Double aortic arch (DAA) is a rare congenital aortic arch anomaly that is usually identified in infancy because of symptoms related to a vascular ring. Acute type A intramural hematoma (IMH) with a focal intimal tear in an adult with DAA is extremely rare, and no consensus has been established regarding emergency management. Seventy-three year-old woman presented with burning pain in the throat and suprasternal notch and was initially suspected of having acute coronary syndrome. Computed tomography angiography (CTA) of the whole aorta and supra-aortic vessels demonstrated a double aortic arch, with the right common carotid artery and right subclavian artery originating from the right arch and the left common carotid artery and left subclavian artery originating from the left arch. After preoperative evaluation, emergency surgery was performed through a median sternotomy. Intraoperatively, a focal intimal tear approximately 2cm in length was identified in the ascending aorta. Given the complex branching anatomy of the double aortic arch, right femoral artery cannulation was used to establish cardiopulmonary bypass in order to minimize invasive manipulation of the arch. Resection of the diseased ascending aorta and graft replacement were performed, and the potential false lumen at the aortic root was obliterated using the adventitial inversion technique. The prosthetic graft was wrapped with bovine pericardium, and the double aortic arch was not addressed during the same operation. The patient experienced recurrent perioperative hypoxemia and was extubated 17h after surgery following respiratory support, lung-protective management, and anti-inflammatory treatment. She was discharged on postoperative day 12. Approximately 1month later, she was readmitted with chest pain, and CTA revealed a newly developed dissection in the proximal right aortic arch. The family declined reoperation, and the patient was subsequently lost to follow-up. In patients with DAA complicated by acute type A IMH with a focal intimal tear, limited ascending aortic replacement in the emergency setting may reduce surgical trauma; however, it may leave a high-risk residual arch segment and increase the risk of clamp-related injury or insufficient resection margins. Perioperative airway compression caused by the vascular ring should be assessed using imaging, and one-stage or staged reconstruction should be planned according to the patient's condition. Strict postoperative blood pressure control and close follow-up are essential to reduce the risk of recurrence.

The myocardium possesses one of the highest vascular densities in the body. The outermost wall layer of large and medium-sized vessels, the adventitia, forms a critical interface between the vasculature and the myocardium and serves as a reservoir for stem and progenitor cells capable of differentiating into all vascular wall lineages as well as innate immune cells, including macrophages. Current cardiac organoid models intrinsically develop networks of endothelial cords and small capillary-like structures that resemble cardiac microvessels. However, these microvessels mostly lack an adventitial compartment in vivo. Here, we present a potential alternative assembloid strategy that combines vascular segments from mouse and human origin with either cardiomyocytes or cardiac spheroids derived from human induced pluripotent stem cells, thereby incorporating large diameter vessels and the vascular adventitia into a cardiac tissue model. Within the assembloids, the myocardial component remained contractile and connected to the vascular adventitia, which displayed cellular sprouting toward the hiPSC-derived cardiac tissue. Immunostaining for vascular and immune markers revealed that the adventitia gave rise to endothelial sprouts and macrophage-like cells which integrated into the myocardial tissue. In summary, we present proof of concept for complex assembloids composed of vessel segments and human iPSC-derived cardiomyocytes which contain and maintain an in vivo-like adventitial compartment. We suggest this model may serve as a platform for investigating myocardial–stromal interactions, cardiac tissue repair, and functional remodeling under both physiological and pathological conditions. Furthermore, the incorporation of large-lumen vessel segments may enable future experimental perfusion, rendering the model particularly suitable for drug testing via intravascular delivery.

Contemporary Approach to Vascular Rings.

ABSTRACTA right‐sided aortic arch, a congenital anomaly of the aortic arch, was initially described by Fioratti and Aglietti in 1963. This condition, associated with formation of a vascular ring, can constrict mediastinal organs such as the trachea and esophagus. We present a case of a 42 year old male with the history of intermittent dysphagia and mild retrosternal discomfort for 6 months. The contrast‐enhanced CT scan revealed a mirror‐image branching pattern of the aortic arch on the right side. A vascular ring was formed and a 1.20 cm Kommerell diverticulum was found behind the esophagus. The diverticulum was small and, therefore, no surgery was carried out. The patient was managed in a conservative manner and at 3 months of follow‐up, he reported an improvement in the symptoms. In this case, the diagnostic approach has played a crucial role in identifying the cause of the difficulty in swallowing in this patient. The initial examination, a mere esophagram, gives a hint of early diagnosis; that is, a smooth depression on the posterior wall of the esophagus and a significant constriction of the lumen caliber. CT scan and endoscopy confirm the presence of a pulsating external compression and the absence of primary esophageal disease. Since this patient does not have severe and progressive symptoms, there is minimal or no risk of aneurysm or dissection caused by Kommerell diverticulum. This case highlights the value of clinical suspicion of rare congenital diseases and comprehensive imaging and conservative management to achieve favorable outcomes in patients with dysphagia due to vascular ring malformation in resource‐limited countries.

