A Comparative Analysis of Open versus Endovascular Techniques for Management of Non-Aortic Cervicothoracic Arterial Injuries

2017 ◽  
Vol 83 (10) ◽  
pp. 1054-1058
Author(s):  
Kelsey Gray ◽  
Brian Beckord ◽  
Ashkan Moazzez ◽  
David Plurad ◽  
Nina Bowens ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Carotid Artery ◽  
Endovascular Repair ◽  
Injury Severity ◽  
Open Group ◽  
Arterial Injuries ◽  
Significant Difference ◽  
Carotid Artery Injuries ◽  
Inpatient Complication ◽  
Open Versus

The objective of this study is to describe the contemporary management of proximal upper extremity and neck arterial injuries by comparing open and endovascular repair at a single institution. This is a retrospective study of 22 patients that sustained subclavian, axillary, and carotid artery injuries from 2011 to 2016 that were managed with open or endovascular repair. There were nine subclavian, eight axillary, and five carotid artery injuries of which 10 (45.5%) underwent endovascular repair and 12 (54.5%) underwent open repair. There was no statistically significant difference between the groups including injury severity score or preoperative hypotension. There were no deaths in the endovascular group, and three (25.0%) deaths in the open group. All patients in the endovascular group were discharged home. In the open group, seven (58.3%) patients had at least one inpatient complication with a mean of 1.1 (standard deviation 1.4) complications per patient. In the endovascular group, there were three (30.0%) patients with inpatient complications and a mean of 0.4 (standard deviation 0.7) complications per patient (P = 0.18). Endovascular management of nonaortic cervicothoracic arterial injuries was successfully performed in hypotensive patients and patients with other life threatening traumatic injuries. Further studies are warranted to look at long-term patency of these repairs and to help develop a protocol to guide decision-making in the management of cervicothoracic injuries.

The Role of CT Angiography in the Diagnosis of Blunt Traumatic Thoracic Aortic Disruption and Unsuspected Carotid Artery Injury

2008 ◽  
Vol 74 (7) ◽  
pp. 580-586
Author(s):  
Walaya C. Methodius-Ngwodo ◽  
Allison B. Burkett ◽  
Paul V. Kochupura ◽  
Eric D. Wellons ◽  
George Fuhrman ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Ct Angiography ◽  
Endovascular Repair ◽  
Innominate Artery ◽  
Artery Dissection ◽  
Carotid Artery Injury ◽  
Artery Injury ◽  
Abdominal Aortic ◽  
Bilateral Carotid ◽  
Carotid Artery Injuries

We have replaced aortography and open thoracic surgery to diagnose and treat blunt traumatic thoracic aortic disruption (TTAD) in favor of CT angiography (CTA) and endovascular repair. The purpose of this study is to review our experience with the management and outcomes of TTAD and associated carotid artery injuries. In January 2003, we initiated a protocol that used CTA to evaluate all patients with suspected TTAD from blunt trauma. When TTAD was diagnosed, patients were managed by endovascular repair using abdominal aortic extension cuffs. Twenty-nine patients with TTAD were managed by endovascular repair. In all patients, abdominal endograft extension cuffs successfully excluded the traumatic disruptions. Six (21%) of these patients had concomitant, unsuspected carotid artery injury diagnosed by CTA. One patient had bilateral carotid artery dissections, sustained irreversible brain injury, and died. Four patients with common carotid dissections were successfully treated by anticoagulation and made uneventful recoveries. One patient with a common carotid–innominate artery dissection and pseudoaneurysm underwent endovascular repair. This study indicates that CTA and endovascular repair provide accurate diagnostic and therapeutic results in the management of blunt TTAD. Furthermore, CTA should include arch and cervical views to detect an unsuspected, concomitant carotid artery injury.

