scholarly journals Coronary Procedures by Left vs. Right Transradial Approach in Bangladeshi Diabetic Population

2016 ◽  
Vol 11 (1) ◽  
pp. 26-29
Author(s):  
Saidur Rahman Khan ◽  
CM Shaheen Kabir
Keyword(s):  
Randomized Study ◽  
Diabetic Patients ◽  
Radial Approach ◽  
Diffuse Disease ◽  
Guide Catheter ◽  
Contrast Volume ◽  
Single Operator ◽  
Diabetic Population ◽  
Coronary Procedures ◽  
Diagnostic Catheter

Background: Radial arterial approach is the usual option for coronary procedures in our hospital. Our aim was to evaluate the safety and efficacy of left radial approach (LRA) compared with right radial approach (RRA) for coronary procedures.Methods: This study is a single centre, single operator randomized study. Only diabetic patients more than 18 years old with bilateral normal allen’s test requiring coronary procedures (CAG and PCI) were included in this study. Study period was since January, 2011 to February, 2012. Primary PCI were excluded from this study. The patients were randomized to LRA or RRA arm for coronary procedures. Primary endpoint for diagnostic CAG was contrast volume and fluroscopy time and secondary endpoint was the prevalence of high grade subclavian tortuosity and number of diagnostic catheters used. Size of the conventional guide catheter (5 or 6 F) was compared in both arms irrespective of left or right coronary PCI.Results: Total 512 diabetic patients were enrolled for CAG and equally divided into LRA (256 patients) or RRA (256 patients) arms. Total 290 PCI was performed (145 LRA and 145 RRA). In CAG, LRA arm showed significantly lower fluroscopy time (p = 0.006) and contrast volume (p= 0.005) though more use of double diagnostic catheter (5 F TIG and JR) was present in LRA group. In PCI, RRA arm needed signicantly more 5 F guide catheter (p=0.001). Subclavian tortuosity were more observed in female RRA group.Conclusions: In diabetic population, CAG by left radial approach was superior to right in terms of amount of contrast and fluroscopy time. Subclavian tortuousity was more observed in right and especially more in female. In PCI, 6 F conventional guide catheters were commonly used in both approache though 5 F guide catheter were used more in right radial approach due to extreme subclavian tortuousity and diffuse disease. Dedicated sheathless guide catheter may resolve this issue.University Heart Journal Vol. 11, No. 1, January 2015; 26-29

Reliability of a Single β-Thromboglobulin Measurement in a Diabetic Population : Importance of PGE1 in Anticoagulant Mixture

1987 ◽  
Vol 57 (02) ◽  
pp. 201-204 ◽  
Author(s):  
P Y Scarabin ◽  
L Strain ◽  
C A Ludlam ◽  
J Jones ◽  
E M Kohner
Keyword(s):  
In Vitro Release ◽  
Mean Value ◽  
Reliable Estimate ◽  
Diabetic Patients ◽  
Single Measurement ◽  
Diabetic Population ◽  
The Difference ◽  
Vitro Release

SummaryDuring the collection of samples for plasma β-thromboglobulin (β-TG) determination, it is well established that artificially high values can be observed due to in-vitro release. To estimate the reliability of a single β-TG measurement, blood samples were collected simultaneously from both arms on two separate occasions in 56 diabetic patients selected for a clinical trial. From each arm, blood was taken into two tubes containing an anticoagulant mixture with (tube A) and without (tube B) PGE!. The overall mean value of B-TG in tube B was 1.14 times higher than in tube A (p <0.01). The markedly large between-arms variation accounted for the most part of within-subject variation in both tubes and was significantly greater in tube B than in tube A. Based on the difference between B-TG values from both arms, the number of subjects with artifically high B-TG values was significantly higher in tube B than in tube A on each occasion (overall rate: 28% and 14% respectively). Estimate of between-occasions variation showed that B-TG levels were relatively stable for each subject between two occasions in each tube. It is concluded that the use of PGEi decreases falsely high B-TG levels, but a single measurement of B-TG does not provide a reliable estimate of the true B-TG value in vivo.

scholarly journals Impact of percutaneous invasive coronary procedures using a radial approach on endothelial function of radial artery

2018 ◽  
Vol 14 (1) ◽  
pp. 95-98 ◽  
Author(s):  
Karol Sabatowski ◽  
Michał Szotek ◽  
Krzysztof Węgrzyn ◽  
Tomasz Tokarek ◽  
Zbigniew Siudak ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Radial Artery ◽  
Radial Approach ◽  
Coronary Procedures

