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1.
J Clin Hypertens (Greenwich) ; 25(12): 1145-1150, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37885359

RESUMEN

This study aimed to evaluate the guiding role of left adrenal vein (LAV) for right adrenal venous sampling (AVS). A total of 347 patients who were diagnosed with primary aldosteronism (PA) and underwent successful AVS procedures from January 2020 to July 2021 were retrospectively analyzed. According to the different quadrant position of the orifice of right adrenal vein (RAV), the area where the orifice of RAV is located is divided into three areas: A, B, and C and the area A is further subdivided into A1, A2, and A3 areas. By counting the area where the orifice of RAV is located, the guiding role of the LAV on the RAV is determined. Most of the orifice of RAV are located in area A, and the proportions of areas A, B, and C was 96.8%, 1.4%, and 1.7%, respectively. In area A, areas A1, A2, and A3 account for 80.9%, 17.0%, and 2.1%, respectively. High body mass index, female and smaller the angle between the LAV and horizontal line was associated with the closer positional relationship between the LAV on the RAV. These findings suggest that most of the horizontal position of the RAV orifice is close to the horizontal position of the most distal end of the LAV, which indicate that the LAV location can play an important role on the guiding for right AVS. Additionally, body mass index, sex, and the angle of the LAV was largely related to location of the orifice of the RAV.


Asunto(s)
Hiperaldosteronismo , Hipertensión , Humanos , Femenino , Estudios Retrospectivos , Glándulas Suprarrenales/irrigación sanguínea , Vena Cava Inferior , Índice de Masa Corporal , Hiperaldosteronismo/diagnóstico , Aldosterona
2.
J Clin Endocrinol Metab ; 109(1): e274-e279, 2023 Dec 21.
Artículo en Inglés | MEDLINE | ID: mdl-37466201

RESUMEN

CONTEXT: Adrenal venous sampling (AVS) is considered the gold standard for differentiating unilateral and bilateral forms of primary aldosteronism. Currently, almost all AVS procedures are performed via femoral vein access. OBJECTIVE: The aim of this study was to evaluate the success rate and safety of AVS via an antecubital approach. METHODS: In a retrospective multicenter study involving 7 Chinese medical centers, patients with primary aldosteronism who underwent AVS via an antecubital approach between January 2012 and December 2018 were analyzed. Successful sampling was determined by a selectivity index (cortisol in the adrenal vein/cortisol in inferior vena cava) greater than 2. RESULTS: A total of 1226 participants (mean age, 47.1 years; 57.9% male) were included. The puncture site was right and left antecubital vein in 1211 (98.8%), and 15 (1.2%) patients. The access of 6 patients (0.5%) was changed to right femoral vein due to the failure of antecubital vein cannulation or anatomic variation of adrenal vein. The success rate of bilateral, right, and left sampling was 91.5%, 94.9%, and 95.1%, respectively. The success rate of bilateral, right, and left sampling increased from 82.9%, 87.1%, and 88.6% during the initial 70 cases (total of initial 10 cases at each center) to 92.0% (P = .012), 95.3% (P = .008), and 95.5% (P = .018) with subsequent cases. Adrenal vein rupture occurred in 5 patients (0.41%), with no sequelae. CONCLUSION: This multicenter study demonstrates that AVS via an antecubital approach is safe and feasible, with a high rate of successful sampling, which may be an alternative to the femoral vein access method.


Asunto(s)
Hiperaldosteronismo , Humanos , Masculino , Persona de Mediana Edad , Femenino , Hiperaldosteronismo/diagnóstico , Hidrocortisona , Glándulas Suprarrenales/irrigación sanguínea , Vena Cava Inferior , Estudios Retrospectivos , Vena Femoral , Aldosterona
3.
J Vasc Interv Radiol ; 34(8): 1353-1358, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37127178

