Maciej Kozioł, P. Piech, M. Maciejewski, W. Surtel
The development of medicine and the ability to conduct effective therapy in increasingly severe cases create the need to develop new methods of continuous and non-invasive monitoring of the patient’s condition. One of the techniques that is widely used in many fields of medicine is photoplethysmography (PPG). The analysis of the latest research indicates that PPG can have much more applications than the measurement of heart rate and arterial saturation of the patient — as shown by the latest research, it can be used in the measurement of many other key parameters. The optimism is the multitude of areas in which PPG monitoring is attempted. There are more and more attempts to use photoplethysmography in diagnosis and evaluation of peripheral vascular diseases, assessment of circulation in diabetic patients and assessment of endothelial function. Authors are focusing on new applications of PPG, its advantages and limitations. Most of them agree that PPG can provide useful knowledge about the patient’s condition while being a quick, easy-to-use and cost-effective technique. The following review was created to critically analyze the latest technical developments and uses of PPG in clinical practice. Sources for the following article were found using the PubMed database using keywords such as “photoplethysmography”, “oxygen saturation” and “pulse oximeter”.
{"title":"The latest applications of photoplethysmography","authors":"Maciej Kozioł, P. Piech, M. Maciejewski, W. Surtel","doi":"10.5603/AA.2019.0005","DOIUrl":"https://doi.org/10.5603/AA.2019.0005","url":null,"abstract":"The development of medicine and the ability to conduct effective therapy in increasingly severe cases create the need to develop new methods of continuous and non-invasive monitoring of the patient’s condition. One of the techniques that is widely used in many fields of medicine is photoplethysmography (PPG). The analysis of the latest research indicates that PPG can have much more applications than the measurement of heart rate and arterial saturation of the patient — as shown by the latest research, it can be used in the measurement of many other key parameters. The optimism is the multitude of areas in which PPG monitoring is attempted. There are more and more attempts to use photoplethysmography in diagnosis and evaluation of peripheral vascular diseases, assessment of circulation in diabetic patients and assessment of endothelial function. Authors are focusing on new applications of PPG, its advantages and limitations. Most of them agree that PPG can provide useful knowledge about the patient’s condition while being a quick, easy-to-use and cost-effective technique. The following review was created to critically analyze the latest technical developments and uses of PPG in clinical practice. Sources for the following article were found using the PubMed database using keywords such as “photoplethysmography”, “oxygen saturation” and “pulse oximeter”.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46114910","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}
J. Tkaczyk, S. Przywara, Michał Terpiłowski, Klaudia Brożyna, M. Iłżecki, P. Terlecki, T. Zubilewicz
Introduction: Abdominal aortic aneurysm (AAA) is a disease exceptionally well suited to screening. Ultrasound- based screening meets all criteria for a screening program according to the WHO, and there is a large evidence supporting its usefulness. Risk factors, mentioned in the available literature, associated with aneurysm formation are advanced age, male gender, tobacco smoking, hypertension, atherosclerotic disease and family or personal history of aortic aneurysms. The aim of the study was to evaluate the incidence of abdominal aortic aneurysms in the population of men and women older than 65 years, in Lublin, Poland and to identify the correlation between risk factors and the AAA incidence. Material and methods: A single-center screening study, for men and women older than 65-years was conducted in Lublin, Poland in May 2018. Patients underwent basic screening ultrasound with measurement of the diameter of abdominal aorta and iliac arteries. Each patient completed anonymous questionnaire to investigate risk factors of developing AAA. Results: 1032 patients, aged 65–91 (median age 71.37) were examined. 569 of them were women and 463 men. 27 aortic aneurysms were detected — 7 in a group of women and 20 in a group of men. The total incidence rate of AAA in our study was 2.62%; 1,23% in women and 4,32% in men. Male gender, cigarette smoking, coronary artery disease and a history of myocardial infarction all appeared to be major risk factors of AAA, with relative risk ranging from 2,75 to 4.53. The median diameter of the abdominal aorta was 19.24 mm and varied in groups of patients with different risk factors. Conclusions: The estimated prevalence of AAA in the screened population is within the range of the values reported in previous publications, however, it may confirm a trend of declining prevalence of AAA showed in some recent studies. The presented study confirms the correlation between the AAA and its major risk factors (male sex, smoking cigarettes, coronary artery disease and history of myocardial infarct) as well as a weak association between AAA and hypertension and a negative correlation with diabetes.
