Correlation of body mass index and waist/hip ratio with severity of coronary artery disease

Background: Obesity assessed by body mass index (BMI) and waist/hip ratio (WHR) are better predictors of cardiovascular disease. However, there is a dearth of data investigating the correlation of BMI and WHR with severity of CAD, particularly among the Indian population. This study aims to investigate the correlation of BMI and WHR with severity of CAD assessed by angiography.Methods: This open-label observational study included patients who underwent angiography, angioplasty, or coronary artery bypass grafting in the past one month. All data such as age, gender as well as anthropometric measurements such as height (meters), weight (kg), and waist circumferences (cm), and hip circumferences (cm) were collected at the first follow-up visit. BMI (kg/m2), body surface area (BSA) (m2), and WHR were calculated. Angiography findings were retrieved from the patient’s own record to note the severity of CAD.Results: In total, 302 patients were analyzed. The mean age of the study sample was 60.5±11.5 years, and 71.9% were males. Mean BMI, BSA, and WHR were 27.0±4.3 kg/m2, 1.3±0.8 m2 and 0.96±0.07, respectively. BMI was not significantly correlated with severity of CAD (p=0.051). In both male and female patients, WHR was not significantly correlated with severity of CAD (male: p=0.256 and female: p=0.851).Conclusions: It has been concluded that BMI and WHR were not significantly correlated with severity of CAD in an Indian population

The short-to-midterm outcomes of geniculate artery embolization for mild-to-moderate osteoarthritis of the knee: a systematic review

Geniculate Artery Embolization (GAE) is a novel, minimally-invasive treatment for mild to moderate Osteoarthritis (OA) associated with musculoskeletal pain. To investigate the outcomes of GAE in patients with mild to moderate OA of the knee using a Quantitative-analysis of the available literature. The PubMed, EMBASE and Cochrane databases were searched for GAE-related studies. Qualitative and quantitative analyses were performed following PRISMA-guidelines. Quantitative-analysis was performed using windows based ‘MedCalc-Statistical-Software version 19.6.1 (2020). Statistical analysis was performed in Stata–IC–13.1(Stata corp-USA). Quantitative-analysis was done using the random-effects model, and the Standardized-Mean-Differences (SMD) were calculated. After a full-text review, 13 studies with 399 knees (345-patients) were included in the qualitative synthesis, 10 were included in the quantitative synthesis. The total WOMAC score improved by a [SMD (95% CI)] of 3.46 points (1.27, 5.65), 3.50 (1.28, 5.71), 3.77 (0.58, 6.96), 5.46 (1.59, 9.33), 2.96 (−0.93, 6.85) compared to baseline at 1, 3, 6, 12, 24 months respectively. The VAS score improved by 2.06 (1.35, 2.76), 2.13 (1.39, 2.87), 2.36 (1.85, 2.90), 2.09 (0.91, 3.28) compared to baseline at 1, 3, 6, 12 months respectively. The Pain WOMAC score improved by SMD 2.97 (0.51, 5.43), 3.77 (0.58, 6.96), 2.27 (0.31, 4.22), 2.27 (0.31, 4.22) compared to baseline at 1, 3, 12, 24 months, respectively. There was a statistically significant change from baseline in all outcome measures after GAE. GAE is a safe and effective method for pain control in mild to moderate OA-associated knee pain in the short and medium term. •This systematic review shows that GAE is safe and effective in managing pain associated with mild to moderate OA.•GAE causes a significant improvement in the Total WOMAC scores indicating increased joint mobility and function.•GAE is a suitable alternative for OA patients who are unable or unwilling to undergo surgery

Prostatic Artery Embolization: Technical Pearls

Abstract Benign prostatic hyperplasia (BPH) is a condition that primarily affects men between the fourth and seventh decades of life, occurring due to enlargement of the prostate which subsequently causes compression of the prostatic urethra causing chronic obstruction of the urinary outflow tract. BPH can cause significant quality-of-life issues such as urinary hesitancy, intermittency, decreased urinary stream, a sensation of incomplete emptying, dysuria, urinary retention, hematuria, and nocturia. Several medical and surgical treatment modalities are available for the treatment of lower urinary tract symptoms and other BPH-related sequela; however, increasingly prostate artery embolization is being utilized in this patient population. Technical demands for this procedure in this population can be significant. This article describes the optimal techniques, tricks, and advanced imaging techniques that can be used to achieve desired technical outcomes

