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  • ISSN: 2378-9344
    Volume 4, Issue 1
    Case Report
    Georgios Papadakis*, Nicos Kessaris, Roberta Brambilla, Irene Mosca, Fatima Defigueiredo, Nikolaos Karydis, and Francis Calder
    Synthetic arteriovenous grafts are a source of infection in 11-35% of the hemodialysis patients. Even when not in use – after these patients receive a transplant – they can serve as a potential source of chronic bacterial infection. Previous reports describe infections in clotted grafts. We present a case of a 'silent infection' in an unused but functioning arteriovenous graft.
    Idil Aktan*, Mazen Abusamaan, Peter Shaw, Robert Battle, Lucia Flors, Christopher M. Kramer, and Aditya M. Sharma
    Behçet's disease is a multi-system, inflammatory disorder with various clinical presentations. Vascular manifestations include arterial and venous thrombosis, aneurysms, and thrombophlebitis. Intra-cardiac mass is a rare presentation and is histologically composed of inflammatory cells, fibrosis, and thrombus. Treatment of vasculo-Behçet's disease includes immune suppression, with consideration of anticoagulation depending upon the risk of bleeding from aneurysms. Invasive procedures should be deferred in patients with vasculo-Behçet's disease because of the increased risk of aneurysm formation. We present a case of vasculo-Behçet's disease complicated by intra-cardiac mass, pulmonary artery aneurysms, and pulmonary artery thrombus while providing a review of the variations in presentation, clinical outcomes, and management of vasculo-Behçet's disease in context with existing literature.
    Ahmed El Watidy1,2*, Mohammed A. Sallam2, Faisal Atawi2, and Ahmed Galal2
    This patient had primary Hypereosinophilic endomyocarditis "Loffler's Endomyocarditis" complicated by intraventricular thrombosis, mitral and tricuspid valve regurgitation, and associated with heparin induced thrombocytopenia syndrome. He underwent valve surgery twice for recurrence of Left ventricular thrombosis and valve dysfunction.
    This rare disease is characterized by peripheral hypereosinophilia and involves the heart in 75% of the cases. The disease carries poor prognosis due to endomyocardial fibrosis, ventricular and atrioventricular valve dysfunction and tendency to develop intraventricular thrombi.
    Research Article
    Stefania Giuffrida*, Paola Bisceglie, Walter Morale, Pierantonio Malfa, Giacomo Calcara, Giuseppe Seminara, Salvatore Dell'Aira, Giuseppe L' Anfusa, Domenico Di Landro, Giorgio Russo, and Domenico Patanee
    Purpose: Juxta-anastomotic area is the critical zone of the distal radio-cephalic fistula for higher frequency of presentation of lesion and lower patency rates versus non-juxta-anastomotic stenosis. Our purpose was to describe our techniques for the treatment of juxta-anastomotic stenosis of failing distal radio-cephalic shunt and evaluate the effectiveness of venous and anastomotic Percutaneous Transluminal Angioplasty (PTA) compared to venous PTA alone of this region.
    Materials and methods: We retrospectively reviewed 175 patients with distal radio-cephalic arteriovenous fistulas (AVFs) with Echo-Color-Doppler (ECD) evidence of venous stenosis of the juxta-anastomotic region without any dynamically significant anastomosis stenosis, treated between 2008 and 2011, having at least 1-year follow-up.
    Two groups were recognized: 1) 103 patients treated with venous juxta-anastomotic and anastomosis PTA ("V configuration PTA"); 2) 72 patients treated only with venous PTA ("Z o V2 configuration PTA"). Surviving Times and Primary patency at 6 and 12 months were evaluated for both groups.
    Results: The immediate post-procedural technical and clinical success was 100% for all the patients. Patients treated with "V configuration PTA" – group 1showed higher survival rate free of target lesion reintervention compared to patients who underwent "Z or V2 configuration PTA"- group 2, with a statistically significant difference (P-value=0.0001) in Surviving Time. PP at 6 and 12 months were respectively 97% and 79.6% in the group 1 and 79.8% and 54.1% in the group 2.
    Conclusions: We always treat venous juxta-anastomotic stenosis of distal radio-cephalic hemodialytic AVFs with PTA of the whole iuxta-anastomotic region in presence or not of dynamically significant stenosis at anastomosis.
    Zhao Haiguang, Zhang Xing, and Lu Xinwu*
    Background and objective: The disease of reticular veins and telangiectasis of lower extremity are very common. Regular treatments of compression stockings and medicines offer limited relief and are not curative. This research is to study the efficacy, safety and patient satisfaction of the combination of sclerotherapy and the long-Pulsed 1064nm Nd: YAG laser in treatment of reticular veins and telangiectasis of lower extremity in China.
    Methods: From January 2015 to July 2016, excluding deep and superficial veins valve insufficiency of the lower extremity through duplex ultrasonography. Patients with simple reticular veins and telangiectasis of the lower extremity were treated with sclerotherapy combined with Nd: YAG 1064nm laser therapy.
    Results: Of the 136 patients: cured in 87 cases, significantly effective in 45 cases, effective in 4 cases, total effective rate is 100%. There were no severe complications in all cases.
    Conclusion: Sclerotherapy and Nd: YAG1064nm laser are for different stages of the treatment process and different caliber of blood vessels. A combination treatment of sclerotherapy and Nd: YAG 1064nm laser for reticular veins and telangiectasia of lower extremity is safe, simple and effective.
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