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Internal Medicine (Tokyo, Japan) Dec 2019Fibromuscular dysplasia (FMD) and segmental arterial mediolysis (SAM) are noninflammatory, nonatherosclerotic arterial diseases that cause aneurysm, occlusion, and... (Review)
Review
Fibromuscular dysplasia (FMD) and segmental arterial mediolysis (SAM) are noninflammatory, nonatherosclerotic arterial diseases that cause aneurysm, occlusion, and thromboses. These diseases are rarely seen in mesenteric arterial lesions; however, as they can be lethal if appropriate management is not provided, the accumulation of clinical information from cases is essential. We herein report the cases of a 57-year-old man diagnosed with FMD and a 63-year-old man diagnosed with SAM. We conclude that an early diagnosis with imaging modalities and clinical information followed by the appropriate treatment improves the prognosis of these arterial diseases.
Topics: Aneurysm; Arterial Occlusive Diseases; Arteries; Early Diagnosis; Female; Fibromuscular Dysplasia; Humans; Male; Mesentery; Middle Aged; Prognosis; Rare Diseases; Thrombosis
PubMed: 31327836
DOI: 10.2169/internalmedicine.3094-19 -
Journal of Vascular Surgery Apr 2015Acute arterial occlusions occur in high shear rate hemodynamic conditions. Arterial thrombi are platelet-rich when examined histologically compared with red blood cells... (Review)
Review
Acute arterial occlusions occur in high shear rate hemodynamic conditions. Arterial thrombi are platelet-rich when examined histologically compared with red blood cells in venous thrombi. Prior studies of platelet biology were not capable of accounting for the rapid kinetics and bond strengths necessary to produce occlusive thrombus under these conditions where the stasis condition of the Virchow triad is so noticeably absent. Recent experiments elucidate the unique pathway and kinetics of platelet aggregation that produce arterial occlusion. Large thrombi form from local release and conformational changes in von Willebrand factor under very high shear rates. The effect of high shear hemodynamics on thrombus growth has profound implications for the understanding of all acute thrombotic cardiovascular events as well as for vascular reconstructive techniques and vascular device design, testing, and clinical performance.
Topics: Animals; Arterial Occlusive Diseases; Arteries; Biomechanical Phenomena; Blood Coagulation; Blood Flow Velocity; Blood Platelets; Hemodynamics; Humans; Kinetics; Models, Cardiovascular; Platelet Aggregation; Regional Blood Flow; Stress, Mechanical; Thrombosis; Vascular Patency; von Willebrand Factor
PubMed: 25704412
DOI: 10.1016/j.jvs.2014.12.050 -
Platelets Dec 2023Thrombus formation is highly dependent upon the physico-chemical environment in which it is triggered. Our ability to understand how thrombus formation is initiated,... (Review)
Review
Thrombus formation is highly dependent upon the physico-chemical environment in which it is triggered. Our ability to understand how thrombus formation is initiated, regulated, and resolved in the human body is dependent upon our ability to replicate the mechanical and biological properties of the arterial wall. Current thrombosis models principally use reductionist approaches to model the complex biochemical and cellular milieu present in the arterial wall, and so researcher have favored the use of models. The field of vascular tissue engineering has developed a range of techniques for culturing artificial human arteries for use as vascular grafts. These techniques therefore provide a basis for developing more sophisticated 3D replicas of the arterial wall that can be used in thrombosis models. In this review, we consider how tissue engineering approaches can be used to generate 3D models of the arterial wall that improve upon current and approaches. We consider the current benefits and limitations of reported 3D tissue engineered models and consider what additional evidence is required to validate them as alternatives to current models.
Topics: Humans; Arteries; Thrombosis; Tissue Engineering; Blood Vessel Prosthesis
PubMed: 36550074
DOI: 10.1080/09537104.2022.2153823 -
Journal of Thrombosis and Haemostasis :... Jun 2011Indwelling arterial catheters (IACs) are used for monitoring and blood sampling purposes in intensive care units. Very limited information is available on the...
BACKGROUND
Indwelling arterial catheters (IACs) are used for monitoring and blood sampling purposes in intensive care units. Very limited information is available on the incidence and risk factors of IAC-related thrombosis in children.
OBJECTIVE
To investigate the incidence and predictors of IAC-related thrombosis in a tertiary care pediatric hospital.
METHODS
For a period of 12 months, detailed information was prospectively recorded for all consecutive children requiring IACs.
RESULTS
Six hundred and fifteen IACs were placed in a total of 473 children at a median age of 0.56 years for a total of 47440.84 catheter hours. Of the 615 IACs, 418 (68%) were placed in the radial artery, 137 (22%) in the femoral artery, 26 (4%) in the umbilical artery, 11 (2%) in the brachial artery, and 23 (3.7%) in another artery. Thrombosis occurred in 20 cases, reflecting an overall incidence of 3.25%. Eighteen of the 20 IAC-related thrombi were located in the femoral arteries, reflecting a relative incidence of 13% (18/137). Newborn age, lower body weight, low cardiac output and increased hematocrit were significantly related with an increased risk of femoral artery thrombosis. In logistic regression analysis, younger age (P<0.001, odds ratio 6.51) was independently associated with an increased thrombotic risk.
