OBJECTIVE: A functionally intact endothelial monolayer is thought to be critical for the adaptive process of vascular remodeling. This study was undertaken to examine the hypothesis that endothelial restoration is a critical determinant of remodeling after balloon angioplasty. METHODS: Rabbits (N=12) were fed a cholesterol-supplemented diet (0.5%) and were subjected ...

Penetrating trauma to the chest leading to coronary artery injury is associated with a high mortality rate, especially in the case of injury to the left anterior descending (LAD) coronary artery. The mortality rate remains high whether they are managed with primary ligation or with coronary artery bypass grafting using ...

Peripheral arterial injuries after blunt trauma commonly follow injuries to adjacent soft tissue, organ, and bone. We present here a case of blunt injury to the lumbar artery and the deep iliac circumflex artery in which there was no adjacent bone fracture, but in which hemorrhagic shock and persistent anemia ...

Blunt vascular trauma is rare as compared with penetrating vascular trauma. The incidence of iliac artery injury has been reported as low as 0.4 per cent of total arterial trauma. Iliac artery injury in blunt trauma is rare because of its anatomic location and protection by the pelvis. This article ...

OBJECTIVE: We evaluated the incidence and organ distribution of arterial extravasation identified using contrast-enhanced helical CT in patients who had sustained abdominal visceral injuries and pelvic fractures after blunt trauma. SUBJECTS AND METHODS: Five hundred sixty-five consecutive patients from four level I trauma centers who had CT scans showing abdominal ...

A sixty year old Yoruba farmer presented at Ela Memorial Medical Centre, Ilorin with recurrent spontaneous bleeding from traumatic left radial artery aneurysm. This was due to a clash between a Fulani Cattle rearer and the Yoruba farmer. This sort of situation is rampant across Nigeria. It has led to ...

We treated a 26-year-old male who sustained a self-inflicted injury to the mediastinum with a crossbow bolt. Injuries involved penetration of the sternum 1 cm below the sternomanubrial joint, right lung, pericardium, ascending aorta, right pulmonary artery, esophagus, and azygos vein. He was treated successfully with cardiopulmonary bypass and hypothermia. ...

Trauma to the subclavian artery and its branches is rare, and usually the result of penetrating injuries. Blunt trauma presents its own peculiar management difficulties, particularly when causing haemorrhage into the thoracic cavity. Cardiothoracic surgeons may be asked to deal with such cases, so an understanding of the anatomy and ...

Vertebral artery injuries are identified more frequently now than in the past for both penetrating and blunt trauma. This is as a result of increased suspicion and awareness, liberal use of color flow Doppler, CT angiography, and traditional four-vessel angiography. The vast majority of patients who are not exsanguinating at ...

PURPOSE: The occurrence of aortic arch branch vessel injury as an isolated occurrence or in association with aortic injury after blunt chest trauma has not been emphasized in the literature. The imaging evaluation is also controversial. METHODS: We reviewed thoracic aortograms of 166 patients examined at our institution from May ...

OBJECTIVE AND IMPORTANCE: Third ventriculostomy for the management of noncommunicating hydrocephalus is a commonly performed procedure with a 5% complication rate. One of the known complications is basilar artery injury. CLINICAL PRESENTATION: We report a case of basilar artery injury, intraventricular hemorrhage, and false aneurysm formation in a 30-month-old boy ...

Mediastinoscopy is a widely used method to achieve pathologic diagnosis of enlarged lymph nodes or undefined mediastinal solid mass. Aortic arch penetration and injury of the supraaortic arteries are rare but very dangerous complications of mediastinoscopy. We describe the hazardous transportation of a 57-year-old woman after mediastinoscopic injury of the ...

The exposure of vascular injuries is contingent on knowledge of anatomy and the limitations and boundaries for proximal and distal control of each artery. In this article, these are conveniently organized into arteries of the neck, of the chest, of the abdomen, and of the extremities. In addition, the interface ...

We determined which angle of flexion best prevents popliteal artery injury during knee surgery. We took MRIs of the knee in the lateral position with the knee in 0 degrees, 45 degrees, 90 degrees, and 120 degrees of flexion in 15 volunteers. The shortest distance between the posterior cortex of ...

BACKGROUND: Recent studies have demonstrated that systemic pharmacological induction of heme oxygenase-1 (HO-1), the inducible isoform of the initial and rate-limiting enzyme for heme catabolism, attenuates neointima formation after experimental vascular injury. We have now investigated the ability of localized adenovirus-mediated HO-1 (Ad-HO-1) gene delivery to modify arterial remodeling after ...

Injuries to the common digital or proper digital arteries during surgery for Dupuytren's contracture are relatively rare but may be underreported. Delay in recognition and inadequate management may result in prolonged ischemia or gangrene and eventually necessitate finger amputation. A patient who sustained inadvertent injury to several digital arteries during ...

Aneurysms of the extracranial arteries are in most cases secondary to atherosclerosis but may also be due to degeneration, congenital abnormalities, trauma or unclear etiology. They present either with bulging in the lateral pharyngeal wall or the neck. Therefore, otolaryngologists are often among the first physicians to see the patient. ...

