The UC San Diego Pulmonary Thromboendarterectomy Program, located in San Diego, California, is recognized worldwide as a pioneer in performing pulmonary thromboendarterectomy, or PTE.
Chronic thromboembolic pulmonary hypertension (CTEPH) is caused by unresolved thromboemboli in the pulmonary arteries, which lead to pulmonary hypertension and, left untreated, right heart failure. This disease can be potentially cured by performing a pulmonary thromboendarterectomy (PTE) to remove the blood clots. The surgery is not without risk and the most worrisome complication is the development of a form of acute lung injury called reperfusion lung injury, which occurs in about 40 percent of patients.. The landmark publication of the ARDSNET study demonstrated that a low tidal volume strategy of mechanical ventilation, decreased morbidity and mortality in patients who had acute respiratory distress syndrome (ARDS). Since then there have been some studies examining the role of a low tidal volume strategy in all patients who are mechanically ventilated. Some studies have demonstrated a decreased incidence of acute lung injury while others have failed to do the same. In patients at high risk ...
Chronic thromboembolic pulmonary hypertension (CTEPH) is a potentially curable condition [1]. The current treatment of choice for CTEPH is pulmonary endarterectomy (PEA) in patients who are considered candidates for surgical therapy. However, some CTEPH patients have thrombotic disease that affects the distal segmental pulmonary artery branches, while others have major medical co-morbidities which make them less than optimal candidates for surgical PEA. So, what are the alternatives when there is an inadequate response to medical therapy with pulmonary vasodilating agents such as Riociguat? Angioplasty has been performed in most vascular beds with excellent results since Dr. Andreas Gruentzig paved the way for balloon angioplasty. However, experience with angioplasty in the pulmonary vasculature has been mostly limited to pediatric patients with congenital pulmonary artery stenosis.. A group from Boston had explored the possibility of performing pulmonary angioplasty to treat patients with CTEPH ...
A 62-year-old male patient was admitted to the cardiology clinic with chest pain. Previously, there was a history of eight coronary stent interventions in four separate sessions, and after coronary angiography, multivessel disease was detected and referred to us for coronary artery bypass grafting (CABG) surgery. After the necessary preparations, 4 x CABG was applied with LIMA-LAD, Ao-D1, Ao-CxOM2, Ao-RCA body on December 28, 2020. Endarterectomy was applied to the patients left anterior descending artery and right coronary artery vessels before bypass grafting. Right coronary artery was opened prior to crux and endarterectomy was performed. During the procedure, the 5 cm stent material was successfully removed together with the endarterectomy plaque by patting it proximally. The patient was discharged after a stable intensive care and service period.. ...
Background Chronic thromboembolic pulmonary hypertension is surgically curable by pulmonary endarterectomy (PEA). It is unclear whether PEA impacts primarily steady state right ventricular afterload (ie, pulmonary vascular resistance (PVR)) or pulsatile right ventricular afterload (ie, pulmonary arterial compliance (CPA)). Our objectives were to (1) quantify PEA specimens and measure the impact of PEA on PVR and CPA in a structure/function study and (2) analyse the effects of haemodynamic changes on long-term survival/freedom of lung transplantation in an outcome study.. ...
Rationale: The clinical severity of right ventricular disease is largely determined by right-to-left ventricular dyssynchrony, i.e., delay of electrical activity between the right and left ventricles. Moreover, in patients with chronic thromboembolic pulmonary hypertension (CTEPH), we found that acute correction of this dyssynchrony by temporary pacing (prior to pulmonary endarterectomy, presently the therapy of choice for CTEPH) results in significant improvement in cardiac output. In this study, we aim to establish whether chronic pacing with the use of implanted pacemakers confers long-lasting improvements in cardiac output and functional class.. Objective: To study whether chronic pacing with implanted pacemakers confers long-lasting improvements in cardiac output and functional class in severely symptomatic CTEPH patients who are not eligible for pulmonary endarterectomy, or those in whom pulmonary endarterectomy has failed.. Study design: Chronic intervention study, double-blinded, ...
