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https://www.readbyqxmd.com/read/29143147/-esc-guidelines-2017-on-peripheral-arterial-diseases-summary-of-the-most-important-recommendations-and-innovations
#1
C Espinola-Klein
The current European Society of Cardiology (ESC) guidelines on peripheral arterial diseases include recommendations on diagnostics and treatment of atherosclerotic manifestations in peripheral arteries. Because of the high coincidence of atherosclerosis in different arterial territories, screening for other atherosclerotic lesions is necessary in patients with clinical symptoms in one vascular bed. Consistent treatment of cardiovascular risk factors is important in all patients with peripheral atherosclerosis...
November 15, 2017: Herz
https://www.readbyqxmd.com/read/29139601/utility-of-the-acc-aha-lesion-classification-as-a-predictor-of-procedural-30-day-and-12-month-outcomes-in-the-contemporary-percutaneous-coronary-intervention-era
#2
James Theuerle, Matias B Yudi, Omar Farouque, Nick Andrianopoulos, Peter Scott, Andrew E Ajani, Angela Brennan, Stephen J Duffy, Christopher M Reid, David J Clark
BACKGROUND: Correlations between the ACC/AHA coronary lesion classification and clinical outcomes in the contemporary percutaneous coronary intervention (PCI) era are not well established. METHODS: We analyzed clinical characteristics and outcomes according to ACC/AHA lesion classification (A, B1, B2, C) in 13,701 consecutive patients from the Melbourne Interventional Group (MIG) registry. Patients presenting with STEMI, cardiogenic shock and out-of-hospital cardiac arrest were excluded...
November 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29139373/primary-malignant-melanoma-of-the-bladder
#3
Maurizio Buscarini, Claudio Conforti, Raffaele Antonelli Incalzi, Cristina Falavolti, Chiara Taffon, Giovanni Muto, Caterina Dianzani
A 81-year-old man was admitted to our university for a second opinion after diagnosis of bladder melanoma in December 2014. His medical history included arterial hypertension, hypothyroidism, peripheral arterial disease treated with a bypass, and corneal transplantation. His medical history was negative for malignant melanoma. He experienced gross hematuria in the absence of any other clinical manifestations, and urine cytology identified atypical cells. The patient underwent transurethral resection of the bladder with diagnosis of melanoma...
2017: Skinmed
https://www.readbyqxmd.com/read/29132880/rivaroxaban-with-or-without-aspirin-in-patients-with-stable-peripheral-or-carotid-artery-disease-an-international-randomised-double-blind-placebo-controlled-trial
#4
Sonia S Anand, Jackie Bosch, John W Eikelboom, Stuart J Connolly, Rafael Diaz, Peter Widimsky, Victor Aboyans, Marco Alings, Ajay K Kakkar, Katalin Keltai, Aldo P Maggioni, Basil S Lewis, Stefan Störk, Jun Zhu, Patricio Lopez-Jaramillo, Martin O'Donnell, Patrick J Commerford, Dragos Vinereanu, Nana Pogosova, Lars Ryden, Keith A A Fox, Deepak L Bhatt, Frank Misselwitz, John D Varigos, Thomas Vanassche, Alvaro A Avezum, Edmond Chen, Kelley Branch, Darryl P Leong, Shrikant I Bangdiwala, Robert G Hart, Salim Yusuf
BACKGROUND: Patients with peripheral artery disease have an increased risk of cardiovascular morbidity and mortality. Antiplatelet agents are widely used to reduce these complications. METHODS: This was a multicentre, double-blind, randomised placebo-controlled trial for which patients were recruited at 602 hospitals, clinics, or community practices from 33 countries across six continents. Eligible patients had a history of peripheral artery disease of the lower extremities (previous peripheral bypass surgery or angioplasty, limb or foot amputation, intermittent claudication with objective evidence of peripheral artery disease), of the carotid arteries (previous carotid artery revascularisation or asymptomatic carotid artery stenosis of at least 50%), or coronary artery disease with an ankle-brachial index of less than 0·90...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29132879/rivaroxaban-with-or-without-aspirin-in-patients-with-stable-coronary-artery-disease-an-international-randomised-double-blind-placebo-controlled-trial
#5
Stuart J Connolly, John W Eikelboom, Jackie Bosch, Gilles Dagenais, Leanne Dyal, Fernando Lanas, Kaj Metsarinne, Martin O'Donnell, Anthony L Dans, Jong-Won Ha, Alexandr N Parkhomenko, Alvaro A Avezum, Eva Lonn, Liu Lisheng, Christian Torp-Pedersen, Petr Widimsky, Aldo P Maggioni, Camilo Felix, Katalin Keltai, Masatsugu Hori, Khalid Yusoff, Tomasz J Guzik, Deepak L Bhatt, Kelley R H Branch, Nancy Cook Bruns, Scott D Berkowitz, Sonia S Anand, John D Varigos, Keith A A Fox, Salim Yusuf
