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2.
Autops. Case Rep ; 8(1): e2018010, Jan.-Mar. 2018. ilus
Article in English | LILACS | ID: biblio-905431

ABSTRACT

Central nervous system (CNS) ischemic events, besides being a common and devastating disease, are accompanied by severe disability and other morbidities. The cause of such events is not always that simple to diagnose, and among the young, a broad spectrum of possibilities should be considered. We present the case of a young man who presented two episodes of CNS ischemia with a 1 year gap between them, which occurred in the same situation while he was walking and carrying a heavy backpack. The second event first presented as a transient ischemic attack followed by a stroke the day after. The diagnostic work-up showed an indentation of the greater cornu of the hyoid bone over the internal carotid artery, which injured the media and intimal layers. At the arterial injury site, a micro thrombus was found, which explained the source of the embolic event to the CNS. The patient was operated on, and the procedure included the resection of the posterior horn of the hyoid bone, the resection of the injured segment of the internal carotid artery followed by carotid­carotid bypass with the great saphenous vein. The postoperative period and the recovery were uneventful as was the 5-month follow-up. We call attention to this unusual cause of stroke and present other cases reported in the literature.


Subject(s)
Humans , Male , Adult , Brain Ischemia/complications , Carotid Artery Injuries/etiology , Hyoid Bone/blood supply , Stroke/complications , Carotid Artery Injuries/diagnosis , Carotid Artery Thrombosis/etiology , Carotid Artery, Internal , Surgical Procedures, Operative
3.
Journal of Stroke ; : 179-186, 2016.
Article in English | WPRIM | ID: wpr-113530

ABSTRACT

BACKGROUND AND PURPOSE: The outcomes of acute internal carotid artery (ICA) terminus occlusions are poor. We classified ICA terminus occlusions into 2 groups according to the occlusion pattern of the circle of Willis and hypothesized that clinical outcomes would significantly differ between them. METHODS: Consecutive patients with acute ICA terminus occlusions evaluated by baseline computed tomographic angiography were enrolled. We investigated the occlusion patterns in the circle of Willis, retrospectively classified patients into simple ICA terminus occlusion (STO; with good Willisian collaterals from neighboring cerebral circulation) and complex ICA terminus occlusion (CTO; with one or more of A2 anterior cerebral artery, fetal posterior cerebral artery occlusion, or hypoplastic/absent contralateral A1; or with poor collaterals from anterior communicating artery) groups, and compared their baseline characteristics and outcomes. RESULTS: The STO group (n=58) showed smaller infarct volumes at 72 hours than the CTO group (n=34) (median, 81 mL [interquartile range, 38-192] vs. 414 mL [193-540], P<0.001) and more favorable outcomes (3-month modified Rankin Scale 0-3, 44.8% vs. 8.8%, P<0.001; 3-month mortality, 24.1% vs. 67.6%, P<0.001). In multivariable analyses, STO remained an independent predictor for favorable outcomes (odds ratio 6.1, P=0.010). CONCLUSIONS: Favorable outcomes in STO group suggested that the outcomes of acute ICA terminus occlusions depend on Willisian collateral status. Documenting the subtypes on computed tomographic angiography would help predict patient outcome.


Subject(s)
Angiography , Anterior Cerebral Artery , Carotid Artery Thrombosis , Carotid Artery, Internal , Cerebral Infarction , Circle of Willis , Collateral Circulation , Endovascular Procedures , Humans , Mortality , Posterior Cerebral Artery , Retrospective Studies
4.
Rev. cuba. med. mil ; 44(4): 446-451, oct.-dic. 2015.
Article in Spanish | LILACS, CUMED | ID: lil-777062

ABSTRACT

Los traumatismos del sistema arterial carotideo son raros y tienen alta mortalidad. Se presenta un caso de trombosis de la arteria carótida interna derecha por una herida por arma de fuego a nivel del cuello con el objetivo de evidenciar en la práctica médica la utilidad de la ecografía Doppler para el diagnóstico temprano de estas lesiones, a pesar de reportarse en la literatura la angiografía, la resonancia magnética nuclear y la angiorresonancia como estudios de elección. Con este caso se pudo afirmar que la trombosis carotidea traumática tiene una incidencia baja, pero no descartable en los traumas de la región cervical. Por esta causa, son frecuentes las complicaciones neurológicas dadas por la oclusión arterial y la ecografía Doppler resultó muy útil en el diagnóstico temprano del paciente.


