Afrasyab Altaf, A. Alam, M. Salahuddin, Momina Khan, M. Mahmood, H. Shah, K. A. Shah
Introduction: Serum potassium levels have been shown in some animal studies to be associated with the process of atherosclerosis. We decided to assess the correlation of serum potassium level in ischemic heart disease patients with disease severity and its relationship with prognosis in terms of major acute cardiac events (MACE). Material and methods: This was a cross-sectional cohort study carried out at cardiology department of Rehman Medical Institute, from July 2016 to 31st Aug. 2018 a period of 26 months. 622 patients were included in the study. Clinical and angiographic characteristics were assessed based on the serum potassium level. Correlation of serum potassium level with Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) and Gensini scores was also evaluated. Follow up for MACE was carried out after one year. Results: Mean serum potassium level was 3.93 ± 0.95 (mEq/l) in coronary artery disease patients. Serum potassium level showed negative correlation with SYNTAX score (r = –0.60, p < 0.05) and Gensini score (r = –0.64, p < 0.05). There was also a significant difference between low and high potassium level in relation to the multi-vessel disease on coronary angiography (p < 0.05). Low potassium level was a good predictor of adverse outcomes as shown by Kaplan-Meier analysis. Multivariate Cox regression analysis showed that serum potassium level and diabetes were independent predictors of MACE (p < 0.05). Conclusion: Low serum potassium level is correlated with more severe coronary atherosclerosis. Low potassium levels are associated with significantly poor outcomes.
一些动物研究表明，血清钾水平与动脉粥样硬化的过程有关。我们决定评估缺血性心脏病患者血清钾水平与疾病严重程度的相关性及其与主要急性心脏事件(MACE)预后的关系。材料和方法:这是一项横断面队列研究，于2016年7月至2018年8月31日在Rehman医学研究所心内科进行，为期26个月。研究纳入了622例患者。根据血清钾水平评估临床和血管造影特征。血清钾水平与经皮冠状动脉介入治疗与心脏手术(SYNTAX)和Gensini评分的相关性也进行了评估。MACE随访1年后进行。结果:冠心病患者平均血钾水平为3.93±0.95 (mEq/l)。血清钾水平与SYNTAX评分(r = -0.60, p < 0.05)和Gensini评分(r = -0.64, p < 0.05)呈负相关。低钾与高钾与冠状动脉造影多支病变的关系也有显著性差异(p < 0.05)。Kaplan-Meier分析显示，低钾水平是不良结局的良好预测因子。多因素Cox回归分析显示，血清钾水平和糖尿病是MACE的独立预测因素(p < 0.05)。结论:低血钾水平与冠状动脉粥样硬化的加重有关。低钾水平与显著不良预后相关。
{"title":"Prognostic significance of serum potassium level for major adverse cardiac events and death in patients with coronary atherosclerotic disease","authors":"Afrasyab Altaf, A. Alam, M. Salahuddin, Momina Khan, M. Mahmood, H. Shah, K. A. Shah","doi":"10.5603/aa.2020.0010","DOIUrl":"https://doi.org/10.5603/aa.2020.0010","url":null,"abstract":"Introduction: Serum potassium levels have been shown in some animal studies to be associated with the process of atherosclerosis. We decided to assess the correlation of serum potassium level in ischemic heart disease patients with disease severity and its relationship with prognosis in terms of major acute cardiac events (MACE). Material and methods: This was a cross-sectional cohort study carried out at cardiology department of Rehman Medical Institute, from July 2016 to 31st Aug. 2018 a period of 26 months. 622 patients were included in the study. Clinical and angiographic characteristics were assessed based on the serum potassium level. Correlation of serum potassium level with Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) and Gensini scores was also evaluated. Follow up for MACE was carried out after one year. Results: Mean serum potassium level was 3.93 ± 0.95 (mEq/l) in coronary artery disease patients. Serum potassium level showed negative correlation with SYNTAX score (r = –0.60, p < 0.05) and Gensini score (r = –0.64, p < 0.05). There was also a significant difference between low and high potassium level in relation to the multi-vessel disease on coronary angiography (p < 0.05). Low potassium level was a good predictor of adverse outcomes as shown by Kaplan-Meier analysis. Multivariate Cox regression analysis showed that serum potassium level and diabetes were independent predictors of MACE (p < 0.05). Conclusion: Low serum potassium level is correlated with more severe coronary atherosclerosis. Low potassium levels are associated with significantly poor outcomes.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46385667","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}
