The International Journal Of Angiology[JOURNAL]
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200 papers
Low-Dose Alteplase versus Conventional Anticoagulation to treat Submassive Pulmonary Embolism in Hispanic Patients.
Zientek E, Talkington K, Gardner J … +5 more , Guo Y, Mukherjee D, Rajachandran M, Siddiqui TS, Nickel NP
Int J Angiol · 2023 Jun · PMID 37207012 · Full text
The use of low-dose tissue plasminogen activator (tPA) in Hispanic patients with submassive pulmonary embolism (PE) is understudied. The purpose of this study is to explore the use of low-dose tPA in Hispanic patients wi...
The use of low-dose tissue plasminogen activator (tPA) in Hispanic patients with submassive pulmonary embolism (PE) is understudied. The purpose of this study is to explore the use of low-dose tPA in Hispanic patients with submissive PE compared with counterparts that received heparin alone. We retrospectively analyzed a single-center registry of patients with acute PE between 2016 and 2022. Out of 72 patients admitted for acute PE and cor pulmonale, we identified six patients that were treated with conventional anticoagulation (heparin alone) and six patients who received low-dose tPA (and heparin afterward). We analyzed if low-dose tPA was associated with differences in length of stay (LOS) and bleeding complications. Both groups were similar in regard to age, gender, and PE severity (based on Pulmonary Embolism Severity Index scores). Mean total LOS for the low-dose tPA group was 5.3 days, compared with 7.3 days in the heparin group ( = 0.29). Mean intensive care unit (ICU) LOS for the low-dose tPA group was 1.3 days compared with 3 days in the heparin group ( = 0.035). There were no clinically relevant bleeding complications documented in either the heparin or the low-dose tPA group. Low-dose tPA for submassive PE in Hispanic patients was associated with a shorter ICU LOS without a significant increase in bleeding risk. Low-dose tPA appears to be a reasonable treatment option in Hispanic patients with submassive PE who are not at high bleeding risk (<5%).
Clinical Profile, Management, and Outcome of Visceral Artery Pseudoaneurysms: 5-Year Experience in a Tertiary Care Hospital.
Shera FA, Shera TA, Choh NA … +5 more , Bhat MH, Shah OA, Shaheen FA, Robbani I, Gojwari T
Int J Angiol · 2023 Jun · PMID 37207010 · Full text
Visceral artery pseudoaneurysms are potentially lethal lesions and tend to rupture in a high proportion of cases, thereby warranting an immediate and active intervention. We present our experience of splanchnic visceral...
Visceral artery pseudoaneurysms are potentially lethal lesions and tend to rupture in a high proportion of cases, thereby warranting an immediate and active intervention. We present our experience of splanchnic visceral artery pseudoaneurysms in a university hospital over a 5-year time interval with emphasis on etiology, clinical presentation, management (endovascular/surgical), and final outcome. This was a retrospective study in which we searched our image database for pseudoaneurysms of visceral arteries over a period of 5 years. The clinical and operative details were retrieved from the medical record section of our hospital. The lesions were analyzed for the vessel of origin, size, etiology, clinical features, mode of treatment, and outcome. Twenty-seven patients with pseudoaneurysms were encountered. Pancreatitis (8) was the most common cause, followed by previous surgery (7) and trauma (6). Fifteen were managed by the interventional radiology (IR) team, 6 by surgery, and in 6 no intervention was done. Technical and clinical success was achieved in all patients in the IR group with few minor complications. Surgery and no intervention carry a high mortality in such a setting (66 and 50%, respectively). Visceral pseudoaneurysms are potentially fatal lesions, commonly encountered after trauma, pancreatitis, surgeries, and interventional procedures. These lesions are easily salvageable by minimally invasive interventional techniques (endovascular embolotherapy), and surgeries carry a lot of morbidity and mortality in such cases and a prolonged hospital stay.
The Relationship of Plasma Aterogenity Index and Mean Platelet Volume with the Risk of Development of 1-Year Total Major Adverse Cardiac Event in Patients with Non-ST Elevation Myocardial Infarction.
Allahverdiyev A, Koyuncu IMA, Kuru B … +2 more , Allahverdiyeva A, Ertas FS
Int J Angiol · 2023 Jun · PMID 37207006 · Full text
In our study, we aimed to reveal the role of plasma atherogenicity index and mean platelet volume in predicting the risk of developing a 1-year major adverse cardiac event (MACE) in patients with non-ST elevation myocard...