Right aortic arch and double arch assessed by prenatal echocardiography: a population-based study.

Circumflex aortic arch is a rare vascular ring, with the circumflex right aortic arch much more common than a left aortic arch. The aortic uncrossing procedure has become the surgical intervention of choice for this anomaly. In younger children, some surgeons prefer a simpler procedure, such as resection of the descending aortic diverticulum or ligation and division of the arterial duct, with the uncrossing procedure reserved for those with residual airway or esophageal compression. We report an aortic uncrossing procedure in a 2-year-old girl with the very rare left circumflex aortic arch who remained symptom-free at 1 year follow-up.

Assessing the value of postnatal echocardiograms prior to congenital duodenal obstruction repair.

BACKGROUND Vascular rings are rare congenital anomalies of the aortic arch system that encircle and compress the trachea and esophagus, leading to respiratory and feeding symptoms that may mimic more common pediatric conditions. Delayed diagnosis remains a challenge, particularly in patients presenting beyond the neonatal period. AIM To describe the clinical presentation, diagnostic approach, anatomical characteristics, surgical management, and postoperative outcomes of pediatric patients diagnosed with complete and incomplete vascular rings at a tertiary referral center. METHODS We conducted a retrospective study of patients diagnosed with vascular rings at the Children’s Heart Center of the American University of Beirut Medical Center between January 2010 and December 2025. All patients underwent transthoracic echocardiography and computed tomography angiography for diagnostic confirmation and surgical planning. RESULTS Eight patients were identified, of whom three (37.5%) were male. The mean age at time of procedure was 17.5 months (range: 8 days to 38 months). Feeding difficulties and chronic respiratory symptoms were the most common presenting features (both 75%). Three patients (37.5%) had associated intracardiac anomalies. Double aortic arch was the most frequent anatomical subtype (50%), followed by right aortic arch with aberrant left subclavian artery (37.5%). All patients underwent surgical repair, with cardiopulmonary bypass required in two cases. There were no operative or in-hospital deaths. Two neonates developed postoperative tracheomalacia. During a mean follow-up of 32 months, complete symptom resolution was observed in 50% of patients, while the remainder demonstrated significant clinical improvement. CONCLUSION Vascular rings remain an important but often underrecognized cause of airway and esophageal compression in infants and young children. Delayed presentation was common in this cohort, underscoring the need for heightened clinical suspicion in patients with persistent respiratory or feeding symptoms. Multimodal imaging and timely surgical intervention result in excellent survival and favorable clinical outcomes, although residual symptoms may persist, particularly in patients with severe preoperative airway compromise.

Background: Vascular rings represent a rare subset of congenital cardiovascular malformations, comprising 1–3% of congenital heart defects. Characterised by abnormal regression of embryonic aortic arches, these anomalies form a compressive circle around the trachea and oesophagus. The resulting symptoms are mechanically driven, ranging from mild dysphagia to life-threatening airway obstruction. Case Presentation: We report the anaesthetic and perioperative management of an 18-day-old, full-term female neonate presenting with critical respiratory distress and dysphagia. Computed tomography angiography confirmed a right aortic arch with an aberrant left subclavian artery (RAA-ALSA) and a left ligamentum arteriosum, forming a complete vascular ring with 60% tracheal stenosis. Management and Outcome: Urgent surgical division of the ligamentum arteriosum via a left posterolateral thoracotomy was performed. Anaesthetic management prioritized the preservation of spontaneous ventilation during inhalational induction to prevent dynamic collapse of the malacic trachea. Following bronchoscopy-guided intubation with a 3.5 mm endotracheal tube and successful surgical decompression, the patient was managed in the pediatric cardiac intensive care unit. Extubation was achieved 48 hours postoperatively, with complete resolution of feeding difficulties and marked respiratory improvement. Conclusion: This case highlights the necessity of meticulous preoperative planning and multidisciplinary collaboration. Successful management of severe vascular rings demands a thorough understanding of patient-specific anatomy, deviation from standard airway paralysis algorithms to preserve intrinsic airway tone, and the immediate availability of advanced airway adjuncts