BACKGROUND: Coronary artery disease is a major cause of morbidity and mortality worldwide, and is a consequence of acute thrombotic events involving activation of platelets and coagulation proteins. Factor Xa inhibitors and aspirin each reduce thrombotic events but have not yet been tested in combination or against each other in patients with stable coronary artery disease. METHODS: In this multicentre, double-blind, randomised, placebo-controlled, outpatient trial, patients with stable coronary artery disease or peripheral artery disease were recruited at 602 hospitals, clinics, or community centres in 33 countries...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29124029/femoro-supragenicular-popliteal-bypass-with-a-bridging-stent-graft-in-a-diffusely-diseased-distal-target-popliteal-artery-alternative-to-below-knee-popliteal-polytetrafluoroethylene-bypass
#6
Joung Hun Byun, Tae Gyu Kim, Yun Gyu Song
Background: Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease. Methods: Between April 2012 and October 2015, 16 patients (18 limbs) with lifestyle-limiting claudication (n=12) or chronic critical limb ischemia (n=6) underwent femoral-above-knee (AK) polytetrafluoroethylene (PTFE) bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29107295/the-fgf21-response-to-fructose-predicts-metabolic-health-and-persists-after-bariatric-surgery-in-obese-humans
#7
Kasper W Ter Horst, Pim W Gilijamse, Ahmet Demirkiran, Bart A van Wagensveld, Mariette T Ackermans, Joanne Verheij, Johannes A Romijn, Max Nieuwdorp, Eleftheria Maratos-Flier, Mark A Herman, Mireille J Serlie
OBJECTIVE: Fructose consumption has been implicated in the development of obesity and insulin resistance. Emerging evidence shows that fibroblast growth factor 21 (FGF21) has beneficial effects on glucose, lipid, and energy metabolism and may also mediate an adaptive response to fructose ingestion. Fructose acutely stimulates circulating FGF21 consistent with a hormonal response. We aimed to evaluate whether fructose-induced FGF21 secretion is linked to metabolic outcomes in obese humans before and after bariatric surgery-induced weight loss...
November 2017: Molecular Metabolism
https://www.readbyqxmd.com/read/29101990/acr-appropriateness-criteria-%C3%A2-iliac-artery-occlusive-disease
#8
Alexander Z Copelan, Baljendra S Kapoor, Ali F AbuRahma, Thomas R Cain, Drew M Caplin, Khashayar Farsad, M-Grace Knuttinen, Margaret H Lee, Joseph J McBride, Jeet Minocha, Stephen P Reis, Paul J Rochon, Colette M Shaw, Jonathan M Lorenz
Iliac artery occlusive disease can present as a sudden-onset acute thrombotic or thromboembolic event or as a chronic progressive atherosclerotic process that presents as claudication progressing to rest pain. Depending on the clinical presentation, the diagnosis is usually confirmed through Doppler vascular ultrasound, CT angiography, or MR angiography; the choice of imaging is usually based on modality availability and the presence of patient comorbidities such as chronic kidney disease. The Trans-Atlantic Inter-Society Consensus II classification system is commonly used to describe the extent of the peripheral vascular disease...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29093711/the-gateway-reflex-a-novel-neuro-immune-interaction-for-the-regulation-of-regional-vessels
#9
REVIEW
Yuki Tanaka, Yasunobu Arima, Daisuke Kamimura, Masaaki Murakami
The gateway reflex is a new phenomenon that explains how immune cells bypass the blood-brain barrier to infiltrate the central nervous system (CNS) and trigger neuroinflammation. To date, four examples of gateway reflexes have been discovered, each described by the stimulus that evokes the reflex. Gravity, electricity, pain, and stress have all been found to create gateways at specific regions of the CNS. The gateway reflex, the most recently discovered of the four, has also been shown to upset the homeostasis of organs in the periphery through its action on the CNS...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29092664/the-perspective-of-the-intensivist-on-inotropes-and-postoperative-care-following-pediatric-heart-surgery-an-international-survey-and-systematic-review-of-the-literature
#10
Peter P Roeleveld, J C A de Klerk
