Subjects -> MEDICAL SCIENCES (Total: 8810 journals)
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INTERNAL MEDICINE (180 journals)                     

Showing 1 - 180 of 180 Journals sorted alphabetically
Abdomen     Open Access  
ACP Hospitalist     Full-text available via subscription   (Followers: 9)
ACP Internist     Full-text available via subscription   (Followers: 10)
ACP Journal Club     Full-text available via subscription   (Followers: 11)
Acta Clinica Belgica     Hybrid Journal   (Followers: 1)
Acute and Critical Care     Open Access   (Followers: 11)
Acute Medicine     Full-text available via subscription   (Followers: 9)
Advances in Hepatology     Open Access   (Followers: 4)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
African Journal of Primary Health Care & Family Medicine     Open Access   (Followers: 6)
African Journal of Thoracic and Critical Care Medicine     Open Access  
American Family Physician     Full-text available via subscription   (Followers: 38)
American Journal of Hypertension     Hybrid Journal   (Followers: 31)
Anales de Medicina Interna     Open Access   (Followers: 1)
Anatomy & Physiology : Current Research     Open Access   (Followers: 9)
Angiology     Hybrid Journal   (Followers: 5)
Annals of Colorectal Research     Open Access   (Followers: 1)
Annals of Internal Medicine     Full-text available via subscription   (Followers: 392)
AORN Journal     Hybrid Journal   (Followers: 27)
Apollo Medicine     Open Access  
Archives of Drug Information     Hybrid Journal   (Followers: 5)
Archivos de Medicina Interna     Open Access   (Followers: 1)
Asia Oceania Journal of Nuclear Medicine & Biology     Open Access   (Followers: 4)
Asian Pacific Journal of Tropical Disease     Full-text available via subscription   (Followers: 3)
Australasian Physical & Engineering Sciences in Medicine     Hybrid Journal   (Followers: 1)
BMI Journal : Bariátrica & Metabólica Iberoamericana     Open Access   (Followers: 1)
BMJ Open Diabetes Research & Care     Open Access   (Followers: 35)
BMJ Quality & Safety     Hybrid Journal   (Followers: 69)
Bone & Joint Journal     Hybrid Journal   (Followers: 138)
Brain Communications     Open Access   (Followers: 4)
Brain Science Advances     Open Access  
Canadian Journal of General Internal Medicine     Open Access   (Followers: 2)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Case Reports in Internal Medicine     Open Access   (Followers: 1)
Cell Death & Disease     Open Access   (Followers: 3)
Cellular and Molecular Gastroenterology and Hepatology     Open Access   (Followers: 3)
Cephalalgia     Hybrid Journal   (Followers: 8)
Cephalalgia Reports     Open Access   (Followers: 4)
Chronic Diseases and Injuries in Canada     Free   (Followers: 1)
Clinical Ethics     Hybrid Journal   (Followers: 13)
Clinical Liver Disease     Open Access   (Followers: 5)
Clinical Nutrition     Hybrid Journal   (Followers: 98)
Clinical Thyroidology     Full-text available via subscription   (Followers: 1)
CNE Pflegemanagement     Hybrid Journal  
Communication Law and Policy     Hybrid Journal   (Followers: 5)
Current Diabetes Reports     Hybrid Journal   (Followers: 30)
Current Hepatology Reports     Hybrid Journal  
Current Research: Integrative Medicine     Open Access  
CVIR Endovascular     Open Access   (Followers: 1)
Der Internist     Hybrid Journal   (Followers: 12)
Diabetes     Full-text available via subscription   (Followers: 603)
Diabetes Care     Full-text available via subscription   (Followers: 578)
Diabetes Internacional     Open Access  
Diabetes Spectrum     Full-text available via subscription   (Followers: 17)
Diagnosis     Hybrid Journal   (Followers: 1)
Egyptian Journal of Bronchology     Open Access  
Egyptian Journal of Internal Medicine     Open Access   (Followers: 1)
Egyptian Journal of Neurosurgery     Open Access  
Egyptian Liver Journal     Open Access   (Followers: 2)
Egyptian Spine Journal     Open Access  
EMC - Aparato Locomotor     Hybrid Journal  
Endovascular Neuroradiology / Ендоваскулярна нейрорентгенохірургія     Open Access   (Followers: 1)
eNeuro     Open Access   (Followers: 3)
Ergonomics     Hybrid Journal   (Followers: 24)
European Journal of Inflammation     Open Access   (Followers: 2)
European Journal of Internal Medicine     Full-text available via subscription   (Followers: 10)
European Journal of Translational Myology     Open Access  
European Radiology Experimental     Open Access   (Followers: 2)
Head and Neck Tumors     Open Access   (Followers: 1)
Health Sociology Review     Hybrid Journal   (Followers: 14)
HemaSphere     Open Access   (Followers: 2)
Hepatology Communications     Open Access  
Hepatoma Research     Open Access   (Followers: 3)
Human Physiology     Hybrid Journal   (Followers: 5)
ImmunoHorizons     Open Access  
Immunological Medicine     Open Access  
Infectious Diseases: Research and Treatment     Open Access   (Followers: 5)
Inflammation and Regeneration     Open Access   (Followers: 2)
Inflammatory Intestinal Diseases     Open Access  
Innere Medizin up2date     Hybrid Journal   (Followers: 1)
Internal and Emergency Medicine     Hybrid Journal   (Followers: 5)
Internal Medicine Journal     Hybrid Journal   (Followers: 9)
International Journal of Abdominal Wall and Hernia Surgery     Open Access   (Followers: 1)
International Journal of Anatomy and Research     Open Access   (Followers: 2)
International Journal of Angiology     Hybrid Journal  
International Journal of Artificial Organs     Hybrid Journal   (Followers: 3)
International Journal of Hyperthermia     Open Access  
International Journal of Internal Medicine     Open Access   (Followers: 3)
International Journal of Noncommunicable Diseases     Open Access  
International Journal of Psychiatry in Clinical Practice     Hybrid Journal   (Followers: 6)
Iranian Journal of Neurosurgery     Open Access   (Followers: 1)
Italian Journal of Anatomy and Embryology     Open Access   (Followers: 1)
JAC-Antimicrobial Resistance     Open Access   (Followers: 4)
JAMA Internal Medicine     Full-text available via subscription   (Followers: 364)
JCSM Clinical Reports     Open Access   (Followers: 3)
JHEP Reports     Open Access  
JIMD Reports     Open Access  
JMV - Journal de Médecine Vasculaire     Hybrid Journal   (Followers: 1)
Joint Commission Journal on Quality and Patient Safety     Hybrid Journal   (Followers: 41)
JOP. Journal of the Pancreas     Open Access   (Followers: 2)
Journal of Basic & Clinical Physiology & Pharmacology     Hybrid Journal   (Followers: 1)
Journal of Bone Oncology     Open Access   (Followers: 1)
Journal of Cancer & Allied Specialties     Open Access  
Journal of Clinical and Experimental Hepatology     Full-text available via subscription   (Followers: 3)
Journal of Clinical Movement Disorders     Open Access   (Followers: 3)
Journal of Community Hospital Internal Medicine Perspectives     Open Access  
Journal of Cutaneous Immunology and Allergy     Open Access  
Journal of Developmental Origins of Health and Disease     Hybrid Journal   (Followers: 2)
Journal of Endoluminal Endourology     Open Access  
Journal of Gastroenterology and Hepatology Research     Open Access   (Followers: 4)
Journal of General Internal Medicine     Hybrid Journal   (Followers: 23)
Journal of Hypertension     Hybrid Journal   (Followers: 14)
Journal of Infectious Diseases     Hybrid Journal   (Followers: 48)
Journal of Interdisciplinary Medicine     Open Access  
Journal of Internal Medicine     Hybrid Journal   (Followers: 11)
Journal of Liver : Disease & Transplantation     Hybrid Journal   (Followers: 7)
Journal of Medical Internet Research     Open Access   (Followers: 24)
Journal of Movement Disorders     Open Access   (Followers: 2)
Journal of Pain and Symptom Management     Hybrid Journal   (Followers: 46)
Journal of Pancreatic Cancer     Open Access  
Journal of Renal and Hepatic Disorders     Open Access  
Journal of Solid Tumors     Open Access   (Followers: 1)
Journal of Sports Medicine and Allied Health Sciences : Official Journal of the Ohio Athletic Trainers Association     Open Access   (Followers: 1)
Journal of the American Board of Family Medicine     Open Access   (Followers: 11)
Journal of the European Mosquito Control Association     Open Access  
Journal of Translational Internal Medicine     Open Access  
Jurnal Vektor Penyakit     Open Access  
La Revue de Medecine Interne     Full-text available via subscription   (Followers: 3)
Lege artis - Das Magazin zur ärztlichen Weiterbildung     Hybrid Journal   (Followers: 1)
Liver Cancer International     Open Access  
Liver Research     Open Access  
Molecular Diagnosis & Therapy     Hybrid Journal   (Followers: 3)
Molecular Therapy - Oncolytics     Open Access  
Multiple Sclerosis and Demyelinating Disorders     Open Access   (Followers: 7)
MYOPAIN. A journal of myofascial pain and fibromyalgia     Hybrid Journal   (Followers: 18)
Neuro-Oncology Advances     Open Access   (Followers: 1)
Neurobiology of Pain     Open Access   (Followers: 2)
Neurointervention     Open Access   (Followers: 6)
Neuromuscular Diseases     Open Access  
Nigerian Journal of Gastroenterology and Hepatology     Full-text available via subscription  
OA Alcohol     Open Access   (Followers: 5)
Oncological Coloproctology     Open Access  
Open Journal of Internal Medicine     Open Access  
Pleura and Peritoneum     Open Access  
Pneumo News     Full-text available via subscription  
Polish Archives of Internal Medicine     Full-text available via subscription   (Followers: 2)
Preventing Chronic Disease     Free   (Followers: 2)
Progress in Transplantation     Hybrid Journal   (Followers: 1)
Prostate International     Open Access   (Followers: 2)
Psychiatry and Clinical Psychopharmacology     Open Access   (Followers: 1)
Pulmonary Therapy     Open Access   (Followers: 2)
Quality of Life Research     Hybrid Journal   (Followers: 20)
Research and Practice in Thrombosis and Haemostasis     Open Access  
Revista Chilena de Fonoaudiología     Open Access   (Followers: 1)
Revista de la Sociedad Peruana de Medicina Interna     Open Access   (Followers: 4)
Revista del Instituto de Medicina Tropical     Open Access  
Revista Hispanoamericana de Hernia     Open Access   (Followers: 1)
Revista Médica Internacional sobre el Síndrome de Down     Full-text available via subscription   (Followers: 1)
Revista Virtual de la Sociedad Paraguaya de Medicina Interna     Open Access   (Followers: 1)
Romanian Journal of Diabetes Nutrition and Metabolic Diseases     Open Access   (Followers: 1)
Romanian Journal of Internal Medicine     Open Access  
Russian Journal of Child Neurology     Open Access   (Followers: 1)
Scandinavian Journal of Primary Health Care     Open Access   (Followers: 8)
Schlaf     Hybrid Journal  
Schmerzmedizin     Hybrid Journal  
Scientific Journal of the Foot & Ankle     Open Access   (Followers: 1)
SciMedicine Journal     Open Access   (Followers: 3)
SEMERGEN - Medicina de Familia     Full-text available via subscription   (Followers: 1)
The Journal of Critical Care Medicine     Open Access   (Followers: 9)
Therapeutic Advances in Chronic Disease     Open Access   (Followers: 8)
Therapeutic Advances in Musculoskeletal Disease     Hybrid Journal   (Followers: 6)
Thieme Case Report     Hybrid Journal   (Followers: 1)
Tijdschrift voor Urologie     Hybrid Journal  
Tissue Barriers     Hybrid Journal   (Followers: 1)
Transactions of the Royal Society of Tropical Medicine and Hygiene     Hybrid Journal   (Followers: 3)
Transgender Health     Open Access   (Followers: 3)
Trends in Anaesthesia and Critical Care     Full-text available via subscription   (Followers: 23)
US Cardiology Review     Open Access  
Vascular and Endovascular Review     Open Access   (Followers: 1)
Ожирение и метаболизм     Open Access  