Dr. Matthew Bacchetta is an Associate Professor of Surgery in the Division of Cardio-thoracic Surgery and the Surgical Director of the Pulmonary Hypertension Comprehensive Care Center of CUMC-NYP. He earned his MD from the Weill Medical College of Cornell University where he also did his general surgical training. Following completion of his Thoracic Surgery Fellowship at Columbia, he was appointed to the Thoracic Surgery faculty at NYP/CUMC. He is also the Surgical Director of the Adult Extracorporeal Membrane Oxygenation Program and the Director of the Pulmonary Thromboendarterectomy Program at NYP/CUMC.. Dr. Bacchettas background in engineering and thoracic surgery has enabled him to become an innovator in the use of mechanical support devices, which can enable patients with pulmonary hypertension to survive through a life-threatening crisis. He is also one of the few skilled surgeons in the US who performs pulmonary thromboendarterectomy for CTEPH (chronic thromboembolic pulmonary ...
article{ kosuyolu_heart_j1465, doi = {10.5578/kkd.3392}, author = {Başar Sareyyüpoğlu, Özgür Yıldırım, Kaan Kırali̇}, title = {Konvansiyonel Çek-Çıkart Yöntemiyle Yapılan Proksimal Koroner Endarterektominin Değişik Sonuçları}, journal = {Koşuyolu Heart J}, year = {2012}, volume = {15}, number = {2}, pages = {090-091}, publisher = {Kartal Koşuyolu High Specialization Training and Research Hospital ...
Pulmonary Endarterectomy is a surgery which allows the removal of clots from the lung. The Department of Cardiothoracic Surgery at National Heart Centre Singapore shares more.
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Carotid artery endarterectomy in the elderly patient has been considered to be a high risk procedure. Recent reevaluation, however, showed that advanced age alone doesnt seem to increase the perioperative surgical risk. We retrospectively reviewed the records for 222 carotid artery endarterectomies, not combined with any other type of surgery, in 195 patients over 70 years-of-age. Twenty-eight patients (14.3%) were asymptomatic, 43% were seen after transient ischemic attacks, 5.1% after reversible ischemic neurologic defects, and 37.4% after stroke. A standard operative protocol was followed. We used a shunt in 45.5% of patients, a standard endarterectomy was performed in 93% of patients, using a patch in 68%. There were three perioperative deaths and seven perioperative strokes in the series; total combined morbidity and mortality was 5.1%. In the 73 patients operated after previous stroke, three died and five suffered a perioperative stroke; total combined morbidity and mortality was 10.9%. ...
Temple University Hospitals Pulmonary Hypertension, Right Heart Failure and Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Program within the Temple Heart and Vascular Institute recently achieved a clinical milestone by performing its 200th pulmonary thromboendarterectomy (PTE) - a complex procedure offered at only a handful of hospitals in the U.S.
Read about the pulmonary thromboendarterectomy surgical procedure performed at UC San Diego and how it can help patients suffering from Chronic Thromboembolic Pulmonary Hypertension (CTEPH).
Treatment of lower limbs atherosclerosis (stage 4) by thromboendarterectomy (costs for program #52221) ✔ Alfried Krupp Hospital in Essen-Ruettenscheid ✔ Department of Vascular Surgery ✔ BookingHealth.com
Learn more about Carotid Artery Endarterectomy at Reston Hospital Center DefinitionReasons for ProcedurePossible ComplicationsWhat to ExpectCall Your Doctorrevision ...
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Background/Aims: Pulmonary endarterectomy (PEA) is the gold standard for treating chronic thromboembolic pulmonary hypertension (CTEPH) in Western countries. The aim of this study was to investigate the long-term outcomes of performing PEA on CTEPH patients in comparison with medical therapy at a si ...
This study showed that selective neuronal damage manifested as a decrease in the BZRs in the non-infarcted cerebral cortex is associated with poor performance on the WCST in the non-disabled patients with unilateral atherosclerotic ICA or MCA disease and no cortical infarction. The BZR index of the ACA territory in the hemisphere affected by arterial disease was significantly higher in WCST-abnormal (low categories achieved for their age) patients than in WCST-normal patients, whereas the BZR index of the MCA territory was significantly different between the two groups when patients with left arterial disease were separately analysed.. This study included ICA and MCA diseases, which may have different impacts on CBF in the ACA territory. Twelve of the 17 studied patients with MCA disease had occlusion of the MCA, in which blood flowing through the ACA is redistributed via the leptomeningeal vessels to compensate for the reduced flow in the MCA, resulting in reduced flow in the ACA territory.30 ...
