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[PMID]: 29214784 [Au] Autor: Lee HG; Kim WK; Yeon JY; Kim JS; Kim KH; Jeon P; Hong SC [Ad] Endereço: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. [Ti] Título: Contrast-Induced Acute Kidney Injury after Coil Embolization for Aneurysmal Subarachnoid Hemorrhage. [So] Source: Yonsei Med J;59(1):107-112, 2018 Jan. [Is] ISSN: 1976-2437 [Cp] País de publicação: Korea (South) [La] Idioma: eng [Ab] Resumo: PURPOSE: Contrast-induced acute kidney injury (CI-AKI) is associated with poor outcomes after percutaneous coronary intervention. However, CI-AKI has rarely been evaluated within the neurovascular field. The aim of this study was to investigate the incidence and clinical implication of CI-AKI after coil embolization in patients with an aneurysmal subarachnoid hemorrhage (aSAH). MATERIALS AND METHODS: Between January 2005 and March 2016, 192 patients who underwent coil embolization were enrolled in this study. CI-AKI was defined as an increase from baseline serum creatinine concentration of >25% or >0.5 mg/dL within 72 hours after coil embolization. A poor clinical outcome was defined as a score of ≥3 on the modified Rankin Scale at one-year post-treatment. RESULTS: A total of 16 patients (8.3%) died as a result of medical problems within one year. CI-AKI was identified in 14 patients (7.3%). Prominent risk factors for one-year mortality included CI-AKI [odds ratio (OR): 16.856; 95% confidence interval (CI): 3.437-82.664] and an initial Glasgow Coma Scale (GCS) score ≤8 (OR: 5.565; 95% CI: 1.703-18.184). A poor clinical outcome was associated with old age (≥65 years) (OR: 7.921; 95% CI: 2.977-21.076), CI-AKI (OR: 11.281; 95% CI: 2.138-59.525), an initial GCS score ≤8 (OR 31.02; 95% CI, 10.669-90.187), and a ruptured aneurysm (p=0.016, OR: 4.278) in posterior circulation. CONCLUSION: CI-AKI seems to be an independent predictor of the overall outcomes of aSAH after endovascular treatment. [Mh] Termos MeSH primário: Lesão Renal Aguda/induzido quimicamente Lesão Renal Aguda/etiologia Aneurisma/terapia Meios de Contraste/efeitos adversos Embolização Terapêutica/efeitos adversos Hemorragia Subaracnóidea/terapia [Mh] Termos MeSH secundário: Lesão Renal Aguda/diagnóstico por imagem Lesão Renal Aguda/mortalidade Adulto Idoso Idoso de 80 Anos ou mais Aneurisma/complicações Aneurisma/diagnóstico por imagem Angiografia Feminino Seres Humanos Incidência Masculino Meia-Idade Hemorragia Subaracnóidea/complicações Hemorragia Subaracnóidea/diagnóstico por imagem Resultado do Tratamento Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Contrast Media) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180309 [Lr] Data última revisão: 180309 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171208 [St] Status: MEDLINE [do] DOI: 10.3349/ymj.2018.59.1.107

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[PMID]: 28470920 [Au] Autor: Rob D; Spunda R; Lindner J; Rohn V; Kunstýr J; Balík M; Rulísek J; Kopecký P; Lips M; Smíd O; Kovárník T; Mlejnský F; Linhart A; Belohlávek J [Ad] Endereço: 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic. [Ti] Título: A rationale for early extracorporeal membrane oxygenation in patients with postinfarction ventricular septal rupture complicated by cardiogenic shock. [So] Source: Eur J Heart Fail;19 Suppl 2:97-103, 2017 May. [Is] ISSN: 1879-0844 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: AIMS: Ventricular septal rupture (VSR) became a rare mechanical complication of myocardial infarction in the era of percutaneous coronary interventions but is associated with extreme mortality in patients who present with cardiogenic shock (CS). Promising outcomes have been reported with the use of circulatory support allowing haemodynamic stabilization, followed by delayed repair. Therefore, we analysed our experience with an early use of Veno-Arterial Extracorporeal Membrane Oxygenation (V-A ECMO) for postinfarction VSR. METHODS AND RESULTS: We conducted