INTRODUCTION: Inotropes are frequently being used in children undergoing heart surgery to prevent or treat low cardiac output syndrome (LCOS). There is only limited evidence that inotropes actually positively influence postoperative outcome. Our aim was to describe the current international practice variation in the use of inotropes following congenital heart surgery. METHODS: We developed an online survey regarding the postoperative use of inotropes. We sent an invitation to all 197 registered members of the Pediatric Cardiac Intensive Care Society (PCICS) to participate in the survey...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29089685/use-of-multidetector-computed-tomography-angiography-of-upper-limb-circulation-in-patients-undergoing-coronary-artery-bypass-grafting-surgery
#11
Hasan B Altinsoy, Ozkan Alatas, Hidayet Kayancicek, Erhan Hafiz, Omer F Dogan
OBJECTIVE: This study aimed to evaluate the bilateral forehand circulation using a 64-channel multidetector computed tomography (MDCT) as a noninvasive method to define criteria for an upper extremity arterial anatomy and pathology prior to the use of arterial conduits. MATERIALS AND METHODS: Fifty-five patients with coronary artery disease who underwent total arterial coronary artery bypass grafting (CABG) were randomly selected for this prospective study. MDCT angiography was performed for 110 examinations of forearm and hand arterial anatomy...
July 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/29079734/limiting-injury-during-saphenous-vein-graft-preparation-for-coronary-arterial-bypass-prevents-metabolic-decompensation
#12
Joyce Cheung-Flynn, Jun Song, Igor Voskresensky, Eric S Wise, Yapu Liu, Yanhua Xiong, Susan S Eagle, Colleen M Brophy, C Robb Flynn
Standard harvest and preparation of human saphenous vein (HSV) for autologous coronary and peripheral arterial bypass procedures is associated with injury and increased oxidative stress that negatively affect graft performance. In this study we investigated the global metabolomic profiles of HSV before (unprepared; UP) and after standard vein graft preparation (AP). AP-HSV showed impaired vasomotor function that was associated with increased oxidative stress, phospholipid hydrolysis and energy depletion that are characteristic of mechanical and chemical injury...
October 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29074114/regional-variation-in-the-cost-of-infra-inguinal-lower-extremity-bypass-surgery-in-the-united-states
#13
Besma J Nejim, Sophie Wang, Isibor Arhuidese, Tammam Obeid, Husain Nader Alshaikh, Hanaa Dakour Aridi, Satinderjit Locham, Mahmoud B Malas
BACKGROUND: Lower extremity bypass (LEB) remains the gold standard revascularization procedure in patients with peripheral arterial disease. The cost of LEB substantially varies based on patient's characteristics and comorbidities. The aim of this study was to assess regional variation in infra-inguinal LEB cost and to identify the specific health care expenditures per service that are associated with the highest cost in each region. METHODS: We identified adult patients who underwent infra-inguinal LEB in the Premier database between June 2009 and March 2015...
October 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29071389/-graft-aneurysms-as-long-term-complication-of-polyester-prostheses-and-their-management-brief-review-based-on-a%C3%A2-systematic-review-of-the-literature
#14
REVIEW
U Barth, K Wasseroth, F Meyer
INTRODUCTION: A material-associated true aneurysm after previous use of a vascular prosthesis for arterial reconstruction mostly in peripheral arterial occlusion disease (PAOD) is considered a rare but serious complication. AIM AND METHOD: The aim of the compact brief review was to describe the rare finding of a true aneurysm of a prosthesis and its diagnosis-specific care including a representative scientific case report, based on selected topic-related references from the medical literature as well as the specific experiences obtained from the successful clinical management in single cases...
October 25, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29049838/predicting-long-term-survival-after-coronary-artery-bypass-graft-surgery
#15
Md N Karim, Christopher M Reid, Mollah Huq, Samuel L Brilleman, Andrew Cochrane, Lavinia Tran, Baki Billah
OBJECTIVES: To develop a model for predicting long-term survival following coronary artery bypass graft surgery. METHODS: This study included 46 573 patients from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZCTS) registry, who underwent isolated coronary artery bypass graft surgery between 2001 and 2014. Data were randomly split into development (23 282) and validation (23 291) samples. Cox regression models were fitted separately, using the important preoperative variables, for 4 'time intervals' (31-90 days, 91-365 days, 1-3 years and >3 years), with optimal predictors selected using the bootstrap bagging technique...
