<abstract xml:lang="en" xmlns="http://www.w3.org/1999/xhtml"><bold>Objectives:</bold> The impact of endovascular surgery on the amputation rate is not clearly determined. The study aims at determining the relationship between the increasing number of endovascular procedures and the incidence of the lower limb amputations.<bold>Patients and methods:</bold> Annual reports comprising 78,250 cases of peripheral arterial disease (PAD) obtained from 8 Lithuanian vascular surgery centers in 2001-2009 were overviewed and analyzed. There were 7,070 procedures of percutaneous transluminal angioplasty (PTA), 31,488 arterial reconstructive operations and 5,340 amputations of the lower limb.<bold>Results:</bold> The number of amputations performed in 2009 increased by 7.4% compared to 2001. In this period the number of patients treated by vascular surgeons increased by 1,748 (22.3%). The number of reconstructive vascular operations remained relatively stable: 3,468 in 2003 compared to 3,376 in 2009. Endovascular procedures performed from 2001 to 2009 increased by 1,277 (309.2%). A strong correlation between the number of patients treated and the growing number of PTA in 2001-2009 was observed (<italic>r</italic> = 0.916, <italic>p</italic> = 0.001). An expansion of endovascular treatment resulted in decreasing number of amputations (<italic>r</italic> = -0.754, <italic>p</italic> &lt; 0.01). The linear regression analysis showed that the increase in PTA by 1% resulted in decline of amputation number by 0.77% (<italic>p</italic> = 0.001).<bold>Conclusions:</bold> Amputation rate is reliant on changes of admissions for critical limb ischemia. With the increasing number of endovascular procedures, amputation rate is decreasing.</abstract>

Vilnius University Clinic of Heart and Vascular Diseases, Vilnius, Lithuania

Vilnius City University Hospital, Vilnius, Lithuania

The impact of endovascular intervention and open surgery on the incidence of lower extremity amputations

<abstract xml:lang="en" xmlns="http://www.w3.org/1999/xhtml"><bold>Objectives:</bold> We used retrospectively ECG synchronized cardiopulmonary computed tomographic angiography (CPCT) for the evaluation of pulmonary arterial thromboembolism (PATE) and aimed at defining the value of this technique in comprehensive anatomic and functional evaluation of cardiopulmonary system in the setting of this severe cardiovascular emergency.<bold>Methods:</bold> Study population comprised of 75 consecutive patients with suspected acute PATE referred for CPCT. Acute PATE was diagnosed in 30 patients (PATE group) and in 45 patients it was ruled out (control group). Right and left ventricular functional parameters were compared between groups and associations with pulmonary arterial thromboembolic burden were defined. Quality of CPCT images for the analysis of the coronary arteries was evaluated using 4 point rating scale in four major coronary arteries - left main, left anterior descending, left circumflex and right coronary artery.<bold>Results:</bold> There were statistically significant differences of the right and left ventricular morphometric and functional parameters between PATE and control group. Multiple linear regression analysis showed that pulmonary artery clot load and left ventricular ejection fraction are significant predictors of reduced right ventricular ejection fraction (beta coefficients -0.516, <italic>p</italic> &lt; 0.05 and 0.490, <italic>p</italic> &lt; 0.05 respectively). The most accurate predictor of markedly reduced right ventricular ejection fraction was right and left ventricular end-diastolic volumes ratio (area under the curve 0.933, <italic>p</italic> &lt; 0.005). Reliable exclusion of significant coronary artery disease was possible in 38 (84.4%) patients of control group and 3 (10%) patients of PATE group.<bold>Conclusions:</bold> In patients with acute PATE, right ventricular dysfunction is accompanied by detectable changes of the left ventricle. Most accurate predictors of markedly reduced right ventricular ejection fraction are right and left ventricular end-diastolic volumes ratio and right and left ventricular diameters ratio. Quality of CPCT images is sufficient for the evaluation of coronary arteries and thoracic aorta allowing exclusion of significant coronary artery disease and dissection of thoracic aorta.</abstract>

