International Journal of Endovascular Treatment and Innovative Techniques

Endovascular Treatment of Infected Aortic Aneurysms: A Retrospective Multicenter Analysis from the GORE®GREAT Registry Study

Gabriele Piffaretti — 2024-11-18

Objective: The Global Registry for Endovascular Aortic Treatment (GREAT), which is a retrospective sponsored registry (W.L Gore & Associates; Flagstaff – AZ; USA), was queried to evaluate the outcomes of infected aortic aneurysms (inf-AAs) after abdominal (EVAR) or thoracic endovascular aortic repair (TEVAR).

Methods: This is a multicenter, observational cohort study. For the current study, all patients were treated only with the standard GORE^® devices for INFAA. Primary graft infections, aorto-enteric fistulae, and graft-enteric fistulae were excluded, as well as cases that did not meet the predefined criteria of an inf-AA. All serious adverse events within 30 days of the procedure were documented by sites. Primary outcomes were early (≤ 30 days) and late survival, and freedom from endograft infection.

Results: Thirty-one (0.6% of the entire GREAT cohort) patients met the inclusion criteria and were included: 23 (74.2%) were males and 8 (25.8%) females. The mean age was 72 years ± 11 (range, 49-92). This included 26 (83.9%) abdominal inf-AAs and 5 (16.1%) thoracic inf-AAs. Operative-related mortality occurred in 1 (3.2%) patient. Immediate conversion to open surgical repair was not required. Mean follow-up was 23.6 ± 15 months (range, 1-49): estimated survival rate was 80% (95%CI, 60.8-90.5) at 12 months, and 53.2% (95%CI, 30.0-71.1) at 48 months. Secondary aortic rupture as well as endograft explanation was also not reported.

Conclusion: Endovascular treatment of inf-AA is feasible and effective. While endograft infection was not detected during the follow-up, long-term results from GREAT registry may reveal how durable T/EVAR could be for inf-AAs.

Effectiveness of Yoga-Based Interventions on Vascular Health: A Comprehensive Review

Megha Pundir — 2024-11-25

Background: Yoga is increasingly recognized as a complementary approach to manage cardiovascular health, particularly in reducing risk factors associated with cardiovascular diseases. While numerous studies suggest that yoga may positively influence vascular health, further synthesis is necessary to understand its efficacy fully.

Objectives: This systematic review aims to evaluate the effectiveness of yoga interventions in managing cardiovascular risk factors, with a focus on hypertension, heart rate variability, lipid profiles, and other related cardiovascular outcomes.

Methods: Various electronic databases were searched for studies assessing the impact of yoga on cardiovascular health. Inclusion criteria encompassed randomized controlled trials and observational studies that analyzed changes in cardiovascular risk factors following yoga interventions. Data were extracted and analyzed for key outcomes related to holistic health changes caused by yoga practice.

Results: Preliminary findings indicate statistically significant improvements in blood pressure, heart rate, and lipid profiles among participants engaged in structured yoga programs compared to control groups. Specific outcomes include a substantial reduction in systolic and diastolic blood pressure, as well as favorable changes in total cholesterol and triglyceride levels.

Conclusion: Yoga interventions demonstrate promise as beneficial adjunct therapies for managing cardiovascular health. Although current evidence supports the positive impact of yoga on key cardiovascular risk factors, further high-quality, large-scale clinical trials are necessary to confirm these outcomes and ascertain the mechanisms underlying yoga's effects on vascular health. Integrating yoga into conventional cardiac rehabilitation programs could enhance overall patient outcomes.

Bite by Bite: Unveiling the Impact of Chewing Sticks on Endovascular Health and Neurovascular Coupling – A Narrative Review

Arjun Ram Roj — 2024-12-09

Objective: This paper aims to explore the effects of chewing sticks, such as miswak (Salvadora persica) and neem (Azadirachta indica), on vascular health and neurovascular coupling, assessing their potential benefits for cardiovascular and cognitive functions.

