SciCombinator

Discover the most talked about and latest scientific content & concepts.

Journal: Journal des maladies vasculaires

25

Rupture is the worst outcome of abdominal aortic aneurysm (AAA). The decision to operate should include counterbalancing the risk of aneurysm rupture against the risk of aneurysm repair, within the context of a patient’s overall life expectancy. Current surgical guidelines are based on population studies, and important variables are missed in predicting individual risk of rupture.

Concepts: Demography, Aortic aneurysm, Life expectancy, Aneurysm, Aortic dissection, Abdominal aortic aneurysm, Aneurysm of sinus of Valsalva, Mathematical model

25

The development of tyrosine kinase inhibitors (TKI) has revolutionized management of patients with chronic myeloid leukemia (CML), transforming this fatal disease into a chronic disease with nearly normal life expectancy. Nilotinib is a second generation TKI targeting the oncoprotein BCR-ABL used in patients in the chronic phase of CML. Several research teams have suggested over recent years that nilotinib might be the causal agent in the development or aggravation of vascular disease, particularly in patients with cardiovascular risk factors or an established cardiovascular disease. We report here the case of a patient who developed severe peripheral arterial disease of the lower limbs that worsened despite optimal medical and surgical care, presenting recurrent re-stenoses after different revascularization techniques (bypass, angioplasty…) associated with aggravation of severe trophic disorders to the point of potentially requiring amputation. Discontinuation of nilotinib enabled a stabilization of the arterial lesions and complete healing of the trophic lesions. This case illustrates the importance of recognizing co-morbid conditions in patients with severe vascular disease and to examine the possibility of drug interactions leading to rapid aggravation of arterial disease with no other cause. Studying the pathophysiological impact of TKIs on the vascular system may open new avenues of research for the investigation of factors triggering arteriosclerosis.

Concepts: Medicine, Cancer, Blood, Atherosclerosis, Blood vessel, Cardiovascular disease, Peripheral vascular disease, Chronic myelogenous leukemia

0

Ischemia-reperfusion, which is characterized by deficient oxygen supply and subsequent restoration of blood flow, can cause irreversible damage to tissue. The vascular surgeon is daily faced with ischemia-reperfusion situations. Indeed, arterial clamping induces ischemia, followed by reperfusion when declamping. Mechanisms underlying ischemia-reperfusion injury are complex and multifactorial. Increases in cellular calcium and reactive oxygen species, initiated during ischemia and then amplified upon reperfusion are thought to be the main mediators of reperfusion injury. Mitochondrial dysfunction also plays an important role. Extensive research has focused on increasing skeletal muscle tolerance to ischemia-reperfusion injury, especially through the use of ischemic conditioning strategies. The purpose of this review is to focus on the cellular responses associated with ischemia-reperfusion, as well as to discuss the effects of ischemic conditioning strategies. This would help the vascular surgeon in daily practice, in order to try to improve surgical outcome in the setting of ischemia-reperfusion.

Concepts: Mitochondrion, Ischemia, Reperfusion injury

0

Peripheral arterial disease is a marker of systemic atherosclerosis; it is associated with a high risk of cardiovascular disease. The aim of our study was to assess the prevalence of peripheral arterial disease by measuring the ankle-brachial pressure index in patients at high cardiovascular risk and to study the risk factors associated with this disease.

Concepts: Cholesterol, Myocardial infarction, Atherosclerosis, Blood vessel, Cardiovascular disease, Blood pressure, Peripheral vascular disease, Cardiovascular system

0

Exercise-induced thrombosis is a rare cause of deep venous thrombosis (DVT) of the upper limb and usually affects young subjects without comorbid conditions. The diagnosis may be challenging.

Concepts: Stroke, Hematology, Vein, Low molecular weight heparin, Inferior vena cava, Deep vein thrombosis, Deep vein, Upper limb

0

Adverse effects of sclerotherapy are rare. They are divided into two categories: immediate and delayed. Immediate adverse effects are mainly represented by visual disturbances. We are reporting the case of an immediate transient faintness following two sessions of foam sclerotherapy.

Concepts: Vein, Varicose veins, Sclerotherapy

0

Vitamin K antagonists (VKA) and direct oral anticoagulants (DOACs) are now in competition. The companies are trying to replace VKA by DOACs, totally or at least greatly VKA should VKA disappear in favor of DOACs? There are still many questions about DOACs. The purpose of this article is to make a well-considered decision in this area. The aim is not to denigrate one or the other but to share things between these two families of anticoagulants. Physicians using these drugs must have a full knowledge about compared efficacy and safety. We feel necessary to increase distance between effective results of the clinical trials and industrial communication around DOACs.

Concepts: Clinical trial, Truth, Effectiveness, Avicenna, Warfarin, Anticoagulant, Vitamin K, Antagonist

0

To assess the frequency of platelet monitoring and bleeding risks associated with the use of injectable anticoagulants in a real life setting and to estimate the associated costs.

Concepts: Evolution, Biology, Life, Microbiology

0

Association between cancer and systemic sclerosis (SSc) has been described. However, paraneoplastic SSc is not well known. The aim of this article is to describe cases of paraneoplastic systemic sclerosis and to compare them to other cases of the literature, to find characteristics that can make suspect a paraneoplastic mechanism when SSc is diagnosed.

Concepts: Oncology, Rheumatology, Scleroderma, Systemic scleroderma, Mucinoses

0

To assess the prevalence and the association between aspirin resistance in critical limb ischemia patients using the VerifyNow(®) bed-side platelet test, and occurrence of cardiovascular morbidity and/or death at one year.

Concepts: Educational psychology, The Association, Ischemia