Introduction: Recently non-thrombotic iliac vein lesions (NIVL) due to their possible role in chronic venous insufficiency on one side and to the development of endovascular venous techniques on the other side have gained much interest. The purpose of this study was to establish if vascular risk and anthropometric factors are associated with the occurrence of NIVL in patients with chronic venous disorders. Material and methods: Thirty-three patients (8 men and 25 women) of the median age of 48 years with primary varicose veins that were qualified for great saphenous veins high ligation and stripping were included. The data concerning age, sex, body mass, height, body mass index, body surface area, hypertension, hypercholesterolemia, smoking and diabetes have been collected. During the varicose vein surgery, both iliac venous axis were interrogated with intravascular ultrasound. Percentage of stenosis of interrogated veins was calculated. The association between analyzed factors and morphology of iliac veins was statistically determined. Results: In a univariate analysis age negatively correlated with left common iliac vein (LCIV) stenosis and male sex, greater weight and body surface area and hypertension were associated with lesser stenosis of left external iliac vein. In a multivariate analysis, only age significantly negatively correlated with LCIV stenosis (p = 0.027). There was a correlation of borderline statistical significance between female sex and LCIV stenosis (p = 0.073). No other correlations were observed. Conclusions: Except for age and possibly sex, there is no association between NIVL and other anthropometric and vascular risk factors.
{"title":"The association between vascular risk factors and the occurrence of non-thrombotic iliac vein lesions in patients with chronic venous disorders","authors":"R. Krzyżański, Ł. Dzieciuchowicz","doi":"10.5603/aa.2020.0009","DOIUrl":"https://doi.org/10.5603/aa.2020.0009","url":null,"abstract":"Introduction: Recently non-thrombotic iliac vein lesions (NIVL) due to their possible role in chronic venous insufficiency on one side and to the development of endovascular venous techniques on the other side have gained much interest. The purpose of this study was to establish if vascular risk and anthropometric factors are associated with the occurrence of NIVL in patients with chronic venous disorders. Material and methods: Thirty-three patients (8 men and 25 women) of the median age of 48 years with primary varicose veins that were qualified for great saphenous veins high ligation and stripping were included. The data concerning age, sex, body mass, height, body mass index, body surface area, hypertension, hypercholesterolemia, smoking and diabetes have been collected. During the varicose vein surgery, both iliac venous axis were interrogated with intravascular ultrasound. Percentage of stenosis of interrogated veins was calculated. The association between analyzed factors and morphology of iliac veins was statistically determined. Results: In a univariate analysis age negatively correlated with left common iliac vein (LCIV) stenosis and male sex, greater weight and body surface area and hypertension were associated with lesser stenosis of left external iliac vein. In a multivariate analysis, only age significantly negatively correlated with LCIV stenosis (p = 0.027). There was a correlation of borderline statistical significance between female sex and LCIV stenosis (p = 0.073). No other correlations were observed. Conclusions: Except for age and possibly sex, there is no association between NIVL and other anthropometric and vascular risk factors.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41926425","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}
Olga Basiak, L. Grabowska-Derlatka, T. Jakimowicz, O. Rowiński
Thoracic endovascular aortic repair (TEVAR) is a method of choice in the treatment of thoracic aorta aneurysms and dissections. In case of a thoracoabdominal aneurysm, endovascular treatment is also being chosen more often, especially in patients with multimorbidity. Despite better results and less invasiveness in comparison to classic open surgery, endovascular treatment is also associated with complications. One of the rarer and usually fatal complications are aortoesophageal fistula (AEF). We present two cases, in which TEVAR complication was AEF. Case 1 was an 87-year-old woman with a history of TEVAR 5 years earlier, who presented increased inflammation parameters, massive gastrointestinal bleeding, and progressive anemia. Case 2 was a 66-year-old woman with a history of TEVAR 6 months earlier, who on admission presented medium increased inflammatory markers and anemia. None of the patients was qualified for surgical treatment. Both patient 1 and patient 2 died during hospitalization. Diagnostic imaging plays a key role in the diagnosis of AEF. CT angiography performed in patients with AEF can show the presence of gas in the sac of aneurysm as a result of infection, a defect in the aortic wall, or thickened esophagus with fluid level. CT angiography of the aorta combined with esophagogastroduodenoscopy (EGD) and contrast-enhanced X-ray examination of the gastrointestinal tract, enables to confirm or exclude the diagnosis of AEF. Atypical clinical feature and increased parameters of inflammation in patients with the history of TEVAR should always suggest the presence of AEF.
