Catheter-directed thrombolysis (CDT) and percutaneous mechanical thrombectomy (PMT) are established endovascular strategies for the treatment of deep vein thrombosis (DVT). However, comparative outcomes data specific to upper extremity deep vein thrombosis (UEDVT) remain limited. Given that PMT is associated with improved outcomes in lower extremity DVT, we hypothesize that PMT is associated with improved mortality and morbidity compared to CDT in treating UEDVT. This study evaluates outcomes associated with CDT versus PMT for UEDVT and Paget-Schroetter Syndrome (PSS). A retrospective cohort study was conducted using the TriNetX US Collaborative Network. Patients diagnosed with UEDVT who underwent CDT (n=1,399) or PMT (n=1,406) between 2005 and 2025 were identified. Patients who received both modalities were excluded. Propensity score matching was performed, yielding 1,198 patients in each cohort (n=2,396) balanced across demographics, comorbidities (including malignancy, type 2 diabetes mellitus, hypertension, coagulation disorders, and end-stage renal disease), and medication use. A subgroup analysis was performed for patients with PSS who underwent CDT or PMT, with similar propensity score matching (n=280). Thirty-day and one-year outcomes were compared using odds ratios (ORs). After matching, pulmonary embolism (PE) rates did not differ significantly between groups at 30 days or one year. Compared with PMT, CDT was associated with significantly higher odds ratio of 30-day mortality (OR, 1.82), myocardial infarction (OR, 2.43), ischemic stroke (OR, 9.11), transfusion (OR, 1.95), 30-day readmission (OR, 2.34), and intracranial hemorrhage (OR, 6.59). These differences persisted at one year, with CDT demonstrating significantly higher OR of mortality (OR, 1.56), myocardial infarction (OR, 2.01), ischemic stroke (OR, 6.69), and intracranial hemorrhage (OR, 3.93). Repeat intervention occurred more frequently in the PMT cohort at one year (12.2% versus 7.68%; OR 1.67). Among patients with PSS, one-year mortality was low in both groups. There were no significant differences in PE or subsequent first rib resection between CDT and PMT treated patients. However, repeat intervention occurred more frequently in the PMT cohort (21.4% vs 10.7%; OR 2.27). In this national propensity-matched analysis, CDT for UEDVT was associated with higher 30-day and one-year morbidity and mortality compared with PMT, whereas PMT was associated with a greater need for repeat intervention. In patients with PSS, CDT and PMT demonstrated similar clinical outcomes, although PMT was associated with higher reintervention rates. These findings suggest differential risk profiles between the two treatment strategies and may inform procedural selection in the management of UEDVT.

The Healthy Choices Team (HCT) is a community-based initiative that addresses health disparities by promoting sustainable behavior change in nutrition, exercise, sleep, and mindfulness within a diverse community in Bexar County, Texas. This initiative was developed in response to Community Health Needs Assessments (CHNAs) conducted at the El Bari Community Health Center, which identified nutrition as a top community health priority. The HCT, now in its fifth year, employs a model emphasizing bi-directional learning, cultural sensitivity, and community ownership. The program involves twice-monthly sessions led by an interdisciplinary team of health professionals, students, and community members, culminating in a graduation ceremony that encourages graduates to return as community ambassadors. The HCT has adapted its curriculum over the years based on community feedback and survey data, with a focus on nutrition, healthy cooking, and other positive lifestyle habits. Pre- and post-program surveys indicate that the HCT has been effective in improving participants’ health knowledge and habits. Specifically, participants demonstrated significant improvements in reading nutrition labels, tracking sodium intake, and increasing their levels of physical activity. These results highlight the importance of community-driven interventions that address cultural nuances and promote active participation. The HCT provides a framework for other community-based programs seeking to foster sustainable behavior change and improve health outcomes. The program’s success is attributed to its emphasis on building trust, fostering a sense of community, and empowering individuals to become agents of change within their own social networks.

Venous thoracic outlet syndrome classically presents with upper extremity venous thrombosis (Padget-Schroetter syndrome). The established treatment pathway includes thrombolysis with early surgical decompression of the thoracic outlet. This case is a 20-year-old woman initially treated erroneously with thrombolysis and subclavian vein stenting, without surgical decompression. Over the next decade, she experienced multiple recurrent complications, requiring several interventions. Despite multiple attempts to overcome the original procedure, her symptoms have reoccurred owing to restenosis and increasingly complex anatomy. This case highlights the importance of early recognition and definitive surgical intervention by trained vascular surgeons to optimize long-term outcomes in venous thoracic outlet syndrome.

Background: In type 2 diabetes mellitus (T2DM), bone and microvascular complications may be linked. Methods: The University of California Davis (UCD) polygenic T2DM and Sprague Dawley healthy control (CTL) rats (N = 48) were divided equally into diabetic and age-matched groups: (1) pre-diabetes, (2) diabetes onset, (3) early-stage T2DM, and (4) late-stage T2DM. Body mass, HbA1c, fasted blood glucose and femoral and tibial lengths were measured. Bones were scanned (μCT; 15 µm) to assess trabecular microarchitecture and density and mid-shaft cortical thickness (Ct.Th, µm), density and porosity. Ossified vessel volume (OsVV, %) and thickness (OsV.Th, µm) were also analyzed. A GLM determined significance at p < 0.05. Body mass and HbA1c were higher (p < 0.05) in all T2DM groups and blood glucose became elevated (p < 0.05) in early-stage T2DM and late-stage T2DM. Results: Tibiae and femora were longer (p < 0.05) with diabetes. Tibial bone volume was lower (p < 0.05) in pre-diabetes (4 ± 1% vs. CTL, 9 ± 2%) and late-stage T2DM (5 ± 2% vs. CTL, 8 ± 2%), and femoral bone volume was lower (p < 0.05) in pre-diabetes (7 ± 1% vs. 12 ± 4%). Cortical density (tibia) was lower (p < 0.05) in pre-diabetes and early-stage T2DM. Trabecular density in the femur was lower (p < 0.05) in all T2DM groups and cortical density was reduced (p < 0.05) in pre-diabetes, diabetes onset, and late-stage T2DM. OsVV in both bones were lower (p < 0.05) during early-stage T2DM. Tibial OsV.Th was higher (p < 0.05) in pre-diabetes (69 ± 14 µm vs. CTL, 56 ± 13 µm) and late-stage T2DM (80 ± 10 µm vs. CTL, 59 ± 13 µm) and higher (p < 0.05) in the femur at diabetes onset (58 ± 14 µm vs. CTL, 40 ± 10 µm). Conclusions: Trabecular and cortical bone varied as diabetes progressed, and the thicker ossified vessels may represent microangiopathy.