CTA) of the abdomen. The patient’s renal function recovered completely following percutaneous transluminal angioplasty (PTA) with stent implantation in the right renal artery at the site of subocclusion. Conclusions: Even in patients with concomitant disorders like type-2 diabetes mellitus (T2DM), hypertension (HTN), or HF, the dilatation of significantly narrowed renal arteries due to severe calcifications can result in complete renal function recovery. Full article

(This article belongs to the Special Issue Vascular Disease: Etiologic, Diagnostic, Prognostic and Therapeutic Research—2nd Edition)

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11 pages, 5482 KiB

Open AccessCase Report

Unique Subclavian Vascular Ring Anomaly: Insights from CT Angiography

by Radu Octavian Baz, Mihaly Enyedi, Cristian Scheau, Andreea Cristiana Didilescu, Radu Andrei Baz and Cosmin Niscoveanu

Life 2025, 15(1), 77; https://doi.org/10.3390/life15010077 - 10 Jan 2025

Viewed by 318

Abstract

Aortic arch anomalies represent a range of congenital vascular malformations resulting from disruptions in the typical embryological development of the aortic arch and its branches. These anomalies, which vary widely in their presentation, can lead to significant clinical symptoms depending on their structure and position. We report the case of a 75-year-old male with intermittent hypertension, palpitations, and episodic warmth in the upper body. Computed tomography (CT) angiography revealed an atypical aortic arch anatomy with a unique right subclavian artery anomaly. The aortic arch displayed a typical orientation but included an additional arterial branch arising from the medial wall of the descending aorta. This aberrant branch with a tortuous aspect coursed posteriorly around the esophagus and merged with the subclavian branch of the brachiocephalic trunk, forming a vascular ring. A possible embryological hypothesis requires the persistence of both the distal segment of the right dorsal aorta and the right seventh intersegmental artery, as well as the right fourth aortic arch; however, the imaging aspect of our patient is not that of a classic double aortic arch. This case emphasizes the importance of advanced imaging techniques, such as CT angiography, in identifying and managing rare vascular anomalies that may influence patient care and clinical outcomes. Full article

(This article belongs to the Special Issue Vascular Disease: Etiologic, Diagnostic, Prognostic and Therapeutic Research—2nd Edition)

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