Browsing by Author "Kostic, Ognjen (58509822500)"

Background: Symptom risk assessment in carotid artery stenosis (CAS) could be improved by parameters that reflect additional risk aspects such as chronic inflammation rate, and atherosclerotic activity on a systemic level. In light of that, we investigated the association of serum matrix metalloproteinases-2,7,9 (MMP-2,7,9), vascular cell adhesion molecule-1 (VCAM-1) and selectins-P and E with symptomatic status, stenosis degree and plaque morphology in CAS patients in order to select parameters that associate to important clinical determinants of the symptom development risk. Methods: The study included 119 CAS patients and 46 healthy subjects. Carotid arteries were examined by color flow Doppler and B-mode Duplex ultrasound. Serum parameters were assessed using commercially available enzyme-linked immunosorbent assays (ELISA). Difference was tested by Mann-Whitney U, Kruskal-Wallis and Chi-square tests, and Spearman’s correlation was tested. Results: MMP-7 and selectin-P levels were higher in CAS than in controls (p<0.001). Positive correlation with stenosis degree was found for MMP-7 (r=0.155, p=0.007), VCAM-1 (r=0.127, p=0.029) and selectin-P (r=0.269, p<0.001). MMP-7 and selectin-P were higher in subjects with Grey-Weale 2, comparing to subjects with Grey-Weale 3 plaques (p=0.036, p=0.009). Selectin-P was lower in the presence of Grey-Weale 4 than in Grey-Weale 2 (p=0.045). Conclusions: Concurrent association of MMP-7 and selectin-P with both stenosis degree and carotid plaque morphology shows the joint influence of these important determinants of symptom risk that is reflected in serum parameters. This indicates that they can supply additional information outside ultrasound CAS assessment only, and their integration in a future multiscale approach for CAS risk prediction could be beneficial. © 2025 Society of Medical Biochemists of Serbia. All rights reserved.

Objective: Screening for abdominal aortic aneurysm (AAA) is recommended in high risk populations based on local conditions. Differences in lifestyle and risk factors between countries with different income status make risk stratification based on geographic location necessary. The majority of epidemiological studies on AAA have reported data from high income countries. The aim of this study was to explore the prevalence and risk factors for AAA in an upper middle income country in Eastern Europe. Methods: A pilot screening project for AAA, supported by a mass media campaign, was conducted in 2023 in seven cities in Serbia. Ultrasound evaluation of the abdominal aorta was performed by a registered vascular surgeon on individuals who agreed to participate. Participants who attended screening completed a questionnaire on demographic and clinical information. To assess risk factors for AAA, univariable logistic regression analysis was performed to compute the odds ratio (OR) with 95% confidence interval (CI). Multivariable logistic regression was subsequently performed with adjustments for sex, age, family history of AAA, and other relevant factors. Results: A total of 4 046 participants (51.2% male and 48.8% female; mean age 68.8 ± 7.6 years) responded to the campaign. An aneurysm was found in 195 (4.8%) screened individuals (8.2% of men and 1.3% of women). In males aged 50 – 64 years, the prevalence of AAA was 5.4%. Male sex, older age, family history of AAA, being a smoker or ex-smoker, being overweight, and alcohol consumption were predictors of AAA in the univariable analysis. After adjustments in the multivariable analysis, male sex (OR 8.04, 95% CI 4.87 – 13.28), older age (OR 1.04, 95% CI 1.02 – 1.07), positive family history (OR 2.47, 95% CI 1.61 – 3.78), smoker status (OR 3.10, 95% CI 2.10 – 4.59), ex-smoker status (OR 2.13, 95% CI 1.39 – 3.27), and being overweight (OR 1.85, 95% CI 1.25 – 2.74) were independent risk factors for AAA. Conclusion: The prevalence of AAA has not been reduced in all countries, and screening strategies might be changed based on local epidemiological data. The results of this pilot study underline the importance of exploring the prevalence of AAA in populations with a high prevalence of smoking. © 2024

Background and Objectives: Persistent sciatic artery (PSA) is a rare congenital vascular anomaly that is often asymptomatic, but can be associated with aneurysm formation and potential complications, such as thromboembolism or aneurysm rupture in some cases. We present a case of a 75-year-old woman with a symptomatic thrombus-containing aneurysm of the left PSA. Materials and Methods: The treatment of the PSA aneurysm involved a successful hybrid approach, which included open surgical bypass and endovascular embolization. The open surgical bypass was performed from the left common femoral artery to the left above-the-knee popliteal artery using a synthetic graft, while the aneurysm exclusion was achieved through endovascular plug embolization. Results: Control angiography revealed complete exclusion of the PSA aneurysm. At the 1-month follow-up, there were no palpable pulsatile masses in the left gluteal region, and the patient reported no symptoms. Conclusions: Given the high incidence of limb- and life-threatening complications associated with a PSA aneurysm, accurate diagnosis and appropriate treatment are crucial. In this case, a combination of open surgical and endovascular techniques resulted in a favorable outcome for the patient, highlighting the effectiveness of the hybrid approach in managing PSA aneurysms. Further studies are warranted to explore and refine treatment strategies for these complex vascular anomalies. © 2023 by the authors.

Endovascular repair has significantly improved the treatment of aortic aneurysms, particularly in older and high-risk patients. However, many studies have not found significant differences in long-term outcomes when comparing open and endovascular repair methods. Additionally, endovascular repair is associated with a higher rate of aortic-related reinterventions compared to open repair (OR), sometimes necessitating late open surgical conversion (LOSC). The increasing number of endovascular aortic aneurysm repairs exposes vascular surgeons to a growing number of patients requiring late open surgical conversion (LOSC) after previous endovascular aneurysm repair (EVAR) or thoracic endovascular aortic repair (TEVAR). LOSC following endovascular procedures is associated with higher perioperative mortality and complication rates compared to primary open repair of aortic aneurysms. This review summarizes the current knowledge, indications, possibilities, and techniques for LOSC after initial endovascular procedures. While the incidence of complications requiring LOSC remains relatively low, the number of endovascular procedures performed has increased significantly over the last decade, suggesting a rise in LOSC procedures as well. Due to the complexity involved, LOSC procedures should be performed in high-volume centers by highly experienced vascular surgeons. This underlines the importance of educating the younger generation of vascular surgeons in both endovascular and open aortic surgery. © 2024 The Author(s).