RESUMEN

PURPOSE: Endovascular data on patients with coexistent renal artery stenosis (RAS) and renal artery aneurysm (RAA) caused by fibromuscular dysplasia (FMD) are scarce, and the outcomes from RAS-specific treatment on RAA remain unclear. This study aimed to evaluate the safety and effectiveness of RAS-specific endovascular management in patients with coexisting RAA caused by FMD. MATERIALS AND METHODS: Clinical and endovascular data on 19 patients with coexistent RAS and RAA caused by FMD who underwent RAS-specific endovascular therapy were analyzed prospectively. An RAA located within 10 mm of the RAS was defined as a stenosis-related RAA (SRAA), and long-term outcomes were evaluated. RESULTS: Nineteen patients (24 RASs and 30 RAAs) underwent endovascular therapy. Twenty-one RASs were treated with balloon angioplasty alone, whereas 3 RASs were treated with stent implantation. None of the RAAs were treated directly. During an average of 4.2 years ± 3.2 of follow-up, systolic and diastolic blood pressures decreased from 183.0 mm Hg ± 19.5 and 120.2 mm Hg ± 19.0 to 127.9 mm Hg ± 10.3 and 80.9 mm Hg ± 6.9, respectively; the number of antihypertensive medications reduced from 1.7 ± 1.0 to 0.8 ± 0.3 (for all, P < .001). The serum creatinine level remained stable. The maximum diameter of all RAAs decreased from 14.6 mm ± 9.7 to 11.3 mm ± 8.4 (P < .001). There was a significant difference in the improvement rate of the maximum diameter between SRAAs (65.0%, 13 of 20) and non-SRAAs (20.0%, 2 of 10) (P = .019). CONCLUSIONS: RAS-specific endovascular therapy is safe and effective and possibly aids in preventing RAA progression in patients with FMD with coexistent RAS and RAA.


Asunto(s)
Aneurisma , Displasia Fibromuscular , Obstrucción de la Arteria Renal , Humanos , Obstrucción de la Arteria Renal/diagnóstico por imagen , Obstrucción de la Arteria Renal/etiología , Obstrucción de la Arteria Renal/terapia , Resultado del Tratamiento , Displasia Fibromuscular/complicaciones , Displasia Fibromuscular/diagnóstico por imagen , Displasia Fibromuscular/terapia , Arteria Renal/cirugía , Aneurisma/diagnóstico por imagen , Aneurisma/etiología , Aneurisma/terapia , Estudios Retrospectivos
4.
Hypertens Res ; 46(5): 1297-1310, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-36869143

RESUMEN

Superselective adrenal arterial embolization (SAAE) appears to be beneficial in primary aldosteronism (PA) patients with lateralized aldosterone secretion (unilateral PA). As confirmed by adrenal vein sampling (AVS), nearly 40% of PA patients would be PA without lateralized aldosterone secretion (bilateral PA). We aimed to investigate the efficacy and safety of SAAE on bilateral PA. We identified 171 bilateral PA patients from 503 PA patients who completed AVS. Thirty-eight bilateral PA patients received SAAE, and 31 completed a median 12-month clinical follow-up. The blood pressure and biochemical improvements of these patients were carefully analyzed. 34% of patients were identified as bilateral PA. Plasma aldosterone concentration, plasma renin activity, and aldosterone/renin ratio (ARR) were significantly improved 24-h after SAAE. SAAE was associated with 38.7% and 58.6% of complete/partial clinical and biochemical success within a median 12-month follow-up. A significant reduction in left ventricular hypertrophy was shown in patients who obtained complete biochemical success compared with partial/absent biochemical success. SAAE was associated with a more apparent nighttime blood pressure reduction than daytime blood pressure reduction in patients with complete biochemical success. No major adverse safety events related to SAAE were reported during the intraoperative, postoperative, and follow-up periods. SAAE was associated with blood pressure and biochemical improvements in part of bilateral PA and appeared safe. The biochemistry success was accompanied by improved cardiac remodeling and a more prominent decrease in nocturnal blood pressure. This study was part of a trial registered with the Chinese Clinical Trial Registry, number ChiCTR2100047689.


Asunto(s)
Aldosterona , Hiperaldosteronismo , Humanos , Glándulas Suprarrenales/irrigación sanguínea , Renina , Presión Sanguínea , Estudios Retrospectivos
5.
Catheter Cardiovasc Interv ; 95 Suppl 1: 641-647, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31943685