{"title":"Prevalence and risk factors of abdominal aortic aneurysm among over 65 years old population in Lublin, Poland","authors":"J. Tkaczyk, S. Przywara, Michał Terpiłowski, Klaudia Brożyna, M. Iłżecki, P. Terlecki, T. Zubilewicz","doi":"10.5603/AA.2019.0001","DOIUrl":"https://doi.org/10.5603/AA.2019.0001","url":null,"abstract":"Introduction: Abdominal aortic aneurysm (AAA) is a disease exceptionally well suited to screening. Ultrasound- based screening meets all criteria for a screening program according to the WHO, and there is a large evidence supporting its usefulness. Risk factors, mentioned in the available literature, associated with aneurysm formation are advanced age, male gender, tobacco smoking, hypertension, atherosclerotic disease and family or personal history of aortic aneurysms. The aim of the study was to evaluate the incidence of abdominal aortic aneurysms in the population of men and women older than 65 years, in Lublin, Poland and to identify the correlation between risk factors and the AAA incidence. Material and methods: A single-center screening study, for men and women older than 65-years was conducted in Lublin, Poland in May 2018. Patients underwent basic screening ultrasound with measurement of the diameter of abdominal aorta and iliac arteries. Each patient completed anonymous questionnaire to investigate risk factors of developing AAA. Results: 1032 patients, aged 65–91 (median age 71.37) were examined. 569 of them were women and 463 men. 27 aortic aneurysms were detected — 7 in a group of women and 20 in a group of men. The total incidence rate of AAA in our study was 2.62%; 1,23% in women and 4,32% in men. Male gender, cigarette smoking, coronary artery disease and a history of myocardial infarction all appeared to be major risk factors of AAA, with relative risk ranging from 2,75 to 4.53. The median diameter of the abdominal aorta was 19.24 mm and varied in groups of patients with different risk factors. Conclusions: The estimated prevalence of AAA in the screened population is within the range of the values reported in previous publications, however, it may confirm a trend of declining prevalence of AAA showed in some recent studies. The presented study confirms the correlation between the AAA and its major risk factors (male sex, smoking cigarettes, coronary artery disease and history of myocardial infarct) as well as a weak association between AAA and hypertension and a negative correlation with diabetes.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48204400","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}
Vikram Singh, G. Kumari, Bimal Chhajer, A. Jhingan, S. Dahiya
Introduction. Enhanced External Counter Pulsation (EECP) is a non-invasive United States Food and Drug Administration (FDA) approved outpatient treatment option for the complex problem of angina, a common symptom of coronary heart disease. A systematic review of the literature searched to assess the effect of EECP on the clinical profile that comprised physiological measurements, biochemical assessments, cardiac clinical symptoms, physical functional status, and Health-Related Quality of Life (HRQoL) in Coronary Heart Disease (CHD) patients. Material and methods. Total 258 EECP research articles from the early stage of EECP development to till date screened. Out of 258 EECP articles, total 60 articles (53 EECP articles for clinical profile and 7 article for HRQoL matched the inclusion criteria and other (n = 198) articles excluded due to irrelevant to study objectives. Results. All enrolled studies showed a significant improvement in angina pectoris and HRQoL with reduction of nitroglycerine use and exercise tolerance. There are several gaps in research has been found for further research to evaluate the EECP effectiveness on Body Mass Index (BMI), Heart Rate, Cholesterol, Triglyceride, High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), HbA1C, SpO2, Vo2max level with a comparative assessment of cardiac and non-cardiac metabolic markers including blood glucose. Conclusions. There is further need of multi-centric randomize controlled trial studies to evaluate the effect of EECP on obese, diabetic, hypertension and other metabolic disease patients and more research required for further modifications in EECP device to cure, prevent and treat chronic diseases by the non-invasive procedure.
