International Journal of Angiology最新文献

{"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":"Hypoxia Due to a Large Right to Left Interatrial Shunt with Normal Right-Sided Filling Pressures in the Setting of a Separation between the Septum Primum and Secundum: A Case Report.","authors":"Nicolas W Shammas,&nbsp;Kathleen Keyes,&nbsp;William Witcik,&nbsp;Jon Robken,&nbsp;Edmund Coyne,&nbsp;Humphrey Wong","doi":"10.1055/s-0042-1749075","DOIUrl":"https://doi.org/10.1055/s-0042-1749075","url":null,"abstract":"<p><p>Hypoxia secondary to right to left interatrial shunting in the setting of normal right-sided filling pressure is an uncommon clinical presentation. We present a case of persistent hypoxia irrespective of body position in a patient with a wide separation between the septum primum and secundum, creating a tunnel channeling flow from the right to the left atrium. Hypoxia resolved instantly following closure of the defect with an Amplatzer occluder under intracardiac echocardiography guidance. Although platypnea-orthodeoxia leads to hypoxia in the setting of normal right-sided filling pressures, the finding of a coexisting wide gap between the septum primum and secundum is likely to have worsened the hypoxia making it severe irrespective of body position. Closure of the interatrial septal defect led to immediate and sustained resolution of the hypoxia.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 3","pages":"202-205"},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421673/pdf/10-1055-s-0042-1749075.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10352052","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":"Ventricular Septal Rupture Complicating an Acute ST-Segment Elevation Myocardial Infarction during the COVID-19 Pandemic.","authors":"Ines V Tanto,&nbsp;Surya Dharma,&nbsp;Dafsah A Juzar,&nbsp;Arinto A H Bono","doi":"10.1055/s-0040-1720971","DOIUrl":"https://doi.org/10.1055/s-0040-1720971","url":null,"abstract":"<p><p>Ventricular septal rupture (VSR) is rare but a lethal complication of acute myocardial infarction (MI). Definite treatment requires the surgical closure of the VSR and coronary artery bypass grafting (CABG). However, the optimal timing for surgery is still controversial, particularly during the novel coronavirus disease 2019 (COVID-19) pandemic where medical procedures should be performed within the safest environment. Before surgery, a proper management in the intensive cardiovascular care unit is essential to maintain the stability of the hemodynamic profile related with VSR and determines the prognosis of the patient. We described a case of VSR complicating an anterior wall MI in a patient who admitted to our hospital during the COVID-19 pandemic that was treated successfully by surgical closure of the VSR and CABG.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 3","pages":"194-196"},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421677/pdf/10-1055-s-0040-1720971.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10371913","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":"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}

{"title":"Novel Use of Dual Guiding Catheters Technique to Prevent Distal Embolization and Slow Flow during PCI of Coronary Stent Thrombosis.","authors":"Vijay Kumar Trehan,&nbsp;Gagan Jain,&nbsp;Puneet Gupta","doi":"10.1055/s-0041-1740319","DOIUrl":"https://doi.org/10.1055/s-0041-1740319","url":null,"abstract":"<p><p>Despite having an incidence of 0.5 to 2%, stent thrombosis has an in-hospital mortality of 15% and myocardial infarction (MI) incidence of 67%. Even with the usage of thrombus aspiration devices and microvasculature vasodilators such as nitroprusside, verapamil, adenosine, and Gp2b/3a inhibitors, the angiographic result of percutaneous coronary intervention of coronary stent thrombosis remains frequently suboptimal due to distal embolization and subsequent slow flow. We describe a novel use of dual guide catheter technique, where one guide acts as conduit for thrombus aspiration catheter and the other for distal placement of balloon trap to prevent distal embolization while managing a case of coronary stent thrombosis to improve the angiographic outcome in this scenario.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 2","pages":"143-145"},"PeriodicalIF":0.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191694/pdf/10-1055-s-0041-1740319.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9852827","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":"External Stenting (Exostenting) to Correct Vascular Torsion and Angulation.","authors":"Michael B Silva,&nbsp;Muhammad Shoaib,&nbsp;Santiago J Miyara,&nbsp;Sara Guevara,&nbsp;Alexia McCann-Molmenti,&nbsp;H Colleen Silva,&nbsp;Stacey Watt,&nbsp;Stefanos Zafeiropoulos,&nbsp;Kei Hayashida,&nbsp;Ryosuke Takegawa,&nbsp;Koichiro Shinozaki,&nbsp;Rishabh C Choudhary,&nbsp;Young Min Cho,&nbsp;Adam M Kressel,&nbsp;Yaser M Alsalmay,&nbsp;Daniel A Grande,&nbsp;Luca Cicalese,&nbsp;Gabriel I Aranalde,&nbsp;Grace Covelli,&nbsp;Lance B Becker,&nbsp;Linda Shore-Lesserson,&nbsp;Ernesto P Molmenti","doi":"10.1055/s-0041-1727132","DOIUrl":"https://doi.org/10.1055/s-0041-1727132","url":null,"abstract":"<p><p>Organ transplantation can be associated with vascular torsions and angulations of both recipient and donor vessels. Such kinks and/or torsions of vessels can compromise the vascular integrity, obstruct inflow and/or outflow, and result in loss of the organ and/or body parts. On many occasions, mild angulations and torsions can be successfully addressed by repositioning the organ. In