Patients with chronic pulmonary thromboembolic disease may benefit from pulmonary thromboendarterectomy, even if the patients dont have severe pulmonary hypertension, according to University of California, San Diego, researchers.
Your vascular surgeon makes an incision in the neck and then removes the plaque contained in the inner lining of your carotid artery. This procedure leaves a smooth, wide-open artery ...
INTRODUCTION: Coronary artery endartectomy (CE) has been used to reconstruct non-bypassable vessels supplying viable myocardium. It is associated with increased mortality and morbidity. We hypothesized that coronary territory selection and concomitant patch arterioplasty may improve clinical outcomes.. METHODS: Multivariable regression was performed on all isolated CABG cases from a prospective database (1990 -2007).. RESULTS: At least one CE was performed in 346 (4%) of all 9535 isolated CABG cases (right coronary artery 69%, left coronary artery 28%, both 3%). Concomitant patch arterioplasty was performed in 10%, in similar proportion to the left and right territories. Patient and operative factors were similar in the CE versus non-CE groups, except the former had longer operative times (cross-clamp time 88+27 vs 78+29 minutes; pump time 109+31 vs 97+33 minutes; both p,0.001). More distal anastomoses were performed in the CE cohort (3.4+0.9 vs 3.0+0.9, p,0.001). The CE cohort had higher 30-day ...
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A plaque tack can be used for holding plaque against blood vessel walls such as in treating atherosclerotic occlusive disease. The plaque tack can be formed as a thin, annular band for holding loose plaque under a spring or other expansion force against a blood vessel wall. Focal elevating elements and/or other features, such as anchors, can be used to exert a holding force on a plaque position while minimizing the amount of material surface area in contact with the plaque or blood vessel wall and reducing the potential of friction with the endoluminal surface. This approach offers clinicians the ability to perform a minimally invasive post-angioplasty treatment and produce a stent-like result without using a stent.
​This book provides a guide to the anatomy and surgical techniques required within thoracic and cardiothoracic surgery. The pros and cons of certain surgical procedures are discussed in relation to the lymphatic system, thyroid gland, chest wall, parathyroid glands, and pulmonary endarterectomy.
Wendy Zempel, lives in MN, I was diagnosed in January of 2011 with Pulmonary Hypertension. I had multiple blood clots in my lungs and the queen of clots residing in my right pulmonary artery right off my heart. The thromboendarterectomy was successful in removing it, but I was left with CTEPH. These last 6 years…
Read about a small study finding arterial stiffness to a greater degree in more CETPH patients than in others with an atherosclerosis risk.
慢性肺血栓塞栓性肺高血圧症患者における肺動脈バルーン形成術後の肺障害の主な原因は血管損傷であ ...
Chronic pulmonary thromboembolic disease is an important cause of severe pulmonary hypertension, and as such is associated with significant morbidity and mortality. The prognosis of this condition reflects the degree of associated right ventricular dysfunction, with predictable mortality related to the severity of the underlying pulmonary hypertension.1 In recent years the epidemiology of this condition has been revised considerably. Once considered a rare condition, chronic thromboembolic pulmonary hypertension (CTEPH) was recently documented to complicate 3.8% of acute pulmonary embolic events.2. CTEPH is the only cause of severe pulmonary hypertension which is potentially curable without the need to resort to lung transplantation. Pulmonary endarterectomy (PEA) is the surgical procedure which removes the obstructing thromboembolic material, resulting in significant improvements (and in many cases normalisation) in right ventricular haemodynamics and function. This procedure requires a high ...