RESUMEN

OBJECTIVES: This study aimed to evaluate the safety and efficiency of percutaneous transluminal angioplasty (PTA) with selective stenting treating Chinese patients with renal artery stenosis (RAS) due to fibromuscular dysplasia (FMD). BACKGROUND: Endovascular data of patients with RAS caused by FMD are scarce in China. METHODS: Clinical data of 105 hypertensive patients with RAS caused by FMD underwent endovascular therapy at a single-site between June 2001 and October 2018 were analyzed retrospectively. Baseline blood pressure, use of antihypertensive medications, renal function, and adverse events at a 1-year follow-up were evaluated. RESULTS: The patients were aged between 10 and 64 years (mean age 26.7 ± 8.2 years) and 52 (49.5%) were female. In total, 105 patients undergoing endovascular therapy involving 124 RASs. Thirty (24.2%), sixty-four (51.6%), and thirty (24.2%) RASs were multifocal, unifocal, and tubular types, respectively. Ninety-four (89.5%) and eleven (10.5%) patients underwent PTA alone and PTA plus stenting, respectively. The technical success rate for endovascular therapy was 95.2% (100/105) without severe complications. During 1-year follow-up (n = 100), the mean systolic and diastolic blood pressure decreased from 157.6 ± 17.5 and 102.3 ± 14.2 to 129.6 ± 12.3 and 81.3 ± 11.1 mmHg, respectively, and the number of antihypertensive medications reduced from 2.2 ± 1.2 to 0.8 ± 1.0 (all p < .001). The cure rate and improved rate of blood pressure was 49.0 and 40.0%, respectively. The serum creatinine levels remained stable. The primary and secondary restenosis rate was 13.4 and 5.8%, respectively. CONCLUSION: Endovascular therapy for treating RAS caused by FMD was technically safe and effective for reducing blood pressure in Chinese patients.


Asunto(s)
Angioplastia/instrumentación , Presión Sanguínea , Displasia Fibromuscular/complicaciones , Hipertensión Renovascular/terapia , Obstrucción de la Arteria Renal/terapia , Stents , Adolescente , Adulto , Angioplastia/efectos adversos , Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Niño , China , Femenino , Displasia Fibromuscular/diagnóstico por imagen , Displasia Fibromuscular/fisiopatología , Humanos , Hipertensión Renovascular/diagnóstico , Hipertensión Renovascular/etiología , Hipertensión Renovascular/fisiopatología , Masculino , Persona de Mediana Edad , Obstrucción de la Arteria Renal/diagnóstico por imagen , Obstrucción de la Arteria Renal/etiología , Obstrucción de la Arteria Renal/fisiopatología , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
6.
Front Genet ; 11: 616988, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33414814

RESUMEN

Delayed repair is a serious public health concern for diabetic populations. Intercellular adhesion molecule 1 (ICAM-1) and Lymphocyte function-associated antigen 1 (LFA-1) play important roles in orchestrating the repair process. However, little is known about their effects on endothelial cell (EC) proliferation and neutrophil activity in subjects with hyperglycemia (HG). We cultured ECs and performed a scratch-closure assay to determine the relationship between ICAM-1 and EC proliferation. Specific internally labeled bacteria were used to clarify the effects of ICAM-1 and LFA-1 on neutrophil phagocytosis. Transwell assay and fluorescence-activated cell sorting analysis evaluated the roles of ICAM-1 and LFA-1 in neutrophil recruitment. ICAM-1+/+ and ICAM-1-/- mice were used to confirm the findings in vivo. The results demonstrated that HG decreased the expression of ICAM-1, which lead to the low proliferation of ECs. HG also attenuated neutrophil recruitment and phagocytosis by reducing the expression of ICAM-1 and LFA-1, which were strongly associated with the delayed repair.

7.
Catheter Cardiovasc Interv ; 95 Suppl 1: 633-640, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31868309

RESUMEN

OBJECTIVE: This study aimed to evaluate the effect of stenting on blood pressure in hypertensive patients with symptomatic proximal subclavian or vertebral artery stenosis. BACKGROUND: Whether posterior circulation revascularization could reduce blood pressure in hypertensive patients with posterior circulation hypoperfusion has not been investigated in humans. METHODS: A total of 48 patients with essential hypertension (33 males; mean age 63.0 ± 8.7 years) with symptomatic proximal subclavian or vertebral artery stenosis who underwent stenting successfully at the Fuwai Hospital were prospectively enrolled between January 2014 and December 2015. All 48 patients were followed up at 1, 3, and 6 months after the procedure. Blood pressure, use of antihypertensive agents, and complications were investigated. RESULTS: Baseline values included office blood pressure of 132/77 ± 10/8 mmHg, mean 24-hr blood pressure of 127/75 ± 12/9 mmHg, and mean antihypertensive agents used of 1.6 ± 0.8. Stenosis of the subclavian and vertebral arteries decreased from 88.9 ± 9.5% and 85.8 ± 7.4% to 5.5 ± 3.5% and 4.6 ± 3.7%, respectively, immediately after the procedure. Reductions in office blood pressure were - 7/-3 (SD 3/2), -9/-4 (5/3), and - 10/-5 (7/5) mmHg at 1, 3, and 6 months, respectively. While 24-hr blood pressures after the procedure reduced by -5/-3 mmHg at 6 months, the total number of antihypertensive agents used at the aforementioned time points was unchanged. CONCLUSION: This first prospective cohort study in humans showed that posterior circulation stenting is apparently effective in reducing blood pressure in hypertensive patients with symptomatic proximal subclavian or vertebral artery stenosis.


