Microsurgery / Endovascular / Combined Treatment of Intracranial Vascular Lesions

2014 ◽  
Vol 75 (S 01) ◽  
Author(s):  
K. Rotim ◽  
V. Kalousek ◽  
M. Boric
Keyword(s):  
Combined Treatment ◽  
Vascular Lesions

Abstract 16148: Possible Implication of Oxidative Stress in Development of Coronary Vascular Lesions in Kawasaki Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kenji Hamaoka ◽  
Tomoyo Yahata ◽  
Chinatsu Suzuki ◽  
Akiko Okamoto-Hamaoka ◽  
Ayako Yoshioka ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Kawasaki Disease ◽  
Acute Phase ◽  
Antioxidative Activity ◽  
Combined Treatment ◽  
Poor Response ◽  
Vascular Lesions ◽  
Reactive Oxygen Metabolites ◽  
Significant Difference ◽  
Response Group

Introduction: Kawasaki disease (KD) is an acute systemic pan-vasculitis prevalent in infants and consequently causes coronary arterial lesions (CALs). Furthermore, it has been reported that CALs in KD may increase the risk of early-onset and progression of arteriosclerosis. In this study, we evaluated the possible implication of oxidative stress (OS) in morbid state and developing vascular lesions by measuring the balance between oxidative stress and antioxidative activity. Methods: Nineteen patients were enrolled to evaluate the dynamics of OS in the acute phase. All patients were treated with IVIG and aspirin. Thirteen patients responded well to IVIG and six did not respond well. Reactive oxygen metabolites (ROM) and biological antioxidant potential (BAP) were measured before (point A), two days (point B) and 1~2 weeks (point C) after IVIG administration, using FREE. OS balance in the chronic-phase was examined in 42 late-phase KD patients (mean age; 16.5 years-old), who included 16 patients without CAL (group D), eight with transient CAL (group E), and 18 with persistent CALs (group F). Results: In the acute phase of KD, OS was enhanced. ROMs in good response group significantly decreased between points A and B, and points B and C (p< 0.05 and p< 0.01, respectively). In poor response group, there was no significant difference in ROM between points A and B. BAP in good response group significantly increased between points A and C (p < 0.01), but not in poor response group. BAP at point A was significantly lower in the poor response group than the good response (p < 0.01). No statistically significant differences in ROM and BAP were observed in groups D ~ F, but ROM was the lowest in group F. Potential antioxidative activity (BAP/dROMs) was significantly higher in group F compared with those in groups D and E (p< 0.05). In KD patients with CALs, ROM was the lowest in the combined therapy with antiplatelet medicine plus statin and/or warfarin, and AR was the highest. Conclusions: In KD, OS was significantly enhanced in acute phase, and changes in ROM and BAP are clinically useful for evaluating and predicting the effects of IVIG therapy. Furthermore, it was suggested that combined treatment of statin or warfarin may increase potential antioxidant activity.

Hybrid treatment of multilevel revascularization in patients with peripheral arterial disease – a multi-centre study in Korea

VASA ◽  
2018 ◽  
Vol 47 (3) ◽  
pp. 235-241 ◽  
Author(s):  
Soon Cheon Lee ◽  
Jin Hyun Joh ◽  
Jeong-Hwan Chang ◽  
Hyung-Kee Kim ◽  
Jang Yong Kim ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Combined Treatment ◽  
Ankle Brachial Index ◽  
Primary Patency ◽  
Limb Ischaemia ◽  
University Hospitals ◽  
Multi Centre Study ◽  
Free Survival ◽  
Technical Success Rate ◽  
Hybrid Treatment

Abstract. Background: Endovascular treatment is an alternative first-line management for peripheral artery disease (PAD). Hybrid treatment (HT) is defined as a combined treatment for patients with PAD using endovascular and open surgery, simultaneously performed in an operating room. The results of HT are reportedly good for multilevel revascularization (MR) in patients with chronic limb ischaemia, and even in older high-risk patients. The goal of this study was to examine the clinical and haemodynamic outcomes of HT in patients who need MR. Patients and methods: Nine university hospitals in Korea participated in this multicentre study. A total of 134 patients with multilevel PAD underwent HT and MR. Patients were enrolled from July 2014 to June 2015 and were followed for 18 months. Results: The mean age of the patients was 68.8 ± 9.93 years and 88.1 % were men. Patients with Rutherford category 2 to 3 and 4 to 6 comprised 59.0 % and 42.0 % of the group, respectively. The technical success rate was 100 %. The primary patency rates at 12 and 18 months were 77.6 % and 63.9 %, respectively. The primary-assisted patency rates at 12 and 18 months were both 90.0 %. The pre-operative mean ankle brachial index (0.43 ± 0.23) increased to 0.87 ± 0.23 at six months post-operatively (t-test, p < 0.05). The amputation free survival rate was 97.1 %. Conclusions: Although outcomes of multilevel PAD are reportedly poor when endovascular treatment alone is used, we have shown that HT is a feasible alternative modality for patients with multilevel PAD, with satisfactory amputation-free survival and freedom from re-intervention rates.

