Reviews in Vascular Medicine最新文献_第7页

Venous Thrombo-embolism prophylaxis: Intermittent pneumatic compression 静脉血栓栓塞预防:间歇气动压缩

Reviews in Vascular Medicine Pub Date : 2013-12-01 DOI: 10.1016/j.rvm.2013.08.005

Mehmet Kurtoglu, Emre Sivrikoz

{"title":"Venous Thrombo-embolism prophylaxis: Intermittent pneumatic compression","authors":"Mehmet Kurtoglu, Emre Sivrikoz","doi":"10.1016/j.rvm.2013.08.005","DOIUrl":"10.1016/j.rvm.2013.08.005","url":null,"abstract":"<div><p><span>Pulmonary embolism (PE) is the most preventable cause of hospital deaths in Europe. Autopsy-proven fatal pulmonary emboli were found in 2.5% of 200 hospitalized medical patients followed-up prospectively. The number of venous thrombo-embolism (VTE) related deaths throughout the Europe (543,454) is more than double the amount of deaths attributed to AIDS, breast cancer, </span>prostate cancer<span><span> and transport accidents combined (209,926). Only 58.5% of surgical patients and 39.5% of medical patients receive the appropriate thrombo-prophylaxis for their conditions. An ideal VTE prophylaxis for any given patient should be (1) risk adjusted, (2) targeted, (3) personalized and (4) effective. Intermittent pneumatic compression<span> (IPC) devices are best suited for: (1) ICU patients who are either bleeding or have a high bleeding risk; (2) low risk elective general abdominal or pelvic surgery patients; (3) high risk elective general abdominal or pelvic surgery patients who have a high bleeding risk. In high risk elective general abdominal or pelvic surgery patients who are not at high risk for major bleeding, combined prophylaxis (IPC+LMWH) are recommended. Combined modalities target virtually all aspects of the Virchow's triad<span><span>: (1) IPC and stockings prevent “stasis”, (2) stockings prevent “endothelial damage”, (3) IPC increases fibrinolysis, and </span>LMWH exert anti-thrombotic effects to prevent “hypercoagulability”. </span></span></span>In patients undergoing major surgery, IPC devices have a broader area of application due to fewer contra-indications and similar efficacy as compared to LMWH. Whenever indicated, every effort should be undertaken to provide a combined prophylaxis method.</span></p></div>","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rvm.2013.08.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83547473","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}

引用次数: 1

What is the relationship between chronic cerebrospinal venous insufficiency and multiple sclerosis? 慢性脑脊髓静脉功能不全与多发性硬化症有何关系?

Reviews in Vascular Medicine Pub Date : 2013-12-01 DOI: 10.1016/j.rvm.2013.08.001

Marian Simka

{"title":"What is the relationship between chronic cerebrospinal venous insufficiency and multiple sclerosis?","authors":"Marian Simka","doi":"10.1016/j.rvm.2013.08.001","DOIUrl":"10.1016/j.rvm.2013.08.001","url":null,"abstract":"<div><p>Although most of the research on multiple sclerosis was focused on its autoimmune aspects, researchers were also considering the roles of other factors, including vascular background of the disease. The idea that multiple sclerosis might be caused by stenoses of the veins draining the brain and spinal cord (the so-called chronic cerebrospinal venous insufficiency), is currently hotly debated by scientific community. Despite conflicting reports, chronic cerebrospinal venous insufficiency seems to be a real clinical phenomenon. However, it remains uncertain how it should be defined and which tests should be used for its detection. Probably this vascular abnormality should be primarily diagnosed using catheter venography, while non-invasive tests, especially Doppler sonography, seem to be of limited diagnostic accuracy. Causative role of these venous lesions in the pathogenesis of multiple sclerosis remains to be established. However, it is unlikely that they are directly triggering multiple sclerosis. Rather, they represent a permissive pathology. Probably chronic cerebrospinal venous insufficiency is linked to multiple sclerosis in such a way that it favors disease development in relatively low-predisposed subjects. Besides, it is suggested that a potential link between chronic cerebrospinal venous insufficiency and other neurodegenerative diseases should be examined.</p></div>","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rvm.2013.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87368280","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}

