International Journal of Angiology最新文献

{"title":"Pericardial Decompression Syndrome: A Comprehensive Review of a Controversial Entity.","authors":"Karan Sarode, Amar Patel, Kedzie Arrington, Rakhee Makhija, Debabrata Mukherjee","doi":"10.1055/s-0044-1780536","DOIUrl":"10.1055/s-0044-1780536","url":null,"abstract":"<p><p>Pericardial decompression syndrome is an ambiguous clinical entity which has generated controversy regarding its existence. Following pericardial decompression, patients experienced clinical deterioration ranging in complications from pulmonary edema to death that could not be attributed to any other distinct clinical pathology. Multiple theories have suggested the pathophysiology behind pericardial decompression syndrome is related to preload-afterload mismatch following pericardial decompression, coronary microvascular ischemia, and stress from high adrenergic state. Our review aims to describe this syndrome by analyzing demographics, etiology of pericardial effusion, method of drainage, volume of pericardial fluid removed, time to decompensation, and clinical outcomes. A systematic review of MEDLINE/PubMed and Google Scholar literature databases were queried for case reports, case series, review articles, and abstracts published in English journals between 1983 and December 2022. Each author's interpretation of echocardiographic and/or pulmonary arterial catheterization data provided in the case reports was used to characterize ventricular dysfunction. Based on our inclusion criteria, 72 cases of pericardial decompression syndrome were included in our review. Our results showed that phenotypic heterogeneity was present based on echocardiographic findings of right/left or biventricular failure with similar proportions in each type of ventricular dysfunction. Time to decompensation was similar between immediate, subacute, and acute cases with presentation varying between hypoxic respiratory failure and shock. This review article highlights theories behind the pathophysiology, clinical outcomes, and therapeutic options in this high mortality condition.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"33 3","pages":"139-147"},"PeriodicalIF":0.5,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916627","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":"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":"<p><p>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.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"33 2","pages":"89-94"},"PeriodicalIF":0.5,"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}

{"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":"33 3","pages":""},"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}

{"title":"Supervised Exercise Training May Improve Postural Control in Patients with Symptomatic Lower Extremity Peripheral Artery Disease","authors":"Francis Degache, Willy Mak, L. Calanca, Lucia Mazzolai, S. Lanzi","doi":"10.1055/s-0043-1777257","DOIUrl":"https://doi.org/10.1055/s-0043-1777257","url":null,"abstract":"Abstract Patients with symptomatic peripheral artery disease (PAD) have been shown to present balance disorders and a history of falling, which are associated with functional and daily life impairments. Although postural control improvement is an important outcome, the benefits of supervised exercise training (SET) on postural control have been seldom investigated in these patients. This article investigates the effects of SET on traditional measures of postural control and on stabilogram-diffusion analysis (SDA) parameters in patients with symptomatic PAD. Patients with symptomatic chronic lower limb claudication were investigated. All subjects who completed the 3-month multimodal SET program and postural control assessment before and after SET were included. Center of pressure trajectory analysis and SDA parameters were investigated using a posturographic platform. Patients were instructed to stand on the platform and maintain balance to their best ability. Treadmill pain-free (PFWD) and maximal (MWD) walking distances were also assessed prior and following SET. Forty-four patients with PAD (65.2 ± 9.8 years, 34% women) were investigated. All postural control parameters were unchanged following SET, except the length of center of pressure displacement as a function of the surface of center of pressure trajectory (LFS), which was significantly increased (before SET: 1.4 ± 0.4; after SET: 1.5 ± 0.5; p  = 0.042). PFWD (before SET: 103.5 ± 77.9 m; after SET: 176.8 ± 130.6 m; p ≤ 0.001) and MWD (before SET: 383.6 ± 272.0 m; after SET: 686.4 ± 509.0 m; p ≤ 0.001) significantly improved following SET. The increased LFS suggests a better postural control accuracy following SET in patients with symptomatic PAD.