Takayasu’s disease
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uvcdThis document discusses Takayasu's Disease and Buerger's Disease, also known as thromboangiitis obliterans (TAO), which have a high prevalence in Oriental countries. It describes an endovascular approach for treating Buerger's Disease, including diagnostic ultrasound findings. The procedure is outlined briefly, noting differences in characteristics for atherosclerosis, diabetic arteriopathy, and Buerger's Disease. Clinical cases are presented before and after the endovascular procedure. The conclusion states the endovascular approach can be effective for Buerger's Disease due to intense vasovasorum development.
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Takayasu arteritis
takayasu arteritis is an autoimmune vasculitis that affects the large and medium vessels...pulseless disease
Takayasu arteritis
Takayasu's arteritis is an inflammatory disease that causes stenosis of the aorta and its main branches. It most commonly affects young women in Asia. Symptoms vary depending on the arteries affected but may include headaches, fatigue, limb claudication, and hypertension. Diagnosis involves assessing symptoms, physical exam findings like blood pressure differences between limbs, and imaging tests like angiograms. Treatment consists of corticosteroids and immunosuppressive drugs to control inflammation, with surgery as needed for complications from narrowed arteries. Strict management of cardiovascular risk factors is also important.
Takayasu arteritis.
Takayasu arteritis is a rare large vessel vasculitis that predominantly involves the aorta and its major branches. It was first described in 1908 by Mikito Takayasu and has various names including pulseless disease. It most commonly affects the subclavian and carotid arteries in women under 50 years old. Diagnosis is based on imaging and clinical criteria as there are no definitive diagnostic tests. Treatment involves steroids and steroid-sparing immunosuppressants, with TNF inhibitors being widely used biologic therapies. Ongoing management focuses on preventing arterial progression and complications like hypertension.
L A R Lecture
1. Giant cell arteritis (GCA) and Takayasu's arteritis are two forms of large vessel vasculitis that predominantly affect elderly and younger populations respectively.
2. GCA most commonly involves branches of the carotid artery and causes headaches, jaw claudication, and vision loss. Takayasu's arteritis mainly affects the aorta and its primary branches and can lead to hypertension, aneurysms, and strokes.
3. Treatment for both involves high-dose glucocorticoids, with additional immunosuppressants sometimes used for refractory or relapsing disease. Careful monitoring is needed due to risks of treatment complications like osteoporosis and fractures.
Giant Cell Arteritis
Giant cell arteritis is a disease that affects medium and large arteries, often causing ischemia. It typically affects older adults and presents with symptoms of temporal headache, jaw claudication, and scalp tenderness. Laboratory tests often show elevated ESR and CRP levels. Diagnosis is made through temporal artery biopsy or response to treatment with corticosteroids like prednisone. Treatment involves high doses of prednisone tapered over two years to prevent vision loss and other complications.
aortoarteritis/takayasu,s
This document presents the case of a 16-year-old female patient with Takayasu's arteritis. She presented with symptoms of breathlessness, swelling in the lower limbs, decreased urine output, and fever. Investigations revealed coarctation of the aorta, renal artery stenosis, dissection of the aorta, and renovascular hypertension. Angiography showed involvement of multiple arteries. She was diagnosed with Takayasu's arteritis based on clinical criteria and imaging findings.
Takayasu arteritis
This document provides an overview of Takayasu Arteritis (TA), including:
- The definition, epidemiology, pathology, and clinical features of TA. Key symptoms include fever, weight loss, and ischemia of the extremities.
- Diagnostic criteria including the Ishikawa, ACR, and Suri criteria, which rely on angiographic and clinical findings.
- Challenges in assessing disease activity, as inflammatory markers may be normal despite active vasculitis.
- The role of non-invasive imaging methods like MRI, CT, and ultrasound in evaluating vessel wall changes and inflammation as markers of active disease.
Takayasusarteritis
Takayasu's arteritis is a rare inflammatory disease that affects large blood vessels. It most commonly involves the aorta and its major branches. It predominantly affects young women of Asian descent. Symptoms can include headaches, fatigue, joint pains, and abnormalities in blood pressure between limbs. Diagnosis involves imaging tests like angiograms to detect vessel narrowing, blockages, or aneurysms. Treatment focuses on controlling inflammation with corticosteroids and immunosuppressants, and managing hypertension through cardiovascular procedures or surgery if needed. Strict control of risk factors is also important to prevent complications like heart disease.
Recommended
Takayasu arteritis
takayasu arteritis is an autoimmune vasculitis that affects the large and medium vessels...pulseless disease
Takayasu arteritis
Takayasu's arteritis is an inflammatory disease that causes stenosis of the aorta and its main branches. It most commonly affects young women in Asia. Symptoms vary depending on the arteries affected but may include headaches, fatigue, limb claudication, and hypertension. Diagnosis involves assessing symptoms, physical exam findings like blood pressure differences between limbs, and imaging tests like angiograms. Treatment consists of corticosteroids and immunosuppressive drugs to control inflammation, with surgery as needed for complications from narrowed arteries. Strict management of cardiovascular risk factors is also important.
Takayasu arteritis.
Takayasu arteritis is a rare large vessel vasculitis that predominantly involves the aorta and its major branches. It was first described in 1908 by Mikito Takayasu and has various names including pulseless disease. It most commonly affects the subclavian and carotid arteries in women under 50 years old. Diagnosis is based on imaging and clinical criteria as there are no definitive diagnostic tests. Treatment involves steroids and steroid-sparing immunosuppressants, with TNF inhibitors being widely used biologic therapies. Ongoing management focuses on preventing arterial progression and complications like hypertension.
L A R Lecture
1. Giant cell arteritis (GCA) and Takayasu's arteritis are two forms of large vessel vasculitis that predominantly affect elderly and younger populations respectively.
2. GCA most commonly involves branches of the carotid artery and causes headaches, jaw claudication, and vision loss. Takayasu's arteritis mainly affects the aorta and its primary branches and can lead to hypertension, aneurysms, and strokes.
