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<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>
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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
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Hydrophilic guide wire-associated renal subcapsular hematoma [RSH] during patent ductus arteriosus [PDA] closure is an extremely rare clinical condition. Herein, we present the case of a 16-year-old adolescent who suffered accidental hydrophilic 0.035-inch guide wire-related RSH during PDA closure. This RSH was diagnosed by computerized tomography and selective renal angiography. It was successfully treated by conservative treatment
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To test the potential role of heart-type fatty acid-binding protein [H-FABP] in detecting increased perioperative cardiac risk in comparison with cardiac troponin I [cTnI] in the early postoperative period. Sixty-seven patients who had clinical risk factors and underwent elective intermediate - or high-risk noncardiac surgery were included in this study. Serum specimens were analyzed for H-FABP and cTnI levels before and at 8 h after surgery. None of the patients had chest pain; 27 had a history of ischemic heart disease, 3 of heart failure, 5 of cerebrovascular diseases, 40 of diabetes and 46 of hypertension. The mean duration of the operations was 2.33 +/- 1.27 h [range 1-6]. In the postoperative period, 27 [40.3%] patients had increased H-FABP levels [>/=7.5 ng/ml]; the median preoperative serum H-FABP level was 0.13 ng/ml [<0.1-5.9] and the median postoperative H-FABP level was 6.86 ng/ml [<0.1-13.7]. Only 1 [1.5%] patient had cTnI >0.1 µg/l during the postoperative period. Correlation analysis revealed that the presence of diabetes was associated with an increased H-FABP level [r = 0.30, p = 0.01]. Of the 27 patients with H-FABP >/=7.5 ng/ml, 21 [87%] had diabetes. There was no significant correlation with other clinical risk factors, type or duration of surgery. The H-FABP levels significantly increased in the postoperative period. Most patients with increased postoperative H-FABP levels were diabetic. High H-FABP levels could alert clinicians to increased perioperative cardiovascular risk and could prevent underdiagnosis, especially in diabetic patients
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Elevated uric acid levels are associated with diastolic dysfunction in chronic heart failure patients. Uric acid is a marker of impaired oxidative metabolism and is correlated with endothelial function. In this study, we investigated whether uric acid levels correlate with the degree of left ventricular diastolic dysfunction [LVDD] in patients with normal ejection fraction. Prospective case-control study Uric acid levels were measured in 201 patients with normal ejection fraction. The study population was divided into two groups as controls and patients with LVVD. Patients with LVDD were divided into two groups according to dysfunction grade. [Normal, n = 64, Grade 1 LVDD, n = 74, Grade 2 LVDD, n = 63]. Interventions: For uric acid analysis, 5 ml of venous-blood was drawn from each patient after at least 8 hours of fasting. Serum uric acid levels were measured and LVDD was assessed by transthoracic echocardiography normal diastolic function group than grade 1 LVDD and grade 2 LVDD groups respectively [4.28 +/- 1.20 mg/dl, 8.17 +/- 2.12 mg/dl, 9.52 +/- 2.30 mg/dl, p < 0.001]. Although Grade 2 LVDD patients had higher uric acid levels, there is no. Our study demonstrated that uric acid dysfunction. Further studies are needed to assess whether inhibition of xanthine oxidase [XO] with allopurinol results in an improvement in diastolic dysfunction