The effect of coronary angiography and femoral access on femoral artery distensibility and elasticity.

AIM OF THE STUDY: The aim of this study was to evaluate the long-term effects of access to the femoral artery for the purposes of coronary angiography through the measurement of femoral artery distensibility and elasticity on the accessed and non-accessed sides. MATERIAL AND METHODS: This cross-sectional study included patients who underwent femoral angiography at least 1 year previously. Those whose femoral artery was accessed once formed Group 1 (n = 59), those who were accessed twice formed Group 2 (n = 57), those accessed 3 times formed Group 3 (n = 55), and those with more than 3 accesses, Group 4 (n = 60). The groups were compared in respect of femoral artery elasticity and distensibility in the accessed and non-accessed sides. RESULTS: No statistically significant difference was determined in respect of femoral distensibility and elasticity in Group 1 (9.40 ± 0.84 vs 9.48 ± 0.75, p = 0.107 and 0.23 ± 0.03 vs 0.23 ± 0.03, p = 0.433, respectively). However, a significant difference was observed between the two sides in terms of distensibility and elasticity in Group 2 (9.02 ± 0.81 vs 9.23 ± 0.75, and 0.21 ± 0.02 vs 0.22 ± 0.02), in Group 3 (8.49 ± 0.77 vs 9.18 ± 0.9 and 0.19 ± 0.02 vs 0.21 ± 0.02), and in Group 4 (8.14 ± 0.74 vs 9.03 ± 0.81 and 0.16 ± 0.01 vs 0.2 ± 0.02, p <0.001, for all comparisons). CONCLUSION: While a single access in the femoral artery for coronary angiography does not affect femoral artery elasticity and distensibility, multiple accesses may have adverse effects.

Assessment of Carotid Artery Distensibility and Elasticity After Laparoscopic Sleeve Gastrectomy: a Prospective Study.

PURPOSE: Although it is well known that obesity increases the risk of atherosclerosis in carotid arteries, it is not clear whether this risk changes after obesity surgery. The aim of this study was to investigate whether weight reduction with a laparoscopic sleeve gastrectomy (LSG) has any effect on distensibility and elasticity which show subclinical atherosclerosis in the carotid arteries of obese individuals. MATERIALS AND METHODS: This prospective study included 130 patients (body mass index (BMI) 48.21 ± 6.97 kg/m2) who underwent LSG. The patients were followed up for 1 year. Comparisons were made of the distensibiliy and elasticity values calculated preoperatively and at 1, 3, 6, and 12 months, postoperatively. RESULTS: There was a statistically significant increase in distensibility and elasticity values from baseline to 1, 3, 6, and 12 months postoperatively (p < 0.001 for both comparisons). The multiple linear regression analysis was used to find the variables affecting both distensibility and elasticity. According to the results, the presence of BMI decreases distensibility percentage change level by 0.38 units (ß= - 0.38, 95% CI - 0.51;- 0.25, p < 0.001). The presence of fasting plasma glucose decreases elasticity percentage change level by 0.20 units. (ß= - 0.20, 95% CI - 0.39; - 0.01, p = 0.037). CONCLUSION: Carotid artery distensibility and elasticity values increase after LSG, and this change could be caused by the change in metabolic parameters and heart geometry. These results may indirectly suggest that subclinical atherosclerosis in carotid arteries has decreased after obesity surgery.

Significance of the Cerebellopontine Cistern Cross-Sectional Area and Trigeminal Nerve Anatomy in Trigeminal Neuralgia: An Anatomical Study Using Magnetic Resonance Imaging.

