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Arterial wounds

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https://www.readbyqxmd.com/read/28445858/the-impact-of-minor-blood-transfusion-on-the-outcome-after-coronary-artery-bypass-grafting
#1
Eeva-Maija Kinnunen, Marco Zanobini, Francesco Onorati, Debora Brascia, Giovanni Mariscalco, Ilaria Franzese, Vito G Ruggieri, Karl Bounader, Andrea Perrotti, Francesco Musumeci, Giuseppe Santarpino, Daniele Maselli, Saverio Nardella, Helmut Gulbins, Riccardo Gherli, Antonino S Rubino, Carmelo Mignosa, Marisa De Feo, Giuseppe Gatti, Francesco Santini, Antonio Salsano, Magnus Dalén, Matteo Saccocci, Daniel Reichart, Giuseppe Faggian, Tiziano Gherli, Francesco Nicolini, Fausto Biancari
PURPOSE: To investigate the impact of minor perioperative bleeding requiring transfusion of 1-2 red blood cell (RBC) units on the outcome after coronary artery bypass grafting (CABG). METHODS: Sixteen cardiac surgical centers contributed to the prospective European CABG registry (E-CABG). 1014 patients receiving 1-2 RBC units during or after isolated CABG were compared to 2264 patients not receiving RBCs. RESULTS: In 827 propensity score matched pairs, transfusion of 1-2 RBC units did not affect the risk of in-hospital/30-day death (p=0...
April 19, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28445461/tumour-ischaemia-by-interferon-%C3%AE-resembles-physiological-blood-vessel-regression
#2
Thomas Kammertoens, Christian Friese, Ainhoa Arina, Christian Idel, Dana Briesemeister, Michael Rothe, Andranik Ivanov, Anna Szymborska, Giannino Patone, Severine Kunz, Daniel Sommermeyer, Boris Engels, Matthias Leisegang, Ana Textor, Hans Joerg Fehling, Marcus Fruttiger, Michael Lohoff, Andreas Herrmann, Hua Yu, Ralph Weichselbaum, Wolfgang Uckert, Norbert Hübner, Holger Gerhardt, Dieter Beule, Hans Schreiber, Thomas Blankenstein
The relative contribution of the effector molecules produced by T cells to tumour rejection is unclear, but interferon-γ (IFNγ) is critical in most of the analysed models. Although IFNγ can impede tumour growth by acting directly on cancer cells, it must also act on the tumour stroma for effective rejection of large, established tumours. However, which stroma cells respond to IFNγ and by which mechanism IFNγ contributes to tumour rejection through stromal targeting have remained unknown. Here we use a model of IFNγ induction and an IFNγ-GFP fusion protein in large, vascularized tumours growing in mice that express the IFNγ receptor exclusively in defined cell types...
April 26, 2017: Nature
https://www.readbyqxmd.com/read/28441850/-clinical-application-of-one-stage-operation-of-epicardial-permanent-pacemaker-implantation-and-cardiac-surgery
#3
C L Ren, S L Jiang, C S Xiao, R Wang, C Q Gao
Objective: To summarize the results and clinical application experience of one-stage operation of epicardial permanent pacemaker implantation and cardiac surgery. Methods: From November 2014 to July 2016, 15 patients (9 males and 6 females) with ages ranging from 50 to 73 (63.5±6.2) years requiring cardiac surgery with bradycardia underwent one-stage operation of epicardial permanent pacemaker implantation and cardiac surgery. All operations were performed under general anesthesia with chest median incision approach...
April 25, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28438400/arteriotomy-closure-devices-in-evar-tevar-and-tavr-a-systematic-review-and-meta-analysis-of-randomised-clinical-trials-and-cohort-studies
#4
REVIEW
B P Vierhout, R A Pol, M El Moumni, C J Zeebregts
OBJECTIVES: Cardiac and vascular surgery benefit from percutaneous interventions. Arteriotomy closure devices (ACDs) enable minimally invasive access to the common femoral artery (CFA). The objective of this review was to assess the differences between ACDs and surgical cut down (SCD) of the CFA regarding the number of complications, duration of surgery (DOS), and hospital length of stay (HLOS). DESIGN: A systematic literature search with predefined search terms was performed using MEDLINE, Embase, and the Cochrane Library (2000-2016)...