Persistent Right Aortic Arch (PRAA) is one of the most frequent congenital vascular system anomalies in dogs, responsible for the formation of a vascular ring that compresses the esophagus and can lead to the development of megaesophagus and recurrent regurgitation, especially during the post-weaning period. Given the clinical relevance of this condition and its potential complications, this study aims to report the anesthetic and surgical management of a PRAA case in a pediatric patient, highlighting the necessary care to minimize perioperative risks. The methodology consists of a case report from the Veterinary Hospital of the Federal Rural University of Pernambuco (UFRPE), involving a four-month-old mixed-breed female dog referred for surgical correction of the anomaly. Preoperative laboratory tests and clinical evaluation were performed, followed by a balanced anesthetic protocol using methadone and midazolam as pre-anesthetic medication, induction with propofol, and maintenance with inhalation anesthesia associated with a constant rate infusion (CRI) of remifentanil and lidocaine. Ultrasound-guided intercostal and serratus plane blocks were performed with bupivacaine and ropivacaine, respectively, along with continuous monitoring throughout the procedure. The intervention lasted approximately two hours and proceeded without relevant anesthetic complications, maintaining cardiovascular and ventilatory stability. In the immediate postoperative period, the patient showed satisfactory recovery with no episodes of regurgitation. It is concluded that the application of multimodal anesthesia, combined with intensive monitoring and adequate airway protection, significantly contributes to the safety and success of perioperative management in patients with PRAA.

Background/objectivesLimited studies have characterized differences in postoperative outcomes between regional anesthetic techniques with systemic analgesia and systemic analgesia alone in thoracotomies for congenital cardiac surgery. This retrospective case series aimed to assess the efficacy of regional anesthetic techniques in improving postoperative outcomes in children undergoing thoracotomies for cardiac surgery in comparison to children who only received systemic analgesia without any regional anesthesia.MethodsPerioperative data from patients under 18 years of age who underwent thoracotomy for coarctation of the aorta or vascular ring repair between January 2017 and March 2022 in a single-center quaternary care children's hospital were collected, including the presence or absence of a regional or neuraxial anesthetic technique. Primary outcomes collected were 24-hour postoperative pain scores and 24-hour opioid consumption. Secondary outcomes collected were incidence of moderate pain, time to extubation, and block complications.ResultsOne hundred and forty patients underwent thoracotomy for coarctation or vascular ring in the study period. Regional or neuraxial anesthesia (paravertebral, erector spinae plane, serratus anterior, or caudal opioid) was utilized in 62 (44.3%) cases. Paravertebral blocks were the most common block. Both groups demonstrated well-controlled pain throughout the first 24 hours. Twenty-four-hour opioid consumption (mg/kg of intravenous morphine equivalents (IME)) was similar between regional and non-regional groups (0.36 (0.20, 0.54) versus 0.39 (0.18, 0.62); p=0.48). There was no statistically significant difference in the incidence of moderate pain between groups. ConclusionsPain was well-controlled in patients who received regional plus systemic analgesia as well as patients who received systemic analgesia alone, with no differences in pain scores, moderate pain, or opioid use between the patient populations.

Rare congenital cardiac disorders emerge from early developmental disturbances that reshape chamber geometry, alter arterial and venous alignment and modify valvular architecture, creating complex structural patterns with distinct physiological consequences. A central rationale for this narrative review is the need to unify scattered morphological insights to support a clearer interpretation of these uncommon conditions across varied clinical environments. This narrative review focuses on integrating the principal anatomical determinants that shape the presentation of rare congenital cardiac anomalies, linking developmental events with structural configurations that influence circulatory behavior, physiological adaptation and long-term functional stability. Literature published from 2015 to 2025 was examined through targeted searches across major scientific databases, selecting studies that offered detailed structural, embryological or imaging-based perspectives relevant to these disorders. The content integrates current understanding of looping deviations, conotruncal malformations, anomalous venous pathways, valvular morphogenesis defects, laterality disturbances, vascular rings and advanced imaging contributions, outlining how each category introduces distinctive shifts in hemodynamic patterns. This narrative review underscores the importance of precise morphological evaluation for early recognition, informed procedural planning, optimized intervention strategies, enhanced risk stratification and comprehensive longitudinal assessment. Consolidated anatomical insight strengthens diagnostic confidence and improves clinical decision-making for individuals presenting with rare congenital cardiac abnormalities. Such integrated knowledge ultimately supports the development of more refined and individualized management pathways.