October 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049809/association-of-quality-improvement-registry-participation-with-appropriate-follow-up-after-vascular-procedures
#16
Benjamin S Brooke, Adam W Beck, Larry W Kraiss, Andrew W Hoel, Andrea M Austin, Amir A Ghaffarian, Jack L Cronenwett, Philip P Goodney
Importance: Ensuring that patients undergo surveillance imaging after surgery is a key quality metric after many vascular procedures. It is unclear whether hospital participation in a national quality improvement registry such as the Vascular Quality Initiative (VQI) achieves this goal. Objective: To determine if hospital participation in the VQI registry is associated with increased rates of surveillance imaging after vascular procedures. Design, Setting, and Participants: A quasi-experimental study used Medicare claims to study 2174 US hospitals in which 1 530 102 patients had undergone an endovascular abdominal aortic aneurysm repair (EVAR), 1 403 067 patients had undergone a lower extremity bypass (LEB) or peripheral vascular intervention (PVI), and 294 942 patients had undergone carotid endarterectomy (CEA) and carotid artery stenting (CAS) procedures between January 1, 2007, and December 31, 2012...
October 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29049782/rotational-speed-modulation-used-with-continuous-flow-left-ventricular-assist-device-provides-good-pulsatility
#17
Noritsugu Naito, Takashi Nishimura, Kei Iizuka, Yoshiaki Takewa, Akihide Umeki, Masahiko Ando, Minoru Ono, Eisuke Tatsumi
OBJECTIVES: Continuous-flow left ventricular assist devices (CF-LVADs) are widely used to treat patients with end-stage heart failure. Although continuous flow is different from physiological flow, patients show improved outcomes after CF-LVAD implantation. A novel rotational speed (RS) modulation system used with CF-LVAD (EVAHEART) has been developed, which can change RS in synchronization with the native cardiac cycle. We conducted the present study to investigate the influence of the system on pulsatility in peripheral perfusion...
August 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049755/is-ministernotomy-superior-to-right-anterior-minithoracotomy-in-minimally-invasive-aortic-valve-replacement
#18
Damian Balmforth, Amer Harky, Kulvinder Lall, Rakesh Uppal
A best evidence topic was constructed according to a structured protocol. The question addressed was whether, in patients undergoing minimally invasive aortic valve replacement (AVR), right anterior thoracotomy (RT) or mini-sternotomy (MS) was superior in terms of postoperative outcome? A total of 840 publications were found using the reported search. Of these, 6 represented the best available evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
November 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049508/outcomes-in-women-and-minorities-compared-with-white-men-1-year-after-everolimus-eluting-stent-implantation-insights-and-results-from-the-platinum-diversity-and-promus-element-plus-post-approval-study-pooled-analysis
#19
Wayne Batchelor, David E Kandzari, Scott Davis, Luis Tami, John C Wang, Islam Othman, Osvaldo S Gigliotti, Amir Haghighat, Sarabjeet Singh, Mario Lopez, Gregory Giugliano, Phillip A Horwitz, Jaya Chandrasekhar, Paul Underwood, Craig A Thompson, Roxana Mehran
Importance: There exist limited outcomes data for women and minorities after contemporary percutaneous coronary intervention (PCI). Objective: To examine 1-year outcomes in women and minorities vs white men after PCI with everolimus-eluting stents. Design, Settings, and Participants: The PLATINUM Diversity study was a single-arm study enrolling women and minorities. Patient-level pooling with the PROMUS Element Plus Post-Approval Study was prespecified...
October 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29049458/long-term-outcomes-of-multiple-arterial-coronary-artery-bypass-grafting-a-population-based-study-of-patients-in-british-columbia-canada
#20
Aihua Pu, Lillian Ding, Jungwon Shin, Joel Price, Peter Skarsgard, Daniel R Wong, John Bozinovski, Guy Fradet, James G Abel
Importance: Although the long-term survival advantage of multiple arterial grafting (MAG) vs the standard use of left internal thoracic artery (LITA) supplemented by saphenous vein grafts (LITA+SVG) has been demonstrated in several observational studies, to our knowledge its safety and other long-term clinical benefits in a large, population-based cohort are unknown. Objective: To compare the safety and long-term outcomes of MAG vs LITA+SVG among overall and selected subgroups of patients...
November 1, 2017: JAMA Cardiology
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