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1.
Urologiia ; (5): 133-138, 2020 Nov.
Artigo em Russo | MEDLINE | ID: mdl-33185361

RESUMO

The prevalence of bladder cancer in Russia over the past 10 years has increased from 49.6 to 74.1 patients per 100,000 population. Hematuria is a life-threatening complication and one of the common causes of mortality in advanced stages of bladder cancer. Conservative methods of hemostasis do not always allow to achieve a stable effect. In addition, in the cases of intractable bleeding, the patients may require surgical treatment. Due to the prevalence of patients with a high anesthetic risk group in bladder cancer patients cohort, the minimally invasive hemostasis technologies are more preferable. This review is devoted to one of such methods - superselective embolization of the urinary bladder arteries.


Assuntos
Embolização Terapêutica , Neoplasias da Bexiga Urinária , Artérias , Hematúria/etiologia , Hematúria/terapia , Humanos , Federação Russa , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/terapia
2.
Angiol Sosud Khir ; 26(3): 9-15, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33063747

RESUMO

Embologenic arterial obstruction remains an extremely important problem of modern medicine. Emboli may affect virtually all arterial vessels of the greater circulation and in some cases arterial emboli may be multiple. The purpose of the present study was to work out a classification of multiple arterial emboli. Analysing the clinical material including over 30 years a total of 1804 patients with embolism of the aorta and major arteries of the limbs made it possible to define the range of the terms used and to submit for discussion a classification describing a situation where emboli affect simultaneously several arteries or occur repeatedly. Both cases involve several emboli migrating from the primary source into the arterial bed, therefore we suggest that all these emboli be called multiple. Simultaneous multiple emboli were classified as combined, multifocal, and layered, with repeated emboli classified as preceding, recurrent, early and remote. Simultaneous emboli were observed in 91 (5%) patients, of these, in 22 - combined, in 49 - multifocal, in 19 - layered, and in 1 case - combined and multifocal. Repeated emboli were revealed at various terms and encountered virtually in each third patient. Overall mortality amongst the patients with embolism of the aorta and arteries of the limbs over 30 years amounted to 13%, having over the last decade decreased to 7.6%. Multiple arterial emboli significantly influenced the outcomes of treatment, with the mortality rate in combined emboli increasing virtually to 50% and that in multifocal and layered emboli exceeding 20% (p<0.05). Early recurrent emboli in the postoperative period were observed in 6.8% of patients, significantly deteriorating the prognosis (mortality - 49.2%). In the remote period, 22.4% of the patients were operated on for recurrent embolism of arteries of the extremities, with more than 25% of the patients having experienced emboli of cerebral or visceral arteries. Recurrent thromboembolic complications played a significant role in the thanatogenesis in each 4th patient.


Assuntos
Arteriopatias Oclusivas , Embolia , Aorta , Arteriopatias Oclusivas/diagnóstico , Artérias/diagnóstico por imagem , Embolia/complicações , Embolia/diagnóstico , Extremidades , Humanos
3.
Khirurgiia (Mosk) ; (9): 69-74, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33030004

RESUMO

Critical limb ischemia, especially in the absence of autologous vein, prosthetic and native vascular infections are isolated diseases for which there currently doesn't have best surgical treatment. Vascular allografts may be the treatment of choice for these patients. In this analysis, we tried to reflect the directions of development of vascular allotransplantation, global trends related to indications for their use, methods of conservation, degradation and endothelial dysfunction. At the present time there doesn't have meta-analyzes on the efficiency of using arterial allografts or other options for implantation (synthetic graft, xenografts) for critical limb ischemia and graft and native infections. Now it is wrong to recommend using them always. Further studies of their performance are necessary. In addition, development of graft control techniques is also needed when rejection develops. Currently, there are no special diagnostic markers, the assessment of which could save patients with immune-mediated dilatation and dysfunction of allografts.


Assuntos
Artérias , Procedimentos Cirúrgicos Reconstrutivos , Aloenxertos , Humanos , Extremidade Inferior , Transplante Homólogo
4.
Khirurgiia (Mosk) ; (9): 102-108, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33030010

RESUMO

OBJECTIVE: To report own experience of endovascular interventions in patients with extended occlusive lesion (TASC II D) of the femoral-popliteal and tibial arteries and concomitant purulent-necrotic wounds. MATERIAL AND METHODS: We have analyzed literature data and own experience of endovascular interventions in patients with extended occlusive lesion (TASC II D) of the femoral-popliteal and tibial arteries and concomitant purulent-necrotic wounds. RESULTS: Endovascular strategy is preferable in a certain subgroup of patients with extended infrainguinal lesions. CONCLUSION: Considering own data, we assumed the need for routine correction of outflow pathways (simultaneous angioplasty of at least 2 tibial arteries). Primary results are encouraging, but further research is required.


