1/203. Bilateral subclavian steal syndrome through different paths and from different sites--a case report.Cases of cerebro-subclavian steal syndrome have been reported in the medical literature since 1960. This most often occurs on the left side because of the higher rate of involvement of the left subclavian artery in comparison to the other brachiocephalic branches of the aortic arch. With the use of the internal mammory artery as a conduit for coronary artery bypass, in the past three decades increasing numbers of coronary-subclavian steal in addition to the cerebro-subclavian steal have been observed. The authors report a case of bilateral subclavian steal syndrome through both vertebral arteries, the right common carotid artery, and the left internal mammory artery, without significant signs and symptoms of cerebral ischemia or anginal pain.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/203. The use of antioxidants in retarding atherosclerosis: fact or fiction?The proposal that antioxidants may retard the progression of atherosclerosis is not new. Published studies examining the effect of antioxidants on experimental antioxidants extend back to 1940. The results have all been inconsistent. However, the data regarding the beneficial effects of retarding atherosclerotic progression are strong enough to warrant continued research on the lipoprotein oxidation theory or atherosclerosis. However, caution is needed to avoid embracing a concept without proof. It should be noted that the National cholesterol education Program does not recommend the use of antioxidant vitamin supplements to reduce CAD. Atherogenesis is produced by multiple factors. To believe that all such factors are mediated by uncontrolled oxidative events is, to say the least, naive. Finally, should antioxidants prove to be effective in retarding coronary atherosclerosis, their place on the therapeutic ladder of CAD prevention would be low. The overwhelmingly proven evidence favors the following factors that have been proven to lower morbidity and mortality due to atherosclerosis: (a) treatment of hypertension, (b) cessation of tobacco use, (c) treatment of dyslipidemia, (d) achieving a normal weight, (e) regular exercise, (f) treatment of homocystinuria, especially in cases with renal disease, and (g) antioxidants.- - - - - - - - - - ranking = 0.5keywords = coronary (Clic here for more details about this article) |
3/203. Atherosclerotic aneurysms of the superficial femoral artery: report of two ruptured cases and review of the literature.Isolated arteriosclerotic aneurysms of the superficial femoral artery are rare. In citing the literature a total of 30 cases in 28 patients in the last 25 years were found. In addition to the above cases, two aged patients with ruptured aneurysms of the superficial femoral artery are reported; these were managed successfully with partial aneurysmectomy and restoration of the circulation of the extremity with a synthetic graft. The prognosis for this type of aneurysm following surgical therapy is good, despite the advanced age of the patients, and amputation is relatively rare, occurring in only two out of the 30 aneurysms (6.6%) reported. The risk of rupture is 46.6% (14/30) and is greater than that found in peripheral aneurysms. This, in association with the possibility of the creation of thrombosis (5/30; 16.6%) or embolization (1/30; 3.3%), threatens the extremity itself as well as the life of the patient, increasing the risk of complications and even death at a rate of 66.6% (20/30). Timely diagnosis, immediate surgical reconstruction and prompt mobilization, however, can guarantee a good prognosis for these aged patients.- - - - - - - - - - ranking = 0.041369970453647keywords = circulation (Clic here for more details about this article) |
4/203. atherectomy tools for arterial treatment.When considering limb salvage in patients with failed bypass or angioplasty, the threshold for cost effective use of atherectomy devices is important. Rotational ablation, in these cases, has offered a significant contribution to patient care. Decreased hospital stay, morbidity and mortality, plus improved quality of life are all factors in the calculation. Interventional radiologists, vascular surgeons and interventional cardiologists aim to maintain function, not to perfectly restore original anatomy. In this respect, percutaneous rotational ablation has a role as a useful device when indicated. Indications should include consideration of the pattern of disease and underlying pathology as much as the site and selection of the lesion. The Rotablator may be the device of choice in many coronary cases and it is an important device in planning peripheral revascularization procedures. It provides an option for patients and physicians who wish to achieve minimal invasion with the best possible results.- - - - - - - - - - ranking = 0.5keywords = coronary (Clic here for more details about this article) |
5/203. Retrograde embolization during saphenous vein graft angioplasty.angioplasty of degenerated saphenous vein grafts is not infrequently complicated by distal embolization of atheromatous debris. We describe an uncommon case in which balloon angioplasty of an old vein graft to a second diagonal branch of the left anterior descending coronary artery was followed by distal embolization. However, the embolization occurred in a retrograde fashion distal to the anastomotic site, resulting in occlusion of the upstream first diagonal branch. The reasons for its occurrence are discussed, together with suggestions for its recognition.- - - - - - - - - - ranking = 0.5keywords = coronary (Clic here for more details about this article) |
