Stent-induced flow disturbances in the ipsilateral external carotid artery following internal carotid artery stenting: a temporary cause of jaw claudication.

Background: We hypothesize that stenting of the internal carotid artery can immediately impede blood flow to the external carotid artery by either plaque shift or stent coverage of the ostium, and thereby cause ischemic symptoms like ipsilateral jaw claudication.

Methods: Thirty-three patients with high-grade asymptomatic stenosis of the internal carotid artery who underwent endovascular treatment were examined by ultrasound of the external carotid artery and performed an exercise test by chewing chewing gum synchronously to an electronic metronome for 3 min. Tests were performed before, the day after, and 1 week after the stenting procedure.

Combined Effects of Inflammatory Status and Carotid Atherosclerosis: A 12-Year Follow-Up Study.

Background And Purpose: Inflammatory responses play a key role in atherogenesis. The aim of this study was to assess the prognostic value of hsCRP (high-sensitivity C-reactive protein) and to evaluate whether degree of carotid stenosis and serum levels of hsCRP jointly predict long-term mortality in asymptomatic patients with carotid atherosclerosis.

Methods: One thousand sixty-five patients with neurological asymptomatic carotid atherosclerosis as evaluated by duplex sonography were prospectively followed for cause-specific mortality.

Vascular puncture site complications - diagnosis, therapy, and prognosis.

The numbers of endovascular procedures have been noted to substantially increase over the past two decades. Besides all the technical advances and the increasing skills of more and more trained interventionists, the vascular access site still offers the possibilities and carries the risk of access site complications, which have not been changed dramatically over the past years. Guidelines on the vascular puncture procedure itself are lacking.

Percutaneous instillation of physiological saline solution for the treatment of femoral pseudoaneuryms.

Objective: To investigate the efficacy of para-aneurysmal saline injection for closure of postcatheterization pseudo-aneurysm (PA) at the vascular access site.

Methods: Fifty-one consecutive patients with postcatheterization PA at the vascular access site were included to undergo percutaneous para-aneurysmal saline injection. In case of technical failure the day after, PA were treated by bovine thrombin injection.

The impact of selectins on mortality in stable carotid atherosclerosis.

Cellular adhesion molecules also known as selectins promote recruitment of inflammatory cells into the arterial wall where they interact with lipid particles leading subsequently to plaque formation. The intercellular adhesion molecule-1 (ICAM-1), the vascular cell adhesion molecule-1 (VCAM-1) and the endothelial-leukocyte adhesion molecule 1 (ELAM-1) also known as E-selectin mediate the attachment of leukocytes and have been implicated in the destabilisation of atherosclerotic plaques. Therefore, we hypothesised that plasma selectin levels are associated with adverse clinical outcome.

Relationship of age and body mass index to skin temperature and skin perfusion in primary Raynaud's phenomenon.

Objective: To assess the relationship of age and body mass index (BMI) to skin temperature and perfusion in patients with primary Raynaud's phenomenon (RP) compared with controls.

Methods: Patients with RP as well as age- and sex-matched controls underwent external cold provocation by exposure to 20 °C water for 1 minute. Before and after cold provocation, skin temperature and skin perfusion were measured.

Renal function and long-term mortality in patients with asymptomatic carotid atherosclerosis.

Renal dysfunction is a risk factor for mortality in patients with atherosclerosis. Estimated glomerular filtration rate (eGFR), cystatin C (CysC) and beta-2-microglobulin (B2M) are measures of renal function. It remains unclear, which of these parameters is the strongest predictor of outcome in patients with atherosclerosis.

[Perspectives of mobile communication in the management of diabetics].

Sufficient control of blood glucose levels has been demonstrated to be associated with improved long-term outcome in patients with diabetes. Recent advances in interface technology allow transfer of measurement data to mobile devices, which enables control, multiple access, and storage of these data and virtually links patients and care-giving physicians. The possibility of alerting predefined addressee in case of measurements below or above certain limits offers some sort of security that cannot be obtained by simply penning a single value to a scratchpad.

The impact of dental disease on mortality in patients with asymptomatic carotid atherosclerosis.

Background: Dental status and oral hygiene are associated with progression of atherosclerosis in patients with carotid stenosis. It remains unclear whether dental disease is a risk factor for mortality in these patients. We evaluated the bearing of dental disease on mortality among patients with asymptomatic carotid atherosclerosis.