Asunto(s)
Angioplastia de Balón/instrumentación , Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Hipertensión/tratamiento farmacológico , Stents , Síndrome del Robo de la Subclavia/terapia , Insuficiencia Vertebrobasilar/terapia , Anciano , Angioplastia de Balón/efectos adversos , Femenino , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos , Síndrome del Robo de la Subclavia/diagnóstico por imagen , Síndrome del Robo de la Subclavia/fisiopatología , Factores de Tiempo , Resultado del Tratamiento , Insuficiencia Vertebrobasilar/diagnóstico por imagen , Insuficiencia Vertebrobasilar/fisiopatología
8.
J Endovasc Ther ; 26(6): 810-815, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31496339

RESUMEN

Purpose: To evaluate the safety and efficacy of endovascular treatment for iliac artery stenosis caused by Takayasu arteritis (TA). Methods: Twenty-three consecutive TA patients (mean age 28.6±9.5 years; 17 women) with 30 iliac artery stenoses underwent percutaneous transluminal angioplasty (PTA) and selective stent implantation between January 2007 and December 2016. All had claudication (Rutherford category 2 or 3). The changes in the Rutherford category, ankle-brachial index (ABI), 6-minute walking capacity, and adverse events were assessed. Results: The success rate of endovascular therapy for iliac artery lesions was 93.3% (28/30). Guidewires could not cross either lesion in a patient with bilateral stenoses. Twenty-four lesions were treated by PTA alone and the other 4 lesions with provisional stents. One patient had a puncture site hematoma. Over an average of 4.8±3.3 years, 18 patients remained asymptomatic or had mild intermittent claudication. The other 4 patients developed moderate to severe intermittent claudication due to progression of a previously existing iliac lesion (n=1) or restenosis (n=3); all 4 underwent PTA. At the last follow-up, improvements were seen in the ABI (0.95±0.12 vs 0.51±0.22, p<0.001), 6-minute walking capacity (409.5±46.1 vs 272.6±32.3 m, p<0.001), and the Rutherford category of 22 patients. One patient died of a hemorrhagic stroke at 27 months due to uncontrolled hypertension. Conclusion: Endovascular therapy was safe and effective in treating TA patients with iliac artery stenosis, with good clinical outcomes in the long term.


Asunto(s)
Angioplastia , Arteriopatías Oclusivas/terapia , Arteria Ilíaca , Claudicación Intermitente/terapia , Arteritis de Takayasu/complicaciones , Adulto , Angioplastia/efectos adversos , Angioplastia/instrumentación , Arteriopatías Oclusivas/diagnóstico por imagen , Arteriopatías Oclusivas/etiología , Arteriopatías Oclusivas/fisiopatología , Constricción Patológica , Femenino , Humanos , Arteria Ilíaca/diagnóstico por imagen , Arteria Ilíaca/fisiopatología , Claudicación Intermitente/diagnóstico por imagen , Claudicación Intermitente/etiología , Claudicación Intermitente/fisiopatología , Masculino , Estudios Retrospectivos , Factores de Riesgo , Stents , Arteritis de Takayasu/diagnóstico , Factores de Tiempo , Resultado del Tratamiento , Grado de Desobstrucción Vascular , Adulto Joven
9.
Catheter Cardiovasc Interv ; 93(S1): 846-850, 2019 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-30569666

