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Small vessel disease

Michael Korenkov
The video-assisted subcutaneous destruction of the sinus tract (VADST) is a novel, minimally-invasive technique for the treatment of pilonidal sinus disease (PSD). This is an advancement of the previously described subcutaneous destruction of the sinus tract and the removal of hairs as well as the long-term vessel-loop drainage of the wound channel (DST). Although the first results of this operation seemed to be promising, some of my colleagues felt that the blind approach to this procedure could be its potential "weak point"...
March 12, 2018: Surgical Technology International
Chakradhari Inampudi, Emmanuel Akintoye, Tomo Ando, Alexandros Briasoulis
Peripheral arterial disease (PAD) refers to narrowing of the peripheral arteries and atherosclerosis is the most important cause. In patients with PAD, revascularization is the preferred therapeutic strategy; nonetheless several patients are not deemed candidates for it due to advanced disease or several comorbidities. The main target of therapeutic angiogenesis is to promote development of new arterial vessels and improve perfusion of ischemic tissue. Angiogenic growth factors such as vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF), hepatocyte growth factor (HGF), administered intramuscularly or intra-arterially, have been shown to promote angiogenesis and development of collateral vasculature in preclinical studies...
March 9, 2018: Current Opinion in Pharmacology
Nicole Gilgen, Ahmed Farah, Bruno Scheller, Marc-Alexander Ohlow, Norman Mangner, Daniel Weilenmann, Jochen Wöhrle, Peiman Jamshidi, Gregor Leibundgut, Sven Möbius-Winkler, Robert Zweiker, Florian Krackhardt, Christian Butter, Leonhard Bruch, Christoph Kaiser, Andreas Hoffmann, Peter Rickenbacher, Christian Mueller, Frank-Peter Stephan, Michael Coslovsky, Raban Jeger
BACKGROUND: The treatment of coronary small vessel disease (SVD) remains an unresolved issue. Drug-eluting stents (DES) have limited efficacy due to increased rates of instent-restenosis, mainly caused by late lumen loss. Drug-coated balloons (DCB) are a promising technique since native vessels remain structurally unchanged. METHODS: BASKET-SMALL 2 is a multicenter, randomized, controlled, non-inferiority trial of DCB vs. DES in native SVD for clinical endpoints...
March 11, 2018: Clinical Cardiology
R Guerrero, C Qin, O Oktay, C Bowles, L Chen, R Joules, R Wolz, M C Valdés-Hernández, D A Dickie, J Wardlaw, D Rueckert
White matter hyperintensities (WMH) are a feature of sporadic small vessel disease also frequently observed in magnetic resonance images (MRI) of healthy elderly subjects. The accurate assessment of WMH burden is of crucial importance for epidemiological studies to determine association between WMHs, cognitive and clinical data; their causes, and the effects of new treatments in randomized trials. The manual delineation of WMHs is a very tedious, costly and time consuming process, that needs to be carried out by an expert annotator (e...
2018: NeuroImage: Clinical
M Gasser, M H Frank, A M Waaga-Gasser
Critical chronic ischemia in patients with underlying arterial occlusive disease requires vascular reconstructive surgery. The limited supply of suitable small-diameter autologous vascular grafts in many patients and obvious disadvantages of synthetic bypass material demand the development of clinically usable tissue-engineered blood vessel substitutes. Despite substantial progress in the field over the last two decades, their implementation into the clinical routine has been challenging. The limited replicative life span of human adult vascular cells and their slow rate of collagenous matrix production in vitro have posed important problems in the development of mechanically robust and biologically functional engineered grafts...
February 2018: Gefässchirurgie: Zeitschrift Für Vaskuläre und Endovaskuläre Chirurgie
Hua Zhou, Yan Tang, Zhi Yuan
White matter (WM) asymmetries of the human brain have been well documented using diffusion tensor imaging (DTI). The purpose of this study was to investigate white matter asymmetry across the whole brain in cerebral small vessel disease (SVD) patients and evaluate the relation between the factors which often represent disease's existence and white matter asymmetry. A total of 105 nondemented elderly with cerebral SVD patients aged between 60 and 85 years were included in this study. All participants underwent T1 MPRAGE, fluid-attenuated inversion recovery and DTI scanning...
2018: Journal of Integrative Neuroscience
Marie-Nathalie Kolopp-Sarda, Pierre Miossec
Cryoglobulins are immunoglobulins precipitating in cold condition. They are classified in 3 types according to the Brouet classification and may lead to vasculitis of small and medium size vessels. Vasculitis is related to vessel obstruction by monoclonal cryoglobulin aggregates in type I cryoglobulins and immune complex deposition in type II and III mixed cryoglobulins. This phenomenon is favored by low temperature, especially in skin, joints, and peripheral nerves, or increased cryoglobulin concentration in kidneys...
