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https://www.readbyqxmd.com/read/28098122/a-case-of-abdominal-aortic-thrombosis-associated-with-the-nephrotic-syndrome
#1
Jannet Labidi, Yosra Selmi, Yosra Ben Ariba, Zied Elloumi, Saleh Othmani
Thromboembolic disease is an important and frequent complication in patients with the nephrotic syndrome (NS), and the consequences are often severe. Usually, the venous system is affected. Arterial thrombosis has rarely been reported and occurs mainly in children. We report the case of a 27-year-old man with a history of NS due to focal and segmental glomerulosclerosis resistant to steroids and cyclosporine, admitted for bilateral pain in the calves. Aortogram revealed a suspended thrombus in the abdominal aorta just below the origin of the renal arteries with embolism into the left tibioperoneal trunk and the right anterior tibial artery...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28095924/sonolysis-in-prevention-of-brain-infarctions-during-internal-carotid-endarterectomy-sonobirdie-trial-study-protocol-for-a-randomized-controlled-trial
#2
Tomáš Hrbáč, David Netuka, Vladimír Beneš, Vladimír Nosáľ, Petra Kešnerová, Aleš Tomek, Táňa Fadrná, Vladimír Beneš, Jiří Fiedler, Vladimír Přibáň, Miroslav Brozman, Kateřina Langová, Roman Herzig, David Školoudík
BACKGROUND: Carotid endarterectomy (CEA) is a beneficial procedure for selected patients with an internal carotid artery (ICA) stenosis. Surgical risk of CEA varies from between 2 and 15%. The aim of the study is to demonstrate the safety and effectiveness of sonolysis (continual transcranial Doppler monitoring, TCD) using a 2-MHz diagnostic probe with maximal diagnostic energy on the reduction of the incidence of stroke, transient ischemic attack (TIA) and brain infarction detected using magnetic resonance imaging (MRI) by the activation of the endogenous fibrinolytic system during CEA...
January 17, 2017: Trials
https://www.readbyqxmd.com/read/28092990/in-hospital-statin-underutilization-among-high-risk-patients-delayed-uptake-of-the-2013-cholesterol-guidelines-in-a-u-s-cohort
#3
Subeer K Wadia, Mark Belkin, Kelsey Chow, Jonathan Nattiv, Andrew Appis, Steven B Feinstein, Kim Allan Williams
OBJECTIVES: Clinician utilization of the 2013 cholesterol lowering guidelines remains variable and unknown. We sought to examine statin prescribing patterns and compare rates among specialists who treat high-risk cardiovascular patients admitted to the hospital. METHODS: We retrospectively (via chart review) examined four specialty groups: (i) Cardiology, (ii) Cardiovascular or Vascular (CV) Surgery, (iii) Neurology, and (iv) Internal Medicine. Adult patients were included based on a discharge diagnosis of acute coronary syndrome, coronary artery bypass graft surgery, carotid endarterectomy, acute ischemic stroke, transient ischemic attack, or high-risk chest pain...
January 17, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28090289/an-international-physician-survey-of-chronic-thromboembolic-pulmonary-hypertension-management
#4
Henning Gall, Ioana R Preston, Barbara Hinzmann, Sabina Heinz, David Jenkins, Nick H Kim, Irene Lang
We conducted an international study to evaluate practices in the diagnosis and management of patients with chronic thromboembolic pulmonary hypertension (CTEPH) globally across different regions. Between August and October 2012, CTEPH-treating physicians completed a 15-minute online questionnaire and provided patient record data for their 2-5 most recent patients with CTEPH. Overall, 496 physicians (Europe: 260; United States: 152; Argentina: 52; Japan: 32) completed the questionnaire and provided patient record data for 1,748 patients...