Carotid artery system traumas are rare and show high mortality rates. The case of right internal carotid artery thrombosis caused by a gunshot injury in the neck was presented in this report to show evidence of the usefulness of Doppler echography in the medical practice for the early diagnosis of these lesions in spite of the fact that literature highlights angiography, nuclear magnetic resonance and angioresonance as the imaging studies of choice. This case confirmed that carotid thrombosis due to trauma has low incidence but it can not be ignored in the cervical región traumas. For these reasons, the neurological complications stemming from artery occlusion are frequent and Doppler echography turned to be very useful for the early diagnosis of this illness in a patient.


Subject(s)
Humans , Male , Angiography/adverse effects , Magnetic Resonance Spectroscopy/methods , Echocardiography, Doppler/methods , Carotid Artery Thrombosis/diagnosis , Coronary Occlusion/complications
5.
Rev. obstet. ginecol. Venezuela ; 74(1): 10-14, mar. 2014. tab
Article in Spanish | LILACS | ID: lil-740370

ABSTRACT

Objetivo: Evaluar los niveles de anticuerpos anticardiolipina en gestantes portadoras del síndrome antifosfolipídico que fueron tratadas en la consulta de medicina interna durante el período 2001-2012. Métodos: Estudio de campo, descriptivo, longitudinal. La población que se estudió fue de 86 pacientes portadoras del síndrome antifosfolipídico. No se tomó en cuenta el criterio del intervalo de al menos 12 semanas para el diagnóstico definitivo. Resultados: En relación con los niveles de IgM e IgG de anticuerpos anticardiolipinas el promedio más alto (30,98) y (19,62) predominó en el primer trimestre del embarazo. El nivel mayor de IgM que se evidenció fue 198, mientras que el menor fue 0,6 durante toda la gestación. Los anticuerpos IgM en el tercer trimestre disminuyeron en 55,81 % con respecto al primer trimestre. Conclusiones: A pesar de que los niveles de anticuerpos son impredecibles, en las últimas etapas de la gestación los anticuerpos anticardiolipinas IgM disminuyeron con respecto a las primeras etapas.


Objective: Evaluate the levels of anticardiolipin antibodies for pregnant carrying the antiphospholipid syndrome that were treated in internal medicine, period 2001-2012. Methods: A descriptive, longitudinal non-experimental and field study. The population studied was 86 patients carrying the SAF, did not take into account the criteria in the interval of at least 12 weeks for definitive diagnosis. Results: In relation to the levels of IgM and IgG anticardiolipin antibodies the highest average (30.98) and (19.62) prevailed in the first trimester of pregnancy. The higher level of IgM was 198, while the lowest was 0.6 during the entire pregnancy. IgM anticardiolipin antibodies in the third quarter decreased by 55.81 % over the first quarter. Conclusions: Although antibody levels are unpredictable, in the latter stages of gestation IgM anticardiolipin antibodies decreased with respect to the early stages.


