W. A. Widodo, A. Mansjoer, Ismail Dilawar, Andri Kurnia, Daniel Ruslim
{"title":"Acute Mediastinal Bleeding with Pleural Escape: Case Report of a Rare Interventional Complication with Unusual Resolve","authors":"W. A. Widodo, A. Mansjoer, Ismail Dilawar, Andri Kurnia, Daniel Ruslim","doi":"10.1055/s-0042-1756487","DOIUrl":"https://doi.org/10.1055/s-0042-1756487","url":null,"abstract":"Acute mediastinal bleeding is a very rare complication of cardiac intervention. It is a life-threatening situation when this condition causes acute compression of the mediastinal area. A 59-year-old man was diagnosed with inferior ST-elevation myocardial infarction with ongoing chest pain and underwent an urgent percutaneous coronary intervention procedure. After coronary stent was implanted, patient complained of chest tightness, and suffocation, blood pressure dropped, O2 saturation dropped, and was difficultly intubated. Image acquisition by C-arm showed a large bulging in aortic arch area. Contrast-enhanced computed tomography ruled out aortic dissection, but noted a large mediastinal mass that was radiated to the neck. The bulging was spontaneously regressed, and a large left pleural effusion was developed. Left pleural tapping was performed on day 7, and a total of 1.5-L hemorrhagic fluid was evacuated. In our case, unusual drainage from mediastinal to pleural space has probably save the patient.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46715615","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}
Ahmed A Shaker, Ahmed H Shehata, Khaled M Alhindawy, Walid El Daly
{"title":"Pure Endovascular versus Hybrid Approach for Management of Iliofemoral Arterial Disease: A Randomized Controlled Trial.","authors":"Ahmed A Shaker, Ahmed H Shehata, Khaled M Alhindawy, Walid El Daly","doi":"10.1055/s-0042-1756622","DOIUrl":"10.1055/s-0042-1756622","url":null,"abstract":"<p><p>Common femoral artery (CFA) atherosclerotic lesions currently remain one of the last limitations for adoption of endovascular repair as the first-line treatment, easy surgical accessibility, and, last but not least, favorable long-term outcomes, still making CFA disease treatment part of the surgical domain. In the last 5 years, improvement of the endovascular equipment and technical skills of the operators have led to an increase in percutaneous CFA procedures. A single-center randomized prospective study of 36 symptomatic (Rutherford 2-4) CFA stenotic or occlusive lesions were included, and patients were randomized over two groups based on the management approach SUPERA versus hybrid technique. Patients had a mean age 60.8 ± 8.2 years. Thirty-two (88.9%) patients reported improvement of the clinical symptoms, 28 (87.5%) patients had intact pulse postoperatively, and 28 (87.5%) had patent vessels. Follow-up showed that none developed reocclusion or restenosis during the period of follow-up. Comparison of difference in peak systolic velocity ratio (PSVR) among study groups showed that the hybrid technique had more reduction of PSVR postintervention compared to the SUPERA group with a <i>p</i> -value of < 0.0001. Safety and feasibility of endovascular approach with the SUPERA stent to the CFA (no stent zone) has low incidence of postoperative morbidity and mortality in well experienced surgical hands.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 2","pages":"88-94"},"PeriodicalIF":0.6,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191691/pdf/10-1055-s-0042-1756622.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499847","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":"Could Plasma CXCL12 Predict Ventricular Dysfunction in Patients with Severe Myocardial Infarction?","authors":"Hussam A S Murad, Marwan A Bakarman","doi":"10.1055/s-0042-1756488","DOIUrl":"10.1055/s-0042-1756488","url":null,"abstract":"<p><p>Plasma level of chemokine CXCL12 can predict adverse cardiovascular outcomes in patients with coronary artery disease, but data on its relationship with severity of coronary stenosis in cases of severe myocardial infarction (MI) are scarce and conflicting. The objective of this study was to investigate link between plasma CXCL12 levels and different grades of left ventricular ejection fraction (LVEF) in statin-treated and -untreated patients with severe MI. A total of 198 consecutive patients with first-time severe MI (ST-elevated myocardial infarction [STEMI], <i>n</i> = 121 and non-ST-elevated myocardial infarction [NSTEMI], <i>n</i> = 77) were recruited from Coronary Care Unit, King Abdulaziz University Hospital. They have one to two coronary arteries blocked ≥50%, or three arteries blocked 30 to 49%. Demographic and clinical criteria were collected and plasma CXCL12 level was measured. No correlations were detected between demographic and clinical criteria and CXCL12 level. While troponin peaks and LVEF significantly differed between STEMI and NSTEMI patients, CXCL12 level showed nonsignificant changes. Plasma CXCL12 levels decreased significantly in statin-treated patients compared with those untreated. From receiver operating characteristic (ROC) analysis, high CXCL12 levels were associated with no statin therapy. For STEMI and NSTEMI patients, area under the receiver operating characteristic curve for CXCL12 test were 0.685 and 0.820, while sensitivity and specificity values were 75.9 and 54.8%, and 73.1 and 84%, respectively. Plasma CXCL12 levels showed nonsignificant changes with different ranges of LVEF and troponin peaks. In patients with severe MI, irrespective of statin therapy, plasma CXCL12 showed no correlation with different ranges of LVEF suggesting that it cannot predict left ventricular dysfunction in these cases. However, cross-sectional design of this study is a limitation.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 3","pages":"165-171"},"PeriodicalIF":0.6,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421681/pdf/10-1055-s-0042-1756488.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10371911","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}
