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Aging-Related Structural and Functional Changes in Cerebral Arteries: Caloric Restriction (CR) Intervention 脑动脉衰老相关的结构和功能改变:热量限制(CR)干预
Pub Date : 2021-09-07 DOI: 10.35248/2329-6925.21.S7.002
M. Mandalá, M. Cipolla
Cerebral arteries play a crucial role in the regulation of blood flow to the brain to satisfy the demand of oxygen and glucose for proper function of the organ. Physiological cerebral blood flow (CBF) is maintained within a normal range in response to changes in blood pressure a mechanism named Cerebral Blood Flow Auto Regulation (CBFAR). Structure and function of cerebral arteries have an important impact on CBFAR. Several studies in human and animals have showed significant morphological and functional changes in cerebral vessels of aged brain associated with a reduced CBF which is also impaired in cerebrovascular pathology linked to brain diseases. Interestingly, one new emergent aspect is the lifelong Calorie Restriction (CR) as a potential intervention to prevent age-related cerebral artery changes and preserve the health of aging brain. This review summarizes the recent literature on the effects of aging on cerebral artery structure and function and the potential of CR as opportunities for prevention and treatment.
脑动脉在调节流向大脑的血液中起着至关重要的作用,以满足大脑正常功能对氧气和葡萄糖的需求。生理脑血流量(CBF)维持在正常范围内以应对血压的变化,这一机制被称为脑血流自动调节(CBFAR)。脑动脉的结构和功能对CBFAR有重要影响。在人类和动物中进行的几项研究表明,老年大脑的脑血管发生了显著的形态和功能变化,这与脑血流减少有关,而脑血流减少也会损害与脑部疾病有关的脑血管病理。有趣的是,一个新出现的方面是终身卡路里限制(CR)作为一种潜在的干预措施,以防止与年龄相关的大脑动脉变化和保持老化的大脑健康。本文综述了近年来关于衰老对脑动脉结构和功能的影响以及CR作为预防和治疗机会的潜力的文献。
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引用次数: 0
Type B Aortic Dissection Patients with Thoracic Endovascular Aortic Repair B型主动脉夹层胸椎血管内主动脉修复术
Pub Date : 2021-01-01 DOI: 10.35248/2329-6925.21.S5.E002
A. Chawla
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引用次数: 0
Endovascular Repair of a Thoracic Aortic Rupture 胸主动脉破裂的血管内修复
Pub Date : 2021-01-01 DOI: 10.35248/2329-6925.21.S6.003
A. Chawla
Endovascular procedures are currently treating more complex cases.In this report, we present the case of a complex aortic rupture in a patient with a type B aortic dissection. We describe step by step the procedure and we describe other alternative surgical and endovascular techniques. We believe that as collective experience grows, endovascular treatment limits can be pushed to replace surgery in more complex cases.. Huge aneurysms can in some cases be felt by pushing on the mid-region. Crack may bring about torment in the midsection or back, low pulse, or loss of cognizance, and frequently brings about death.