April 21, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28429889/omentin-treatment-of-epicardial-fat-improves-its-anti-inflammatory-activity-and-paracrine-benefit-on-smooth-muscle-cells
#5
Ángel Fernández-Trasancos, Rosa María Agra, Jose María García-Acuña, Ángel Luis Fernández, José Ramón González-Juanatey, Sonia Eiras
OBJECTIVE: Epicardial adipose tissue (EAT) in coronary artery disease is insulin resistant and has a proinflammatory profile. This study examined the regulation of EAT by exogenous omentin and its consequence on vascular cells. METHODS: Stromal vascular cells (SC) of EAT and subcutaneous adipose tissue (SAT) from patients who underwent heart surgery were cultured and exposed to adipogenic factors with or without omentin. Proinflammatory cytokine regulation by omentin was analyzed in SC and mature adipocytes...
April 21, 2017: Obesity
https://www.readbyqxmd.com/read/28425594/trilobed-pedicled-superior-gluteal-artery-perforator-flap-for-lumbosacral-defect-coverage
#6
Ji Min Kim, Jun Ho Lee, Deuk Young Oh, Suk-Ho Moon
BACKGROUND: There are many available options for the coverage of lumbosacral area defects. Surgeons usually use the superior gluteal artery perforator flap (SGAP) by rotational fashion, which risks complications, such as wound dehiscence or skin necrosis at the Y-point on the donor site due to the tension. In this report, the authors present the experience of using trilobed pedicled SGAP flaps in coverage of the lumbosacral area defects. METHODS: From 2011 to 2015, 16 trilobed pedicled SGAP flaps were performed for the coverage of sacral defects in our facility...
April 20, 2017: Microsurgery
https://www.readbyqxmd.com/read/28424126/the-novel-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-to-explore-a-retroperitoneal-hematoma-in-a-hemodynamically-unstable-patient
#7
Martin D Rosenthal, Ahsan Raza, Stephanie Markle, Chasen A Croft, Alicia M Mohr, R Stephen Smith
Balloon occlusion of the aorta was first described by C.W. Hughes in 1954, when it was used as a tamponade device for three wounded soldiers during the Korean War suffering from intra-abdominal hemorrhage. Currently, the device is indicated in trauma patients as a surrogate for resuscitative thoracotomy. Brenner et al. reported a case series describing the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in advanced hemorrhagic shock. Their conclusion was that "it is a feasible method for proximal aortic control...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28423122/development-and-validation-of-a-stratification-tool-for-predicting-risk-of-deep-sternal-wound-infection-after-coronary-artery-bypass-grafting-at-a-brazilian-hospital
#8
Michel Pompeu Barros Oliveira Sá, Paulo Ernando Ferraz, Artur Freire Soares, Rodrigo Gusmão Albuquerque Miranda, Mayara Lopes Araújo, Frederico Vasconcelos Silva, Ricardo de Carvalho Lima
Objective: Deep sternal wound infection following coronary artery bypass grafting is a serious complication associated with significant morbidity and mortality. Despite the substantial impact of deep sternal wound infection, there is a lack of specific risk stratification tools to predict this complication after coronary artery bypass grafting. This study was undertaken to develop a specific prognostic scoring system for the development of deep sternal wound infection that could risk-stratify patients undergoing coronary artery bypass grafting and be applied right after the surgical procedure...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28422830/management-of-the-extensive-thoracic-defects-after-deep-sternal-wound-infection-with-the-rectus-abdominis-myocutaneous-flap-a-retrospective-case-series
#9
Yue-Hua Li, Zhao Zheng, Jiaomei Yang, Lin-Lin Su, Yang Liu, Fu Han, Jia-Qi Liu, Da-Hai Hu
Deep sternal wound infection is a severe complication after open heart surgery. According to the different severity and dimensions of the deep sternal wound infection, the treatment method is different. In this study, we aimed to describe our experience with the rectus abdominis myocutaneous flap for large sternal wound management, especially when 1 or 2 internal mammary arteries were absent.Between October 2010 and January 2016, a retrospective review of 9 patients who suffered from the extensive thoracic defects after deep sternal wound infection was conducted...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28413025/biochemical-and-biological-attributes-of-matrix-metalloproteinases
#10
Ning Cui, Min Hu, Raouf A Khalil
Matrix metalloproteinases (MMPs) are a family of zinc-dependent endopeptidases that are involved in the degradation of various proteins in the extracellular matrix (ECM). Typically, MMPs have a propeptide sequence, a catalytic metalloproteinase domain with catalytic zinc, a hinge region or linker peptide, and a hemopexin domain. MMPs are commonly classified on the basis of their substrates and the organization of their structural domains into collagenases, gelatinases, stromelysins, matrilysins, membrane-type (MT)-MMPs, and other MMPs...