a retrospective search of institutional database for patients presenting with postinfarction VSR from January 2007 to June 2016. Data from 31 consecutive patients (mean age 69.5 ± 9.1 years) who were admitted to hospital were analysed. Seven out of 31 patients with VSR who were in refractory CS received V-A ECMO support preoperatively. ECMO improved end-organ perfusion with decreased lactate levels 24 hours after implantation (7.9 mmol/L vs. 1.6 mmol/L, p = 0.01), normalized arterial pH (7.25 vs. 7.40, p < 0.04), improved mean arterial pressure (64 mmHg vs. 83 mmHg, p < 0.01) and lowered heart rate (115/min vs. 68/min, p < 0.01). Mean duration of ECMO support was 12 days, 5 out of 7 patients underwent surgical repair, 4 were weaned from ECMO, 3 survived 30 days and 2 survived more than 1 year. The most frequent complication (5 patients) and the cause of death (3 patients) was bleeding. CONCLUSIONS: Our experience suggests that early V-A ECMO in patients with VSR and refractory CS might prevent irreversible multiorgan failure by improved end-organ perfusion. Bleeding complications remain an important limitation of this approach. [Mh] Termos MeSH primário: Oxigenação por Membrana Extracorpórea/métodos Choque Cardiogênico/terapia Ruptura do Septo Ventricular/complicações [Mh] Termos MeSH secundário: Idoso Angiografia Feminino Seguimentos Hemodinâmica/fisiologia Seres Humanos Masculino Estudos Retrospectivos Fatores de Risco Choque Cardiogênico/etiologia Choque Cardiogênico/fisiopatologia Resultado do Tratamento Ruptura do Septo Ventricular/diagnóstico Ruptura do Septo Ventricular/fisiopatologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180305 [Lr] Data última revisão: 180305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170505 [St] Status: MEDLINE [do] DOI: 10.1002/ejhf.852

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[PMID]: 29237359 [Au] Autor: Cragg J; Lowry D; Hopkins J; Parker D; Kay M; Duddy M; Tiwari A [Ad] Endereço: 1 Department of Vascular Surgery, University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom. [Ti] Título: Safety and Outcomes of Ipsilateral Antegrade Angioplasty for Femoropopliteal Disease. [So] Source: Vasc Endovascular Surg;52(2):93-97, 2018 Feb. [Is] ISSN: 1938-9116 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: PURPOSE: Previous reports have suggested higher periprocedural complications after ipsilateral antegrade femoral arterial access (AA). We looked at a contemporary series comparing complication rates between AA and contralateral retrograde femoral arterial access (RA) for femoropopliteal angioplasty. METHOD: A prospective review of all cases between 2010 and 2015 in a United Kingdom tertiary vascular center. Demographical and procedural data were obtained for those undergoing percutaneous femoropopliteal angioplasty. The primary outcome looked at periprocedural complications including retroperitoneal hematoma, pseudoaneurysm, hematoma requiring transfusion, arteriovenous fistulation, and surgical intervention. Secondary outcomes included contrast and radiation doses in addition to procedural failure leading to major amputation. RESULTS: A total of 556 (66% male) patients underwent femoropopliteal angioplasty, 461 (82%) via AA. Groups were of comparable age, sex, comorbidity, and symptomatology. AA patients had a lower body mass index, 26 versus 29 ( P = .005). No significant difference was seen in periprocedural (15.8% AA vs 11.6% RA; P = 0.292) or access site complications (3.7% AA vs 1.1% RA; P = 0.186). There was less need for a closure device, 40.3% AA vs 73% RA ( P < .01), less contrast, 94 mL AA: 114 mL RA ( P < .001), and less radiation, 3487 cGy cm AA: 9697 cGy cm RA ( P < .001). Arterial access was also associated with greater technical success of 83.8%: 73.3% RA ( P = .002). CONCLUSIONS: Arterial access is associated with higher technical success and reduced contrast/radiation doses with no significant difference in complications compared to RA