To determine whether berberine (BBR) attenuates angiotensin II (Ang II)-induced endothelial dysfunction by antagonizing AT1R and modulating the phosphodiesterase 4b (PDE4b)-related signaling pathway. Primary aortic endothelial cells were isolated and cultured from control and Ang II-induced hypertensive mice. Human umbilical vein endothelial cells (HUVECs), mouse aortic endothelial cells (MAECs) and ex vivo mouse aortae were treated with Ang II (1 µ mol/L), in the presence or absence of BBR, or the PDE4b inhibitor piclamilast. Quantitative real-time PCR (qPCR), Western blot, immunofluorescence, and microplate assays were employed to assess mRNA and protein expressions of PDE4b, Ang II type 1 receptor (AT1R), endothelial nitric oxide synthase (eNOS) and protein kinase B (PKB, as known as Akt) phosphorylation, and intra- and extracellular nitric oxide (NO) levels. Vascular ring assays were conducted to evaluate the endothelium-dependent relaxation (EDR) of isolated mouse aortae. In addition, molecular docking and cellular thermal shift assays were performed to investigate the interaction between BBR and the AT1R, with comparison to valsartan. Ang II reduced eNOS phosphorylation and NO levels in HUVECs and impaired EDR in isolated mouse aortae (P<0.01), which were reversed by BBR co-treatment (P<0.05). BBR showed a binding free energy of -8.6 kCal/mol with AT1R and significantly enhanced AT1R thermal stability in 60, 65, 75 °C, exhibiting similar effects as valsartan in 60, 65, 75 °C (all P<0.05). Ang II upregulated PDE4b mRNA and protein levels in HUVECs and MAECs, while BBR reversed this effect in HUVECs (P<0.05 or P<0.01). Ang II also suppressed Akt phosphorylation in HUVECs, which was restored by BBR, like the effect of piclamilast (P<0.05 or P<0.01). BBR ameliorates Ang II-induced endothelial dysfunction primarily by antagonizing AT1R, suppressing PDE4b expression and restoring Akt/eNOS signaling. These findings provide mechanistic insights into BBR's endothelial-protective actions and highlight its therapeutic potential in treating hypertension-related vascular complications.

Vascular rings are rare anomalies of congenital cardiovascular. This study aimed to assess the outcome of surgical repair of congenital vascular rings in children. This retrospective study reviewed data from 237 patients with congenital vascular rings who underwent surgical division from January 2008 to October 2022. The mean age of patients was 12 months (Interquartile range, IQR, 6, 32 months) and their mean weight was 9.5kg (IQR, 8, 14kg). The data revealed that 153 patients (65%) were boys. The complete vascular rings consisted of a Double aortic arch (DAA, 33%), Right aortic arch (RAA) with left ligamentum arteriosum (LLA, 39%), and circumflex aorta (0.8%). The incomplete vascular rings consisted of a pulmonary artery sling (PAS, 26%), innominate artery compression syndrome (0.4%), and Left aortic arch (LAA) with Aberrant right subclavian artery (ARSCA, 0.8%). There were 3 hospital deaths (1.3%) and only one late death during the study. The overall mortality was 1.7% (4 patients). Eighteen patients underwent reintervention for complications. The overall survival rates at 1, 5, and 10 years were 98.3%, 98.3%, and 98.3%, respectively. The rate of freedom from residual symptoms at 1, 5, and 10 years was 97%, 91.3%, and 86.2%, respectively. The results show that surgical repair of congenital vascular rings in pediatric patients yields excellent outcomes: most patients' symptoms improved and only a small proportion required reintervention. Although the pulmonary artery sling forms an incomplete vascular ring, it is associated with a higher incidence of tracheal stenosis and an increased risk of persistent postoperative respiratory symptoms. These observations suggest that more proactive intraoperative management of tracheal stenosis should be considered during the primary operation.

