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Peri-interventional Triple Therapy With Dabigatran Improves Vasomotion and Promotes Endothelialization in Porcine Coronary Stenting Model.

Front Cardiovasc Med 2021 2;8:690476. Epub 2021 Jul 2.

Department of Cardiology, Medical University of Vienna, Vienna, Austria.

We evaluated the short and long-term effect of peri-interventional dabigatran therapy on vasomotion, endothelialization, and neointimal formation in a porcine coronary artery stenting model. Stenting of coronary arteries induces local inflammation, impairs vasomotion and delays endothelialization. Twenty-eight animals underwent percutaneous coronary intervention (PCI) with drug eluting stents. Read More

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Chronic Thromboembolic Pulmonary Hypertension Medical Management.

Methodist Debakey Cardiovasc J 2021 1;17(2):e29-e33. Epub 2021 Jul 1.

Houston Methodist Hospital, Houston, Texas.

Chronic thromboembolic pulmonary hypertension (CTEPH) is a common long-term complication of pulmonary embolism characterized by thromboembolic obstruction of the pulmonary arteries, vascular arteriopathy, vascular remodeling, and ultimately pulmonary hypertension (PH). Although pulmonary endarterectomy (PEA) surgery is the standard of care, approximately 40% of patients in the international CTEPH registry were deemed inoperable. In addition to lifelong anticoagulation, the cornerstone of PH-specific medical management is riociguat, a soluble guanylate cyclase stimulator. Read More

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Clopidogrel-Induced Interstitial Lung Disease: A Case Report.

Ther Clin Risk Manag 2021 12;17:711-715. Epub 2021 Jul 12.

Department of Pulmonary, Allergy and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.

In patients, with cerebral infarction resulting from intracranial arterial stenosis, the combined administration of clopidogrel and aspirin may be needed for to prevent subsequent ischemic attacks. Clopidogrel has an inevitable adverse effect profile, and the most common complications are related to hemorrhagic propensity. A 79-year-old female patient had used aspirin (100 mg/day) for cerebral infarction and then a dual antiplatelet regimen of aspirin and clopidogrel (75 mg/day) because of severe stenosis in both anterior cerebral arteries. Read More

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Klüver-Bucy syndrome secondary to a nondominant middle cerebral artery ischemic stroke: a case report and review of the literature.

J Med Case Rep 2021 Jul 15;15(1):346. Epub 2021 Jul 15.

Department of Neurology, Prince Sultan Military Medical City (PSMMC), MakkahAl Mukarramah Road, As Sulimaniyah, PO Box 7897, Riyadh, Saudi Arabia.

Background: Klüver-Bucy syndrome is a rare and complex neurobehavioral cluster that occurs in humans and results from a temporal lobe lesion. It can be associated with a variety of causes. Stroke is a rarely reported cause of this syndrome. Read More

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Absent Left Anterior Descending Coronary Artery as a Potential Cause of Ischemic Stroke: A Case Report.

Am J Case Rep 2021 Jul 12;22:e931109. Epub 2021 Jul 12.

Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

BACKGROUND Embolic stroke of undetermined source (ESUS) represents 20-30% of ischemic strokes, with a high risk of recurrence. It usually requires an extensive diagnostic evaluation to address the potential etiologies. Coronary artery anomaly (CAA) of the left anterior descending artery (LAD) is uncommon, and it is known to be linked to myocardial complications. Read More

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Unusual presentation of moyamoya disease with popliteal involvement: case report and review of the literature.

J Vasc Bras 2021 Jun 21;20:e20200216. Epub 2021 Jun 21.

Alaaddin Keykubat University, Medical School, Alanya/Antalya, Turkey.

Moyamoya disease is a rare disorder that involves the cerebrovascular system. Usually, it leads to occlusion of the arteries of the cerebral system and causes cerebral circulatory complaints. A 48-year-old female patient was admitted to our clinic with intermittent claudication in both legs. Read More

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The Most Common Clinical Features of Kawasaki Disease Patients in King Abdulaziz Medical City.