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"8 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139232983","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":"Successful Endovascular Treatment of Postbiopsy AVF in Transplanted Kidneys: Lessons Learned from Two Cases in Multiorgan Transplant Recipients","authors":"Sven Želalić, B. Šimunov, Bojana Maksimović, Rea Mužar, Mario Laganović, V. Vidjak","doi":"10.1055/s-0043-1777256","DOIUrl":"https://doi.org/10.1055/s-0043-1777256","url":null,"abstract":"Abstract Allograft biopsy is a cornerstone in the management of transplanted kidneys. It is a safe procedure, often performed in the outpatient setting. A rare complication is formation of a postbiopsy arteriovenous fistula (AVF). We present here a report of two cases of postbiopsy AVFs treated endovascularly. Selective embolization is a safe and effective method of treatment of postbiopsy AVFs in renal allografts.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"4 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139233182","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":"Current Evidence and Future Directions of Omega-3 Supplementation and Cardiovascular Disease Risk","authors":"B. Dwiputra, Anwar Santoso, Budhi Setianto Purwowiyoto, B. Radi, B. Pandhita, Serlie Fatrin, A. M. Ambari","doi":"10.1055/s-0043-1777258","DOIUrl":"https://doi.org/10.1055/s-0043-1777258","url":null,"abstract":"Abstract Omega-3 supplementation has a controversial role in the secondary prevention of cardiovascular diseases. Despite large clinical trials published over the years, the evidence of omega-3 in preventing cardiovascular diseases, especially coronary heart disease, is still inconclusive. However, recent clinical trials using higher dose of omega-3 or highly purified esters of omega-3 shows promising result, with reduction in cardiovascular death and incidence of cardiovascular disease. This review aims to summarize the possible mechanism of omega-3 in preventing cardiovascular disease and future directions of research regarding the benefit of omega-3 in cardiovascular disease.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"97 11","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139238889","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":"Three-Dimensional Morphometric Analysis of Anterior Cerebral Circulation Aneurysms","authors":"Giancarlo Saal-Zapata, Melanie Walker, Rosa Cervantes-Medina, Rodolfo Rodríguez-Varela","doi":"10.1055/s-0043-1774740","DOIUrl":"https://doi.org/10.1055/s-0043-1774740","url":null,"abstract":"Abstract This article assesses the association between anterior circulation morphometry and the presence of intracranial aneurysm using three-dimensional rotational angiography (3DRA). A retrospective analysis at a Peruvian academic medical center between December 2018 and February 2020 identified 206 patients with unruptured intracranial aneurysms and matched controls who underwent 3DRA. Angiographic images were obtained per standard of care, and measurements of the vasculature were performed using 3DRA vascular automated software. A total of 163 aneurysms and 43 control angiograms were evaluated. Women represented 82.5% of the cases and the mean age was 55.9 years (standard deviation ± 14.2). In multivariate analysis, five specific features were found to be statistically significant predictors for presence of an anterior circulation aneurysm: female sex (odds ratio [OR] = 2.71; p  = 0.048), C-shape of the middle cerebral artery (MCA) (OR = 2.73; p  = 0.018), distal internal carotid artery (ICA) diameter (OR = 3.42; p  = 0.012), ICA bifurcation angle (OR = 1.02; p  = 0.036), and length of the carotid siphon (OR = 1.08; p  = 0.047). Features detected on 3DRA suggest morphological characteristics of the ICA and MCA may be predictive for intracranial aneurysm. Our findings build from prior reports by demonstrating five specific patient and imaging features associated with anterior circulation aneurysms. While 3DRA is the standard of care in many settings, medical centers with resource limitations may not have access to this technique. The demographic and morphological features identified in our study may have correlates that if detected on contrast computed tomography or magnetic resonance imaging studies, may be used to help screen for a higher level of care in select patients.