Subject(s)
Humans , Female , Pregnancy , Antiphospholipid Syndrome , Pregnancy Complications , Syphilis , Carotid Artery Thrombosis/complications , Immunoglobulin M
6.
Article in English | WPRIM | ID: wpr-343127

ABSTRACT

A kind of thrombus-targeted lipid-coated microbubbles were prepared, and the target property of the microbubbles and the effects of different methods detecting thrombosis in vessels were observed. Phospholipid-coated microbubbles were prepared by membrane-hydration method. Thrombus-targeted lipid-coated fluorocarbon microbubbles were labeled with specific fluorescence and then integrated to the thrombus in vivo and ex vivo through an avidin biotin system. The thrombus was immediately observed for the distribution and property of the thrombus-targeted microbubbles under the optical microscope, fluorescence microscope and transmission electron microscope. The carotid thrombosis models were set up in rabbits, and the effects of different methods detecting thrombosis in vessels were observed. The diameter of the phospholipid-coated microbubbles was 0.8-2.5 μm, and even reached nanoscale in some of them. The zeta electric potential was about -11 mV and the concentration was about 1.08×10(10)/mL. Immunofluorescence of rapid frozen sections in vivo and ex vivo showed that massive targeted lipid-coated microbubbles flocked around fresh blood clots and some aggregated within them under the light and fluorescence microscope. The number of aggregated microbubbles ex vivo was greater than that observed in the experiment in vivo, and the fluorescence observed in the experiment ex vivo was stronger than that in the experiment in vivo. The same imaging was observed under the electron microscope. Models of carotid thrombosis in rabbits were established successfully. Effects of detecting thrombosis by means of thrombosis-targeted microbubble ultrasonoraphy and Sono Vue ultrasonography in vessels were more satisfactory than those by Color Doplor Flow Imaging (CDFI), ordinary microbubbles and Three Dimensions-time of flight MR angiography (3D-TOF-MRA) (P<0.01). Compared to ordinary microbubbles ultrasonography, thrombosis-targeted microbubbles ultrasonography had the advantages whenever in imaging quality or in imaging time. Thrombus-targeted phospholipid-coated microbubbles were prepared successfully by membrane-hydration method. They could aggregate rapidly in fresh blood clots and enter deep into the internal part of the thrombus both in vivo and ex vivo, and had the targeted property of strongly conjugating with the thrombus. Compared to other thrombosis detection methods, ultrasonography with thrombosis-targeted microbubbles has obvious advantages in detecting thrombosis in vessels, mainly in: non-invasiveness, safety, good image quality, accuracy, and longer imaging time.


Subject(s)
Animals , Carotid Artery Thrombosis , Diagnostic Imaging , Contrast Media , Drug Compounding , Methods , Female , Image Enhancement , Methods , Lipids , Male , Microbubbles , Rabbits , Reproducibility of Results , Sensitivity and Specificity , Ultrasonography , Methods
8.
Rev. paul. pediatr ; 30(1): 144-147, 2012. ilus
Article in Portuguese | LILACS | ID: lil-618460

ABSTRACT

Relatar um caso de trombose de artéria carótida interna secundária relacionada a trauma de palato mole em criança. DESCRIÇÃO DO CASO: Criança admitida com quadro de alteração do nível de consciência, sonolência, afasia e hemiplegia direita; tinha antecedente de trauma corto contuso leve em palato mole há oito horas. A investigação tomográfica evidenciou acidente vascular isquêmico secundário à interrupção do fluxo sanguíneo em território de artéria cerebral média esquerda. A arteriografia mostrou oclusão da artéria carótida interna imediatamente distal à sua origem, com aspecto radiológico de "ponta de lápis", obstruindo o fluxo sanguíneo na região. A paciente foi submetida à investigação para doença pró-trombótica e cardíaca, contudo, não foi detectada nenhuma alteração. A administração de enoxaparina em dose terapêutica por três semanas conduziu à melhora clínica progressiva. Após três semanas de seguimento, a paciente não mostrava sequelas motoras. COMENTÁRIOS: As lesões intraorais são frequentes em crianças e a maioria evolui sem complicações. A trombose da artéria carótida interna é uma complicação rara, mas bem documentada destas lesões e decorre da compressão do vaso com trombogênese localizada. A taxa de mortalidade relatada é de 30 por cento e as sequelas ocorrem em 85 por cento dos casos.


