Purpose: To report a single-center series of patients with type B aortic dissection treated with the Multilayer Flow Modulator (MFM). Materials and Methods: Over a 36-month period, 23 patients (median age 53 years; 20 men) with complicated type B aortic dissections (2 acute, 5 subacute, and 16 chronic) were treated with the MFM. Primary endpoints of rupture or dissection-related death, overall mortality, and reintervention were evaluated using the Kaplan-Meier method; estimates for freedom from the endpoints are reported with the 95% confidence interval (CI). Secondary outcomes included technical success, adverse events, and aortic remodeling. Clinical and imaging data were collected preoperatively, directly postoperatively, and annually to 36 months for analysis using computational fluid dynamics (CFD). Results: Initial technical success was 91.3%. The estimates of the endpoints at 12 months were 100% for freedom from rupture or aortic-related death, 95.7% for freedom from overall mortality, and 91.3% for freedom from reintervention. No device-related neurological or systemic complications occurred, and no additional reinterventions were needed during follow-up. A total of 144 branches overstented by the MFM remained patent. Morphologic analysis of the aortic dissection showed progressive true lumen volume increase (75.9%, p<0.001) with concomitant false lumen volume decrease (42.8%, p<0.001); the CFD analyses showed increased laminar flow. Conclusion: In the current series, the MFM provided a safe and feasible treatment option for complicated acute, subacute, and chronic type B aortic dissections, with high technical success, low mortality, and active aortic remodeling. Further studies should elucidate the long-term safety of the MFM and its effectiveness in a larger patient cohort.

Purpose: To report Multilayer Flow Modulator (MFM) implantation from the sinotubular junction to the distal infrarenal aorta in the treatment of type B aortic dissection (TBAD) and demonstrate aortic remodeling using computational fluid dynamics (CFD) analysis over the course of 3-year follow-up. Case Report: A hypertensive patient with complicated TBAD required thoracic endovascular aortic repair due to severe thoracic pain associated with rapid progression of the false lumen aneurysm toward the distal aortic arch. Under general anesthesia, 2 aortic multilayer stents were placed over a 0.035-inch stiff guidewire in the compressed true lumen. The aorta was covered with 2 MFM stents between the sinotubular junction and the distal infrarenal aorta. Serial computed tomography scans showed progressive remodeling of the entire dissected aortic wall, with an excellent result at 24 months. Morphological and CFD vascular analysis confirmed the aortic remodeling, with a false lumen index drop from a preoperative 4.04 to 0.01 at 36 months. Conclusion: Endovascular aortic repair with multilayer stents is a promising treatment for complicated TBAD due to the unique ability of these devices to stabilize the entire aortic wall without compromising the flow in the major aortic side branches.

Recently, multilayer stents for type B aortic dissections (TBAD) have been proposed to decrease false lumen flow, increase and streamline true lumen flow, and retain branch vessel patency. We aimed to provide a protocol with standardized techniques to investigate aortic remodeling of TBAD by multilayer flow modulators (MFM) in static geometric and hemodynamic analyses. Combining existing literature and new insights, a standardized protocol was designed. Using pre- and postoperative CT scans, geometric models were constructed, lumen dimensions were calculated, computational fluid dynamics (CFD) models were composed, and velocity and pressures were calculated. Sixteen TBAD cases treated with MFM were included for analysis. For each case, aortic remodeling was analyzed using post-processing medical imaging software. After 3D models were created, geometrical anatomical measurements were performed, and meshes for finite element analysis were generated. MFM cases were compared pre- and postoperatively; true lumen volumes increased (p < 0.001), false lumen volumes decreased (p = 0.001), true lumen diameter at the plane of maximum compression (PMC) increased (p < 0.001), and false lumen index decreased (p = 0.008). True lumen flow was streamlined, and the overall fluid velocity and pressures decreased (p < 0.001 and p = 0.006, respectively). This protocol provided a standardized method to evaluate the effects of MFM treatments in TBAD on geometric analyses, PMC, and CFD outcomes.

