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Recently, there has been growing interest in the role of circular RNAs (circRNAs) in the progression of human cancers. Cellular senescence, a known anti-tumour mechanism, has been observed in several types of cancer. However, the regulatory interplay of circRNAs with cellular senescence in pancreatic cancer (PC) is still unknown. Therefore, we identified circHIF-1α, hsa_circ_0007976, which was downregulated in senescent cells using circRNA microarray analysis. Meanwhile, significantly upregulated expression of circHIF-1α in pancreatic cancer tissue detected by reverse transcription-polymerase chain reaction (RT-qPCR) and in situ hybridization (ISH). High circHIF-1α expression levels were found to independently predict poor survival outcomes. Subsequent treatments with DOX and H 2 O 2 resulted in significantly lower levels of circHIF-1α. CircHIF-1α knockdown induces cellular senescence and suppresses PC proliferation in vitro experiments. The ability of circHIF-1α knockdown to suppress the progression of PC cells was further confirmed in vivo experiments. Our results showed that circHIF-1α is mainly presented in the nucleus of PC cells, also in the cytoplasm. Mechanistically, circHIF-1α inhibited senescence and accelerated the progression of PC cells through miR-375 sponging, thereby promoting HIF-1α expression levels. Nuclear circHIF-1α interacted with human antigen R protein (HUR) to increase HIF-1α expression. Thus, our results demonstrated that circHIF-1α ameliorates senescence and exacerbates growth in PC cells by increasing HIF-1α through targeting miR-375 and HUR, suggesting that targeting circHIF-1α offers a potential therapeutic candidate for PC., Competing Interests: Declarations. Ethics approval and consent to participate: The study was performed after approval by the ethics committee of Affiliated Hospital of Guizhou Medical University. Pancreatic cancer specimens were obtained from patients undergoing surgical resection at Affiliated Hospital of Guizhou Medical University. All experiments involving human specimens were approved by the Ethical Review Committee of Affiliated Hospital of Guizhou Medical University. Written informed consent from the donors for the research use of tissues in this study were obtained prior to the acquisition of the specimens. All animal experimentation protocols and procedures were approved by the Animal Committees of Affiliated Hospital of Guizhou Medical University. Consent for publication: All authors agree to publish. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Purpose: Endovascular therapy (EVT) has emerged as a primary approach for managing femoropopliteal artery (FPA) lesions, leveraging drug-eluting stents (DESs), and drug-coated balloons (DCBs), to enhance clinical outcomes. Although a full DES coverage strategy is effective in treating complex lesions, concerns over long-term complications prompt the exploration of alternative strategies. The aim of this study was to investigate clinical result of combination therapy of DES with DCB and compare them with full DES implantation., Materials and Methods: This retrospective, single-center study analyzed 131 patients with occlusive FPA lesions treated at our institution between 2019 and 2022. Patients with Rutherford classification stages 2 to 5 who underwent successful EVT were included. The study compared the outcomes of the drug-within-drug (DWD) strategy, ie, combining DES for failed vessel preparation segments and DCB for successful ones, with those of full DES implantation. The primary outcomes were the primary patency rates, and the secondary outcomes included clinically-driven target lesion revascularization (CD-TLR) rates, restenosis patterns, and survival outcomes., Results: Of the 131 patients initially considered, 118 met the inclusion criteria, with 45 in the DWD group and 73 in the full metal jacket (FMJ) stent group. The DWD group demonstrated equivalent 1-year primary patency rates (85.3%) to the FMJ group (87.9%, p=0.239). Similarly, no significant differences in CD-TLR rates were found between the 2 groups. The restenosis patterns and subsequent treatment strategies were not significantly different., Conclusion: The DWD strategy offers a viable alternative to full DES coverage in treating long-segment FPA lesions, with comparable restenosis and target lesion revascularization (TLR) rates. This approach may mitigate risks associated with full-length stenting, such as thrombosis, and challenges in repeat revascularizations by tailoring treatment to lesion characteristics. The DWD strategy represents a promising approach for complex FPA lesions, providing a balanced solution that potentially reduces long-term complications while maintaining effective patency and revascularization rates., Clinical Impact: The efficacy of drug-eluting stents (DES) in treating femoropopliteal artery (FPA) lesions has been well demonstrated. However, concerns remain regarding complications such as thrombotic occlusion and aneurysmal degeneration, especially when full stemt coverage of whole lesions is performed. The "Drug-with-Drug" (DWD) strategy, which involves implanting DES only at sites with severe dissection or residual stenosis after pre-balloon dilation and using drug coated balloons (DCB) for segments successfully prepared without stenting, has shown comparable outcomes to full stent coverage. Unlike traditional bailout stenting or spot stenting, the DWD approach maximizes the benefits of drug technology and presents a valuable option for treating long-segment FPA lesions., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Supera interwoven stents (IWS) have a unique interwoven structure; thus, precise stent placement can be challenging as they are prone to elongation, shortening, and invagination. Particularly, invagination limits long-term patency. This proposed method aims to remove invaginated IWS., Case Presentation: A 70-year-old man presented with intermittent claudication in his left lower limb. Endovascular therapy was conventionally performed, and a 5.5 × 40 mm IWS was placed after balloon dilatation; however, invagination occurred. The invaginated IWS was successfully removed by a threading 0.014" wire through the outside of the stent strut, and a snare catheter was used to hold it in place from the inside. Then, while still in place, the 0.014" wire and snare catheter were driven into the guiding sheath., Conclusions: This practical and easy approach to remove invaginated IWS from the body relies on the particular structural characteristics., (© 2024. The Author(s).)

