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https://www.readbyqxmd.com/read/28420842/the-development-of-marked-collateral-circulation-due-to-inferior-vena-cava-filter-occlusion-in-a-patient-with-chronic-thromboembolic-pulmonary-hypertension-complicated-with-anti-phospholipid-syndrome
#1
Hajime Kasai, Nobuhiro Tanabe, Ken Koshikawa, Yasutaka Hirasawa, Toshihiko Sugiura, Seiichiro Sakao, Koichiro Tatsumi
A 30-year-old Japanese man was diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH) with lupus anticoagulants (LAs) in 2003. He underwent pulmonary endarterectomy after the placement of an inferior vena cava filter (IVCF) in 2004, and treatment with warfarin was continued. In 2014, IVCF occlusion and marked collateral circulation were noted during an examination for transient dyspnea; however, his warfarin level was within the therapeutic range for 88.9% of the time from 2003 to 2014. We herein report a rare case of CTEPH and LAs with IVCF occlusion; in such cases, intense treatment may be required...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28414666/just-a-puff-of-smoke
#2
A Leonard
CASE: A 44 year old woman with a history of stroke s/p aneurysm clipping, seizure, and substance abuse was brought to the hospital after a family member received a call from her friend saying she was acting unusual and may have had a seizure while hanging out on the street. At her baseline, she needed modest assistance in daily activities after her CVA and conversed without issue. Her mother died of a stroke. On exam the patient was afebrile, normotensive with mild tachycardia to 110...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28402400/unplanned-cardiac-reoperations-and-interventions-during-long-term-follow-up-after-the-norwood-procedure%C3%A2
#3
Eva Sames-Dolzer, Gregor Gierlinger, Michaela Kreuzer, Julia Schrempf, Roland Gitter, Christoph Prandstetter, Gerald Tulzer, Rudolf Mair
OBJECTIVES: Patients with hypoplastic left heart syndrome or related malformations are predominantly treated with a 3-stage palliation. Anatomic or physiologic problems can lead to unplanned additional surgical or catheter interventions during single ventricle palliation. Changes in operative technique may have an impact on the reoperation rate. METHODS: Between 1997 and 2014, 317 Norwood procedures were performed at our centre. A retrospective single centre investigation was carried out concerning incidence, timing, indication and type of unplanned interstage cardiac reoperations and catheter interventions during follow-up of Norwood patients...
April 11, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28401281/ct-angiography-and-3d-imaging-in-aortoiliac-occlusive-disease-collateral-pathways-in-leriche-syndrome
#4
REVIEW
Sameer Ahmed, Siva P Raman, Elliot K Fishman
Collateral pathways in aortoiliac occlusive disease are essential for arterial blood flow to the abdomen, pelvis, and lower extremities. These pathways can be broadly divided into systemic-systemic, visceral-visceral, and systemic-visceral collateral networks. MDCT angiography is the most commonly used modality for the diagnostic evaluation of patients with aortoiliac occlusive disease, allowing excellent evaluation of stenotic arterial segments, as well as beautifully illustrating resulting collateral pathways (particularly when utilizing 3D reconstruction techniques)...
April 11, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28400985/spanning-from-the-west-to-east-an-updated-review-on-endovascular-treatment-of-intracranial-atherosclerotic-disease
#5
REVIEW
Mohammed Hussain, Neil Datta, Zhe Cheng, David Dornbos, Asif Bashir, Ibrahim Sultan, Tapan Mehta, Faris Shweikeh, Paul Mazaris, Nora Lee, Amre Nouh, Xiaokun Geng, Yuchuan Ding
Ischemic stroke is a major cause of morbidity and mortality, incurring significant cost. Intracranial atherosclerotic disease (ICAD) accounts for 10-15% of ischemic stroke in Western societies, but is an underlying pathology in up to 54% of ischemic strokes in Asian populations. ICAD has largely been treated with medical management, although a few studies have examined outcomes following endovascular treatment. Our objective was to summarize the major trials that have been performed thus far in regard to the endovascular treatment of ICAD and to provide direction for future management of this disease process...
