Publications by authors named "Sina Zarrintan"

66 Publications

Rare anastomosis between the ascending pharyngeal and vertebral arteries via the hypoglossal canal: A cadaveric case report.

Anat Cell Biol 2021 Jul 22. Epub 2021 Jul 22.

Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, USA.

We present a rare case of external carotid artery-vertebral artery anastomosis via the ascending pharyngeal artery, diagnosed upon cadaveric dissection. The ascending pharyngeal artery gave rise to a branch to the hypoglossal canal, which is a variation of a true persistent fetal hypoglossal artery. Knowledge of persistent carotid-vertebrobasilar anastomoses is important as these fetal vessels can contribute significantly to the posterior cerebral circulation. Only 10 cases of external carotid artery-vertebrobasilar artery anastomoses have been reported to our knowledge, and our case presents the first cadaveric dissection of this rare variation.
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http://dx.doi.org/10.5115/acb.21.093DOI Listing
July 2021

Iliofemoral Vein Stenting in a Patient with Pelvic Metastasis.

Vasc Specialist Int 2021 Jun 30;37:18. Epub 2021 Jun 30.

Phlebology Research Group, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

We report a case of an 81-year-old woman with extensive pelvic lymphadenopathy that caused severe stenosis and occlusion of the right common and external iliac veins and proximal common femoral vein. Pelvic lymphadenopathy resulted from the recurrence of a previous right ovarian epithelial tumor. The patient had severe right lower extremity edema, consistent with severe venous insufficiency. She was treated with high-pressure balloon angioplasty (12-14 mm in diameter) and four self-expanding stents (14-10 mm diameter, 80-40 mm length). The postoperative response was dramatic to a near-complete resolution of the edema. The venous clinical severity scores were 10 and 2 at presentation and 6 months after the follow-up, respectively. Balloon angioplasty and stenting are safe and effective methods for providing symptomatic relief for lower extremity venous insufficiency in patients with extensive and unresectable pelvic masses.
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http://dx.doi.org/10.5758/vsi.200080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8245847PMC
June 2021

An Ultrasound Evaluation of the Vertebral Artery in Patients With Vertebral Artery Hypoplasia.

Cureus 2021 May 14;13(5):e15020. Epub 2021 May 14.

Department of Neurosurgery, Tulane University School of Medicine, New Orleans, USA.

Purpose The aim of the current study was to assess and compare Doppler ultrasound findings, especially the resistivity index (RI), among and between patients with vertebral artery hypoplasia (VAH) and normal populations. Material and methods Fifteen consecutive patients with VAH (mean age 54 ± 21 years) and 15 sex-matched controls without VAH (mean age 54 ± 22 years) were selected for the study. The vertebral arteries (VA) were examined with Doppler ultrasound. We also explored each group for sex and age differences (young: age ≤ 50, old: age >50). Results The mean RI (MRI), right RI (RRI), left RI (LRI), non-dominant-side RI, and dominant-side RI were significantly higher in the Case Group than the Control Group. In the Case Group, the affected-side RI (A.RI) was significantly higher than the normal side, while the normal side peak systolic velocity was significantly higher than the affected side. The MRI and A.RI were significantly higher in older patients. We also found a significant negative correlation between the mean diameter (MD) and MRI. MRI and A.RI both correlated positively with age in the Case Group, while left peak systolic velocity decreased significantly with age in the Control Group [p-values < 0.05]. Conclusion The dominant VA had a higher RI in the Case Group than the Control Group. It can therefore be inferred that the dominant VA in patients with VAH does not work completely normally, thus making these patients even more susceptible to vertebrobasilar insufficiency and possible strokes.
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http://dx.doi.org/10.7759/cureus.15020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8197781PMC
May 2021

Iliac vein stenting in a patient with lower extremity swelling resulting from diffuse pelvic mass: A case report.

J Cardiovasc Thorac Res 2021 23;13(1):84-86. Epub 2020 Dec 23.

