Vascular Investigation and Therapy最新文献

{"title":"Close association between carotid and coronary atherosclerosis analyzed through SYNTAX score","authors":"Piero Levantino, G. Polizzi, S. Evola, G. Leone, G. Evola, G. Novo, S. Novo","doi":"10.4103/VIT.VIT_5_19","DOIUrl":"https://doi.org/10.4103/VIT.VIT_5_19","url":null,"abstract":"AIM: This study analyzed the association between carotid and coronary atherosclerosis, particularly in terms of the severity as well as the extension of the disease. MATERIALS AND METHODS: We have recruited a consecutive series of 478 patients (admitted to the Cardiology Unit of University Hospital Paolo Giaccone during 2004–2014). These patients underwent both carotid Doppler ultrasound and coronary angiography. Sex, age, and traditional cardiovascular risk factors were considered. The SYNTAX score was used to grade the complexity of coronary disease. RESULTS: The present study revealed a clear association between carotid atherosclerosis and coronary disease: 68.2% of the examined population showed atherosclerosis in both carotid and coronary arteries. The absence of carotid atherosclerosis was predominantly associated with angiographically normal coronary arteries (37.6%) rather than a single-vessel disease (22.8%), a two-vessel disease (21.8%), or a three-vessel disease (17.8%). When carotid atherosclerosis was present, a normal coronary angiography was uncommon (13.5%), while the detection of a single-vessel disease was more frequent (17.2%), a two-vessel disease was even more frequent (27.6%), and the highest rate described was related to a three-vessel coronary artery disease (CAD) (41.6%). The thickness of the carotid lesion was directly proportional to the number of diseased coronary vessels, and it was also related to the severity of coronary involvement measured by the SYNTAX score. CONCLUSIONS: This study has shown a strong correlation between carotid atherosclerosis and CAD, in terms of extension, and most importantly, severity. It is fundamental to consider a systemic approach to atherosclerosis to obtain an adequate stratification of patients with cardiovascular risk factors and an appropriate therapeutic management and reduce the incidence of adverse events, improving the quality of life and prolonging survival.","PeriodicalId":34849,"journal":{"name":"Vascular Investigation and Therapy","volume":"11 1","pages":"1 - 7"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82525354","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":"Retrospective study of hepatic encephalopathy by different transjugular intrahepatic portosystemic shunt ways in portal hypertension","authors":"Xin Huo, X. Cui, Min Wang, Chong Jing, Yue Wu, Xin Yu, Hui Zhou, Wenpeng Li, X. Cai, Guan-Zhou Zhou, Yonghua Zhang","doi":"10.4103/VIT.VIT_6_19","DOIUrl":"https://doi.org/10.4103/VIT.VIT_6_19","url":null,"abstract":"OBJECTIVE: The objective of the study was to evaluate the effectiveness and safety of the use of different shunting ways in patients with liver cirrhosis undergoing transjugular intrahepatic portosystemic shunt (TIPS). MATERIALS AND METHODS: We analyzed the data of 36 patients with liver cirrhosis who received de novo TIPS implantation. Sixteen patients had elective TIPS by shunting the blood to the left downstream veins and 20 to the right ones. All patients were followed up for 2 years. We assessed hepatic encephalopathy (HE), rebleeding, and survival rate in all patients post-TIPS. RESULTS: Under our surgical procedure, more post-TIPS HE was observed in the TIPS-left group, whereas rebleeding was detected in the TIPS-right group (P < 0.05). CONCLUSIONS: The decision regarding TIPS placement way for portal hypertension patients needs individualization to allow its safe use, with concomitant improvement in perioperative morbidity.","PeriodicalId":34849,"journal":{"name":"Vascular Investigation and Therapy","volume":"331 1","pages":"15 - 18"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80501540","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":"Severe vertebral artery stenosis treated by directional atherectomy","authors":"Yongquan Gu, Jian-ming Guo, Lianrui Guo, S. Cui, H. Aridi, M. Malas, Z. Tong, Yi-xia Qi, L. Qi","doi":"10.4103/VIT.VIT_17_18","DOIUrl":"https://doi.org/10.4103/VIT.VIT_17_18","url":null,"abstract":"We report the outcomes of directional atherectomy using a distal protective device and drug-coated balloon angioplasty in four patients with severe atherosclerotic