引用次数: 7

Infra-renal abdominal aortic aneurysm dilation ratio (AADR): A different measurement technique for intervention 肾下腹主动脉瘤扩张比(AADR):一种不同的干预测量技术

Reviews in Vascular Medicine Pub Date : 2013-12-01 DOI: 10.1016/j.rvm.2013.08.003

Ali Kordzadeh, Gui Han Lee, Alan Askari, Yiannis Panayiotopoulos

{"title":"Infra-renal abdominal aortic aneurysm dilation ratio (AADR): A different measurement technique for intervention","authors":"Ali Kordzadeh, Gui Han Lee, Alan Askari, Yiannis Panayiotopoulos","doi":"10.1016/j.rvm.2013.08.003","DOIUrl":"10.1016/j.rvm.2013.08.003","url":null,"abstract":"<div><h3>Introduction</h3><p>To test the null hypothesis that the proposed abdominal aortic aneurysm (AAA) dilation ratio (AADR) obtained by dividing the widest diameter of the infra-renal AAA by the immediate native (normal) infra-renal aorta in millimetres, fails to provide accurate information about the risk of rupture in the female population, small or various sizes of infra-renal AAAs.</p></div><div><h3>Methods</h3><p>A retrospective study of 112 patients that underwent an infra-renal AAA repair<span> on elective, urgent and or immediate basis with prior computed tomography angiogram (CTA) or computed tomography (CT).</span></p></div><div><h3>Results</h3><p><span>The mean AADR was 2.3 for asymptomatic group (</span><em>n</em>=73) and 3.3 for symptomatic group (<em>n</em>=28) (<em>p</em><0.0001). The mean AADR was 2.88 for the tender AAA group (<em>n</em>=14) and 3.78 for the ruptured group (<em>n</em>=14) (<em>p</em><0.0042).</p></div><div><h3>Conclusion</h3><p>Study suggests a lower threshold for female population that do not meet the interventional size. AADR≤2.8 could be a reasonable criteria for intervention irrespective of the aneurysm size. AADR can assist in doubtful or borderline scenarios, especially during the management of symptomatic patients as higher AADR>2.8 warrants an immediate operation. Finally, the AADR can be important in less privileged centres where ultrasonography (USS) and not repeated CT scan is permissible.</p></div>","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rvm.2013.08.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82700524","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}

引用次数: 0

Temperature and abdominal aortic aneurysm rupture: A myth or reality 温度与腹主动脉瘤破裂:神话还是现实

Reviews in Vascular Medicine Pub Date : 2013-06-01 DOI: 10.1016/j.rvm.2013.05.002

Ali Kordzadeh, Alan Askari, Tom Browne, Ioannis Prionidis, Yiannis Panayiotopoulos

{"title":"Temperature and abdominal aortic aneurysm rupture: A myth or reality","authors":"Ali Kordzadeh, Alan Askari, Tom Browne, Ioannis Prionidis, Yiannis Panayiotopoulos","doi":"10.1016/j.rvm.2013.05.002","DOIUrl":"10.1016/j.rvm.2013.05.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Various studies have suggested seasonal and monthly atmospheric pressure correlation to Abdominal Aortic Aneurysm (AAA) rupture frequencies. However, such correlation to monthly/seasonal temperature and its alteration has never been studied directly. The objective of this study is to demonstrate whether temperature and its alteration are indeed associated with incidences of infra-renal AAA rupture.</p></div><div><h3>Patients and methods</h3><p>A total of 50 (<em>n</em>=50) ruptured AAA over a 5-year period were recruited. Local meteorological data on temperature were obtained from UK Meteorological Office.</p></div><div><h3>Results</h3><p>The <em>p</em> value (<0.1) (Student's <em>t</em>-test) was insignificant for temperature difference (mean=0.58°C; range, −4.6 to 3.8°C; 95% CI±°0.72), no correlation was identified between mean monthly/seasonal temperature and mean monthly/seasonal rupture incidence (Pearson) (<em>n</em>=12; <em>r</em>=0.075; <em>p</em><0.81; <em>rsq</em>=0.0057) (<em>n</em>=4; <em>r</em>=−0.188; <em>p</em><0.8118; <em>rsq</em>=0.0354).</p></div><div><h3>Conclusion</h3><p>The findings appear to confirm that temperature alteration on monthly/seasonal basis has no impact on AAA rupture incidences.</p></div>","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rvm.2013.05.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84343593","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}

引用次数: 0

Sizing and planning for TEVAR: How to do? TEVAR的规模和规划:如何做?

