Cardiovascular Journal of Africa最新文献

{"title":"Mini-crush versus provisional stenting in coronary bifurcation lesions: long-term results from a real-world cohort.","authors":"Fahrettin Turna, Mehmet Şirin Yıldız, Emre Eynel, İbrahim Kocayigit, Havva Kocayigit, Asım Enhos","doi":"10.5830/CVJA-2026-025","DOIUrl":"https://doi.org/10.5830/CVJA-2026-025","url":null,"abstract":"<p><strong>Background: </strong>The optimal stenting strategy for coronary bifurcation lesions remains a topic of debate, particularly regarding the long-term comparative effectiveness of mini-crush and provisional techniques.</p><p><strong>Methods: </strong>We analysed consecutive patients undergoing bifurcation percutaneous coronary intervention (PCI) treated with either provisional stenting or a planned mini-crush strategy. True bifurcation lesions were classified according to the Medina classification, and only those with lesions classified as 1.1.1, 1.0.1, and 0.1.1 were included. The primary endpoint was a composite of all-cause mortality and target lesion revascularisation (TLR). Time-to-event outcomes were assessed using the Kaplan-Meier method and compared using the log-rank test. Multivariable Cox proportional hazards regression was performed to identify independent predictors of outcomes. A prespecified subgroup analysis was conducted for patients with true bifurcation lesions (Medina 1.1.1).</p><p><strong>Results: </strong>A total of 157 patients (92 with provisional stenting and 65 with mini-crush) were included, with a median follow-up exceeding seven years. Event-free survival did not differ significantly between the two techniques (log-rank p = 0.738). In multivariable analysis, after adjusting for age, prior PCI, multivessel disease, and lesion complexity, the stenting technique was not independently associated with the composite endpoint (adjusted HR 1.05, 95% CI 0.49-2.27; p = 0.90). In the Medina 1.1.1 subgroup, long-term mortality and TLR rates were also comparable across strategies.</p><p><strong>Conclusion: </strong>In our real-world cohort, both mini-crush and provisional stenting strategies were associated with similar long-term clinical outcomes. After adjusting for patient and lesion complexity, the stenting technique did not predict long-term prognosis, suggesting that anatomical and clinical factors may outweigh procedural strategy in bifurcation PCI.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"396-403"},"PeriodicalIF":0.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological and neurocognitive outcomes of routine deep hypothermic circulatory arrest with open distal anastomosis in ascending aortic and aortic root aneurysm surgery.","authors":"Mehmet Inanc Yesilkaya, Anıl Karaagac, Gulbun Asuman Yuksel, Tolga Can, Yusuf Kagan Pocan, Ozan Erturk, Burak Bozkurt, Mehmet Kaplan","doi":"10.5830/CVJA-2026-014","DOIUrl":"https://doi.org/10.5830/CVJA-2026-014","url":null,"abstract":"<p><p>This study aimed to evaluate postoperative neurological and neurocognitive changes in patients undergoing ascending aortic and aortic root aneurysm surgery using the deep hypothermic circulatory arrest technique with open distal anastomosis performed without cerebral perfusion. Thirty-six patients (83.3% male, n = 30; 16.7% female, n = 6) were included. Demographic, operative, and postoperative data were recorded. Each patient underwent the Mini-Mental State Examination (MMSE), the Oktem Verbal Memory Processes Test (OVMPT), and the Wechsler Memory Scale-Visual Reproduction Test (WMS-VR) before and one week after surgery. Cerebral oxygen saturation levels were continuously monitored using near-infrared spectroscopy. Postoperative OVMPT scores showed significant improvement (p < 0.001). No significant change was observed in the WMS-VR, while MMSE scores showed a slight but significant postoperative decline (p < 0.001). No associations were found between neurocognitive outcomes and operative variables. These findings indicate that this procedure can be performed with acceptable early neurological outcomes.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"325-331"},"PeriodicalIF":0.