{"title":"Aortoesophageal fistula as a complication of thoracic aorta stent graft implantation: two cases and literature review","authors":"Olga Basiak, L. Grabowska-Derlatka, T. Jakimowicz, O. Rowiński","doi":"10.5603/aa.2020.0012","DOIUrl":"https://doi.org/10.5603/aa.2020.0012","url":null,"abstract":"Thoracic endovascular aortic repair (TEVAR) is a method of choice in the treatment of thoracic aorta aneurysms and dissections. In case of a thoracoabdominal aneurysm, endovascular treatment is also being chosen more often, especially in patients with multimorbidity. Despite better results and less invasiveness in comparison to classic open surgery, endovascular treatment is also associated with complications. One of the rarer and usually fatal complications are aortoesophageal fistula (AEF). We present two cases, in which TEVAR complication was AEF. Case 1 was an 87-year-old woman with a history of TEVAR 5 years earlier, who presented increased inflammation parameters, massive gastrointestinal bleeding, and progressive anemia. Case 2 was a 66-year-old woman with a history of TEVAR 6 months earlier, who on admission presented medium increased inflammatory markers and anemia. None of the patients was qualified for surgical treatment. Both patient 1 and patient 2 died during hospitalization. Diagnostic imaging plays a key role in the diagnosis of AEF. CT angiography performed in patients with AEF can show the presence of gas in the sac of aneurysm as a result of infection, a defect in the aortic wall, or thickened esophagus with fluid level. CT angiography of the aorta combined with esophagogastroduodenoscopy (EGD) and contrast-enhanced X-ray examination of the gastrointestinal tract, enables to confirm or exclude the diagnosis of AEF. Atypical clinical feature and increased parameters of inflammation in patients with the history of TEVAR should always suggest the presence of AEF.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"26 1","pages":"76-80"},"PeriodicalIF":0.2,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49378758","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}
D. Janczak, Marcin Merenda, Andrzej Litarski, K. Pormańczuk, M. Malinowski, Jakub Kobecki, Mariusz Chabowski
Background. Pekniety tetniak aorty jest definiowany jako krwawienie poza przydanke poszerzonej ściany aorty. Czestośc wystepowania peknietego tetniaka aorty brzusznej (PTAB) waha sie pomiedzy 5.6 a 17.5 na 100.000 mieszkancow w ciągu roku i wydaje sie malec w ciągu ostatnich dwoch dekad. Celem pracy byla ocena wynikow leczenia pacjentow z peknietym tetniakiem aorty brzusznej Material i metoda: Do analizy wlączono pacjentow operowanych z powodu peknietego tetniaka aorty brzusznej w Klinice Chirurgicznej 4 Wojskowego Szpitala Klinicznego z Polikliniką we Wroclawiu w latach 2011-2017. Z powodu peknietego tetniaka aorty brzusznej operowano lącznie 140 pacjentow. Ocene wynikow leczenia przeprowadzono na podstawie retrospektywnej analizy dokumentacji medycznej pacjentow, oceniającej wyniki leczenia w oparciu o nastepujące parametry: śmiertelnośc okolo- i pooperacyjna, powazne powiklania okolo- i pooperacyjne (ostry zespol wiencowy, niedokrwienie jelit, niewydolnośc nerek, niewydolnośc oddechowa, niedokrwienie konczyn dolnych). Wyniki Uzyskane wyniki potwierdzają, pomimo ciąglego postepu, wysoką śmiertelnośc oko-lo-i pooperacyjną z powodu peknietego tetniaka aorty brzusznej. Dalszy rozwoj techniki operacyjnej z leczeniem wewnątrznaczyniowym (EVAR), postepowania anestezjologicznego, moze pozwolic na uzyskanie lepszych wynikow leczenia. Wymaga to jednak duzego wysilku organizacyjnego z zapewnieniem calodobowej dostepności wielospecjalistycznego zespolu (chirurg naczyniowy, anestezjolog, technik radiolog, personel pielegniarski), z mozliwością wykonywania procedur wewnątrznaczyniowych. Wnioski Leczenie operacyjne pacjentow z peknietym tetniakiem aorty brzusznej nadal wiąze sie z wysokimi wskaźnikami śmiertelności i znaczną ilością powiklan pooperacyjnych.