contrary to previous reports. [Mh] Termos MeSH primário: Angioplastia/métodos Artéria Femoral Doença Arterial Periférica/terapia Artéria Poplítea/fisiopatologia [Mh] Termos MeSH secundário: Idoso Idoso de 80 Anos ou mais Angiografia Angioplastia/efeitos adversos Bases de Dados Factuais Inglaterra Feminino Artéria Femoral/diagnóstico por imagem Artéria Femoral/fisiopatologia Seres Humanos Masculino Meia-Idade Doença Arterial Periférica/diagnóstico por imagem Doença Arterial Periférica/fisiopatologia Artéria Poplítea/diagnóstico por imagem Dose de Radiação Exposição à Radiação/efeitos adversos Exposição à Radiação/prevenção & controle Estudos Retrospectivos Fatores de Risco Centros de Atenção Terciária Fatores de Tempo Resultado do Tratamento [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180228 [Lr] Data última revisão: 180228 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171215 [St] Status: MEDLINE [do] DOI: 10.1177/1538574417739762

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[PMID]: 28468953 [Au] Autor: Randhawa MS; Reed GW; Grafmiller K; Gornik HL; Shishehbor MH [Ad] Endereço: From the Department of Cardiovascular Medicine, Cleveland Clinic, OH; and School of Medicine, Case Western Reserve University, Cleveland, OH. [Ti] Título: Prevalence of Tibial Artery and Pedal Arch Patency by Angiography in Patients With Critical Limb Ischemia and Noncompressible Ankle Brachial Index. [So] Source: Circ Cardiovasc Interv;10(5), 2017 May. [Is] ISSN: 1941-7632 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Approximately 20% of patients undergoing ankle brachial index testing for critical limb ischemia have noncompressible vessels because of tibial artery calcification. This represents a clinical challenge in determining tibial artery patency. We sought to identify the prevalence of tibial artery and pedal arch patency by angiography in these patients. METHODS AND RESULTS: One hundred twenty-five limbs (of 89 patients) with critical limb ischemia and ankle brachial index ≥1.4 who underwent lower extremity angiograms within 1 year were included. Reviewers of angiography were blinded to results of physiological testing. Tibial artery vessels were classified as completely occluded, significantly stenosed (≥50%), or patent (<50% stenosis). The sensitivity of toe brachial index and pulse volume recording to predict tibial artery disease was also determined. Of 125 limbs with noncompressible ankle brachial index, 72 (57.6%) anterior tibial and 80 (64%) posterior tibial arteries were occluded. Another 23 (18.4%) anterior tibial and 13 (10.4%) posterior tibial arteries had ≥50% stenosis. Pulse volume recording was moderate to severely dampened in 54 of 119 (45.4%) limbs. Toe brachial index <0.7 was found in 75 of 83 (90.4%) limbs. Moderate to severe pulse volume recording dampening was 43.6% sensitive, whereas toe brachial index <0.7 was 89.7% sensitive in diagnosing occluded or significantly stenotic tibial artery disease. The pedal arch was absent or incomplete in 86 of 103 (83.5%) limbs. CONCLUSIONS: Among patients with critical limb ischemia and noncompressible ankle brachial index results, the prevalence of occlusive tibial and pedal arch disease is very high. Toe brachial index <0.7 is more sensitive in diagnosing occluded and significantly stenotic tibial artery disease in these patients compared with ankle pulse volume recording. [Mh] Termos MeSH primário: Angiografia Índice Tornozelo-Braço Isquemia/diagnóstico Doença Arterial Periférica/diagnóstico Artérias da Tíbia/diagnóstico por imagem Calcificação Vascular/diagnóstico Grau de Desobstrução Vascular [Mh] Termos MeSH secundário: Idoso Idoso de 80 Anos ou mais Constrição Patológica Estado Terminal Feminino Seres Humanos Isquemia/diagnóstico por imagem Isquemia/epidemiologia Isquemia/fisiopatologia Masculino Meia-Idade Ohio/epidemiologia Doença Arterial Periférica/diagnóstico por imagem Doença Arterial Periférica/epidemiologia Doença Arterial Periférica/fisiopatologia Valor Preditivo dos Testes Prevalência Estudos Retrospectivos Índice de Gravidade de Doença Artérias da Tíbia/fisiopatologia Ultrassonografia Doppler Calcificação Vascular/diagnóstico por imagem Calcificação Vascular/epidemiologia Calcificação Vascular/fisiopatologia [Pt] Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180227 [Lr] Data última revisão: 180227 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170505 [St] Status: MEDLINE

