Raka A Nugraha, Hary S Muliawan, Nyityasmono T Nugroho, Muhammad Ikhsan, Suko Adiarto
{"title":"Catastrophic Concomitant Arterial and Venous Thrombosis in a Mild COVID-19-Positive Patient.","authors":"Raka A Nugraha, Hary S Muliawan, Nyityasmono T Nugroho, Muhammad Ikhsan, Suko Adiarto","doi":"10.1055/s-0041-1735200","DOIUrl":"10.1055/s-0041-1735200","url":null,"abstract":"<p><p>Since its first discovery in late 2019, coronavirus disease 2019 (COVID-19) has been a global burden associated with significant morbidity and mortality. COVID-19 has been correlated with the development of hypercoagulable state that predisposes the patients to a higher risk of thromboembolism. Current evidence suggests higher incidence of thrombosis, particularly venous thrombosis, among hospitalized COVID-19 patients, mostly with critical illness. On the other hand, there is currently no data regarding the incidence of vivid thrombosis in ambulatory patients with mild COVID-19 and the incidence of concomitant arterial and venous thrombosis in COVID-19 is extremely rare. Herein, we describe catastrophic outcomes of concomitant lower limb arterial and venous thrombosis in a patient with mild COVID-19. This report highlights the occurrence of concomitant arterial and venous thrombosis in ambulatory setting and that this phenomenon resulted in catastrophic clinical consequences.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 3","pages":"197-201"},"PeriodicalIF":0.5,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421675/pdf/10-1055-s-0041-1735200.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10371906","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}
Sidhi Laksono, B. Setianto, Mohammad Iqbal, A. S. Prawara
{"title":"Understanding Pacemaker-Induced Cardiomyopathy Incidence and Predictors in Patients with Right Ventricular Pacing: A Systematic Review","authors":"Sidhi Laksono, B. Setianto, Mohammad Iqbal, A. S. Prawara","doi":"10.1055/s-0041-1735206","DOIUrl":"https://doi.org/10.1055/s-0041-1735206","url":null,"abstract":"Abstract This study aimed to figure out the incidence and predictors of pacemaker-induced cardiomyopathy (PICM) in patients with right ventricular (RV) pacing. We systematically searched in PubMed on March 18, 2020, for English language abstract and full-article journals, using the following criteria: pacemaker induced cardiomyopathy AND right ventricular AND pacemaker AND patients AND human NOT implantable cardioverter defibrillator NOT ICD NOT animal. Four studies were included in this review after filtering 35 studies through year of publication and abstract selection. The average PICM incidence from 1,365 patients included from the four studies was 10.7 to 13.7%. One study stated that preimplantation left ventricular ejection fraction (LVEF) was the predictor for the development of PICM. Three studies mentioned that RV pacing burden was the predictor for the development of PICM. However, the percentage differ in three studies: ≥20, >40, and 60%. In addition, one of the studies also included interventricular dyssynchrony as another predictor. The incidence of PICM in patients with RV pacing ranged from 10.7 to 13.7%. Preimplantation LVEF, interventricular dyssynchrony, and burden of RV pacing are reported as the predictors for the development of PICM in patients with RV pacing.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47619912","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}
Suko Adiarto, Novi Kurnianingsih, Indra Prasetya, Faris W Nugroho, Raman Uberoi
{"title":"Successful Primary PCI in Stanford Type A Aortic Dissection Complicated by Inferior ST-Elevation Myocardial Infarction: A Case in a Facility with No Surgical Backup.","authors":"Suko Adiarto, Novi Kurnianingsih, Indra Prasetya, Faris W Nugroho, Raman Uberoi","doi":"10.1055/s-0041-1735205","DOIUrl":"10.1055/s-0041-1735205","url":null,"abstract":"<p><p>Mortality of type A aortic dissection (TAAD) complicated with coronary malperfusion syndrome is very high even when emergency surgery is performed. Several reports suggested that primary percutaneous coronary intervention (PPCI) followed by immediate corrective surgery may reduce mortality. In many countries, immediate transfer to an aortic surgery center may not be possible. We report a case of TAAD complicated by coronary malperfusion successfully treated with PPCI followed by elective corrective surgery. A 48-year-old man was referred to emergency department with acute inferior ST-elevation myocardial infarction (STEMI) and underwent PPCI. During the procedure, we realized that the cause of STEMI was TAAD. We decided to continue because the patient experienced seizures and bradycardia. Subsequently, echocardiography and computed tomography confirmed the dissection. The patient was discharged and referred to the National Cardiovascular Center where he underwent successful elective surgery. In this patient, immediate revascularization was lifesaving and served as a bridging procedure before surgical correction.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"1 1","pages":"62-65"},"PeriodicalIF":0.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10861288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41573171","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}
