Search

Background: The initial assessment of cardiovascular risk in patients undergoing lower limb revascularization surgery is crucial to minimize complications and improve outcomes. This study aims to determine if the iliac calcium score (ICS) serves as a cardiologic risk marker by examining its correlation with the coronary calcium score (CCS) in these patients., Methods: This prospective observational single-center study included 248 patients with critical limb ischemia undergoing revascularization procedures from January 2022 to June 2023. Baseline characteristics such as age, gender, smoking status, comorbidities, and clinical status were recorded. CCS and ICS were calculated using preoperative computed tomography angiography. Multiple linear regression identified significant predictors of ICS, including CCS, iliac intima-media thickness (i-IMT), coronary artery disease, diabetes, chronic kidney disease, hypertension, dyslipidemia, and smoking., Results: The study population had a mean age of 74.4 years, 83.86% male. Significant correlations were found between ICS and CCS (Pearson r = 0.34, P < 0.001) and between ICS and i-IMT (Pearson r = 0.35, P < 0.001). Regression analysis revealed significant predictors for ICS, including CCS (coefficient = 1.808, P < 0.0001), i-IMT (coefficient = 3.11, P < 0.0001), coronary artery disease (coefficient = 11.94, P = 0.042), diabetes (coefficient = 19.59, P = 0.002), chronic kidney disease (coefficient = 11.79, P < 0.0001), and hypertension (coefficient = 22.10, P = 0.001). Dyslipidemia and smoking did not show significant associations with ICS., Conclusions: The ICS shows a statistically significant association with the CCS and i-IMT in patients undergoing lower limb revascularization surgery. This correlation suggests that ICS reflects vascular calcification patterns like those observed in coronary arteries. Further studies are needed to explore this relationship in diverse patient populations and under varying clinical conditions., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: The repair of ruptured abdominal aortic aneurysms (R-AAA) entails high mortality. This study aims to analyze differences in postoperative outcomes., Methods: A meta-analysis was conducted of 8 studies involving 26 473 patients, evaluating 30-day mortality rates by comparing open surgical repair with endovascular repair and stratifying results by sex., Results: The 30-day mortality rate was 23.0% in women versus 13.0% in men, with an odds ratio (OR) of 2.05. Women had higher rates of postoperative complications, such as stroke (6.0% vs. 4.0%) and renal failure (8.0% vs. 5.0%), as well as prolonged ICU stay (12.3 ± 6.4 days vs. 10.2 ± 5.7 days)., Conclusion: These findings highlight the importance of adjusting surgical approaches to improve outcomes in women with R-AAA. Continued prospective studies are recommended to optimize treatment protocols., (Copyright © 2025 AEC. Published by Elsevier España, S.L.U. All rights reserved.)

Background: The most common complication after endovascular aortic aneurysm repair (EVAR) is continuous sac perfusion, known as endoleak. Evaluating markers released from the aneurysm wall into circulation has been suggested as a possible alternative for detecting endoleaks. The aim of this study was to examine whether circulating concentrations of different proinflammatory interleukins (IL-1β, IL-2, IL-6, IL-8), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor alpha (TNF-α) were elevated in patients with endoleak after EVAR., Methods: A prospective observational study with 100 patients undergoing elective EVAR was conducted. Blood samples were taken before surgery, at 7 days, 6 months, and 12 months after EVAR to quantify the mentioned cytokines using a Bio-Plex assay. Patients were followed up for 12 months to detect endoleak occurrence., Results: In patients with endoleak, mean concentrations of certain cytokines in plasma differed significantly from those without endoleak: preoperative IL-8 (9.83; P < 0.001), preoperative MCP-1 (75.94; P = 0.003), preoperative TNF-α (5.46; P = 0.05), among others. A binary logistic regression analysis revealed that preoperative IL-8 (P = 0.003), MCP-1 at 7 days postoperative (P = 0.002), and IL-1 at 12 months postoperative were significantly associated with endoleak, with IL-1 being the most influential biomarker (odds ratio = 2.2). A receiver operating characteristic curve showed an area under the curve of 0.7, with cutoff points of 33.4 for preoperative IL-8, 145 for MCP-1 at 7 days postoperative, and 2.3 for IL-1 at 12 months postoperative., Conclusions: This study suggests that inflammatory biomarkers such as IL-1, IL-8, MCP-1, and TNF-α have the potential to serve as important adjuncts to conventional imaging techniques in monitoring patients post-EVAR. These biomarkers may help identify individuals at higher risk of developing endoleaks, guiding more focused and timely imaging follow-up. However, their practical applicability requires further investigation., (Copyright © 2024 Elsevier Inc. All rights reserved.)