Background and Objectives: Thermography is a non-invasive diagnostic technique that measures skin surface temperatures to reflect normal or abnormal physiology. This review explores the clinical utility of thermography in diagnosing and monitoring stroke, with an emphasis on its clinical applications. Materials and Methods: This systematic review followed PRISMA guidelines, with a protocol published prior to analysis. Three databases were screened up to end of 2024. Article selection was conducted in two stages: title and abstract screening using Rayyan^®, followed by full-text eligibility assessment. Discrepancies were resolved through consensus. Risk of bias assessment was performed with ROBINS-I. Narrative synthesis was planned in addition to descriptive statistics. Results: A total of 20 studies were included after screening 277 records. Thermography emerged as a promising tool for stroke patients in both the acute and chronic phases. In the acute phase, it demonstrated potential in detecting early signs of carotid occlusive disease by identifying temperature differences in the forehead or neck regions. Additionally, thermography contributed to the differential diagnosis of Wallenberg syndrome. In the chronic phase, it exhibited clinical utility in monitoring rehabilitation progress. Conclusions: Thermography shows promise as a non-invasive tool for stroke assessment and monitoring. While preliminary studies suggest physiological relevance, its clinical utility remains investigational and requires further validation.

Atherosclerosis is the major cause of cardiovascular diseases (CVD) in the world. It is a multifocal disease that leads to plaque formation and subsequent ischemia in the arteries of the body. Atherosclerotic obstructive peripheral artery disease causes disturbance of blood delivery to the tissues, which can be translated as temperature decrease on the skin surface, making surface temperature an important indicator of vascular health. Even though there are many classical diagnostic tools for assessing patients with peripheral vascular dysfunction, they have many limitations. On the other hand, infrared thermography imaging presents a noninvasive, relatively cheap, quick and reliable method that does not require direct doctor-to-patient contact. It provides a real time screening information of the tissue perfusion, based on the skin surface temperature. In this article, we present a case of a patient with type B aortic dissection, treated with an endovascular approach. A postprocedural closure device complication led to an acute left lower limb ischemia during the night, which was promptly diagnosed with the help of an onsite high-resolution infrared thermography optimized by specialized AI based software performed by the physician on duty followed by remote evaluation by the operator. The obstruction was treated immediately with successful endovascular recanalization and flow restoration and again evaluated with the thermographic camera confirming excellent tissue vascular result. Infrared thermography imaging can be a time-saving method for physicians, while being a very convenient method for the patient and that is why we advocate on the usage of specialized software supported high resolution thermography imaging as a supplementary diagnostic modality for patients with peripheral artery disease.

Acute pulmonary embolism is the third most common cause of cardiovascular mortality in the world. The sudden pressure overload of the right ventricle, caused by the thrombotic masses in the pulmonary artery, may quickly progress to profound cardiogenic shock. That results in a mortality rate of more than 50% in patients with a massive form of pulmonary embolism. In such cases, systemic fibrinolysis is warranted, which leads to rapid improvement of the right ventricular function and hemodynamic stabilization. The thrombolytic effect of systemic fibrinolysis is, unfortunately, accompanied by an almost 5 times increased risk of bleeding, especially intracranial one. Therefore, in most cases, for patients with uncompromised hemodynamics, only anticoagulation treatment is offered. Interventional treatment of acute pulmonary embolism consists of the usage of very low-dose fibrinolytic devices or percutaneous thrombus aspiration devices. The goal is to provide rapid removal of the thrombotic masses from the pulmonary artery circulation while keeping the hemorrhagic risk at a minimum. This paper will try to provide a concise review of the most widely used and available devices, together with the latest clinical data, supporting their use. Also, the future perspectives in the field of endovascular treatment of acute pulmonary embolism will be presented.

Първата имплантация на TAVI клапа е проведена през 2002 г. от Cribier и колеги. Оттогава до днес отчитаме съществен прогрес на технологията, с появата на нови поколения – по-нископрофилни, по-дълготрайни и по-стабилни при позиционирани TAVI протези. Настоящата публи-кация представя резултатите от едноцентров опит с TAVI процедури в рамките на осемгодишен период. През периода от 2013 до ноември 2022 г. в „Аджибадем Сити Клиник Сърдечно-съдов център“ са проведени общо 354 TAVI процедури. Две основни оперативни стратегии са използвани – стандартна и минималистична. От първата процедура през 2013 г. до средата на 2018 г. е използван предимно стандартния подход (съдовохирургичен достъп, обща анестезия, директна имплантация на клапата, където е възможно). След това като стандартен подход в Центъра се въведе минималистичния (перкутанен достъп, без интубационна анестезия, задължителна предилатация на клапата и използване на rapid pacing). The first TAVI implantation was performed in 2002 by Cribier and colleagues. From then, we have seen significant progress in technology, with the appearance of new generations – lower-profile, longer-lasting and more stable during positioning TAVI prostheses. The present publication presents single-center results and experience with TAVI procedures over an eight-year period. During the period 2013 – November 2022 a total of 354 TAVI procedures were performed in Acibadem City Clinical Cardiovascular Center. Two operating strategies are used – standard and minimalist approach. From the first procedure in 2013 until mid-2018 the standard approach (surgical vascular access, general anesthesia, direct valve implantation where possible) was mostly used. Then, the minimalist approach (percutaneous access, no intubation anesthesia, mandatory valve predilation and use of rapid pacing) was introduced as a standard approach in the center.

Haemodynamic changes in mitral regurgitation underlie triggering of patient’s symptoms and development of heart failure. A number of endovascular methods for the correction of mitral regurgitation successfully counteract pathological hemodynamics and thus manage to improve both the manifestations of heart failure and the patient's symptoms. This article is a review of the physiology of the mitral valve and the changes that occur in the presence of mitral regurgitation. The peculiarities of the hemodynamics of the left atrium in the conditions of mitral regurgitation and after some types of transcatheter treatment – edge-to-edge correction of the valve with Mitraclip and the implantation of an occluder in paraprosthetic mitral regurgitation are considered. The change in left atrial parameters immediately after correction of the defect is of value both for the assessment of immediate procedural success and for the patient's prognosis.

Ендолийкът е едно от най-честите усложнения при ендоваскуларното лечение на аортни аневризми и представлява персистираща перфузия на аневризмалния сак, което може да доведе до неговото експандиране и евентуално руптуриране. Има различни типове ендолийкове в зависимост от мястото на захранване с кръв, независимо от броя и вида на другите ангажирани съдове (ендолийк тип I A/B/С, тип II, тип III, тип IV и тип V). Златният стандарт за диагностицирането на ендолийк е компютърната томография (КТ). Тъй като няма общоприет консенсус за лечение на тази патология в тази статия представяме най-ефективните ендоваскуларни методи за справяне с различните видове ендолийкове. Endoleak represents the most common complication after endovascular aortic aneurysm repair (EVAR) and is defi ned as persistent perfusion of the aneurysmal sac, which subsequently could lead to its expansion and possibly rupture. There are different types of endoleaks, depending on their infl ow source, regardless of the number and type of other vessels involved in the outfl ow (endoleak type I A/B/С, type II, type III, type IV and type V). The current gold standard for the diagnosis of endoleak is the contrast-enhanced helical computed tomography (CT). Since, there is no generally accepted consensus for the best surveillance and treatment methods for this pathology, in this article we will present the most effective endovascular interventions for the successful management of the different types of endoleaks.