Possibilities of optimization of pregnancy preparation in the presence of conditions accompanied by endothelial dysfunction

The implementation of the reproductive function is one of the main components of women’s quality of life. Despite significant progress in the treatment of infertility and prevention of reproductive losses, these problems are still relevant. It is also important to timely diagnose various pathological processes in order to determine the tactics of preparing women for pregnancy and its further management, taking into account the pathogenetic characteristics of diseases. Various attempts have been made to optimize both diagnostic and therapeutic approaches. Special attention is paid to identifying risk groups and ensuring the most effective preparation for pregnancy, taking into account possible risk factors for adverse outcomes. Adequate diagnostics of background pathology and the use of proven effective methods of pregravid preparation can significantly improve pregnancy outcomes. Peculiarities of the vascular system functioning may affect both the life of the woman in general and the outcome of pregnancy. Endothelial dysfunction is a component of pathogenesis of many nosologies (diabetes mellitus, chronic venous disease, hypertension, autoimmune pathology, etc.). Restoration of vascular endothelial dysfunction and, as a consequence, prevention of probable vascular complications is one of the new goals in the preventive approach to pregnancy. The promising center of this approach is considered to be the drug sulodexide. The three main effects of this drug – antithrombotic, anti-inflammatory and defensive in relation to endothelium – provide a significant increase in pregnancy preparation possibilities in many nosologies. This review presents its main features and areas of use.

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3D modeling of the vascular system

Journal of Theoretical and Applied Vascular Research ◽

10.24019/jtavr.8 ◽

2016 ◽

Vol 1 (1) ◽

pp. 51-58 ◽

Cited By ~ 1

Author(s):

Jean François Uhl ◽

Maxime Chahim ◽

François Cros ◽

Amina Ouchene ◽

◽

...

Keyword(s):

Augmented Reality ◽

3D Modeling ◽

Vascular System ◽

Arterial System ◽

Chronic Venous Disease ◽

Venous Disease ◽

Software Products ◽

Operative Planning ◽

Morphological Modeling ◽

Pre Treatment

The 3D modeling of the vascular system could be achieved in different ways: In the venous location, the morphological modeling by MSCT venography is used to image the venous system: this morphological modeling tool accurately investigates the 3D morphology of the venous network of our patients with chronic venous disease. It is also a fine educational tool for students who learn venous anatomy, the most complex of the human body. Another kind of modeling (mathematical modeling) is used to simulate the venous functions, and virtually tests the efficacy of any proposed treatments. To image the arterial system, the aim of 3D modeling is to precisely assess and quantify the arterial morphology. The use of augmented reality before an endovascular procedure allows pre-treatment simulation, assisting in pre-operative planning as well as surgical training. In the special field of liver surgery, several 3D modeling software products are available for computer simulations and training purposes and augmented reality.

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The Role of Endothelial Dysfunction and Inflammation in Chronic Venous Disease

Annals of Vascular Surgery ◽

10.1016/j.avsg.2017.06.131 ◽

2018 ◽

Vol 46 ◽

pp. 380-393 ◽

Cited By ~ 39

Author(s):

Ricardo Castro-Ferreira ◽

Rita Cardoso ◽

Adelino Leite-Moreira ◽

Armando Mansilha

Keyword(s):

Endothelial Dysfunction ◽

Chronic Venous Disease ◽

Venous Disease

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Chronic venous disease as a clinical manifestation of tibial osteochondroma

Jornal Vascular Brasileiro ◽

10.1590/s1677-54492013000200013 ◽

2013 ◽

Vol 12 (2) ◽

pp. 163-169

Author(s):

Marcelo Fernandes Lima ◽

Ilidio Almeida Lima ◽

Sergio Luiz Bizerra Oliveira ◽

Vanessa Heinrich Barbosa de Oliveira Lima ◽

Carlos Alexandre de Souza Rocha

Keyword(s):

Lower Limb ◽

Benign Tumor ◽

Vascular Complications ◽

Common Type ◽

Chronic Venous Disease ◽

Long Bone ◽

Venous Disease ◽

Distal Extremity ◽

Pseudoaneurysm Formation ◽

Left Lower Limb

Osteochondromas are the most common type of benign tumor of the skeleton. They most frequently affect the distal extremity of the femur, with the tibia being the second most commonly affected long bone. Vascular complications of these lesions are rare, but pseudoaneurysm formation is the most frequently reported of them. In this case report, we describe a case of compression of the popliteal neurovascular bundle by a tibial osteochondroma in a diabetic patient who had been admitted to hospital to treat an infected lesion on his left foot and complained of edema and paresthesia of the left lower limb.