Division of Vascular & Endovascular Surgery, Department of General & Vascular Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

We report a 66-year-old male patient with severe right lower extremity swelling resulting from diffuse pelvic mass with compression on right external iliac vein. The patient had papillary urothelial carcinoma of bladder seven years ago and radical cystectomy and ureterostomy was performed. Recurrence of malignancy had occurred five years after the operation. The patient had also bilateral diffuse lung metastasis. The external iliac vein had severe stenosis and invasion of pelvic mass into the vein was evident on venography. Venoplasty of external iliac vein was performed throughout the stenosis. A venous stent of 80 mm length and 12 mm diameter was introduced over the guidewire and deployed in the external iliac vein. Dramatic clinical response was evident since postoperative day two. Swelling of right lower extremity was resolved dramatically on three-month and six-month follow-up visits. We believe that endovascular venous recanalization of iliac veins is feasible and safe in patients with unresectable and diffuse pelvic masses.
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http://dx.doi.org/10.34172/jcvtr.2020.57DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007898PMC
December 2020

Hereditary thrombophilia and thrombosis of tunneled hemodialysis catheters: A single center study.

J Cardiovasc Thorac Res 2021 19;13(1):79-83. Epub 2021 Jan 19.

Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Vascular access thrombosis increases the risk of mortality and morbidity in end-stage renal disease (ESRD) patients on hemodialysis (HD). This study aimed to evaluate hereditary thrombophilia factors in HD patients and its association with tunneled cuffed catheters' thrombosis. In this cross-sectional study, 60 consecutive patients with ESRD on HD with tunneled cuffed catheters were selected. Inherited thrombophilia factors (Anti-thrombin III, Protein C, Protein S, and Factor V Leiden) were measured and the patients were followed for 3 months to evaluate the incidence of catheter-related thrombosis. The association between these factors and catheter thrombosis was assessed. The mean age of patients was 60.30 ± 8.69 years. Forty-seven patients (78.30%) were female and thirteen patients (21.70%) were male. The most common cause of ESRD was diabetes mellitus (41.67%). The most catheter site was the right internal jugular vein (55%). There were 22 (36.67%) and 8 (13.33%) cases of thrombosis and mortality, respectively. The association between hereditary thrombophilia factors and catheter thrombosis was not statistically significant ( > 0.05). In this small group of our patients, the frequency of hereditary thrombophilia was not significantly different between those with and without thrombosis of tunneled HD catheter.
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http://dx.doi.org/10.34172/jcvtr.2021.06DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007903PMC
January 2021

Accessory Vertebral Artery: An Embryological Review With Translation from Adachi.

Cureus 2021 Feb 19;13(2):e13448. Epub 2021 Feb 19.

Department of Neurosurgery, Tulane University School of Medicine, New Orleans, USA.

The vertebral arteries arise from the posterior superior aspect of the bilateral subclavian arteries and course superiorly through the transverse foramina of C1-C6 vertebrae before joining one another along the anterior surface of the pons. Developmental variations during the fourth to sixth weeks of embryonic development may result in the formation of accessory vertebral arteries, i.e., ipsilateral vertebral arteries of dual origin. This anatomical variation is distinct from and often confused with vertebral artery duplications and fenestrations. This article reviews the anatomy and embryology of the accessory vertebral artery with excerpts from Buntaro Adachi's classic text on vascular anatomical variations. Knowledge of accessory vertebral vessels is important during vascular and spinal procedures of the head and neck. Furthermore, these variations have been associated with cerebrovascular pathologies, such as stroke, dissection, and other hemodynamic anomalies.
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http://dx.doi.org/10.7759/cureus.13448DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7982507PMC
February 2021

Review of the external carotid plexus: anatomy, function, and clinical manifestations.

Anat Cell Biol 2021 Jun;54(2):137-142

Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.

The external carotid plexus is a combination of postganglionic sympathetic fibers derived from the superior cervical ganglion. This plexus travels along the external carotid artery and continues onto the artery's branches. The external carotid plexus plays an important role in innervating the mid and lower face. Therefore, implications to the plexus may result in facial abnormalities. Herein, we review the anatomy, function, and review its clinical applications.
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http://dx.doi.org/10.5115/acb.20.308DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8225485PMC
June 2021

Saccular mycotic aneurysm of descending thoracic aorta secondary to vertebral hydatid disease: A rare case.

Vascular 2021 Feb 17:1708538121994370. Epub 2021 Feb 17.

Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, USA.

Background/objective: Hydatid disease of the aorta is very rare. Hydatid disease can result in saccular aneurysm of the thoracic and abdominal aorta.

Case Report: We report a rare case of saccular aneurysm of the distal descending thoracic aorta. The diameter of the aneurysm was 60 mm. It was managed by Thoracic Endovascular Aneurysm Repair. After 41 months, computed tomography angiography revealed a multi-loculated cystic lesion with 86 × 83×80 mm dimensions in the prevertebral area at the T10-T11 level with bony destruction and erosion of the anterior margin of the vertebral bodies. A computed tomography-guided fine-needle aspiration of the paravertebral cystic lesion was performed. Microscopic study of the fine-needle aspiration specimen demonstrated diagnostic of hydatid disease.

Conclusion: It is concluded that the case was a mycotic aneurysm of the thoracic aorta secondary to vertebral hydatid disease.
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http://dx.doi.org/10.1177/1708538121994370DOI Listing
February 2021

Acute right upper extremity ischemia resulting from true aneurysmof right brachial artery: A case report.

J Cardiovasc Thorac Res 2020 24;12(4):337-340. Epub 2020 Nov 24.

Division of Vascular & Endovascular Surgery, Department of General & Vascular Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

We report a case of 66-year-old woman with true aneurysm of the right brachial artery. She presented with acute upper extremity ischemia. The hand was cold and parenthesized and distal pulses were absent. CT angiography (CTA) revealed a 20*25 mm true brachial artery aneurysm. The aneurysm was thrombosed without distal run-off. We excised the aneurysm and reestablished the arterial flow by a reverse saphenous interposition graft. The postoperative course was uneventful.
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http://dx.doi.org/10.34172/jcvtr.2020.54DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828753PMC
November 2020

Outcomes of transcarotid revascularization with dynamic flow reversal versus carotid endarterectomy in the TCAR Surveillance Project.

Semin Vasc Surg 2020 Jun - Sep;33(1-2):24-30. Epub 2020 Oct 9.

Division of Vascular and Endovascular Surgery, University of California San Diego, La Jolla, CA 92093. Electronic address:

Carotid endarterectomy remains the reference standard procedure for carotid revascularization in patients with significant carotid artery stenosis. However, carotid artery stenting was established as a minimally invasive procedure for patients who are not candidates for open surgery due to medical or anatomic high-risk factors. However, despite years of technical refinement and significant improvement in proper patient selection and aggressive medical management, carotid artery stenting via the transfemoral approach has been scrutinized due to a higher risk of stroke or death in the perioperative period compared with carotid endarterectomy. The higher risk of stroke after carotid artery stenting was attributed to manipulation of the diseased aortic arch and the carotid lesion before placement of distal embolic protection devices, as well as failure of these devices to provide adequate neuroprotection. These limitations led to the development of transcarotid artery revascularization, which avoids the need to cross the aortic arch through direct access to the common carotid artery and utilizes a robust neuroprotection mechanism through clamping the proximal carotid artery and establishing active reversal of cerebral blood flow to clear embolic debris. Earlier studies have demonstrated favorable outcomes after transcarotid artery revascularization in high-risk patients. In this study, we aimed to compare the in-hospital outcomes of transcarotid artery revascularization with those of carotid endarterectomy in patients with symptomatic and asymptomatic carotid artery stenosis.
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http://dx.doi.org/10.1053/j.semvascsurg.2020.10.001DOI Listing
December 2020

The Premasseteric Branch of the Facial Artery: A Review and Translation of Adachi's Work.

Cureus 2020 Sep 18;12(9):e10538. Epub 2020 Sep 18.

Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, USA.

The premasseteric branch of the facial artery is a variable posterior branch that is closely associated with the anterior border of the masseter muscle. Since its first description, the premasseteric branch has been described using different terms such as the masseteric or posterior branch of the facial artery. While the artery's anatomy is known, it is infrequently discussed in the literature. This manuscript reviews the artery's origin, course, and importance during maxillofacial procedures, especially those involving manipulation of the masseter. We also provide a translation of Adachi's 1928 German text describing the branch.
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http://dx.doi.org/10.7759/cureus.10538DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7574994PMC
September 2020

Abu Al-Qasim Al-Zahrawi (936-1013 CE), Icon of Medieval Surgery.

