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EuroIntervention : Journal of EuroPCR... Nov 2015
Topics: Arterial Occlusive Diseases; Humans; Radial Artery
PubMed: 26603983
DOI: 10.4244/EIJV11I7A148 -
European Journal of Vascular and... Aug 1998Differentiating total occlusion from tight stenosis of the internal carotid artery is crucial with regard to treatment and prognosis. At our institution, the diagnosis...
OBJECTIVES
Differentiating total occlusion from tight stenosis of the internal carotid artery is crucial with regard to treatment and prognosis. At our institution, the diagnosis of carotid stenosis is based on duplex scanning. In cases of occlusion, duplex is not reliable, and angiography is performed, thereby increasing morbidity. We tried to determine whether a combination of duplex scanning and CT angiography (CTA) can replace angiography in the diagnosis of carotid occlusion.
DESIGN
Prospective study.
MATERIALS AND METHODS
From 1995 to 1997, 148 patients were diagnosed as having carotid occlusion by duplex scanning. CTA was performed on all patients. Forty-four patients underwent angiography and 10 patients were surgically explored. Both procedures were considered "gold standard" for the diagnosis of occlusion.
RESULTS
Arteries found to be occluded by both CTA and duplex scan were confirmed as occluded by angiography or operation in 95% of the cases (42/44). Arteries found to be occluded by duplex but patent by CTA were confirmed as patent in 100% of cases (10/10). CTA has a significantly higher positive predicting value for diagnosing occlusion than duplex scan (95% vs. 77%, p value < 0.01).
CONCLUSIONS
Combination of duplex scanning and CTA is safe and accurate in the diagnosis of carotid occlusion and can replace angiography in most cases, thereby reducing morbidity.
Topics: Adult; Aged; Aged, 80 and over; Arterial Occlusive Diseases; Carotid Artery, Internal; Carotid Stenosis; Female; Humans; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Tomography, X-Ray Computed; Ultrasonography, Doppler, Duplex
PubMed: 9728432
DOI: 10.1016/s1078-5884(98)80154-8 -
The American Journal of Case Reports Jan 2018BACKGROUND Popliteal artery entrapment syndrome (PAES) results from an anomalous relationship between the popliteal artery and the myofascial structures of the popliteal... (Review)
Review
BACKGROUND Popliteal artery entrapment syndrome (PAES) results from an anomalous relationship between the popliteal artery and the myofascial structures of the popliteal fossa. The most common presenting symptoms include intermittent pain in the feet and calves on exercise, resulting in lameness. PAES can lead to popliteal artery thrombosis, stenosis, distal arterial thromboembolism, or arterial aneurysm. The treatment of PAES includes surgical exploration with fasciotomy, myotomy, or sectioning of fibrous band formation, to release the popliteal artery. However, in cases with thrombotic occlusion, thromboendarterectomy with venous patch arterioplasty, or venous graft arterial bypass surgery may be required. This report describes the presentation and surgical management of a case of PAES presenting with limb pain and includes a review of the literature on this condition. CASE REPORT A previously healthy 47-year-old woman presented with a 20-day history of sudden pain in the left lower limb, associated with pallor and a loss of arterial pulses below the knee. Angiography of the affected limb showed occlusion of the left supragenicular popliteal artery, with arterial occlusion, suggestive of arterial thrombus. Imaging of the right popliteal artery, which was not occluded, showed that it was medially deviated. An ipsilateral saphenous vein graft was used to bypass the left supragenicular popliteal artery to the infragenicular popliteal artery, resulting in resolution of the patient's symptoms. CONCLUSIONS PAES is rare and can be under-diagnosed, possibly due to lack of knowledge of this condition. However, if the diagnosis is made early, the prognosis is usually favorable, following appropriate surgical treatment.
Topics: Angiography; Arterial Occlusive Diseases; Female; Humans; Middle Aged; Popliteal Artery; Saphenous Vein; Syndrome; Thrombosis; Treatment Outcome; Vascular Patency
PubMed: 29311538
DOI: 10.12659/ajcr.905170 -
Medicine Mar 2022Limb-shaking syndrome is a special manifestation of transient ischemic attack, resulting from internal carotid artery (ICA) occlusion. Extra-articular manifestations of... (Review)
Review
RATIONALE
Limb-shaking syndrome is a special manifestation of transient ischemic attack, resulting from internal carotid artery (ICA) occlusion. Extra-articular manifestations of rheumatoid arthritis (RA) are likely to occur in patients with severe or active RA. RA may accelerate atherosclerotic processes through inflammation. Here, we present a case of ICA occlusion related to poorly controlled RA that presented with continuous hand shaking.
PATIENT CONCERNS
A 73-year-old man with a history of poorly controlled RA developed total occlusion of the right ICA in recent 4 months. He presented with 2 days of continuous and rhythmic left-hand shaking before admission.
DIAGNOSIS
The patient was suspected to have transient ischemic attack resulting from ICA occlusion.
