Małoinwazyjne leczenie tętniaków tętnicy podobojczykowej jako skuteczny i bezpieczny sposób leczenia pacjentów z licznymi obciążeniami, na przykładzie doświadczeń zespołu Oddziału Chirurgii Naczyń z Pododdziałem Zabiegów Endowaskularnych Szpitala im. Jana

The authors present a review of literature concerning symptoms, diagnosis, prognosis and treatment of subclavian artery aneurysms, which constitute 0.13–0.5% of all peripheral arterial aneurysms. Usually, they are asymptomatic and remain undiagnosed for a long time or may cause troublesome symptoms, diagnostic errors and serious threats. A large part of even asymptomatic subclavian artery aneurysms require surgical treatment. Once detected, the presence of subclavian artery aneurysm should incline to look for aneurysms in other locations, as they coexist in 33–47%. Based on our observations, we have presented the possibilities of an effective and safe therapeutic approach, including endovascular methods, particularly in patients with significant burdens.Autorzy przedstawiają przegląd doniesień dotyczących objawów, rozpoznawania, rokowania i leczenia tętniaków tętnicy podobojczykowej, które stanowią 0,13–0,5% wszystkich tętniaków tętnic obwodowych. Tętniaki tętnicy podobojczykowej najczęściej przebiegają bezobjawowo, pozostając długo nierozpoznane, lub mogą być przyczyną uciążliwych dolegliwości, pomyłek diagnostycznych i poważnych zagrożeń. Znaczna część tętniaków nawet bezobjawowych tętnicy podobojczykowej wymaga leczenia zabiegowego. Po wykryciu tętniaka tętnicy podobojczykowej należy również poszukiwać tętniaków w innych lokalizacjach, które współistnieją w 33–47%. Na podstawie własnych obserwacji przedstawiono możliwości skutecznego i bezpiecznego postępowania terapeutycznego, w tym metod wewnątrznaczyniowych, w szczególności w grupie chorych z istotnymi obciążeniami

Distal neuroprotection system as option for right subclavian artery ostial recanalization

We present the case of a 49-year-old woman with neurological symptoms and severe atherosclerosis of aortic arch branches affecting subclavian and carotid arteries. Our patient has a history of transient ischemic attack and recurrent paresthesias of her right arm. We present a double access intervention using a distal embolic neuroprotection device during ostial right subclavian artery recanalization. We recommend that use of an embolic protection device in right subclavian artery ostial recanalization should be considered

Coexistence and management of abdominal aortic aneurysm and coronary artery disease

Background: Abdominal aortic aneurysm (AAA) and coronary atherosclerosis share common risk factors. In this study, a single-center management experience of patients with a coexistence of AAA and coronary artery disease (CAD) is presented.Methods: 271 consecutive patients who underwent elective AAA repair were reviewed. Coronary imaging in 118 patients was considered suitable for exploration of AAA coexistence with CAD.Results: Significant coronary stenosis (> 70%) were found in 65.3% of patients. History of cardiac revascularization was present in 26.3% of patients, myocardial infarction (MI) in 31.4%, and 39.8% had both. In a subgroup analysis, prior history of percutaneous coronary intervention (PCI) (OR = 6.9, 95% CI 2.6–18.2, p < 0.001) and patients’ age (OR = 1.1, 95% CI 1.0–1.2, p = 0.007) were independent predictors of significant coronary stenosis. Only 52.0% (40/77) of patients with significant coronary stenosis underwent immediate coronary revascularization prior to aneurysm repair: PCI in 32 cases (4 drug-eluting stents and 27 bare metal stents), coronary artery bypass graft in 8 cases. Patients undergoing revascularization prior to surgery had longer mean time from coronary imaging to AAA repair (123.6 vs. 58.1 days, p < 0.001). Patients undergoing coronary artery evaluation prior to AAA repair had shorter median hospitalization (7 [2–70] vs. 7 [3–181] days, p = 0.007) and intensive care unit stay (1 [0–9] vs. 1 [0–70] days, p = 0.014) and also had a lower rate of major adverse cardiovascular events or multiple organ failure (0% vs. 3.9%, p = 0.035). A total of 11.0% of patients had coronary artery aneurysms.Conclusions: Patients with AAA might benefit from an early coronary artery evaluation strategy

In vitro and in silico studies of functionalized polyurethane surfaces toward understanding biologically relevant interactions

The solid-aqueous boundary formed upon biomaterial implantation provides a playground for most biochemical reactions and physiological processes involved in implant-host interactions. Therefore, for biomaterial development, optimization, and application, it is essential to understand the biomaterial-water interface in depth. In this study, oxygen plasma-functionalized polyurethane surfaces that can be successfully utilized in contact with the tissue of the respiratory system were prepared and investigated. Through experiments, the influence of plasma treatment on the physicochemical properties of polyurethane was investigated by atomic force microscopy, attenuated total reflection infrared spectroscopy, differential thermal analysis, X-ray photoelectron spectroscopy, secondary ion mass spectrometry, and contact angle measurements, supplemented with biological tests using the A549 cell line and two bacteria strains (Staphylococcus aureus and Pseudomonas aeruginosa). The molecular interpretation of the experimental findings was achieved by molecular dynamics simulations employing newly developed, fully atomistic models of unmodified and plasma-functionalized polyurethane materials to characterize the polyurethane-water interfaces at the nanoscale in detail. The experimentally obtained polar and dispersive surface free energies were consistent with the calculated free energies, verifying the adequacy of the developed models. A 20% substitution of the polymeric chain termini by their oxidized variants was observed in the experimentally obtained plasma-modified polyurethane surface, indicating the surface saturation with oxygen-containing functional groups.Peer reviewe