2017: Progress in Molecular Biology and Translational Science
https://www.readbyqxmd.com/read/28407473/trimodal-rescue-of-hind-limb-ischemia-with-growth-factors-cells-and-nanocarriers-fundamentals-to-clinical-trials
#11
Rajesh Laksmanan, Gopi Ukani, Muhammad Tipu Rishi, Nilanjana Maulik
Peripheral Artery Disease is a severe medical condition commonly characterized by critical or acute limb ischemia. Gradual accumulation of thrombotic plaques in peripheral arteries of the lower limb may lead to intermittent claudication or ischemia in muscle tissue. Ischemic muscle tissue with lesions may become infected, resulting in a non-healing wound. Stable progression of the non-healing wound associated with severe ischemia might lead to functional deterioration of the limb, which, depending on the severity, can result in amputation...
April 13, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28402472/direct-sternal-administration-of-vancomycin-and-gentamicin-during-closure-prevents-wound-infection%C3%A2
#12
Martin Andreas, Moritz Muckenhuber, Doris Hutschala, Alfred Kocher, Florian Thalhammer, Paul Vogt, Tatjana Fleck, Guenther Laufer
OBJECTIVES: Deep sternal wound infection is still a major complication in patients undergoing cardiac surgery. We previously identified mammary artery harvesting as a risk factor for decreased antibiotic tissue penetration. In addition, other risk factors including diabetes may inhibit sufficient tissue penetration of perioperative antibiotic prophylaxis. A novel closure protocol applying 2 topical antibiotics and further recommendations for sternal wiring was introduced at our department to decrease the incidence of sternal wound infections...
April 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28395882/should-studies-on-glanzmann-thrombasthenia-not-be-telling-us-more-about-cardiovascular-disease-and-other-major-illnesses
#13
REVIEW
Alan T Nurden
Glanzmann thrombasthenia (GT) is a rare inherited bleeding disorder caused by loss of αIIbβ3 integrin function in platelets. Most genetic variants of β3 also affect the widely expressed αvβ3 integrin. With brief mention of mouse models, I now look at the consequences of disease-causing ITGA2B and ITGB3 mutations on the non-hemostatic functions of platelets and other cells. Reports of arterial thrombosis in GT patients are rare, but other aspects of cardiovascular disease do occur including deep vein thrombosis and congenital heart defects...
April 4, 2017: Blood Reviews
https://www.readbyqxmd.com/read/28394520/-laparoscopic-partial-nephrectomy-with-superselective-balloon-embolization-of-renal-artery
#14
A V Maksimov, A G Martov, L P Pavlov, P A Neustroev, R R Vinokurov
AIM: To use superselective balloon embolization of segmental branches of the renal artery for intraoperative hemostasis during partial nephrectomy for renal malignancy. MATERIALS AND METHODS: From October 2015 to September 2016, 11 patients, including 3 males and 8 females aged 29-72 (mean 56.8) years underwent laparoscopic partial nephrectomy with superselective balloon embolization. In 5 and 6 cases the tumors were located in the right and left kidney, respectively, and in 7, 1 and 3 cases they were found in lower, upper and middle segments, respectively...
April 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28393434/multivisceral-transplantation-for-abdominal-tumors-in-children-a-single-center-experience-and-review-of-the-literature
#15
Eliza Lee, Nicole Hodgkinson, Rima Fawaz, Khashayar Vakili, Heung Bae Kim
Standard management of intra-abdominal pediatric solid tumors requires complete resection. However, tumors with multiple organ and vascular involvement present a unique surgical challenge. We conducted a retrospective chart review of four patients, aged 2-14 years, undergoing MVT for intra-abdominal tumors with significant involvement of the visceral arteries and/or portomesenteric venous system at our institution. Indications for MVT included hepatocellular carcinoma, inflammatory myofibroblastic tumor, and two cases of hepatoblastoma...
