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Roychowdhury T, Klarin D, Levin MG, Spin JM, Rhee YH, Deng A, Headley CA, Tsao NL, Gellatly C, Zuber V, Shen F, Hornsby WE, Laursen IH, Verma SS, Locke AE, Einarsson G, Thorleifsson G, Graham SE, Dikilitas O, Pattee JW, Judy RL, Pauls-Verges F, Nielsen JB, Wolford BN, Brumpton BM, Dilmé J, Peypoch O, Juscafresa LC, Edwards TL, Li D, Banasik K, Brunak S, Jacobsen RL, Garcia-Barrio MT, Zhang J, Rasmussen LM, Lee R, Handa A, Wanhainen A, Mani K, Lindholt JS, Obel LM, Strauss E, Oszkinis G, Nelson CP, Saxby KL, van Herwaarden JA, van der Laan SW, van Setten J, Camacho M, Davis FM, Wasikowski R, Tsoi LC, Gudjonsson JE, Eliason JL, Coleman DM, Henke PK, Ganesh SK, Chen YE, Guan W, Pankow JS, Pankratz N, Pedersen OB, Erikstrup C, Tang W, Hveem K, Gudbjartsson D, Gretarsdottir S, Thorsteinsdottir U, Holm H, Stefansson K, Ferreira MA, Baras A, Kullo IJ, Ritchie MD, Christensen AH, Iversen KK, Eldrup N, Sillesen H, Ostrowski SR, Bundgaard H, Ullum H, Burgess S, Gill D, Gallagher K, Sabater-Lleal M, Surakka I, Jones GT, Bown MJ, Tsao PS, Willer CJ, Damrauer SM. Genome-wide association meta-analysis identifies risk loci for abdominal aortic aneurysm and highlights PCSK9 as a therapeutic target. Nat Genet 2023; 55:1831-1842. [PMID: 37845353 PMCID: PMC10632148 DOI: 10.1038/s41588-023-01510-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/22/2023] [Indexed: 10/18/2023]
Abstract
Abdominal aortic aneurysm (AAA) is a common disease with substantial heritability. In this study, we performed a genome-wide association meta-analysis from 14 discovery cohorts and uncovered 141 independent associations, including 97 previously unreported loci. A polygenic risk score derived from meta-analysis explained AAA risk beyond clinical risk factors. Genes at AAA risk loci indicate involvement of lipid metabolism, vascular development and remodeling, extracellular matrix dysregulation and inflammation as key mechanisms in AAA pathogenesis. These genes also indicate overlap between the development of AAA and other monogenic aortopathies, particularly via transforming growth factor β signaling. Motivated by the strong evidence for the role of lipid metabolism in AAA, we used Mendelian randomization to establish the central role of nonhigh-density lipoprotein cholesterol in AAA and identified the opportunity for repurposing of proprotein convertase, subtilisin/kexin-type 9 (PCSK9) inhibitors. This was supported by a study demonstrating that PCSK9 loss of function prevented the development of AAA in a preclinical mouse model.
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Affiliation(s)
- Tanmoy Roychowdhury
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA.
- Department of Genetics, Yale School of Medicine, New Haven, CT, USA.
| | - Derek Klarin
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
| | - Michael G Levin
- Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Joshua M Spin
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Yae Hyun Rhee
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Alicia Deng
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Colwyn A Headley
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Noah L Tsao
- Department of Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Corry Gellatly
- Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Verena Zuber
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- UK Dementia Research Institute at Imperial College, Imperial College London, London, UK
| | - Fred Shen
- University of Michigan Medical Scientist Training Program, University of Michigan, Ann Arbor, MI, USA
| | - Whitney E Hornsby
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Ina Holst Laursen
- Department of Clinical Immunology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Shefali S Verma
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Philadelphia, PA, USA
| | - Adam E Locke
- Regeneron Genetics Center, LLC, Tarrytown, NY, USA
| | | | | | - Sarah E Graham
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Ozan Dikilitas
- Department of Internal Medicine, Mayo Clinic Rochester, Rochester, MN, USA
- Department of Cardiovascular Medicine and the Gonda Vascular Center, Mayo Clinic Rochester, Rochester, MN, USA
- Mayo Clinician Investigator Training Program, Mayo Clinic Rochester, Rochester, MN, USA
| | | | - Renae L Judy
- Department of Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Ferran Pauls-Verges
- Unit of Genomics of Complex Diseases, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Jonas B Nielsen
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway
| | - Brooke N Wolford
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ben M Brumpton
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jaume Dilmé
- Department of Vascular and Endovascular Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Olga Peypoch
- Unit of Genomics of Complex Diseases, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
- Department of Vascular and Endovascular Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - Todd L Edwards
- Division of Epidemiology, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dadong Li
- Regeneron Genetics Center, LLC, Tarrytown, NY, USA
| | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rikke L Jacobsen
- Department of Clinical Immunology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Minerva T Garcia-Barrio
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Jifeng Zhang
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Lars M Rasmussen
- Department of Clinical Biochemistry, Odense University Hospital, Elite Research Centre of Individualized Medicine in Arterial Disease (CIMA), Odense, Denmark
| | - Regent Lee
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Ashok Handa
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Anders Wanhainen
- Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - Kevin Mani
- Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden
| | - Jes S Lindholt
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Elite Research Centre of Individualized Medicine in Arterial Disease (CIMA), Odense, Denmark
| | - Lasse M Obel
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Elite Research Centre of Individualized Medicine in Arterial Disease (CIMA), Odense, Denmark
| | - Ewa Strauss
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Grzegorz Oszkinis
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
- Department of Vascular and General Surgery, Institute of Medical Sciences, University of Opole, Opole, Poland
| | - Christopher P Nelson
- Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Katie L Saxby
- Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Joost A van Herwaarden
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Sander W van der Laan
- Central Diagnostics Laboratory, Division Laboratories, Pharmacy, and Biomedical genetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jessica van Setten
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mercedes Camacho
- Unit of Genomics of Complex Diseases, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Frank M Davis
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA
| | - Rachael Wasikowski
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jonathan L Eliason
- Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Dawn M Coleman
- Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Peter K Henke
- Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Santhi K Ganesh
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Y Eugene Chen
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Weihua Guan
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - James S Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Nathan Pankratz
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Ole B Pedersen
- Department of Clinical Immunology, Zealand University Hospital-Køge, Køge, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Weihong Tang
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Kristian Hveem
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Daniel Gudbjartsson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Hilma Holm
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
| | - Kari Stefansson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Aris Baras
- Regeneron Genetics Center, LLC, Tarrytown, NY, USA
| | - Iftikhar J Kullo
- Department of Cardiovascular Medicine and the Gonda Vascular Center, Mayo Clinic Rochester, Rochester, MN, USA
| | - Marylyn D Ritchie
- Department of Genetics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Alex H Christensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kasper K Iversen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Nikolaj Eldrup
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Vascular Surgery, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Henrik Sillesen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sisse R Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henning Bundgaard
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | | | - Stephen Burgess
- MRC Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Chief Scientific Advisor Office, Research and Early Development, Novo Nordisk, Copenhagen, Denmark
| | - Katherine Gallagher
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA
| | - Maria Sabater-Lleal
- Unit of Genomics of Complex Diseases, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
- Cardiovascular Medicine Unit, Department of Medicine, Karolinska Institutet, Center for Molecular Medicine, Stockholm, Sweden
| | - Ida Surakka
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Gregory T Jones
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Matthew J Bown
- Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Philip S Tsao
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Cristen J Willer
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA.
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA.
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA.
| | - Scott M Damrauer
- Department of Surgery, Corporal Michael Crescenz VA Medical Center, Philadelphia, PA, USA.
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
- Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
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Czajkowska MJ, Wolf BJ, Oszkinis G, Dorobisz AT. Proximal vertebral artery surgery. Results of treatment of ischemia of the rhombencephalon (hindbrain). Simultaneous carotid and vertebral artery decompression procedures. Acta Angiologica 2022. [DOI: 10.5603/aa.2022.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Mansilha A, Viddal B, Krievins D, McLain D, Petkov D, Adili F, DE Borst G, Oszkinis G, Fourneau I, Cvjetko I, Kakisis J, Maeso J, Scott J, Tijunaitis K, Cassar K, Velicka L, Gasparini M, Widmer M, Gargiulo M, Ionac M, Chakfé N, Staffa R, Suominen V, Szeberin Z. European training requirements in vascular surgery. INT ANGIOL 2022; 41:91-104. [PMID: 35138075 DOI: 10.23736/s0392-9590.22.04841-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Armando Mansilha
- UEMS Section and Board of Vascular Surgery, Faculty of Medicine, University of Porto, Porto, Portugal -
| | - Beate Viddal
- UEMS Section and Board of Vascular Surgery, Norway
| | | | | | | | - Farzin Adili
- UEMS Section and Board of Vascular Surgery, Germany
| | - Gert DE Borst
- UEMS Section and Board of Vascular Surgery, the Netherlands
| | | | | | - Ivan Cvjetko
- UEMS Section and Board of Vascular Surgery, Croatia
| | - John Kakisis
- UEMS Section and Board of Vascular Surgery, Greece
| | - Jordi Maeso
- UEMS Section and Board of Vascular Surgery, Spain
| | | | | | - Kevin Cassar
- UEMS Section and Board of Vascular Surgery, Malta
| | - Linas Velicka
- UEMS Section and Board of Vascular Surgery, Lithuania
| | | | | | | | - Mihai Ionac
- UEMS Section and Board of Vascular Surgery, Romania
| | - Nabil Chakfé
- UEMS Section and Board of Vascular Surgery, France
| | - Robert Staffa
- UEMS Section and Board of Vascular Surgery, Czech Republic
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Dzieciuchowicz Ł, Tomczak J, Strauss E, Oszkinis G. Mid-Term Results of Endovascular Aneurysm Sealing in the Treatment of Abdominal Aortic Aneurysm With Unfavorable Morphology. Vasc Endovascular Surg 2020; 55:39-49. [PMID: 33034263 DOI: 10.1177/1538574420965736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To report mid-term results of endovascular aneurysm sealing (EVAS) of abdominal aortic aneurysms (AAA) deemed unsuitable for a standard endovascular aneurysm repair (EVAR). METHODS A prospectively maintained database of 42 patients with EVAR-unfavorable anatomy treated by EVAS combined with chimney grafts in case of the proximal AAA neck shorter than 5 mm was analyzed. Early outcomes included final angiographic result, intra- and early post-operative deaths, and complications. Mid-term outcomes included all-cause mortality (ACM), aneurysm-related mortality (ARM), patency of the stents, occurrence of endoleaks, serious complications and graft failures defined as the AAA growth of more than 5 mm, type I endoleak, occlusion of the stent-graft or chimney graft, aorto-duodenal fistula, or aneurysm rupture. RESULTS The procedure was completed in all patients. Twenty-eight chimney grafts were implanted in 19 patients. Patients were followed for a median of 24 months (range 12-34 months). There were 2 intraoperative ruptures and 1 patient died in an early postoperative period. The cumulative ACM was 15, 21, and 36% at 12, 24, and 36 months, respectively, and the cumulative ARM was 8, 11, and 27% at 12, 24, and 36 months, respectively. Three out of 5 aneurysm-related deaths were due to a secondary aorto-duodenal fistula. The cumulative incidence of graft failure was 20, 27, and 42% at 12, 24, and 36 months, respectively. The cumulative incidence of an endoleak was 5, 9, and 23% at 12, 24, and 36 months, respectively. The graft failure increased significantly both ACM (p = .012) and ARM (p = .00003). The implantation of chimney grafts at the initial procedure increased ARM significantly (p = .008). The presence of an endoleak did not have any significant influence on ACM and ARM. CONCLUSION Patients treated with EVAS for AAAs with EVAR-unfavorable anatomy, especially those with chimney grafts, exhibit a high risk of graft failure and subsequent death.
