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An overview of randomized controlled trials on endovascular treatment for chronic cerebrospinal venous insufficiency in multiple sclerosis patients
2020
AbstractAbout ten years ago it was hoped that venous angioplasty for abnormal veins, primarily the internal jugular veins, will be a much awaited treatment for multiple sclerosis. Yet, a majority of randomized clinical trials on endovascular treatment for chronic cerebrospinal venous insufficiency did not reveal clinical efficacy of these procedures in multiple sclerosis patients. Still, a detailed analysis of these trials suggests that they were poorly designed, underpowered and endovascular techniques used were often far from being optimal. Nonetheless, even considering weak points of these trials, it can be concluded that venous angioplasty should not be used as a routine treatment modal…
Long-Term Clinical Outcomes After Percutaneous Coronary Intervention for Ostial/Mid-Shaft Lesions Versus Distal Bifurcation Lesions in Unprotected Le…
2013
Objectives The aim of this study was to compare, in a large all-comer registry, the long-term clinical outcomes after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for ostial/mid-shaft lesions versus distal bifurcation lesions in unprotected left main coronary artery (ULMCA) stenosis. Background Limited data are available regarding clinical outcomes following DES implantation at the different ULMCA sites. Methods Patients with ULMCA stenosis treated by PCI with DES were analyzed in this multinational registry. Results A total of 1,612 patients were included: 482 were treated for ostial/mid-shaft lesions versus 1,130 for distal bifurcation lesions. At a median follo…
Balloon aortic valvuloplasty, Impella insertion and complex coronary intervention: is this all feasible fully percutaneously via upper limb access?
2021
Complex high-risk indicated patients (CHIP) with a limited vascular access constitute a real challenge for percutaneous coronary interventions (PCI), particularly if they require mechanical circulatory support devices. A 73-year-old man with recent non-ST segment elevation myocardial infraction, depressed left ventricular function (ejection fraction, 40%), aortic stenosis (max/mean gradient, 50/32 mm Hg; aortic valve area and its index, 1.0 cm2 and 0.5 cm2/m2) and numerous comorbidities (including recently diagnosed lung cancer in the initial phase) was scheduled by the heart team for balloon aortic valvuloplasty (BAV) and Impella-supported complex PCI of the left main (LM) and the left ant…
1043 Evaluation of Pediatric Testes After Surgery by Laser Doppler and White Light Spectroscopy
2012
Aim To evaluate testes after unilateral orchiopexy Laser Doppler and white light spectroscopy and compare microcirculation with contralaterat testis and healthy controls. Methods A combination of the laser Doppler (determination of blood flow) and white light spectroscopy (determination of oxygen saturation and hemoglobin amount) is used to determine microcirculation at two different depth levels non-invasively. Patients were recruited after unilateral orchiopexy. Controls were age-matched boys without relevant disease. Ethical approval was obtained. Results 99 patients were included after unilateral orchiopexy at the age of 3.5 years (+-2.9 years). 65% underwent surgery after their second …
Blood pressure reduction following treatment with positive airway pressure in sleep apnea: data from the European Sleep Apnea Database
2020
Abstract Introduction Positive airway pressure (PAP) treatment modifies blood pressure (BP) in patients with obstructive sleep apnea (OSA). We aimed to explore which factors that influence the BP response to PAP therapy in the European Sleep Apnea Database (ESADA). Methods A total of 2662 OSA patients with PAP therapy ≥90 days were included in the analysis (74% male, age 55±11 years, body mass index 32.3±6.1 kg/m2, 47% hypertensives, apnea-hypopnea index 40±24 events/h, treatment duration 1.0±1.1 years, PAP compliance 5.2±1.9 h/day). Anthropometric data, co-medications and office BP were assessed at baseline and follow-up visit. Results Systolic and diastolic BP were modestly reduced after …
Recombinant FVIII Products (Turoctocog Alfa and Turoctocog Alfa Pegol) Stable Up to 40°C
2021
Mariasanta Napolitano,1 Arne Agerlin Olsen,2 Anne Mette Nøhr,2 Hermann Eichler3 1Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo Reference Regional Center for Thrombosis and Hemostasis, Hematology Unit, Palermo, Italy; 2Novo Nordisk A/S, Biopharm Manufacturing Development, Gentofte, Denmark; 3Saarland University and Saarland University Hospital, Institute of Clinical Haemostaseology and Transfusion Medicine, Homburg (Saar), GermanyCorrespondence: Anne Mette NøhrBiopharm Manufacturing Development, Novo Nordisk A/S, Nybrovej 80, Gentofte 2820, DenmarkTel +45 3075 1619Email amnq@novonordisk.…
Cerebral Autoregulation in Non-Brain Injured Patients: A Systematic Review.
2021
Introduction: Cerebral autoregulation (CA) plays a fundamental role in the maintenance of adequate cerebral blood flow (CBF). CA monitoring, through direct and indirect techniques, may guide an appropriate therapeutic approach aimed at improving CBF and reducing neurological complications; so far, the role of CA has been investigated mainly in brain-injured patients. The aim of this study is to investigate the role of CA in non-brain injured patients.Methods: A systematic consultation of literature was carried out. Search terms included: “CA and sepsis,” “CA and surgery,” and “CA and non-brain injury.”Results: Our research individualized 294 studies and after screening, 22 studies were anal…
Lateralization Effects on Cerebral Blood Flow in Patients With Unilateral Pulsatile Tinnitus Measured With Arterial Spin Labeling
2020
Purpose: To investigate cerebral blood flow (CBF) differences in patients with left- and right-sided pulsatile tinnitus (LPT and RPT) and healthy controls (HCs) to further explore the lateralization effects of PT using arterial spin labeling (ASL). Methods: ASL data from 21 RPT patients, 17 LPT patients and 21 HCs were reviewed. Voxel-wise analysis and region of interest analysis were performed to explore differences in CBF among the three groups. Tinnitus Handicap Inventory (THI) score and tinnitus duration were obtained from each patient. Results: Voxel-wise analysis showed that the CBF of the left inferior parietal gyrus was increased in both RPT and LPT patients compared with HCs (P < 0…
Implementation of computed tomography angiography (CTA) and computed tomography perfusion (CTP) in Polish guidelines for determination of cerebral ci…
2021
Background: Brain death/death by neurologic criteria (BD/DNC) guidelines are routinely analyzed, compared and updated in the majority of countries and are later implemented as national criteria. At the same time, extensive works have been conducted in order to unify clinical procedures and to validate and implement new technologies into a panel of ancillary tests. Recently evaluated computed tomography angiography and computed tomography perfusion (CTA/CTP) seem to be superior to traditionally used digital subtraction angiography (DSA), transcranial Doppler (TCD) and cerebral perfusion scintigraphy for diagnosis of cerebral circulatory arrest (CCA). In this narrative review, we would like t…
Cerebral Blood Flow Regulation Under the Conditions of Arterial Hypoxia
1978
Pronounced arterial hypoxia induces a decrease of cerebrovascular resistance and an increase of total and regional cerebral blood flow. Under the conditions of normal arterial blood pressure and normal acid base status, the changes of both parameters commence when the oxygen tension in the arterial blood decreases below approximately 50 mm Hg. At the same time, the oxygen tension in the cerebral venous blood reaches values below approximately 28 mm Hg. Different authors [23, 28, 30, 31, 33] reported that cerebral blood flow responses to PaO2 decrease are threshold at these oxygen tensions. The threshold oxygen tension of cerebral venous blood was accorded a special significance because Noel…