Multiple sites of vascular dilation or aneurysmal disease and matrix metalloproteinase genetic variants in patients with abdominal aortic aneurysm.

Objective: The objective of this study was to assess whether functional genetic polymorphisms of matrix metalloproteinases (MMPs) 1, 3, 9, and 12 are associated with arterial enlargements or aneurysms of the thoracic aorta or popliteal arteries in patients with abdominal aortic aneurysm (AAA).

Methods: The associations between MMP1 (-1607 G in/del, rs1799750), MMP3 (-1171 A in/del rs35068180), MMP9 (13-26 CA repeats around -90, rs2234681, rs917576, rs917577), and MMP12 (G/T missense variation, rs652438) polymorphisms and enlargements or aneurysms of the thoracic aorta and popliteal arteries were tested in 169 consecutive AAA patients.

Results: Thoracic aorta enlargement or aneurysm (TE/A; maximum diameter, >35 mm) was detected in 34 patients (20.

Treatment of Complex Abdominal Aortic Aneurysms with Parallel Graft-Endovascular Aneurysm Repair. Retrospective Analysis of a Single Center Experience and Midterm Results.

Background: We sought to evaluate the midterm results of parallel-graft-endovascular aneurysm repair (pg-EVAR) for complex aortic anatomy in high-risk candidates for open surgical repair of abdominal aortic aneurism (AAA).

Methods: Clinical and radiographic information on 35 patients treated by pg-EVAR between March 2010 and December 2015 was retrospectively reviewed and analyzed. All patients presented with symptomatic aneurysms and were treated within 3 days of clinical presentation.

Endovascular Management of Infected Femoral Artery Pseudoaneurysms in High-Risk Patients: A Case Series.

We report our experience with the urgent treatment of two high-risk patients with infected femoral artery pseudoaneurysms (IFAPs) with the placement of a self-expandable covered stent (SECS). In both cases, there was no perioperative mortality and the aneurysm exclusion was successful without early or late stent thrombosis/stent fracture nor acute or chronic limb ischemia or limb loss. There was no recurrence of local or systemic infection during the follow-up period.

Management of an Iatrogenic Pseudoaneurysm of the Superior Gluteal Artery by Percutaneous Ultrasound-Guided Thrombin Injection: A Case Report.

We report the unusual case of a pseudoaneurysm of the superior gluteal artery (SGA) as a complication of a bone marrow biopsy. A 75-year-old man presented with pain and swelling of the left buttock 1 month after a bone marrow biopsy of the left iliac crest. The patient was treated by percutaneous ultrasound-guided thrombin injection (UGTI).

Neoplastic Embolization from Cardiac Papillary Fibroelastoma with Unusual Presentation: A Case Report.

Papillary fibroelastoma is the second most frequent primary tumor of the heart. We report the case of a cardiac papillary fibroelastoma, arising from the interatrial septum, symptomatic from distal embolization to lower limb arteries. Such a clinical presentation is extremely infrequent for cardiac papillary fibroelastomas.

Growth Rate of Small Abdominal Aortic Aneurysms and Genetic Polymorphisms of Matrix MetalloProteases-1, -3, and -9.

Genetic variants of matrix metalloproteases (MMPs)-1, -3, and 9, together with clinical variables, might predict the growth rate (GR) of abdominal aortic aneurysm (AAA). Genotyping of MMP-1 (-1,607 G+/G-), MMP-3 (- 1,171 6A/5A), and MMP-9 microsatellite (13-26 cytosine-adenosine repeats around -90) from peripheral blood was performed in 137 AAA patients with two AAA diameter measurements (at least 3 months to 1 year apart). When the same technique (either ultrasound or computed tomography) was used for the two measurements, yearly GR was estimated and compared with MMP genotype and clinical features by linear and binary logistic regression.

Internal jugular vein pyogenic capillary hemangioma: a case report.

Internal jugular vein hemangioma, also called pyogenic granuloma, is a rare tumor. Such a neoformation was accidentally discovered and excised in a middle-aged man. Histologic and immunohistochemical investigations were performed, and this case is compared with the poor amount of similar ones described in the literature.

