111,997 research outputs found
The role of free iron in cardiovascular diseases - Part I
No full textAn unavoidable consequence of the aerobic
mechanism is the production of super-oxides and peroxides
known as "Reactive Oxygen Species" (ROSs). These
substances can trigger a number of biological reactions
not particularly dangerous at physiological concentration.
However, in presence of iron such reactions greatly enhance
the radicals production and, in particular, determine
the release of strongly reactive and toxic radicals as
the hydroxyl radical (OH.). Many chronic inflammatory
conditions share this underlying disequilibrium of the iron
induced radical-antiradical balance. Aim of the present
review is to enlighten the role of the free or weakly chelated
portion of iron in vascular and cardiac diseases
Open repair with resection and reimplantation for popliteal artery aneurysm
No full textPopliteal artery aneurysms are the most frequent type of peripheral arterial aneurysm and can be repaired by either open or endovascular techniques. An 81-year-old man presented with leg swelling and during duplex ultrasound examination was diagnosed a popliteal aneurysm. The transverse diameter was 3.6 × 4.5cm, length 2.8cm, one run-off vessel patent. The popliteal aneurysm was asymptomatic for clinical signs of limb ischaemia. We opted for an open surgical repair through a posterior approach. During dissection of the popliteal artery above and below the aneurysm, the two non-diseased popliteal extremities appeared to be very close, leading to the decision to perform an end-to-end anastomosis between the two arterial extremities. The patient was discharged after three days with no adverse events. Follow-up consisted of duplex ultrasound examination at one, three and six months, and then annually. At the six-month follow-up there was no restenosis at the anastomosis
Superficial femoral artery catheterisation with two parallel guidewires after femoris profunda artery cannulation in antegrade percutaneous femoral access
No full textNo abstract availabl
Revascularisation through the obturator foramen of lower limbs with a compromised ipsilateral groin due to infection
No full textINTRODUCTION Infra-inguinal vascular reconstruction with active groin infection is a concerning issue. Using resistant grafts to infection is the most adopted approach. However, in absence of these materials in acute situations, the trans-obturator approach allows for limb revascularisation avoiding the infected site. We evaluated the effectiveness of this approach in patients who needed lower limb revascularisation with an ipsilateral groin infection. MATERIALS AND METHODS A retrospective study was conducted over a four-year period. RESULTS Over this period, 13 patients underwent trans-obturator reconstructions (13 external iliac–popliteal above-knee and one aortobipopliteal above-knee bypass). Seven patients had been previously revascularised and were admitted for graft infection (six infra-inguinal bypasses, one axillo-bifemoral bypass). Four presented with acute limb ischaemia, three with groin haematoma and one with a groin abscess. The remaining cases consisted of drug-addicted patients with injury of femoral vessels due to self-injection of drugs. The patients underwent reconstructions with autologous grafts which complicated early with groin haematoma. After transobturator revascularisation, the groin underwent debridement with applying vacuum-assisted wound closure device. CONCLUSION The transobturator approach could be considered as a chance for lower limb revascularisation in case of ipsilateral groin infection. Moreover, avoiding the infected site allowed us to focus separately and safely on the treatment of the inguinal wound
Coil embolization as an alternative endovascular approach for ruptured superficial femoral artery aneurysms
No full textPurpose: True aneurysms of the superficial femoral artery (SFAA) are rare and, the endovascular approach using covered stents has gained more popularity. We report an endovascular alternative using embolization coils for treatment of a ruptured SFAA.
Case description: An 88-old male admitted for a ruptured true SFAA (67×52mm in diameter and 70mm in length) presenting with painful mass pulsating in the proximal third of the left thigh. His surgical history consisted of an infrarenal abdominal aneurysm treated by open surgery and an ipsilateral popliteal aneurysm treated with prosthetic bypass by a medial approach; this was revealed to be occluded at the CT scan evaluation. The patient was asymptomatic for limb ischaemia, therefore we decided to perform embolization of the SFA with coils (MReye®Embolization Coil, Cook Medical, Bloomington,USA). Under local anaesthesia, via a 5-Fr sheath and an antegrade approach, coils were deployed first at the distal neck of the SFAA and then to its proximal neck. On the angiogram, complete aneurysm sac thrombosis with no leaks was achieved. At 6-month follow-up, the SFAA remained occluded, and the patient had not developed any sign of limb ischaemia.
Conclusion: Coil embolization of SFAA in selected cases represents a feasible and safe endovascular alternative
The effectiveness of the prevention measures on stroke incidence in patients with ipsilateral carotid disease
No full textBackground: The aim of this study is to assess the possible causes of cerebral ischemic events for ipsilateral carotid stenosis in the era of the best medical therapy. Methods: This is a retrospective and observational study conducted on patients entered into stroke protocol and subsequently underwent carotid endarterectomy (CEA) for ipsilateral stenosis at the University-Hospital of Ferrara. A 4-year period of time (January 2014 to December 2017) was investigated and demographic data, comorbidities, current medical therapies and instrumental examinations performed prior hospitalization were collected. Results: We identified 78 patients who underwent CEA for symptomatic carotid stenosis. The mean age was 62 (range 52 to 76), 64.1% were male. Among those, 20% presented with acute internal carotid occlusion, 60% had a stenosis >90%, 14% between 70-90%, 6% of 60-69% and 32% had a contralateral stenosis >60%. Moreover, 82.4% of them were not aware of having carotid stenosis since they had never been assessed with duplex ultrasound. Among these patients 49% were not under antiplatelet/anticoagulant medication, 46 patients had systemic hypertension but untreated in 74.5% of them, 31 patients had dyslipidemia without taking statin-therapy in 66.7% of cases, 35 patients had hyperglycemia but untreated in 70% as confirmed measuring glycated hemoglobin and 52.9% were smokers. Among patients who were aware of having hemodynamic carotid stenosis, 33% of them was documented a scarce adherence to the medical therapy and 22% was not set up an adequate one. Conclusions: The non-diagnosed carotid stenosis and insufficient medical treatment due to uninvestigated cardiovascular diseases revealed to be frequent in patients with symptomatic carotid stenosis. This suggests that more should be done to enrich the screening strategies in order to offer better prevention from cardiovascular events
Exercise-based functional recovery from severe upper extremity arterial disease due to bilateral subclavian artery obstruction in a person with giant cell arteritis
No full textWe report the case of a 71-year-old woman diagnosed with giant cell arteritis with bilateral subclavian and axillary obstruction and severe arm claudication that occurred 3 months earlier and was non-regressed after corticosteroids. Before possible revascularization, the patient was initiated to a personalized home-based graded exercise program including walking, hand-bike pedaling, and muscle strength training. During the 9 months of treatment, the patient progressively improved radial pressure values (10 to 85 mmHg), hand temperature values by infrared-thermography (+2.1 °C), arm endurance, and forearm muscle oxygenation by near-infrared spectroscopy. Home-based graded exercise proved to be a noninvasive option for upper limb claudication
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