In our study, we aimed to reveal the role of plasma atherogenicity index and mean platelet volume in predicting the risk of developing a 1-year major adverse cardiac event (MACE) in patients with non-ST elevation myocardial infarction (NSTEMI). This study, which was planned from the retrospective cross-sectional study model, was performed with 100 patients diagnosed with NSTEMI and scheduled for coronary angiography. The laboratory values of the patients were evaluated, the atherogenicity index of plasma was calculated, and the 1-year MACE status was evaluated. In total, 79 of the patients were male and 21 were female. The average age is 60.8 years. At the end of the first year, the MACE improvement rate was found to be 29%. The PAI value was below 0.11 in 39% of the patients, between 0.11 and 0.21 in 14%, and above 0.21 in 47%. The 1-year MACE development rate was found to be significantly higher in diabetic patients and patients with hyperlipidemia. Lymphocyte count and triglyceride values of the patients in the high-risk group of atherogenic index of plasma (AIP) were found to be higher than the patients in the low-risk group. The neutrophil/lymphocyte, thrombocyte/lymphocyte ratios and high-density lipoprotein values of the patients in the high-risk group of AIP were found to be lower than those in the low-risk group. The rate of MACE development was found to be significantly higher in patients in the high-risk group of AIP ( = 0.02). No correlation was found between the mean platelet volume and the MACE development status. While no significant relationship was found between MPV and MACE in NSTEMI patients, AIP, which includes atherogenic parameters, was found to be correlated with MACE.
Risk Factors of Asymptomatic Carotid Artery Disease in Geriatric Evaluated Using Carotid Intima-Media Thickness (IMT) Measurement, the First Indonesian Population Study.
Pratama D, Rahmaditya FS, Utama AJ … +2 more , Suhartono R, Muradi A
Int J Angiol · 2023 Jun · PMID 37207004 · Full text
Carotid artery disease in geriatric is one of the important etiologies of stroke, which topped the cause of mortality in Indonesia. Specific prevention should be done as early as asymptomatic disease occurred. Initial as...
Carotid artery disease in geriatric is one of the important etiologies of stroke, which topped the cause of mortality in Indonesia. Specific prevention should be done as early as asymptomatic disease occurred. Initial assessment can be performed using ultrasound by measuring the intima-media thickness (IMT) of carotid artery, which can evaluate earlier progression of the atherosclerosis process. Unfortunately, we do not have risk factors categorization that show us which geriatric population fall under high-risk stratification to be screened. Study was done to Indonesian geriatric population. Asymptomatic carotid disease was tested positive if IMT was > 0.9 mm without any previous neurological symptoms. Correlation of the result was statistically tested with risk factors of atherosclerotic process, such as sex, body mass index, presence of hypertension, diabetes mellitus, and hypercholesterolemia. Study obtained 104 subjects and showed the prevalence of asymptomatic carotid disease was 37.5%. Two risk factors: diabetes mellitus and hypercholesterolemia were statistically significant ( = 0.01) with odds ratio (OR) 3.56 (1.31-9.64, 95% confidence interval [CI]) and OR 2.85 (1.25-6.51, CI 95%), respectively. Logistic regression showed the risk was 69.2% by having two of these comorbidities, 47.2 or 42.5% if diabetes mellitus or hypercholesterolemia was present. As diabetes mellitus and hypercholesterolemia were proved to be significant risk factors for asymptomatic carotid artery disease, we recommend performing ultrasound screening to measure carotid artery IMT for geriatric population who had diabetes mellitus and/or hypercholesterolemia for asymptomatic carotid artery disease to be diagnosed and further treated.
How an Aggressive Treatment of No-reflow Phenomenon in Primary Percutaneous Coronary Intervention with High Thrombus Burden can Achieve a Grade III TIMI-flow: A Case Report.
Martha JW, Putra ICS, Kamarullah W … +2 more , Husink A, Sihite TA
Int J Angiol · 2025 Sep · PMID 40771288 · Full text
The management of the no-reflow phenomenon is still being debated by experts as there is no specific algorithm, limited recommended drug choices, and insufficient data regarding the combination of drugs in currently avai...
