Publications by authors named "Manuel Stern"
Article Synopsis
- The study evaluated three-year outcomes of endovascular treatment (EVT) for peripheral arterial disease (PAD) in patients with severe calcified lesions in the common femoral artery (CFA), using data from the Duesseldorf PTA Registry.
- A total of 150 patients were analyzed, with 66 undergoing rotational excisional atherectomy (REA) followed by drug-coated balloon (DCB) angioplasty, and 84 receiving DCB alone; the procedural success rate was high at 97%.
- Findings indicated that EVT is safe and effective, showing high primary and secondary patency rates, low major adverse limb events (MALEs), and major adverse cardiovascular events (MACEs) after three years, suggesting that RE
Article Synopsis
- * Thirty patients with symptomatic peripheral artery disease underwent assessments before, immediately after, and four months after EVT or control angiography to evaluate changes in peripheral hemodynamics and aortic function.
- * Results indicated significant improvements in peripheral blood flow, aortic function, and left ventricular diastolic function following EVT, suggesting it may be an effective intervention for these patients.
Article Synopsis
- Managing chronic limb-threatening ischemia (CLTI) is tough because it’s hard to gauge oxygen levels in ulcers; this study explored how near-infrared spectroscopy (NIRS) could help.
- The research involved 43 CLTI patients where 27 received endovascular treatment (EVT) and 16 were treated conservatively; results showed significant increases in tissue oxygen saturation (StO) after EVT, unlike in the control group.
- The study concluded that improvements in NIRS-measured StO corresponded to a decrease in wound size and severity, suggesting NIRS could be a beneficial tool for monitoring CLTI outcomes alongside traditional methods like the ankle-brachial index (ABI).
Article Synopsis
- Bifemoral arterial access is often used in transcatheter aortic valve implantation (TAVI), and pseudoaneurysms (PSA) can occur as a complication, with a 2.2% incidence found in a study of 2,063 patients.
- Patients with PSA had different health profiles, including lower platelet counts, more heart failure symptoms, and varying treatments (like (N)OACs and aspirin) compared to those without PSA.
- While PSA is linked to increased access site bleeding and longer hospital stays, it does not impact one-year mortality rates, and treatment outcomes for PSA are generally positive.
Article Synopsis
- The study investigates how transcatheter aortic valve implantation (TAVI) affects peripheral microvascular tissue saturation (StO2) in patients with severe aortic stenosis.
- Patients were assessed before and after TAVI, measuring cardiac output, blood pressure, arterial stiffness, and StO2 levels using near-infrared spectroscopy.
- Results showed that while cardiac output increased after TAVI, StO2 levels temporarily decreased and then returned to baseline, with changes in StO2 linked to renal function.
Article Synopsis
- Macrophages are crucial in vascular inflammation and predicting cardiovascular issues; this study used Fluorine-19 MRI to visualize and quantify macrophage activity in pigs after carotid artery angioplasty.
- Eight minipigs underwent mild and severe vascular injuries, followed by the injection of a perfluorocarbon agent three days later to track inflammatory responses using imaging techniques.
- Results showed successful angioplasty in all subjects, with notable macrophage infiltration and no serious adverse effects; imaging was particularly effective in detecting responses from severe injuries, correlating F MRI signals with macrophage density.
Article Synopsis
- The case discusses the importance of ECG interpretation in acute coronary syndrome, particularly when ST-elevation myocardial infarction is not present.
- A patient showing acute chest pain along with biphasic or deeply inverted T-waves in leads V2-V3 indicates a high risk for myocardial infarction.
- Immediate evaluation by a cardiologist and coronary angiography are essential for proper diagnosis and treatment.
Endovascular snare retrieval of an Angio-Seal causing acute limb ischemia.
Clin Case Rep
December 2021
Article Synopsis
- Vascular complications (VCs) are a significant risk following artery catheterization, potentially leading to serious health issues.
- Vascular closure devices, while commonly used, can sometimes lead to vessel blockages that necessitate surgical intervention.
- This case report illustrates the successful endovascular retrieval of an obstructed Angio-Seal device, demonstrating an effective approach to manage complications in patients with existing health conditions.
