Reviews in Vascular Medicine最新文献

{"title":"Emerging role of various signaling pathways in the pathogenesis and therapeutics of atherosclerosis","authors":"Yash Prashar,&nbsp;Ritu,&nbsp;Souravh Bais ,&nbsp;Naresh Singh Gill","doi":"10.1016/j.rvm.2017.05.001","DOIUrl":"10.1016/j.rvm.2017.05.001","url":null,"abstract":"<div><p><span><span>Atherosclerosis<span><span> is a leading cause of mortality and morbidity in the western world. It is no longer a disease attributed mainly to the high lipid<span> content of the body but has come to be regarded as a chronic inflammatory disease<span> with an autoimmune component. Studies which explore the interactions between molecular and cellular elements generally focus on pathophysiologic aspect of atherosclerosis. The focus has now shifted to the novel risk factors and the genetic predisposition which has further broadened the pathogenetic mechanisms. Hence, It's high time to understand these processes in depth so that new markers and </span></span></span>treatments<span> which target mechanisms specially inflammation which is now the most exact cause of atherosclerosis. Moreover, the diagnosis and management is the guiding element in the understanding, progression of chronic diseases like atherosclerosis. Therefore, targeting and understanding of biochemical pathways would help in more accurate diagnosis and management of disease. Additionally, the use of antihyperlipidemic and anti-inflammatory drugs for the treatment of atherosclerosis was only possibility but it had average results. Henceforth, delving into newer areas or novel </span></span></span>drug<span><span><span><span> targets like endoglin receptor, PPARα, </span>squalene synthase<span>, thyroid hormone analogues, </span></span>scavenger receptors<span>, Leucotriene receptors<span><span><span><span>, calcium signaling, </span>Pentraxin, </span>nitric oxide<span>, heat shock proteins, </span></span>Liver X Receptors<span>, shear stress pathway, CD14, endotoxin signaling, and </span></span></span></span>nuclear factor kappa B give better treatment possibilities to control the process of atherosclerosis. Therefore, the review briefly focuses on molecular mechanisms involved in the evolution of the atherosclerotic plaque and different novel targets that act at the starting stage of the plaque form to the </span></span>thrombus formation in the atherosclerosis that may pave the way for selecting optimal therapies and preventing plaque complications.</p></div>","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rvm.2017.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84655768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placenta percreta with iatrogenic megaureter: A maternal near miss case presentation","authors":"Ahmed Samy El-Agwany","doi":"10.1016/j.rvm.2017.04.006","DOIUrl":"10.1016/j.rvm.2017.04.006","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Placenta percreta<span>, is a rare pregnancy disorder in which the placenta penetrates the uterine </span></span>myometrium<span> and can invade the surrounding organs. It is a potentially life-threatening condition with severe maternal morbidity<span><span> and mortality. Both sonography and MRI are used for </span>prenatal diagnosis of placenta accreta. Prenatal diagnosis allows management of these patients in specialized tertiary centers, where a multidisciplinary approach will improve the outcome. A team of anesthesiologist, obstetrician, urologist, neonatologist, and blood bank officer is needed for successful management of these patients.</span></span></p></div><div><h3>Purpose</h3><p>Management and complications of placenta percreta in rare blood group.</p></div><div><h3>Methods</h3><p>We present the case of a young age multigravida with placenta percreta and blood group 0 negative.</p></div><div><h3>Results</h3><p><span><span><span>She was managed by cesarean hysterectomy after bilateral </span>internal iliac artery<span> ligation before proceeding with placenta removal that was not recommended but aiming for excision and conservative surgical treatment with iatrogenic </span></span>bladder<span> injury and ureteral ligation<span><span> that was not diagnosed intraoperative. We encountered a fullness in the retro-peritoneum that was not progressing so we considered it as hematoma but was revealed later as acute ureteric dilation from ligation. Due to poor availability of blood, she recieved limited amount. After 10 hours, she was mild hemodynamically unstable with right hydronephrosis and abdominal collection on ultrasound. She was reoperated with </span>ureter caherterization and </span></span></span>evacuation of hematoma. The patient was discharged 10 days after in good condition.