The management of the no-reflow phenomenon is still being debated by experts as there is no specific algorithm, limited recommended drug choices, and insufficient data regarding the combination of drugs in currently available guidelines. Thus, in this case report, we would like to propose a new combination of drugs as an alternative to the recommended drugs of choice in the treatment of no-reflow phenomenon. A 41-year-old man arrived at the emergency department complaining of chest pain 30 minutes prior to arrival. However, the patient was later diagnosed with extensive anterior ST-elevation myocardial infarction, KILLIP classification I, which was caused by the entire blockage of the proximal left anterior descending coronary artery. Angiography was conducted after stent placement during the main percutaneous coronary intervention and revealed grade I thrombolysis in myocardial infarction (TIMI)-flow with no coronary artery blockage. We then used an intracoronary approach to give nitroglycerin, heparin, and eptifibatide. The findings of posttreatment angiography revealed an improvement in coronary blood flow with a grade II TIMI flow. Furthermore, intravenous injection of eptifibatide and morphine effectively restored perfusion to a grade III TIMI flow. Aggressive and precise treatment with a drug of choice is required to counteract the no-reflow phenomenon. Presently, only a limited range of first-line medications are available to treat this condition. Not only that, but several of the prescribed medications are not easily accessible, especially in developing countries. Therefore, we offer a novel combination medicaments consisting of nitroglycerin, heparin, and glycoprotein IIb/IIIa inhibitor as an alternative treatment of the no-reflow phenomenon.
Incidence of Myocarditis Associated with Diphtheria, Tetanus, and Pertussis Vaccine: A Rare Case Series.
Iqbal M, Febrianora M, Putra ICS … +2 more , Pramudyo M, Achmad C
Int J Angiol · 2025 Jun · PMID 40365148 · Full text
Myocarditis induced by diphtheria-tetanus-pertussis (DTP) vaccination is extremely rare, accounting for only two cases thus far. Hence, to supplement knowledge regarding its pathogenesis and treatment, we reported two ca...
Myocarditis induced by diphtheria-tetanus-pertussis (DTP) vaccination is extremely rare, accounting for only two cases thus far. Hence, to supplement knowledge regarding its pathogenesis and treatment, we reported two cases of myocarditis associated with DTP vaccination in adults. Two patients (a 40-year-old female and a 43-year-old male) presented with mild symptoms and were hemodynamically stable. In both patients, the DTP vaccination was given 4 and 6 days before admission. Both patients had prolonged corrected QT interval (QTc), poor left ventricular function, and high troponin levels at admission. However, numerous ST segment depression was only noted in the first case. Bacteriology and virology study results were negative for any pathogen. No atherosclerotic lesions were observed by coronary angiography. Cardiac magnetic resonance imaging was only performed in the second case, which confirmed the diagnosis of myocarditis. Initial therapy was administered with a beta-blocker, angiotensin-converting enzyme inhibitor, and intravenous methylprednisolone. Nonetheless, in the first case, rapid clinical deterioration and sudden cardiac death occur within 3 days of hospitalization. Learn from the first case, a high-dose intravenous immunoglobulin (IVIG) treatment was initiated in the second case, which resulted in an improvement in left ventricular function and clinical symptoms, as well as a significant reduction in QTc interval and troponin levels. Rapid diagnostic testing and early recognition of the fulminant course is mandatory, allowing clinicians to aggressively treat the patient with high-dose intravenous immune globulin, thus obtaining a better outcome.
Treatment of Cardiogenic Shock and Refractory Ventricular Fibrillation: Pulling Out All the Stops.
Glazier MM, Kaki A
Int J Angiol · 2024 Sep · PMID 39131805 · Full text
We report the case of a 62-year-old woman who presented with an acute inferior wall myocardial infarction complicated by cardiogenic shock and refractory ventricular fibrillation. Following prolonged resuscitation in the...
We report the case of a 62-year-old woman who presented with an acute inferior wall myocardial infarction complicated by cardiogenic shock and refractory ventricular fibrillation. Following prolonged resuscitation in the emergency room, she was transferred to the cardiac catheterization laboratory where, as a first step, mechanical circulatory support with venoarterial extracorporeal membrane oxygenation (ECMO) was established. Next, a right heart catheterization study was performed, followed by coronary angiography and angioplasty of the infarct-related artery. Promptly on transfer to the intensive care unit, a hypothermia protocol was initiated. By postprocedure day 1, the patient's ventricular fibrillation had resolved, mean arterial pressure was >65 mm Hg, and pulmonary artery diastolic pressure was 10 mm Hg. Echocardiography demonstrated complete recovery of left ventricular systolic function. Lactate levels had fallen from 11.0 mmol/L (pre-ECMO) to 1.2 mmol/L. The patient was successfully weaned off pressor and ECMO support within 24 hours of the percutaneous coronary intervention procedure. She was extubated on postprocedure day 2 and discharged home on day 6. At 26-month follow-up, she remains well, angina free, neurologically intact, and without evidence of heart failure. The treatment algorithm used in this case should be considered favorably in the management of patients presenting with acute myocardial infarction complicated by cardiogenic shock and refractory ventricular fibrillation.
