BackgroundThe role of multiorgan damage in the mortality caused by ischemic limb injury is still not clarified. The objective of this study was to examine the potential protective effects of hyperbaric oxygen (HBO) and iloprost (IL) therapy on lung damage induced by limb ischemia/reperfusion injury in a rabbit model, using both biochemical and histopathological aspects.MethodsForty New Zealand white rabbits were randomly allocated into one of five study groups: HBO group (single session of HBO treatment); IL group (25 ng/kg/min infusion of IL); HBO + IL group (both HBO and IL); Control group (0.9% saline only); and a sham group. Acute hind limb ischemia-reperfusion was established by clamping the abdominal aorta for 1 h. HBO treatment and IL infusion were administrated during 60 min of ischemia and 60 min of reperfusion period. Blood pH, partial pressure of oxygen, partial pressure of carbon dioxide and levels of bicarbonate, sodium, potassium, creatine kinase, lactate dehydrogenase, and tumor necrosis factor alpha were determined at the end of the reperfusion period. Malondialdehyde was measured in the plasma and lung as an indicator of free radicals. After sacrifice, left lungs were removed and histopathological examination determined the degree of lung injury.ResultsIn the control group, blood partial pressure of oxygen and bicarbonate levels were significantly lower and creatine kinase, lactate dehydrogenase, malondialdehyde and tumor necrosis factor-α levels were significantly higher than those of the HBO group, IL group, HBO + IL group and sham group. Similarly, the malondialdehyde levels in the lung tissue and plasma levels were significantly lower in the treatment groups compared with the control group. The extent of lung injury according to the histological findings was significantly higher in the control group.ConclusionsThese results suggest that both HBO and IL therapies and their combination might be effectively used in the prevention of lung injury after ischemia/reperfusion injury of the lower extremities.

Objective: To examine the biochemical and histopathological effects of ischemia/reperfusion (I/R) injury in a ruptured abdominal aortic aneurysm (RAAA) model in rats, and to investigate the potential protective role of resveratrol. Methods: Thirty-two male Sprague-Dawley rats were randomly assigned into four groups—control, I/R, sham (I/R + solvent/dimethyl sulfoxide), and I/R + resveratrol. The control group underwent midline laparotomy only. In the other groups, infrarenal vascular clamps were attached following 60-min shock to the abdominal aorta. Ischemia was applied for 60 min followed by reperfusion for 120 min. In the I/R + resveratrol group, intraperitoneal 10 mg/kg resveratrol was administered 15 min prior to ischemia and immediately before reperfusion. The I/R + dimethyl sulfoxide group received dimethyl sulfoxide, and the I/R group was given saline solution. All animals were sacrificed by exsanguination from the carotid artery at the end of the experiment. In addition to histopathological examination of the rat kidney tissues, malondialdehyde, glutathione, catalase, and nitric oxide levels were also investigated. Results: A decrease in glutathione, catalase and nitric oxide levels, together with increases in malondialdehyde levels, numbers of apoptotic renal tubular cells, caspase-3 levels, and tubular necrosis scores, were observed in the IR and I/R + dimethyl sulfoxide groups. In contrast, resveratrol increased glutathione, catalase and nitric oxide levels in renal tissues exposed to I/R, while reducing malondialdehyde levels, apoptotic renal tubular cell numbers, caspase-3 levels, and tubular necrosis scores. Conclusion: Our findings suggest that resveratrol can be effective against I/R-related acute kidney damage developing during RAAA surgery by reducing oxidative stress and apoptosis.

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Introduction Ischemia-associated mortality caused by aortic cross-clamps, as in ruptured abdominal aorta aneurysm surgeries, and reperfusion following their removal represent some of the main emergency conditions in cardiovascular surgery. The purpose of our study was to examine the potential protective effect of tea grape against aortic occlusion-induced lung injury using biochemical, histopathological, immunohistochemical, and quantitative analyses. Methods Thirty-two male Sprague-Dawley rats were randomly assigned into four groups: control (healthy), glycerol + ischemia/reperfusion (I/R) (sham), I/R, and I/R + tea grape. Results Following aortic occlusion, we observed apoptotic pneumocytes, thickening in the alveolar wall, edematous areas in interstitial regions, and vascular congestion. We also observed an increase in pulmonary malondialdehyde (MDA) levels and decrease in pulmonary glutathione (GSH). However, tea grape reduced apoptotic pneumocytes, edema, vascular congestion, and MDA levels, while increased GSH levels in lung tissue. Conclusion Our findings suggest that tea grape is effective against aortic occlusion-induced lung injury by reducing oxidative stress and apoptosis.

