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Peripheral Arterial Obstructive Disease

C Antza, I Doundoulakis, M Natsis, V Kotsis
Artery disease can be identified from ankle-brachial index (peripheral artery disease), pulse wave velocity (arterial stiffness), carotid intima media thickness (atherosclerosis) and flow-mediated dilation (endothelial disfunction). Arterial stiffness is a marker of cardiovascular disease associated with cardiovascular events. Increased vascular ageing is the acceleration of arterial stiffness inappropriate for the given chronological age. Treatment of early vascular ageing seems to be important if we target on primary cardiovascular prevention...
December 4, 2018: Current Pharmaceutical Design
Rodolfo Pini, Enrico Gallitto, Gianluca Faggioli, Chiara Mascoli, Andrea Vacirca, Cecilia Fenelli, Mauro Gargiulo, Andrea Stella
OBJECTIVE: The appropriateness of endovascular aneurysm repair (EVAR) of uncomplicated abdominal aortic aneurysm depends on the risk-benefit ratio, particularly in elderly patients with short life expectancy. The aim of this study was to assess the efficacy of EVAR in >80-year-old patients by evaluating their postoperative survival and analyzing the possible predictors of late mortality. METHODS: All consecutive patients aged >80 years undergoing elective EVAR from 2006 to 2015 were prospectively evaluated...
November 23, 2018: Journal of Vascular Surgery
Thorunn Scheving Eliasdottir
PURPOSE: Continuous peripheral pulse oximetry for monitoring adequacy of oxygenation is probably the most important technological advance for patients' monitoring and safety in the last decades. Pulse oximetry has the disadvantage of measuring the peripheral circulation, and the only mean to measure oxygen content of the central circulation is by invasive technology. Determination of blood oxyhaemoglobin saturation in the retinal vessels of the eye can be achieved noninvasively through spectrophotometric retinal oximetry which provides access to the central nervous system circulation...
November 2018: Acta Ophthalmologica
Hatim Seoudy, Nathalie Güßefeld, Johanne Frank, Sandra Freitag-Wolf, Georg Lutter, Matthias Eden, Ashraf Yusuf Rangrez, Christian Kuhn, Norbert Frey, Derk Frank
INTRODUCTION: The implications of prosthesis-patient mismatch (PPM) in the context of transcatheter aortic valve implantation (TAVI) are still controversial. The objective of our study was thus to investigate the incidence and prognostic impact of PPM after TAVI. METHODS: Our analysis included 613 TAVI patients in whom the indexed effective orifice area (iEOA) after TAVI was obtained in vivo using echocardiography. Prosthesis sizing was guided by pre-procedural ECG-gated computed tomography...
November 19, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
László Wagner, István Wittmann, László Piros, Réka P Szabó, Péter Szakály
Diabetes increases the risk of different kidney diseases. The most important is diabetic nephropathy, however, ischemic kidney disease, chronic pyleonephritis and papilla necrosis may also develop. The prognosis of diabetic nephropathy has improved recently, however, it is still the primary cause of dialysis and transplantation. Cardiovascular diseases predict mostly mortality in diabetic patients, however, cerebrovascular insults and peripheral obstructive arterial diseases necessitating lower limb amputations are also important...
November 2018: Orvosi Hetilap
Paweł Balsam, Monika Gawałko, Michał Peller, Agata Tymińska, Krzysztof Ozierański, Martyna Zaleska, Katarzyna Żukowska, Katarzyna Szepietowska, Kacper Maciejewski, Marcin Grabowski, Mariusz Borkowski, Łukasz Kołtowski, Anna Praska-Oginska, Inna Zaboyska, Grzegorz Opolski, Janusz Bednarski
Congestive heart failure (CHF) and atrial fibrillation (AF) frequently coexist and are associated with increased risk of cardiovascular events.To compare baseline characteristics, comorbidities and pharmacotherapy in AF patients with concomitant CHF to those without CHF.The study included 3506 real-life AF patients with (37.1%) and without CHF - participants of the multicentre, retrospective MultiCenter expeRience in AFib patients Treated with OAC (CRAFT) trial (NCT02987062).All patients were treated with non-vitamin K antagonist oral anticoagulants (NOAC) or vitamin K antagonists (VKA)...
November 2018: Medicine (Baltimore)
Nadav Teich, Dmitry Pevni, Rephael Mohr, Nahum Nesher, Amir Kramer, Yosef Paz, Yanai Ben-Gal
BACKGROUND: The use of two bilateral internal thoracic artery grafting (BITA) was shown to lead to survival benefit. However, operators are reluctant to use BITA with peripheral vascular disease (PVD) because of concerns of increased rates of sternal wound infection and lack of studies supporting survival benefit compared with single internal thoracic artery (SITA) grafting. The aim of this study is to compare outcome BITA grafting versus of SITA and vein grafts in PVD patients. PATIENTS AND METHODS: Six hundred and twenty-one PVD patients who underwent BITA between 1996 and 2011 were compared with 372 patients who underwent SITA...
