RESUMEN
INTRODUCTION: It is well known that peripheral artery disease (PAD) and coronary artery disease (CAD) coexist and therefore, patients diagnosed with PAD have an increased chance of developing concomitant CAD. CAD-related complications could be a leading cause of postoperative mortality in individuals with PAD undergoing vascular surgery. We present a case series of 48 patients who underwent coronary angiography before vascular surgery and an updated review of previous reports to determine the prevalence of concomitant CAD in a convenience sample of Iranian patients. METHODS: This cross-sectional study was performed on 48 patients with confirmed PAD admitted to Imam Ali Hospital, affiliated with the Kermanshah University of Medical Sciences (KUMS), Kermanshah Province, Iran. A vascular surgeon diagnosed PAD based on the patient's symptoms, Doppler ultrasound, and CT angiography (CTA). All patients underwent coronary angiography to determine if they also had CAD. We defined significant CAD as a ≥70% luminal diameter narrowing of a major epicardial artery or a ≥50% narrowing of the left main coronary artery. RESULTS: Of 48 patients, 35 (72.9%) were male, 13 (27.1%) were female, and the mean age was 64.18±12.11 years (range, 30 to 100 years). The incidence of CAD in patients with PVD was 85.42% (41/48). The patients with CAD were more likely to be hypertensive than those without CAD (80.5 vs. 14.3, p-value<0.001). Of 41 patients with CAD, 9 (22.0%) had one-vessel disease, 10 (24.3%) had two-vessel disease, and 22 (53.7%) had three-vessel disease. CONCLUSION: Hypertension was a significant risk factor for CAD. Patients with hypertension and multiple major coronary risk factors scheduled for PVD surgery should be carefully evaluated for concomitant CAD.
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Angiografía Coronaria , Enfermedad de la Arteria Coronaria , Enfermedad Arterial Periférica , Humanos , Masculino , Femenino , Irán/epidemiología , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/epidemiología , Estudios Transversales , Prevalencia , Enfermedad Arterial Periférica/epidemiología , Enfermedad Arterial Periférica/complicaciones , Factores de Riesgo , Persona de Mediana Edad , Anciano , Anciano de 80 o más AñosRESUMEN
INTRODUCTION AND OBJECTIVE: Ultrasound of the saphenous vein and measurement of the vein diameter may have a role in determining the severity of varicose veins. This study aimed to compare the saphenous vein diameter with the CEAP classification, as the reference standard in determining the severity of chronic venous diseases, in patients with lower limbs varicose veins free from saphenous vein reflux. METHODS: In this cross-sectional study, 100 patients with lower limbs varicose veins (saphenous vein) and free from saphenous vein reflux were enrolled. Demographic data (age, gender, body mass index (BMI)) were collected using a checklist. The severity of varicose veins was determined using the standard CEAP classification. The saphenous vein diameter was measured using ultrasonography. RESULTS: Mean age of the patients was 43 years and there were 68 female patients. According to the CEAP classification, 13 patients had no varicose veins (CEAP class C0). However, 87 patients had varicose veins (65 patients with class C1, one patient with class C2, and 21 patients with class C3). Mean saphenous vein diameter in the whole sample was 6.7 mm. There was no significant relationship between the severity of varicose veins determined by CEAP classification and mean saphenous vein diameter measured by ultrasound. Mean saphenous vein diameter in C0, C1, C2, and C3 groups were respectively 1.7 mm, 6.7 mm, 8 mm, and 8.7 mm (P= 0.71). On the other hand, mean saphenous vein diameter was higher significantly in those with higher body mass index (BMI) and among older patients. CONCLUSION: The results of this study showed that saphenous vein diameter did not differ significantly between CEAP C0 through C4 classes. However, the severity of varicose vein was more prominent in older patients and those with higher BMI.
