0000000000008781
AUTHOR
Juha Salenius
Peripheral arterial disease, diabetes and postural balance among elderly Finns: a population-based study
Background and aims: Little is known about the role of peripheral arterial disease (PAD)in the development of balance impairment. The aim of this study was to assess postural balance among people having PAD or PAD combined with diabetes. Methods: As part of the comprehensive health examination of the Health 2000 survey (two-stage stratified cluster sampling), 1323 people aged 65 years or older took part in balance assessments using a force platform system. The presence of PAD was confirmed with data from the National Hospital Discharge Registry. Individuals with hospitalization due to PAD were regarded as having severe disease, whereas those with solely self-reported diagnosis were consider…
Identification of optimal device combinations for the chimney endovascular aneurysm repair technique within the PERICLES registry
Abstract Objective The ideal stent combination for chimney endovascular aneurysm repair remains undetermined. Therefore, we sought to identify optimal aortic and chimney stent combinations that are associated with the best outcomes by analyzing the worldwide collected experience in the PERformance of chImney technique for the treatment of Complex aortic pathoLogiES (PERICLES) registry. Methods The PERICLES registry was reviewed for patients with pararenal aortic disease electively treated from 2008 to 2014. Eleven different aortic devices were identified with three distinct subgroups: group A (n = 224), nitinol/polyester; group B (n = 105), stainless steel/polyester; and group C (n = 69), n…
Classification of Chimney EVAR-Related Endoleaks: Insights from the PERICLES Registry
Juxtarenal aortic aneurysms (JAAs) pose significant challenges for endovascular aneurysm repair (EVAR). A short or absent infrarenal neck typically excludes standard EVAR as a viable or reasonable treatment option. In this context, the use of chimney grafts (chEVAR) is gaining in popularity and applicability. These grafts are designed to course in the aortic lumen outside the main stent-graft to maintain normal perfusion to the involved target branches. As such, they may represent a promising and less resource-intensive option for management of JAAs. However, this technical strategy is not without challenges of its own, particularly the inevitable creation of “gutters” that result from the …
Incidence and prognostic factors related to major adverse cerebrovascular events in patients with complex aortic diseases treated by the chimney technique
Abstract Objective Endovascular aneurysm repair (EVAR) with the chimney technique (ch-EVAR) has been used for the treatment of aortic aneurysms as an alternative approach to fenestrated endografting or open repair. Nonetheless, the need for an upper extremity arterial access may contribute to a higher risk for periprocedural cerebrovascular events. This study reports on the perioperative cerebral and major adverse cardiac and cerebrovascular events (MACCE) after ch-EVAR. Methods The PERICLES registry (PERformance of the chImney technique for the treatment of Complex aortic pathoLogiES) is an international, retrospective multicenter study evaluating the performance of ch-EVAR for the treatme…
Peripheral arterial disease and its clinical significance in nonagenarians
The purpose of this study was to characterize the prevalence and clinical features of peripheral arterial disease (PAD) among 90-year-old individuals and to assess its relationship to lower extremity functional status and survival over one year.A prospective, population- based study of all 90-year-old residents of Jyväskylä, Finland. Fifty-eight out of the 79 registered residents were examined for ankle-brachial index (ABI). Lower extremity functional status was assessed as self-reported difficulty in performing specific physical activities of daily living (PADL). In a subgroup of 36 individuals, lower extremity functioning was further assessed by measuring walking endurance and walking vel…
Results of chimney endovascular aneurysm repair as used in the PERICLES Registry to treat patients with suprarenal aortic pathologies
Background: The prevailing evidence calls for using chimney/snorkel endovascular repair (ch-EVAR) with one or two chimney grafts. No studies up to now focus on its applicability and results for the treatment of suprarenal aortic pathologies (SRAP). Hence, we evaluated the clinical and radiologic results of ch-EVAR treatment for SRAP placing three or more chimney grafts within the PERICLES Registry. Methods: Data from 517 patients suffering complex aortic pathologies treated by ch-EVAR between 2008 and 2014 at 13 European and U.S. centers were retrospectively reviewed and analyzed. Results: Sixty-seven ch-EVAR-treated patients (12.9% of the entire PERICLES cohort) presented SRAP (83.5% elect…
Absent pedal pulse and impaired balance in older people: a cross-sectional and longitudinal study
Background and aims: The purpose of this study was to determine the relationship between abnormal pedal pulse status and postural balance in older people. Methods: Prospective, population-based cohort study of older residents in the city of Jyvaskyla, Finland. A total of 419 individuals aged 75 or 80 at baseline, with known lower extremity pulse status and balance tests performed on a force platform, were eligible for analysis. Results: Cross-sectionally, persons with both dorsal pedal artery pulses absent were found to sway more (p=0.047 anteroposterior velocity, normal standing eyes-open position). The risk of being unable to do the full tandem stance was twofold (OR=2.20, 95% CI 1.29–3.7…