Nowadays, carotid artery stenting (CAS) offers a potential alternative to carotid endarterectomy (CEA). CAS main advantages over CEA are the less invasive approach and the almost equal performance to CEA in terms of stroke prevention and complications. One of the most important factors which played significant role to CAS evolution ...

The initial therapeutic approach to acute ischemic stroke consists of thrombolytic therapy and early initiation of supportive care, usually commenced prior to the determination of the underlying stroke etiology. Varying stroke mechanisms may call for specific, etiology-based treatment. The majority of strokes result from cardioembolism, large-vessel atherothromboembolism, and small-vessel occlusive ...

The management of cervicocephalic arterial dissections raises many unsolved issues such as: how to best acutely treat patients who present with ischemic stroke or occasionally with sub-arachnoid hemorrhage? How to best prevent ischemic stroke in patients who present with purely local signs such as headache, painful Horner Syndrome or neck ...

The development of targeted therapies for pulmonary arterial hypertension currently based on prostaglandin, nitric oxide, and endothelin pathways has resulted in major advances in the treatment of patients with pulmonary arterial hypertension. This article reviews the current evidence that supports both the use of mono- and combination therapy. The article ...

In the randomised Carotid Revascularization Endarterectomy versus Stenting Trial (CREST), the primary endpoint did not differ between carotid artery stenting and carotid endarterectomy in patients with symptomatic and asymptomatic stenosis. A prespecified secondary aim was to examine differences by sex. Patients who were asymptomatic or had had a stroke or ...

This study compared characteristics of Kawasaki disease (KD) in Filipino and non-Filipino children. Filipino KD patients had a higher coronary artery Z-score (P = 0.016) and aneurysm rate (P = 0.021) than KD patients of non-Filipino Asian and non-Asian descent.

PURPOSE: To evaluate CT reconstruction parameters to improve stent lumen visualization in vitro. MATERIAL AND METHODS: 12 latest superficial femoral artery (SFA) stents were placed in a vessel phantom (diameter 4.7mm, intravascular attenuation 250HU, extravascular density 50HU). Stents were imaged with a 128-slice scanner (SOMATOM Definition Flash, Siemens, Germany) with ...

INTRODUCTION: We describe the successful treatment of pulmonary arterial aneurysms in Behçet's syndrome using a tumor necrosis factor (TNF) inhibitor. METHODS: A case is reported of Behçet's syndrome complicated by pulmonary arterial aneurysms that responded to anti-TNF therapy. This is accompanied by a literature review of previously published cases. We ...

: Autologous free flap breast reconstruction using the internal mammary artery is common; however, its use may compromise treatment of occult coronary artery disease. The authors investigated whether internal mammary artery harvest for breast reconstruction is compatible with future use for coronary bypass. : An anatomic analysis of 10 preserved ...

Systemic arterial air embolism is a rarely encountered but much feared complication of percutaneous lung biopsy. We present a comprehensive review of iatrogenic air embolism post-lung biopsy, a complication that is often suboptimally managed. This review was inspired by our own institutional experience and we use this to demonstrate that ...

Standard measurement criteria for vertebral artery origin (VAO) stenosis have not yet been established. We propose such criteria and report on interrater agreement using two measurement methods in a series of patients referred for endovascular therapy. Three experienced angiography raters independently reviewed magnified cerebral angiograms. The formula [1 - (Ds/Dn)] ...

Background: Occupational radiation exposure is a growing problem due to the increasing number and complexity of interventional procedures performed. Radial artery access has reduced the number of complications at the price of longer procedure duration. Radpad® scatter protection is a sterile, disposable bismuth-barium radiation shield drape that should be able ...

Two cases are reported of flap loss following microsurgical perforator flap breast reconstruction in patients diagnosed with a factor V Leiden mutation. Factor V Leiden is the most common inherited cause of hypercoagulability, leading to an increased risk of thrombotic events. The first patient underwent a deep inferior epigastric artery ...

