BACKGROUND:: Much of the brain is perfused by penetrating arteries that are the "single source" of blood to their surrounding tissues. These tissues should be equally vulnerable to ischemia from embolic occlusion, but there are questions about whether emboli have access to the penetrating arteries serving the deep brain tissues. ...

Pulmonary arterial hypertension (PAH) is a chronic lung disease with poor diagnosis and limited therapeutic options. The currently available therapies are ineffective in improving the quality of life and reducing mortality rates. There exists a clear unmet medical need to treat this disease, which necessitates the discovery of novel therapeutic ...

In patients with chronic kidney disease (CKD), coronary artery calcification occurs at two distinct sites in the vessel wall: the intima and the media. Arterial media calcification (AMC), a nonocclusive condition, affects hemodynamics differently compared to arterial intima calcification (AIC), which occurs in atherosclerotic plaques. Arterial calcification is considered a ...

Obstructed pulmonary venous drainage - either in association with total anomalous pulmonary venous drainage, congenital stenosis, or post-repair stenosis - is associated with poor outcome. Post-repair stenosis typically involves fibrotic scar tissue extending from the site of anastomosis. "Sutureless" repair techniques avoid direct left atrial-pulmonary vein suture lines by instead ...

Rest pain, tissue loss, and gangrene are manifestations of critical limb ischemia caused by peripheral arterial disease and define a patient subgroup at highest risk for major limb amputation. Patients with nonhealing lower extremity wounds should be screened for the risk factors for peripheral arterial disease and offered noninvasive vascular ...

Epithelioid hemangioendothelioma is a rare neoplasm of vascular endothelial origin. It can develop in any tissue, but it occurs primarily in the soft tissue, liver, and rarely in the lung. Pulmonary epithelioid hemangioendothelioma can present in the thorax in various manifestations. In the typical pulmonary forms, epithelioid hemangioendothelioma presents as ...

Transcatheter aortic valve replacement (TAVR) has become an attractive alternative for patients with severe aortic stenosis at high surgical risk. We describe a step-by-step approach to performing TAVR with the SAPIEN XT valve.

A 49-year-old man presented with chest pain and was given a diagnosis of aortic dissection based on computed tomography (CT) findings. Two days later the dissection reached the origin of the celiac artery and there was poor blood flow from the body to the tail of the pancreas and fundus ...

The tentorial branch of the superior cerebellar artery (SCA) is not well known and is underreported in the literature. In the present study, the authors report and describe a dural branch arising from the SCA that was encountered during the surgical treatment of a tentorial dural arteriovenous fistula (DAVF). The ...

We present a case of left breast necrosis following coronary artery bypass grafting which was misdiagnosed as a breast cancer. Breast necrosis after myocardial revascularization is an extremely rare complication of the surgical procedure using the most conventional graft which is the left internal mammary artery. The left internal mammary ...

The indication for carotid endarterectomy (CEA) or carotid artery stenting (CAS) has not been established, although the beneficial effects of these surgical treatments for severe cervical carotid stenosis have been confirmed by clinical trial studies. We report our clinical results of CAS and CEA and suggest an appropriate treatment strategy, ...

Variations of the median nerve and ulnar artery have been well documented in the literature. In the present case, splitting of the median nerve by the ulnar artery is presented. Our literature searches revealed that there was no article, to our knowledge, describing such splitting. We think that this variation ...

Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary hypertension that may develop in patients with connective tissue diseases (CTD). Most cases have been reported in patients with systemic sclerosis, though associations with systemic lupus erythematosis and mixed connective tissue disease have also been described. PVOD is characterised by ...

We describe an infant presenting with contractures of the fingers, a large ventricular septal defect (VSD), and severe pulmonary artery dilatation. He had clinical and echocardiographic features of both neonatal or infantile Marfan syndrome (MFS) and congenital contractural arachnodactyly. After surgical VSD closure, the aortic root developed progressive dilatation while ...

Objectives: The present study was aimed at evaluating telomere length in blood and in different vascular tissues with or without atheroma, in 3 groups of subjects: a group of atherosclerotic subjects who underwent surgery (Atherosclerosis-Surgery), a second group of subjects with asymptomatic atherosclerotic carotid plaques but who did not undergo ...

Human pythiosis is an emerging and life-threatening infectious disease caused by Pythium insidiosum. It occurs primarily in tropical, subtropical and temperate areas of the world, including Thailand. The aim of this report is to present the first pediatric case of typical vascular pythiosis. A 10-year-old boy with underlying β-thalassemia presented ...

Phosphodiesterases (PDEs) modulate the cellular proliferation involved in the pathophysiology of pulmonary hypertension (PH) by hydrolyzing cAMP and cGMP. The present study was designed to determine whether any of the recently identified PDEs (PDE7-PDE11) contribute to progressive pulmonary vascular remodeling in PH. All in vitro experiments were performed with lung ...

The management of incidental unruptured aneurysms remains a matter of controversy; middle-sized or large anterior circulation incidental aneurysms, in young or middle age patients, should be considered for treatment. Surgical clipping is an accepted treatment for middle cerebral artery unruptured aneurysms. Ischemic events can occur even in cases of incidental ...

