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Introduction: Stroke remains the leading cause of disability and death worldwide. Carotid endarterectomy (CEA) reduces the incidence of ischemic stroke or death in patients with symptomatic carotid artery stenosis more effective than pharmacological therapy alone. Neurogranin is a potential marker of brain injury previously investigated mainly in neurodegenerative diseases (Alzheimer disease), but also in ischemic stroke and traumatic brain injury. Material and methods: The aim of the research was to investigate the changes in serum level concentrations of neurogranin in patients undergoing CEA. 22 patients with severe carotid artery stenosis underwent CEA. Serum levels of Neurogranin were measured by an enzyme-linked immunosorbent assay (ELISA) test at 24 h before CEA, 12 and 48 h after the surgery. Results: Serum neurogranin levels show a tendency to decrease after an uncomplicated CEA, however the difference is not statistically significant (p > 0.05). Conclusions: Serum neurogranin level does not significantly change after the CEA, therefore it may not be an useful marker of brain damage after the procedure. There is still need for further studies on bigger group of patients and patients with neurological complications to confirm these findings. [ABSTRACT FROM AUTHOR]

Introduction: Buerger's Disease (BD), or thromboangiitis obliterans (TAO), is a vasculoocclusive disorder of unknown etiology. Cigarette smoking is considered to be the main risk factor for the development of TAO. This study aimed to assess the activation of platelets in patients with BD compared to a control group. Materials and methods: Thirty patients (24 men and six women, median age 51.4 years) with TAO were included in the study. In the control group there were 20 healthy adults (16 men and four women, median age 44.0 years). Platelet activation was measured by light aggregometry and flow cytometry methods with and without platelet activators, such as thrombin receptor agonist peptide (TRAP-6) and adenosine diphosphate (ADP). Results: The velocity and intensity of aggregation increased in patients with TAO (p <0.05). MFI (mean fluorescence intensity) of P-selectin, CD63 (GP53-component of lysosomal membrane), and PAC-1 (platelet activation complex-1) on platelets increased in patients (p <0.05). Significantly higher aggregation velocities were noted in smoking patients in response to collagen (Coll) and to arachidonic acid (AA) compared to non-smoking ones. Aggregation velocity in response to AA was higher in heavy smokers compared to all smokers. A significantly higher intensity of aggregation was found in moderate smokers in response to epinephrine (EPI) and AA compared to non-smoking ones. A positive correlation between cholesterol concentrations and its fractions (LGL, TG), and platelet aggregation and the MFI of platelets, was found in patients with an increased cholesterol level. The aggregation velocity with EPI and AA was negatively correlated with HDL level. [ABSTRACT FROM AUTHOR]

Endovascular aneurysm repair (EVAR) is a minimally invasive technique alternative to conventional open surgical aneurysm repair. Nowadays, the majority of abdominal aortic aneurysms (AAAs) with suitable anatomy are primarily treated using EVAR; however, conventional EVAR procedure is associated with the necessity of contrast agent administration and exposure to ionizing radiation, which carries a risk not only for patients but also for the surgical team. Furthermore, the EVAR procedure may be unfeasible for patients with renal insufficiency and other contraindications to intravascular contrast agent administration, i.e. contrast allergy. An even less invasive guidance method for EVAR procedures seems to be intravascular ultrasound (IVUS), which may abolish the risk associated with contrast media usage and radiation exposure. The literature review concerns the latest research about IVUS guidance during EVAR to establish the current application of this imaging modality in daily clinical practice, its efficiency, advantages and drawbacks. [ABSTRACT FROM AUTHOR]

This review delves into the intricate roles of CD8+ T cells, Th17 cells, regulatory T cells (Tregs), and Toll-like receptors (TLRs) in the pathogenesis of atherosclerosis, with a particular focus on Lower Extremity Arterial Disease (LEAD). CD8+ T cells are highlighted for their dual role in atherosclerosis, acting as both exacerbators and potential protectors within the atherosclerotic environment. Their cytotoxic activity towards cells within plaques can promote necrotic core formation and plaque instability, while certain subsets, particularly regulatory CD8+ T cells, may exert atheroprotective effects through immunosuppressive functions. Th17 cells, known for their production of pro-inflammatory cytokines, are implicated in promoting inflammation and disease progression, suggesting that targeting Th17 cells could be a viable therapeutic strategy. Conversely, Tregs are identified for their potential to maintain immune balance and prevent excessive inflammatory responses, thereby stabilizing atherosclerotic lesions. The article also explores the role of TLRs in recognizing pathogen-associated and damage-associated molecular patterns, triggering inflammatory responses that contribute to atherosclerosis development and progression. By understanding the complex interplay between these immune components, the article suggests that modulating the activity of CD8+ T cells, balancing Th17 and Treg responses, and targeting TLR-mediated signalling pathways could offer new avenues for therapeutic intervention in atherosclerosis and LEAD. This comprehensive review underscores the need for targeted therapies that can modulate immune responses, highlighting the potential of immune system targeting in managing atherosclerosis and preventing LEAD complications. [ABSTRACT FROM AUTHOR]