3. Treatment for both involves high-dose glucocorticoids, with additional immunosuppressants sometimes used for refractory or relapsing disease. Careful monitoring is needed due to risks of treatment complications like osteoporosis and fractures.
Giant Cell Arteritis
Giant cell arteritis is a disease that affects medium and large arteries, often causing ischemia. It typically affects older adults and presents with symptoms of temporal headache, jaw claudication, and scalp tenderness. Laboratory tests often show elevated ESR and CRP levels. Diagnosis is made through temporal artery biopsy or response to treatment with corticosteroids like prednisone. Treatment involves high doses of prednisone tapered over two years to prevent vision loss and other complications.
aortoarteritis/takayasu,s
This document presents the case of a 16-year-old female patient with Takayasu's arteritis. She presented with symptoms of breathlessness, swelling in the lower limbs, decreased urine output, and fever. Investigations revealed coarctation of the aorta, renal artery stenosis, dissection of the aorta, and renovascular hypertension. Angiography showed involvement of multiple arteries. She was diagnosed with Takayasu's arteritis based on clinical criteria and imaging findings.
Takayasu arteritis
This document provides an overview of Takayasu Arteritis (TA), including:
- The definition, epidemiology, pathology, and clinical features of TA. Key symptoms include fever, weight loss, and ischemia of the extremities.
- Diagnostic criteria including the Ishikawa, ACR, and Suri criteria, which rely on angiographic and clinical findings.
- Challenges in assessing disease activity, as inflammatory markers may be normal despite active vasculitis.
- The role of non-invasive imaging methods like MRI, CT, and ultrasound in evaluating vessel wall changes and inflammation as markers of active disease.
Takayasusarteritis
Takayasu's arteritis is a rare inflammatory disease that affects large blood vessels. It most commonly involves the aorta and its major branches. It predominantly affects young women of Asian descent. Symptoms can include headaches, fatigue, joint pains, and abnormalities in blood pressure between limbs. Diagnosis involves imaging tests like angiograms to detect vessel narrowing, blockages, or aneurysms. Treatment focuses on controlling inflammation with corticosteroids and immunosuppressants, and managing hypertension through cardiovascular procedures or surgery if needed. Strict control of risk factors is also important to prevent complications like heart disease.
Takayasu arteritis
Takayasu arteritis (TA) is a rare nonspecific inflammatory disease of unknown cause, predominantly affecting
the aorta and its main branches, coronary arteries, and pulmonary arteries of young females. It induces a variety
of nonspecific inflammatory symptoms and ischemic symptoms due to stenotic lesions. Further progression
of TA causes destruction of the arterial wall media, leading to aortic regurgitation and aneurysms or
rupture of the involved arteries. Although serological tests specific for TA are not available, new better biomarkers
are emerging such as pentraxin3 and matrix metalloproteinases. Recent advances in imaging modalities
including magnetic resonance angiography, computed tomography (CT), sonography, and fluorodeoxy
glucose positron emission tomography/CT (FDG-PET/CT) allow earlier and accurate diagnosis of TA. Duration
between onset of the disease and diagnosis has become much shorter during the last decade. Medical treatment
for TA is also changing. In addition to the traditional glucocorticoids and immunosuppressants, many
new biological agents are being applied to patients with TA refractory to conventional treatment with favorable
results. As for treatment for vascular complications, efficacy of endovascular treatment is still a matter of
controversy because of the high rate of restenosis at an early stage after the procedure. Based on these advances,
the prognosis and quality of life of TA patients have improved to a great deal. However, there are
many issues that remain to be solved in the management of TA.
Takayashu arteritis
takayasu arteritis is inflammatory disorder of medium sized arteries of unknown etiology, prevent in young female. lead to life threatening complication and long lasting morbidity. early diagnosis and treatment prevent complication and improve quality of life
Takayasu arteritis imaging
Takayasu arteritis is a chronic inflammatory disease that primarily affects large arteries like the aorta and its branches. Accurate early diagnosis is important to improve outcomes for patients. Imaging like CT angiography and MR angiography are essential non-invasive tools to detect luminal narrowing, wall thickening, and other vascular abnormalities associated with Takayasu arteritis. Differential diagnosis includes other diseases like atherosclerosis and giant cell arteritis that can present similarly on imaging. Characteristic findings on CT and MR imaging can help establish the diagnosis of Takayasu arteritis.
Estenose c
Carotid vascular disease is a leading cause of stroke in the US. Treatment options include carotid endarterectomy (CEA) surgery and nonsurgical carotid revascularization using angioplasty and stenting. Studies have shown conflicting results comparing the two approaches. CEA is generally recommended but angioplasty and stenting may be better for high-risk surgical patients or those with significant comorbidities. More research is still needed to refine treatment recommendations.
Takayasu arteritis.fin al
Takayasu arteritis is an idiopathic inflammatory disease that primarily affects large elastic arteries, especially the aorta and its branches. It most commonly occurs in young females. The disease involves occlusive or ectatic changes in the arteries and can present with nonspecific early symptoms or later with signs of ischemia due to arterial occlusion. Diagnosis is based on criteria that consider clinical features, imaging findings, and laboratory tests showing inflammation. Treatment involves management of symptoms and immunosuppression.
Challenges in Managing Takayasu Arteritis
Takayasu Arteritis is a chronic inflammatory disease that affects large blood vessels. The document discusses challenges in managing the disease course and activity over time. It summarizes guidelines for determining disease activity versus remission using clinical features, biomarkers and imaging. Medical management focuses on controlling inflammation with steroids, DMARDs and biologics. Surgery is indicated for complications like aortic aneurysms or critical stenosis when disease is inactive.
