International Journal of Angiology最新文献

{"title":"Contemporary Treatment of Pulmonary Embolism: Medical Treatment and Management.","authors":"Stephen Moreland,&nbsp;Debabrata Mukherjee,&nbsp;Nils P Nickel","doi":"10.1055/s-0042-1750329","DOIUrl":"https://doi.org/10.1055/s-0042-1750329","url":null,"abstract":"<p><p>Pulmonary embolus (PE) is defined as obstruction of the pulmonary artery or one of its branches by material (e.g., thrombus, tumor, air, or fat) but most commonly due to thrombus originating from the lower extremity deep veins. We reviewed the current literature describing the optimal medical treatment and management of PE. Databases (PubMed, the Cochrane Library, Embase, EBSCO, Web of Science, and CINAHL) were searched for relevant studies and guidelines for management of patients with PE. The initial approach to patients with suspected PE should focus upon stabilizing the patient while further workup for risk stratification is in progress. In most cases, anticoagulation should ideally be started even prior to confirming PE, if risk-benefit regarding suspicion of PE and bleeding risk is favorable. Once the diagnosis is confirmed, risk stratification will guide further therapies consisting of anticoagulation, thrombolysis, or catheter-directed interventions. Data for initial, long-term, and indefinite anticoagulation, and factors that determine whether or not a patient can be treated in the outpatient setting, are reviewed and discussed.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 3","pages":"155-161"},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9507607/pdf/10-1055-s-0042-1750329.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9832970","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":"Epidemiology, Pathophysiology, and Management of Coronary Artery Disease in the Elderly.","authors":"Kahtan Fadah, Aimee Hechanova, Debabrata Mukherjee","doi":"10.1055/s-0042-1751234","DOIUrl":"10.1055/s-0042-1751234","url":null,"abstract":"<p><p>Elderly patients over the age of ≥ 75 years are especially susceptible to coronary artery disease (CAD) as age is an important nonmodifiable risk factors for atherosclerosis and a predictor of poorer outcomes. In fact, CAD is a major cause of mortality and morbidity in this population. Due to concerns of functional frailty, comorbidities, and patient preference of conservative to no treatment have played a role in reducing the interest in pursuing prospective studies in this high-risk group. In this review, we provide an overview of the epidemiology, pathophysiology, and management of CAD in older adults.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 4","pages":"244-250"},"PeriodicalIF":0.5,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9803549/pdf/10-1055-s-0042-1751234.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10060156","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":"Cardiac and Hemodynamic Manifestations of Hereditary Hemorrhagic Telangiectasia.","authors":"Ahmed Farhan, Muhammad A Latif, Anum Minhas, Clifford R Weiss","doi":"10.1055/s-0042-1745842","DOIUrl":"10.1055/s-0042-1745842","url":null,"abstract":"<p><p>The autosomal dominant trait hereditary hemorrhagic telangiectasia (HHT) causes multiorgan dysplastic lesions of the vasculature that can activate multiple physiological cascades leading to a broad array of cardiovascular diseases. Up to 78% of patients with HHT develop hepatic arteriovenous malformations (AVMs), which cause a hyperdynamic circulatory state secondary to hepatic/portal shunting. This condition can eventually progress to high-output cardiac failure (HOCF) with continued peripheral tissue hypoxemia. Treatment for HOCF is often limited to supportive measures (diuretics and treatment of anemia); however, recent studies using systemic bevacizumab have shown promise by substantially reducing the cardiac index. In the context of liver AVMs and high cardiac output, the pulmonary vasculature can also experience high flow. Without adequate dilation of pulmonary vessels, post-capillary pulmonary hypertension can develop. Another form of pulmonary hypertension observed in HHT, pulmonary arterial hypertension, is caused by HHT-related mutations in <i>ENG</i> and <i>ACVRL1</i> causing congestive arteriopathy. Post-capillary pathogenesis is addressed by reducing the high-output state, whereas the pre-capillary state is treated with supportive mechanisms (diuretics, oxygen) and agents targeting pulmonary vasoreactivity: endothelin-1 receptor antagonists and phosphodiesterase-5 inhibitors. If either form of pulmonary hypertension is left untreated or proves refractory and progresses, the common hemodynamic complication is right heart failure. Targeted right heart therapies involve similar strategies to those of pulmonary arterial hypertension, with several experimental approaches under study. In this review, we describe in detail the mechanisms of pathogenesis, diagnosis, and treatment of the hemodynamic complications and associated cardiovascular diseases that may arise in patients with HHT.