血管内手术目前用于治疗更复杂的病例。在这个报告中,我们提出的情况下,一个复杂的主动脉破裂的病人与B型主动脉夹层。我们一步一步地描述手术过程,并描述其他替代手术和血管内技术。我们相信,随着集体经验的增长,在更复杂的病例中,血管内治疗可以取代手术。在某些情况下,通过按压中间区域可以感觉到巨大的动脉瘤。裂纹可引起腹部或背部疼痛、脉搏降低或丧失认知能力,并经常导致死亡。
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引用次数: 0
Validating Effect of Sulodexide in Treatment of Claudication Pain and Chronic Limb-Threatening Ischemia 舒洛地特治疗跛行性疼痛和慢性肢体缺血的疗效验证
Pub Date : 2021-01-01 DOI: 10.35248/2329-6925.21.9.409
L. Kubícek, M. Dvorak, R. Staffa
Background: Peripheral arterial disease is a chronical disease which can lead to a sever quality of life reduction and in certain cases there is no indication or even possibility for revascularization and these patients are reliant on conservative therapy such as Sulodexide medication. Objective: In the retrospective study we evaluated effect of newly administrated Sulodexide therapy for patients with peripheral arterial disease both in cases of claudication pain and patients with chronic limb-threatening ischemia (CLTI). Methods: During a three year period we started Sulodexide therapy in 34 claudication and 38 CLTI cases with no contemporary revascularization procedure. Patients were followed for 4 and 8 months with claudication interval, Rutherford classification and CLTI evaluation. Results: We observed overall positive effect of Sulodexide in both groups. In claudication group there was a prolongation of average pain-free walking distance (PFWD) from 144 m at the baseline to 376 m at 4 months and 430 m at 8 months. In the second group all 38 patients started with CLTI symptoms, after 4 months 6 patients remained with CLTI and after 8 months 3 more had recurrence of CLTI. Conclusion: We observed a significant improvement both in PFWD in claudication sub-group and even in a clinical status of majority of the patients in CLTI sub-group. This effect of Sulodexide on CLTI patients was not yet thoroughly described in any available literature. According to our observations, Sulodexide seem to be a potent auxiliary therapy for patient with peripheral arterial disease even in the case CLTI.
背景:外周动脉疾病是一种慢性疾病,可导致严重的生活质量下降,在某些情况下,没有指征甚至没有可能进行血运重建,这些患者依赖于保守治疗,如舒洛地特药物。目的:通过回顾性研究,评价新给药舒洛地特治疗外周动脉疾病伴跛行性疼痛和慢性肢体威胁性缺血(CLTI)患者的疗效。方法:在三年的时间里,我们对34例跛行和38例CLTI患者进行了舒洛地特治疗,没有进行当代血运重建术。随访4个月和8个月,进行跛行间隔、卢瑟福分级和CLTI评价。结果:两组患者均观察到舒洛地特的总体疗效。跛行组的平均无痛步行距离(PFWD)从基线时的144 m延长至4个月时的376 m和8个月时的430 m。在第二组中,所有38例患者开始时均有CLTI症状,4个月后6例患者仍存在CLTI, 8个月后3例患者复发。结论:我们观察到跛行亚组的PFWD明显改善,甚至大多数CLTI亚组患者的临床状态也有明显改善。舒洛地特对CLTI患者的这种影响尚未在任何现有文献中得到充分描述。根据我们的观察,舒洛地德似乎是一种有效的辅助治疗外周动脉疾病的患者,即使在CLTI的情况下。
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引用次数: 0
The Smoking Paradox: A Twist in the Tale of Vasospastic Angina. 吸烟悖论:血管痉挛性心绞痛故事的转折。
Matthew V Tran, Eric Marceau, Pei-Yu Lee, Mark Chandy, Ian Y Chen

Cigarette smoking is undoubtedly the single most important risk factor and trigger for vasospastic angina, a condition also known as Prinzmetal angina secondary to coronary artery vasospasm. Even decades before vasospastic angina was first described by Dr. Myron Prinzmetal and his colleagues in 1959, there had been suspected connections between smoking and coronary artery vasospasm in what was alluded to then as "tobacco angina." The intimate relationship between smoking and vasospastic angina has since been extensively researched and validated through decades of epidemiological and clinical studies. The fact that smoking would aggravate vasospastic angina comes with very little surprise, as it has been shown to adversely impact many of the disease processes thought to underlie vasospastic angina, including autonomic dysfunction, endothelial dysfunction, smooth muscle hyperactivity, and genetic susceptibility. While avoidance of smoking is the first logical step in managing smokers with vasospastic angina, there have been reported cases of vasospastic angina paradoxically triggered by smoking cessation or relieved with smoking resumption or nicotine replacement therapy. Thus, there appears to be patient-specific factors that could significantly alter the close connection between smoking and vasospastic angina, warranting further mechanistic investigations. In this review, we will examine this complicated relationship between smoking and vasospastic angina from multiple perspectives (historical, mechanistic, and clinical) and call attention to the "smoking paradox," which, with further elucidation, may provide additional insight into the complex mechanisms of VSA and potentially new strategies to treat medically refractory VSA, at least in selected individuals.