December 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/28078914/appropriate-patient-selection-for-carotid-revascularization-procedures-is-urgently-needed
#5
Kosmas I Paraskevas, Frank J Veith, Dimitri P Mikhailidis, Christos D Liapis
The identification/selection of appropriate patient subgroups with asymptomatic carotid artery stenosis and the performance of prophylactic carotid endarterectomy (CEA)/carotid artery stenting (CAS) exclusively on these asymptomatic patient subgroups is currently one of the "hottest" topics in vascular surgery. It is now clear that offering CEA/CAS to asymptomatic carotid patients based only on the degree of carotid stenosis is unjustified and scientifically flawed. On the other hand, offering only best medical therapy to every asymptomatic patient, irrespective of certain high-risk criteria (such as the detection of microemboli by transcranial Doppler, intraplaque hemorrhage, silent embolic infarcts on brain computed tomography/magnetic resonance imaging, elevated biomarkers, family history), is equally wrong...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28076622/impact-of-surgeon-experience-during-carotid-endarterectomy-operation-and-effects-on-perioperative-outcomes
#6
Volkan Yüksel, Ahmet Coskun Ozdemir, Serhat Huseyin, Orkut Guclu, Fatma Nesrin Turan, Suat Canbaz
Objective: We evaluated the effect of surgeon experience on complication and mortality rates of carotid endarterectomy operation. Methods: Fifty-nine consecutive patients who underwent carotid endarterectomy between January 2013 and February 2016 were divided into two groups. Patients who had been operated by surgeons performing carotid endarterectomy for more than 10 years were allocated to group 1 (experienced surgeons; n=34). Group 2 (younger surgeons; n=25) consisted of patients operated by surgeons independently performing carotid endarterectomy for less than 2 years...
November 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28071288/vulnerable-carotid-plaque-imaging-and-histopathology-without-a-dedicated-mri-receiver-coil
#7
Laura A Fitzpatrick, Nadav Berkovitz, Marlise P Dos Santos, Nevin Majeed, Rafael Glikstein, Santanu Chakraborty, John P Veinot, Grant Stotts, Alain Berthiaume, Robert Chatelain
Stroke is associated with vulnerable carotid artery plaques showing specific histopathologic features, namely a lipid-rich necrotic core, intraplaque hemorrhage, ulceration, and thin fibrous cap. While ultrasound and computed tomography (CT) can identify carotid plaques and determine the extent of stenosis, magnetic resonance imaging (MRI) provides further information regarding plaque composition and morphology. In this feasibility study, three patients with symptomatic, moderately stenosed plaques were imaged with CT angiography (CTA) and MRI (3T and 1...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28070049/-common-factors-for-ischemic-cerebral-stroke-in-coronary-artery-bypass-grafting-in-patients-with-concomitant-carotid-and-coronary-artery-severe-stenosis
#8
Lei Huang, Feng Kuang, Zhonggui Shan, Yiquan Lai, Hongwei Guo
To analyze two common factors for perioperative ischemic stroke in patients with concomitant carotid and coronary artery severe stenosis and to improve the therapeutic effect.
 Methods: A total of 44 patients with multi-vessel coronary artery disease combined with carotid stenosis, who admitted to the Department of Cardiac Surgery, the First Affiliated Hospital of Xiamen University from 2008 to 2014, were enrolled in this study. Among them, 32 cases were male, 12 cases was female. All patients received coronary artery bypass grafting after treatment of neck diseases...
December 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28054896/staged-or-combined-approach-for-carotid-endarterectomy-in-patients-undergoing-coronary-artery-bypass-grafting-a-5-year-long-experience
#9
Kursad Oz, Ünal Aydın, Mugisha Kyaruzi, Zeynep Karaman, Onur Selçuk Göksel, Mehmet Yeniterzi, Ihsan Bakir
BACKGROUND: Optimal surgical approach for patients with hemodynamically significant carotid and coronary disease remains controversial. We analyzed our 5-year experience and compared early and long-term outcome following staged and combined carotid and coronary artery bypass. METHODS: 312 consecutive patients undergoing carotid endarterectomy and coronary artery bypass between 2008 and 2013 were prospectively enrolled in the study. Patients were scheduled for a staged (carotid endarterectomy followed by coronary artery bypass within 1 week) procedure (Group S) unless they were unstable in terms of cardiac status (were deemed to a combined procedure; Group C)...
7, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/28045369/carotid-endarterectomy-following-thrombolysis-for-acute-ischaemic-stroke
#10
Naz Ahmed, Damian Kelleher, Manmohan Madan, Sarita Sochart, George A Antoniou
BACKGROUND: Insufficient evidence exists to support the safety of carotid endarterectomy (CEA) following intravenous thrombolysis (IVT) for acute ischaemic stroke. Our study aimed to report a single-centre experience of patients treated over a five-year period. PATIENTS AND METHODS: Departmental computerised databases were interrogated to identify patients who suffered an ischaemic stroke and subsequently underwent thrombolysis followed by CEA. Mortality and stroke within 30 days of surgery were defined as the primary outcome end points...
