scholarly journals Endovascular aortic repair reduces gluteal oxygenation

2019 ◽  
Vol 8 (5) ◽  
pp. 205846011985011
Author(s):  
Mikkel Taudorf ◽  
Michael B Nielsen ◽  
Torben V Schroeder ◽  
Lars Lönn ◽  
Henning B Nielsen
Keyword(s):  
Medical Records ◽  
Near Infrared ◽  
Endovascular Aortic Repair ◽  
Muscle Oxygenation ◽  
Ambulatory Setting ◽  
Hypogastric Artery ◽  
Gluteal Muscle ◽  
Aortic Repair ◽  
Before And After ◽  
Observational Study Design

Background Provoked gluteal claudication is a known risk after endovascular aortic repair (EVAR). Lowered gluteal muscle oxygenation (SgmO2) may be demonstrated by near-infrared spectroscopy (NIRS). Purpose To evaluate NIRS-determined SgmO2 in EVAR patients. Material and Methods NIRS-determined SgmO2 was used in an observational study design (n = 17). From the ambulatory setting, seven EVAR patients were included with reported gluteal claudication from medical records. In 10 patients scheduled for EVAR, SgmO2 was measured before and after the procedure. NIRS sensors were applied bilaterally on the gluteal region. Treadmill walking (12% incline, 2.4 km/h) was introduced to stress gluteal muscles. Results A reduced SgmO2 with regional side difference ( P < 0.05) was noted in all 10 patients following EVAR and four reported gluteal claudication. In patients with gluteal claudication (n = 7), treadmill decreased SgmO2. The time to recover the SgmO2 was prolonged for tissue exposed to occluded hypogastric artery (median = 512 s, range = 73–1207 s vs. median = 137, range = 0–643 s; P = 0.046). Conclusions EVAR affects gluteal muscle oxygenation. NIRS could be used to assess whether gluteal claudication is related to lowered SgmO2.

Hypogastric Artery Stenting for Chronic Intermittent Spinal Cord Ischemia After Thoracic Endovascular Aortic Repair

2020 ◽  
Vol 27 (5) ◽  
pp. 801-804
Author(s):  
Catharina Gronert ◽  
Nikolaos Tsilimparis ◽  
Giuseppe Panuccio ◽  
Ahmed Eleshra ◽  
Fiona Rohlffs ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Ischemia ◽  
Thoracic Endovascular Aortic Repair ◽  
Neurological Symptoms ◽  
Endovascular Aortic Repair ◽  
Hypogastric Artery ◽  
Lower Extremity Weakness ◽  
Aortic Repair ◽  
The Right

Purpose: To report a case of chronic intermittent spinal cord ischemia (SCI) after thoracic endovascular aortic repair (TEVAR) and its successful treatment using hypogastric artery stenting. Case Report: A 79-year-old patient presented in May 2013 with a thoracic aortic aneurysm (TAA) and a contained rupture. He urgently underwent TEVAR that covered 274 mm of descending thoracic aorta without immediate postoperative signs of acute SCI. At 3-month follow-up, he reported repeating incidents of sudden lower extremity weakness leading to a fall with a humerus fracture. A neurological consultation revealed the tentative diagnosis of intermittent SCI caused by TEVAR and initially recommended a conservative approach. During the following year there was no clinical improvement of the symptoms. Computed tomography angiography showed a high-grade stenosis of the right hypogastric artery, which was stented in November 2014 to improve the collateral network of spinal cord perfusion. Following treatment, the patient had no further neurological symptoms; at 32 months after the reintervention, the imaging follow-up documented a patent stent and continued exclusion of the TAA. Conclusion: Intermittent neurological symptoms after TEVAR should be suspected as chronic intermittent SCI. The improvement of collateral networks of the spinal cord by revascularization of the hypogastric artery is a viable treatment option.

Comparison between maximal lengthening and shortening contractions for biceps brachii muscle oxygenation and hemodynamics

2010 ◽  
Vol 109 (3) ◽  
pp. 710-720 ◽  
Author(s):  
Makii Muthalib ◽  
Hoseong Lee ◽  
Guillaume Y. Millet ◽  
Marco Ferrari ◽  
Kazunori Nosaka
Keyword(s):  
Muscle Damage ◽  
Near Infrared ◽  
Biceps Brachii ◽  
Oxygenation Index ◽  
Creatine Kinase Activity ◽  
Muscle Oxygenation ◽  
Biceps Brachii Muscle ◽  
Before And After ◽  
Tissue Oxygenation Index ◽  
Systemic Oxygen