O. Abidoye, Andrew Johnson, Y. Cho, H. Ogbuagu, Hasan Choudhury, R. Takegawa, Kei Hayashida, K. Shinozaki, T. Aoki, Y. Okuma, S. Zanos, S. Zafeiropoulos, D. Giannis, D. O. Pipolo, L. Becker, Santiago J. Miyara, Sara Guevara, E. Molmenti
{"title":"Upper-Extremity Deep Venous Thrombosis after Whole Blood Donation—A Case Report","authors":"O. Abidoye, Andrew Johnson, Y. Cho, H. Ogbuagu, Hasan Choudhury, R. Takegawa, Kei Hayashida, K. Shinozaki, T. Aoki, Y. Okuma, S. Zanos, S. Zafeiropoulos, D. Giannis, D. O. Pipolo, L. Becker, Santiago J. Miyara, Sara Guevara, E. Molmenti","doi":"10.1055/s-0042-1756216","DOIUrl":"https://doi.org/10.1055/s-0042-1756216","url":null,"abstract":"Upper-extremity deep venous thrombosis (UEDVT) after whole blood donation is rarely reported. Blood donation has a low rate of complications and is typically safe. A small percentage of blood donors experience donation-related events such as UEDVT, which are extremely rare. We are reporting a rare case of a UEDVT following blood donation. This is an extremely rare event; only five cases were reported to our knowledge. A 22-year-old Caucasian woman with a past medical history of provoked pulmonary embolism completed 6 months of apixaban and negative thrombophilia workup presented to the hospital with complaints of progressive pain and swelling in her right arm. The patient reports donating blood using her right arm in January 2021. Phlebotomy duration for blood donation was approximately 10minutes. She reported pain and swelling several days after blood donation. Subsequently, a duplex ultrasound showed a thrombus in the right brachial vein. The patient was started on apixaban for 6 months. Although most whole blood donors do not experience complications, DVT is a rare complication from whole blood donation with severe consequences. It should be considered in a donor with worsening pain and swelling.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47753033","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":"Mechanical Function of the Atrial Diastole: A New Discovery","authors":"S. Raju","doi":"10.1055/s-0042-1753493","DOIUrl":"https://doi.org/10.1055/s-0042-1753493","url":null,"abstract":"","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45243919","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}
Ahmad Dawalibi, Muhammad Atif Mazhar, Sadia Qazi, P. Ganguly, Ayman Behiery
{"title":"Vascular Abnormalities in a Pelvic Ectopic Kidney: How a Dissection-Based Program Improves the Knowledge of Clinical Anatomy","authors":"Ahmad Dawalibi, Muhammad Atif Mazhar, Sadia Qazi, P. Ganguly, Ayman Behiery","doi":"10.1055/s-0042-1756486","DOIUrl":"https://doi.org/10.1055/s-0042-1756486","url":null,"abstract":"Anatomy is a vital basic science for safe and effective medical practice and its significance increases several folds when it is taught in a clinically relevant manner. In today's time-compressed modern medical curricula, the importance of dissection-based anatomy programs is integral to teaching–learning outcome. Sound anatomical knowledge is critical to safe clinical and surgical practice as it is fundamental to the career of future doctors. In this pictorial essay, we present a case of a left ectopic pelvic kidney during one of the faculty-guided dissection sessions at the Alfaisal University. Such an anomaly motivated students to perform further meticulous dissection and to engage in detailed discussions after identifying associated abnormal findings. It is believed that these practices at the very start of the medical journey of students will effectively enhance their clinical reasoning skills by integrating basic and clinical anatomy.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45778646","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":"Involvement of AGE and Its Receptors in the Pathogenesis of Hypertension in Elderly People and Its Treatment.","authors":"Kailash Prasad","doi":"10.1055/s-0042-1756175","DOIUrl":"10.1055/s-0042-1756175","url":null,"abstract":"<p><p>Both systolic and diastolic blood pressures increase with age up to 50 to 60 years of age. After 60 years of age systolic pressure rises to 84 years of age but diastolic pressure remains stable or even decreases. In the oldest age group (85-99 years), the systolic blood pressure (SBP) is high and diastolic pressure (DBP) is the lowest. Seventy percent of people older than 65 years are hypertensive. This paper deals with the role of advanced glycation end products (AGE) and its cell receptor (RAGE) and soluble receptor (sRAGE) in the development of hypertension in the elderly population. Plasma/serum levels of AGE are higher in older people as compared with younger people. Serum levels of AGE are positively correlated with age, arterial stiffness, and hypertension. Low serum levels of sRAGE are associated with arterial stiffness and hypertension. Levels of sRAGE are negatively correlated with age and blood pressure. Levels of sRAGE are lower in patients with arterial