BACKGROUND: Hyperactive thyroid gland in patients that are unable to tolerate or accept standard therapy is a common clinical problem. Aim of the study was to evaluate effectiveness of partial thyroid arterial embolization in patients with hyperthyroidism. MATERIAL/METHODS: From May 2004 to November 2005 partial thyroid gland embolization was performed ...

BACKGROUND:: The Neuroform™ Stent has facilitated the endovascular treatment of wide-necked cerebral aneurysms. It is unknown which factors pose risks of thromboembolic events following stent placement. Objective: This series is the largest single-center study reporting on incidence of and factors influencing thromboembolic complications following Neuroform™ stent placement. METHODS:: 235 patients ...

PURPOSE: To determine the correlation of maximal diameter measurements with volumetric evaluation of size after endovascular aortic repair (EVAR) of abdominal aortic aneurysms (AAA) using computed tomography angiography (CTA) and to survey its applicability for clinical follow-up. MATERIALS AND METHODS: 73 consecutive patients (2 females, 71 males; age 38-84 years; ...

OBJECTIVES: Carotid stenosis accounts for 20% of ischemic strokes and can be managed with pharmacotherapy alone or in conjunction with carotid endarterectomy or stenting. The management of asymptomatic carotid stenosis is controversial amongst physicians. The aim of this study was to explore patient preferences for the potential management options using ...

PURPOSE: In this study we investigate the relationship between (18)F-fluorodeoxyglucose (FDG) metabolism and future aneurysm expansion measured by serial duplex ultrasound. Current screening programmes are increasing the identification of patients with abdominal aortic aneurysm (AAA). The management of these patients remains challenging and methods of risk stratification are sought. METHODS: ...

BACKGROUND: Paraplegia remains a significant complication of thoracoabdominal aortic surgery. The study of this spinal cord ischemia and reperfusion injury (SCIR) has been stifled by the constraints of current models. Large animal models are costly and restricting with regard to mechanisms of both injury and protection. While few studies of ...

BACKGROUND AND IMPORTANCE:: Formation of cerebral de novo aneurysms (CDNA) is rare, and pathogenesis remains obscure. We analyzed factors involved in formation of CDNA and suggest guidelines for follow-up of patients. CLINICAL PRESENTATION:: We retrospectively reviewed intracranial aneurysms at our institute and published reports from 1964 to 2008. Eleven patients ...

Introduction: The aim of this study was to compare intra-individual contrast enhancement in multidetector-row computed tomography using the low-osmolar monomeric iopromide 300 and the iso-osmolar dimeric iodixanol 320. Methods: Repeated computed tomography scanning of the chest of five pigs was performed under standardised conditions using iopromide 300 (300 mg I/mL) and iodixanol ...

Abstract Purpose: To evaluate the pulsatility of the iliac arteries and compare their distension at several levels that might influence preoperative stent-graft sizing and the long-term durability of stent-graft sealing and fixation. Methods: Preoperative dynamic computed tomographic angiography (CTA) scans of 30 patients (24 men; median age 75 years, range 60-85) ...

Pulmonary veno-occlusive disease (PVOD) is a rare disorder that can be misdiagnosed as idiopathic pulmonary arterial hypertension (PAH) and accounts for 5-10% of cases initially considered as idiopathic PAH. PVOD and idiopathic PAH share a similar clinical presentation, genetic background and hemodynamic profile. A definite diagnosis of PVOD necessitates a ...

All patients with stable coronary artery disease require medical therapy to prevent disease progression and recurrent cardiovascular events. Three classes of medication are essential to therapy: lipid-lowering, antihypertensive, and antiplatelet agents. Lipid-lowering therapy is necessary to decrease low-density lipoprotein cholesterol to a target level of less than 100 mg per ...

The purpose of this study was to determine, first, the accuracy with which radiologists reading posteroanterior chest radiographs differentiate whether a central venous line is in the superior vena cava or the azygos vein and, second, the circumstances in which radiologists may omit the lateral view to determine the position ...