INTERVENTIONS
Antiplatelets and antiepileptic drugs were used for continuous nonepileptic focal myoclonus. A disease-modifying antirheumatic drug-based regimen for RA was developed to prevent further atherosclerosis.
OUTCOMES
Following the initial intervention, continuous hand shaking subsided on hospital day 7. Prednisolone was titrated as an active RA control. At the 6-month follow-up visit, neither painful wrist swelling nor recurrent shaking of the hand was noted.
LESSONS
Continuous hand shaking (nonepileptic focal myoclonus) can be the initial presentation of ICA occlusion in patients with poorly controlled RA. Every patient with RA should be treated aggressively with anti-rheumatic agents since RA is an independent risk factor for stroke. Additionally, every patient with RA should be surveyed for ICA stenosis, especially in those with poor control.
Topics: Aged; Arterial Occlusive Diseases; Arthritis, Rheumatoid; Carotid Artery Diseases; Carotid Artery, Internal; Humans; Ischemic Attack, Transient; Male; Myoclonus; Tremor; Ultrasonography
PubMed: 35244076
DOI: 10.1097/MD.0000000000029001 -
Biochemical and Biophysical Research... Apr 2017Although chronic kidney disease (CKD) is strongly associated with onsets of cardiovascular disease (CVD), the pathogenic mechanism between these diseases has not been...
Although chronic kidney disease (CKD) is strongly associated with onsets of cardiovascular disease (CVD), the pathogenic mechanism between these diseases has not been fully understood. To develop and validate new therapeutic strategies for this complication, appropriate experimental models that reflect the complexity of the underlying pathophysiology are needed. The Osborne-Mendel (OM) rat was identified as an atherosclerosis-prone and a premature-death rat strain among 16 inbred rat strains when fed high-cholesterol containing diet. When fed high-cholesterol diet, OM rats showed simultaneous occurrence of aortic aneurysm, aortic dissection, peripheral artery occlusion, and left atrial thrombosis. OM rats had significantly lower max dP/dt and higher min dP/dt than F344 rats did, indicating impaired left ventricle contractility and relaxation. OM rats developed renal dysfunction, showing increased urinary albumin excretion. OM rats also showed mild hypertension, decreased endothelial function, and enhanced coagulation and platelet aggregation, compared with F344 rats. We now report that OM rat would be a novel spontaneous animal model which simultaneously demonstrates cardiac and renal dysfunction, and CVD events. This model could be a useful model for the pre-clinical testing of pharmacological therapies and could provide new insight into potential targets and pathways for the treatment of CKD and CVD.
Topics: Animals; Aortic Aneurysm; Arterial Occlusive Diseases; Blood Pressure; Cholesterol, Dietary; Diet, High-Fat; Disease Models, Animal; Heart Atria; Heart Diseases; Heart Rate; Humans; Kidney Diseases; Male; Peripheral Arterial Disease; Rats, Inbred F344; Rats, Inbred Strains; Species Specificity; Survival Analysis; Thrombosis; Time Factors
PubMed: 28088517
DOI: 10.1016/j.bbrc.2017.01.049 -
JACC. Cardiovascular Interventions May 2021
Topics: Arterial Occlusive Diseases; Coronary Angiography; Humans; Radial Artery; Treatment Outcome
PubMed: 34016422
DOI: 10.1016/j.jcin.2021.03.038 -
Journal of Radiology Case Reports Mar 2015Chronic innominate artery occlusion with acute right internal carotid terminus thromboembolism and successful revascularization using simultaneous local...
Chronic innominate artery occlusion with acute right internal carotid terminus thromboembolism and successful revascularization using simultaneous local thromboaspiration and mechanical thrombectomy has not been previously described. A 51-year-old male presented with transient left hemiparesis. A CT angiogram of the head and neck demonstrated chronic occlusion of the right innominate artery with no intracranial thromboembolism. More profound symptoms recurred twelve hours after admission. A diagnostic catheter-based angiogram confirmed occlusion of the innominate artery and identified hyper-acute right carotid terminus thromboembolism. Angioplasty of the innominate artery was followed by simultaneous mechanical and aspiration thrombectomy of the right internal carotid artery terminus. Combination local thromboaspiration and mechanical thrombectomy was shown in this case to be effective in achieving a favorable clinical outcome.
Topics: Angiography; Arterial Occlusive Diseases; Brachiocephalic Trunk; Carotid Artery Thrombosis; Carotid Artery, Internal; Diagnosis, Differential; Humans; Male; Mechanical Thrombolysis; Middle Aged; Paresis; Suction; Tomography, X-Ray Computed
PubMed: 25926931
DOI: 10.3941/jrcr.v9i3.1750 -
BMJ Case Reports Aug 2017We report a case of an 8-year-old girl with posterior fossa abnormalities, haemangioma, arterial lesions, cardiac abnormalities or coarctation of the aorta and eye...
