International Journal of Angiology最新文献_第2页

How to Penetrate the Wall of an Unintentionally Deployed Wallstent in the External Carotid Artery for Stenting of an Internal Carotid Artery Lesion 如何穿透颈外动脉中无意部署的壁式支架壁，以对颈内动脉病变进行支架植入术

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International Journal of Angiology Pub Date : 2024-04-25 DOI: 10.1055/s-0044-1786395

Arash Hashemi, Alireza Serati, Arsis Ahmadieh, E. Khalilipur, Lida Ghaffari, M. Movahed

引用次数: 0

Contemporary Management of Pulmonary Embolism: Review of the Inferior Vena Cava ﬁlter and Other Endovascular Devices 肺栓塞的当代治疗：回顾下腔静脉过滤器和其他血管内设备

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International Journal of Angiology Pub Date : 2024-04-23 DOI: 10.1055/s-0044-1785231

KaChon Lei, Michael Dicaro, Nadia Tak, Scott Turnbull, Ala W. Abdallah, Tillman Cyrus, Tahir Tak

引用次数: 0

Role of Extracorporeal Membrane Oxygenation in the Treatment of Massive Pulmonary Embolism 体外膜氧合在治疗大面积肺栓塞中的作用

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International Journal of Angiology Pub Date : 2024-04-17 DOI: 10.1055/s-0044-1782658

Hugh A. Glazier, Amir Kaki

{"title":"Role of Extracorporeal Membrane Oxygenation in the Treatment of Massive Pulmonary Embolism","authors":"Hugh A. Glazier, Amir Kaki","doi":"10.1055/s-0044-1782658","DOIUrl":"https://doi.org/10.1055/s-0044-1782658","url":null,"abstract":"Massive/high-risk pulmonary embolism (PE) is associated with a 30-day mortality rate of approximately 65%. In searching for strategies that may make a dent on this dismal mortality rate, investigators have, over the last decade, shown renewed interest in the potential beneficial role of venoarterial (V-A) extracorporeal membrane oxygenation (ECMO) in the treatment of patients with high-risk PE. There is a dearth of high-quality evidence regarding the value of ECMO in the treatment of massive PE. Studies examining this issue have generally been retrospective, often single center and frequently with small patient numbers. Moreover, these reported studies are not matched with appropriate controls, and, accordingly, it is difficult to regulate for inherent treatment bias. Not surprisingly, there are no randomized controlled trials examining the value of ECMO in the treatment of massive PE, as such trials would pose formidable feasibility challenges. Over the past several years, there has been increasing support for upfront use of V-A ECMO in the treatment of massive PE, when it is complicated by cardiac arrest. In those patients without cardiac arrest, but who have contraindications for thrombolysis, V-A ECMO combined with anticoagulation may be used to stabilize the patient. If after 3 to 5 days, such patients demonstrate persistent right ventricular dysfunction, embolectomy (either surgical or catheter based) should be performed. Well-designed, multicenter, prospective studies are urgently needed to better define the role of V-A ECMO in the treatment of patients with massive PE.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140693841","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

Epidemiology, Etiology, and Pathophysiology of Pulmonary Embolism 肺栓塞的流行病学、病因学和病理生理学

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International Journal of Angiology Pub Date : 2024-04-12 DOI: 10.1055/s-0044-1785487

Catherine R. Glazier, F. Baciewicz

{"title":"Epidemiology, Etiology, and Pathophysiology of Pulmonary Embolism","authors":"Catherine R. Glazier, F. Baciewicz","doi":"10.1055/s-0044-1785487","DOIUrl":"https://doi.org/10.1055/s-0044-1785487","url":null,"abstract":"Over the last 20 years, there has been a progressive increase in the incidence of pulmonary embolism (PE) diagnosis in the United States, Europe, and Australia. Increased use of computed tomography pulmonary angiography has likely contributed in part to this rising incidence. However, it is pertinent to note that the burden of comorbidities associated with PE, such as malignancy, obesity, and advanced age, has also increased over the past 20 years. Time-trend analysis in North American, European, and Asian populations suggests that mortality rates associated with PE have been declining. The reported improved survival rates in PE over the past 20 years are likely, at least in part, to be the result of better adherence to guidelines, improved risk stratification, and enhanced treatment. Factors contributing to the development of venous thromboembolism (VTE) include stasis of blood, hypercoagulability, endothelial injury, and inflammation. In 70 to 80% of cases of PE, the thrombi embolizes from the proximal deep veins of the lower extremities and pelvis. Strong risk factors for VTE include lower extremity fractures and surgeries, major trauma, and hospitalization within the previous 3 months for acute myocardial infarction or heart failure with atrial fibrillation. Acute PE causes several pathophysiological responses including hypoxemia and right ventricle (RV) failure. The latter is a result of pulmonary artery occlusion and associated vasoconstriction. Hemodynamic compromise from RV failure is the principal cause of poor outcome in patients with acute PE.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140712252","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