SCMR Edition – Issue 56
The article discusses new cardiac parametric mapping techniques for T1 and T2 mapping that provide pixel-based maps of myocardial relaxation times. These techniques can detect diffuse myocardial pathologies missed by conventional imaging by quantifying subtle tissue changes. T1 mapping in particular shows potential for diagnosing diseases involving diffuse fibrosis. Standardization of mapping methods is still needed to ensure consistent quantitative results. The efficient, single breath-hold nature of new mapping sequences improves clinical applicability for detecting early disease changes.
Zilstra Tapas Slides
The TAPAS study was a single-center, randomized trial that compared thrombus aspiration to conventional PCI in STEMI patients. The study found that thrombus aspiration resulted in improved myocardial perfusion and ST-segment resolution compared to conventional PCI. At 30 days, improved myocardial perfusion predicted lower rates of death and reinfarction. At 1 year follow up, thrombus aspiration was associated with lower mortality and a composite of mortality or non-fatal reinfarction compared to conventional PCI alone.
Carotid Artery Stenosis Dr Pankaj Rathi DM Traine Shri Aurobindo Medical Coll...
Carotid artery stenosis refers to a 50% or greater blockage of the carotid arteries, which supply blood to the brain. The document discusses the anatomy of the carotid arteries and risk factors for ischemic stroke such as atherosclerosis. For asymptomatic patients, screening with carotid duplex ultrasound may be considered for those with multiple cardiovascular risk factors. Medical management including statins, blood pressure control, and aspirin can significantly reduce stroke risk. For high-risk asymptomatic patients, carotid endarterectomy or stenting may be options. Symptomatic patients with greater than 50% stenosis are generally treated with carotid revascularization, especially if additional risk factors are present.
Takayasu arteritis
Takayasu arteritis is a rare type of vasculitis that causes inflammation of the aorta and its main branches, which can lead to narrowed or aneurysmal arteries. It most commonly affects young Asian women. Treatment aims to relieve arterial inflammation and prevent complications through medications like glucocorticoids and immunosuppressants, though the condition can be challenging to manage long-term. Diagnosis involves examining blood tests, imaging of arteries, and ruling out other conditions through angiography, MRI, or ultrasound.
Primary Percutaneus coronary intervention
Primary PCI involves performing urgent angioplasty and potentially stenting of the culprit artery in STEMI patients, with the goal of reopening the blocked vessel within 90 minutes of first medical contact. It is the preferred reperfusion strategy when it can be performed promptly by an experienced team. Factors such as patient age, time to treatment, comorbidities, and initial flow in the artery help determine whether primary PCI or thrombolysis is most appropriate. Optimal anticoagulation and antiplatelet regimens along with adjunctive therapies like manual thrombectomy can improve outcomes of primary PCI.
Crest
1) The CREST trial compared outcomes of carotid artery stenting (CAS) and carotid endarterectomy (CEA) for treatment of carotid artery stenosis and found they had similar rates of the primary composite outcome of periprocedural stroke, heart attack, or death as well as subsequent ipsilateral strokes.
2) Periprocedural strokes were lower in the CEA group while periprocedural heart attacks were lower in the CAS group.
3) Younger patients had slightly better outcomes with CAS while CEA remained effective, with low risks of recurrent strokes after either procedure indicating durability, especially when combined with medical therapy.
Carotid Stenosis
A 77-year-old female presented to the emergency department with difficulty breathing and was found to have pulmonary edema and left ventricular hypertrophy. During her hospital stay, a carotid bruit was discovered and Doppler ultrasound revealed 80-99% stenosis of the right carotid artery. She was scheduled for a right carotid endarterectomy to address the high-grade stenosis, a procedure she tolerated well without complications. Medical management has improved for asymptomatic carotid stenosis but intervention may still benefit high-risk patients.
Late shone complex case report and literature review
1) Shone complex is a rare congenital heart disease consisting of four left-sided obstructive lesions: coarctation of the aorta, parachute mitral valve, supravalvular mitral ring, and subaortic stenosis.
2) A 33-year-old woman presented with worsening dyspnea and was found to have Shone complex, consisting of previous repair of coarctation, parachute mitral valve, and subaortic stenosis.
3) She underwent successful mitral valve replacement, resection of the subaortic membrane, and left ventricular myectomy, with excellent postoperative recovery.
Carotid Endarterectomy in Stroke Prevention Update
This document discusses carotid endarterectomy for stroke prevention. It provides background on strokes, defines different types of strokes, and outlines diagnostic techniques. The bulk of the document focuses on carotid endarterectomy, describing what it is, the history of the procedure, how it is performed, and results from major clinical trials demonstrating its effectiveness in reducing stroke risk compared to medical management alone for patients with significant carotid artery stenosis. The document emphasizes awareness of new techniques and treatments to prevent strokes.
Takayasu arteritis
he diseased aorta in Takayasu’s arteritis features areas of ectasia and stenosis; the aorta is left with very little elastic tissue due to diffuse fibrosis of the intima, media, and externa. Stent-supported endovascular aortoplasty and surgical revascularization are associated with higher complication and recurrence rates, even with regular immunomodulation follow-up. Unlike atheromatous disease, the inflexible artery is vulnerable to dissection, and is as “brittle as glass” during balloon angioplasty. Therefore, some authors suggest self-expanding stent or stent-graft supported angioplasty for this condition, with high-pressure dilation,to overcome fibrosis caused by panarteritis. However, the incidence of dissection in this situation appears to be under-reported.
Thrombus aspiration in ppci
Manual thrombus aspiration during primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) was not associated with reduced long-term mortality according to a study of 10,929 patients. While thrombus aspiration was linked to higher procedural success rates and lower in-hospital complications, long-term survival was similar between patients who received thrombus aspiration and those who underwent PPCI only. After adjusting for differences in patient characteristics and procedures using propensity score matching, thrombus aspiration during PPCI was still not found to reduce mortality risk.
Asymptomatic Carotid Stenosis
This document discusses when revascularization may be appropriate for asymptomatic patients with carotid artery stenosis.