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Várices , Insuficiencia Venosa , Adulto , Anciano , Enfermedad Crónica , Estudios Transversales , Femenino , Vena Femoral , Humanos , Masculino , Vena Safena/diagnóstico por imagen , Várices/diagnóstico por imagen , Insuficiencia Venosa/diagnóstico por imagenRESUMEN
INTRODUCTION: In addition to open endoaneurysmorrhaphy (EA) for treating the abdominal aortic aneurysm (AAA), other approaches such as endovascular aneurysm repair (EVAR) is gaining attention. Renal dysfunction could be a complication of these surgical techniques. We decided to compare renal function in EVAR vs. EA in patients operated for infrarenal AAAs. METHODS: Two groups of patients with AAA were included in this retrospective study. The first group (28 cases) consisted of patients who underwent AAA repair by EA technique and the second group included 12 patients who underwent EVAR for AAA repair. Serum creatinine levels measured one week, one month, three months, six months, and one year after the surgeries were documented. Through calculating the glomerular filtration rate (GFR) and scoring by the RIFLE criteria (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease), the patients' renal function was evaluated. RESULTS: Of 40 patients included, three cases had diabetes mellitus (7.5%), 16 cases had hypertension (40%), 16 were smokers (40%), and 12 cases had a ruptured AAA (30%). The mean time of onset or increase of renal dysfunction compared to baseline in both groups was 6.45 days. The lowest time for patients with renal dysfunction (GFR less than 60) was from the onset and the highest time was 90 days after surgery. GFR of patients before surgery (76.9 in the EVAR group, vs. 56.2 in the EA group; Pâ¯=â¯0.015) and one year after the surgery (84.1 in the EVAR group, vs. 57.7 in the EA group; Pâ¯=â¯0.027) was differed significantly. The RIFLE criterion also was significantly different at the end of the first year in the two groups (Pâ¯=â¯0.042). CONCLUSION: Based on the results, we concluded that the changes in renal function in EA group were more than EVAR group during one year. It may be necessary to follow patients undergoing these surgeries for a longer period to understand the prognosis of these patients better.
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Aneurisma de la Aorta Abdominal , Implantación de Prótesis Vascular , Procedimientos Endovasculares , Aneurisma de la Aorta Abdominal/cirugía , Implantación de Prótesis Vascular/efectos adversos , Procedimientos Endovasculares/efectos adversos , Humanos , Riñón/fisiología , Arteria Renal , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del TratamientoRESUMEN
BACKGROUND AND OBJECTIVE: Minimally invasive procedures such as foam sclerotherapy and radiofrequency ablation (RFA) have gained attention for treatment of incompetent great saphenous vein (GSV). The objective of this study was to compare recurrence rate and quality of life between foam sclerotherapy and RFA in patients with incompetent GSV varicose veins. METHODS: In this parallel single-blinded randomized clinical trial, 60 adult patients with primary varicose veins due to incompetent GSV (CEAP classes C2-4EPAsPr) were included and randomly divided to receive RFA or foam sclerotherapy. Health-related quality of life (HRQOL) was assessed by the Short Form 36, and the Aberdeen Varicose Vein Questionnaire (AVVQ) was applied to assess the impact of varicose veins on quality of life of the patients. In addition, pain severity after the procedures was investigated by a visual analog scale (VAS) (range, 0 to 10). The patients were followed at 1 week, 1 month, 3 months, and 6 months postoperation. GSV reflux and recurrence was assessed by color Doppler ultrasound examination after 6 months. RESULTS: Twenty-eight patients in RFA and 27 patients in foam sclerotherapy remained for the final analyses. The time interval from the procedure and recovery to daily normal activities was 1 day in both groups. Mean (±SD) pain VAS score in RFA group decreased from preintervention score of 7.35 (±3.28) to 1.21 (±0.68); P < .0001. Likewise, this score decreased from 6.64 (±2.04) to 1.29 (±0.91) in foam sclerotherapy group. HRQOL scores increased gradually at 1, 3, and 6 months after the intervention. AVVQ scores decreased significantly 1 week postintervention in both groups. After 6 months, 17.9% (5 patients) in RFA group and 14.8% (4 patients) in foam sclerotherapy group had recurrence of GSV reflux (P = .52). CONCLUSION: Both foam sclerotherapy and RFA were effective in treatment of GSV reflux. Comparable findings were observed between the 2 groups regarding postoperative pain, recovery time, HRQOL, and AVVQ scores.