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VASA. Zeitschrift Für Gefässkrankheiten

Michael K W Lichtenberg, Rick de Graaf, Wilhelm F Stahlhoff, Ahmet Özkapi, Tienush Rassaf, Frank Breuckmann
BACKGROUND: We sought to determine the patency and clinical symptom relief of the Venovo venous stent in the endovascular treatment of non-thrombotic (NIVL) or post-thrombotic venous obstruction (PTO) of the iliofemoral track over a period of 6 months. PATIENTS AND METHODS: A total of 80 patients (45 female, mean age 57 years) treated in 2016 and 2017 were included in the Arnsberg venous registry. Clinical improvement was determined by the revised venous clinical severity score (rVCSS) as well as the clinical, etiologic, anatomic and pathophysiologic (CEAP) score...
November 19, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Joël Constans, Alessandra Bura-Rivière, Adriana Visona, Marianne Brodmann, Pierre Abraham, Dan-Mircea Olinic, Juraj Madaric, Sabine Steiner, Isabelle Quéré, Lucia Mazzolai, Jill Belch, Christian Heiss, Zsolt Pécsvárady, Karel Roztocil, Mary-Paula Colgan, Dragan Vasic, Anders Gottsäter, Evangelos Dimakakos, Ali Chraim, Pavel Poredoš, Patrick H Carpentier, Jean-Claude Wautrecht, Agata Stanek, Vinco Boc
Chronic critical lower limb ischemia (CLI) has been defined as ischemia that endangers the leg. An attempt was made to give a precise definition of CLI, based on clinical and hemodynamic data (Second European Consensus). CLI may be easily defined from a clinical point of view as rest pain of the distal foot or gangrene or ulceration. It is probably useful to add leg ulcers of other origin which do not heal because of severe ischemia, and to consider the impact of frailty on adverse outcome. From a hemodynamic viewpoint there is no consensus and most of the existing classifications are not based upon evidence...
November 19, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Andreas S Peters, Markus Wortmann, Thomas H Fleming, Peter P Nawroth, Thomas Bruckner, Dittmar Böckler, Maani Hakimi
BACKGROUND: The enzyme glyoxalase1 (GLO1) is the main opponent in the degradation of the reactive metabolite methylglyoxal (MG), which by glycation of macromolecules is involved in atherogenesis. Reduced GLO1-activity in atherosclerotic tissue is known to be associated with diabetes. It has been shown that treatment of patients with type 2 diabetes with metformin leads to increased GLO1-activity in peripheral-blood-cells. The aim of this study was to evaluate whether metformin treatment increases GLO1-activity in atherosclerotic lesions of patients with type 2 diabetes...
November 13, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Richard Shemilt, Hala Bagabir, Chim Lang, Faisel Khan
Far-infrared (FIR) is a form of thermal radiation, which may have beneficial effects on cardiovascular health. Clinical studies suggest that FIR irradiation may have therapeutic effects in heart failure, myocardial ischaemia and may improve flow and survival of arteriovenous fistula. Animal studies have suggested a wide range of potential mechanisms involving endothelial nitric oxide synthase and nitric oxide bioavailability, oxidative stress, heat shock proteins and endothelial precursor cells. However, the exact cellular and molecular mechanism of FIR on the cardiovascular system remains elusive...
November 13, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Stephen Hofmeister, Matthew B Thomas, Joseph Paulisin, Nicolas J Mouawad
The management of vascular emergencies is dependent on rapid identification and confirmation of the diagnosis with concurrent patient stabilization prior to immediate transfer to the operating suite. A variety of technological advances in diagnostic imaging as well as the advent of minimally invasive endovascular interventions have shifted the contemporary treatment algorithms of such pathologies. This review provides a comprehensive discussion on the current state and future trends in the management of ruptured abdominal aortic aneurysms as well as acute aortic dissections...
November 8, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Giovanna Negrão de Figueiredo, Katharina Müller-Peltzer, Vincent Schwarze, Johannes Rübenthaler, Dirk-André Clevert
Conventional ultrasound is worldwide the first-line imaging modality for the prompt diagnosis in the daily practice because it is a cost-effective and easy to perform technique. The additional application of contrast media has been used to enhance the intravascular contrast and to improve the imaging diagnostic accuracy in the detection, classification and follow-up of vascular pathologies. Contrast-enhanced ultrasound has the advantage of being a safe, fast and dynamic non-invasive imaging tool with excellent results in the diagnosis of acute aortic pathologies, especially the detection of endoleaks after endovascular aneurysm repair...