Ann Vasc Surg 2020 Nov 29;69:437-440. Epub 2020 Jul 29.

School of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.

Abu al-Qasim Al-Zahrawi (936-1013 common era [CE]), also known in the West as Albucasis, was a great Arab physician and surgeon of the late 10th and early 11th centuries CE. He is best known for his surgical knowledge and expertise. His greatest contribution to medicine is the Kitab al-Tasrif, which includes thirty treatises on medical sciences. His early and great contributions to the field of surgery were seminal. For his endeavors in this field, a number of surgeons and scholars have dubbed him the "Father of Operative Surgery".
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http://dx.doi.org/10.1016/j.avsg.2020.07.012DOI Listing
November 2020

Effect of Different Levels of Positive End-Expiratory Pressure (PEEP) on Respiratory Status during Gynecologic Laparoscopy.

Anesth Pain Med 2020 Apr 18;10(2):e100075. Epub 2020 Apr 18.

Division of Vascular and Endovascular Surgery, Department of General & Vascular Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: During gynecologic laparoscopy, pneumoperitoneum, and the position of the patient's head can lead to pathophysiologic changes in cardiovascular and respiratory systems, complicating the management of anesthesia in these patients. One of the strategies for improving the respiratory status of patients undergoing laparoscopy is the use of Positive End-Expiratory Pressure (PEEP).

Objectives: This study aimed to evaluate the effect of different levels of PEEP on the respiratory status of patients undergoing gynecologic laparoscopy.

Methods: In this clinical trial, 60 patients with ASA I were randomly assigned to three groups to control anesthesia: ZEEP (PEEP 0 cmHO; 20 cases), PEEP (PEEP 5 cmHO; 20 cases), and PEEP (PEEP 10 cmHO; 20 cases). Respiratory and hemodynamic variables of patients were compared before general anesthetic induction and immediately after CO insufflation at intervals of 5, 10, 20, 30, and 60 min and the end of the operation in the three study groups.

Results: The PEEP application improved pH, PaCO, and PaO levels at the end of pneumoperitoneum compared to baseline when compared with the non-use of PEEP (ZEEP group). Also, the frequency of dysrhythmia in the use of PEEP in controlled ventilation was significantly lower in patients with PEEP (P < 0.05). The application of PEEP resulted in similar effects to PEEP in the levels of respiratory variables.

Conclusions: The PEEP application is associated with improved arterial blood gas in patients with gynecologic laparoscopy. The use of PEEP has a greater effect on the improvement of respiratory parameters and complications of pneumoperitoneum.
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http://dx.doi.org/10.5812/aapm.100075DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322673PMC
April 2020

Simultaneous resection of abdominal aortic aneurysm and left renal cell carcinoma: A rare case and review of the literature.

J Cardiovasc Thorac Res 2020 7;12(2):152-155. Epub 2020 Jan 7.

Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, USA.

We report a rare case of concomitant abdominal aortic aneurysm (AAA) and left renal cell carcinoma (RCC). The patient was an 81-year old man who presented with vague abdominal pain. The investigations revealed a 110*73*62 mm AAA together with 69*56 left renal mass. Open repair of AAA with left radical nephrectomy was conducted. A simultaneous procedure is safe and does not increase morbidity and mortality in selected cases.
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http://dx.doi.org/10.34172/jcvtr.2020.26DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321004PMC
January 2020

Management of traumatic subclavian artery injuries in a high-volume vascular surgery center in Iran.

J Cardiovasc Thorac Res 2020 5;12(2):145-149. Epub 2020 May 5.