BackgroundAortic occlusion is rare catastophic pathology with high rates of mortality and severe morbidity. In this study, we aimed to share our experience in the management of aortic occlusion and to assess the outcomes of extra-anatomic bypass procedures.MethodsEighteen patients who had undergone extra-anatomic bypass interventions in the cardiovascular surgery department of our tertiary care center between July 2009 and May 2013 were retrospectively evaluated. All patients were preoperatively assessed with angiograms (conventional, computed tomography, or magnetic resonance angiography) and Doppler ultrasonography. Operations consisted of bilateral femoral thromboembolectomy, axillobifemoral extra-anatomic bypass and femoropopliteal bypass and were performed on an emergency basis.ResultsIn all patients during early postoperative period successful revascularization outcomes were obtained; however, one of these operated patients died on the 10th postoperative due to multiorgan failure. The patients were followed up for a mean duration of 21.2±9.4 months (range, 6 to 36 months). Amputation was not warranted for any patient during postoperative follow-up.ConclusionTo conclude, acute aortic occlusion is a rare but devastating event and is linked with substantial morbidity and mortality in spite of the recent advances in critical care and vascular surgery. Our results have shown that these hazardous outcomes may be minimized and better rates of graft patency may be achieved with extra-anatomic bypass techniques tailored according to the patient.

Bu çalışmada, infrarenal abdominal aort anevrizması olan hastalarda endovasküler anevrizma tamirine ilişkin erken ve orta dönem sonuçlarımız sunuldu. Ça lış mapla nı:Aralık 2011-Ocak 2017 tarihleri arasında endovasküler anevrizma tamiri yapılan toplam 154 hasta (136 erkek, 18 kadın; ort. yaş 71.7 yıl; dağılım, 55-94 yıl) retrospektif olarak incelendi. Hastaların demografik özellikleri, işlem öncesi ek tanıları, mortalite ve morbidite oranları, yoğun bakım ünitesinde ve hastanede kalış süreleri, kullanılan kan ürünü miktarları, komplikasyonlar ve yeniden girişimler dahil olmak üzere veriler kaydedildi. Bul gu lar: Yedi hastaya anevrizma rüptürü nedeniyle acil koşullarda girişim uygulanırken, 147 hastaya elektif cerrahi yapıldı. Ortalama takip süresi 35 (dağılım, 12-72) ay, yoğun bakım ünitesinde kalış süresi 1.1 (dağılım, 1-4) gün ve hastanede kalış süresi 3.1 (dağılım, 3-7) gün idi. Tedavi süresince ortalama 0.3 ünite eritrosit süspansiyonu kullanıldı. On altı hastada kaçak, iki hastada greft bacağında tıkanıklık, altı hastada anevrizma çapında artış ve beş hastada yara iyileşme problemi görüldü. İki hastaya kros femoral baypas, üç hastaya balon dilatasyon, üç hastaya proksimal ekstansiyon ve dört hastaya distal ekstansiyon uygulandı. İşlem sırasında bir hastada mortalite gelişti. Total mortalite oranı 7% ve ilk 30 günlük mortalite oranı 2% idi. So nuç:Çalışma sonuçlarımız endovasküler anevrizma tamirinin düşük cerrahi mortalite oranı, kısa yoğun bakım ünitesi ve hastane yatışı ve daha az kan ürünü kullanımı dahil olmak üzere birtakım avantajlara sahip olduğunu göstermektedir. Ayrıca, bu teknik yüksek riskli komorbid hastalarda rejyonel anestezi ile birlikte gerçekleştirilebilir.

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Endovascular aneurysm repair (EVAR) is an adequate means for treating infrarenal abdominal aortic aneurysms (AAA). However, secondary interventions are required in approximately 15% to 20% of patients. The aim of this paper was to report our knowledge with stent grafts in secondary interventions after EVAR in a 73-year-old patient. One of the exceptional complications of EVAR are endoleaks which may lead to expansion of aneurysm and rupture if not repaired.