Introduction. Endovascular revascularization is a peripheral artery disease therapy used to improve blood flow in blood vessels. The objective of this study was to analyze the types and prevalence of ...comorbidities in patients with indications for carotid artery revascularization, as well as early results of endovascular carotid artery revascularization in relation to periprocedural complications. Material and Methods. This retrospective study was conducted from October 2014 to October 2019 and included 96 patients. Descriptive and comparative statistical analysis was performed in all patients, male and female, and those with both symptomatic and asymptomatic carotid diseases. Results. The study included 96 patients, of whom 69.8% were male and 30.2% were female. A successful endovascular procedure was performed in 89.6% of patients, while in 10.4% of patients the procedure failed. The distribution of patients by sex, age and the duration of procedure, showed a statistically significant difference (p < 0.05) in the age (p = 0.0003) and duration of the procedure (p = 0.022). The comparison of two groups of patients, with symptomatic and asymptomatic carotid atherosclerotic disease, hyperlipoproteinemia (p = 0.015) showed a statistically significant difference (p < 0.05) between the two groups. Conclusion. Endovascular revascularization has a high success rate in the treatment of atherosclerotic disease of the carotid arteries as well as low periprocedural morbidity and mortality. The analysis of gender-related differences, we concluded that endovascular revascularization lasts significantly longer in female patients, and that the average age is significantly higher in male patients compared to females. We also concluded that hyperlipoproteinemia is a major risk factor for carotid artery disease. Key words: Carotid Stenosis; Stroke; Cerebral Revascularization; Endovascular Procedures; Treatment Outcome; Stents; Atherosclerosis; Minimally Invasive Surgical Procedures: Risk Factors; Comorbidity Uvod. Endovaskularna revaskularizacija podrazumeva rekonstrukciju obolelog krvnog suda metodama koje se koriste da poboljsaju protok krvi kroz krvni sud. Cilj rada bila je analiza komorbiditeta po tipu i ucestalosti javljanja kod pacijenata sa indikacijom za revaskularizaciju karotidnih arterija, kao i analiza ranih rezultata endovaskularne revaskularizacije karotidnih arterija u odnosu na periproceduralne komplikacije. Materijal i metode. Retrospektivna studija izmedu oktobra 2014. i oktobra 2019. godine obuhvatila je 96 pacijenata. Radena je deskriptivna i komparativna statistika za celu populaciju izmedu grupe muskog i zenskog pola i simptomatske i asimptomatske karotidne bolesti. Rezultati. Istrazivanjem je obuhvaceno 96 bolesnika, od kojih je 69,8% bilo muskog, dok je 30,2% bilo zenskog pola. Uspesno izvrsena endovaskularna procedura je uradena kod 89,6% bolesnika, dok kod 10,4% bolesnika procedura nije uspela. Poredenjem pacijenata po polu, starosti (p = 0,0003) i trajanja procedure (p = 0,022) pokazala se statisticki znacajna razlika (p < 0,05). Poredenjem dve grupe pacijenata sa simptomatskom i asimptomatskom karotidnom aterosklertoskom bolescu, hiperlipoproteinemija, (p = 0,015) pokazala se takode statisticki znacajna razlika (p < 0,05). Zakljucak. Endovaskularnom revaskularizacijom se postize visok uspeh lecenja aterosklerotske bolesti karotidnih arterija, pracena je malim periproceduralnim morbiditetom i mortalitetom. Analizom rezultata po polu, zakljucili smo da endovaskularna revaskularizacija znacajno duze traje kod pacijenata zenskog pola i daje prosecna starost znacajno veca kod pacijenata muskog pola u odnosu na zenski pol. Zakljucili smo i da hiperlipoproteinemija ima znacajnu ulogu u simptomatologiji karotidne bolesti, kao i daje hiperlipoproteinemija znacajan faktor rizika za bolest karotidne arterije. Kljucne reci: karotidna stenoza; mozdani udar; cerebralna revaskularizacija; endovaskularne procedure; ishod lecenja; stentovi; ateroskleroza; minimalno invazivne hirurske procedure; faktori rizika; komorbiditet
Progressive industrialization in recent decades has contributed to the increase of metal levels in the environment, which has a dangerous impact on human health, primarily pregnant women. In this ...study, we aimed to compare levels of various elements in maternal and umbilical cord (UC) plasma samples collected from 125 healthy pregnant women, conduct correlation analysis among paired plasma samples, and compare our data with other populations worldwide. The study design included the following elements: essential (Mn, Co, Cu, Zn, Se, Mo), non-essential (Be, Al, Ni, As, Rb, Sr, Cd, Sb, Pb, U), rare earth (La, Pr, Ce, Nd, Sm, Eu, Gd, Dy, Ho, Er), and noble metals (Ru, Rh, Re, Pt). Levels of 30 elements were higher in maternal plasma than in UC plasma samples. However, no disparities at the statistically significant level were found for Be, Zn, Rb, Cd, Ce, and Ho. Correlation analysis among paired plasma samples revealed only positive/synergistic correlations of different strengths between most elements. Compared to other countries across the globe, our participants had considerably lower plasma levels of Zn and higher levels of Co, Ni, and As. This study provides not only a new and deeper comprehension, but also the first insight into the levels, correlation, distribution, and potential transplacental transfer of 30 elements.