           

Similar Journals
Journal Cover
International Journal of Angiology
Journal Prestige (SJR): 0.279
Citation Impact (citeScore): 1
Number of Followers: 0  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1061-1711 - ISSN (Online) 1615-5939
Published by Thieme Publishing Group Homepage  [243 journals]
  • Erratum to: Efficacy of Coronary Computed Tomography Angiography for the
           De Novo Detection of Chronic Total Occlusion Prior to Coronary
           Angiography: A Preliminary and Retrospective Study
    • Int J Angiol 2020; 29: e1-e1
      DOI: 10.1055/s-0041-1723814



      Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Int J Angiol 2020; 29: e1-e12021-03-03T00:00:00+0100
      Issue No: Vol. 29, No. 04 (2021)
       
  • An “Occult” Popliteal Vein Aneurysm Causing Pulmonary Embolism
    • Authors: Oladiran; Adedapo, Maharaj, Dale, Ariyanayagam, Dinesh, Darling, Ralph Clement
      Abstract: Popliteal vein aneurysm (PVAs), though uncommon, can be a cause of pulmonary emboli. They can also result in pulmonary vein embolism despite the use of anticoagulation therapy.We report the case of an otherwise fit, 64-year-old male who had a history of sudden onset of dyspnea on exercise with near syncope.A computed tomography pulmonary angiogram confirmed filling defects in the lung bases in keeping with pulmonary emboli. He was anticoagulated and a venous duplex scan revealed a fusiform suprageniculate PVA with no evidence of thrombus in the lumen. He underwent resection of the aneurysm with lateral vein patch graft repair and was placed on anticoagulation for 6 months with no recurrence after 2 years of follow-up.PVAs are rare and can either be symptomatic or asymptomatic. We advise early surgical treatment to prevent the significant morbidity and mortality associated with thromboembolization.Written consent was obtained from the patient for publication of case and use of images.
      Citation: Int J Angiol ; : -
      PubDate: 2021-04-20T00:00:00+01:00
      DOI: 10.1055/s-0041-1725994
       
  • Performance of Primary Angioplasty for STEMI during the COVID-19 Outbreak
    • Authors: Dharma; Surya, Dakota, Iwan, Firdaus, Isman, Danny, Siska Suridanda, Zamroni, Dian, Yudha, Ardi, Susanto, Agus, Siswanto, Bambang Budi
      Abstract: There has been concern whether the declining cases of ST-segment elevation myocardial infarction (STEMI) during the coronavirus disease 2019 (COVID-19) outbreak associate with primary angioplasty performance.We assessed the performance of primary angioplasty in a tertiary care hospital in Jakarta, Indonesia, by comparing the door-to-device (DTD) time and thrombolysis in myocardial infarction (TIMI) flow after angioplasty between two periods of admission: during the outbreak of COVID-19 (March 1 to May 31, 2020) and before the outbreak (March 1, to May 31, 2019).Overall, there was a relative reduction of 44% for STEMI admission during the outbreak (n = 116) compared with before the outbreak (N = 208). Compared with before the outbreak period (n = 141), STEMI patients who admitted during the outbreak and received primary angioplasty (n = 70) had similar median symptom onset-to-angioplasty center admission (360 minutes for each group), similar to radial access uptake (90 vs. 89.4%, p = 0.88) and left anterior descending infarct-related artery (54.3 vs. 58.9%, p = 0.52). The median DTD time and total ischemia time were longer (104 vs. 81 minutes, p 
      Citation: Int J Angiol ; : -
      PubDate: 2021-04-20T00:00:00+01:00
      DOI: 10.1055/s-0041-1727133
       
  • Relationship between Mean Platelet Volume and Critical Limb Ischemia in
           Diabetes Mellitus Patients
    • Authors: Rachmanadi; Muhammad Berian, Ismail, Muhamad Taufik, Anggraeni, Vita Yanti
      Abstract: Background The prevalence of diabetes mellitus continues to increase from year to year. Critical limb ischemia (CLI) is one of the complications of diabetes mellitus with a high mortality rate and requires amputation if not treated properly. Mean platelet volume (MPV) is an indicator of platelet activation and is expected to be a predictor of CLI in diabetes mellitus patients. Aim This article investigates the relationship between MPV and the incidence of CLI in diabetes mellitus patients. Method This case–control study was conducted using the vascular registry of Dr. Sardjito Hospital, Yogyakarta, Indonesia, from January 2016 to December 2016. The relationship between MPV and the incidence of CLI was analyzed using bivariate and multivariate analysis. Result There was a significant association between MPV and incidence of CLI in diabetes mellitus patient both on bivariate analysis (p = 0.035) and multivariate analysis (p = 0.029). Diabetes mellitus patients with MPV values of ≥ 9.8 fl had a protective effect to prevent the incidence of CLI (bivariate analysis: odds ratio [OR] = 0.366, 95% confidence interval [CI] = 0.142–0.943; multivariate analysis: adjusted OR = 0.288, 95% CI = 0.09–0.88). Confounding factors such as sex, age, obesity, and use of antiplatelet agents were not associated with the incidence of CLI (p > 0.05). Meanwhile, history of dyslipidemia as a confounding factor was significantly associated with the incidence of CLI (p 
      Citation: Int J Angiol ; : -
      PubDate: 2021-04-20T00:00:00+01:00
      DOI: 10.1055/s-0041-1726468
       