{"title":"Effectiveness of enhanced external counter pulsation on clinical profile and health-related quality of life in patients with coronary heart disease: a systematic review","authors":"Vikram Singh, G. Kumari, Bimal Chhajer, A. Jhingan, S. Dahiya","doi":"10.5603/AA.2018.0021","DOIUrl":"https://doi.org/10.5603/AA.2018.0021","url":null,"abstract":"Introduction. Enhanced External Counter Pulsation (EECP) is a non-invasive United States Food and Drug Administration (FDA) approved outpatient treatment option for the complex problem of angina, a common symptom of coronary heart disease. A systematic review of the literature searched to assess the effect of EECP on the clinical profile that comprised physiological measurements, biochemical assessments, cardiac clinical symptoms, physical functional status, and Health-Related Quality of Life (HRQoL) in Coronary Heart Disease (CHD) patients. Material and methods. Total 258 EECP research articles from the early stage of EECP development to till date screened. Out of 258 EECP articles, total 60 articles (53 EECP articles for clinical profile and 7 article for HRQoL matched the inclusion criteria and other (n = 198) articles excluded due to irrelevant to study objectives. Results. All enrolled studies showed a significant improvement in angina pectoris and HRQoL with reduction of nitroglycerine use and exercise tolerance. There are several gaps in research has been found for further research to evaluate the EECP effectiveness on Body Mass Index (BMI), Heart Rate, Cholesterol, Triglyceride, High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), HbA1C, SpO2, Vo2max level with a comparative assessment of cardiac and non-cardiac metabolic markers including blood glucose. Conclusions. There is further need of multi-centric randomize controlled trial studies to evaluate the effect of EECP on obese, diabetic, hypertension and other metabolic disease patients and more research required for further modifications in EECP device to cure, prevent and treat chronic diseases by the non-invasive procedure.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42439130","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. Szopiński, E. Pleban, Maciej Stryga, P. Ciostek
Introduction. Promising results of endovascular abdominal aortic aneurysm treatment prompts one to consider applying the method in order to manage complications following the previous open procedures in the aorto-iliac segment. The study aimed at assessing the technical feasibility of applying endovascular methods to manage complications in this group. Material and methods. From December 2009 to August 2018, 26 patients (24 males, 2 females) with a mean age of 72 years, underwent endovascular procedures as reinterventions to manage paraanastomotic aneurysms and new true aneurysms in aorto-iliac segment. Twenty one bifurcated, two branched devices and five tube stent-grafts have been implanted. Results. One immediate open conversion was performed. Eventually, in all of the analysed cases, perianastomotic pseudoaneurysms and true aneurysms were successfully managed. Two cases of type I endoleaks were noticed and managed intraoperatively. No deaths occurred in the perioperative period. In six patients, there were early local complications and early general complications were reported in eight patients. The average length of hospital stay was seven days. Patients have been followed up for 6 to 90 months. No endoleaks nor stent-graft migrations have been reported. Five deaths have been noted not connected with the secondary intervention. Sixteen patients remain in follow-up. Conclusions. Endovascular perianastomotic aneurysm treatment is technically feasible and associated with a low risk of perioperative complications, and a high surgical efficacy. When planning the reintervention, one should take into account the altered anatomy of the aorto-iliac segment. Familiarity with the equipment and experience in the endovascular techniques is of crucial significance.
{"title":"Endovascular treatment of late complications of open surgical repair in abdominal aortic and iliac segment","authors":"P. Szopiński, E. Pleban, Maciej Stryga, P. Ciostek","doi":"10.5603/AA.2018.0022","DOIUrl":"https://doi.org/10.5603/AA.2018.0022","url":null,"abstract":"Introduction. Promising results of endovascular abdominal aortic aneurysm treatment prompts one to consider applying the method in order to manage complications following the previous open procedures in the aorto-iliac segment. The study aimed at assessing the technical feasibility of applying endovascular methods to manage complications in this group. Material and methods. From December 2009 to August 2018, 26 patients (24 males, 2 females) with a mean age of 72 years, underwent endovascular procedures as reinterventions to manage paraanastomotic aneurysms and new true aneurysms in aorto-iliac segment. Twenty one bifurcated, two branched devices and five tube stent-grafts have been implanted. Results. One immediate open conversion was performed. Eventually, in all of the analysed cases, perianastomotic pseudoaneurysms and true aneurysms were successfully managed. Two cases of type I endoleaks were noticed and managed intraoperatively. No deaths occurred in the perioperative period. In six patients, there were early local complications and early general complications were reported in eight patients. The average length of hospital stay was seven days. Patients have been followed up for 6 to 90 months. No endoleaks nor stent-graft migrations have been reported. Five deaths have been noted not connected with the secondary intervention. Sixteen patients remain in follow-up. Conclusions. Endovascular perianastomotic aneurysm treatment is technically feasible and associated with a low risk of perioperative complications, and a high surgical efficacy. When planning the reintervention, one should take into account the altered anatomy of the aorto-iliac segment. Familiarity with the equipment and experience in the endovascular techniques is of crucial significance.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47019552","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}
A. Gerkowicz, Mateusz Socha, A. Pietrzak, T. Zubilewicz, D. Krasowska
Psoriasis is a common, chronic immune-mediated multifactorial skin disease. In its pathogenesis altered differentiation and hyperproliferation of keratinocytes, dysregulation of immunological cell functions, together with abnormal angiogenesis are involved. Angiogenesis is defined as the formation of new blood vessels from the pre-existing vascular bed. This complex and multistep process is regulated by different factors among which vascular endothelial growth factor (VEGF) is considered to be the most important. The aim of this paper is a review of the current literature considering the role of vascular endothelial growth factor in psoriasis. Many studies have focused on the role of VEGF in psoriasis and revealed its increased serum and tissue levels which correlated with disease severity. Recent data indicate that VEGF is not only responsible for angiogenesis, but also regulates keratinocyte differentiation. Moreover, it has been suggested that vascular endothelial growth factor could be a link between psoriasis and its comorbidities. So far, there are single clinical cases that reported clearance of psoriasis after anti-VEGF therapy. Therefore, the VEGF pathway might be a potential new therapeutic alternative leading to improvement of psoriasis. However, further clinical studies are needed to evaluate the efficacy and safety of this therapy in psoriasis.