Validity of Routinely Reported Rutherford Scores Reported by Clinicians as Part of Daily Clinical Practice.
van der Heijden LLM, Marang-van de Mheen PJ, Thielman L … +3 more , Stijnen P, Hamming JF, Fourneau I
Int J Angiol · 2024 Sep · PMID 39131806 · Full text
Routinely reported structured data from the electronic health record (EHR) are frequently used for secondary purposes. However, it is unknown how valid routinely reported data are for reuse. This study aimed to assess th...
Routinely reported structured data from the electronic health record (EHR) are frequently used for secondary purposes. However, it is unknown how valid routinely reported data are for reuse. This study aimed to assess the validity of routinely reported Rutherford scores by clinicians as an indicator for the validity of structured data in the EHR. This observational study compared clinician-reported Rutherford scores with medical record review Rutherford scores for all visits at the vascular surgery department between April 1, 2016 and December 31, 2018. Free-text fields with clinical information for all visits were extracted for the assignment of the medical record review Rutherford score, after which the agreement with the clinician-reported Rutherford score was assessed using Fleiss' Kappa. A total of 6,633 visits were included for medical record review. Substantial agreement was shown between clinician-reported Rutherford scores and medical record review Rutherford scores for the left ( = 0.62, confidence interval [CI]: 0.60-0.63) and right leg ( = 0.62, CI: 0.60-0.64). This increased to the almost perfect agreement for left ( = 0.84, CI: 0.82-0.86) and right leg ( = 0.85, CI: 0.83-0.87), when excluding missing clinician-reported Rutherford scores. Expert's judgment was rarely required to be the deciding factor (11 out of 6,633). Substantial agreement between clinician-reported Rutherford scores and medical record review Rutherford scores was found, which could be an indicator for the validity of routinely reported data. Depending on its purpose, the secondary use of routinely collected Rutherford scores is a viable option.
Ambulatory Care Management in Low Blood Pressure Patient with HFrEF.
Panjaitan FH, Hasanah DY, Yonas E … +1 more , Soerarso R
Int J Angiol · 2025 Sep · PMID 40771294 · Full text
Heart failure (HF) affects an estimated 38 million people globally, with most published research estimating a prevalence of 1 to 2% of the adult population. Low blood pressure (BP) is reported in 10 to 15% of patients wi...
Heart failure (HF) affects an estimated 38 million people globally, with most published research estimating a prevalence of 1 to 2% of the adult population. Low blood pressure (BP) is reported in 10 to 15% of patients with HF in clinical trials, although this proportion is much more frequent in routine clinical practice. Low BP in outpatients has a better outcome compared to inpatients. Low BP is often a restricting factor in the use and uptitration of guideline-directed medical therapy (GDMT). A 57-year-old male presented himself to the HF clinic with complaints of bloating, shortness of breath, and fatigue. The patient had a history of acute coronary syndrome and cardiac arrest, but the results of coronary angiography showed nonsignificant coronary artery disease. Cardiomegaly was seen on chest X-ray. Electrocardiogram showed pathologic q wave II, III, and AvF with poor r wave progression on V1-V6. The patient was admitted due to acute decompensated HF with hypotension. After the initial decongestion patient was treated with sacubitril/valsartan, bisoprolol, and spironolactone in the outpatient clinic. Patient complaints and BP slowly improved during the outpatient phase. Hypotension remains a challenge in implementing GDMT in HF patients. By following the steps according to algorithm and current guidelines, GDMT can be optimized in these patients.
Transmitral Thrombectomy via Minithoracotomy in a Patient with Takotsubo Cardiomyopathy.
Takahashi H, Matsuo J, Gotake Y … +1 more , Sugimoto T
Int J Angiol · 2024 Dec · PMID 39502346 · Full text
Left ventricular thrombus is a complication of myocardial infarction, ventricular aneurysm, myocarditis, and cardiomyopathies, such as Takotsubo syndrome. We report the case of a 74-year-old woman who was diagnosed as le...
Left ventricular thrombus is a complication of myocardial infarction, ventricular aneurysm, myocarditis, and cardiomyopathies, such as Takotsubo syndrome. We report the case of a 74-year-old woman who was diagnosed as left ventricular thrombus resulting from transient Takotsubo syndrome. The thrombus was completely removed using video-assisted thoracoscopy through right minithoracotomy. This approach is less invasive and can provide better visualization, thereby avoiding left ventriculotomy.