Cureus 2021 May 19;13(5):e15127. Epub 2021 May 19.

Cardiology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU.

Background Kawasaki disease (KD) is an acute idiopathic vasculitis affecting the small and medium-sized arteries especially coronary artery (CA). it occurs in childhood mostly below five years of age. Objective This study aims to identify the most common clinical features among KD patients in King Abdulaziz Medical City in Jeddah, Saudi Arabia from 1/1/1982 to 31/12/2018. Read More

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A case report of takotsubo syndrome complicated by ischaemic stroke: the clinical dilemma of anticoagulation.

Eur Heart J Case Rep 2021 Mar 15;5(3):ytab051. Epub 2021 Mar 15.

Cardiothoracic and Vascular Department, Cardiology Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Heart Tower-Room 807, Largo Città d'Ippocrate, 84131 Salerno, Italy.

Background: Takotsubo syndrome (TTS) is an acute and transient heart failure syndrome due to reversible myocardial dysfunction characterized by a wide spectrum of possible clinical scenarios. About one-fifth of TTS patients experience adverse in-hospital events. Thromboembolic complications, especially stroke, have been reported, albeit in a minority of patients. Read More

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Quantitative analysis of in-vivo microbubble distribution in the human brain.

Sci Rep 2021 Jun 3;11(1):11797. Epub 2021 Jun 3.

Biomedical Engineering, University of Virginia, Charlottesville, VA, USA.

Microbubbles (MB) are widely used as contrast agents to perform contrast-enhanced ultrasound (CEUS) imaging and as acoustic amplifiers of mechanical bioeffects incited by therapeutic-level ultrasound. The distribution of MBs in the brain is not yet fully understood, thereby limiting intra-operative CEUS guidance or MB-based FUS treatments. In this paper we describe a robust platform for quantification of MB distribution in the human brain, allowing to quantitatively discriminate between tumoral and normal brain tissues and we provide new information regarding real-time cerebral MBs distribution. Read More

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"Two for One", Novel Dual Left Anterior Descending Artery (LAD) Variant: Type XIII.

Cureus 2021 Apr 27;13(4):e14717. Epub 2021 Apr 27.

Cardiology, Northwell Health, Manhasset, USA.

Dual left anterior descending artery (LAD) is a rare phenomenon that occurs in less than one percent of the population. To date, 12 variants have been identified. Proper identification of coronary vessels is crucial in emergent situations that require prompt action, such as percutaneous coronary intervention (PCI). Read More

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Haemochromatosis in a kidney transplant recipient: a case report.

BMC Nephrol 2021 May 29;22(1):201. Epub 2021 May 29.

Department of Nephrology, Medical University of Lublin, Jaczewskiego street 8, 20-090, Lublin, Poland.

Background: Iron overload is inevitably related to chronic kidney disease (CKD) treatment. Haemochromatosis leads to multiorgan damage and is associated with increased mortality. Primary haemochromatosis is the most common autosomal recessive disease in white populations. Read More

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Pregnancy outcome in Takayasu arteritis.

BMJ Case Rep 2021 May 26;14(5). Epub 2021 May 26.

Obstetrics and Gynaecology, JIPMER, Puducherry, Tamil Nadu, India.

A young pregnant woman, G2P1L1, was admitted for safe confinement at 40 weeks of gestation with Takayasu arteritis. She was diagnosed with Takayasu arteritis in 2016 when she had polyarthritis, hypertension and asymmetrical peripheral pulses. Her CT angiogram showed involvement of branches of aortic arch and coeliac trunk. Read More

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Takayasu's Arteritis in a 33-Year-Old Male.

Cureus 2021 Apr 19;13(4):e14557. Epub 2021 Apr 19.

Internal Medicine, Army Medical College, Rawalpindi, PAK.

