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At least 757 records · Page 42Linked to original sources
PubMed2004

Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT).

BACKGROUND AND PURPOSE: The natural history and long-term prognosis of cerebral vein and dural sinus thrombosis (CVT) have not been examined previously by adequately powered prospective studies. METHODS: We performed a multinational (21 countries), multicenter (89 centers), prospective observational study. Patients were followed up at 6 months and yearly thereafter. Primary outcome was death or dependence as assessed by modified Rankin Scale (mRS) score >2 at the end of follow-up. RESULTS: From May 1998 to May 2001, 624 adult patients with CVT were registered. At the end of follow-up (median 16 months), 356 patients (57.1%) had no symptom or signs (mRS=0), 137 (22%) had minor residual symptoms (mRS=1), and 47 (7.5%) had mild impairments (mRS=2). Eighteen (2.9%) were moderately impaired (mRS=3), 14 (2.2%) were severely handicapped (mRS=4 or 5), and 52 (8.3%) had died. Multivariate predictors of death or dependence were age >37 years (hazard ratio [HR]=2.0), male sex (HR=1.6), coma (HR=2.7), mental status disorder (HR=2.0), hemorrhage on admission CT scan (HR=1.9), thrombosis of the deep cerebral venous system (HR=2.9), central nervous system infection (HR=3.3), and cancer (HR=2.9). Fourteen patients (2.2%) had a recurrent sinus thrombosis, 27 (4.3%) had other thrombotic events, and 66 (10.6%) had seizures. CONCLUSIONS: The prognosis of CVT is better than reported previously. A subgroup (13%) of clinically identifiable CVT patients is at increased risk of bad outcome. These high-risk patients may benefit from more aggressive therapeutic interventions, to be studied in randomized clinical trials.

Adolescent↗
PubMed2005

Response of atrial fibrillation to pulmonary vein antrum isolation is directly related to resumption and delay of pulmonary vein conduction.

BACKGROUND: The role of pulmonary vein (PV) isolation in ablative treatment of atrial fibrillation (AF) has been debated in conflicting reports. We sought to compare PV conduction in patients who had no AF recurrence (group I), patients who could maintain sinus rhythm on antiarrhythmic medication (group II), and patients who had recurrent AF despite antiarrhythmic medication (group III) after PV antrum isolation (PVAI). METHODS AND RESULTS: PV conduction was examined in consecutive patients undergoing second PVAI for AF recurrence. We also recruited some patients cured of AF to undergo a repeat, limited electrophysiological study at >3 months after PVAI. All patients underwent PVAI with an intracardiac echocardiography (ICE)-guided approach with complete isolation of all 4 PV antra (PVA). The number of PVs with recurrent conduction and the shortest atrial to PV (A-PV) conduction delay was measured with the use of consistent Lasso positions defined by ICE. Late AF recurrence was defined as AF >2 months after PVAI with the patient off medications. Patients in groups I (n=26), II (n=37), and III (n=44) did not differ at baseline (38% permanent AF; ejection fraction 53+/-6%). Recurrence of PV-left atrial (LA) conduction was seen in 1.7+/-0.8 and 2.2+/-0.8 PVAs for groups II and III but only in 0.2+/-0.4 for group I (P=0.02). In patients with recurrent PV-LA conduction, the A-PV delay increased from the first to second procedure by 69+/-47% for group III, 267+/-110% for group II, and 473+/-71% for group I (P<0.001). When pacing was at a faster rate, A-PV block developed in all 5 of the group I patients with recurrent PV-LA conduction. CONCLUSIONS: The majority of patients with drug-free cure show no PV-LA conduction recurrence. Substantial A-PV delay is seen in patients able to maintain sinus rhythm on antiarrhythmic medication or cured of AF compared with patients who fail PVAI.

Anticoagulants↗
PubMed2004

Human saphenous vein and coronary bypass surgery: ultrastructural aspects of conventional and "no-touch" vein graft preparations.

Coronary artery bypass graft surgery (CABG) is routinely used to restore blood flow to diseased cardiac muscle due to coronary artery disease. The patency of conventional grafts decreases with time, which is due to thrombosis and formation of neointima. A primary cause of graft failure is the mechanical damage inflicted to the graft during harvesting, including removal of surrounding tissue accompanied by high pressure saline distension to overcome vasospasm (both causing considerable mechanical trauma). The aim of this study was to compare the ultrastructural features of human saphenous vein (SV) grafts harvested conventionally and grafts prepared using an atraumatic 'no-touch' harvesting technique introduced by Souza (1996). The results of this study showed a better preservation of the lumenal endothelium and medial vascular smooth muscle (SM) in 'no-touch' versus conventional grafts. A 'fast' (within 30 min) response of SM cells to conventional harvesting was noted where features of both SM cell division and apoptosis were observed. It is concluded that the 'preserved' nature of the 'no-touch' aortocoronary SV grafts renders them less susceptible to thrombotic and atherosclerotic factors than grafts harvested conventionally. These features are suggested to contribute to the improved early patency rate described using the no-touch technique of SV harvesting.