A Very Rare Cause of Thrombotic Peripheral Occlusion.
Kretzschmar D, Thieme M, Aschenbach R … +2 more , Schulze PC, Möbius-Winkler S
Int J Angiol · 2023 Mar · PMID 36727155 · Full text
A 45-year-old healthy woman presented with claudication of the right leg. The resting ankle-brachial index (ABI) was reduced to 0.6, and a duplex scan revealed an occlusion of the right popliteal artery. Angiography pres...
A 45-year-old healthy woman presented with claudication of the right leg. The resting ankle-brachial index (ABI) was reduced to 0.6, and a duplex scan revealed an occlusion of the right popliteal artery. Angiography presented a patent superficial femoral artery that ends above the knee joint. Laterally, there was delayed retrograde contrast filling of the popliteal artery. After exploring the internal iliac artery, we crossed a thrombotic occlusion of a persisting sciatic artery (PSA). Local thrombolysis with recombinant tissue plasminogen activator (1 mg/h) was initiated. The Angiography 18 hours later showed a reduction of thrombotic material and relevant stenosis in the proximal part of the vessel. Residual thrombus and the stenosis were covered by two stentgrafts (Gore Viabahn Endoprosthesis) that were stabilized by an interwoven stent (Supera). Final angiography displayed a patent sciatic artery and a three-vessel run off. Postinterventional ABI was normalized to 1.0. The magnetic resonance imaging 6 days after the intervention demonstrated a patent PSA again and a normal blood flow on the left leg. A PSA should be included in the differential diagnosis of lower limb ischemia or suspected aneurysm formation. We demonstrated the feasibility of an interventional approach with an excellent outcome in this case.
Single-Center Study Evaluating Long-Term Major Adverse Outcomes with the Use of Paclitaxel-Coated Balloons in Treating Infrainguinal Arterial Disease.
Shammas NW, Sharis E, Shammas GA … +1 more , Jones-Miller S
Int J Angiol · 2023 Mar · PMID 36727154 · Full text
Paclitaxel drug-coated balloons (DCB) have been shown to reduce target lesion revascularization (TLR) rate, but recently an association between paclitaxel and an increase in mortality at 5-year was reported. We reviewed...
Paclitaxel drug-coated balloons (DCB) have been shown to reduce target lesion revascularization (TLR) rate, but recently an association between paclitaxel and an increase in mortality at 5-year was reported. We reviewed the 5-year mortality and freedom from TLR rates from a single center among patients that received DCB. Consecutive patients that received DCB from July 8, 2015 to November 27, 2019 with follow-up obtained from medical records and review of official death certificates were reviewed. The primary objective was total mortality and TLR rates with cumulative exposure to paclitaxel-coated balloons. Demographic, angiographic, clinical, and procedural variables were collected. Causes of mortality were classified according to death certificates. Descriptive analysis was performed on all variables. Kruskal-Wallis test was used to compare the total length of DCBs in those who were alive and those who died by the end of study. Kaplan-Meier (KM) was used to plot the freedom from mortality up to 5 years. A total of 91 symptomatic patients received the Lutonix balloon at index to treat femoropopliteal arterial disease and subsequently received either Lutonix or in.PACT during the follow-up phase for additional procedures. Age was 68.4 ± 10.8 years (56.0% males). Critical limb ischemia was present in 20.9%. There was no statistical difference in mortality between the median total number of balloons used among patients who were alive versus those who died (2.5 vs. 3.0, -value = 0.89). Also, there was no statistical difference in the total length of DCB balloons used between those who were alive and those who died at the end of the study (p-value = 0.39). There were no in-hospital amputation or death. At 5-year follow-up KM freedom from TLR was 78.5%. A total of 13 patients died during follow-up. Of these 10 received only the Lutonix balloon and 3 did receive both Lutonix and In.PACT. The yearly KM freedom from mortality for the Lutonix only cohort were 92.7, 89.1, 85.5, 83.6, and 81.8% at 1, 2, 3, 4, and 5 years, respectively. Freedom from TLR and mortality at 5 years appears to be favorable with the use of DCB, predominantly Lutonix balloon in this cohort. This data needs to be supported prospectively by a larger number of patients.
Infarct Size and Long-Term Clinical Outcomes of Prasugrel versus Clopidogrel in Patients with Acute Coronary Syndrome Undergoing Coronary Artery Stenting: A Prospective Randomized Study.