Division of Vascular & Endovascular Surgery, Department of General & Vascular Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Subclavian artery injury is an uncommon vascular trauma with potential morbidity and mortality. Management of subclavian artery trauma requires open and endovascular techniques and timely and efficacious decision is mandatory. We retrospectively reviewed traumatic subclavian artery injuries in a high-volume vascular surgery center in Iran. In a retrospective study, we assessed subclavian artery injuries during 6 years in ShohadaTajrish Medical Center. Background characteristics, type of incision, type of operation and outcome of patients were evaluated. A total of 14 patients had subclavian artery injury (mean age 29.9 ± 13.4 years, 92.9% male). Trauma was in left and right sides in eight (57.1%) and six patients (42.9%) respectively. Arteriorrhaphy, interposition and ligation of injured artery was done in 7 (50.0%), 3 (21.4%) and 4 (28.6%) patients respectively. Associated nerve injury was present in six patients (42.9%). Endovascular proximal control was obtained in six patients (42.9%) prior to vascular exposure. Time of patient referral did not have significant association with shock or type of operation ( > 0.05). Although traumatic subclavian artery injuries are rare, its vascular exposures and reconstructions are of potential clinical concern. Endovascular interventions can facilitate proximal control. In addition, endovascular repair by covered stent is an alternative to open surgery.
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http://dx.doi.org/10.34172/jcvtr.2020.24DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321003PMC
May 2020

Comparing open conventional carpal tunnel release with mini-incision technique in the treatment of carpal tunnel syndrome: A non-randomized clinical trial.

Ann Med Surg (Lond) 2020 Jul 16;55:119-123. Epub 2020 May 16.

Division of Vascular & Endovascular Surgery, Department of Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Carpal tunnel syndrome (CTS) is the most common nerve entrapment neuropathy which is the result of the compression of the median nerve in the wrist. Currently, there is no consensus about the best treatment option. The purpose of this clinical trial was to compare the clinical outcomes of patients undergoing open CT release with mini-incision CT release.

Patients And Methods: This clinical trial included 75 patients with CTS who were divided into two groups of 45 and 30 patients to undergo open-CT release or mini incision CT release respectively. Patients were evaluated pre-operatively, days after the surgery and then five months after the operation to record outcomes. At follow-up, the visual analogue scale (VAS) scores for pain, patients' satisfaction, return to work, length of scar, paresthesia, grip and opposition strength were measured.

Results: A total of 75 patients (mean age: 52.13 years, 73.3% female) underwent CTS surgery. Forty-five patients (60%) had open-CT release and 30 patients (40%) had mini-incision CT release. Postoperative pain and scar length were significantly lower in the mini incision group compared to open group (p < 0.001). The mini-incision CT group returned to work earlier than open group with higher satisfaction (p < 0.001). No significant differences were observed between two groups in respect to the improvement of the opposition, grip and paresthesia (p > 0.05).

Conclusion: Our study demonstrated that mini-incision CT release improves pain more effectively and has better quality of life because of smaller length of scar, immediate return to work and higher overall satisfaction. Neurosensory and motor improvements were also seen in both techniques with the same clinical impact.
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http://dx.doi.org/10.1016/j.amsu.2020.05.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7251294PMC
July 2020

An Invited Commentary on: Moderate and severe exacerbations have a significant impact on health-related quality of life, utility, and lung function in patients with chronic obstructive pulmonary disease: A meta-analysis.

Authors:
Sina Zarrintan

Int J Surg 2020 06 5;78:166-167. Epub 2020 May 5.

Division of Vascular & Endovascular Surgery, Department of General & Vascular Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Shahrdari St., 1989934148, Tehran, Iran; Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address:

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http://dx.doi.org/10.1016/j.ijsu.2020.04.074DOI Listing
June 2020

Surgical operations during the COVID-19 outbreak: Should elective surgeries be suspended?

Authors:
Sina Zarrintan

Int J Surg 2020 Jun 14;78:5-6. Epub 2020 Apr 14.

Department of Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address:

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http://dx.doi.org/10.1016/j.ijsu.2020.04.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194740PMC
June 2020

A commentary on "Findings requiring immediate surgery in blunt abdominal trauma patients with isolated free fluid without solid organ injury on abdominal computed tomography: Retrospective laboratory, clinical and radiologic analysis. A case control study" (Int. J. Surg. 2020; Epub ahead of print).

Authors:
Sina Zarrintan

Int J Surg 2020 05 2;77:132-133. Epub 2020 Apr 2.

Division of Vascular & Endovascular Surgery, Department of General & Vascular Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address:

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http://dx.doi.org/10.1016/j.ijsu.2020.03.064DOI Listing
May 2020

Angiographic evaluation of traumatic arterial injuries of the upper limbs: a retrospective study.