vertebral artery stenosis. All cases were clinically successful with complete resolution of the symptoms. Immediate and postoperative results showed a good technical success. These results suggest that vertebral artery stenosis treated with directional atherectomy is technically feasible and may be a safe and effective option when performed by experienced endovascular surgeons.","PeriodicalId":34849,"journal":{"name":"Vascular Investigation and Therapy","volume":"79 1","pages":"110 - 114"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80871599","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":"Pathophysiological mechanisms of chronic venous disease and their role in C0s clinical class","authors":"A. Nicolaides, E. Bouskela","doi":"10.4103/VIT.VIT_2_19","DOIUrl":"https://doi.org/10.4103/VIT.VIT_2_19","url":null,"abstract":"The aim of this review is to provide a clear understanding of the pathophysiological mechanisms of chronic venous disease (CVD) at different clinical stages and the possible role of these mechanisms in the development of symptoms in C0s clinical class of the Clinical, Etiologic, Anatomic, and Pathophysiologic classification, which consists of symptomatic patients without any visible or palpable signs of venous disease. The prevalence of C0s class in several epidemiological studies varies between 13% and 23% of the general population. Wall remodeling and valve destruction due to white cell endothelial interaction is the main cause of primary varicose veins, while deep vein thrombosis produces secondary changes leading to the postthrombotic syndrome. The underlying mechanism of the skin changes and ulceration is venous hypertension, which is transmitted to the skin microcirculation. Over the last 10 years, an improved videocapillaroscopic technique, the orthogonal polarization spectral imaging technique demonstrated that quantitative measurements in the skin microcirculation are progressively altered from C1 to C6 patients and that values in CVD patients are significantly different from healthy individuals (P < 0.05): capillary diameter increases and capillary morphology worsens from C2 to C5; diameter of the dermal papilla and diameter of the capillary bulk increase from C3 to C5; and functional capillary density (FCD) decreases from C4 to C5. In addition, significant changes have been shown between C0a and C0s patients despite the presence of normal conventional duplex scans in the latter: a decrease of FCD and an increase in the diameter of the dermal papilla. Functional abnormalities found to be present in C0s patients by recent studies include increased compliance of the venous wall (hypotonic phlebopathy), dilatation of deep veins in the calf producing an abnormally increased venous volume, reduction in emptying of venous reservoir, reduction in the venoarteriolar response on standing, and blood reflux in small venules despite a normal conventional duplex scan. However, most of the studies are small, and their findings need to be confirmed by larger series. It remains to be seen whether functional changes and microcirculatory changes respond to venoactive medications in parallel to the relief of symptoms.","PeriodicalId":34849,"journal":{"name":"Vascular Investigation and Therapy","volume":"103 1","pages":"103 - 109"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84658487","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":"Hyperthermic isolated limb perfusion: Does it still have a role?","authors":"J. Reid, Michael Rooke, Colin Hawksmith, C. Jurisevic, M. Brown, S. Neuhaus","doi":"10.4103/VIT.VIT_18_18","DOIUrl":"https://doi.org/10.4103/VIT.VIT_18_18","url":null,"abstract":"BACKGROUND: Hyperthermic-isolated limb perfusion (ILP) with melphalan is an established modality for the treatment of irresectable malignancy of an extremity, including melanoma. ILP isolates the affected limb from the systemic circulation, using an extracorporeal bypass circuit, and administering high-dose intra-arterial chemotherapy. While this technique remains the “gold standard” and is practiced at high-volume surgical oncology centers worldwide, as new systemic treatments have become available, it is timely to review the current place of regional chemotherapy. PATIENTS AND METHODS: Twenty-six ILPs were performed between 2006 and 2013 at a single center. Patient's parameters, clinical outcomes, and survival were evaluated. Twenty procedures were for melanoma, five for sarcoma, and one for extensive basal cell