The prognostic impact of soluble apoptosis-stimulating fragment on mortality in patients with carotid atherosclerosis.

Background And Purpose: Markers of apoptosis are associated with cardiovascular disease. The soluble apoptosis-stimulating fragment (sFAS) was found to be a predictor for outcome in patients with heart failure, but its importance in patients with atherosclerotic disease has not been fully understood as yet. The aim of the present study was to investigate the impact of sFAS on all-cause and cardiovascular mortality in patients with atherosclerosis in the carotid arteries.

Beta 2 microglobulin and the risk for cardiovascular events in patients with asymptomatic carotid atherosclerosis.

Background And Purpose: Atherosclerosis is a chronic inflammatory disease. Ongoing inflammation is associated with elevated levels of beta 2 microglobulin (B2M). We investigated B2M levels in a large cohort of patients with carotid atherosclerosis for the occurrence of major adverse cardiovascular events.

Prognostic value of plasma d-dimer levels in patients with glioblastoma multiforme - Results from a pilot study.

Glioblastoma multiforme (GBM), the most common primary tumor of the central nervous system, is associated with a state of hypercoagulability. We hypothesized that tumor activity is displayed by elevated d-dimer plasma levels and that d-dimer might be used as a predictor of survival in patients with glioblastoma multiforme. We studied effects on clinical outcomes of d-dimer levels obtained two to three weeks following histologic confirmation of the diagnosis of GBM at surgery or needle biopsy, but prior to chemotherapy or radiation therapy, in 23 patients.

Auricular electroacupuncture reduces frequency and severity of Raynaud attacks.

Background: Acupuncture has been shown to influence skin perfusion and the subjective cold perception threshold. Therefore, we hypothesized that auricular electroacupuncture (EA) might reduce symptoms in primary Raynaud's phenomenon (PRP).

Methods: Twenty-six patients with PRP received 6 cycles of auricular EA.

Polymorphism of the palladin gene and cardiovascular outcome in patients with atherosclerosis.

Background: A single-nucleotide polymorphism (SNP) in the palladin gene (PALLD, rs7439293) has recently been reported to be associated with coronary heart disease (CHD) in two case-control studies as well as in a large population-based cohort (Atherosclerosis Risk in Communities study, ARIC). Its clinical relevance, however, has not been evaluated prospectively. We investigated whether the risk allele (A) of PALLD rs7439293 (G>A) is associated with the occurrence of future major cardiovascular events (MACE) in a cohort of patients with prevalent carotid atherosclerosis.

D-dimer testing in the diagnosis of transfemoral pseudoaneurysm after percutaneous transluminal procedures.

Objective: Pseudoaneurysms are characterized by extravascular circulation and therefore may lead to an activation of the coagulation cascade. We investigated d-dimer levels in patients with and without postcatheterization femoral pseudoaneurysms and hypothesized that d-dimer levels correlate with the presence of pseudoaneurysms at the vascular access site.

Methods: Patients with clinical suspected groin pseudoaneurysms after transluminal procedures were eligible.

Cystatin C and the risk for cardiovascular events in patients with asymptomatic carotid atherosclerosis.

Background And Purpose: Renal dysfunction is a risk factor for cardiovascular events in patients with atherosclerosis. Unlike serum creatinine or estimated glomerular filtration rate, cystatin C reflects renal dysfunction independent of factors such as sex, weight, and race. We investigated whether baseline serum levels of cystatin C predict major cardiovascular events in patients with asymptomatic carotid atherosclerosis and compared the predictive value of cystatin C to these established markers of renal function.

Correlation of infrared thermography and skin perfusion in Raynaud patients and in healthy controls.

Background: We aimed to investigate the correlation of infrared thermography (IT) with laser Doppler perfusion imager (LDPI) among patients with primary Raynaud's phenomenon and healthy controls.

Methods: Forty-seven individuals were included: we examined 25 patients with primary Raynaud's phenomenon and 22 age and gender matched healthy controls. IT of the volar surface of the subjects' left hands was performed to record skin temperature while skin perfusion of the same area was determined using LDPI.

Balloon angioplasty versus stenting with nitinol stents in intermediate length superficial femoral artery lesions.

Background: Recent randomized trials investigating stent implantation compared with balloon angioplasty for treatment of superficial femoral artery (SFA) disease have given divergent results in short (mean 5 cm) and intermediate (mean 10 cm) lesions. We reinvestigated whether primary nitinol stenting is associated with a morphologic and clinical benefit when compared with percutaneous transluminal angioplasty with optional stenting (PTA) in intermediate-length lesions.

