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At least 19 recordsLinked to original sources

[Histochemical and histoenzymatic study of experimental endarteritis in rabbits. II. Aortic endarteritis].

The placement of a polyethylene cuff around the abdominal aorta of 20 male rabbits 2,5 to 3 months old induce an adventitial reaction characterized by edema (7th day), fibroblastic proliferation (7th - 15th day), fibrosis and sclerosis (2nd - 3rd month), changes in the media including cytoenzymatic activation (1st - 3rd week), signs of hypoxia, degenerative and productive processes leading to intimal tickening. Histoenzymatic characteristics of the intimal thickening cells look like activities of smooth muscle cells, while the activities of some cellular areas recalled those of endothelial cells (high aerobic oxydoreductases and ATP/ase activities). This histoenzymatic duality is perhaps related to the histogenetic filiation of the intimal thickening cells. Histochemical data (metachromasia, alcianophilia, APS +) suggest that these cells are able to synthesize different elements of the extracellular matrix. All these features resemble femoral endarteritis obtained by the same process; moreover, in aorta the endarteritis evolves more slowly, the cellular proliferation is later and focused, the signs of hypoxia and necrosis and more pronounced. These differences are probably related to structural and metabolic dissimilarities of the two vessels, and to differences in their cellular reactivity.

Animals↗

[Histochemical and histoenzymatic study of experimental endarteritis in rabbits. I. Femoral endarteritis].

The parietal reaction after placing a cuff of polyethylene around the femoral artery has been studied in 18 (2,5 - 3 months old) male rabbits by using histologic, histochemical (4 macromolecular substances) and histoenzymatic techniques (16 enzymatic activities). Studies were performed on the 1st, 3rd, 5th, 15th and 21st day, and every 15 days during the 3 months of the experiment. This process induced rapidly in each animal a parietal reaction with adventitial oedema (1st day), hypoxia of the media (1st -5th day), cytoenzymatic activation followed by a cellular transformation and proliferation of the intima-media, that forms a diffuse intimal thickening (adaptation). Most cells of the thickening were, by their enzymatic activities, quite comparable to immature smooth muscle cells, which probably emigrated from the media: intense LDH, NADH2 - TR; moderate G6P-DH, SDH, NADPH2 - TR, alpha-GP-DH, ATP/ase; weak ICHD, beta-HB-DH. Moreover, some reactions (accentuation of beta-Glu/ase, UDGP-DH, Glu-DH, 5'N/ase) besides suggested the active participation of the cells in the production of extracellular conjonctive constituents, because the histochemical studies revealed the presence of metachromatic glycosamino-glycanes and positive APS substances during the edification of the diffuse intimal thickening. In advanced thickening, an histoenzymatic duality was observed, that might prove the double origin of the thickening cells: some superficial cells had the enzymatic characteristics of endothelial cells (increased activity of aerobic oxydoreductases). At every stage of the study, the thickening cells differed from the atherocytes by a lack of lipids in their cytoplasm.

Animals↗

Does the risk of infective endarteritis justify routine patent ductus arteriosus closure?

OBJECTIVES: The risk of infective endarteritis in patients with patent ductus arteriosus seems to have declined during the last 30-40 years, and cases of patent ductus arteriosus complicated by infective endarteritis are now very rare. Moreover, with the introduction of antibiotics, there has been a dramatic reduction in mortality from infective endocarditis. Despite these changes, however, the prevention of infective endarteritis has remained the principal indication, apart from haemodynamic reasons, for surgical patent ductus arteriosus closure. The aim of this study was to ascertain whether prevention of infective endarteritis is still a justifiable indication for routine closure in all cases of patient ductus arterious. METHODS: The records of 270 paediatric and adult cases of patent ductus arteriosus was reviewed with respect to infective endarteritis. All Swedish death certificates issued during the period 1960-93 were checked for the occurrence of patent ductus arteriosus in combination with infective endarteritis. RESULTS: There had been no cases of infective endarteritis over an aggregate of 1196 years at risk. Of nearly three million deaths in Sweden during the period 1960-93 two cases were due to infective endarteritis as a complication of patent ductus arteriosus. CONCLUSION: The present findings suggest routine closure of a patent ductus arteriosus, for the sole purpose of eliminating the risk of infective endarteritis, is unnecessary.

Adult↗

Septic endarteritis of the femoral artery following angioplasty.

A case of septic endarteritis that occurred in the femoral artery following percutaneous transluminal coronary angioplasty (PTCA) is reported, and nine previously reported cases of this complication are reviewed. In each case Staphylococcus aureus was identified as the pathogen. For all cases in which a complete clinical description was available, endarteritis occurred following repeated PTCA or repuncture PTCA (i.e., a second catheterization at the original site of insertion for diagnostic purposes). The characteristic manifestations of endarteritis in this setting included bacteremia (all 10 cases), the formation of a pseudoaneurysm (six), distal emboli (five), and regional septic arthritis or osteomyelitis (five of six cases that included the information needed to determine the presence of these conditions). In each case, treatment included 4-6 weeks of iv antibiotics and surgery, most frequently resection of the pseudoaneurysm and vascular bypass. We recommend surveillance for the signs of endarteritis, especially after repeated catheterization, and use of the contralateral site when repeated catheterization is indicated. When the ipsilateral site is used, the administration of prophylactic antibiotics should be considered.