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[PMID]: 29384923 [Au] Autor: Shi ZX; Yang J; Liang HW; Cai ZH; Bai B [Ad] Endereço: Department of Interventional Radiology. [Ti] Título: Emergency transcatheter arterial embolization for massive gastrointestinal arterial hemorrhage. [So] Source: Medicine (Baltimore);96(52):e9437, 2017 Dec. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: To evaluate the different arteriographic manifestations of acute arterial massive hemorrhage of the gastrointestinal (GI) tract and the efficacy of emergency transcatheter arterial embolization (ETAE).A total of 88 patients with acute massive GI bleeding who experienced failure of initial endoscopy and/or conservative treatment were referred to our interventional department for acute GI arteriography from January 2007 to June 2015. After locating the source of bleeding, appropriate embolic agents, such as spring coil, hydroxyl methyl acrylic acid gelatin microspheres, polyvinyl alcohol (PVA) particles, etc., were used to embolize the targeted vessels. The angiographic manifestations and the effects of embolization of acute arterial massive hemorrhage of the GI tract were retrospectively analyzed.Of the 88 patients, 54 were diagnosed with arterial hemorrhage of the upper GI tract and 34 with arterial hemorrhage of the lower GI tract. Eighty cases were associated with positive angiography, which showed the following: contrast extravasation (only); gastroduodenal artery stenosis; pseudoaneurysm (only); pseudoaneurysm rupture with contrast extravasation; pseudoaneurysms merged with intestinal artery stenosis; GI angiodysplasia; and tumor vascular bleeding. Eight cases were diagnosed with negative angiography. Seven-two patients underwent successful hemostasis, and a total of 81 arteries were embolized. The technical and clinical success rates (no rebleeding within 30 days) in performing transcatheter embolization on patients with active bleeding were 100% and 84.71%, respectively (72 of 85). Within 30 days, the postoperative rebleeding rate was 15.29% (13/85). Of these rebleeding cases, 2 patients were formerly treated with "blind embolization," 7 underwent interventional embolic retreatment, and 3 had surgical operations. All cases were followed-up for 1 month, and 3 patients died from multiple organ failure. No serious complications such as bowel ischemia necrosis were observed.ETAE is a safe, effective, and minimally invasive treatment; because of the diversified arteriographic manifestations of acute GI hemorrhage, the proper selection of embolic agents and the choice of reasonable embolization method are essential for successful hemostasis. [Mh] Termos MeSH primário: Embolização Terapêutica Procedimentos Endovasculares Hemorragia Gastrointestinal/diagnóstico por imagem Hemorragia Gastrointestinal/terapia [Mh] Termos MeSH secundário: Doença Aguda Adolescente Adulto Idoso Angiografia Emergências Feminino Hemorragia Gastrointestinal/etiologia Seres Humanos Masculino Meia-Idade Estudos Retrospectivos Resultado do Tratamento Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180209 [Lr] Data última revisão: 180209 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180201 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000009437