HISTÓRICO DO COMPRIMENTO TOTAL DE TAMBAQUI (Colossoma macropomum, CHARACIFORMES: CHARACIDAE, CUVIER, 1818) DESEMBARCADO NO MERCADO DE TEFÉ, AMAZONAS, BRASIL, COM NOVE RECOMENDAÇÕES PARA O MANEJO PESQUEIRO DA ESPÉCIE

2008 ◽  
Vol 2 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Jorge Iván Sánchez-Botero ◽  
Danielle Sequeira Garcez ◽  
Wesllen Chaves Cortezão
Keyword(s):  
Sustainable Development ◽  
Standard Deviation ◽  
Environmental Protection ◽  
Fisheries Management ◽  
Historical Data ◽  
Colossoma Macropomum ◽  
Pressure Diffusion ◽  
Significant Difference ◽  
Efficient Mechanisms ◽  
Solimões River

This study evaluates the total length of tambaqui (Colossoma macropomum ) captured in the middle Solimões river and traded during seven years (1993, 1997 and 2000 to 2005) in the Tefé market, Amazon, Brazil. The Mamirauá Institute of Sustainable Development obtained measurements of the total lengths from 42207 individuals. The length average was 45.23 ± 6.29 cm (minim um of 13 cm and maximum of 105.5 cm ) and the mode was 45 cm . From the total tambaquis, 92.86% were smaller than 55 cm and 7.14% measured 58.24 ± 5.41 cm on average. Medium and standard deviation of the lengths recorded in all years showed sizes below the established by the environmental federal agency. The Kruskal Wallis test showed that there is no significant difference between the abundances and medium sizes of the captures during all months of the year. The historical data of the tambaqui fisheries for the middle Solimões region indicate that individuals of this species have been constantly captured at sizes below the minim um length of reproduction. Nine recommendations for tambaquis fisheries management in the region related to more efficient mechanisms of inspection, auto-ecology studies of the species, environmental protection, reduction of fishery pressure, diffusion and educational cam paigns that aim to correct exploitation of this resource are presented in this manuscript.

PENGARUH PENDIDIKAN KESEHATAN REPRODUKSI PADA PEER GROUP (TEMAN SEBAYA) TERHADAP PENGETAHUAN DAN PERSEPSI REMAJA TENTANG PENDEWASAAN USIA PERKAWINAN DI SMA NEGERI 1 KECAMATAN NAMORAMBE KAB. DELI SERDANG 2018

2020 ◽  
Vol 1 (2) ◽  
pp. 56-66
Author(s):  
Irma Linda
Keyword(s):  
Standard Deviation ◽  
Health Education ◽  
Reproductive Health ◽  
Peer Group ◽  
Peer Groups ◽  
A Value ◽  
Significant Difference ◽  
Reproductive Health Education ◽  
The Mean ◽  
Adolescent Perceptions

Background: Early marriages are at high risk of marital failure, poor family quality, young pregnancies at risk of maternal death, and the risk of being mentally ill to foster marriage and be responsible parents. Objective: To determine the effect of reproductive health education on peer groups (peers) on the knowledge and perceptions of adolescents about marriage age maturity. Method: This research uses the Quasi experimental method with One group pre and post test design, conducted from May to September 2018. The statistical analysis used in this study is a paired T test with a confidence level of 95% (α = 0, 05). Results: There is an average difference in the mean value of adolescent knowledge between the first and second measurements is 0.50 with a standard deviation of 1.922. The mean difference in mean scores of adolescent perceptions between the first and second measurements was 4.42 with a standard deviation of 9.611. Conclusion: There is a significant difference between adolescent knowledge on the pretest and posttest measurements with a value of P = 0.002, and there is a significant difference between adolescent perceptions on the pretest and posttest measurements with a value of p = 0.001. Increasing the number of facilities and facilities related to reproductive health education by peer groups (peers) in adolescents is carried out on an ongoing basis at school, in collaboration with local health workers as prevention of risky pregnancy.

scholarly journals A Comparative Study of Open Versus Endovascular Repair of Inflammatory Abdominal Aortic Aneurysms