stiffness and hypertension than patients with high levels of sRAGE. AGE could induce hypertension through numerous mechanisms including, cross-linking with collagen, reduction of nitric oxide, increased expression of endothelin-1, and transforming growth factor-β (TGF-β). Interaction of AGE with RAGE could produce hypertension through the generation of reactive oxygen species, increased sympathetic activity, activation of nuclear factor-kB, and increased expression of cytokines, cell adhesion molecules, and TGF- β. In conclusion, the AGE-RAGE axis could be involved in hypertension in elderly people. Treatment for hypertension in elderly people should be targeted at reduction of AGE levels in the body, prevention of AGE formation, degradation of AGE in vivo, downregulation of RAGE expression, blockade of AGE-RAGE interaction, upregulation of sRAGE expression, and use of antioxidants.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 4","pages":"213-221"},"PeriodicalIF":0.5,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9803554/pdf/10-1055-s-0042-1756175.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10536694","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":"Classification and Stratification of Pulmonary Embolisms.","authors":"Cody Russell, Suresh Keshavamurthy, Sibu Saha","doi":"10.1055/s-0042-1756218","DOIUrl":"https://doi.org/10.1055/s-0042-1756218","url":null,"abstract":"<p><p>Pulmonary embolism remains a leading cause of cardiovascular mortality. Presentation and outcomes are variable among patients and require rapid risk stratification for assessment and prognosis, as well as selection of appropriate treatment. Over the past several decades, several different models and parameters have become available to assess risk and classify pulmonary embolism into different risk categories. Some patients may be candidates for early discharge or complete outpatient treatment, while some may require invasive diagnostics and intensive monitoring. In this review, we summarize contemporary guidelines and methods for classification and risk stratification in an effort to provide tools for physicians to use in their management of patients with acute pulmonary embolisms.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 3","pages":"162-165"},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9507558/pdf/10-1055-s-0042-1756218.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10492936","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":"Diagnosis, Diagnostic Tools, and Risk Stratification for Contemporary Treatment of Pulmonary Embolism.","authors":"Taylor C Remillard, Arber Kodra, Michael Kim","doi":"10.1055/s-0042-1756177","DOIUrl":"https://doi.org/10.1055/s-0042-1756177","url":null,"abstract":"<p><p>Pulmonary embolism (PE) is quite common and is associated with significant morbidity and mortality. It is estimated that it is the cause of approximately 100,000 annual deaths in the United States. With great variability in presenting symptoms of PE, poor recognition of PE can be fatal. As such, many risk scores have been created to identify the sickest patients. Choosing the appropriate imaging modality is also critical. Invasive pulmonary angiography was once the gold standard to establish the diagnosis. With the advent of nuclear imaging, V/Q scans, invasive angiography has been phased out for diagnosing acute PE. At present, the standard for diagnosis of acute PE is computed tomography pulmonary angiography. In select patient cohorts, nuclear studies remain the modality of choice. Once the diagnosis of acute PE is established, there is a broad spectrum of severity in outcome which has led to substantial focus and development of risk stratification prediction models. We will discuss making the proper diagnosis with contemporary diagnostic tools and risk stratifying patients with PE to receive the correct treatment.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 3","pages":"150-154"},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9507591/pdf/10-1055-s-0042-1756177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10053083","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}
Scarlett Tohme, Joshua S Newman, Christopher Gasparis, Frank Manetta
{"title":"Massive Embolism: Knife versus PCI.","authors":"Scarlett Tohme, Joshua S Newman, Christopher Gasparis, Frank Manetta","doi":"10.1055/s-0042-1755573","DOIUrl":"https://doi.org/10.1055/s-0042-1755573","url":null,"abstract":"<p><p>Pulmonary embolism is the third most common cardiovascular syndrome with an estimated up to 25% of patients presenting with sudden death. For those who survive, a mainstay of management for patients with hemodynamic stability is anticoagulation; however, recommendations and options are rapidly changing for patients with submassive or massive pulmonary embolism with hemodynamic instability. Catheter-based and surgical approaches offer efficacious management options for unstable patients or patients with contraindications to anticoagulation; however, both approaches have inherent benefits and risk. This article seeks to offer a brief review on the recommendations and options for management of pulmonary embolism from both surgical and catheter-based perspectives.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 3","pages":"179-187"},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9507597/pdf/10-1055-s-0042-1755573.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10409982","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}