Verticillium wilt of potatoes is an important soil-borne disease of potatoes, with reported yield losses exceeding 40%. It is caused by Verticillium species, most notably Verticillium dahliae. Symptoms include leaf chlorosis, limp and flaccid leaves, stunted growth, vascular discoloration towards the stem base, and discoloration of the vascular ring of the tuber. Infection may lead to premature plant decline 4-6 weeks before natural senescence, a condition known as potato early dying. While early dying can occur due to Verticillium alone, symptom severity may increase with co-infection by Pectobacterium spp. or plant-parasitic nematodes. Early dying can also be caused by Colletotrichum coccodes and nutritional deficiencies in the absence of Verticillium. The objective of this guide is to provide detailed information on methods related to disease diagnosis, including isolation, morphological and molecular identification, pathogen detection, isolate storage, and pathogenicity testing for verticillium wilt of potatoes.

Aberrant right subclavian artery is a common anatomical variant of the embryonic aortic arch, with a prevalence ranging from 0.4 to 2.0%. Although frequently associated with vascular rings or congenital cardiac defects, prenatal assessment primarily relies on the three-vessel and trachea view in ultrasonography. Currently, there is no consensus regarding whether isolated ARSA necessitates invasive diagnostic procedures. This study aimed to evaluate the necessity of routine invasive prenatal diagnosis for fetuses with sonographically isolated ARSA. By conducting a long-term postnatal follow-up of a large cohort and utilizing Bayesian analysis for risk assessment, we sought to provide empirical data to support clinical decision-making. The fetuses diagnosed with ARSA via prenatal ultrasound at Hefei Maternal and Child Health Care Hospital from January 2019 to December 2022 were retrospectively analyzed. They were divided into isolated ARSA and non-isolated ARSA groups based on the presence or absence of other ultrasound abnormalities. Within each of these two groups, the fetuses were further categorized into diagnostic and undiagnosed subgroups based on whether they underwent invasive prenatal diagnosis. The study explored the baseline characteristics, genetic testing results, pregnancy outcomes, infant feeding and developmental status, and the results of neonatal color Doppler ultrasound re-examinations in these two groups. A total of 540 cases of ARSA fetuses were identified, including 449 cases (83.1%) of isolated ARSA and 91 cases (16.9%) of non-isolated ARSA. There were no statistically significant differences in baseline characteristics such as age, pre-pregnancy BMI, and history of diabetes between the two groups (P > 0.05). However, the proportion of non-invasive prenatal testing (NIPT) applications and the pregnancy termination rate were significantly higher in the non-isolated group compared to the isolated group (P < 0.05). Pregnancy outcomes revealed that there were 496 live births (91.6%), while 44 cases (8.1%) chose to terminate their pregnancies due to chromosomal abnormalities and/or severe structural abnormalities. Among the 90 fetuses that underwent invasive prenatal diagnosis, the overall detection rate of chromosomal abnormalities was 11.1%. The detection rates for isolated and non-isolated ARSA were 9.1% (6/66) and 16.7% (4/24), respectively, with no statistically significant difference between the two groups (P > 0.05).The follow-up results of live births showed that 25 (5.0%) of 496 cases had abnormal phenotypes. Among 446 live births with isolated ARSA, 10 cases (2.2%) were found to have abnormal manifestations, with 1.6% (1/66 cases, diagnosed as 21-trisomy mosaicism) in the invasive diagnosis group and 2.4% (9/380 cases) in the undiagnosed group. The difference between the two groups was not statistically significant (P > 0.05). In contrast, the abnormal phenotype rate of live births with non-isolated ARSA was nearly 30.0%. Bayesian risk assessment indicated that the overall posterior risk of abnormal phenotype for isolated ARSA was 2.46% (95% HDI: 1.195%-4.080%), and whether or not invasive diagnosis was performed did not alter this risk. Among the 407 live births that did not undergo invasive diagnosis, 17 cases (4.2%) exhibited abnormalities during follow-up, among whom, genetic testing identified pathogenic variants in two neonates. The positive predictive value for postnatal aberrant clinical symptoms in fetuses with sonographically isolated ARSA is low (2.24%). In the absence of additional ultrasound markers or significant risk factors, routine invasive prenatal diagnosis is not recommended. Comprehensive genetic counseling should be prioritized to facilitate informed and autonomous decision-making by pregnant women and their families.