Aged↗

Femoral endarteritis associated with percutaneous suture closure: new technology, challenging complications.

OBJECTIVE: Use of percutaneous suture closure devices after catheter-based interventions is increasing. We recently have seen several severe femoral arterial wall infections after use of such devices. The purpose of this study was to examine the incidence, comorbid associations, and management of femoral arterial infections associated with percutaneous suture closure devices. METHODS: We retrospectively reviewed all infectious complications that occurred after 2223 consecutive cardiac catheterization procedures performed over 12 months in a university-affiliated community teaching hospital. Outcome variables included demographics, procedural details, infection, type of arterial reconstruction required, mortality, and limb loss. RESULTS: During this study, 822 patients received percutaneous suture devices. Infection developed in 6 patients (0.7%). The incidence of diabetes in the population undergoing percutaneous suture closure was 219 of 822 patients (26.6%). Three comorbid conditions, noted in multiple patients with infectious complications, included diabetes mellitus, obesity, and placement of a percutaneous suture closure device within the past 6 months. Invasive femoral endarteritis developed in 4 patients. Gram-positive cocci predominated in 4 patients. In 1 patient with polymicrobial infection catastrophic complications developed, including multiple anastomotic ruptures and hemorrhage. A new method of repair that incorporated double-thickness everted saphenous vein was used in 2 patients, and safe arterial closure was achieved. There was 1 late fatality on postoperative day 36. Limb salvage was achieved in all patients. CONCLUSIONS: Femoral endarteritis complicating percutaneous suture closure is a challenging new problem for vascular surgeons and can result in catastrophic complications. Customary techniques that use saphenous vein patch or interposition grafting are not adequate in all circumstances. Successful outcome requires operative exploration in patients with suspected infection. Removal of the percutaneous suture closure device and debridement to normal arterial wall is recommended in all patients with suspected femoral endarteritis, based on positive intraoperative Gram stains or abnormal appearance of the adjacent femoral artery. Early success with an autologous bolstered repair is reported. Caution is advised when considering the use of a percutaneous suture closure device in patients with comorbid conditions including diabetes, obesity, and previously implanted devices.

Arteritis↗

Endarteritis and mycotic aortic aneurysm caused by an oral strain of Actinobacillus actinomycetemcomitans.

Actinobacillus actinomycetemcomitans was isolated from blood cultures of a 33-year-old febrile patient with a previously undiagnosed coarctation of the aorta. Subgingival samples from diseased periodontal pockets revealed the presence of A. actinomycetemcomitans. An infected (mycotic) aortic aneurysm and endarteritis were diagnosed and surgically treated. The identity of blood and oral clinical isolates of A. actinomycetemcomitans was supported by genetic analysis, including fingerprinting by restriction fragment length polymorphism, ribotyping, and random amplified polymorphic DNA; biotyping; and antibiogram typing. These data strongly suggest that the periodontal pockets were the primary source of A. actinomycetemcomitans endarteritis in this case.

Actinobacillus Infections↗

Congestive heart failure due to aortic incompetence with intestinal infarction due to endarteritis obliterans.

A 27-year-old man with congestive heart failure due to aortic incompetence and subsequent intestinal infarction was found at laparotomy to have extensive necrosis of the bowel due to proliferative endarteritis. Symptoms resolved following treatment with prednisolone and cyclophosphamide, and replacement of the aortic valve. The sub-total occlusion produced by endarteritis obliterans may lead to acute end-organ infarction if cardiac output is reduced.

Adult↗

Septic endarteritis and fatal iliac wall rupture after endovascular stenting of the common iliac artery.

A 52-year-old female with arterial occlusive disease underwent an uneventful percutaneous transluminal angioplasty and placement of a vascular metallic stent in the left common iliac artery. Ten days later she presented with clinical symptoms of septic endarteritis. Shortly after re-admittance, an emergency laparotomy had to be performed because of an acute retroperitoneal bleeding. Rupture of the common iliac artery directly overlaying the penetrating stent was found but control of haemorrhage was of no avail. In this report of a case, septic endarteritis following placement of a vascular metallic stent preceded fatal rupture of the common iliac artery. This up to now unknown constellation requires surgical intervention without undue delay.

Angioplasty, Balloon↗

Aortic coarctation endarteritis in an adult: case report with cardiovascular magnetic resonance imaging findings and review of the literature.