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but life-threatening disease resulting from unresolved thromboembolic obstructions. Pulmonary endarterectomy (PEA) surgery is the gold-standard treatment as it is potentially curative; however, not all patients are deemed operable and up to one-third have persistent or recurrent CTEPH after the procedure. Pulmonary arterial hypertension (PAH) and CTEPH have similar clinical presentations and histopathological features, so agents shown to be effective in PAH have often been prescribed to patients with CTEPH in the absence of proven therapies. However, clinical evidence for this strategy is not compelling. A number of small uncontrolled trials have investigated endothelin receptor antagonists, prostacyclin analogues and phosphodiesterase type 5 inhibitors in CTEPH with mixed results, and a phase III study of the endothelin receptor antagonist bosentan met only one of its two co-primary end-points. Recently, however, the soluble ...
BACKGROUND Chronic thromboembolic pulmonary hypertension (CTEPH) is associated with proximal pulmonary artery obstruction and vascular remodeling. We hypothesized that pulmonary arterial smooth muscle (PASMC) and endothelial cells (PAEC) may actively contribute to remodeling of the proximal pulmonary vascular wall in CTEPH. Our present objective was to characterize PASMC and PAEC from large arteries of CTEPH patients and investigate their potential involvement in vascular remodeling. METHODS Primary cultures of proximal PAEC and PASMC from patients with CTEPH, with non-thromboembolic pulmonary hypertension (PH) and lung donors have been established. PAEC and PASMC have been characterized by immunofluorescence using specific markers. Expression of smooth muscle specific markers within the pulmonary vascular wall has been studied by immunofluorescence and Western blotting. Mitogenic activity and migratory capacity of PASMC and PAEC have been investigated in vitro. RESULTS PAEC express CD31 on their
In the 2009 European Guidelines on the diagnosis and treatment of pulmonary hypertension (PH), one section covers aspects of pathophysiology, diagnosis and treatment of chronic thromboembolic pulmonary hypertension (CTEPH). The practical implementation of the guidelines for this disease is of crucia …
Chronic Thromboembolic Pulmonary Hypertension (CTEPH) is a rare and potentially fatal form of elevated blood pressure in the lungs.
TY - JOUR. T1 - Long-Term Outcomes after Percutaneous Transluminal Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension. AU - Inami, Takumi. AU - Kataoka, Masaharu. AU - Yanagisawa, Ryoji. AU - Ishiguro, Haruhisa. AU - Shimura, Nobuhiko. AU - Fukuda, Keiichi. AU - Yoshino, Hideaki. AU - Satoh, Toru. PY - 2016/12/13. Y1 - 2016/12/13. KW - angioplasty. KW - angioplasty, balloon. KW - hypertension, pulmonary. KW - thromboembolism. UR - http://www.scopus.com/inward/record.url?scp=85006052065&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=85006052065&partnerID=8YFLogxK. U2 - 10.1161/CIRCULATIONAHA.116.024201. DO - 10.1161/CIRCULATIONAHA.116.024201. M3 - Letter. C2 - 27956405. AN - SCOPUS:85006052065. VL - 134. SP - 2030. EP - 2032. JO - Circulation. JF - Circulation. SN - 0009-7322. IS - 24. ER - ...
The significant risk of fatal myocardial infarction after carotid endarterectomy in patients with coronary disease long has been recognized. In 1,546 consecutive carotid endarterectomies performed in 1,238 patients over the last 10 years, angina pectoris was present in 17% (212/1,238) of patients; a further 32% (396/1,238) of patients were asymptomatic, but had a history of myocardial infarction. The perioperative mortality (30 day) in the 1,306 consecutive endarterectomies in 1,026 patients without symptomatic coronary artery disease was 1.5% (15/1,026 patients). Of the 212 patients with symptoms, 85 carotid endarterectomies were performed in 77 patients without prior coronary bypass operation with an operative mortality of 18.2% (14/77 patients). The remaining 135 patients had 155 carotid endarterectomies but were treated by either prior coronary artery bypass (84 patients) or simultaneous carotid endarterectomy and coronary artery bypass (51 patients) with an operative mortality of 3% (4/135 ...
