Comparison of surgical and endovascular left subclavian artery revascularization during thoracic aortic endovascular repair: a systematic review and meta-analysis.

Objective: The purpose of this systematic review and meta-analysis was to incorporate data from the latest clinical studies and compare the safety and efficacy of surgical left subclavian artery (LSA) revascularization and endovascular LSA revascularization during thoracic endovascular aortic repair (TEVAR). Methods: This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the PROSPERO database on 16 April 2023 (CRD42023414579). The Embase, MEDLINE (PubMed), and the Cochrane Library databases were searched from January 2000 to May 2023. Results: A total of 14 retrospective cohort studies with a total of 1,695 patients, were included for review. The peri-operative stroke rates of the surgical and endovascular LSA revascularization groups were 3.8% and 2.6%, respectively (P = 0.97). The peri-operative technical success rates for the surgical and endovascular LSA revascularization groups were 95.6% and 93.0%, respectively (P = 0.24). The peri-operative spinal cord ischemia rates were 1.6% (n = 18) and 1.9% (n = 7) in the surgical and endovascular LSA revascularization groups, respectively (P = 0.90). The peri-operative type Ⅰ endoleak rates for the surgical and endovascular LSA revascularization groups were 6.6% and 23.2%, respectively (P = 0.25). The subgroup analysis showed that the incidence of peri-operative type I endoleak in the parallel stent group was significantly higher than that in the surgical LSA revascularization group (P < 0.0001). The peri-operative left upper limb ischemia rates for the surgical and endovascular LSA revascularization groups were 1.2% and 0.6%, respectively (P = 0.96). The peri-operative mortality rates of the surgical and endovascular LSA revascularization groups were 2.0% and 2.0%, respectively (P = 0.88). Conclusion: There was no significant difference in the terms of short-term outcomes when comparing the two revascularization techniques. The quality of evidence assessed by GRADE scale was low to very-low. Surgical and endovascular LSA revascularization during TEVAR were both safe and effective. Compared with surgical LSA revascularization techniques, parallel stent revascularization of LSA significantly increased the rate of type I endoleak.

Effect of stent treatment on hemodynamics in iliac vein compression syndrome with collateral vein.

BACKGROUND: Iliac vein compression syndrome (IVCS) leads to blood flow obstruction in the lower extremities and is usually treated with stents, but stenting may worsen the hemodynamics and increase the risk of thrombosis in the iliac vein. The present work evaluates the advantages and disadvantages of the stent on IVCS with a collateral vein. METHODS: The computational fluid dynamics method is adopted to analyze the preoperative and postoperative flow fields in a typical IVCS. The geometric models of the iliac vein are constructed from medical imaging data. The porous model is used to simulate the flow obstruction in IVCS. RESULTS: The preoperative and postoperative hemodynamic characteristics in the iliac vein are obtained, e.g., the pressure gradient at two ends of the compressive region and the wall shear stress. It is found that the stenting restores the blood flow in the left iliac vein. CONCLUSION: Impacts of the stent are classified into short-term and long-term effects. The short-term effects are beneficial in relieving IVCS, i.e., shortening the blood stasis and reducing the pressure gradient. The long-term effects increase the risk of thrombosis in the stent, i.e., enlarging wall shear stress due to a large corner and a diameter constriction in the distal vessel, and suggests the need to develop a venous stent for IVCS.

A stable and quantitative method for dimensionality reduction of aortic centerline.

Aortic dissection (AD) is a fatal aortic disease with high mortality. Assessing the morphology of the aorta is critical for diagnostic and surgical decisions. Aortic centerline projection methods have been used to evaluate the morphology of the aorta. However, there is a big difference between the current model of primary plane projection (PPP) and the actual shape of individuals, which is not conducive to morphological statistical analysis. Finding a method to compress the three-dimensional information of the aorta into two dimensions is helpful to clinical decision-making. In this paper, the evaluation parameters, including contour length (CL), enclosure area, and the sum of absolute residuals (SAR), were introduced to objectively evaluate the optimal projection plane rather than artificial subjective judgment. Our results showed that the optimal projection plane could be objectively characterized by the three evaluation parameters. As the morphological criterion, SAR is optimal among the three parameters. Compared to the optimal projection plane selected by traditional PPP, our method has better AD discrimination in the analysis of aortic tortuosity, and is conducive to the clinical operation of AD. Thus, it has application prospects for the preprocessing techniques for the geometric morphology analysis of AD.