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[PMID]: 29382000 [Au] Autor: Zhang B; Zou Y; Yang M; Niu G [Ad] Endereço: Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Peking University, Beijing, China. [Ti] Título: Endovascular management of renal artery aneurysms induced by neurofibromatosis type 1: A case report. [So] Source: Medicine (Baltimore);96(47):e8858, 2017 Nov. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: RATIONALE: Neurofibromatosis type 1 (NF-1) is an autosomal dominant disorder characterized by cafe au lait macules and neurofibromatosis. Renal artery aneurysms are relatively uncommon. Endovascular techniques are effective in treating renal aneurysms but successful cases are rarely reported in NF-1 adults. PATIENT CONCERNS: The patient was one 23-year-old female presented with hypertension, multiple café-au-lait spots ≥15 mm, and plexiform neurofibroma. Renal artery aneurysms were found by ultrasound. DIAGNOSES: NF-1 was diagnosed based on clinical manifestations and confirmed by gene test. Renal artery aneurysms were diagnosed based on computed tomography. INTERVENTIONS: Bilateral renal artery angiography was performed and 3 aneurysms were found sequentially on the left anterior superior segmental artery. Microcoil embolization of aneurysms was undertaken. OUTCOMES: The patient's blood pressure decreased after the procedure with reduction of medicine. A 3-month follow-up unilateral selective renal angiogram demonstrated little change in size of aneurysms, and no opacification of the aneurysmal sac was found. Serum creatinine remained in normal range at 3-month. LESSONS: Successful endovascular treatment for NF-1 related renal artery aneurysms in adults is reported for the 1st time with preserved renal function and improved hypertension. Endovascular procedure is considered to be feasible and effective for renal artery aneurysms induced by NF-1. [Mh] Termos MeSH primário: Aneurisma/terapia Procedimentos Endovasculares/métodos Neurofibromatose 1/complicações Artéria Renal/diagnóstico por imagem [Mh] Termos MeSH secundário: Aneurisma/etiologia Angiografia/métodos Embolização Terapêutica/métodos Feminino Seres Humanos Neurofibroma Plexiforme Stents Adulto Jovem [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180209 [Lr] Data última revisão: 180209 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180201 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000008858

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[PMID]: 29332910 [Au] Autor: Kato K; Kato T; Hayano S; Fukasawa Y; Numaguchi A; Hattori T; Saito A; Sato Y; Hayakawa M [Ad] Endereço: Department of Pediatrics, Nagoya University Graduate School of Medicine. [Ti] Título: Successful Infant Pneumonectomy with Unilateral Pulmonary Artery Occlusion Test. [So] Source: Int Heart J;59(1):237-239, 2018 Jan 27. [Is] ISSN: 1349-3299 [Cp] País de publicação: Japan [La] Idioma: eng [Ab] Resumo: The use of unilateral pulmonary artery occlusion (UPAO) test for the preoperative evaluation of pneumonectomy was reported in adult patients. On the contrary, in infants, no strategies have yet been recommended to predict hemodynamics after pneumonectomy, nor has use of the UPAO test been reported. We describe the first case of infant with abnormal pulmonary circulation in whom successful pneumonectomy was performed after preoperative evaluation using UPAO test. Right pneumonectomy was planned for an 8-month-old girl, because of decreased right pulmonary function, high risk of pneumothorax, and impaired left lung expansion due to overexpansion caused by severe left bronchial stenosis and bronchomalacia. However, she had also prolonged pulmonary hypertension and there was difficulty in accurate echocardiographic evaluation of its severity due to concomitant left pulmonary artery stenosis. Furthermore, contrast-enhanced computer tomography suggested a certain degree of right pulmonary venous flow, discordant with the result showing scarce right pulmonary flow in perfusion scintigraphy. Predicting postoperative hemodynamic changes was therefore considered difficult. To evaluate these concerns, we performed cardiac catheterization and UPAO test to simulate postoperative hemodynamics. Pulmonary arteriography showed