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The evaluation of hemodynamic conditions in critical limb-threatening ischemia (CLTI) patients is inevitable in endovascular interventions. In this study, the performance of color-coded digital subtraction angiography (ccDSA) and the recently developed color-coded digital variance angiography (ccDVA) was compared in the assessment of key time parameters in lower extremity interventions. The observational study included 19 CLTI patients who underwent peripheral vascular intervention at our institution in 2020. Pre- and post-dilatational images were retrospectively processed and analyzed by a commercially available ccDSA software (Kinepict Medical Imaging Tool 6.0.3; Kinepict Health Ltd., Budapest, Hungary) and by the recently developed ccDVA technology. Two protocols were applied using both a 4 and 7.5 frames per second acquisition rate. Time-to-peak (TTP) parameters were determined in four pre- and poststenotic regions of interest (ROI), and ccDVA values were compared to ccDSA read-outs. The ccDVA technology provided practically the same TTP values as ccDSA (r = 0.99, R2 = 0.98, p < 0.0001). The correlation was extremely high independently of the applied protocol or the position of ROI; the r value was 0.99 (R2 = 0.98, p < 0.0001) in all groups. A similar correlation was observed in the change in passage time (r = 0.98, R2 = 0.96, p < 0.0001). The color-coded DVA technology can reproduce the same hemodynamic data as a commercially available DSA-based software; therefore, it has the potential to be an alternative decision-supporting tool in catheter labs. [ABSTRACT FROM AUTHOR]

Previous research confirmed gut dysbiosis and translocation of selected intestinal bacteria into the vessel wall in abdominal aortic aneurysm patients. We studied the stool, blood, thrombus and aneurysm microbiomes of 21 abdominal aortic aneurysm patients using 16S rRNA sequencing. Our goals were to determine: 1. whether the microbiome characteristic of an aneurysm differs from that of a healthy vessel, 2. whether bacteria detectable in the aneurysm are translocated from the gut through the bloodstream, 3. whether the enzymatic activity of the aneurysm microbiome can contribute to the destruction of the vessel wall. The abundance of Acinetobacter, Burkholderia, Escherichia, and Sphingobium in the aneurysm samples was significantly higher than that in the microbiome of healthy vessels, but only a part of these bacteria can come from the intestine via the blood. Environmental bacteria due to the oral cavity or skin penetration route, such as Acinetobacter, Sphingobium, Enhydrobacter, and Aquabacterium, were present in the thrombus and aneurysm with a significantly higher abundance compared to the blood. Among the enzymes of the microbiome associated with the healthy vessel wall, Iron-chelate-transporting ATPase and Polar-amino-acid-transporting ATPase have protective effects. In addition, bacterial Peptidylprolyl isomerase activity found in the aneurysm has an aggravating effect on the formation of aneurysm. [ABSTRACT FROM AUTHOR]

Aortic pressure can be estimated using one-dimensional arterial flow simulations. This study demonstrates that two peripheral pressure measurements can be used to acquire the central pressure curve through the patient-specific optimization of a set of system parameters. Radial and carotid pressure measurements and parameter optimization were performed in the case of 62 patients. The two calculated aortic curves were in good agreement, Systolic and Mean Blood Pressures differed on average by 0.5 and −0.5 mmHg, respectively. Good agreement was achieved with the transfer function method as well. The effect of carotid clamping is demonstrated using one resulting patient-specific arterial network. [ABSTRACT FROM AUTHOR]

The Circle of Willis (CoW) is the main collateral system, and its morphological variants are more common in patients who have severe carotid artery stenosis. Earlier data suggest that optical coherence tomography angiography (OCTA) may help to assess the changes in cerebral vascular perfusion by imaging the retinal blood flow. In this single-center prospective clinical study, patients scheduled for carotid endarterectomy (CEA) underwent preoperative computed tomography angiography (CTA) of the extra- and intracranial cerebral circulation. OCTA imaging was performed one week before surgery and postoperatively one month later. The patients were divided into two subgroups based on CTA evaluation of CoW: compromised CoW or non-compromised CoW (containing hypoplastic and normal segments). The effect of the patient's age, OCTA scan quality (SQ), CoW morphology, laterality, and surgery on superficial capillary vessel density (VD) in the macula were assessed in multivariable regression models using linear mixed models. We found that VD significantly decreased with aging (−0.12%; 95%CI: −0.07–−0.15; p < 0.001) and was significantly higher in patients with non-compromised CoW morphology (by 0.87% 95%CI (0.26–1.50); p = 0.005). After CEA, retinal blood flow significantly improved by 0.71% (95%CI: 0.18–1.25; p = 0.01). These results suggest that in the case of carotid artery occlusion, patients with non-compromised CoW have more preserved ocular blood flow than subjects with compromised CoW due to remodeling of the intra-orbital blood flow. Measuring the retinal blood flow might be used as a relevant and sensitive indicator of collateral cerebrovascular circulation. [ABSTRACT FROM AUTHOR]