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Clinical characteristics of patients based on the POL-AF registry compared to the registries of the pre - NOACs era. Do we still treat the same individuals? 基于POL-AF登记的患者的临床特征与NOACs前时代的登记相比较。我们还在治疗同样的人吗?
Pub Date : 1900-01-01 DOI: 10.15761/vdt.1000189
J. Bednarski, Elwira Bakuła-Ostalska, I. Gorczyca, O. Jelonek, B. Wożakowska-Kapłon, B. Uziębło-Życzkowska, M. Maciorowska, M. Wójcik, R. Błaszczyk, R. Rajtar-Salwa, T. Tokarek, J. Bil, Michał Wojewódzki, Anna Szpotowicz, M. Krzciuk, M. Gawałko, A. Kapłon-Cieślicka, A. Tomaszuk-Kazberuk, A. Szyszkowska, M. Wełnicki, A. Mamcarz
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引用次数: 0
Endovascular repair of a ruptured thoracic saccular aneurysm in a patient with MAGIC Syndrome: Case report and review of the literature MAGIC综合征患者胸椎囊性动脉瘤破裂的血管内修复术:病例报告及文献复习
Pub Date : 1900-01-01 DOI: 10.15761/vdt.1000167
S. Nikas, Konstantinos Tigkiropoulos, I. Lazaridis, Nikoletta Kolaki, M. Tympanidou, Kyriakos Stavridis, D. Karamanos, N. Saratzis
Purpose: To present the succesfull endovascular repair of impending rupture of thoracic saccular aneurysm in patient with MAGIC syndrome. Case: A 51-year-old man with a history of MAGIC syndrome was transferred to our vascular unit with a 3 days history of thoracic pain and hemoptysis. Contrast enhanced computed tomography depicted a contained rupture of a saccular aneurysm in the distal part of descending thoracic aorta. The patient was successfully managed with thoracic endovascular aortic repair (TEVAR) and Anti-TNFa factor. His immediate postoperative course was uneventful. Follow up at 2 months depicted thrombosed saccular aneurysm with excellent patency and absence of migration and endoleak. Conclusion: Mid-term outcome of endovascular repair in patients with MAGIC syndrome seems to be safe. Due to the nature of the disease and its rarity, more studies are necessary to establish its efficacy. *Correspondence to: Tigkiropoulos K, Vascular Unit,1st Department of Surgery, Aristotle University Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece, Tel: 00306944173723; E-mail: kostastig@yahoo.com Received: July 23, 2019; Accepted: July 30, 2019; Published: August 02, 2019 Introduction MAGIC (Mouth And Genital ulcers with Inflamed Cartilage) syndrome is a very rare entity, which includes clinical manifestations of Behçet’s disease (BD) and Relapsing Polychondritis (RP) [1]. Aneurysms are considered a common complication in patients with MAGIC syndrome (21.1%), even under immunosuppression therapy, requiring emergency surgery due to its clinical presentation. Vascular involvement occurs in 14.7%-27.7% of Behcet’s Disease patients [2-4]. Aortic aneurysm is well described pathology even in this subpopulation, and its optimal treatment with immunosuppressant therapy and surgical treatment, remains to be defined. In Relapsing Polychondritis patients, aneurysms or aortitis develop in 5-10% of the patients and are multiple in 50% of them, usually involving the ascending aorta [2]. They are characterized by their presence even during remission of the disease and under lifelong immunosuppression therapy [3]. Aortic involvement is generally asymptomatic, most patients present with sudden rupture of the arterial wall with devastating and poor outcome. These aneurysms typically have a faster growing rate and rupture more easily, due to the inflammatory nature of the underlying disease. The recommended treatment for aneurysmatic disease in patients with Behçet’s Disease and Relapsing Polychondritis is based on series of isolated cases reports with small number of patients, including lifelong immunosuppressant therapy and surgical intervention, either open or endovascular. We report the successful endovascular repair of a ruptured saccular aneurysm in descending thoracic aorta followed by Anti-TNFa therapy in a patient with MAGIC syndrome.