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Assessment of arterial stiffness in patients with chronic lower extremity venous disease: An observational study

Phlebology The Journal of Venous Disease ◽

10.1177/0268355515591394 ◽

2015 ◽

Vol 31 (5) ◽

pp. 349-355 ◽

Cited By ~ 2

Author(s):

Ahmet Çağrı Aykan ◽

Seda Menteşe ◽

Emre Doğan ◽

İsmail Gökhan Çavuşoğlu ◽

Duygun Altıntaş Aykan ◽

...

Keyword(s):

Arterial Stiffness ◽

Vascular System ◽

Ankle Brachial Index ◽

Density Lipoprotein ◽

Severe Form ◽

Chronic Venous Disease ◽

Major Adverse Cardiovascular Events ◽

Control Group ◽

Venous Disease ◽

Cross Sectional

Objectives Arterial stiffness is associated with major adverse cardiovascular events. Chronic venous insufficiency (CVI) is severe form of chronic venous disease (CVD). The aim of this study is to investigate arterial stiffness by cardio-ankle vascular index (CAVI) in patients with CVI. Methods This observational and cross-sectional study involved 87 subjects with CVI and 86 healthy subjects. All subjects underwent ultrasonography examination. CAVI was measured by VaSera-1000 CAVI instrument. Results High density lipoprotein cholesterol (HDL) was significantly lower in patients with CVI than controls (46.83 ± 9.25 mg/dl vs 51.33 ± 11.13 mg/dl, p = 0.004). Body mass index (BMI) was significantly higher in CVI patients than controls (28.53 ± 4.10 kg/m2 vs 26.37 ± 5.16 kg/m2, p = 0.003). Ankle brachial index (ABI) was significantly lower in patients with CVI compared to controls (1.08 ± 0.08 vs 1.14 ± 0.11, p < 0.001). CAVI was significantly higher in patients with CVI than controls (7.94 ± 1.37 vs 6.73 ± 1.16, p < 0.001). Mean arterial pressure (MAP) was significantly higher in patients with CVI than control group (105.41 ± 10.77 mmHg vs 99.70 ± 11.17 mmHg, p = 0.001). CAVI ( p < 0.001, Odds ratio (OR) = 2.033, 95% Confidence interval (CI) = 1.493–2.768), ABI ( p = 0.003, OR = 0.003, 95% CI = 0.001–0.137), female sex ( p < 0.001, OR = 3.949, 95% CI = 1.613–9.663), and HDL ( p < 0.001, OR = 0.923, 95% CI = 0.883–0.964) were the independent predictors of CVI. A CAVI value > 7.9 had a sensitivity 64.4% and a specificity of 94.7% for predicting the presence of CVI in ROC analysis (area under curve = 0.791, 95% CI = 0.723–0.849, p < 0.001). Conclusion CAVI is independently increased in CVI patients. Therefore CVI may be accepted a form of vascular sclerosis and vascular system should be evaluated in continuum not isolated.

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The Role of Endothelial Dysfunction and Inflammation in Chronic Venous Disease

Journal of Vascular Surgery Venous and Lymphatic Disorders ◽

10.1016/j.jvsv.2018.05.013 ◽

2018 ◽

Vol 6 (4) ◽

pp. 552-553

Author(s):

R. Castro-Ferreira ◽

R. Cardoso ◽

A. Leite-Moreira ◽

A. Mansilha

Keyword(s):

Endothelial Dysfunction ◽

Chronic Venous Disease ◽

Venous Disease

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Vascular complications in diabetes mellitus: the role of endothelial dysfunction