J Cardiovasc Thorac Res 2020 28;12(1):69-72. Epub 2019 Oct 28.

Department of General & Vascular Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

The aim of this study was to evaluate the mechanism and type of upper limb arterial trauma in Iranian population. Fifty-one patients with upper limb trauma were evaluated over a 4-year period with conventional angiography at the Tabriz Imam Hospital, Iran. Twenty-four patients (19 men, 5 women with a mean age of 27.5 ± 11.8 years) had arterial injuries. Blunt trauma was more frequent than penetrating trauma (87.5%). The most cause of trauma was traffic accidents and the brachial artery was the most frequently affected artery. In 87.5% cases associated bone injuries were observed. Patients with blunt upper limb injuries must be evaluated for vascular integrity timely, especially in traffic accidents because vascular injuries after traffic accidents need to be referred to vascular centers. The results of this article are of potential use and clinical importance because precise diagnosis of vascular insults are essential to restore injured extremities.
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http://dx.doi.org/10.34172/jcvtr.2020.11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080338PMC
October 2019

Comparison of Split Thickness Skin Grafts and Flaps in Bilateral Chronic Axillary Hidradenitis Suppurativa.

World J Plast Surg 2020 Jan;9(1):55-61

Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Hidradenitis suppurativa is a chronic inflammatory disease with multiple inflammatory nodules and abscesses. We aimed to compare split thickness skin graft (STSG) and flaps in bilateral chronic refractory axillary hidradenitis suppurativa.

Methods: Thirty patients were investigated from March 21, 2010 to March 20, 2015. Debridement of involved skin and subcutaneous fat was done until deep fascia. The second operation was a reconstructive procedure to cover bilateral axillary wounds with STSG in left side and random fasciocutaneous flaps in the right side.

Results: Mean age of patients was 35.2±9.3 years. There were 16 men (53.3%) and 14 women (46.7%). Duration of the disease before trial was 6.5±2.1 years. The association between pain at one-month follow-up for graft or flap sites was not significant. The patients did not have pain at flap and graft sites at three-month, six-month and one-year follow-ups. Twenty-four patients (80.0%) had normal ranges of motion at one-month follow-up. At six-month and one-year follow-ups, all patients had bilateral normal ranges of motion. All patients were satisfied from symmetry of flap and graft sites at six-month and one-year follow-ups. All patients were satisfied from graft and flap donor sites at six-month and one-year follow-ups. At one-month, three-month, six-month and one-year follow-ups, recurrence of hidradenitis suppurativa was not seen.

Conclusion: Both STSGs and fasciocutaneous flaps were successful and satisfactory for tissue coverage in patients with axillary hidradenitis suppurativa. We recommend this technique in cases of bilateral axillary hidradenitis suppurativa.
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http://dx.doi.org/10.29252/wjps.9.1.55DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068188PMC
January 2020

A commentary on "The current state of animal models in research: A review" (Int J Surg 2019; Epub ahead of Print).

Int J Surg 2019 12 8;72:154-155. Epub 2019 Nov 8.

School of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.

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http://dx.doi.org/10.1016/j.ijsu.2019.10.052DOI Listing
December 2019

A commentary on: Prognostic effect of troponin elevation in patients undergoing carotid endarterectomy with regional anesthesia - A prospective study (Int. J. Surg. 2019;71:66-71).

Authors:
Sina Zarrintan

Int J Surg 2019 11 8;71:169. Epub 2019 Oct 8.

Division of Vascular & Endovascular Surgery, Department of General & Vascular Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

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http://dx.doi.org/10.1016/j.ijsu.2019.10.002DOI Listing
November 2019

Avicenna (980-1037 CE) and his Early Description and Classification of Dementia.

J Alzheimers Dis 2019 ;71(4):1093-1098

Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark.