Yabe T, Noike R, Okubo R … +2 more , Amano H, Ikeda T
Int J Angiol · 2023 Mar · PMID 36727153 · Full text
The antiplatelet drug prasugrel inhibits platelet aggregation early after oral administration. This study examined whether prasugrel is effective in inhibiting infarct size and can reduce the incidence of major adverse c...
The antiplatelet drug prasugrel inhibits platelet aggregation early after oral administration. This study examined whether prasugrel is effective in inhibiting infarct size and can reduce the incidence of major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS). This study was a single-center, prospective, randomized pilot study. Among 80 ACS patients treated at our institution between August 2014 and September 2015, 76 ACS patients who underwent stenting and achieved thrombolysis in myocardial infarction flow grade 3 were assigned to receive aspirin plus prasugrel (prasugrel group; = 37) or aspirin plus clopidogrel (clopidogrel group; = 39). The primary endpoint was survival free of MACE. The secondary endpoint was the evaluation of infarct size defined as the area under the curve (AUC) of troponin I, calculated using the linear trapezoidal method. During follow-up (mean, 1262.4 ± 599.6 days), 14 patients showed MACE. No significant differences in CYP2C19 genotype were seen between groups. AUC of troponin I up to 72 hours after intervention tended to be smaller in the prasugrel group (1,927.1 ± 2,189.3 ng/mL) than in the clopidogrel group (3,186.0 ± 3,760.1 ng/mL, = 0.08). Cumulative incidence of MACE was significantly higher in the clopidogrel group (log-rank test; = 0.02). Compared with clopidogrel, prasugrel was associated with reduced infarct size and lower frequency of long-term outcomes among ACS patients undergoing stenting.
Clinical and Hemodynamic Factors Associated with Low Gradient Severe Rheumatic Mitral Stenosis.
Soesanto AM, Roeswita D, Atmosudigdo IS … +2 more , Adiarto S, Sahara E
Int J Angiol · 2023 Mar · PMID 36727152 · Full text
Discrepancy between narrowed mitral valve area and transmitral gradient is not uncommon, suggesting the presence of low gradient (LG)-severe mitral stenosis (MS). Some clinical and hemodynamic factors are believed to ass...
Discrepancy between narrowed mitral valve area and transmitral gradient is not uncommon, suggesting the presence of low gradient (LG)-severe mitral stenosis (MS). Some clinical and hemodynamic factors are believed to associate with LG-severe MS. Transthoracic echocardiography reports were reviewed retrospectively to evaluate the association of all clinical and hemodynamic parameters with LG-severe MS. A 36% of total 322 patients was in the LG-severe MS group. In multivariate analysis, atrial fibrillation (95% confidence interval [CI] 4.60-16.71, odds ratio [OR] 8.77), net atrioventricular compliance > 4 mL/mm Hg (95% CI 3.96-14.25, OR 7.51), tricuspid regurgitation maximal velocity (TR Vmax) > 3.4 m/s (95% CI 0.13-0.48, OR 0.25), stroke volume index ≤ 35 mL/m (95% CI 1.49-6.25, OR 3.05), female gender (95% CI 1.30-5.33, OR 2.63), and severe tricuspid regurgitation (95% CI 1.04-5.50, OR 2.39) were found to be associated with LG-severe MS. Atrial fibrillation, net atrioventricular compliance, TR Vmax, stroke volume index, female gender, and severe TR were associated with low transmitral gradient in patients with severe MS.
5-Year Follow-Up of Endovascular Management in a Patient with Chronic Concomitant DeBakey Type II and IIIa Aortic Dissection.
Siddiq T, Dakota I, Adiarto S … +4 more , Indriani S, Sugisman S, Permana AR, Shu C
Int J Angiol · 2023 Mar · PMID 36727150 · Full text
The incidence of chronic concomitant DeBakey Type II and IIIa aortic dissection is uncommon and complex. Since the mortality rate is very high, it requires a precise and holistic treatment plan. In some cases, when the p...
The incidence of chronic concomitant DeBakey Type II and IIIa aortic dissection is uncommon and complex. Since the mortality rate is very high, it requires a precise and holistic treatment plan. In some cases, when the patients refuse to undergo open surgery or the patients' condition is not suitable for open surgery, thoracic endovascular aortic repair (TEVAR) is the recommended therapeutic approach. In this case, a patient refused to undergo open surgery and chose TEVAR instead. The patient survived the procedure and lived for years. We present the case of a successful TEVAR procedure in a patient with chronic concomitant DeBakey Type II and IIIa aortic dissection in a 51-year-old man and the 5-year postoperative follow-up of the patient's condition.