Adjuvant Supplementation with L-Carnitine in Diabetic Population and its effects on Lipid Parameters

2021 ◽  
Vol 15 (8) ◽  
pp. 2017-2019
Author(s):  
Rao Salman Aziz ◽  
Usman Saeed ◽  
Nasim Aslam Ghumman ◽  
Muhammad Arshad ◽  
Asif Sohail ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Triglyceride Level ◽  
Clinical Care ◽  
Diabetic Patients ◽  
Healthy Population ◽  
Patients With Diabetes ◽  
Diabetic Population ◽  
Large Discount ◽  
The Impact ◽  
Lipid Parameters

Background: Diabetes is a complicated disease requires continuous clinical care, to govern blood sugar. Aim: To decides the impact of management of L carentin to diabetics at the lipid profile. Methods: This study turned into performed on 120 diabetic Patients had been decided on from endocrinology and diabetes, inside decided on standards. The Patients distributed into three Strata (1st Strata of healthy population and two Strata of patients with diabetes who were on metformin and glibenclamide, one Strata took a L carnitine in a dose of 1000 mg TDS and a Strata dealing with a placebo for a period of ninety days). Results: It is observed those who are on Lcarnitine, confirmed a large discount (p <0.05) with inside the triglyceride level, at the same time as no large adjustments had been located withinside the level of cholesterol and HDL and LDL. Conclusion: These study outcomes that management of L carentin improved profile of lipid in type-2diabetic Patients. Keyword: Dyslipidemia, Diabetes mellitus (DM), l-carnitine (LC).

CORRELATION BETWEEN SERUM MAGNESIUM AND LIPID PROFILE IN DIABETIC PATIENTS AND ITS ASSOCIATION WITH COMPLICATIONS.

2021 ◽  
pp. 14-18
Author(s):  
Pankaj Kumar Singh ◽  
Dhaval Kumar Bhadja ◽  
Mohit Bhatnagar ◽  
Mandeep Joshi ◽  
Shreya Verma
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Total Cholesterol ◽  
Diabetic Complications ◽  
Serum Magnesium ◽  
Diabetic Patients ◽  
Diabetic Population ◽  
Inpatient Department

Background and aim: The present study was conducted to evaluate serum Magnesium and lipid prole in diabetic patients and to nd out any correlation between serum magnesium and lipid prole in diabetic patients and its association with complications. Material and Methods: In the present study, 70 diagnosed Type 2 diabetes mellitus patients aged >30 years attending Diabetic Outpatient and Inpatient Department at Vivekananda Polyclinic giving their consent for inclusion were considered to be included in the study as Cases. Results:In present the study, mean S. magnesium levels of patients with diabetic complications were found to be signicantly lower (1.09±0.22 mg/dl) as compared to that of patients in whom no diabetic complications were seen (2.19±0.71) and this difference was signicant statistically.Conclusions: In the diabetic population correlations of serum magnesium and Total cholesterol, triglyceride, LDL and VLDL were Mild while HDL was of moderate level. Among controls correlations of Serum Magnesium with Total cholesterol, triglyceride, LDL, VLDL, and HDL were found to be weak and not found to be statistically signicant.

Abstract P338: Incidence, Predictors and Impact of Infarct in New Territory in Escape Na1 Trial

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Nishita Singh ◽  
Martha Marko ◽  
Petra Cimflova ◽  
Johanna Ospel ◽  
Nima Kashani ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Endovascular Therapy ◽  
Randomized Study ◽  
Maximum Diameter ◽  
Vascular Territory ◽  
Poor Clinical Outcome ◽  
Guide Catheter ◽  
Ct And Mri