November 7, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Mirko Hirschl, Michael Kundi
BACKGROUND: In randomized controlled trials (RCTs) direct acting oral anticoagulants (DOACs) showed a superior risk-benefit profile in comparison to vitamin K antagonists (VKAs) for patients with nonvalvular atrial fibrillation. Patients enrolled in such studies do not necessarily reflect the whole target population treated in real-world practice. MATERIALS AND METHODS: By a systematic literature search, 88 studies including 3,351,628 patients providing over 2.9 million patient-years of follow-up were identified...
November 5, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Alex Wallace, Yash Pershad, Aman Saini, Sadeer Alzubaidi, Sailendra Naidu, Grace Knuttinen, Rahmi Oklu
Acute limb ischemia (ALI), a subclass of critical limb ischemia, is a medical emergency. The cause of ALI is usually thrombotic or embolic in nature, and the specific etiology often dictates the appropriate therapy. While the diagnosis is a clinical with common presenting symptoms, advances in ultrasound, computed tomography, and magnetic resonance technology have impacted the diagnosis and subsequent therapy. In ALI, the time to revascularization is critical and computed tomography angiography (CTA) provides a highly sensitive and specific technique for rapidly identifying occlusions and precisely defining vascular anatomy prior to interventions...
October 30, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Noemi Galas, Ingrid Becker, Tomasz Ficon, Maik Sakrauski, Rita Reichert, Wael Ahmad, Spyridon Mylonas, Jan Brunkwall, Payman Majd
BACKGROUND: Peripheral arterial disease (PAD) is one of the major manifestations of general atherosclerosis and strongly associated with increased cardiovascular morbidity and mortality. Because only few epidemiologic studies are available concerning the prevalence of PAD in inhabitants ≥ 80 years of age, we screened inhabitants of nursing care homes in Germany for PAD and cardiovascular diseases and to assess the one year mortality. PATIENTS AND METHODS: We conducted a prospective cohort study, screening inhabitants of 42 nursing homes for PAD...
October 30, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Jos C van den Berg
This paper will give an overview of the relevant anatomy, management and imaging, aspects as well as therapeutic aspects of traumatic pelvic fractures with vascular injuries.
October 26, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Karin Yeung, Jonas Peter Eiberg, Henrik Kehlet, Eske Kvanner Aasvang
BACKGROUND: Arterial surgery for lower limb ischaemia is a frequently performed procedure in patients with severe cardio-pulmonary comorbidities, making them high-risk patients for acute postoperative complications with a need for prolonged stay in the post-anaesthesia care unit (PACU). However, detailed information on complications during the PACU stay is limited, hindering mechanism-based interventions for early enhanced recovery. Thus, we aimed to systematically describe acute complications and related risk factors in the immediate postoperative phase after infrainguinal arterial surgery...
October 24, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Cheong J Lee, Rory Loo, Max V Wohlauer, Parag J Patel
Although management paradigms for certain arterial trauma, such as aortic injuries, have moved towards an endovascular approach, the application of endovascular techniques for the treatment of peripheral arterial injuries continues to be debated. In the realm of peripheral vascular trauma, popliteal arterial injuries remain a devastating condition with significant rates of limb loss. Expedient management is essential and surgical revascularization has been the gold standard. Initial clinical assessment of vascular injury is aided by readily available imaging techniques such as duplex ultrasonography and high resolution computed tomographic angiography...
October 17, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Joseph Pultar, Patricia P Wadowski, Simon Panzer, Thomas Gremmel
Antiplatelet agents significantly reduce mortality and morbidity in ischemic heart disease, cerebrovascular disease and peripheral artery disease (PAD), and are therefore part of guideline-driven daily medical treatment in these patients. Due to its beneficial effects in the secondary prevention of atherothrombotic events, aspirin remains the most frequently prescribed antiplatelet agent in cardiovascular disease. In patients with acute coronary syndromes (ACS) and in those undergoing angioplasty with stent implantation dual antiplatelet therapy with aspirin and an adenosine diphosphate (ADP) receptor antagonist is indicated...