November 6, 2018: Coronary Artery Disease
Lachmandath Tewarie, Ajay K Moza, Mohammad Amen Khattab, Rüdiger Autschbach, Rashad Zayat
PURPOSE: Timing and ideal reconstructive approach in deep sternal wound infection (DSWI) and mediastinitis still remain controversially debated. We present our own combined surgical strategy of bilateral pectoralis major muscle flap (BPMMF) or omental flap (OF) transposition. METHODS: Between July 2010 and July 2016, poststernotomy patients with DSWI and mediastinitis underwent a secondary wound closure with modified BPMMF (Group A, center for disease control class (CDC)-II, n = 21; Group B, CDC-III, n = 20) or with OF (Group C, CDC-III, n = 19) following vacuum-assisted closure (VAC)...
November 7, 2018: Annals of Thoracic and Cardiovascular Surgery
Juan Marco Figueira Gonçalves, María Dolores Martín Martínez, Lina Inmaculada Pérez Méndez, Miguel Ángel García Bello, Ignacio Garcia-Talavera, Sara García Hernández, David Díaz Pérez, Natalia Bethencourt Martín
The COMCOLD score was developed to quantify the impact of comorbidities on health status in patients with chronic obstructive pulmonary disease (COPD). The objective of this study is to evaluate the association between health status in outpatients with COPD according to COMCOLD score and the GOLD 2017 groups according to symptoms (B and D vs. A and C) and exacerbations (C and D vs. A and B). 439 patients were included. The average score was 2.4 ± 3. 48% of cases had a COMCOLD score >0. The most symptomatic patients (B and D vs...
November 6, 2018: COPD
Ahmet Erdoğan, Arife Polat Düzgün, Kubra Erdoğan, Murat Bulut Özkan, Faruk Coşkun
Diabetic foot ulcer is a common chronic complication of diabetes mellitus. In addition to conventional primary therapy, there are adjuvant therapy methods such as hyperbaric oxygen therapy for the healing of diabetic foot ulcer wounds. The present study aimed to determine the efficacy of hyperbaric oxygen therapy in diabetic foot ulcers based on Wagner classification. It was performed retrospectively from prospectively collected data. One hundred thirty patients with diabetic foot ulcers were assessed in 2 groups: 1 group received hyperbaric oxygen therapy; the other group did not...
November 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Anna M Nordenskjöld, Bo Lagerqvist, Tomasz Baron, Tomas Jernberg, Nermin Hadziosmanovic, Harmony R Reynolds, Per Tornvall, Bertil Lindahl
BACKGROUND: Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is common. There are limited data on the mechanisms and prognosis for reinfarction in MINOCA patients. METHODS: In this observational study of MINOCA patients hospitalized in Sweden and registered in the SWEDEHEART registry between July 2003 and June 2013 and followed until December 2013 we identified 9,092 unique patients with MINOCA out of 199,163 MI admissions in total. The 570 (6...
October 24, 2018: American Journal of Medicine
Carlos Branco, Gonçalo F Coutinho, Filipe Soares, Pedro E Antunes, Manuel J Antunes
BACKGROUND: Complete revascularization is the gold standard of coronary artery bypass grafting (CABG). However, the rationale for revascularization of all diseased vessels is questionable. We aimed at evaluating the impact of multiple versus single grafts in each diseased coronary territory in the long-term survival and incidence of major adverse cardiac and cerebrovascular events (MACCE). METHODS: From January/00 to November/15, 5.694 consecutive patients were submitted to isolated CABG, of whom 4...
January 2018: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Fehmi Kacmaz, Adnan Kaya, Muhammed Keskin, Serdar Keceoglu, Ibrahim Halil Algin, Bayram Yilmazkaya, Erdogan Ilkay
Objective Buerger's disease is one of the worst diseases causing peripheral artery occlusions (especially lower extremity) with increased morbidity and mortality. Endovascular treatment of the diseased arteries gains preference over bypass surgery nowadays. Here, we aimed to present the clinical outcomes of 16 consecutive Buerger's disease patients underwent extended endovascular recanalization which is a new technique to restore direct blood flow to at least one foot artery, with the performance of angioplasty for each tibial and foot artery obstructions...
October 10, 2018: Vascular
Todd H Wagner, Brack Hattler, Faisal G Bakaeen, Joseph F Collins, G Hossein Almassi, Jacquelyn A Quin, Frederick L Grover, Muath Bishawi, A Laurie W Shroyer
BACKGROUND: Coronary artery bypass surgery (CABG) is a common surgical treatment for ischemic heart disease. Little is known about the long-term costs of conducting the surgery on-pump or off-pump. METHODS: As part of the Randomized On/Off Bypass follow-up study, we followed 2,203 participants randomized to on-pump (n = 1,099) and off-pump (n = 1,104) CABG for 5 years using Department of Veterans Affairs and Medicare administrative data. We examined annual costs through 5 years, standardized to 2016 dollars, using multivariate regression models, controlling for site and baseline patient factors...
