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Vascular Medicine

Daniel Shpilsky, Sebhat Erqou, Sanjay R Patel, Kevin E Kip, Oluremi Ajala, Aryan Aiyer, Patrick J Strollo, Steven E Reis, Oladipupo Olafiranye
Studies have reported an association between obstructive sleep apnea (OSA) and cardiovascular disease (CVD) morbidity and mortality. Proposed mechanisms include endothelial dysfunction and atherosclerosis. We aimed to investigate the associations of OSA with endothelial dysfunction and subclinical atherosclerotic coronary artery disease (CAD), and assess the impact of race on these associations. We used data from the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study, a community-based prospective cohort with approximately equal representation of black and white participants...
March 1, 2018: Vascular Medicine
Trisha L Roy, Thomas L Forbes, Andrew D Dueck, Graham A Wright
Magnetic resonance imaging (MRI) has advanced significantly in the past decade and provides a safe and non-invasive method of evaluating peripheral artery disease (PAD), with and without using exogenous contrast agents. MRI offers a promising alternative for imaging patients but the complexity of MRI can make it less accessible for physicians to understand or use. This article provides a brief introduction to the technical principles of MRI for physicians who manage PAD patients. We discuss the basic principles of how MRI works and tailor the discussion to how MRI can evaluate anatomic characteristics of peripheral arterial lesions...
March 1, 2018: Vascular Medicine
Ghazi Alotaibi, Cynthia Wu, Ambikaipakan Senthilselvan, Michael Sean McMurtry
Pulmonary embolism (PE) is a major cause of mortality and morbidity. It is known that the risk of death varies by provoking factors; however, it is unknown if the risk of death persists beyond the initial diagnosis among patients with cancer-associated and non-cancer provoked patients. In this study, we aimed to investigate the effect of cancer on overall, short- and long-term mortality in a cohort of consecutive incident PE patients. Using administrative databases, we identified all incident cases of PE between 2004 and 2012 in Alberta, Canada...
March 1, 2018: Vascular Medicine
Ann H Kim, Gener Augustin, Andrew Shevitz, Hannah Kim, Michael R Trivonovich, Alexis R Powell, Norman Kumins, Robert Tarr, Vikram S Kashyap
The decision to intervene for internal carotid stenosis often depends on the degree of stenosis seen on duplex ultrasound (US). The aim of this study is to compare the diagnostic accuracy of two criteria: modified University of Washington (UW) and 2003 Carotid Consensus Panel (CCP). All patients undergoing US in an accredited (IAC) vascular laboratory from January 2010 to June 2015 were reviewed ( n=18,772 US exams). Patients receiving a neck computed tomography angiography (CTA) within 6 months of the US were included in the study ( n=254)...
March 1, 2018: Vascular Medicine
Anthony N Hage, Ravi N Srinivasa, Steven D Abramowitz, Kyle J Cooper, Minhaj S Khaja, Geoff D Barnes, Jeffrey Forris Beecham Chick
Thrombosis of the inferior vena cava and iliac veins, known as iliocaval thrombosis, is a common cause of significant morbidity. Patients with chronic iliocaval obstruction often present with life-limiting occlusive symptoms secondary to recurrent lower extremity deep venous thrombosis, swelling, pain, venous stasis ulcers, or phlegmasia. Endovascular iliocaval reconstruction is a technically successful procedure that results in favorable clinical outcomes and stent patency rates with few complications and is often able to relieve debilitating symptoms in affected patients...
March 1, 2018: Vascular Medicine
Hannah R Begley, Bruce H Gray
No abstract text is available yet for this article.
March 1, 2018: Vascular Medicine
Edwin A Takahashi, Christopher J Reisenauer, Andrew H Stockland, Haraldur Bjarnason, Melissa J Neisen, Newton B Neidert, William S Harmsen, Courtney N Day, Sanjay Misra
This study examined the potential correlation between pulmonary embolism (PE) attenuation on computed tomography pulmonary angiography (CTPA) and pulmonary artery hemodynamic response to catheter-directed thrombolysis (CDT) in 10 patients with submassive PE. Treatment parameters, PE attenuation, clot burden, computed tomography signs of right ventricle dysfunction and right ventricular systolic pressure at echocardiography were retrospectively analyzed to determine correlation with pulmonary artery pressure improvement using Spearman correlation...
March 1, 2018: Vascular Medicine
Victor Aboyans, Philippe Lacroix
No abstract text is available yet for this article.
March 1, 2018: Vascular Medicine
Luisa Brant, Daniel Bos, Larissa Fortunato Araujo, M Arfan Ikram, Antonio Lp Ribeiro, Sandhi M Barreto
Impaired microvascular endothelial function may be implicated in the etiology of cognitive decline. Yet, current data on this association are inconsistent. Our objective is to investigate the relation of microvascular endothelial function to cognitive performance in the ELSA-Brasil cohort study. A total of 1521 participants from ELSA-Brasil free of dementia underwent peripheral arterial tonometry (PAT) to quantify microvascular endothelial function (PAT-ratio and mean baseline pulse amplitude (BPA)) and cognitive tests that covered the domains of memory, verbal fluency, and executive function at baseline...