  • Management of ST Elevation Myocardial Infarction (STEMI) in Different
           Settings
    • Authors: Partow-Navid; Rod, Prasitlumkum, Narut, Mukherjee, Ashish, Varadarajan, Padmini, Pai, Ramdas G.
      Abstract: ST-segment elevation myocardial infarction (STEMI) is a life-threatening condition that requires emergent, complex, well-coordinated treatment. Although the primary goal of treatment is simple to describe—reperfusion as quickly as possible—the management process is complicated and is affected by multiple factors including location, patient, and practitioner characteristics. Hence, this narrative review will discuss the recommended management and treatment strategies of STEMI in the circumstances.
      Citation: Int J Angiol ; : -
      PubDate: 2021-03-24T00:00:00+0100
      DOI: 10.1055/s-0041-1723944
       
  • COVID-19 in an Asymptomatic Renal Transplant Recipient Employed in the
           Health Care Setting: A Case Report
    • Authors: Adnani; Harsha, Khatri, Akshay, Agrawal, Nirav, Molmenti, Ernesto, Bhaskaran, Madhu
      Abstract: During the ongoing pandemic, there have been varying presentations of coronavirus disease 2019 (COVID-19) infection, with the concern that patients who are immunosuppressed (due to underlying medical conditions and/or therapies) are at higher risk of severe disease. We report the case of an elderly renal transplant recipient working in a long-term health care facility who was being monitored by weekly surveillance testing and tested positive for COVID-19 by polymerase chain reaction (PCR) testing, despite having no clinical symptoms. He recovered with supportive care, despite being on multiple long-term immunosuppressant drugs and having multiple comorbidities. Additionally, it was found that he did not mount an antibody response, when he tested negative by serologic testing. Through this case, we wish to highlight the unique clinical scenario of asymptomatic patients who may have an underwhelming immune response to COVID-19, but may nevertheless be an important source of dissemination. We further discuss the probable mechanism of such asymptomatic presentations in immunosuppressed patients, while reinforcing the importance of self-isolation of COVID-19 patients (particularly in asymptomatic health care workers).
      Citation: Int J Angiol ; : -
      PubDate: 2021-03-11T00:00:00+0100
      DOI: 10.1055/s-0041-1725183
       
  • Stents as Bridge to Arterial Switch Operation for D-Transposition of Great
           Arteries Late Presenter
    • Authors: Liman; Novita Gemalasari, Prakoso, Radityo
      Abstract: We report a 5-month-old infant with dextro-transposition of great arteries (D-TGA) with intact ventricular septum (IVS) who had low left ventricular mass index, small patent ductus arteriosus (PDA), and stretched patent foramen ovale. The patient had respiratory failure due to pneumonia. The surgical intervention was considered very high risk. Thus, the patient underwent PDA stenting with balloon predilation technique followed by atrial septal stenting with false impression of dislodgement—“pseudo-dislodgement” because of inadvertent retraction of patent foramen ovale that was confirmed by transthoracic echocardiography guidance. After the procedure, the left ventricular mass index improved and patient was planned for arterial switch operation. The combined approach of PDA and atrial septal stenting may provide potential nonsurgical method of ventricular preparation for D-TGA/IVS late presenter, acting as a bridge to arterial switch operation especially those living in remote areas.
      Citation: Int J Angiol ; : -
      PubDate: 2021-03-11T00:00:00+0100
      DOI: 10.1055/s-0041-1726129
       
  • Repeated Cerebral Infarction Immediately after Bypass Graft Angiography: A
           Case Report
    • Authors: Monden; Masaki, Murata, Nobuhiro, Takahashi, Kurara, Fukamachi, Daisuke, Okumura, Yasuo
      Abstract: A cerebral infarction (CI) is a common complication of coronary angiography (CAG); however, repeated CIs in the immediate period after a CAG have not been reported yet. The patient in the present study experienced left upper quadrant blindness immediately after internal thoracic arteriography, and magnetic resonance imaging (MRI) showed a high-intensity area in the right occipital lobe. Despite the administration of antithrombotic therapy, the patient became transiently comatose for 6 hours. MRI showed a new high-intensity area in the left thalamus. A noninvasive assessment should be considered before internal thoracic arteriography to prevent the risk of complications.
      Citation: Int J Angiol ; : -
      PubDate: 2021-03-11T00:00:00+0100
      DOI: 10.1055/s-0041-1725182
       
  • Aortic Delamination—A Possible Precursor of Impending Catastrophe
    • Authors: Saeyeldin; Ayman, Zafar, Mohammad A., Baldassarre, Lauren A., Mojibian, Hamid, Ziganshin, Bulat A., Mukherjee, Sandip K., Elefteriades, John A.
      Abstract: Aortic diameter is a powerful predictor of adverse aortic events, such as aortic rupture or dissection, forming the basis of prophylactic surgical repair criteria. Limited evidence is available regarding the association of aortic wall thickness (AWT) with these adverse aortic events. We present the case and surgical video of a 73-year-old man with chest pain and an increased AWT, who underwent ascending aortic repair and deep hemiarch placement under deep hypothermic circulatory arrest. Surgical pathology demonstrated evidence of aortic delamination and medial separation, indicative of an impending dissection. The patient recovered uneventfully, and his chest pain ultimately resolved after open repair. In this patient, increased AWT was felt to be the precursor to a potential aortic catastrophe.
      Citation: Int J Angiol ; : -
      PubDate: 2021-03-11T00:00:00+0100
      DOI: 10.1055/s-0040-1718546
       
  • A Rare Case of Thrombus Aspiration Device Stuck in the Stent
    • Authors: Gupta; Himanshu, Rajan, Palanivel, Singh, Harkant, Agstam, Sourabh, Revaiah, Pruthvi C.
      Abstract: Hardware loss and entrapment during percutaneous coronary intervention is one of the important complications, which an interventionist should anticipate in his practice. Basic knowledge about various extraction methods is essential to bail out in such situations. We describe a 74-year-old male, in whom a used thrombuster device got stuck in struts of an already deployed stent in the right coronary artery. The device could not be retrieved via various percutaneous maneuvers, necessitating an emergency surgical device retrieval and concomitant coronary bypass.
      Citation: Int J Angiol ; : -
      PubDate: 2021-03-03T00:00:00+0100
      DOI: 10.1055/s-0041-1724041
       
  • Erratum to: Reliability of the Mangled Extremity Severity Score in the
           Management of Peripheral Vascular Injuries in Children: A Retrospective
           Review
    • Int J Angiol
      DOI: 10.1055/s-0041-1723815



      Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Int J Angiol ; : -2021-03-03T00:00:00+0100
       
  • Myocardial Infarction with Nonobstructive Coronary Artery
           Disease—Definition, Etiopathogenesis, Diagnosis, and Management
    • Authors: Baghdasaryan; Patrick, Natarajan, Balaji, Nalbandian, Madlena, Varadarajan, Padmini, Pai, Ramdas G.
      Abstract: Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a complex clinical syndrome that is characterized by evidence of acute myocardial infarction in the absence of significant epicardial coronary artery disease on angiography. The term “MINOCA” encompasses a group of heterogeneous diseases with varying underlying mechanisms and each with its own pathophysiology. Overlooked plaque rupture or erosion and coronary vasospasm are the most common causes of MINOCA and can be diagnosed by routine intracoronary imaging and vasoreactivity testing, respectively. Coronary microvascular dysfunction is a less recognized, albeit an important cause of morbidity in patients presenting with MINOCA. Although MINOCA is a rare presentation of acute coronary syndrome, it is not a benign disorder and can have adverse consequences if untreated. In this article, we aim to review the pathogenesis, clinical characteristics, and finally propose a systematic approach in the diagnosis and management of patients with MINOCA.
      Citation: Int J Angiol ; : -
      PubDate: 2021-03-03T00:00:00+0100
      DOI: 10.1055/s-0041-1724040
       