It summarizes evidence from clinical trials showing a reduction in stroke risk from revascularization compared to medical therapy alone. Revascularization risks have decreased over time with improvements in technology and operator experience.
The document recommends identifying high-risk patients for revascularization based on plaque characteristics like morphology and microemboli, as well as factors like impaired vasomotor reactivity, silent cerebral infarcts, and progression of stenosis over time. Detection of these high-risk features can help select asymptomatic patients that may benefit from revascularization.
Buergers Disease Leech Therapy
The document summarizes six case studies of patients with thromboangiitis obliterans (Buerger's disease) who were treated with leech therapy. All six patients were male smokers between the ages of 44-63 presenting with symptoms like gangrene, pain, and loss of circulation in fingers and toes. They underwent between 3-8 sessions of leech therapy, applying 5-8 leeches per session. After completing leech therapy, all patients' subjective symptoms disappeared and gangrenous lesions healed without requiring amputation. The document discusses the potential mechanisms of action and therapeutic effects of leech therapy for Buerger's disease.
Seminar on buergers disease and raynauds disease
Raynaud's disease and thromboangitis obliterans (Buerger's disease) are caused by reduced blood flow to the extremities. Raynaud's disease involves intermittent vasoconstriction of arteries in fingers and toes in response to cold or stress, causing discoloration and pain. Buerger's disease causes inflammation and blood clots in lower extremity arteries and veins, which can lead to gangrene if untreated. Both diseases require lifestyle modifications like avoiding cold and tobacco to prevent attacks and progression. Treatment involves medications to improve circulation, surgery to relieve symptoms, and amputation in severe cases of Buerger's disease.
Buerger’s disease
Buerger's disease is a non-atherosclerotic, inflammatory disease that causes blockages in the small and medium arteries and veins of the limbs, especially the legs. It is strongly associated with tobacco use and is characterized by recurring blood clots and inflammation within blood vessels that supply the arms and legs. The main symptoms are pain, discoloration, and ulcers in the legs that worsen with walking or standing. Treatment focuses on complete cessation of tobacco use and medications or surgery to improve blood flow.
Buergers disease by dr .ravinder narwal
Buerger's disease, also called thromboangiitis obliterans (TAO), is an inflammatory vascular disease that causes the small and medium arteries of the limbs to narrow and become blocked. It most commonly affects the arteries in the legs and feet. The disease is more common in men than women and usually presents between the ages of 20-45. Smoking is a major risk factor, with over 99% of patients with Buerger's disease being smokers. Treatment focuses on cessation of smoking and may include medications to improve blood flow, surgical procedures, and rehabilitation involving exercise and mobility training.
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Takayasu arteritis
Takayasu arteritis (TA) is a rare nonspecific inflammatory disease of unknown cause, predominantly affecting
the aorta and its main branches, coronary arteries, and pulmonary arteries of young females. It induces a variety
of nonspecific inflammatory symptoms and ischemic symptoms due to stenotic lesions. Further progression
of TA causes destruction of the arterial wall media, leading to aortic regurgitation and aneurysms or
rupture of the involved arteries. Although serological tests specific for TA are not available, new better biomarkers
are emerging such as pentraxin3 and matrix metalloproteinases. Recent advances in imaging modalities
including magnetic resonance angiography, computed tomography (CT), sonography, and fluorodeoxy
glucose positron emission tomography/CT (FDG-PET/CT) allow earlier and accurate diagnosis of TA. Duration
between onset of the disease and diagnosis has become much shorter during the last decade. Medical treatment
for TA is also changing. In addition to the traditional glucocorticoids and immunosuppressants, many
new biological agents are being applied to patients with TA refractory to conventional treatment with favorable
results. As for treatment for vascular complications, efficacy of endovascular treatment is still a matter of
controversy because of the high rate of restenosis at an early stage after the procedure. Based on these advances,
the prognosis and quality of life of TA patients have improved to a great deal. However, there are
many issues that remain to be solved in the management of TA.
Takayashu arteritis
takayasu arteritis is inflammatory disorder of medium sized arteries of unknown etiology, prevent in young female. lead to life threatening complication and long lasting morbidity. early diagnosis and treatment prevent complication and improve quality of life
Takayasu arteritis imaging
Takayasu arteritis is a chronic inflammatory disease that primarily affects large arteries like the aorta and its branches. Accurate early diagnosis is important to improve outcomes for patients. Imaging like CT angiography and MR angiography are essential non-invasive tools to detect luminal narrowing, wall thickening, and other vascular abnormalities associated with Takayasu arteritis. Differential diagnosis includes other diseases like atherosclerosis and giant cell arteritis that can present similarly on imaging. Characteristic findings on CT and MR imaging can help establish the diagnosis of Takayasu arteritis.
Estenose c
Carotid vascular disease is a leading cause of stroke in the US. Treatment options include carotid endarterectomy (CEA) surgery and nonsurgical carotid revascularization using angioplasty and stenting. Studies have shown conflicting results comparing the two approaches. CEA is generally recommended but angioplasty and stenting may be better for high-risk surgical patients or those with significant comorbidities. More research is still needed to refine treatment recommendations.
Takayasu arteritis.fin al
Takayasu arteritis is an idiopathic inflammatory disease that primarily affects large elastic arteries, especially the aorta and its branches. It most commonly occurs in young females. The disease involves occlusive or ectatic changes in the arteries and can present with nonspecific early symptoms or later with signs of ischemia due to arterial occlusion. Diagnosis is based on criteria that consider clinical features, imaging findings, and laboratory tests showing inflammation. Treatment involves management of symptoms and immunosuppression.
Challenges in Managing Takayasu Arteritis
Takayasu Arteritis is a chronic inflammatory disease that affects large blood vessels. The document discusses challenges in managing the disease course and activity over time. It summarizes guidelines for determining disease activity versus remission using clinical features, biomarkers and imaging. Medical management focuses on controlling inflammation with steroids, DMARDs and biologics. Surgery is indicated for complications like aortic aneurysms or critical stenosis when disease is inactive.