Features of vulnerable plaques and clinical outcome of UA/NSTEMI: Relationship with matrix metalloproteinase functional polymorphisms.

Objective: To assess the association of matrix metalloproteinases (MMP) genetic polymorphism (PM) with plaques vulnerability and clinical outcome of acute vascular events.

Methods: MMP-1 (-1607 G in/del), MMP-3 (-1171 A in/del), and MMP-9 microsatellite ((13-26) CA repeats around -90) PMs have been determined (i) in 204 patients with cerebrovascular disease to assess the association with features of vulnerability in carotid plaques and prevalence of stroke, (ii) in 208 patients with UA/NSTEMI to assess the association with in-hospital clinical outcome.

Results: Plaques from carriers of MMP-1 G insertion showed significantly smaller plaques and thicker fibrous cap.

Spontaneous recanalization of occluded internal carotid artery after minor stroke. The role of surgical treatment.

Late spontaneous recanalization of internal carotid artery is a very rare event. We describe three cases which came to our observation in which the occlusion was demonstrated both by angiography and Doppler ultrasound. Two of them had surgical treatment and the histological exam of the plaque showed multiple recanalization foci.

Local heparin, superficial vein thrombosis.

Local, topical effects of heparins on the skin still need deeper investigations. The lack of evidence is mainly due to the lack of large investments in this field. Three main local actions of heparin on the skin can be defined: (1) the anticoagulant action, (2) the microcirculatory-modulatory action determining important control of the microcirculation in case of excessive vasoconstriction or vasodilatation, and (3) the "facilitatory action" on skin permeability, allowing other drugs to diffuse better and faster into the skin (producing a therapeutic effect).

Management of superficial vein thrombosis and thrombophlebitis: status and expert opinion document.

Superficial vein thrombosis is characterized by clotting of superficial veins (ie, following direct trauma) with minimal inflammatory components. Superficial thrombophlebitis is a minimally thrombotic process of superficial veins associated with inflammatory changes and/or infection. Treatments generally include analgesics, elastic compression, anti-inflammatory agents, exercise and ambulation, and, in some cases, local or systemic anticoagulants.

Endovascular treatment of endoleaks after endovascular abdominal aortic aneurysm repair: personal experience.

Purpose: This paper describes the different endovascular treatments (cuffs, endografts and embolisation) available for types I, II and III endoleaks occurring after endovascular abdominal aortic aneurysm repair (EVAR).

Materials And Methods: From January 2000 to June 2006, 134 patients (118 men, 16 women; mean age 75.1 years) underwent EVAR.

MMP-9 microsatellite polymorphism: association with the progression of intima-media thickening and constrictive remodeling of carotid atherosclerotic plaques.

Intima-media thickening (IMT) of carotid arteries and constrictive remodeling (CR) of atherosclerotic plaques are vascular pathologic characteristics that precede the onset of vascular events. SMC migration and proliferation are linked both to IMT and CR and are matrix metalloproteinase 9 (MMP-9) dependent. A genetic polymorphism (PM) of MMP-9, a CA (13-27) microsatellite in the promoter region, which accounts for differential expression of MMP-9, could be linked to progression of IMT and CR.

Prevention of edema and flight microangiopathy with Venoruton (HR), (0-[beta-hydroxyethyl]-rutosides) in patients with varicose veins.

The aim of this open study was the evaluation of the effects of HR (Venoruton) at a dose of 1 g/day on the prevention and control of flight microangiopathy and edema in subjects with varicose veins and moderate chronic venous insufficiency flying for more than 11 hours. Patients with varicose veins, edema, but without initial skin alterations or complications, were included. Measurements of skin laser Doppler (LDF) resting flux (RF) venoarteriolar response (VAR), ankle swelling (RAS), and edema were made within 12 hours before and within 3 hours after the flights.

An unusual complication of open aortic surgery: hemorrhage due to the iatrogenic rupture of a renal cyst.