April 2017: Aging and Disease
https://www.readbyqxmd.com/read/28397019/intra-arterial-high-signals-on-arterial-spin-labeling-perfusion-images-predict-the-occluded-internal-carotid-artery-segment
#6
Shu Sogabe, Junichiro Satomi, Yoshiteru Tada, Yasuhisa Kanematsu, Kazuyuki Kuwayama, Kenji Yagi, Shotaro Yoshioka, Yoshifumi Mizobuchi, Hideo Mure, Izumi Yamaguchi, Takashi Abe, Nobuaki Yamamoto, Keiko T Kitazato, Ryuji Kaji, Masafumi Harada, Shinji Nagahiro
PURPOSE: Arterial spin labeling (ASL) involves perfusion imaging using the inverted magnetization of arterial water. If the arterial arrival times are longer than the post-labeling delay, labeled spins are visible on ASL images as bright, high intra-arterial signals (IASs); such signals were found within occluded vessels of patients with acute ischemic stroke. The identification of the occluded segment in the internal carotid artery (ICA) is crucial for endovascular treatment. We tested our hypothesis that high IASs on ASL images can predict the occluded segment...
April 10, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28395793/visceral-aneurysms-old-paradigms-new-insights
#7
REVIEW
M J E van Rijn, S Ten Raa, J M Hendriks, H J M Verhagen
True visceral artery aneurysms (VAAs) are a rare entity with an incidence of 0.01-2%. The risk of rupture varies amongst the different types of VAAs and is higher for pseudo aneurysms compared with true aneurysms. Size, growth, symptoms, underlying disease, pregnancy and liver transplantation have all been associated with increased risk of rupture. Mortality rates after rupture are around 25%. The splenic artery is most commonly affected and the etiology is predominantly atherosclerosis. Open repair can be done by simple ligation or reconstruction of the artery, while endovascular options include embolization or using a stent graft...
February 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28395788/diagnosis-and-treatment-of-chronic-mesenteric-ischemia-an-update
#8
REVIEW
Jeroen J Kolkman, Robert H Geelkerken
Although the prevalence of mesenteric artery stenoses (MAS) is high, symptomatic chronic mesenteric ischemia (CMI) is rare. The collateral network in the mesenteric circulation, a remnant of the extensive embryonal vascular network, serves to prevent most cases of ischemia. This explains the high incidence of MAS and relative rarity of cases of CMI. The number of affected vessels is the major determinant in CMI development. Most subjects with single vessel mesenteric stenosis do not develop ischemic complaints...
February 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28394873/effects-of-percutaneous-coronary-intervention-on-viable-myocardium-and-heart-function-of-diabetic-patients-with-chronic-total-occlusion
#9
Guowei Zhou, Wenyi Yang, Liang Li
OBJECTIVE: The aim of this study was to compare the effects of percutaneous coronary intervention (PCI) on coronary chronic total occlusion patients with (DM) or without (NDM) diabetes mellitus. METHODS: A total of 78 patients were divided into DM group and NDM group according to whether the patient has DM. The results of PCI were analyzed using quantitative coronary analysis. In addition, all the patients underwent Tc-MIBI (methoxyisobutylisonitrile) single-photon emission computed tomography (SPECT) and ultrasonic cardiogram in the first week and the sixth month after PCI to evaluate PCI results...
April 7, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28386041/prevalence-of-imaging-biomarkers-to-guide-the-planning-of-acute-stroke-reperfusion-trials
#10
Bin Jiang, Robyn L Ball, Patrik Michel, Tudor Jovin, Manisha Desai, Ashraf Eskandari, Zack Naqvi, Max Wintermark
BACKGROUND AND PURPOSE: Imaging biomarkers are increasingly used as selection criteria for stroke clinical trials. The goal of our study was to determine the prevalence of commonly studied imaging biomarkers in different time windows after acute ischemic stroke onset to better facilitate the design of stroke clinical trials using such biomarkers for patient selection. METHODS: This retrospective study included 612 patients admitted with a clinical suspicion of acute ischemic stroke with symptom onset no more than 24 hours before completing baseline imaging...