To describe a child with internal carotid artery thrombosis secondary to trauma of the soft palate. CASE DESCRIPTION: Child presented with altered level of consciousness, drowsiness, aphasia, right hemiplegia, and a history of trauma, with mild concussion of the soft palate eight hours prior to admission. CT scan showed ischemic stroke secondary to interruption of blood flow in the area of the left middle cerebral artery. Arteriography showed occlusion of the carotid artery just distal to its origin, with radiological appearance of "pencil tip", obstructing blood flow in the region. Patient underwent investigation for pro-thrombotic and heart diseases, which was negative. The child received enoxaparin at therapeutic dose for three weeks, showing progressive clinical improvement. After three weeks, the patient did not show motor problems. COMMENTS: Intraoral lesions are common in children, but most of them evolve without complications. However, the internal carotid artery thrombosis is a rare but well documented complication of these lesions and results from the vessel compression with localized thrombogenesis. The mortality rate is about 30 percent, and sequels are seen in 85 percent of cases.


Subject(s)
Humans , Male , Child, Preschool , Carotid Artery, Internal , Palate, Soft/injuries , Stroke , Carotid Artery Thrombosis/complications
9.
Article in English | WPRIM | ID: wpr-35457

ABSTRACT

BACKGROUND: To compare the predictability of the Framingham Risk Score (FRS), United Kingdom Prospective Diabetes Study (UKPDS) risk engine, and the Systematic Coronary Risk Evaluation (SCORE) for carotid atherosclerosis and peripheral arterial disease in Korean type 2 diabetic patients. METHODS: Among 1,275 registered type 2 diabetes patients in the health center, 621 subjects with type 2 diabetes participated in the study. Well-trained examiners measured the carotid intima-media thickness (IMT), carotid plaque, and ankle brachial index (ABI). The subject's 10-year risk of coronary heart disease was calculated according to the FRS, UKPDS, and SCORE risk scores. These three risk scores were compared to the areas under the curve (AUC). RESULTS: The odds ratios (ORs) of all risk scores increased as the quartiles increased for plaque, IMT, and ABI. For plaque and IMT, the UKPDS risk score provided the highest OR (95% confidence interval) at 3.82 (2.36, 6.17) and at 6.21 (3.37, 11.45). For ABI, the SCORE risk estimation provided the highest OR at 7.41 (3.20, 17.18). However, no significant difference was detected for plaque, IMT, or ABI (P = 0.839, 0.313, and 0.113, respectively) when the AUCs of the three risk scores were compared. When we graphed the Kernel density distribution of these three risk scores, UKPDS had a higher distribution than FRS and SCORE. CONCLUSION: No significant difference was observed when comparing the predictability of the FRS, UKPDS risk engine, and SCORE risk estimation for carotid atherosclerosis and peripheral arterial disease in Korean type 2 diabetic patients.


Subject(s)
Ankle Brachial Index , Area Under Curve , Carotid Artery Diseases , Carotid Artery Thrombosis , Carotid Intima-Media Thickness , Coronary Disease , Diabetes Mellitus, Type 2 , United Kingdom , Humans , Odds Ratio , Peripheral Arterial Disease , Risk Assessment
10.
Article in Chinese | WPRIM | ID: wpr-341623

