Vascular Medicine

Vascular Medicine

  • Paulo Eduardo Ocke Reis added an answer:
    Can anyone help me find information/guidelines for segmental pressure testing s/p bypass graft and stenting?

    Good day, I am reaching out to the research community in an effort to find information/guidelines for segmental pressure testing s/p bypass graft and stenting. If there are articles that you may know of on this subject I would appreciate your help.

    Jay Shafer

    Paulo Eduardo Ocke Reis · Universidade Federal Fluminense

    Dear James Shafer ,

    I hope this attached can help you!

    Best Regards,

    Paulo

  • Josef Veselka added an answer:
    What is the best imaging modality to detect and measure atherosclerotic plaque regression and stabilization?
    Noinvasive (US, CT, MRI) or Invasive (Angio, IVUS, OCT, Lipiscan, etc.)
    Josef Veselka · University Hospital Motol, 2nd Medical School, Charles University, Czech Republic

    Try to use NIRS-IVUS catheters. Near infrared spectroscopy is able to determine the amount of lipids in the plaque and brings another piece of information than more traditional metohods - OCT and plain IVUS.

  • Paulo Eduardo Ocke Reis added an answer:
    Can anyone help with a vascular closure system for a Dacron graft after thrombolytic therapy?
    I am planning a thrombolytic therapy for graft thrombosis of Aorto left femoral bypass (symptoms present for10 days). Do you have any experience with any of the vascular closure systems I can use for a previously placed Dacron graft?
    Paulo Eduardo Ocke Reis · Universidade Federal Fluminense

    Dear All,

    Do you have experience with Exoseal?

  • Panayot Tanchev added an answer:
    How frequently do you use novel anticoagulants in the treatment of venous thromboembolism?
    I am interested in your experience regarding VTE.
    Panayot Tanchev · Medical University of Sofia

    Dear Rivaroxaban fans, I can not imagine how patients with severe VTE, and especiially those with severe PE accompanied by hemodynamic failure and pulmonary hypertension would be treated with oral anticoagulants. Those patients need IC, intravenous (easily controlable) anticoagulants  or fibrinolysis. In elective cases with massive PE there are indications for pulmonary embolectomy in the conditions of cardio-pulmonary bypass. 

  • Pao Yen added an answer:
    Is it possible to decrease the heart rate by 20 bpm in 6 months?
    Starting from a 80 bpm, is it possible to decrease it to 60 in 6 months by performing both aerobic and anaerobic training?
    How long -if possible- would a person need to decrease it by 20 by performing only aerobic training?
    Pao Yen · University of California, Berkeley
    6 months is really too short even to change all the bad habits of a person since birth. Perhaps, you can explore one very risky thing - to modify the brain by powerful meditation. When I studied the effect of taichi on microcirculations in internal organs, I found that taichi healing (improvement of microcirculations) can happen simply by slowing down the movements until my brain thinks that I am not moving. There was no involvement of meditation and Qi or Ying/Yang kind of stuff. So, why many taichi masters followed Taoist teachings and learned the meditation type of Qigong (different from Qigong stretching exercises)? After much reading and logic deductions, I’ve concluded that this type of Qigong is to modify one’s brain cells to possess supernatural powers, e.g. raising body temperature, generating static charge or some other wave forms that they call it Qi (similar to electric eels), turning the brain into a large reception dish to see or hear things from other brains, or having illusions & vivid dreams (like seeing ghosts or out-of-body experience), etc. It is likely that they modify the brain by moving a microwave hot spot and do some soldering by trial and error, without any circuit diagram. After each attempt, a permanent damage will be made and cannot be undone. After many attempts, a brain tumor or many tumors may be found. If you are successful...and still sane, some of these supernatural powers have healing functions because they can raise heart rates (see attachment below). As I said, this is risky, and possibly deadly. I don’t know if you can find some brain surgeons to attest to it.
  • Asif Ahmed added an answer:
    What is the relationship between hydrogen sulfide and endothelial dysfunction?
    Or, how and by which mechanism can hydrogen sulfide modulate endothelial dysfunction?
    Asif Ahmed · Aston University
    Loss of eNOS activity is an established contributor to endothelial dysfunction. There is a dynamic competition between superoxide and lipid radicals for reaction with NO. NO only stimulates superoxide-dependent lipid oxidation when the production rate of NO is less than superoxide. H2S application augments NO bioavailability and signaling. A recent study showed that in eNOS phosphomutant mice H2S failed to rescue H2S-mediated cytoprotection.

    Endothelial dysfunction is a hallmark also of preeclampsia. Recently, it was shown that plasma H2S in preeclamptic women is reduced and in a pregnant mouse model loss of H2S leads to preeclampsia like condition.