{"title":"The role of VEGF in psoriasis: an update","authors":"A. Gerkowicz, Mateusz Socha, A. Pietrzak, T. Zubilewicz, D. Krasowska","doi":"10.5603/AA.2018.0019","DOIUrl":"https://doi.org/10.5603/AA.2018.0019","url":null,"abstract":"Psoriasis is a common, chronic immune-mediated multifactorial skin disease. In its pathogenesis altered differentiation and hyperproliferation of keratinocytes, dysregulation of immunological cell functions, together with abnormal angiogenesis are involved. Angiogenesis is defined as the formation of new blood vessels from the pre-existing vascular bed. This complex and multistep process is regulated by different factors among which vascular endothelial growth factor (VEGF) is considered to be the most important. The aim of this paper is a review of the current literature considering the role of vascular endothelial growth factor in psoriasis. Many studies have focused on the role of VEGF in psoriasis and revealed its increased serum and tissue levels which correlated with disease severity. Recent data indicate that VEGF is not only responsible for angiogenesis, but also regulates keratinocyte differentiation. Moreover, it has been suggested that vascular endothelial growth factor could be a link between psoriasis and its comorbidities. So far, there are single clinical cases that reported clearance of psoriasis after anti-VEGF therapy. Therefore, the VEGF pathway might be a potential new therapeutic alternative leading to improvement of psoriasis. However, further clinical studies are needed to evaluate the efficacy and safety of this therapy in psoriasis.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41857334","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}
Lipedema is a chronic, progressive disorder of adipose tissue, found almost exclusively in women, that involves disproportionate subcutaneous fat depositions, leading to progressive and symmetric enlargement of the legs. The condition usually appears at puberty or in the third decade of life. Many patients report a family history of such disorder. The diagnosis is usually based on the physical examination and medical history. If left untreated, lipedema may result in secondary lymphatic dysfunction, physical impairment and mental problems, leading to significant damage to patient’s quality of life. The condition is frequently misdiagnosed as lymphedema or mistreated as obesity. Other than that, the differential diagnosis includes chronic venous insufficiency, constitutional variability of the legs, lipohypertrophy, Dercum’s disease, Madelung’s disease. The treatment options include diet and compression therapy, conservative treatment of secondary edema and surgical interventions. There is an urgent need for further studies on the pathogenesis of lipedema, epidemiology, diagnostic criteria and possible curative treatment.