</p></div><div><h3>Conclusions</h3><p><span>A decision between radical and conservative strategies for placenta accreta must be made based on the degree of placental infiltration and other variables: the patient's hemodynamic<span> status and her desire to remain fertile. In our opinion, cesarean hysterectomy remains the best therapeutic option to treat placenta percreta. Radical surgery should be done for poor availability of blood especially in rare blood types in other types of placenta accreta. Fullness in the retroperitoneal space should not be ligated except after excluding ureter dilatation<span> and confirming hematoma by aspiration and disscetion. Megaureter may be gestational or pathological from ureteric ligation that is differentiated by hydronephrosis. Internal iliac artery ligation followed by cesarean hysterectomy with no trial of removal of placenta should be done to limit blood loss in placenta percreta. Fullness of bladder after repair should be washed as may be </span></span></span>blood clot<span> retention from bleeding. Megaureter could be presented intraoperative within minutes of ligation of the ureter","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rvm.2017.04.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90768608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple interrupted uterine transverse compression sutures with uterine artery ligation: A simple technique for intraoperative bleeding from abnormal placentation and atonic lower uterine segment","authors":"Ahmed Samy El-Agwany","doi":"10.1016/j.rvm.2017.04.004","DOIUrl":"10.1016/j.rvm.2017.04.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Fertility preserving surgery is rarely performed in placenta accreta and atonic thinned out lower uterine segment is frequently encountered.</p></div><div><h3>Aim</h3><p>To evaluate our new method of uterine conservation in abnormal placentation and oozing from the lower uterine segment.</p></div><div><h3>Methods</h3><p>Multiple interrupted uterine plicating transverse compression sutures with combined multiple level uterine artery ligation were performed over 24 cases.</p></div><div><h3>Results</h3><p><span>Six cases were excluded for hemodynamic instability and placenta percreta. It was sucessful in all cases of thinned out lower segment and </span>placenta previa but failed in two cases of placenta accreta.</p></div><div><h3>Conclusion</h3><p>Conservative management for atonic lower uterine segment and abnormal placentation through modified transverse B-lynch suture can be performed with high success and conserving female fertility.</p></div>","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rvm.2017.04.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90809759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of vein graft stenosis and assessment of sustainability of outcomes: Two sides of the same coin in vein graft surveillance","authors":"Matthew Thomas,&nbsp;Reza Mofidi","doi":"10.1016/j.rvm.2017.04.002","DOIUrl":"10.1016/j.rvm.2017.04.002","url":null,"abstract":"<div><p>Autologous veins are the conduit of choice when performing an infra-inguinal arterial bypass procedure. However these grafts are at risk of failure. This is multifactorial in nature and relates to patient factors, factors relating to the procedure as well as adaptive processes which occur after the formation of an infrainguinal bypass graft. Duplex ultrasound assessment of haemodynamic findings within the graft is the most accurate method of identifying vein graft stenosis and identifying grafts which are at risk of failure. Duplex ultrasound examination findings together with clinical factors can be used to individualise vein graft surveillance. This review examines the steps involved in a successful vein graft surveillance program, how to optimise the cost utility of vein graft surveillance by identifying the grafts which are at highest risk of failure and how there has been a paradigm shift away from surgical revision and towards endovascular revision of failing infrainguinal grafts.</p></div>","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rvm.2017.04.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77389381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placental polyps with uterine vascular malformation mimics: Management dilemma","authors":"Ahmed Samy El-Agwany","doi":"10.1016/j.rvm.2017.04.001","DOIUrl":"10.1016/j.rvm.2017.04.001","url":null,"abstract":"<div><h3>Purpose</h3><p>Abnormal uterine bleeding after abortion or delivery requires special management. Sonography with clinical and laboratory findings are important to narrow the differential diagnoses. Presence of increased uterine vascularity and arteriovenous shunting can be detected in retained trophoblastic tissue, gestational trophoblastic disease, and placental polyps and uterine vascular malformation are mainly related to failure of detection of associated pathology in the uterus on ultrasound. Here we are describing to both as a same entity for simplicity.</p></div><div><h3>Methods and results</h3><p>We present two cases of placental polyp with uterine vascular malformation, one case after abortion and the other case after vaginal delivery. The first case was multiparous female complaining of abnormal uterine bleeding three month after delivery. Ultrasound revealed diffuse uterine vascularity with echogenic vascular mass with blood flow velocity less than 40<!--> <!-->cm/s that was evacuated and packed using hysteroscopy. The second case was also multiparus female complaining of abnormal uterine bleeding two months after abortion. Ultrasound revealed abnormal vascularity from perimetrium to the endmometrial mass. Hysteroscopic removal of the mass was done. Both patients were discharged after two days with menses resumed regularly afterwards.