A Brief Historical Perspective on Pulmonary Embolism 肺栓塞历史简述

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International Journal of Angiology Pub Date : 2024-04-05 DOI: 10.1055/s-0044-1782603

Clinton T. Morgan, Sibu P. Saha

引用次数: 0

Endothelial-Derived Microparticles Associate with Hospital Major Adverse Cardiovascular Events but not with Long-Term Adverse Events in Acute Myocardial Infarction 内皮细胞衍生的微颗粒与急性心肌梗死的医院主要不良心血管事件有关，但与长期不良事件无关

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International Journal of Angiology Pub Date : 2024-04-02 DOI: 10.1055/s-0044-1785488

A. B. Hartopo, D. S. Mayasari, Ira Puspitawati, Astrid K. Putri, B. Setianto

{"title":"Endothelial-Derived Microparticles Associate with Hospital Major Adverse Cardiovascular Events but not with Long-Term Adverse Events in Acute Myocardial Infarction","authors":"A. B. Hartopo, D. S. Mayasari, Ira Puspitawati, Astrid K. Putri, B. Setianto","doi":"10.1055/s-0044-1785488","DOIUrl":"https://doi.org/10.1055/s-0044-1785488","url":null,"abstract":"Endothelial-derived microparticles (EDMP) are markers of vascular function and convey roles in coagulation, inflammation, vasoactivity, angiogenesis, and cellular apoptosis, which implicate acute myocardial infarction (AMI). This study aimed to investigate whether, among AMI, on-admission EDMP counts affect hospital major adverse cardiovascular events (MACE) and whether the change of EDMP in 30-day posthospital discharge affects long-term follow-up MACE. The research design was a prospective cohort study. The subjects were 119 patients diagnosed and hospitalized with AMI, who were enrolled consecutively. The EDMP was measured on hospital admission and repeated 30-day posthospital discharge. The outcomes were in the hospital MACE comprised of cardiac mortality, heart failure, cardiogenic shock, reinfarction, and resuscitated ventricular arrhythmia. Furthermore, long-term follow-up were performed on 30-day, 90-day, and 1-year posthospital AMI discharge. The on-admission EDMP counts were significantly higher in subjects with hospital MACE compared with those without (median [interquartile range]: 27,421.0 [6,956.5–53,184.0] vs. 11,617.5 [4,599.0–23,336.7] counts/µL, p = 0.028). The EDMP counts cutoff value of >26,810.0 counts/µL (52.4% sensitivity, 81.6% specificity) had significantly increased hospital MACE occurrence (adjusted odd ratio: 4.45, 95% confidence interval: 1.47–13.53, p = 0.008). The EDMP counts were significantly increased after 30-day posthospital discharge. Both on-admission and 30-day EDMP counts and the changes in EDMP counts did not impact MACE on the long-term follow-up. In conclusion, higher on-admission EDMP counts were independently associated with hospital MACE among AMI. However, on-admission and 30-day postdischarge EDMP and their changes did not impact long-term follow-up MACE.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140751867","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

Anticoagulation in the Management of Acute Pulmonary Embolism-A Review. 急性肺栓塞治疗中的抗凝疗法--综述。

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International Journal of Angiology Pub Date : 2024-03-12 eCollection Date: 2024-06-01 DOI: 10.1055/s-0044-1782537

Raul Del Toro Mijares, Adrian Rojas Murguia, Mateo Porres-Aguilar, Debabrata Mukherjee

{"title":"Anticoagulation in the Management of Acute Pulmonary Embolism-A Review.","authors":"Raul Del Toro Mijares, Adrian Rojas Murguia, Mateo Porres-Aguilar, Debabrata Mukherjee","doi":"10.1055/s-0044-1782537","DOIUrl":"10.1055/s-0044-1782537","url":null,"abstract":"Venous thromboembolism (VTE) is a very frequent cardiovascular entity that encompasses deep vein thrombosis and pulmonary embolism (PE). This last entity represents a major cause of cardiovascular morbidity and mortality. The incidence of PE and the rate of PE-related morbidity significantly increase with age, race, and underlying medical conditions, such as malignancy. Given the recent advances in diagnostic strategies and algorithms, patients can be risk assessed and treated promptly to avoid disease progression. Anticoagulation is the mainstay of treatment for acute PE that is not hemodynamically unstable. Direct oral anticoagulants, such as apixaban, rivaroxaban, or edoxaban, are currently the preferred agents for the treatment of patients who present with acute PE or for long-term treatment. Treatment duration should be continued for at least 3 months, and all patients should be assessed for extended duration of therapy based on the precipitating factors that led to the development of the VTE. Novel anticoagulant agents targeting factor XI/XIa are currently being investigated in phases 2 and 3 clinical trials, representing an attractive option in anticoagulation therapies in patients with VTE. For hemodynamically unstable patients, systemic thrombolysis is the treatment of choice, and it may also be of benefit-in reduced dose-for patients with intermediate to high risk who are at risk of hemodynamic collapse.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11152618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283676","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}

