[Revascularisation of Asymptomatic Carotid Stenosis - Reasonable or Obsolete?].

Recommendations for surgical versus conservative treatment of asymptomatic carotid stenosis (ACS) are based on prospective randomized trials, some of which were performed several decades ago. However, during this time, "best medical treatment" (BMT) for conservative therapy of arteriosclerotic patients has evolved significantly. Because of the associated risk reduction of ACS, surgical therapy is increasingly being questioned.

Preventing Lower Limb Graft Thrombosis after Infrainguinal Arterial Bypass Surgery with Antithrombotic Agents (PATENT Study): An International Expert Based Delphi Consensus.

(1) Background: High-level evidence on antithrombotic therapy after infrainguinal arterial bypass surgery in specific clinical scenarios is lacking. (2) Methods: A modified Delphi procedure was used to develop consensus statements. Experts voted on antithrombotic treatment regimens for three types of infrainguinal arterial bypass procedures: above-the-knee popliteal artery; below-the-knee popliteal artery; and distal, using vein, prosthetic, or biological grafts.

ORal anticoagulation risks late aortic intervention in Conservatively managed type B Aortic dissection (ORCA study).

Objectives: Single-center retrospective cohort study to evaluate the impact of oral anticoagulation (OAC) on long-term outcomes of conservatively managed acute type B aortic dissection.

Methods: Clinical and morphological data of eligible patients from a high-volume vascular centre from 1 January 2003 through 31 December 2020 were evaluated. Patients were excluded for: type A or non-A-non-B dissection, isolated abdominal dissection, intramural haematoma and connective tissue disease.

Acute abdominal aortic occlusion: A 16-year single-center experience.

Background: Acute abdominal aortic occlusion (AAO) is a rare vascular emergency associated with high morbidity and mortality. In the present study, we analyzed the clinical management and outcomes for a consecutive patient series during a 16-year period.

Methods: We included all patients with an acute AAO and bilateral acute limb ischemia who had been treated between 2004 and 2019.

Substitution of perioperative albumin deficiency disorders (SuperAdd) in adults undergoing vascular, abdominal, trauma, or orthopedic surgery: protocol for a randomized controlled trial.

Background: Hypalbuminemia is associated with numerous postoperative complications, so a perioperative albumin substitution is often considered. The objective of SuperAdd is to investigate whether substitution of human albumin, aiming to maintain a serum concentration > 30 g/l, can reduce postoperative complications in normovolemic surgical patients in comparison with standard care.

Methods/design: SuperAdd is a single-center, prospective, randomized, outcome-assessor blinded, patient blinded controlled trial.

Biobanking: Objectives, Requirements, and Future Challenges-Experiences from the Munich Vascular Biobank.

Collecting biological tissue samples in a biobank grants a unique opportunity to validate diagnostic and therapeutic strategies for translational and clinical research. In the present work, we provide our long-standing experience in establishing and maintaining a biobank of vascular tissue samples, including the evaluation of tissue quality, especially in formalin-fixed paraffin-embedded specimens (FFPE). Our Munich Vascular Biobank includes, thus far, vascular biomaterial from patients with high-grade carotid artery stenosis ( = 1567), peripheral arterial disease ( = 703), and abdominal aortic aneurysm ( = 481) from our Department of Vascular and Endovascular Surgery (January 2004⁻December 2018).

Patient characteristics and outcomes of carotid endarterectomy and carotid artery stenting: analysis of the German mandatory national quality assurance registry - 2003 to 2014.

Aim: In Germany, every surgical or endovascular procedure on the extracranial carotid artery is documented in a mandatory quality assurance registry. The purpose of this study is to describe the patient characteristics, the indications for treatment, and the short-term outcomes as well as to analyse the corresponding trends from 2003 to 2014.

Methods: Data on demographics, peri-procedural measures, and outcomes were extracted from the annual quality reports published by the Federal Agency for Quality Assurance and the Institute for Applied Quality Improvement and Research in Health Care.

Expression of a metalloproteinase family of ADAMTS in human vulnerable carotid lesions.

Aims: ADAMTS family of metalloproteases (a disintegrin and metalloprotease with thrombospondin motifs) possesses high proteolytic activity especially regarding proteoglycans. Their expression pattern in carotid plaques is as-yet unknown. The aim of the study was therefore the analysis of expression of ADAMTS1, 4, 5, and 13 and their inhibitors TIMP-1 and TIMP-3 in stable and unstable carotid plaques.

Single-dose gadobutrol in comparison with single-dose gadobenate dimeglumine for magnetic resonance imaging of chronic myocardial infarction at 3 T.

Objectives: The aim of this study was to compare the contrast-to-noise ratio (CNR) values of infarct and remote myocardium as well as infarct and blood after application of 0.1 mmol/kg gadobutrol and 0.1 mmol/kg gadobenate dimeglumine on late gadolinium enhancement magnetic resonance (MR) images.

Expression and cellular localization of metalloproteases ADAMs in high graded carotid artery lesions.

