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At least 811 records · Page 45Linked to original sources
PubMed1999

Visualization of dermal blood vessels--capillaroscopy.

Intravital capillaroscopy is the only noninvasive method available that visualizes directly the nutritional dermal capillaries. It can determine (in vivo): capillary morphology, including size, shape and tortuosity; capillary density; intercapillary distance; volume fraction (the percentage of skin occupied by microvessels); and changes in red cell velocity within capillaries. When capillaroscopy is performed using a video recording system, this permits real-time imaging of the cutaneous capillaries with retrospective analysis of capillary dynamics. Furthermore, when fluorescent dyes are injected intravenously, plasma-perfused capillaries are delineated allowing the calculation of several perfusion indices. Intravital capillaroscopy therefore permits the assessment of static as well as dynamic aspects of the skin microcirculation.

Aging↗
PubMed2002

Dextran sulfate (Selesorb) plasma apheresis improves vascular changes in systemic lupus erythematosus.

Apheresis has been effective as rescue therapy in patients with severe, therapy-resistant, systemic lupus erythematosus (SLE). Its benefit in patients with less severe but therapy-resistant SLE is not known. Dextran sulfate apheresis was applied as a rescue therapy for therapy-resistant vasculitic skin lesions in a 30 year old female patient with a 9 year history of SLE in combination with antiphospholipid syndrome and Raynaud's phenomenon. Partial remission was achieved after 9 immunoadsorption sessions, as documented by marked improvement of skin lesions and an increase of capillary density in the nailfold area. Further improvement was noted with maintenance therapy using mycophenolate mofetil. Dextran sulfate apheresis can be applied safely in patients with moderate therapy-resistant SLE disease activity when severe immunodeficiency and cytotoxic adverse effects should be avoided.

Adsorption↗
PubMed2001

Long-term results of infrainguinal arterial reconstruction with spliced veins are equal to results with non-spliced veins.

OBJECTIVES: to determine the long term patency of spliced and non-spliced infrainguinal vein grafts. METHODS: a prospective registry of all patients undergoing infrainguinal arterial reconstruction with autogenous vein material was retrospectively interrogated. RESULTS: between October 1988 and August 2000, 515 infrainguinal arterial reconstructions were performed on 472 patients. A total of 429 bypasses were performed with uninterrupted greater saphenous vein, 86 reconstructions using spliced vein segments. There was no significant difference in primary (63% vs 57%) and primary assisted patency (81% vs 81%) of limb salvage (88% vs 91%) at 5 years. Limb salvage was not different (88% and 91% respectively). CONCLUSION the splicing of vein grafts does not compromise patency of limb salvage.

Aged↗
PubMed2001

Rarefaction of skin capillaries in patients with anginal chest pain and normal coronary arteriograms.

AIMS: Patients with arterial hypertension often have a reduction in capillary density (rarefaction) and a reduction in coronary flow reserve because of functional and structural alterations of the coronary microcirculation. Patients with chest pain and normal coronary arteriograms may have coronary microvascular dysfunction, but it is not known whether capillary rarefaction plays a role in the pathogenesis of this syndrome. The aim of this study was to compare capillary density in hypertensive and normotensive subjects with anginal chest pain and normal coronary arteriograms vs asymptomatic hypertensives and healthy controls. METHODS AND RESULTS: We studied 49 patients with typical anginal chest pain, positive exercise testing and normal coronary arteriograms; 22 were hypertensive and 27 were normotensive. We used intra-vital video-microscopy to examine the skin of the dorsum of the middle finger of the non-dominant hand before and after maximization of perfused capillaries with venous congestion. Mean capillary density was significantly lower in patients with chest pain and normal coronary arteriograms independent of their blood pressure level, compared to normotensive healthy controls. Differences were found both at baseline [51+/-2 (hypertensive) and 52+/-2 (normotensive) vs 65+/-2 (controls) per 0.56 mm(2) respectively], (P<0.0001) and after maximization [57+/-3 (hypertensive) and 59+/-2 (normotensive) versus 75+/-3 (controls) respectively] (P<0.0001). CONCLUSIONS: Skin capillary density is significantly lower in patients with chest pain and normal coronary arteriograms compared to normotensive controls. The pathophysiological importance of capillary rarefaction in patients with chest pain and normal coronary arteriograms remains unknown. Further studies are needed to determine whether the abnormality is associated with myocardial flow disturbances such that the findings can be extended to the heart.