SCMR Edition – Issue 56
The article discusses new cardiac parametric mapping techniques for T1 and T2 mapping that provide pixel-based maps of myocardial relaxation times. These techniques can detect diffuse myocardial pathologies missed by conventional imaging by quantifying subtle tissue changes. T1 mapping in particular shows potential for diagnosing diseases involving diffuse fibrosis. Standardization of mapping methods is still needed to ensure consistent quantitative results. The efficient, single breath-hold nature of new mapping sequences improves clinical applicability for detecting early disease changes.
Zilstra Tapas Slides
The TAPAS study was a single-center, randomized trial that compared thrombus aspiration to conventional PCI in STEMI patients. The study found that thrombus aspiration resulted in improved myocardial perfusion and ST-segment resolution compared to conventional PCI. At 30 days, improved myocardial perfusion predicted lower rates of death and reinfarction. At 1 year follow up, thrombus aspiration was associated with lower mortality and a composite of mortality or non-fatal reinfarction compared to conventional PCI alone.
Carotid Artery Stenosis Dr Pankaj Rathi DM Traine Shri Aurobindo Medical Coll...
Carotid artery stenosis refers to a 50% or greater blockage of the carotid arteries, which supply blood to the brain. The document discusses the anatomy of the carotid arteries and risk factors for ischemic stroke such as atherosclerosis. For asymptomatic patients, screening with carotid duplex ultrasound may be considered for those with multiple cardiovascular risk factors. Medical management including statins, blood pressure control, and aspirin can significantly reduce stroke risk. For high-risk asymptomatic patients, carotid endarterectomy or stenting may be options. Symptomatic patients with greater than 50% stenosis are generally treated with carotid revascularization, especially if additional risk factors are present.
Takayasu arteritis
Takayasu arteritis is a rare type of vasculitis that causes inflammation of the aorta and its main branches, which can lead to narrowed or aneurysmal arteries. It most commonly affects young Asian women. Treatment aims to relieve arterial inflammation and prevent complications through medications like glucocorticoids and immunosuppressants, though the condition can be challenging to manage long-term. Diagnosis involves examining blood tests, imaging of arteries, and ruling out other conditions through angiography, MRI, or ultrasound.
Primary Percutaneus coronary intervention
Primary PCI involves performing urgent angioplasty and potentially stenting of the culprit artery in STEMI patients, with the goal of reopening the blocked vessel within 90 minutes of first medical contact. It is the preferred reperfusion strategy when it can be performed promptly by an experienced team. Factors such as patient age, time to treatment, comorbidities, and initial flow in the artery help determine whether primary PCI or thrombolysis is most appropriate. Optimal anticoagulation and antiplatelet regimens along with adjunctive therapies like manual thrombectomy can improve outcomes of primary PCI.
Crest
1) The CREST trial compared outcomes of carotid artery stenting (CAS) and carotid endarterectomy (CEA) for treatment of carotid artery stenosis and found they had similar rates of the primary composite outcome of periprocedural stroke, heart attack, or death as well as subsequent ipsilateral strokes.
2) Periprocedural strokes were lower in the CEA group while periprocedural heart attacks were lower in the CAS group.
3) Younger patients had slightly better outcomes with CAS while CEA remained effective, with low risks of recurrent strokes after either procedure indicating durability, especially when combined with medical therapy.
Carotid Stenosis
A 77-year-old female presented to the emergency department with difficulty breathing and was found to have pulmonary edema and left ventricular hypertrophy. During her hospital stay, a carotid bruit was discovered and Doppler ultrasound revealed 80-99% stenosis of the right carotid artery. She was scheduled for a right carotid endarterectomy to address the high-grade stenosis, a procedure she tolerated well without complications. Medical management has improved for asymptomatic carotid stenosis but intervention may still benefit high-risk patients.
Late shone complex case report and literature review
1) Shone complex is a rare congenital heart disease consisting of four left-sided obstructive lesions: coarctation of the aorta, parachute mitral valve, supravalvular mitral ring, and subaortic stenosis.
2) A 33-year-old woman presented with worsening dyspnea and was found to have Shone complex, consisting of previous repair of coarctation, parachute mitral valve, and subaortic stenosis.
3) She underwent successful mitral valve replacement, resection of the subaortic membrane, and left ventricular myectomy, with excellent postoperative recovery.
Carotid Endarterectomy in Stroke Prevention Update
This document discusses carotid endarterectomy for stroke prevention. It provides background on strokes, defines different types of strokes, and outlines diagnostic techniques. The bulk of the document focuses on carotid endarterectomy, describing what it is, the history of the procedure, how it is performed, and results from major clinical trials demonstrating its effectiveness in reducing stroke risk compared to medical management alone for patients with significant carotid artery stenosis. The document emphasizes awareness of new techniques and treatments to prevent strokes.
Takayasu arteritis
he diseased aorta in Takayasu’s arteritis features areas of ectasia and stenosis; the aorta is left with very little elastic tissue due to diffuse fibrosis of the intima, media, and externa. Stent-supported endovascular aortoplasty and surgical revascularization are associated with higher complication and recurrence rates, even with regular immunomodulation follow-up. Unlike atheromatous disease, the inflexible artery is vulnerable to dissection, and is as “brittle as glass” during balloon angioplasty. Therefore, some authors suggest self-expanding stent or stent-graft supported angioplasty for this condition, with high-pressure dilation,to overcome fibrosis caused by panarteritis. However, the incidence of dissection in this situation appears to be under-reported.
Thrombus aspiration in ppci
Manual thrombus aspiration during primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) was not associated with reduced long-term mortality according to a study of 10,929 patients. While thrombus aspiration was linked to higher procedural success rates and lower in-hospital complications, long-term survival was similar between patients who received thrombus aspiration and those who underwent PPCI only. After adjusting for differences in patient characteristics and procedures using propensity score matching, thrombus aspiration during PPCI was still not found to reduce mortality risk.