Gender Influence on Abdominal Aortic Aneurysm Surgery in a Caribbean Population.
Harnarayan P, Budhooram S, Harnanan D … +3 more , Ramdass MJ, Islam S, Naraynsingh V
Int J Angiol · 2023 Mar · PMID 36727148 · Full text
Female patients with abdominal aortic aneurysms (AAAs) are usually less common and older than their male counterparts. We report on AAA disease in a Caribbean nation with respect to gender and review their outcomes relat...
Female patients with abdominal aortic aneurysms (AAAs) are usually less common and older than their male counterparts. We report on AAA disease in a Caribbean nation with respect to gender and review their outcomes relative to the male population. Data were collected prospectively and analyzed retrospectively for patients with AAAs who underwent surgery from 2001 to 2018. Sixty patients were diagnosed with AAA with 44 going on to have surgical repair of which 35 were males, aged 61 to 89 (mean age 73.4 years). Nine women ages 44 to 74 years (mean age 60.8 years) had surgical intervention, three being between 40 and 49 years. The size of aneurysms in these patients ranged from 4.3 to 11.0 cm in diameter (average 6.95 cm), female patients having an average diameter of 6.7 cm. Of the 44 patients, 43 underwent open and one endovascular repair. Thirty-three were elective cases and 11 were ruptured with 32 aorto-aortic and 13 aorto-iliac repairs. There were nine fatalities, three elective and six ruptured, with only one being female. Women had similar outcomes to men in all age groups with young patients having good results. Female AAA patients are usually older, undergo less surgical procedures especially if endovascular, and have worse outcomes than their male counterparts. Our study showed that the females were younger but had similar outcomes to the male patients. The female Caribbean patients may present at much younger ages than in continental populations and this may be due to genetic, ethnic, or lifestyle factors.
Intravascular Lithotripsy in Calcified Peripheral Lesions: Single-Center JEN-Experience.
Aftanski P, Thieme M, Klein F … +3 more , Schulze PC, Möbius-Winkler S, Kretzschmar D
Int J Angiol · 2023 Mar · PMID 36727147 · Full text
Peripheral artery disease (PAD) shows increasing need for revascularization therapy. Interventional success in calcified lesions is limited. Here, intravascular lithotripsy (IVL), modifying intimal and medial calcium, is...
Peripheral artery disease (PAD) shows increasing need for revascularization therapy. Interventional success in calcified lesions is limited. Here, intravascular lithotripsy (IVL), modifying intimal and medial calcium, is a promising treatment approach. A single-center, prospective all-comers registry for patients undergoing peripheral IVL was established to examine treatment success in PAD with severe vessel calcification. Periprocedural safety events as well as short-term and intermediate follow-up clinical data were evaluated. Between December 2018 and January 2021 all consecutive patients receiving peripheral lithotripsy at our center were analyzed. Clinical and angiographic data were evaluated. Angiographic images were analyzed using a semiautomatic software for quantitative vessel analysis. Eighty-five lesions in 61 limbs were treated with IVL in 51 patients presenting with Rutherford classes 2 to 5. Most lesions (68%) were localized in the superficial femoral artery. Mean calcified lesion length was 102.5 mm (10-390 mm), with a median peripheral arterial calcium score of 3, indicating a highly calcified status. In 58% of the patients, IVL was used as a stand-alone therapy. IVL resulted in a mean acute luminal gain of 2.6 ± 0.9 mm, resulting in stenosis reduction by 42.1 ± 15%. Mean ankle brachial index (ABI) improved significantly from 0.6 to 0.8 ( < 0.0001) on day 1 after the intervention and remained stable at 6 months. This large real-world data of peripheral IVL reports compelling safety in a complex patient cohort. For the first time, clinical follow-up data demonstrated a sustained significant improvement in ABI after 6 months.
A Comprehensive Research Schema for the Characterization of Aortic Aneurysms.
Alslaim H, Sanampudi S, Raissi D … +6 more , Fu W, Behr AY, Issa M, Sheppard MB, Weintraub NL, Winkler M
Int J Angiol · 2023 Mar · PMID 36727146 · Full text
A robust, accurate, and standardized approach to measurement of the aorta is critical to improve the predictive accuracy of these aortic measurements, and to investigate other aortic imaging biomarkers. Developing a comp...