Iloprost (Ventavis(®), Bayer Schering Pharma, Germany) is a synthetic prostacyclin that is used in its inhalative form for the therapy of pulmonary arterial hypertension. Long-term therapy can increase exercise capacity and quality of life. The use of modern nebulizers especially designed for the administration of iloprost guarantees the pulmonary deposition ...

Background Patients in neurological critical care units often have lengthy stays that require extended vascular access and invasive hemodynamic monitoring. The traditional approach for these patients has relied heavily on central venous and pulmonary artery catheters. The aim of this study was to evaluate peripherally inserted central catheters as an ...

Abstract Background: Previous imaging studies have demonstrated that the beneficial impact of high-dose statins on the progression of coronary atherosclerosis associates with their ability to lower levels of low-density lipoprotein cholesterol (LDL-C) and C-reactive protein (CRP) and to raise high-density lipoprotein cholesterol (HDL-C). The Study of Coronary Atheroma by InTravascular ...

OBJECTIVE: Endovascular aneurysm repair (EVAR) has reduced early adverse outcomes from abdominal aortic aneurysm (AAA) repair. Preferential use of EVAR may have altered the profile of patients who undergo open repair. The validity of scoring systems such as the Glasgow Aneurysm Score (GAS), devised when open surgery was the only ...

Spontaneous sac size regression of a giant abdominal aortic aneurysm (AAA) is a rare event that has not been previously described. We report a case of an 89-year-old woman with a known 9-cm AAA, which was diagnosed in 2003. The patient had refused any kind of treatment at that time. ...

A thorough understanding of the anatomy of the pineal region, particularly venous drainage, is critical for gaining open surgical access to the pineal gland. The adverse sequelae after intraoperative venous occlusion are assumed to be catastrophic but have been scarcely reported. We report a case of pineocytoma in which the ...

Radial artery occlusion (RAO) can result from transradial catheterization. We compared the incidence of RAO with 2 heparin dosage regimens after transradial coronary angiography, and we evaluated the efficacy and safety of transient homolateral ulnar artery compression to achieve acute radial artery recanalization. Patients referred for coronary angiography were randomized ...

INTRODUCTION: Main purpose of our study is to demonstrate the spectral and color Doppler ultrasonography (DUS) findings that would indicate hepatic artery stenosis (HAS) after liver transplantation and to report our single center results. Moreover we want to establish role and limits of the different imaging techniques in detecting HAS, ...

Predisposing risk factors, clinical course, and prognosis of spontaneous coronary artery dissection (SCAD) remain poorly understood. We reviewed medical records and coronary angiograms of patients admitted to our institution with the diagnosis of SCAD from 1999 through 2010. A definite diagnosis of SCAD required the agreement of 2 blinded board-certified ...

Cerebral arteriovenous malformations (AVMs) have been occasionally reported to bleed from their venous side. This may particularly be the case when venous ectasias or aneurysms develop in the setting of steno-occlusive venopathy. Venous side hemorrhage should be suspected when the hematoma is centered on the venous pouch or when a ...

The persistent air leak due to alveolopleural fistula is not an uncommon complication of pneumothorax, particularly secondary ones. Endobronchial valves initially designed for lung volume reduction are the latest tool in the therapeutic armamentarium. We present a patient with chronic obstructive pulmonary disease (COPD) with a persistent air leak in ...

Coronary artery calcium (CAC) is associated with the presence of coronary artery disease (CAD) and cardiovascular risk factors. However, the relation between cardiovascular risk factors and CAD has not yet been fully elucidated in patients with a zero or low coronary artery calcium score (CACS). The purpose of this study ...

Object It is well known that spontaneous intradural vertebral artery dissection (siVAD) is an important cause of nontraumatic subarachnoid hemorrhage (SAH). The factors that influence whether SAH develops, however, remain unclear. The aim of this study was to investigate whether clinical characteristics and imaging findings are different in patients with ...