October 16, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Xin Li, Daniel Staub, Vasileios Rafailidis, Mohammed Al-Natour, Sanjeeva Kalva, Sasan Partovi
Ultrasound has been established as an important diagnostic tool in assessing vascular abnormalities. Standard B-mode and Doppler techniques have inherent limitations with regards to detection of slow flow and small vasculature. Contrast-enhanced ultrasound (CEUS) is a complementary tool and is useful in assessing both the macro- and microvascular anatomy of the aorta. CEUS can also provide valuable physiological information in real-time scanning sessions due to the physical and safety profiles of the administered microbubbles...
October 16, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Mathias Kaspar, Iris Baumgartner, Daniel Staub, Heinz Drexel, Christoph Thalhammer
Early detection of vascular damage in atherosclerosis and accurate assessment of cardiovascular risk factors are the basis for appropriate treatment strategies in cardiovascular medicine. The current review focuses on non-invasive ultrasound-based methods for imaging of atherosclerosis. Endothelial dysfunction is an accepted early manifestation of atherosclerosis. The most widely used technique to study endothelial function is non-invasive, flow-mediated dilation of the brachial artery under high-resolution ultrasound imaging...
October 16, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Paweł Lewandowski, Jakub Baran, Paweł Maciejewski, Andrzej Budaj
BACKGROUND: Iatrogenic pseudoaneurysms (IPA) are treated with ultrasound-guided thrombin injections (UGTI). We describe a novel technique for IPA repair that applies UGTI with thrombin foam (UGTFI). METHODS AND RESULTS: Successful obliteration of 6 IPAs (IPA without a neck, n = 5; with a neck, n = 1) in 6 patients (2 males, aged 68 ± 1 years, 4 females, aged 59 ± 11 years) was performed by using UGTFI. The dose of administered thrombin was 25-75 IU. No microembolization phenomenon and no serious clinical complications were observed...
October 16, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Vinko Boc, Anja Boc, Urban Zdešar, Aleš Blinc
BACKGROUND: Percutaneous endovascular revascularisation interventions are increasingly used in treatment of lower extremity artery disease and may expose patients to substantial radiation. PATIENTS AND METHODS: Dose-area product (DAP) was retrospectively analysed in 1063 consecutive interventions performed in adult patients with lower extremity artery disease in a single tertiary medical centre. Differences between procedure types, stratified according to anatomical region and arterial lesion complexity were evaluated...
October 16, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Uwe Wahl, Ingmar Kaden, Andreas Köhler, Tobias Hirsch
Hypothenar or thenar hammer syndrome (HHS) and hand-arm vibration syndrome (HAVS) are diseases caused by acute or chronic trauma to the upper extremities. Since both diseases are generally related to occupation and are recognised as occupational diseases in most countries, vascular physicians need to be able to distinguish between the two entities and differentiate them from other diagnoses. A total of 867 articles were identified as part of an Internet search on PubMed and in non-listed occupational journals...
October 16, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Christiana Anastasiadou, Chrisostomos Maltezos, George Galyfos, Sotirios Giannakakis, Nikos Zannes, Nikos Makris, Georgios Sachsamanis, Gerasimos Papacharalambous
A carotid artery pseudoaneurysm in an irradiated neck is a rare entity with possible devastating results and management should be multidisciplinary. We present a successful endovascular treatment of a late carotid artery pseudoaneurysm following patch endarterectomy and cervical radiotherapy.
September 28, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Lewis D Hahn, Anand M Prabhakar, Evan J Zucker
Aortic injury remains a major contributor to morbidity and mortality from acute thoracic trauma. While such injuries were once nearly uniformly fatal, the advent of cross-sectional imaging in recent years has facilitated rapid diagnosis and triage, greatly improving outcomes. In fact, cross-sectional imaging is now the diagnostic test of choice for traumatic aortic injury (TAI), specifically computed tomography angiography (CTA) in the acute setting and CTA or magnetic resonance angiography (MRA) in follow-up...
September 28, 2018: VASA. Zeitschrift Für Gefässkrankheiten
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