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  • ISSN: 2378-9344
    Volume 7, Issue 2
    Research Article
    Egle Kavaliunaite*, Katrine Lawaetz Kristensen, Marie Dahl, and Jes Sanddal Lindholt
    Objective: To investigate the association between alcohol intake and the progression of abdominal aortic aneurysms (AAAs) in large Danish population-based randomised screening trial. We hypothesised that moderate amounts of alcohol decreased the growth rate of AAAs.
    Design: Cohort study of a population-based prospective randomised screening trial.
    Methods: Standardised ultrasound scans measurement of maximum antero-posterior infrarenal aortic diameter. If an AAA was found at baseline, men were invited to annual ultrasound surveillance for up to five years. Simple and multiple linear regressions with potential confounders based on an automated empirical procedure. Post hoc power calculation.
    Materials: 25 083 men were assigned for baseline, triple screening which included evaluation of AAAs, peripheral arterial disease (PAD) and hypertension. Questionnaires provided information regarding alcohol intake, co-morbidity and use of drugs.
    Results: The prevalence of AAA was 3.3%. One unit increase in alcohol intake increased the growth rate by 4.3% (CI -0.9 to 9.8) in crude analysis and by 3.1% (Cl -1.64 to 8.05) in adjusted analysis. Increase in one unit of alcohol changed the hazard ratio for the AAA need for repair by 1.03 (Cl 0.91-1.16). Post hoc power calculation revealed coefficient R at 80% power, 5% significant level and a sample size of 417 is 0.134.
    Conclusion: Our study did not find the protective effect of alcohol. The risk of an AAA progressing increased with every additional unit of alcohol, although, no statistically significant associations were exposed.
    Guilherme Cabral De Andrade*, Alexandre Leszczynski and Eduardo Rafael Pereira
    Object: Microarteriovenous malformations (micro-AVMs) defined by Yasargil, represent a subgroup of cerebral AVMs with a nidus diameter <1cm and corresponding to 7% of all cerebral AVMs and 21% of AVMs after hemorrhage. Hemodynamic and structural factors can predispose bleeding, the small size and flow characteristics prevent presentation with usual symptoms as seizures. The authors' present 3 cases with endovascular treatment and a literature review.
    Methods: In a review since 2011, we found three patients (two males and one female) with micro AVMS. Two had intraparenchymal hematoma and initial DSA was negative. A third patient had epilepsy and daily seizures with unruptured left temporal micro AVM. In the literature review the key words used were: “micro arteriovenous malformation”, “arterio venous malformation”, “occult arteriovenous malformation” and “embolization”.
    Results: In all cases micro AVM was confirmed diagnosis with a DSA, 3D reconstruction DSA and superlective DSA. All underwent embolization with embolic liquid EVOH (SQUID 18®) and total occlusion and no procedures complications. All had good clinical mRS 0 in long term follow up and no recanalization in angiography FU.
    Conclusion: Patients with micro-AVMs generally present with large intracranial hemorrhages and neurological deficits. An initial angiography may be negative in suggestive cases, then delayed or superselective angiography and 3D DSA is recommended. Surgery is the treatment of choice for large volume hematomas. Embolization may be a safe alternative and should be considered as an alternative to surgical resection.
    Short Communication
    Recek C*
    Saphenous reflux is responsible for the hemodynamic disorders in patients with primary varicose veins. The actual undesirable impact depends on the reflux volume as well as on the performance ability of the calf pump expressed as ejected volume; these two factors work against each other. The deleterious effect of saphenous reflux can be mitigated by the compensatory increased performance of the calf pump. Both factors can be quantified using the parameter refill volume obtained by strain gauge plethysmography. The reflux volume can be computed by subtraction of the value of refill volume with reflux from the value of refill volume after abolition of reflux. The ejected volume is the volume that has been ejected during a series of calf muscle contraction; it matches with the value of the refill volume after abolition of saphenous reflux. The hemodynamic impact of saphenous reflux is expressed as a percentage indicating to which extent the saphenous reflux disturbs the efficiency of the calf pump using the formula: reflux volume divided by ejected volume X 100.
    Case Report
    Recek C*
    Object: Dural arteriovenous ?stula (DAVFs) of sphenoparietal sinus or “Breschet's Sinus” are a very rare form of intracranial arteriovenous malformation and also very inusual cause of subarachnoid hemorrhage.
    Methods: We present a case of 68 years old woman that presented a very rare bilateral middle fossa dural arterio venous fistula (DAVF´s) of Breschet sinus manifesting only as a subarachnoid hemorrhage (SAH) Fisher IV. Selective angiography revealed dural arterio venous shunts between the bilateral middle meningeal arteries and sphenoparietal/ Breschet sinus without supply of both internal carotid arteries.
    Results: Successful treatment was achieved by bilateral extra cranial transarterial embolization with non-adhesive embolic liquid and total occlusion.
    Conclusion: The Breschet sinus can be a paleontological remnant and its presentation as a dural arterio venous fistula and subarachnoid hemorrhage is something very unusual, this being the only case in the literature with bilateral and SAH presentation, however its treatment is safe and efficient by embolization with non-adhesive liquids embolics through the dural arterial approach.
    Perspective
    Maly I*, Julinek S and Klein D
    Endolaser therapy insufficiency of the superficial veins system of the lower limbs at present demonstrated indubitable affectivities and advantages for the patients at all the world and there are, in vast majority of the cases method therapy the first choice. It had been very well tolerated by the patients, and now also with long-lasting effects, more than ten years.
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