Aged↗
PubMed2001

Angiographic and histologic changes in artery, vein and portal vein after placement of bare or covered Z-stent; an experimental study in dogs.

The aim of this study was to examine stenosis in the aorta, portal vein (PV), and inferior vena cava (IVC) after bare and covered Z-stent placement. Eight beagles underwent bare (n=4) or polytetrafluoroethylene (PTFE) covered (n=4) Z-stent placement in the aorta, PV, and IVC. Angiography was performed 1 and 3 weeks later to evaluate stenosis. The animals were sacrificed after 3 weeks for histopathologic examination. Angiographic findings revealed that stenosis in the bare stent group tended to be smaller than in the covered stent group in 3 vessels and stenosis tended to be smaller in the order of the aorta, PV and IVC in either group. In both groups, stenosis in the PV and IVC was mainly caused by organized thrombus. In addition, in the covered stent group, the space between the cover and native vessel wall (subgraft space) was formed and filled with neointima in every vessel. Preventing thrombus formation in the PV and IVC after bare and covered stent placement and reducing the subgraft space in the aorta after covered stent placement are important for minimizing stenosis.

Animals↗
PubMed1992

[Retinal vein occlusion. III. Initial experience with therapy of retinal vein occlusion with an argon laser].

The authors report the results of laser treatment in 11 patients with chronic oedema of the macula and 6 patients with neovascularizations of the retina and disk of the optic nerve in occlusion of a branch of the retinal vein. In the treatment of chronic oedema of the macula they used their own modification of quadrant barrage suggested by L'Esperance and grid photocoagulation. After a mean follow up period of 3.2 years they achieved a resulting vision of 6/12 or better in 9 of 11 patients, i.e. in 82%, the poorest results were 6/18 in two patients of 11, i.e. in 18%. In the treatment of neovascularizations they used the method of sector photocoagulation. In all six patients, i.e. in 100% they observed regression of neovascularizations. During 2.5-3 years after photocoagulation they did not observe a relapse of neovascularization or haemorrhage into the vitreous body. The results of photocoagulation treatment in chronic oedema of the macula and treatment of neovascularization are of a long-term character.

Fluorescein Angiography↗
PubMed1989

[Erythrocyte aggregation and retinal vein occlusion. Preliminary data for a randomized study on the efficacy of anti-erythrocyte aggregation (troxerutin) in retinal vein occlusion].

Erythrocyte aggregation (EAg) is one of the principal determinants of blood viscosity at low shearing rates (slow flow). The retinal venous circulation, characterised by a slow circulatory rate and a high resistance to flow, creates a favourable environment for the formation of erythrocyte aggregates. EAg and other laboratory parameters (haematocrit, fibrinogen, plasma proteins, clotting) were measured in 64 patients presenting with retinal vein occlusion (RVO) and 64 controls matched for age, sex, risk factors (HT, diabetes, smoking) and concomitant vascular disease. Statistical analysis of the results demonstrated a significant difference between the RVO group and the control group for fibrinogen (p = 0.03) and erythrocyte aggregation (p = 0.00003 for the aggregation index at 10 sec and p = 0.0002 for the threshold of partial dissociation). The rise in the fibrinogen level alone cannot explain the increased erythrocyte aggregation. These results demonstrate that the increased EAg largely explains the hyperviscosity reported by other authors and suggest that it plays an important role in the pathogenesis of RVO.

Adult↗
PubMedDate not supplied

[Study of the sclerosing of varicose veins: comparison between natural fibrinolysis in the blood of the cubital vein and the labeled fibrinogen test in the sclerosed leg].

After intravaricose injection of 3% ethoxysclerol a slight hyperfibrinolysis appears in the blood of a cubital vein. This is too weak to judge of the reality of the sclerosis. On the other hand, a very marked fibrinolysis is not seen after injection of ethoxysclerol. Fibrinogen labelled with iodine 131 however permits an exact control of what is happening at the site of the sclerosant injection. The reaction develops slowly, reaching its maximum not until 5 days after the injection of sclerosant. There is therefore no need to fear a sudden thrombosis which might be difficult to control.

Adult↗