吸烟无疑是血管痉挛性心绞痛的唯一最重要的危险因素和触发因素,这种情况也被称为继发于冠状动脉血管痉挛的普林兹金属心绞痛。早在1959年Myron Prinzmetal博士和他的同事首次描述血管痉挛性心绞痛之前的几十年,人们就怀疑吸烟和冠状动脉血管痉挛之间存在联系,当时被称为“烟草心绞痛”。吸烟和血管痉挛性心绞痛之间的密切关系已经通过几十年的流行病学和临床研究得到了广泛的研究和证实。吸烟会加重血管痉挛性心绞痛的事实并不令人惊讶,因为它已经被证明对许多被认为是血管痉挛性心绞痛基础的疾病过程产生不利影响,包括自主神经功能障碍、内皮功能障碍、平滑肌多动和遗传易感性。虽然避免吸烟是管理血管痉挛型心绞痛吸烟者的第一个合乎逻辑的步骤,但有报道称,血管痉挛型心绞痛是由戒烟引发的,或通过恢复吸烟或尼古丁替代疗法得到缓解。因此,似乎存在患者特异性因素可以显著改变吸烟与血管痉挛性心绞痛之间的密切联系,需要进一步的机制研究。在这篇综述中,我们将从多个角度(历史、机制和临床)研究吸烟和血管痉挛性心绞痛之间的复杂关系,并呼吁关注“吸烟悖论”,通过进一步的阐明,可能会为VSA的复杂机制和治疗难治性VSA的潜在新策略提供更多的见解,至少在特定的个体中。
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引用次数: 0
Vascular Surgery Procedures in Patients with COVID-19 Infection COVID-19感染患者的血管手术程序
Pub Date : 2021-01-01 DOI: 10.35248/2329-6925.21.S5.003
A. Chawla
Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness. Patients with COVID-19 infection undergoing vascular surgery procedures showed poor 30-days survival. Age >65 years, preoperative lymphocytes 500 (UI/L), and postoperative acute renal failure, ARDS and need for major amputation were identified as prognostic factors of 30-days mortality.
大多数感染COVID-19病毒的人会出现轻度至中度呼吸道疾病,无需特殊治疗即可康复。老年人和那些有心血管疾病、糖尿病、慢性呼吸系统疾病和癌症等潜在疾病的人更有可能患上严重疾病。接受血管手术的COVID-19感染患者30天生存率较低。年龄>65岁、术前淋巴细胞500 (UI/L)、术后急性肾功能衰竭、急性呼吸窘迫综合征(ARDS)和需要大截肢是30天死亡率的预后因素。
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引用次数: 0
Tracheo-innominate Artery Fistula Rare and Fatal Complication: Editorial 气管无名动脉瘘罕见且致命的并发症:社论
Pub Date : 2021-01-01 DOI: 10.35248/2329-6925.21.S5.E005
R. Khalil
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引用次数: 0
Why Patients With Spider Veins in The Leg Have Recurrence of Their Conditions By Using Sclerotherapy or Other Kinds of Treatment Recommended Nowadays 为什么腿上的蜘蛛静脉患者使用硬化疗法或目前推荐的其他治疗方法会复发
Pub Date : 2021-01-01 DOI: 10.35248/2329-6925.21.9.423
H. Ling
Introduction: Spider veins as known as telangiectasia can result from small superficial blood vessels in the skin. According to Western medicine’s point of view, spider veins rarely cause health problems and had a cosmetic problem and the treatment aims to improve the aspect. Purpose: the purpose of this study is to demonstrate that patients with spider veins have chakras’ energy centers deficient in energy that is leading to Blood stagnation and this is not only cosmetic issue but it is an important clinical meaning that these patients need to be treated to prevent or treat other present and future conditions that can come from energy deficient root. Methods: through two cases reports (70 and 75 years-old female patients) that went to the me clinic to treat their other clinical condition that was different from the spider veins (pain in the hip and pain in the shoulder respectively). Both patients were submitted to radiesthesia procedure which showed that both were without any energy in the chakras’ energy centers, rated in one, with