OBJECTIVES: To assess timeliness of carotid endarterectomy services in the United Kingdom. DESIGN: Observational study with follow-up to March 2008. SETTING: UK hospitals performing carotid endarterectomy. PARTICIPANTS: UK surgeons undertaking carotid endarterectomy from December 2005 to December 2007. MAIN OUTCOME MEASURES: Provision and speed of delivery of appropriate assessments of patients; carotid endarterectomy and operative mortality; 30 day postoperative mortality. RESULTS: 240 (61% of those eligible) consultant surgeons took part from 102 (76%) hospitals and trusts. Of 9913 carotid endarterectomies recorded on hospital episode statistics, 5513 (56%) were included. Of the patients who underwent endarterectomy, 83% had a history of transient ischaemic attack or stroke. Of these recently symptomatic patients, 20% had their operation within two weeks of onset of symptoms and 30% waited more than 12 weeks. Operative mortality was 0.5% during the inpatient stay and 1.0% (95% confidence interval 0.7%
Clinical trial for Chronic Thromboembolic Pulmonary Hypertension , A Study to Evaluate Efficacy and Safety of Macitentan 75 mg in Inoperable or Persistent/Recurrent Chronic Thromboembolic Pulmonary Hypertension
Prostacyclins are vasodilatory agents used in the treatment of pulmonary arterial hypertension. The direct effects of prostacyclins on right heart function are still not clarified. The aim of this study was to investigate the possible direct inotropic properties of clinical available prostacyclin mimetics in the normal and the pressure-overloaded human right atrium. Trabeculae from the right atrium were collected during surgery from chronic thromboembolic pulmonary hypertension (CTEPH) patients with pressure-overloaded right hearts, undergoing pulmonary thromboendarterectomy (n = 10) and from patients with normal right hearts operated by valve replacement or coronary bypass surgery (n = 9). The trabeculae were placed in an organ bath, continuously paced at 1 Hz. They were subjected to increasing concentrations of iloprost, treprostinil, epoprostenol, or MRE-269, followed by isoprenaline to elicit a reference inotropic response. The force of contraction was measured continuously. The expression of
CREST Trial Points to Endarterectomy as Preferred Stroke Preventive Strategy. A comparison of endarterectomy versus stenting in treating carotid artery stenosis shows that stent recipients are at higher risk for stroke within 30 days of the procedure, according to a New England Journal of Medicine study released online. Investigators in the CREST trial randomized some 2500 patients with carotid artery stenosis to either stenting or endarterectomy. After a median follow-up of 2.5 years, the groups showed no significant difference in the primary endpoint - a composite of stroke, myocardial infarction, or death from any cause during the periprocedural period, or ipsilateral stroke within 4 years.. However, the 4-year rate of stroke or death significantly favored endarterectomy. When the individual outcomes were examined, there were significantly more periprocedural strokes after stenting, and more MIs after endarterectomy.. Editorialists conclude that endarterectomy remains the preferred treatment ...
CTEPH is characterised by a chronic increase in RV afterload and wall stress. Initially, these burdens result in RV hypertrophy characterised by increases in RV wall thickness and cell size through the addition of sarcomeres [95, 96]. This process is the result of the intrinsic ability of cardiac muscle cells to sense and respond to mechanical load [96]. At first, the increase in RV wall thickness results in decreased wall stress and improved pumping effectiveness by unloading of the individual muscle fibres [96], and RV function more closely resembles the left ventricle [97]. These changes are referred to as adaptive remodelling. This process is not limited to patients with CTEPH, but also occurs in patients with PAP ,25 mmHg and chronic thromboembolic disease (CTED) [97]. This was demonstrated in a study using a conductance catheter, in which differences between patients with CTED, CTEPH and controls were observed in pressure-volume loop morphology, most notably during systolic ejection ...
Forty consecutive patients undergoing thromboendarterectomy for total internal carotid artery occlusion were studied in an attempt to determine a) whether careful case selection could be expected to reduce future postoperative mortality and morbidity, b) whether the achieved patency rate justified early operation and c) whether patients in whom patency was restored and maintained had a better long-term prognosis. The results show that a group of patients can be selected that will have low postoperative mortality and morbidity. The success rate for restoration of blood flow is high, particularly if the operation is performed soon after occlusion. The long-term prognosis in patients in whom patency of the internal carotid artery is restored and maintained appears to be better than in those with persistent occlusion of the carotid artery. ...