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NT-proBNP in women with gestational hypertension, uncomplicated preeclampsia, normotensive pregnancies, and echocardiographic correlations.","authors":"Dolina Gencheva, Fedya Nikolov, Ekaterina Uchikova, Blagovesta Pencheva, Rosen Mihaylov","doi":"10.5830/CVJA-2026-037","DOIUrl":"https://doi.org/10.5830/CVJA-2026-037","url":null,"abstract":"<p><strong>Objective: </strong>To determine and compare serum NT-proBNP levels among women with gestational hypertension (GH), uncomplicated preeclampsia (PE), and normotensive pregnancies, and to assess their associations with maternal characteristics and echocardiographic parameters.</p><p><strong>Methods: </strong>This prospective, single-centre study analysed 35 women with GH, 36 with uncomplicated PE, and 50 healthy pregnant controls. All participants underwent clinical evaluation, comprehensive two-dimensional echocardiography, and biomarker testing.</p><p><strong>Results: </strong>NT-proBNP concentrations were significantly lower in the GH group (42.3 ± 52.0 pg/mL) compared to both normotensive pregnancies (50.1 ± 40.3 pg/mL; p = 0.04) and uncomplicated PE cases (87.7 ± 75.3 pg/mL; p = 0.002). No significant difference was observed between uncomplicated PE and controls. ROC curve analysis demonstrated a moderate discriminatory ability of NT-proBNP for GH versus PE (AUC = 0.71); women with levels ≤ 6.25 pg/mL were 7.9 times more likely to have GH than PE. In normotensive pregnancy, NT-proBNP correlated with parameters of cardiac chamber dilation. In PE, higher NT-proBNP levels were associated with more favourable left ventricular functional indices, whereas fewer correlations were observed in the GH cohort.</p><p><strong>Conclusion: </strong>NT-proBNP levels differ significantly among hypertensive disorders of pregnancy and may reflect distinct pathophysiological mechanisms and cardiovascular adaptation patterns.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"365-374"},"PeriodicalIF":0.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of preoperative systemic immune-inflammation index and atherogenic index of plasma with early postoperative clinical outcomes in patients undergoing isolated elective coronary artery bypass grafting with cardiopulmonary bypass.","authors":"Ömer Göç, Murat Ziya Bağış","doi":"10.5830/CVJA-2026-038","DOIUrl":"10.5830/CVJA-2026-038","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Coronary artery disease (CAD) is a complex cardiovascular condition associated with multifaceted pathophysiological mechanisms such as inflammation, thrombotic activation, endothelial dysfunction, and an atherogenic lipid profile. The cardiopulmonary bypass (CPB) process, in turn, may influence early postoperative clinical outcomes by inducing a systemic inflammatory response, oxidative stress, and alterations in organ perfusion. Consequently, the assessment of practical indices reflecting the inflammatory and atherogenic burden during the preoperative period is of clinical importance. This preliminary retrospective study aimed to evaluate how preoperative systemic immune-inflammation index (SII) and atherogenic index of plasma (AIP) values associate with early postoperative clinical outcomes in patients with CAD undergoing isolated elective coronary artery bypass grafting with CPB.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective, single-centre, observational study included 50 adult patients who underwent elective cardiac surgery with CPB due to CAD. Preoperative blood count results for neutrophil, lymphocyte and platelet counts, and lipid profile results for triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) levels were recorded. SII was calculated using the platelet × neutrophil/lymphocyte formula; AIP was calculated using the log10 (TG/HDL-C) formula. The relationships between preoperative SII and AIP values and postoperative lactate, postoperative creatinine, the development of acute kidney injury (AKI), duration of mechanical ventilation, and length of stay (LOS) in the intensive care unit (ICU) were evaluated. Postoperative lactate and creatinine values were obtained from routine early postoperative laboratory records. AKI was defined according to creatinine-based criteria within the first 48 postoperative hours. TG and HDL-C values used for AIP calculation were recorded in mg/dL.