A RAND/UCLA-Modified VAS Study on Telemedicine, Telehealth, and Virtual Care in Daily Clinical Practice of Vascular Medicine.

Telemedicine is increasingly used in several fields of healthcare, including vascular medicine. This study aimed to investigate the views of experts and propose clinical practice recommendations on the possible applications of telemedicine in vascular medicine. A clinical guidance group proposed a set of 67 clinical practice recommendations based on the synthesis of current evidence and expert opinion.

Update About the Management of Low-Density Lipoprotein Cholesterol and Hypertriglyceridemia in Lower Extremity Peripheral Artery Disease Patients: Consensus of the French Society of Vascular Medicine and the French Society for Vascular and Endovascular Surgery.

Background: A French intersociety consensus on behalf the Société Française de Médecine Vasculaire and the Société de Chirurgie Vasculaire et Endovasculaire was proposed in 2021 for the management of patients with lower extremity peripheral artery disease (LEAD). Recent studies have been published and an update of this consensus about the management of low-density lipoprotein cholesterol (LDLc) and hypertriglyceridemia was required.

Methods: A steering committee of 12 vascular physicians and surgeons defined questions of interest about LDLc and hypertriglyceridemia management.

The 2023 Belgian clinical guidance on anticoagulation management in hospitalized and ambulatory COVID-19 patients.

COVID-19 is associated with an increased risk for thrombotic complications. The trials investigating the optimal thromboprophylactic dose are performed in challenging times and seemingly produce conflicting evidence. The burdensome circumstances, divergent endpoints, and different analytical approaches hamper comparison and extrapolation of available evidence.

Current management and screening of peripheral and coronary artery disease in people with diabetes mellitus in Europe. The PADDIA/CADDIA survey.

Aims: This survey aimed to evaluate the current management and screening of coronary artery disease and peripheral artery disease in people with type 2 diabetes mellitus (T2DM) in Europe, utilizing the 2013 ESC/EASD (European Society of Cardiology/European Association for the Study of Diabetes) guidelines as a benchmark.

Methods: The PADDIA/CADDIA survey is a European medical research collaboration targeting cardiologists, vascular physicians, diabetologists and general practitioners from Austria, Belgium, France, Germany, Italy, Netherlands and United Kingdom.

Results: The questionnaire was completed by sixty-three physicians, of whom 75% declared assessing the cardiovascular risk of people with T2DM mostly without using a risk score (59%).

EACVI recommendations on cardiovascular imaging for the detection of embolic sources: endorsed by the Canadian Society of Echocardiography.

Cardioaortic embolism to the brain accounts for approximately 15-30% of ischaemic strokes and is often referred to as 'cardioembolic stroke'. One-quarter of patients have more than one cardiac source of embolism and 15% have significant cerebrovascular atherosclerosis. After a careful work-up, up to 30% of ischaemic strokes remain 'cryptogenic', recently redefined as 'embolic strokes of undetermined source'.

[Anticoagulation of diabetic patients with nonvalvular atrial fibrillation].

Patients with diabetes have a higher risk of nonvalvular atrial fibrillation (NVAF), cerebral embolisms and anticoagulant-related intracranial bleeding when compared to nondiabetic patients. Non-vitamin K oral anticoagulants (NOACs) are progressively replacing antivitamin K agents among patients with NVAF. They are as efficacious as warfarin to reduce the risk of cerebral and systemic embolisms while reducing the risk of both severe and cerebral hemorrhages.

Disparities Between International Guidelines (AHA/ESC/ESVS/ESVM/SVS) Concerning Lower Extremity Arterial Disease: Consensus of the French Society of Vascular Medicine (SFMV) and the French Society for Vascular and Endovascular Surgery (SCVE).

Several international guidelines concerning lower extremity arterial disease (LEAD) have been published recently, in particular, by the American Heart Association the European Society of Cardiology/European Society for Vascular Surgery, the European Society for Vascular Medicine and the Society for Vascular Surgery. These guidelines differ in some respects and certain issues are not addressed. The objective of this consensus driven by the French Societies of vascular Medicine and surgery was to analyze the disparities between the different guidelines, as well as certain issues not covered, and develop proposals with regard to these points.

[Coagulopathies, thrombotic risk and anticoagulation in COVID-19].

Clinical observations indicate that COVID-19 often provokes coagulopathies, which have been associated with high morbidity and mortality rates. These coagulopathies likely result from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection-elicited systemic inflammation and endothelial damage. Patients with severe COVID-19 are at high risk of venous and arterial thromboembolic diseases; they can also develop disseminated intravascular coagulation in the most advanced stages of the disease.

Belgian clinical guidance on anticoagulation management in hospitalised and ambulatory patients with COVID-19.

Objectives: COVID-19 predisposes patients to thrombotic disease. The aim of this guidance document is to provide Belgian health-care workers with recommendations on anticoagulation management in COVID-19 positive patients.

Methods: These recommendations were based on current knowledge and a limited level of evidence.

Guidance for the Management of Patients with Vascular Disease or Cardiovascular Risk Factors and COVID-19: Position Paper from VAS-European Independent Foundation in Angiology/Vascular Medicine.

COVID-19 is also manifested with hypercoagulability, pulmonary intravascular coagulation, microangiopathy, and venous thromboembolism (VTE) or arterial thrombosis. Predisposing risk factors to severe COVID-19 are male sex, underlying cardiovascular disease, or cardiovascular risk factors including noncontrolled diabetes mellitus or arterial hypertension, obesity, and advanced age. The VAS-European Independent Foundation in Angiology/Vascular Medicine draws attention to patients with vascular disease (VD) and presents an integral strategy for the management of patients with VD or cardiovascular risk factors (VD-CVR) and COVID-19.

[Direct oral anticoagulants : therapeutic breakthroughs over the past decade].

In the past decade atrial fibrillation (AF) and venous thromboembolic disease (VTE) treatment have been revolutionized by direct oral anticoagulants (DOACs). Compared to vitamin K antagonists, DOACs have interesting advantages : standardized dosages (no need for monitoring), fast action, short half-life, (no food interaction and lower risk of intracranial bleeding). In addition to VTE and AF, DOACs have specific indications : prevention of postorthopedic surgery VTE and more recently, prevention of cardiovascular events in patients with stable coronaropathy and/or peripheral artery disease.

[Therapeutic revolution in the treatment of aortic stenosis : transcatheter aortic valve implantation (TAVI )].

Eighteen years after the birth of the concept, TAVI (Transcatheter Aortic Valve Implantation) has established itself as the treatment of choice for symptomatic patients with severe aortic valve stenosis at high surgical risk. Unlike surgical prosthesis, the benefit of which has been validated in observational studies, indications for TAVI are now based on the results of large randomized trials. The TAVI revolution continues today with the miniaturization of the equipment, the development of new closure systems, the availability of a wider range of prosthesis sizes and the growing experience of operators, all contributing to the widening of indications to lower risk patients.

[How Itreat ... extended duration of anticoagulation in lower-limb deep venous thrombosis].

Treatment of lower-limb deep vein thrombosis comprises three phases : the initial phase that includes the first 5 to 21 days, the long-term phase that includes the following 3 to 6 months and a potential extended phase (indefinite duration). After 3 to 6 months of anticoagulation, the treatment must be re-evaluated. Full or reduced dosage or complete cessation of anticoagulants can be proposed according to the individual benefit-risk balance.