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 2","pages":"75-82"},"PeriodicalIF":0.5,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9341259/pdf/10-1055-s-0042-1745842.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9765027","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":"A Comprehensive Research Schema for the Characterization of Aortic Aneurysms.","authors":"Hossam Alslaim, Sreeja Sanampudi, Driss Raissi, Weibo Fu, Amanda Y Behr, Mohamed Issa, Mary B Sheppard, Neal L Weintraub, Michael Winkler","doi":"10.1055/s-0042-1744275","DOIUrl":"10.1055/s-0042-1744275","url":null,"abstract":"<p><p>A robust, accurate, and standardized approach to measurement of the aorta is critical to improve the predictive accuracy of these aortic measurements, and to investigate other aortic imaging biomarkers. Developing a comprehensive and generic schema for characterization of the aorta to enable investigators to standardize data that are collected across all aorta research. A systematic review of the literature was conducted to identify and assess schemata of aortic measurement and description. The schemata were reported and discussed to guide the synthesis of a comprehensive schema. We propose the International College of Angiology Aortic Research Schema as a comprehensive design that fills the gaps left behind by previously reported schemata. It is intended to be applicable for all clinically relevant purposes, including endograft development for aneurysm repair and for the accurate characterization of the aortic anatomy. This schema divides the aorta into 14 segments and 2 sections (thoracic and abdominal aortas). The segmentation proposed can be used in addition to specific measurements taken for any aneurysm including the neck, and maximal and minimal diameters of the aneurysm.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 1","pages":"34-42"},"PeriodicalIF":0.6,"publicationDate":"2022-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9886451/pdf/10-1055-s-0042-1744275.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9703159","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":"Pathophysiology, Diagnosis, and Management of Coronary No-Reflow Phenomenon.","authors":"Gagan Kaur,&nbsp;Patrick Baghdasaryan,&nbsp;Balaji Natarajan,&nbsp;Prabhdeep Sethi,&nbsp;Ashis Mukherjee,&nbsp;Padmini Varadarajan,&nbsp;Ramdas G Pai","doi":"10.1055/s-0041-1735949","DOIUrl":"https://doi.org/10.1055/s-0041-1735949","url":null,"abstract":"<p><p>Coronary no-reflow phenomenon is a lethal mechanism of ongoing myocardial injury following successful revascularization of an infarct-related coronary artery. Incidence of this phenomenon is high following percutaneous intervention and is associated with adverse in-hospital and long-term outcomes. Several mechanisms such as ischemia-reperfusion injury and distal microthromboembolism in genetically susceptible patients and those with preexisting endothelial dysfunction have been implicated. However, the exact mechanism in humans is still poorly understood. Several investigative and treatment strategies within and outside the cardiac catheterization laboratory have been proposed, but they have not uniformly shown success in reducing mortality or in preventing adverse left ventricular remodeling resulting from this condition. The aim of this article is to provide a brief and concise review of the current understanding of the pathophysiology, clinical predictors, and investigations and management of coronary no-reflow phenomenon.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 2","pages":"107-112"},"PeriodicalIF":0.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9296268/pdf/10-1055-s-0041-1735949.