Background: Because of revisions to insurance reimbursement costs, medical fees have changed for investigations and percutaneous coronary intervention (PCI) treatment of chronic coronary syndrome (CCS). In this retrospective study, we investigated these changes and their effects on mortality and cardiovascular events., Methods and results: We included 1,483 patients who underwent elective PCI for CCS between April 2010 and September 2019. The primary outcomes were changes in PCI procedure fees and all included hospitalization fees due to the biennial revisions of reimbursement costs across 5 time periods (~2 years each). Secondary outcomes were rates of survival and freedom from major adverse cerebral and cardiovascular events (MACCE) in each time period. Patient characteristics were generally unchanged over the study period; however, treatment procedures changed significantly, with changes in the approach site (from transfemoral to transradial access; P<0.0001) and final device (from bare-metal stents to drug-eluting stents; P<0.0001), and an increase in the use of imaging modalities (P<0.0001). Medical fee parameters (primary outcomes) decreased significantly from 2010 to 2019 (P<0.001): PCI procedure fees decreased by 25%, whereas all included hospitalization fees decreased by 20%. There were no significant differences in survival or freedom-from-MACCE rates between periods., Conclusions: Because of revisions to reimbursement prices, there were rapid and significant decreases in PCI procedure and hospitalization fees for CCS. These changes had no effect on mortality or cardiovascular events.

Chronic total occlusion (CTO) in the femoropopliteal artery is challenging to treat. The Wingman catheter system is a novel device for CTO penetration with a nitinol/stainless steel beveled tip. There is a lack of real-world clinical data indicating the success rate. We evaluated the efficacy of the Wingman system. This was a single-center retrospective study. We enrolled 27 consecutives patients who underwent treatment for femoropopliteal CTO using the Wingman system in 2021. The primary outcome was success of CTO-crossing and secondary outcomes were success of the procedure, Wingman-related complications, and predictors for success of Wingman crossing. The mean age of the study population was 76 years and the mean CTO length was 122 mm. The success rate of Wingman crossing was 40.7% and the overall procedure success rate was 100%. Only one case of embolism and one of perforation associated with the Wingman procedure were seen; both were successfully recovered. Univariate analysis revealed in-stent occlusion and non-severe calcification to be factors associated with success (16.7% vs 0%, p = 0.012 and 12.5% vs 50.0%, p = 0.036, respectively). These real-world data of the Wingman system demonstrate it to be a safe and one of option for treating femoropopliteal CTO., (© 2022. Springer Japan KK, part of Springer Nature.)

Background: The role of catheter-based imaging in peripheral interventions for lower extremity artery disease (LEAD) has increased with percutaneous interventions. To clarify the relation between intravascular ultrasound (IVUS) information and procedure selection strategy for endovascular treatment therapy (EVT) of the femoropopliteal artery in the real-world clinical settings wherein new endovascular technologies (NETs), including drug-coated balloon (DCB), drug-eluting stent (DES), and covered stent-graft (CS). Our retrospective multicenter analysis examined symptomatic 970 patients treated by EVT for de novo femoropopliteal lesions with IVUS guidance. The decision tree analysis was performed retrospectively to determine the association of IVUS and angiography parameters with the strategy selection of endovascular procedures. We divided the study population according to the developed tree, and identified the most popular strategy selection in each subgroup. We finally examined whether the restenosis risk would be different among respective subgroups of the tree., Results: During the study periods, plain old balloon angioplasty, DCB, and bare nitinol stent were most frequently selected (25.3%, 23.9%, and 23.8%, respectively). The drug-eluting stent (DES), covered stent (CS), and spot stent strategies were used in 7.3%, 11.5%, and 8.1%. NETs had the lowest restenosis risk in the overall population. The decision tree had a depth of six branches and divided the patients into 11 subgroups by IVUS and angiography parameters. The restenosis rate was similarly low among these 11 subgroups when the most popular NET in each subgroup was selected (P = 0.94)., Conclusions: The use of IVUS data along with angiography data would standardize the selection of endovascular procedures and can improve patency outcomes if NETs are used properly., (© 2022. The Author(s).)

