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The article discusses the field of vascular medicine and the importance of collaboration for success in this specialty. Vascular medicine intersects with various disciplines, and practitioners aim to provide comprehensive, patient-centered care. Early career professionals face challenges such as limited training programs and competition for positions, but they can strategically navigate this terrain by researching available programs and seeking mentorship. Mid-career professionals must balance collaboration and expertise to avoid dissatisfaction, while senior career professionals play a crucial role as mentors and advocates for the field. By prioritizing collaboration, ongoing professional development, and strategic networking, vascular medicine specialists can make a lasting impact on patient care, research, and education. [Extracted from the article]

This article discusses a case of Klippel-Trenaunay syndrome (KTS) in a 55-year-old man. KTS is a congenital anomaly characterized by cutaneous port-wine capillary malformations, hemihypertrophy of bone and soft tissues, and venous malformations. The patient had a history of vascular malformations, recurrent bleeding, and pulmonary embolism. The diagnosis was established based on the clinical presentation. Treatment for KTS involves a multidisciplinary approach, with symptomatic care being the mainstay and the potential use of low-dose sirolimus or targeted therapies. [Extracted from the article]

Background: Patients with lymphedema and lipedema share physical exam findings that may lead to misdiagnosis. Poor mobility is common in patients with obesity and patients with lymphedema and lipedema. This may constitute a risk factor for venous thromboembolism (VTE). Our objective was to evaluate the association of VTE in obese patients with lymphedema and lipedema. Methods: The National Inpatient Sample (NIS) was searched from 2016 to 2020 to identify hospital admissions of obese female patients with lymphedema and lipedema. Patients were analyzed in the context of presence or absence of VTE while adjusting for complex cluster sampling techniques. Predictors of VTE were accessed by multivariable regression. Results: Lymphedema was identified in 189,985 patients and lipedema in 50,645 patients. VTE was observed in 3.12% (n = 374,210) of patients with obesity. In patients with obesity, VTE was more common in patients with lymphedema than without (2.6% vs 1.6%; p < 0.01). Similarly, VTE was more common in patients with lipedema than without (0.6% vs 0.4%; p < 0.01). After multivariable logistic regression, VTE events in obese patients with lymphedema were higher versus without (OR 1.6; CI 1.08–2.43; p = 0.02). Similarly, VTE events were more common in obese patients with lipedema versus obese patients without lipedema (OR 1.20; CI 1.03–1.41; p = 0.02). Conclusions: In this hypothesis-generating study, lymphedema and lipedema show a positive association with VTE after adjusting for baseline patient characteristics such as obesity, which is a known independent risk factor for VTE. Mechanisms whereby lymphedema and lipedema are associated with VTE should be investigated. [ABSTRACT FROM AUTHOR]

The article presents a case study of an 18-year-old man diagnosed with leiomyosarcoma after presenting with recurrent iliofemoral deep venous thrombosis (DVT). Topics discussed include the diagnostic imaging findings, histological characteristics of the tumor, and the treatment approach involving systemic chemotherapy.

This article discusses a case of nonuremic calciphylaxis, a rare condition characterized by nonhealing skin ulcers caused by arterial calcification and thrombosis. The patient, a 66-year-old woman with a history of coronary artery disease, presented with a necrotic ulcer on her left calf and unintentional weight loss. Initial laboratory assessments were unremarkable, but a biopsy of the ulcer revealed calciphylaxis. Further investigation found a renal mass, confirming renal cell carcinoma. The patient was started on sodium thiosulphate treatment but unfortunately died shortly after a nephrectomy. Nonuremic calciphylaxis is associated with various factors, including vitamin D toxicity, primary hyperparathyroidism, malignancy, and anticoagulation. Sodium thiosulphate is considered the main treatment for this condition. [Extracted from the article]