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10531524","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":"Assessment of the CHIVA and the ASVAL Method.","authors":"Cestmir Recek","doi":"10.1055/s-0041-1741469","DOIUrl":"https://doi.org/10.1055/s-0041-1741469","url":null,"abstract":"<p><p>In this article, the CHIVA and ASVAL methods are assessed from the hemodynamic point of view. The CHIVA method comprises complicated, unusual terminology and new perceptions, such as closed and open shunts, fractionation of the hydrostatic pressure, subdivision of the venous network. The principal part of the CHIVA theory is the drainage of venous blood from the thigh saphenous system into the deep lower leg veins through the preserved saphenous trunk after high ligation at the saphenofemoral junction, which is considered as a beneficial, physiological phenomenon. In reality, this is recurrent reflux producing ambulatory venous hypertension. The main impact of the CHIVA procedure is the elimination of the saphenous reflux by high ligation at the saphenofemoral junction; thus it can be presumed that the CHIVA procedure yields similar results like the crossectomy. The ASVAL procedure is de facto the modification of the old Madelung method that was the prevalent surgical procedure before the Trendelenburg era in the 19th century. The results after ASVAL were not checked by plethysmography; there is a good case to suppose that the results after the ASVAL method would comply with those after sclerotherapy.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 2","pages":"83-87"},"PeriodicalIF":0.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9272252/pdf/10-1055-s-0041-1741469.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10681549","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":"Cephalic Vein Aneurysm in the Distal Forearm Managed with Sclerotherapy-A Rare Case Report and Literature Review.","authors":"Ashima Mahajan,&nbsp;Syed T Fazal,&nbsp;Sanjay Mehta,&nbsp;Narender S Kataria,&nbsp;Vipul Nanda","doi":"10.1055/s-0042-1743252","DOIUrl":"https://doi.org/10.1055/s-0042-1743252","url":null,"abstract":"<p><p>Venous aneurysm of upper extremities is rare entity. We report a rare case of large cephalic vein (CV) aneurysm in a 41-year-old man who presented as slowly growing painless swelling at distal forearm along the lateral aspect. Duplex ultrasound showed aneurysm originating from the anterior wall of the CV with venous waveform pattern on Doppler. It was managed successfully with percutaneous sclerotherapy.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 2","pages":"92-96"},"PeriodicalIF":0.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9296263/pdf/10-1055-s-0042-1743252.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10258604","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":"Deep Venous Thrombosis and Ulcers of Lower Limbs: Ultrasound Findings in 156 Patients.","authors":"Alberto Garavello,&nbsp;Stefania Gilardi,&nbsp;Paola Fiamma,&nbsp;Valentina Toti,&nbsp;Massimo Tozzi,&nbsp;Pietro Fransvea","doi":"10.1055/s-0042-1743408","DOIUrl":"https://doi.org/10.1055/s-0042-1743408","url":null,"abstract":"<p><p>Venous ulcers (VUs) of lower limbs affect 1% of Western population. In most cases, ultrasounds show only superficial venous insufficiency (SVI), but a deep venous insufficiency (DVI) may also be present without a history of deep vein thrombosis (DVT). To assess SVI and DVI in DVT-positive and DVT-negative patients with VU, a retrospective cohort of 123 patients entered the study (50 male and 73 female, minimum age 29 years and maximum age 90 years, and mean 70.6 years). In 56 patients (45.5%), ulcer was on the right leg, in 52 (42.3%) on the left leg, and in 15 patients (12.2%), ulcer was bilateral, resulting in a total number of 138 limbs in the study. Sixty-six patients suffered DVT, while in 72 anamnesis was negative. Color duplex ultrasound was performed on both limbs, which revealed insufficiencies of superficial and/or deep veins in 18 limbs which had not been affected by an ulcer or a previous DVT. So the study was on 156 limbs. SVI were substantially overlapping in two groups ( <i>p</i> -value = 0.593), while combined SVI and DVI was 72.5% in DVT positive limbs ( <i>p</i> -value = 0.001). In 70% of cases with a femoral vein insufficiency ( <i>p</i> -value = 0.036) or popliteal vein insufficiency (PVI) ( <i>p</i> -value 0,003), a DVT history was present. Of 18 limbs, although not affected by ulcer or previous DVT, eight were positive for DVI (two femoral veins and six popliteal veins). In the patient with VU, the history of DVT is a strong predictor of DVI insufficiency. In DVT-positive patients with ulcer, the number of \"combined superficial and deep insufficiencies\" appears to be particularly significant and surgical treatment must take this into account. A previous DVT has a low impact on great and small saphenous insufficiencies in ulcer patients; these were substantially overlapping in DVT-positive and DVT-negative patients. The 18 limbs with DVI and SVI without ulcer and DVT history were unexpected result. We think these patients must have a close follow-up to avoid the onset of a VU.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 2","pages":"113-119"},"PeriodicalIF":0.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9272312/pdf/10-1055-s-0042-1743408.