</p></div><div><h3>Conclusions</h3><p>Uterine vascular malformations may be associated with heavy bleeding. They should be suspected on ultrasound with anechoic structures with positive Doppler signal. Dilatation and curettage is therapeutic for evacuation of placental polyps but can induce massive, life-threatening bleeding in cases with uterine arteriovenous shunting or malfomration (AVM), thus it should be done with caution in endometrial pathology with high velocity flow more than 40<!--> <!-->cm/s as infection and adhesions are associated. Treatment of uterine AVM varies from medical management (hormonal therapy), minimally invasive uterine artery embolization to more definitive surgical hysterectomy, depending upon age of the patient, size, site of the lesion, and the desire to retain future fertility.</p></div>","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rvm.2017.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80682875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum purpura fulminans","authors":"Ahmed Samy El-Agwany","doi":"10.1016/j.rvm.2017.04.005","DOIUrl":"10.1016/j.rvm.2017.04.005","url":null,"abstract":"<div><p><span><span>Purpura Fulminans is a severe disorder of acute onset with high morbidity and mortality. Purpura fulminans (PF) is a hematological emergency in which there is </span>skin necrosis<span> and disseminated intravascular coagulation<span>. This may progress rapidly to multi-organ failure caused by thrombotic occlusion of small and medium-sized blood vessels. PF may complicate severe sepsis. It most often occurs with sudden appearance of symmetrical, tender, ecchymotic skin lesions usually involving the lower extremities. Early recognition and early therapy with appropriate antibiotics and heparin is known to limit both morbidity and mortality. This article reports a case of Purpura Fulminans presented with DIC after </span></span></span>hemorrhagic shock<span> of postpartum hemorrhage.</span></p></div>","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rvm.2017.04.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73556993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous small vessel vasculitis of the lower legs","authors":"M. Papi","doi":"10.1016/J.RVM.2017.04.003","DOIUrl":"https://doi.org/10.1016/J.RVM.2017.04.003","url":null,"abstract":"","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89257273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling vasomotion","authors":"A. Fasano ,&nbsp;A. Farina ,&nbsp;A. Caggiati","doi":"10.1016/j.rvm.2016.10.001","DOIUrl":"https://doi.org/10.1016/j.rvm.2016.10.001","url":null,"abstract":"<div><p><span><span>The phenomenon of vasomotion, consisting in periodic oscillations of </span>blood vessels walls is particularly important at the scale of small vessels and exhibits different features in </span>arterioles<span> (in which flow is mainly driven by the hydraulic pressure gradient) and in venules provided with valves preventing back flow and helping centripetal hematic propulsion. Here we formulate a model for both situations, based on approximations of the flow equations implied by the smallness of the radius-to-length ratio. For venules we postulate the presence of an inlet and an outlet valve and we show that the model reproduces the periodic pressure pulses that have been detected in the experimental literature devoted to venules of the batwing.</span></p><p>We have developed a model for describing the vasomotion, i.e. the flow in oscillating arterioles and oscillating venules. In arterioles vasomotion has little effect while in venules equipped with valves contraction-expansion cycles exert a propulsive action on the blood. The model reproduces reasonably well the data reported in the experimental literature.</p></div>","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rvm.2016.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137347578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WITHDRAWN: Etiology and mechanisms of age-related arterial stiffening","authors":"N. Boutagy, T. Werner","doi":"10.1016/J.RVM.2016.12.001","DOIUrl":"https://doi.org/10.1016/J.RVM.2016.12.001","url":null,"abstract":"","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72859696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-thrombotic syndrome – Recent aspects of prevention, diagnosis and clinical management","authors":"Takashi Yamaki","doi":"10.1016/j.rvm.2016.07.001","DOIUrl":"10.1016/j.rvm.2016.07.001","url":null,"abstract":"<div><p>Post-thrombotic syndrome (PTS) is the most frequent chronic complication of acute deep vein thrombosis (DVT). However, gaps in our current understanding of the risk factors, diagnostic criteria, preventive strategies, and even treatment modalities for PTS prevent clinicians from employing measures that could reduce the occurrence of this disorder and the associated morbidity. This review provides an overview of the important elements of PTS, including recent multifaceted aspects related to its definition, pathophysiology, risk factors, prevention and management.</p></div>","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rvm.2016.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84703856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}