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age of the patients included in the study was 61.8 ± 9.7 years, and 32 (64.0%) were male. The median SII score was 762.4 (485.2-1189.6), and the mean AIP score was 0.58 ± 0.21. AKI developed in 11 patients (22.0%). SII scores were significantly correlated with postoperative lactate levels (r = 0.421, p = 0.002), ICU LOS (r = 0.368, p = 0.009), duration of mechanical ventilation (r = 0.331, p = 0.019), and postoperative creatinine levels (r = 0.394, p = 0.005). AIP values showed a significant positive correlation with postoperative lactate levels (r = 0.287, p = 0.043) and postoperative creatinine levels (r = 0.302, p = 0.033) but did not show a significant association with ICU LOS or duration of mechanical ventilation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Higher preoperative SII values were associated with less favourable early postoperative parameters, including postoperative lactate and creatinine levels, mechanical ventilation duration, and ICU LOS, in this small retrospec","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"386-392"},"PeriodicalIF":0.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admission neutrophil-to-lymphocyte ratio and target-vessel failure after bifurcation percutaneous coronary intervention in acute coronary syndrome.","authors":"Mehmet Akif Erdöl, Ayse İrem Demirtola, Çağrı Yayla, Kadriye Gayretli Yayla, Ahmet Göktuğ Ertem, Adnan Burak Akçay","doi":"10.5830/CVJA-2026-035","DOIUrl":"https://doi.org/10.5830/CVJA-2026-035","url":null,"abstract":"<p><strong>Background: </strong>Coronary bifurcation lesions represent one of the most complex settings in patients with acute coronary syndrome (ACS) and are associated with worse outcomes after percutaneous coronary intervention (PCI). In addition to anatomical complexity, systemic inflammation may influence long-term vessel-related outcomes. The neutrophil-to-lymphocyte ratio (NLR) is a simple marker of inflammatory burden, but its prognostic value in ACS patients undergoing bifurcation PCI remains unclear.</p><p><strong>Methods: </strong>This retrospective single-centre study included ACS patients treated with bifurcation PCI using a two-stent strategy between 2022 and 2025. Target-vessel failure (TVF) was defined as a composite of cardiac death, target-vessel-related myocardial infarction, and repeat target-vessel revascularisation. Independent predictors of TVF were evaluated using multivariable logistic regression.</p><p><strong>Results: </strong>A total of 106 patients were included, with a median follow-up of 29 months. TVF occurred in 22 patients (20.8%). Patients with TVF had significantly higher NLR values and higher SYNTAX scores. In multivariable analysis, both NLR and SYNTAX score remained independently associated with TVF.</p><p><strong>Conclusion: </strong>In ACS patients undergoing bifurcation PCI, increased inflammatory burden reflected by NLR and greater coronary complexity are independently associated with TVF, supporting the use of combined inflammatory and angiographic risk assessment after PCI.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"318-324"},"PeriodicalIF":0.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex cardiac and porcelain aorta surgery in patients with untreated familial hypercholesterolaemia: a case report.","authors":"Rahma Kallel, Hela Ben Jemaa, Faten Dhouib, Hela Fendri, Amal Samet, Imed Frikha, Hichem Denguir","doi":"10.5830/CVJA-2026-036","DOIUrl":"https://doi.org/10.5830/CVJA-2026-036","url":null,"abstract":"<p><p>Familial hypercholesterolaemia (FH) is a genetic disorder characterised by elevated levels of circulating low-density lipoprotein cholesterol. Serious presentations are challenging to treat. We report a case of complex cardiovascular outcomes in a 28-year-old man with diabetes mellitus and untreated FH. The diagnostic workup was compatible with a homozygous phenotype. The patient presented with a non-ST-elevation myocardial infarction, which revealed severe premature three-vessel coronary artery disease with significant proximal blockages, including severe ostial left main stenosis, as well as severe valvular and supravalvular aortic stenosis. Aortic computed tomography angiography (CTA) confirmed the presence of a porcelain aorta and guided the surgical repair. Despite the porcelain aorta, the patient underwent conventional cardiac and aortic surgery with an uneventful post-operative course. This case highlights a rare case of successful cardiac and aortic surgery in the context of a porcelain aorta, performed safely by experienced surgeons using current perfusion and operative techniques guided by CTA imaging. Ongoing efforts are required to improve early detection and prompt management of FH.