Dr. Gustavo A. Heresi presents Serum CXC-Chemokine Ligand 10 is Associated with Severity of Chronic Thromboembolic Pulmonary Hypertension, recorded live at the UC San Diego Health Sulpizio Cardiovascular Center National Proceedings: CTEPH 2017., TV Network
TY - JOUR. T1 - Which Doppler velocity is best for assessing suitability for carotid endarterectomy?. AU - Lewis, Stephanie. AU - Wardlaw, Joanna. PY - 2002/1/9. Y1 - 2002/1/9. N2 - Objective: To evaluate which velocity, or combination of velocities, from carotid Doppler ultrasonography (DU), achieved the closest agreement with an assessment of suitability for carotid endarterectomy from intra-arterial angiograms (IAA).Methods: We prospectively collected data from 148 consecutive patients (288 carotids), who had DU and IAA (blinded assessment) before possible carotid endarterectomy. We halved our data by randomly selecting the left or right carotid artery for each patient. We used one half to calibrate our DU results to IAA (to decide which velocity corresponded with what degree of angiographic stenosis). Using this analysis, each artery in the other half of the data was defined as suitable (80-99% stenosed) or unsuitable for carotid endarterectomy. We evaluated every individual, and combination ...
The Tei (or myocardial performance) index has been investigated extensively in the assessment of LV function (5,9,11,16). There is now a growing body of literature evaluating the utility of tissue Doppler imaging and the RV Tei index in patients with RV dysfunction and pulmonary hypertension (4,6-8,12,17,18). The Tei index is derived solely by Doppler measurements and thus is not affected by RV geometry. Initially, the RV Tei index was calculated using pulsed-wave Doppler recordings of RV inflow and outflow (4,6,7), but more recent studies have shown that tissue Doppler imaging of the lateral tricuspid annulus allows simpler (and equally accurate) measurements of RV Tei index (10,12). This method eliminates the need for 2 separate Doppler interrogations (RV inflow and RV outflow) and therefore negates the effect of heart rate variability.. RV dysfunction is associated with an increase in RV Tei index (7), and work in animal models has shown a graded response of the Tei index to increases in RV ...
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TY - JOUR. T1 - Perioperative result of carotid endarterectomies with venous patch angioplasty. AU - Tsao, Nai Wen. AU - Hsu, Chiao Po. AU - Kan, Chung Ben. AU - Lai, Shiau Ting. AU - Yu, Tarng Jenn. AU - Weng, Zen Chung. AU - Shih, Chun Che. AU - Wang, Jih Shiuan. AU - Yung, Ming Chi. AU - Huang, Cheng Hsiung. PY - 2002. Y1 - 2002. N2 - Background. Carotid endarterectomy (CEA) is an effective treatment of carotid stenosis to reduce the risk of stroke. The purpose of the current study is to investigate the result of surgical treatment of carotid stenosis in Taipei Veterans General Hospital. Methods. The medical records of 103 patients receiving 113 CEA with or without patch angioplasty in our service between January 1993 and July 1999 were reviewed retrospectively. The clinical and operative variables were collected for analysis. According to the method of carotid arteriotomy closure, all operations were categorized into 3 groups: 76 CEA with venous patch angioplasty, 27 CEA with synthetic ...
A deletion/insertion (Del/Ins) polymorphism of 28 base pairs (bp) in the 3′ untranslated region (UTR) of fibrinogen alpha gene ( FGA) was associated with thromboembolic diseases, but the underlying me
Synonyms for Endarterectomy, carotid in Free Thesaurus. Antonyms for Endarterectomy, carotid. 4 words related to endarterectomy: ablation, cutting out, extirpation, excision. What are synonyms for Endarterectomy, carotid?
