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https://www.readbyqxmd.com/read/28300677/wound-disruption-after-lower-extremity-bypass-surgery-is-a-predictor-of-subsequent-development-of-wound-infection
#1
Faisal Aziz, Tiffany Bohr, Erik B Lehman
OBJECTIVES: Despite advances in endovascular surgery, lower extremity arterial bypass (LEB) remains the gold standard treatment for severe, symptomatic Peripheral Arterial Disease (PAD). With recent changes in healthcare, there has been an increasing emphasis on reducing the hospital length of stay (LOS). The purpose of this study is to identify the postoperative complications, which occur after discharge from hospital, and to find risk factors for developing such complications. METHODS: The 2013 lower extremity revascularization -targeted American College of Surgeons (ACS-NSQIP) database and generalized 2013 general and vascular surgery ACS-NSQIP PUF were used for this study...
March 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28296239/stent-placement-in-the-superficial-femoral-and-proximal-popliteal-arteries-with-the-innova-self-expanding-bare-metal-stent-system
#2
Richard J Powell, Michael R Jaff, Herman Schroë, Andrew Benko, Juan Diaz-Cartelle, Stefan Müller-Hülsbeck
OBJECTIVES: The SuperNOVA trial was designed to evaluate performance of the Innova Vascular Self-Expanding Stent System (Boston Scientific, Marlborough, MA) for treating lesions in the femoropopliteal arteries. METHODS: Patients with chronic lower limb peripheral artery disease (Rutherford category 2, 3, or 4) and atherosclerotic lesions in the native superficial femoral and/or proximal popliteal artery (lengths 30-190 mm) were enrolled in this single-arm, multinational study...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28290878/-immediate-outcomes-of-coronary-artery-bypass-grafting-in-patients-with-multifocal-atherosclerosis-gender-differences
#3
A N Sumin, E V Korok, R A Gaifulin, S V Ivanov, O L Barbarash
AIM: To assess the impact of presence of multifocal atherosclerosis (MFA) and gender differences on immediate outcomes after coronary artery bypass grafting (CABG) in patients with ischemic heart disease (IHD). MATERIAL AND METHODS: Medical records of patients with MFA, who underwent elective CABG (n=764, 655 men, 109 women) were reviewed retrospectively. RESULTS: Women were older (<0.001), and more often were overweight (<0.001), had diabetes (<0...
August 2016: Kardiologiia
https://www.readbyqxmd.com/read/28289103/bone-structural-changes-after-gastric-bypass-surgery-evaluated-by-hr-pqct-a-two-year-longitudinal-study
#4
Vikram Vinod Shanbhogue, René Klinkby Støving, Katrine Diemer Frederiksen, Stine Hanson, Kim Brixen, Jeppe Gram, Niklas Rye Jorgensen, Stinus Hansen
Objective, design and methods: Roux-en-Y gastric bypass (RYGB) has proved successful in attaining sustained weight loss but may lead to metabolic bone disease. To assess impact on bone mass and structure, we measured areal bone mineral density at the hip and spine by dual-energy x-ray absorptiometry, and volumetric BMD (vBMD) and bone microarchitecture at the distal radius and tibia by high-resolution peripheral quantitative CT in 25 morbidly obese subjects (15 females, 10 males) at 0, 12 and 24 months after RYGB...
March 13, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28274749/plasma-fibrinogen-level-as-a-potential-predictor-of-hemorrhagic-complications-after-catheter-directed-thrombolysis-for-peripheral-arterial-occlusions
#5
REVIEW
Michiel H F Poorthuis, Eelco C Brand, Constantijn E V B Hazenberg, Roger E G Schutgens, Jan Westerink, Frans L Moll, Gert J de Borst
BACKGROUND: The benefit of catheter-directed thrombolysis for peripheral arterial occlusions is limited by hemorrhagic complications. Plasma fibrinogen level (PFL) has been suggested as a predictor of these hemorrhagic complications, but the accurateness of prediction is unknown. We summarized the available evidence on the predictive value of PFL for hemorrhagic complications after catheter-directed thrombolysis for acute or subacute peripheral native artery or arterial bypass occlusions...
