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Vascular occlusions

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https://www.readbyqxmd.com/read/29239852/management-specificities-for-abdominal-pelvic-and-vascular-penetrating-trauma
#1
E Hornez, F Béranger, T Monchal, Y Baudouin, G Boddaert, H De Lesquen, S Bourgouin, Y Goudard, B Malgras, G Pauleau, V Reslinger, N Mocellin, C Natale, L Meyrat, J-P Avaro, P Balandraud, S Gaujoux, S Bonnet
Management of patients with penetrating trauma of the abdomen, pelvis and their surrounding compartments as well as vascular injuries depends on the patient's hemodynamic status. Multiple associated lesions are the rule. Their severity is directly correlated with initial bleeding, the risk of secondary sepsis, and lastly to sequelae. In patients who are hemodynamically unstable, the goal of management is to rapidly obtain hemostasis. This mandates initial laparotomy for abdominal wounds, extra-peritoneal packing (EPP) and resuscitative endovascular balloon occlusion of the aorta (REBOA) in the emergency room for pelvic wounds, insertion of temporary vascular shunts (TVS) for proximal limb injuries, ligation for distal vascular injuries, and control of exteriorized extremity bleeding with a tourniquet, compressive or hemostatic dressings for bleeding at the junction or borderline between two compartments, as appropriate...
November 24, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29239686/recurrent-posterior-circulation-infarcts-secondary-to-vertebral-artery-external-compression-treated-with-endovascular-deconstruction
#2
Aldo Fabrizio Berti, Atif Zafar, Asad Ikram, Christopher S Calder, Danielle Eckart Sorte
When multiple, recurrent infarcts occur in spite of maximal medical management, the level of suspicion for atypical vascular injury should be heightened. We present a case of a patient who presented with recurrent posterior circulation infarcts despite optimized medical management. On imaging, he was found to have external anatomical vertebral artery muscular and/or osseous compression leading to repetitive vascular injury and strokes. Recurrent intimal injury and vertebral artery to intracranial emboli despite anticoagulation and subsequent dual antiplatelet therapy necessitated definitive operative management...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29237489/self-expanding-nitinol-stents-of-high-versus-low-chronic-outward-force-in-de-novo-femoropopliteal-occlusive-arterial-lesions-bioflex-cof-trial-study-protocol-for-a-randomized-controlled-trial
#3
Alexander Wressnegger, Alexandra Kaider, Martin A Funovics
BACKGROUND: Self-expanding nitinol stents must be oversized at least by a minimal amount to ensure contact with the vessel wall and prevent migration. Once the stent is deployed it exerts a continuous force upon the vascular wall, termed chronic outward force (COF). Animal studies have found an increased neointimal hyperplasia in stents with high oversizing and thus high COF. Data about correlation between COF and neointimal hyperplasia in humans are currently lacking. The objective of the BIOFLEX-COF trial is to prospectively investigate differences in formation of intimal hyperplasia at 1 and 2 years after implantation of nitinol stents with high versus low COF in de novo femoropopliteal occlusive arterial lesions...
December 14, 2017: Trials
https://www.readbyqxmd.com/read/29236169/current-treatment-of-central-retinal-artery-occlusion-a-national-survey
#4
Teddy S Youn, Patrick Lavin, Morgan Patrylo, Joseph Schindler, Howard Kirshner, David M Greer, Matthew Schrag
BACKGROUND: Central retinal artery occlusion (CRAO) is an ophthalmological emergency, the retinal analog of a stroke. To date there is no consensus or national guidelines on how this disorder should be managed. As academic neurologists and ophthalmologists treat CRAO frequently, we set out to understand how these clinicians approach patients with CRAO with a national survey. METHODS: We identified university-associated teaching hospitals offering vascular neurology, neuro-ophthalmology and/or retina fellowships in the US and asked the directors of the programs to respond to questions in an open response format to profile the acute management of CRAO at their institution...