{"title":"Relevant Nomenclature Considerations during Coronary Artery Contrast Injection.","authors":"Brett Thomas Snodgrass","doi":"10.1055/s-0041-1735202","DOIUrl":"https://doi.org/10.1055/s-0041-1735202","url":null,"abstract":"Note: This letter is a reply to: Valencia D, Linares J, Das S, ValenciaV,YatsynovichY.UncommonCoronaryAbnormalities in a Patient with Discoid Lupus Erythematosus. Int J Angiol. 2020 Dec;29(4):260–262. doi: 10.1055/s-0039-1696978. Epub 2019 Sep 12. PMID: 33268978; PMCID: PMC7690985. Fig. 3B in the report by Valencia et al1 states that the image demonstrates connections between the coronary veins and the heart chambers. The arrow heads are reported to be connections between the coronary veins and heart chambers.1 However, the right-most arrow head is adjacent to a contrast-dense vessel which appears to be a distributary of the injected right coronary artery. Instead of a connection between the coronary vein and heart chamber, this appears to be a connection between the coronary artery and heart chamber, similar to the vessels described byWearn et al and noted by other angiographers.2 Parenthetically, the arterial-cameral connections first reported by Vieussens in 17063 and later described byWearn in 19334 are distinct from the vein-cameral connection first reported by Thebesius in 1708.5 In conclusion, the authors1 appear to demonstrate cardiac arteriocameral connections and not cardiac venocameral connections. Funding None.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"30 4","pages":"298"},"PeriodicalIF":0.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8608474/pdf/10-1055-s-0041-1735202.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39936272","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}
{"title":"Laser Doppler Measurements of Systolic Blood Pressure on the First and Second Toe in Patients with Peripheral Arterial Disease","authors":"S. Rosfors, A. Modin, J. Petrini","doi":"10.1055/s-0041-1735237","DOIUrl":"https://doi.org/10.1055/s-0041-1735237","url":null,"abstract":"Abstract Laser Doppler was used to measure toe blood pressure (TBP) in 40 consecutive patients with various degree of peripheral arterial disease. The aim of this methodological study was to increase the usefulness of TBP by exploring the interchangeability between TBP from the first and second toe and by investigating daily routine reproducibility and measurement variability. According to our study design pressure values were based on three measurements that were averaged. At simultaneous measurements, TBP of the first toe was 71 mm Hg (standard deviation [SD] 25) compared with 70 mm Hg (SD 25) on the second toe. The correlation (r) between first and second toe pressure measurements was 0.84 and intraclass correlation coefficient (ICC) was 0.84. The difference between TBP on the first and second toe was not related to gender, diabetes, or magnitude of the pressures. Repeated TBP measurements of the right first toe after disconnection of cuffs, 5 to 10 minutes rest, and reconnection of cuffs had a coefficient of variation (CV) of 9% and an ICC of 0.93. CV for toe-brachial index (TBI) was 8%. Our results show that measurements of TBP from the second toe to a large extent are interchangeable with those assessed from the first toe and can be used in clinical situations where measurements from the first toe are not feasible. Flow detection with three averaged laser Doppler measurements generates TBP and TBI with low variability.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2021-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47457319","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}
Omair Shah, N. Choh, T. Shera, F. Shera, T. Gojwari, Feroze A. Shaheen, I. Robbani