January 3, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28045242/evidence-for-periprocedural-antiplatelet-therapy-heparinization-and-bridging-of-coumarin-therapy-in-carotid-revascularization
#11
Art Brand, Gert J DE Borst
Thromboembolism prevention is a crucial factor determining both the natural outcome and outcome of intervention of stenotic atherosclerotic carotid artery pathology. Roughly 80% of all natural course cerebral ischemic events are caused by thromboembolism, versus 20% due to hemodynamic insufficiency. The risk of periprocedural cerebral (micro) thromboembolization during carotid revascularization is considered to be even higher, with a higher rate in carotid artery stenting (CAS) as compared to carotid endarterectomy (CEA)...
January 3, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28041804/endovascular-treatment-of-the-common-femoral-artery-in-the-vascular-quality-initiative
#12
Jeffrey J Siracuse, Kathryn Van Orden, Jeffrey A Kalish, Mohammad H Eslami, Marc L Schermerhorn, Virendra I Patel, Denis Rybin, Alik Farber
OBJECTIVE: Endovascular interventions of the common femoral (CFA) and deep (DFA) femoral arteries are becoming more common. However, there is very little published data for guidance. Our objective was to analyze practice patterns and outcomes from these interventions. METHODS: The Vascular Quality Initiative (2010-2015) was queried for all endovascular interventions of the CFA and DFA. Cases that were emergent or for acute limb ischemia were excluded. Those with isolated CFA with or without DFA treatment were analyzed...
December 29, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28024850/volume-of-subclinical-embolic-infarct-correlates-to-long-term-cognitive-changes-after-carotid-revascularization
#13
Wei Zhou, Brittanie D Baughman, Salil Soman, Max Wintermark, Laura C Lazzeroni, Elizabeth Hitchner, Jyoti Bhat, Allyson Rosen
OBJECTIVE: Carotid intervention is safe and effective in stroke prevention in appropriately selected patients. Despite minimal neurologic complications, procedure-related subclinical microemboli are common and their cognitive effects are largely unknown. In this prospective longitudinal study, we sought to determine long-term cognitive effects of embolic infarcts. METHODS: The study recruited 119 patients including 46% symptomatic patients who underwent carotid revascularization...
December 23, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28018819/a-technical-modification-for-establishing-selective-antegrade-cerebral-perfusion-during-pulmonary-endarterectomy
#14
Martin Czerny, Patrick von Samson, Bernward Passlick, Friedhelm Beyersdorf, Johannes Kroll
Pulmonary endarterectomy (PEA) due to chronic thromboembolic pulmonary hypertension (CTEPH) is mainly performed in deep hypothermic circulatory arrest without additional cerebroprotective means. A 49-year-old man was treated by PEA for CTEPH by using selective antegrade cerebral perfusion by advancing the tip of the systemic perfusion cannula into the brachiocephalic trunk. The postoperative course was uneventful.