The authors describe a clinical case of a retroperitoneal hemorrhage due to rupture of a voluminous renal cyst during a conventional open aortic surgery. Intraoperative trauma is to be considered the cause of bleeding. In most cases the clinical evolution of the patient is benign and conservative treatment is sufficient.

Endovascular treatment of external iliac artery injuries after hip arthroplasty.

Purpose: To report endovascular repair of injuries to the external iliac artery during hip surgery.

Case Reports: Two elderly women with histories of chronically infected hip prostheses were found to have iatrogenic leaking pseudoaneurysms of the external iliac artery due to hip surgery trauma in the past. Both were treated successfully with a Jostent Peripheral Stent-Graft.

Middle aortic syndrome: an atypical case--a case report.

This case concerns a 61-year-old woman presenting with middle aortic syndrome treated by an aortoaortic thoracoabdominal polytetrafluoroethylene bypass and a right renal Dacron bypass. The case was atypical because of the patient's advanced age at the time of clinical presentation.

[The subclavian-carotid bypass as a method for treating obstruction of the common carotid].

Common carotid artery occlusion is a relatively uncommon lesion (0.5-5% of patients with cerebral ischaemia). Cerebral revascularization is possible only in case of patent carotid bifurcation, three patients, all of them symptomatic (2 TIA's and 1 amaurosis fugax) with a complete common carotid artery occlusion have been treated with a subclavian-carotid artery by-pass (2 PTFE, 1 reversed saphenous vein).

[Ischemic heart disease and postoperative mortality in major vascular surgery. An up-to-date diagnostic approach].

Background: The aim of this study is to evaluate the efficacy the dobutamine stress echocardiography in predicting the perioperative cardiac risk of patients undergoing major vascular surgery.

Methods: Seventy-seven consecutive and not selected patients, undergoing a surgical treatment requiring aortic cross clamping, were assessed also with a transthoracic dobutamine stress echocardiography. With electrocardiographic and echocardiographic monitoring ventricular ischemia or wall motion abnormalities, 5 micrograms/kg per min of chlorhydrate dobutamine for 5 minutes were infused, followed by other 10 micrograms/kg per min increased up to 40 micrograms/kg per min.

Arterial injury of the axilla: an unusual case after blunt trauma of the shoulder.

The lesion of an axillary artery after a shoulder dislocation without bone fractures is very rare. The most common lesion is the subtotal transection of the vessel. Vascular injuries may be associated with nervous lesions whose incidence ranges from 27 to 44%.

[Endovascular treatment of isolated aneurysms of the hypogastric artery: technical considerations apropos of 2 cases].

Isolated aneurysm of the internal iliac artery is uncommon, with an incidence approaching 0.4%; its diagnosis is difficult; its natural course is progressive expansion and rupture. Two cases of hypogastric aneurysms, promptly treated with embolization, are reported.

[Local excision of rectal cancer in early phase as an alternative to major surgery].

The authors analyse the role of local excision as curative procedure of low rectal early cancer. In their opinion it's very important to select the patients in accordance with some characteristics of the tumor (site, grading, mobility, depth, size, stage, involvement of locoregional nodes, ploidia). Intrarectal ultrasonography is thought be the most important diagnostic tool, both in preoperative diagnosis and in postoperative follow-up; it has a high sensibility to define the parietal invasion of rectal cancer and to recognize metastatic nodes.

[Intraoperative iliac angioplasty and distal revascularization: is it an efficacious method in the high-risk patient?].

The fact that iliac femoro-popliteal areas are both simultaneously interested in some high risk patients, frequently is cause of several problems in the indication of the surgical treatment. So, we have decided to practice an iliac Angioplasty peroperatively as a method of iliac revascularization in association with the surgical repairment of the femoro-popliteal area. Results of 20 patients with 23 surgical procedures during a period of two years is reported.

[Dacron-EXS prosthesis in axillo-femoral bypass].

Twenty-eight axillary by-pass were performed in 27 patients using a dacron externally supported prosthesis. This group of patients has been compared with two other groups in which a dacron knitted (20 p.) or a PTFE (55 p.