Asymptomatic Carotid Stenosis
This document discusses when revascularization may be appropriate for asymptomatic patients with carotid artery stenosis.
It summarizes evidence from clinical trials showing a reduction in stroke risk from revascularization compared to medical therapy alone. Revascularization risks have decreased over time with improvements in technology and operator experience.
The document recommends identifying high-risk patients for revascularization based on plaque characteristics like morphology and microemboli, as well as factors like impaired vasomotor reactivity, silent cerebral infarcts, and progression of stenosis over time. Detection of these high-risk features can help select asymptomatic patients that may benefit from revascularization.
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Carotid Artery Stenosis Dr Pankaj Rathi DM Traine Shri Aurobindo Medical Coll...
Carotid Artery Stenosis Dr Pankaj Rathi DM Traine Shri Aurobindo Medical Coll...
Late shone complex case report and literature review
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Carotid Endarterectomy in Stroke Prevention Update
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Viewers also liked
Buergers Disease Leech Therapy
The document summarizes six case studies of patients with thromboangiitis obliterans (Buerger's disease) who were treated with leech therapy. All six patients were male smokers between the ages of 44-63 presenting with symptoms like gangrene, pain, and loss of circulation in fingers and toes. They underwent between 3-8 sessions of leech therapy, applying 5-8 leeches per session. After completing leech therapy, all patients' subjective symptoms disappeared and gangrenous lesions healed without requiring amputation. The document discusses the potential mechanisms of action and therapeutic effects of leech therapy for Buerger's disease.
Seminar on buergers disease and raynauds disease
Raynaud's disease and thromboangitis obliterans (Buerger's disease) are caused by reduced blood flow to the extremities. Raynaud's disease involves intermittent vasoconstriction of arteries in fingers and toes in response to cold or stress, causing discoloration and pain. Buerger's disease causes inflammation and blood clots in lower extremity arteries and veins, which can lead to gangrene if untreated. Both diseases require lifestyle modifications like avoiding cold and tobacco to prevent attacks and progression. Treatment involves medications to improve circulation, surgery to relieve symptoms, and amputation in severe cases of Buerger's disease.
Buerger’s disease
Buerger's disease is a non-atherosclerotic, inflammatory disease that causes blockages in the small and medium arteries and veins of the limbs, especially the legs. It is strongly associated with tobacco use and is characterized by recurring blood clots and inflammation within blood vessels that supply the arms and legs. The main symptoms are pain, discoloration, and ulcers in the legs that worsen with walking or standing. Treatment focuses on complete cessation of tobacco use and medications or surgery to improve blood flow.
Buergers disease by dr .ravinder narwal
Buerger's disease, also called thromboangiitis obliterans (TAO), is an inflammatory vascular disease that causes the small and medium arteries of the limbs to narrow and become blocked. It most commonly affects the arteries in the legs and feet. The disease is more common in men than women and usually presents between the ages of 20-45. Smoking is a major risk factor, with over 99% of patients with Buerger's disease being smokers. Treatment focuses on cessation of smoking and may include medications to improve blood flow, surgical procedures, and rehabilitation involving exercise and mobility training.
Raynauds Phenomenon-Dignosis & Evaluation
Raynaud's phenomenon is characterized by episodic vasospasm and ischemia of the extremities in response to cold or stress. Attacks typically involve color changes from white to blue to red. Primary Raynaud's has no known cause, while secondary Raynaud's is associated with underlying conditions like scleroderma. Nifedipine is currently the only drug approved for treatment, though research continues on therapies like topical nitroglycerin and rho kinase inhibitors to promote vasodilation.
Buerger’s disease
This document provides details about examining a patient with Buerger's disease, including assessing symptoms, medical history, physical examination findings, and vascular tests. The physical exam focuses on inspecting and palpating the lower limbs, assessing pulses, testing vascular insufficiency through Buerger's angle and capillary refill time, and examining any ulcers or gangrene. The goals are to evaluate the severity of peripheral vascular disease and ischemia.
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Spinal tb
Tuberculosis was popularly known as consumption for a long time. Scientists know it as an infection caused by M. tuberculosis. In 1882, the microbiologist Robert Koch discovered the tubercle bacillus, at a time when one of every seven deaths in Europe was caused by TB
Causes of vertigo
Vertigo is caused by abnormalities in the vestibular system and can have many underlying causes. It is useful to classify vertigo into four main groups: positional vertigo, vertigo as an isolated symptom, vertigo with deafness and tinnitus, and vertigo with neurological signs. Common causes of positional vertigo include benign paroxysmal positional vertigo and disequilibrium of aging. Vertigo as an isolated symptom can be due to conditions like vestibular neuronitis. Vertigo accompanied by deafness and tinnitus is often caused by Meniere's disease or labyrinthitis. Neurological causes of vertigo include tumors, multiple sclerosis, and vertebrobasilar insufficiency.
Otosclerosis
Otosclerosis is a metabolic bone disease that causes abnormal bone growth in the ossicles of the middle ear, commonly fixing the stapes bone. It most often presents between ages 15-45 and risk factors include family history and metabolic abnormalities. Symptoms include hearing loss and tinnitus. Diagnosis involves audiometry, otoscopic examination, and CT scan. Treatment options include stapedotomy or stapedectomy surgery as well as hearing aids or fluoride therapy for non-surgical candidates or those who decline surgery. The goal of treatment is to restore hearing by improving sound conduction through the middle ear.
Otosclerosis
Otosclerosis is a metabolic bone disease that causes abnormal bone growth in the ossicles of the middle ear, commonly fixing the stapes bone. It most often presents between ages 15-45 and risk factors include family history and metabolic abnormalities. Symptoms include hearing loss and tinnitus. Diagnosis involves audiometry, otoscopic examination, and CT scan. Treatment options include stapedotomy or stapedectomy surgery as well as hearing aids or fluoride therapy for non-surgical candidates or those who decline surgery. The goal of treatment is to restore hearing by improving sound conduction through the middle ear.
