The Journal of Japanese College of Angiology
Online ISSN : 1880-8840
Print ISSN : 0387-1126
ISSN-L : 0387-1126
Volume 52 , Issue January
Showing 1-14 articles out of 14 articles from the selected issue
The 5lst Annual Meeting; Panel Discussion 1
Original Article
  • Shunsuke Sato, Hitoshi Matsuda, Yutaka Iba, Hiroshi Tanaka, Hiroaki Sa ...
    2012 Volume 52 Issue January Pages 1-4
    Published: January 11, 2012
    Released: January 11, 2012
    JOURNALS FREE ACCESS
    Objective: To investigate the short-term and long-term results of surgical treatment for Abdominal Aortic Aneurysm (AAA) in patients older than 85 years old.
    Methodology: A retrospective study was conducted involving 106 patients older than 85 years old who underwent surgical treatment through graft replacement (GR) or endovascular aneurysm repair (EVAR) for AAA between 1989 and 2010. For the 13 patients with ruptured AAA, GR was indicated. As for the 93 patients with non-ruptured AAA, GR was indicated in 67 while EVAR was indicated in 26. The life expectancy was 5.37 (2.96–7.97) years at the time of surgery.
    Results: The hospital mortality for ruptured AAA cases was 30.8%. In non-ruptured cases, the hospital mortality after GR was 6.0% and after EVAR was 0% which were remarkably low. The overall survival rate was 74.2% at 3 years and 46.0% at 5 years. Comparing GR and EVAR in non-ruptured cases, survival rate at 3 years (78.1%/71.1%) and at 5 years (50.0%/71.1%) showed no significant difference (p=0.544). Among 54 patients with non-ruptured AAA whose life expectancy has passed, 25 had died before the period of life expectancy and 29 (53.7%) had lived for life expectancy.
    Conclusions: Our surgical strategy for AAA in patients over 85 years old could be justified in the aspect of life expectancy.
    Download PDF (310K)
Review Article
  • Takayuki Kunisawa
    2012 Volume 52 Issue January Pages 5-11
    Published: January 11, 2012
    Released: January 11, 2012
    JOURNALS FREE ACCESS
    A few decades ago, the quality of anesthesia for elderly patients and patients with severe diseases was not good and anesthetic techniques were not satisfactory; however, many problems have been solved by the development of intravenous anesthetics and ultrasound devices. Target-controlled infusion systems, replacing conventional infusion methods such as dose per time, have enabled accurate adjustment of anesthesia depth leading to suitable anesthesia conditions and high-quality emergence. Transesophageal echocardiography (TEE) has enabled not only decision-making for surgical indications during surgery but also appropriate management for fluid therapy using real-time measurement of left ventricular volume and function. The development of ultrasound-guided nerve blocks has enabled us to avoid general anesthesia which has a risk of causing unstable hemodynamics. Dexmedetomidine, which has organ-protective effects, can improve the condition of the patient after surgery. We have a mission over the next decade to change the experience to evidence. If we accomplish this, we will be able to provide patients and surgeons the most preferable and suitable conditions for surgery. Since we believe that this is what we must do, we continue doing daily anesthetic management and research to accomplish this mission.
    Download PDF (498K)
The 5lst Annual Meeting; Panel Discussion 2
Original Article
The 5lst Annual Meeting; Panel Discussion 3
Original Article
  • Takashi Shibuya, Takashi Shintani, Seiji Edogawa, Hisashi Satoh
    2012 Volume 52 Issue January Pages 19-23
    Published: January 11, 2012
    Released: January 11, 2012
    JOURNALS FREE ACCESS
    In this study, we retrospectively reviewed 36 cases that required surgical treatment in the femoropopliteal regions (46 regions) because of the development of obstructions after stent placement in these patients. Of the 46, stents were placed in 37 involved regions (80.4%) that included the common femoral and popliteal arteries; such as the common femoral, entire length of superficial femoral, or popliteal arteries, and the anastomosis site created during femoropopliteal bypass surgeries (Group A). In contrast, 9 involved regions (19.6%) did not include the common femoral or popliteal arteries; the stents were primarily localized in the superficial femoral artery (Group B). Symptoms of stent occlusion were more severe in the former group of patients, who subsequently required peripheral artery bypass surgery. These results indicate that placement of stents in the common femoral artery and popliteal arteries should be avoided.
    Download PDF (614K)
The 5lst Annual Meeting; Panel Discussion 4
Review Article
Original Article
  • Nobuto Origuchi
    2012 Volume 52 Issue January Pages 31-34
    Published: January 11, 2012
    Released: January 11, 2012
    JOURNALS FREE ACCESS
    A risk management strategy to prevent thromboembolism is described. 1. Some patients with thrombi in varicose veins show defects on lung perfusion scintigrams and a case of venous thromboembolism (VTE) was encountered after stripping of varicose veins. 2. Emergent surgical treatment is now selected when patients suffer from thrombi adjacent to a deep vein and spinal anesthesia has been changed to general anesthesia for early ambulation. Furthermore, elastic stockings are now used instead of elastic bandages for hemostasis. 3. In order to prevent postoperative VTE, the VTE Working Group prepared a checklist of vascular disorders for all patients scheduled for surgical treatment in all departments. High risk patients visit the vascular division, and the appropriate preventive measures are discussed by our staff. 4. The Anticoagulant Working Group is evaluating the use of medicines and dietary supplements of all patients scheduled for surgery. As a general rule, anticoagulants should be stopped before the operation; however, in some patients, heparin is used for the prevention of cerebral thromboembolism. Stripping of varicose veins can be performed safely without stopping anticoagulants. In conclusion, the significance of thromboembolism should be recognized by all hospital staff and systematic steps should be taken to prevent its occurrence.