decreased but significant right pulmonary arterial and venous flows. Measurements including pulmonary artery pressure and cardiac index showed no marked changes after occlusion. Based on UPAO test results, the operation was successfully performed and hemodynamics remained stable postoperatively. The UPAO test may be useful for infants with cardiopulmonary impairment to evaluate the tolerability of pneumonectomy. [Mh] Termos MeSH primário: Anormalidades Múltiplas Broncomalácia/cirurgia Testes de Função Cardíaca/métodos Pneumonectomia/métodos Artéria Pulmonar/fisiopatologia Circulação Pulmonar/fisiologia Estenose de Artéria Pulmonar/cirurgia [Mh] Termos MeSH secundário: Angiografia Broncomalácia/congênito Broncomalácia/diagnóstico Feminino Seres Humanos Lactente Artéria Pulmonar/diagnóstico por imagem Cintilografia Estenose de Artéria Pulmonar/congênito Estenose de Artéria Pulmonar/diagnóstico Resistência Vascular Função Ventricular Direita/fisiologia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180206 [Lr] Data última revisão: 180206 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180116 [St] Status: MEDLINE [do] DOI: 10.1536/ihj.16-606

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[PMID]: 29279534 [Au] Autor: Her AY; Lim KH; Shin ES [Ad] Endereço: Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine. [Ti] Título: Transcatheter Retrieval of Embolized Atrial Septal Defect Occluder Device by Waist Capture Technique. [So] Source: Int Heart J;59(1):226-228, 2018 Jan 27. [Is] ISSN: 1349-3299 [Cp] País de publicação: Japan [La] Idioma: eng [Ab] Resumo: This case study describes the successful percutaneous transcatheter retrieval of an embolized Amplatzer occluder device using the "waist capture technique" in a patient with an atrial septal defect. This technique allowed for stability of the Amplatzer device, compression of the atrial discs for easier removal, prevention of further embolization, and minimal injury to vasculature during device retrieval. This novel and effective technique can be used safely for the retrieval of Amplatzer devices in the venous system. [Mh] Termos MeSH primário: Cateterismo Cardíaco/métodos Remoção de Dispositivo/métodos Embolia/cirurgia Comunicação Interatrial/cirurgia Dispositivo para Oclusão Septal/efeitos adversos [Mh] Termos MeSH secundário: Angiografia Ecocardiografia Transesofagiana Embolia/diagnóstico Embolia/etiologia Comunicação Interatrial/diagnóstico Seres Humanos Masculino Meia-Idade Falha de Prótese Reoperação [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180206 [Lr] Data última revisão: 180206 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171228 [St] Status: MEDLINE [do] DOI: 10.1536/ihj.17-227

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[PMID]: 29311538 [Au] Autor: Carneiro Júnior FCF; Carrijo ENDA; Araújo ST; Nakano LCU; de Amorim JE; Cacione DG [Ad] Endereço: Service of Vascular and Endovascular Surgery, Federal University of São Paulo, São Paulo, SP, Brazil. [Ti] Título: Popliteal Artery Entrapment Syndrome: A Case Report and Review of the Literature. [So] Source: Am J Case Rep;19:29-34, 2018 Jan 09. [Is] ISSN: 1941-5923 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND Popliteal artery entrapment syndrome (PAES) results from an anomalous relationship between the popliteal artery and the myofascial structures of the popliteal fossa. The most common presenting symptoms include intermittent pain in the feet and calves on exercise, resulting in lameness. PAES can lead to popliteal artery thrombosis, stenosis, distal arterial thromboembolism, or arterial aneurysm. The treatment of PAES includes surgical exploration with fasciotomy, myotomy, or sectioning of fibrous band formation, to release the popliteal artery. However, in cases with thrombotic occlusion, thromboendarterectomy with venous patch arterioplasty, or venous graft arterial bypass surgery may be required. This report describes the presentation and surgical management of a case