March 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28273212/role-of-micrornas-in-the-treatment-of-type-2-diabetes-mellitus-with-roux-en-y-gastric-bypass
#6
Z Zhu, J Yin, D C Li, Z Q Mao
The aim of this study was to investigate the effect of Roux-en-Y gastric bypass (RYGB) on the peripheral blood microRNAs (miRNAs) of patients with type 2 diabetes mellitus (T2DM). miRNAs are small 20- to 22-nucleotide (nt) noncoding RNAs. They constitute a novel class of gene regulators that negatively regulate gene expression at the post-transcriptional level. miRNAs play an important role in several biological processes. Twelve patients with T2DM who were scheduled to undergo laparoscopic RYGB surgery were separated into two groups, using a body mass index of 30 kg/m2 as a cut-off point...
March 2, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28265466/safety-and-efficacy-of-two-trabecular-micro-bypass-stents-as-the-sole-procedure-in-japanese-patients-with-medically-uncontrolled-primary-open-angle-glaucoma-a-pilot-case-series
#7
Daisuke Shiba, Shingo Hosoda, Saori Yaguchi, Naoki Ozeki, Kenya Yuki, Kazuo Tsubota
Purpose. To evaluate efficacy and safety of a trabecular micro-bypass stent system when used as the sole procedure in Japanese patients with medically uncontrolled primary open-angle glaucoma (POAG). Design. Prospective nonrandomized interventional pilot study. Methods. Ten eyes of 10 Japanese patients with medically uncontrolled POAG taking three ocular hypotensive medications were treated using only the implantation of two iStent trabecular micro-bypass stents. Each patient continued to take the same ocular hypotensive medications used preoperatively throughout the study...
2017: Journal of Ophthalmology
https://www.readbyqxmd.com/read/28258020/lower-extremity-bypass-surgery-on-patients-transferred-from-other-hospitals-is-associated-with-increased-morbidity-and-mortality
#8
Faisal Aziz, Youngmin Chu, Erik B Lehman
BACKGROUND: Despite advances in endovascular surgery, lower extremity arterial bypass remains the gold standard treatment for severe, symptomatic peripheral arterial disease (PAD). Patients who are transferred to other hospitals have generally complex medical problems compared to those patients who are directly admitted from home. The purpose of this study is to identify factors associated with an interfacility transfer in patients with PAD and compare the postoperative outcomes of these patients to those who are directly admitted to the hospital...
February 28, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28257772/contemporary-outcomes-of-endovascular-intervention-for-critical-limb-ischemia
#9
REVIEW
Pratik K Dalal, Anand Prasad
Critical limb ischemia (CLI) remains a significant cause of morbidity and mortality in patients with peripheral arterial disease. Optimal treatment strategies for CLI remain controversial. The only randomized trial comparing surgical with endovascular revascularization suggests no significant difference in limb salvage between open surgical bypass and angioplasty. Although novel endovascular strategies are now available, their efficacies remain largely untested in a randomized fashion. This review provides an overview of the data surrounding contemporary outcomes of endovascular therapy with an emphasis on current knowledge gaps...
April 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28254547/surgical-repair-of-axillary-artery-aneurysm-in-a-2-year-old-child-a-case-report
#10
Asaad G Beshish, Tsovinar Arutyunyan
Peripheral aneurysm and pseudo-aneurysm of an artery is a well-recognized, but rare phenomenon in children. We report a case of an axillary artery aneurysm in a 2 year-old boy with Methicillin Resistant Staphylococcus Aureus (MRSA) septic shock, Acute Respiratory Distress Syndrome (ARDS), and Multi-Organ Dysfunction Syndrome (MODS). Definitive surgical treatment with left axillary artery aneurysm exclusion and bypass with greater saphenous vein graft was performed. To our knowledge, this is the only axillary artery aneurysm ever reported in a child...
February 27, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28250690/aortoiliac-reconstruction-in-the-setting-of-in-stent-restenosis
#11
H S Natraj Setty, T R Raghu, B C Srinivas, C M Nagesh, Babu Reddy, Jayashree Kharge, B K Geetha, B N Krishnamurthy, Shivanand Patil, C N Manjunath
Complex iliac artery obstructions, particularly bilateral stenosis or total iliac artery occlusions, are usually treated with aortofemoral or aortobifemoral graft surgery. However, surgical treatment is associated with 3% mortality rate and significant morbidity such as intestinal ischemia, spinal cord injury, and ureteral damage. Percutaneous interventions of aortic bifurcation offer a promising alternative to surgery with potentially lower morbidity and mortality risk. We report a case of peripheral artery disease who had underwent right transfemoral iliac angioplasty with femoropopliteal bypass presented again with bilateral lower limb ischemia, who was successfully treated with stent implantation with the kissing balloon technique...
