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Vascular Medicine

Jeffrey S Berger, Beth L Abramson, Renato D Lopes, Gretchen Heizer, Frank W Rockhold, Iris Baumgartner, F Gerry R Fowkes, Peter Held, Brian G Katona, Lars Norgren, W Schuyler Jones, Marcus Millegård, Juuso Blomster, Craig Reist, William R Hiatt, Manesh R Patel, Kenneth W Mahaffey
Patients with peripheral artery disease (PAD) are at heightened risk of cardiovascular morbidity and mortality. We sought to evaluate the risk of concomitant coronary artery disease (CAD) in patients with symptomatic PAD versus PAD without diagnosed CAD, and whether ticagrelor was superior to clopidogrel in reducing that risk. The EUCLID trial randomized 13,885 patients with PAD to antithrombotic monotherapy with ticagrelor or clopidogrel. CAD was defined as prior myocardial infarction (MI), percutaneous coronary intervention (PCI), or coronary artery bypass graft (CABG) surgery...
July 1, 2018: Vascular Medicine
Aaron W Aday, Scott Kinlay, Marie D Gerhard-Herman
Although the resting ankle-brachial index (ABI) is commonly used as a tool to diagnose peripheral artery disease (PAD), several additional indices measured after exercise may have increased sensitivity for identifying PAD. The aim of this study was to determine the utility of resting ABI and three post-exercise physiological parameters for diagnosing PAD confirmed by arterial imaging studies. For each qualifying study, we assessed the performance measures for identifying PAD for resting ABI < 0.90, exercise ABI < 0...
July 1, 2018: Vascular Medicine
Tarek A Hammad, Kim G Smolderen, John A Spertus, Philip G Jones, Mehdi H Shishehbor
An exercise ankle-brachial index (ABI) test can provide further insight into the functional significance of peripheral artery disease (PAD). The variability in its use, associated patient factors and its relation to patients' symptoms are unknown. From the international PORTRAIT registry, we identified 1131 patients with PAD. We fit a hierarchical logistic regression model, adjusting for patient factors, country and site, to examine predictors of and variation in ordering exercise ABI testing. We also examined the associations between test components and health status as quantified by the Peripheral Artery Questionnaire (PAQ) using semi-parametric regression methods...
June 1, 2018: Vascular Medicine
Klaas Frederik Franzen, Johannes Willig, Silja Cayo Talavera, Moritz Meusel, Friedhelm Sayk, Michael Reppel, Klaus Dalhoff, Kai Mortensen, Daniel Droemann
The introduction of electronic cigarettes has led to widespread discussion on the cardiovascular risks compared to conventional smoking. We therefore conducted a randomized cross-over study of the acute use of three tobacco products, including a control group using a nicotine-free liquid. Fifteen active smokers were studied during and after smoking either a cigarette or an electronic cigarette with or without nicotine (eGo-T CE4 vaporizer). Subjects were blinded to the nicotine content of the electronic cigarette and were followed up for 2 hours after smoking a cigarette or vaping an electronic cigarette...
June 1, 2018: Vascular Medicine
Jessica L Fetterman, Naomi M Hamburg
No abstract text is available yet for this article.
June 1, 2018: Vascular Medicine
Natalie S Evans, Elizabeth V Ratchford
No abstract text is available yet for this article.
June 1, 2018: Vascular Medicine
Pedro Paulo Teixeira E Silva Torres, Vanessa Oliveira Magalhães, Leandro Rocha Spoton, Edson Marchiori
No abstract text is available yet for this article.
June 1, 2018: Vascular Medicine
Damianos G Kokkinidis, Haekyung Jeon-Slaughter, Houman Khalili, Emmanouil S Brilakis, Nicolas W Shammas, Subhash Banerjee, Ehrin J Armstrong
With growing use of drug-coated balloons (DCB) for femoropopliteal (FP) artery interventions, there is limited information on rates of real-world adjunctive stent use and its association with short and long-term outcomes. We report on 225 DCB treated FP lesions in 224 patients from the Excellence in Peripheral Artery Disease (XLPAD) registry (NCT01904851) between 2014 and 2016. Cochran-Mantel-Haenszel and Wilcoxon rank sum statistics were used to compare stented (planned or 'bail-out') versus non-stented DCB treated lesions...
June 1, 2018: Vascular Medicine
Mark A Davison, Derek M Norton, Andrew M Popoff, Christopher W Seder, Robert J March
A Dacron wrap aortoplasty has been described as an adjunct to reduction ascending aortoplasty for the repair of Type A aortic dissections. We report a case of an uncomplicated hemiarch repair with wrap aortoplasty of the distal anastomosis which resulted in severe acute hemolysis. Despite only minimal focal graft deformation on imaging, the patient was found to have a flow gradient across the distal anastomosis, which was reduced by > 50% following release of the outer graft wrap. To our knowledge, only 29 additional cases of hemolytic anemia following aortic dissection repair have been described in the English literature...
June 1, 2018: Vascular Medicine
Ridhima Kapoor, Colby Ayers, Alexis Visotcky, Peter Mason, Jacquelyn Kulinski
The ankle-brachial index (ABI) is a predictor of cardiovascular events, mortality and functional status. Some studies have noted a higher prevalence of peripheral artery disease in females compared to males. Differences in height might account for these observed sex differences, but findings are conflicting. The 2003-2004 National Health and Nutrition Examination Survey (NHANES) cohort includes participants from 15 geographic locations, selected annually to represent the general population. Sample-weighted multivariable linear and logistic regression modeling was performed with ABI as the dependent variable and height and sex as primary exposure variables of interest...