carcinoma (BCC). RESULTS: ILP was well tolerated with few intraoperative or postoperative complications. Within the melanoma group, limb toxicities were low with one Grade III and no severe (Wieberdink IV+) toxicities. Limb salvage was achieved in 2/5 sarcoma patients. At 6 weeks' postprocedure, 13 melanomas, two sarcomas, and the BCC patient reported a complete response (16/26). However, 5 years after the last procedure, and a median follow-up of 23 months, the majority of melanoma and all sarcoma patients went on to develop local recurrence or metastatic disease. CONCLUSIONS: ILP is a useful technique to provide high-dose chemotherapy to refractory limb malignancy to provide effective palliation, delay progression, or even obtain cure. However, as new effective systemic therapies emerge, the role of isolated regional chemotherapy (ILP and isolated limb infusion) needs to be reevaluated.","PeriodicalId":34849,"journal":{"name":"Vascular Investigation and Therapy","volume":"15 1","pages":"87 - 92"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81047489","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":"Near-infrared spectroscopy of the thigh fails to discriminate cyclists with arterial endofibrosis from normal asymptomatic athletes","authors":"T. Julienne, M. Ammi, J. Hersant, S. Henni, P. Abraham","doi":"10.4103/VIT.VIT_1_19","DOIUrl":"https://doi.org/10.4103/VIT.VIT_1_19","url":null,"abstract":"BACKGROUND: This study is to assess the applicability and performance of the near-infrared spectroscopy (NIRS) in the diagnosis of exercise-induced arterial endofibrosis (EIAE). METHODS: NIRS was measured on each thigh, in 12 highly trained asymptomatic cyclists (controls) and 14 EIAE patients highly trained competition cyclists. All patients had an incremental bicycle stress test until exhaustion or symptom limitation. Results are presented as median (25°; 75° centiles) and between groups difference calculated with Mann–Whitney test. RESULTS: Six of the NIRS recordings technically failed: three in controls and three in EIAE patients due to probe disconnection. In the remaining nine controls and 11 EIAE patients, no difference was found at peak exercise for tissue saturation index (−2.0% [−8.5; 2.1] vs. −4.0% [−5.9; 5.5]; P = 0.710) or for half-time recovery (42.0 s [24.9; 105.0] vs. 42.0 s [33.0; 112.7]; P = 0.905) between EIAE and controls, respectively. CONCLUSION: NIRS, when available, does not satisfactorily discriminate patients with EIAE from asymptomatic healthy athletes.","PeriodicalId":34849,"journal":{"name":"Vascular Investigation and Therapy","volume":"14 1","pages":"93 - 97"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87851364","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":"A retrospective analysis of eosinophilic disorder on poststroke pneumonia","authors":"Xin Huo, Wanchen Shi, Tianqi Zhang, Libin Guo, Y. Liu","doi":"10.4103/VIT.VIT_3_19","DOIUrl":"https://doi.org/10.4103/VIT.VIT_3_19","url":null,"abstract":"OBJECTIVE: The objective of the study was to evaluate the role of eosinophil on the outcome and prognosis in stroke patients with pneumonia. PATIENTS AND METHODS: The study included 526 patients with ischemic stroke; the patients were divided into two groups according to whether the patients were complicated with pneumonia or not. All patients were supervised by the National Institutes of Health Stroke Scale (NIHSS) score in 2 weeks. RESULTS: Stroke patients without pneumonia were observed a higher eosinophil count and lower platelet distribution width (PDW) compared to the patients with pneumonia (P < 0.05). Eosinophil counts continued to decrease in patients with pneumonia along with an increasing NIHSS score in 2 weeks. Logistic regression identified dysphagia, eosinophil count, and PDW as predictors of NIHSS scores in poststroke patients with pneumonia. CONCLUSIONS: Our data suggested that eosinophil counts might have a significant role on outcomes in poststroke patients with pneumonia. The results underscored that the interaction between eosinophils and platelets might be a treatment target to improve the outcomes in stroke patients.","PeriodicalId":34849,"journal":{"name":"Vascular Investigation and Therapy","volume":"100 1","pages":"98 - 102"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73263900","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":"Commentary on paper “Severe vertebral artery stenosis treated by directional atherectomy” by Yongquan Gu, et al. Vasc