Classic teaching suggests that blunt thoracic aortic rupture (BTAR) results from high-speed deceleration injury mechanisms. Our recent experience with a patient who sustained fatal aortic rupture resulting from a low-speed crushing injury emphasizes the importance of maintaining a high index of suspicion for BTAR, even in patients with "low-risk" injury ...

Elbow dislocations are most often the result of a hyperextension mechanism with the forearm levered and displaced posterior to the humerus. Recurrent instability and arterial disruption are uncommon sequelae of this injury. Any asymmetry in distal pulses after joint reduction demands a study of arterial anatomy (arteriogram or duplex scan) ...

Background- Vascular smooth muscle cell (VSMC) proliferation is a critical factor in the neointima formation that causes restenosis after coronary angioplasty (PTCA). Desferri-exochelin 772SM (D-EXO), a highly diffusible, lipophilic iron chelator secreted by Mycobacterium tuberculosis, inhibits proliferation of VSMCs in culture. We hypothesized that treatment with D-EXO would inhibit neointima ...

BACKGROUND: Elevated plasma levels of plasminogen activator inhibitor type 1 (PAI-1) are associated with myocardial infarction, atherosclerosis, and restenosis. PAI-1 is increased in atherosclerotic arteries and failed vein grafts. No experimental data, however, support a causal relationship between elevated PAI-1 expression and vascular lesions. Paradoxically, data generated in PAI-1 knockout ...

PURPOSE: Alpha-1-antitrypsin (AAT) is the major circulating elastase inhibitor. Deficiency of elastase inhibition leads to emphysema and vascular abnormalities including accelerated neointima. Because recent evidence suggests that tissue AAT levels determine inhibitory function, the authors hypothesize that local tissue-based expression of AAT limits elastase activity sufficiently to guide arterial response ...

Forty-seven patients with cervical spine trauma were evaluated prospectively with magnetic resonance imaging (MRI) and angiography (MRA) to determine the incidence of vertebral artery injury. Twelve patients (25%) had vertebral artery injuries (one bilateral), and occlusion was identified in nine patients and dissection in four. The vertebral artery injury did ...

Cardiac injury following blunt chest trauma is known to occur, but traumatic rupture of ventricular septum is a rare injury, especially following blunt chest trauma. A case of a 20-year-old male is presented who fell on his back from a 9th-floor window and was resuscitated for 3 hours to no ...

Cerebral injury is a major cause of mortality and morbidity of coronary artery bypass grafting. Stroke occurs in 3% of patients and is largely caused by embolization of atheromatous debris during manipulation of the diseased aorta. Cognitive impairment, which is predominantly caused by microembolization of gaseous and particulate matter, mainly ...

A college football player sustained a contusion to his anterior neck, over the carotid artery. Less than a minute later he fainted, then experienced episodes of postural dizziness with bradycardia and hypotension. He completely recovered within 3 hours from the time of injury. An unusual but possible cause of this ...

OBJECTIVES: The role of P-selectin in the process of restenosis was evaluated using a recombinant immunoglobulin (Ig) chimera form of its ligand, soluble P-selectin glycoprotein ligand-Ig (rPSGL-Ig), as a competitive inhibitor for the natural ligand on leukocytes. BACKGROUND: Inflammation and coagulation activation after vascular injury may be an important factor ...

BACKGROUND: Blunt cerebrovascular injuries (BCVIs), once thought to be rare, have been recognized with increasing frequency in recent years. An incidence of 0.33% for carotid artery injury (CAI) was noted from our institution, with 24% stroke-related mortality. Vertebral artery injury (VAI) has been thought both rare and of questionable significance. ...

Strokes in children related to sports injuries are rare, but pediatric trampoline injuries are dramatically increasing. Minor trauma to the vulnerable extracranial vertebral arteries as they travel superficially through the dorsum of the neck can begin a cascade of events that results in arterial dissection, thrombus formation, and embolization with ...

Traumatic injury to the innominate artery is a rare occurrence. A literature review reveals that penetrating wounds account for the overwhelming majority of these injuries. Fewer than 90 cases of innominate artery injury caused by blunt trauma have been documented. Over the past 12 months the trauma service successfully treated ...

Three ureteral injuries (two proximal, one middle) associated with retroperitoneal repair of aortic abdominal aneurysms are reported. The authors believe these represent traction injuries that are related to the use of stationary retractors and suggest that complete anterior mobilization of the left kidney from its posterior fossa will decrease the ...

Extreme acceleration and deceleration forces as well as axial loading are exerted at the occipito-cervical junction of drivers involved in high-velocity motor vehicle accidents, especially with fastened seatbelts. Injury at this level, usually lethal, can go unrecognized despite modern emergency management of the unconscious patient. A precise neurologic and radiographic ...

Cerebrovascular disruption frequently results from head and neck trauma. Injury to the extra- and intracranial carotid artery is uncommon but is associated with a high rate of death and permanent neurologic deficit. In this article, injuries to the carotid artery are reviewed with emphasis on the mechanisms, clinical manifestations, radiologic ...