Assuntos
Artérias/cirurgia , Necrose/cirurgia , Procedimentos Cirúrgicos Vasculares , Arteriopatias Oclusivas , Humanos , Artéria Poplítea , Stents
5.
Science ; 370(6513)2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33033191

RESUMO

Since the advent of the vascular anastomosis by Alexis Carrel in the early 20th century, the repair and replacement of blood vessels have been key to treating acute injuries, as well as chronic atherosclerotic disease. Arteries serve diverse mechanical and biological functions, such as conducting blood to tissues, interacting with the coagulation system, and modulating resistance to blood flow. Early approaches for arterial replacement used artificial materials, which were supplanted by polymer fabrics in recent decades. With recent advances in the engineering of connective tissues, including arteries, we are on the cusp of seeing engineered human arteries become mainstays of surgical therapy for vascular disease. Progress in our understanding of physiology, cell biology, and biomanufacturing over the past several decades has made these advances possible.


Assuntos
Artérias , Prótese Vascular , Engenharia Tecidual/métodos , Doenças Vasculares/cirurgia , Técnicas de Cultura de Células , Humanos
6.
Rev Med Suisse ; 16(711): 1970-1973, 2020 Oct 21.
Artigo em Francês | MEDLINE | ID: mdl-33085252

RESUMO

Arterial punctures are frequent procedures performed by hospital internists. It provides crucial information on acid-base status, oxygenation and the quality of gas exchanges. Nevertheless, this intervention is often painful and carries potential risks. This review aims to summarize the literature about this subject and to address the accuracy of the results obtained by point-of-care analysis.


Assuntos
Artérias/metabolismo , Gasometria/métodos , Punções/efeitos adversos , Humanos , Dor/etiologia , Sistemas Automatizados de Assistência Junto ao Leito
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4996-4999, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019108

RESUMO

This work presents a new technique for the noninvasive measurement of systolic blood pressure (sBP), mean blood pressure (mBP) and diastolic blood pressure (dBP) using photo-plethysmographic (PPG) sensors when an artery is exposed to an external pressure. Two sets of experiments were performed: a first study combining PPG with an oscillometric device and the second combining PPG with a force/pressure sensor. These two experiments enable the estimation of BP values. PPG results were found to be comparable to oscillometric results, with bias and precision errors of -0.81 and 5.26 for sBP, 1.12 and 5.61 for mBP and 1.67 and 9.09 for dBP (n = 28). Furthermore, amplification over the brachial-to-finger path was found to be 1.02 ± 0.08 for mBP (n = 20) confirming that mBP does not undergo any amplification along the arterial tree whereas, for sBP, an amplification of 1.20 ± 0.12 (n = 7) was found for green wavelength, 1.35 ± 0.09 (n = 6) for red wavelength and 1.36 ± 0.09 (n = 6) for infrared wavelength. Thus, amplification for sBP is bigger for red and infrared wavelengths compared to green one.


Assuntos
Pressão Arterial , Determinação da Pressão Arterial , Artérias , Pressão Sanguínea , Humanos , Oscilometria
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 469-472, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018029

RESUMO

Up until now estimation of arterial compliance has been performed either by analysis of arterial pressure changes with respect to volume changes or by inference based on pulse wave velocity (PWV). In this study we demonstrate the possibility of an approach to assess arterial compliance by fusing the two information sources namely the pressure/volume relationship obtained from oscillography and PWV data. The goal is to assess arterial properties easily and robustly, enhancing current hemodynamic monitoring. The approach requires as input signals: an electrocardiogram (ECG), a photo- plethysmogram (PPG) and the arterial oscillation as measured during non-invasive blood pressure measurements based on oscillometry with a cuff. These signals are fused by an algorithm using Bayesian principles underpinned by a physiological model. In our simulations, we demonstrate the feasibility to infer arterial compliance by our proposed strategy. A very first measurement on a healthy volunteer supports our findings from the simulation.Clinical Relevance- Arterial compliance/stiffness is recognized as a key hemodynamic parameter, which is not easily accessible and not a standard parameter currently. The presented method and obtained results are encouraging for future research in this area.