目的:介绍血管内修复术治疗MAGIC综合征胸椎囊性动脉瘤破裂的成功方法。病例:51岁男性,有MAGIC综合征病史,有3天胸痛和咯血病史,转至血管科。增强ct显示胸降主动脉远端囊状动脉瘤破裂。患者成功地接受了胸血管内主动脉修复术(TEVAR)和抗tnf因子治疗。他术后的过程很顺利。随访2个月后发现血栓形成的囊性动脉瘤具有良好的通畅性,无迁移和内漏。结论:MAGIC综合征患者血管内修复的中期结果是安全的。由于该疾病的性质及其罕见性,需要更多的研究来确定其疗效。*通讯:Tigkiropoulos K,塞萨洛尼基亚里士多德大学外科一科血管科,希腊塞萨洛尼基Papageorgiou总医院,电话:00306944173723;邮箱:kostastig@yahoo.com收稿日期:2019年7月23日;录用日期:2019年7月30日;MAGIC(口腔和生殖器溃疡伴炎性软骨)综合征是一种非常罕见的疾病,其临床表现包括behet病(BD)和复发性多软骨炎(RP)[1]。动脉瘤被认为是MAGIC综合征患者的常见并发症(21.1%),即使在免疫抑制治疗下,由于其临床表现需要紧急手术。14.7%-27.7%的白塞病患者发生血管受累[2-4]。即使在这个亚群中,主动脉瘤也是一种很好的病理描述,其最佳治疗方法是免疫抑制剂治疗和手术治疗,仍有待确定。在复发性多软骨炎患者中,5-10%的患者会出现动脉瘤或主动脉炎,50%的患者会出现多发性,通常累及升主动脉。它们的特点是即使在疾病缓解期和终身免疫抑制治疗bbb下也存在。主动脉受累通常无症状,大多数患者表现为动脉壁突然破裂,具有破坏性和不良预后。由于潜在疾病的炎症性,这些动脉瘤通常生长速度更快,更容易破裂。behet病和复发性多软骨炎患者动脉瘤性疾病的推荐治疗是基于少数患者的一系列孤立病例报告,包括终身免疫抑制剂治疗和手术干预,无论是开放的还是血管内的。我们报道一例MAGIC综合征患者经抗tnf治疗后,成功的血管内修复胸降主动脉囊状动脉瘤破裂。
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引用次数: 0
Management of huge ascending aortic pseudo aneurysm with transcatheter device 经导管装置治疗巨大升主动脉假性动脉瘤
Pub Date : 1900-01-01 DOI: 10.15761/vdt.1000158
Nadeem Sadiq, D. Kamal, M. Sultan, S. Aziz, Khurram Akhtar, Syed Asif Akbar Shah, A. Mehmood, Aziz
Pseudoaneurysm of ascending aorta is potentially fatal but well-recognized and infrequent complication after cardiac surgeries. The presentation can be varied and may develop early as in our case or may develop even after years. Our patient had VSD closure along with RV band Resection four month earlier to the development of pseudoaneurym. Transcatheter device closure was performed with 24mm atrial setal occluder without any procedural complication. To the best of our knowledge this is the largest device ever used for closure of post surgical pseudoaneurysm.
升主动脉假性动脉瘤是心脏手术后常见的致命并发症。表现可以是多种多样的,可能像我们的病例一样早期发展,也可能在多年后发展。我们的病人在假性动脉瘤发生的四个月前进行了室间隔关闭和RV带切除术。经导管装置闭合采用24mm房间隔封堵器,无任何手术并发症。据我们所知,这是迄今为止用于术后假性动脉瘤闭合的最大装置。
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引用次数: 2
Endovenous laser ablation of incompetent saphenous veins with a 1940 nm laser 4040nm激光静脉内消融无能大隐静脉
Pub Date : 1900-01-01 DOI: 10.15761/vdt.1000190
Cavallini Alvise, Ferrari Ruffino Salvatore, Marcer Daniela
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引用次数: 0
Ultrasound assisted catheter directed thrombolysis and aspiration thrombectomy for acute limb ischemia caused by embolization of infective endocarditis vegetations 超声辅助导管溶栓及吸入性取栓治疗感染性心内膜炎植物栓塞所致急性肢体缺血
Pub Date : 1900-01-01 DOI: 10.15761/VDT.1000178
K. Kang, R. Maholic, Gurjaipal Kang
Background: Endocarditis can cause peripheral emboli leading to acute limb ischemia (ALI). The standard of care for ALI from Infective Endocarditis (IE) is not established. Case Presentation: 19-year-old male with mitral valve IE had acute bilateral limb ischemia. On the left leg, the angiograms showed occlusion of iliac and superficial femoral (SFA) arteries. These lesions were unsuccessfully treated with balloon angioplasty but overnight Ultrasound catheter directed thrombolysis or Ekos thrombolysis (Ekos corporation) given at 24 mg of tissue plasminogen activator for 12 hours resulted in patency of SFA and Iliac arteries. However, the profunda femoris artery (PFA) became occluded due to embolization after Ekos lysis. Balloon angioplasty of PFA was unsuccessful and Rheolytic thrombectomy failed as well but direct aspiration of the vegetation material with a 7F guiding catheter was successful and the PFA patency was recovered, however there was distal embolization resulted in occlusion of the distal popliteal artery. Aspiration thrombectomy was successful in causing one vessel patency to the foot. The right leg had occluded PFA and popliteal artery and balloon angioplasty failed but again an excellent response to overnight Ekos thrombolysis was seen with patency of popliteal artery. The aspiration material was sent to pathology laboratory and showed IE emboli. The patient had a good angiographic and clinical result from percutaneous ultrasound catheter directed thrombolysis. The mitral valve needed to be replaced but the lower extremities had no further clinical sequelae over 6 months of follow up. Conclusions: IE septic emboli may be treated with ultrasound enhanced catheter directed thrombolysis and also by aspiration thrombectomy. Balloon angioplasty alone led to poor outcomes in our patient.