Objectives: The peak systolic velocity (PSV) and end‐diastolic velocity (EDV) obtained by carotid duplex ultrasound (CDU) imaging of the internal carotid arteries (ICAs) are parameters used to determine the severity of ICA stenosis. Severe aortic stenosis (AS) results in a parvus‐et‐tardus pattern on spectral Doppler waveforms; however, the impact of severe AS on CDU velocities is unclear. The purpose of this study was to assess the impact of severe AS on CDU velocities by evaluating changes in CDU velocities before and after aortic valve replacement (AVR) Methods: A single‐center retrospective review of patients with severe AS who underwent surgical AVR and who had preoperative and postoperative CDU examinations performed within 12 months of each other was conducted. Patients with any carotid intervention between the preoperative and postoperative CDU were excluded. Results: We identified 92 patients who satisfied all inclusion criteria. The mean age was 72.2 years; 71.7% were men; the mean preoperative aortic valve area ± SD was 0.8 ± 0.2 cm2; and the mean time from preoperative to postoperative AVR CDU was 182.3 ± 98.4 days. The peak aortic valve gradient decreased from 62.5 to 22.0 mm Hg after AVR (P <.001); however, there were no significant changes in the PSV or EDV in either the right or left ICA. Conclusions: Although severe AS may cause characteristic changes in the spectral Doppler waveform on CDU imaging, there is no significant effect on the ICA PSV or EDV. Adjustments in velocity criteria to determine the degree of carotid artery stenosis in patients with substantial AS may not be necessary. [ABSTRACT FROM AUTHOR]

Pulmonary embolism (PE) is a common thrombotic event that is variable in its presentation. Depending on the patients' risk for mortality, guidelines provide several treatment strategies including thrombolysis, catheter-directed therapies, pulmonary embolectomy, anticoagulation, and inferior vena cava filters. However, there is considerable disagreement between guidelines regarding the optimal treatment strategy for patients, particularly for those with intermediate-risk PE. In order to provide rapid and individualized care, PE response teams (PERT) have been developed. These teams consist of members from different specialties with a particular interest in PE, varying technical skills, and clinical experience, thereby allowing for a multidisciplinary approach. PERT allows for consensus decision making, and for rapid intervention in patients whose conditions worsen. In this review, we provide an overview of treatment guidelines for PE, and of results from recent clinical trials involving patients with submassive PE. In addition, we discuss an outline of our approach and use of PERT. [ABSTRACT FROM AUTHOR]

Background: Fibromuscular dysplasia (FMD) can result in life-threatening complications, including stroke and heart attack. Many FMD patients complain of feeling like they are living with a "ticking time bomb". Purpose: The purpose of this study was to examine the impact of FMD symptoms and complications on quality of life, anxiety, and depression. Methods: A cross-sectional design was conducted. Patients in an FMD registry were mailed surveys (n = 339). SF-36 scale, PROMIS SF Anxiety and Depression scores were compared to symptoms and complications of FMD, and other diseases. Analysis: Pearson's chi-square or Fisher's exact tests, or Kruskal-Wallis or ANOVAwere used. Alpha of 0.05 was assumed. Analyses were performed using SAS® Software. Results: Of 162 (47.8%) surveys received, 156 were female (97.5%), 130 had carotid and vertebral involvement (80.2%). Patients reporting stroke (p=0.004) and transient ischemic attack (TIA) (p=0.046) had higher mean depression. Higher RAND SF-36 Mental Component Score (MCS) was associated with decrease in stroke (p=0.004) and TIA (p=0.002), heart, and lung disease, and diabetes (≤0.05). Thosewith hypertension (p=0.015) had lower RAND SF-36 Physical Component Scores (PCS). Those with migraine, tinnitus, neck, dizziness, flank, abdominal, or leg pain, and other symptoms (p<0.001) had lower PCS. After backward selection removed non-significant factors,migraine (p=0.004), neck (p=0.002) and leg pain (p=0.001) were predictors of decreased PCS. Migraine (p<0.001), neck (p=0.002), and flank pain (p=0.010) were predictors of decreasedMCS. Conclusions: Those who reported symptoms and complications consistent with carotid or vertebral involvement had lower MCS and PCS, increased depression, and anxiety. More research is needed to examine ways to address quality of life in this population. Practice Implications: Patients with FMD live with high risk for stroke and heart attack. Careful assessment of symptoms can help nurses improve care and quality of life in patients with FMD. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 32-year-old male patient diagnosed with right-sided abdominal and back pain caused by cannabis use. Topics discussed include the medical history of the patient, the diagnosis of his disease through spontaneous renal artery dissection, its symptoms and causes, and the treatment options given to him.