6/203. Mediastinal irradiation: A risk factor for atherosclerosis of the internal thoracic arteries.Previous radiotherapy to the thorax is a risk factor for coronary artery disease. patients with radiation-induced atherosclerosis tend to be young and frequently have lesions involving the coronary ostia and left anterior descending artery. Bypass is often the most suitable method of revascularization, and given the young age of the patient, arterial conduits would be considered superior to vein grafts. However, the internal thoracic arteries can lie within the radiation field and may not be free of atherosclerosis. A 40-year-old man who required coronary artery bypass grafting for multivessel coronary artery disease 11 years following radiotherapy for Hodgkin's lymphoma is reported. Preoperative angiography showed that the right internal thoracic artery had significant atherosclerosis and was unsuitable as a conduit.- - - - - - - - - - ranking = 2keywords = coronary (Clic here for more details about this article) |
7/203. coronary artery bypass grafting in a case with severe aortic atheromatosis associated with abdominal aortic aneurysm.A 69-year-old man with coronary artery disease associated with abdominal aortic aneurysm underwent a one-stage operation utilizing a low-flow cardiopulmonary bypass. Ordinary cardiopulmonary bypass was abandoned as a result of severe atheromatous finding in the entire aorta. However, coronary artery bypass grafting without cardiopulmonary bypass was hazardous as a result of heart enlargement and deteriorating function. Therefore, the abdominal aortic aneurysm was first replaced with a bifurcated graft. coronary artery bypass grafting with two arterial grafts was then performed successfully on the beating heart with the support of a low-flow cardiopulmonary bypass connected to the bifurcated graft.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
8/203. Revascularization of occluded internal carotid arteries by hypertrophied vasa vasorum: report of four cases.OBJECTIVE AND IMPORTANCE: The vasa vasorum are involved in the pathophysiological development of carotid artery atherosclerosis, providing vascular support to the thickened intima and plaque. When advanced atherosclerosis causes carotid artery occlusion, the vasa vasorum may serve as a means of revascularization. CLINICAL PRESENTATION: We studied four patients with internal carotid artery occlusion who exhibited revascularization, distal to the occlusion, by small vascular channels that were inconsistent with recanalization through the thrombus. The channels had an angiographic appearance consistent with their being hypertrophied vasa vasorum. Significant collateral circulation was provided by the revascularization. INTERVENTION: All four patients exhibited adequate collateral circulation and were treated with antiplatelet or anticoagulation medication. CONCLUSION: The vasa vasorum have not been previously reported to contribute to the revascularization of occluded arteries. The four cases presented in this report suggest that the vasa vasorum can be a source of collateral circulation after carotid artery occlusion secondary to atherosclerotic disease.- - - - - - - - - - ranking = 0.12410991136094keywords = circulation (Clic here for more details about this article) |
9/203. Successful Wallstent implantation for extensive iatrogenic renal artery dissection in a patient with fibromuscular dysplasia.PURPOSE: To describe a case of renal artery stenosis with fibromuscular dysplasia (FMD) and extensive iatrogenic dissection treated with Wallstent implantation. methods AND RESULTS: An 83-year-old woman with a history of coronary artery disease and hypertension presented at another facility with exertional angina and poorly controlled hypertension. Renal arteriography uncovered a critical right renal artery stenosis with severe FMD. However, angioplasty resulted in extensive dissection of the renal artery, for which the patient was referred to our institution. The renal artery was recanalized via the left brachial approach with restoration of flow using a Wallstent and a Palmaz stent. The patient's blood pressure was controllable after this procedure, and follow-up duplex imaging with flow velocities at 6 months showed patent right renal artery stents. CONCLUSIONS: Owing to its length and flexibility, the Wallstent endoprosthesis was a useful treatment modality in this case of extensive renal artery dissection.- - - - - - - - - - ranking = 0.5keywords = coronary (Clic here for more details about this article) |
10/203. Severe diffuse atherosclerotic lesions of right gastroepiploic artery graft.The incidence of arteriosclerosis of the right gastroepiploic artery (RGEA) has not been widely known. We experienced one patient in whom the RGEA had severe diffuse atherosclerotic lesions and luminal narrowing, and was therefore determined to be unsuitable as a coronary bypass conduit at operation.- - - - - - - - - - ranking = 0.5keywords = coronary (Clic here for more details about this article) |
| | Next -> |