We describe a case of coarctation endarteritis in an adult and review the literature pertaining to this condition. Adult coarctation endarteritis is a rare entity but often represents the initial presentation of coarctation. Diagnosis is critically important given the risk of rupture. Cardiovascular magnetic resonance imaging can be helpful in management.

Adolescent↗

[Capillary blood flow and oxygen consumption in the leg muscles in obliterating endarteritis].

Free oxygen tension (pO2) and tissue blood flow (by the rate of elimination of hydrogen from the tissues after its single inhale) at rest and after functional stresses (oxygen inhalation, walking) were studied polarographically in healthy persons (10), patients with obliterating endarteritis (25) and obliterating atherosclerosis (22). It was shown that the rate of pO2 and capillary blood flow reduction in the tissues and peculiarities of their changes in response to functional stresses aid in establishing the precise differential diagnosis of obliterating endarteritis and atherosclerosis, a stage of the disease and also in evaluating the efficacy of treatment.

Adult↗

[Pathomorphology and morphogenesis of obliterating endarteritis].

The author has examined the pathomorphological arterial changes in 37 amputated legs of patients with obliterating endarteritis. He has studied the principal morphogenetic stages of the disease. Obliterating endarteritis was shown to have an inflammatory origin. Its morphogenesis was found to be characterized by the main stages appearing in the following order: fibrinoid swelling and necrosis of the intima; lymphoid-macrophagal infiltration of the intima (sometimes with presence of giant multinuclear cells) involving the media; intimal hyperplasia and thrombosis occluding the vascular lumen; sclerosis of the vascular wall. At different levels of the amputated limb one could find different stages of the pathologic process due to the undulating character of the disease. The distal sites of the major arteries (mainly located in the lower third of the crus) were the first to undergo changes, and the disease progressed proximally.

Adult↗

Analysis of infective endarteritis in patent ductus arteriosus.

This study reports on infective endarteritis in 14 children with patent ductus arteriosus over a period of 6 years. Infective endarteritis mostly involved the small ducts and was previously undiagnosed. These patients were given antibiotic treatment for a variable period of 4 to 10 weeks, and all except 1 underwent subsequent closure.

Adolescent↗

Septic endarteritis due to intra-arterial catheters for cancer chemotherapy. I. Evaluation of an outbreak. II. Risk factors, clinical features and management, III. Guidelines for prevention.

A cluster of three cases of staphylococcal septic endarteritis originating from percutaneously inserted brachial artery catheters for regional cancer chemotherapy prompted an epidemiologic and clinical study of bacteremic infections associated with this therapeutic modality. Nine cases were identified over a 3 1/2-year period (1.6% of all catheterizations), all caused by Staphylococcus aureus. The cluster followed discontinuation of hexachlorophene for scrub of the extremity prior to cannulation; phage-typing suggested the three cases were caused by the patients' own strains of Staphylococcus. These infections produced a distinctive clinical syndrome which facilitates implicating the catheter in the genesis of fever occurring in a patient receiving intra-arterial chemotherapy: early localized pain (89%) and hemorrhage (78%), and Osler's nodes distally (44%), later followed by local inflammation (78%), purulence (56%) and signs of systemic sepsis (100%) (each factor, p less than or equal to .005). Duration of cannulation did not influence susceptibility to infection. However, difficult cannulations or need for repositioning the catheter (p = .0096), prior radiation therapy (p = .033), leukopenia (p less than .05) and hypoalbuminemia (p less than .05) were all associated with septicemia. In the 25 months since implementation of specific control measures, there have been no further catheter-related septicemia in 310 catheterization (p less than .001). Guide-lines for prevention and management of these infections are provided.

Adult↗

Persistent iliac endarteritis with pseudoaneurysm formation following balloon-expandable stent placement.

We present a patient who developed endarteritis and pseudoaneurysm formation complicating iliac artery stent placement. Blood cultures grew Staphylococcus aureus. Three weeks after antibiotic treatment, the aortic bifurcation and the stents were removed, together with the left common iliac artery pseudoaneurysm. As with any other implantable device, septic complications are dreaded and should be recognized and treated early. Consideration may be given to the use of appropriate prophylactic antibiotics.

Aortic Diseases↗

[Septic endarteritis after angiography].

Infectious complications after angiography are rare. We treated a 72-year-old man who developed staphylococcus aureus endarteritis after angiography resulting in delayed rupture of the common iliac artery. Diagnostic problems, type of bacteria involved and therapeutic implications are discussed.

Aged↗

Endarteritis of the aortic arch in Turner's syndrome with cystic degeneration of the aorta.

We present a case of a 36-year-old 45 XO Turner syndrome with bicuspid aortic valve, dilatation of the ascending aorta and of the major branches of the aortic arch and multiple cysts of the aortic wall. This was complicated by endarteritis of the base of the aortic arch and production of an intraluminal structure (intra-aortic debris). She also presented reactive pleural effusion and involvement of the pulmonary artery which was complicated by pulmonary embolism. Possible aetiological mechanisms are discussed.

Adult↗