Reviews in Vascular Medicine Pub Date : 2013-06-01 DOI: 10.1016/j.rvm.2013.07.001

Bernd Muehling

引用次数: 2

Understanding acute aortic type B dissection: Are there new horizons in patient selection? 了解急性主动脉B型夹层:患者选择是否有新的前景?

Reviews in Vascular Medicine Pub Date : 2013-06-01 DOI: 10.1016/j.rvm.2013.05.001

H.T.C. Veger, J.F. Hamming, M.J.T. Visser

{"title":"Understanding acute aortic type B dissection: Are there new horizons in patient selection?","authors":"H.T.C. Veger, J.F. Hamming, M.J.T. Visser","doi":"10.1016/j.rvm.2013.05.001","DOIUrl":"10.1016/j.rvm.2013.05.001","url":null,"abstract":"<div><p><span>Aortic dissection<span> (AD) still represents the most lethal aortic emergency<span><span>. The presentation of thoracic pain of severe intensity and sudden onset is suspect for AD. Physical examination does not result in reliable findings for AD. For confirming or ruling out AD </span>CTA<span> or MRA must be performed; the choice should depend on the availability. Multiple studies have identified predictors of poor outcome at admission (eGFR <60</span></span></span></span>  <span>mm) and during admission (patency of the false lumen). Despite the identified predictors of poor outcome today’s treatment<span> modality depends whether the acute type B AD (ABAD) is categorized as either uncomplicated or complicated. Open surgery is replaced by endovascular therapy (fenestration and/or endovascular stent grafting) for treatment of complicated ABAD. The treatment for uncomplicated ABAD is still medical management. Once complications occur the prognosis declines, with hospital mortality greater than 50%. The Acute uncomplicated type B Dissection Stent-grafting OR Best Medical Treatment (ADSORB) Study randomizing ABAD treated with best medical therapy with and without stent grafts may answer the question to whether early intervention in uncomplicated dissection reduces the risk of late complications. Improvement in diagnostic modalities for ABAD, in particular MRI, result in more insight in morphology and flow dynamics. More information of flow dynamics and pressures in both lumen can result in better understanding of the dissection and contribute to risk analysis of the dissection. These insights may result in better patient selection and early intervention in uncomplicated ABAD reducing morbidity and mortality.</span></span></p></div>","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rvm.2013.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72919992","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}

引用次数: 0

Focus on corona phlebectatica: Diagnostic, significance and predictive value in chronic venous disorders 关注静脉冠状病:慢性静脉疾病的诊断、意义和预测价值

Reviews in Vascular Medicine Pub Date : 2013-06-01 DOI: 10.1016/j.rvm.2013.07.002

Jean-François Uhl , André Cornu-Thenard , Patrick H. Carpentier , Pier Luigi Antignani