Capillaries↗
PubMed2005

Superficial vein surgery and SEPS for chronic venous insufficiency.

Venous insufficiency in its severe forms leads to skin changes which, in turn may be treated by surgical therapy. Interventions are directed towards correction of the underlying abnormal venous physiology. This involves removal of varicose veins and ablation of incompetent axial veins and relevant perforating veins. In performing ablation of saphenous vein reflux, techniques include high ligation with stripping, radiofrequency ablation, endovenous laser therapy, and foam sclerotherapy. Incompetent perforator interruption can be accomplished surgically by subfascial endoscopic perforator surgery (SEPS) or controlled sclerotherapy using ultrasound. A variety of techniques have emerged to manage the varicose veins themselves. Surgical treatment of chronic venous insufficiency with high ligation in the groin and inversion stripping of the great saphenous vein to the knee combined with stab avulsion of varicose veins continues to be the standard in treatment of varicose veins. There are few comparisons of sclerotherapy of perforating veins with SEPS, but SEPS has become the most popular of surgical options.

Angioscopy↗
PubMed2002

[Aortic reconstruction and resection of malignant tumors--one- or two-stage procedure?].

Surgical tactics in case of aortic aneurysms and simultaneously performed cancer resections are not uniform and still remain a matter of debate. From Jan. 1, 1995 - Oct. 31, 2001 we operated on 37 patients suffering from aortic aneurysms (34 infrarenal, 2 combined thoraco- abdominal, 1 thoracic aneurysm) and cancer (11 esophageal, 6 gastric carcinomas, 3 small-bowel tumors, 5 large-bowel, and 12 renal carcino-mas). None of the above mentioned patients presented with any graft infection, or other severe p. op. complications. According to these results, the one-stage operation of aortic aneurysms and cancer resection is feasible if appropriate care is given to patients selection, technical details and the rules of antisepsis, without affecting surgical morbidity and mortality.

Aged↗
PubMed2005

[Imaging techniques for showing the morphology and surface structure of extracranial internal carotid artery plaques].

Methods of determining plaques in the extracranial internal carotid artery are ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI). The goal of this overview is to introduce these methods and discuss their diagnostic and clinical significance. Ultrasound has the capability of showing the echogenity of the plaques. This method seems to demonstrate a relationship with the incidence of hemispheric symptoms. A histological association could only rarely be seen. The surface structure can only be clearly and correctly evaluated in individual cases under optimal circumstances. Computed tomography is capable of showing the calcium content and specific site of the plaques. However, lipid content and fibrous tissue cannot be deduced reliably. The currently available image resolutions limit a detailed imaging of surface characteristics. Magnetic resonance imaging provides, in vitro, a correct rendering of plaque composition and endoluminal surface structure. In vivo it is possible to recognize both the fibrous cap and necrotic core as well as intraplaque hemorrhage. Because of certain artefacts more detailed images are difficult to interpret. In conclusion, further clinical trials should reveal, whether these methods can be set in clinical routine to detect plaque surface and morphology for stratifying patients at risk of hemispheric symptoms during the spontaneous course as well as during carotid interventions.

Angiography↗
PubMed1998

Transcatheter endomyocardial laser revascularization: a feasibility test.

By means of a special catheter system, a total of 76 endomyocardial laser channels were percutaneously produced in a controllable manner at selected sites in 6 beating canine hearts. Acute patency of channels (length = 4-11 mm, diameter = 0.5-1.2 mm) was documented angioscopically and histologically. This minimally invasive method might be useful for revascularising certain patients with ischemic heart disease without resorting to open-chest surgery.

Angioscopy↗
PubMedDate not supplied

Color-Doppler sonography in chronic venous insufficiency: what the radiologist should know.

