Comparison of Doppler Ultrasound and Digital Subtraction Angiography in extracranial stenosis.

OBJECTIVE: Evaluating the degree of extracranial stenosis is important in predicting the risk of cerebrovascular events and to assess if the patient can benefit from any intervention. Non-invasive methods, like Doppler Ultrasonography (DUS) are preferred to invasive methods such as Digital Subtraction Angiography (DSA). METHODS: In this retrospective study, the level of agreement between DUS and DSA regarding the degree of stenosis of Internal Carotid Arteries (ICAs) and Vertebral Arteries (VAs) was assessed. The degree of ICA stenosis was classified into 5 groups. DSA was assumed as the gold standard. VA stenosis was classified into two groups of more or less than 50% stenosis. RESULTS: A total of 428 ICAs were assessed. Based on DSA results, DUS could estimate the degree of arterial stenosis in groups of 0-15% stenosis and 100% stenosis most accurately, and the least accuracy was in groups of 50-69% and 70-99% stenosis. The overall agreement between DUS and DSA in the classified ICA stenosis was moderate (Weighted Kappa = 0.565, P < 0.001). Also, the agreement of DUS and DSA when classifying ICA stenosis into two groups of above and below 50%, was moderate (Kappa = 0.583, P < 0.001). DUS was most sensitive and specific in the group of 100% stenosis (Sensitivity: 0.75 Specificity: 0.99) as well as the group of 1-15% stenosis (Sensitivity: 0.80 Specificity: 0.76). Also, DUS was least sensitive in group of 50-69% stenosis (Sensitivity: 0.11 Specificity: 0.94). Regarding VAS, 108 arteries were assessed and the agreement between DUS and DSA was fair (Kappa = 0.248, CI95 = -0.013 - 0.509, P < 0.01). CONCLUSIONS: DUS can be used as the first-line screening tool for detecting extra cranial arteries stenosis. The practicality of the DUS as a screening tool for extracranial VAs stenosis appears to be limited.

Innovative techniques for thread lifting of face and neck.

BACKGROUND: To investigate the efficacy and outcomes associated with eyebrow, midface, mandibular, and neck lifting using the innovative techniques. MATERIALS AND METHODS: In this prospective review chart study, a total of 151 patients, were included in the study from January 2016 to May 2017. All participants underwent thread lifting using our innovative thread-lift technique for head and neck. The patients were followed up first week, first, third, and sixth month after lifting surgery. Outcomes were assessed by two surgeon and patients based on the GAIS score. All data were analyzed by SPSS-17 software with chi-square test. RESULTS: A total of 151 patients (mean age: 52.49 ± 10.67, range: 27-78 years), 16 (10.6%) men and 135 (89.4%) women, were included in the study. The most common sites for the face-lifting surgery were the mandible (49.7%), midface (37.1%), neck (7.9%), and eyebrow (5.3%), respectively. The level of satisfaction increased from 77.5% in the first week after surgery to 89.4% in the sixth month after surgery for patients, remained unchanged, 96% for the surgeon, and increased from 74.8% to 94.7% for the independent surgeon. The highest rate of potential complications after the lifting surgery was related to ecchymosis (23.2%), followed by complications of tumefaction (6.6%), pain (6.6%), and pain (5.2%). CONCLUSION: The results showed that the level satisfaction of patients and surgeons increased over time. It seems that facial rejuvenation thread lifting with this innovative technique is effectiveness, safe, and cosmetically more acceptance with minor complications than other face-lifting techniques.

Outcomes in thread lift for face and neck: A study performed with Silhouette Soft and Promo Happy Lift double needle, innovative and classic techniques.

INTRODUCTION: Increased demand for rejuvenation of the aging face has led to the evolution of various plastic surgery techniques. This study was conducted to evaluate the surgical efficacy and outcomes of the absorbable suture suspension system related to eyebrow, midface, mandibular, and neck lifting. MATERIALS AND METHODS: In this prospective review chart clinical study, a total of 193 patients were included in the study from January 2016 to May 2017. All participants underwent thread lifting using the Proma Happy Lift double needle and Silhouette Soft threads. The patients were followed up for first week and first, third, and sixth month after lifting surgery. Outcomes were assessed by two surgeons and patients based on the GAIS score. RESULTS: A total of 193 patients (mean age: 52.22 ± 11.74 year, range: 25-89), 23 (11.9%) men and 170 (88.1%) women, were included in the study. The most common sites for the face lifting surgery were the jawline (46.1%), midface (33.7%), eyebrows (12.4%), and neck (7.8%). The level of satisfaction increased from 94% in the first week after surgery to 99% in the sixth month after surgery for patients, increased from 94% to 99% for surgeon 1, and increased from 83% to 98% for surgeon 2. CONCLUSION: The results showed that the level of satisfaction of patients and surgeons increased over time. These results demonstrated that facial rejuvenation thread lift with Proma Happy Lift double needle and Silhouette Soft threads is a being cosmetically more acceptance, safe, and effective procedure associated with minor complications.