    Thus the relationship between endothelial dysfunction and hydrogen sulfide exists and is also interdependent of eNOS.
  • Closed account asked a question:
    International Journal Of Medicine and Medical Sciences Sombody knows the true Impact Factor ?
    I want to know the true impact factor of this journal
  • Ismail Hassan Ibrahim added an answer:
    What is the risk of having hypertension(160/90) + gout(9)?
    What is the risk of having hypertension(160/90) + gout(9)?
    Ismail Hassan Ibrahim · King Fahd Military Medical Complex
    Uric acid is a known herald of hypertension...Treatment is indicated once being symptomatic/ problematic and/ or exceeding cut-off of 10mg/dl...Needless to reemphasize that both hyperuricemia and hypertension are independent cardiovascular risk factors and need to be rigorously attended to forestall adverse outcomes at an era of comorbidities and polypharmacy; a lot of confounders are difficult to pinpoint in the arena!!! Again, pros and cons of medications as well as personalization of overall management should be poised by the end of the day...
  • David Bunton added an answer:
    Does anyone know which research lab can perform the antidiabetic and vasodilation activity?
    Vasodilation activity is important for my synthesized heterocycles.
    David Bunton · Biopta Ltd.
    In our lab we can run this type of in vitro experiment in human blood vessels from both healthy patients and those with type 2 diabetes. Kind regards, David Bunton
  • Prasanna Kumar Reddy added an answer:
    How effective is the Hemorrhoid Artery Ligation (HAL) procedure?
    HAL is supposed to be an effective and recent option for third degree prolapsed hemorrhoids. I have started doing HAL procedures just recently. I'd like to know about the experiences others.
    Prasanna Kumar Reddy · Apollo Hospitals
    It is a good proceedure with minimal pain.The learning curve is Identification of haemorroidal arteris with the doppler.we noticed initial swelling which required reassuring .I am following up for bleeding and recurrence.
  • Cesare De Gregorio added an answer:
    What would be the optimum time to resume antiplates in a post PCI patient having recent subarachnoid hemorrhage?
    Subarachnoid hemorrhage in a post-PCI patient on antiplates is a double jeopardy. Antiplatelet drug(s) is essential in a patient undergoing PTCA with stenting. On the other hand, intracranial hemorrhage is a contraindication to use of such drugs. Commonly antiplatelet drugs are stopped, and restarted 6 weeks or more after stabilization. Clipping of the culprit vessel may have an important role.
    Cesare De Gregorio · Università degli Studi di Messina
    If I understand well, you are talking about a patient who already had PCI+ stenting, and then SAH. This is one of the greatest unanswered clinical problems, which doesn't have just one solution. In my opinion, as Dr Oteh M said, it depends on how serious the SAH was, on how has it been resolved (if possible), and on how much time ago the patient had PCI and stenting. The second anti-platelet drug (tyeno) must be stopped. About Aspirin I have no data in patient at intermediate or high thrombotic risk, whereas I usually decide about withdrawal in low thrombotic risk (e.g. 12 months after DES or 6 months after BMS).
    Regards
  • Chetan Nimgulkar added an answer:
    To which extent are the use of murine aortic arch transplantation studies for atherosclerotic plaque regression valid?
    Any video protocols available.
    Chetan Nimgulkar · National Indtitute of Nutrition (ICMR)
    Hi, I am also working on atherosclerosis regression but pharmaceutical approach. As per my knowledge if we can transplant heart, we can transplant aortic arch too. It can give great lead of survival of animal with suppressed atheroinflammation and its aid lesion progression. However regression of plaque may not be possible because controlling inflammatory lesion progression and foam cell deposition within the lesion is still not in a control. But we can try to reverse the foam cell motility so that entrapped foam cell can emigrate from fatty plaques intima and regression can be possible.
    This is only my point of view. If you have new idea regarding this you can share. Thanks for new approach.
  • Paulo Eduardo Ocke Reis added an answer:
    Is there a vascular center studying explanted aortic endograft?
    I will explant two endograft in the next DAMS.
    Paulo Eduardo Ocke Reis · Universidade Federal Fluminense
    That`s in important information!
    Thank`s Luigi
  • Karima Akool Al-Salihi added an answer:
    Has anyone isolated rat pericytes and used antibodies for characterization?
    I´d like to isolate rat pericytes but my problem is that I cannot find rat antibodies that are suited for flow cytometry. Has anyone faced the same problems and can recommend antibodies that work against rat PDGFR beta or NG2? Any help would be appreciated.
    Karima Akool Al-Salihi · http://scholar.google.co.uk/citations?user=JyubnQQAAAAJ&hl=en
    Please read these also
  • Marco Antonio Prado Nunes added an answer:
    What factors may be related to the adaptation of prosthesis in patients with major lower limb amputations?
