Postoperative serum mir-28-5p level has predictive value for the prognosis after endovascular abdominal aortic aneurysm repair.

BACKGROUND: We explored the clinical significance of miR-28-5p pre- and post-endovascular abdominal aortic aneurysm repair (EVAR) in abdominal aortic aneurysm (AAA) patients. METHODS: Subjects included AAA patients receiving EVAR and non-AAA people without statistical differences from AAA patient in comorbidities/Framingham risk score. Fasting elbow venous blood (4 mL) was collected in the morning of the day of EVAR surgery and in the morning of 3 months post-EVAR. Pre-/post-EVAR serum miR-28-5p expression, AAA maximum diameter alterations, CD3+/CD4+/CD8+/TC/TG pre-/post-EVAR, and the correlations between miR-28-5p and AAA maximum diameter were investigated. Prediction of miR-28-5p on post-EVAR mortality, prognosis, and independent factors of post-EVAR death were analyzed using receiver operating characteristic curve (ROC)/Kaplan-Meier curve/univariable and multivariable Cox regression. According to the cut-off value of ROC curve for postoperative miR-28-5p was the cut-off value, and the patients were classified into the miR-28-5p high- and low-expression groups. The survival or death of both groups were compared after 48-month follow-up. RESULTS: Serum miR-28-5p levels in AAA patients dropped post-EVAR. AAA patients showed notable differences in CD3+/CD4+/CD8+/TC/TG levels pre-/post-EVAR. The miR-28-5p low-expression group exhibited higher CD3+/CD4+ and lower CD8+/TC/TG levels. We observed a positive correlation between post-EVAR miR-28-5p and AAA maximum diameter and between the pre-/post-EVAR miR-28-5p fold change and the AAA maximum diameter change. Postoperative miR-28-5p demonstrated good predictive value for postoperative death. Hypertension, Framingham risk score, TC, TG, and miR-28-5p were independent influencing factors of post-EVAR death. CONCLUSION: EVAR decreased serum miR-28-5p expression in AAA patients. Post-operative miR-28-5p level and pre-/post-operative fold change level are positively-correlated with AAA diameter.

Assessing postoperative wound infection rates in ultrasound-guided microwave ablation versus conventional surgery for varicose veins.

Varicose veins are the prevalent vascular disorder that has conventionally been managed via risky postoperative wound infections and conventional surgery. While ultrasound-guided microwave ablation (UMA) has gained attention as a minimally invasive alternative, there is still a lack of research examining its comparative effectiveness. A prospective comparative investigation was undertaken in the Zhejiang region of China from January to November 2023, involving 140 patients who had received the diagnosis of primary varicose veins. An equal number of 70 patients underwent UMA and conventional surgery. Exclusion criteria for the study encompassed adult patients aged 18-65, with the exception of those who had undergone prior venous surgery, deep vein thrombosis or peripheral arterial disease. The demographical characteristics, procedural details and complication profiles of patients who developed postoperative wound infections within 30 days were analysed statistically. The outcomes demonstrated that postoperative wound infections were significantly diminished (5.7%) with UMA in comparison to conventional surgery (17.1%). In addition, the average duration of procedures and length of hospital stay for UMA patients were both reduced, although neither of these differences was found to be statistically significant (p > 0.05). Infection management, age and gender distribution of varicose veins were comparable between the two groups (p > 0.05). A significant inverse correlation was observed between the severity of varicose veins and postoperative outcomes, as determined by the regression analysis (p < 0.05). Using UMA to treat varicose veins showed promise as an alternative to conventional surgery, specifically in minimizing the incidence of postoperative wound infections. Additional research and clinical consideration are needed regarding the potential transition toward minimally invasive techniques in treatment of varicose veins, as suggested by these results.