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Management and prognosis of nonpulmonary large arterial disease in patients with Behçet disease.

OBJECTIVE: The purpose of this study was to evaluate and report our treatment policies in the management of nonpulmonary arterial aneurysms in Behçet disease and to assess the prognosis in a cohort of 25 patients diagnosed between 1996 and 2007 by formally reassessing their outcome at the present time. METHODS: We identified 25 patients (24 men/1 woman) with Behçet disease with nonpulmonary aneurysms (n = 23) or occlusions (n = 2) between 1996 and 2007. All patients fulfilled the International Study Group Criteria for Behçet disease. Aneurysms were demonstrated with contrast-enhanced computed

[Chronic thromboembolic pulmonary hypertension: surgical treatment with thromboendarterectomy].

BACKGROUND AND OBJECTIVES: Pulmonary thromboendarterectomy (PTE) is considered the potential curative treatment for chronic thromboembolic pulmonary hypertension (CTEPH). We analysed the results of the PTE application in our institution. PATIENTS AND METHODS: From February 1996 to December 2007, 30 patients with CTEPH underwent video-assisted PTE. Preoperative hemodynamic data were: systolic pulmonary artery pressure (SPAP) 87+/-17mmHg, mean pulmonary artery pressure (MPAP) 51+/-11mmHg, pulmonary total resistance 1067+/-485dynes x s x cm(-5), pulmonary vascular resistance 873+/-389dynes x s x…

Recurrent carotid disease: will stents be an alternative to surgery?

PURPOSE: To report the results of balloon angioplasty in recurrent carotid occlusive disease and evaluate the potential for stent implantation. METHODS AND RESULTS: Between April 1991 and September 1995, 15 patients with carotid restenosis underwent 17 endoluminal procedures in 3 common carotid and 14 internal carotid arteries. Two postdilation complications (dissection and acute occlusion) required prompt stenting; one common carotid artery was stented for postdilation residual stenosis. One recurrent lesion was also stented 6 months after initial angioplasty. One stroke, 1 silent cerebral i

Transcranial Doppler monitoring of cerebral flow velocities during surgical occlusion of the carotid artery.

Transcranial Doppler (TCD) was used to assess collateral flow and to quantitate perfusion velocity changes in a group of 18 patients requiring temporary or permanent surgical occlusion of the internal carotid artery for treatment of their cerebrovascular lesions. Velocity measurements were correlated with times of occlusion and neurological outcome in order to assess safe vessel occlusion times and the need for an intraoperative shunt. These data were used to calculate a perfusion velocity index (PVi), which indicated that values greater than 2 were well tolerated, and values of less than 1 we

Risk factors for venous thromboembolism after vascular surgery and implications for chemoprophylaxis strategies.

OBJECTIVE: Venous thromboembolism (VTE) is an important cause of postoperative morbidity and mortality. However, the reported incidence after major vascular surgery has ranged from as low as 1% to >10%. Furthermore, little is known about optimal chemoprophylaxis regimens or rates of postdischarge VTE in this population. In the present study, we aimed to better characterize the rates of in-hospital and postdischarge VTE after major vascular surgery, the role of chemoprophylaxis timing, and the association of VTE with mortality. METHODS: A single-center retrospective study of 1449 major vascula

Carotid chemodectomas: long-term results of subadventitial resection with deliberate external carotid resection.

The aim of this study was to evaluate the short-term and long-term results of the subadventitial resection of carotid chemodectomas and to v … ine dilatations for spasm of the ICA, five autogenous vein grafts, two prosthetic bypasses, and one endarterectomy associated with a patch angioplasty. All patients were followed up until 2006. At 3 months, the observed complications were the sequelae of a homolateral hemispheric accident due to thrombosis of a vein graft, eight peripheral facial nerve palsies, …

A score system to determine the 5-year survival in patients with asymptomatic carotid stenosis under best medical therapy: Results from the Carotid Asymptomatic Stenosis study.

BACKGROUND: Current international guidelines do not recommend carotid revascularization in patients with asymptomatic carotid artery stenosi … ) observational cohort study including patients with ACAS > 60% (North American Symptomatic Carotid Endarterectomy Trial criteria) started in 2019 and ended in 2025. Patients were not considered for carotid revascularization due to high surgical risk or the absence of plaque vulnerability features. BMT was defined as regular intake of antiplatelet therapy and st …

Endovascular-first revascularization is as safe and efficacious as open-first revascularization for acute limb ischemia.

BACKGROUND: The independent effect of the initial revascularization strategy-open surgery-first (OS) vs endovascular-first (EV)-on the outco … categorized according to the initial treatment strategy: OS (surgical thrombectomy with or without endarterectomy or bypass) or EV (catheter-directed thrombolysis, rheolytic thrombectomy, or vacuum-assisted aspiration thrombectomy with adjunctive angioplasty, stenting, or atherectomy). The outcomes included major amputation, mortality, and AFS at 90 days and th …

Micro- and nanoplastics are elevated in femoral atherosclerotic plaques compared with undiseased arteries.

OBJECTIVE: As plastic production continues to accelerate, the byproducts increasingly fill the environment. Once degraded into micronanoplas … ase. METHODS: Common femoral artery plaques were collected from patients undergoing common femoral endarterectomy for medically refractory lower extremity peripheral arterial disease. These samples were then sectioned, frozen, and analyzed using pyrolysis gas chromatography/mass spectrometry for MNP content by polymer. A total of 12 polymers were investigated i …

Female and male patients have similar outcomes after transcarotid artery revascularization in prospective trials.