This paper presents the research on vehicle fleet energy efficiency impact upon overall vehicle effectiveness. Transport companies and companies with own vehicle fleets tend to enhance their resource ...effectiveness, and to increase their transport service quality with the objective of attaining a competitive position on the market. Since energy consumed for transport operations is an important transport process resource, a method for assessing transport process effectiveness has been developed with the objective of increasing vehicle fleet effectiveness and its energy efficiency, and the overall vehicle effectiveness human indicator has been defined accordingly. The developed method was then implemented in an actual vehicle fleet and variations of the overall vehicle effectiveness human indicator were researched, as well as specific energy consumptions for respective net transport volumes depending on the following indicators: vehicle payload capacity utilization rate and mileage utilization rate. It is shown that specific energy consumption influences overall vehicle effectiveness depending on both the payload capacity utilization rate and mileage utilization rate.
Introduction. Endovascular revascularization is a peripheral artery disease
therapy used to improve blood flow in blood vessels. The objective of this
study was to analyze the types and prevalence of ...comorbidities in patients
with indications for carotid artery revascularization, as well as early
results of endovascular carotid artery revascularization in relation to
periprocedural complications. Material and Methods. This retrospective study
was conducted from October 2014 to October 2019 and included 96 patients.
Descriptive and comparative statistical analysis was performed in all
patients, male and female, and those with both symptomatic and asymptomatic
carotid diseases. Results. The study included 96 patients, of whom 69.8%
were male and 30.2% were female. A successful endovascular procedure was
performed in 89.6% of patients, while in 10.4% of patients the procedure
failed. The distribution of patients by sex, age and the duration of
procedure, showed a statistically significant difference (p < 0.05) in the
age (p = 0.0003) and duration of the procedure (p = 0.022). The comparison
of two groups of patients, with symptomatic and asymptomatic carotid
atherosclerotic disease, hyperlipoproteinemia (p = 0.015) showed a
statistically significant difference (p < 0.05) between the two groups.
Conclusion. Endovascular revascularization has a high success rate in the
treatment of atherosclerotic disease of the carotid arteries as well as low
periprocedural morbidity and mortality. The analysis of gender-related
differences, we concluded that endovascular revascularization lasts
significantly longer in female patients, and that the average age is
significantly higher in male patients compared to females. We also concluded
that hyperlipoproteinemia is a major risk factor for carotid artery disease.
Introduction. Carotid endarterectomy is an efficient surgical procedure of
primary and secondary prevention of ischemic stroke in asymptomatic and
symptomatic patients with extracranial carotid ...artery disease. Material and
Methods. In this paper we analyzed incidence, risk factors, potential causes
and preventive measures for early stroke after carotid endarterectomy in
patients (809) who underwent surgery for carotid artery stenosis at the
Clinic of Vascular and Endovascular Surgery of the Clinical Center of
Vojvodina in Novi Sad during a five year period (April 2013 - March 2018).