December 13, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29234529/the-effectiveness-of-ureteric-metal-stents-in-malignant-ureteric-obstructions-a-systematic-review
#5
REVIEW
Panagiotis Kallidonis, Dimitrios Kotsiris, Francesco Sanguedolce, Panteleimon Ntasiotis, Evangelos Liatsikos, Athanasios Papatsoris
Objective: To review the literature on the effectiveness, safety and long-term patency of ureteric metal mesh stents (MSs), as a variety of MSs have been used for managing malignant ureteric obstruction over the last three decades. Materials and methods: A systematic review using the search string; Ureter∗ AND (stent OR endoprosthesis) AND metal∗ was conducted on PubMed, Scopus, Web of science and Cochrane Library online databases in May 2016. Prospective, retrospective, and comparative studies including MSs were included...
December 2017: Arab Journal of Urology
https://www.readbyqxmd.com/read/29233575/midkine-controls-arteriogenesis-by-regulating-the-bioavailability-of-vascular-endothelial-growth-factor-a-and-the-expression-of-nitric-oxide-synthase-1-and-3
#6
Thomas Lautz, Manuel Lasch, Julia Borgolte, Kerstin Troidl, Judith-Irina Pagel, Amelia Caballero-Martinez, Eike Christian Kleinert, Barbara Walzog, Elisabeth Deindl
Midkine is a pleiotropic factor, which is involved in angiogenesis. However, its mode of action in this process is still ill defined. The function of midkine in arteriogenesis, the growth of natural bypasses from pre-existing collateral arteries, compensating for the loss of an occluded artery has never been investigated. Arteriogenesis is an inflammatory process, which relies on the proliferation of endothelial cells and smooth muscle cells. We show that midkine deficiency strikingly interferes with the proliferation of endothelial cells in arteriogenesis, thereby interfering with the process of collateral artery growth...
November 26, 2017: EBioMedicine
https://www.readbyqxmd.com/read/29233197/takayasu-arteritis-in-paediatrics
#7
Marisa Di Santo, Erica V Stelmaszewski, Alejandra Villa
Takayasu arteritis is an idiopathic chronic granulomatous panarteritis predominantly affecting the aorta and its main branches. Although idiopathic, genetic contribution to disease susceptibility is being increasingly recognised. Rare in children, Takayasu arteritis is a worldwide disease with significant morbidity and mortality. Its diagnosis is a challenge and requires awareness of the condition as clinical features at presentation are non-specific and assessing disease activity is difficult. In the inflammatory stage, treatment is essential to prevent the insidious course and vascular damage: stenotic, occlusive lesions, aneurysms, and aortic regurgitation...
December 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29233190/microvascular-effects-of-intravenous-esmolol-in-patients-with-normal-cardiac-function-undergoing-postoperative-atrial-fibrillation-a-prospective-pilot-study-in-cardiothoracic-surgery
#8
William Fornier, Matthias Jacquet-Lagrèze, Thomas Collenot, Priscilla Teixeira, Philippe Portran, Rémi Schweizer, Michel Ovize, Jean-Luc Fellahi
BACKGROUND: Postoperative atrial fibrillation (POAF) is commonplace after cardiothoracic surgery. A rate control strategy using short-acting beta blockers is recommended as a first-line therapy in patients without hemodynamic instability. Microcirculatory effects of POAF and esmolol have not yet been investigated. We hypothesized that POAF without hemodynamic instability would induce microvascular dysfunction which could be reversed by intravenous esmolol. METHODS: Twenty-five cardiothoracic surgical patients with POAF were included in the study...
December 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29229703/orai1-plays-a-crucial-role-in-central-sensitization-by-modulating-neuronal-excitability
#9
Yannong Dou, Jingsheng Xia, Ruby Gao, Xinghua Gao, Frances M Munoz, Dongyu Wei, Yuzhen Tian, James E Barrett, Seena Ajit, Olimpia Meucci, James W Putney, Yue Dai, Huijuan Hu
Pathological pain is a common and debilitating condition that is often poorly managed. Central sensitization is an important mechanism underlying pathological pain. However, candidate molecules involved in central sensitization remain unclear. Store-operated calcium channels (SOCs) mediate important calcium signals in non-excitable and excitable cells. SOCs have been implicated in a wide variety of human pathophysiological conditions including immunodeficiency, occlusive vascular diseases and cancer. However, the role of SOCs in central nervous system (CNS) disorders has been relatively unexplored...