March 8, 2018: Autoimmunity Reviews
Raffaele Pesavento, Paolo Prandoni
Chronic thromboembolic pulmonary hypertension (CTEPH) is an uncommon and late complication of pulmonary embolism resulting from misguided remodelling of residual pulmonary thromboembolic material and small-vessel arteriopathy. CTEPH is the only form of pulmonary hypertension (PH) potentially curable by pulmonary endarterectomy (PEA). Unfortunately, several patients have either an unacceptable risk-benefit ratio for undergoing the surgical intervention or develop persistent PH after PEA. Novel medical and endovascular therapies can be considered for them...
March 2, 2018: Thrombosis Research
Bian Liu, Kui Kai Lau, Linxin Li, Caroline Lovelock, Ming Liu, Wilhelm Kuker, Peter M Rothwell
BACKGROUND AND PURPOSE: It has been hypothesized that cerebral small vessel disease (SVD) and chronic renal impairment may be part of a multisystem small-vessel disorder, but their association may simply be as a result of shared risk factors (eg, hypertension) rather than to a systemic susceptibility to premature SVD. However, most previous studies were hospital based, most had inadequate adjustment for hypertension, many were confined to patients with lacunar stroke, and none stratified by age...
March 9, 2018: Stroke; a Journal of Cerebral Circulation
Matilde Balbi, Matthieu P Vanni, Max J Vega, Gergely Silasi, Yuki Sekino, Jamie D Boyd, Jeffrey M LeDue, Timothy H Murphy
Small vessel disease is characterized by sporadic obstruction of small vessels leading to neuronal cell death. These microinfarcts often escape detection by conventional magnetic resonance imaging and are identified only upon postmortem examination. Our work explores a brain-wide microinfarct model in awake head-fixed mice, where occlusions of small penetrating arterioles are reproduced by endovascular injection of fluorescent microspheres. Mesoscopic functional connectivity was mapped longitudinally in awake GCaMP6 mice using genetically encoded calcium indicators for transcranial wide-field calcium imaging...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
Alfredo E Rodriguez, Carlos Fernandez-Pereira, Juan Mieres, Hernan Pavlovsky, Juan Del Pozo, Alfredo M Rodriguez-Granillo, David Antoniucci
In recent years angiographic risk scores have been introduced in clinical practice to stratify different levels of risk after percutaneous coronary interventions (PCI). The SYNTAX score included all intermediate lesions in vessels ≥1.5 mm, consequently, multiple stent implantation was required. Four years ago, we built a new angiographic score in order to guide PCI strategy avoiding stent deployment both in intermediate stenosis as in small vessels, therefore these were not scored (ERACI risk score). The purpose of this mini review is to validate the strategy of PCI guided by this scoring, taking into account long term follow up outcomes of two observational and prospective registries where this policy was used...
February 13, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Di Tang, Siyuan Chen, Ding Hou, Jingchen Gao, Li Jiang, Jie Shi, Qinge Liang, Deling Kong, Shufang Wang
As an effective clinic treatment for cardiovascular disease, vascular transplantation gains much acceptance recently. However, due to the acute thrombosis and intimal hyperplasia, long-term failure of synthetic grafts after implanted in small diameter blood vessel decelerates its commercial use. The continued acute inflammation and delayed endothelialization have been considered as fundamental reasons. To enhance the adhesion and organization of endothelial cells (ECs) and improve the vascular remodeling process, we have constructed a vascular graft based on electrospun polycaprolactone (PCL) matrix, on which organoselenium-immobilized polyethyleneimine (SePEI) for in situ nitric oxide (NO) generation and hyaluronic acid (HA) grafted with poly (ethylene glycol) (PEG) modified Tyr-Ile-Gly-Ser-Arg (YIGSR) for antifouling and EC adhesion were deposited through electrostatic layer-by-layer assembly...
March 1, 2018: Materials Science & Engineering. C, Materials for Biological Applications
Saverio La Francesca, Johnathon M Aho, Matthew R Barron, Ellen W Blanco, Sherif Soliman, Lena Kalenjian, Ariel D Hanson, Elisaveta Todorova, Matthew Marsh, KaLia Burnette, Harout DerSimonian, Robert D Odze, Dennis A Wigle
Treatment of esophageal disease can necessitate resection and reconstruction of the esophagus. Current reconstruction approaches are limited to utilization of an autologous conduit such as stomach, small bowel, or colon. A tissue engineered construct providing an alternative for esophageal replacement in circumferential, full thickness resection would have significant clinical applications. In the current study, we demonstrate that regeneration of esophageal tissue is feasible and reproducible in a large animal model using synthetic polyurethane electro-spun grafts seeded with autologous adipose-derived mesenchymal stem cells (aMSCs) and a disposable bioreactor...