A robust, accurate, and standardized approach to measurement of the aorta is critical to improve the predictive accuracy of these aortic measurements, and to investigate other aortic imaging biomarkers. Developing a comprehensive and generic schema for characterization of the aorta to enable investigators to standardize data that are collected across all aorta research. A systematic review of the literature was conducted to identify and assess schemata of aortic measurement and description. The schemata were reported and discussed to guide the synthesis of a comprehensive schema. We propose the International College of Angiology Aortic Research Schema as a comprehensive design that fills the gaps left behind by previously reported schemata. It is intended to be applicable for all clinically relevant purposes, including endograft development for aneurysm repair and for the accurate characterization of the aortic anatomy. This schema divides the aorta into 14 segments and 2 sections (thoracic and abdominal aortas). The segmentation proposed can be used in addition to specific measurements taken for any aneurysm including the neck, and maximal and minimal diameters of the aneurysm.
Effects of Moderate Intensity Aerobic Exercise to FSTL-1 Regulation in Atherosclerosis: A Systematic Review.
Damay VA, Setiawan S, Lesmana R … +2 more , Akbar MR, Lukito AA
Int J Angiol · 2023 Mar · PMID 36727145 · Full text
Moderate intensity exercise is considered as a primary step to prevent coronary artery diseases (CADs) by stimulated FSTL-1 secretion as a novel myokines to improve endothelial cell function, prevent arterial stiffness,...
Moderate intensity exercise is considered as a primary step to prevent coronary artery diseases (CADs) by stimulated FSTL-1 secretion as a novel myokines to improve endothelial cell function, prevent arterial stiffness, or vascular inflammation. This review aims to provide the current evident role of FSTL-1 as a novel myokine secreted during exercise to prevent atherosclerosis progression. A systematic review using databases from (PubMed), ScienceDirect, and The Cochrane Library, was conducted up to October 2021 to identify all the eligible experimental and observational studies that assess how moderate intensity exercises stimulate FSTL-1 secretion to prevent atherosclerosis. Results were described through narrative synthesis of the evidence. From 84 retrieved references, 15 studies met the inclusion criteria and were included in this review. The overall results suggest that exercise or physical activity can stimulate myokines secretion, especially in FSTL-1. FSTL-1 is a myokine or adipokine that plays a potential role in preventing atherosclerosis by various mechanisms such as via improvement of endothelial functions, suppression of smooth muscle cells (SMCs) proliferation, and reduction of arterial thickening. FSTL-1 is a relatively new and less known myokine, but probably holds a key role in assessing how moderate intensity aerobic exercise prevents atherosclerosis progression by preventing endothelial dysfunction, arterial stiffness, or vascular inflammation.
Involvement of AGE and Its Receptors in the Pathogenesis of Hypertension in Elderly People and Its Treatment.
Prasad K
Int J Angiol · 2022 Dec · PMID 36588874 · Full text
Both systolic and diastolic blood pressures increase with age up to 50 to 60 years of age. After 60 years of age systolic pressure rises to 84 years of age but diastolic pressure remains stable or even decreases. In the...
Both systolic and diastolic blood pressures increase with age up to 50 to 60 years of age. After 60 years of age systolic pressure rises to 84 years of age but diastolic pressure remains stable or even decreases. In the oldest age group (85-99 years), the systolic blood pressure (SBP) is high and diastolic pressure (DBP) is the lowest. Seventy percent of people older than 65 years are hypertensive. This paper deals with the role of advanced glycation end products (AGE) and its cell receptor (RAGE) and soluble receptor (sRAGE) in the development of hypertension in the elderly population. Plasma/serum levels of AGE are higher in older people as compared with younger people. Serum levels of AGE are positively correlated with age, arterial stiffness, and hypertension. Low serum levels of sRAGE are associated with arterial stiffness and hypertension. Levels of sRAGE are negatively correlated with age and blood pressure. Levels of sRAGE are lower in patients with arterial stiffness and hypertension than patients with high levels of sRAGE. AGE could induce hypertension through numerous mechanisms including, cross-linking with collagen, reduction of nitric oxide, increased expression of endothelin-1, and transforming growth factor-β (TGF-β). Interaction of AGE with RAGE could produce hypertension through the generation of reactive oxygen species, increased sympathetic activity, activation of nuclear factor-kB, and increased expression of cytokines, cell adhesion molecules, and TGF- β. In conclusion, the AGE-RAGE axis could be involved in hypertension in elderly people. Treatment for hypertension in elderly people should be targeted at reduction of AGE levels in the body, prevention of AGE formation, degradation of AGE in vivo, downregulation of RAGE expression, blockade of AGE-RAGE interaction, upregulation of sRAGE expression, and use of antioxidants.
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