of PAES presenting with limb pain and includes a review of the literature on this condition. CASE REPORT A previously healthy 47-year-old woman presented with a 20-day history of sudden pain in the left lower limb, associated with pallor and a loss of arterial pulses below the knee. Angiography of the affected limb showed occlusion of the left supragenicular popliteal artery, with arterial occlusion, suggestive of arterial thrombus. Imaging of the right popliteal artery, which was not occluded, showed that it was medially deviated. An ipsilateral saphenous vein graft was used to bypass the left supragenicular popliteal artery to the infragenicular popliteal artery, resulting in resolution of the patient's symptoms. CONCLUSIONS PAES is rare and can be under-diagnosed, possibly due to lack of knowledge of this condition. However, if the diagnosis is made early, the prognosis is usually favorable, following appropriate surgical treatment. [Mh] Termos MeSH primário: Arteriopatias Oclusivas/cirurgia Artéria Poplítea Veia Safena/transplante Trombose/cirurgia [Mh] Termos MeSH secundário: Angiografia/métodos Arteriopatias Oclusivas/diagnóstico por imagem Arteriopatias Oclusivas/etiologia Feminino Seres Humanos Meia-Idade Artéria Poplítea/diagnóstico por imagem Artéria Poplítea/cirurgia Síndrome Trombose/diagnóstico por imagem Resultado do Tratamento Grau de Desobstrução Vascular [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180205 [Lr] Data última revisão: 180205 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180110 [St] Status: MEDLINE

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[PMID]: 28941396 [Au] Autor: Wang Z; Martin KH; Dayton PA; Jiang X [Ad] Endereço: Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA; State Key Laboratory of Precision Measuring Technology & Instruments, Tianjin University, Tianjin 300072, PR China. [Ti] Título: Real-time ultrasound angiography using superharmonic dual-frequency (2.25MHz/30MHz) cylindrical array: In vitro study. [So] Source: Ultrasonics;82:298-303, 2018 01. [Is] ISSN: 1874-9968 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: Recent studies suggest that dual-frequency intravascular ultrasound (IVUS) transducers allow detection of superharmonic bubble signatures, enabling acoustic angiography for microvascular and molecular imaging. In this paper, a dual-frequency IVUS cylindrical array transducer was developed for real-time superharmonic imaging. A reduced form-factor lateral mode transmitter (2.25MHz) was used to excite microbubbles effectively at 782kPa with single-cycle excitation while still maintaining the small size and low profile (5Fr) (3Fr=1mm) for intravascular imaging applications. Superharmonic microbubble responses generated in simulated microvessels were captured by the high frequency receiver (30MHz). The axial and lateral full-width half-maximum of microbubbles in a 200-µm-diameter cellulose tube were measured to be 162µm and 1039µm, respectively, with a contrast-to-noise ratio (CNR) of 16.6dB. Compared to our previously reported single-element IVUS transducers, this IVUS array design achieves a higher CNR (16.6dBvs 11dB) and improved axial resolution (162µmvs 616µm). The results show that this dual-frequency IVUS array transducer with a lateral-mode transmitter can fulfill the native design requirement (∼3-5Fr) for acoustic angiography by generating nonlinear microbubble responses as well as detecting their superharmonic responses in a 5Fr form factor. [Mh] Termos MeSH primário: Angiografia/instrumentação Ultrassonografia/instrumentação [Mh] Termos MeSH secundário: Desenho de Equipamento Técnicas In Vitro Microbolhas Microvasos Imagens de Fantasmas Transdutores [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S. [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180123 [Lr] Data última revisão: 180123 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170924 [St] Status: MEDLINE

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