OBJECTIVE: Sex disparities in outcomes after carotid revascularization have long been a concern, with several studies demonstrating increased postoperative death and stroke for female patients after either carotid endarterectomy or transfemoral stenting. Adverse events after transfemoral stenting are higher in female patients, particularly in symptomatic cases. Our objective was to investigate outcomes after transcarotid artery revascularization (TCAR) stratified by patient sex hypothesizing that the results would be similar between males and females. METHODS: We analyzed prospectively collec…

Aptamers: Potential Diagnostic and Therapeutic Agents for Blood Diseases.

Aptamers are RNA/DNA oligonucleotide molecules that specifically bind to a targeted complementary molecule. As potential recognition elements with promising diagnostic and therapeutic applications, aptamers, such as monoclonal antibodies, could provide many treatment and diagnostic options for blood diseases. Aptamers present several superior features over antibodies, including a simple in vitro selection and production, ease of modification and conjugation, high stability, and low immunogenicity. Emerging as promising alternatives to antibodies, aptamers could overcome the present limitations

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… A phase II clinical trial proposed to study the effect of ARC1779 on cerebral microembolism in patients undergoing carotid endarterectomy in the immediate postoperative period, and it planned to recruit 100 patients. However, the study had to be suspended after recruiting only 36 patients [ 64 ]. … The von Willebrand inhibitor ARC1779 reduces cerebral embolization after carotid endarterectomy: A randomized trial. Stroke. 2011;42:2149–2153. doi: 10.1161/STROKEAHA.111.616649. 65. Wood J.P., Ellery P.E.R., Maroney S.A., Mast A.E. Biology of tissue factor pathway inhibitor. Blood J. Am. Soc. …

Surgical embolectomy for internal carotid artery terminus occlusion.

The aim of this study was to assess the efficacy and safety of surgical embolectomy for internal carotid artery terminus (ICA-T) occlusion. Twenty-five consecutive patients with acute ischemic stroke attributed to embolic ICA-T occlusion who underwent surgical embolectomy were retrospectively reviewed. Twenty-four patients were examined based on magnetic resonance imaging, with one patient included based on a computed tomography scan. Recanalization rate, recanalization time, complications, National Institutes of Health Stroke Scale (NIHSS) score improvement at 1 month, and modified Rankin Sca

Comparison of hybrid procedure and open surgical revascularization for multilevel infrainguinal arterial occlusive disease.

OBJECTIVE: To compare outcomes of hybrid (combined surgical and endovascular) procedures (HYBRID) with open surgical reconstructions (OPEN) in patients with multilevel infrainguinal artery occlusive diseases. DESIGN: Case series study with retrospective analysis of prospectively collected nonrandomized data. METHODS: Between 2008 and 2012, 64 patients underwent OPEN and 43 underwent HYBRID. Patient characteristics, technique success, clinical improvement, and procedure-related morbidity were reviewed and compared. Patency rates and limb salvages were analyzed and compared using Kaplan-Meier

Results of external iliac artery reconstruction in avid cyclists.

OBJECTIVE: We report the midterm results of external iliac artery reconstruction in 25 high-performance cyclists. METHODS: Cyclists undergoing arterial reconstruction for symptomatic external iliac arteriopathy at a single institution between October 2004 and August 2010 were identified. With Institutional Review Board approval, data were collected from medical record review and telephone interview. Results were analyzed with χ(2) or independent t-test. RESULTS: Twenty-five patients (31 limbs) underwent operation, which included arterial reconstruction with or without inguinal ligament relea

Infrainguinal atherectomy: a retrospective review of a single-center experience.

By decreasing plaque burden, atherectomy provides an alternative to angioplasty and stenting as a means of revascularizing patients with peripheral arterial disease. A new atherectomy device (SilverHawk) has recently been approved by the Food and Drug Administration, but the results with its use are unclear. We analyzed a series of consecutive patients undergoing atherectomy. We retrospectively reviewed the charts of 35 patients undergoing infrainguinal (IF) atherectomy in 38 limbs. The Trans-Atlantic Inter-Society Consensus (TASC) classification and Society of Vascular Surgery runoff scores w

The influence of aging on the prognostic value of the revised cardiac risk index for postoperative cardiac complications in vascular surgery patients.

OBJECTIVE: The Lee-risk index [Lee-index] was developed to predict major adverse cardiac events [MACE]. However, age is not included as a risk factor. The aim was to assess the value of the Lee-index in vascular surgery patients among different age categories. METHODS: Of 2642 patients cardiovascular risk factors were noted to calculate the Lee-index. Patients were divided into four age categories; < or = 55 (n=396), 56-65 (n=650), 66-75 (n=1058) and > 75 years (n=538). Outcome measures were postoperative MACE (cardiac death, MI, coronary revascularization and heart failure). The performance

Cranial nerve injuries after carotid artery surgery. A prospective study of 663 operations.

OBJECTIVE: To establish the incidence of cranial nerve injuries caused by carotid artery surgery. METHODS: During the years 1982 to 1992, 689 carotid artery operations were performed at Malmö General Hospital. Of these 656 were pre- and postoperatively examined at the Department of Phoniatrics concerning the function of the cranial nerves IX, X, and XII. RESULTS: There was injury to one or more of the examined nerves after 75 operations (11.4%). In 70 (10.7%) operations the hypoglossal nerve was injured, in eight (1.2%) the recurrent laryngeal nerve, in two (0.3%) the glossopharyngeal nerve