{"title":"Wyniki lecznia operacyjnego pękniętych tętniaków aorty brzusznej (PTAB) w materiale własnym","authors":"D. Janczak, Marcin Merenda, Andrzej Litarski, K. Pormańczuk, M. Malinowski, Jakub Kobecki, Mariusz Chabowski","doi":"10.5603/aa.2020.0001","DOIUrl":"https://doi.org/10.5603/aa.2020.0001","url":null,"abstract":"Background. Pekniety tetniak aorty jest definiowany jako krwawienie poza przydanke poszerzonej ściany aorty. Czestośc wystepowania peknietego tetniaka aorty brzusznej (PTAB) waha sie pomiedzy 5.6 a 17.5 na 100.000 mieszkancow w ciągu roku i wydaje sie malec w ciągu ostatnich dwoch dekad. Celem pracy byla ocena wynikow leczenia pacjentow z peknietym tetniakiem aorty brzusznej Material i metoda: Do analizy wlączono pacjentow operowanych z powodu peknietego tetniaka aorty brzusznej w Klinice Chirurgicznej 4 Wojskowego Szpitala Klinicznego z Polikliniką we Wroclawiu w latach 2011-2017. Z powodu peknietego tetniaka aorty brzusznej operowano lącznie 140 pacjentow. Ocene wynikow leczenia przeprowadzono na podstawie retrospektywnej analizy dokumentacji medycznej pacjentow, oceniającej wyniki leczenia w oparciu o nastepujące parametry: śmiertelnośc okolo- i pooperacyjna, powazne powiklania okolo- i pooperacyjne (ostry zespol wiencowy, niedokrwienie jelit, niewydolnośc nerek, niewydolnośc oddechowa, niedokrwienie konczyn dolnych). Wyniki Uzyskane wyniki potwierdzają, pomimo ciąglego postepu, wysoką śmiertelnośc oko-lo-i pooperacyjną z powodu peknietego tetniaka aorty brzusznej. Dalszy rozwoj techniki operacyjnej z leczeniem wewnątrznaczyniowym (EVAR), postepowania anestezjologicznego, moze pozwolic na uzyskanie lepszych wynikow leczenia. Wymaga to jednak duzego wysilku organizacyjnego z zapewnieniem calodobowej dostepności wielospecjalistycznego zespolu (chirurg naczyniowy, anestezjolog, technik radiolog, personel pielegniarski), z mozliwością wykonywania procedur wewnątrznaczyniowych. Wnioski Leczenie operacyjne pacjentow z peknietym tetniakiem aorty brzusznej nadal wiąze sie z wysokimi wskaźnikami śmiertelności i znaczną ilością powiklan pooperacyjnych.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"26 1","pages":"1-8"},"PeriodicalIF":0.2,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45752005","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}
P. Wierzchowski, P. Brazis, A. Migdalski, A. Jawień
Subclavian vein thrombosis is relatively rare. It constitutes 4 to 10% of all cases of venous thrombosis and is often associated with compression or canniulation of the subclavian vein. We present the case of patient with Paget-Schroetter syndrome treated in our center for right subclavian vein thrombosis as a result of the venous thoracic outlet syndrome (VTOS). In the case described below, VTOS was unrecognized and the stent fracture following endovascular treatment led to a relapse of venous thrombosis. Secondary angioplasty and stenting with subclavian vein decompression was successfully made. The patient was regularly monitored throughout the following year and there was no relapse of clinical symptoms. Conclusions: in case of subclavian vein thrombosis decompression is a very important step in the management of VTOS. It prevents recurrence of thrombosis and potential complications.