Invest Ther 2018;1:110-4","authors":"A. Nicolaides","doi":"10.4103/VIT.VIT_4_19","DOIUrl":"https://doi.org/10.4103/VIT.VIT_4_19","url":null,"abstract":"","PeriodicalId":34849,"journal":{"name":"Vascular Investigation and Therapy","volume":"74 1","pages":"115 - 115"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85881778","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":"The cardioprotective role of melatonin against myocardial injury in patients undergoing coronary artery bypass grafting surgery","authors":"Karrar H Dwaich, F. Al-amran, B. I. M. AL-Sheibani, N. Yousif, N. Hadi","doi":"10.4103/VIT.VIT_12_18","DOIUrl":"https://doi.org/10.4103/VIT.VIT_12_18","url":null,"abstract":"BACKGROUND: Myocardial ischemia/reperfusion injury associated with coronary artery bypass graft (CABG) surgery characterizes as a clinically critical problem. The incidence of oxidative stress, inflammation, and apoptosis are induced throughout the reperfusion of the cardiac muscles following ischemia. The present study aims to examine the protective role of melatonin in ameliorating the degree of myocardial injury in patients undergoing bypass surgery, and whether this effect is dose related. PATIENTS AND METHODS: A total of 45 patients who were undergoing CABG in (Al-Najaf Cardiac Center, Al-Najaf, Iraq) were enrolled in this study between January 2015 and November 2015. Patients were randomly allocated into three study groups: placebo-controlled group (C), low-dose melatonin treatment group, 10 mg capsule once daily (M1) and high-dose melatonin treatment group 20 mg capsule once daily (M2). RESULTS: Compared to the control group, there was a significant increase in the plasma level of melatonin associated with a significant reduction in plasma levels of high sensitive C-reactive protein, creatine kinase isoenzyme muscle/brain, and cardiac troponin-I, in the melatonin groups (Group M1 and M2) compared to the control group, (P < 0.05) in melatonin-treated groups. Comparing the two melatonin study groups, the changes in the parameters mentioned above were more significant in the M2 group compared to the M1 group (P < 0.05). CONCLUSION: These findings suggested that melatonin administration can ameliorate the degree of myocardial injury, dose-dependent effects.","PeriodicalId":34849,"journal":{"name":"Vascular Investigation and Therapy","volume":"119 4 1","pages":"41 - 49"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88748877","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":"Oscillometric pulse wave analysis in newly diagnosed never treated Gujarati hypertensives","authors":"J. Solanki, H. Mehta, C. Shah","doi":"10.4103/VIT.VIT_14_18","DOIUrl":"https://doi.org/10.4103/VIT.VIT_14_18","url":null,"abstract":"INTRODUCTION: Hypertension is on a high with preponderance of undiagnosed and untreated at-risk individuals. Pulse wave analysis (PWA) provides noninvasive assessment of arterial stiffness and central hemodynamic parameters. It provides more discrete and direct inference about cardiovascular aging that is expected to be exaggerated with systemic hypertension. MATERIALS AND METHODS: A case–control study was conducted in 116 newly diagnosed, never treated, apparently healthy hypertensives and 116 matched nonhypertensive controls. Oscillometric PWA was accomplished by Mobil-o-Graph (IEM, Germany) to derive cardiovascular parameters that were further analyzed. P < 0.05 was considered statistically significant. RESULTS: Cases showed significantly higher brachial arterial parameters (blood pressure [BP], heart rate, and rate pressure product); arterial stiffness (augmentation pressure, augmentation index, pulse wave velocity, total arterial stiffness, and pulse pressure amplification); and central hemodynamics (central BP, cardiac output, and stroke work) than age-, gender-, and height-matched controls. Major study parameters correlated with BP, heart rate, and age, but in multiple regressions, they were independent of most of these parameters. CONCLUSIONS: Oscillometric PWA is feasible in our population. It revealed beyond brachial BP abnormal profile suggestive of early cardiovascular aging in new and never treated hypertensives. It also suggests further work to consolidate and explore these results.","PeriodicalId":34849,"journal":{"name":"Vascular Investigation and Therapy","volume":"24 1","pages":"62 - 67"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82812349","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}