Chronic venous insufficiency (CVI) is a pathologic condition caused by valvular incompetence, with or without associated venous outflow obstruction, which may affect both the superficial and the deep venous system, causing venous hypertension and stasis. The most common form of CVI is primary varicose veins due to the insufficiency of the saphenous system. Color-Doppler sonography (CDS) is actually the main diagnostic technique of imaging for CVI. In this article, we describe the anatomy, the technique, and the information necessary to the radiologist to perform CDS in chronic venous insufficiency. The knowledge of the venous anatomy is the cornerstone for an adequate sonographic examination. The venous network in the lower extremities is divided into three systems: superficial, deep, and perforating veins. Deep veins are "comitantes" to the corresponding arteries and run under the muscular fascia. Superficial veins course into the subcutaneous fat, superficially to the deep muscular fascia; the main superficial veins are the greater and lesser saphenous and their tributaries. Connection between the saphenous veins are defined as communicating veins. Superficial and deep veins are connected by perforating veins, with flow directed, under normal circumstances, from the superficial to the deep system. The main perforating are the Hunter in the mid thigh, the Dodd in the lower thigh, the Boyd in the upper calf, and the Cockett's in the middle and lower calf. Sonographic examination must be performed in the upright and supine position. Compression sonography and color and PW Doppler are systematically employed to assess the absence of deep venous thrombosis. Femoro-popliteal veins are evaluated with color and PW Doppler for valvular insufficiency with reflux by performing Valsalva maneuver and calf compression. The sapheno-femoral and sapheno-popliteal junctions are examined to identify type of junction, continence, accessory saphenous, and incompetent collaterals. Perforating veins are usually identified at the medial aspect of the thigh and at the medial, lateral, and posterior aspects of the leg. Outward flow (lasting more than 500 ms) in the perforating veins should be considered a sign of their incompetence. Several surgical and interventional procedures are now available for the treatment of the CVI, as follows: vein ligation and stripping, stab avulsion, endoluminal occlusion of the saphenous trunks, subfascial endoscopic perforator surgery, and valvuloplasty.

Angioplasty↗
PubMed2002

Morphologic changes in the microcirculation induced by chronic smoking habit: a videocapillaroscopic study on the human labial mucosa.

BACKGROUND: Cigarette smoking has been identified as a major risk factor for cardiovascular and pulmonary diseases. Although an impressive literature does exist on the subject, no evidence is available on morphologic changes induced with chronic smoking habit in the human microcirculation. SUBJECTS AND METHODS: One hundred healthy subjects, 50 smokers and 50 nonsmokers, underwent videocapillaroscopy of the labial mucosa. For each subject, the caliber of capillary loops, the number of visible capillary loops, the background optical transmittance, the tortuousness of capillary loops, the presence of microaneurysms, the presence of microhemorrhages, and the cumulative smoking habit (pack-year index) were noted. RESULTS: Smokers had a lower caliber of capillary loops (P <.001), with a higher number of visible capillary loops (P <.001), a lower background optical transmittance (P <.001), and a more marked tortuousness of capillary loops (P <.001). Microaneurysms and microhemorrhages were absent in nonsmokers, and 1 smoker of 3 had microaneurysms alone, and 1 smoker of 3 had both microaneurysms and microhemorrhages. A significant correlation was found between cumulative smoking habit and tortuousness of capillary loops (P <.001) and between cumulative smoking habit and total score (tortuousness score + microaneurysm score + microhemorrhage score; P <.005). CONCLUSION: Chronic smoking habit does induce significant morphologic changes in the microcirculation of the human labial mucosa, and these changes can be easily and comfortably recorded with videocapillaroscopy.

Adult↗
PubMed2000

Quantitative nailfold capillary microscopy findings in patients with acrocyanosis compared with patients having systemic sclerosis and control subjects.

BACKGROUND: The morphologic capillary microscopy (capillaroscopy) pattern of acrocyanosis is characterized by hemorrhages, pericapillary edema, and widened capillaries. These findings can result in a difficult differential diagnosis with systemic sclerosis (SSc). OBJECTIVE: We sought to quantify the characteristics of the capillaroscopy pattern that distinguishes patients with acrocyanosis from patients with SSc and control subjects. METHODS: A videomicroscope with fiberoptic illumination and personal computer-based image processing was used to measure capillary density, giant capillaries, loop width, and arterial and venous limbs in 10 patients with acrocyanosis, 10 patients with SSc, and 10 healthy control subjects. RESULTS: Acrocyanotic patients differed in every quantitative parameter both from control subjects and patients with SSc. In particular, capillary density, which was reduced compared with that of control subjects, was much higher than that of patients with SSc: one giant capillary per finger was observed in 2 patients with acrocyanosis, whereas more than 2 giant capillaries per finger were observed in each patient with SSc. CONCLUSION: These differences may aid in making the distinction between the capillaroscopy patterns in acrocyanosis and SSc.

Adult↗