{"title":"Stent fracture after endovascular treatment patient with subclavian vein thrombosis – difficult diagnosis and complication of venous thoracic outlet syndrome","authors":"P. Wierzchowski, P. Brazis, A. Migdalski, A. Jawień","doi":"10.5603/aa.2020.0003","DOIUrl":"https://doi.org/10.5603/aa.2020.0003","url":null,"abstract":"Subclavian vein thrombosis is relatively rare. It constitutes 4 to 10% of all cases of venous thrombosis and is often associated with compression or canniulation of the subclavian vein. We present the case of patient with Paget-Schroetter syndrome treated in our center for right subclavian vein thrombosis as a result of the venous thoracic outlet syndrome (VTOS). In the case described below, VTOS was unrecognized and the stent fracture following endovascular treatment led to a relapse of venous thrombosis. Secondary angioplasty and stenting with subclavian vein decompression was successfully made. The patient was regularly monitored throughout the following year and there was no relapse of clinical symptoms. Conclusions: in case of subclavian vein thrombosis decompression is a very important step in the management of VTOS. It prevents recurrence of thrombosis and potential complications.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"26 1","pages":"40-44"},"PeriodicalIF":0.2,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47692389","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}
Peripheral vascular diseases constitute one of the most significant medical and social problems. Physiotherapy plays an important role among and in addition to various treatment modalities. Physiotherapy for vascular applied in vessel disease treatment primaliry consists of resonable and regular exercises and activities, and selected physical procedures. The review paper presents current data concerning the most commonly applied exercises and physical procedures in selected peripheral vascular diseases.
{"title":"The role of physical activity in prevention and treatment of peripheral vascular disorders","authors":"J. Pasek, Agata Stanek, G. Cieślar","doi":"10.5603/aa.2020.0004","DOIUrl":"https://doi.org/10.5603/aa.2020.0004","url":null,"abstract":"Peripheral vascular diseases constitute one of the most significant medical and social problems. Physiotherapy plays an important role among and in addition to various treatment modalities. Physiotherapy for vascular applied in vessel disease treatment primaliry consists of resonable and regular exercises and activities, and selected physical procedures. The review paper presents current data concerning the most commonly applied exercises and physical procedures in selected peripheral vascular diseases.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"26 1","pages":"19-27"},"PeriodicalIF":0.2,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47761822","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}
S. Surma, T. Czober, Tomasz Lepich, Oskar Sierka, G. Bajor
Atherosclerosis is a inflammatory-immunological-degenerative process. Cardiovascular diseases account for 42% of premature deaths among men and 52% of premature deaths among woman. Identification of classical biomarkers of atherosclerosis, such as LDL, HDL and triglycerides may not be helpful in patients with moderate or unusual cardiovascular risk. Non-classical indicators of atherosclerosis include markers of the inflammatory proces, mar-kers of atherosclerotic plaque injury, acute phase proteins, ischemic markers, markers of tissue necrosis, markers of myocardial dysfunction. The identification of CVD biomarkers enables the classification of patients to appropriate cardiovascular risk groups. Knowledge about the CVD risk group makes it possible to take rapid therapeutic intervention aimed at limiting this risk. Pharmacotherapy for cardiovascular diseases is primarily based on lowering cholesterol’s level in the blood. Additional properties of statins (the most important lipid-lowering drugs) enable their pleiotropic effect by limiting the progression of atherosclerotic lesions by reducing the volume of atherosclerotic plaque. Further research on the pathogenesis of atherosclerosis will allow to learn new risk factors and new biomarkers of this disease.