    We observed that the prevalence of adaptation to lower limb prostheses was 38%. And patients with a low level of education were the least frequently adapted to the prosthesis.
    Marco Antonio Prado Nunes · Universidade Federal de Sergipe
    Hi Aria Tsam? How can I refer on VA/DoD Evidence-Based Practice Working Group site?
    Thank you
  • What is the impact of physical activity, screen time, diet drinks and weather on CV disease?
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  • What is the best strategy for using ultrasound therapy in acute arterial disease?
    What intensity of ultrasound energy is used to dissolve thrombi and is there a standard protocol available?
    Paulo Magno Martins Dourado · University of São Paulo
    I think it is possible to perform these studies in mice. What is the ultrasound machine that you use? It allows assessment of perfusion in real time and contrast enhancement? You will need to apply high energy pulses for the dissolution of thrombi. How has the mHz probe you use? A probe from 20 to 25 MHz is required. The machine that I know that has these transducers is the Visual Sonic.
  • Paulo Eduardo Ocke Reis added an answer:
    What is the best management of femoral artery pseudoaneurysm?
    It is usual to encounter pseudoaneurysm of femoral artery of large size due to delayed diagnosis as whole attention in trauma goes initially to bony injury if there is fracture of bones. In this situation either vascular injury is missed or iatrogenic injury of artery may lead to pseudoaneurysm. So, what should be the best mode of intervention in femoral artery pseudoaneurysm.
    Paulo Eduardo Ocke Reis · Universidade Federal Fluminense
    Before 1991, femoral pseudoaneurysms were treated surgically. Recently, the development of effective minimally invasive therapies has resulted in their use. Principles of surgery are: obtain control proximal and distal, open and evacuate the aneurysm sac, identify the puncture site, and repair with suture with local regional anesthesia. Percutaneous balloon occlusion via the contralateral femoral artery is an alternative, less invasive method to obtain iliac control. In the event of rupture or rapid expansion, especially in patients with hypotension and shock, the aneurysm sac is opened immediately with no attempt at proximal control. The hematoma is evacuated and hemostasis achieved by direct digital manual compression of the bleeding puncture site.
  • Mallu Abhiram Charan Tej asked a question:
    Can anyone help with Drabkin's assay standard hemoglobin solution and in vivo matrigel plug assay?
    Can human hemoglobin be used to prepare the standard curve for Drabkin's assay to estimate the hemoglobin concentration in the matrigel plug injected in mice?
  • Anton Elkin asked a question:
    Does anyone have comparative experience with Tubulcus, Ulcer X and Juxta-CURES?
    Duration of treatment, recurrences and so on.
  • Alexander Petrovitch added an answer:
    ASS, Clopidogrel, mono/dual, Warfarin mono, plus antiplatelets? How long?
    In peripheral interventions: Do you make any difference in use of antiplatelet therapy after bare metal stent / drug eluting stent / drug eluting balloon / covered stents? What is your regime like?
    Alexander Petrovitch · Zentralklinik Bad Berka
    Without other concomitant vascular diseases our procedures for peripherals are:
    For BMS we give 4 weeks clopidogrel 75 and ASS100, followed by life-long ASS.
    In case of propaten-covered prothesis (gore - viaban) we give ASS100 and clopidogrel 75 for 6 mths, followed by life-long ASS100.
    In case of DEB we give ASS100 and clopidogrel 75 mg for 3 mths, followed by ASS100 life-long - due to the prolonged "epithelial wound". For DES same procedure like propaten-covered prothesis.
  • Alan Coulson added an answer:
    Are there any researcher who works on, or know something about a mechanical device for vascular anastomosis?
    I am working on a specific circular instrument for end to side vascular anastomoses and I am eager to know about other efforts made by my colleagues.
    Alan Coulson · Sandhills Regional Medical Center
    I refer you to Shenoy J Vasc Surgery 38 229 (free down load on my publications). This describes vascular clips for dialysis access. There was also a company that made circular and linear stapling devices for aorto-saphenous vein-coronary artery anastomosis; we did trials in the 1990's. Never became widely used. I forget the cpmpany's name.
  • Pier Luigi Antignani added an answer:
    Between Phlegmasia alba dolens and Phlegmasia cerulea dolens which one is more sever and which one is more common to occure?
    They are both related to deep vein thrombosis,
    Pier Luigi Antignani · Nuova Villa Claudia, Rome, Italy
    Both the conditions appear only if the femoroiliac veins are closed because are due to massive thrombosis.
    At the present, the endovascular treatment can reduce the rate of amputation in the coerulea form.
    The fibrinolitic treatment is the first choice and the anticoagulant treatment is mandatory.
  • Marc Vorpahl added an answer:
    Could you please tell me someone who experienced in carotid revascularization and choice of procedure either stenting or endarterectomy?