Assuntos
Artérias , Análise de Onda de Pulso , Teorema de Bayes , Complacência (Medida de Distensibilidade) , Humanos , Oscilometria
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2598-2601, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018538

RESUMO

INTRODUCTION: Arterial-ventricular coupling (AVC) has been recognized as a key determinant of global cardiovascular performance. Diastolic dysfunction (DD) occurs when inadequate filling of the ventricles is related to an abnormal elevation of intracardiac filling pressures. In some cases, DD is evidenced during cardiac stress, provoked by exercise. OBJECTIVE: To evaluate AVC in individuals with stress evidenced DD, in relation to controls. MATERIALS AND METHODS: Stress echocardiography was applied to assess cardiac function during exercise. Arterial-ventricular coupling was evaluated, based on the assessment of left ventricular and arterial elastances. RESULTS: AVC showed a significant difference at peak exercise compared to controls, basically due to a loss of cardiac contractility. CONCLUSION: The manifestation of AVC coupling imbalance could act as a complementary parameter to support the diagnosis of DD.


Assuntos
Artérias , Ventrículos do Coração , Exercício Físico , Humanos , Contração Miocárdica , Projetos Piloto
10.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2703-2706, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018564

RESUMO

This work is aimed to establish engineering theories of the coupled longitudinal and radial motion of the arterial wall. By treating the arterial wall as a piano string in the longitudinal direction and as a viscoelastic material in the circumferential direction, and considering pulsatile pressure and wall shear stress from axial blood flow in an artery, the fully-formed governing equations of the coupled motion of the arterial wall are obtained and are related to the engineering theories of axial blood flow for a unified engineering understanding of blood circulation in the cardiovascular (CV) system. The longitudinal wall motion and the radial wall motion are essentially a longitudinal elastic wave and a transverse elastic wave, respectively, traveling along the arterial tree, with their own propagation velocities dictated by the physical properties and geometrical parameters of the arterial wall. The longitudinal initial tension is essential for generating a transverse elastic wave in the arterial wall to accompany the pulsatile pressure wave in axial blood flow. Under aging and subclinical atherosclerosis, propagation of the two elastic waves and coupling of the two elastic waves weakens and consequently might undermine blood circulation.


Assuntos
Artérias , Fenômenos Fisiológicos Sanguíneos , Movimento (Física) , Estresse Mecânico
11.
Rev Med Suisse ; 16(709): 1849-1852, 2020 Oct 07.
Artigo em Francês | MEDLINE | ID: mdl-33026726

RESUMO

For safe procedures, the surgeon performing thyroid gland surgeries must know precisely the anatomical relationships of the inferior laryngeal nerve with other cervical structures, in particular the inferior laryngeal artery and its branches. Classic descriptions of these relationships are based almost exclusively on the observation of Caucasian populations. However, this study shows that there are important differences between Caucasian and Sub-Saharian ethnic group, differences that any surgeon having the opportunity to operate in Africa should know to limit the risk of iatrogenic nerve damage and its morbid consequences.


Assuntos
Grupo com Ancestrais do Continente Africano , Artérias/cirurgia , Grupos Étnicos , Nervo Laríngeo Recorrente/cirurgia , Glândula Tireoide/cirurgia , África/etnologia , Grupo com Ancestrais do Continente Europeu , Humanos , Laringe/irrigação sanguínea , Laringe/cirurgia
13.
Kyobu Geka ; 73(9): 667-670, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-32879269

RESUMO

This is a 3-case report of successful descending thoracic and thoracoabdominal aortic surgery by preserving the spinal perfusion artery (SPA) identified preoperatively. In Case 1, an 85-year-old woman, computed tomography (CT) showed Crawford type Ⅴ thoracoabdominal aortic aneurysm (TAAA:60 mm) and a SPA originated from L2. In Case 2, a 76-year-old man, CT revealed type Ⅳ TAAA( 58 mm) and a SPA originated from Th11. In Case 3, a 74-year-old man, CT detected an infectious pseudoaneurysm(44 mm) in the descending thoracic aorta with 2 SPAs originating from Th10 and L2. The ranges of graft replacement were Th7-Th12, Th12-L4, and Th8-Th10, respectively, while preserving all SPAs. All patients recovered well without postoperative neurological deficits. Although the protective effect of the SPA preservation against the spinal cord ischemia is still controversial, preoperative identification of the SPA was useful for planning a surgical strategy for descending thoracic and thoracoabdominal aortic repair surgery.