{"title":"Lipedema: a clinical entity","authors":"Paweł Łyszczak, A. Szuba","doi":"10.5603/AA.2018.0020","DOIUrl":"https://doi.org/10.5603/AA.2018.0020","url":null,"abstract":"Lipedema is a chronic, progressive disorder of adipose tissue, found almost exclusively in women, that involves disproportionate subcutaneous fat depositions, leading to progressive and symmetric enlargement of the legs. The condition usually appears at puberty or in the third decade of life. Many patients report a family history of such disorder. The diagnosis is usually based on the physical examination and medical history. If left untreated, lipedema may result in secondary lymphatic dysfunction, physical impairment and mental problems, leading to significant damage to patient’s quality of life. The condition is frequently misdiagnosed as lymphedema or mistreated as obesity. Other than that, the differential diagnosis includes chronic venous insufficiency, constitutional variability of the legs, lipohypertrophy, Dercum’s disease, Madelung’s disease. The treatment options include diet and compression therapy, conservative treatment of secondary edema and surgical interventions. There is an urgent need for further studies on the pathogenesis of lipedema, epidemiology, diagnostic criteria and possible curative treatment.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47947523","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}
M. Iłżecki, M. Majewski, P. Terlecki, S. Przywara, W. Rogala, Janusz Rybak, T. Zubilewicz
Introduction. Over time, endovascular techniques of abdominal aortic aneurysm repair became the principal methods of treatment of this potentially fatal disease. Currently, endovascular aneurysm repair (EVAR) constitutes an effective alternative to open surgery, also in cases of aneurysm rupture. Low degree of invasiveness is the main advantage of this method. Introduction of a system enabling percutaneous stent-graft implantation appears to be the next step in the development of endovascular AAA surgery. Aim of the study is to evaluate the Prostar XL® closure device with regard to clinical effectiveness, safety, cost-effectiveness. Material and methods. The study included 100 patients (from January 2013 to December 2015) subject to endovascular abdominal aortic aneurysm repair in the infrarenal region of the aorta with the application of the Prostar Xl® closure device. Most patients were operated under epidural anaesthesia. Local anaesthesia (1% Lidocaine) was used in 36 patients due to comorbidities. A possible application of the closure system depended on a preoperative assessment of common femoral arteries using ultrasonography. Presence of atherosclerotic plaque on the anterior wall of the vessel disqualified the patient from percutaneous endovascular aneurysm repair (PEVAR). The main part of the procedure consisted of stent-graft implantation into the abdominal aortic aneurysm. In the final stage, puncture site on the anterior wall of common femoral arteries was closed using previously placed sutures of the Prostar XL system. The wound in the inguinal region was closed with a skin suture. Results. The analysis of obtained results demonstrated significantly shorter mean hospitalization times in patients treated with PEVAR compared to EVAR. Low rates and types of observed complications in the study group (PEVAR) compared to the control group (EVAR) are strongly in favour the percutaneous technique (PEVAR) of endovascular aortic abdominal aneurysm repair in the infrarenal region of the aorta, confirming its minimally invasive character.
{"title":"The utility of Prostar XL percutaneous vascular closure device after stent-graft implantation for infrarenal abdominal aortic aneurysms","authors":"M. Iłżecki, M. Majewski, P. Terlecki, S. Przywara, W. Rogala, Janusz Rybak, T. Zubilewicz","doi":"10.5603/AA.2018.0014","DOIUrl":"https://doi.org/10.5603/AA.2018.0014","url":null,"abstract":"Introduction. Over time, endovascular techniques of abdominal aortic aneurysm repair became the principal methods of treatment of this potentially fatal disease. Currently, endovascular aneurysm repair (EVAR) constitutes an effective alternative to open surgery, also in cases of aneurysm rupture. Low degree of invasiveness is the main advantage of this method. Introduction of a system enabling percutaneous stent-graft implantation appears to be the next step in the development of endovascular AAA surgery. Aim of the study is to evaluate the Prostar XL® closure device with regard to clinical effectiveness, safety, cost-effectiveness. Material and methods. The study included 100 patients (from January 2013 to December 2015) subject to endovascular abdominal aortic aneurysm repair in the infrarenal region of the aorta with the application of the Prostar Xl® closure device. Most patients were operated under epidural anaesthesia. Local anaesthesia (1% Lidocaine) was used in 36 patients due to comorbidities. A possible application of the closure system depended on a preoperative assessment of common femoral arteries using ultrasonography. Presence of atherosclerotic plaque on the anterior wall of the vessel disqualified the patient from percutaneous endovascular aneurysm repair (PEVAR). The main part of the procedure consisted of stent-graft implantation into the abdominal aortic aneurysm. In the final stage, puncture site on the anterior wall of common femoral arteries was closed using previously placed sutures of the Prostar XL system. The wound in the inguinal region was closed with a skin suture. Results. The analysis of obtained results demonstrated significantly shorter mean hospitalization times in patients treated with PEVAR compared to EVAR. Low rates and types of observed complications in the study group (PEVAR) compared to the control group (EVAR) are strongly in favour the percutaneous technique (PEVAR) of endovascular aortic abdominal aneurysm repair in the infrarenal region of the aorta, confirming its minimally invasive character.