  • Pathophysiology, Diagnosis, and Management of Coronary No-Reflow
           Phenomenon
    • Authors: Kaur; Gagan, Baghdasaryan, Patrick, Natarajan, Balaji, Sethi, Prabhdeep, Mukherjee, Ashis, Varadarajan, Padmini, Pai, Ramdas G.
      Abstract: Coronary no-reflow phenomenon is a lethal mechanism of ongoing myocardial injury, following successful revascularization of an infarct-related coronary artery. Incidence of this phenomenon is high following percutaneous intervention, and is associated with adverse in-hospital and long-term outcomes. Several mechanisms such as ischemia-reperfusion injury and distal microthromboembolism in genetically susceptible patients and those with preexisting endothelial dysfunction have been implicated. However, the exact mechanism in humans is still poorly understood. Several investigative and treatment strategies within and outside the cardiac catheterization laboratory have been proposed, but have not uniformly shown success in reducing mortality or in preventing adverse left ventricular remodeling resulting from this condition. The aim of this article is to provide a brief and concise review of the current understanding of the pathophysiology, clinical predictors, and investigations and management of coronary no-reflow phenomenon.
      Citation: Int J Angiol ; : -
      PubDate: 2021-03-03T00:00:00+0100
      DOI: 10.1055/s-0041-1725979
       
  • Effect of PCSK9 E670G and R46L Polymorphisms on Major Adverse
           Cardio-Cerebrovascular Events in Patients with ST-Segment Elevation
           Myocardial Infarction Undergoing Primary Percutaneous Coronary
           Intervention
    • Authors: Santoso; Anwar, Yulianto, Yulianto, Simarmata, Hendra, Putra, Abhirama Nofandra, Listiyaningsih, Erlin
      Abstract: Major adverse cardio-cerebrovascular events (MACCE) in ST-segment elevation myocardial infarction (STEMI) are still high, although there have been advances in pharmacology and interventional procedures. Proprotein convertase subtilisin/Kexin type 9 (PCSK9) is a serine protease regulating lipid metabolism associated with inflammation in acute coronary syndrome. The MACCE is possibly related to polymorphisms in PCSK9. A prospective cohort observational study was designed to confirm the association between polymorphism of E670G and R46L in the PCSK9 gene with MACCE in STEMI. The Cox proportional hazards model and Spearman correlation were utilized in the study. The Genotyping of PCSK9 and ELISA was assayed.Sixty-five of 423 STEMI patients experienced MACCE in 6 months. The E670G polymorphism in PCSK9 was associated with MACCE (hazard ratio = 45.40; 95% confidence interval: 5.30–390.30; p = 0.00). There was a significant difference of PCSK9 plasma levels in patients with previous statin consumption (310 [220–1,220] pg/mL) versus those free of any statins (280 [190–1,520] pg/mL) (p = 0.001).E670G polymorphism of PCSK9 was associated with MACCE in STEMI within a 6-month follow-up. The plasma PCSK9 level was higher in statin users.
      Citation: Int J Angiol ; : -
      PubDate: 2021-02-18T00:00:00+0100
      DOI: 10.1055/s-0041-1722875
       
  • Therapeutic Options for Left Main, Left Main Equivalent, and Three-Vessel
           Disease
    • Authors: Glazier; James J., Ramos-Parra, Bayoan, Kaki, Amir
      Abstract: Patients with left main, left main equivalent, and three-vessel coronary artery disease (CAD) represent an overlapping spectrum of patients with advanced CAD that is associated with an adverse prognosis. Guideline-directed medical therapy is a necessary but often insufficient treatment option, as such patients frequently need mechanical revascularization by either coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI). In patients with advanced CAD presenting with acute myocardial infarction, PCI, of course, is the preferred treatment option. For stable patients with advanced CAD, CABG surgery remains the standard of care. However, observations from the SYNergy between Percutaneous Coronary Intervention with TAXus and Cardiac Surgery (SYNTAX) trial suggest that PCI may be a useful alternative in patients with three-vessel disease with a low SYNTAX score as well as in patients with left main disease and a low or intermediate SYNTAX score. In the subset of patients with diabetes mellitus, the Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease trial unequivocally demonstrated the superiority of CABG surgery in improving outcomes. The findings of the recently published Everolimus-Eluting Stent System versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization and Nordic–Baltic–British Left Main Revascularization study trials point to a favorable role for PCI in certain low-to-moderate risk patients with left main stem disease.
      Citation: Int J Angiol ; : -
      PubDate: 2021-02-12T00:00:00+0100
      DOI: 10.1055/s-0041-1723977
       
  • Functional Assessment of Coronary Artery Lesions—Old and New Kids on
           the Block
    • Authors: Patel; Prashant, Rao, Ravi, Sethi, Prabhdeep, Mukherjee, Ashis, Varadarajan, Padmini, Pai, Ramdas G.
      Abstract: Angiography is inaccurate in assessing functional significance of coronary lesions, and often stenoses deemed severe on angiographic assessment do not restrict coronary blood flow at rest or with maximal dilatation. Angiography-guided revascularization has not shown improvement in hard clinical outcomes in stable ischemic heart disease (SIHD). Most current guidelines for SIHD recommend invasive functional assessment of lesions to guide revascularization if prior evidence of ischemia is not available. There has been several recent advances and development of novel methods in this arena. Various contemporary clinical trials have been undertaken for validation of these indices. Here we review the physiological basis, tools, techniques, and evidence base for various invasive (resting as well as hyperemic) and noninvasive methods for functional assessment of coronary lesions. Left main stenosis, bifurcation lesions, serial stenosis, and acute coronary syndrome each causes unique disequilibrium that may affect measurements and require special considerations for accurate functional assessment.
      Citation: Int J Angiol ; : -
      PubDate: 2021-02-12T00:00:00+0100
      DOI: 10.1055/s-0041-1723942
       
  • Management of ST-Elevation Myocardial Infarction in High-Risk Settings
    • Authors: Omer; Mohamed A., Exaire, Jose E., Jentzer, Jacob C., Sandoval, Yader B., Singh, Mandeep, Cagin, Charles R., Elgendy, Islam Y., Tak, Tahir
      Abstract: Despite the widespread adoption of primary percutaneous intervention and modern antithrombotic therapy, ST-segment elevation myocardial infarction (STEMI) remains the leading cause of death in the United States and remains one of the most important causes of morbidity and mortality worldwide. Certain high-risk patients present a challenge for diagnosis and treatment. The widespread adoption of primary percutaneous intervention in addition to modern antithrombotic therapy has resulted in substantial improvement in the short- and long-term prognosis following STEMI. In this review, we aim to provide a brief analysis of the state-of-the-art treatment for patients presenting with STEMI, focusing on cardiogenic shock, current treatment and controversies, cardiac arrest, and diagnosis and treatment of mechanical complications, as well as multivessel and left main-related STEMI.
      Citation: Int J Angiol ; : -
      PubDate: 2021-02-12T00:00:00+0100
      DOI: 10.1055/s-0041-1723941
       
  • Optical Coherence Tomography of Coronary Arteries
    • Authors: Roland; Robert, Veselka, Josef
      Abstract: Intravascular imaging, particularly optical coherence tomography, has brought significant improvement in diagnostic and therapeutical approaches to coronary artery disease and has offered superior high-resolution visualization of coronary arteries. The ability to obtain images of intramural and transmural coronary structures allows the study of the process of atherosclerosis, effect of therapies, mechanism of acute coronary syndrome and stent failure, and performance of new devices and enables the interventional cardiologist to optimize the effect of percutaneous coronary intervention. In this review, we provide the summary of the latest published data on clinical use of optical coherence tomography as well as practical algorithm for optical coherence tomography-guided percutaneous coronary intervention for daily interventional practice.
      Citation: Int J Angiol ; : -
      PubDate: 2021-02-12T00:00:00+0100
      DOI: 10.1055/s-0041-1724019
       
  • Isolated Spontaneous Mesenteric Artery Dissection: A Rare Entity
    • Authors: Pradhan; Akshyaya, Bhandari, Monika, Vishwakarma, Pravesh, Kumar, Shailendra, Rai, Anurag
      Abstract: Isolated spontaneous dissection of the mesenteric artery in the absence of involvement of the aorta or its branches is an uncommon vascular entity. It is generally seen in males and presents with gastrointestinal symptoms due to mesenteric ischemia. However, asymptomatic cases are increasingly being diagnosed due to increased use of computed tomography (CT) angiography. The course is usually self-limiting, and conservative management with bowel rest, strict blood pressure control, anticoagulants, sedatives for pain, and close observation usually suffices. Surgery or endovascular stenting is usually reserved for those exhibiting bowel ischemia or impending rupture. We report a case of a young female with isolated spontaneous mesenteric artery dissection with thrombus, which did not improve with medical therapy and was managed promptly by surgery due to the presence of bowel ischemia.
      Citation: Int J Angiol ; : -
      PubDate: 2021-02-03T00:00:00+0100
      DOI: 10.1055/s-0040-1718544
       