Ubiquitin-specific peptidase 22 promotes proliferation and metastasis in human colon cancer.

Colon cancer is one of the most common malignant tumors in the world; however, the mechanism underlying the progression of colon cancer remains unclear. In the present study, the expression of ubiquitin-specific peptidase 22 (USP22) in paraffin sections of human colon cancer tissues and normal colon tissues were examined using immunohistochemistry. The human colon cancer cell lines HCT116 and HT29 were used for USP22 knockdown experiments, and functional assays were performed. The results demonstrated that compared with normal colon tissues, human colon cancer tissues exhibited upregulated expression of USP22 and this was associated with tumor lymph node metastasis and tumor stage in colon cancer tissues. In addition, upregulated expression of USP22 was significantly correlated with both lower relapse-free survival and lower overall survival rates in patients with colon cancer. When USP22 was silenced in colon cancer cell lines, this resulted in a decrease in cell proliferation and metastatic behaviors. Furthermore, Bmi-1 and Cyclin D2 were found to be positively regulated by USP22, which may have mediated the tumorigenic effects of USP22 in human colon cancer. The results of the present study may have significant implications for examining the underlying mechanisms of cancer development and the potential development of cancer therapeutics.

Resveratrol Induces Endothelial Progenitor Cells Angiogenesis via MiR-542-3p by Targeting Angiopoietin-2 and Involves in Recanalization of Venous Thrombosis.

BACKGROUND Endothelial progenitor cells (EPCs) play an important role in therapeutic angiogenesis. Besides, resveratrol (RSV) exerts many pharmacological functions in regulation of cell function. Furthermore, microRNAs (miRNAs) have been considered to be of great significance in biological process. In this study, we aimed to investigate the effect of RSV on EPCs and its potential mechanism that involved in recanalization of venous thrombosis. MATERIAL AND METHODS EPCs were treated with RSV, and angiogenic functions was evaluated by tube formation and migration assays. miR-542-3p expression level in EPCs was assessed and exogenously modified. Bioinformatic analysis was applied to detect the potential target of miR-542-3p. Effects of RSV treatment in vivo venous thrombosis rat model were evaluated. RESULTS RSV enhanced angiogenic function of EPCs and decreased expression of miR-542-3p. Dual luciferase reporter gene and western blot results confirmed angiopoietin-2 (ANGPT2) was a direct target of miR-542-3p. It was found that inhibition of miR-542-3p contributed to angiogenesis of EPCs and elevated ANGPT2 protein level. Finally, in a rat model of venous thrombosis, RSV-treated EPCs promoted recanalization of thrombi. CONCLUSIONS We demonstrated that RSV can contribute to progenitor cells angiogenesis via miR-542-3p by targeting ANGPT2, subsequently enhanced recanalization of thrombi.

MiR-150 promotes angiogensis and proliferation of endothelial progenitor cells in deep venous thrombosis by targeting SRCIN1.

Venous thromboembolism (VTE), encompassing deep venous thrombosis (DVT) and pulmonary embolism (PE), is the third most common cardiovascular disease. miR-150 is one of important microRNAs which play critical role in various cellular function such as endothelial progenitor cells (EPCs). In this study, we investigate the effect of miR-150 on EPCs function ex vivo and thrombus resolution in vivo. We determined miR-150 expression in EPCs isolated from DVT patients and control subjects by RT-PCR. Potential target of miR-150 was confirmed by bioinformatics analysis and luciferase reporter respectively. The angiogenesis and proliferation were tested by MTT and tube formation assay. A murine model of venous thrombosis was developed as in vivo model. Finally, the effect of miR-150 on EPCs with inferior venous thrombosis were evaluated in vivo. Our data showed that miR-150 was downregulated in EPCs from DVT patients. By using miR-150 agomir and antagomir, we found that miR-150 promoted angiogenesis and proliferation of EPCs. Bioinformatics analysis revealed SRCIN1 as a target of miR-150 and SRCIN1 knockdown inhibited function of EPCs. Forced expression of miR-150 contributed thrombus resolution in a murine model of venous thrombosis. In general, miR-150 was downregulated in EPCs from DVT. Upregulation of miR-150 promoted angiogenesis and proliferation of EPCs by targeting SRCIN1 in vitro and thrombus resolution in vivo.

Systematic Review and Meta-Analysis of Iliofemoral Stenting for Post-thrombotic Syndrome.