    I am being protected stenting about 8 years in Symptomatic Carotid Disease. Because there is continuing debate inthis topic and I want to know the common idea in RG scientists.
    Marc Vorpahl · Universität Witten/Herdecke
    It is a very complex sometimes very individual story.
    http://circ.ahajournals.org/content/121/14/1661.full
    The guidelines http://my.americanheart.org/idc/groups/ahamah-public/@wcm/@sop/@spub/documents/downloadable/ucm_430166.pdf
    I would suggest an experienced vascular board team/ center which provides both options.
  • Axel Schlitt added an answer:
    Know about a direct thrombin inhibitor for not-previously-diagnosed-HIT after cardiac surgery, in PTS needing anticoagulant therapy?
    I mean do not the use of direct thrombin inhibitor as a substitute for heparin during cardiopulmonary bypass, but for the acute treatment of HIT occurred after cardiac surgery in patient requiring anticoagulation for mechanical heart valve prosthesis but with INR value not yet in therapeutic range.
    Axel Schlitt · Martin Luther University of Halle-Wittenberg
    Argatroban is also an option but be aware that the reinitiation of an anticoagulation with VKA (if indicated) will be complicated by the elevation of the INR this drug (see attached the case from Uwe Raaz and me from 2009 to show the problem).
  • Swayam Prakash Srivastava added an answer:
    How do we do a primary mouse endothelial cell culture from kidney for a fibrogenesis and endothelial mesenchymal transition study?
    The Endothelial cells (HMVEC cells) require various growth factors for its growth. How can it be grown in the conditional media containing negligible amount of growth factors? I think, to study in primary culture is the best way for that. If you have any appropriate way to study, will you please let me know?
    Swayam Prakash Srivastava · Kanazawa Medical University
    Thanking you for suggestion.
  • Marijan Bosevski asked a question:
    Could we use flow mediated vasodilation in risk stratification of high (median) risk pts?
    For example coronary, hypertenion pts?
  • Marco Cei added an answer:
    How would you manage a patient with metallic aortic valve and under warfarin who presented with dense left sided hemiplegia?
    I have a 65-year-old female with metallic aortic valve on warfarin, presented with dense left sided hemiplegia. Brain CT showed massive right hemisphere infarction. The patient admitted to the ward as a stroke attributed to valvular lesion. The cardiologist strongly recommends continuing warfarin to prevent further thromboembolic showering and to prevent valve dysfunction, while the neurologist strongly recommends holding warfarin as the risk of intra-infarct bleeding is high. In view of these two contradictory opinions, how would I manage this case? I need experts’ opinion
    Marco Cei · Independent Researcher
    Dear Fahmi, thank you for sharing this unlucky case. Ill-fated cases are seldom reported in the literature. However, strokes in patients with prosthetic heart valves and/or atrial fibrillation despite adequate anticoagulation are not rare in my experience, so they are undoubtedly worth of discussion. I would add some personal thoughts to this discussion. 1) If this case would have been included in a clinical trial, I would probably adjudicate the death to heart valve thrombosis. Sudden death is not the usual clinical presentation of ischemic stroke superimposed bleeding. 2) A two weeks period of warfarin suspension is reasonable when facing a very large brain infarction, but this seems to me a too long time for a patient with a mechanical valve. 3) To my knowledge the only result one can expect from a prophylactic dose of LMWH is the prevention of deep vein thrombosis. 4) In my country, no LMWH is licensed for use in atrial fibrillation or in patients with mechanical heart valves, at any dosage. This is a very relevant legal pitfall. I would therefore have preferred standard heparin in continuos infusion, with close neurologic monitoring, resuming warfarin as soon as possible under clinical judgement. I agree with José, since unfractionated heparin is easily stopped if the neurological state deteriorates. 5) You've certainly done the right thing in daily monitoring with echocardiography. I agree also with aspirin.
  • Prasad Challa added an answer:
    Which would you prefer - a coronary angioplasty via the ulnar or radial route?
    Ulnar vessels have a wider caliber but are relatively deeper in course.
    Prasad Challa · Queensland Health
    Radial would be the preferred choice.Ulnar though is a bigger vessel hemostaisis post procedure is difficult with ulnar interventions and invariably has very high incidence of a hematoma as the ulnar vessel is deeper and compression with the existing devices for radial are not ideal .I use ulnar only if I have no other choice

About Vascular Medicine

Vascular medicine (angiology) is the medical specialty which studies the diseases of circulatory system and of the lymphatic system, i.e., arteries, veins and lymphatic vases, and its diseases.

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