Imaging modalities have developed to provide precise information in the assessment of lower extremity artery disease (LEAD), including both quantitative measurements and morphological assessment. However, a lack of standardization for the evaluation methods introduces inconsistency and potential risk. This consensus document from Japan Endovascular Treatment Conference (JET) summarizes the methods of measurement and assessment of intravascular ultrasound (IVUS), optical frequency domain imaging (OFDI), and angioscopy. We propose standardized approaches for the evaluation of these modalities in endovascular therapy (EVT)., (© 2022. The Author(s) under exclusive licence to Japanese Association of Cardiovascular Intervention and Therapeutics.)

The number of breeding pairs of crested ibis ( Nipponia nippon ) in Hanzhong, China has recovered remarkably from 2 to 511 from 1981 to 2019. Although the crested ibis has been closely monitored, the habitat preference of the bird has not been well studied despite the extensive increase in abundance. We used nest site data from the past 39 years and 30 environmental variables to develop species distribution models for each year. We applied random forest to select important environmental variables, and used logistic regressions to quantify the changes in habitat preferences in 39 years, taking into account the effects of interaction and quadratic terms. We found that six variables had strong impacts on nest site selection. The interaction term of rice paddies and waterbodies, and the quadratic term of precipitation of the wettest quarter of the year were the most important correlates of nest presence. Human impact at nest sites changed from low to high as birds increased their use of ancestral habitats with abundant rice paddies. We concluded that during the population recovery, the crested ibises retained their dependence on wetlands, yet moved from remote areas to populated rural regions where food resources had recovered due to the ban of pesticide use.

Purpose: To assess the utility of intravascular ultrasound (IVUS) during below-the-knee (BTK) interventions for patients with chronic limb-threatening ischemia (CLTI). Materials and Methods: This retrospective single-center study included 216 symptomatic patients (mean age 74.2±9.5 years; 167 men) with CLTI and BTK steno-occlusive disease who underwent successful balloon angioplasty between January 2016 and August 2018. Data from 88 vessels (58 patients) treated with IVUS-guided procedures were compared with corresponding values from 242 vessels (158 patients) treated with angiography-guided procedures. The primary outcomes included procedure-related variables of balloon size, contrast dose, and complication rates, as well as changes in ankle-brachial index (ABI) and skin perfusion pressure (SPP). Secondary outcomes included IVUS determination of vessel size, wire route, and calcification severity, as well as technical success and clinically-driven target lesion revascularization (TLR), limb salvage, and wound healing rates in the Rutherford category 5/6 patients as evaluated by propensity score matching analysis. Results: The patient and lesion characteristics were similar in both groups. The mean balloon size for IVUS-guided procedures was significantly larger (2.45±0.4 mm) compared with that for angiography-guided procedures (2.23±0.4 mm; p<0.001). The technical success (p=0.56) and complication rates (p=0.16) were similar between the groups. The postprocedure dorsal and plantar SPP and change in dorsal SPP improved more in the IVUS-guided group (p<0.001, p=0.015, and p=0.02, respectively). The IVUS-guided group had a significantly better wound healing rate than the angiography-guided group (p=0.006), although the freedom from TLR and limb salvage rates were similar between the groups (p=0.16 and p>0.99, respectively). Conclusion: IVUS-guided interventions for BTK lesions were safe and effective in accurately assessing the lesions. The results suggest that IVUS guidance of endovascular procedures has the potential to influence better clinical outcomes than angiography-guided angioplasty.

To assess the safety and efficacy of routine use of ultrasound-guided puncture and the use of vascular closure device (VCD) in patients undergoing endovascular therapy (EVT) through femoral access. This was a single-center, non-randomized clinical study that enrolled 513 patients undergoing EVT via femoral artery access in which hemostasis was achieved using VCDs (406-patient EXOSEAL arm and 107-patient PROGLIDE arm). All cases were performed by routine use of ultrasound-guided access. The primary endpoint was the achievement of hemostasis without periprocedural and 30-day incidence of major or minor access site-related complications. The primary endpoint was achieved in 91.6 % of the cases (470/513) with a higher success rate in the EXOSEAL arm (93.6). Major complications were observed in 5 patients (0.9 %) in total cohort and 3 patients (0.7 %) treated with EXOSEAL arm vs. 2 patients (1.8 %) with PROGLIDE arm (p = 0.32). Combined treatment two VCDs with the routine ultrasound guidance access for patients who underwent the EVT procedure showed high efficacy and safety outcomes.