Vertigo and dizzines
1. Dizziness and vertigo are common yet imprecise symptoms that can have many underlying causes and need to be differentiated.
2. Vertigo is a type of dizziness characterized by a perception of motion or spinning, which can be caused by problems in the inner ear or central nervous system.
3. Benign paroxysmal positional vertigo (BPPV) is an extremely common cause of vertigo brought on by changes in head position, characterized by short-lived, intense episodes of vertigo with horizontal nystagmus.
Management of Femoral Head Osteonecrosis.
The document discusses management of femoral head osteonecrosis, including its causes, diagnosis, classification systems, and treatment options. MRI is highlighted as the most sensitive diagnostic tool. Conservative treatments are recommended for early stages, while hip replacement is usually needed once collapse or secondary degeneration occurs. The key is early diagnosis and treatment to preserve the hip joint.
Vascular stressors
Peripheral vascular disease is caused by occlusion of the lower extremity arteries, most commonly due to atherosclerosis. It can cause intermittent claudication, critical limb ischemia, ulceration, gangrene and acute limb ischemia. Diagnosis is made through duplex ultrasound, angiography and assessment of pulses, skin changes, pain and sensation. Treatment involves risk factor modification, pain management, maintaining fluid volume, thrombolysis, angioplasty, stenting, bypass surgery and amputation in severe cases. Other vascular conditions affecting the arteries include Buerger's disease, Raynaud's phenomenon, aneurysm.
Tuberculosis of spine
Tuberculosis of the spine, also known as Pott's disease, is caused by Mycobacterium tuberculosis infection that spreads to the vertebrae. It most commonly involves the lower thoracic spine. Symptoms may include back pain, stiffness, deformity, and neurological deficits in 20% of cases. Diagnosis is made through clinical features, imaging such as x-rays showing vertebral destruction, and tests like tuberculin skin test or biopsy. Treatment involves anti-tuberculosis medications and surgery to correct deformities or treat neurological complications. Management aims to diagnose early, begin medical treatment promptly, and use surgery aggressively to prevent deformity and achieve good outcomes.
Urine.cytology
Urine cytology is useful for diagnosing urothelial carcinoma (UC), especially high-grade UC. It has high sensitivity for detecting high-grade lesions but is less reliable for low-grade UC and papillary urothelial neoplasms of low malignant potential (PUNLMP) due to their more subtle cytological features and lower shed cell numbers. Cytology is best at detecting high-grade UC, which has a high mortality rate, but is less helpful for monitoring and detecting low-grade neoplasms, which are rarely aggressive. While this limits cytology for low-grade lesions, cystoscopy can readily identify them.
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The sandbag used to support the patient's head during surgery should be removed, and the head position should be corrected if necessary to improve venous drainage and reduce the risk of hematoma formationThe sandbag used to support the patient's head during surgery should be removed, and the head position should be corrected if necessary to improve venous drainage and reduce the risk of hematoma formationThe sandbag used to support the patient's head during surgery should be removed, and the head position should be corrected if necessary to improve venous drainage and reduce the risk of hematoma formation
Epidural abcess a case presentation
This document presents a case study of a 68-year-old female patient who presented to the emergency department with worsening lower back pain, lower limb weakness, loss of sensation, urinary retention, and fever. Imaging revealed an extensive precontrast T1 hyperintense thoracolumbar spinal canal extramedullary collection consistent with a spinal epidural abscess. The patient was treated with hemodialysis, IV antibiotics, and a neurosurgery consultation was obtained. The document reviews spinal epidural abscesses, including risk factors, pathogenesis, diagnosis, differential diagnosis, management, and key points.
Epidural abcess a case presentation
This document presents a case study of a 68-year-old female patient who presented to the emergency department with worsening lower back pain, lower limb weakness, loss of sensation, urinary retention, and fever. Imaging revealed an extensive precontrast T1 hyperintense thoracolumbar spinal canal extramedullary collection consistent with a spinal epidural abscess. The patient was treated with hemodialysis, IV antibiotics, and a neurosurgery consultation was obtained. The document reviews spinal epidural abscesses, including risk factors, pathogenesis, diagnosis, differential diagnosis, management, and key points.
CASO CLÍNICO EVC.pptx caso clinico medicina interna
This document presents the case of a 50-year-old female patient who was admitted to the emergency room with right hemiparesis and sensory loss. She had recently undergone a hysterectomy and right salpingo-oophorectomy for myomas and an ovarian tumor. Neurological examination revealed right hemiplegia, sensory loss, and dysarthria consistent with a right cerebellar infarction. Laboratory tests and imaging studies including MRI were performed. She was diagnosed with a post-operative hypercoagulable state leading to a right cerebellar infarction. The patient was discussed with neurology and other services and treated medically.
Pagests disease,eosinophilic granuloma,heterotopic ossification
1) The document reviews Paget's disease of bone, discussing its epidemiology, pathophysiology, clinical presentation, diagnosis, and management. It affects bone remodeling and can cause pain, deformity, fractures, and neurological complications.
2) Treatment may involve medications like calcitonin and bisphosphonates to reduce symptoms and prevent complications. Surgery is occasionally needed for deformity correction or joint replacement, with careful attention to bleeding risks.
3) Complications of Paget's disease include arthritis, fractures, neurological problems, and rare malignant transformation. Management involves a multidisciplinary approach with medications, surgery, and lifestyle modifications.
osteomylitis
This document discusses infectious diseases of bone, including osteomyelitis and Pott's disease. It defines osteomyelitis as inflammation of bone and bone marrow that can be acute, subacute, or chronic. It is caused by bacteria such as Staphylococcus aureus in most cases. Pott's disease is a form of spinal tuberculosis that affects the thoracolumbar vertebrae and can cause kyphosis, cord compression, or paraplegia if left untreated. The document also covers hereditary bone disorders like achondroplasia, osteogenesis imperfecta, and osteopetrosis, as well as metabolic bone diseases including osteoporosis.