CONCLUSIONS
This study demonstrates that arterial thrombosis occurs with an increased incidence in children requiring IACs in the femoral location. Younger age is independently associated with an increased risk of thrombosis. The radial location is safe, and should be preferred to the femoral location.
Topics: Adolescent; Age Factors; Arteries; Catheters, Indwelling; Child; Child, Preschool; Female; Humans; Incidence; Infant; Male; Prognosis; Prospective Studies; Regression Analysis; Risk Factors; Thrombosis
PubMed: 21449925
DOI: 10.1111/j.1538-7836.2011.04271.x -
Cells Aug 2019Adipose tissue accumulation is an independent and modifiable risk factor for cardiovascular disease (CVD). The recent CVD European Guidelines strongly recommend regular...
Adipose tissue accumulation is an independent and modifiable risk factor for cardiovascular disease (CVD). The recent CVD European Guidelines strongly recommend regular physical exercise (PE) as a management strategy for prevention and treatment of CVD associated with metabolic disorders and obesity. Although mutations as well as common genetic variants, including the Val66Met polymorphism, are associated with increased body weight, eating and neuropsychiatric disorders, and myocardial infarction, the effect of this polymorphism on adipose tissue accumulation and regulation as well as its relation to obesity/thrombosis remains to be elucidated. Here, we showed that white adipose tissue (WAT) of humanized knock-in BDNFVal66Met (BDNF) mice is characterized by an altered morphology and an enhanced inflammatory profile compared to wild-type BDNF. Four weeks of voluntary PE restored the adipocyte size distribution, counteracted the inflammatory profile of adipose tissue, and prevented the prothrombotic phenotype displayed, per se, by BDNF mice. C3H10T1/2 cells treated with the Pro-BDNFMet peptide well recapitulated the gene alterations observed in BDNF WAT mice. In conclusion, these data indicate the strong impact of lifestyle, in particular of the beneficial effect of PE, on the management of arterial thrombosis and inflammation associated with obesity in relation to the specific BDNF Val66Met mutation.
Topics: Adipocytes; Adipose Tissue, White; Animals; Arteries; Brain-Derived Neurotrophic Factor; Cell Line; Gene Knock-In Techniques; Inflammation; Mice; Physical Conditioning, Animal; Polymorphism, Single Nucleotide; Thrombosis
PubMed: 31405230
DOI: 10.3390/cells8080875 -
Transplant International : Official... Sep 2011The only arterial pathway available after liver transplantation is the hepatic artery. Therefore, hepatic artery thrombosis can result in graft loss necessitating...
The only arterial pathway available after liver transplantation is the hepatic artery. Therefore, hepatic artery thrombosis can result in graft loss necessitating re-transplantation. Herein, we present evidence of neovascularization at long-term follow-up in a series of transplant patients with hepatic artery thrombosis. We termed this phenomenon "neovascularized liver". Hepatic artery thrombosis was noted in 30/407 cases (7.37%), and occurred early in 13 patients (43.3%) and late (>30 days) in 17 (56.7%) patients. At the time of this study, 11 (36.7%) patients had a neovascularized liver. Those patients with neovascularized liver and normal liver function were closely followed. Of these patients, 10 (91%) showed evidence of neovascularized liver by imaging, and an echo-Doppler arterial signal was recorded in all patients. The mean interval between the diagnosis of hepatic artery thrombosis and neovascularized liver was 4.1 months (range of 3-5.5 months). Liver histology showed an arterial structure in 4 (36.4%) patients. Four factors were associated with development of neovascularized liver: late hepatic artery thrombosis, early hepatic artery stenosis, site of thrombosis, and Roux-en-Y anastomosis. The overall survival rate at 54 months was 90.9%. In conclusion, a late hepatic artery thrombosis may be quite uneventful and should not automatically lead to re-transplantation.
Topics: Adult; Anastomosis, Surgical; Hepatic Artery; Humans; Liver; Liver Transplantation; Neovascularization, Physiologic; Thrombosis
PubMed: 21740470
DOI: 10.1111/j.1432-2277.2011.01293.x -
British Medical Journal Feb 1980
Topics: Adolescent; Adult; Arteries; Contraceptives, Oral; Female; Humans; Risk; Thrombosis; United Kingdom
PubMed: 7357362
DOI: 10.1136/bmj.280.6210.332-a -
European Journal of Vascular and... Nov 2008To quantify the risk of DVT in arterial surgery, and to assess the need for prophylaxis. (Review)
Review
OBJECTIVE
To quantify the risk of DVT in arterial surgery, and to assess the need for prophylaxis.
METHODS
A search was carried out through Medline, Embase and Cochrane databases to identify published studies on DVT in arterial surgery. To quantify the risk of DVT both randomised and prospective non-randomised studies were included for analysis. However, to assess the need for prophylaxis only randomised controlled trials were considered.
RESULTS
Twenty three prospective studies that evaluated DVT in arterial surgery were identified. Ten reported data about DVT in aortic surgery, seven studies evaluated DVT in general vascular surgery, three studied DVT in infra-inguinal vascular surgery and three studied DVT incidence in patients after limb amputations.
