International Journal of Angiology最新文献

{"title":"Ambulatory Care Management in Low Blood Pressure Patient with HFrEF","authors":"Fajar H. Panjaitan, D. Hasanah, E. Yonas, R. Soerarso","doi":"10.1055/s-0043-1761271","DOIUrl":"https://doi.org/10.1055/s-0043-1761271","url":null,"abstract":"Abstract Heart failure (HF) affects an estimated 38 million people globally, with most published research estimating a prevalence of 1 to 2% of the adult population. Low blood pressure (BP) is reported in 10 to 15% of patients with HF in clinical trials, although this proportion is much more frequent in routine clinical practice. Low BP in outpatients has a better outcome compared to inpatients. Low BP is often a restricting factor in the use and uptitration of guideline-directed medical therapy (GDMT). A 57-year-old male presented himself to the HF clinic with complaints of bloating, shortness of breath, and fatigue. The patient had a history of acute coronary syndrome and cardiac arrest, but the results of coronary angiography showed nonsignificant coronary artery disease. Cardiomegaly was seen on chest X-ray. Electrocardiogram showed pathologic q wave II, III, and AvF with poor r wave progression on V1-V6. The patient was admitted due to acute decompensated HF with hypotension. After the initial decongestion patient was treated with sacubitril/valsartan, bisoprolol, and spironolactone in the outpatient clinic. Patient complaints and BP slowly improved during the outpatient phase. Hypotension remains a challenge in implementing GDMT in HF patients. By following the steps according to algorithm and current guidelines, GDMT can be optimized in these patients.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46843872","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":"Increased Prevalence of Pulmonary Embolism during the COVID-19 Pandemic in the US: An Infodemiological Analysis.","authors":"Camilla Mattiuzzi, Giuseppe Lippi","doi":"10.1055/s-0043-1761291","DOIUrl":"10.1055/s-0043-1761291","url":null,"abstract":"","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 3","pages":"193"},"PeriodicalIF":0.6,"publicationDate":"2023-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10371912","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":"The Importance of Engaging in Scientific Research during Medical Training.","authors":"Tanzim Bhuiya, Amgad N Makaryus","doi":"10.1055/s-0042-1759542","DOIUrl":"10.1055/s-0042-1759542","url":null,"abstract":"<p><p>Many components of required skills and competencies exist, and are felt to contribute to the successful completion of training for independent practice in the medical field as a physician. These requirements are documented and detailed in a temporal fashion during the training period and used for advancement during training as well as documentation of successful completion of that training. While clinical skill development that allows optimal care and treatment of patients is of utmost importance during this training, other components of the training are important and contribute to the ideal development of a well-rounded and credentialed physician. One of these other components which is very important and needs to be recognized is the engagement of medical trainees across disciplines in academic and research scholarly activity. This engagement is an important component of medical training, and the development of skills and didactics geared toward efficient and accurate performance of research is essential.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 3","pages":"153-157"},"PeriodicalIF":0.6,"publicationDate":"2023-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10352053","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":"Single-Center Study Evaluating Long-Term Major Adverse Outcomes with the Use of Paclitaxel-Coated Balloons in Treating Infrainguinal Arterial Disease.","authors":"Nicolas W Shammas, Elizabeth Sharis, Gail A Shammas, Susan Jones-Miller","doi":"10.1055/s-0042-1759818","DOIUrl":"10.1055/s-0042-1759818","url":null,"abstract":"<p><p>Paclitaxel drug-coated balloons (DCB) have been shown to reduce target lesion revascularization (TLR) rate, but recently an association between paclitaxel and an increase in mortality at 5-year was reported. We reviewed the 5-year mortality and freedom from TLR rates from a single center among patients that received DCB. Consecutive patients that received DCB from July 8, 2015 to November 27, 2019 with follow-up obtained from medical records and review of official death certificates were reviewed. The primary objective was total mortality and TLR rates with cumulative exposure to paclitaxel-coated balloons. Demographic, angiographic, clinical, and procedural variables were collected. Causes of mortality were classified according to death certificates. Descriptive analysis was performed on all variables. Kruskal-Wallis test was used to compare the total length of DCBs in those who were alive and those who died by the end of study. Kaplan-Meier (KM) was used to plot the freedom from mortality up to 5 years. A total of 91 symptomatic patients received the Lutonix balloon at index to treat femoropopliteal arterial disease and subsequently received either Lutonix or in.PACT during the follow-up phase for additional procedures. Age was 68.4 ± 10.8 years (56.0% males). Critical limb ischemia was present in 20.9%. There was no statistical difference in mortality between the median total number of balloons used among patients who were alive versus those who died (2.5 vs. 3.0, <i>p</i> -value = 0.89). Also, there was no statistical difference in the total length of DCB balloons used between those who were alive and those who died at the end of the study (p-value = 0.39). There were no in-hospital amputation or death. At 5-year follow-up KM freedom from TLR was 78.5%. A total of 13 patients died during follow-up. Of these 10 received only the Lutonix balloon and 3 did receive both Lutonix and In.PACT. The yearly KM freedom from mortality for the Lutonix only cohort were 92.7, 89.1, 85.5, 83.6, and 81.8% at 1, 2, 3, 4, and 5 years, respectively. Freedom from TLR and mortality at 5 years appears to be favorable with the use of DCB, predominantly Lutonix balloon in this cohort. This data needs to be supported prospectively by a larger number of patients.