BACKGROUND: Computed tomographic coronary angiography (CTCA) has gained clinical acceptance for the detection of obstructive coronary artery disease. Although single-center studies have demonstrated excellent accuracy, multicenter studies have yielded variable results. The true diagnostic accuracy of CTCA in the "real world" remains uncertain. We conducted a field evaluation comparing multidetector ...

Despite advances in the treatment of pulmonary arterial hypertension, a truly restorative therapy has not been achieved. Attention has been given to circulating angiogenic cells (CACs, also termed early endothelial progenitor cells) due to their ability to home to sites of vascular injury and regenerate blood vessels. We studied the ...

OBJECTIVE: To compare carotid artery stenting with open carotid surgery for the treatment of symptomatic or asymptomatic carotid artery stenosis in terms of stroke, myocardial infarction, and death at 30 days. DESIGN: A meta-analysis of parallel randomized clinical trials (RCTs) (blind or open) published (full article available) in English. SETTING: ...

Jaw claudication could result from external carotid artery (ECA) occlusive disease. Carotid artery stenting (CAS) has been shown to worsen the disease in the ECA. This could potentially worsen the symptoms in patients with pre-existing jaw claudication undergoing CAS. Meanwhile, ECA endarterectomy is routinely done during internal carotid artery endarterectomy ...

The purpose of this analysis was to characterize the progression of coronary atherosclerosis in patients with concomitant peripheral arterial disease (PAD). Peripheral arterial disease is associated with adverse cardiovascular outcomes. The impact of concomitant PAD on coronary atherosclerosis progression in patients with coronary artery disease has not been well established. ...

Multilayer stents are already being used for the treatment of peripheral aneurysms. In France, they are currently under evaluation in the treatment of thoraco-abdominal aneurysms. We have used multilayer stents to treat aneurysmal evolution of thoraco-abdominal residual type B dissection. Third month computed tomography (CT)-scan showed a false channel no ...

OBJECTIVE: To evaluate the effect of transdermal nitroglycerin on Doppler velocity waveforms of the uterine, umbilical and middle cerebral arteries in patients with severe preeclampsia. METHOD: This was a prospective study of 30 singleton pregnancies with severe preeclampsia and abnormal uterine and umbilical artery Doppler waveforms (gestational age range: 24 ...

INTRODUCTION: To determine the optimal length for initial insertion of central venous catheters (CVCs) and to evaluate whether a recommended depth predicted optimal positioning of CVCs. MATERIALS AND METHODS: All patients who were CVC-cannulated and who underwent chest computed tomography (CT) during a 10-month period were included. We measured the ...

OBJECTIVE: To evaluate the accuracy of dual-energy CT angiography (DE-CTA) maximum intensity projections (MIPs) in symptomatic peripheral arterial occlusive disease (PAOD). METHODS: In 58 patients, DE-CTA of the lower extremities was performed on dual-source CT. In a maximum of 35 arterial segments, severity of the most stenotic lesion was graded ...

Kawasaki disease (KD) is a multisystem vasculitis affecting coronary arteries in children. Patients, refractory to standard treatment with intravenous immunoglobulin and aspirin, show higher rates of coronary artery dilation. Early tumor necrosis factor α receptor antagonism in KD may provide effective adjunctive therapy. The EATAK trial is a multicenter, double-blind, ...

The incidence of chronic stable angina has risen significantly over the past few decades and may affect as many as 15 000-40 000 individuals per million in the US and Europe. Whereas there are fundamental pathophysiologic differences between chronic stable angina and acute coronary syndrome, the importance of optimal medical ...

The majority of coronary angioplasty is done via the femoral artery, with vascular complications being a major adverse event. Bivalirudin has been shown to reduce bleeding complication and improve outcomes. The use of bivalirudin in radial interventions has largely been limited due to the routine use of heparin for the ...