ABSTRACT
The case of very late everolimus-eluting stent thrombosis in left arteria descendant (LAD) was presented. Risk factors and possible ways of this complication prevention are discussed.
Subject(s)
Coronary Artery Disease , Coronary Thrombosis , Drug-Eluting Stents , Percutaneous Coronary Intervention , Humans , Prosthesis Design , Treatment OutcomeABSTRACT
AIM: To evaluate the importance of lipoprotein(a) for the evaluation of cardiovascular risk in patient under 40 years of age after acute myocardial infarction or acute cerebral circulation disorder. MATERIALS AND METHODS: We analysed the data from two departments of the Regional Vascular Centre for 2013-2015 including 90 case histories of patients of different age (mean 57.8 ± 3.4 yr) and studied standard risk factors, such as age, sex, smoking habits, dyslipidemia, aggravated heredity, arterial hypertension (AH), obesity. Standard examination of 7 patients under 40 years of age was supplemented by measuring lipoprotein(a) by the immunoturbodimetric method regarding the levels over 0.3 g/l as abnormally elevated. RESULTS: The study group was dominated by young and middle-aged men (85.2 and 84% respectively). The key risk factors were increased LDLP level (88%) and smoking (70%) in patients under the age of 40 and AH in middle-aged men (100%, p < 0.004). Arterial hypertension was also diagnosed in 59% of the younger subjects. Increased LDLP levels most frequently occurred in senior patients (90%). The group of patients under 40 yr included 15% of those having a single risk factor. In this group, 22% of the patients were at high risk calculated prior to the development of vascular events, 58% at moderate and 20% at low risk. 42.8% of the patients had elevated lipoprotein(a) levels. CONCLUSION: Based on the relative risk scoring scale, 22% of the patients under 40 years of age were at risk of myocardial infarction or cerebral circulation disorders prior to the development of vascular events. However, these patients like those of other age groups frequently had traditional risk factors, such as smoking (67.5%), AH and dyslipidemia (66.6% each). Total cholesterol was elevated only in 47.6% of the patients while LDLP and LP(a) in 92 and 42.8% respectively.
Subject(s)
Cerebrovascular Disorders , Lipoprotein(a)/blood , Myocardial Infarction , Smoking/epidemiology , Adult , Age Factors , Cerebrovascular Disorders/diagnosis , Cerebrovascular Disorders/epidemiology , Dyslipidemias/epidemiology , Female , Humans , Hypertension/epidemiology , Male , Middle Aged , Myocardial Infarction/diagnosis , Myocardial Infarction/epidemiology , Obesity/epidemiology , Risk Assessment , Risk Factors , Russia/epidemiologyABSTRACT
To improve surgical outcomes in patients with complicated recurrent, radiation-induced, giant and multiple vesicovaginal fistulas, we have developed a new combined method of fistuloplasty (patent 21350999). The method was used in 12 of 32 operations made in 1997-2007 in the urological clinic of the Kazan Medical University for vesicovaginal fistula in patients aged 19 to 72 years. The technique was applied in women with vesicovaginal fistula located close to the ureteral orifice. Good results of the operation were achieved due to leak-proof sutures, accurate dissection of the bladder from the vagina and intact blood supply of the tissues. Two surgical approaches were used: transvesical and vaginal. Neither complications nor relapses occurred in all 12 patients operated by the proposed technique of combined fistuloplasty which proved to be effective in recurrent, complicated, combined fistulas and is a method of choice in complicated, recurrent, radiation-induced, giant and multiple fistulas.