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Affiliation(s)
- Łukasz Dzieciuchowicz
- Department of Vascular Surgery and Vascular Diseases, Institute of Medical Sciences, 49792University of Zielona Góra, Zielona Góra, Poland
| | - Jolanta Tomczak
- Department of Vascular and Endovascular Surgery, Angiology and Phlebology, 37807Poznan University of Medical Sciences, Poznań, Poland
| | - Ewa Strauss
- Department of Vascular and Endovascular Surgery, Angiology and Phlebology, 37807Poznan University of Medical Sciences, Poznań, Poland.,Institute of Human Genetics, Polish Academy of Sciences, Poznań, Poland
| | - Grzegorz Oszkinis
- Department of General and Vascular Surgery, University of Opole, Opole, Poland
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Kruszyna Ł, Dzieciuchowicz Ł, Strauss E, Oszkinis G. Midterm Results of the Treatment of Penetrating Abdominal Aortic or Iliac Artery Ulcer with the BeGraft Balloon-Expandable Covered Stent-A Single-Center Experience. Ann Vasc Surg 2020; 69:382-390. [PMID: 32504793 DOI: 10.1016/j.avsg.2020.05.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/17/2020] [Accepted: 05/21/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The purpose of the study was to evaluate the feasibility and efficacy of the novel BeGraft covered stent for the treatment of abdominal penetrating aortic ulcer (PAU) or penetrating ulcers of the iliac arteries (PUIAs). METHODS This was a single-center observational study, which included 24 consecutive patients who underwent endovascular surgery due to abdominal PAU or PUIA between June 2017 and September 2019. Demographics of patients, lesion characteristics, diameter and length of the BeGraft stents, and postoperative events were prospectively collected and retrospectively analyzed. Follow-up examinations were performed at 1, 6, 12, and 24 months with clinical and hemodynamic evaluation. Outcome measures included technical success, perioperative complications, and stent patency. RESULTS A total of 24 patients (13 men and 11 women), with a median age of 67 years (range, 42-81 years), were analyzed. Among them, 20 patients were symptomatic, and 4 patients underwent elective surgery because of the size of PAU. A total of 54 BeGraft stents (26 aortic and 28 peripheral) were successfully delivered and deployed to cover 13 aortic and 13 common iliac artery ulcer lesions. The technical success rate was 100%. The average procedural time was 53.8 ± 12.8 min. Complications included one case of the access-site pseudoaneurysm, which was successfully treated by thrombin injection. During a median follow-up of 20.5 months (range, 6-33 months), all stents remained patent, without endoleak or ulcer recurrence. CONCLUSIONS BeGraft stents used during endovascular treatment of abdominal PAU and PUIA lesions are associated with favorable outcomes regarding technical success and patency. The primary use of BeGraft covered stents provides a valid option for patients with abdominal PAU. Long-term follow-up is required to confirm these promising results.
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Affiliation(s)
- Łukasz Kruszyna
- Department of General and Vascular Surgery, University of Medical Sciences, Poznan, Poland.
| | - Łukasz Dzieciuchowicz
- Department of General and Vascular Surgery, University of Medical Sciences, Poznan, Poland
| | - Ewa Strauss
- Department of General and Vascular Surgery, University of Medical Sciences, Poznan, Poland; Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Grzegorz Oszkinis
- Department of General and Vascular Surgery, University of Medical Sciences, Poznan, Poland; Department of Vascular and General Surgery, University Hospital, Opole University, Medical College, Opole, Poland
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Strauss E, Tomczak J, Stelcer M, Grobelna M, Oszkinis G. Genetic Variants in Selenoprotein Genes Selenos, GPX4, and SEPP1, but not Selenoprotein Levels, are Associated with the Development of Peripheral Artery Disease and the Inter-individual Variation in the Ankle-Brachial Index. Eur J Vasc Endovasc Surg 2019. [DOI: 10.1016/j.ejvs.2019.06.931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dzieciuchowicz Ł, Krzyżański R, Kruszyna Ł, Krasinski Z, Gabriel M, Oszkinis G. The intravascular ultrasound morphometry of iliac veins in subjects without severe chronic venous insufficiency and its implications for treatment indications and stent size selection. Phlebology 2019; 35:354-360. [DOI: 10.1177/0268355519880032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives The purpose of this study is to report the intravascular ultrasound morphometry of iliac veins and its relation to demographic and anthropometric factors in subjects without chronic venous insufficiency. Methods Thirty-three patients, without chronic venous insufficiency – qualified to great saphenous vein stripping due to unilateral, primary varicose veins – participated in the study. During the surgery, left and right external iliac veins, common iliac veins and inferior vena cava were interrogated with intravascular ultrasound. The morphometric analysis included measurement of a cross-sectional area at normal, non-stenosed vein segments (ref-CSA) and at the point of the most prominent narrowing (minimal lumen area (MLA)). Based on these measurements, a percentage of stenosis (S%) and calculated lumen diameter of interrogated veins were determined according to the following formulas, S% = (ref-CSA–MLA)/ref-CSA × 100 and CLD = 2 × √(ref-CSA/π), respectively. Results Median ref-CSA, S% and calculated lumen diameter were 265.3 mm2, 45.8% and 18.4 mm for inferior vena cava; 193.9 mm2, 62.4% and 15.7 mm for left common iliac veins; 166.9 mm2, 35.7% and 14.2 mm for right common iliac veins; 136.5 mm2, 48.0% and 12.8 mm for left external iliac veins and 140.9 mm2, 46.3% and 13.5 mm for right external iliac veins. There were statistically significant differences between left and right common iliac veins ref-CSA, common iliac veins S% and common iliac veins calculated lumen diameter (p = 0.03, p < 0 and p = 0.03, respectively). The S% of left external iliac veins was greater in women 52.2 versus 37.2% in men (p = 0.04). Neither age nor anthropometric factors had any influence on the calculated lumen diameter of the analysed veins. A negative correlation between the left common iliac veins S% and the age was observed (p = 0.03). Conclusions In adult subjects, the calculated lumen diameter of the common iliac veins is greater on the left side and is not influenced by age and body size. Common iliac vein stenosis occurs more frequently on the left side, decreases with age and tends to be more frequent in women.
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Affiliation(s)
- Łukasz Dzieciuchowicz
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Radosław Krzyżański
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Łukasz Kruszyna
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Zbigniew Krasinski
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Marcin Gabriel
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Grzegorz Oszkinis
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
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8
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Gajewski T, Szajek K, Stȩpak H, Łodygowski T, Oszkinis G. The influence of the nylon balloon stiffness on the efficiency of the intra-aortic balloon occlusion. Int J Numer Method Biomed Eng 2019; 35:e3173. [PMID: 30447053 DOI: 10.1002/cnm.3173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 09/10/2018] [Accepted: 11/08/2018] [Indexed: 06/09/2023]
Abstract
In interventional procedures, the balloon inflation is used to occlude the artery and thus reduce bleeding. There is no practically accepted measure of the procedure efficiency. A finite element method model with state-of-the-art modelling techniques was built in order to predict the occlusion levels under the influence of different balloon inflation and its material stiffness. The geometries of a healthy human thoracic aorta and an occlusion balloon were idealized. The non-linear constitutive material of Gasser-Ogden-Holzapfel model was employed for the thoracic aorta; the balloon was model as the hyperelastic model. The realistic physiological blood pressure and the balloon inflation pressures were applied to simulate the different occlusion levels. The final outcome shows an important influence of the material stiffness on the balloon deformation and thus the occlusion efficiency.