ABSTRACT

A novel fibrinolytic enzyme subtilisin FS33, which exhibits much higher activity for decomposing fibrin than urokinase, was purified from Douchi, a traditional soybean-fermented food in China. In order to increase bio-utilization and thrombus targetability of subtilisin FS33 labeled by fluorescein isothiocyanate (FITC), the surface modified liposomes encapsulating subtilisin FS33 and FITC with a synthetic peptide Arg-Gly-Asp-Ser (RGDS), being putatively a specific antagonist of fibrinogen receptor on platelet membrane, were prepared and used to evaluate the therapeutic efficacy in a rat model thrombotic carotid artery. The arterial thrombosis was induced by applying two pieces of filter paper (1 x 2 cm) saturated with 10% of ferric chloride (FeCl3). The rats were infused via the jugular vein with either liposomes carrying BSA (control group) or RGDS-liposomes carrying subtilisin FS33 at doses of 2000 and 4000 U/kg. The plasma of the group infused with RGDS-liposomes showed higher antithrombotic and fibrinolytic activity than did the control group within 15-120 min after infusing. The higher the dose was gived, the higher the activity was shown. APTT(activiated partial thromboplastin time), PT (prothrombin time) and TT (thrombin time) were extended remarkably (P < 0.05, P < 0.01), and FDP (fibrinogen degradation products) also increased greatly (P < 0.01), while ELT (euglobulinlysis time) decreased obviously (P < 0.05). FITC content in heart and brain evidently increased (P < 0.05), and results of D-dimer test were all positive. In addition, the venous thrombi in brain and kidney were dissolved totally or partly as observed by patholgical section. All these indicated that subtilisin FS33 enhanced the antithrombotic and fibrinolytic activities in rat, and RGDS-liposomes improved, in a certain degree, the thrombolytic specificity for targeting to thrombus.


Subject(s)
Animals , Carotid Artery Thrombosis , Drug Therapy , Drug Carriers , Drug Delivery Systems , Female , Fibrinolytic Agents , Liposomes , Chemistry , Male , Oligopeptides , Chemistry , Random Allocation , Rats , Rats, Wistar , Subtilisins
11.
Article in English | WPRIM | ID: wpr-308769

ABSTRACT

<p><b>OBJECTIVE</b>To observe the pharmaceutical effect of Chinese drugs for activating blood circulation (Xiongshao Capsule, XSC, ) and for activating blood circulation and detoxification (Xiongshao Capsule and Huanglian Capsule, XSHLC, ) in terms of the indices of thrombosis, inflammatory reaction and tissue damage related factors in experimental carotid artery thrombosis rats.</p><p><b>METHODS</b>Fifty Wistar rats were randomly divided into the sham operation group, the model group, the Simvastatin group (SG), the activating blood circulation (ABC) group, and the activating blood circulation and detoxifying (ABCD) group, with 10 rats in each group. Simvastatin (1.8 mg/kg), XSC (0.135 g/kg) and XSHLC (0.135 g/kg) were administered to Simvastatin, ABC and ABCD group by gastrogavage, and an equal volume of normal saline was given to the sham operation group and the model group. After 2 weeks of successive medication, the rats in the model and all drug therapy groups were made into experimental carotid artery thrombosis model. The serum levels of matrix metalloproteinases (MMP-9), tissue inhibitors to metalloproteinase (TIMP-1), granule membrane protein-140 (GMP-140), tissue-type plasminogen activator (t-PA), high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were detected with enzyme-linked immunoassay 24 h later.</p><p><b>RESULTS</b>Compared with the model group, the levels of serum GMP-140, hs-CRP, IL-6 and MMP-9 were significantly decreased, and the level of t-PA was significantly increased in the ABC and ABCD group ( P<0.05), while the level of serum hs-CRP in ABCD group decreased significantly compared with that in the ABC group (P<0.05).</p><p><b>CONCLUSIONS</b>Chinese drugs both for activating blood circulation and for activating blood circulation and detoxifying have good effects on regulating indices of thrombosis, inflammatory reaction and tissue damage in experimental carotid artery thrombosis rats. The effect of activating blood circulation and detoxifying drugs on regulating the level of serum hs-CRP is superior to that of activating blood circulation drug alone.</p>


Subject(s)
Animals , Biomarkers , Blood , Blood Circulation , C-Reactive Protein , Metabolism , Carotid Artery Thrombosis , Drug Therapy , Pathology , Carotid Artery, Common , Pathology , Drugs, Chinese Herbal , Pharmacology , Therapeutic Uses , Female , Inflammation , Blood , Interleukin-6 , Blood , Male , Matrix Metalloproteinase 9 , Blood , P-Selectin , Blood , Rats , Rats, Wistar , Tissue Inhibitor of Metalloproteinase-1 , Blood , Tissue Plasminogen Activator , Blood
12.
Korean Circulation Journal ; : 288-291, 2010.
Article in English | WPRIM | ID: wpr-221278

ABSTRACT

A 64-year-old man complaining of pulsatile headache was admitted. Imaging studies revealed a near-total occlusion of the right proximal internal carotid artery (ICA) with slow antegrade flow into the distal ICA. Right cerebral flow was supplied by collateral flow through the posterior communicating and ophthalmic arteries. He was successfully treated by carotid artery stenting. No new neurological deficit or transient ischemic attack occurred after treatment.