This case presents a 2-year-old spayed female cat that developed a complete esophageal stricture following 14 days of oral dry doxycycline therapy. Following treatment, the patient developed symptoms of regurgitation, loss of appetite, and vomiting. Direct radiography revealed marked aerophagia in the esophagus, while contrast radiography showed esophageal dilatation at the level of the first thoracic vertebra (T1) and complete stricture preventing the contrast medium from passing into the stomach. Endoscopic examination verified a complete stricture in the middle esophagus, and computed tomography (CT) revealed that the stricture was localized at T1; no extraluminal mass or vascular ring anomaly was identified. The absence of a history of anesthesia, foreign body ingestion, or trauma in the medical history confirms that the stricture developed due to chemical damage to the esophageal mucosa caused by doxycycline in capsule form. Reports in the literature indicate that administering doxycycline capsules to cats without adequate fluids increases the risk of esophageal ulceration and scarring. Unfortunately, because of the poor prognosis of the complete stricture in the patient, the patient's poor general condition, and the owner's reluctance to pursue treatment, the decision was made to euthanize the patient. In conclusion, the presented case highlights the diagnostic value of combined radiography, contrast esophagography, endoscopy, and computed tomography for diagnosing esophageal strictures that develop after oral administration of doxycycline. Furthermore, it is essential to consider the pharmaceutical formulation and administration technique for oral drug delivery to cats to prevent potential complications.

Vascular function is a direct factor affecting blood pressure, and it is a primary strategy for clinically controlling hypertension by regulating the constriction/relaxation of blood vessels. This study evaluates the vasodilatory and anti-hypertensive effects of norisoboldine (NOR), an isoquinoline alkaloid in Ayurvedic medicine. The rat thoracic aorta was isolated to investigate the vasodilatory effect, and L-NAME-induced hypertensive rats were established, respectively. In the isolated vascular ring, removal of the endothelium resulted in a significant decrease in the vasodilatory effect. Pretreatment with L-NAME, ODQ, KT5823, WT, Tri, Dilt, calcium-free solution, TG, Gd3+, 2-APB, Indo, 4-AP, Gli, and BaCl2 inhibited the vasodilatory effect of NOR. In vascular endothelial cells, NOR promoted eNOS phosphorylation and inhibited TNF-α-induced expression of ICAM-1 and VCAM-1. SBP and DBP were significantly decreased after administration of different doses of NOR in the femoral vein of rats. In addition, NOR significantly reduced the blood pressure of L-NAME-induced hypertensive rats, up-regulated the serum levels of NO, cGMP, and CAT, and down-regulated MDA, IL-6, and TNF-α in hypertensive rats. NOR administration improved pathological changes in the thoracic aorta by regulating the arrangement of thoracic aortic smooth muscle cells, decreasing the thickness of the thoracic aortic wall, and reducing the degree of collagen deposition and fibrosis. In conclusion, the vasodilatory mechanisms of NOR were related to the Ca2+-eNOS signaling pathway, including the PGI2 and various K+/Ca2+ channels, the inositol triphosphate receptor (IP3R) calcium release, and the α-adrenergic receptor pathway. The anti-hypertensive mechanism of NOR may be related to increased NO and cGMP bioavailability, inhibition of oxidative stress and inflammatory responses, and improved vascular remodeling.

Aerobic exercise is an effective intervention for T2DM, but its impact on coronary artery function in T2DM remains unclear due to limitations in non-invasive assessments. This study aimed to evaluate the effects of moderate intensity aerobic exercise (MIAE) on coronary artery fibrosis and vascular function in T2DM rats. Male Sprague-Dawley rats were randomly assigned to four groups: control (CON), control exercise (CE), T2DM (DM), and T2DM exercise (DE). The exercise groups underwent eight weeks of MIAE. Blood glucose levels were measured by glucometer, TC, TG, LDL-C, HDL-C, insulin, TNF-α, IL-1β, and IL-6 levels were assessed by Elisa. Coronary artery morphology was analyzed by HE and multiphoton microscopy. Vascular ring experiments evaluated the endothelium-dependent and independent vasorelaxation of the coronary artery. Eight weeks of MIAE significantly improved circulating glucose-lipid metabolism (P < 0.05) and reduced TNF-α, IL-6, and IL-1β (P < 0.05) in T2DM rats. Following MIAE, coronary artery collagen and fiber content were significantly reduced, accompanied by notable improvements in endothelial and smooth muscle function. MIAE reduces vascular fibrosis and improves coronary endothelial cell and smooth muscle function by regulating disturbances in circulating glucose-lipid metabolism and inhibiting inflammatory responses.

Vascular Ring: A Diagnostic Challenge Highlighted by Imaging