  • Kidney-Pancreas Transplant Recipients Experience Higher Risk of
           Complications Compared to the General Population after Undergoing Coronary
           Artery Bypass Grafting
    • Authors: Perdue; Jordyn M., Ortiz, Alejandro C., Parsikia, Afshin, Ortiz, Jorge
      Abstract: This retrospective analysis aims to identify differences in surgical outcomes between pancreas and/or kidney transplant recipients compared with the general population undergoing coronary artery bypass grafting (CABG). Using Nationwide Inpatient Sample (NIS) data from 2005 to 2014, patients who underwent CABG were stratified by either no history of transplant, or history of pancreas and/or kidney transplant. Multivariate analysis was used to calculate odds ratio (OR) to evaluate in-hospital mortality, morbidity, length of stay (LOS), and total hospital charge in all centers. The analysis was performed for both nonemergency and emergency CABG. Overall, 2,678 KTx (kidney transplant alone), 184 PTx (pancreas transplant alone), 254 KPTx (kidney-pancreas transplant recipients), and 1,796,186 Non-Tx (nontransplant) met inclusion criteria. KPTx experienced higher complication rates compared with Non-Tx (78.3 vs. 47.8%, p 
      Citation: Int J Angiol ; : -
      PubDate: 2021-02-03T00:00:00+0100
      DOI: 10.1055/s-0040-1721680
       
  • Variceal Veins Embolization and Left Renal Vein Stenting in a Patient with
           Combined Nutcracker and May–Thurner Syndrome
    • Authors: Aghdasi; Sina, Serati, Ali Reza, Moosavi, Jamal, Emami, Sepideh, Movahed, Mohammad Reza
      Abstract: Nutcracker syndrome is defined as a compression of left renal vein leading to symptomatic hematuria and flank pain. There are very few reports about its association with May–Thurner syndrome that is related to compression of left iliac vein causing severe leg edema. We are reporting a rare case of a patient having both conditions successfully treated with sequential percutaneous interventions. This case and treatment options are discussed in detail.
      Citation: Int J Angiol ; : -
      PubDate: 2021-01-29T00:00:00+0100
      DOI: 10.1055/s-0040-1721704
       
  • Angiotensin-Receptor Blockade Improves Inflammation and Endothelial
           Dysfunction in Ankylosing Spondylitis: ARB-AS Study
    • Authors: Garg; Nidhi, Krishan, Pawan, Syngle, Ashit
      Abstract: Cardiovascular (CV) disease is the leading cause of premature death in ankylosing spondylitis (AS). Atherosclerosis and AS share similar pathogenic mechanisms. The proven benefits of angiotensin-receptor blockers (ARBs) in atherosclerotic cardiovascular disease and their role in immune mediation provide strong rationale to investigate its impact with olmesartan on inflammation and endothelial dysfunction in AS. To investigate the effect of olmesartan on inflammation and endothelial dysfunction in AS. 40 AS patients were randomized to receive 24 weeks of treatment with olmesartan (10 mg/day, n = 20) and placebo (n = 20) as an adjunct to existing stable antirheumatic drugs. Markers of endothelial function included the following: flow-mediated dilation (FMD) assessed by AngioDefender, endothelial progenitor cells (EPCs) estimated by flow cytometry, nitrite (nitric oxide surrogate), intracellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) and inflammatory measures including Bath ankylosing spondylitis disease activity index (BASDAI), ankylosing spondylitis disease activity score (ASDAS) and bath ankylosing spondylitis functional index (BASFI); erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP); proinflammatory cytokines (interleukin-1 [IL-1], IL-6, tumor necrosis factor-α [TNF-α]) and marker of oxidative stress– thiobarbituric acid reactive substances (TBARS) estimated at baseline and after treatment. Health assessment questionnaire disability index (HAQDI), 36-item short form survey (SF-36), and systematic coronary risk evaluation (SCORE) were estimated using standard tools. FMD improved significantly in the olmesartan group (5.83 ± 0.31% to 7.68 ± 0.27%, p  ≤  0.05) as compared with placebo (5.89 ± 0.35% to 6.04 ± 0.32%, p = 0.33). EPC population, nitrite, VCAM-1, and TBARS levels improved significantly in olmesartan group as compared with placebo (p ≤ 0.05). Olmesartan significantly decreased ASDAS, BASDAI, BASFI, ESR, CRP, IL-6, TNF-α, and SCORE as compared with placebo. HAQDI and SF-36 (PH) scores improved significantly in olmesartan group as compared with placebo. Olmesartan reduces inflammatory disease activity, improves quality of life (QOL), and decreases CV risk demonstrating the immunomodulatory, vasculoprotective, and cardioprotective potential of this drug in AS.
      Citation: Int J Angiol ; : -
      PubDate: 2021-01-29T00:00:00+0100
      DOI: 10.1055/s-0040-1722738
       
  • Curcumin's Effect on Inflammatory Response following Percutaneous Coronary
           Intervention in Adult Patients with Stable Coronary Heart Disease
    • Authors: Silalahi; Todung, Alwi, Idrus, Suyatna, Frans, Sartika, Katarina D.
      Abstract: Cardiovascular diseases play major roles in the health problems worldwide especially in Indonesia. Percutaneous coronary intervention (PCI) is a minimally invasive procedure with relatively low complications. However, high inflammatory response post-PCI has showed adverse events even after administration of standard medication. Previous studies showed that curcumin was able to reduce inflammatory response in adult patients with stable coronary heart disease (CHD). This article determines the efficacy of oral administration of curcumin in reducing inflammatory response post-PCI with stable CHD. A double-blind randomized controlled trial on 50 adult patients comparing curcumin and placebo was performed in Cipto Mangunkusumo General Hospital and Jakarta Heart Center within April and June 2015. Either curcumin (45 mg/day) or placebo was given 7 days prior to PCI until 2 days after PCI. Inflammatory markers (high-sensitivity C-reactive protein [hsCRP] and soluble CD40 ligand [sCD40L]) were measured in three phases (7 days prior PCI, 24 hours post-PCI, and 48 hours post-PCI). There were no significant differences in the reduction of hsCRP and sCD40L between curcumin and placebo groups in three phases of measurement. Curcumin significantly reduce the serum hsCRP (p = 0.006) and sCD40L (p = 0.002) 7 days before PCI to 48 hours post-PCI. The decrement of hsCRP (–14.2% vs. –7.4%) and sCD40L (–24.3% vs. –13.2%) from 24 to 48 hours post-PCI was higher in the curcumin group than placebo group. The administration of curcumin 45 mg dose daily for 7 days prior PCI until 48 hours post-PCI is useful in reducing inflammatory response post-PCI with stable CHD.
      Citation: Int J Angiol ; : -
      PubDate: 2021-01-29T00:00:00+0100
      DOI: 10.1055/s-0040-1720969
       
  • Medical and Revascularization Management of Stable Ischemic Heart Disease:
           An Overview
    • Authors: Radaideh; Qais, Shammas, Nicolas W., Daher, Ghassan E., Rachwan, Rayan Jo
      Abstract: Stable ischemic heart disease (SIHD) affects approximately 10 million Americans with 500,000 new cases diagnosed each year. Patients with SIHD are primarily managed in the outpatient setting with aggressive cardiovascular risk factor modification via medical therapy and lifestyle changes. Currently, this approach is considered as the mainstay of treatment. The recently published ISCHEMIA trial has established the noninferiority of medical therapy in comparison to coronary revascularization in patients with moderate to severe ischemia. Percutaneous coronary intervention is currently recommended for patients with significant left main disease, large ischemic myocardial burden, and patients with severe refractory angina despite maximal medical therapy.
      Citation: Int J Angiol ; : -
      PubDate: 2021-01-21T00:00:00+0100
      DOI: 10.1055/s-0040-1722739
       
  • The Swollen Calf of Reperfusion Injury. An Addition to the Spectrum of
           Pseudothrombophlebitis
    • Int J Angiol
      DOI: 10.1055/s-0040-1721805



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      Int J Angiol ; : -2021-01-21T00:00:00+0100
       
