The role of apolipoprotein (a) in pathogenesis and clinical course of deep venous thrombosis.

UNLABELLED: Deep venous thrombosis is widespread disease, which complications, like: pulmonary embolism and postphlebitis syndrome areimportant social problem. There are many well-known and accurately described risk factors, though in many cases etiology remains unexplained. Further research into causes of deep venous thrombosis seem to be fully justified. The aim of the study was the evaluation of the influence of apolipoprotein (a) serum level in patients with deep venous thrombosis and the changes of its concentration during the treatment. MATERIALS AND METHODS: 26 patients with newly diagnosed deep venous thrombosis (DVT) were enrolled to the study. Diagnosis of DVT was established by use of physical examination and duplex Doppler. Measurements of apolipoprotein (a) and D-dimers serum level were recorded on the following days, starting from the day of the initial diagnosis: 1, 7, 14 and 84. RESULTS: Statistically significant increase of the level of serum apolipoprotein (a) has been found during properly conducted treatment. CONCLUSIONS: Alterations of the concentration of serum apoliprotein (a) during the deep venous thrombosis treatment, indicates the involvement of apolipoprotein (a) in pathogenesis of deep venous thrombosis.

Minimally invasive, endovenous laser treatment of varicose veins in patients with von Willebrand disease.

The presented report presents a minimally invasive approach for the treatment of varicose veins in patients with chronic venous disease and coexisting von Willebrand disease, the most common inherited bleeding disorder. Conventional stripping of an insufficient great saphenous vein and varicose vein surgery, carries a potential risk of serious bleeding complications in this specific group of patients. It is related to the extent of open surgery, significant tissue trauma, and possible post-operative bleeding of wounds. Less aggressive techniques, such as endovenous laser treatment or radiofrequency ablation, gain increasing popularity as a valuable and equally efficient alternative to conventional surgery in patients with varicose veins. Both of these endovenous techniques seem to have special indications in patients with bleeding disorders. Shortening of hospitalization, quick recovery time and return to normal daily activities, optimal cosmetic effect of the procedure, are also advantageous. The paper presents the technique and results of endovenous laser treatment of great saphenous vein insufficiency and varicose veins in a patient with type I von Willebrand disease. Available data on peri-operative care standards, optimization of the safety of procedures, and prevention of bleeding complications in surgical patients with von Willebrand disease, specifically undergoing varicose veins surgery are analysed.

[Ophthalmological complications associated with clinically significant carotid stenosis]. / Objawy oczne towarzyszace klinicznie znaczacemu zwezeniu tetnicy szyjnej.

The aim of the study was to show ocular manifestations in carotid artery occlusive disease, with pathogenesis, diagnostic and therapeutic abilities of this changes. Carotid arteries are the main route by which the blood is supplied to the cerebrum and eyes. Clinical significant carotid artery stenosis is mainly caused by atherosclerosis. Most frequent neurological symptoms are transient ischemic attacks (TIA) and temporary visual loss (amaurosos fugax) are most common ocular symptoms. Other ocular pathologies in fundus examination are retinal embolies, retinal vein occlusion, anterior ischemic optic neuropathy, ocular ischemic syndrome or glaucoma. Most dangerous complications are stroke, blindness, or even patients death. Besides clinical examination the diagnosis is usually confirmed by carotid artery color Doppler ultrasound, magnetic resonance angiography and retinal fluorescein angiography. It is important to refer a patient with suspected or confirmed significant carotid artery stenosis for appropriate evaluation and treatment to a endovascular surgeon.