Article: Milestones in thromboangiitis obliterans. A position paper of the VAS-European Independent Foundation in Angiology/Vascular Medicine - International Angiology 2021 Jul 08 - Minerva Medica - Journals

Gefitinib is a new molecular-targeted agent for the treatment of patients with advanced non-small cell lung cancer that fail to respond to conventional chemotherapy. Gefitinib is considered to be well tolerated and less toxic compared with conventional cytotoxic drugs. However, interstitial lung disease (ILD) has been reported as a serious adverse effect. The precise management of a gefitinib responder having severe adverse events remains unknown. We report the case of gefitinib readministration in a patient with lung adenocarcinoma who had once responded but in whom treatment had to be discontinued owing to gefinitib-related ILD. A dramatic response was achieved both at the time of initial treatment (250 mg/day) and at readministration of gefitinib (125 mg/day). The effectiveness of gefitinib therapy in our patient could be explained in part by the presence of an activating mutation of epidermal growth factor receptor (EGFR) gene, L858R in exon 21, which was identified in the primary tumor. A reduced dose of gefitinib might be sufficient for patients having tumors with EGFR gene mutations, and that the currently approved dose may be excessively potent in some of these patients, thus resulting in the onset of adverse events.

Chronic venous disease is a common medical condition of the lower limbs that affects a large number of people in every part of the world including the Indian subcontinent. The disease is insidious in nature and therefore often ignored in the early stages. In advanced stages, it causes significant discomfort in the affected limbs which adversely influences quality of life, work hours and treatment expenses. The present article reviews the various aspects of the disease including its pathophysiology and recent management updates. Cardiovasc. j. 2019; 12(1): 59-63

In 2023, the VAS international working group on Buerger’s Disease (BD) recommended two diagnostic criteria based on a prior Delphi study: “definitive” and “suspected”. The “definitive” criteria are history of smoking, typical angiography, and typical histopathological features. All three features are mandatory to confirm a “definitive” diagnosis of BD. The conundrum is—what features should be considered typical of BD angiography? According to this review, segmental occlusion of infrapopliteal arteries, corkscrew collaterals that appear to continue the occluded arterial segment (Martorell’s sign) or bypass the segmental occlusion, absence of atherosclerotic plaque or aneurysm could differentiate BD from ASO. Hence, for “typical” BD angiography, these manifestations should certainly be considered. However, data for differentiating angiography patterns of BD from the small- and medium-sized vasculitis including Behcet’s disease, scleroderma, hepatitis associated vasculitis, and anti-phospholipid syndrome are limited. Further studies for investigating the angiography pattern in BD patients in early and late presentation of BD, particularly in the patients with long-term follow up, are highly recommended.

Peripheral Vascular Disease (PVD) is an emerging public health problem in Bangladesh that has tremendous social and economic implications. Unfortunately, there is a general lack of adequate understanding about this disease among primary care physicians and common people. This is why patients present late to vascular care which poses significant difficulties in the treatment and increases cost burden. Late presentation also increases the rate of limb loss. Treatment of PVD is rapidly evolving with the advent of endovascular modalities. The article provides a review of the basic aspects of PVD as well as the present status of care. Bangladesh Heart Journal 2019; 34(2) : 137-145