April 6, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28385458/moyamoya-disease-with-occlusion-of-bilateral-vertebral-arteries-and-the-basilar-artery-fed-by-the-collateral-vessels-of-vertebral-arteries-a-rare-case-report
#11
Xiaofeng Deng, Dong Zhang, Yan Zhang, Rong Wang, Bo Wang, Jizong Zhao
The main change of moyamoya disease (MMD) is steno-occlusion at the terminal portion of the bilateral internal carotid arteries (ICAs). Occlusion of distal portions of the bilateral vertebral arteries (VAs) in MMD has never been reported. An 18-year old female was admitted with repeated headache for 13years. Cerebral digital subtraction angiography (DSA) demonstrated occlusion of bilateral ICAs at their terminal portions, moyamoya vessels at the skull base, occlusion of bilateral distal VAs and the basilar artery (BA) fed by the tortuous collateral vessels arising from the cervical segment of VAs...
April 3, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28382613/reduced-internal-carotid-artery-flow-in-color-coded-carotid-duplex-sonography
#12
Fu-Yi Yang, Po-Ren Hsu, Shinn-Kuang Lin
PURPOSE: Reduced flow in the internal carotid artery (ICA) is related to cerebral ischemia. We established a classification of reduced ICA flow through color-coded carotid duplex (CCD) sonography. METHODS: We retrospectively reviewed 25,000 CCD images in sonography laboratory. RESULTS: Reduced ICA flow [flow volume (FV) less than 100 mL/min] was found in 1.2% of all studies, and 270 patients were enrolled. We included 8% patients with lesions proximal to the ICA in Group A, 27% with lesions at the proximal ICA in Group B, 49% with lesions distal to the visible ICA in Group C, and 16% with unknown causes in Group D...
December 15, 2016: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/28382269/hybrid-coronary-artery-revascularization-for-takayasu-arteritis-with-major-visceral-collateral-circulation-from-the-left-internal-thoracic-artery
#13
Hyung Tae Sim, Jeong-Won Kim, Jae Suk Yoo, Kwang Ree Cho
Coronary arterial involvement in Takayasu arteritis (TA) is not uncommon. Herein, we describe a case of TA with celiac trunk and superior mesenteric artery occlusion combined with coronary artery disease. Bilateral huge internal thoracic arteries (ITAs) and the inferior mesenteric artery provided the major visceral collateral circulation. After percutaneous intervention to the right coronary artery, off-pump coronary artery bypass grafting for the left coronary territory was done using a right ITA graft and its large side branch because of its relatively minor contribution to the visceral collateral circulation...
April 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28373785/chronic-total-coronary-occlusion-recanalization-current-techniques-and-new-devices
#14
REVIEW
Jan-Erik Gülker, Lars Bansemir, Heinrich G Klues, Alexander Bufe
Percutaneous coronary intervention (PCI) of total chronic coronary occlusion (CTO) still remains a major challenge. The prevalence of a CTO has been reported to be up to 30% among patients with a clinical indication for coronary angiography. Progress has been made with further advanced interventional techniques and continuously sophisticated interventional tools. Nevertheless the number of interventions carried out to recanalize a CTO is less than 10% of all procedures. Benefits of a successful CTO recanalization include relief of angina pectoris and ischemia-related dyspnea, substantial improvement in left ventricular function and, avoidance of surgery treatment...
April 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28373302/predictors-for-symptomatic-intracranial-hemorrhage-after-endovascular-treatment-of-acute-ischemic-stroke
#15
Yonggang Hao, Dong Yang, Huaiming Wang, Wenjie Zi, Meng Zhang, Yu Geng, Zhiming Zhou, Wei Wang, Haowen Xu, Xiguang Tian, Penghua Lv, Yuxiu Liu, Yunyun Xiong, Xinfeng Liu, Gelin Xu
BACKGROUND AND PURPOSE: Symptomatic intracranial hemorrhage (SICH) pose a major safety concern for endovascular treatment of acute ischemic stroke. This study aimed to evaluate the risk and related factors of SICH after endovascular treatment in a real-world practice. METHODS: Patients with stroke treated with stent-like retrievers for recanalizing a blocked artery in anterior circulation were enrolled from 21 stroke centers in China. Intracranial hemorrhage was classified as symptomatic and asymptomatic ones according to Heidelberg Bleeding Classification...