CONCLUSION
There is a wide variation in the reported incidence of DVT in arterial surgery (2%-24%). This is mostly due to the diversity of screening methods used and the inclusion or exclusion of below knee DVT. There is insufficient evidence to make a valid conclusion regarding the routine use of anticoagulants prophylaxis in arterial surgery. However, until such evidence becomes available, DVT prophylaxis in patients undergoing arterial surgery will continue to be guided by evidence gained from studies of general surgical patients.
Topics: Amputation, Surgical; Anticoagulants; Aorta; Arteries; Drug Administration Schedule; Evidence-Based Medicine; Hemorrhage; Humans; Pulmonary Embolism; Risk Assessment; Vascular Surgical Procedures; Venous Thrombosis
PubMed: 18774312
DOI: 10.1016/j.ejvs.2008.07.007 -
Respiratory Care Feb 2019Pediatric ARDS continues to be a management challenge in the ICU with prolonged hospitalizations and high mortality. Thromboembolic pulmonary embolism and in situ... (Review)
Review
Pediatric ARDS continues to be a management challenge in the ICU with prolonged hospitalizations and high mortality. Thromboembolic pulmonary embolism and in situ pulmonary artery thrombosis might represent underappreciated thrombotic processes for a subset of these patients. Although well described in the adult literature, descriptions of pulmonary thromboses with pediatric ARDS are limited to case reports. However, many risk factors for pulmonary thromboses are present in children with ARDS (eg, coagulopathy, endothelial injury, central venous catheters, concomitant inflammatory diseases), suggesting a much higher incidence is plausible. Based on an interpretation of animal, pediatric, and adult data, we propose a diagnostic algorithm to facilitate a timely and accurate diagnosis. Observing an alveolar dead space fraction ≥ 0.25, or either a 50% increase in physiologic dead space/tidal volume or a central venous saturation ≤ 60% over 24 h, triggers the algorithm. Together with targeted heparin treatment and right ventricular afterload reduction, clinical outcomes might improve if this particular patient subgroup can be identified early. While anticoagulation is recommended in adults with confirmed pulmonary embolism and low early mortality risk, data for children are limited.
Topics: Adult; Algorithms; Animals; Blood Gas Analysis; Child; Female; Humans; Male; Pulmonary Artery; Pulmonary Embolism; Respiratory Dead Space; Respiratory Distress Syndrome, Newborn; Risk Assessment; Risk Factors; Thrombosis; Tidal Volume
PubMed: 30584066
DOI: 10.4187/respcare.06106 -
Journal of Vascular Surgery Jun 2018Increasing data supports the role of bacterial inflammation in adverse events of cardiovascular and cerebrovascular diseases. In our previous research, DNA of bacterial...
OBJECTIVE
Increasing data supports the role of bacterial inflammation in adverse events of cardiovascular and cerebrovascular diseases. In our previous research, DNA of bacterial species found in coronary artery thrombus aspirates and ruptured cerebral aneurysms were mostly of endodontic and periodontal origin, where Streptococcus mitis group DNA was the most common. We hypothesized that the genomes of S mitis group could be identified in thrombus aspirates of patients with lower limb arterial and deep venous thrombosis.
METHODS
Thrombus aspirates and control blood samples taken from 42 patients with acute or acute-on-chronic lower limb ischemia (Rutherford I-IIb) owing to arterial or graft thrombosis (n = 31) or lower limb deep venous thrombosis (n = 11) were examined using a quantitative real-time polymerase chain reaction to detect all possible bacterial DNA and DNA of S mitis group in particular. The samples were considered positive, if the amount of bacterial DNA in the thrombus aspirates was 2-fold or greater in comparison with control blood samples.
RESULTS
In the positive samples the mean difference for the total bacterial DNA was 12.1-fold (median, 7.1), whereas the differences for S mitis group DNA were a mean of 29.1 and a median of 5.2-fold. Of the arterial thrombus aspirates, 57.9% were positive for bacterial DNA, whereas bacterial genomes were found in 75% of bypass graft thrombosis with 77.8% of the prosthetic grafts being positive. Of the deep vein thrombus aspirates, 45.5% contained bacterial genomes. Most (80%) of bacterial DNA-positive cases contained DNA from the S mitis group. Previous arterial interventions were significantly associated with the occurrence of S mitis group DNA (P = .049, Fisher's exact test).
CONCLUSIONS
This is the first study to report the presence of bacterial DNA, predominantly of S mitis group origin, in the thrombus aspirates of surgical patients with lower limb arterial and deep venous thrombosis, suggesting their possible role in the pathogenesis of thrombotic events. Additional studies will, however, be needed to reach a final conclusion.
Topics: Adult; Aged; Aged, 80 and over; Arteries; DNA, Bacterial; Female; Humans; Lower Extremity; Male; Middle Aged; Prospective Studies; Real-Time Polymerase Chain Reaction; Streptococcal Infections; Streptococcus mitis; Thrombosis; Veins
PubMed: 28847664
DOI: 10.1016/j.jvs.2017.05.090