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We thank Kataoka and colleagues for their comments about our article and the potential utility of percutaneous transluminal pulmonary angioplasty (PTPA) after pulmonary endarterectomy (PEA) surgery. Chronic thromboembolic pulmonary hypertension is described by a 2-compartmental model, with proximal vessel obstructions that are surgically accessible and a small vessel vasculopathy found in nonobstructed vessels. This explains why patients can have residual pulmonary hypertension post-PEA despite a good surgical clearance. In our cohort, we reported that 51% (397 of 788 patients who survived the operative period) had a mean pulmonary artery pressure of ≥25 mm Hg at reassessment.1 Despite this finding, the majority of patients remained in a good functional status with only 187 of 397 patients being treated with off-license pulmonary vasodilator therapy during a mean follow-up of 4.3 years.. In patients not suitable for PEA because of the distribution of disease, there have also been a number of ...
Isolated pulmonary artery involvement by large vessel vasculitis is rare. This case report describes two patients with large vessel pulmonary vasculitis initially thought to have chronic thromboembolic pulmonary hypertension who had their diagnosis revised following pulmonary endarterectomy surgery. Advances in imaging techniques such as positron emission tomography and magnetic resonance imaging have permitted complementary radiological methods of diagnosis and follow up of large vessel disease and these are discussed in conjunction with the immunosuppressive and operative management of these patients.. ...
Endarterectomy is a surgical procedure to remove the atheromatous plaque material, or blockage, in the lining of an artery constricted by the buildup of deposits. It is carried out by separating the plaque from the arterial wall. It was first performed on a superficial femoral artery in 1946 by Portuguese surgeon, João Cid dos Santos, at the University of Lisbon. In 1951, E. J. Wylie, an American, performed it on the abdominal aorta. The first successful reconstruction of the carotid artery was performed by Carrea, Molins, and Murphy in Argentina, later in the same year. The procedure is widely used on the carotid artery of the neck as a way to reduce the risk of stroke, particularly when the carotid artery is narrowed. A carotid endarterectomy may itself cause a stroke at the time of operation. Endarterectomy is also used as a supplement to a vein bypass graft at the sites of surgical anastomosis. Pulmonary hypertension caused by chronic thromboembolic disease (CTEPH) may be amenable to ...
Risk Factors for Stroke, Myocardial Infarction, or Death Following Carotid Endarterectomy : Results from the International Carotid Stenting ...
Plaque composition in plexogenic and thromboembolic pulmonary hypertension: the critical role of thrombotic material in pultaceous core formation ...
Introduction Pulmonary Embolism (PE) is a frequent diagnosis and the incidence of Chronic Thromboembolic pulmonary hypertension (CTEPH) after a single acute episode of PE is higher than expected - in one prospective long-term study 3.8% at 2 years (Pengo et al 2004). A diagnosis of CTEPH carries a 30% 5 year mortality and early diagnosis is vital if treatment is to be of success although successful treatment options remain limited.. We hypothesized that by following up all new diagnoses of PE we would pick up early cases of CTEPH and identify risk factors for those developing CTEPH. We also hypothesized that thrombolysis as per the BTS guidelines would reduce the subsequent incidence of CTEPH.. ...
TY - JOUR. T1 - Higher risk factor burden and worse outcomes in urban carotid endarterectomy patients. AU - Chaturvedi, Seemant. AU - Madhavan, Ramesh. AU - Santhakumar, Sunitha. AU - Mehri-Basha, Maysaa. AU - Raje, Nikita. PY - 2008/11/1. Y1 - 2008/11/1. N2 - BACKGROUND AND PURPOSE-Previous multicenter carotid endarterectomy (CEA) studies had screening criteria for patient comorbidities and very few blacks. We assessed the hypothesis that CEA results from two urban hospitals would approximate those of the previous multicenter trials. METHODS-A retrospective chart review was completed at two urban hospitals for CEA procedures done in 2003 and 2004. Demographic information and past medical history was recorded. In hospital perioperative complications (stroke or myocardial infarction [MI]) were noted. We calculated an expected perioperative stroke rate based on trial figures and our proportion of symptomatic and asymptomatic patients. RESULTS-Patients in our cohort had significantly higher rates ...