exception of the seventh chakra that was normal, rated in eight. The author treated their condition with Chinese dietary counseling avoiding some kinds of foods, acupuncture and auricular acupuncture with apex ear bloodletting and homeopathy medications according to the theory entitled Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine. Results: Both patients improved from their initial symptoms that took them to the treatment but they also said that they improved from the appearance of the spider veins in the legs and said to me that their legs were more beautiful and they are very grateful for their improvement because both searched for this kind of treatment using local injection of medication but always the spider veins reappear again. Conclusion: the conclusion of this study is that spider vein are symptoms that has a meaning in the back ground, that means that the patient has internal energy deficiency and the treatment of this condition, replenishing the energy of these five massive organs, that were in the lowest level, demonstrated through radiesthesia procedure, is of paramount importance to treat the root of spider vein formation and the treatment of this condition (energy deficiency) can prevent many present and other future health problems that both patients could have.
简介:蜘蛛静脉被称为毛细血管扩张,可由皮肤表面的小血管引起。根据西医的观点,蜘蛛静脉很少引起健康问题,有美容问题,治疗的目的是改善这方面。目的:本研究的目的是证明患有蜘蛛静脉的患者的脉轮能量中心缺乏能量,导致血液停滞,这不仅仅是美容问题,而且这是一个重要的临床意义,这些患者需要治疗,以预防或治疗其他现在和未来可能来自能量缺乏根源的疾病。方法:通过2例70岁和75岁女性患者到me诊所治疗与蜘蛛静脉不同的其他临床症状(分别为髋部疼痛和肩部疼痛)的病例报告。两位病人都接受了放射治疗,结果显示,他们的脉轮能量中心都没有任何能量,评分为1分,除了第7个脉轮正常,评分为8分。笔者根据“中医五行体质顺势疗法”的理论,采用忌食、针灸、耳尖放血、顺势药物等中医饮食咨询方法治疗。结果:两名患者都从最初的症状得到改善,他们接受了治疗,但他们也说他们从腿部的蜘蛛静脉外观得到改善,并告诉我他们的腿更漂亮了,他们非常感谢他们的改善,因为他们都在寻找这种治疗方法,使用局部注射药物,但总是蜘蛛静脉再次出现。结论:这项研究的结论是蜘蛛静脉是一种有意义的症状,这意味着病人体内能量不足,这种情况的治疗,补充这五个巨大器官的能量,这是在最低水平,通过放射麻醉程序证明,治疗蜘蛛静脉形成的根源是至关重要的,治疗这种情况(能量缺乏)可以预防许多现在和未来的健康问题,这两个病人可能会有。
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引用次数: 1
Emergency Endovascular Treatment of Recurrent Internal Carotid Artery False Aneurysm Complicated By Carotid-Cutaneous Fistula and Life-Threatening Bleeding 复发性颈内动脉假性动脉瘤并发颈动脉皮瘘及危及生命的出血的急诊血管内治疗
Pub Date : 2021-01-01 DOI: 10.35248/2329-6925.9.37.406
F. Santis, R. Chiappa, Cristina Margot Chaves, M. Millarelli
Background: Carotid pseudoaneurysms can generally be the result of arterial wall degeneration developed after carotid endarterectomy, previous spontaneous carotid dissection, post-traumatic neck injuries, non-vascular procedures and, rarely, infections. The ideal surgical management of extracranial carotid artery false aneurysms is still controversial and treatment should be tailored to the aneurysm’s aetiology, anatomy and presentation. Case presentation: We describe the case of an 81-year-old man presented with an enlarged pulsatile cervical mass coupled with a small cutaneous