Methods: We randomly assigned 73 patients with severe claudication or chronic limb ischemia and average 8 cm long (range 3-20 cm) SFA stenosis or occlusion to primary stent implantation (n = 34) or PTA (n = 39).

Inflammation and adverse cardiovascular outcome in patients with renal artery stenosis and peripheral artery disease.

Objectives: We hypothesized that high sensitivity C-reactive protein (hs-CRP) and the presence of renal artery stenosis (RAS) might conjointly predict future major adverse cardiovascular events (MACE) in patients with peripheral artery disease (PAD).

Background: Clinical outcome in PAD is determined by the extent of atherosclerosis affecting additional vascular beds and the activity of the atherosclerotic process reflected by inflammatory serum markers. Data on the predictive value of hs-CRP on outcome in PAD patients with RAS is limited.

Access site management after peripheral percutaneous transluminal procedures: Neptune pad compared with conventional manual compression.

Purpose: To investigate the safety and efficacy of the procoagulant wound dressing Neptune Pad (Biotronik, Berlin, Germany) compared with those of conventional manual compression for access site management after peripheral percutaneous interventions.

Materials And Methods: The study was approved by the institutional ethics committee, and all patients gave written informed consent. Two hundred one consecutive patients were enrolled and were randomly assigned to be treated with the Neptune Pad (n = 100) or conventional manual compression (n = 101).

Complications after peripheral vascular interventions in octogenarians.

Purpose: To investigate the incidence of complications after peripheral vascular interventions in patients aged 80 years and older compared to patients below the age of 80.

Methods: During a 20-month period, 619 consecutive patients (354 men; mean age 67 years, range 59-87) undergoing balloon angioplasty and stenting for lower limb revascularization were enrolled in the study. The incidence of procedure-related, access-site, and major complications within 30 days post intervention were recorded and compared between patients aged 80 years and older (n=72, 11.

Increasing carotid plaque echolucency is predictive of cardiovascular events in high-risk patients.

Purpose: Carotid plaque echolucency seen at ultrasonography (US) is a potential indicator of plaque instability and may help identify patients at risk for major adverse cardiovascular events (MACEs). The authors performed this study to determine whether decreasing gray-scale median (GSM) levels at repeat carotid US examinations are associated with future MACEs.

Materials And Methods: The study was approved by the institutional ethics committee and all patients provided informed consent.

Decreasing incidence of critical limb ischemia after intra-aortic balloon pump counterpulsation.

The authors investigated the incidence of critical limb ischemia (CLI) in 187 patients with intra-aortic balloon pump (IABP) support during a 6-year study period and determined risk factors and long-term outcome (median 5 years) after discharge from a cardiac intensive care unit. Cardiogenic shock following acute myocardial infarction was the predominant cause of IABP support. CLI occurred in 10% of the patients after IABP implantation.

Conventional balloon angioplasty versus peripheral cutting balloon angioplasty for treatment of femoropopliteal artery in-stent restenosis: initial experience.

Purpose: To prospectively determine whether cutting balloon angioplasty, when compared with conventional balloon angioplasty (CBA), improves morphologic and clinical outcome in patients with femoropopliteal in-stent restenosis.

Materials And Methods: Patients with symptomatic femoropopliteal in-stent restenosis were randomly assigned to undergo CBA or peripheral cutting balloon angioplasty (PCBA) for treatment of lesions up to 20 cm in length. Patients were followed up clinically and with duplex ultrasonography (US) at 1, 3, and 6 months for occurrence of a restenosis of 50% or higher.

De novo superficial femoropopliteal artery lesions: peripheral cutting balloon angioplasty and restenosis rates--randomized controlled trial.

Purpose: To prospectively determine, in a randomized controlled trial, whether cutting balloon angioplasty (CBA) yields superior morphologic and clinical outcomes at 6 months compared with the 6-month outcomes after conventional percutaneous transluminal angioplasty (PTA) in patients with short de novo superficial femoropopliteal artery (SFA) lesions.

Materials And Methods: This study was approved by the ethics committees of the two participating centers, and informed consent was obtained from all patients. The authors randomly assigned 43 patients (26 men, 17 women; median age, 69 years) who had 5 cm or shorter de novo SFA lesions in association with intermittent claudication or chronic limb ischemia to undergo CBA or PTA.