  • AGE–RAGE Stress and Coronary Artery Disease
    • Authors: Prasad; Kailash
      Abstract: Coronary artery atherosclerosis and atherosclerotic plaque rupture cause coronary artery disease (CAD). Advanced glycation end products (AGE) and its cell receptor RAGE, and soluble receptor (sRAGE) and endogenous secretory RAGE (esRAGE) may be involved in the development of atherosclerosis. AGE and its interaction with RAGE are atherogenic, while sRAGE and esRAGE have antiatherogenic effects. AGE–RAGE stress is a ratio of AGE/sRAGE. A high AGE–RAGE stress results in development and progression of CAD and vice-versa. AGE levels in serum and skin, AGE/sRAGE in patients with CAD, and expression of RAGE in animal model of atherosclerosis were higher, while serum levels of esRAGE were lower in patients with CAD compared with controls. Serum levels of sRAGE in CAD patients were contradictory, increased or decreased. This contradictory data may be due to type of patients used, because the sRAGE levels are elevated in diabetics and end-stage renal disease. AGE/sRAGE ratio is elevated in patients with reduced or elevated levels of serum sRAGE. It is to stress that AGE, RAGE, sRAGE, or esRAGE individually cannot serve as universal biomarker. AGE and sRAGE should be measured simultaneously to assess the AGE–RAGE stress. The treatment of CAD should be targeted at reduction in AGE levels, prevention of AGE formation, degradation of AGE in vivo, suppression of RAGE expression, blockade of RAGE, elevation of sRAGE, and use of antioxidants. In conclusion, AGE–RAGE stress would initiate the development and progression of atherosclerosis. Treatment modalities would prevent, regress, and slow the progression of CAD.
      Citation: Int J Angiol ; : -
      PubDate: 2021-01-21T00:00:00+0100
      DOI: 10.1055/s-0040-1721813
       
  • Relationship between Whole Blood Viscosity and Lesion Severity in Coronary
           Artery Disease
    • Authors: Ceyhun; Gökhan, Birdal, Oğuzhan
      Abstract: Objective This article investigates the relationship of fractional flow reserve (FFR) with whole blood viscosity (WBV) in patients who were diagnosed with chronic coronary syndrome and significant stenosis in the major coronary arteries and underwent the measurement of FFR. Material and Method In the FFR measurements performed to evaluate the severity of coronary artery stenosis, 160 patients were included in the study and divided into two groups as follows: 80 with significant stenosis and 80 with nonsignificant stenosis. WBVs at low shear rate (LSR) and high shear rate (HSR) were compared between the patients in the significant and nonsignificant coronary artery stenosis groups. Results In the group with FFR 
      Citation: Int J Angiol ; : -
      PubDate: 2021-01-19T00:00:00+0100
      DOI: 10.1055/s-0040-1720968
       
  • Ventricular Septal Rupture Complicating an Acute ST-Segment Elevation
           Myocardial Infarction during the COVID-19 Pandemic
    • Authors: Tanto; Ines V., Dharma, Surya, Juzar, Dafsah A., Bono, Arinto A.H.
      Abstract: Ventricular septal rupture (VSR) is rare but a lethal complication of acute myocardial infarction (MI). Definite treatment requires the surgical closure of the VSR and coronary artery bypass grafting (CABG). However, the optimal timing for surgery is still controversial, particularly during the novel coronavirus disease 2019 (COVID-19) pandemic where medical procedures should be performed within the safest environment. Before surgery, a proper management in the intensive cardiovascular care unit is essential to maintain the stability of the hemodynamic profile related with VSR and determines the prognosis of the patient. We described a case of VSR complicating an anterior wall MI in a patient who admitted to our hospital during the COVID-19 pandemic that was treated successfully by surgical closure of the VSR and CABG.
      Citation: Int J Angiol ; : -
      PubDate: 2021-01-11T00:00:00+0100
      DOI: 10.1055/s-0040-1720971
       
  • Thomas F. Whayne, Jr., MD, PhD, FICA (1937–2020)
    • Int J Angiol 2020; 29: 215-215
      DOI: 10.1055/s-0040-1719150



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      Int J Angiol 2020; 29: 215-2152020-11-26T00:00:00+0100
      Issue No: Vol. 29, No. 04 (2020)
       
  • New Horizons in Lower Limb Ischemia- Pathophysiology and Management
    • Int J Angiol 2020; 29: 141-142
      DOI: 10.1055/s-0040-1716437



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      Int J Angiol 2020; 29: 141-1422020-08-31T00:00:00+01:00
      Issue No: Vol. 29, No. 03 (2020)
       
  • Management of Chronic Total Occlusion of Coronary Artery
    • Authors: Mares; Adriana, Mukherjee, Debabrata
      Abstract: Chronic total occlusion (CTO) of a coronary artery is typically defined as a completely occluded artery without any antegrade flow and a duration of at least 3 months. We reviewed the current literature describing the optimal management of CTO including the role of revascularization and choice of modality, i.e., percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery. Databases (PubMed, the Cochrane Library, Embase, EBSCO, Web of Science, and CINAHL) were searched and relevant studies of patients with CTO were selected for review. The prevalence of coronary artery CTOs is approximately 25% among patients undergoing coronary angiography for angina. Available data suggests that PCI of CTO can be a technically complex procedure with relatively lower success rates compared with non-CTO PCI and typically associated with a higher complication rate especially at nonspecialized centers. Furthermore, successful CTO-PCI is associated with symptomatic improvement but does not appear to improve mortality, myocardial infarction, stroke, and repeat revascularization rates. Based on contemporary data, PCI of CTO lesions may be considered in patients with incapacitating angina despite treatment with optimal guideline-directed medical therapy and in whom based on coronary anatomy there is a reasonable chance of technical success with an acceptable risk.
      Citation: Int J Angiol ; : -
      PubDate: 2020-12-03T00:00:00+0100
      DOI: 10.1055/s-0040-1721478
       
  • Will Remdesivir Reshape Cardiovascular Practice in COVID 19 Era'
    • Authors: Idhrees; A. Mohammed, Suthakaran, Prasanna Karthik, Valooran, George Jose, Bashir, Mohamad
      Abstract: Infection with the novel coronavirus, SARS-CoV2, produces the clinical syndrome COVID-19. COVID-19 is a systemic illness inducing hyperinflammation and cytokine storm affecting multiple organs including the myocardium which is reflected in elevated cardiac biomarkers such as troponin, lactate dehydrogenase, and creatinine kinase MB. Furthermore, COVID-19 has been implicated in increased predilection to thromboembolic phenomena. Hence, mortality in patients with associated cardiovascular disease has been higher compared with the cohort with no cardiovascular comorbidity. It is entirely unknown how remdesivir will change the facet of cardiovascular medicine and surgery. In the present constantly changing climate, this review of remdesivir and its association with cardiovascular disease is comprehensive as of June 17, 2020 and it highlights the science behind this drug and its potential implications to cardiovascular practice.
      Citation: Int J Angiol ; : -
      PubDate: 2020-12-03T00:00:00+0100
      DOI: 10.1055/s-0040-1721403
       
  • Acute Embolic Occlusion of Renal Artery after the Bentall Procedure: the
           Role of Primary Renal Angioplasty
    • Authors: Indriani; Suci, Adiarto, Suko, Andriantoro, Hananto, Sunu, Ismoyo, Siddiq, Taofan, Dakota, Iwan
      Abstract: Acute renal occlusion is an uncommon emergency problem in daily practice. The diagnosis is often missed or delayed not only because of its rarity but also nonspecific of clinical presentation. Sudden and complete termination of arterial blood supply to the kidney may lead to renal infarction and a complete loss of renal function. Although the need of early revascularization is uniformly recommended, but the methods has not been established. We presented a case of acute thromboembolic renal artery occlusion in patient who had a history of Bentall's surgery. Renal infarction and artery occlusion were clearly visualized by computed tomography angiogram (CTA). The patient was successfully treated with angioplasty and stenting of main renal artery with complete disappearance of symptoms and recovery of his renal function.
      Citation: Int J Angiol ; : -
      PubDate: 2020-11-26T00:00:00+0100
      DOI: 10.1055/s-0040-1720972
       
  • An Unusual Presentation of Mycotic Popliteal Artery Pseudoaneurysm due to
           Pasteurella multocida Infection
    • Authors: Orgiu; Antoni, Zanier, Thomas, Kashi-Dakhil, Mahine, Zaimi, Rym, Dakhil, Bassel, Longuet, Pascale, Bagan, Patrick
      Abstract: Pasteurella multocida, a zoonotic infectious pathogen, is a rare cause of mycotic aneurysms in human hosts. A 76-year-old man was admitted at our emergency unit for a superinfection of his right limb. The patient was initially treated for a knee arthritis. After a first-line antibiotherapy, the patient was referred to the vascular department for the management of a right acute limb ischemia. The work-up revealed a ruptured pseudoaneurysm of the popliteal artery. The ruptured artery was surgically explanted, and a femoropopliteal bypass was then performed. Pasteurella multocida was detected after bacterial analysis of the aneurysm. The postoperative course was uneventful. This case is the first reported case, to our knowledge, of a popliteal artery pseudoaneurysm due to Pasteurella multocida infection.
      Citation: Int J Angiol ; : -
      PubDate: 2020-11-26T00:00:00+0100
      DOI: 10.1055/s-0040-1718545
       
