A Novel Treatment of Very Rare Anomaly; Breast Pseudoaneurysm Developed During Pregnancy.

Pseudoaneurysms (PA) in the arterial supply of the breast are quite rare and mostly iatrogenic secondary to biopsies. Breast PAs after blunt trauma is even rarer. In this paper, a case of breast PAs secondary to blunt trauma and its percutaneous treatment using human thrombin injection and after N-butyl cyanoacrylate is presented.

Aortic knob calcification and cardioankle vascular index in asymptomatic hypertensive patients.

BACKGROUND: Patients with hypertension are predisposed to atherosclerosis of large vessels and are at increased risk of target organ damage and related clinical sequelae. Cardioankle vascular index (CAVI) is a novel parameter of arterial stiffness and a surrogate marker of subclinical atherosclerosis. The aim of the present study was to investigate the relation between aortic knob calcification (AKC) and CAVI in asymptomatic hypertensive patients. METHODS AND RESULTS: Sixty patients with AKC and age-matched sex-matched 60 control individuals without AKC were enrolled. Patients with known or having symptoms of atherosclerotic vascular diseases were excluded. AKC was assessed on chest radiography. CAVI was measured using the VaSera - 1000 CAVI instrument. AKC patients had higher CAVI values compared with those without AKC (11.8±3.9 vs. 8.2±2.1, P<0.001). Patients with subclinical atherosclerosis (CAVI≥9) had higher percent of AKC compared with those who had no atherosclerosis (CAVI<9) (72 vs. 34%, P<0.001). CONCLUSION: The presence of AKC on chest radiography may provide important predictive information of arterial stiffness and subclinical atherosclerosis in asymptomatic hypertensive patients.

Fragmented QRS may predict increased arterial stiffness in asymptomatic hypertensive patients.

OBJECTIVE: Detection of increased arterial stiffness could prevent patients from being mistakenly classified as being at a low or a moderate risk, when they actually are at a high risk. The main aim of present study was to investigate the relation between fragmented QRS (fQRS) on ECG and the cardio-ankle vascular index (CAVI), which is a novel parameter of arterial stiffness in asymptomatic hypertensive patients. METHODS AND RESULTS: Seventy-five asymptomatic hypertensive patients with fQRS and 75 age-matched and sex-matched control individuals without fQRS were enrolled. Patients with fQRS had higher CAVI values compared with those without fQRS (8.6 ± 1.4 vs. 7.9 ± 1.3, P=0.01). In univariate analyses, there was a significant association between increased CAVI and age (P<0.001) and fQRS (P=0.003). Multivariate binary logistic regression analyses showed fQRS (95% confidence interval: 0.122-0.675, P=0.004) and age (95% confidence interval: 1.022-1.105, P=0.002) as the independent determinants of increased CAVI. The sensitivity and specificity of fQRS for predicting abnormal CAVI were 55 and 76%, respectively. CONCLUSION: The presence of fQRS on ECG may provide important predictive information on arterial stiffness in asymptomatic hypertensive patients.

Relationship between aortic valve sclerosis and different vascular damage markers: an observational study.

OBJECTIVE: Although aortic valve sclerosis (AVS) and atherosclerosis may share same atherosclerotic process, there is still a controversy whether AVS may be related to atherosclerotic and nonatherosclerotic processes. The purpose of present study was to investigate this relation. METHODS: In this cross-sectional and observational study, we enrolled 60 patients diagnosed with AVS and risk factor matched 76 subjects without AVS. Applanation tonometry was applied to assess the augmentation index and aortic pulse-wave velocity (PWV). Control and AVS group were examined by B-mode ultrasound to measure the intima-media thickness (IMT). Continuous variables were compared using unpaired t-test and Mann-Whitney U test. Logistic regression analysis was performed in order to find independent predictors of AVS. RESULTS: PWV and augmentation index did not differ between control and AVS groups (11.2±3.6 vs 12±3.2, p=0.18 and 26±7.6 vs 27±9.8, p=0.2 respectively). But IMT was significantly higher in AVS group than in control one (0.76 mm±0.17 vs 0.6 mm±0.16; p<0.001). There was a significant positive bivariate correlation between the presence of AVS, IMT (r=0.43, p<0.001), male gender(r=0.31, p<0.001), augmentation index (r=0.17, p:0,04), and age (r=0.36, p<0.001). Logistic regression analysis demonstrated that only IMT (OR: 1.46, 95% CI: 1.1-1.9, p=0.009) and age (OR: 1.1, 95% CI: 1.01-1.16, p=0.013) were independent predictors of AVS. CONCLUSION: Increased IMT but not PWV in subjects with AVS compared to control group may suggest that, AVS is probably a multifactorial disease, related to the both atherosclerotic and nonatherosclerotic processes.

Aortic knob calcification and coronary artery lesion complexity in non-ST-segment elevation acute coronary syndrome patients.

OBJECTIVES: Coronary artery lesion complexity is important for risk stratification of acute coronary syndrome (ACS) patients undergoing cardiac catheterization. SYNTAX score is a pure angiographic measure of anatomic coronary complexity. Chest radiography is a routine examination for evaluating patients with chest pain. There have been no studies to date exploring the relation between aortic knob calcification (AKC) and coronary lesion complexity assessed by SYNTAX score. STUDY DESIGN: 135 consecutive patients with first time diagnosis of non-ST segment elevation ACS were enrolled. SYNTAX score was calculated by dedicated computer software. Aortic calcification was assessed visually. RESULTS: Patients with AKC had higher SYNTAX score compared to those without AKC (16±6 vs. 11±7, p=0.019). Also, patients with AKC had higher TIMI risk score and were more elderly. Linear regression analysis demonstrated AKC (95% confidence interval [CI] 1.7-6.9, p=0.002), diabetes (95% CI, 1.1-5.7, p=0.005), and smoking (95% CI, 1.2-13.5, p=0.004) as independent determinants of SYNTAX score. CONCLUSION: Aortic calcification detected on chest X-ray is an independent predictor of complex coronary artery lesions in patients with ACS.