背景:心内膜炎可引起外周栓塞导致急性肢体缺血(ALI)。感染性心内膜炎(IE)引起ALI的护理标准尚未建立。病例介绍:19岁男性二尖瓣IE急性双侧肢体缺血。左腿血管造影显示髂和股浅动脉(SFA)闭塞。球囊血管成形术未能成功治疗这些病变,但夜间超声导管引导溶栓或Ekos溶栓(Ekos公司)给予24 mg组织型纤溶酶原激活剂12小时导致SFA和髂动脉通畅。然而,由于Ekos溶解后栓塞,股深动脉(PFA)被阻塞。PFA球囊成形术不成功,溶栓术也失败,但7F导管直接吸入植体材料成功,PFA恢复通畅,但远端栓塞导致腘动脉远端闭塞。抽吸取栓术成功地使足部的一条血管通畅。右腿PFA和腘动脉闭塞,球囊血管成形术失败,但过夜Ekos溶栓后腘动脉通畅,反应良好。抽吸材料送往病理实验室,显示IE栓子。经皮超声导管引导溶栓,患者血管造影及临床结果良好。需要更换二尖瓣,但下肢在随访6个月后没有进一步的临床后遗症。结论:IE脓毒性栓塞可采用超声增强导管引导溶栓治疗,也可采用吸入性取栓。单纯球囊血管成形术导致本例患者预后不佳。
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引用次数: 0
Serum levels of nitric oxide and endothelin-1 in vasculopathy managed with hyperbaric oxygen therapy 高压氧治疗对血管病变患者血清一氧化氮和内皮素-1水平的影响
Pub Date : 1900-01-01 DOI: 10.15761/vdt.1000172
S. Dragic, Danica Momčičević, Biljana Zlojutro, Milka Jandrić, T. Kovačević, V. Djajić, A. Gajić, G. Talić, P. Kovacevic
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引用次数: 1
A long-term analysis in the primary and secondary prevention in Atrial Fibrillation 房颤一级和二级预防的长期分析
Pub Date : 1900-01-01 DOI: 10.15761/vdt.1000170
C. Tanislav, D. Erkapic, D. Guenduez, Marco Meyer, Marina Herceg, K. Kostev
Background: We aimed to investigate prescriptions for oral anticoagulants (OACs) in atrial fibrillation (AF) newly diagnosed patients (2009-2018). Analyzing both primary and secondary prevention, we also evaluated variables associated with OAC prescription. Methods: This study is based on data from the representative nationwide Disease Analyzer database (IQVIA). Patients with an initial AF diagnosis between 2009 and 2018 were selected and categorized as stroke or non-stroke, as well as according to their CHA 2 DS 2 -VASc score (<2 or ≥ 2). The prevalence of OAC use was calculated (2009-2018). We adopted multivariate logistic regression models to analyze differences. Results: The proportion of OAC therapy increased from 32.2% in 2009 to 56.9% in 2018 in stroke patients and from 26.6% to 48.9% in non-stroke patients with CHD 2 DS 2 -VASc scores ≥ 2. When comparing AF patients treated with OACs in 2016-2018 versus those in 2009-2011, we observed a slight increase in age, but a considerable increase in dementia. In 2016-2018 neither age nor dementia were associated with prescription of OAC in stroke patients. Furthermore, in stroke patients, OAC treatment was negatively associated with ischemic heart disease (IHD) (29.8% in treated versus 46.0% in non-treated patients, p<0.001). In non-stroke patients with CHA 2 DS 2 -VASc scores ≥ 2, OAC therapy was negatively associated with an age >80 years, peripheral artery disease, IHD, and dementia. Conclusion: A considerable increase in OAC-treated patients with CHA 2 DS 2 -VASc scores ≥ 2 was noted from 2009 to 2018. There is still a restrain considering OA in AF patients in primary prevention in elderly >80 years and those with dementia.