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28018503/neurocognitive-improvement-in-patients-undergoing-carotid-endarterectomy-for-atherosclerotic-occlusive-carotid-artery-disease
#15
Rashid Usman, Muhammad Jamil, Imran Ul Haq, Amir Ali Memon
Objectives: To assess the improvement in neurocognitive functions after carotid endarterectomy (CEA) under local anesthesia (LA) in patients with carotid bifurcation occlusive disease. Place and duration of study: Department of Vascular Surgery, Combined Military Hospital Lahore from January 2013 to January 2015. Patients and Methods: A total of 79 patients with carotid artery occlusive disease, having no history of major stroke, depression, or dementia underwent CEA under LA. Cognitive functions were assessed 3 days before surgery and then 4 weeks and 12 weeks after the surgery using the Addenbrookes cognitive examination (ACE) score and General Practitioner Assessment of Cognition (GPCOG) Score...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28018501/regional-anesthesia-with-dexmedetomidine-infusion-a-feasible-method-for-the-awake-test-during-carotid-endarterectomy
#16
Jonggeun Lee, Up Huh, Seunghwan Song, Sung Woon Chung, Sang Min Sung, Han Jin Cho
Background: Carotid endarterectomy (CEA) is the standard treatment modality for the prevention of stroke in patients with carotid stenosis. This study reports our experiences during CEA with routine awake tests under regional anesthesia (RA) combined with light sedation by dexmedetomidine infusion. Materials and Methods: We retrospectively reviewed 23 patients who had undergone CEA between April 2013 and June 2015. All patients underwent the awake test during CEA with cervical plexus block and light sedation by continuous dexmedetomidine infusion...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28018499/advantages-of-selective-use-of-intraluminal-shunt-in-carotid-endarterectomy-a-study-of-122-cases
#17
Muhammad Jamil, Rashid Usman, Salma Ghaffar
Objectives: To assess the advantage of selective use of shunt in carotid endarterectomy (CEA) under local anesthesia. Materials and Methods: A total of 122 consecutive patients fulfilling international guidelines were included. Shunt was used selectively only in cases of bilateral severe carotid artery occlusive disease or in those patients who developed neurological symptoms on clamping of carotid artery. Follow up was done weekly for one month; then every month for 3 months; and then every 3 months for a year...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28011757/haemodynamic-effects-of-riociguat-in-inoperable-recurrent-chronic-thromboembolic-pulmonary-hypertension
#18
Nick H Kim, Andrea M D'Armini, Friedrich Grimminger, Ekkehard Grünig, Marius M Hoeper, Pavel Jansa, Eckhard Mayer, Claus Neurohr, Gérald Simonneau, Adam Torbicki, Chen Wang, Arno Fritsch, Neil Davie, Hossein-Ardeschir Ghofrani
OBJECTIVE: We compared the haemodynamic effects of riociguat in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) or persistent/recurrent CTEPH after pulmonary endarterectomy in the Chronic Thromboembolic Pulmonary Hypertension Soluble Guanylate Cyclase-Stimulator Trial 1 study. METHODS: Patients with inoperable or persistent/recurrent CTEPH (n=261; mean± SD age 59±14 years; 66% women) were randomised to riociguat (up to 2.5 mg three times daily) or placebo...
December 23, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28011672/inflamed-human-carotid-plaques-evaluated-by-pet-ct-exhibit-increased-temperature-insights-from-an-in-vivo-study
#19
Konstantinos Toutouzas, Iosif Koutagiar, Georgios Benetos, Constantina Aggeli, Alexandros Georgakopoulos, Emmanouil Athanasiadis, Nikoletta Pianou, Sofoklis Trachanellis, Nikolaos Patelis, George Agrogiannis, Pavlos Kafouris, Konstantinos Filis, Nikolaos Bessias, Christos Klonaris, George Spyrou, Eleftherios Tsiamis, Elias Siores, Efstratios Patsouris, Dennis Cokkinos, Dimitrios Tousoulis, Constantinos D Anagnostopoulos
AIMS: To explore the relationship between temperature measurements derived by microwave radiometry (MWR) and carotid flurodeoxyglucose (FDG) uptake and assess their association with histological and immunohistochemistry findings in patients with high-grade carotid stenosis. METHODS AND RESULTS: In 21 patients undergoing carotid endarterectomy, carotid inflammation was evaluated by both FDG positron emission/computed tomography (FDG-PET/CT) imaging and MWR measurements...
December 23, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28010865/the-modified-operative-technique-of-partial-eversion-carotid-endarterectomy
#20
Richard McBride, Johnathan Porter, Haytham Al-Khaffaf
We report a modified operative technique termed partial eversion carotid endarterectomy (PECE). During a 9-year period (2006-2015), 352 patients underwent PECE. Indications for surgery, intraoperative details, and outcomes were recorded. The initial 185 patients had carotid duplex ultrasound imaging at 6 weeks and then at 6, 12, and 24 months. Subsequent patients had carotid imaging at 4 to 6 weeks. Indications included stroke (76), transient ischemic attack (153), and amaurosis fugax (33); 58 patients were asymptomatic, and 32 patients had surgery before cardiac surgery...
January 2017: Journal of Vascular Surgery
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