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49344465","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. The aim of this study was to evaluate the effectiveness of the endovascular treatment of atherosclerotic stenosis/occlusion of the popliteal artery according to TASC II recommendations using the Jaguar SM self-expanding stent depending on the modifiable and unmodifiable risk factors of repeated stenosis/occlusions. Material and methods. The study included 126 men and 46 women aged 46–95 years in 2011–2015. Surgeries were performed in the scheduled and emergency mode. Angioplasty of the popliteal artery with the Jaguar stent implantation was performed in patients with severe chronic limb ischaemia and critical limb ischaemia. Post-operative popliteal artery patency was evaluated in relation to sex, obesity, diabetes, smoking tobacco, and patency of the lower extremity arteries. Results. The postoperative patient follow-up was conducted for 60 months, demonstrating 67% patency after 12 months, 59% patency after 24 months, 53% patency after 36 months, 45% patency after 48 months, and 31% patency after 60 months. Conclusions. The Jaguar™ stent implantation is an effective and safe method of treatment of atherosclerotic stenosis and occlusion of the popliteal artery. The occlusion was found in patients with the risk factors such as: obesity, diabetes, and tobacco smoking, limited runoff arteries in the lower leg. Stent fracture did not occur in any patient.
{"title":"Angioplasty of the popliteal artery using the Jaguar™ stent","authors":"P. Potoczny, P. Janik, A. Uryniak","doi":"10.5603/AA.2018.0015","DOIUrl":"https://doi.org/10.5603/AA.2018.0015","url":null,"abstract":"Introduction. The aim of this study was to evaluate the effectiveness of the endovascular treatment of atherosclerotic stenosis/occlusion of the popliteal artery according to TASC II recommendations using the Jaguar SM self-expanding stent depending on the modifiable and unmodifiable risk factors of repeated stenosis/occlusions. Material and methods. The study included 126 men and 46 women aged 46–95 years in 2011–2015. Surgeries were performed in the scheduled and emergency mode. Angioplasty of the popliteal artery with the Jaguar stent implantation was performed in patients with severe chronic limb ischaemia and critical limb ischaemia. Post-operative popliteal artery patency was evaluated in relation to sex, obesity, diabetes, smoking tobacco, and patency of the lower extremity arteries. Results. The postoperative patient follow-up was conducted for 60 months, demonstrating 67% patency after 12 months, 59% patency after 24 months, 53% patency after 36 months, 45% patency after 48 months, and 31% patency after 60 months. Conclusions. The Jaguar™ stent implantation is an effective and safe method of treatment of atherosclerotic stenosis and occlusion of the popliteal artery. The occlusion was found in patients with the risk factors such as: obesity, diabetes, and tobacco smoking, limited runoff arteries in the lower leg. Stent fracture did not occur in any patient.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47761100","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}
M. Iłżecki, P. Terlecki, S. Przywara, T. Urbanek, A. Pedrycz-Wieczorska, Shawn Dave, T. Zubilewicz
Introduction. The purpose of the study was to assess the effectiveness of endovascular mechanochemical ablation of the Great Saphenous vein and the Small Saphenous vein (GSV/SSV) using the use of Flebogrif® catheter and method, based on results obtained from the analysis of 200 patients. Material and methods. 200 patients underwent mechanochemical ablation using the Flebogrif® technique, of the 200 patients, 172 patients experienced insufficiency of the GSV and 28 experienced insufficiencies of the SSV. Follow-up assessment was established by outpatient appointments at 1, 3, 6, and 12 months postoperatively. During each subsequent visit, the result of the procedure was evaluated with the use of ultrasound. Furthermore, the intensity of clinical manifestations was assessed with the use of VCSS, CEAP, VASP scales. Any complications were also noted. Results. During 12-month follow-up the number of participants decreased to 168 (152 female, 16 male). Complete closure of the vein was achieved in 154 patients (140 female, 14 male). According to adopted criteria, 15 cases of recanalization were detected (10 complete and 5 partial). Based on the obtained results the effectiveness of the method was assessed at 92%. Conclusions. The statistical analysis of the 12-month follow-up data allowed us to conclude the following the procedural method had 92% of effectiveness at 12-month follow-up, vein diameter was not a significant limitation for the application of the technique, there was a low rate of serious complications, and adverse cosmetic effect was minimal. However , the method requires further long-term follow-up to allow for a complete assessment.