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Affiliation(s)
- Tomasz Gajewski
- Institute of Structural Engineering, Poznań University of Technology, Poznań, Poland
| | - Krzysztof Szajek
- Institute of Structural Engineering, Poznań University of Technology, Poznań, Poland
| | - Hubert Stȩpak
- Department of Vascular and Endovascular Surgery, Angiology, and Phlebology, Poznań University of Medical Sciences, Poznań, Poland
| | - Tomasz Łodygowski
- Institute of Structural Engineering, Poznań University of Technology, Poznań, Poland
| | - Grzegorz Oszkinis
- Department of General and Vascular Surgery, Poznań University of Medical Sciences, Poznań, Poland
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9
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Strauss E, Tomczak J, Staniszewski R, Oszkinis G. Associations and interactions between variants in selenoprotein genes, selenoprotein levels and the development of abdominal aortic aneurysm, peripheral arterial disease, and heart failure. PLoS One 2018; 13:e0203350. [PMID: 30188935 PMCID: PMC6126836 DOI: 10.1371/journal.pone.0203350] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 08/20/2018] [Indexed: 11/25/2022] Open
Abstract
Background Little is known on the role of selenoprotein genes in cardiovascular disease. This study examines the associations of the SEPP1, SELENOS, TXNRD1, TXNRD2, GPX4, and SOD2 polymorphisms and selenoprotein P (SeP) and thioredoxin concentrations with the development of abdominal aortic aneurysm (AAA) and aortoiliac occlusive disease (AOID), as well as their influence on cardiac phenotype. Methods 564 patients with AAA, 400 patients with AIOD, and 543 controls were enrolled and characterized for coronary artery disease, myocardial infarction, and systolic heart failure (HF) occurrence. In AAA, the coexistence of peripheral arterial disease (PAD) was examined. Genotypes were determined using TaqMan-based assays. Selenoprotein concentration was assessed using the ELISA method. Results The SELENOS rs34713741T, SEPP1 rs3877899A, and GPX4 rs713041T alleles were related to a 30–60% increase in the AIOD/PAD risk in the recessive or dominant model (all associations at P < .05). The SEPP1 rs3877899A allele was a protective factor for the development of AAA without concomitant PAD (OR = 0.68 for the dominant model, P = .014), but not AAA with concomitant PAD. The cumulative two-locus effects of selenoprotein genes on the AAA/AIOD risk were observed, including the multiplicative interaction between the SELENOS rs34713741T and GPX4 rs713041T alleles (both in the recessive model) affecting the AIOD risk (OR = 5.27, P = .001) and its clinical phenotype. Coexistence of HF in aortic diseases was related to both the SEPP1 rs7579A allele (OR = 1.83 for carriers, P = .013) and increased SeP concentrations; SeP level ≥8.5 mg/mL caused a 3.5-fold increase in the risk of HF. In AAA, SeP levels were correlated with BMI (r = -0.575, P < .0001). Conclusions Our results provide evidence that selenoprotein polymorphisms constitute a risk factor for HF and peripheral atherosclerosis, but prevent the development of AAA. Excessive weight might result in reduced antioxidant reserve efficiency in AAA. Validation studies are required to establish whether SeP concentration may be a marker for HF.
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Affiliation(s)
- Ewa Strauss
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
- * E-mail:
| | - Jolanta Tomczak
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Ryszard Staniszewski
- Department of Vascular and Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Sciences, Poznan, Poland
| | - Grzegorz Oszkinis
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
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10
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Murawa D, Murawa P, Oszkinis G, Biczysko W. Long-Term Consequences of Total Gastrectomy: Quality of Life, Nutritional Status, Bacterial Overgrowth and Adaptive Changes in Esophagojejunostomic Mucosa. Tumori 2018; 92:26-33. [PMID: 16683381 DOI: 10.1177/030089160609200106] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The aim of the study was to evaluate long-term quality of life and adaptive changes in the mucosa of the proximal section of the small intestine used for esophagojejunostomy reconstruction in stomach cancer patients after total gastrectomy. MATERIAL AND METHODS Thirty-one patients who had undergone stomach cancer-related total gastrectomy were included in the study, which spanned a period of 48 to 127 months (79.6 months on the average) after the surgery. The analysis included: a) evaluation of selected biochemical parameters; b) microbiological evaluation of esophagojejunostomic area; c) evaluation of adaptive changes in esophagojejunostomic mucosa using light and electron microscopy; d) quality of life evaluation with a Troidl questionnaire. RESULTS Quality of life was subjectively rated as good or very good by almost all subjects. The analyzed biochemical parameters were within the range of normal values in all the subjects with the exception of mild abnormalities in alkaline phosphatase and vitamin B12 levels in some patients. Microbiological examination of mucosal specimens from below the esophagojejunostomy revealed significant bacterial flora overgrowth in all the patients, with streptococci being the most abundant species. Light and electron microscopy examination of the epithelium confirmed it was normal and characteristic of a healthy small intestine. CONCLUSIONS Long-term quality of life in patients after complete stomach resection is considered good or very good, irrespective of the reconstruction method used, and the esophagojejunostomic mucosa of the reconstructed area is normal and typical for a healthy small intestine.
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Affiliation(s)
- Dawid Murawa
- 1st Clinic of Surgical Oncology, Great Poland Cancer Center, Wielkopolskie Centrum Onkologii, Poznaf, Poland.
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11
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Zielinski M, Inston N, Krasinski Z, Gabriel M, Oszkinis G. The forearm basilic vein looped transposition fistula as a tertiary option for upper limb vascular access. J Vasc Access 2018; 19:596-601. [DOI: 10.1177/1129729818764137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: The forearm basilic vein can serve as an option for haemodialysis access but may not be possible in cases where the wrist arteries are unsuitable. In this setting, the forearm basilic vein can be used in a looped transposition with a brachial artery anastomosis. Aims: The aims of this study were to assess the outcome of forearm basilic vein looped transposition as an option for vascular access. Material and methods: Data from January 2007 to December 2010 were prospectively collected and analysed. Outcome measures were operative success, complications, maturation and primary and secondary patency following 5 years of follow-up. Results: From a total of 583 patients receiving autologous vascular access for haemodialysis, 24 (4.1%) underwent a forearm basilic vein looped transposition. The median age was 60 years (range, 27–80 years), with a slight male predominance (13 male:11 female). Mean follow-up was 34 months (1–60 months). Two patients died and other three were transplanted with subsequent fistula closure. All procedures were successful (100%); however, maturation failure occurred in one case (4.2%). No serious perioperative complications were observed. In two cases, we observed late false aneurysm formation requiring intervention. Primary patency at 1, 2, 3 and 5 years was the following: 77%, 62%, 21% and 10%, whereas secondary patency was the following: 81%, 71%, 61% and 32%, respectively. Conclusion: Autologous forearm basilic vein looped transposition is an effective surgical procedure for the creation of access for haemodialysis. This may be a useful option in patients with compromised peripheral arterial diameter or flow and should be considered in patients with a suitable forearm basilic vein.
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Affiliation(s)
- Maciej Zielinski
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Nicholas Inston
- Department of Renal Surgery, Queen Elizabeth Hospital, University Hospital Birmingham, Birmingham, UK
| | - Zbigniew Krasinski
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Marcin Gabriel
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Grzegorz Oszkinis
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznań, Poland
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12
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Abstract
Background The aim of the present paper is to assess the gait pattern of patients with Peripheral Artery Disease (PAD). A more specific aim is to compare the gait pattern of PAD patients before and after the appearance of intermittent claudication symptoms. Methods The study involved 34 PAD patients with a claudication distance ≥200 m and 20 participants without PAD, who formed the control group. The gait pattern of PAD patients was assessed twice: before the appearance of intermittent claudication symptoms (pain-free conditions) and after the appearance of intermittent claudication symptoms (pain conditions). Results Compared to the control group, PAD patients presented a statistically significant decrease in step length both during pain-free conditions (52.6 ± 12.5 vs. 72.8 ± 18.5 cm, p = 0.008) and in pain conditions (53.3 ± 13.3 vs. 72.8 ± 18.5 cm, p = 0.006). As for the remaining spatiotemporal parameters, there were no differences observed between the patient group and the controls. Intermittent claudication symptom induced by the walking test on the treadmill did not bring about any new abnormalities in the gait pattern or intensify the existing abnormalities of the gait. Conclusions PAD patients have a tendency to shorten their step length regardless of the presence of intermittent claudication.
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Affiliation(s)
- Maria Szymczak
- Clinic of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznań, Poland.
| | - Paweł Krupa
- Faculty of Physical Education, Sport and Rehabilitation, E. Piasecki Academy of Physical Education, Poznań, Poland
| | - Grzegorz Oszkinis
- Clinic of General and Vascular Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Marian Majchrzycki
- Clinic of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznań, Poland
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13
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Dzieciuchowicz L, Kotwicka M, Gabriel M, Szczęśniak-Chmielecka A, Krasińska B, Oszkinis G, Majewski W, Krasiński Z. Sex hormone receptors in varicose veins of women with premenstrual syndrome. Phlebologie 2018. [DOI: 10.1055/s-0037-1622215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryThe pathogenesis of premenstrual tension syndrome is not fully understood. It has been hypothesized that the interaction between sex hormones and target organs is the key event in its pathogenesis. Aim: The purpose of the study was to examine the differences in the prevalence of smooth muscle cells with sex hormones receptors in varicose veins of women with and without premenstrual tension syndrome (PS). Patients, methods: Samples of great saphenous vein were obtained from 50 women during varicose vein surgery. They were divided into group I (20 women with clinically diagnosed PS) and group II (30 women without PS). Estrogen and progesterone receptors were detected with an immunohistochemical method. Superficial densities of smooth muscle cells positive to estrogen and progesterone receptors were analyzed with densitometric program IM-AN and automatic image analyzer Magicall. The results were compared with t-Student test. Results: There were no differences in superficial density of smooth muscle cells positive to estrogen receptors between the groups. In contradiction to this, superficial density of smooth muscle cells positive to progesterone receptors was higher in group with PS than in patients without, 343 (±171) and 240 (±123), respectively. The difference was statistically significant (p < 0.05). Conclusion: The amount of cells with sex hormone receptors, not the level of hormones, could play a role in PS pathology. Our results show that progesterone is more important than estrogen in effector organs.