Two-year outcomes comparing Embosphere® microspheres versus Imipenem Cilastatin for genicular artery embolization in patients with moderate to severe knee osteoarthritis

Genicular artery embolization (GAE) is a novel technique and has the potential to provide midterm relief of pain for patients with mild-to-moderate knee osteoarthritis resistant to conservative management. This study compares the efficacy and safety of trisacryl gelatin microspheres to Imipenem/Cilastatin particles for GAE with 2 years of clinical follow-up. In this retrospective study, eight patients with knee osteoarthritis (11 knees) who underwent GAE with 100–300 μm trisacryl gelatin microspheres particles were compared with six patients (nine knees) who underwent GAE with Imipenem/Cilastatin particles. Clinical outcomes were evaluated at 3-month and 24-month follow-ups and compared to baseline using the WOMAC questionnaire. The median follow-up was 796 days (range: 736–808). There were no significant differences in clinical outcome measures at the 3-month or 24-month follow-up. Both embolic materials resulted in a decrease in Pain WOMAC and Total WOMAC scores at 3 months (p < 0.05), and the effect of treatment on Pain WOMAC and Total WOMAC score reduction was sustained until the 24-month follow-up (p < 0.05). Minor events (Clavien-Dindo classification grade I) included transient cutaneous color change (n = 3) and transient leg numbness (n = 1) after embolization with trisacryl gelatin microspheres particles (p = 0.08). All minor adverse events resolved spontaneously. There were no major adverse events. One hundred to three hundred μm trisacryl gelatin microspheres particles can be considered for genicular artery embolization and is comparable to Imipenem/Cilastatin particles in pain reduction of moderate to severe knee osteoarthritis. A sustained effect is observed for up to 2 years of follow-up

Long-Term Effects of Proximal Splenic Artery Embolization on Splenic Volume and Platelet Count

The spleen is the most commonly injured visceral organ in blunt abdominal trauma. Post-splenectomy infection risk has led to the shift toward spleen preserving procedures and splenic artery embolization (SAE) is now the treatment of choice for hemodynamically stable patients with splenic injury. This study aims to assess the long-term effect of SAE on splenic volume and platelet count. Using CPT codes, 66 patients who underwent SAE were identified, and 14 of those who had the necessary imaging and laboratory follow-up were included in the study. Indications for SAE were portal hypertension in 8 patients, bleeding in 4 patients, and thrombocytopenia in 1, and one patient had a separate indication. Splenic volume was calculated by automated volumetric software (Aquarius, TeraRecon, Inc.). Paired t-tests were performed to compare splenic volume and platelets before and after SAE. Fourteen patients (7 males, 7 females) with a mean age of 51 ± 11.95 years underwent SAE and were followed by a repeat computed tomography scan at an average of 733.57 days. Nine SAEs were performed using vascular plugs, 3 using micro coils, and 2 out of that were with Gelfoam slurry, and 2 using coils only. All embolizations were technically successful with complete cessation of flow. Mean splenic volumes pre- and post-SAE were 903.5 ± 523.73 cm3 and 746.5 ± 511.95 cm3, respectively, representing a mean decrease of 8.31% compared to baseline [P = 0.346]. Minimum platelet counts (x103) pre-SAE (within 3 months) and post-SAE (2 weeks to 3 months after the procedure) were 55.79 ± 57.11 and 116 ± 145.40, respectively. The minimum platelet count showed a statistically significant mean increase of 134.92% (P = 0.033). The splenic volume is not altered significantly by SAE in the long term. Similarly, the platelet count is also not significantly altered at 3 months follow-up. This study, although small, suggests that SAE is a safe intervention that can preserve splenic volume and function in the long term