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Vascular Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Assessment of vascular injuries can be challenging and missed vascular injuries can have devastating consequences. Fortunately, the widespread availability of computed tomography angiography (CTA) has revolutionized the diagnosis of vascular injury and the key to recognition in many cases is a high index of suspicion coupled with a low threshold for imaging.
Neurology
Published in Faye Hill, Sash Noor, Neel Sharma, Tiago Villanueva, Medical and Surgical Emergencies for Students and Junior Doctors, 2021
Faye Hill, Sash Noor, Neel Sharma
A CT scan of the brain followed by a lumbar puncture, if the scan is negative, are the mainstay investigations. A lumbar puncture should not be performed in cases of elevated intracranial pressure, hydrocephalus or intracranial mass and it helps to determine the presence of red blood cells and xanthochromia. Cerebral angiography should be performed in patients with a subarachnoid haemorrhage to determine the presence and anatomical features of aneurysmal formation. In cases where cerebral angiography cannot be performed, magnetic resonance angiography and computed tomography angiography should be considered.
Standard autologous tissue flaps for whole breast reconstruction
Published in Steven J. Kronowitz, John R. Benson, Maurizio B. Nava, Oncoplastic and Reconstructive Management of the Breast, 2020
Steven J. Kronowitz, John R. Benson, Maurizio B. Nava
Although not essential, imaging provides a roadmap to the largest perforators and can lead to faster intraoperative decision-making. Various vascular imaging modalities including duplex Doppler, computed-tomography angiography, and magnetic resonance angiography have been used19 (Figure 22.5.6). However, these are expensive, time-consuming procedures and are not without risk. Computed-tomography angiography specifically exposes the patient to significant radiation doses and carries a carcinogenic risk.20
Treatment of chronic internal carotid artery occlusion by ipsilateral external carotid endarterectomy
Published in British Journal of Neurosurgery, 2023
Yeshuai Hu, Hai Qian, Xiang’en Shi
During the surgery, the intima and carotid plaque of the common carotid artery (CCA) and at the beginning of ECA were successfully removed. We then explored the ICA and found that it was completely occluded, so we tried to remove the plaque at the beginning of ICA (as showed in Supplementary Figures S1A–B). To our astonishment, backflow was obtained after the removal of the clot and revealed that most of the blood flow comes from ECA, and a small part comes from ICA. In the second day after operation, the limb weakness and cold feeling were improved significantly. The postoperative computed tomography angiography (CTA) showed continuous blood flow in ECA, while small amount blood flow in ICA (Figure 4). Postoperative PET-CT revealed that metabolism in right hemisphere was significantly increased compared to the left side, as well as to that before operation (Figure 5). One year after operation, CTA revealed the caliber and the blood flow of right ICA significantly increased (Figure 6).
Place in therapy of anti-IL-17 and 23 in psoriasis according to the severity of comorbidities: a focus on cardiovascular disease and metabolic syndrome
Published in Expert Opinion on Biological Therapy, 2022
Emanuele Trovato, Pietro Rubegni, Francesca Prignano
Along this line, studies demonstrated a protective role of anti-IL-17 mAbs. A recent prospective observational study analyzed 290 patients to characterize coronary arterial plaque before and after biological therapy with anti-TNF, anti-IL-12/23, and anti-IL-17 [14]. Patients were studied with computed tomography angiography (CCTA) in a 52-week follow-up period. The results highlighted a reduction in the extension of coronary and non-calcified plaque after 1 year of treatment with biologics with concomitant significant reduction of the fibro-lipid and of the necrotic part. Reduction in coronary plaque extension was significantly greater with anti-IL-17 than anti-IL-12/23, and non-calcified plaque extension reduction was about 5% with anti-TNF, 12% with anti-IL-17, and 2% with anti-IL-12/23 [15].
Association between platelet counts and morbidity and mortality after endovascular repair for type B aortic dissection
Published in Platelets, 2022
Enmin Xie, Jitao Liu, Yuanhui Liu, Yuan Liu, Ling Xue, Ruixin Fan, Nianjin Xie, Huanyu Ding, Binquan Hu, Lyufan Chen, Xinyue Yang, Fan Yang, JianFang Luo
Between January 2010 to December 2017, 992 consecutive patients with TBAD who underwent TEVAR were identified from the prospectively maintained database at Guangdong Provincial People’s Hospital (Guangdong, China). Patients were diagnosed by contrast-enhanced computed tomography angiography (CTA) according to the criteria of Stanford classification [3]. Subjects were excluded for the following reasons: 1) previous aortic surgery; 2) malignant tumor; 3) connective diseases; 4) traumatic aortic dissection; 5) missed pre- or postoperative platelet records; 6) missed pre- or postoperative serum creatinine records; 7) other known causes of preoperative thrombocytopenia, including hypersplenism, idiopathic thrombocytopenic purpura, and myelodysplastic syndrome. The remaining 892 patients were included for a retrospective analysis (Figure. S1). This study was approved and granted an informed consent waiver by the Guangdong Provincial People’s Hospital Ethics Board as it was a retrospective study.