{"title":"Magnetic Resonance Imaging in Cardiac Amyloidosis: Unraveling the Stealth Entity","authors":"Omair Shah, N. Choh, T. Shera, F. Shera, T. Gojwari, Feroze A. Shaheen, I. Robbani","doi":"10.1055/s-0041-1735948","DOIUrl":"https://doi.org/10.1055/s-0041-1735948","url":null,"abstract":"Abstract Amyloidosis is a systemic disease involving many organs. Cardiac involvement is a significant cause of morbidity and mortality in these patients. Diagnosis of cardiac amyloidosis is based on endomyocardial biopsy which however is invasive and associated with complications. Noninvasive methods of diagnosis include magnetic resonance imaging (MRI) with various methods and sequences involved. Our study aims at describing MRI features of cardiac amyloidosis including new imaging sequences and to prognosticate the patients based on imaging features. We included 35 patients with suspected cardiac amyloidosis who underwent MRI at our center over 4 years. All images were retrieved from our archive and assessed by an experienced radiologist. Common morphological features in our patients included increased wall thickness of left ventricle (LV) (16. 1 ± 4.1 mm), right ventricle (RV) (6.3 ± 1.1 mm), and interatrial septum (6.2 ± 0.8 mm). Global late gadolinium enhancement (LGE) (n = 21 [65%]) including subendocardial or transmural was the most common pattern followed by patchy enhancement. Global transmural LGE was associated with worse prognosis. Four types of myocardial nulling patterns were observed on postcontrast time to invert (TI) scout imaging: normal nulling pattern (myocardium nulls after blood and coincident with spleen) and abnormal nulling pattern (ANP) which is further divided into three types: Type 1—myocardium nulls before blood pool but coincident with spleen, Type 2—myocardium nulling coincident with blood but not coincident with spleen, and Type 3—features of both Type 1 and Type 2. Type 3 ANP was the most common (n = 23) nulling pattern in our patients. Cardiac MRI is an essential in noninvasive diagnosis of cardiac amyloidosis. Transmural global LGE serves as a poor prognosticator in these patients. “Three-tier” TI scout imaging is essential to avoid false-negative enhancement results. Type 3 ANP is the most specific nulling pattern in cardiac amyloidosis.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2021-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46463839","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":"Percutaneous Coronary Intervention with Stenting versus Coronary Artery Bypass Grafting in Stable Coronary Artery Disease.","authors":"Ian C Glenn, Gabriele M Iacona, Abeel A Mangi","doi":"10.1055/s-0041-1735238","DOIUrl":"10.1055/s-0041-1735238","url":null,"abstract":"<p><p>The debate over coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) with stent placement for the treatment of stable multivessel coronary artery disease (CAD) continues in spite of numerous studies investigating the issue. This paper reviews the most recent randomized control trials (RCT) and meta-analyses of pooled RCT data to help address this issue. General trends demonstrated that CABG was superior in all-cause mortality and fulfilling the need for repeat revascularization. These advantages tended to be more pronounced in multivessel CAD and diabetes, and less so in left main CAD. PCI showed a consistently lower rate of cerebrovascular events. CABG continues to offer significant advantages over PCI, even as drug-eluting stent technology continues to evolve. The ideal endpoint for comparing PCI and CABG remains to be determined. Furthermore, additional research is required to further refine patient selection criteria for each intervention.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"30 3","pages":"221-227"},"PeriodicalIF":0.5,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8580606/pdf/10-1055-s-0041-1735238.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39711684","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}
Sophie Elhomsy, J. Chrusciel, Stéphane Sanchez, Paul Elhomsy, J. Guillaumat
{"title":"Clinical Efficacy and Safety of Long-Term Compression in Patients with Mixed Arterial and Venous Etiology Ulcers in the Leg","authors":"Sophie Elhomsy, J. Chrusciel, Stéphane Sanchez, Paul Elhomsy, J. Guillaumat","doi":"10.1055/s-0041-1735204","DOIUrl":"https://doi.org/10.1055/s-0041-1735204","url":null,"abstract":"Abstract Elastic compressions are standard treatment for leg ulcers of venous etiology. The effect of compressions on ulcers of mixed (arterial or venous) etiology, however, has rarely been studied. The objective of this study was to evaluate the variation in transcutaneous oxygen pressure (TcPO2) in patients with ulcers of mixed arterial or venous etiology treated with 1 month of compression. This prospective cohort study was conducted at a university hospital in France. Patient eligibility was for those attending a consultation of a work-up of a leg ulcer of mixed arterial-venous etiology lasting at least 4 to 6 weeks. Compressions were prescribed according to the hemodynamic status and were evaluated by the ankle-brachial index and toe-brachial index using a decision-making algorithm based on French national guidelines. Quality of life was assessed using the Short-Form 36-Item (SF-36) questionnaire. In total, 32 patients were included between September 30, 2018 and May 31, 2019. A difference was observed between TcPO2 before compression (49.3 ± 13.01 mm Hg) and after 1 month (51.2 ± 15.05 mm Hg), average change 1.9 ± 2.04 mm Hg (p = 0.025). The average ulcer size prior to compression was 49 ± 102 cm2 versus 37 ± 94 cm2 after 1 month of effective compression, corresponding to a reduction of 12 ± 8 cm2 (p < 0.001). There was a reduction in the bodily pain dimension of the SF-36. Compressions adapted to the hemodynamic status led to an increase in TcPO2, a reduction in wound size, and an improvement to bodily pain in patients with leg ulcers of mixed arterial-venous etiology.