BACKGROUND: Therapeutic approaches to reduce the neointimal formation caused by balloon injury have been focused mainly on experimental models of restenosis in the rat carotid artery. However, restenosis in rat carotid artery may not replicate the coronary arterial responses to injury in larger animals and humans. METHODS: In this study, ...

BACKGROUND: Vascular remodeling is a major component of atherosclerotic and restenotic processes. The aim of this study was to evaluate remodeling at two different axial loci in a restenotic (double-injury) coronary artery model in the hypercholesterolemic minipig. METHODS: The cross-sectional area (CSA) of the lumen, artery and neointima following a ...

Traumatic injury of the aorta, inferior vena cava, and iliac vessels due to penetration of the anterior anulus fibrosus and anterior longitudinal ligament is a recognized complication of lumbar disc surgery. The authors report, to the best of their knowledge, the first case of discectomy-related superior rectal artery injury treated ...

The mortality rate from cardiac rupture by blunt chest injury is high. Here, we report a case of 27-year-old male who suffered a right atrial rupture by blunt chest injury and was successfully treated. The hemodynamics were stabilized by pericardiocentesis with a 5F Pigtail catheter for cardiac tamponade and rapid ...

Mediastinal impalement injuries are rare and often fatal. Very few instances of survival after mediastinal impalement have been reported. We present the unusual case of an 18-year-old man who was involved in a motor vehicle crash in which a wooden fencepost intruded through the windshield and impaled him through the ...

Pulmonary injuries resulting from blunt chest trauma remain a common clinical entity for critical care and emergency nurses. In this article, the epidemiology and mechanism of injury most often observed in patients with blunt chest trauma are reviewed. Selected pulmonary injuries are discussed in terms of mechanism of injuries, assessment ...

The purpose of this study was to examine the patterns of injury and the strategies of surgical repair of iatrogenic vascular injuries from a percutaneous vascular suturing device after arterial cannulation. We retrospectively reviewed the clinical experience from an academic vascular surgical practice over a 2-year period. The subjects were ...

The purpose of this study was to evaluate our experience with the diagnosis and management of vascular injuries in a group of high-performance athletes. Between June 1994 and June 2000, we treated 26 patients who sustained vascular complications as a result of athletic competition. Clinical presentation, type of athletic competition, ...

Blunt thoracic trauma resulting in both tricuspid valve rupture and coronary artery injury is uncommon, encompasses a large spectrum of presentations and, therefore, can be difficult to diagnose. This report illustrates the heterogeneous presentation and clinical course of two patients with such a combination of cardiac injuries. The patient with ...

Background. Although arterial injuries occur rarely (1,15%), they often lead to serious consequences (13% limb amputation), and can be the cause of patient deaths (9%).<br /> Material and methods. The research involved 23 cases of traumatic injury to arteries in patients admitten for traumatic surgery to the Emergency Room at ...

Macrophages play a critical role in the development and progression of atherosclerosis. This study was designed to examine the effect of the glucocorticoid, dexamethasone, (Dex), on macrophage accumulation after acute arterial injury. Twenty New Zealand white rabbits were fed a 2% cholesterol, 6% peanut oil, rabbit chow diet for one ...

BACKGROUND AND OBJECTIVE: The atherosclerotic arterial injuries lead to many life threatening vascular incidents. It has been well documented that inflammatory processes play an important role in atherogenesis. Intensive studies are undertaken to find a serum marker of inflammatory reaction correlated with arterial injuries. METHODS: In our study we measured ...

BACKGROUND: Penetrating trauma to the neck traversing zones II and III may cause considerable damage to soft tissues and neurovascular structures. Delayed sequelae of vascular injuries, such as pseudoaneurysm (PA), may present weeks to months after the initial injury. METHODS: We report an unusual case of a traumatic PA of ...

Traumatic vascular lesions can occur after severe or even the most mild of head and cervical trauma. The initial evaluation of the injured patient must be thorough and the clinical suspicion of vascular injury must be highly suspected based on the mechanism of injury. Traumatic vascular injuries can be broadly ...

Based on observations that vascular smooth muscle cells (VSMC) from spontaneously hypertensive rats (SHR) have altered resting potentials as well as abnormal cell proliferation rates, neointima formation after controlled balloon injury was compared in arteries from SHR and Wistar Kyoto rats (WKY). SHR aortic VSMC showed hyperpolarized resting membrane potentials ...

Insulin-like growth factor (IGF)-I stimulates vascular smooth muscle cell (VSMC) migration and proliferation, which are fundamental to neointimal hyperplasia in postangioplasty restenosis. IGF-I action is modulated by several high-affinity IGF binding proteins (IGFBPs). IGFBP-4 is the predominant IGFBP produced by VSMCs and is a potent inhibitor of IGF-I action. However, ...

Vascular restenosis is one of the major concerns for the management of coronary artery disease using therapeutic vascular procedures. Treatments with thrombin-specific inhibitors, hirudin or hirulog-1, reduced ischemic events in coronary artery disease patients. Early started and prolonged infusions of these thrombin inhibitors partially prevented balloon catheter injury induced restenosis ...