OBJECTIVE: Stent placements are considered as a treatment for post-thrombotic syndrome (PTS) with iliofemoral obstruction, but the application of these iliofemoral venous stents has also caused a lot of controversy. The purpose of this systematic review and meta-analysis was to summarise the efficacy and safety of venous stents in PTS with obstruction in iliofemoral venous segments. METHODS: MEDLINE, EMBASE, and the Cochrane Central Register for Controlled Trials databases and key references were searched up to 15 January 2018. The main relevant outcomes included technical success, peri-operative complications, symptom resolution, a change of symptom scores, and long-term patency of the stents. RESULTS: Overall, 504 limbs of 489 patients from seven studies were included in this study. A GRADE assessment showed the quality of the evidence was "very low" for 11 relevant outcomes. The technical success rate was 95%. The pooled rate of complications including 30 day thrombotic event, per-operative venous injury, and back pain was 3.4%, 18.14%, and 52%, respectively. The rates of ulcer healing, pain and oedema relief were 75.66%, 52%, and 42%, respectively. The primary, assisted primary and secondary patency rates were 83.36%, 90.59%, and 94.32%, respectively, at 12 months and 67.98%, 82.26%, and 86.10%, respectively, at 36 months. CONCLUSIONS: Endovenous stenting has the potential to be effective and has a low risk of peri-operative complications. The quality of evidence to support this treatment is very low. Endovenous iliofemoral stenting should be considered a treatment option for PTS with iliofemoral obstruction.

Human cancer cells suppress behaviors of endothelial progenitor cells through miR-21 targeting IL6R.

Deep vein thrombosis (DVT) is a severe clinical process and has a high rate of fatality. Cancer patients have a high incidence rate of venous thrombosis complication and increase the mortality of cancer patients for 2-8 times. The mechanisms involved in human cancers and venous thrombosis remains unclear. In this study, we determined miR-21 expressed higher in human breast cancer, colon cancer and hepatocellular cancer tissues compared with normal tissues and expressed higher in exosomes of breast cancer and hepatocellular cancer cell lines compared with normal cells. MiR-21 dramatically suppressed proliferation, migration and invasion of endothelial progenitor cells (EPCs), which performed promoting role in thrombus repairment and resolution. High levels of miR-21 in exosomes of human cancers dramatically inhibited behaviors of EPCs, and depletion of miR-21 abrogated the decreased proliferation, migration and invasion of EPCs induced by human cancer cells. Moreover, IL6R (interleukin 6 receptor) was identified to be a direct target of miR-21 and promoted cell proliferation, migration and invasion of EPCs. Therefore, the miR-21-IL6R pathway contributed to behaviors of EPCs and consequently mediated the vein thrombosis in patients with cancer. MiR-21-IL6R pathway based therapeutic methods would be beneficial to decrease the complicated venous thrombosis in cancer patients and promote thrombus resolution.

Histological and Pathological Assessment of miR-204 and SOX4 Levels in Gastric Cancer Patients.

Gastric cancer is one of the most common cancers and the efficient therapeutic methods are limited. Further study of the exact molecular mechanism of gastric cancer to develop novel targeted therapies is necessary and urgent. We herein systematically examined that miR-204 suppressed both proliferation and metastasis of gastric cancer AGS cells. miR-204 directly targeted SOX4. In clinical tissue research, we determined that miR-204 was expressed much lower and SOX4 expressed much higher in gastric cancer tissues compared with normal gastric tissues. Associated analysis with clinicopathological parameters in gastric cancer patients showed miR-204 was associated with no lymph node metastasis and early tumor stages whereas SOX4 was associated with lymph node metastasis and advanced tumor stages. In addition, miR-204 and SOX4 were negatively correlated in tissues from gastric cancer patients. Our findings examined the important role of miR-204 and SOX4 played in gastric cancer, and they could be used as candidate therapeutic targets for gastric cancer therapy.

[Effects of batroxobin and electric cauterization on vascular remodeling of rabbit with a removal of carotid arterial adventitia].