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"381-385"},"PeriodicalIF":0.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of computed tomography-derived fractional flow reserve in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation: a single-centre feasibility study.","authors":"Soner Aksüyek, Fatih Koca, Abdulsamet Arslan, Mehmet Demir, Mehmet Melek, Hasan Arı, Alper Karakus","doi":"10.5830/CVJA-2026-032","DOIUrl":"https://doi.org/10.5830/CVJA-2026-032","url":null,"abstract":"<p><strong>Objective: </strong>Coronary artery disease (CAD) is prevalent in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). Computed tomography-derived fractional flow reserve (CT-FFR) may provide non-invasive functional assessment using existing TAVI planning imaging to evaluate CT-FFR diagnostic performance compared with invasive coronary angiography (ICA) for identifying functionally significant CAD in TAVI candidates.</p><p><strong>Methods: </strong>This single-centre retrospective study included 37 patients with severe AS undergoing TAVI (June 2016-June 2023). All underwent pre-procedural coronary CT angiography and ICA. CT-FFR was retrospectively analysed using deep learning-based software (threshold < 0.81 for significant stenosis). Diagnostic performance was assessed per-vessel (52 coronary arteries) using ICA as reference standard.</p><p><strong>Results: </strong>Mean age was 79.2 ± 8.4 years; 56.7% were male. ICA identified significant CAD in 14 patients (37.8%), involving 21 lesions. CT-FFR successfully analysed all 52 vessels in the final cohort (mean value 0.86 ± 0.11) identifying 20 lesions (38.4%) as functionally significant; however, 8 of 62 initially screened patients (12.9%) were excluded due to insufficient CT image quality, reflecting a relevant limitation of clinical feasibility. CT-FFR demonstrated sensitivity 80.9% (95% CI: 58.1%-94.6%), specificity 93.5% (95% CI: 78.6%-99.2%), positive predictive value 85.0%, negative predictive value 90.6%, and diagnostic accuracy 88.5%. No significant difference existed between CT-FFR and ICA classifications (p > 0.05). At 30 days, no deaths, myocardial infarctions, or strokes occurred.</p><p><strong>Conclusion: </strong>CT-FFR provides good diagnostic performance for detecting haemodynamically significant CAD in TAVI candidates. Integration into routine workflows may reduce purely diagnostic invasive procedures while maintaining accuracy. Larger prospective studies are needed to validate these findings.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"375-380"},"PeriodicalIF":0.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is routine chest X-ray necessary after ultrasound-guided TIVAP insertion through the internal jugular vein?","authors":"Kübra Gözaçık Karakoç, Tamer Cebe, Anıl AkbaŞ, Bekir Yıldız, Gökhan Karakoç","doi":"10.5830/CVJA-2026-027","DOIUrl":"https://doi.org/10.5830/CVJA-2026-027","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated routine chest X-ray necessity following ultrasound-guided totally implantable venous access port (TIVAP) placement via internal jugular vein.</p><p><strong>Materials and methods: </strong>We retrospectively analysed 97 adults who underwent ultrasound-guided TIVAP placement at a tertiary cardiovascular surgery clinic in Eastern Turkey (December 2023-December 2024). Intraoperative port functionality (blood aspiration/fluid infusion) and postprocedural chest X-ray findings were assessed. Catheter positions were categorised as optimal, suboptimal, or malpositioned.</p><p><strong>Results: </strong>Among 97 patients (56.7% male; mean age 57.4 ± 15.0 years), pneumothorax occurred in one patient (1.0%), requiring intervention. Nineteen patients (19.6%) had suboptimal/malpositioned catheter tips but required no corrective action as port functionality remained intact. Radiographic findings prompted intervention in only one patient (1.0%).</p><p><strong>Conclusions: </strong>Routine post-procedural chest X-ray identified catheter tip malpositioning in a subset of patients; however, these findings did not alter clinical management in the absence of port dysfunction. Selective imaging in patients with failed port functionality may safely reduce unnecessary radiation exposure and healthcare costs without compromising outcomes.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"358-364"},"PeriodicalIF":0.