Introduction: Infarct in new territory (INT) is a known complication of endovascular therapy. We assessed the prevalence, predictors and clinical relevance of INT Methods: We included patients from the ESCAPE-NA1: a multicenter, international randomized study that assessed the efficacy of intravenous nerinetide in patients with acute ischemic stroke who underwent EVT within 12 hours from onset. All imaging was re-evaluated, and INT was defined by presence of infarct in new vascular territory, outside the baseline target occlusion(s) on follow up CT and MRI. INT’s were classified by maximum diameter (<2mm, 2-20mm and >20mm) and location. Results: Of 1099 analyzed patients in ESCAPE NA1, 107 had INT (9.7%, mean age 67 years, 51.4% females). There were no differences at baseline in those with vs without INT. Most INTs (75.7%) were angiographically occult and 41(38.3%) were > 20mm. The most common INT territory was the ACA alone or in combination with MCA/PCA (30.3%). The presence of emboli in new territory angiographically was significantly associated with INT (OR 16.39, 95%CI 8.14-33.09). Alteplase use, balloon guide catheter use, nerinetide and initial occlusion site did not predict INT. INT patients had higher final median infarct volumes compared to non-INT (44.5cc vs 23.3cc, P<0.001). Large INT (diameter of >20mm) were associated with poor clinical outcome compared to INT (<2mm) OR (mRS 0-2) 0.17, 95%CI 0.05-0.55). Conclusion: Infarcts in new territory are common and are associated with poor outcome.

Abstract 13485: Prevalence and Treatment of “Balloon Uncrossable” Coronary Chronic Total Occlusions

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Siddharth Patel ◽  
Nagendra Pokala ◽  
Rohan Menon ◽  
Anna Kotsia ◽  
Vijay Raja ◽  
...  
Keyword(s):  
Coronary Intervention ◽  
The Other ◽  
Technical Failure ◽  
Procedure Time ◽  
Common Cause ◽  
Chronic Total Occlusions ◽  
Guide Catheter ◽  
Contrast Volume ◽  
Percutaneous Coronary ◽  
Similar Incidence

Background: In percutaneous coronary intervention (PCI) of coronary chronic total occlusions (CTOs), inability to cross the lesion with a balloon is the second most common cause of technical failure following inability to cross the lesion with a guidewire. While various techniques have been reported for such "balloon uncrossable" CTOs, the frequency and outcomes of these techniques have received limited study. Methods: We retrospectively examined 373 consecutive CTO PCIs performed at our institution between 2005 and 2013 to determine the frequency and outcomes of “balloon uncrossable” CTOs. Results: Mean age was 63.7 ± 8.3 years and 98.9% of the patients were men. Twenty four patients (6.4%) were found to have a "balloon uncrossable" CTO. These patients had similar clinical and angiographic characteristics compared to the other CTO PCI patients (Table). Successful crossing of the lesion was achieved in 22 of 24 patients (91.7%) using a variety of techniques, such as successive balloon inflations (43.5%), microcatheter advancement (21.7%), laser (8.7%), increased guide catheter support (13.0%), and subintimal lesion crossing (13.0%) (Figure). Patients with “balloon uncrossable” CTOs had longer procedure time (184.5 ± 77.9 vs. 134.0 ± 69.0 min, p<0.01), fluoroscopy time (55.2 ± 24.9 vs. 37.9 ± 20.8 min, p<0.01), and received higher contrast volume (404.4 ± 137.9 vs. 351.7 ± 138.5 ml, p=0.085), but had similar incidence of major complications (8.3% vs. 3.2%, p=0.25) compared to patients without “balloon uncrossable” CTOs. Conclusion: “Balloon uncrossable” CTOs occur in 6.4% of contemporary CTO PCIs and can be successfully treated in most patients using a variety of techniques.

scholarly journals EFFECT OF GLYCAEMIC CONTROL ON PITUITARY GONADOTROPHINS OF TYPE 2 DIABETIC SUBJECTS IN ENUGU, NIGERIA

2018 ◽  
Vol 6 (8) ◽  
pp. 16-24
Author(s):  
Maduka Ignatius C ◽  
Nnamdi Ngozika A
Keyword(s):  
Glycaemic Control ◽  
Diabetic Patients ◽  
Male Population ◽  
Female Population ◽  
Control Subjects ◽  
Good Glycaemic Control ◽  
Diabetic Population ◽  
Control Evaluation ◽  
Group B ◽  
The Impact