RESUMEN

OBJECTIVES: To evaluate the safety and feasibility of simultaneous endovascular therapy for supra-arch multivessel stenosis. BACKGROUND: Limited data are currently available on simultaneous intervention for supra-arch multivessel stenosis because of concerns regarding the high incidence of procedure-related complications. METHODS: From January 2005 to December 2012, the clinical data of 256 consecutive inpatients who underwent simultaneous intervention for supra-arch multivessel stenosis were retrospectively analyzed. The primary end point was a composite of any type of stroke or neurological death within 30 days. RESULTS: In total, 535 supra-arch vessels underwent endovascular therapy. In total, 234, 21, and 1 patient underwent simultaneous intervention of 2, 3, and 4 supra-arch vessels, respectively. The lesions involved only the anterior circulation in 40.2% (103/256), only the posterior circulation in 10.5% (27/256), and the combined circulations in 49.2% (126/256) patients. The overall procedural success rate was 99.6% (533/535). The incidence of the primary end point was 3.5%. According to the lesion location, the incidence of the primary end point was 3.9% (4/103), 0% (0/27), and 4.0% (5/126) in the patients who underwent endovascular treatment for the anterior circulation alone, posterior circulation alone, and combined circulations, respectively. According to the number of supra-arch lesions, the incidence of the primary end point was 3.4% (8/234), 4.8% (1/21), and 0% (0/1) in the patients who underwent simultaneous intervention of 2, 3, and 4 vessels, respectively. CONCLUSIONS: The study showed that simultaneous intervention for supra-arch multivessel stenosis was safe and technically feasible.


Asunto(s)
Estenosis Carotídea/terapia , Procedimientos Endovasculares , Síndrome del Robo de la Subclavia/terapia , Insuficiencia Vertebrobasilar/terapia , Anciano , Estenosis Carotídea/diagnóstico por imagen , Estenosis Carotídea/mortalidad , Estenosis Carotídea/fisiopatología , China/epidemiología , Bases de Datos Factuales , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/mortalidad , Estudios de Factibilidad , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Accidente Cerebrovascular/epidemiología , Síndrome del Robo de la Subclavia/diagnóstico por imagen , Síndrome del Robo de la Subclavia/mortalidad , Síndrome del Robo de la Subclavia/fisiopatología , Factores de Tiempo , Resultado del Tratamiento , Insuficiencia Vertebrobasilar/diagnóstico por imagen , Insuficiencia Vertebrobasilar/mortalidad , Insuficiencia Vertebrobasilar/fisiopatología
10.
J Clin Hypertens (Greenwich) ; 20(9): 1302-1309, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-30027575

RESUMEN

The time trends regarding the etiology of renal artery stenosis (RAS) are changing, but few investigations have focused on these issues. This study aimed to analyze the time trends regarding the etiology of RAS in a large patient sample from the China Center for Cardiovascular Disease. Consecutive inpatients with RAS from January 1999 to December 2016 were enrolled in this study. The etiologic diagnosis of RAS was based on established criteria. We retrospectively analyzed the time trends regarding the etiology of RAS during an 18-year period. A total of 2905 patients with RAS were enrolled. There were 2393 (82.4%) patients with atherosclerosis (AS), 345 (11.9%) with Takayasu arteritis (TA), 126 (4.3%) with fibromuscular dysplasia (FMD), and 41 (1.4%) with other causes. Among all patients (n = 2905), patients aged ≤ 40 years (n = 450), patients aged >40 years (n = 2455), female patients (n = 1097), male patients (n = 1808), female patients aged >40 years (n = 808), and male patients aged >40 years (n = 1647), there were a gradual increase in the proportion of atherosclerotic RAS (P < 0.05), a gradual decrease in the proportion of RAS caused by TA (P < 0.05), and almost no change in the proportion of RAS caused by FMD during the 18-year period (P > 0.05). The data show that the primary causes of RAS are AS, TA, and FMD. The proportion of RAS caused by AS and TA gradually increased and decreased, respectively, over time, and the proportion of RAS caused by FMD showed no significant change.