背景:我们旨在调查2009-2018年房颤(AF)新诊断患者口服抗凝剂(OACs)的处方情况。分析了一级和二级预防,我们还评估了与OAC处方相关的变量。方法:本研究基于具有代表性的全国疾病分析数据库(IQVIA)的数据。选择2009年至2018年间首次诊断为房颤的患者,并根据他们的CHA 2 DS 2 -VASc评分(80岁、外周动脉疾病、IHD和痴呆)将其分类为卒中或非卒中。结论:从2009年到2018年,oac治疗的CHA 2 DS 2 -VASc评分≥2的患者显著增加。在80岁以上老年人和痴呆患者的一级预防中考虑房颤患者的OA仍有一定的局限性。
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引用次数: 0
Disparities in lower extremity amputation among native americans with diabetic foot ulcerations 印第安人糖尿病足溃疡患者下肢截肢的差异
Pub Date : 1900-01-01 DOI: 10.15761/VDT.1000176
Lyndsay A. Kandi, Tze-Woei Tan
It is a well-documented declaration that the Native American (NA)/ American Indian (AI) population is disproportionately affected by many chronic conditions. Among the chronic and often fatal ailments, diabetes mellitus (DM) is a prevailing diagnosis [1]. According to the 2017 American Diabetes Association, DM is responsible for significant deaths and is a substantial cost to society at $327 billion USD in the United States (US) [2]. Complications of DM include peripheral artery disease (PAD), a macrovascular complication, and peripheral neuropathy (PN), a microvascular condition, which in turn cascade into other adverse health outcomes [3,4]. Impaired vascular flow and loss of sensitivity to the extremities, particularly to the feet, likewise increases risk of diabetic foot ulceration (DFU) [3,4]. As a consequence of an infected foot ulceration and subsequent osteomyelitis or gangrene, patients may undergo lower extremity amputation (LEA) [4,5]. DFU not only limits mobility and causes pain and discomfort, but foot ulceration may even increase mortality rates and reduce life expectancy [6,7]. The rate of recurrence for DFU within 1 year is roughly 40%, about 60% within 3 years, and 65% within 5 years [8].
这是一个有充分证据的声明,美洲原住民(NA)/美洲印第安人(AI)人口受到许多慢性病的不成比例的影响。在慢性且经常致命的疾病中,糖尿病(DM)是一个普遍的诊断[1]。根据2017年美国糖尿病协会(American Diabetes Association)的数据,糖尿病是导致大量死亡的原因,在美国(US),糖尿病给社会造成了3270亿美元的巨大成本[2]。糖尿病的并发症包括外周动脉疾病(PAD)和外周神经病变(PN),前者是一种大血管并发症,后者是一种微血管疾病,它们反过来会引发其他不良的健康结果[3,4]。血管流动受损和四肢(尤其是足部)敏感性丧失同样会增加糖尿病足溃疡(DFU)的风险[3,4]。由于感染的足部溃疡和随后的骨髓炎或坏疽,患者可能会进行下肢截肢(LEA)[4,5]。足部溃疡不仅限制活动能力,引起疼痛和不适,而且足部溃疡甚至可能增加死亡率,降低预期寿命[6,7]。DFU 1年内复发率约为40%,3年内复发率约为60%,5年内复发率为65%[8]。
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引用次数: 1
Surgical outcomes of and suggestions for carotid endarterectomy in patients on hemodialysis: report of 7 cases and literature review 血液透析患者颈动脉内膜切除术的手术效果及建议:附7例报告并文献复习
Pub Date : 1900-01-01 DOI: 10.15761/vdt.1000186
Masaaki Hokari, Daisuke Shimbo, Masayuki Gekka, K. Uchida, K. Asaoka, Koji Itamoto
{"title":"Surgical outcomes of and suggestions for carotid endarterectomy in patients on hemodialysis: report of 7 cases and literature review","authors":"Masaaki Hokari, Daisuke Shimbo, Masayuki Gekka, K. Uchida, K. Asaoka, Koji Itamoto","doi":"10.15761/vdt.1000186","DOIUrl":"https://doi.org/10.15761/vdt.1000186","url":null,"abstract":"","PeriodicalId":206117,"journal":{"name":"Vascular Diseases and Therapeutics","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126571821","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}
引用次数: 0
A case report with Transesophageal Echocardiography and CMR 经食管超声心动图及CMR 1例报告
Pub Date : 1900-01-01 DOI: 10.15761/vdt.1000192
Nguyen Tuan Vu
{"title":"A case report with Transesophageal Echocardiography and CMR","authors":"Nguyen Tuan Vu","doi":"10.15761/vdt.1000192","DOIUrl":"https://doi.org/10.15761/vdt.1000192","url":null,"abstract":"","PeriodicalId":206117,"journal":{"name":"Vascular Diseases and Therapeutics","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133087053","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}
引用次数: 0
期刊
Vascular Diseases and Therapeutics
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