Pharmacomechanical thrombectomy (PMT) has appeared as an effective treatment modality for deep venous thrombosis (DVT). The study aimed to assess the efficacy of the Cleaner™ thrombectomy device for ...acute DVT.
Sixteen consecutive patients presenting with extensive iliofemoral and/or femoropopliteal acute DVT and managed at our institution between February 2013 and May 2014 were retrospectively reviewed. The patients underwent PMT with the Cleaner device after insertion of vena caval filters. For underlying stenotic lesions, balloon angioplasty and/or stent placement was performed.
PMT with the Cleaner device was successful in 14 patients with complete restoration of flow. No clinical signs of pulmonary thromboembolism was recorded after the procedure. Thrombectomy failed in 2 patients. For the rest of the patients, balloon angioplasty was performed to relieve underlying stenotic lesions. Nine of them underwent additional stenting.
Our initial experience suggests that the Cleaner device can be used in acute DVT. However, further studies involving larger patient populations are warranted to determine long-term results.
Objectives: It was known that oxidative/antioxidative balance shifted to oxidative side in patients with coronary artery disease. The aim of this study is to evaluate the relationship between ...coronary artery disease and total antioxidant status, oxidative stress index. Materials and methods: The study group consisted of 87 consecutive patients who were hospitalized for coronary angiography. Plasma total oxidative status (TOS) and total antioxidative capacity (TAC) levels were measured and oxidative stress index (OSI) was calculated. Results: The TAC values increased statistically significant in the four tertile compared with the first tertile (1.9 ± 0.2 vs 2.0 ± 0.2 mmol Trolox Eq/l) and the TOS values decreased non- significantly in the four tertile ( 5.2 ± 2.8 vs 7.2 ± 5.4 µmol H2O2 Eq/l) as compared to the patients in the first tertile. According to the number of diseased vessels, plasma oxidative characteristics did not differ between the three groups. Conclusions: Plasma TAC levels increased in subjects with coronary atherosclerosis and severity of coronary atherosclerosis is related with TAC.
We evaluated the effectiveness of an accessibility-enhanced multimedia informational educational program in reducing depression and anxiety increasing satisfaction with the information and materials ...received by patients in coronary care unit.
We selected 100 patients from among the patients who stayed at or who underwent surgery at one of two ICUs for any reason who satisfied the eligibility criteria, and agreed to participate in the research. The participants were included in the control or experimental group by random selection. The patients completed the Hospital Anxiety Depression Scale during ICU admission and 1week after hospital discharge.
The difference in HADSA score was significantly greater in patients who received education than in patients who did not receive multimedia nursing education (4.2±0.58 vs. 0.6±0.42; p<.01). Additionally, the difference in HADSD score was significantly greater in patients who received multimedia nursing education (2.2±0.53 vs. 0.64±0.46; p<.01).
This study showed that anxiety and depression associated with hospital can be reduced with multimedia nursing education.
Aim:
The aim of the present study was to investigate the predictive value of preoperative neutrophil–lymphocyte ratio (NLR) in postoperative saphenous vein graft patency in patients undergoing ...coronary artery bypass grafting (CABG) surgery.
Method:
We retrospectively analyzed 444 patients who had undergone CABG and a further control coronary angiography due to recurrence of symptoms. The patients were divided into tertile groups according to the NLR. The primary end point was 50% saphenous vein graft stenosis or more or complete occlusion.
Result:
The saphenous vein graft failure in the 3 groups based on NLR was 33%, 66.2%, and 79.1%, in the low-, middle- and high-risk groups, respectively. In multivariate regression modeling, current smoker, diabetes mellitus, target artery diameter <1.5 mm, and NLR independently predicted saphenous vein graft patency in patients after CABG. Conclusion: Preoperative NLR is clearly an independent predictor of saphenous vein graft patency in patients after CABG.
Prevention of the development of paraplegia during the repair of the damage caused by descending thoracic and thoracoabdominal aneurysms remains an important issue. Therefore, we investigated the ...protective effect of atorvastatin on ischemia-induced spinal cord injury in a rabbit model.
Thirty-two rabbits were divided into the following four equally sized groups: group I (control), group II (ischemia-reperfusion), group III (atorvastatin treatment) and group IV (atorvastatin withdrawal). Spinal cord ischemia was induced by clamping the aorta both below the left renal artery and above the iliac bifurcation. Seventy-two hours postoperatively, the motor function of the lower limbs of each animal was evaluated according to the Tarlov score. Spinal cord and blood samples were obtained for histopathological and biochemical analyses.
All of the rabbits in group II exhibited severe neurological deficits. Atorvastatin treatment (groups III and IV) significantly reduced the level of motor dysfunction. No significant differences were observed between the motor function scores of groups III and IV at the evaluated time points. Light microscopic examination of spinal cord tissue samples obtained at the 72nd hour of reperfusion indicated greater tissue preservation in groups III and IV than in group II.
This study demonstrates the considerable neuroprotective effect of atorvastatin on the neurological, biochemical and histopathological status of rabbits with ischemia-induced spinal cord injury. Moreover, the acute withdrawal of atorvastatin therapy following the induction of spinal cord ischemia did not increase the neuronal damage in this rabbit model.