fistula, which had developed in roughly 1 year. He had undergone several carotid operations over the last 15 years (endarterectomy, venous-patch-angioplasty for restenosis and bovine-pericardial patch-angioplasty for a pseudoaneurysm). Methods: A CT-Scan revealed a recurrent pseudoaneurysm. Due to the previous multiple cervicotomies, the aneurysm wall was very closely adjacent to the skin plane; no gas bubbles or cervical fluid collections were evident. The patient rejected treatment at first, but six months later suffered major bleeding from the fistula. Results: The pseudoaneurysm was emergency excluded with a Viabhan-Stent-graft while the external carotid artery was occluded via vascular-plug. The fistula healed spontaneously in four months. There was no pseudo-aneurysm recurrence, endoleak or any sign of graft infection at 36-month follow-up. Conclusion: We present a singular case of emergency endovascular treatment of recurrent post-surgical internal carotid artery pseudoaneurysm complicated by a carotid-cutaneous and life-threatening bleeding. In these cases emergency endovascular treatment via covered-stent-graft represents the most effective, definitive or “bridge” management option. Carotid sheath protection via a myo-cutaneous flap could be considered in cases of previous multiple cerivcotomies.
背景:颈动脉假性动脉瘤通常是由于颈动脉内膜切除术、既往自发性颈动脉夹层、创伤后颈部损伤、非血管性手术以及极少数感染后发生的动脉壁变性所致。颅外颈动脉假性动脉瘤的理想手术治疗仍有争议,治疗应根据动脉瘤的病因、解剖结构和表现量身定制。病例介绍:我们描述了一例81岁的男性,在大约1年内出现了一个增大的搏动性宫颈肿块,并伴有一个小的皮瘘。在过去的15年里,他接受了几次颈动脉手术(动脉内膜切除术,静脉血管修补术治疗再狭窄,牛心包血管修补术治疗假性动脉瘤)。方法:ct扫描显示复发性假性动脉瘤。由于之前的多次颈部切开术,动脉瘤壁非常靠近皮肤平面;没有明显的气泡或宫颈积液。患者最初拒绝治疗,但六个月后瘘管大出血。结果:假性动脉瘤经维亚罕支架紧急排除,颈外动脉经血管栓闭塞。4个月后瘘管自行愈合。在36个月的随访中,无假性动脉瘤复发、内漏或任何移植物感染的迹象。结论:我们报告一例急诊血管内治疗复发性术后颈内动脉假性动脉瘤并发颈动脉皮肤和危及生命的出血。在这些病例中,通过覆盖支架移植进行急诊血管内治疗是最有效、最明确或“桥接”的治疗选择。在既往多次宫颈切除术的病例中,可以考虑通过肌皮瓣保护颈动脉鞘。
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引用次数: 0
Endovascular Aneurysm Repair: Editorial 血管内动脉瘤修复:社论
Pub Date : 2021-01-01 DOI: 10.35248/2329-6925.21.S6.E001
Himanshu Chawla, Anita Chamoli
An aortic aneurysm is a protruding, expansion or expanding in the mass of a vein, typically a course, that is because of shortcoming or degeneration that creates in a segment of the supply route divider. Very much like an inflatable, the aneurysm amplifies, extending the dividers of the course more slender which bargains the supply route divider's capacity to extend any further. Now, an aneurysm is in danger of cracking and causing possibly lethal dying, similarly as an inflatable will pop when exploded excessively.
主动脉瘤是一种突出的,扩张的或扩张的静脉肿块,通常是一个过程,这是由于缺陷或退化,在供应路线分隔的一部分造成的。就像充气一样,动脉瘤会扩大,将路线的分隔物拉长得更细,从而削弱了供应路线分隔物进一步延伸的能力。现在,动脉瘤有破裂的危险,可能会导致致命的死亡,就像充气气球过度爆炸会爆裂一样。
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引用次数: 0
期刊
Journal of Vascular Medicine & Surgery
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