Results and Discussion. Early operative stroke was registered in 12 patients
with no significant difference between symptomatic (2.8%) and asymptomatic
(1.1%) patients (odds ratio - 2,56, 95% confidence interval - 0.8063 to
8.1770 standard deviation 1,596; p = 0,11). Contralateral carotid occlusion
(odds ratio - 3.1154, 95% confidence interval - 1.1620 to 8.3522, p =
0.0239) and no dual antiplatelet therapy (odds ratio - 3.1154, 95%
confidence interval - 1.8537 to 526.4871; p = 0.0169) were pointed out as
risk factors for operative stroke. Most of the perioperative and early
postoperative strokes after carotid endarterectomy were due to
arterial-arterial thromboembolism, intracerebral hemorrhage and acute
carotid occlusion that developed rarely and were associated with severe
neurological deficit. Conclusion. Even though our results are in agreement
with the literature data, additional measures for surgical quality control
would further decrease the incidence of operative stroke.
nema
Aims
Natriuretic peptide (NP) uptake varies in Emergency Departments (EDs) across Europe. The ‘Peptide for Life’ (P4L) initiative, led by Heart Failure Association, aims to enhance NP utilization for ...early diagnosis of heart failure (HF). We tested the hypothesis that implementing an educational campaign in Western Balkan countries would significantly increase NP adoption rates in the ED.
Methods and results
This registry examined NP adoption before and after implementing the P4L‐ED study across 10 centres in five countries: Bosnia and Herzegovina, Croatia, Montenegro, North Macedonia, and Serbia. A train‐the‐trainer programme was implemented to enhance awareness of NP testing in the ED, and centres without access received point‐of‐care instruments. Differences in NP testing between the pre‐P4L‐ED and post‐P4L‐ED phases were evaluated. A total of 2519 patients were enrolled in the study: 1224 (48.6%) in the pre‐P4L‐ED phase and 1295 (51.4%) in the post‐P4L‐ED phase. NP testing was performed in the ED on 684 patients (55.9%) during the pre‐P4L‐ED phase and on 1039 patients (80.3%) during the post‐P4L‐ED phase, indicating a significant absolute difference of 24.4% (95% CI: 20.8% to 27.9%, P < 0.001). The use of both NPs and echocardiography significantly increased from 37.7% in the pre‐P4L‐ED phase to 61.3% in the post‐P4L‐ED phase. There was an increased prescription of diuretics and SGLT2 inhibitors during the post‐P4L‐ED phase.
Conclusions
By increasing awareness and providing resources, the utilization of NPs increased in the ED, leading to improved diagnostic accuracy and enhanced patient care.
Background/Aim. Popliteal artery aneurysm (PAA) is the most common peripheral artery aneurysm and the second most common aneurysm following abdominal aortic aneurysm (AAA). Still, its incidence is ...rare, and treatment is non-standardized. The collection of data in a multicenter registry could improve the diagnosis and treatment of PAA. SerbVasc is a newly established data collection collaboration among vascular centers in Serbia. The aim of this study was to present common surgical practices in the diagnosis and treatment of patients with PAA in hospitals in Serbia. Methods. Vascular centers in Serbia that accepted the invitation collected data retrospectively concerning patients operated on for PAA from 2012 to 2018. Data regarding symptoms, preoperative diagnostics, vascular and endovascular techniques, and postoperative results were collected. This data set was submitted to the VASCUNET international project of PAA for data analysis between the countries. The same data set was used for a detailed analysis of the contemporary treatment of PAA in six hospitals in Serbia: University Clinical Center of Serbia, ?Dedinje? Cardiovascular Institute, Military Medical Academy, University Clinical Center Novi Sad, University Clinical Center Nis, and General Hospital Uzice. Results. From 2012 to 2018, in six hospitals in Serbia, data for 342 procedures on treating PAA were collected for 329 (96.2%) men and only 13 (3.8%) women. The incidence of PAA repair was 6.8 operations per million inhabitants a year. The mean age of patients was 64.34 years (ranging from 29 to 87). A total of 223 (65.8%) elective procedures were performed. Am-putation and hospital survival were considered the main outcomes. Thrombosis was recorded in 110 (32.5%) pa-tients as a cause for surgery, and rupture was recorded in 5 patients. The mean diameter of the aneurysm was 35.3 mm, and a slightly larger diameter was recorded in ruptured aneurysms ? 43.8 mm on average. Both synthetic and vein grafts were used in elective and urgent procedures equally. Endovascular procedures were performed in 6 (1.8%) cases. Conclusion. This study confirms the importance of registry-based collection of data and their analysis. It showed that the national incidence of PAA in Serbia is low and that well-organized, even institution-based, screening algorithms should improve identifying such patients and increase the number of electively treated PAA. Educating vascular surgeons to use the posterior approach could improve vascular healthcare.