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48182894","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":"Left Main Coronary Artery Disease in Diabetics: Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting?","authors":"Logan Disney, Chandrashekhar Ramaiah, Meghna Ramaiah, Suresh Keshavamurthy","doi":"10.1055/s-0041-1730446","DOIUrl":"10.1055/s-0041-1730446","url":null,"abstract":"<p><p>The choice between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for myocardial revascularization in patients with left main disease (LMD) is controversial. There is general agreement that CABG is appropriate for all patients, and PCI is acceptable for those with low-to-intermediate anatomic complexity. However, there is uncertainty about the relative safety and efficacy of PCI in patients with more complex LMD and with comorbidities such as diabetes. No direct comparison trial has focused on revascularization in diabetic patients with LMD, and thus conclusions on the topic are subject to the limitations of subgroup analysis, as well as the heterogeneous exclusion criteria, and methodologies of individual trials. The available evidence suggests that among diabetics, CABG is superior in patients with LMD with SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and dardiac surgery) score greater than 33, distal bifurcation disease, or multivessel disease. PCI may be appropriate in those with less-extensive disease or those with limited life expectancy or high surgical risk.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"30 3","pages":"194-201"},"PeriodicalIF":0.5,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8580605/pdf/10-1055-s-0041-1730446.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39711681","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}
Aaron R Dezube, Jake Rauh, Michael Dezube, Mark Iafrati, JoAnn Rigo, Paula Muto
{"title":"Correlation between Restless Leg Syndrome and Superficial Venous Reflux.","authors":"Aaron R Dezube, Jake Rauh, Michael Dezube, Mark Iafrati, JoAnn Rigo, Paula Muto","doi":"10.1055/s-0041-1730447","DOIUrl":"https://doi.org/10.1055/s-0041-1730447","url":null,"abstract":"<p><p>Restless leg syndrome (RLS) is a common cause of lower extremity discomfort. We hypothesized that patients with RLS symptoms have higher rates of deep and superficial venous reflux (SVR). Retrospective review of patients ≥18 years of age evaluated in a venous center from December 2018 to February 2019. Differences in rates of RLS symptoms, demographics, comorbidities, and clinical and radiologic presence of venous disease were analyzed. Overall, 207 patients were analyzed; 140 (67.6%) reported RLS symptoms ( <i>n</i> = 25 with prior RLS diagnosis). RLS symptoms were more common with superficial or combined superficial and deep venous reflux (DVR) compared with those without reflux ( <i>p</i> < 0.001). Patients with RLS symptoms as opposed to those without had similar demographics and comorbidities (all <i>p</i> > 0.05) but increased rates of venous pain, phlebitis, family history of venous disease, lower extremity swelling and SVR, and combined SVR and DVR (all <i>p</i> < 0.05). Our multivariable logistic regression found presence of SVR, and family history of venous reflux was associated with RLS symptomatology (all <i>p</i> < 0.001). Ninety-nine patients with RLS underwent ablation; of them, 93 had duplex-proven reflux resolution of which 81 (87%) reported RLS symptom improvement. This included 13 of 16 (81.3%) with prior RLS diagnosis. SVR is associated with increased rates of RLS symptoms in a vein center population. Therefore, RLS symptoms should trigger a targeted venous evaluation. Our results suggest that venous ablation may lead to resolution of RLS symptoms in patients with SVR, but randomized prospective trials with strict RLS definition criteria are warranted to confirm these outcomes.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"30 4","pages":"285-291"},"PeriodicalIF":0.6,"publicationDate":"2021-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8608464/pdf/10-1055-s-0041-1730447.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39936271","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}