Befor the surgery, your doctor will talk to you about how to prepare for carotid endarterectomy (CEA). Besides, he may conduct tests to examine your carotid arteries.
TY - JOUR. T1 - Safety and efficacy of fixed-dose heparin in carotid endarterectomy. AU - Poisik, Alexander. AU - Heyer, Eric J.. AU - Solomon, Robert A.. AU - Quest, Donald O.. AU - Adams, David C.. AU - Baldasserini, Catherine Moses. AU - McMahon, Donald J.. AU - Huang, Judy. AU - Kim, Louis J.. AU - Choudhri, Tanvir F.. AU - Connolly, E. Sander. PY - 1999/1/1. Y1 - 1999/1/1. N2 - OBJECTIVE: Although fixed dosage of heparin is frequently used during vascular surgery, there are very few studies that document the appropriateness of this type of dosing. We have undertaken a prospective study to determine the physiological response to a fixed dose of heparin, using a conventional measure of anticoagulation, and have correlated this measure with complications. METHODS: We studied 140 consecutive patients undergoing elective carotid endarterectomy. Serial activated clotting times (ACT values) were obtained in duplicate before administration of heparin, 15 minutes after application of a carotid ...
By American Academy of Neurology, Stroke affects more than 700,000 people in the United States per year. A blockage of a blood vessel is responsible for about 80 percent of strokes. Carotid endarterectomy is the most frequently performed operation to prevent stroke. There is scientific evidence to support its use to prevent future stroke, according to a clinical practice guideline published in the September 27, 2005 issue of Neurology, the scientific journal of the American Academy of Neurology (AAN). The guideline updates the 1990 AAN statement on carotid endarterectomy ...
Carotid Endarterectomy with Iatrogenic Cranial Nerve Damage. This custom medical exhibit features a lateral view of the left neck revealing the anatomy in the region of a Carotid Endarterectomy surgery. Additional images show the location of the cranial nerves, and the function of CN X, XI and XII (vagus, glossopharyngeal and hypoglossal nerves) which were damaged in this particular case.
Carotid Endarterectomy with Iatrogenic Cranial Nerve Damage. This custom medical exhibit features a lateral view of the left neck revealing the anatomy in the region of a Carotid Endarterectomy surgery. Additional images show the location of the cranial nerves, and the function of CN X, XI and XII (vagus, glossopharyngeal and hypoglossal nerves) which were damaged in this particular case.
• Between June 1984 and January 1986, 155 carotid endarterectomies were performed with routine shunting. Serial duplex scanning was performed during an 18-month
Adempas: Riociguat belongs to the class of medications called soluble guanylate cyclase stimulators. It works to reduce the blood pressure in the lungs by opening the blood vessels that connect the heart to the lungs. It is used to treat Chronic Thromboembolic Pulmonary Hypertension (CTEPH) where surgery is not possible and CTEPH that continues or has returned after surgery.
Riociguat is used to treat chronic thromboembolic pulmonary hypertension (CTEPH) in people who cannot be treated with surgery, or in people who have undergone surgery but still have symptoms. Riociguat can treat certain symptoms of CTEPH and can improve your ability to exercise. Riociguat is also used to treat pulmonary...
Read about how the vasodilator Adempas (riociguat) improves the ability of endothelial progenitor cells in chronic thromboembolic pulmonary hypertension.
Riociguat (Adempas) has been approved by the FDA for the treatment of adults with two forms of pulmonary hypertension. Riociguat is indicated for patients with chronic thromboembolic pulmonary hypertension (CTEPH) after surgery or patients who cannot undergo surgery, to improve their ability to exercise. The drug is also indicated for patients with pulmonary arterial hypertension (World Health Organization Group 1) to improve their ability to exercise and to delay clinical worsening of the condition.. Riociguat belongs to a class of drugs called soluble guanylate cyclase stimulators, which promotes vasodilation and helps increase blood flow and decrease BP. It is the first drug in its class approved to treat two types of pulmonary hypertension.. Riociguat carries a Boxed Warning alerting patients and healthcare professionals that the drug should not be used in pregnant women because it can harm the fetus. Female patients can receive the drug only through the risk evaluation and mitigation ...