Ultrasound screening for abdominal aortic aneurysm in primary care.

Introduction: Abdominal aortic aneurysm (AAA) constitutes a pathology with high mortality. There is currently no screening program implemented in primary care in Spain.

Objectives: To evaluate the usefulness of ultrasound in the detection of AAA in the at-risk population in primary care.

Unilateral Proptosis (Exophthalmos) Caused by Axillary-Subclavian Venous Thrombosis in a Patient with Upper Extremity Arteriovenous Dialysis Fistula.

Arterialization of orbital veins is most often due to dural arteriovenous malformations of the cavernous sinus area. We report an unusual case of unilateral proptosis (exophthalmos) caused by arterialized retrograde venous flow in the external jugular vein and cavernous sinus in a patient with an upper extremity hemodialysis fistula and ipsilateral acute central venous thrombosis. The patient's symptoms improved after surgical closure of the hemodialysis fistula.

Carotid artery stenting has similar outcomes in men and women.

Background: The aim of carotid interventions is to prevent cerebrovascular events. Endovascular treatment (carotid-artery-stenting/CAS) has become established as an alternative to open surgery in some cases. Historically, female sex has been considered as a perioperative risk factor, however, there are few studies regarding this hypothesis when it comes to CAS.

Mortality of COVID-19 patients with vascular thrombotic complications.

Purpose: To analyze the survival of patients hospitalized with COVID-19 and who presented some vascular thrombotic complication.

Material And Methods: All consecutive patients with COVID-19 who were treated during the months of March and April 2020 at our institution were included. All patients were symptomatic and the thrombotic event objectively confirmed.

Mortality of covid-19 patients with vascular thrombotic complications.

Objective: To analyze the survival of patients hospitalized with covid-19 and who presented some vascular thrombotic complication.

Material And Methods: All consecutive patients with covid-19 who were treated during the months of March and April 2020 at our institution were included. All patients were symptomatic and the thrombotic event objectively confirmed.

National Diagnostic Reference Levels for Endovascular Aneurysm Repair and Optimisation Strategies.

Objective: The International Commission on Radiological Protection (ICRP) has highlighted the large number of medical specialties using fluoroscopy outside imaging departments without programmes of radiation protection (RP) for patients and staff. Vascular surgery is one of these specialties and endovascular aneurysm repair (EVAR) is one of the most challenging procedures requiring RP guidance and optimisation actions. The recent European Directive on Basic Safety Standards requires the use and regular update of diagnostic reference levels (DRL) for interventional procedures.

COVID-19-Related Aortic Thrombosis: A Report of Four Cases.

COVID-19 may predispose patients to an increased risk of thrombotic complications through various pathophysiological mechanisms. Most of the reports on a high incidence of thrombotic complications are in relation to deep vein thrombosis and pulmonary embolism, while the evidence about arterial thrombosis in patients with COVID-19 is limited. We describe 4 cases of aortic thrombosis and associated ischemic complications in patients with severe SARS-CoV-2 infection.

Atrial Fibrillation and Surgical Patients with Peripheral Arterial Disease.

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice and its prevalence rate significantly increases with age. The prognostic implication of AF in surgical patients with peripheral arterial disease (PAD) has not been analyzed. The aims of this study were to analyze the prevalence of AF among patients operated on with symptomatic PAD, and to determine whether these patients are at a higher risk of death or amputation.

Cost-effectiveness of Carotid Surgery.

Background: The purpose of this study is to determinate the cost-effectiveness of carotid endarterectomy (CEA) versus transfemoral stenting (TFS) and transcervical stenting (TCS) in a short- and long-term basis in symptomatic and asymptomatic patients.

Methods: From January 2003 to December 2014, patients from the vascular department, with symptomatic or asymptomatic carotid stenosis, who were clinically and anatomically suitable for TFS, TCS, or CEA, were included. Prospective cost data for each individual procedure and complication during follow-up were obtained from the diagnosis-related group.

Lower Expression of Genes Involved in Protection against Oxidative Stress in Symptomatic Carotid Atherosclerosis.

Background: Oxidative stress is increased in atherosclerosis, manifested both in blood and tissue (atherosclerotic plaque). We aim at describing the expression of a number of genes related to oxidative stress response in carotid atherosclerotic plaques and their relation to symptomatic state.

Methods: We have studied the messenger RNA expression levels for genes related to oxidative stress in a population of 44 patients undergoing carotid endarterectomy, according to the presence (24 patients) or absence (20 patients) of symptoms.

[Identifying clinical risk factors in recurrent idiopathic deep venous thrombosis].

Background And Objective: Oral anticoagulant therapy for more than 6 months in patients with an episode of idiopathic thromboembolic disease is controversial. The objective was to determine predictive clinical signs that identify patients at increased risk of thromboembolic recurrence after stopping anticoagulant therapy for 6 months after an episode of idiopathic deep vein thrombosis (DVT).