April 3, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28366054/advanced-imaging-in-acute-ischemic-stroke
#16
Craig Kilburg, J Scott McNally, Adam de Havenon, Philipp Taussky, M Yashar S Kalani, Min S Park
The evaluation and management of acute ischemic stroke has primarily relied on the use of conventional CT and MRI techniques as well as lumen imaging sequences such as CT angiography (CTA) and MR angiography (MRA). Several newer or less-established imaging modalities, including vessel wall MRI, transcranial Doppler ultrasonography, and 4D CTA and MRA, are being developed to complement conventional CT and MRI techniques. Vessel wall MRI provides high-resolution analysis of both extracranial and intracranial vasculature to help identify previously occult lesions or characteristics of lesions that may portend a worse natural history...
April 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28365567/use-of-p53-silenced-endothelial-progenitor-cells-to-treat-ischemia-in-diabetic-peripheral-vascular-disease
#17
Nabanita Kundu, Cleyton C Domingues, Cyril Chou, Neeki Ahmadi, Sara Houston, D Joseph Jerry, Sabyasachi Sen
BACKGROUND: Peripheral vascular disease is a major diabetes mellitus-related complication. In this study, we noted that expressions of proapoptotic p53 gene and its downstream cascade gene such as p21 are upregulated in hyperglycemia. Therefore, we investigated whether p53- and p21-silenced endothelial progenitor cells (EPCs) were able to survive in hyperglycemic milieu, and whether transplantation of either p53 knockout (KO) or p21KO or p53- and p21-silenced EPCs could improve collateral vessel formation and blood flow in diabetic vaso-occlusive peripheral vascular disease mouse models...
April 1, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28356405/the-pathophysiology-of-chronic-thromboembolic-pulmonary-hypertension
#18
REVIEW
Gérald Simonneau, Adam Torbicki, Peter Dorfmüller, Nick Kim
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare, progressive pulmonary vascular disease that is usually a consequence of prior acute pulmonary embolism. CTEPH usually begins with persistent obstruction of large and/or middle-sized pulmonary arteries by organised thrombi. Failure of thrombi to resolve may be related to abnormal fibrinolysis or underlying haematological or autoimmune disorders. It is now known that small-vessel abnormalities also contribute to haemodynamic compromise, functional impairment and disease progression in CTEPH...
March 31, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28352979/time-resolved-3d-rotational-angiography-4d-dsa-of-the-lenticulostriate-arteries-display-of-normal-anatomic-variants-and-collaterals-in-cases-with-chronic-obstruction-of-the-mca
#19
S Kammerer, M Mueller-Eschner, J Berkefeld, S Tritt
PURPOSE: The lenticulostriate arteries (LSA) and other perforators may play a role for collateral supply in cases with ischemia due to stenosis or occlusions of the middle cerebral artery (MCA). Purpose of this case series was to evaluate the potential of time-resolved 3D rotational angiography data sets (4D DSA) for detailed visualization of anatomic variants of LSA feeders and for display of local collaterals involving the LSA in cases with chronic MCA obstruction. METHODS: Multiplanar and volume rendering reconstructions of 4D DSA data were computed in addition to standard postprocessing in 24 patients who had indications for 3D rotational angiography (3DRA) of the internal carotid artery (ICA) without pathologies of the ICA, middle cerebral artery (MCA) and anterior cerebral artery (ACA) main stems (n = 18) or with stenosis or chronic occlusion of the MCA (n = 6)...
March 28, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28349710/endovascular-devices-and-revascularization-techniques-for-limb-threatening-ischemia-in-individuals-with-diabetes
#20
Jayer Chung
Diabetes mellitus (DM) is a rapidly worsening global epidemic over the last thirty-five years. The increased prevalence of DM has changed the phenotypic expression of atherosclerotic limb threatening ischemia (LTI), resulting in an increase in lesions in the tibial vessels. These patients are also afflicted with peripheral neuropathy, foot deformities, and medial calcification of the vasculature. In response to the evolving phenotype of atherosclerosis, newer minimally invasive tools and techniques have been developed to improve the blood supply in LTI...
March 1, 2017: Journal of Diabetes Science and Technology
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