  • Free-Floating Thrombus in the Distal Internal Carotid Artery Causing a
           Stroke
    • Authors: Papadoulas; Spyros, Moulakakis, Konstantinos, Kouri, Natasa, Zampakis, Petros, Kakkos, Stavros K.
      Abstract: We present a patient suffering from a stroke with a free-floating thrombus extending up to the distal internal carotid artery. The thrombus was totally resolved after a 2-week anticoagulation regimen without leaving behind any severe residual stenosis in the carotid bulb. The optimal treatment of this rare condition remains uncertain. We report some important treatment strategies that have been used in the literature, emphasizing the anticoagulation as the mainstay of therapy. Immediate surgical and interventional manipulations carry the risk of thrombus dislodgement and embolization and should be considered if there are recurrent symptoms despite medical management.
      Citation: Int J Angiol ; : -
      PubDate: 2020-11-26T00:00:00+0100
      DOI: 10.1055/s-0040-1720973
       
  • Reliability of the Mangled Extremity Severity Score in the Management of
           Peripheral Vascular Injuries in Children: A Retrospective Review
    • Authors: Mousa; Ahmed, Zakaria, Ossama M., Elkalla, Mai A., Abdelsattar, Lotfy A., Al-Game'a, Hamad
      Abstract: This study was aimed to evaluate different management modalities for peripheral vascular trauma in children, with the aid of the Mangled Extremity Severity Score (MESS). A single-center retrospective analysis took place between 2010 and 2017 at University Hospitals, having emergencies and critical care centers. Different types of vascular repair were adopted by skillful vascular experts and highly trained pediatric surgeons. Patients were divided into three different age groups. Group I included those children between 5 and 10 years; group II involved pediatrics between 11 and 15 years; while children between 16 and 21 years participated in group III. We recruited 183 children with peripheral vascular injuries. They were 87% males and 13% females, with the mean age of 14.72 ± 04. Arteriorrhaphy was performed in 32%; end-to-end anastomosis and natural vein graft were adopted in 18% and 29% respectively. On the other hand, 20% underwent bypass surgery. The age groups I and II are highly susceptible to penetrating trauma (p = 0.001), while patients with an extreme age (i.e., group III) are more susceptible to blunt injury (p = 0.001). The MESS has a significant correlation to both age groups I and II (p = 0.001). Vein patch angioplasty and end-to-end primary repair should be adopted as the main treatment options for the repair of extremity vascular injuries in children. Moreover, other treatment modalities, such as repair with autologous vein graft/bypass surgery, may be adopted whenever possible. They are cost-effective, reliable, and simple techniques with fewer postoperative complication, especially in poor/limited resources.
      Citation: Int J Angiol ; : -
      PubDate: 2020-11-26T00:00:00+0100
      DOI: 10.1055/s-0040-1720970
       
  • The Half-Century Mark: Explant of Ball and Cage Valve after 50 Years
    • Authors: Pupovac; Stevan S., Koss, Elana, Hartman, Alan R., Manetta, Frank
      Abstract: This is a case report of a 69-year-old man with chronic hemolysis and worsening diastolic heart failure, secondary to known periprosthetic leak, who underwent a reoperative mitral valve replacement 50 years following initial implantation of a Starr–Edwards ball and cage valve.
      Citation: Int J Angiol ; : -
      PubDate: 2020-11-05T00:00:00+0100
      DOI: 10.1055/s-0040-1720967
       
  • Transplant Renal Artery Stenosis Revascularization: Common Distal External
           Iliac Bypass
    • Authors: Miyara; Santiago J., Ortiz, Christopher C., Guevara, Sara, Molmenti, Alexia, Tamayo-Enriquez, Gerardo, Cho, Young Min, Cagliani, Joaquin A., Molinas, Jorge, Hayashida, Kei, Shinozaki, Koichiro, Takegawa, Ryosuke, Krishnasastry, K. V., Becker, Lance B., Molmenti, Ernesto P.
      Abstract: Stenosis proximal to transplant renal artery anastomoses are complications leading to allograft dysfunction. This study was aimed to evaluate a novel surgical approach to renal allograft revascularization, taking into consideration the length of time elapsed since transplantation. We describe an arterial bypass using a polytetrafluoroethylene (PTFE) graft from the common iliac artery (proximal to the renal artery implantation) to the external iliac artery (distal to the renal artery implantation) that allows the adequate revascularization of both the transplant kidney, as well as the lower extremity. This technique provides several advantages when compared with previously described procedures to revascularize a transplanted kidney with an iliac artery stenosis proximal to the allograft implantation site. Benefits of this technique include (1) no need to repair the stenosis, (2) no need to take down and redo the arterial anastomosis, (3) no need to perform a dissection around the renal hilum of the transplanted kidney, (4) no requirement to address the anastomosis transfer, and (5) no need to perfuse the kidney with preservation fluid at the time of repair and/or (6) avoidance of potential injury to the renal parenchyma and/or hilum during dissections. Adequate perfusion of the organ, as well as of the lower extremity was verified by serial Doppler duplex ultrasound evaluations. Hence, we describe a novel revascularization technique in instances of kidney transplant and lower extremity ischemia.
      Citation: Int J Angiol ; : -
      PubDate: 2020-09-22T00:00:00+01:00
      DOI: 10.1055/s-0040-1714663
       
  • Life-Threatening Hematuria as Initial Presentation of a Complicated
           Transplant Renal Artery Pseudoaneurysm
    • Authors: Miyara; Santiago J., Becker, Lance B., Guevara, Sara, Lau, Lawrence, Nair, Vinay V., Jandovitz, Nicholas, Fahmy, Ahmed E., Grodstein, Elliot, Winnick, Aaron M., Kirsch, Claudia, Rolston, Daniel M., Bhaskaran, Madhu C., Hayashida, Kei, Shinozaki, Koichiro, Takegawa, Ryosuke, Cho, Young Min, Cagliani, Joaquin A., Isa, Arton, Al-Roubaie, Mustafa, Krishnasastry, K. V., Teperman, Lewis W., Molmenti, Ernesto P.
      Abstract: In this case report, we describe the clinical course of a complicated transplant renal artery (TRA) pseudoaneurysm, clinically featured by gross and massive hematuria one month after a kidney transplant was performed on a 50 year-old male patient. TRA pseudoaneurysm is a rare but potentially life-threatening complication that may result in bleeding, infection, graft dysfunction/loss, lower limb ischemia/loss, hemorrhagic shock, and death. TRA pseudoaneurysm treatment remains challenging as it needs to be tailored to the patient characteristics including hemodynamic stability, graft function, anatomy, presentation, and pseudoaneurysm features. This publication discusses the clinical scenario of massive gross hematuria that derived from a retroperitoneal hematoma which originated from an actively bleeding TRA pseudoaneurysm. This case highlights the combined approach of endovascular stent placement and subsequent transplant nephrectomy as a last resort in the management of intractable bleeding from a complicated TRA pseudoaneurysm. To the best of our knowledge, this is the first published case report of an actively bleeding TRA anastomotic pseudoaneurysm that caused a massive retroperitoneal bleed that in turn evacuated via the bladder after disrupting the ureter-to-bladder anastomosis. A temporizing hemostatic arterial stent placed percutaneously allowed for a safer and controlled emergency transplant nephrectomy.
      Citation: Int J Angiol ; : -
      PubDate: 2020-09-16T00:00:00+01:00
      DOI: 10.1055/s-0040-1716327
       
  • A New Technique to Puncture and Remove a PTCA Balloon that Fails to
           Deflate
    • Authors: Pasamanickam; Kannan, Rajadurai, Jeyamalar, Choo, Gim-Hooi
      Abstract: We present the first clinical report and describe the technique of using a modified Heartrail II guiding catheter to successfully puncture and remove a coronary angioplasty balloon that failed to deflate after stent implantation.
      Citation: Int J Angiol ; : -
      PubDate: 2020-09-16T00:00:00+01:00
      DOI: 10.1055/s-0040-1715084
       