Introduction: Stroke remains one of the main causes of morbidity and mortality worldwide. Carotid endarterectomy (CEA) reduces the incidence of ischemic stroke or death in patients with symptomatic carotid artery stenosis more effectively than pharmacological therapy alone. SBDPs (spectrin breakdown products): SBDP 120, SBDP145, and SBDP150 are the product of proteolysis of αII-spectrin (280 kDa) — an important structural component of the neuronal cytoskeleton, particularly present in axons. Increased serum level of SBDPs was previously observed in traumatic brain injury, subarachnoid hemorrhage (SAH), or brain ischemia. Material and methods: The aim of our study was to investigate changes in serum levels of SBDP120 and SBDP145 in patients undergoing uncomplicated CEA. The study included 22 patients with severe carotid artery stenosis, qualified for CEA. Blood samples were taken from the antecubital vein at three different intervals (24 h before CEA, 12 and 48 h after surgery). SBDP’s serum levels were measured by a commercially available enzyme-linked immunosorbent assay (ELISA). Results: The study showed that serum SBDP120 levels were significantly decreased 48 h after CEA when compared to the level before the surgery. SBDP145 levels were significantly decreased 12h after the procedure and then remained at a similar level 48h after CEA. Conclusions: In patients with high-grade carotid artery stenosis SBDP120 and SBDP145 serum level decreases after an uncomplicated CEA, therefore alterations from this curve may be a marker of neurological complications after the procedure. Higher SBDP levels before the procedure may represent brain damage caused by chronic ischemia. [ABSTRACT FROM AUTHOR]

False aneurysms of arteries in upper extremities are relatively rare. They occur in 2% of all false aneurysms, and axillary artery aneurysms are very uncommon. Open reconstructive surgery of axillary aneurysms bears a high risk of local and general complications. Progress in endovascular surgery, and especially miniaturization of delivery systems for stents and stent-grafts, has enabled their application in the treatment of small-size, peripheral arteries. Our article presents a case of an extremely obese woman - 170 kg, 57 years old - who presented with a massive, false aneurysm of the left axillary artery that resulted from an epilepsy attack. She was successfully treated with endovascular deployment of covered stent Viabahn™ ø 6 mm x 50 mm (W.L. Gore), performed with the randez-vous technique. After 5-year-long follow-up, the stent-graft is patent, in the correct position, without radiological signs of migration or endoleaks. [ABSTRACT FROM AUTHOR]

Introduction: Endarterectomy of the internal carotid artery (CEA) is a surgical procedure used to prevent cerebral ischemic stroke. Available data from previous literature indicates that CEA may lead to complications in the form of cerebral ischemia-reperfusion syndrome and oxidative stress. The aim of this study was to evaluate the serum levels of oxidative stress-related biomarkers such as 8-hydroxydeoxyguanosine (8-OHdG) and malondialdehyde (MDA) in patients who underwent CEA. Material and methods: Twenty-four patients with severe internal carotid artery stenosis participated in the study. Serum samples were taken from patients at three different times: within 24 hours preoperatively to CEA, 12 hours postoperatively, and 48 hours postoperatively. Serum 8-OHdG and MDA levels were measured using a commercially available enzyme-linked immunosorbent assay. Results: Serum 8-OHdG levels indicated statistically significant elevation 12 hours after surgery when compared to preoperative levels (p < 0.05). A further increase in the concentration of this parameter was observed 48 hours after surgery when compared to the previous measurement, however, this increase was no longer statistically significant (p = 0.05). Furthermore, serum MDA levels also indicated a statistically significant elevation 48 hours after surgery when compared to preoperative levels (p < 0.05). Conclusion: Our study showed that CEA causes an increase in blood levels of 8-OHdG and MDA, which may be related to the occurrence of oxidative stress during cerebral ischemia-reperfusion injury. Therefore, 8-OHdG and MDA may represent corresponding markers of cerebral ischemia-reperfusion complications in patients undergoing CEA. [ABSTRACT FROM AUTHOR]