Assuntos
Aneurisma da Aorta Abdominal , Aneurisma da Aorta Torácica , Isquemia do Cordão Espinal , Idoso , Idoso de 80 Anos ou mais , Artérias , Feminino , Humanos , Masculino , Perfusão , Medula Espinal , Tomografia Computadorizada por Raios X
14.
Niger J Clin Pract ; 23(9): 1221-1228, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32913160

RESUMO

Background: : Vascular injuries are commonly seen in both emergency services and forensic medicine practise. They are often life-threatening, with high morbidity and mortality rates. Aims: This study aimed to retrospectively evaluate extremity vascular injuries and the associated treatment approaches. Methods: After obtaining approval from the ethics committee of the university, those patients admitted to the emergency department of Adiyaman between 1 February 2013 and 31 August 2018 were included in this study. The patients' data were obtained through the electronic records system, and the cases were evaluated according to the age, gender and cause of injury, including blunt force trauma injuries (accidents, traffic accidents, crush injuries and occupational accidents) and penetrating injuries (stabbing, gunshot wounds, suicide attempts and assaults). Additionally, the injuries were evaluated based on the extremity, according to the anatomical location and whether the injury was life-threatening. Results: This study included 76 patients with extremity vascular injuries; 65 were males (85.52%), 11 were females (14.48%) and their average age was 33.24 ± 15.85 years. Forty-five (59.2%) of the patients had upper extremity vascular injuries, and 31 (40.3%) had lower extremity vascular injuries. In addition to arterial injuries, 26 (34.21%) of the patients had venous injuries and 22 (28.94%) had nerve injuries. Nine of these patients had neurological deficits due to their nerve injuries. All of the patients were revascularized within 3-5 hours, and none of the patients required amputations. Conclusion: The primary goals in extremity vessel injury cases are to prevent mortality, especially after major vascular injuries, and save the extremity from amputation. With a fast, effective and multi-disciplinary approach, an accurate diagnosis and effective surgical intervention can prevent morbidity and mortality as well as reduce the rate of undesirable complications.


Assuntos
Extremidade Inferior/irrigação sanguínea , Extremidade Inferior/lesões , Procedimentos Cirúrgicos Vasculares/métodos , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/cirurgia , Ferimentos Penetrantes/diagnóstico por imagem , Acidentes de Trânsito , Adolescente , Adulto , Artérias/diagnóstico por imagem , Artérias/lesões , Angiografia por Tomografia Computadorizada , Extremidades , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Ferimentos por Arma de Fogo/complicações , Ferimentos por Arma de Fogo/epidemiologia , Ferimentos por Arma de Fogo/cirurgia , Ferimentos não Penetrantes/complicações , Ferimentos não Penetrantes/epidemiologia , Ferimentos Penetrantes/epidemiologia , Ferimentos Penetrantes/cirurgia , Adulto Jovem
15.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(6): 814-821, 2020 Jun 30.
Artigo em Chinês | MEDLINE | ID: mdl-32895207

RESUMO

OBJECTIVE: To evaluate the effect of using free double- leaf perforator flap posterolateral calf peroneal artery in anatomical reconstruction of the oropharyngeal structure after ablation of advanced oropharyngeal carcinoma. METHODS: Twenty-six patients with oropharyngeal defects after ablation of oropharyngeal malignancies were recruited, including 12 with carcinoma in the tongue base, 5 in the latenral pharyngeal wall and 9 in the soft palate. Between July, 2016 and July, 2018, the patients underwent surgeries for reconstruction of the oropharyngeal defects using flaps. The areas of tissue defects repaired by double-leaf perforator flaps ranged from 40.5 to 72.5 cm2. Reconstruction was performed for oropharyngeal defects in the soft palate, pterygopalate, parapharyngeal, pterygo- mandibular, and tongue base tissues. The patients' outcomes including mouth opening, functions of deglutition, linguistic function, restoration of palatopharyngeal anatomical structure and postoperative survival were evaluated, and their quality of life was assessed using FACT-H&N scale (Chinese Edition). RESULTS: All the 26 patients with transplantation of the free flaps survived. Six months after the operation, the oropharyngeal function and anatomical structure of the patients were basically restored. The questionnaire survey showed that the patients' physical, social/family, emotional and functional conditions, the total score of the core scale, items scores for the head and neck, and the total score of the scale all improved significantly after the operation compared with those before the operation (P < 0.05). CONCLUSIONS: The free peroneal artery bilobate perforator flap in the posterolateral crus, which seldom has anatomical variations of the blood vessels, allows flexible design and contains rich tissue volume to facilitate defect repair with different approaches and ranges. The application of this flap, which is an ideal perforator flap for reconstruction of the oropharyngeal structure and function, can improve the quality of life of patients following operations for advanced oropharyngeal cancer.