Article Synopsis
- DAPT (dual antiplatelet therapy) with aspirin and clopidogrel is common for PAD patients post-angioplasty, but HTPR (high on treatment platelet reactivity) is frequent and linked to MALE (major adverse limb events).
- In a study of 71 CLI (critical limb ischemia) patients, HTPR was found in 64.8% of cases, but there was no difference in MALE or MACCE (major adverse cardiac and cerebrovascular events) between HTPR and non-HTPR patients.
- Notably, bleeding complications were higher in patients with effective responses to DAPT, suggesting that CLI patients may need different antithrombotic strategies.
Article Synopsis
- Angioplasty for peripheral artery disease (PAD) significantly lowers both aortic and brachial blood pressure, particularly after treating iliac and femoropopliteal arteries.
- A study on 30 patients showed notable reductions in systolic and diastolic aortic blood pressure following angioplasty, while a larger cohort of 381 patients confirmed similar findings for brachial blood pressure.
- The results suggest that endovascular treatment can effectively manage blood pressure in PAD patients, especially for those with higher baseline levels.
Article Synopsis
- High on-treatment platelet reactivity (HTPR) to dual antiplatelet therapy (DAPT) is common in patients with peripheral artery disease (PAD) and may increase the risk of major adverse limb events (MALE) after angioplasty.
- In a study of 102 PAD patients, 36% experienced HTPR to clopidogrel, 11% to aspirin, and another 11% to both medications.
- Patients with dual HTPR had a significantly higher rate of MALE at six months compared to those with sufficient platelet inhibition, suggesting the need for better antithrombotic strategies in these patients.
Article Synopsis
- The study examined the impact of non-sustained ventricular tachycardia (NSVT) in patients with implantable cardioverter-defibrillators (ICDs) who hadn't experienced prior sustained arrhythmias.
- Out of 157 patients analyzed, those with NSVT showed significantly higher rates of appropriate ICD therapies and unplanned hospitalizations for heart failure compared to those without NSVT.
- The findings suggest that NSVT is a key predictor for the need for further treatments and hospitalizations, particularly in patients with ischemic cardiomyopathy.
Article Synopsis
- β-Endorphin plays a key role in mood, pain management, immune function, and behavior stability, and is produced in the nervous system and skin, especially in response to UV light.
- A study investigated the effects of visible blue light on β-endorphin production in human skin cells and found that blue light exposure significantly increased β-endorphin levels both in skin cell cultures and in healthy individuals.
- The study suggested that the increase in β-endorphin is linked to the non-enzymatic production of nitric oxide, which enhances β-endorphin production in both skin cells and possibly in the brain, highlighting a multi-step process facilitated by nitric oxide.
Article Synopsis
- The study investigated the effects of whole body exposure to visible blue light on blood pressure and endothelial function in healthy males.
- Blue light exposure significantly lowered systolic blood pressure and increased heart rate, along with improved forearm blood flow and endothelial function.
- The findings suggest that visible blue light could enhance cardiovascular health by promoting the release of nitric oxide from the skin.
Article Synopsis
- Nitric oxide (NO), produced by NOS3, plays a crucial role in protecting against myocardial ischemia/reperfusion injury and affects left ventricular remodeling after a heart attack.
- Researchers created chimeric mice to compare the effects of NOS3 presence in circulation versus just in endothelial cells after induced heart attacks.
- Findings showed that mice lacking circulating NOS3 had worse outcomes, indicated by larger heart volumes, lower pressure, and more scar tissue in the heart compared to those with NOS3 present in both blood cells and endothelial cells.
Article Synopsis
- Nitric oxide (NO) produced by endothelial NO synthase (NOS3) is crucial in protecting the heart during ischemia/reperfusion injury, with a focus on its role in various blood cells, including red blood cells (RBCs).
- The study involved creating chimeric mice with different expressions of NOS3 to examine how it influences myocardial infarction severity, revealing that mice with NOS3 only in endothelium had poorer heart function and larger infarcts compared to those with NOS3 in both blood cells and the endothelium.
- Findings indicated that circulating NOS3 in blood cells helps reduce heart damage and maintain RBC function during acute myocardial ischemia/reperfusion, highlighting its potential therapeutic importance.