{"title":"Selected biomarkers of atherosclerosis - clinical aspects","authors":"S. Surma, T. Czober, Tomasz Lepich, Oskar Sierka, G. Bajor","doi":"10.5603/aa.2020.0005","DOIUrl":"https://doi.org/10.5603/aa.2020.0005","url":null,"abstract":"Atherosclerosis is a inflammatory-immunological-degenerative process. Cardiovascular diseases account for 42% of premature deaths among men and 52% of premature deaths among woman. Identification of classical biomarkers of atherosclerosis, such as LDL, HDL and triglycerides may not be helpful in patients with moderate or unusual cardiovascular risk. Non-classical indicators of atherosclerosis include markers of the inflammatory proces, mar-kers of atherosclerotic plaque injury, acute phase proteins, ischemic markers, markers of tissue necrosis, markers of myocardial dysfunction. The identification of CVD biomarkers enables the classification of patients to appropriate cardiovascular risk groups. Knowledge about the CVD risk group makes it possible to take rapid therapeutic intervention aimed at limiting this risk. Pharmacotherapy for cardiovascular diseases is primarily based on lowering cholesterol’s level in the blood. Additional properties of statins (the most important lipid-lowering drugs) enable their pleiotropic effect by limiting the progression of atherosclerotic lesions by reducing the volume of atherosclerotic plaque. Further research on the pathogenesis of atherosclerosis will allow to learn new risk factors and new biomarkers of this disease.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"26 1","pages":"28-39"},"PeriodicalIF":0.2,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44138936","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}
Anna Szarnecka-Sojda, W. Jacheć, M. Polewczyk, Agnieszka Łętek, Jarosław Miszczuk, A. Polewczyk
Objectives Progression of renal failure leads to an increase in the number of patients who require forming dialysis access. Old age and a rising morbidity make it impossible to form a native arteriovenous fistula and a permanent catheter becomes the first choice. The presence of a catheter frequently generates complications, including infections, which may result in a higher mortality rate. Patients and methods A retrospective analysis data has been conducted, involving 398 patients who had permanent catheters implanted from 2010 to 2016. Out of this group, 65 patients who suffered infection-related complications have been identified. Risk factors for infection and a survival rate of the population have been estimated. Results Between 2010 and 2016, 495 catheters were implanted for 398 patients aged 68.73(13.26) years on average. 92 catheter-related infections (23.1%) were recorded in 65 patients. A higher risk of infection has been noted among younger patients, with coronary disease and heart failure. Patients affected by infection had 35.38% survivability as against 38.14% for those with no infection: p= 0.312. A higher mortality risk was identified among patients suffering catheter-related infections with cardiac implants and vascular prostheses. Unfavourable prognosis was for infections occurring together with hypotension, high leucocytosis, a low number of platelets and a high leukocyte/platelet ratio. Conclusion Dialysis patients who use permanent catheters run a high risk of infection-related complications, especially younger patients suffering from coronary conditions and heart failure. Severe catheter-related infections lead to a high mortality rate, therefore it is necessary to limit this form of access.
{"title":"Infection-related complications in patients with end stage renal failure dialyzed through a permanent catheter","authors":"Anna Szarnecka-Sojda, W. Jacheć, M. Polewczyk, Agnieszka Łętek, Jarosław Miszczuk, A. Polewczyk","doi":"10.5603/aa.2020.0002","DOIUrl":"https://doi.org/10.5603/aa.2020.0002","url":null,"abstract":"Objectives Progression of renal failure leads to an increase in the number of patients who require forming dialysis access. Old age and a rising morbidity make it impossible to form a native arteriovenous fistula and a permanent catheter becomes the first choice. The presence of a catheter frequently generates complications, including infections, which may result in a higher mortality rate. Patients and methods A retrospective analysis data has been conducted, involving 398 patients who had permanent catheters implanted from 2010 to 2016. Out of this group, 65 patients who suffered infection-related complications have been identified. Risk factors for infection and a survival rate of the population have been estimated. Results Between 2010 and 2016, 495 catheters were implanted for 398 patients aged 68.73(13.26) years on average. 92 catheter-related infections (23.1%) were recorded in 65 patients. A higher risk of infection has been noted among younger patients, with coronary disease and heart failure. Patients affected by infection had 35.38% survivability as against 38.14% for those with no infection: p= 0.312. A higher mortality risk was identified among patients suffering catheter-related infections with cardiac implants and vascular prostheses. Unfavourable prognosis was for infections occurring together with hypotension, high leucocytosis, a low number of platelets and a high leukocyte/platelet ratio. Conclusion Dialysis patients who use permanent catheters run a high risk of infection-related complications, especially younger patients suffering from coronary conditions and heart failure. Severe catheter-related infections lead to a high mortality rate, therefore it is necessary to limit this form of access.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"26 1","pages":"9-18"},"PeriodicalIF":0.2,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47918161","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}