June 1, 2018: Vascular Medicine
Leili Pourafkari, Catherine Choi, Reza Garajehdaghi, Arezou Tajlil, Hasan H Dosluoglu, Nader D Nader
The neutrophil-lymphocyte ratio (NLR), as a marker of inflammation, is associated with the severity of peripheral artery disease (PAD). The role of the NLR on predicting future complications after elective revascularization for patients with PAD remains unknown. We aimed to examine the role of the NLR in the development of major adverse limb events (MALE) and the long-term mortality of these patients. We evaluated 1708 revascularization procedures from May 2001 to December 2015 at the Veterans Affairs Western New York Healthcare System from a prospectively maintained vascular database that included demographics, comorbidities and pre-procedural medications...
May 1, 2018: Vascular Medicine
Teresa Martin-Gonzalez, Graeme Penney, Debra Chong, Meryl Davis, Tara M Mastracci
Fusion imaging is standard for the endovascular treatment of complex aortic aneurysms, but its role in follow up has not been explored. A critical issue is renal function deterioration over time. Renal volume has been used as a marker of renal impairment; however, it is not reproducible and remains a complex and resource-intensive procedure. The aim of this study is to determine the accuracy of a fusion-based software to automatically calculate the renal volume changes during follow up. In this study, computerized tomography (CT) scans of 16 patients who underwent complex aortic endovascular repair were analysed...
May 1, 2018: Vascular Medicine
Kim G Smolderen, Mary E Plomondon, Ehrin J Armstrong, Edward Hess, Stephen Waldo, Thomas T Tsai, Thomas M Maddox
The association between depression and peripheral artery disease (PAD) outcomes remains widely understudied. In patients with PAD undergoing a peripheral vascular intervention (PVI) who have a recent diagnosis of depression, it is unknown what their long-term outcomes are and what factors may mediate an adverse risk. We therefore studied 797 consecutive patients undergoing PVI across 33 Veterans Affairs (VA) centers. Depression and outcomes were documented from patients' medical records. Outcomes included: (1) all-cause death; (2) non-fatal cardiovascular events (myocardial infarction, stroke); and (3) PAD-related events (including repeat PVI or amputation)...
May 1, 2018: Vascular Medicine
Joel L Ramirez, Laura M Drudi, S Marlene Grenon
The incidence of depression has been rising rapidly, and depression has been recognized as one of the world's leading causes of disability. More recently, depression has been associated with an increased risk of symptomatic atherosclerotic disease as well as worse perioperative outcomes in patients with cardiovascular disease. Additionally, recent studies have demonstrated an association between depression and peripheral artery disease (PAD), which has been estimated to affect more than 200 million people worldwide...
May 1, 2018: Vascular Medicine
Ayman Elbadawi, Colin Wright, Dhwani Patel, Yu Lin Chen, Justin Mazzillo, Pamela Cameron, Geoffrey D Barnes, Scott J Cameron
The impact of the Pulmonary Embolism Response Team (PERT) model on trainee physician education and autonomy over the management of high risk pulmonary embolism (PE) is unknown. A resident and fellow questionnaire was administered 1 year after PERT implementation. A total of 122 physicians were surveyed, and 73 responded. Even after 12 months of interacting with the PERT consultative service, and having formal instruction in high risk PE management, 51% and 49% of respondents underestimated the true 3-month mortality for sub-massive and massive PE, respectively, and 44% were unaware of a common physical exam finding in patients with PE...
May 1, 2018: Vascular Medicine
Freya Droege, Kruthika Thangavelu, Boris A Stuck, Andreas Stang, Stephan Lang, Urban Geisthoff
There are only a few published studies that demonstrate associations between life expectancy, severe comorbidities, and their complications in patients with hereditary hemorrhagic telangiectasia (HHT). Relatives of 73 deceased patients with suspected HHT completed a questionnaire about causes of death, and symptoms and comorbidities that the patients had developed. We compared the data for 55 cases where HHT had been clinically confirmed with the general population. Patients suffering from HHT lost, on average, 19 years (SD 11 years) of potential life compared to the general population...
May 1, 2018: Vascular Medicine
Ming Chen, Amie Goodin, Hong Xiao, Qiong Han, Driss Raissi, Joshua Brown
Variation in the use of inferior vena cava filters (IVCFs) across hospitals has been observed, suggesting differences in quality of care. Hospitalization metrics associated with venous thromboembolism (VTE) patients have not been compared based on IVCF utilization rates using a national sample. We conducted a descriptive retrospective study using the Nationwide Readmissions Database (NRD) to delineate the variability of hospitalization metrics across the hospital quartiles of IVCF utilization for VTE patients...
May 1, 2018: Vascular Medicine
Yiyan Liu
No abstract text is available yet for this article.
May 1, 2018: Vascular Medicine
Julia Loewenthal, Ankit Patel, Robert Kurtz, Gregory Piazza
No abstract text is available yet for this article.
May 1, 2018: Vascular Medicine
Mary M McDermott, Charlotte A Peterson, Robert Sufit, Luigi Ferrucci, Jack M Guralnik, Melina R Kibbe, Tamar S Polonsky, Lu Tian, Michael H Criqui, Lihui Zhao, James H Stein, Lingyu Li, Christiaan Leeuwenburgh
In people without lower extremity peripheral artery disease (PAD), mitochondrial DNA copy number declines with aging, and this decline is associated with declines in mitochondrial activity and functional performance. However, whether lower extremity ischemia is associated with lower mitochondrial DNA copy number and whether mitochondrial DNA copy number is associated with the degree of functional impairment in people with PAD is unknown. In people with and without PAD, age 65 years and older, we studied associations of the ankle-brachial index (ABI) with mitochondrial DNA copy number and associations of mitochondrial DNA copy number with functional impairment...
May 1, 2018: Vascular Medicine
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