2013 ◽  
Vol 57 (5) ◽  
pp. 40S
Author(s):  
Stavros K. Kakkos ◽  
Konstantinos O. Papazoglou ◽  
Ioannis A. Tsolakis ◽  
George Lampropoulos ◽  
Spyros I. Papadoulas ◽  
...  
Keyword(s):  
Comparative Study ◽  
Endovascular Repair ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Open Versus

scholarly journals Sitagliptin on carotid intima-media thickness in type 2 diabetes and hyperuricemia patients: a subgroup analysis of the PROLOGUE study

2021 ◽  
Vol 12 ◽  
pp. 204062232110269
Author(s):  
Yipin Zhao ◽  
Huawei Wang ◽  
Dazhi Ke ◽  
Wei Deng ◽  
Yingying Ji ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Carotid Artery ◽  
Conventional Therapy ◽  
Therapy Group ◽  
Controlled Trial ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness ◽  
Significant Difference

Background and Aims: Studies have shown that dipeptidyl peptidase-4 (DDP-4) inhibitors have anti-atherosclerotic effects. However, in the PROLOGUE study, sitagliptin failed to slow the progression of carotid intima-media thickness (CIMT) relative to conventional therapy. We conducted a post hoc analysis of the PROLOGUE study and compared the effects of sitagliptin and conventional therapy on changes in CIMT in subgroups with or without hyperuricemia. Methods: The PROLOGUE study was a randomized controlled trial of 442 patients with type 2 diabetes mellitus (T2DM). Patients were randomized to receive sitagliptin added therapy or conventional therapy. Based on the serum uric acid levels of all study populations in the PROLOGUE study, we divided them into hyperuricemia subgroup ( n = 104) and non-hyperuricemia subgroup ( n = 331). The primary outcome was changed in carotid intima-media thickness (CIMT) parameters compared with baseline during the 24 months treatment period. Results: In the hyperuricemia subgroup, compared with the conventional therapy group, the changes in the mean internal carotid artery (ICA)-IMT and max ICA-IMT at 24 months were significantly lower in the sitagliptin group [−0.233 mm, 95% confidence interval (CI) (−0.419 to 0.046), p = 0.015 and −0.325 mm, 95% CI (−0.583 to −0.068), p = 0.014], although there was no significant difference in the common carotid artery CIMT. Conclusion: The results of our analysis indicated that sitagliptin attenuated the progression of CIMT than conventional therapy in T2DM and hyperuricemia patients.

scholarly journals POS0586 RHEUMATOID ARTHRITIS IS AN INFLAMMATORY DISEASE WITH A HIGH CARDIOVASCULAR RISK

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 526.1-526
Author(s):  
L. Nacef ◽  
H. Riahi ◽  
Y. Mabrouk ◽  
H. Ferjani ◽  
K. Maatallah ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Internal Carotid ◽  
Subclinical Atherosclerosis ◽  
External Carotid ◽  
Significant Difference ◽  
The Mean ◽  
The Right