Clinic of Thoracic Diseases, Allergology and Radiology, Faculty of Medicine, Vilnius University

Centre of Radiology and Nuclear Medicine, Vilnius University Hospital Santariskiu Klinikos

Clinic of Cardiac and Vascular Diseases, Faculty of Medicine, Vilnius University

Centre of Cardiology and Angiology, Vilnius University Hospital Santariskiu Klinikos

Diagnostic value of retrospectively ECG synchronised cardiopulmonary computed tomographic angiography in patients with clinically suspected acute pulmonary embolism

<abstract xml:lang="en" xmlns="http://www.w3.org/1999/xhtml"><bold>Objectives:</bold> According to the latest WHO data, coronary heart disease deaths in Lithuania reached 38.3% of total deaths. Based on the unfavourable situation with cardiovascular morbidity and mortality in Lithuania the Lithuanian High Cardiovascular Risk (LitHiR) programme aimed at estimation and aggressive managing of cardiovascular risk factors. This paper describes the Lithuanian High Cardiovascular Risk programme protocol.<bold>Design and methods:</bold> In 2006 the Lithuanian High Cardiovascular Risk programme was started. LitHiR programme recruited men - at the age of 40-54 years and women - 50-64 years without overt cardiovascular disease. The two-level approach - primary health care institutions (PHCI) and specialized cardiovascular prevention units (CVPU) - was applied. The subjects selected were tested for cardiovascular risk and those with high cardiovascular risk were sent to secondary (CVPU) level, for other the plan of preventive measures of risk factor reduction was created. In years 2006-2010 overall 266,391 persons (36.9% from all target population) were examined. Among them 164,657 subjects (61.8%) were tested for the first time, 68,832 (25.8%) were tested repeatedly one time, 32,848 subjects (12.3%) were tested repeatedly for two and more times.<bold>Conclusions:</bold> The programme aimed at estimation and managing of cardiovascular risk factors striving to reduce acute cardiovascular event related morbidity and mortality, to slow down the progression of sub-clinical atherosclerosis into overt cardiovascular disease, to increase the number of newly identified cases of diabetes, metabolic syndrome and latent course of atherosclerosis related diseases, to decrease hospitalizations for treatment of arterial hypertension and coronary heart disease.</abstract>

Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania

Department of Cardiovascular, Medicine Vilnius University, Vilnius, Lithuania

Lithuanian University of Health Sciences, Kaunas, Lithuania

Lithuanian High Cardiovascular Risk (LitHiR) primary prevention programme - rationale and design

<abstract xml:lang="en" xmlns="http://www.w3.org/1999/xhtml"><bold>Objective:</bold> The aim of the study was to estimate the decrease in ionizing radiation exposure dose using adaptive tube voltage, tube current parameters and individualized contrast media injection protocol compared to basic retrospectively ECG-gated CCTA protocol and to compare image quality.<bold>Methods:</bold> This retrospective study consisted of 30 consecutive patients who had body mass index (BMI) between 25 kg/m2 and 30 kg/m2 and underwent retrospectively ECG-gated CCTA. We have enrolled 15 patients which were scanned with an adaptive tube voltage, tube current and an individualized contrast media injection protocol (study group), the other 15 patients underwent basic retrospectively ECG-gated CCTA protocol (control group). Comparison of ionizing radiation effective dose, subjective and objective image quality was accomplished. Differences in ionizing radiation effective dose were deemed statistically significant if <italic>p</italic> &lt; 0.01, for other variables we considered a <italic>p</italic> value of less than 0.05 to be statistically significant.<bold>Results:</bold> he difference of a mean effective dose between study and control groups was statistically significant (6.39 ± 0.88 mSv and 17.44 ± 2.45 mSv, <italic>p</italic> &lt; 0.01). Despite significantly higher image noise, significantly lower contrast-to-noise ratio and signal-to-noise ratio in a study group, both groups showed comparable average image quality (62.03±16.85 and 39.98±8.79, <italic>p</italic> &lt; 0.01; 5.16±2.03 and 7.71±1.28, <italic>p</italic> &lt; 0.01; 3 (2.5-3) and 2.75 (2.75-3), <italic>p</italic> = 0.95).<bold>Conclusions:</bold> Despite higher image noise compared to basic retrospectively ECG-gated CCTA protocol, adaptive tube voltage, tube current parameters and individualized contrast media injection protocol allows substantial reduction in ionizing radiation exposure dose to a patient (up to 63%) with an adequate image quality for the evaluation of coronary arteries.</abstract>