January 2017: Journal of Natural Science, Biology, and Medicine
https://www.readbyqxmd.com/read/28246076/rac1-pharmacological-inhibition-rescues-human-endothelial-dysfunction
#12
Albino Carrizzo, Carmine Vecchione, Antonio Damato, Flavio di Nonno, Mariateresa Ambrosio, Franco Pompeo, Enrico Cappello, Luca Capocci, Mariangela Peruzzi, Valentina Valenti, Giuseppe Biondi-Zoccai, Antonino G M Marullo, Silvia Palmerio, Roberto Carnevale, Chiara C Spinelli, Annibale A Puca, Speranza Rubattu, Massimo Volpe, Junichi Sadoshima, Giacomo Frati, Sebastiano Sciarretta
BACKGROUND: Endothelial dysfunction contributes significantly to the development of vascular diseases. However, a therapy able to reduce this derangement still needs to be identified. We evaluated the effects of pharmacological inhibition of Rac1, a small GTPase protein promoting oxidative stress, in human endothelial dysfunction. METHODS AND RESULTS: We performed vascular reactivity studies to test the effects of NSC23766, a Rac1 inhibitor, on endothelium-dependent vasorelaxation of saphenous vein segments collected from 85 subjects who had undergone surgery for venous insufficiency and from 11 patients who had undergone peripheral vascular surgery...
February 28, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28245519/pharmacokinetics-of-tranexamic-acid-in-neonates-and-infants-undergoing-cardiac-surgery
#13
Ralph Gertler, Michael Gruber, Stanislas Grassin-Delyle, Saïk Urien, Klaus Martin, Peter Tassani-Prell, Siegmund Braun, Simon Burg, Gunther Wiesner
AIM: Tranexamic acid (TXA) continues to be one of the antifibrinolytics of choice during paediatric cardiac surgery. However, in infants less than one year of age, the optimal dosing based on pharmacokinetic (PK) considerations is still under discussion. METHODS: 43 children less than one year of age were enrolled. 37 required the use of cardiopulmonary bypass (CPB) while 6 were operated on without CPB. 50 mg kg(-1) TXA i.v. at the induction of anaesthesia was followed by 50 mg kg(-1) into the CPB prime in the CPB group...
February 28, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28236917/outcomes-of-native-superficial-femoral-artery-chronic-total-occlusion-recanalization-after-failed-femoropopliteal-bypass
#14
Mark G Davies, Hosam F El-Sayed
OBJECTIVE: When a bypass fails, the options are lysis, redo bypass, or endovascular intervention. If lysis of the original bypass is not considered an option, which is better-redo bypass or attempts at endovascular recanalization of the native system? This retrospective study examined the outcomes of native superficial femoral artery (SFA) chronic total occlusion (CTO) recanalization compared with redo bypass after failed femoropopliteal bypass. METHODS: Patients presenting with a symptomatic failed femoropopliteal bypass that underwent attempted CTO endovascular (EV) recanalization of the native SFA or a redo femoropopliteal bypass (BP) from 2000 to 2015 were analyzed...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28229168/cd14-cd16-nonclassical-monocytes-are-associated-with-endothelial-dysfunction-in-patients-with-coronary-artery-disease
#15
Karol Urbanski, Dominik Ludew, Grzegorz Filip, Magdalena Filip, Agnieszka Sagan, Piotr Szczepaniak, Grzegorz Grudzien, Jerzy Sadowski, Barbara Jasiewicz-Honkisz, Tomasz Sliwa, Boguslaw Kapelak, Eilidh McGinnigle, Tomasz Mikolajczyk, Tomasz J Guzik
Endothelial dysfunction and inflammation are key mechanisms of vascular disease. We hypothesised that heterogeneity of monocyte subpopulations may be related to the development of vascular dysfunction in coronary artery disease (CAD). Therefore, we examined the relationships between monocyte subsets (CD14(++)CD16(-) "classical - Mon1", CD14(++)CD16(+) "intermediate - Mon2" and CD14(+)CD16(++) "nonclassical - Mon3"), endothelial function and risk factor profiles in 130 patients with CAD undergoing coronary artery bypass grafting...