According to the World Health Organization (WHO), dementia is a disorder that occurs as result of a neurodegenerative process in brain, and usually is chronic or progressive by nature. Most descriptions of senile dementia date back to Alois Alzheimer. In 1906, Alzheimer described the first patient, Auguste Deter, who suffered from the disorder that later became known as Alzheimer's disease. Although, the history of the disease before 1906 is quite rich, little has been said about the contributions of ancient and medieval physicians to the understanding of dementia. Over the centuries, the concept of senile dementia changed from an inevitable mental decline with aging, to different sets of clinical features with narrow limits of diagnosis of a disease in its own right. Documentation of the historical origins of prevention, diagnosis, and therapies of dementia would make an important contribution to a more complete understanding of this pathological degeneration of dementia. The present review focuses on the contributions of Avicenna (AD 980-1037) to the development of diagnosis and the discovery of etiology of different forms of dementia, with the goal of revealing the extent to which dementia was understood in the golden age of Islam in Persia.
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http://dx.doi.org/10.3233/JAD-190345DOI Listing
November 2020

Axillary Artery Aneurysm in a 3-Year-Old Child: A Rare Case and Review of the Literature.

Ann Vasc Surg 2020 Jan 23;62:499.e1-499.e4. Epub 2019 Aug 23.

Department of General & Vascular Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

We report a rare case of 4 cm true aneurysm of left axillary artery in a 3-year-old girl. Computed tomography angiography confirmed the diagnosis. Open surgical repair with resection and primary end-to-end anastomosis was performed. The patient did not have any complication after 1-year follow-up. Axillary artery aneurysm is extremely rare in pediatric population. Previous reports of this rare entity are discussed comprehensively.
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http://dx.doi.org/10.1016/j.avsg.2019.06.028DOI Listing
January 2020

Commentary on: Nigerian surgical outcomes - A report of 7-day prospective cohort study and external validation of the African surgical outcomes study surgical risk calculator.

Authors:
Sina Zarrintan

Int J Surg 2019 09 16;69:166-167. Epub 2019 Jul 16.

Division of Vascular & Endovascular Surgery, Department of General & Vascular Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

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http://dx.doi.org/10.1016/j.ijsu.2019.07.012DOI Listing
September 2019

Vascularized gastroepiploic lymph node transfer significantly improves breast cancer-related lymphedema.

J Surg Oncol 2020 Jan 16;121(1):163-167. Epub 2019 Jul 16.

Department of General & Vascular Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Vascularized lymph node transfer (VLNT) is a surgical treatment for lymphedema. Multiple methods have been described and each has significant disadvantages.

Study Design: We performed VLNT in patients with upper extremity lymphedema resulting from breast cancer surgery. We used lymph nodes of the greater curvature of the stomach (VLNTg). We describe outcomes of the patients suffering from postmastectomy lymphedema who received VLNTg for treatment of lymphedema. Harvest from the periphery of the left gastroepiploic vessel was conducted.

Results: We retrospectively reviewed data of 24 female patients suffering from lymphedema following breast cancer treatment who underwent lymph node transplantation from 2012 to 2017. Axillary lymphadenectomy had been performed in all cases. In 18 patients, upper limb lymphedema was present for at least 1 year (mean = 5.6 years; range, 1-15 years). In 6 patients, it was present for only a few months (mean = 5 months; range, 3-8 months).

Conclusions: The greater curvature of the stomach nodes (VLNTg) is an excellent option for the treatment of upper extremity lymphedema because there is no risk of complications and the scar is easily concealed. Improvement from lymphedema can be expected in a majority of patients.
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http://dx.doi.org/10.1002/jso.25607DOI Listing
January 2020

Effect of N-acetylcysteine on liver and kidney function tests after surgical bypass in obstructive jaundice: A randomized controlled trial.

Asian J Surg 2020 Jan 4;43(1):322-329. Epub 2019 Jul 4.

Section of Kidney Transplantation, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: It has been shown that N-acetylcysteine may be useful in correcting postoperative hepatic and renal function in many pathological conditions. The present study aimed to examine the effect of N-acetylcysteine on liver and kidney function tests after surgical bypass in patients with obstructive jaundice.

Methods: & Materials: A total of 30 patients with obstructive jaundice who were candidates for bypass surgery were enrolled in this randomized clinical trial. In the case group, intravenous N-acetylcysteine (200 mg/kg per hour in the first 8 h, followed by 100 mg/kg per hour for another 16 h, the same dose for another 24 h) was administered postoperatively. Liver and renal function tests (serum AST, ALT, ALP, GGT, bilirubin, and creatinine) were compared between two groups, as well as duration of hospitalization and ICU stay.