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14
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Domagała Z, Stępak H, Drapikowski P, Kociemba A, Pyda M, Karmelita-Katulska K, Dzieciuchowicz Ł, Oszkinis G. Geometric verification of the validity of Finite Element Method analysis of Abdominal Aortic Aneurysms based on Magnetic Resonance Imaging. Biocybern Biomed Eng 2018. [DOI: 10.1016/j.bbe.2018.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Herzog A, Oszkinis G, Planer D, Ziaja K, Kruszyna Ł, Stanisić MG, Ziaja D, Ishaaya AA, Kuczmik W. Atherectomy using a solid-state laser at 355 nm wavelength. J Biophotonics 2017; 10:1271-1278. [PMID: 28106949 DOI: 10.1002/jbio.201600209] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 11/09/2016] [Accepted: 12/13/2016] [Indexed: 06/06/2023]
Abstract
Peripheral arterial disease (PAD), caused by atherosclerotic processes, is allied with an increased risk of ischemic events, limb loss, and death. Recently, the use of a solid-state laser at 355 nm within a hybrid catheter was suggested for that purpose. In this work, short nanosecond pulses of a solid-state laser at 355 nm delivered through a hybrid catheter, composed of optical fibers and a blunt mechanical blade, are used to conduct a pre-clinical study and two clinical cases. The pre-clinical study consisted of an atherosclerotic calcified cadaveric leg and a porcine in vivo trial within the iliac artery, respectively. The clinical cases include chronic total occlusions with a calcified lesion. The occluded cadaveric leg is recanalized successfully and no evidence of thermal necrosis is indicated in the histopathology analysis of the porcine study. No arterial wall damage is demonstrated on the animals' treated arteries and no significant impact on blood count and biochemistry analysis is noted in the animal trial. Successful recanalization of the occluded arteries followed by balloon angioplasty is obtained in both clinical cases. Our work constitutes a proof of concept for using a solid-state pulsed laser at 355 nm in atherectomy.
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Affiliation(s)
- Amir Herzog
- Department of Electrical and Computer Engineering, Ben-Gurion University, Beer-Sheva, Israel
| | - Grzegorz Oszkinis
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - David Planer
- Department of Cardiology, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
| | - Krzysztof Ziaja
- Department of General and Vascular Surgery, Silesian Medical University, Katowice, Poland
| | - Łukasz Kruszyna
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Michał Goran Stanisić
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Damian Ziaja
- Department of General and Vascular Surgery, Silesian Medical University, Katowice, Poland
| | - Amiel A Ishaaya
- Department of Electrical and Computer Engineering, Ben-Gurion University, Beer-Sheva, Israel
| | - Wacław Kuczmik
- Department of General and Vascular Surgery, Silesian Medical University, Katowice, Poland
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Thompson M, Youssef M, Jacob R, Zerwes S, Reijnen M, Szopinski P, Berg P, Oszkinis G, Holden A. Early Experience With Endovascular Aneurysm Sealing in Combination With Parallel Grafts for the Treatment of Complex Abdominal Aneurysms: The ASCEND Registry. J Endovasc Ther 2017; 24:764-772. [DOI: 10.1177/1526602817731103] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
| | - Marwan Youssef
- Department of Vascular Surgery, University Hospital, Mainz, Germany
| | - Rudolf Jacob
- Department of Vascular Surgery, Augsburg Hospital, Augsburg, Germany
| | - Sebastian Zerwes
- Department of Vascular Surgery, Augsburg Hospital, Augsburg, Germany
| | - Michel Reijnen
- Department of Vascular Surgery, Rijnstate Hospital, Arnhem, the Netherlands
| | | | - Patrick Berg
- Department of Vascular Surgery, Marienhospital Kevelaer, Germany
| | | | - Andrew Holden
- Department of Interventional Radiology, Auckland City Hospital, Auckland, New Zealand
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17
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Tomkowski W, Kuca P, Urbanek T, Chmielewski D, Krasiński Z, Pruszczyk P, Windyga J, Oszkinis G, Jawień A, Burakowski J, Dybowska M, Kęsik J, Zubilewicz T. Venous thromboembolism — recommendations on the prevention, diagnostic approach and management. The 2017 Polish Consensus Statement. Acta Angiologica 2017. [DOI: 10.5603/aa.2017.0008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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18
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Puślecki M, Perek B, Stefaniak S, Siniawski A, Oszkinis G, Jemielity M. Successful surgical treatment of a subtotal descending aortic occlusion. Cardiovasc J Afr 2017; 28:e1-e3. [PMID: 28470326 PMCID: PMC5488048 DOI: 10.5830/cvja-2016-012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 02/17/2016] [Indexed: 11/10/2022] Open
Abstract
We present the case of a 33-year-old man with middle aortic syndrome. The final diagnosis was established with magnetic resonance imaging. He underwent a successful aorto-aortic bypass. Two-year follow-up imaging showed the new graft was patent, with no abnormalities at the anastomosis sites. At the last follow-up examination he was asymptomatic with no neurological dysfunction.
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Affiliation(s)
- Mateusz Puślecki
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Bartlomiej Perek
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Sebastian Stefaniak
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.
| | - Andrzej Siniawski
- Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Grzegorz Oszkinis
- Department of Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Jemielity
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
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19
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Kramek JT, Stępak H, Oszkinis G. Endoleaks after endovascular abdominal aortic aneurysm repair. JMS 2017. [DOI: 10.20883/jms.2017.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Traditional surgical repair and endovascular repair (EVAR) are the treatment options for abdominal aortic aneurysm repair. EVAR as less invasive becomes a significant and widely accepted way of treatment aortic aneurysms with expanding number of procedures. This technique has a lover short-term mortality and a shorter hospital stay but is not free from complications. The most common complication after EVAR are endoleaks. For the first time summarised and assessed in 1997. Although it is often asymptomatic but may cause aneurysm expanding and rupture. Endoleak is defined as persistent blood flow into the aneurysm sac. It can be revealed intra-operatively or during the follow up – CT; arteriography, angio-MRI enables endoleak diagnosis. Usage of duplex sonography is questionable. In this mini-review we summarise endolek diagnostic, classification and treatment options.
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20
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Domagala Z, Stepak H, Drapikowski P, Dzieciuchowicz L, Pyda M, Karmelita-Katulska K, Oszkinis G. Biomechanical factors in Finite Element Analysis of abdominal aortic aneurysms. Acta Angiologica 2017. [DOI: 10.5603/aa.2016.0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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21
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Abstract
Aim: Under the supervision of the Department of General and Vascular Surgery of Poznan University of Medical Sciences, a questionnaire was distributed online or as a paper version to medical students (MSs) in order to better understand the attitudes towards surgery as a specialty and to determine the reasons why students do and do not choose vascular surgery as their career path. Materials and methods: The questionnaire was distributed online or as a paper version to MSs in the 3rd, 5th, and 6th year of the PUMS 6-year M.D. program. It provided the data on the year of study, grade point average (GPA), sex, age, respondent’s specialty choice, 33 questions with responses on a 1-5 Likert scale (1 was the least important reason and 5 was the most important reason), and 2 questions with socres between 0 and 4. A total of 136 Polish MSs of PUMS completed the survey. Results: For MSs who choose vascular surgery as their career path, “endovascular capabilities of vascular surgery” and “higher income possibilities than a general surgeon” were the most important reasons. The “poor availability of work in other places than the vascular surgery department of your choice, few such clinics in the region” was the most important reason not to choose vascular surgery. A role of gender was also noted - 13% of male MSs classified gender as an “important factor”, in contrast to 60% of female MSs. Conclusions: The findings of this study might help to develop better strategies to attract future trainees to surgical specialties, particularly vascular surgery, and improve work environment.
