The procedures appeared to be safe and well tolerated by the patients, regardless of the actual impact of the endovascular treatments for venous pathology on the clinical course of multiple sclerosis, which warrants long-term follow-up.

The aim of the study is to evaluate the prevalence and incidence of myocardial dysfunction (MD) and heart failure (HF) in long-lasting (≥10 years) type 1 diabetes without cardiovascular disorders or with hypertension or coronary heart disease (CHD). The study included 1,685 patients with type 1 diabetes (mean baseline age, 51 years; diabetes duration, 36 years). In all patients, echocardiography was performed, NT-proBNP levels were measured, and clinical symptoms were evaluated. A 7-year follow-up was conducted to monitor systolic and diastolic manifestations of MD and HF. At the end of the follow-up period, the prevalence of HF in the entire group was 3.7 %, and the incidence was 0.02 % per year. The prevalence of MD was 14.5 % and the incidence –0.1 % per year. MD and HF were observed only in hypertensive or CHD patients. At baseline, subjects with diastolic HF constituted 85 % of the HF population and those with systolic HF the remaining 15 %. Baseline HF predictors included age, diabetes duration, HbA1c levels, CHD, systolic blood pressure >140 mmHg, and GFR <60 mL/min/1.73 m2. In patients with type 1 diabetes, MD and HF occurred only when diabetes coexisted with cardiovascular disorders affecting myocardial function. The prevalence and incidence of HF in patients with hypertension and CHD were relatively low. While the cause of this observation remains uncertain, it could probably be explained, at least partially, by the cardioprotective effect of concomitant treatment.

Our research has shown that currently used extracranial sonographic criteria for the detection of obstructive venous abnormalities in the IJVs are of limited diagnostic value. For the time being, diagnosis of this vascular pathology should be given using catheter venography.

Objective: Procedural characteristics, including stent design, may influence the outcome of carotid artery stenting (CAS). A thorough comparison of the effect of stent design on outcome of CAS is thus warranted to allow for optimal evidence-based clinical decision making. This study sought to evaluate the effect of stent design on clinical and radiological outcomes of CAS.Methods: A systematic search was conducted in MEDLINE, Embase, and Cochrane databases in May 2018. Included were articles reporting on the occurrence of clinical short-and long-term major adverse events (MAE, any stroke or death) or radiological adverse events (new ischemic lesions on postprocedural magnetic resonance diffusion-weighted imaging (MR-DWI), restenosis or stent fracture) in different stent designs used to treat carotid artery stenosis.Random effects models were used to calculate combined overall effect sizes. Meta-regression was performed to identify the effect of specific stents on MAE rates. Results: From 2,654 unique identified articles, two randomized controlled trials and 66 cohort studies were eligible for analysis (including 46,728 procedures). Short-term clinical MAE rates were similar for patients treated with open cell versus closed cell or hybrid stents. Use of Acculink stent was associated with a higher risk of MAE compared to Wallstent (RR: 1.51, p=0.03), as was true for use of Precise stent versus Xact stent (RR: 1.55, p<0.001). Long-term clinical MAE rates were similar for open versus closed cell stents. Use of open cell stents predisposed to a 25% higher chance (RR: 1.25; p=0.03) of developing postprocedural new ischemic lesions on MR-DWI. No differences were observed in incidence of restenosis, stent fracture, or intraprocedural hemodynamic depression with respect to different stent design. [Type here] Conclusions: Stent design does not affect short-or long-term clinical MAE rates in patients undergoing CAS. Furthermore, the division in open and closed cell stent design might conceal true differences in single stent efficacy. Nevertheless, open cell stenting resulted in a significantly higher number of MR-DWI-detected subclinical postprocedural new ischemic lesions compared with closed cell stenting. An individualized patient data meta-analysis,including future studies with prospective homogenous study design, is required to adequately correct for known risk factors and provide definite conclusions with respect to carotid stent design for specific subgroups.