Results: Postoperatively, decrease in mean serum AST (p = 0.01), ALT (p = 0.02), ALP (p = 0.01), GGT (p = 0.04) and bilirubin (total, p = 0.02, direct, p = 0.01) levels compared to the preoperative values was significantly more among cases compared to those in controls. Changes in serum creatinine, however, did not differ significantly between two groups (p = 0.18). Hospital and ICU stays were also not different between two study groups (p = 0.27 and p = 0.94 respectively).

Conclusion: On the basis of our findings, intravenous N-acetylcysteine in patients with obstructive jaundice could significantly preserve liver function after bypass surgery. Effect of this medication on renal function; however, was not statistically significant.

Trial Registration: Iranian Registry of Clinical Trial: IRCT2016041016473N7.
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http://dx.doi.org/10.1016/j.asjsur.2019.05.009DOI Listing
January 2020

Isolated inferior vena cava aneurysm: a case report.

J Cardiovasc Thorac Res 2019 14;11(1):72-74. Epub 2019 Mar 14.

Shohada-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

We report a rare case of inferior vena cava (IVC) aneurysm in a 22-year old Afghan-Iranian male patient. CT scan illustrated a saccular aneurysm of IVC originating from right side of the IVC below the renal veins (a saccular type 3 IVC aneurysm). We planned open resection and repair of the aneurysm. The patient had well recovery after the operation and his follow-up did not reveal any morbidity. IVC aneurysm is a rare clinical entity. Its diagnosis necessitates precise clinic suspicion and the management is based on anatomical location and associated anomalies.
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http://dx.doi.org/10.15171/jcvtr.2019.12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6477102PMC
March 2019

Iliac vein aneurysms: a comprehensive review.

J Cardiovasc Thorac Res 2019 19;11(1):1-7. Epub 2019 Feb 19.

Division of Vascular & Endovascular Surgery, Department of General & Vascular Surgery, Shohada-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Iliac vein aneurysm is a rare clinical entity. Iliac venous tract is the least commonlocation for venous aneurysms. There are a few cases of common, external and internal iliac veinaneurysms in the literature. However, undiagnosed and ruptured iliac venous aneurysms couldhave hazardous consequences. Herein, we reviewed all literature cases of iliac vein aneurysms.Their potential diagnostic and therapeutic challenges are discussed. Following a systematic search, 50 cases of iliac venous aneurysms wereidentified. We used MEDLINE [1900-March 2018] and EMBASE [until March 2018]. MeSHterms of iliac vein/veins/venous, hypogastric, inferior vena cava and aneurysm/aneurysms wereused. Fifty patients with venous aneurysms located in common, external or internal iliac veinswere found in our systematic search. Seventeen patients were female (35.4%) and 31 patients weremale (64.6%). The age range was 13 to 70 years of age. The aneurysm was located in right side in17 patients (34%). It was located in left side in 29 patients (58%) and it was bilateral in 4 patients(8%). The aneurysm was located in common, external and internal iliac veins in 15 (30%), 31(62%) and 4 (8%) patients respectively. The aneurysm was due to a previous arteriovenousfistula (AVF) in 19 patients (38%) and of them, 16 patients (32%) had a history of AVF resultingfrom a previous trauma. 29 patients (59.2%) underwent open surgical treatment. Five patients(10.2%) underwent endovascular treatment. One patient (2.0%) underwent hybrid treatment.Conservative treatment was used in 14 patients (28.6%). Iliac vein aneurysms are extremely rare. Its diagnosis necessitates precise clinicalsuspicion and the treatment is based on patients' clinical scenario and radiological features. Bothopen and endovascular techniques could be feasible. Iliac vein aneurysms are more commonin men. Left sided aneurysms are more common. The most common anatomic location isexternal iliac vein. The most common cause of iliac aneurysms is dilatation of vein secondary toa traumatic AVF.
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http://dx.doi.org/10.15171/jcvtr.2019.01DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6477113PMC
February 2019
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