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 1","pages":"48-55"},"PeriodicalIF":0.6,"publicationDate":"2023-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9886447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10643432","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":"Role of Vascular Receptors in the Development of Hypertension in the Elderly Population.","authors":"Shlomo Yosef Shaulian, Amgad N Makaryus, Roman Zeltser","doi":"10.1055/s-0042-1759650","DOIUrl":"10.1055/s-0042-1759650","url":null,"abstract":"<p><p>Hypertension is a disease common in adults, with many risk factors and potentially life-threatening outcomes. Blood pressure is controlled by receptors that inform the brain about the amount of pressure inside the arteries, and the amount of oxygen and carbon dioxide in the blood, respectively. Research has revealed that baroreflex sensitivity (BRS) decreases with increasing age and that there is a high correlation between hypertension and low BRS. However, various studies with differing results have indicated that high blood pressure is what causes BRS to decline, and vice versa. Several studies have shown very conflicting results on the correlation between chemoreflex and age; there have been indications of chemoreflex having a positive, negative, and zero correlation with age. In several experiments, the surgical removal of the chemoreceptors of hypertensive rats was followed by a decrease in blood pressure. These animal experiments, and an additional noninvasive human experiment in which the chemoreceptors were temporarily \"shut off,\" are reasons why more attention should be given to chemoreceptors as a route of alleviating hypertension.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 4","pages":"260-266"},"PeriodicalIF":0.6,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9803552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10466868","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":"Invasive Coronary Physiology Study in Multivessel Coronary Artery Disease","authors":"Agita Maryalda Zahidin, A. A. Alkatiri, A. S. Mangkuanom, N. Iryuza, D. Firman","doi":"10.1055/s-0042-1759620","DOIUrl":"https://doi.org/10.1055/s-0042-1759620","url":null,"abstract":"Abstract Assessment of relationship between the angiographic stenosis severity and the coronary blood flow is complex. Coronary angiography has many limitations that may impair the judgment of stenosis severity and then affect decision-making regarding intervention. Myocardial perfusion imaging by single-photon emission tomography (MPI-SPECT) is used for a long time to help clinical decisions of interventions, but has limitations, such as issues with identification of extensive coronary artery disease (CAD). Fractional flow reserve (FFR) is a gold standard index for investigating the physiological significance of a coronary stenosis. The instantaneous wave-free ratio (iFR) is a hyperemia-free measurement and easier method to achieve physiological assessment to measure the severity of coronary stenosis. We present a case of multivessel coronary artery disease (MVCAD) patient who was treated with iFR-guided percutaneous coronary intervention (PCI) and emphasize the importance of physiological assessment in PCI. A 63-year-old male with multiple cardiovascular risk factors came to our center with chief complaint of stable angina since 1 year. He underwent MPI-SPECT and the result showed 2.5% of ischemia burden. Coronary angiography showed MVCAD. Surgical conference decided to do PCI. iFR-guided PCI was performed in this case. Our case highlights the importance of iFR as an important cardiology–physiology-based tool as a guide in management decisions for MVCAD. iFR as an alternative approach to physiological study is noninferior compared with FFR-guided PCI.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45075568","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":"Low-Dose Alteplase versus Conventional Anticoagulation to treat Submassive Pulmonary Embolism in Hispanic Patients.","authors":"Emily Zientek, Kelsey Talkington, Joshua Gardner, Yi Guo, Debabrata Mukherjee, Manu Rajachandran, Tariq S Siddiqui, Nils P Nickel","doi":"10.1055/s-0042-1758386","DOIUrl":"10.1055/s-0042-1758386","url":null,"abstract":"<p><p>The use of low-dose tissue plasminogen activator (tPA) in Hispanic patients with submassive pulmonary embolism (PE) is understudied. The purpose of this study is to explore the use of low-dose tPA in Hispanic patients with submissive PE compared with counterparts that received heparin alone. We retrospectively analyzed a single-center registry of patients with acute PE between 2016 and 2022. Out of 72 patients admitted for acute PE and cor pulmonale, we identified six patients that were treated with conventional anticoagulation (heparin alone) and six patients who received low-dose tPA (and heparin afterward). We analyzed if low-dose tPA was associated with differences in length of stay (LOS) and bleeding complications. Both groups were similar in regard to age, gender, and PE severity (based on Pulmonary Embolism Severity Index scores). Mean total LOS for the low-dose tPA group was 5.3 days, compared with 7.3 days in the heparin group ( <i>p</i>  = 0.29). Mean intensive care unit (ICU) LOS for the low-dose tPA group was 1.3 days compared with 3 days in the heparin group ( <i>p</i>  = 0.035). There were no clinically relevant bleeding complications documented in either the heparin or the low-dose tPA group. Low-dose tPA for submassive PE in Hispanic patients was associated with a shorter ICU LOS without a significant increase in bleeding risk. Low-dose tPA appears to be a reasonable treatment option in Hispanic patients with submassive PE who are not at high bleeding risk (<5%).