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Affiliation(s)
- Malwina K. Grobelna
- Szpital Kliniczny Przemienienia Pańskiego Uniwersytetu Medycznego im. Karola Marcinkowskiego Klinika Chirurgii Ogólnej i Naczyń
| | - Hubert Stępak
- Szpital Kliniczny Przemienienia Pańskiego Uniwersytetu Medycznego im. Karola Marcinkowskiego Klinika Chirurgii Ogólnej i Naczyń
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Jones GT, Tromp G, Kuivaniemi H, Gretarsdottir S, Baas AF, Giusti B, Strauss E, Van't Hof FNG, Webb TR, Erdman R, Ritchie MD, Elmore JR, Verma A, Pendergrass S, Kullo IJ, Ye Z, Peissig PL, Gottesman O, Verma SS, Malinowski J, Rasmussen-Torvik LJ, Borthwick KM, Smelser DT, Crosslin DR, de Andrade M, Ryer EJ, McCarty CA, Böttinger EP, Pacheco JA, Crawford DC, Carrell DS, Gerhard GS, Franklin DP, Carey DJ, Phillips VL, Williams MJA, Wei W, Blair R, Hill AA, Vasudevan TM, Lewis DR, Thomson IA, Krysa J, Hill GB, Roake J, Merriman TR, Oszkinis G, Galora S, Saracini C, Abbate R, Pulli R, Pratesi C, Saratzis A, Verissimo AR, Bumpstead S, Badger SA, Clough RE, Cockerill G, Hafez H, Scott DJA, Futers TS, Romaine SPR, Bridge K, Griffin KJ, Bailey MA, Smith A, Thompson MM, van Bockxmeer FM, Matthiasson SE, Thorleifsson G, Thorsteinsdottir U, Blankensteijn JD, Teijink JAW, Wijmenga C, de Graaf J, Kiemeney LA, Lindholt JS, Hughes A, Bradley DT, Stirrups K, Golledge J, Norman PE, Powell JT, Humphries SE, Hamby SE, Goodall AH, Nelson CP, Sakalihasan N, Courtois A, Ferrell RE, Eriksson P, Folkersen L, Franco-Cereceda A, Eicher JD, Johnson AD, Betsholtz C, Ruusalepp A, Franzén O, Schadt EE, Björkegren JLM, Lipovich L, Drolet AM, Verhoeven EL, Zeebregts CJ, Geelkerken RH, van Sambeek MR, van Sterkenburg SM, de Vries JP, Stefansson K, Thompson JR, de Bakker PIW, Deloukas P, Sayers RD, Harrison SC, van Rij AM, Samani NJ, Bown MJ. Meta-Analysis of Genome-Wide Association Studies for Abdominal Aortic Aneurysm Identifies Four New Disease-Specific Risk Loci. Circ Res 2016; 120:341-353. [PMID: 27899403 PMCID: PMC5253231 DOI: 10.1161/circresaha.116.308765] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 10/28/2016] [Accepted: 11/21/2016] [Indexed: 02/06/2023]
Abstract
Supplemental Digital Content is available in the text. Rationale: Abdominal aortic aneurysm (AAA) is a complex disease with both genetic and environmental risk factors. Together, 6 previously identified risk loci only explain a small proportion of the heritability of AAA. Objective: To identify additional AAA risk loci using data from all available genome-wide association studies. Methods and Results: Through a meta-analysis of 6 genome-wide association study data sets and a validation study totaling 10 204 cases and 107 766 controls, we identified 4 new AAA risk loci: 1q32.3 (SMYD2), 13q12.11 (LINC00540), 20q13.12 (near PCIF1/MMP9/ZNF335), and 21q22.2 (ERG). In various database searches, we observed no new associations between the lead AAA single nucleotide polymorphisms and coronary artery disease, blood pressure, lipids, or diabetes mellitus. Network analyses identified ERG, IL6R, and LDLR as modifiers of MMP9, with a direct interaction between ERG and MMP9. Conclusions: The 4 new risk loci for AAA seem to be specific for AAA compared with other cardiovascular diseases and related traits suggesting that traditional cardiovascular risk factor management may only have limited value in preventing the progression of aneurysmal disease.
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Affiliation(s)
| | - Gerard Tromp
- For the author affiliations, please see the Appendix
| | | | | | | | - Betti Giusti
- For the author affiliations, please see the Appendix
| | - Ewa Strauss
- For the author affiliations, please see the Appendix
| | | | - Thomas R Webb
- For the author affiliations, please see the Appendix
| | - Robert Erdman
- For the author affiliations, please see the Appendix
| | | | | | - Anurag Verma
- For the author affiliations, please see the Appendix
| | | | | | - Zi Ye
- For the author affiliations, please see the Appendix
| | | | | | | | | | | | | | | | | | | | - Evan J Ryer
- For the author affiliations, please see the Appendix
| | | | | | | | | | | | | | | | - David J Carey
- For the author affiliations, please see the Appendix
| | | | | | - Wenhua Wei
- For the author affiliations, please see the Appendix
| | - Ross Blair
- For the author affiliations, please see the Appendix
| | - Andrew A Hill
- For the author affiliations, please see the Appendix
| | | | - David R Lewis
- For the author affiliations, please see the Appendix
| | - Ian A Thomson
- For the author affiliations, please see the Appendix
| | - Jo Krysa
- For the author affiliations, please see the Appendix
| | | | - Justin Roake
- For the author affiliations, please see the Appendix
| | | | | | - Silvia Galora
- For the author affiliations, please see the Appendix
| | | | | | | | - Carlo Pratesi
- For the author affiliations, please see the Appendix
| | | | | | | | | | | | | | - Hany Hafez
- For the author affiliations, please see the Appendix
| | | | | | | | | | | | - Marc A Bailey
- For the author affiliations, please see the Appendix
| | - Alberto Smith
- For the author affiliations, please see the Appendix
| | | | | | | | | | | | | | | | | | | | | | | | - Anne Hughes
- For the author affiliations, please see the Appendix
| | | | | | | | - Paul E Norman
- For the author affiliations, please see the Appendix
| | | | | | | | | | | | | | | | | | - Per Eriksson
- For the author affiliations, please see the Appendix
| | | | | | - John D Eicher
- For the author affiliations, please see the Appendix
| | | | | | | | - Oscar Franzén
- For the author affiliations, please see the Appendix
| | - Eric E Schadt
- For the author affiliations, please see the Appendix
| | | | | | - Anne M Drolet
- For the author affiliations, please see the Appendix
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23
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Strauss E, Supinski W, Radziemski A, Oszkinis G, Pawlak AL, Gluszek J. Is hyperhomocysteinemia a causal factor for heart failure? The impact of the functional variants of MTHFR and PON1 on ischemic and non-ischemic etiology. Int J Cardiol 2016; 228:37-44. [PMID: 27863359 DOI: 10.1016/j.ijcard.2016.11.213] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 11/06/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND Hyperhomocysteinemia was found to be uniformly associated with the development of heart failure (HF) and HF mortality; however, it is uncertain whether this relation is causative or not. We used Mendelian randomization to examine the associations of the methylene tetrahydrofolate gene (MTHFR) and paraoxonase 1 gene (PON1) variants as a proxy for lifelong exposure to high Hcy and Hcy-thiolactone concentrations with the development of HF in men aged ≤60years and the occurrence of adverse effects at one-year follow-up. METHODS The study enrolled 172 men with HF: 117 with ischemic etiology (iHF) related to coronary artery disease (CAD) and 55 with non-ischemic etiology (niHF) related to dilated cardiomyopathy (DCM). The reference group of 329 CAD patients without HF and the control group of 384 men were also analyzed. RESULTS Hyperhomocysteinemia (OR=2.0, P<0.05) and the MTHFR 677TT/1298AA, 677CC/1298CC genotypes (OR=1.6, P=0.03) were associated with HF regardless of its etiology, especially among normotensives (OR=4.6, P=0.001 and OR=2.3, P=0.003, respectively). In niHF, the PON1 162AA (OR=2.3, P=0.03) and 575AG+GG (OR=0.46, P=0.01) genotypes also influenced the risk. The interaction between HDLC<1mmol/L and the PON1 575GG genotype was found to influence the risk of iHF (OR=7.2, P=0.009). Hyperhomocysteinemia improved the classification of niHF patients as 'high-risk' by 10.1%. Ejection fraction <30% and DCM increased the probability of HF death or re-hospitalization within one year. CONCLUSION Our results provide evidence that hyperhomocysteinemia is a causal factor for niHF in DCM, while dysfunctional HDL could contribute to the pathogenesis of iHF.
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Affiliation(s)
- Ewa Strauss
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszynska 32, 60-479 Poznan, Poland; Department of General and Vascular Surgery, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland.
| | - Wieslaw Supinski
- Regional Public Hospital, Dekerta 1, 66-400 Gorzow Wielkopolski, Poland
| | - Artur Radziemski
- Department of Hypertension, Angiology and Internal Medicine, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
| | - Grzegorz Oszkinis
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
| | - Andrzej Leon Pawlak
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszynska 32, 60-479 Poznan, Poland
| | - Jerzy Gluszek
- The State Higher Vocational School in Kalisz, Nowy Swiat 4, 62-800 Kalisz, Poland
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Affiliation(s)
- Iwona Rospond-Kubiak
- Department of Ophthalmology, Poznan University of Medical Sciences, Poznan, Poland
| | - Grzegorz Oszkinis
- Department of Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Jaroslaw Kociecki
- Department of Ophthalmology, Poznan University of Medical Sciences, Poznan, Poland
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25
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Oszkinis G, Perek B, Perek A, Ladzinska M, Kruszyna L. Unusual case of successful treatment of a ruptured thoracoabdominal aneurysm in elderly woman. Acta Angiologica 2016. [DOI: 10.5603/aa.2015.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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26
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Kociemba A, Karmelita-Katulska K, Stajgis M, Oszkinis G, Pyda M. Distinguishing high-flow from low-flow vascular malformations using maximum intensity projection images in dynamic magnetic resonance angiography - comparison to other MR-based techniques. Acta Radiol 2016; 57:565-71. [PMID: 26560553 DOI: 10.1177/0284185115615005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 10/09/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND In addition to ultrasound, magnetic resonance imaging (MRI) is considered a suitable, non-invasive technique to assess the type and extent of vascular malformations. The distinction between low- and high-flow lesions is crucial because it determines appropriate patient treatment. PURPOSE To distinguish high-flow from low-flow lesions on the basis of the enhancement pattern on MIP images acquired from dynamic time-resolved MR angiography (MRA) and compare it with previously described MR-based methods. MATERIAL AND METHODS We examined 25 consecutive patients with previously diagnosed vascular malformations. Next, each malformation was classified as "high-flow" or "low-flow" using the following criteria: (i) findings on T1-weighted (T1W) and T2-weighted (T2W) imaging (signal voids, signal intensity); (ii) the time interval between the start of arterial enhancement and the onset of lesion enhancement (artery-lesion time); (iii) the time of maximum lesion enhancement; and (iv) analysis of the slope of the enhancement curve. RESULTS Of the 25 patients, seven had high-flow and 18 had low-flow malformations. Signal voids on spin-echo T1W images were observed only in four of seven high-flow malformations and in two of 18 low-flow malformations. Analysis of signal intensity on T2W images showed increased signal intensity in 17 of 18 low-flow malformations, and in two of seven high-flow lesions. Calculation of the artery-lesion time, maximum enhancement time, and slope revealed significant differences between the high- and low-flow groups. CONCLUSION In conclusion, the slope of the enhancement curve appears to be useful in distinguishing between high- and low-flow vascular malformations. Standardization of MR image evaluation criteria is essential.