Subject(s)
Carotid Arteries , Carotid Artery Thrombosis , Carotid Artery, Internal , Headache , Humans , Ischemic Attack, Transient , Middle Aged , Ophthalmic Artery , Stents
13.
Article in English | WPRIM | ID: wpr-721027

ABSTRACT

BACKGROUND: Fucoidan is a highly sulfated glycosaminoglycan, which has a molecular structure similar to that of heparin. The antithrombotic effects of fucoidan in vitro have been widely reported, but its antithrombotic effects in vivo as well as its other biological properties in vitro have not been well investigated. METHODS: This study investigated the effects and mechanism of fucoidan from Fucus vesiculosus on thrombosis both in vitro and in vivo. A ferric chloride-induced mouse carotid artery thrombosis model was used to determine the antithrombotic effects of fucoidan in vivo. Additionally, changes in the levels of proinflammatory cytokines and chemokines were examined in vascular cells treated with fucoidan. RESULTS: In vivo studies employing a ferric chloride-induced mouse carotid artery thrombosis model indicated that fucoidan had a stronger antithrombotic activity than heparin. Further, vascular cells treated with fucoidan demonstrated a decrease in proinflammatory cytokine and chemokine production as well as inhibition of proliferation. CONCLUSION: The major findings of this study showed that fucoidan has a stronger antithrombotic effect than heparin in vivo and that fucoidan has an inhibitory effect on proinflammatory cytokine production and proliferation of vascular cells.


Subject(s)
Animals , Carotid Artery Thrombosis , Chemokines , Cytokines , Fucus , Glycosaminoglycans , Heparin , Mice , Molecular Structure , Polysaccharides , Thrombosis
15.
Arq. neuropsiquiatr ; 67(2a): 278-283, June 2009. ilus, tab
Article in English | LILACS | ID: lil-517042

ABSTRACT

OBJECTIVE: To describe five cases of giant carotid cavernous aneurysms which evolved with spontaneous thrombosis of internal carotid artery (STICA), with emphasis at epidemiology, clinical presentation, natural history, related factors and neurological outcome. METHOD: There were 711 consecutives patients with 802 aneurysms with and without surgical treatment during a period of 19 years. We selected 35 patients with 40 carotid cavernous aneurysms (5 percent) of which 20 (50 percent) were giant aneurysms. Among those cases, 5 patients evolved with STICA (25 percent). Symptoms and findings at presentation were recorded and compared with those at outcome. RESULTS: Clinical presentation was commonly related to atherosclerotic factors such as elevated blood pressure (80 percent), diabetes mellitus (40 percent) and dislipidemy (40 percent). All patients presented with hemicranial headache, ophthalmparesy and retro bulbar pain, and after STICA all presented improvement of symptoms. After STICA, 4 patients had regression of deficit, 2 partial and 2 complete. Four patients had sensorial trigeminal neuropathy in V1 and V2 territories, also showing improvement of symptoms after STICA. CONCLUSION: STICA is a common outcome in giant carotid cavernous aneurysms, and is related with significant improvement of symptoms; however, it may be catastrophic for those patients without efficient collateral circulation.