Eccentric contractions (ECC) require lower systemic oxygen (O2) and induce greater symptoms of muscle damage than concentric contractions (CON); however, it is not known if local muscle oxygenation is lower in ECC than CON during and following exercise. This study compared between ECC and CON for changes in biceps brachii muscle oxygenation [tissue oxygenation index (TOI)] and hemodynamics [total hemoglobin volume (tHb) = oxygenated-Hb + deoxygenated-Hb], determined by near-infrared spectroscopy over 10 sets of 6 maximal contractions of the elbow flexors of 10 healthy subjects. This study also compared between ECC and CON for changes in TOI and tHb during a 10-s sustained and 30-repeated maximal isometric contraction (MVC) task measured immediately before and after and 1–3 days following exercise. The torque integral during ECC was greater ( P < 0.05) than that during CON by ∼30%, and the decrease in TOI was smaller ( P < 0.05) by ∼50% during ECC than CON. Increases in tHb during the relaxation phases were smaller ( P < 0.05) by ∼100% for ECC than CON; however, the decreases in tHb during the contraction phases were not significantly different between sessions. These results suggest that ECC utilizes a lower muscle O2 relative to O2 supply compared with CON. Following exercise, greater ( P < 0.05) decreases in MVC strength and increases in plasma creatine kinase activity and muscle soreness were evident 1–3 days after ECC than CON. Torque integral, TOI, and tHb during the sustained and repeated MVC tasks decreased ( P < 0.01) only after ECC, suggesting that muscle O2 demand relative to O2 supply during the isometric tasks was decreased after ECC. This could mainly be due to a lower maximal muscle mass activated as a consequence of muscle damage; however, an increase in O2 supply due to microcirculation dysfunction and/or inflammatory vasodilatory responses after ECC is recognized.

Comparison of Fluid Dynamics Variations Between Chimney and Fenestrated Endografts for Pararenal Aneurysms Repair: A Patient Specific Computational Study as Motivation for Clinical Decision-Making

2019 ◽  
Vol 53 (7) ◽  
pp. 572-582 ◽  
Author(s):  
Konstantinos G. Moulakakis ◽  
John Kakisis ◽  
Eleni Gonidaki ◽  
Andreas M. Lazaris ◽  
Sokrates Tsangaris ◽  
...  
Keyword(s):  
Endovascular Repair ◽  
Clinical Decision Making ◽  
Computational Study ◽  
Fluid Dynamic ◽  
Renal Arteries ◽  
Aortic Aneurysms ◽  
Endovascular Aortic Repair ◽  
Patient Specific ◽  
Aortic Repair ◽  
Before And After

Background-Aim: Limited data exist concerning the fluid dynamic changes induced by endovascular aortic repair with fenestrated and chimney graft modalities in pararenal aneurysms. We aimed to investigate and compare the wall shear stress (WSS) and flow dynamics for the branch vessels before and after endovascular aortic repair with fenestrated and chimney techniques. Methods: Modeling was done for patient specific pararenal aortic aneurysms employing fenestrated and chimney grafts (Materialise Mimics 10.0) before and after the endovascular procedure, using computed tomography scans of patients. Surface and spatial grids were created using the ANSYS CFD meshing software 2019 R2. Assessment of blood flow, streamlines, and WSS before and after aneurysm repair was performed. Results: The endovascular repair with chimney grafts leaded to a 43% to 53% reduction in perfusion in renal arteries. In fenestrated reconstruction, we observed a 15% reduced perfusion in both renal arteries. In both cases, we observed a decrease in the recirculation phenomena of the aorta after endovascular repair. Concerning the grafts of the renal arteries, we observed in both the transverse and longitudinal axes low WSS regions with simultaneous recirculation of the flow 1 cm distal to the ostium sites in both aortic graft models. High WSS regions appeared in the sites of ostium. Conclusions: We observed reduced renal perfusion in chimney grafts compared to fenestrated grafts, probably caused by the long and kinked characteristics of these devices.

Association between ACE Gene I/D Polymorphism of Men of Han Nationality in Northern China and the Effects of HiHiLo on Muscle Oxygenation

2012 ◽  
Vol 518-523 ◽  
pp. 5573-5577
Author(s):  
Duo Qi Zhou ◽  
Yang Hu ◽  
Dong Mei Luo ◽  
Yan Chun Li ◽  
Long Yan Yi
Keyword(s):  
Near Infrared ◽  
Northern China ◽  
Training Programme ◽  
Muscle Oxygenation ◽  
Ace Gene ◽  
Non Invasive ◽  
Han Nationality ◽  
Hypoxic Training ◽  
Hypoxic Environment ◽  
Before And After

To explore the association between Insertion/Deletion polymorphism of the angiotensin converting enzyme (ACE) gene and the effects of Living High-Exercise High-Training Low (HiHiLo) on muscle oxygenation (MO), Seventy-one healthy men of Han nationality in northern China underwent HiHiLo training for 4 weeks. Training programme was as follows: exposure in hypoxic environment (14.5%~14.8%O2, 10h/day), three times hypoxic training per week (15.4%O2), and training at sea level. Resting MO, exercising MO and resuming MO were measured by non-invasive near infrared spectroscopy (NIRS) before and after the protocol, and the ACE gene I/D polymorphism was detected by PCR. The findings indicated that exercising MO and resuming MO all increased markedly after training (P< 0.05), but resting MO declined. As to genotypes, no significant differences were in the baseline MO among groups before HiHiLo. Increase in resting MO and exercising MO in II and ID groups were more than those in DD groups, but decline in resuming MO in II and ID groups was less than those in DD groups.The present study suggested that HiHiLo could be helpful for developing individual resting MO and exercising MO, but harmful for resuming MO. Moreover, MO of men carrying II and ID probably were more sensitive to the hypoxic training than those carrying DD.

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