Patients And Methods: A prospective study which included 306 consecutive patients with a first episode of idiopathic DVT from June 2012 to June 2014.

Endovascular management of splenic artery aneurysms.

Visceral aneurysms are rare clinical entities, being the most common in this group of pathology the aneurysms of the splenic artery. Its prevalence is estimated between 0.2 and 9.

Prognostic significance of an elevated neutrophil-lymphocyte ratio in the amputation-free survival of patients with chronic critical limb ischemia.

Background: The aim of this study was to investigate the utility of admission neutrophil-lymphocyte ratio (NLR) in predicting the amputation-free survival (AFS) of patients with critical limb ischemia (CLI) who underwent an elective infrainguinal therapeutic intervention.

Methods: All patients with CLI undergoing elective infrainguinal vascular surgery (open or endovascular) at a single university teaching hospital between January 2005 and December 2009 were retrospectively identified from a prospectively maintained database. The primary end point was AFS.

Endovascular management of radiotherapy-induced injury to brachiocephalic artery using covered stents.

Actinic vascular lesions tend to be stenotic-occlusive lesions. In this article, we present 2 exceptional cases of pseudoaneurysms caused by radionecrosis of the supra-aortic trunks. Both patients were treated by a retrograde carotid approach and deployment of a self-expanding covered stent.

Shotgun wound and pellet embolism to the intracranial carotid artery.

Missile embolism into the cerebral circulation is a very unusual complication of shotgun wounds to the chest or neck. We report a case of an 11-year-old boy who sustained an air gunshot wound and pellet embolism to the intracranial carotid artery. The cerebral artery pellet embolus resulted in contralateral hemiplegia.

[Ecodoppler evaluation on the progress of atherosclerotic disease in patients undergoing contralateral carotid endarterectomy].

Purpose: The clinical utility of monitoring by Doppler ultrasound patients undergoing carotid endarterectomy is not clearly established. Our goal is to evaluate by echo-Doppler the progress of contralateral stenosis in a real environment, in order to assess its usefulness.

Material And Methods: Retrospective study with Doppler ultrasound monitoring in patients undergoing carotid endarterectomy for a period of 3 years.

Open surgical repair and endovascular treatment in adult coarctation of the aorta.

Background: The aim of this study was to compare the results of endovascular therapy (covered stenting) with surgical technique to repair aortic coarctation in adults.

Methods: A prospective study of 11 patients who were treated during the past 10 years was carried out. Of these, five patients underwent endoprosthesis (group A) and six an open surgical repair (group B).

Mortality in patients undergoing open aortoiliac surgery: prognostic value of troponin T in the immediate postoperative period.

Background: Patients undergoing open aortoiliac surgery constitute a high-risk subgroup. The aim of this study was to evaluate the relationship between postoperative troponin T (TnT) elevation with the associated postoperative mortality, and mean hospital stay.

Methods: This was a prospective observational study of consecutive patients who underwent open aortoiliac surgery during 2006.

Endovascular therapy of ascending thoracic aorta.

We describe the endovascular treatment given to a patient who, after surgery on the ascending thoracic aorta due to acute type A dissection (Bentall's procedure), developed a pseudoaneurysm 12 cm in diameter of the ascending aorta at the brachiocephalic trunk. Firstly, an extra-anatomical carotid-carotid bypass was performed, which was followed by endovascular treatment, excluding the aortic arch from the origin of both coronary arteries to the origin of the left common carotid artery, occluding the brachiocephalic trunk. For accurate placement of the endoprosthesis, the device was released after cardiac arrest with adenosine.

[Posterior nutcracker syndrome: retroaortic renal vein associated with arteriovenous fistula and renal cancinoma. Report of a case and review of literature].

Vascular retroperitoneal alterations are little frequent and nevertheless, more diagnosed. We presented a case of association very little frequents in which a vascular congenital malformation is related to the presence of a renal arteriovenous fistula and a left renal carcinoma in a patient who only presented hematuria. These vascular variations must be considered at the moment for planning a surgery with the purpose of making it safer and to avoid complications.

Effect of the anticoagulant therapy in the incidence of post-thrombotic syndrome and recurrent thromboembolism: Comparative study of enoxaparin versus coumarin.

Objective: We evaluated the effect of long-term anticoagulant treatment (enoxaparin vs coumarin) in patients with deep venous thrombosis (DVT) as to incidence of post-thrombotic syndrome (PTS) and recurrent venous thromboembolism. We also analyzed the impact of thrombus regression after the anticoagulant treatment for these two outcomes.

Methods: A prospective study was designed in which 165 patients with symptomatic, unilateral, first-episode DVT were randomized to a long-term anticoagulant treatment with coumarin or enoxaparin during at least 3 months.