OBJETIVO: Relatar cinco casos de aneurismas gigantes intracavernosos que evoluíram com trombose espontânea da artéria carótida interna (TEACI), estudando-se: prevalência, apresentação clínica, história natural, fatores associados e prognóstico neurológico. MÉTODO: Análise de 711 pacientes consecutivos com diagnóstico de 802 aneurismas cerebrais submetidos a tratamento clínico ou cirúrgico num período de 19 anos. Foram identificados 40 aneurismas intracavernosos, sendo que 20 desses eram gigantes. Dentre esses, 5 pacientes com aneurismas gigantes intracavernosos que evoluíram com TEACI (25 por cento). Os sintomas e sinais neurológicos da apresentação foram registrados e comparados ao término do acompanhamento. RESULTADOS: Todos pacientes apresentavam cefaléia hemicraniana, apresentavam oftalmoplegia e dor retro-orbitária. Freqüentemente estavam associados a fatores ateroscleróticos como HAS (80 por cento), diabetes melito (40 por cento) e dislipidemia (40 por cento) e após a TEACI evoluíram com melhora desses sintomas. Após a TEACI, 4 pacientes tiveram regressão do déficit, sendo que em 2 a regressão do déficit foi total. Quatro pacientes apresentavam hipostesia no território de V1 e V2. Todos apresentaram melhora desse sintoma. CONCLUSÃO: A TEACI é uma evolução comum em aneurismas intracavernosos gigantes, e está associada à melhora importante dos sintomas. No entanto pode ser catastrófica naqueles pacientes sem circulação colateral eficiente.


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Carotid Artery, Internal , Carotid Artery Diseases/complications , Carotid Artery Thrombosis/etiology , Intracranial Aneurysm/complications , Cerebral Angiography , Carotid Artery Diseases/diagnosis , Carotid Artery Diseases/surgery , Intracranial Aneurysm/diagnosis , Intracranial Aneurysm/surgery , Magnetic Resonance Imaging , Retrospective Studies , Young Adult
16.
Salud(i)ciencia (Impresa) ; 16(5): 543-547, nov. 2008.
Article in Spanish | LILACS | ID: biblio-836576

ABSTRACT

Los aneurismas coronarios son una patología infrecuente, con una incidencia variable según la población estudiada. La causa más frecuente es la aterosclerosis coronaria, por lo que suele asociarse a estenosis en las coronarias. Realizamos una revisión de todos los estudios angiográficos efectuados en los últimos 10 años en nuestro laboratorio, más de 12 000 pacientes. Trece pacientes mostraron dilataciones aneurismáticas en las coronarias sin relación con estenosis adyacentes. El motivo de ingreso fue un síndrome coronario agudo en la mayoría de los casos, lo que pone de manifiesto la elevada morbilidad asociada de esta patología. Tiene una clara relación con el sexo masculino, sin que hayamos podido encontrar una explicación para esta asociación. A pesar de la ausencia de estenosis coronarias asociadas, creemos que la enfermedad aterosclerótica podría ser su causa etiológica. Debido a la ausencia de grandes registros no se conoce la evolución real de los aneurismas coronarios sin estenosis significativas asociadas y de probable etiología aterosclerótica. En función de nuestra experiencia y de la revisión bibliográfica efectuada, el tratamiento farmacológico conservador es una buena opción en la mayor parte de los pacientes, con buen pronóstico en la evolución a mediano y largo plazo.


Subject(s)
Coronary Aneurysm/classification , Coronary Aneurysm/diagnosis , Carotid Artery Diseases , Aneurysm , Angiography , Cardiovascular Diseases , Carotid Artery Thrombosis , Risk
17.
Article in Chinese | WPRIM | ID: wpr-814162