We report a case of an 8-year-old girl with posterior fossa abnormalities, haemangioma, arterial lesions, cardiac abnormalities or coarctation of the aorta and eye abnormalities syndrome with right carotid aplasia and complete basilar occlusion. The patient initially presented at 2.5 weeks of age with a growing right facial haemangioma involving segments 1, 3 and 4. Initial MRI at 2.5 weeks of age revealed an extraconal right orbital haemangioma without posterior fossa abnormalities and MR angiography (MRA) 3 weeks later showed right internal carotid aplasia. A follow-up MRA and cerebral angiography at 8 years of age revealed a complete occlusion of the basilar artery that was not appreciated on previous imaging. Neurological function remains normal, meeting all age-appropriate milestones.
Topics: Abnormalities, Multiple; Aortic Coarctation; Arterial Occlusive Diseases; Basilar Artery; Carotid Artery, Internal; Cerebral Angiography; Child; Diagnosis, Differential; Echocardiography; Eye Abnormalities; Female; Humans; Neurocutaneous Syndromes
PubMed: 28814594
DOI: 10.1136/bcr-2017-221055 -
Journal of Neurology, Neurosurgery, and... Dec 2004In internal carotid artery (ICA) occlusion, increased oxygen extraction fraction (OEF) indicates inadequate collateral blood flow distal to the occlusion, which may be...
BACKGROUND
In internal carotid artery (ICA) occlusion, increased oxygen extraction fraction (OEF) indicates inadequate collateral blood flow distal to the occlusion, which may be caused by poor function of collateral pathways. In ICA occlusion, the circle of Willis may be the major collateral pathway, while the collaterals through the ophthalmic artery and leptomeningeal vessels may be recruited when collateral flow through the circle of Willis is inadequate. Conversely, ischaemic lesions may affect the adequacy of collateral blood flow by reducing the metabolic demand of the brain.
OBJECTIVE
To determine whether the pattern of collateral pathways and the type of infarcts are independent predictors of OEF in ICA occlusion.
METHODS
We studied 42 patients with symptomatic ICA occlusion. The presence of Willisian, ophthalmic, or leptomeningeal collaterals was evaluated by conventional four vessel angiography. The infarcts on magnetic resonance imaging were categorised as territorial, border zone (external or internal), striatocapsular, lacunar, and other white matter infarcts. The value of OEF in the affected hemisphere was measured with positron emission tomography as an index of haemodynamic impairment.
RESULTS
Using multivariate analysis, the presence of any ophthalmic or leptomeningeal collaterals and the absence of striatocapsular infarcts were significant and independent predictors of increased OEF.
CONCLUSIONS
In patients with symptomatic ICA occlusion, the supply of collateral flow, which is affected by the pattern of collateral pathways, and the metabolic demand of the brain, which is affected by the type of infarct, may be important factors determining the severity of haemodynamic impairment.
Topics: Aged; Arterial Occlusive Diseases; Brain; Carotid Artery Diseases; Cerebral Angiography; Cerebral Infarction; Female; Hemodynamics; Humans; Male; Middle Aged; Positron-Emission Tomography; Regional Blood Flow; Severity of Illness Index
PubMed: 15548485
DOI: 10.1136/jnnp.2004.040261 -
The Journal of Invasive Cardiology Dec 2018This study evaluated whether use of different spasmolytic regimens (nitroglycerin or verapamil) administered soon after sheath insertion affects postprocedure radial... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
This study evaluated whether use of different spasmolytic regimens (nitroglycerin or verapamil) administered soon after sheath insertion affects postprocedure radial artery occlusion (RAO) in patients who underwent transradial catheterization.
METHODS AND RESULTS
We performed a post hoc analysis of a randomized trial evaluating the use of 500 μg intra-arterial nitroglycerin just before sheath removal in 1706 patients undergoing transradial catheterization. Patients who received 200 μg or 300 μg nitroglycerin after sheath placement (group A; n = 688) were compared with patients who received 5 mg verapamil after sheath placement (group B; n = 1018). The primary endpoint was RAO diagnosed by Doppler ultrasound examination at 1 calendar day after the procedure. Logistic regression was used to determine predictors of RAO. RAO occurred in 16.0% of group A and 5.4% of group B. After adjustment for potential confounders, neither the use of verapamil nor nitroglycerin was associated with RAO (odds ratio [OR], 1.24; 95% confidence interval [CI], 0.51-3.02; P=.62). Radial artery compression >4 hours was the strongest predictor of RAO (OR, 5.41; 95% CI, 2.31-12.65; P<.001).
CONCLUSIONS
In this study, the use of verapamil or nitroglycerin as a spasmolytic regimen was not associated with RAO. Given the strong association between duration of radial compression and RAO, further studies are needed to determine the interaction between vasodilator agents and compression protocols on RAO.
Topics: Arterial Occlusive Diseases; Cardiac Catheterization; Dose-Response Relationship, Drug; Female; Humans; Incidence; India; Indonesia; Injections, Intra-Arterial; Male; Middle Aged; Nitroglycerin; Radial Artery; Republic of North Macedonia; Ultrasonography, Doppler; Vasodilator Agents; Verapamil
PubMed: 30504515
DOI: No ID Found