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Jonathan C. DeLong Erin P. Ward Thinzar M. Lwin Kevin T. Brumund Kaitlyn J. Kelly Santiago Horgan Michael Bouvet 《Surgery》2018,163(2):388-392
Background
Our aim was to evaluate the ease and utility of using indocyanine green fluorescence angiography for intraoperative localization of the parathyroid glands.Methods
Indocyanine green fluorescence angiography was performed during 60 parathyroidectomies for primary hyperparathyroidism during a 22-month period. Indocyanine green was administered intravenously to guide operative navigation using a commercially available fluorescence imaging system. Video files were graded by 3 independent surgeons for strength of enhancement using an adapted numeric scoring system.Results
There were 46 (77%) female patients and 14 (23%) male patients whose ages ranged from 17 to 87 (average 60) years old. Of the 60 patients, 43 (71.6%) showed strong enhancement, 13 (21.7%) demonstrated mild to moderate vascular enhancement, and 4 (6.7%) exhibited little or no vascular enhancement. Of the 54 patients who had a preoperative sestamibi scan, a parathyroid adenoma was identified in 36, while 18 failed to localize. Of the 18 patients who failed to localize, all 18 patients (100%) had an adenoma that fluoresced on indocyanine green imaging. The operations were performed safely with minimal blood loss and short operative times.Conclusion
Indocyanine green angiography has the potential to assist surgeons in identifying parathyroid glands rapidly with minimal risk. 相似文献44.
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Simon Hsu Dena E. Rifkin Michael H. Criqui Natalie C. Suder Pranav Garimella Charles Ginsberg Antoinette M. Marasco Belinda J. McQuaide Emma J. Barinas-Mitchell Matthew A. Allison Christina L. Wassel Joachim H. Ix 《Journal of vascular surgery》2018,67(6):1855-1863.e1
Background
Chronic kidney disease (CKD) is strongly associated with peripheral artery disease (PAD). Detection of subclinical PAD may allow early interventions for or prevention of PAD in persons with CKD. Whether the presence of atherosclerotic plaque and femoral intima-media thickness (IMT) are associated with kidney function is unknown.Methods
We performed a cross-sectional observational study of 1029 community-living adults. We measured superficial and common femoral artery IMT and atherosclerotic plaque presence by ultrasound. Estimated glomerular filtration rate (eGFR; continuous) and eGFR <60 mL/min/1.73 m2 (binary) were evaluated as outcomes.Results
Mean age was 70 ± 10 years, mean eGFR was 78 ± 17 mL/min/1.73 m2, and 156 (15%) individuals had eGFR <60 mL/min/1.73 m2; 260 (25%) had femoral artery plaque. In models adjusted for demographics and cardiovascular risk factors, individuals with femoral artery plaque had mean eGFR approximately 3.0 (95% confidence interval, ?5.3 to ?0.8) mL/min/1.73 m2 lower than those without plaque (P < .01). The presence of plaque was also associated with a 1.7-fold higher odds of eGFR <60 mL/min/1.73 m2 (95% confidence interval, 1.1-2.8; P < .02). Associations were similar in persons with normal ankle-brachial index. The directions of associations were similar for femoral IMT measures with eGFR and CKD but were rendered no longer statistically significant with adjustment for demographic variables and cardiovascular disease risk factors.Conclusions
Femoral artery plaque is significantly associated with CKD prevalence in community-living individuals, even among those with normal ankle-brachial index. Femoral artery ultrasound may allow evaluation of relationships and risk factors linking PAD and kidney disease earlier in its course. 相似文献48.
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Francesco Caiazza Katarzyna Oficjalska Miriam Tosetto James J. Phelan Sinéad Noonan Petra Martin Kate Killick Laura Breen Fiona O&#x;Neill Blathnaid Nolan Simon Furney Robert Power David Fennelly Charles S. Craik Jacintha O&#x;Sullivan Kieran Sheahan Glen A. Doherty Elizabeth J. Ryan 《The American journal of pathology》2019,189(10):1916-1932