Factor V Leiden distribution : could it shed some light on the pre-history of Europe and the Near East?

Polymorphism of clotting factor V, comprising Arg506Gln substitution in the factor V molecule, commonly known as Factor V Leiden, represents the most common heritable risk factor for thrombotic events in Indo-Europeans and some Semitic nations. Although it is suggested that this mutation is associated with a survival advantage that has facilitated the spread of this polymorphism in the human population, in this paper we argue against such a Darwinian evolutionary mechanism responsible for the high prevalence of FV Leiden in some countries. Instead, we propose that cultural, climatic, and geographic factors played a role. Taking into account the current distribution of FV Leiden polymorphism and the results of recent assessments of pre-historic human DNA, we suggest that actually the origin of FV Leiden mutation did not occur in the Near East, as is widely believed, but rather in a small isolated population of so-called Basal Eurasians, probably in northern Africa. This founder group probably migrated to the Near East during the Younger Dryas, a geological period associated with climate cooling. Here, they mixed with local people; still Factor V Leiden mutation remained very prevalent in this population. The invention of agriculture, which took place approximately 2,000 years later, gave the descendants of Basal Eurasians an enormous advantage over hunter-gatherers, and probably enabled a successful spread of FV Leiden polymorphism to Europe, Central Asia, and towards the Indian subcontinent

Technique of endovascular rheolytic thrombectomy using AngioJet for treatment of acute pulmonary embolism

We present a technique of endovascular rheolytic thrombectomy using the AngioJet system for the treatment of acute pulmonary embolism. We describe the procedure in detail, suggesting the optimal catheter, wires and potential complications during the procedure. Recent advances in endovascular techniques, such as aspiration thrombectomy, endovascular thrombus fragmentation devices and rheolytic or rotational thrombectomy, suggest that the endovascular approach can represent an alternative for pharmacological thrombolysis and surgical embolectomy

Endovascular management of carotid artery dissections with the use of new generation stents and protection systems

Dissection of the internal carotid artery (ICA) is a rare disease, but in young patients is responsible for about 20% of cerebral events. We presented three different cases of ICA dissection, including one iatrogenic and two spontaneous ones, which were successfully managed endovascularly, with the use of different techniques, different protection devices and stents. In this article, the clinical management and details of procedures were described

Endovascular management of carotid artery dissections with the use of new generation stents and protection systems

Dissection of the internal carotid artery (ICA) is a rare disease, but in young patients is responsible for about 20% of cerebral events. We presented three different cases of ICA dissection, including one iatrogenic and two spontaneous ones, which were successfully managed endovascularly, with the use of different techniques, different protection devices and stents. In this article, the clinical management and details of procedures were described

Zakrzepica zatok żylnych — diagnostyka, leczenie farmakologiczne i alternatywne leczenie endowaskularne z zastosowaniem systemów do trombektomii

Aim The aim of the article is to discuss the pathophysiology, clinical picture and neuroimaging of cerebral vein thrombosis, and present modern methods of treatment, including endovascular treatment. Methods Based on the available literature, the results of pharmacological treatment were analyzed, as well as the results of alternative endovascular treatment, currently still reserved for patients with or without an adequate response to pharmacological treatment - anticoagulant therapy. Results Clinical symptoms of venous sinus thrombosis are often non-specific and require careful neurological and imaging diagnostics. This is important because venous thrombosis is rare, affects mainly young people (mean age 35), but it is associated with a serious percentage of serious complications (up to 1% of strokes, mainly hemorrhagic etiology), and about 13% may to the death of patients. Imaging methods, pharmacological treatment and alternative treatment with thrombolytic therapy and endovascular techniques are presented. In addition, the first in Poland case of treatment of a patient with venous thrombosis with thrombectomy systems is presented as a rescue treatment, resulting in a good clinical effect. Conclusions Cerebral venous thrombosis is a relatively rare and often misdiagnosed disease. Knowledge of the clinical picture, methods of treatment, including endovascular treatment, may improve the prognosis and reduce the rate of complications.  Cel: Celem artykułu jest omówienie patofizjologii, obrazu klinicznego,neuroobrazowania zakrzepicy żył mózgowych oraznowoczesnych metod leczenia, z uwzględnieniem leczeniaendowaskularnego.Metody: Na podstawie dostępnego piśmiennictwa przeanalizowanowyniki leczenia farmakologicznego oraz alternatywnegopostępowania endowaskularnego, obecnie wciąż zarezerwowanegodla chorych bez odpowiedzi lub z nieadekwatną odpowiedziąna leczenie farmakologiczne przeciwkrzepliwe.Wyniki: Objawy kliniczne zakrzepicy zatok żylnych są częstoniespecyficzne i wymagają dokładnej diagnostyki neurologiczneji obrazowej. Jest to o tyle istotne, że zakrzepica zatok żylnychwystępuje rzadko, dotyczy głównie młodych osób (średniawieku 35 lat), ale jest obarczona dużym odsetkiem poważnychpowikłań (stanowi do 1% udarów, głównie o etiologii krwotocznej),a w około 13% może prowadzić do zgonu pacjentów.Przedstawiono metody obrazowania, leczenie farmakologicznegooraz alternatywne leczenie z zastosowaniem leczeniatrombolitycznego, a także technik endowaskularnych. Dodatkowozaprezentowano pierwszy w Polsce przypadek leczeniapacjentki z zakrzepicą zatok żylnych, u której po zastosowaniusystemów trombektomii, jako leczenia ratunkowego, uzyskanodobry efekt kliniczny.Wnioski: Zakrzepica zatok żylnych jest schorzeniem stosunkoworzadkim i często źle rozpoznanym. Znajomość obrazu klinicznego,sposobów leczenia, w tym postępowania endowaskularnego,może poprawić rokowanie i zmniejszyć odsetek powikłań