The aim of the study was to examine the content and molecular differentiation of glycosaminoglycans (GAGs) in the wall of varicose veins. The studied material consisted of normal, varicose veins and varicose veins complicated by thrombophlebitis collected during operations on 26 patients. In the wall of varicose veins the mean GAGs’ content as well as the content of sulphated GAGs, except heparan sulphate was increased, whereas the amount of hyaluronic acid was decreased. Furthermore, the increased quantitative ratio between sulphated and nonsulphated GAGs was demonstrated. The results indicate an evident extracellular matrix remodelling in the wall of varicose veins particularly those complicated by thrombophlebitis, that is characterised by alterations in the content and molecular differentiation of GAGs.
Worldwide, stroke is the second leading cause of death and a major cause of disability. However, the mortality of stroke differs between countries and geographical regions. In high-income countries, i.e. in the United States, stroke has fallen from the third to the fourth leading cause of death. The risk for ischaemic stroke increases with the degree of internal carotid artery stenosis. 70-99% carotid artery stenosis (according to NASCET) in symptomatic patients is an indication for a vascular intervention since this group will achieve significant benefits from surgical treatment. Asymptomatic patients with 60-99% (according to NASCET) carotid artery stenosis may also benefit from surgical procedures when at least one-factor conditioning a high risk of ischaemic stroke incidence exists. These factors may include morphological structure features of atherosclerotic plaque described in imaging examinations that are indicative of its instability and specific clinical predispositions. The paper presents stages of unstable atherosclerotic plaque development and features of its morphological structure that may significantly increase the risk for ischaemic stroke and compares them with current guidelines:
The escalating population of individuals afflicted with end-stage renal disease necessitates the provision of secure and efficacious vascular access for hemodialysis, with arteriovenous fistulas representing a preferred option. Nonetheless, the creation of dialysis fistulas may entail complications, including the occurrence of fistula aneurysms that may require surgical intervention. This study included eight patients with large aneurysms of dialysis fistulas and aimed to evaluate the safety and effectiveness of classic, endovascular, or hybrid methods for fistula reconstruction or ligation, depending on the indications. Vascular interventions were performed on patients on chronic hemodialysis and on those in whom hemodialysis was discontinued due to the proper functioning of the transplanted kidney. Performed procedures were considered safe and effective. The reconstructed fistulas provided the patients with patent vascular access, allowing for continued hemodialysis. No re-aneurysmal dilatation of the reconstructed or ligated fistulas was observed. Regular monitoring of dialysis fistulas is crucial to detect complications in time. Guidelines should be established to specify the dimensions at which fistula aneurysm should be excised and whether to remove asymptomatic aneurysms at all. For patients who have undergone kidney transplantation, outlines should indicate when the fistula should be preserved and when it should be ligated.
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