Department of Radiology, Nuclear Medicine and Medical Physics, Faculty of Medicine, Vilnius University

Centre of Radiology and Nuclear Medicine, Vilnius University Hospital Santariškiu Klinikos

Department of Clinical Radiation Monitoring, Vilnius University Hospital Santariškiu Klinikos

Centre of Cardiology and Angiology, Vilnius University Hospital Santariškiu Klinikos

Comparison of retrospectively ECG-gated coronary computed tomography with and without adaptive tube voltage, tube current parameters and individualized contrast media injection protocol to reduce ionizing radiation dose

<abstract xml:lang="en" xmlns="http://www.w3.org/1999/xhtml">Chronic thromboembolic pulmonary hypertension is a progressive and disabling disease with high morbidity and mortality. Pulmonary endarterectomy has been approved as a first choice treatment for chronic thromboembolic pulmonary hypertension with obstruction of proximal pulmonary arteries. The aim of the article is to describe our first experience in this kind of treatment. Diagnosis of chronic thromboembolic pulmonary hypertension, criteria for the surgery, operative technique and results, perioperative management are discussed.</abstract>

Clinic of Cardiovascular Diseases, Faculty of Medicine, Vilnius University

Centre of Cardiac Surgery, Vilnius University Hospital Santariskiu Klinikos

Clinic of Infections, Chest Deseases, Dermatovenerology and Allergology, Faculty of Medicine, Vilnius University

Centre of Anestesiology, Intensive Care and Pain Management, Vilnius University Hospital Santariskiu Klinikos

Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: A case report and review of the literature

AHEAD OF PRINT

Volume 29 (2023): Issue 1 (January 2023)

Volume 28 (2022): Issue 1 (January 2022)

Volume 27 (2022): Issue 1 (January 2022)

Volume 26 (2020): Issue 1 (January 2020)

Volume 25 (2019): Issue 1 (January 2019)

Volume 24 (2018): Issue 1 (August 2018)

Volume 23 (2017): Issue 1 (June 2017)

Volume 22 (2016): Issue 1 (June 2016)

Volume 21 (2015): Issue 2 (December 2015)

Volume 21 (2015): Issue 1 (June 2015)

Volume 20 (2014): Issue 2 (December 2014)

Volume 20 (2014): Issue 1 (June 2014)

Volume 19 (2013): Issue 2 (December 2013)

Volume 19 (2013): Issue 1 (June 2013)

Volume 18 (2012): Issue 2 (June 2012)

Volume 18 (2012): Issue 1 (January 2012)

Seminars in Cardiovascular Medicine

 The journal covers all fields of cardiovascular medicine and mostly reflects status of cardiovascular medicine in the Baltic States, but also publishes papers submitted by authors from other countries. Why subscribe and read   The journal reflects status of cardiovascular medicine in the Baltic States and also contains articles from renowned authors.   Why submit   Fast reviewing and publishing.   Rejection Rate   20%   Archiving  Sciendo archives the contents of this journal in Portico - digital long-term preservation service of scholarly books, journals and collections.  Plagiarism Policy  The editorial board is participating in a growing community of Similarity Check System's users in order to ensure that the content published is original and trustworthy. Similarity Check is a medium that allows for comprehensive manuscripts screening, aimed to eliminate plagiarism and provide a high standard and quality peer-review process. 