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Affiliation(s)
- Anna Kociemba
- First Clinic of Cardiology, Department of Cardiology, University of Medical Sciences, Poznan, Poland
| | | | - Marek Stajgis
- Department of General Radiology, University of Medical Sciences, Poznan, Poland
| | - Grzegorz Oszkinis
- Department of Vascular Surgery, University of Medical Sciences, Poznan, Poland
| | - Małgorzata Pyda
- First Clinic of Cardiology, Department of Cardiology, University of Medical Sciences, Poznan, Poland
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27
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Gabriel M, Tomczak J, Snoch-Ziółkiewicz M, Dzieciuchowicz Ł, Strauss E, Oszkinis G. Comparison of Superb Micro-Vascular Ultrasound Imaging (SMI) and Contrast-Enhanced Ultrasound (CEUS) for Detection of Endoleaks After Endovascular Aneurysm Repair (EVAR). Am J Case Rep 2016; 17:43-6. [PMID: 26806053 PMCID: PMC4732548 DOI: 10.12659/ajcr.895415] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patient: Male, 68 Final Diagnosis: Unusual clinical course Symptoms: None Medication: — Clinical Procedure: Angio CT Specialty: Surgery
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Affiliation(s)
- Marcin Gabriel
- Department of General and Vascular Surgery, Poznań University of Medical Sciences, Poznań, Poland
| | - Jolanta Tomczak
- Department of General and Vascular Surgery, Poznań University of Medical Sciences, Poznań, Poland
| | | | - Łukasz Dzieciuchowicz
- Department of General and Vascular Surgery, Poznań University of Medical Sciences, Poznań, Poland
| | - Ewa Strauss
- Department and Clinic of General and Vascular Surgery, Poznań University of Medical Sciences, Poznań, Poland
| | - Grzegorz Oszkinis
- Department of General and Vascular Surgery, Poznań University of Medical Sciences, Poznań, Poland
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28
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Strauss E, Stelcer M, Zawadzki P, Tomczak J, Oszkinis G. [Effect of smoking on the incidence of adverse outcomes and ischemic wounds in peripheral artery disease]. Przegl Lek 2016; 73:712-717. [PMID: 29688830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Smoking is a major risk factor for peripheral artery disease (PAD), which correlates with progression of the disease, the prevalence of chronic wounds, amputation incidence and mortality. On the other hand, abstinence from smoking has a beneficial effect on the bypass grafts patency after surgical revascularization. Poland fits in the steady decline in the percentage of smokers, but there is a lack of current data, whether those changes are observed also in patients with PAD and whether they lead to the improvement of health condition. OBJECTIVE This study evaluated the impact of smoking and other known risk factors for cardiovascular disease on the occurrence of PAD, the risk of adverse outcomes (death, amputation, tissue necrosis), development of chronic wounds and their healing after arterial revascularization. MATERIALS AND METHODS The study was conducted in groups of 208 patients with PAD scheduled for surgical treatment (28.4% of patients with adverse outcomes of PAD, 38.5% of patients with ischemic wounds) and 190 control subjects. The study groups were interviewed concerning smoking, characterized by known risk factors for cardiovascular disease, and in the incidence of amputation, and deaths within 30 days after surgery. In the group of 48 patients with ischemic wounds a prospective assessment of the progress of wound healing in terms of changes in the wound advancement and changes in pain severity associated with wounds was performed. RESULTS Over 90% of patients with PAD were smokers: 53.8% former and 36.5% past in relation to 27.4% and 14.7%, respectively, in the control group (p <0.0001). Among patients, a higher proportion of former smokers was found in those with poorer health condition: with adverse outcomes of PAD (48.0% vs 64.1%, p <0.05), and with ischemic wounds (70.7% vs 65.1%, p = 0.056). Advanced age, female sex, and the presence of diabetes were associated with both, the presence of PAD adverse outcomes, as well as the development of ischemic wounds. In the prospective study, major factors prolonging the process of wound healing were advanced age, diabetes and smoking (evaluated as peaks years of smoking). CONCLUSIONS Smoking is still the most common risk factor for PAD, and smoking cessation is the result of the deterioration of health condition. Simultaneously this factor, in addition to diabetes, advanced age and female sex, affects both the risk of unfavorable course of PAD and decrease the progress of wound healing. Control of risk factors for cardiovascular disease should be especially careful in women in whom, despite the lower PAD incidence, further prognosis of disease progression seem worse.
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Karaś K, Wachal K, Kościński T, Oszkinis G. Use of Negative Pressure Wound Therapy after Endovascular Revascularization in a Patient with Diabetic Foot Syndrome Complicated by Sepsis. NPWTJ 2015. [DOI: 10.18487/npwtj.v2i2.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Pacjent lat 60, przyjęty do szpitala z powodu ostrego niedokrwienia kończyny dolnej prawej z martwiczymi zmianami po stronie grzbietowej i zewnętrznej stopy. Zmiany martwicze o szybko postępującym charakterze - owrzodzenia III/IV stopień według klasyfikacji Wagnera. Pacjent choruje na cukrzycę typu drugiego oraz na nadciśnienie tętnicze. Chory pali papierosy w ilości 1,5 paczki dziennie od 40 lat, prowadzi siedzący tryb życia. Leczenie zachowawcze polegało na miejscowym zastosowaniu maści z antybiotykiem o szerokim spektrum działania. Chorego poddano operacji rewaskularyzacyjnej i leczeniu opatrunkiem podciśnieniowym. Niewłaściwa pielęgnacja opatrunku V.A.C. i niekorzystne warunki zewnętrzne w oddziale chirurgicznym przyczyniły się prawdopodobnie do rozwoju zakażenia miejscowego i posocznicy co w konsekwencji było przyczyną amputacji kończyny.
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30
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Rospond-Kubiak I, Oszkinis G, Kociecki J. Intraarterial thrombocytic material revelative of essential thrombocytaemia in a 59-year-old woman. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- I. Rospond-Kubiak
- Department of Ophthalmology; Poznan University of Medical Sciences; Poznan Poland
| | - G. Oszkinis
- Department of Vascular Surgery; Poznan University of Medical Sciences; Poznan Poland
| | - J. Kociecki
- Department of Ophthalmology; Poznan University of Medical Sciences; Poznan Poland
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31
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Dzieciuchowicz Ł, Snoch-Ziółkiewicz M, Oszkinis G, Frankiewicz M. Superior mesenteric artery dissection as a complication of an endovascular attempt to treat aneurysms of the pancreaticoduodenal arteries. Interact Cardiovasc Thorac Surg 2015; 21:539-41. [PMID: 26078383 DOI: 10.1093/icvts/ivv157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 05/04/2015] [Indexed: 11/14/2022] Open
Abstract
A case of iatrogenic dissection of the superior mesenteric artery (SMA) in a 42-year old woman during an attempt of endovascular treatment of aneurysms of the pancreaticoduodenal arteries coexisting with a stenosis of the coeliac trunk is presented. The dissection occurred most probably during insertion of an introducer sheath into the SMA. The patient at that moment reported a short-lasting abdominal pain and after that remained asymptomatic. Due to technical difficulties, the attempt of endovascular management of pancreaticoduodenal aneurysms was abandoned. The completion angiography revealed the occlusion of the SMA. The patient underwent an emergency laparotomy; pancreaticoduodenal aneurysms were excised and SMA dissection was repaired with endarterectomy and a patch closure. Postoperative recovery was uneventful and the patient remained asymptomatic during a 30-month follow-up. The case underscores the importance of completion angiography after endovascular interventions in the SMA since the early period of its occlusion may be asymptomatic.
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Affiliation(s)
- Łukasz Dzieciuchowicz
- Department and Clinic of General and Vascular Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Magdalena Snoch-Ziółkiewicz
- Department and Clinic of General and Vascular Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Grzegorz Oszkinis
- Department and Clinic of General and Vascular Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Maciej Frankiewicz
- Department of Radiology, Poznan University of Medical Sciences, Poznań, Poland
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32
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Strauss E, Waliszewski K, Oszkinis G, Staniszewski R. Polymorphisms of genes involved in the hypoxia signaling pathway and the development of abdominal aortic aneurysms or large-artery atherosclerosis. J Vasc Surg 2015; 61:1105-13.e3. [DOI: 10.1016/j.jvs.2014.02.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 02/04/2014] [Accepted: 02/06/2014] [Indexed: 12/29/2022]
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33
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Mikołajczyk-Stecyna J, Korcz A, Gabriel M, Pawlaczyk K, Oszkinis G, Słomski R. Gene polymorphism -418 G/C of tissue inhibitor of metalloproteinases 2 is associated with abdominal aortic aneurysm. J Vasc Surg 2015; 61:1114-9. [DOI: 10.1016/j.jvs.2013.12.045] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 12/18/2013] [Accepted: 12/21/2013] [Indexed: 10/25/2022]
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34
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Mikołajczyk-Stecyna J, Korcz A, Gabriel M, Pawlaczyk K, Oszkinis G, Słomski R. Erratum: Risk factors in abdominal aortic aneurysm and aortoiliac occlusive disease and differences between them in the Polish population. Sci Rep 2015. [PMCID: PMC3889106 DOI: 10.1038/srep03771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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35
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Maj M, Staniszewski R, Żabicki B, Oszkinis G. Dislocation of a bare metal stent from the left main coronary artery to the right internal carotid artery. Kardiol Pol 2015; 73:303. [PMID: 25892267 DOI: 10.5603/kp.2015.0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 05/28/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Magdalena Maj
- Department of General and Vascular Surgery, Medical University, Poznan, Poland.