{"title":"Focus on corona phlebectatica: Diagnostic, significance and predictive value in chronic venous disorders","authors":"Jean-François Uhl , André Cornu-Thenard , Patrick H. Carpentier , Pier Luigi Antignani","doi":"10.1016/j.rvm.2013.07.002","DOIUrl":"10.1016/j.rvm.2013.07.002","url":null,"abstract":"<div><h3>Background</h3><p>Corona phlebectatica (corona) is a clinical sign associated with chronic venous disorders (CVD). It is a good predictor for skin changes indicating a decompensation of the disease. However, it is not yet included in the clinical part of the CEAP classification, mainly due to the lack of operational criteria for its positive diagnosis.</p></div><div><h3>Aim</h3><p>To focus on the diagnostic and predictive values of corona, and to answer some relevant questions: How to define relevant operational criteria for a simple and reliable diagnosis in daily practice? Is the diagnosis reproducible? What is the value of this sign for the prognosis of CVD and their treatment?</p></div><div><h3>Results</h3><p>In order to clinically define corona, the association of blue telangiectases and stasis spots has the best specificity, and the blue telangiectases is the most sensible item. Their associated presence can be considered as a good operational criterion for the positive diagnosis of corona.</p><p>Corona has also shown to be significantly correlated with the presence of incompetent leg perforator veins.</p><p>The presence of corona also has a high value to predict the occurrence of skin changes and venous ulceration in the next few years of evolution of the disease.</p></div><div><h3>Conclusion</h3><p>Corona should no longer be considered as simple telangiectases of the foot (C1). It is a simple and reliable clinical entity, extremely relevant for the severity of the disease.</p><p>This is the reason why a careful examination of the ankle should be done in any patient with CVD.</p></div>","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rvm.2013.07.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80004246","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}

引用次数: 0

Results and clinical consequences of trials on thoracic endografting 胸腔内植入术的临床效果

Reviews in Vascular Medicine Pub Date : 2013-06-01 DOI: 10.1016/j.rvm.2013.07.003

Ruth Benson, Benjamin O. Patterson, Ian M. Loftus

引用次数: 1

Surgery of venous valve 静脉瓣膜手术

Reviews in Vascular Medicine Pub Date : 2013-03-01 DOI: 10.1016/j.rvm.2013.02.002

Alberto Caggiati , Lorenza Caggiati

引用次数: 5

Foam sclerotherapy of saphenous veins—Results and side effects 泡沫硬化治疗隐静脉的效果及副作用

Reviews in Vascular Medicine Pub Date : 2013-03-01 DOI: 10.1016/j.rvm.2013.02.003

Jean-Luc Gillet

{"title":"Foam sclerotherapy of saphenous veins—Results and side effects","authors":"Jean-Luc Gillet","doi":"10.1016/j.rvm.2013.02.003","DOIUrl":"10.1016/j.rvm.2013.02.003","url":null,"abstract":"<div><p>Ultrasound-guided foam sclerotherapy<span> (UGFS) has become a common treatment of sephenous veins incompetence. The use of homemade foam is world-wide widespread though it is off-label in many countries.</span></p></div><div><h3>Objective</h3><p>The objective of this review is to present the results and the main side effects and complications of UGFS of saphenous veins.</p></div><div><h3>Method</h3><p>The method of this review is based on analyses of prospective randomized controlled trials (RCT) and case control studies including a large number of patients.</p></div><div><h3>Results—efficacy</h3><p>RCTs have demonstrated that UGFS is more efficient than liquid sclerotherapy. 1% polidocanol foam is not statistically less efficient than 3% polidocanol foam. Compared with the other methods of treatment of saphenous veins, RCTs have demonstrated that, though the failure rate was slightly higher after UGFS, the rate of recurrence and the clinical outcome were similar at 2 and 3-year follow-up.</p></div><div><h3>Complications</h3><p><span><span>Severe thromboembolic events are very rare. The frequency of </span>deep vein thrombosis (DVT) is estimated at 0.6%. Most of DVTs are distal. However we recommend applying prophylactic measures </span>in patients with a high risk of thromboembolism.</p><p>Neurological complications—while millions of foam sclerotherapy sessions have been performed worldwide, only a few cases of stroke have been reported. No death or stroke with significant after-effects related to the injection of foam has been reported to date. Prevention is based on the quality of foam and the injected volume (maximum of 10<!--> <span><span>mL per session according to the recommendations). Visual disturbances correspond to migraine with aura and are not </span>transient ischemic attacks.</span></p></div><div><h3>Conclusion</h3><p>UGFS is a safe and cost-effective therapy for patients with saphenous vein incompetence.</p></div>","PeriodicalId":101091,"journal":{"name":"Reviews in Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rvm.2013.02.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91167292","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}

引用次数: 6