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Biomedical subjects

Beate Hugl

Publications and source records attributed to Beate Hugl.

7 recordsLinked to original sources
PubMed2006

Effect of age and gender on restenosis after carotid endarterectomy.

Several studies have suggested that the benefits of CEA may be gender-dependent. The purpose of this study was to focus on age and gender outcomes after CEA. Three hundred seventy-two CEAs were performed in 344 patients (115 females, 229 males; mean age 72.9 years). Mean follow-up was 25.8 months. Data were collected retrospectively by chart review, and follow-up data were obtained by clinical examination and duplex ultrasound. Recurrent stenosis was defined as >50% and/or occlusion. Three hundred and seventy-two CEAs were performed in 120 female and 252 male carotid arteries: 97.3% of patients underwent patch angioplasty (bovine pericardium 71.5%, Dacron 21.8%, vein 3.8%, and polytetrafluoroethylene 0.3%) and 2.7% of patients underwent eversion endarterectomy. Perioperative mortality rate (30-day) was 0.8% (0% of females vs. 1.2% of males), and stroke rate was 0.5% (1.7% of females vs. 0% of males), with no significant gender difference (p = 0.554 and p = 0.103, respectively). Follow-up ultrasound revealed 21 (7%) restenoses (>50%) and/or occlusions, with a significantly higher rate of restenosis in females (14% vs. 3.9% in males, p = 0.008) and in patients <70 years of age at time of surgery (p = 0.003). There was no age difference between women and men with restenosis. Although there was no statistical difference in occurrence of restenosis between Dacron and bovine patch (p = 0.62), females who underwent patch angioplasty with Dacron were more likely to develop restenosis (p = 0.052). CEA is a low-risk procedure for significant carotid stenosis; however, females are more likely to develop restenosis after carotid surgery, especially with Dacron patches. Younger patients appear to be at a higher risk of restenosis after surgery.

Age Distribution↗
PubMed2005

Design, synthesis, physical and chemical characterisation, and biological interactions of lectin-targeted latex nanoparticles bearing Gd-DTPA chelates: an exploration of magnetic resonance molecular imaging (MRMI).

The physical and chemical parameters involved in the design and synthesis of biospecifically targeted nanoparticulate contrast media for magnetic resonance molecular imaging (MRMI) were explored in this pilot investigation. Latex nanoparticles 100, 400 and 900 nm in diameter were doubly derivatised, first with tomato lectin and then with gadolinium(III)-diethylenetriamine pentaacetic acid (Gd-chelates) to target them to epithelial and endothelial glycocalyceal N-glycans and to generate contrast enhancement in magnetic resonance imaging (MRI). After intravenous injection into mice, human placental cotyledons or human Vena saphena magna, contrasty images of the vascular structures were obtained in 1.5 T MRI with spatial resolution 0.1 mm in the imaging plane and 0.6 mm in the z axis, persisting >60 min and resistant to washing out by buffer rinses. Ultrastructural analysis of the nanoparticles revealed the targeting groups at the nanoparticle surfaces and the distribution of the Gd-chelates within the nanoparticles and enabled counts for use in determining relaxivity. The relaxivity values revealed were extremely high, accounting for the strong MR signals observed. Occasionally, nanoparticles larger than 100 nm were seen in close spatial association with disrupted regions of cell membrane or of collagen fibrils in the extracellular matrix. The data suggest that 100-nm nanoparticles generate adequate contrast for MRMI and cause least disruption to endothelial cell surfaces.

Animals↗
PubMed2005

Peripheral ischemia caused by paradoxical embolization: an underestimated problem?

Although a patent foramen ovale (PFO) is often found in younger patients with transient ischemic attacks or stroke, paradoxical embolization through PFO is rarely considered as a cause of acute limb ischemia. We report a single-center experience of 5 consecutive patients with limb-threatening ischemia due to paradoxical embolization within a one-year period. All patients were treated by catheter thrombectomy and long-term oral anticoagulation after surgery. The fact that the 5 embolectomies made up 10% of all embolectomies performed in our center during this time interval may indicate that the role of paradoxical embolization is still underestimated in peripheral embolic disease.

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PubMed2005

Endovascular aortic aneurysm repair with the Zenith AAA Endovascular Graft: does gender affect procedural success, postoperative morbidity, or early survival?

The purpose of this study was to analyze the effect of gender on deployment, early morbidity, and survival after endovascular aortic aneurysm repair (EVAR) using the Zenith Endovascular Graft. Data were obtained from the U.S. Multicenter Zenith Endograft trial and complemented with results from the Zenith female registry, including 40 women (10.9%) and 326 men (89.1%). Data analysis included preoperative medical risk factors, aneurysm morphology, deployment, and postoperative morbidity data, and 30-day and 1-year results. Preoperatively, women more often had experienced thromboembolic events (13% vs 4.3%; P = 0.04), but less angina pectoris (24% vs 49%; P = 0.002) or myocardial infarction (18% vs 38%; P = 0.01) compared with men. Women had more angulated aneurysm necks and narrower iliac arteries compared with men. Procedural success, cardiovascular, pulmonary, renal, bowel-related, neurologic, or other adverse events were comparable, as were 30-day and 1-year survival. Females experienced more wound dehiscences (5.0% vs 0.0%; P = 0.01) and open surgical conversions in the first year (5%) compared with men (0.31%) (P = 0.03). With more challenging aneurysm morphologies, women were found to be at a higher risk for conversion in the first year after EVAR using the Zenith endograft. This however does not translate into inferior survival or higher overall morbidity compared with men.

Age Factors↗
PubMedDate not supplied

Subtotal tongue necrosis in delayed diagnosed giant-cell arteritis: a case report.

Giant-cell arteritis (GCA) is a chronic systemic vasculitis of large- and medium-sized vessels, mainly affecting elderly patients. Headache, vision impairment, jaw claudication, and scalp tenderness are common symptoms. However, diagnosis can be difficult because GCA can affect almost every vascular pathway and lead to a variety of possible manifestations. We report the case of a belated diagnosed GCA, resulting in nearly complete necrosis of the mobile part of the tongue, visual impairment, and neurologic as well as intestinal ischemic symptoms. Aggressive immunosuppressive treatment resolved the symptoms, but the patient remained severely morbid because of bilateral necrosis of the mobile part of the tongue. In any case of unclear ischemic symptoms in an elderly patient, one must keep GCA in mind as the possible culprit disease.

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PubMedDate not supplied

Long-term results of endovascular aneurysm repair with aortouni-iliac custom-made stent grafts.

The purpose of this study was to review the outcome of endovascular abdominal aortic aneurysm repair (EVAR) using custom-made aortouni-iliac (AUI) devices with femorofemoral bypass. Between June 1999 and March 2001, 23 consecutive patients (1 female, 22 male) at high risk of open aortic aneurysm repair underwent EVAR with custom devices in an AUI configuration. The mean follow-up was 37 months (range 2-72 months), and the mean age was 76.8 years (range 67.5-88.7 years). Increased surgical risk was evidenced by 92% and 69% of patients with significant pulmonary or cardiac disease, respectively. The preoperative mean aneurysm diameter (n = 23) 62 +/- 8.2 mm was significantly greater than the postoperative diameter, (n = 23) 54 +/- 16.4 mm. Ten endoleaks occurred. Migration of the stent graft occurred in 9% (n = 2). Secondary interventions were necessary in 23%, whereas tertiary interventions were required in 9%. Patients at high risk of open aneurysm repair received sufficient protection from aneurysm rupture with custom-made AUI devices.

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