Methods: A comprehensive literature review was conducted to analyze existing studies related to the physiological effects of chewing sticks. Emphasis was placed on their impact on vascular health, neurovascular coupling, and the mechanisms behind these effects, including the stimulation of the trigeminal nerve and the release of norepinephrine.

Results: Chewing stimulates the trigeminal nerve, which promotes the release of norepinephrine from the locus coeruleus, enhancing vascular dilation and regulating blood pressure. This process supports neurovascular coupling and may protect the blood-brain barrier, thereby improving cerebral circulation and reducing risks associated with cognitive decline and cardiovascular diseases. Additionally, the bioactive compounds found in chewing sticks—such as antioxidants and antimicrobial agents—may help reduce systemic inflammation and promote overall vascular health.

Conclusion: Chewing sticks represent a potential cost-effective and accessible strategy for improving cardiovascular and cognitive health, especially in populations with limited healthcare access. While preliminary findings are promising, further research, including clinical trials, is necessary to fully elucidate the therapeutic potential of chewing sticks for enhancing vascular and cognitive functions.

Design of ROSES Application to Endocranial Procedures with AI Help

Guido Danieli — 2024-12-30

This article presents the application of the ROSES system in intracranial procedures, integrating artificial intelligence (AI) to enhance precision and safety. The system uses advanced robotic actuators and disposable tools to manage microcatheters and guidewires, enabling efficient stent placement while minimizing contact with aneurysms. By leveraging angiographic data to create 3D vascular models, the AI determines optimal pathways, calculates stent dimensions, and identifies critical curvatures. This approach allows for automated or manual intervention based on procedural requirements, reducing the need for physician presence during high-risk stages. The innovation significantly lowers radiation exposure and improves procedural outcomes in complex intracranial surgeries, offering a promising step toward more autonomous endovascular systems. Importantly, this system reduces the necessity for a doctor to be physically present with the patient, as the AI and robotic components can manage much of the procedure remotely. This advancement could greatly enhance the efficiency and safety of medical procedures.

Trends in Pancreatic Cancer Related Mortality: A Retrospective Analysis using CDC WONDER Database

Nikhil Duseja — 2024-12-31

Background: Pancreatic cancer is 8th most prevalent cancer in the United States with a very high mortality rate. Understanding the epidemiology of Pancreatic cancer is important in identifying the causes and developing preventive strategies.

Methodology: Data from the death certificates spanning from 1999-2020, sourced from CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) was analyzed. To quantify national annual trends in pancreatic cancer-related mortality, the Joinpoint Regression Program was used to determine the annual percent change (APC) with 95% CI in age-adjusted mortality rates (AAMRs) per 100,000 people for all ages stratified by year, gender and regions.

Results: Pancreatic neoplasm claimed about 847,589 lives across all age groups in the US from 1999-2000. The AAMR for pancreatic cancer peaked at 2020 with 11.7 [APC 0.2275 95% CI: 11.6-11.8]. The AAMR for pancreatic cancer-related deaths was 11(95%CI: 10.9=11.1) in 2003 and it increased to 11.3(95%CI: 11.2-11.3) in 2006 (APC 0.87* 95%CI: 11.2-11.4). Men had consistently higher AAMRs than women across all age groups throughout the study period of 1999-2000 (overall AAMR men: 13.2 (95% CI: 13.1-13.2); overall AAMR women: 9.9 (95% CI: 9.9-10)). Geographically; the lowest mortality was displayed by the Western regions (AAMR 10.5, 95% CI: 10.2-10.7), followed by Southern (AAMR 11.1, 95%CI: 10.9-11.4), followed by Midwestern (AAMR 11.7, 95%CI: 10.9 -11.4), followed by Northeast region (AAMR 11.9, 95%CI: 11.6-12.1).

Conclusion: We observed an overall annual increase in mortality trends related to pancreatic cancer especially in men and certain regions like Northeast region of the United States. These results emphasize the immediate necessity for a comprehensive strategy to address this lethal illness, encompassing breakthroughs in medical research, focused public health initiatives, and extensive governmental reforms.