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awake off-pump no-touch aorta coronary artery bypass grafting in a patient with interstitial lung disease during the COVID-19 pandemic.","authors":"Mehmet Sanser Ates, Zumrut Tuba Demirozu","doi":"10.5830/CVJA-2026-039","DOIUrl":"https://doi.org/10.5830/CVJA-2026-039","url":null,"abstract":"<p><strong>Background: </strong>Off-pump coronary artery bypass grafting (OPCABG) is favoured to reduce surgical trauma during myocardial revascularisation. Severe chronic respiratory conditions, such as interstitial lung disease, are known to significantly complicate perioperative management and long-term survival. For patients with a history of serious cerebral infarction or advanced respiratory disease, awake OPCABG under high thoracic epidural anaesthesia (TEA) provides a highly beneficial alternative to conventional general anaesthesia.</p><p><strong>Case presentation: </strong>A 71-year-old male with a 10-year history of chronic interstitial pulmonary fibrosis presented with exertional dyspnoea. Coronary angiography and transthoracic echocardiography revealed two-vessel disease. Based on preoperative pulmonary function tests and the high risk of prolonged endotracheal intubation, the patient was deemed a high-risk candidate for general anaesthesia. In July 2020, during the COVID-19 pandemic, he underwent awake off-pump no-touch aorta double coronary artery bypass grafting using arterial revascularisation under TEA. The patient's recovery was uneventful, and he was discharged on the fifth postoperative day.</p><p><strong>Conclusion: </strong>Awake OPCABG under TEA is a viable strategy for elderly patients with severe interstitial lung disease who face substantial risks from general anaesthesia and cardiopulmonary bypass. This complex approach should be restricted to referral centres with extensive experience in advanced off-pump surgery and thoracic epidural anaesthesia techniques.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"354-357"},"PeriodicalIF":0.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with cerebrovascular complications in a cohort of patients with autosomal dominant polycystic kidney disease in South Africa.","authors":"Cedric Xavier Mbobnda Kapche, Alain Assounga","doi":"10.5830/CVJA-2026-041","DOIUrl":"https://doi.org/10.5830/CVJA-2026-041","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of intracranial aneurysms (IAs) in individuals with autosomal dominant polycystic kidney disease (ADPKD) is about 6%-25%. This rate is higher than that of the general population and is associated with increased morbidity and mortality. Studies in Africa are sparse. Therefore, we aimed to describe the clinical manifestations, imaging features, and long-term prognoses of patients with cerebrovascular complications to inform screening and improve patients' awareness.</p><p><strong>Methods: </strong>We reviewed the records of patients with ADPKD admitted to Inkosi Albert Luthuli Central Hospital from January 2006 to June 2024. We reviewed 298 records to identify 14 patients who presented with cerebrovascular complications, including intracerebral haemorrhage (ICH), subarachnoid haemorrhage (SAH), unruptured intracranial aneurysms (UIAs), and spontaneous subdural haematoma (sSDH). We analysed their clinical manifestations, imaging characteristics, and outcomes.</p><p><strong>Results: </strong>The prevalence of cerebrovascular complications was 4.7%. Patients were predominantly men, and the median age at the time of the study was 45 years (range, 31-72). Black Africans and Indians/Asians were the most represented. Ten participants presented with IAs, a prevalence of 3%, of which 5 were ruptured. These presented as ICH in 2 patients, SAH in 2 patients, and concurrent ICH and SAH in 1 patient. The remaining 5 cases were unruptured. Caucasians and Indians were more likely to present with IAs and have a family history of ADPKD. Black Africans predominantly presented with sSDH (3 out of 4) of unknown aetiology. Black Africans had a reduced risk of IA. Intracranial bleeding was significantly associated with higher systolic blood pressure.</p><p><strong>Conclusion: </strong>IAs and intracranial bleeds are the most common cerebrovascular events in ADPKD patients. Black Africans were less likely to present with IAs. Good blood pressure control may reduce the risk of intracranial bleeding.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"332-338"},"PeriodicalIF":0.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}