</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 2","pages":"131-135"},"PeriodicalIF":0.6,"publicationDate":"2022-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9551568","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":"COVID-19 in an Asymptomatic Renal Transplant Recipient Employed in the Health Care Setting: A Case Report.","authors":"Harsha Adnani,&nbsp;Akshay Khatri,&nbsp;Nirav Agrawal,&nbsp;Ernesto Molmenti,&nbsp;Madhu Bhaskaran","doi":"10.1055/s-0041-1725183","DOIUrl":"https://doi.org/10.1055/s-0041-1725183","url":null,"abstract":"<p><p>During the ongoing pandemic, there have been varying presentations of coronavirus disease 2019 (COVID-19) infection, with the concern that patients who are immunosuppressed (due to underlying medical conditions and/or therapies) are at higher risk of severe disease. We report the case of an elderly renal transplant recipient working in a long-term health care facility who was being monitored by weekly surveillance testing and tested positive for COVID-19 by polymerase chain reaction (PCR) testing, despite having no clinical symptoms. He recovered with supportive care, despite being on multiple long-term immunosuppressant drugs and having multiple comorbidities. Additionally, it was found that he did not mount an antibody response, when he tested negative by serologic testing. Through this case, we wish to highlight the unique clinical scenario of asymptomatic patients who may have an underwhelming immune response to COVID-19, but may nevertheless be an important source of dissemination. We further discuss the probable mechanism of such asymptomatic presentations in immunosuppressed patients, while reinforcing the importance of self-isolation of COVID-19 patients (particularly in asymptomatic health care workers).</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 4","pages":"289-291"},"PeriodicalIF":0.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1725183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10466865","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":"The Potential of AFX Iliac Extension in Abdominal Aortic Aneurysms with High Iliac Tortuosity.","authors":"Yuta Kikuchi,&nbsp;Norifumi Ohtani,&nbsp;Hiroyuki Kamiya","doi":"10.1055/s-0041-1729736","DOIUrl":"https://doi.org/10.1055/s-0041-1729736","url":null,"abstract":"<p><p>Recently, endovascular aortic aneurysm repair (EVAR) is the most common surgery for abdominal aortic aneurysm (AAA). However, iliac limb complications of EVAR often cause problems in patients with high iliac tortuosity. There is no difference of rate of iliac limb complication among EVAR devices, such as Excluder, Endurant, and Zenith in high iliac tortuosity. But there has been not reported about AFX. We studied AFX iliac extension as it is the only stent graft with an endoskeletal framework. This study aimed to evaluate the AFX iliac extension patency in a case in vitro and to use it in seven cases of AAA with high iliac tortuosity. The silicon tube inserted in the AFX iliac extension was flexed at 30, 60, 90, and 120 degrees, and the lumen of the iliac extension was monitored using an underwater camera in the circulatory system. During the experiment, the Iwaki Bellows Pump (IWAKI CO., LTD., Tokyo, Japan) produced a pulsating flow. We used this in seven patients with AAA high iliac tortuosity cases between November 2018 and May 2019. If the silicon tube inserted in the AFX iliac extension was flexed at 60 and 120 degrees, the stent protruded into the lumen. However, the graft was dilated at all degrees. All seven patients with AFX iliac extension had no complications and a patent iliac artery. The AFX iliac extension can reduce iliac limb complications in cases of high iliac tortuosity.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 4","pages":"267-272"},"PeriodicalIF":0.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9803538/pdf/10-1055-s-0041-1729736.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10466866","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":"Complex Arterial Pathology of Angiomyolipomas of Tuberous Sclerosis.","authors":"Christopher D Yeisley,&nbsp;Shima Tafreshi,&nbsp;Joseph Moirano,&nbsp;Eric Gandras,&nbsp;David Siegel","doi":"10.1055/s-0042-1743253","DOIUrl":"https://doi.org/10.1055/s-0042-1743253","url":null,"abstract":"<p><p>Based on observations at angiography, it was hypothesized that angiomyolipomas (AMLs) associated with tuberous sclerosis complex (TSC) have a more robust parasitic blood supply and require more complex embolization involving lower order vessels compared with the non-TSC patients' AMLs. This was a retrospective review of 71 patients who underwent angiography and embolization for renal AML at multiple centers within a single health system. All of the patients with TSC (11/11) were found to have \"complex\" tumor vascular supply. Of the patients with sporadic AML, 51/60 (85%) had \"simple\" tumor vascular supply. Sporadic cases with a complex tumor blood supply were larger tumors, with an average size of 11.5 cm. This study supports our hypothesis that AMLs associated with TSC have more complex tumor vascularity compared with sporadic lesions, and aims to better prepare interventionalists to deal with the complex cases.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 4","pages":"284-288"},"PeriodicalIF":0.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9803532/pdf/10-1055-s-0042-1743253.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9291607","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}