Na początku 2020 świat obiegla informacja o wybuchu epidemii spowodowanej nowym koronawirusem w Chinach. COVID-19 (Coronavirus Desease 19) jest zlozoną jednostką chorobową, obejmującą glownie dolne drogi odde-chowe. Objawia sie przede wszystkim gorączką i kaszlem, ktory moze byc zarowno suchy, jak i mokry. Gorączka, najbardziej stala cecha tej choroby, moze jednak nie wystepowac w wieku podeszlym jak i u immunoniekompetentnych. W związku z brakiem leczenia przyczynowego, powinniśmy skupic sie przede wszystkim na profilaktyce. Nasze dzialania z zakresu kardiotorakochirurgii i chirurgii naczyniowej dotyczące chorych z COVID-19 lub chorych podejrzanych powinny byc oparte o proste i jednoznacznie opracowane zasady. Zalecenia, ktore proponujemy, oparte są na podstawie wytycznych American College of Surgeons, Society for Vascular Surgery i zalecen Polskiego Towarzystwa Okuli-stow
{"title":"What should surgeon know about COVID-19?","authors":"Aleksandra Krasińska, M. Wichrowska, Z. Krasiński","doi":"10.5603/aa.a2020.0007","DOIUrl":"https://doi.org/10.5603/aa.a2020.0007","url":null,"abstract":"Na początku 2020 świat obiegla informacja o wybuchu epidemii spowodowanej nowym koronawirusem w Chinach. COVID-19 (Coronavirus Desease 19) jest zlozoną jednostką chorobową, obejmującą glownie dolne drogi odde-chowe. Objawia sie przede wszystkim gorączką i kaszlem, ktory moze byc zarowno suchy, jak i mokry. Gorączka, najbardziej stala cecha tej choroby, moze jednak nie wystepowac w wieku podeszlym jak i u immunoniekompetentnych. W związku z brakiem leczenia przyczynowego, powinniśmy skupic sie przede wszystkim na profilaktyce. Nasze dzialania z zakresu kardiotorakochirurgii i chirurgii naczyniowej dotyczące chorych z COVID-19 lub chorych podejrzanych powinny byc oparte o proste i jednoznacznie opracowane zasady. Zalecenia, ktore proponujemy, oparte są na podstawie wytycznych American College of Surgeons, Society for Vascular Surgery i zalecen Polskiego Towarzystwa Okuli-stow","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"26 1","pages":"47-50"},"PeriodicalIF":0.2,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46253622","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}
N. Wiśniewska, Emil Kania, A. Płoński, J. Głowiński
Worldwide, stroke is the second leading cause of death and a major cause of disability . However, the mortality of stroke differs between countries and geographical regions. In high-income countries, i.e. in the United States, stroke has fallen from the third to the fourth leading cause of death. The risk for ischaemic stroke increases with the degree of internal carotid artery stenosis. 70–99% carotid artery stenosis (according to NASCET) in symptomatic patients is an indication for a vascular intervention since this group will achieve significant benefits from surgical treatment. Asymptomatic patients with 60–99% (according to NASCET) carotid artery stenosis may also benefit from surgical procedures when at least one-factor conditioning a high risk of ischaemic stroke incidence exists. These factors may include morphological structure features of atherosclerotic plaque described in imaging examinations that are indicative of its instability and specific clinical predispositions. The paper presents stages of unstable atherosclerotic plaque development and features of its morphological structure that may significantly increase the risk for ischaemic stroke and compares them with current guidelines: Management of Atherosclerotic Carotid and Vertebral Artery Disease: 2017 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS).
{"title":"Pathogenesis regarding development and structure of unstable atherosclerotic plaque in internal carotid artery in relation to high risk factors of an ischaemic stroke. Current status of knowledge","authors":"N. Wiśniewska, Emil Kania, A. Płoński, J. Głowiński","doi":"10.5603/aa.2019.0013","DOIUrl":"https://doi.org/10.5603/aa.2019.0013","url":null,"abstract":"Worldwide, stroke is the second leading cause of death and a major cause of disability . However, the mortality of stroke differs between countries and geographical regions. In high-income countries, i.e. in the United States, stroke has fallen from the third to the fourth leading cause of death. The risk for ischaemic stroke increases with the degree of internal carotid artery stenosis. 70–99% carotid artery stenosis (according to NASCET) in symptomatic patients is an indication for a vascular intervention since this group will achieve significant benefits from surgical treatment. Asymptomatic patients with 60–99% (according to NASCET) carotid artery stenosis may also benefit from surgical procedures when at least one-factor conditioning a high risk of ischaemic stroke incidence exists. These factors may include morphological structure features of atherosclerotic plaque described in imaging examinations that are indicative of its instability and specific clinical predispositions. The paper presents stages of unstable atherosclerotic plaque development and features of its morphological structure that may significantly increase the risk for ischaemic stroke and compares them with current guidelines: Management of Atherosclerotic Carotid and Vertebral Artery Disease: 2017 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS).","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47841674","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}
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