ABSTRACT
<p><b>INTRODUCTION</b>Percutaneous endovascular therapy is an accepted and preferred procedure for symptomatic subclavian artery disease. However, the technical feasibility and effectiveness of treating chronic total occlusion of the subclavian artery with this approach is uncertain. We aimed to evaluate the initial and mid-term results of endovascular therapy for patients with symptomatic chronic total occlusion of the left subclavian artery.</p><p><b>METHODS</b>Consecutive patients who underwent balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery between January 2010 and February 2014 were included.</p><p><b>RESULTS</b>Overall, 16 patients (10 male, 6 female; mean age 56 ± 13 years) underwent balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery. 6 (37.5%) had arm claudication, 8 (50.0%) had vertebrobasilar insufficiency and 2 (12.5%) had coronary steal. 18 balloon-expandable stents were implanted in 15 patients. Central luminal passage was not achieved in one patient because of the subintimal position of the guidewire (procedural success rate 93.8%). There were no procedure-related complications. Mean preprocedural and postprocedural systolic blood pressure differences between the upper extremities were 37 ± 13 (range 25-60) mmHg and 11 ± 9 (range 5-38) mmHg, respectively; the improvement was statistically significant. Outpatient follow-up revealed one asymptomatic restenosis at two years. The patency rate at two years was 93.3%.</p><p><b>CONCLUSION</b>Balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery is safe and effective, with good acute success rate and mid-term patency. Prospective randomised studies on larger patient populations would provide more precise results.</p>
ABSTRACT
Objective: The aim of this study was to evaluate the left [LV] and right [RV] ventricular function in euthyroid Hashimoto's thyroiditis [eHT] patients
Subjects and Methods:Forty-five patients diagnosed with eHT and 45 age- and gendermatched control subjects were enrolled in this study. Echocardiographic parameters reflecting RV and LV functions such as chamber dimensions, ejection fraction, fractional shortening, conventional and tissue Doppler-derived early and late filling velocities [E, A, E', A'], isovolumic relaxation [IVRT] and contraction [IVCT] times, ejection time [ET], deceleration time [DT], Tei index, pulmonary acceleration time [PAcT] and tricuspid annular plane systolic excursion [TAPSE] of patients with eHT were compared to those of control subjects using the paired-samples t test or Wilcoxon signedrank test
Results:Regarding the LV function, compared to the controls patients with eHT had a higher LV-Tei index [0.6 +/- 0.2 vs. 0.4 +/- 0.1, p < 0.001], higher DT [p < 0.001] and IVRT [p < 0.001] values, and higher E/E' ratios [p = 0.04]. In contrast, the peak E wave velocity [p = 0.02], E/A ratio [p = 0.01] and ET [p = 0.02] were significantly lower in the eHT group than amongst the controls. The RV, Tei index [0.40 +/- 0.11 vs. 0.28 +/- 0.07, p < 0.001], TAPSE [2.0 +/- 0.3 vs. 2.2 +/- 0.2 mm, p < 0.001], PAcT [124.3 +/- 22.6 vs. 149.4 +/- 18.3 ms, p < 0.001], A' [p = 0.007] and IVCT [p = 0.001] were significantly higher in patients with eHT than the controls. However, the tricuspid E/A ratio [p = 0.01], E' [p = 0.03] and E'/A' ratio [p = 0.001] were significantly lower in the eHT patients than the control group
Conclusions:This study demonstrated that both RV and LV functions were impaired in patients with eHT
ABSTRACT
The incidence of multivessel coronary artery ectasias (CAEs) among patients undergoing coronary artery angiography is very rare. All three coronary vessels can be affected by CAE, but most patients have an isolated arterial ectasia, commonly the right coronary artery. In this report we present two cases with inferior myocardial infarction that was likely caused by thrombotic occlusion of CAEs.