{"title":"A new device for minimally invasive mechano-chemical method of saphenous vein ablation. Report of 12 months of follow up","authors":"M. Iłżecki, P. Terlecki, S. Przywara, T. Urbanek, A. Pedrycz-Wieczorska, Shawn Dave, T. Zubilewicz","doi":"10.5603/AA.2018.0013","DOIUrl":"https://doi.org/10.5603/AA.2018.0013","url":null,"abstract":"Introduction. The purpose of the study was to assess the effectiveness of endovascular mechanochemical ablation of the Great Saphenous vein and the Small Saphenous vein (GSV/SSV) using the use of Flebogrif® catheter and method, based on results obtained from the analysis of 200 patients. Material and methods. 200 patients underwent mechanochemical ablation using the Flebogrif® technique, of the 200 patients, 172 patients experienced insufficiency of the GSV and 28 experienced insufficiencies of the SSV. Follow-up assessment was established by outpatient appointments at 1, 3, 6, and 12 months postoperatively. During each subsequent visit, the result of the procedure was evaluated with the use of ultrasound. Furthermore, the intensity of clinical manifestations was assessed with the use of VCSS, CEAP, VASP scales. Any complications were also noted. Results. During 12-month follow-up the number of participants decreased to 168 (152 female, 16 male). Complete closure of the vein was achieved in 154 patients (140 female, 14 male). According to adopted criteria, 15 cases of recanalization were detected (10 complete and 5 partial). Based on the obtained results the effectiveness of the method was assessed at 92%. Conclusions. The statistical analysis of the 12-month follow-up data allowed us to conclude the following the procedural method had 92% of effectiveness at 12-month follow-up, vein diameter was not a significant limitation for the application of the technique, there was a low rate of serious complications, and adverse cosmetic effect was minimal. However , the method requires further long-term follow-up to allow for a complete assessment.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46059100","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. Carotid endarterectomy (CEA) is a method of treatment of carotid stenosis, which significantly reduces the risk of ischemic stroke. This procedure may affect the patient’s neurocognitive functioning. The aim of the study was to evaluate the occurrence of neurocognitive disorders and to determine the functional status of the patients undergoing CEA. Material and methods. The study group consisted of 102 people who underwent CEA. Studies were performed preoperatively and repeated on the fourth postoperative day. The following scales were used: the Mini-Mental State Examination (MMSE), Activities of Daily Living Scale (ADL), Instrumental Activities of Daily Living (IADL) and the Hamilton Depression Rating Scale (HAM-D). Results. The average number of points obtained by patients in the MMSE, both before and after surgery is 26 points to 30 that may be obtained, which shows a subtle cognitive impairment. Almost every patient showed fitness both in terms of basic (ADL), as well as complex (IADL) activities before and after surgery. Conclusions. Low or average level of cognitive performance is observed in most subjects, both before and after CEA. There are many different factors that can affect the cognitive functions. The functional status of patients stood without significant changes.
{"title":"Neurocognitive dysfunctions and functional state of patients after internal carotid endarterectomy","authors":"Dorota Kozak-Putowska, J. Iłżecka, T. Zubilewicz","doi":"10.5603/AA.2018.0016","DOIUrl":"https://doi.org/10.5603/AA.2018.0016","url":null,"abstract":"Introduction. Carotid endarterectomy (CEA) is a method of treatment of carotid stenosis, which significantly reduces the risk of ischemic stroke. This procedure may affect the patient’s neurocognitive functioning. The aim of the study was to evaluate the occurrence of neurocognitive disorders and to determine the functional status of the patients undergoing CEA. Material and methods. The study group consisted of 102 people who underwent CEA. Studies were performed preoperatively and repeated on the fourth postoperative day. The following scales were used: the Mini-Mental State Examination (MMSE), Activities of Daily Living Scale (ADL), Instrumental Activities of Daily Living (IADL) and the Hamilton Depression Rating Scale (HAM-D). Results. The average number of points obtained by patients in the MMSE, both before and after surgery is 26 points to 30 that may be obtained, which shows a subtle cognitive impairment. Almost every patient showed fitness both in terms of basic (ADL), as well as complex (IADL) activities before and after surgery. Conclusions. Low or average level of cognitive performance is observed in most subjects, both before and after CEA. There are many different factors that can affect the cognitive functions. The functional status of patients stood without significant changes.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46395697","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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