Takayasu's arteritis (TA), commonly referred to as "pulseless" disease, is a large-vessel inflammatory vasculitis most commonly affecting the aorta and its major branches. Due to its irregular nature, it has the propensity to involve any organ system thus leading to a wide spectrum of clinical features. Most patients affected by TA are females in their second or third decades of lives. Read More

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Frequent occurrence of postbreakfast syncope due to carotid sinus syndrome after surgery for hypopharyngeal cancer: A case report.

Medicine (Baltimore) 2021 May;100(20):e25959

Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama.

Rationale: Syncope often occurs in patients with advanced head and neck cancers due to the stimulation of the autonomic nervous system by the tumor. Here, we describe a case of frequent syncopal episodes after laryngopharyngectomy for hypopharyngeal cancer. As all syncopal episodes were observed during the forenoon, we also evaluated the heart rate variability using ambulatory electrocardiography to determine why the syncopal episodes occurred during a specified period of the day. Read More

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Topographic Anatomy of the Zygomatico-Orbital Artery: Implications for Improving the Safety of Temporal Augmentation.

Plast Reconstr Surg 2021 Jul;148(1):19e-27e

From the State Key Laboratory of Oral Diseases, National State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, and Department of Cosmetic and Plastic Surgery, Oral and Maxillofacial Surgery, West China Hospital of Stomatology, the Department of Radiology, West China Hospital, and the Department of Human Anatomy, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University.

Background: Anatomical knowledge of the zygomatico-orbital artery and its most relevant clinical applications is essential for ensuring the safety of filler injection into the temporal region. The purpose of this study was to provide the precise position, detailed course, and relationship with surrounding structures of the zygomatico-orbital artery.

Methods: Fifty-eight patients who underwent head contrast-enhanced three-dimensional computed tomography and 10 fresh frozen cadavers were investigated. Read More

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Radiologic mimics of pulmonary embolism.

Postgrad Med 2021 Jun 14:1-7. Epub 2021 Jun 14.

Department of Medicine, Division of Pulmonary & Critical Care Medicine, Cedars-Sinai Medical Center - Venous Thromboembolism and Pulmonary Vascular Disease Research Program, Los Angeles, California, United States.

The diagnosis of pulmonary embolism (PE) is often made more challenging by the presence of diseases that can mimic thromboembolic disease. There is no specific or sensitive constellation of clinical signs or symptoms that can be used to diagnose PE. Ventilation/perfusion scans can have false-positive findings related to mediastinal conditions that can compress the pulmonary arteries, and pulmonary hemorrhage can resemble PE on V/Q scanning with potentially devastating consequences if anticoagulation is started. Read More

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Bilateral carotid webs.

Neuroradiol J 2021 May 18:19714009211017783. Epub 2021 May 18.

Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.

Carotid web is thought to be a focal intimal variant of fibromuscular dysplasia, which comprises a high risk of stroke because of blood stasis and subsequent coagulative reactions that occur distal to the web. These lesions generally involve the posterolateral wall of the carotid and their developmental pathogenesis is controversial. This case report describes a 51-year-old woman who presented to the hospital with sudden onset aphasia, right hemi-sensory loss, and right visual field cut. Read More

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[Superior Mesenteric Artery Bypass Grafting from the Ascending Aorta Using a Saphenous Vein Graft for Treatment of Acute Aortic Dissection with Abdominal Malperfusion:Report of a Case].

Kyobu Geka 2021 May;74(5):388-391

Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.

A 50-year-old man presented with abdominal pain and numbness in the right leg. He was diagnosed with type A acute aortic dissection with malperfusion of the superior mesenteric artery(SMA) and the right external iliac artery. Before median sternotomy, we made median celiotomy and anastomosed a saphenous vein graft to SMA. Read More

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Peripheral Gangerene, an Unusual Presentation of Infantile Kawasaki: A Case Report and Literature Review.

Case Rep Rheumatol 2021 13;2021:6629405. Epub 2021 Apr 13.

Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Diagnosing infantile Kawasaki disease with atypical symptoms is difficult, and it also has higher risk of coronary abnormalities which is one of the most common complications of KD. Other complications such as pericardial effusion, mitral insufficiency, congestive heart failure, myocardial systolic dysfunction, and systemic vasculitis were also reported. Peripheral gangrene and necrosis are among the rare complications of this systemic vasculitis. Read More

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A case report of acute Leriche syndrome: aortoiliac occlusive disease due to embolization from left ventricular thrombus caused by myocarditis.

BMC Cardiovasc Disord 2021 Apr 30;21(1):220. Epub 2021 Apr 30.

Centre for Research and Development, Uppsala University/Region Gävleborg, 801 87, Gävle, Sweden.

Background: Leriche syndrome is the triad of symptoms consisting of claudication, erectile dysfunction, and absence of femoral pulses. Inflammatory disease of the heart muscle, myocarditis, may occur because of immune system activation, drug exposure or infections.

Case Presentation: A 31-year-old man with no previous medical history presented to the emergency department with acute back pain that had started suddenly during weightlifting, which was initially misdiagnosed as spinal disc herniation. Read More

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Large Hemorrhagic Extrascleral Ciliary Body Melanoma Recurrence Treated With Transarterial Embolization and Coiling Followed by Exenteration.

Ophthalmic Plast Reconstr Surg 2021 Apr 28. Epub 2021 Apr 28.

Department of Radiology Regional Hospital St. Gallen Department of Dermatology Regional Hospital St. Gallen Department of Pathology Regional Hospital St. Gallen Department of Ophthalmology, Regional Hospital St. Gallen University of Zurich, Zurich, Switzerland.

A 59-year-old male patient who suffered from a systemically metastasized, large extrascleral uveal melanoma recurrence of the left eye presented with active hemorrhage from the tumor. He had undergone proton beam irradiation for an epithelioid ciliary body melanoma 4 years before presentation and was lost to follow-up. Magnetic resonance angiography showed vascularization of the lesion via the ophthalmic and maxillary artery. Read More

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Isolated Cervical Pain Revealing a Common Carotid Artery Dissection in a Child Following a Minor Trauma: A First Pediatric Case Report and a Review of the Literature.

Neurol India 2021 Mar-Apr;69(2):478-479

Department of Neurology, Military Hospital of Tunis, Monfleury, Tunis, Tunisia.

Background: Cervical artery dissections are not exceptional in the pediatric population. Typically, it affects the internal carotid artery or the vertebral artery. To our knowledge, this is the first case of common carotid artery (CCA) dissection in a child. Read More

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Cardiac Involvement in Sarcomatoid Renal Cell Carcinoma.

Cureus 2021 Mar 24;13(3):e14076. Epub 2021 Mar 24.

Pathology, Ain Shams University, Cairo, EGY.

Pulmonary emboli (PE) in malignancy are usually related to hypercoagulability; however, in rare situations, direct tumor emboli are the etiology of pulmonary embolism. We present here a case of a 68-year-old male with known stage IV sarcomatoid renal cell carcinoma who came to the emergency department (ED) complaining of shortness of breath. A CT scan was done that showed bilateral segmental PE and a cardiac mass in the right ventricle that was consistent with known renal cell carcinoma. Read More

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Effectiveness and safety of tocilizumab in patients with refractory or severe Takayasu's arteritis: A prospective cohort study in a Chinese population.

Joint Bone Spine 2021 Apr 20;88(5):105186. Epub 2021 Apr 20.

Departments of Rheumatology, Zhongshan Hospital, Fudan University, 180, Fenglin Road, 200032 Shanghai, People's Republic of China; Evidence-base Medicine Center, Fudan University, 200032 Shanghai, People's Republic of China. Electronic address:

Objective: To assess the effectiveness and safety of tocilizumab (TCZ) in treating severe/refractory Takayasu's arteritis (TAK).

Methods: A prospective cohort study was started on 1 November 2013 and terminated on 10 June 2020. Thirty-seven patients diagnosed as severe/refractory TAK, treated with TCZ combined with or without immunosuppressors were enrolled. Read More

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Severe neonatal pulmonary artery hypertension rescued with vasopressin.