Glycation is considered to be the main molecular basis of several diabetic complications. Association between chronic hyperglycaemia and the development of long-term diabetic-specific complications have been reported but are yet to be completely understood. In this study, the effect of glycaemic control on pituitary gonadotrophins (FSH and LH) was evaluated in male and female diabetics in Enugu, Nigeria. Two hundred and twenty four (240) diabetic patients (92 males and 148 females) within the age range of 31 – 73 years, who were receiving treatment, were randomly recruited for the study. One hundred and thirty four (134) age- and sex-matched apparently healthy volunteers (44 males and 90 females) were recruited as the control subjects. The study subjects were grouped into three categories: Male population (40-72 years), Group A Female population (<50 years) and Group B Female population (≥50 years). The impact of glycaemic control on various parameters was evaluated by classifying the diabetic patients into 3 subgroups on the basis of their HbA1c levels:  Good (HbA1c < 7%), Fair (HbA1c 7 to 8%) and (Poor HbA1c > 8 %) glycaemic status. Fasting blood sugar, HbA1c, FSH and LH were determined for all the subjects. The results obtained revealed that the male diabetics had significantly lower (p<0.05) FSH levels when compared with the control subjects. In the two groups of female diabetic subjects, the FSH levels were significantly lower (p<0.05) when compared with their respective control subjects. The glycaemic control evaluation and correlation of HbA1c with the gonadotrophins in the male diabetic population show no statistically significant results. However, in the female diabetic population, subjects with poor glycaemic status show significantly increased (p<0.001) LH levels compared to those with good glycaemic control. In addition, in group B female diabetic population, HbA1c gave significant positive correlation with both FSH (r=0.261, p=0.014) and LH (r = 0.338, p<0.001). This suggests that there is a direct relationship between HbA1c and the gonadotrophic hormones. As glycaemic control is compromised, these hormones tend to increase. This study generally reveals increasing trend in the levels of the gonadotrophins across the different glycaemic status. It can be concluded that good glycaemic control of diabetes can exert better influences on pituitary gonadotrophins.

Abstract 1122‐000229: Simultaneous Transarterial‐Transvenous Contrast Injection to Reveal Connection Point for Treatment of Carotid Cavernous Fistula

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Chintan Rupareliya ◽  
Justin F Fraser ◽  
Lila Sheikhi
Keyword(s):  
High Pressure ◽  
Cavernous Sinus ◽  
Femoral Vein ◽  
Academic Medical Center ◽  
Arterial System ◽  
Arterial Phase ◽  
Contrast Injection ◽  
Vein Access ◽  
Guide Catheter ◽  
Diagnostic Catheter

Introduction : Cavernous sinus (CS) via inferior petrosal sinus (IPS) access can present a challenge in the treatment of carotid‐cavernous fistulas (CCF) due to anatomical variations, tortuosity, and/or difficult visualization of IPS given high retrograde flow through the fistulous connection. Methods : A 58‐year‐old male was referred to our academic medical center for three weeks of right eye pain, now complicated by redness, diplopia and blurry vision. Magnetic Resonance Imaging (MRI) brain at the outside hospital revealed hemorrhagic lesion in right parietotemporal region. Computerized tomography‐angiogram (CTA) of the head revealed filling of cavernous sinus during an arterial phase suspicious for CCF. Under general anesthesia, after accessing right common femoral artery, 4 French (F) cook catheter (Cook Medical LLC, Bloomington, IN) was advanced over 0.035 angled glide wire to the proximal right internal carotid artery. Contrast injected through the ICA showed the CS but not the IPS (Fig. 1A). Through the left common femoral vein, access was obtained using an Infinity guide catheter (Stryker Neurovascular, Fremont, CA) and Catalyst 5 (Stryker Neurovascular, Fremont, CA) distal access catheter. A Synchro 2 soft microwire (Stryker Neurovascular, Fremont, CA) was advanced through Echelon 10 (Medtronic, Minneapolis, MN) microcatheter. The venous guide catheter was advanced into right internal jugular vein (IJV) and the distal access catheter was placed into sigmoid jugular junction. Injection of contrast revealed the IPS, but not the CS (Fig. 1B). A subsequent simultaneous hand injection with the microcatheter within the IPS and the diagnostic catheter in the left ICA elucidated the venous‐venous connection (Fig. 1C,) allowing for subsequent navigation and complete treatment of the fistula through IPS using target coils (Fig. 1D). Results : Given the arterial system is a high‐pressure system and the usual direction of flow of contrast would be from the high‐pressure ICA to the low‐pressure CS, injecting a simultaneous contrast bolus from the venous end would oppose the arterial contrast flow. As a result, the fistulous connection that was previously obscured became visible allowing roadmap imaging guiding navigation into the CS. Conclusions : Use of simultaneous trans‐arterial/trans‐venous contrast injection is relatively simple compared to other reported techniques to reveal an obscure connection point. It also shortens the duration of endovascular tools in the bloodstream and thus, reduces the potential complication rate. Further use of this technique on larger study samples is important to validate its general use.

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