引用次数: 0

Diagnostic Strategies in Pulmonary Embolism. 肺栓塞的诊断策略。

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International Journal of Angiology Pub Date : 2024-02-12 eCollection Date: 2024-06-01 DOI: 10.1055/s-0044-1779661

Margaret Mary Glazier, James J Glazier

{"title":"Diagnostic Strategies in Pulmonary Embolism.","authors":"Margaret Mary Glazier, James J Glazier","doi":"10.1055/s-0044-1779661","DOIUrl":"10.1055/s-0044-1779661","url":null,"abstract":"Key to the diagnosis of pulmonary embolism (PE) is a careful bedside evaluation. After this, there are three further diagnostic steps. In all patients, estimation of the clinical probability of PE is performed. The other two steps are measurement of D-dimer when indicated and chest imaging when indicated. The clinical probability of PE is estimated at low, moderate, or high. The prevalence of PE is less than 15% among patients with low clinical probability, 15 to 40% with moderate clinical probability, and >40% in patients with high clinical probability. Clinical gestalt has been found to be very useful in estimating probability of PE. However, clinical prediction rules, such as Wells criteria, the modified Geneva score, and the PE rule out criteria have been advocated as adjuncts. In patients with high clinical probability, the high prevalence of PE can lower the D-dimer negative predictive value, which could increase the risk of diagnostic failure. Consequently, patients with high probability for PE need to proceed directly to chest imaging, without prior measurement of D-dimer level. Key studies in determining which low to moderate probability patients require chest imaging are the Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism (ADJUST-PE), the Simplified diagnostic management of suspected pulmonary embolism (YEARS), and the Pulmonary Embolism Graduated D-Dimer trials. In patients with low clinical probability, PE can be excluded without imaging studies if D-dimer is less than 1,000 ng/mL. In patients in whom there is not a low likelihood for PE, this can be excluded without imaging studies if the D-dimer is below the age-adjusted threshold.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11152624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283586","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}

引用次数: 0

Chronic Limb-Threatening Ischemia does not Enclose a Homogenous Population: Time for a More Detailed Classification 危及肢体的慢性缺血并不包括同质人群：是时候进行更详细的分类了

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International Journal of Angiology Pub Date : 2023-12-15 DOI: 10.1055/s-0043-1777414

Schraepen Cédric, van der Laan Lijckle, Smet Nick, Meulenbroek Anne, Fourneau Inge

{"title":"Chronic Limb-Threatening Ischemia does not Enclose a Homogenous Population: Time for a More Detailed Classification","authors":"Schraepen Cédric, van der Laan Lijckle, Smet Nick, Meulenbroek Anne, Fourneau Inge","doi":"10.1055/s-0043-1777414","DOIUrl":"https://doi.org/10.1055/s-0043-1777414","url":null,"abstract":"Abstract Objective Chronic limb-threatening ischemia (CLTI) is associated with high morbidity and mortality. Classification methods differentiate into patients with rest pain or with ischemic ulcers. No distinction is made between the presence or absence of rest pain in patients with ischemic ulcers. Our aim is to determine any differences in outcome between these subdivisions so we can improve preoperative counseling and risk assessment. Methods This multicenter retrospective cohort study included all patients revascularized for a first episode of CLTI between 2013 and 2018. The cohort was divided in three groups: patients with solely rest pain (RP), solely ischemic ulcers (IU), and patients with both rest pain and ischemic ulcers (RP + IU). Baseline characteristics, morbidity, and mortality were analyzed. Results A total of 624 limbs in 599 patients were included: 225 (36.1%) in the rest pain group, 169 (27.1%) in the ischemic ulcers group, and 230 (36.2%) in combined group. Amputation rates were higher in the combined group at 6 months. Mortality rates were significantly higher in the ischemic ulcers group and the combined group at 6 months and 1 year. Conclusions Patients with solely rest pain have significantly lower mortality rates in comparison to patients with ischemic ulcers. Rest pain did not affect mortality rates in patients with ulcers. There was a higher amputation rate in patients with combined rest pain and ischemic ulcers because the presence of rest pain CLTI patients had a significant negative effect on amputation risk. A separate subdivision for patients with combined ulcers and rest pain is indicated.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139000700","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

An Atypical Presentation of Decubitis Angina in a Patient with Coronary Artery Disease and Aortic Regurgitation: Case Report 冠状动脉疾病和主动脉瓣反流患者褥疮性心绞痛的非典型表现：病例报告

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International Journal of Angiology Pub Date : 2023-12-12 DOI: 10.1055/s-0043-1777343

E. Yetkın, Hasan Atmaca, K. Yalta

引用次数: 0