Primitive trigeminal artery variants (PTAVs) are one of the rare persistent fetal anastomoses between the carotid and vertebrobasilar circulations. They originate from the internal carotid artery and join one of the cerebellar arteries instead of the basilar artery. We present an 82-year-old woman with subarachnoid hemorrhage due to a ruptured ...

During educational dissection of the abdomen in a female Caucasian cadaver, an unusual origin of an accessory right hepatic artery from the left gastric artery was observed. The left gastric artery was the first branch of the celiac trunk, but ended trifurcating into two abnormal large gastric branches and an ...

Background. The thrombosis risk is increased in active ulcerative colitis. The limited number of reported complications have predominantly been cerebrovascular but other vessel territories may also be affected. Patient. During a severe attack of ulcerative colitis a 37-year-old woman suffered occlusion of all left coronary artery branches. Serial angiographies showed ...

We report a case of fusiform type of abdominal aortic aneurysm which was found during the routine dissection of a cadaver, done for teaching the undergraduate medical students. The aneurysm was seen unruptured and positioned below the renal arteries, just above the aortic bifurcation. This study illustrates the microscopic and ...

To identify the relationship between the magnitude of leptomeningeal collaterals (LMC) on digital subtraction angiography (DSA) and regional cerebral blood volume (rCBV)/regional cerebral blood flow (rCBF) mismatch on computed tomography perfusion (CTP) in patients with acute middle cerebral artery (MCA) occlusion. We reviewed the clinical records, and neuroimaging studies in ...

Atherosclerotic aortic arch plaques (AAP) have been linked to an increased risk of thrombo-embolic events as a cause of acute ischemic stroke of undetermined etiology. To find out the presence of atherosclerotic plaques in aortic arch and their potential role as a source of embolism in cerebral infarction of undetermined ...

Cardiovascular disease is one of the leading cause of mortality in the US and especially, coronary artery disease increases with an aging population and increasing obesity. Currently, bypass surgery using autologous vessels, allografts, and synthetic grafts are known as a commonly used for arterial substitutes. However, these grafts have limited ...

A 69-year-old man with chronic thromboembolic pulmonary hypertension (CTEPH) was on amblatory oxygen inhalation therapy (3 L/min) and scheduled for percutaneous transluminal pulmonary angioplasty (PTPA). The patient's New York Heart Association functional status was class III with recent worsening of dyspnea and apparent leg edema. Transthoracic echocardiography revealed right ventricular enlargement ...

A 65-year-old female patient with severe mitral valve stenosis plus coronary artery disease was scheduled for mitral valve replacement and 2-vessel coronary artery bypass graft (CABG) surgeries simultaneously. After a successful procedure, resistance was met on a CVC withdrawal. During postoperative fluoroscopy, fixation of the catheter at the heart was ...

We present a case of a 63-year-old male undergoing attempted basilar artery embolization using a right transradial artery approach in which continuous pulse oximetry of the ipsilateral thumb uncovered unanticipated hand ischemia during the procedure. A preprocedural evaluation using pulse oximetry of the right thumb demonstrated normal waveform and maintenance ...

Embolus occlusion of pulmonary arteries can result in elevated pulmonary blood pressures, often resulting in pulmonary hypertension (PH). Experimental observations have shown that small emboli (diameter <170μm) can have a disproportionate effect on pulmonary vascular resistance (PVR) compared with larger emboli for the same tissue occlusion. We present an anatomically ...

Portal hypertension is caused by both increased portal blood flow due to arterial vasodilation and augmented intrahepatic vascular resistance due to sinusoidal constriction. In this study, we examined the possible involvement of resident macrophages in the tone regulation of splanchnic blood vessels using bile duct ligated (BDL) portal hypertensive rats ...

Atherosclerosis is the main cause of coronary artery aneurysm, however they can be observed in connective tissue diseases such as systemic lupus erythematosus and vasculitis. Kawasaki's disease and polyarteritis nodosa (PAN) are the systemic vasculitis that more often present coronary artery aneurysms. There are descriptions in the literature that small ...

Symptomatic carotid artery plaque ulceration is associated with distinct plaque components such as a large lipid-rich necrotic core (LR-NC) in ischemic stroke patients with a ≥50% carotid stenosis. We evaluated the associations between carotid artery plaque ulceration and plaque characteristics in ischemic stroke patients with ≥50% stenosis, as well as ...

OBJECTIVE: To investigate if pregnancy associated plasma protein-A (PAPP-A) was present in the vulnerable plaque, and if not, to find alternative hypothesis for the release of PAPP-A. DESIGN AND METHODS: Vulnerable plaques and control tissues were examined by immunohistochemistry. Volunteers and patients with non-atherosclerotic disease were examined for release of ...

BACKGROUND: While the prevalence of calcified aortic valve disease continues to rise and no pharmacological treatments exist, little is known regarding the pathogenesis of the disease. Proteoglycans and the glycosaminoglycan hyaluronan are involved in calcification in arteriosclerosis and their characterization in calcified aortic valves may lend insight into the pathogenesis ...