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36
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Strauss E, Oszkinis G, Staniszewski R. SEPP1 gene variants and abdominal aortic aneurysm: gene association in relation to metabolic risk factors and peripheral arterial disease coexistence. Sci Rep 2014; 4:7061. [PMID: 25395084 PMCID: PMC4231327 DOI: 10.1038/srep07061] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 10/29/2014] [Indexed: 11/09/2022] Open
Abstract
An inadequate selenium level is supposed to be a risk factor for cardiovascular diseases. However little is known about variation of the genes encoding selenium-containing proteins that would confirm the causality in these diseases. The aim of this study was to analyze the relationships between two functional variants of selenoprotein P gene (SEPP1 rs3877899G>A, rs7579G>A) and the occurrence of abdominal aortic aneurysm (AAA) and aortoiliac occlusive disease (AIOD), as well as their metabolic risk factors. In AAA, the rs3877899A allele was associated with higher systolic blood (P < .003) and pulse pressure (P < .003) values (recessive model), and with coexistence of peripheral arterial disease (PAD; carriers: P = .033). The other SEPP1 variants were associated with BMI values and influenced the risk of aortic diseases, depending on body weight. The strongest associations in the case-control analysis was found between the presence of the rs3877899G-rs7579G haplotype and development of AAA in overweight and obese subjects (OR = 1.80, 95%CI = 1.16-2.79, P = .008). The higher BMI values were correlated with lower age of AAA patients and larger size of aneurysm. Our results suggests the potential role of the selenoprotein P in pathogenesis of AAA. Future studies should consider the role of the rs3877899G-rs7579G haplotype as a risk factor for aggressive-growing AAAs.
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Affiliation(s)
- Ewa Strauss
- 1] Institute of Human Genetics, Polish Academy of Sciences, Strzeszynska 32, 60-479 Poznan, Poland [2] Department of General and Vascular Surgery, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
| | - Grzegorz Oszkinis
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
| | - Ryszard Staniszewski
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
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37
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Wysocka E, Walczak W, Michalak S, Nowicki M, Tomczak J, Kruszyna L, Oszkinis G. Inflammatory and oxidative stress markers in plasma of critical limb ischemia patients. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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38
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Jaworucka-Kaczorowska A, Oszkinis G, Huber J, Wiertel-Krawczuk A, Gabor E, Kaczorowski P. Saphenous vein stripping surgical technique and frequency of saphenous nerve injury. Phlebology 2014; 30:210-6. [PMID: 24906907 PMCID: PMC4390525 DOI: 10.1177/0268355514539316] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives Saphenous nerve injury is the most common complication after surgical treatment of varicose veins. The aim of this study was to establish its frequency at great saphenous vein long stripping when four methods of surgery were applied. Methods Eighty patients were divided into four groups depending on different stripping methods. Sensory transmission in saphenous nerve and sensory perception of shank were examined before surgery and two weeks, three and six months afterwards with clinical neurophysiology methods. Results In 36% of patients, surgeries caused the injury of saphenous nerve mainly by proximal stripping without invagination (65%, group I). Transmission disturbances ceased completely after three months in patients undergoing distal stripping with invagination (group IV), while in group I they persisted for six months in 35%. Group IV patients were the least injured and group I the most. Conclusion Neurophysiological findings may suggest that distal stripping with vein invagination gives the best saphenous nerve sparing.
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Affiliation(s)
- Aleksandra Jaworucka-Kaczorowska
- Second Department of Surgery, General and Vascular Surgery Clinic, University of Medical Sciences, Poznań, Poland Department of Pathophysiology of Locomotor Organs, University of Medical Sciences, Poznań, Poland
| | - Grzegorz Oszkinis
- Second Department of Surgery, General and Vascular Surgery Clinic, University of Medical Sciences, Poznań, Poland
| | - Juliusz Huber
- Department of Pathophysiology of Locomotor Organs, University of Medical Sciences, Poznań, Poland
| | | | - Elżbieta Gabor
- Department of Pathophysiology of Locomotor Organs, University of Medical Sciences, Poznań, Poland
| | - Paweł Kaczorowski
- Second Department of Surgery, General and Vascular Surgery Clinic, University of Medical Sciences, Poznań, Poland
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39
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Karaźniewicz-Łada M, Danielak D, Rubiś B, Burchardt P, Oszkinis G, Główka F. The influence of genetic polymorphism of Cyp2c19 isoenzyme on the pharmacokinetics of clopidogrel and its metabolites in patients with cardiovascular diseases. J Clin Pharmacol 2014; 54:874-80. [DOI: 10.1002/jcph.323] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 04/28/2014] [Indexed: 12/22/2022]
Affiliation(s)
- Marta Karaźniewicz-Łada
- Department of Physical Pharmacy and Pharmacokinetics; Poznan University of Medical Sciences; 6 Święcickiego Street Poznań Poland
| | - Dorota Danielak
- Department of Physical Pharmacy and Pharmacokinetics; Poznan University of Medical Sciences; 6 Święcickiego Street Poznań Poland
| | - Błażej Rubiś
- Department of Clinical Chemistry and Molecular Diagnostics; Poznan University of Medical Sciences; 49 Przybyszewskiego Street Poznań Poland
| | - Paweł Burchardt
- Division of Cardiology-Intensive Therapy, Department of Internal Medicine; Poznan University of Medical Sciences; 49 Przybyszewskiego Street Poznań Poland
| | - Grzegorz Oszkinis
- Department of General and Vascular Surgery; Poznan University of Medical Sciences; 1/2 Długa Street Poznań Poland
| | - Franciszek Główka
- Department of Physical Pharmacy and Pharmacokinetics; Poznan University of Medical Sciences; 6 Święcickiego Street Poznań Poland
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40
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Mikołajczyk-Stecyna J, Korcz A, Gabriel M, Pawlaczyk K, Oszkinis G, Słomski R. Risk factors in abdominal aortic aneurysm and in Polish population aortoiliac occlusive disease and differences between them [corrected]. Sci Rep 2013; 3:3528. [PMID: 24346221 PMCID: PMC3866687 DOI: 10.1038/srep03528] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 11/18/2013] [Indexed: 11/09/2022] Open
Abstract
Abdominal aortic aneurysm (AAA) and aortoiliac occlusive disease (AIOD) are multifactorial vascular disorders caused by complex genetic and environmental factors. The purpose of this study was to define risk factors of AAA and AIOD in the Polish population and indicate differences between diseases.
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Affiliation(s)
| | - Aleksandra Korcz
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, 60-479, Poland
| | - Marcin Gabriel
- Department of Vascular Surgery, Poznan University of Medical Sciences, Poznan, 61-848, Poland
| | - Katarzyna Pawlaczyk
- Department of Hypertension, Internal Medicine, and Vascular Diseases, Poznan University of Medical Sciences, Poznan, 61-848, Poland
| | - Grzegorz Oszkinis
- Department of Vascular Surgery, Poznan University of Medical Sciences, Poznan, 61-848, Poland
| | - Ryszard Słomski
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, 60-479, Poland
- Department of Biochemistry and Biotechnology of the Poznan University of Life Sciences, Poznan, 60-632, Poland
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Korcz A, Zakerska O, Pawlaczyk K, Molinska-Glura M, Oszkinis G, Slomski R, Gabriel M. MMP-13 (−77A>G) gene polymorphism is not a susceptibility factor of abdominal aortic aneurysm or aortoiliac occlusive disease. Vascul Pharmacol 2012. [DOI: 10.1016/j.vph.2011.08.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Strauss E, Waliszewski K, Oszkinis G, Staniszewski R. [Gene-environment interaction for the HIF1-A 1772C>T polymorphisms and cigarette smoking increase susceptibility to abdominal aortic aneurysm]. Przegl Lek 2012; 69:744-749. [PMID: 23421024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Pathological changes in the vascular vessels, such as the presence of atherosclerotic plaques or aneurysmal dilatations, are associated with the local conditions of ischemial/hypoxia. Polymorphisms in the HIF1A gene, encoding an oxygen-regulated HIF-1 subunit (HIF-1a), determine inter-individual variability in vascular response to hypoxia. Stimulation of selected pathways, related to this response (i.e. angiogenesis) is impaired by cigarette smoke exposure. In this work, we examined the associations between 1772C>T polymorphism (rs11549465) located in the coding region of HIF1A gene (Pro582-Ser), smoking and the occurrence of abdominal aortic aneurysm (AAA). Moreover, the relations of these factors with the presence of peripheral arterial disease (PAD) in patients with AAA were studied. The case-control study was designed, in which a group of 1060 Caucasian subjects: 535 AAA patients and 525 controls, was analyzed. Data regarding smoking status were collected using questionnaire. Past and current smokers were analyzed together. In the group of 220 AAA subjects the coexistence of PAD was characterized. HIF-1A genotypes were assessed by PCR-RFLP method. Genetic-environmental interactions were examined by a two-by-four tables. In these analyzes, logistic regression models were used to adjusting for the relevant covariates. The frequency of HIF1A 1772T allele in AAA group (0,067) was similar to that observed in the control group (0,070). In the analyses of genetic-environmental interactions was observed that the co-occurrence of HIF1A 1772CT and TT genotypes and exposure to tobacco smoke has a strong multiplicative effect on the susceptibility to the AAA development. The age and gender adjusted odds ratios (ORs) were: 7,6 for smoking alone (p<0,0001); 0,65 for 1772CT and TT genotypes alone (p=0,3) and 14,4for smoking plus 1772CT and TT genotypes (p<0,0001). The proportion of smokers carrying 1772T allele was higher among patients with advanced form of PAD (femoro-popliteal or aorto-iliac occlusion, 18%) as compared to the frequency in the rest of AAA patients (9,3%, p=0,05). In a multivariate analysis smoking in combination with the HIF1A 1772T allele occurrence was the strongest independent predictor of AAA (OR=14,5; p<0,0001). In conclusion, HIF1A 1772T allele enhances theAAA risk determined by smoking and promotes the development of a more complex phenotype of the disease in smokers (with coexisting severe peripheral arterial disease).