Spinal Tuberculosis: Current Concepts Dr. rajasekaran
1) Spinal tuberculosis commonly affects the thoracolumbar region and presents with nonspecific symptoms like backache. It can lead to abscess formation, deformity, and neurological deficits if left untreated.
2) Diagnosis involves correlating clinical findings with imaging like MRI and lab tests. Definitive diagnosis requires culture, histopathology or PCR identification of M. tuberculosis.
3) Treatment involves a 9-12 month course of multidrug antitubercular chemotherapy. Surgery may be needed for complications like deformity, instability or neurological deficits. The goals of surgery are decompression, debridement, stability and deformity correction.
2007 perugia, università di medicina. quale terapia nelle channelopatie
This document discusses channelopathies, which are inherited arrhythmogenic diseases caused by mutations in ion channels or carriers that predispose individuals to ventricular tachycardias and sudden cardiac death. It provides an overview of various channelopathies including arrhythmogenic right ventricular dysplasia (ARVD), catecholaminergic polymorphic ventricular tachycardia (CPVT), Brugada syndrome, and long/short QT syndromes. For each condition, it discusses etiology, clinical presentation, diagnosis, risk stratification, and therapeutic approaches including antiarrhythmic drugs, ablation, and implantable cardioverter defibrillators. The document emphasizes that risk stratification criteria are not well defined for these conditions and management recommendations
Epilepsy
Epilepsy is defined as two or more unprovoked seizures and is caused by underlying brain dysfunction. It is a common neurological disease with varying prevalence worldwide. The causes of epilepsy are often unknown, though common causes in developed countries include cerebrovascular disease, tumors, alcohol use, and head trauma. Epilepsy results from an imbalance between excitation and inhibition in the brain, which can be caused by structural abnormalities. Diagnosis is based on eyewitness accounts of seizures, which can include generalized convulsions or localized symptoms. Investigations help characterize seizures and guide management.
ADESIYAKAN MANAGEMENT OF SIMPLE MULTINODULAR GOITRE2
1) The document provides an outline for the management of simple multinodular goitre, covering topics such as history, epidemiology, investigations, treatment, and complications.
2) Treatment is typically surgical, with options including subtotal thyroidectomy, near-total thyroidectomy, or total thyroidectomy depending on the situation.
3) Potential complications include recurrent laryngeal nerve injury, hypocalcemia, hypothyroidism, recurrence, and wound infection. Careful surgical technique and postoperative monitoring can help prevent complications.
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Takayasu’s disease
- 1. Takayasu’s DiseaseTakayasu’s Disease NewNew Louay Altarazi, M.D Damascus, Syria
- 2. Case 1Case 1
- 3. Case 2Case 2
- 4. Case 3Case 3
- 5. Buerger’s DiseaseBuerger’s Disease New endovascular approachNew endovascular approach Louay Altarazi, M.D Damascus, Syria
- 6. "Oriental" countries are well known for certain life style and"Oriental" countries are well known for certain life style and history, they also share certain characteristic vascularhistory, they also share certain characteristic vascular pathologies and social reactions to disease and treatment.pathologies and social reactions to disease and treatment. Buerger’s disease “TAO” may be the most typicalBuerger’s disease “TAO” may be the most typical entity due to its high prevalence in our regionentity due to its high prevalence in our region and rarity in occidental population, theand rarity in occidental population, the difficulties to deal with the characteristicdifficulties to deal with the characteristic psychic background of those young patients andpsychic background of those young patients and the increase of young smokers in orientalthe increase of young smokers in oriental societies.societies. In Syria this pathology presents 6 -15% of allIn Syria this pathology presents 6 -15% of all foots critical ischemia cases andfoots critical ischemia cases and More than 70% of male young's foot necrosisMore than 70% of male young's foot necrosis
- 7. What Treatment ? (literature)What Treatment ? (literature)
- 8. Ultrasonic diagnosticUltrasonic diagnostic corkscrew appearance, bidirectional flowcorkscrew appearance, bidirectional flow
- 9. Inclusion CriteriaInclusion Criteria Olin’s Diagnostic criteriaOlin’s Diagnostic criteria
- 10. The procedureThe procedure (in brief)(in brief) before during after
- 11. Before during afterBefore during after The procedureThe procedure (in brief)(in brief)
- 12. Before during afterBefore during after The procedureThe procedure (in brief)(in brief)
- 13. Before during afterBefore during after The procedureThe procedure (in brief)(in brief)
- 14. Angiosomal conceptAngiosomal concept A T PER P T
- 16. BTK endovascular proceduresBTK endovascular procedures characteristicscharacteristics Atherosclerosis Diabetic arteriopathy Buerger’s disease Pain during procedure slightly painful specially during inflating balloons painless Can be very Painful Recoil after PTA Possible leading to Vascular reoclusion Very rare Frequent but often transitory Wire & cath- balloon passage Relatively easy somehow difficult Difficult needs hard pushability Subintimal way Almost possible Sometimes feasible impossible Incomplete recanalization Rarely useful ineffective Can be effective du to intense vasavasorium development
- 18. From January 2006 to July 2011From January 2006 to July 2011
- 19. Clinical ImprovementClinical Improvement ((21 patients followed for 6-30 months)21 patients followed for 6-30 months) One major and three minor amputation
- 20. Before afterBefore after Clinical caseClinical case
- 21. Before afterBefore after Clinical caseClinical case
- 22. Before afterBefore after Clinical caseClinical case
- 23. Before afterBefore after Clinical caseClinical case
- 24. Before afterBefore after Clinical caseClinical case
- 25. Before afterBefore after Clinical caseClinical case