Objective: Currently, percutaneous aortic valve (PAV) replacement devices are being investigated to treat aortic stenosis in patients deemed to be of too high a risk for conventional open-chest surgery. Successful PAV deployment and function are heavily reliant on the tissue-stent interaction. Many PAV feasibility trials have been conducted with porcine ...

Arterial recanalization and subsequent reperfusion have extensively demonstrated their ability to restore the brain function when performed shortly after acute ischemic stroke. However, arterial recanalization does not necessarily lead to brain tissue reperfusion. This review provides an update of current approaches to improve the efficacy profile of brain tissue reperfusion ...

Abstract  Surgery for infective mitral valve endocarditis should include resection/debridement of all infected tissue, but this may leave behind insufficient-autologous mitral valve tissue for an adequate repair. Effective mitral valve repair using only bovine pericardium is feasible even in the presence of extensive endocarditis involving a large part of the ...

BACKGROUND AND PURPOSE: Recent advances in endovascular devices have been aimed at providing high density, mesh-like metallic materials across the aneurysm neck, in place of coil technology. Therefore our aim was to report the in vivo preclinical performance of a self-expanding intrasaccular embolization device. MATERIALS AND METHODS: Elastase-induced aneurysms were ...

Bronchial vascular angiogenesis takes place in a variety of lung inflammatory conditions such as asthma, cystic fibrosis, lung cancer, and chronic pulmonary thromboembolic disease. However, it is unclear whether neovascularization is predominantly appropriate and preserves lung tissue or whether it contributes further to lung pathology through edema formation and inflammation. ...

A 72-year-old woman with no significant medical history presented to the emergency room for severe dyspnoea. The initial clinical diagnosis was acute pulmonary embolism. Heparin infusion was initiated while awaiting a computed tomographic scan but the patient's condition deteriorated dramatically and stat echocardiogram showed tamponade. Post-evacuation echo showed a dilated ...

To investigate the potential role of four and a half Lin-11, Isl-1, and Mec-3 (FHL1) protein in the pathogenesis of thoracic aortic dissection (TAD). The expression levels and localization of FHL1 protein in aortic tissue of TAD were analyzed using Western blot and immunohistochemistry. Furthermore, small interfering ribonucleic acid was ...

Purpose: Intra-venous thrombolysis (IVT) with recombinant tissue plasminogen activator (r-tPA) is the standard treatment of acute ischemic stroke in Taiwan. However, there are many limitations to this treatment, such as the three-hour therapeutic time window and an age limit of 18 to 80 years. Case report: We reported a 15-year-old ...

The past 4 decades have witnessed tremendous strides in the evolution of endovascular technology with increased operator experience, greater availability of more sophisticated and versatile endovascular devices, and advances in imaging modalities. In an attempt to limit the physiologic derangements associated with aortic crossclamping and extensive tissue dissection during traditional ...

Although malformations involving the ventricular outflow tracts are often described as conotruncal malformations, there is no consensus as to the lesions included in, or excluded from, this category, reflecting, in part, the current lack of precise definitions of the embryonic truncus and conus. Analysis of development of the outflow tract ...

We report a case of a patient with an infected abdominal aortic aneurysm due to Staphylococcus versus Brucellar spine infection complicated by aortic aneurysm with chronic contained leak. A 75-year-old patient who had a history of Brucellosis 4 years ago presented one year later with 4.5 cm infra renal abdominal ...

Pancreatic adenocarcinoma remains the fourth leading cause of cancer-related death and is one of the most aggressive human tumors. At present, surgical resection is the only potentially curative treatment. Early neck division is inadequate when invasion of the superior mesenteric artery (SMA) is suspected or in cases of replaced or ...

Ehlers-Danlos syndrome (EDS) type IV is characterized by its clinical manifestations, which are easy bruising, thin skin with visible veins, and rupture of arteries, uterus, or intestines. Arterial complications are the leading cause of death in vascular EDS because they are unpredictable and surgical repair is difficult due to tissue ...

Coronary artery perforation as a result of percutaneous coronary intervention is a rare complication which may result in cardiac tamponade, myocardial infarction and death. Perforation of a saphenous vein graft is unusual and generally requires surgical intervention. We describe a novel percutaneous approach that facilitated the successful management of a ...

A case of cerebral venous thrombosis with intraparenchymal and subarachnoid hemorrhages was initially treated unsuccessfully with mechanical and pharmacologic thrombolysis using intrathrombus tissue plasminogen activator (tPA) and angioplasty, and later successfully treated with an intravascular ultrasound tPA infusion catheter. This new microcatheter allowed direct infusion of tPA while using local ...

Atherosclerosis and its associated complications remain the primary cause of death in humans. Aging is the main contributor to atherosclerosis, compared with any other risk factor, yet the specific manner in which age increases risk (the 'aging-risk' mechanism) remains elusive. A novel concept for atherosclerosis risk implicates a lack of ...