Asunto(s)
Aterosclerosis/epidemiología , Displasia Fibromuscular/epidemiología , Obstrucción de la Arteria Renal/etiología , Arteritis de Takayasu/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Aterosclerosis/complicaciones , Niño , China/epidemiología , Femenino , Displasia Fibromuscular/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Arteritis de Takayasu/complicaciones , Adulto Joven
11.
Int Urol Nephrol ; 50(10): 1879-1886, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29948863

RESUMEN

PURPOSE: To compare the nephrotoxic effects of iodixanol and iopamidol in patients undergoing peripheral angiography. METHODS: Patients scheduled for peripheral angiography were randomly assigned to the iodixanol group (n = 463) and iopamidol group (n = 458). The primary endpoint was the incidence of contrast associated acute kidney injury (CA-AKI), which was defined as an increase ≥ 25% or ≥ 44.2 µmol/l (0.5 mg/dl) in serum creatinine (SCr) from baseline within 72 h after receiving contrast media (CM). The secondary endpoints were the mean peak SCr increase within 72 h after receiving CM and major adverse renal events (SCr increased by two times after 30 days, the need for dialysis treatment, rehospitalization for acute renal failure, or kidney-related death) during hospitalization and within 30 day postdischarge. RESULTS: The incidence of CA-AKI did not differ significantly between the iodixanol group and iopamidol group (18.1% vs. 16.8%; p = 0.595). There was no significant difference in the mean peak SCr increase between the iodixanol group and iopamidol group (10.4 ± 13.0 vs. 10.6 ± 14.3 µmol/l, p = 0.919). There were four patients [1 (0.2%) patient in the iodixanol group and 1 (0.7%) patients in the iopamidol group, p = 0.609] with doubling of SCr; no other adverse renal events were observed. CONCLUSIONS: Our data showed that the nephrotoxicity of iodixanol was comparable with that of iopamidol in patients undergoing peripheral angiography.


Asunto(s)
Lesión Renal Aguda/inducido químicamente , Medios de Contraste/efectos adversos , Creatinina/sangre , Yopamidol/efectos adversos , Ácidos Triyodobenzoicos/efectos adversos , Lesión Renal Aguda/sangre , Lesión Renal Aguda/diagnóstico , Anciano , Angiografía/métodos , Método Doble Ciego , Procedimientos Endovasculares , Femenino , Tasa de Filtración Glomerular , Humanos , Yopamidol/administración & dosificación , Masculino , Estudios Prospectivos , Factores de Riesgo , Ácidos Triyodobenzoicos/administración & dosificación
12.
J Vasc Surg ; 68(5): 1406-1413, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-29789215

RESUMEN

OBJECTIVE: The objective of this study was to evaluate 30-day and long-term clinical outcomes and influencing factors of in-stent restenosis (ISR) after stenting for symptomatic stenosis of the vertebral V1 segment. METHODS: The clinical and follow-up data of 301 consecutive patients (mean age, 64 ± 8 years; 252 men) with symptomatic V1 stenosis who underwent stenting at the Fuwai Hospital between January 2010 and June 2016 were collected retrospectively. The 30-day and long-term follow-up of stroke and death after stenting and the recurrence of symptoms, ISR, and repeated revascularization were assessed. RESULTS: Technical success was 100%. The mean stenosis of lesions was reduced from 82.8% ± 7.6% to 4.4% ± 4.0% immediately after 312 stents (165 bare-metal stents [BMSs] and 147 drug-eluting stents) were implanted. The overall risk of combined any stroke and death was 1.0% (3/301) within 30 days after stenting. The rates of freedom from any stroke and death were 98.2%, 96.8%, and 91.4% at 1 year, 3 years, and 5 years, respectively. After a mean follow-up of 2.9 ± 1.5 years, 46 (15.8%) patients developed ISR, of whom 19 (6.5%) were symptomatic. Twenty-two (7.6%) patients with ISR underwent repeated revascularization. The primary and assisted patency rates were 90.0% and 95.4%, 82.6% and 90.3%, and 80.3% and 87.9% at 1 year, 3 years, and 5 years, respectively. BMS (hazard ratio, 2.02; 95% confidence interval, 1.01-4.06; P < .05) and diabetes (hazard ratio, 1.87; 95% confidence interval, 1.04-3.37; P = .04) were independently associated with an increased risk of ISR. CONCLUSIONS: Percutaneous stent placement for symptomatic V1 stenosis is safe and associated with a good long-term patency rate. BMS and diabetes are independent predictive factors of ISR.