February 1, 2018: Vascular Medicine
Dereck L Salisbury, Rebecca Jl Brown, Ulf G Bronas, Laura N Kirk, Diane Treat-Jacobson
Peripheral artery disease (PAD) is a manifestation of generalized atherosclerosis which results in hemodynamic compromise of oxygen and substrate delivery to the lower extremity skeletal muscles. Hemodynamic assessments are vital in PAD diagnosis and in the evaluation of strategies aimed at treating claudication (i.e. exercise training, revascularization, and pharmacological agents). Venous occlusion plethysmography (VOP) is a century-old, non-invasive technique used to quantify limb blood flow and has been used to evaluate hemodynamic compromise in patients with PAD...
February 1, 2018: Vascular Medicine
Tianyue Pan, Zheng Wei, Yuan Fang, Zhihui Dong, Weiguo Fu
Early-phase clinical trials in patients with critical limb ischemia (CLI) have shown positive results of mononuclear cell therapy. The current meta-analysis investigated whether cluster of differentiation (CD) 34+ mononuclear cell therapy (CD34+ MCT) is effective for no-option CLI. Ten randomized controlled clinical studies of CD34+ MCT for no-option CLI with 479 patients were identified and analyzed for pooled results. Compared to control groups, the CD34+ MCT was associated with lower total amputation (odds ratio (OR): 0...
February 1, 2018: Vascular Medicine
Peta Ellen Tehan, Alex Louise Barwick, Mathew Sebastian, Vivienne Helaine Chuter
The postexercise ankle-brachial index (ABI) is recommended in patients with normal resting ABI when peripheral artery disease (PAD) is suspected. The aims of this study were to determine the comparative diagnostic accuracy of the resting and postexercise ABI for detecting PAD, and, the effect of the presence of diabetes on these. Three methods of interpretation currently in use were also investigated: a reduction in postexercise ABI by >20% compared to resting ABI, an ABI value of ≤0.90 postexercise, or a reduction in systolic ankle pressure of >30 mmHg postexercise...
February 1, 2018: Vascular Medicine
Natalie S Evans, Elizabeth V Ratchford
No abstract text is available yet for this article.
February 1, 2018: Vascular Medicine
Florence H Sheehan, R Eugene Zierler
Healthcare providers who use peripheral vascular and cardiac ultrasound require specialized training to develop the technical and interpretive skills necessary to perform accurate diagnostic tests. Assessment of competence is a critical component of training that documents a learner's progress and is a requirement for competency-based medical education (CBME) as well as specialty certification or credentialing. The use of simulation for CBME in diagnostic ultrasound is particularly appealing since it incorporates both the psychomotor and cognitive domains while eliminating dependency on the availability of live patients with a range of pathology...
February 1, 2018: Vascular Medicine
Pamela L Lutsey, Mary R Rooney, Aaron R Folsom, Erin D Michos, Alvaro Alonso, Weihong Tang
Little is known about whether markers of vitamin D metabolism are associated with the development of abdominal aortic aneurysm (AAA), though these markers have been linked to other cardiovascular diseases. We tested the hypotheses that risk of AAA is higher among individuals with low serum concentrations of 25-hydroxy vitamin D [25(OH)D], and among those with elevated concentrations of calcium, fibroblast growth factor 23 (FGF23), phosphorus, and parathyroid hormone (PTH) using data from a cohort of black and white individuals with long-term follow-up...
February 1, 2018: Vascular Medicine
Joshua A Beckman
No abstract text is available yet for this article.
January 1, 2018: Vascular Medicine
Nathan K Itoga, Hataka R Minami, Meenadachi Chelvakumar, Keon Pearson, Matthew M Mell, Eran Bendavid, Douglas K Owens
Screening for asymptomatic peripheral artery disease (aPAD) with the ankle-brachial index (ABI) test is hypothesized to reduce disease progression and cardiovascular (CV) events by identifying individuals who may benefit from early initiation of medical therapy. Using a Markov model, we evaluated the cost effectiveness of initiating medical therapy (e.g. statin and ACE-inhibitor) after a positive ankle-brachial index (ABI) screen in 65-year-old patients. We modeled progression to symptomatic PAD (sPAD) and CV events with and without ABI screening, evaluating differences in costs and quality-adjusted life years (QALYs)...
January 1, 2018: Vascular Medicine
Sundeep Shenoy, Aditya Sharma, Patrick Norton, Sohil Patel
No abstract text is available yet for this article.
January 1, 2018: Vascular Medicine
Stefan Acosta, Anders Gottsäter, Gunnar Engström, Olle Melander, Moncef Zarrouk, Peter M Nilsson, J Gustav Smith
Pathogenesis of abdominal aortic aneurysm (AAA) is unclear. The aim of this study was to evaluate inflammatory and hemodynamic plasma biomarkers as predictors for AAA in the prospective longitudinal cohort of middle-aged individuals from the cardiovascular cohort of the Malmö Diet and Cancer Study ( n=5551; 1991-94). C-reactive protein, cystatin C, copeptin, N-terminal pro-B-type natriuretic peptide (N-BNP), midregional pro-atrial natriuretic peptide (MR-proANP) and conventional risk factors at baseline were measured in patients with incident AAA during follow-up and compared to individuals without a diagnosis of AAA...
January 1, 2018: Vascular Medicine
Marie N Waddles, Ginny Mitchell, Melissa J Snider, Michael R Go, Talal Attar
No abstract text is available yet for this article.
January 1, 2018: Vascular Medicine
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