Biomedical subjects

Duncan J Parry

Publications and source records attributed to Duncan J Parry.

3 recordsLinked to original sources

PubMed2004

Atherothrombotic risk factor clustering in healthy male relatives of male patients with intermittent claudication.

OBJECTIVE: Family history is an independent risk factor for premature acute myocardial infarction; in contrast, familial risk for peripheral arterial disease (PAD) has yet to be determined. Elevated levels of hemostatic proteins are consistently predictive for cardiovascular risk in "healthy" subjects, and may cluster with underlying insulin resistance. Atherothrombotic risk factor clustering occurs in first-degree relatives of subjects with coronary artery disease and type 2 diabetes. These may contribute to the enhanced cardiovascular risk in these subjects, and we hypothesised that familial clustering may occur in PAD. The objective of this study was to measure atherothrombotic risk factors in healthy male first-degree relatives of men with intermittent claudication, with emphasis on thrombotic risk. METHODS: One hundred sixty-five healthy male first-degree relatives were compared with control subjects matched for age, sex, and race (n = 165), free from a personal or family history of premature cardiovascular disease. Primary outcome measures were fibrinogen, von Willebrand factor, factor VII clotting activity (FVII:C), and factor XIII levels. Atherosclerotic risk factors were measured, and subjects were genotyped for common functional polymorphisms (factor VII r353q and fibrinogen B beta-455). RESULTS: Relatives had higher mean levels of fibrinogen (3.04 vs 2.89 g/L; P = .021), FVII:C (117% vs 104%; P = .000), factor XIII B subunit (1.11 vs 1.01 IU/mL; P = .000), and complex (A 2 B 2 ; 1.18 vs 1.11 IU/mL; P = .021). At multivariate analysis the association between relative status and fibrinogen, FVII:C, and factor XIII B subunit levels were independent of other variables. CONCLUSIONS: The healthy male relatives of men with PAD have elevated levels of fibrinogen, factor VII, and factor XIII. Our results support the existence of thrombotic risk factor clustering in this population at "high risk."

Adolescent↗

PubMed2002

Type II endoleaks: predictable, preventable, and sometimes treatable?

OBJECTIVE: The purpose of this study was to evaluate the effect of preoperative coil embolization of lumbar and inferior mesenteric arteries on the incidence of type II endoleak after endovascular abdominal aortic aneurysm repair. METHODS: The subjects were consecutive patients who underwent EVAR between January 1996 and January 2001. Patent aortic side branches were identified with preprocedural spiral computed tomographic scanning and calibrated angiography. Coil embolization was performed before EVAR. Patients were followed up with plain radiographs and ultrasound and dual phase spiral computed tomographic scans. Digital subtraction angiography was performed when endoleak was suspected. The outcome measures were the incidence of type II endoleaks and changes in maximum aortic sac diameter (Dmax). RESULTS: Forty patients underwent EVAR, with a median duration of follow-up of 24 months (range, 3 to 48 months). Before surgery, the inferior mesenteric artery was patent in 16 patients (45%) and the lumbar arteries in 21 patients (53%). Inferior mesenteric artery embolization was successful in 13 of 16 patients (81%). Lumbar embolization was attempted in 13 patients and was successful in eight (62%). During EVAR, successful sac exclusion was achieved in 38 patients (95%). None of the patients who underwent embolization before EVAR had type II endoleak develop, eight of 13 patients (62%) with patent lumbar arteries had endoleaks develop (P =.006), and three of these patients subsequently underwent successful coil embolization. Type II endoleak was associated with a 2.0-mm median increase in Dmax (P =.045). A 3.0-mm median reduction in Dmax was seen in the absence of type II endoleak (P =.002). CONCLUSION: Type II endoleaks are predictable, preventable, and sometimes treatable. Significant sac shrinkage occurs in the absence of lumbar endoleak but not in the presence of type II endoleak.

Aged↗

PubMed2002

Persistent sciatic vessels, varicose veins, and lower limb hypertrophy: an unusual case or discrete clinical syndrome?

Persistent sciatic artery is a rare congenital anomaly with a high incidence rate of aneurysmal degeneration and risk of thromboembolization or rupture. Despite a number of recognized associations, the presence of coexistent venous anomalies is extremely rare. We present the case of a 27-year-old woman with atypical left-sided varicose veins and soft tissue hypertrophy. Imaging showed persistence of both sciatic artery and vein. Whether these anomalies are an incidental finding or represent a discrete clinical syndrome remains unclear. We emphasize that unusual distribution varicose veins may be associated with underlying persistent sciatic vessels and recommend formal duplex scan assessment for these anomalies.

Adult↗