Background/Objectives: Microplastics (MPs) are emerging environmental contaminants with potential implications for human health. Experimental studies suggest that MPs accumulate in the liver and promote inflammatory and fibrotic changes, but evidence from human tissues remains limited. This study investigated the presence of suspected MP-like particles in post-mortem human liver tissue and their associations with clinical, biochemical, hematological and histopathological parameters. Methods: Post-mortem liver tissue samples were collected from 55 adults. Suspected MP-like particles were extracted using hydrogen peroxide digestion, filtration, Nile Red staining and image-based quantification. Histopathological evaluation assessed inflammation, fibrosis, necrosis and fatty liver degeneration. Polarized light microscopy was used as a supportive morphological assessment method. Statistical analyses included Mann–Whitney U tests, Fisher’s exact tests and Spearman correlation analysis. Results: Detectable hepatic suspected MP-like particles were identified in 9 of 55 individuals (16.4%). Individuals with detectable suspected MP-like particles had significantly lower alanine aminotransferase (ALT) levels and leukocyte counts. The hepatic suspected MP-like particle burden showed weak positive correlation with liver fibrosis and inflammation and weak inverse correlation with ALT levels and leukocyte count. Fisher’s exact test showed that liver fibrosis and liver inflammation were significantly associated with detectable hepatic suspected MP-like particles, with higher unadjusted odds observed in the corresponding 2 × 2 contingency tables. No statistically significant associations were found for liver necrosis or fatty liver degeneration. Conclusions: Detectable suspected MP-like particles were identified in post-mortem human liver tissues and were more closely associated with fibrotic and inflammatory histopathological changes than with routine biochemical abnormalities. Larger studies using standardized detection methods are needed to confirm these results.

Background/Objectives: Chronic low-grade inflammation and lipid metabolism play an important role in the development of obesity and type 2 diabetes mellitus (T2DM). The ratio of high-sensitivity C-reactive protein to high-density lipoprotein cholesterol (hs-CRP/HDL-C) integrates these pathways and it has been proposed as a novel biomarker of metabolic risk. However, evidence regarding its association with obesity and T2DM remains limited. Methods: This retrospective cross-sectional study included data from 413 adults, comprising 251 individuals with T2DM and 162 individuals without T2DM. Obesity status was assessed separately according to BMI categories. The hs-CRP/HDL-C ratio was divided into quartiles, with the lowest quartile used as the reference category. Its associations with obesity and T2DM were evaluated using multivariable logistic regression and restricted cubic spline analysis. Subgroup analyses were conducted to evaluate the consistency of these associations across different population subgroups. Results: A significantly positive association was noted between the hs-CRP/HDL-C ratio and the presence of T2DM. Compared with individuals in the lowest quartile, those in the higher quartiles of the hs-CRP/HDL-C ratio had significantly higher odds of T2DM. In the fully adjusted model, each unit increase in the hs-CRP/HDL-C ratio was associated with higher odds of T2DM (OR = 1.59, 95% CI: 1.14–2.20, p = 0.006), whereas the association with obesity was attenuated and lost statistical significance after full adjustment. RCS analysis confirmed a significant overall association between the hs-CRP/HDL-C ratio and T2DM risk (p-overall = 0.034). Although the hs-CRP/HDL-C ratio was associated with obesity in the crude model (OR = 1.40, 95% CI: 1.05–1.70, p = 0.019), the association was not significant after adjustment (OR = 1.18, 95% CI: 0.90–1.56, p = 0.229). Conclusions: In our study, an elevated hs-CRP/HDL-C ratio was significantly associated with the presence of T2DM and may represent a marker associated with metabolic inflammation, particularly in individuals with glycometabolic disorders.

Background/Objectives: Digoxin, a positive inotropic agent with a narrow therapeutic window, is used in heart failure but carries toxicity risks. This study aims to characterize the profile of digoxin-associated adverse drug reactions reported in the EudraVigilance database, focusing on drug–drug interactions, dosing errors, and off-label use. Methods: Descriptive and disproportionality analyses were performed on Individual Case Safety Reports (ICSRs) until 25 January 2026. Digoxin was compared with other inotropic agents by calculating the Reporting Odds Ratio and 95% confidence intervals. Results: Digoxin recorded 11,426 ICSRs, with a predominance in patients aged 65–85 years (46.4%) and over 85 years (25.1%). Higher reporting probabilities were identified for the terms “Drug interaction” and “Overdose” compared to other inotropes. Fatal outcomes were reported in 19 cases related to drug interactions and 41 cases related to overdose. Consistent disproportionality signals were found for gastrointestinal, renal, and nervous system disorders. Off-label use was reported in 0.8% of cases and was associated with unfavorable clinical outcomes. Risks are exacerbated by polypharmacy and renal decline in elderly patients. Conclusions: Digoxin toxicity and cardiac complications are the primary drivers of reported morbidity. This risk profile highlights the need for the rigorous clinical monitoring, precise dose adjustments and heightened vigilance regarding drug–drug interactions.