Patients who have undergone the elephant trunk procedure because of aortic dissection may subsequently present with a descending aortic aneurysm. We describe the technique of “endograft aortic ...control by inflating a compliant aortic occlusion balloon,” in which a balloon is placed in the proximal descending aortic graft without cross-clamping to avert problems of hemorrhage at the second stage of the elephant trunk procedure.
Objective The aim of this study was to evaluate the pretreatment effect of cilostazol on spinal cord ischemia-reperfusion injury. Design Prospective, interventional study. Setting Research ...laboratory, single institution. Participants Twenty-four New Zealand white rabbits. Interventions Twenty-four rabbits were divided into 3 equal groups: group I (sham), group II (ischemia-reperfusion, control group), and group III (cilostazol, administered orally 30 mg/kg/day for 3 days before the surgery). Spinal cord ischemia was induced by clamping the aorta both below the left renal artery and above the iliac bifurcation for 30 minutes. Seventy-two hours postoperatively, the motor function of the lower limbs was evaluated in each animal according to the modified Tarlov score. Spinal cord and blood samples were taken for histopathologic and biochemical analyses at the 72nd hour of reperfusion. Measurements and Main Results All rabbits in the ischemia-reperfusion group (group II) showed severe neurologic deficits. The median (IQR) Tarlov scores postoperatively at 72 hours in groups I, II, and III were 5.0(-), 2.0(1.0), and 4.5(1.0), respectively. Administration of cilostazol resulted in a significant reduction in motor dysfunction when compared with the ischemia-reperfusion group (p<0.001). In the ischemia-reperfusion group, serum and tissue glutathione peroxidase and superoxide dismutase activity were significantly less compared with the sham group (group I) (p<0.05). Serum and tissue glutathione peroxidase and superoxide dismutase levels in the cilostazol-treated group (group III) were higher compared with the ischemia-reperfusion group (p<0.05). In the cilostazol-treated group, serum and tissue malondialdehyde levels were lower compared with the ischemia-reperfusion group (p<0.05). Histopathologic analysis found decreased neuronal injury in the cilostazol group when compared with the ischemia-reperfusion group (p< 0.05). Conclusions This study showed that pretreatment with cilostazol significantly ameliorated neurologic functional outcome and attenuated neuronal histopathologic injury after transient aortic occlusion in rabbits.
Background Trimetazidine is an anti-ischemic agent that is used to treat angina and it has cardioprotective effects without inducing any significant hemodynamic changes. It inhibits the long-chain ...mitochondrial 3-ketoacyl coenzyme A thiolase enzyme in the myocyte and can improve cardiac mitochondrial metabolism, as well as scavenge free radicals. The aim of this double-blind prospective randomized study was to investigate the effect of preoperative use of trimetazidine on the reduction of oxidative stress during coronary artery bypass grafting (CABG) under cardiopulmonary bypass (CPB). Methods and Results The study group (group T) and the control group (group C) each comprised 12 patients. Pretreatment began 2 weeks before CABG with trimetazidine (60 mg/day po); the control group did not receive any medication. Serial blood samples were collected before and after CPB for measurement of the serum concentrations of these major endogenous antioxidant enzyme systems, which are markers for oxidative degradation of the cellular membranes; postoperative levels were significantly different between the groups (p<0.05). There were no significant difference in hemodynamic values. Conclusion The findings suggest that pretreatment with trimetazidine alleviates malondialdehyde production and preserves endogenous antioxidant capacity during CABG with CPB and cardioplegic arrest. (Circ J 2006; 70: 1169 - 1173)
Abstract Background N -acetylcysteine (NAC), a precursor of reduced glutathione, has been in clinical use primarily as a mucolytic. In addition, NAC is well known for their free radical scavenging ...and antioxidant properties. Increasing of reactive oxygen products occurring during cardiac surgery can play an important role in postoperative adhesion formation. We investigated to the efficacy of the NAC for postoperative pericardial adhesions. Methods Sixteen New Zealand white rabbits (2.5–3 kg) were used and categorized into two groups including study (use of NAC) and control groups. In both groups, the pericardium was opened longitudinally, and the exposed epicardial surfaces were abraded with dry gauze. The rabbits were divided into two groups: Group 1 was treated with the sponge, which impregnated with NAC solution, (10%, 300 mg/3 ml) and applied over the abraded epicardium for 5 min ( n =8). Group 2 was the control, and the sponge, which was impregnated with 3-ml isotonic NaCl solution (0.9%), was applied onto the surface of the abraded epicardium for 5 min ( n =8). After a period of 2 weeks, the animals were sacrificed. The scores of adhesion were graded by macroscopic examination, and the pericardial tissues were analyzed microscopically in point of inflammation and fibrosis. Results In Group 1, the adhesion scores were significantly lower compared with the control group Group 1 vs. 2; 1 (1–2) vs. 3 (2–3), P <.001. No significant difference was found between the groups in terms of the severity of inflammation Group 1 vs. 2; 1.5 (1–3) vs. 2.5 (1–3), P =.083. There was a difference between groups in terms of the degree of fibrosis Group 1 vs. 2; 2 (1–2) vs. 3 (2–3), P =.007. Conclusions The use of NAC for preventing postoperative pericardial adhesions was reduced to adhesion and fibrosis scores in an experimental rabbit model. There was no statistically significant difference between groups in terms of inflammatory scores. The NAC effectively prevented the formation of pericardial adhesion.
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