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9452222","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":"Erectile Dysfunction in Individuals with Type 1 Diabetes is Associated with Long-term Metabolic Control and Diabetic Complications: A Cross-Sectional Study.","authors":"Mikołaj Kamiński,&nbsp;Michał Kulecki,&nbsp;Paweł Lachowski,&nbsp;Dominika Kasprzak,&nbsp;Ania Kulczycka,&nbsp;Maria Kozłowska,&nbsp;Daria Klause,&nbsp;Aleksandra Uruska,&nbsp;Mateusz Michalski,&nbsp;Dorota Zozulińska-Ziółkiewicz","doi":"10.1055/s-0041-1735209","DOIUrl":"https://doi.org/10.1055/s-0041-1735209","url":null,"abstract":"<p><p><b>Background</b>  Erectile dysfunction (ED) affects approximately 38% of individuals with type 1 diabetes (T1DM). Skin autofluorescence (AF) reflects skin advanced glycation end product (AGE) deposits and is a marker of long-term glycemia control. <b>Objective</b>  The study investigates the relationship between ED and diabetes control in patients with T1DM. <b>Methods</b>  Adult patients with T1DM visiting the Diabetology Department were cross-sectionally investigated. Medical history, anthropometric features, and laboratory findings were collected. All individuals filled the International Index of Erectile Function (IIEF-5). IIEF-5 total score < 22 represented the presence of ED. AF was measured on the volar aspect of the forearm using AGE Reader. Insulin resistance (IR) was assessed by the estimated glucose disposal rate. Descriptive statistics and multivariate logistic regression analyses were performed. The adjusted covariates were general risk factors of ED. <b>Results</b>  Of a total of <i>n</i>  = 70 patients, <i>n</i>  = 30 (42.9%) suffered from ED. The presence of ED was associated with higher glycated hemoglobin level (OR, 95% CI; 1.62, 1.02-2.60; <i>p</i>  = 0.043), presence of at least one diabetic complication (3.49, 1.10-11.03; <i>p</i>  = 0.03), and skin AF (9.20, 1.60-52.94; <i>p</i>  = 0.01), but not with IR (0.78, 0.57-2.60; <i>p</i>  = 0.12). Skin AF values ≥ 2.2 indicates presence of ED with a sensitivity of 70.0% and a specificity of 77.5%. Area under the curve was equal to 0.72 (95% CI: 0.60-0.85). <b>Conclusions</b>  The presence of ED in individuals with T1DM is associated with HbA1c, the presence of at least one diabetic complication, and skin AF.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 2","pages":"97-106"},"PeriodicalIF":0.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9272316/pdf/10-1055-s-0041-1735209.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9074318","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":"Recognizing Kounis Syndrome, the Unusual Possible Culprit of Acute Coronary Syndrome: A Rare Case Report","authors":"William Kamarullah, D. K. Firmansyah","doi":"10.1055/s-0042-1743564","DOIUrl":"https://doi.org/10.1055/s-0042-1743564","url":null,"abstract":"Kounis syndrome encompasses acute coronary syndrome features associated with severe vasospasm of the coronary artery. It is related to allergic anaphylactic reaction triggered by the release of inflammatory cells and mediators. This entity, however, is often not properly diagnosed. In this report, we aimed to discuss a case of Kounis syndrome mimicking acute coronary syndrome. We presented a 58-year-old man with dyspnea, chest pain, dizziness, and itchiness 30 minutes following sodium diclofenac ingestion. His physical examination was remarkable for shock with hypoxia and features of anaphylactic reaction. An urgent electrocardiogram was obtained, manifesting deep ST-segment depression in anterolateral leads with ST elevation of aVR, which hinted a severe three-vessel disease or left main disease. Allergic acute coronary syndrome was suspected. Thus, the patient was managed with fluid resuscitation, epinephrine, and corticosteroid injection along with acute coronary syndrome treatment algorithm with a favorable clinical response. One-hour serial ECG showed complete resolution of ST depression with aVR normalization. This pointed to possible acute coronary spasm. No further coronary intervention was performed, the patient was discharged after 2 days in good condition and planned for further cardiac evaluation during follow-up. Kounis syndrome is an intriguing process caused by the presence of two disease entities that must be treated simultaneously. The difficulty in treating this condition stems from the fact that treating one of both entities may aggravate the other. Thus, a comprehensive approach and health education are strongly advised to ensure that this condition does not reoccur in the future.","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44657443","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}