cases where the abnormal findings persist, maneuvers such as placing a fat pad to create a smoother curve, or even opening the peritoneum (in the case of kidney transplants) to allow for a better positioning of the organ, are associated with successful outcomes. When such torsions/angulations persist despite these approaches, further innovative tactics are required. In the current report, we propose a technique that involves longitudinally opening of a synthetic graft that is rigid enough to maintain its shape, such as a ringed polytetrafluoroethylene graft, and placing it as an external stent around the angulated/torsioned vessel. This maneuver will correct the underlying vascular compromise without having to perform any further invasive interventions, such as reimplanting the organ or resecting part of the involved vessel. Although primarily illustrated for application by describing an instance in which exostenting was applied during kidney transplantation, our approach could be applied to any vessel under many circumstances where angulations/twists are encountered. In this report, we describe the use of an external stent, also called exostenting, to correct a severe torsion/angulation of the external iliac artery in a kidney transplant recipient where all other measures were unsuccessful.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 2","pages":"128-130"},"PeriodicalIF":0.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191687/pdf/10-1055-s-0041-1727132.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9497006","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":"Intracaval Leiomyoma with Intracardiac Extension.","authors":"Gabriele M Iacona,&nbsp;Serge Harb,&nbsp;Venkatesh Krishnamurthi,&nbsp;James J Yun","doi":"10.1055/s-0041-1736442","DOIUrl":"https://doi.org/10.1055/s-0041-1736442","url":null,"abstract":"<p><p>The objective of this study was to explain step by step how to achieve a complete resection of an intravascular leiomyoma. A 48-year-old woman was referred to our institution with progressive dyspnea on exertion, lightheadedness, and previous history of total abdominal hysterectomy and bilateral salpingo-oophorectomy for a uterine leiomyoma echocardiography, computed tomography, and magnetic resonance imaging of the heart and abdomen/pelvis were performed and an intracaval mass with extension into the right heart and pulmonary artery was identified. After multidisciplinary review, a single-stage sternotomy-laparotomy procedure on cardiopulmonary bypass (with beating heart, mild hypothermia, and no deep hypothermic circulatory arrest) ensured complete resection of a giant intravenous leiomyoma (IVL). Multidisciplinary approach, multimodality imaging, and single-stage sternotomy-laparotomy procedure on cardiopulmonary bypass (with heart beating and mild hypothermia) ensure complete resection of IVL.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 2","pages":"136-139"},"PeriodicalIF":0.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191695/pdf/10-1055-s-0041-1736442.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499845","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":"Risk Factors of Asymptomatic Carotid Artery Disease in Geriatric Evaluated Using Carotid Intima-Media Thickness (IMT) Measurement, the First Indonesian Population Study.","authors":"Dedy Pratama,&nbsp;Fajar Satria Rahmaditya,&nbsp;Alexander Jayadi Utama,&nbsp;Raden Suhartono,&nbsp;Akhmadu Muradi","doi":"10.1055/s-0042-1750040","DOIUrl":"https://doi.org/10.1055/s-0042-1750040","url":null,"abstract":"<p><p>Carotid artery disease in geriatric is one of the important etiologies of stroke, which topped the cause of mortality in Indonesia. Specific prevention should be done as early as asymptomatic disease occurred. Initial assessment can be performed using ultrasound by measuring the intima-media thickness (IMT) of carotid artery, which can evaluate earlier progression of the atherosclerosis process. Unfortunately, we do not have risk factors categorization that show us which geriatric population fall under high-risk stratification to be screened. Study was done to Indonesian geriatric population. Asymptomatic carotid disease was tested positive if IMT was > 0.9 mm without any previous neurological symptoms. Correlation of the result was statistically tested with risk factors of atherosclerotic process, such as sex, body mass index, presence of hypertension, diabetes mellitus, and hypercholesterolemia. Study obtained 104 subjects and showed the prevalence of asymptomatic carotid disease was 37.5%. Two risk factors: diabetes mellitus and hypercholesterolemia were statistically significant ( <i>p</i>  = 0.01) with odds ratio (OR) 3.56 (1.31-9.64, 95% confidence interval [CI]) and OR 2.85 (1.25-6.51, CI 95%), respectively. Logistic regression showed the risk was 69.2% by having two of these comorbidities, 47.2 or 42.5% if diabetes mellitus or hypercholesterolemia was present. As diabetes mellitus and hypercholesterolemia were proved to be significant risk factors for asymptomatic carotid artery disease, we recommend performing ultrasound screening to measure carotid artery IMT for geriatric population who had diabetes mellitus and/or hypercholesterolemia for asymptomatic carotid artery disease to be diagnosed and further treated.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 2","pages":"95-99"},"PeriodicalIF":0.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191689/pdf/10-1055-s-0042-1750040.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9707302","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}