    Download PDF (289K)
Review Article
  • Junko Endo, Fumiaki Terasawa, Masaaki Suko, Harukatsu Mikami, Takayuki ...
    2012 Volume 52 Issue January Pages 35-39
    Published: January 11, 2012
    Released: January 11, 2012
    JOURNALS FREE ACCESS
    The number of aortic valve stenoses (AS) caused by arteriosclerosis increases recently. The aim of this study was to determine the association of AS and arteriosclerosis-related disease. 60 patients with valvular AS and peak aortic jet pressure gradient of more than or equal to 36 mmHg, diagnosed by Doppler echocardiography, were identified in our database from 1995 to 2005. In patients who underwent aortic valve replacement (AVR), survival rate of patients with peripheral artery disease (PAD) was 63%, 50%, and 33% while survival rate of patients without PAD was 100%, 85%, and 59% at 1, 5, and 10 years. In patients who have not undergone AVR, survival rate with PAD was 63% and 13%, while those without PAD was 96% and 61% at 1 and 5 years. All patients with PAD complicated another arteriosclerosis-related disease and most of them died from cardiovascular disease. This study is a retrospective study. Although the population is not large enough and the evaluation of AS is diagnosed only by pressure gradient of echocardiography, this study indicates the possibility that combination with PAD influence the mortality rate of AS. It may be important to control progression of arteriosclerosis for improvement in survival rates of AS.
    Download PDF (338K)
Original Article
  • Shunsuke Kiuchi, Muneyasu Kawasaki, Osamu Hirashima, Yodo Shintani, Ka ...
    2012 Volume 52 Issue January Pages 41-45
    Published: January 11, 2012
    Released: January 11, 2012
    JOURNALS FREE ACCESS
    Objectives: One form of etiology in coronary spastic angina (CSA) is vascular endothelial cell dysfunction which causes vascular distensibility disorder. On the other hand, cardio-ankle vascular index (CAVI) is a new parameter of arterial stiffness. This study aims to reveal the relationship between CSA and CAVI.
    Methodology: The subjects included were 41 patients who received the induction examination of coronary spasm with angiography. We evaluated the CSA (S) Group and the normal (N) Group, and compared the two groups. The laboratory findings (lipid and glucose profile), blood pressure, smoking, age, sex, ankle-brachial index (ABI), and CAVI were analyzed.
    Results: CAVI in the S Group was significantly higher than in the N Group (S: 8.78±0.82, N: 7.73±1.04, P=0.004). There were no significant differences in the other analyzed findings.
    Conclusion: The study revealed that vascular endothelial dysfunction caused CSA and increased CAVI.
    Download PDF (279K)
  • Sugako Kobayashi, Yasuhisa Akaiwa, Masaru Takekubo, Osamu Namura, Nori ...
    2012 Volume 52 Issue January Pages 47-52
    Published: January 11, 2012
    Released: January 11, 2012
    JOURNALS FREE ACCESS
    The purpose of this study was to investigate the prevalence and characteristics of renal artery stenosis (RAS) in patients with chronic kidney disease (CKD) by duplex ultrasonography. From April 2007 to July 2010, renal artery duplex scanning was performed in 219 patients. CKD was defined as having estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73 m2 or proteinuria. In 113 patients with CKD, RAS was found in 20 patients (18%). It was significantly higher than the non-CKD group (6%) (p=0.006). Renal duplex ultrasonography is a useful diagnostic tool for identification of RAS in patients with CKD.
    Download PDF (381K)
  • Masato Sato, Motomi Ando, Kan Kaneko, Yoshiro Higuchi, Hiroshi Kondo, ...
    2012 Volume 52 Issue January Pages 53-58
    Published: January 10, 2012
    Released: January 11, 2012
    JOURNALS FREE ACCESS
    We reviewed the results of thromboembolectomy, which was performed for the treatment of chronic thromboembolic pulmonary hypertension, 1 year after the operation. We obtained hemodynamic and respiratory data of 60 patients from the 112 patients who were operated at our institute. The hemodynamic parameters such as mean pulmonary arterial pressure, pulmonary vascular resistance, and cardiac index were significantly improved after the operation, and this improvement of pulmonary hemodynamics persisted even a year after the operation. A significant improvement in gas exchange was observed immediately after the operation and a further elevation in the partial pressure of oxygen in arterial blood (PaO2) was observed 1 year after the operation.
    Download PDF (561K)
Case Report
feedback
Top