Asunto(s)
Procedimientos Endovasculares/instrumentación , Stents , Arteria Vertebral/cirugía , Insuficiencia Vertebrobasilar/cirugía , Anciano , China , Angiografía por Tomografía Computarizada , Stents Liberadores de Fármacos , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/mortalidad , Femenino , Humanos , Masculino , Metales , Persona de Mediana Edad , Diseño de Prótesis , Recurrencia , Estudios Retrospectivos , Factores de Riesgo , Accidente Cerebrovascular/etiología , Factores de Tiempo , Resultado del Tratamiento , Grado de Desobstrucción Vascular , Arteria Vertebral/diagnóstico por imagen , Arteria Vertebral/fisiopatología , Insuficiencia Vertebrobasilar/diagnóstico por imagen , Insuficiencia Vertebrobasilar/mortalidad , Insuficiencia Vertebrobasilar/fisiopatología
13.
Catheter Cardiovasc Interv ; 91(S1): 623-631, 2018 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-29359504

RESUMEN

OBJECTIVE: To evaluate immediate and long-term clinical outcomes of stenting for middle aortic syndrome (MAS) caused by Takayasu arteritis (TA). BACKGROUND: Studies of endovascular stenting for the treatment of MAS caused by TA are scare. METHODS: Data from 48 consecutive TA patients (mean 33.3 ± 12.6 years) with MAS treated by stenting in our institution between January 2010 and July 2016 were collected and retrospectively analyzed. Thirty-day and long-term follow-up clinical outcomes after aorta stenting were assessed. RESULTS: Stenting was successful in all patients. The mean stenosis and peak systolic pressure gradient of aorta lesions were reduced from 81.3 ± 8.0% and 70.7 ± 18.4 mm Hg to 14.7 ± 8.3% and 14.0 ± 5.8 mm Hg immediately after the 54 stents were implanted. One patient developed retroperitoneal hemorrhage and one developed flow-limiting dissection that involved bilateral renal arteries perioperatively. Both patients recovered without sequela. Compared with baseline, the ankle brachial index (0.92 ± 0.19 vs. 0.75 ± 0.22), mean systolic blood pressure (149.5 ± 19.1 vs. 179.0 ± 28.4 mm Hg) and antihypertensive drugs (1.1 ± 0.7 vs. 3.1 ± 0.9) significantly improved after an average follow-up of 3.1 years (all P < .001). A total of 5 (10.9%) patients developed in-stent restenosis, which were resolved by reintervention (restenting in 3 patients and re-angioplasty alone in 2 patients). No major adverse events occurred during follow up. CONCLUSIONS: Percutaneous aortic stenting is highly efficacious and safe in treating patients with MAS caused by TA with good immediate and long-term clinical outcomes.


Asunto(s)
Angioplastia de Balón/instrumentación , Aorta Abdominal/cirugía , Aorta Torácica/cirugía , Enfermedades de la Aorta/cirugía , Arteriopatías Oclusivas/cirugía , Stents , Arteritis de Takayasu/complicaciones , Adolescente , Adulto , Angioplastia de Balón/efectos adversos , Aorta Abdominal/diagnóstico por imagen , Aorta Abdominal/fisiopatología , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/fisiopatología , Enfermedades de la Aorta/diagnóstico por imagen , Enfermedades de la Aorta/etiología , Enfermedades de la Aorta/fisiopatología , Aortografía/métodos , Arteriopatías Oclusivas/diagnóstico por imagen , Arteriopatías Oclusivas/etiología , Arteriopatías Oclusivas/fisiopatología , China , Angiografía por Tomografía Computarizada , Constricción Patológica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Síndrome , Arteritis de Takayasu/diagnóstico , Arteritis de Takayasu/tratamiento farmacológico , Factores de Tiempo , Resultado del Tratamiento , Grado de Desobstrucción Vascular , Adulto Joven
14.
Catheter Cardiovasc Interv ; 91(S1): 632-638, 2018 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-29356307