Assuntos
Retalhos de Tecido Biológico , Neoplasias Orofaríngeas , Retalho Perfurante , Artérias , Humanos , Qualidade de Vida , Procedimentos Cirúrgicos Reconstrutivos , Transplante de Pele , Lesões dos Tecidos Moles
16.
Nat Commun ; 11(1): 4549, 2020 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-32917889

RESUMO

Arterial macrophages have different developmental origins, but the association of macrophage ontogeny with their phenotypes and functions in adulthood is still unclear. Here, we combine macrophage fate-mapping analysis with single-cell RNA sequencing to establish their cellular identity during homeostasis, and in response to angiotensin-II (AngII)-induced arterial inflammation. Yolk sac erythro-myeloid progenitors (EMP) contribute substantially to adventitial macrophages and give rise to a defined cluster of resident immune cells with homeostatic functions that is stable in adult mice, but declines in numbers during ageing and is not replenished by bone marrow (BM)-derived macrophages. In response to AngII inflammation, increase in adventitial macrophages is driven by recruitment of BM monocytes, while EMP-derived macrophages proliferate locally and provide a distinct transcriptional response that is linked to tissue regeneration. Our findings thus contribute to the understanding of macrophage heterogeneity, and associate macrophage ontogeny with distinct functions in health and disease.


Assuntos
Artérias/citologia , Arterite/imunologia , Diferenciação Celular/fisiologia , Homeostase/fisiologia , Macrófagos/fisiologia , Envelhecimento/fisiologia , Angiotensina II/administração & dosagem , Angiotensina II/imunologia , Animais , Artérias/fisiologia , Medula Óssea/fisiologia , Transplante de Medula Óssea , Linhagem da Célula , Modelos Animais de Doenças , Feminino , Células-Tronco Hematopoéticas/fisiologia , Humanos , Masculino , Camundongos , Camundongos Transgênicos , RNA-Seq , Regeneração/fisiologia , Análise de Célula Única , Quimeras de Transplante
17.
J Med Vasc ; 45(5): 241-247, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32862980

RESUMO

OBJECTIVE: The persistent sciatic artery (PSA) is a rare congenital anomaly with a high rate of aneurysm formation, occlusion and stenosis. It may lead to severe complications including thrombosis, distal embolisation, or aneurysm rupture. We reported herein our experience in the management of PSA and its complications, and discuss the therapeutic options. METHODS: Eight patients with 10 PSA were managed in our institutions between 1985 and 2017. An analysis was done for the clinical data, surgical technique, and results. RESULTS: The series included six women and two men. The median age of the patients was 66,5 years (37-80 years). Physical examination found a pulsatile gluteal mass in five patients, sciatic neuropathy in two cases. Four patients had an acute ischemia of the lower limb. Cowie's sign was described in only two patients (diminished or absent femoral pulse but presence of popliteal pulse). Digital subtraction angiography was performed in all patients, and was completed with a computed tomography angiography (CTA) with a diagnosis of PSA, associated with a symptomatic aneurysmal lesion in seven cases and with an occlusion in one case. The treatment was surgical in all cases: bipolar exclusion of the aneurysm and bypass between the iliac artery and the PSA distal to the aneurysm was performed in four cases, only proximal and distal ligation was done in 2 other cases. A Chopart amputation was necessary in 2 cases. CONCLUSION: We consider that the treatment of PSA is usually surgical in symptomatic cases. Surgical techniques depend on symptoms and classification describing anatomy of the PSA. However, future studies should compare the open versus the endovascular approach to optimize patient selection criteria and identify the most safe and effective strategy. In an asymptomatic patient, PSA does not require any intervention; continued follow-up is required because of the high incidence of aneurysmal formation and the risk of thromboembolic events.


Assuntos
Artérias/anormalidades , Isquemia/etiologia , Extremidade Inferior/irrigação sanguínea , Doença Arterial Periférica/etiologia , Malformações Vasculares/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Amputação , Artérias/diagnóstico por imagem , Artérias/cirurgia , Feminino , Humanos , Isquemia/diagnóstico por imagem , Isquemia/cirurgia , Ligadura , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico por imagem , Doença Arterial Periférica/cirurgia , Fatores de Tempo , Resultado do Tratamento , Enxerto Vascular , Malformações Vasculares/diagnóstico por imagem
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