December 11, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29229445/optical-coherence-tomography-angiography
#10
REVIEW
Richard F Spaide, James G Fujimoto, Nadia K Waheed, Srinivas R Sadda, Giovanni Staurenghi
Optical coherence tomography (OCT) was one of the biggest advances in ophthalmic imaging. Building on that platform, OCT angiography (OCTA) provides depth resolved images of blood flow in the retina and choroid with levels of detailed far exceeding that obtained with older forms of imaging. This new modality is challenging because of the need for new equipment and processing techniques, current limitations of imaging capability, and rapid advancements in both imaging and in our understanding of the imaging and applicable pathophysiology of the retina and choroid, and the requirement for understanding the origins of image artifacts...
December 8, 2017: Progress in Retinal and Eye Research
https://www.readbyqxmd.com/read/29229114/estradiol-mediates-the-long-lasting-lung-inflammation-induced-by-intestinal-ischemia-and-reperfusion
#11
Evelyn Thais Fantozzi, Ana Cristina Breithaupt-Faloppa, Fernanda Yamamoto Ricardo-da-Silva, Sara Rodrigues-Garbin, Daniel Cancelli Romero, Adriana da Silva Rodrigues, Yanira Riffo-Vasquez, Wothan Tavares-de-Lima
BACKGROUND: Lung inflammation is one of the main consequences of intestinal ischemia reperfusion (intestinal IR) and, in severe cases, can lead to acute respiratory distress syndrome and death. We have previously demonstrated that estradiol exerts a protective effect on lung edema and cytokine release caused by intestinal IR in male rats. MATERIALS AND METHODS: We investigated the role of estradiol on the generation of interleukin (IL)-1β, IL-10, vascular endothelial growth factor (VEGF), and cytokine-induced neutrophil chemoattractant 1 (CINC-1) in a female rat model of intestinal IR...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29226477/cell-therapy-for-critical-limb-ischemia-an-integrated-review-of-pre-clinical-and-clinical-studies
#12
REVIEW
Mohammad Qadura, Daniella C Terenzi, Subodh Verma, Mohammed Al-Omran, David A Hess
Critical limb ischemia (CLI), the most severe form of peripheral artery disease, is characterized by pain at rest and non-healing ulcers in the lower extremities. For patients with CLI, where the extent of atherosclerotic artery occlusion is too severe for surgical bypass or percutaneous interventions, limb amputation remains the only treatment option. Thus, cell-based therapy to restore perfusion and promote wound healing in patients with CLI is under intense investigation. Despite promising preclinical studies in animal models, transplantation of bone marrow (BM) derived cell populations in patients with CLI has shown limited benefit preventing limb amputation...
December 11, 2017: Stem Cells
https://www.readbyqxmd.com/read/29225873/migration-of-emboli-in-the-retinal-artery-case-report
#13
Alexandr Stepanov, Marketa Machackova, Tereza Rehakova, Nada Jiraskova, Jan Lestak
Branch retinal artery occlusion (BRAO) is a prevalent vascular occlusive disorder of the eye. In transient BRAO, an embolus temporarily blocks the vessel and then moves on resulting in recovery of blood circulation. In this case, we have documented migration of the embolus with recovery of perfusion of the retina and improvement of visual acuity in a patient with transient BRAO. Early diagnosis and fast action are important in the case of patients with retinal artery occlusion.
December 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29224939/the-association-of-statin-therapy-with-the-primary-patency-of-femoral-and-popliteal-artery-stents
#14
Derek de Grijs, Pedro Teixeira, Steven Katz
OBJECTIVE: It has long been known that hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) broadly reduce cardiovascular events in patients with peripheral vascular disease. It was the goal of this study to determine whether there is an association between statin therapy and primary patency after stenting of superficial femoral and popliteal arteries. METHODS: The records of all patients undergoing primary nitinol stenting of the femoral and popliteal arteries at a single institution and by a single surgeon during a 10-year period were reviewed...
December 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29224266/-application-of-liver-three-dimensional-visualization-technologies-in-the-treatment-planning-of-hepatic-malignant-tumor
#15
P P Li, Z H Wang, G Huang, Z P Huang, Y Li, J S Ni, H Liu, C H Fang, W P Zhou
Objective: To discuss the application of three dimentional(3D)visualization technologies in treatment plan of hepatic malignant tumor. Methods: The clinical data of 300 patients with liver malignant tumor who received treatment from January 2016 to January 2017 in the Third Department of Hepatic Surgery of Eastern Hepatobiliary Surgery Hospital was retrospectively analyzed in this study, including 221 male and 79 female patients aged from 7 to 76 years with median age of 54 years. The median height was 168 cm (115-183 cm), the median weight was 65 kg (20-105 kg) and the median tumor volume was 142 ml (23-2 493 ml)...