April 9, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28390919/symptomatic-deep-femoral-artery-pseudoaneurysm-endovascular-exclusion-case-report-and-literature-review
#16
Felice Pecoraro, Ettore Dinoto, Umberto M Bracale, Giovanni Badalamenti, Arduino Farina, Guido Bajardi
Deep femoral artery pseusoaneurysms (DFAPs) are rare and generally occur after penetrating trauma or surgical procedures. A 36-year old obese man presented with pain in correspondence of the anterior-lateral thigh after 6 months from gunshot wound. Duplex and computed tomography (CT) showed a bilobed right DFAP (maximal diameter 12.9 cm). The patient was managed urgently, under local anaesthesia, by placement in the distal DFA of a Viabahn 8 x 100mm stent-graft (W L Gore & Associates, Inc). The post-operative course was uneventful and the 24-months CT showed regular stent-graft patency and 20 mm DFPA shrinkage...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28360090/testosterone-prevents-cutaneous-ischemia-and-necrosis-in-males-through-complementary-estrogenic-and-androgenic-actions
#17
Caroline Chenu, Marine Adlanmerini, Frederic Boudou, Elodie Chantalat, Anne-Laure Guihot, Celine Toutain, Isabelle Raymond-Letron, Patricia Vicendo, Alain-Pierre Gadeau, Daniel Henrion, Jean-Francois Arnal, Francoise Lenfant
OBJECTIVE: Chronic nonhealing wounds are a substantial medical concern and are associated with morbidity and mortality; thus, new treatment strategies are required. The first step toward personalized/precision medicine in this field is probably in taking sex differences into account. Impaired wound healing is augmented by ischemia, and we previously demonstrated that 17β-estradiol exerts a major preventive effect against ischemia-induced skin flap necrosis in female mice. However, the equivalent effects of testosterone in male mice have not yet been reported...
March 30, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28357467/-ulcers-in-obesity-associated-chronic-venous-insufficiency
#18
L Scholl, M Dörler, M Stücker
BACKGROUND: Chronic venous insufficiency is a frequently occurring disease consisting of a characteristic symptom complex and ulcerations. Normally, varicose veins with reflux or obstruction can be found. However, these symptoms have also been described in obese people and are considered functional chronic venous insufficiency. The aim of this work was to present patients with ulceration in obesity-associated chronic venous insufficiency and to describe typical features of ulceration in obese people...
March 29, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28353362/anti-coagulation-complications-in-pregnancies-with-severe-pulmonary-arterial-hypertension
#19
Tiffany Herrero, Erin Martin, David S Poch, Hilary A Roeder
BACKGROUND: Epoprostenol, a potent vasodilator, is the treatment of choice for severe pulmonary arterial hypertension (PAH) in pregnancy. However, its inhibition of platelet aggregation increases the risk of coagulation complications with conjunctive use of anti-coagulants for thromboprophylaxis. CASES: Case 1 demonstrates a pregnancy complicated by thrombocytopenia. Case 2 describes a pregnancy with newly-diagnosed PAH at 35 weeks who delivered by repeat cesarean delivery complicated by a wound hematoma...
March 29, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28345420/peroneal-perforator-pedicle-propeller-flap-for-lower-leg-soft-tissue-defect-reconstruction-clinical-applications-and-treatment-of-venous-congestion
#20
Lifeng Shen, Yiyang Liu, Chun Zhang, Qiaofeng Guo, Wenhua Huang, Kelvin Kian Loong Wong, Shimin Chang
Objective To describe the characteristics of the perforator vessel in the peroneal artery of the lower leg and to explore the use of perforator pedicle propeller flaps to repair soft tissue defects in the lower leg, heel and foot. Methods This retrospective study enrolled patients with soft tissue defects of the distal lower leg, heel and foot who underwent surgery using peroneal perforator-based propeller flaps. The peroneal artery perforators were identified preoperatively by colour duplex Doppler ultrasound...
January 1, 2017: Journal of International Medical Research
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