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135552674","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":"Rare Case of Chronic Limb-Threatening Ischemia in a 32-Year-Old Patient with Nephrotic Syndrome: A Case Report","authors":"Jonathan Edbert Afandy, Taofan Taofan, Suci Indriani, Edwin Adhi Darmawan Batubara, Suko Adiarto","doi":"10.1055/s-0043-1774739","DOIUrl":"https://doi.org/10.1055/s-0043-1774739","url":null,"abstract":"Abstract Chronic limb-threatening ischemia represents the end stage of peripheral artery disease (PAD), primarily affecting individuals over 60 years old. While quite rare, nephrotic syndrome (NS) is recognized for increasing the susceptibility to arterial thromboembolism (ATE). A 32-year-old male complained of resting pain in his left leg and pain after walking 50 meters with his right leg. He had a 9-year history of NS confirmed through biopsy and was on a daily regimen of 2 × 360 mg mycophenolic acid and 1 × 8 mg methylprednisolone. He had no history of hypertension, diabetes, or smoking. Atrophy and ulcers were observed on his left leg. Laboratory tests revealed elevated D-dimer and borderline high cholesterol levels. The right ankle-brachial index was 0.5, and for the left, it was 0.33. Computed tomography angiography identified occlusion in the left external iliac artery and right superficial femoral artery (SFA). The patient underwent percutaneous transluminal angioplasty with a plain balloon on both legs and an additional drug-eluting stent on the left SFA. He was discharged on rivaroxaban, clopidogrel, aspirin, simvastatin, mycophenolic acid, and methylprednisolone, with no complaints. The mechanism behind NS-caused ATE remains unclear, although it is associated with the loss of anticoagulants in urine, increased procoagulant activity, altered fibrinolytic systems, thrombocytosis, and enhanced platelet activation. Prolonged corticosteroid therapy in NS management also amplifies the risk of thromboembolism by promoting a hypercoagulable state. We suspected NS and the prolonged use of corticosteroids as risk factors for ATE, manifested as PAD in our patient. While optimal NS therapy may reduce the risk of PAD, prolonged corticosteroid use should be closely monitored.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135552682","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":"From the President","authors":"R. MacLeod","doi":"10.1177/00031313231178572","DOIUrl":"https://doi.org/10.1177/00031313231178572","url":null,"abstract":"","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"73 1","pages":"12 - 12"},"PeriodicalIF":0.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64795035","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":"Relationship between Hemoglobin Concentration at Admission with the Incidence of No-Reflow Phenomenon and In-Hospital Mortality in Acute Myocardial Infarction with Elevation of ST Segments in Patients who underwent Primary Percutaneous Coronary Intervention.","authors":"Kiagus Muhammad Andri Akbar,&nbsp;Surya Dharma,&nbsp;Hananto Andriantoro,&nbsp;Renan Sukmawan,&nbsp;Arwin Saleh Mangkuanom,&nbsp;Vidya Gilang Rejeki","doi":"10.1055/s-0042-1742308","DOIUrl":"https://doi.org/10.1055/s-0042-1742308","url":null,"abstract":"<p><p>Anemia in acute ST-segment elevation myocardial infarction (STEMI) is associated with a pro-coagulant state, contributing to the incidence of no-reflow phenomenon and increased mortality following primary percutaneous coronary intervention (PPCI). However, clinical data remain contradictory. The objective of our study was to evaluate the association of admission hemoglobin (Hb) concentration and in-hospital mortality of STEMI patients' post-PPCI, as well as final thrombolysis in myocardial infarction (TIMI) flow. A cross-sectional study was performed from the database of Jakarta Acute Coronary Syndrome Registry, consisting of 3,071 STEMI patients who underwent PPCI between January 2014 and December 2019. No-reflow phenomenon was defined as final TIMI flow <3 of the infarct-related artery. Outcome measures were the occurrence of no-reflow and in-hospital mortality. Anemia criteria were based on the World Health Organization. Anemia was found in 550 patients (17.9%). Patients with anemia were older (60 ± 10 years, <i>p</i>  < 0.001), predominantly women (20.7 vs. 11.2%, <i>p</i>  < 0.001), TIMI risk score >4 (45.8 vs. 30.4%, <i>p</i>  < 0.00), and Killip classification >1 (25.8 vs. 20.8%, <i>p</i>  < 0.009). Anemia at admission was not associated with no-reflow phenomenon (odds ratio [OR] = 0.889; 95% confidence interval [CI] = 0.654-1.209, <i>p</i>  = 0.455). Multivariate regression models showed that anemia was not associated with in-hospital mortality (OR = 0.963; 95% CI = 0.635-1.459, <i>p</i>  = 0.857) and with no-reflow phenomenon (OR = 0.939; 95% CI = 0.361-2.437, <i>p</i>  = 0.896). Anemia upon admission was not related to the no-reflow phenomena or in-hospital mortality in STEMI patients undergoing PPCI.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 2","pages":"106-112"},"PeriodicalIF":0.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191690/pdf/10-1055-s-0042-1742308.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499844","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}