February 23, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28225505/nonrevascularizable-buttock-claudication-improved-with-sildenafil-a-case-report
#16
Loukman Omarjee, Audrey Camarzana, Samir Henni, Pierre Abraham
RATIONALE: Sildenafil, a phosphodiesterase-5-inhibitor (PDE5i), could represent a new treatment in addition to the medical treatment and advice to walk in peripheral arterial disease (PAD). PATIENT CONCERNS AND DIAGNOSES: We report a case of a 62-year-old heavy smoker man who developed a buttock claudication and a severe walking limitation following an aorto-bi-femoral bypass in 1992. Since 2003, each year, he has been referred for investigation of bilateral buttock claudication on treadmill using transcutaneous oxygen pressure (tcpO2) measurement during exercise to argue for the vascular origin of the walking impairment...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28215312/prevalence-of-clinical-thiamine-deficiency-in-individuals-with-medically-complicated-obesity
#17
Anand Nath, Tung Tran, Timothy R Shope, Timothy R Koch
Thiamine is a vitamin whose deficient can result in multiorgan symptoms. We described an 18% prevalence of clinical thiamine deficiency after gastric bypass surgery. Our hypotheses are that individuals with medically complicated obesity frequently have clinical thiamine deficiency and that diabetes mellitus is a mechanism for development of clinical thiamine deficiency. This is a single institution, retrospective observational study of consecutive patients with a body mass index of at least 35 kg/m(2) who were evaluated in preoperative gastrointestinal bariatric clinic from 2013 to 2015...
January 2017: Nutrition Research
https://www.readbyqxmd.com/read/28203541/anesthetic-considerations-in-robotic-mitral-valve-surgery
#18
Kent H Rehfeldt, J Valery Andre, Matthew J Ritter
The robotic approach to cardiac surgery offers patients numerous potential advantages compared with a traditional sternotomy approach including shorter hospital length of stay, reduced pain, fewer blood transfusions, and a quicker return to normal daily activities. At the same time, robotic cardiac surgery requires that the anesthesiologist employs several subspecialty skillsets in order to provide optimal care for these patients. Multiple different regional anesthesia techniques may be used to improve analgesia, reduce opioid dosages, and facilitate rapid extubation at the conclusion of the case...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28202439/variable-reliability-of-surrogate-measures-of-insulin-sensitivity-after-roux-en-y-gastric-bypass
#19
Kirstine N Bojsen-Moller, Carsten Dirksen, Maria S Svane, Nils B Jørgensen, Jens J Holst, Erik A Richter, Sten Madsbad
Roux-en-Y gastric bypass (RYGB) induces weight loss and improves insulin sensitivity when evaluated by the hyperinsulinemic-euglycemic clamp (HEC). Surrogate indices of insulin sensitivity calculated from insulin and glucose concentrations at fasting or after an oral glucose tolerance test (OGTT) are frequently used, but have not been validated after RYGB. Our aim was to evaluate whether surrogate indices reliably estimate changes in insulin sensitivity after RYGB. Four fasting (inverse-HOMA-IR, HOMA2-%S, QUICKI, revised-QUICKI) and three OGTT-derived surrogates (Matsuda, Gutt, OGIS) were compared with HEC-estimated peripheral insulin sensitivity (Rd or Rd/I, depending on how the index was originally validated) and the tracer-determined hepatic insulin sensitivity index (HISI) in patients with preoperative type 2 diabetes (n=10) and normal glucose tolerance (n=10) 1 week, 3 months and 1 year postoperatively...
February 15, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28194409/a-variant-in-cox-2-gene-is-associated-with-left-main-coronary-artery-disease-and-clinical-outcomes-of-coronary-artery-bypass-grafting
#20
Hanning Liu, Zhengxi Xu, Cheng Sun, Dachuan Gu, Xiao Teng, Yan Zhao, Zhe Zheng
As a particular severe phenotype of coronary artery disease (CAD), left main coronary artery disease (LMCAD) is heritable. Genetic variants related to prostaglandin metabolism are associated with LMCAD. Cyclooxygenase-2 (COX-2), a key synthase in prostaglandin pathways, displays high density in atherosclerotic lesions and promotes early atherosclerosis in CAD progression. We hypothesized that genetic variants in COX-2 gene contribute to LMCAD phenotype susceptibility compared to more peripheral coronary artery disease (MPCAD)...
2017: BioMed Research International
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