BMJ Case Rep 2021 Apr 15;14(4). Epub 2021 Apr 15.

Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

An inborn term neonate weighing 2600 g developed meconium aspiration syndrome at birth. Baby had respiratory failure requiring high-frequency oscillatory ventilation support at 15 hours of life. He additionally developed hypotension with left ventricular dysfunction noted on point-of-care echocardiography (POCE), which required dopamine and epinephrine infusions. Read More

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[COVID-19 infection presenting as a myocardial infarction. Report of one case].

Rev Med Chil 2020 Dec;148(12):1848-1854

Departamento de Cardiología, Hospital Clínico, Universidad de Chile, Santiago, Chile.

Isolated cardiac involvement of COVID-19 is an infrequent presentation, and myocardial infarction is even less common. We report a 30-year-old man presenting with retrosternal pain of insidious onset whose intensity increases suddenly. On admission, the patient had tachycardia and an EKG showed a 1 mm ST-elevation and diffuse PQ segment depression. Read More

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December 2020

[Lower limb ischemia in giant cell arteritis. Report of one case].

Rev Med Chil 2020 Oct;148(10):1513-1517

Departamento de Cirugía Vascular y Endovascular, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Giant cell arteritis is more common in women older than 60 years, is associated with systemic inflammation symptoms and mainly involves the aortic arch and cranial arteries, specially the temporal artery. Symptomatic lower extremity arterial stenosis or occlusion is uncommon and can lead to limb loss. We report a 73-year-old woman presenting with a one-month history of lower extremity intermittent claudication of sudden onset. Read More

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October 2020

Comparison of Outcomes for Open Popliteal Artery Aneurysm Repair Using Vein and Prosthetic Conduits.

Ann Vasc Surg 2021 Apr 2. Epub 2021 Apr 2.

Division of Vascular and Endovascular Surgery, Department of Surgery, New York University Langone Medical Center, New York, NY. Electronic address:

Background: Autologous vein is considered the preferred conduit for lower extremity bypass. There is, however, limited literature regarding conduit choice for open popliteal artery aneurysm (PAA) repair. We sought to compare outcomes of PAA repair using vein versus prosthetic conduits. Read More

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Nonischemic Dilated Cardiomyopathy in Untreated Long-Term Psoriatic Arthritis: A Newly Recognized Association: A Case Report with Mini Review.

Am J Case Rep 2021 Apr 2;22:e930041. Epub 2021 Apr 2.

Department of Rheumatology, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ, USA.

BACKGROUND Psoriasis is a chronic inflammatory skin disease associated with multiple comorbidities including psoriatic arthritis (PsA), atherosclerotic disease, metabolic syndrome, diabetes, hypertension, obesity, and depression. Interestingly, nonischemic cardiomyopathy, especially dilated cardiomyopathy (DCM), has been associated with psoriasis and reported in only in a few cases in the literature. CASE REPORT We report the rare case of a 58-year-old man with a medical history of untreated severe psoriasis and PsA who presented with a sudden onset of shortness of breath. Read More

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Adrenergic tone benefits cardiac performance and warming tolerance in two teleost fishes that lack a coronary circulation.

J Comp Physiol B 2021 Jul 18;191(4):701-709. Epub 2021 Mar 18.

Department of Biological and Environmental Sciences, University of Gothenburg, PO Box 463, 405 30, Gothenburg, Sweden.

Tolerance to acute environmental warming in fish is partly governed by the functional capacity of the heart to increase systemic oxygen delivery at high temperatures. However, cardiac function typically deteriorates at high temperatures, due to declining heart rate and an impaired capacity to maintain or increase cardiac stroke volume, which in turn has been attributed to a deterioration of the electrical conductivity of cardiac tissues and/or an impaired cardiac oxygen supply. While autonomic regulation of the heart may benefit cardiac function during warming by improving myocardial oxygenation, contractility and conductivity, the role of these processes for determining whole animal thermal tolerance is not clear. Read More

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