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Affiliation(s)
- Ewa Strauss
- Instytut Genetyki Człowieka Polskiej Akademii Nauk w Poznaniu Zakład Funkcji Kwasów Nukleinowych.
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Zabicki B, Juszkat R, Stajgis P, Małaczyński P, Oszkinis G. [Superselective embolization of ileo-cecal artery branch in patient with massive bleeding from lower part of gastrointestinal tract]. Przegl Lek 2012; 69:366-368. [PMID: 23276038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Authors have reported a case report of 79-years-old male patient who in second day after endarterectomy of left cartoid artery presented massive bleeding from lower part of gastro-intestinal tract. After diagnostic examinations intravascular embolization of pathologic artery with use of microcoil has been performed. Treatment was succesful free from complications.
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Affiliation(s)
- Bartosz Zabicki
- Zakład Radiologii Klinicznej Katedry Radiologii Uniwersytetu Medycznego, K. Marcinkowskiego w Poznaniu Szpital Kliniczny Przemienienia Pańskiego w Poznaniu
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Korcz A, Mikołajczyk-Stecyna J, Gabriel M, Zowczak-Drabarczyk M, Pawlaczyk K, Kalafirov M, Oszkinis G, Słomski R. Angiotensin-Converting Enzyme (ACE, I/D) Gene Polymorphism and Susceptibility to Abdominal Aortic Aneurysm or Aortoiliac Occlusive Disease. J Surg Res 2009; 153:76-82. [DOI: 10.1016/j.jss.2008.03.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2007] [Revised: 03/08/2008] [Accepted: 03/11/2008] [Indexed: 11/26/2022]
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Oszkinis G, Pukacki F, Juszkat R, Weigele JB, Gabriel M, Krasinski Z, Zieliński M, Krejza J. Restenosis after carotid endarterectomy: incidence and endovascular management. Interv Neuroradiol 2008; 13:345-52. [PMID: 20566103 DOI: 10.1177/159101990701300405] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Accepted: 11/12/2007] [Indexed: 11/15/2022] Open
Abstract
SUMMARY Surgical procedures designed to restore vascular patency for a recurrent stenosis following carotid endarterectomy (CEA) are burdened with technical difficulties as well as with the possibility of serious neurological complications. An endovascular approach employing transluminal percutaneous angioplasty and stenting (PTAS) is a promising solution to these problems. We aimed to evaluate the incidence of carotid artery restenosis following CEA, and to evaluate the safety and efficacy of treating post-CEA restenosis with an endovascular technique (PTAS). One hundred and two patients who underwent CEA for symptomatic and asymptomatic stenosis were included in the analysis. Clinical and sonographic follow-up examinations identified carotid artery restenosis in 16 patients, who fulfilled our criteria for endovascular treatment. Carotid PTAS was performed on symptomatic patients with a stenosis over 60% of the artery lumen (n=7) and in asymptomatic patients with a stenosis over 80% (n=9). The post-PTAS patients were evaluated by duplex sonography every three months over a 24 month follow-up period for evidence of restenosis. The cumulative incidence of post-CEA carotid restenosis qualifying for PTAS was 9.3% during an average 12-month follow-up interval. The average time from CEA to carotid PTAS was 11 months. All 16 endovascular procedures were technically successful. All of the carotid arteries were widely patent following PTAS. There were no immediate perioperative complications. One patient died two days after carotid PTAS from a cerebral hemorrhage. Thirteen of the 16 patients remained asymptomatic and had no sonographic evidence of significant restenosis during the 24- month post-PTAS follow-up period. One patient developed a symptomatic 80% restenosis proximal to the stent six months after carotid PTAS. Another patient developed an asymptomatic 60% restenosis proximal to the stent at 24 months. One patient was lost to follow-up. Following CEA, there is a significant risk of developing a symptomatic or high-grade carotid artery restenosis requiring correction. Endovascular treatment (PTAS) of a recurrent stenosis after CEA is a safe and effective alternative to repeat carotid surgery.
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Affiliation(s)
- G Oszkinis
- Department of General and Vascular Surgery, Poznań University of Medical Sciences Poznań, Poland -
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Dzieciuchowicz Ł, Majewski W, Słowiński M, Krasiński Z, Jawien AA, Bieda K, Oszkinis G, Gabriel M, Zapalski S. Improved Outcome after Rupture of Abdominal Aortic Aneurysm over an 18-Year Period. Ann Vasc Surg 2008; 22:25-9. [DOI: 10.1016/j.avsg.2007.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2007] [Revised: 08/30/2007] [Accepted: 09/14/2007] [Indexed: 11/29/2022]
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Krejza J, Swiat M, Pawlak MA, Oszkinis G, Weigele J, Hurst RW, Kasner S. Suitability of Temporal Bone Acoustic Window: Conventional TCD Versus Transcranial Color-Coded Duplex Sonography. J Neuroimaging 2007; 17:311-4. [PMID: 17894619 DOI: 10.1111/j.1552-6569.2007.00117.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE AND BACKGROUND To determine whether the proportion of patients with suitable temporal bone acoustic windows is different for conventional transcranial Doppler sonography (TCD) and transcranial color-coded duplex sonography (TCCS), based on a head-to-head comparison in the same population of patients. SUBJECTS AND METHODS Ninety patients, age 22-88 years (mean 57.1 +/- 11.7 years), 46 women and 44 men, 66 Caucasian, 19 African-American, and five Hispanic, underwent routine conventional TCD and the TCCS examination close in time to each other. Suitability of temporal bone acoustic window was defined by ability to insonate the middle and posterior and/or anterior cerebral arteries, while partial suitability was defined by ability to detect the posterior cerebral artery but not the middle cerebral artery. To compare proportions of suitable temporal bone windows for both sonographic methods, exact sign test by Liddell was used. RESULTS Bilateral absence of temporal bone acoustic window was reported in six patients when studied with both conventional TCD and TCCS, whereas at least unilateral absence was reported in 10 patients. Partial, at least unilateral, suitability was reported in 11 patients with conventional TCD, and in 7 with TCCS. All differences in proportions were not significant (two-sided P>0.05). CONCLUSIONS This study suggests that success rate of insonating the intracranial vessels through the temporal bone acoustic window is the same for conventional TCD and imaging TCCS.
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Affiliation(s)
- Jaroslaw Krejza
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
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Juszkat R, Pukacki F, Oszkinis G, Zarzecka A, Majewski W. Intramural Hematoma of the Thoracic Aorta as a Form of Aortic Dissection. Cardiovasc Intervent Radiol 2007; 30:1056-60. [PMID: 17671808 DOI: 10.1007/s00270-007-9132-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2006] [Revised: 10/27/2006] [Accepted: 11/16/2006] [Indexed: 12/25/2022]
Abstract
Intramural hematoma (IMH) of the thoracic aorta is a complication with unknown etiology and a poorly predictable prognosis. There is also considerable controversy about the management and prognosis of IMH as well as the treatment. We present two cases of endovascular treatment of IMH with stent-graft placement. On the basis of references, we discuss risks of progression of the given pathology and possible complications. Despite the lack of uniform opinion about the management of this disorder, we present our observations of and experiences with endovascular treatment of IMH of the thoracic aorta.
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Affiliation(s)
- Robert Juszkat
- Department of Radiology, Karol Marcinkowski Medical University, Poznań, Poland.
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Bryl W, Miczke A, Hoffmann K, Pupek-Musialik D, Brzeziński J, Oszkinis G, Winckiewicz M, Juszkat R. [Chronic intestinal ischemia--not rare cause of abdominal pains--case description]. Pol Merkur Lekarski 2007; 23:52-54. [PMID: 18051830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Chronic intestinal ischemia is a diagnostic problem for the physicians from internal department as well for the surgeons. The clinical manifestation of this disease is not clear and the symptoms are similar to many other disorders. This requires from the physician a wide knowledge and many-sided diagnostic process. The success depends also on the good cooperation between radiologist and vascular surgeon. The authors presents the case of 59-aged patient with occlusion of superior mesenteric artery. After the angioplasty there was a complete relief of ischemic symptoms.
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Affiliation(s)
- Wiesław Bryl
- Department of Internal Diseases, Metabolic Disturbances and Hypertension Medical, University of Poznań, Poland.
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Brzeziński J, Oszkinis G, Marzec E. Dielectric relaxation of a protein–water system in atherosclerotic artery wall. Med Biol Eng Comput 2007; 45:525-9. [PMID: 17541670 DOI: 10.1007/s11517-007-0181-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2006] [Accepted: 03/27/2007] [Indexed: 11/28/2022]
Abstract
Measurements of the dielectric properties of healthy and atherosclerotic human artery tissues were made in the frequency range of 100 Hz-100 kHz and temperatures from 22 to 260 degrees C. The temperature dependencies of the dielectric parameters for healthy tissues reveal distinctively the temperature ranges corresponding to the release of water up to 200 degrees C and the decomposition processes of elastin and collagen, above this temperature. The influence of atherosclerosis on the dielectric properties of artery tissues is significant in the whole temperature range. The relative permittivity for atherosclerotic tissues at the same temperature is much lower than for the healthy tissues. This suggests, that the polarization in atherosclerotic tissues due to protons hopping between a smaller number of sites than in healthy tissues, as a results of the thermal degradation of collagen-water. The data obtained above 200 degrees C indicate that the atherosclerosis induces the higher physico-chemical changes in the collagen when compared to elastin.
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Affiliation(s)
- J Brzeziński
- Department of General and Vascular Surgery, Poznań University of Medical Sciences, Długa 1/2, 61-848, Poznan, Poland
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