Vascular trauma of the hand – a systematic review

VASA ◽  
2019 ◽  
Vol 48 (3) ◽  
pp. 205-215 ◽  
Author(s):  
Uwe Wahl ◽  
Ingmar Kaden ◽  
Andreas Köhler ◽  
Tobias Hirsch
Keyword(s):  
Duplex Sonography ◽  
Vascular Trauma ◽  
Vascular Lesions ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Limited Information ◽  
Endovascular Interventions ◽  
Provocation Tests ◽  
Objective Basis ◽  
Allen Test

Abstract. Hypothenar or thenar hammer syndrome (HHS) and hand-arm vibration syndrome (HAVS) are diseases caused by acute or chronic trauma to the upper extremities. Since both diseases are generally related to occupation and are recognised as occupational diseases in most countries, vascular physicians need to be able to distinguish between the two entities and differentiate them from other diagnoses. A total of 867 articles were identified as part of an Internet search on PubMed and in non-listed occupational journals. For the analysis we included 119 entries on HHS as well as 101 papers on HAVS. A professional history and a job analysis were key components when surveying the patient’s medical history. The Doppler-Allen test, duplex sonography and optical acral pulse oscillometry were suitable for finding an objective basis for the clinical tests. In the case of HHS, digital subtraction angiography was used to confirm the diagnosis and plan treatment. Radiological tomographic techniques provided very limited information distal to the wrist. The vascular component of HAVS proved to be strongly dependent on temperature and had to be differentiated from the various other causes of secondary Raynaud’s phenomenon. The disease was medicated with anticoagulants and vasoactive substances. If these were not effective, a bypass was performed in addition to various endovascular interventions, especially in the case of HHS. Despite the relatively large number of people exposed, trauma-induced circulatory disorders of the hands can be observed in a comparatively small number of cases. For the diagnosis of HHS, the morphological detection of vascular lesions through imaging is essential since the disorder can be accompanied by critical limb ischaemia, which may require bypass surgery. In the case of HAVS, vascular and sensoneurological pathologies must be objectified through provocation tests. The main therapeutic approach to HAVS is preventing exposure.

A Case of Catatonia in a 14-Year-Old Girl with Schizophrenia Treated with Electroconvulsive Therapy

2013 ◽  
Vol 41 (1) ◽  
pp. 69-74 ◽  
Author(s):  
Frank Häßler ◽  
Olaf Reis ◽  
Steffen Weirich ◽  
Jacqueline Höppner ◽  
Birgit Pohl ◽  
...  
Keyword(s):  
Case Report ◽  
Treatment Response ◽  
Electroconvulsive Therapy ◽  
Rating Scale ◽  
Combined Treatment ◽  
Adolescent Patient

This article presents a case of a 14-year-old female twin with schizophrenia who developed severe catatonia following treatment with olanzapine. Under a combined treatment with amantadine, electroconvulsive therapy (ECT), and (currently) ziprasidone alone she improved markedly. Severity and course of catatonia including treatment response were evaluated with the Bush-Francis Catatonia Rating Scale (BFCRS). This case report emphasizes the benefit of ECT in the treatment of catatonic symptoms in an adolescent patient with schizophrenic illness.

Initial evaluation of the effectiveness of individual and group plus individual (combined) treatment

2013 ◽  
Author(s):  
Halley J. Brown ◽  
Lois A. Huebner ◽  
Zac E. Imel ◽  
Alexandra R. Kelly ◽  
Elizabeth Duszak ◽  
...  
Keyword(s):  
Combined Treatment ◽  
Initial Evaluation

Combined Treatment of Craniopharyngiomas

2016 ◽  
Vol 77 (S 02) ◽  
Author(s):  
Maxim Kutin ◽  
Alexandr Konovalov ◽  
Pavel Kalinin ◽  
Dmitry Fomichev ◽  
B. Kadashev ◽  
...  
Keyword(s):  
Combined Treatment

Management of Haemophilia A with Antibodies - The Effect of Combined Treatment with Factor VIII, Hydrocortisone and Cyclophosphamide

1985 ◽  
Vol 54 (04) ◽  
pp. 776-779 ◽  
Author(s):  
U Hedner ◽  
L Tengborn
Keyword(s):  
Factor Viii ◽  
Combined Treatment ◽  
Factor Ix ◽  
Treatment Schedule ◽  
High Antibody ◽  
Anamnestic Response ◽  
Short Intervals ◽  
Low Responders ◽  
Antibody Levels ◽  
High Responders

SummaryImmune tolerance has by several methods been induced in haemophiliacs with antibodies. A conversion of “high responders” into “low responders” was previously reported after repeated moderate factor IX doses over periods of 7-10 days in combination with cyclophosphamide and steroids in two patients with haemophilia B and inhibitors. This paper reports similar results in a heamophilia A patient by giving factor VIII, cyclophosphamide, and steroids during relatively short periods of time (7-8 days). The anamnestic response markedly decreased already following the first treatment and never exceeded a level of 1 u/ml (˜ 3 BU/ml) even when boosted with ordinary factor VIII doses for only 3 days. It is concluded that the markedly decreased secondary antibody response is most probably the result of factor VIII given at short intervals (twice a day) for periods of up to about one week when given in combination with cyclophosphamide and steroids. The same effect may be achieved by other methods. The treatment schedule suggested in the present paper is, however, simple and avoids long periods of high antibody levels. Furthermore, the total factor VIII dose used is lower than suggested in most other treatment schedules, which makes the treatment substantially less expensive.

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