AIM: To evaluate the relationship between trigeminal neuralgia (TN) and potential magnetic resonance imaging (MRI)-related measurements in patients with TN. MATERIAL AND METHODS: Retrospective analysis of 104 patients with TN was performed. MRI studies of 98 healthy controls were included in the study to compare the parameters with TN patients’ measurements. MRI measurements of cerebellopontine cistern (CPC) cross-sectional area, trigeminal-pontine angle (TPA) width, and trigeminal nerve cisternal segment length and thickness were assessed on both symptomatic and asymptomatic sides using 1.5T MRI with constructive interference in steady-state sequences. The images were interpreted by two radiologists blinded to the affected sides of the patients. RESULTS: There were significant differences between the symptomatic and asymptomatic sides in terms of mean trigeminal nerve length (8.8 ± 2.34 mm vs. 9.39 ± 2.29 mm; respectively, p=0.001) and thickness (20.9 ± 9.6 mm2 vs. 25 ± 9.98 mm2, respectively; p < 0.001). The median cerebellopontine cistern cross-sectional area was considerably lower on the symptomatic side compared with the asymptomatic side [201 mm2 (interquartile range=93) vs. 224.5 mm2 (interquartile range=77), respectively; p < 0.001]. There were no significant differences between the trigeminal-pontine angle width on either side (38.32 ± 10.38 vs. 38.78 ± 10.9, respectively; p=0.679). There were no statistically significant differences between the right and left sides regarding these parameters in the control group. CONCLUSION: Smaller CPC cross-sectional area, trigeminal nerve length, and trigeminal nerve thickness on MRI were demonstrated to commonly exist on the symptomatic side in patients with TN. We suggest that this narrow space may increase the risk of vascular compression on the nerve.

Endovascular Treatment of a Patient with Moyamoya Disease and Seckel Syndrome: A Case Report.

Seckel syndrome and Moyamoya diseases are different entities that rarely associated with each other. Several cases presenting with both these diseases were reported. Intracerebral artery aneurysms and collateral vessels can be seen with Moyamoya. They are commonly treated with medical treatment. We present a 12-years old patient with both Seckel syndrome and Moyamoya disease presented with middle cerebral artery aneurysm which was treated with endovascular modalities.

Portal venous diameter in children: normal limits according to age, weight and height.

PURPOSE: To establish the normal limits of portal vein diameter according to age, height and weight. MATERIALS AND METHODS: One hundred and sixty-eight healthy children, ages ranging from 1 month to 15 years were examined by ultrasound. Portal vein diameters at hepatic port, weight and height were recorded. RESULTS: A range of normal limits for portal veneous diameter according to age, weight and height are obtained and presented in tables. CONCLUSION: Knowing the normals for portal venous diameter in every age group in children is mandatory in differentiating disease. The tables according to age, weight and height will definitely be helpful in the work-up process.

Microbial analysis of the autogenous bone collected by bone filter during oral surgery: a clinical study.

PURPOSE: The purposes of the study presented are to identify the microbial content of the collected bone debris and to determine the antibacterial efficiency of chlorhexidine mouth rinse in reducing the microbial content of the collected bone debris. PATIENTS AND METHODS: Twenty-five patients who had asymptomatic fully impacted mandibular third molars bilaterally underwent surgical removal for prophylactic and orthodontic considerations. Immediately before surgery all patients rinsed with 10 mL of their assigned solution (chlorhexidine or sterile saline) for 2 minutes. Before surgical removal of the teeth, bone debris was collected with a stringent aspiration protocol from the ramus by bone filter. The microbial content of the bone debris was assessed and the bacterial levels between the 2 groups were compared statistically. RESULTS: All samples from both groups (chlorhexidine or sterile saline) yielded viable microorganisms. There was no significant difference between the mean/median colony-forming units (CFU)/g values of both group samples, for aerobes (Streptococcus salivarius) and anaerobes (Bacteroides, Peptococcus, Peptostreptococcus, and Veillonella species). With regard to total microorganisms, the mean CFU/g derived from the chlorhexidine group samples were 1.5 x 10(8) CFU/g per bone sample compared with 1.5 x 10(9) CFU/g for the sterile saline control group (P < .05). CONCLUSION: Although chlorhexidine rinsing immediately before surgery reduced the levels of total microorganisms when compared with stringent aspiration protocol alone, it has not been found effective on aerobic Streptococcus salivarius and, importantly, on anaerobes. The reduced bacterial levels may still carry high infectious risk and may lead to failure in autogenous grafting procedures in oral surgery.