Publications by authors named "Kamil Stepkowski"

2 Publications

  • Page 1 of 1

Volumetric Flow Changes in Extracranial Arteries in a Symptomatic Patient with Significant Bilateral Carotid Artery Stenosis: A Case Study and Literature Review.

Am J Case Rep 2020 Oct 2;21:e927202. Epub 2020 Oct 2.

Department of General, Endocrine and Vascular Surgery, Medical University of Warsaw, Warsaw, Poland.

BACKGROUND Hemodynamically significant carotid artery stenoses are rarely diagnosed in people under 60 years of age, being mainly secondary to other concomitant diseases. Cerebral blood flow volume, which correlates with cerebrovascular reserve and susceptibility of ischemic symptoms occurrence, may aid in the diagnosis and monitoring of patients with carotid artery disease. In this report we present the case of a patient with significant bilateral carotid stenosis, focusing on the ultrasonographically measured changes in blood flow volume in extracranial arteries following surgeries. CASE REPORT A 41-year-old man with a positive history of transient ischemic attack (TIA)  was referred to our department after being diagnosed with significant 80% to 85% right internal carotid artery (ICA) and 60% left ICA stenosis. After successful carotid endarterectomy, the flow volume in extracranial arteries significantly increased (from 755 mL/min to 1053 mL/min) due to an increase of flow volume in the right ICA. With the progression of left ICA stenosis, cerebral blood flow decreased, and the patient presented with a second TIA. Following the successful treatment of the left ICA stenosis (consisting of carotid endarterectomy and stent implantation because neointimal hyperplasia resulted in significant, recurrent 80% left ICA stenosis), an increase in flow volume was observed. CONCLUSIONS Assessment of the blood flow volume in extracranial arteries may be an effective tool in monitoring patients with carotid stenoses. Due to the lack of literature on this topic, further research on cerebral blood flow volume in surgical and non-surgical patients is needed to understand this phenomenon.
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October 2020

Prevalence of obstructive sleep apnea in patients with peripheral arterial diseases.

Sleep Breath 2020 Sep 14;24(3):1035-1041. Epub 2019 Nov 14.

Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Background: The presence of obstructive sleep apnea (OSA), a novel cardiovascular risk factor, contributes to the development of peripheral arterial diseases (PAD). There is a lack of data showing how often these diseases coexist.

Aims: The aim of the study was to determine the prevalence of OSA in the population of patients with PAD.

Methods: Patients previously qualified for the first revascularization due to PAD were included in the study. All patients underwent an overnight sleep study to detect OSA. Diagnosis of OSA was made when the apnea-hypopnea index (AHI) was ≥5 per hour.

Results: From 141 patients (60% men, age 69.6 ± 9.5 years), OSA was diagnosed in 68 patients (48%). OSA occurred in mild form (5 ≤ AHI < 15/h) in 39 cases (28%), in moderate form (15 ≤ AHI < 30/h) in 21 cases (15%), and in severe form (AHI ≥ 30/h) in 8 cases (6%). Patients without OSA had significantly lower body mass index (BMI; 26.9 ± 5.5 vs. 27.7 ± 5.3 kg/m, p = 0.01) and lower hip circumference (97.4 ± 11.7 vs. 98.7 ± 7.4, p = 0.04). There were no differences in the distribution of other investigated cardiovascular risk factors and diseases between these groups. There were no significant differences in OSA distribution or its severity between patients with lower extremity artery disease and carotid artery disease.

Conclusions: The prevalence of OSA in patients with PAD is very high, affecting nearly half of the studied population.
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September 2020