March 7, 2018: Scientific Reports
Giuseppe Tarantini, Giulia Masiero, Alberto Barioli, Valeria Paradies, Georgios Vlachojannis, Paola Tellaroli, Bernardo Cortese, Gaetano di Palma, Attilio Varricchio, Alfonso Ielasi, Bruno Loi, Giuseppe Steffenino, Daisuke Ueshima, Marco Mojoli, Pieter Smits
BACKGROUND: Patients with small vessel disease (SVD) are at higher risk of adverse events after PCI compared to non-SVD patients. In this subset, the use of bioresorbable vascular scaffolds (BVS) has raised particular concern. OBJECTIVE: We aimed to compare outcomes of Absorb BVS versus a 2nd-generation metallic everolimus-eluting stents (EES) in the SVD setting, by pooling patients from three large, prospective studies. METHODS: Patients with SVD (reference vessel diameter ≤2...
March 7, 2018: Catheterization and Cardiovascular Interventions
Ashish Joshi, Sushil Falodia, Naveen Kumar, R L Solanki
Strictures of the small intestine have been attributed many causes of Crohn's disease, nonsteroidal anti-inflammatory drugs, neoplastic, post-surgical, and corrosive ingestion. Opium as a cause of small intestine strictures has not been described. Six cases of opium addicts diagnosed with small intestine strictures were selected after excluding the possible etiology of strictures. Investigations like upper gastrointestinal endoscopy, colonoscopy (in patients with small intestinal obstruction), barium meal follow-through, and histopathology of strictures were done in all patients...
March 7, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Jing Yu, Ning Xu, Ying Zhao, Jinlu Yu
The anterior choroidal artery (AChA) is a critical artery in brain physiology and function. The AChA is involved in many diseases, including aneurysm, brain infarct, Moyamoya disease (MMD), brain tumor, arteriovenous malformation (AVM), etc. The AChA is vulnerable to damage during the treatment of these diseases and is thus a very important vessel. However, a comprehensive systematic review of the importance of the AChA is currently lacking. In this study, we used the PUBMED database to perform a literature review of the AChA to increase our understanding of its role in neurophysiology...
2018: International Journal of Medical Sciences
Iain D Croall, Daniel J Tozer, Barry Moynihan, Usman Khan, John T O'Brien, Robin G Morris, Victoria C Cambridge, Thomas R Barrick, Andrew M Blamire, Gary A Ford, Hugh S Markus
Importance: Blood pressure (BP) lowering is considered neuroprotective in patients with cerebral small vessel disease; however, more intensive regimens may increase cerebral hypoperfusion. This study examined the effect of standard vs intensive BP treatment on cerebral perfusion in patients with severe small vessel disease. Objective: To investigate whether standard vs intensive BP lowering over 3 months causes decreased cerebral perfusion in small vessel disease...
March 5, 2018: JAMA Neurology
Gurpreet Jaswal, Walter Swardfager, Fu-Qiang Gao, Sean M Nestor, Anoop Ganda, Hugo Cogo-Moreira, Demetrios J Sahlas, Donald T Stuss, Alan Moody, Sandra E Black
The relationships between cholinergic system damage and cerebrovascular disease are not entirely understood. Here, we investigate associations between atrophy of the substantia innominata (SI; the origin of cortical cholinergic projections) and measures of large and small vessel disease; specifically, elongation of the juxtaposed internal carotid artery termination and Cholinergic Pathways Hyperintensity scores (CHIPS). The study (n = 105) consisted of patients with Alzheimer's disease (AD) and/or subcortical ischemic vasculopathy, and elderly controls...
February 10, 2018: Neurobiology of Aging
Francesc Jiménez-Altayó, Judith Sànchez-Ventura, Elisabet Vila, Lydia Giménez-Llort
Cardiovascular disease resulting from oxidative stress and inflammation can exacerbate Alzheimer's disease. This brief report provides the first evidence of compromised small peripheral mesenteric resistance artery (MRA) properties in 15-month-old 3xTg-AD mice. Females showed worse physiologically relevant MRA structural (increased passive external and internal diameters, cross sectional area) and functional (increased active internal diameter) alterations suggesting sex-dependent dysfunctions. At both physiological and high intraluminal pressures, vascular alterations correlated with the anxious-like behavioral profile, in a sex-dependent manner...
February 28, 2018: Journal of Alzheimer's Disease: JAD
Pankaj D Mehta, Bruce A Patrick, Marc Barshatzky, Sangita P Mehta, Janusz Frackowiak, Bozena Mazur-Kolecka, Jerzy Wegiel, Thomas Wisniewski, David L Miller
N-terminally truncated pyroglutamate amyloid-β (Aβ) peptide starting at position 3 represents a significant fraction of Aβ peptides (pE3-Aβ) in amyloid plaques of postmortem brains from patients with Alzheimer's disease (AD) and older persons with Down syndrome (DS). Studies in transgenic mouse models of AD also showed that pE3-Aβ is a major component of plaques, and mouse monoclonal antibody to pE3-Aβ appears to be a desirable therapeutic agent for AD. Since small peptides do not typically elicit a good immune response in mice, but do so favorably in rabbits, our aims were to generate and partially characterize a rabbit monoclonal antibody (RabmAb) to pE3-Aβ...
August 22, 2018: Journal of Alzheimer's Disease: JAD
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