RESUMEN

OBJECTIVES: The purpose of this study was to evaluate 1-year results and influencing factors of carotid artery stenting (CAS) before open heart surgery (OHS). BACKGROUND: Currently, the clinical outcomes and influencing factors of CAS followed by OHS still remain controversial. METHODS: Three hundred twenty-three consecutive patients scheduled for CAS and OHS were enrolled in this study. The primary endpoint was a composite of major stroke, myocardial infarction, or death within 1 year after CAS. RESULTS: The incidence of the primary endpoint was 5.6% (18/323). The Cox regression analysis revealed that an interval of ≤5 days between CAS and OHS (HR, 4.85, 95% CI, 1.87-12.58; P = 0.001), congestive heart failure (HR, 4.08, 95% CI, 1.45-11.51; P = 0.008), and renal insufficiency (HR, 4.56, 95% CI, 1.28-16.32; P = 0.020) could independently predict the incidence of the primary endpoint. The rate of the primary endpoint from CAS to 30 days after OHS was 4.6% (15/323). An interval of ≤5 days between CAS and OHS (OR, 4.51, 95% CI, 1.52-13.36; P = 0.007) and congestive heart failure (OR, 5.32, 95% CI, 1.63-17.43; P = 0.006) were identified as independent risk factors for the primary endpoint rate from CAS to 30 days after OHS by logistic regression analysis. CONCLUSIONS: CAS followed by OHS is a safe and effective treatment for patients with concomitant carotid and cardiac disease within 1-year follow up. The interval between CAS and OHS, congestive heart failure, and renal insufficiency could obviously influence the 1-year results.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Estenosis Carotídea/cirugía , Procedimientos Endovasculares/instrumentación , Cardiopatías/cirugía , Stents , Anciano , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Procedimientos Quirúrgicos Cardíacos/mortalidad , Estenosis Carotídea/complicaciones , Estenosis Carotídea/diagnóstico por imagen , Estenosis Carotídea/mortalidad , China , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/mortalidad , Femenino , Cardiopatías/complicaciones , Cardiopatías/diagnóstico por imagen , Cardiopatías/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/etiología , Estudios Prospectivos , Medición de Riesgo , Factores de Riesgo , Accidente Cerebrovascular/etiología , Factores de Tiempo , Resultado del Tratamiento
15.
Physiol Mol Biol Plants ; 23(4): 817-825, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29158631

RESUMEN

High temperature stress is a major obstacle in rice productivity. Considerable progress has been made on studying heat tolerance (HT) at different stages. However, the genetic basis of HT at the booting stage is poorly understood. In this study, we analyzed the morphological features of a heat-sensitive japonica cultivar Sasanishiki under natural high temperature stress at the booting stage. The anthers became smaller and the number, and fertility, of pollen grains were decreased significantly. As a result, there was a dramatic reduction in spikelet fertility. In contrast, the indica cultivar Habataki showed high HT and normal spikelet fertility under high temperature stress. Additonally, a set of chromosome segment substitution lines, derived from Sasanishiki and Habataki, were evaluated for HT related quantitative trait loci (QTLs) across two environments in the natural field. A total of 12 QTLs associated with HT were detected, of which, 5 were identified in two environments, and 7 in one environment. Furthermore, one of the major-effect QTLs (qHTB3-3) detected on the long arm of chromosome 3, was confirmed using overlapping substituted lines. qHTB3-3 was finally mapped between the two markers RM3525 and 3-M95, approximately 2.8 Mb apart. These findings and further gene cloning of qHTB3-3 will help us better understand the molecular control of HT in rice, and may contribute to the development of high HT rice varieties.

16.
J Genet ; 94(1): 67-73, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25846878

RESUMEN

Female-sterile line can be used as a pollinator which has a great potential for hybrid seeds production. However, reports on female fertility are fewer than male fertility. Here, we characterized a recessive female fertility weakening mutant ff1(t) from rice. The spikelet fertility was seriously affected in the mutant. Reciprocal crosses and pollen vitality assay suggest that the decreased fertility was caused by the defective female gametophytes. Further investigation indicated that the mutant ovary development was inhibited before fertilization and failed swelling after flowering. Genetic analysis and fine mapping showed that the mutant was controlled by a single recessive gene, residing on a 16.8 kb region on the long arm of chromosome 1. The gene annotation indicated that there was only one putative gene encoding lysine decarboxylase-like protein in this region, which was allelic to LOG. Further, the sequence analysis was carried out and a substitution at the splice site of intron 2 / exon 3 was revealed in ff1(t) mutant, resulting in the change of reading frame. The finding of novel allele of LOG locus will facilitate the understanding of the mechanisms of female gametophyte development.


Asunto(s)
Genes de Plantas , Oryza/genética , Secuencia de Bases , Carboxiliasas/genética , Mapeo Cromosómico , Fertilidad/genética , Anotación de Secuencia Molecular , Oryza/fisiología , Proteínas de Plantas/genética , Análisis de Secuencia de ADN
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