Metalloproteases with a disintegrin domain (ADAM) has already been implicated in various cellular processes such as cytokine and growth factor shedding, proliferation, migration, and degradation of extracellular matrix. Their role in the development and progression of atherosclerosis in carotid lesions is however unknown. The aim of the study was to analyze expression of proteolytic ADAMs (8, 9, 10, 12, 15, 17) and their inhibitors TIMP-1, -3 in patients with high-graded carotid artery stenosis.

Angiographic assessment of cardiac allograft vasculopathy: results of a Consensus Conference of the Task Force for Thoracic Organ Transplantation of the German Cardiac Society.

Angiograms of cardiac transplant (HTx) recipients were to be evaluated in a ring experiment and a joint consensus on criteria of angiographic evaluation of coronary arteries of HTx patients was to be reached. Twenty-four coronary angiograms from 11 hospitals were circulated. One hundred eighty-eight blinded evaluations were returned.

Depression and disease severity as correlates of everyday physical activity in heart transplant candidates.

It is unclear to what extent patients awaiting heart transplantation (HTx) engage in physical activities. We examined the everyday physical activity and its associations with depressive symptoms and disease severity in 318 patients newly registered for HTx in the multi-site study 'Waiting for a New Heart' (aged 53.5 +/- 11.

Deazaadenosine prevents leukozyte evasion during acute cardiac allograft rejection by suppression of adhesion molecule expression.

Background: In the initial phase after cardiac transplantation, mononuclear cells infiltrate the graft initiating a relevant impulse for rejection. 3-Deazaadenosin (c3Ado), an analog of adenosine, has demonstrated in vitro anti-inflammatory properties. Furthermore, in vivo studies on arteriosclerosis development and septic myocardial dysfunction c3Ado revealed reduced cellular infiltration.

The influence of antigen-dependent and antigen-independent factors on the development of graft vasculopathy in a fully allogeneic cardiac allograft model in the rat.

Graft vasculopathy (GVP) is one of the major obstacles to long-term graft and patient survival after cardiac transplantation and a major reason for morbidity and mortality. Antigen-dependent and antigen-independent factors play causal roles in the development of GVP. The aim of this study was to evaluate antigen-dependent and -independent factors in the development of GVR in a clinically relevant fully allogeneic rat cardiac model under immunosuppression with cyclosporine (CyA).

Apoptotic cell death during accelerated rejection in sensitized rat recipients of cardiac allografts.

Accelerated rejection due to host sensitization to major histocompatibility complex antigens is a critical problem in clinical organ transplantation in patients who have previously received an organ transplant, experienced acute rejection episodes, received blood transfusions, or been pregnant. The precise pathologic mechanisms underlying accelerated rejection have not been characterized. Herein, we describe apoptosis during T- and B-cell-driven accelerated rejection of cardiac allografts in presensitized recipients.

FR167653 Ameliorates expression of proinflammatory mediators in human umbilical venous endothelial cells and human monocytes.

p38MAP kinase plays a crucial role in intracellular signal transduction of inflammation. The inhibitor of p38 MAP kinase, FR167653, has been proven to be effective to suppress proinflammatory cytokines tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta in various animal models. The aim of our study was to investigate p38MAP kinase inhibition by FR167653 on the inflammatory profile of cells involved in vascular injury.

Beneficial effects of intravenously administered N-3 fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a prospective randomized study.

Background: Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting operation (CABG). Experimental data have shown antiarrhythmic effects of n-3 polyunsaturated fatty acids (PUFA) on myocardial cells. Orally administered PUFA could significantly reduce the rate of postoperative AF.

Measurement of myocardial oxygen tension: a valid and sensitive method in the investigation of transmyocardial laser revascularization in an acute ischemia model.

Background: The effect of transmyocardial laser revascularization (TMLR) on microperfusion and oxygen supply was studied in an acute ischemia model, using 35 pigs, with 13 serving as controls.

Methods: Measurement of tissue oxygen tension was compared with the semiquantitative measurement of microperfusion using contrast echocardiography and infrared laser Doppler. All methods were used before and after coronary occlusion and after TMLR.

Preconditioning with ozone abrogates acute rejection and prolongs cardiac allograft survival in rats.

Acute cardiac allograft rejection remains a major cause of morbidity and mortality after heart transplantation and predisposes for the development of graft vasculopathy. The aim of this study was to investigate the immunomodulatory effect of preconditioning of the donor and recipient with medical ozone (O(3)/O(2)) on acute allograft rejection. Minimizing the initial ischemia-reperfusion injury may result in a reduction of graft vasculopathy and ameliorate long-term outcomes after cardiac transplantation.

AP-1 and STAT-1 decoy oligodeoxynucleotides attenuate transplant vasculopathy in rat cardiac allografts.

Aims: Cardiac allograft vasculopathy (CAV) continues to be an unsolved clinical problem requiring the development of new therapeutic strategies. We have previously demonstrated that ex vivo donor allograft treatment with decoy oligodeoxynucleotides (ODN) targeting the transcription factors, activator protein-1 (AP-1) or signal transducer and activator of transcription-1 (STAT-1), delays acute rejection and prolongs cardiac allograft survival. Here, we investigated whether this treatment regime also prevents the occurrence of CAV in a fully allogeneic rat heart transplantation model.