ABSTRACT

OBJECTIVE@#To establish and evaluate a rabbit model of arterial thrombosis by modified thread-drawing.@*METHODS@#Fifty-three rabbits were randomly divided into 6 groups: a normal group, a ligating group,a collagen encapsulated thread-drawing group,a aspirin group,a clopidogrel group, and an aspirin clopidogral group. The endovascular pathological changes in the rabbits were observed, and D-fructose-1,6-diphosphate trisodium salt octahydrate (FDP), D-Dimer and tissue factor (TF) were detected with enzyme linked immunosorbent assay.@*RESULTS@#In the thread-drawing group, thrombus was obvious, and the endovascular elastic membrane was injured seriously compared with the ligating group. After being treated with aspirin and clopidogrel, most arterial thrombus was softened, dissolved and absorbed. Compared with that in the modified thread-drawing group,wet and dry weight of thrombus increased,and the level of D-Dimer, FDP and TF also increased in the modified thread-drawing group (P<0.01). After being treated by aspirin and/or clopidogrel, the wet and dry weight of thrombus and the level of D-Dimer, FDP and TF decreased compared with the control (P<0.01). Aspirin plus clopidogral could obviously reduce the wet and dry weight of thrombus, and reduce the level of D-Dimer and FDP (P<0.01). Aspirin plus clopidogral could obviously inhibit the formation of TF compared with aspirin (P<0.05).@*CONCLUSION@#Arterial thrombosis model by collagen encapsulated thread-drawing which is visible, repeatable and effective is better than thread-drawing. It is suitable for screening anti-thrombosis drugs and evaluating their effect.


Subject(s)
Animals , Carotid Artery Thrombosis , Pathology , Collagen , Disease Models, Animal , Endothelium, Vascular , Pathology , Male , Rabbits , Random Allocation
18.
Neurointervention ; : 83-86, 2008.
Article in Korean | WPRIM | ID: wpr-730158

ABSTRACT

Acute occlusion of the intracranial internal carotid artery (ICA) bifurcation, so-called "carotid T occlusion," extends from distal portion of the internal carotid into the proximal segments of the middle and anterior cerebral arteries. This carotid T occlusion has been associated with low recanalization rates and poor prognosis. An 83-year-old man underwent successful transarterial suction thrombectomy using manual compression of ipsilateral common carotid artery for the treatment of acute carotid T-occlusion. Herein, we report this case and discuss the technical aspect.


Subject(s)
Aged, 80 and over , Anterior Cerebral Artery , Arterial Occlusive Diseases , Carotid Artery Thrombosis , Carotid Artery, Common , Carotid Artery, Internal , Humans , Prognosis , Suction , Thrombectomy
19.
Article in English | WPRIM | ID: wpr-236291

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the effects of propyl gallate (PrG) on the thrombus formation time and the coagulation/fibrinolysis system in an experimental carotid artery thrombosis model in rats.</p><p><b>METHODS</b>Fifty SD rats were randomly divided into 5 groups (10 animals/group): the normal group (normal saline 2 mL/kg), the model group (normal saline, 2 mL/kg), the heparin control group (1,250 IU/kg), the low dose PrG group (30 mg/kg), and the high dose PrG group (60 mg/kg). Thirty minutes after intravenous injection of saline or the corresponding drugs, a carotid artery thrombus was induced by continuous electric stimulation in all rats except for those in the normal group. The duration from the initiation of the electric stimulation to the sudden drop in carotid temperature was recorded as the thrombus formation time. Levels of plasma tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) were determined by ELISA.</p><p><b>RESULTS</b>PrG (30 and 60 mg/kg) can prolong the thrombus formation time, but the effect was obviously weaker than that of heparin (P<0.05, P<0.01). Compared with the model group, PrG (30 and 60 mg/kg) elevated the plasma activity of t-PA (both P<0.05) and showed an increasing tendency in elevating the ratio of t-PA/PAI-1 (P>0.05), while it had no significant effect on the level of PAI-1.</p><p><b>CONCLUSION</b>PrG has a certain antithrombotic effect and can slightly regulate the imbalance of the t-PA /PAI-1 ratio.</p>


Subject(s)
Animals , Blood Coagulation , Carotid Artery Thrombosis , Drug Therapy , Female , Fibrinolysis , Male , Plasminogen Activator Inhibitor 1 , Blood , Propyl Gallate , Pharmacology , Therapeutic Uses , Rats , Rats, Sprague-Dawley , Tissue Plasminogen Activator , Blood
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