OBJECTIVE: To explore the topical hemostatic effects of batroxobin (BX) and electric cauterization (EC) on capillary hemorrhage of rabbit with a removal of carotid arterial adventitia. METHODS: A total of 27 New Zealand rabbits were randomly divided into control, BX and EC groups. Each group received BX (2 kU/L), EC (power = 40 W) and saline for topical hemostasis after a removal of carotid arterial adventitia and blunt dissection. The animals were euthanized by 0, 14 and 28 d post-operation. The specimens of adventitia removal section were divided into three parts for histology (hematoxylin and eosin, MASSON & transmission electron microscope), immunohistochemistry (IHC) [monocyte chemoattractant protein-1 (MCP-1), transforming growth factor-ß1 (TGF-ß1) and vascular endothelial growth factor (VEGF)] and reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: At Day 28 post-operation, the remodeling index, stenotic rate and collagen fiber density of BX and EC groups were (0.753 ± 0.0739) and (0.618 ± 0.0989), (0.298 ± 0.030)% and (0.363 ± 0.039)%, (15.4 ± 3.5)% and (23.4 ± 5.1)% respectively. There was statistically significant difference between two groups (P < 0.05) while no difference existed between hemocoagulase and control groups. The results of electron microscopy showed that the atrial fibroblasts of EC group increased markedly versus BX group. As demonstrated by RT-PCR and IHC, the expressions of MCP-1, TGF-ß1 and VEGF in BX group were lower than those in EC group (P < 0.05) while no difference versus the control group. CONCLUSION: As a safe and effective topical hemostatic method, BX can effectively decrease inflammation response and reduce vascular remodeling and narrowing in rabbits with a removal of carotid arterial adventitia. And its effect mimic closely natural conditions.

Hemocoagulase atrox reduces vascular modeling in rabbit carotid artery adventitia.

OBJECTIVE: This study aimed to compare the effects of hemocoagulase atrox and cauterization hemostasis on intimal hyperplasia and explore the effect of hemocoagulase atrox on vascular modeling in rabbit carotid artery adventitia. METHODS: A total of 27 rabbits were randomly divided into 3 groups (0d, 14d, 28d). They were anaesthetized using an intramuscular injection of phenobarbital sodium (1 ml/kg). The left and right common carotid arteries were exposed and capillary hemorrhaged after blunt dissection of the adventitia layers of common carotid arteries. Nine rabbits in each group were again randomly divided into 3 groups, in which animals were respectively treated with hemocoagulase (2 U/ml), cauterization (power = 40 w) and saline (as control). Groups of animals were euthanized at 0, 14 and 28 days after surgery. The samples were equally divided in the middle of the adventitia removal section to obtain equal parts for histologic, immunohistochemical and molecular biologic analysis. The vascular repair after adventitial stripping was observed by HE staining, Masson staining and transmission electron microscopy. The expression of carotid MCP-1, PCNA, TGF-ß1, α-SMA and VEGF were measured at different time points by RT-PCR and immunohistochemical staining. RESULTS: HE staining and Masson staining showed that hemocoagulase atrox had a significantly stronger effect on reducing intimal hyperplasia than the cauterization after 14 and 28 days. The results of RT-PCR showed that the expression of MCP-1, TGF-ß1, α-SMA and VEGF in hemocoagulase atrox-treated animals were lower than that of cauterization-treated animals. CONCLUSION: Our results suggested that hemocoagulase atrox as a topical hemostatic is safety and efficiently and it can accelerate adventitia restoration and decrease intimal proliferation.

[The topically hemostatic effects of batroxobin on the carotid arteries adventitia removal rabbit].

OBJECTIVE: To observe the topically hemostatic effects of batroxobin (BX) in different concentrations on the carotid arteries adventitia removal rabbit. METHODS: 18 rabbits were removed vascular adventitia by collagenase digestion and mechanical dissection, causing capillary hemorrhage. Then all of them were randomly divided into 6 groups: blank control, negative control group, 0.5, 1, 2 and 4 kU/L (U/ml) BX group. The hemostatic time and bleeding volume were observed to compare the hemostatic effect of each group. Haematoxylin-eosin, Masson staining and immunohistochemistry were performed to assure adventitia removed. RESULTS: It was feasible to remove vascular adventitia with collagenase digestion and mechanical dissection. The hemostatic time and bleeding volume were significantly different (P < 0.05) from 0.5 U/ml BX group [(97 ± 20)s,(0.102 ± 0.013)g/cm(2)] of the negative control group[(143 ± 33)s,(0.130 ± 0.023) g/cm(2)]. With the increase of BX concentration, there was a significant difference (P < 0.05) between 2 U/ml BX group (32 ± 13,0.056 ± 0.015) and 1 U/ml BX group (32 ± 13,0.056 ± 0.015), but there was no statistical significance (P > 0.05) between 2 U/ml BX group and 4 U/ml BX group (28 ± 14,0.053 ± 0.012). Thus, the best topical hemostatic concentration of BX was 2 U/ml. CONCLUSION: The topical hemostatic effect of batroxobin is reliable in small area of blood oozing.