Clinical Science ◽

10.1042/cs20050025 ◽

2005 ◽

Vol 109 (2) ◽

pp. 143-159 ◽

Cited By ~ 396

Author(s):

Casper G. Schalkwijk ◽

Coen D. A. Stehouwer

Keyword(s):

Endothelial Dysfunction ◽

Endothelial Function ◽

Type I Diabetes ◽

Vascular Complications ◽

Adverse Outcomes ◽

Diabetic Microangiopathy ◽

Type I ◽

The Metabolic Syndrome ◽

Complex Organ

The endothelium is a complex organ with a multitude of properties essential for control of vascular functions. Dysfunction of the vascular endothelium is regarded as an important factor in the pathogenesis of diabetic micro- and macro-angiopathy. Endothelial dysfunction in Type I and II diabetes complicated by micro- or macro-albuminuria is generalized in that it affects many aspects of endothelial function and occurs not only in the kidney. The close linkage between microalbuminuria and endothelial dysfunction in diabetes is an attractive explanation for the fact that microalbuminuria is a risk marker for atherothrombosis. In Type I diabetes, endothelial dysfunction precedes and may cause diabetic microangiopathy, but it is not clear whether endothelial dysfunction is a feature of the diabetic state itself. In Type II diabetes, endothelial function is impaired from the onset of the disease and is strongly related to adverse outcomes. It is not clear whether impaired endothelial function is caused by hyperglycaemia or by other factors. Impaired endothelial function is closely associated with and may contribute to insulin resistance regardless of the presence of diabetes. Endothelial dysfunction in diabetes originates from three main sources. Hyperglycaemia and its immediate biochemical sequelae directly alter endothelial function or influence endothelial cell functioning indirectly by the synthesis of growth factors, cytokines and vasoactive agents in other cells. Finally, the components of the metabolic syndrome can impair endothelial function.

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Duffy antigen / receptor for chemokines correlates with inflammatory reaction in rats with venous hypertension: implication for the pathogenesis of primary chronic venous disease

VASA ◽

10.1024/0301-1526/a000327 ◽

2014 ◽

Vol 43 (1) ◽

pp. 47-54 ◽

Cited By ~ 1

Author(s):

Weibin Huang ◽

Weiwei Qin ◽

Lei Lv ◽

Haoyv Deng ◽

Hao Zhang ◽

...

Keyword(s):

Mononuclear Cells ◽

Early Stage ◽

Antigen Receptor ◽

Venous Hypertension ◽

Skin Tissue ◽

Chronic Venous Disease ◽

Venous Disease ◽

Dependent Manner ◽

Time Points ◽

Duffy Antigen

Background: Duffy antigen / receptor for chemokines (DARC) possesses high affinity for several chemokine subgroups of CC and CXC. Although DARC has been shown to play a role in many inflammatory diseases, its effect on chronic venous disease (CVD) remains unidentified. We explored whether the expression of DARC in skin tissue was activated under venous hypertension as well as the relationships between DARC and inflammation. Materials and methods: The inflammation in a rat model of venous hypertension caused by a femoral arterial-venous fistula (AVF) was studied. At specified intervals the pressure in the femoral veins was recorded within 42 days. Hindlimb skin specimens were harvested at different time points. The expressions of DARC, interleukin-8 (IL-8), and monocyte chemotactic protein-1 (MCP-1) in skin tissue were examined. Mononuclear cells infiltrated in skin tissue were detected. Results: Femoral venous pressures in AVF groups increased significantly at different time points (P < 0.01). DARC was expressed in skin tissue and its expression level increased significantly in AVF groups from the 7nd day on and was enhanced in a time-dependent manner within 42 days (P < 0.05). Meanwhile, both MCP-1 and IL-8 had higher levels, accompanied by increased mononuclear cells infiltrating into skin tissue (P < 0.05). Conclusions: A rat AVF model which can maintain venous hypertension for at least 42 days is competent for researching the pathogenesis of CVD. DARC, which plays a role in the inflammation of skin tissue under venous hypertension, may become a new molecular target for diagnosis and treatment of CVD at a very early stage.

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