December 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29224239/personalized-stepwise-vascular-control-during-complex-hepatectomy-involving-hepatocaval-confluence
#16
Lei Dou, Zong-Ping Yu, Hui-Yuan Yang, Ji Ran, Yi-Fa Chen, Xiao-Ping Chen
BACKGROUND: This study introduces an innovative stepwise vascular control technique to address the high risk of massive bleeding from main hepatic veins and the retro-hepatic inferior vena cava during hepatectomy involving hepatocaval confluence. METHODS: From January 2010 to July 2016, 80 patients underwent stepwise vascular occlusion during complex liver resection involving hepatocaval confluence. Relevant clinical data were collected and compared with those obtained in parallel studies...
December 10, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29222966/optimizing-functional-outcomes-in-mandibular-condyle-reconstruction-with-the-free-fibula-flap-using-computer-aided-design-and-manufacturing-technology
#17
Z-Hye Lee, Tomer Avraham, Casian Monaco, Ashish A Patel, David L Hirsch, Jamie P Levine
PURPOSE: Mandibular defects involving the condyle represent a complex reconstructive challenge for restoring proper function of the temporomandibular joint (TMJ) because it requires precise bone graft alignment for full restoration of joint function. The use of computer-aided design and manufacturing (CAD/CAM) technology can aid in accurate reconstruction of mandibular condyle defects with a vascularized free fibula flap without the need for additional adjuncts. The purpose of this study was to analyze clinical and functional outcomes after reconstruction of mandibular condyle defects using only a free fibula graft with the help of virtual surgery techniques...
November 15, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29222393/protect-proximal-balloon-occlusion-together-with-direct-thrombus-aspiration-during-stent-retriever-thrombectomy-evaluation-of-a-double-embolic-protection-approach-in-endovascular-stroke-treatment
#18
Christian Maegerlein, Sebastian Moench, Tobias Boeckh-Behrens, Manuel Lehm, Dennis M Hedderich, Maria Teresa Berndt, Silke Wunderlich, Claus Zimmer, Johannes Kaesmacher, Benjamin Friedrich
PURPOSE: Stent retriever-based mechanical thrombectomy (MT) for emergent large vessel occlusions (ELVO) is often complicated by thrombus fragmentation causing distal embolization and embolization to new vascular territories. Well-established embolic protection approaches include proximal flow arrest and distal aspiration techniques during stent retriever maneuvers. Aiming at the reduction of thrombus fragmentation during MT we evaluated a technical approach combining proximal balloon occlusion together with direct thrombus aspiration during MT: the PROTECT technique...
December 8, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29222291/evolving-treatment-paradigms-in-sickle-cell-disease
#19
REVIEW
Ramasamy Jagadeeswaran, Angela Rivers
Sickle cell disease (SCD) is an inheritable hemoglobinopathy characterized by polymerization of hemoglobin S in red blood cells resulting in chronic hemolytic anemia, vaso-occlusive painful crisis, and multiorgan damage. In SCD, an increased reactive oxygen species (ROS) generation occurs both inside the red blood cells and inside the vascular lumen, which augment hemolysis and cellular adhesion. This review discusses the evolving body of literature on the role of ROS in the pathophysiology of SCD as well as some emerging therapeutic approaches to SCD with a focus on the reduction of ROS...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222244/cardiovascular-care-of-patients-with-chronic-myeloid-leukemia-cml-on-tyrosine-kinase-inhibitor-tki-therapy
#20
REVIEW
Mary C Barber, Michael J Mauro, Javid Moslehi
Cardiovascular (CV) health has emerged as an important consideration in patients with chronic myeloid leukemia (CML) because of improved prognosis. Indeed, the success of BCR-ABL1 tyrosine kinase inhibitors (TKIs) has increased the focus on survivorship and late toxicity in oncological care. Survivorship issues in this population include CV disease prevention, given its prevalence in the general population. The introduction of BCR-ABL1 TKIs represented a unique concept of indefinite cancer therapy, only recently evolving to include "treatment-free remission...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
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