Introduction. Carotid endarterectomy is an efficient surgical procedure of primary and secondary prevention of ischemic stroke in asymptomatic and symptomatic patients with extracranial carotid ...artery disease. Material and Methods. In this paper we analyzed incidence, risk factors, potential causes and preventive measures for early stroke after carotid endarterectomy in patients (809) who underwent surgery for carotid artery stenosis at the Clinic of Vascular and Endovascular Surgery of the Clinical Center of Vojvodina in Novi Sad during a five year period (April 2013 - March 2018). Results and Discussion. Early operative stroke was registered in 12 patients with no significant difference between symptomatic (2.8%) and asymptomatic (1.1%) patients (odds ratio - 2,56, 95% confidence interval - 0.8063 to 8.1770 standard deviation 1,596; p = 0,11). Contralateral carotid occlusion (odds ratio - 3.1154, 95% confidence interval - 1.1620 to 8.3522, p = 0.0239) and no dual antiplatelet therapy (odds ratio - 3.1154, 95% confidence interval 1.8537 to 526.4871; p = 0.0169) were pointed out as risk factors for operative stroke. Most of the perioperative and early postoperative strokes after carotid endarterectomy were due to arterial-arterial thromboembolism, intracerebral hemorrhage and acute carotid occlusion that developed rarely and were associated with severe neurological deficit. Conclusion. Even though our results are in agreement with the literature data, additional measures for surgical quality control would further decrease the incidence of operative stroke. Key words: Stroke; Carotid Artery Diseases; Endarterectomy, Carotid; Prophylactic Surgical Procedures; Risk Factors; Carotid Stenosis; Intraoperative Complications; Postoperative Complications Uvod. Karotidna endarterektomija predstavlja efikasnu meru primarne i sekundarne prevencije mozdanog udara kod pacijenata sa oboljenjem karotidnih arterija, a koji nemaju simptome i pacijenata koji ih imaju. Materijal i metode. U ovom radu analizirani su ucestalost, faktori rizika, potencijalni uzrocnici i mere prevencije mozdanog udara kod pacijenata (809) koji su zbog ekstrakranijalne karotidne bolesti operisani na Klinici za vaskularnu i endovaskularnu hirurgiju Klinickog centra Vojvodine u periodu od pet godina (april 2013. - mart 2018.). Rezultati i diskusija. Mozdani udar registrovan je kod 12 pacijenata sa ucestaloscu do 2,8% kod pacijenata sa simptomima i 1,1% kod pacijenata bez simptoma, bez znacajne statisticke razlike (odnos verovatnoce 2,56, 95% interval poverenja od 0.8063 do 8.1770 standardna devijacija 1,596 p = 0,11). Od drugih faktora rizika, znacajnim su se pokazali kontralateralna okluzija arterije (odnos verovatnoce 3.1154, 95% interval poverenja 1.1620 do 8.3522, p = 0.0239) i odsustvo dvojne antiagregacione terapije (odnos verovatnoce 3.1154, 95% interval poverenja 1.8537 do 5264871, p = 0.0169). Najveci broj perioperativnih i postoperativnih mozdanih udara razvio se kao posledica arterio-arterijske embolizacije, a mozdano krvarenje i akutna karotidna tromboza su bili retki uzrocnici povezani sa dubljim neuroloskim deficitom i losijom prognozom. Zakljucak. I pored toga sto su dobijeni rezultati u skladu sa zvanicnim preporukama, mere operativne kontrole kvaliteta koje su predlozene mogle bi dodatno da smanje rizik od mozdanog udara kod operisanih pacijenata. Kljucne reci: mozdani udar; oboljenje karotidnih arterija; karotidna endarterektomija; preventivne hirurske procedure; faktori rizika; karotidna stenoza; intraoperativne komplikacije; postoperativne komplikacije Abbreviations OR--odds ratio CI--confidence interval SD--standard deviation PAD--peripheral artery disease CT--computerized tomography ICA--internal carotid artery MCA--middle cerebral artery ICU--intensive care unit DAPT--dual antiplatelet therapy NIHSS--National Institutes of Health Stroke Scale HITS--high intensity transient signals
PDF