  • Asymptomatic Females Are at Higher Risk for Perioperative TIA/Stroke and
           Males Are at Higher Risk for Long-Term Mortality after Carotid Artery
           Stenting: A Vascular Quality Initiative Analysis
    • Authors: Erben; Young, Li, Yupeng, Da Rocha-Franco, Joao A., Tawk, Rabih G., Barrett, Kevin M., Freeman, William D., Lin, Michelle, Huang, Josephine F., Miller, David, Farres, Houssam, Brott, Thomas G., Meschia, James F., Hakaim, Albert G.
      Abstract: The study aims to review the sex differences with respect to transient ischemic attack (TIA)/stroke and death in the perioperative period and on long-term follow-up among asymptomatic patients treated with carotid stenting (CAS) in the vascular quality initiative (VQI). All cases reported to VQI of asymptomatic CAS (ACAS) patients were reviewed. The primary end point was risk of TIA/stroke and death in the in-hospital perioperative period and in the long-term follow-up. The secondary end point was to evaluate predictors of in-hospital perioperative TIA/stroke and mortality on long-term follow-up after CAS. There were 22,079 CAS procedures captured from January 2005 to April 2019. There were 5,785 (62.7%) patients in the ACAS group. The rate of in-hospital TIA/stroke was higher in female patients (2.7 vs. 1.87%, p = 0.005) and the rate of death was not significant (0.03 vs. 0.07%, p = 0.66). On multivariable logistic regression analysis, prior/current smoking history (odds ratio = 0.58 [95% confidence interval or CI = 0.39–0.87]; p = 0.008) is a predictor of in-hospital TIA/stroke in females. The long-term all-cause mortality is significantly higher in male patients (26.9 vs. 15.7%, p 
      Citation: Int J Angiol ; : -
      PubDate: 2020-09-16T00:00:00+01:00
      DOI: 10.1055/s-0040-1712506
       
  • Endarterectomy for Iliac Occlusive Disease during Kidney Transplantation:
           A Multicenter Experience
    • Authors: Sorrells; William S., Mao, Shennen A., Taner, Timucin, Jadlowiec, Caroline C., Farres, Houssam, Davila, Victor, Money, Samuel R., Stone, William M., Al-Khasawneh, Mohammad, Da Rocha-Franco, Joao A. Da Rocha, Oldenburg, Warner A., Oderich, Gustavo S., Taner, C. Burcin, Hakaim, Albert G., Erben, Young
      Abstract: Little is known about the surgical challenges and outcomes of kidney transplantation (KT) in the face of severe iliac occlusive disease (IOD). We aim to examine our institution's experience and outcomes compared with all KT patients. Retrospective review of our multi-institutional transplant database identified patients with IOD requiring vascular surgery involvement for iliac artery endarterectomy at time of KT from 2000 to 2018. Clinical data, imaging studies, and surgical outcomes of 22 consecutive patients were reviewed. Our primary end-point was allograft survival. Secondary end-points included mortality and perioperative complications. A total of 6,757 KT were performed at our three sites (Florida, Arizona, and Minnesota); there were 22 (0.32%) patients receiving a KT with concomitant IOD requiring iliac artery endarterectomy. Mean patient age was 61.45 ± 7 years. There were 13 (59.1%) male patients. The most common etiology of renal failure was diabetic nephropathy in 10 patients (45.5%) followed by a combination of hypertensive/diabetic nephropathy in five patients (22.7%), and hypertensive nephrosclerosis in three patients (13.6%). The majority (n = 16, 72.7%) of patients received renal allografts from deceased donors and six (27.3%) were recipients from living donors. Mean time from dialysis to transplantation was 2.9 ± 2.9 years. Mean follow-up was 3.5 ± 2.5 years. Mean length of hospital stay was 6.3 ± 4.3 days (range: 3–18 days). Graft loss within 90 days occurred in two (9.1%) patients, one due to renal vein thrombosis and another due to acute tubular necrosis. Overall allograft survival was 90.1% at 1-year and 86.4% at 3-year follow-up. Overall mortality occurred in 6 (27.3%) patients. Perioperative complications (Clavien-Dindo Grade 2–4) occurred in 13 (59.1%) patients, including 10 (45.5%) with acute blood loss anemia requiring transfusion, 2 (9.1%) reoperations for hematoma evacuation, 1 (4.5%) ischemic colitis requiring total abdominal colectomy, and 1 (4.5%) renal vein thrombosis requiring nephrectomy. IOD patients selected for KT are not common and although challenging, they have similar outcomes to our standard KT patients. The 1- and 3-year allograft survivals were 90.1 and 86.4% versus 96.0 and 90.3% in the general KT patient population. With these excellent outcomes, we recommend expanding the criteria for KT to include patients with IOD with prior vascular surgery consultation to prevent progression of IOD or prevention of wait list removal in select patients who are otherwise good candidates for KT.
      Citation: Int J Angiol ; : -
      PubDate: 2020-08-30T00:00:00+01:00
      DOI: 10.1055/s-0040-1714752
       
  • Interhospital Transfer versus Direct Admission in Patients with Acute
           ST-Segment Elevation Myocardial Infarction
    • Authors: Dharma; Surya, Dakota, Iwan, Andriantoro, Hananto, Firdaus, Isman, Anandira, Citra P., Radi, Basuni
      Abstract: There is concern whether patients with ST-segment elevation myocardial infarction (STEMI) who admitted to a percutaneous coronary intervention (PCI) center from interhospital transfer is associated with longer reperfusion time compared with direct admission. We evaluated the reperfusion delays in patients with STEMI who admitted to a primary PCI center through interhospital transfer or direct admission. We retrospectively analyzed 6,494 consecutive STEMI patients admitted between 2011 and 2019. Compared with direct admission (n = 4,121; 63%), interhospital transferred patients (n = 2,373) were younger (55 ± 10 vs. 56 ± 10 years, p 
      Citation: Int J Angiol ; : -
      PubDate: 2020-07-25T00:00:00+01:00
      DOI: 10.1055/s-0040-1714686
       
  • A Sequential Approach to the Management of Ostial Coronary Lesions via the
           Modified Flower Petal Technique
    • Authors: Ermis; Emrah, Ucar, Hakan, Allahverdiyev, Samir, Yildirim, Erkan
      Abstract: There is still no consensus on the optimal technique for performing percutaneous coronary intervention (PCI) in ostial coronary lesions, due to potential complications. The modified flower petal technique is one of the techniques to management of ostial lesions. It seems suitable technique in terms of covering the coronary ostium well. In this report, we discuss a patient who underwent PCI with sequential modified flower petal technique, first to the left anterior descending artery ostial lesion, and then to the circumflex artery (CXA) upon the ostium of CXA was affected after the procedure following coronary angiography.
      Citation: Int J Angiol ; : -
      PubDate: 2020-07-15T00:00:00+01:00
      DOI: 10.1055/s-0039-3401045
       
  • Renal Transplant Artery Inflow Stenosis Treated with Femorofemoral Bypass
    • Authors: Ortiz; Christopher Chiodo, Miyara, Santiago J., Cagliani, Joaquin A., Cho, Young Min, Guevara, Sara, Hayashida, Kei, Shinozaki, Koichiro, Clement, Damian, Becker, Lance B., Wang, Bo, Krishnasastry, K.V., Teperman, Lewis W., Molmenti, Ernesto P.
      Abstract: In this case report we describe a novel and successful revascularization approach in instances of allograft and distal limb ischemia after kidney transplantation. Stenosis proximal to transplant renal artery anastomoses is a complication leading to allograft dysfunction and/or loss. We present a femorofemoral bypass graft with ringed polytetrafluoroethylene (PTFE). In this occasion, revascularization was achieved by a backflow mechanism. The approach described achieved its goal of revascularizing the allograft as well as the distal extremity, with both short- and long-term successful outcomes. Benefits of this approach when compared with re-implantation or procedures directly involving the transplant renal artery include minimization of ischemic time, no need to repair the stenosis, anastomoses with vessels of greater diameter, no need to perfuse the kidney, no need to take down the renal artery anastomosis, no need to dissect the transplanted kidney, and no further lower extremity ischemia. This approach does not require any proximal temporary inflow occlusion (as seen with stent placement) or clamping of the arterial inflow to the kidney. This procedure was completed without having to infuse any preservation fluid into the kidney.
      Citation: Int J Angiol ; : -
      PubDate: 2020-05-16T00:00:00+01:00
      DOI: 10.1055/s-0040-1709502
       
  • Internal Carotid Artery Dissection Treated with C-Guard Stent
    • Authors: Saal-Zapata; Giancarlo, Durand, Walter, Valer, Dante, Rodríguez, Rodolfo
      Abstract: Internal carotid dissection is the most common cause of stroke in the young population. Stroke, the presence of a pseudoaneurysm, and decreased artery lumen with cerebral flow impairment are indications for treatment. Medical therapy with antithrombotic drugs and endovascular therapy with stenting are the main available options. The C-Guard stent is an open cell mesh-covered dual layer stent that has been mainly used in cases of internal carotid artery stenosis with a post-operative reduction in stroke incidence. Thus, we present two cases of internal carotid artery dissections of the cervical segment treated with the open cell dual-layer C-Guard stent without complications.
      Citation: Int J Angiol ; : -
      PubDate: 2020-04-28T00:00:00+01:00
      DOI: 10.1055/s-0040-1708839
       
 
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