September 28, 2018: Annals of Thoracic Surgery
Yunzhe Wang, Cong-Lin Liu, Jes S Lindholt, Guo-Ping Shi, Jinying Zhang
OBJECTIVE/BACKGROUND: The development of an abdominal aortic aneurysm (AAA) involves extensive extracellular matrix remodelling, leading to aortic wall weakening. This process is mediated by proteases, including cysteinyl cathepsins. Cystatins are their endogenous inhibitors. This study tested whether plasma cystatin B levels in patients with AAA differed from those of healthy controls. METHODS: Plasma samples from patients with AAA and age matched controls were selected from the Viborg Vascular (VIVA) screening trial for AAA...
September 24, 2018: European Journal of Vascular and Endovascular Surgery
Demet Ozkaramanli Gur, Ozcan Gur, Savas Guzel, Aydin Akyuz, Selami Gurkan, Seref Alpsoy, Nisa Simge Gulec, Fatma Koc
AIM: Peripheral artery disease (PAD) is a manifestation of atherosclerosis with poor prognosis. It is generally complicated by vascular calcification, which is located either in the intima as patchy infiltrates; or circumferentially in the media, also known as medial arterial calcification (MAC). Obstructive PAD is reflected by low anklebrachial index (ABI ≤ 0.9), whereas MAC is revealed by high ABI (ABI >1.4). Considering the increase in cardiovascular mortality at both ends of the ABI spectrum, this study aimed to explore the underlying pathology through cytokines with established prognostic significance; namely pentraxin-3(PTX3), high sensitivity C-reactive protein (hsCRP), copeptin, soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), NT-proBNP, and neopterin...
September 25, 2018: Journal of Atherosclerosis and Thrombosis
Damian Hudziak, Adrianna M Nowak, Radosław Gocoł, Radosław Parma, Joanna Ciosek, Andrzej Ochała, Marek Deja, Wojciech Wojakowski
AIM OF STUDY: The aim of the study was to assess safety TAVI procedure through the common carotid artery in high-vascular-risk patients. METHODS: The approach was selected by a multidisciplinary (cardiologists and cardiac surgeons) heart team after analyzing preoperative coronary angiography, TTE and MSCT of the peripheral arteries. Patients with the following conditions were qualified to the transcarotid access: severe PAD (stenotic, heavily calcified), tortuous or small diameter < 6 mm iliofemoral arteries, descending and abdominal aortic disease...
September 13, 2018: Minerva Cardioangiologica
Karri T Utriainen, Juhani K Airaksinen, Olli J Polo, Harry Scheinin, Ruut M Laitio, Kari A Leino, Tero J Vahlberg, Tom A Kuusela, Timo T Laitio
OBJECTIVE: Obstructive sleep apnea (OSA) is common in peripheral arterial disease (PAD) and associates with high mortality after surgery. Since abnormal heart rate variability (HRV) is predictive of postoperative complications, we investigated the relations of HRV with PAD, OSA and major adverse cardiovascular and cerebrovascular events (MACCE). MATERIALS AND METHODS: Seventy-five patients (67±9 years) scheduled for sub-inguinal revascularization and 15 controls (63±6 years) underwent polysomnography and HRV analyses...
2018: PloS One
Hongbao Ma, Steven Lee, Yan Yang, Puneet Bedi, Shyan-Yih Chou
Tubulointerstitial fibrosis (TIF) is a hallmark of chronic kidney disease resulting from diverse etiologies and predicts severity and progression of the kidney disease. To investigate the pathogenesis of TIF, complete unilateral ureteral obstruction (UUO) is the most widely used animal model. However, UUO precludes evaluation of renal function. In the present study, we created a rat model of chronic partial ureteral obstruction (PUO), which allowed assessment of renal function at different intervals after obstruction...
August 23, 2018: Pathophysiology: the Official Journal of the International Society for Pathophysiology
Anouk W Vaes, Martijn A Spruit, Jan Theunis, Emiel F M Wouters, Patrick De Boever
BACKGROUND: Patients with COPD are frequently diagnosed with cardiovascular disease. Peripheral endothelial dysfunction is an underlying mechanism and can be used as an early marker of cardiovascular impairment. To date, little is known on the association between peripheral endothelial dysfunction, cardiovascular risk factors and measurements of exercise capacity in patients with COPD. Therefore, we aimed to determine the relation between endothelial function and patient characteristics, cardiovascular risk factors and (micro)vascular and functional performance in patient with CODP...
September 2018: Respiratory Medicine
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