Background:Hypertension, diabetes, and dyslipidemia are traditional risk factors of cardiac events. Carotid ultrasonography is an available way to detect subclinical atherosclerosis.Objectives:This study aimed to compare the intima-media thickness in RA patients based on their personal cardiovascular (CV) history of hypertension (hypertension), diabetes, and dyslipidemia.Methods:The present study is a prospective study conducted on Tunisian RA patients in the rheumatology department of Mohamed Kassab University Hospital (March and December 2020). The characteristics of the patients and those of the disease were collected.The high-resolution B-mode carotid US measured the IMT, according to American Society of Echocardiography guidelines. The carotid bulb below its bifurcation and the internal and external carotid arteries were evaluated bilaterally with grayscale, spectral, and color Doppler ultrasonography using proprietary software for carotid artery measurements. IMT was measured using the two inner layers of the common carotid artery, and an increased IMT was defined as ≥0.9 mm. A Framingham score was calculated to predict the cardiovascular risk at 10-year.Results:Forty-seven patients were collected, 78.7% of whom were women. The mean age was 52.5 ±11.06 [32-76]. The rheumatoid factor (RF) was positive in 57.8% of cases, and anti-citrullinated peptide antibodies (ACPA) were positive in 62.2% of cases. RA was erosive in 81.6% of cases. Hypertension (hypertension) was present in 14.9% of patients, diabetes in 12.8% of patients, and dyslipidemia in 12.8% of patients. Nine patients were active smokers. The mean IMT in the left common carotid (LCC) was 0.069 ±0.015, in the left internal carotid (LIC) was 0.069 ±0.015, in the left external carotid (LEC) was 0.060 ±0.023. The mean IMT was 0.068 ±0.01 in the right common carotid (RCC), 0.062 ±0.02 in the right internal carotid (RIC), and 0.060 ±0.016 in the right external carotid (REC). The IMT was significantly higher in the left common carotid (LCC) in patients with hypertension (p=0.025). There was no significant difference in the other ultrasound sites (LIC, LEC, RCC, RIC, and REC) according to the presence or absence of hypertension. The IMT was also significantly increased in patients with diabetes at LCC (p=0.017) and RIC (p=0.025). There was no significant difference in the IMT at different ultrasound sites between patients with and without dyslipidemia.Conclusion:Hypertension was significantly associated with the increase in IMT at the LCC level in RA patients. Diabetes had an impact on IMT in LCC and RIC. However, dyslipidemia did not affect the IMT at the different ultrasound sites.References:[1]S. Gunter and al. Arterial wave reflection and subclinical atherosclerosis in rheumatoid arthritis. Clinical and Experimental Rheumatology 2018; 36: Clinical E.xperimental.[2]Aslan and al. Assessment of local carotid stiffness in seronegative and seropositive rheumatoid arthritis. SCANDINAVIAN CARDIOVASCULAR JOURNAL, 2017.[3]Martin I. Wah-Suarez and al, Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case-control study. Int J Rheum Dis. 2018;1–7.[4]Gobbic C and al. Marcadores subclínicos de aterosclerosis y factores de riesgo cardiovascular en artritis temprana. Subclinical markers of atherosclerosis and cardiovascular risk factors in early arthritis marcadores subclínicos de aterosclerose e fatores de risco cardiovascular na artrite precoce.Disclosure of Interests:None declared

Staged angioplasty: A sensible approach to prevent hyperperfusion syndrome after carotid artery stenting? A meta-analysis

2021 ◽  
pp. 159101992110183
Author(s):  
Bingyang Zhao ◽  
Xinzhao Jiang ◽  
Pei Wang ◽  
Zhongyu Zhao ◽  
Jing Mang ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Meta Analysis ◽  
Random Effect ◽  
Thromboembolic Events ◽  
Current Recommendation ◽  
Hyperperfusion Syndrome ◽  
Asian Populations ◽  
Significant Difference ◽  
Vessel Dissection

Objective To investigate whether staged angioplasty (SAP) is a safe and effective treatment to prevent hyperperfusion syndrome after carotid artery stenting (CAS). Methods A systematic literature search was performed according to established criteria to identify eligible articles published before October 2020. Pooled dichotomous data were presented as odds ratios (OR) and corresponding 95% confidence intervals (CI) using random-effect models. The efficacy endpoints were hyperperfusion syndrome (HPS), hyperperfusion phenomenon (HPP), and intracerebral hemorrhage (ICH). The safety endpoint was post-procedural thromboembolic events. The feasibility of the procedure was assessed by device-related adverse events (vessel dissection and failed angioplasty) in SAP. Results Ten studies (1030 participants) were eligible. SAP was superior to regular CAS in preventing HPS (OR = 0.35, 95% CI 0.14–0.86, P = 0.02). There was no significant difference in the rate of thromboembolic events between the SAP group and the regular CAS group. The rates of vessel dissection and failed angioplasty with the use of a 3.0-mm-diameter balloon were 5.4% and 0.4%, respectively. Conclusion SAP may reduce the incidence of post-CAS HPS without increasing procedure-related complications. A 3.0-mm-diameter balloon used in SAP may be appropriate for Asian populations. However, the confounded study design and confused definitions of reporting items hinder the current recommendation of SAP in clinical use.

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