SOURCES:

UpToDate: “Patient education: Deep vein thrombosis (DVT) (Beyond the Basics),” “Patient education: Pulmonary embolism (Beyond the Basics).”

CDC: “Venous Thromboembolism (Blood Clots): Diagnosis and Treatment,” “Venous Thromboembolism (Blood Clots): What Is VTE?”

National Heart, Lung, and Blood Institute: “Venous Thromboembolism,” “Lung VQ Scan.”

Society for Vascular Surgery: “Pulmonary Embolism.”

American Lung Association: “Learn About Pulmonary Embolism.”

MedlinePlus: “D-Dimer Test,” “Critical Care.”

UCSF Health: “Pulmonary Angiography.”

Harvard Medical School: “Ventilation-Perfusion Scan or V-Q Scan.”

Johns Hopkins: “Hematology.”

Cleveland Clinic: “Deep Vein Thrombosis (DVT): Diagnosis and Tests,” “Deep Vein Thrombosis (DVT): Management and Treatment.”

Mayo Clinic: “Deep vein thrombosis (DVT),” “MRI,” “CT Scan.”

American Academy of Family Physicians: “What is deep vein thrombosis (DVT)?”

National Blood Clot Alliance (NBCA): “Find a Healthcare Provider.”

National Institutes of Health: “How to Spot and Prevent Deep Vein Thrombosis.”

North American Thrombosis Forum: “Visiting the Emergency Department for a Blood Clot: What to Expect.”

UW Medicine: “Treating Blood Clots.”

Jefferson Health: “Deep Vein Thrombosis (DVT).”

The American Journal Of Managed Care : “Venous Thromboembolism: Role Of Pharmacists And Managed Care Considerations.”

Chest : “Accuracy of ultrasonography performed by critical care physicians for the diagnosis of DVT.”

Indiana Hemophilia & Thrombosis Center: “FAQs: Clotting Disorder Treatment at the IHTC.”

Tri-City Cardiology: “Deep Vein Thrombosis (DVT) Overview.”

Society for Vascular Surgery: “What is a Vascular Surgeon?” “Why do you need to see a vascular surgeon?”

Society for Cardiovascular Angiography and Interventions: “Treating Deep Vein Thrombosis with Angioplasty and Stenting.”

American College of Cardiology Foundation: “Acute Pulmonary Embolism: The Case for a Successful Comprehensive Treatment Program.”

You wear a cuff to measure not only your blood pressure but also the stiffness of your arteries, among other vascular readings, from home. You conduct your own vision tests for eyeglasses without leaving the house. You pee in your own toilet to capture urine samples you share remotely with your doctor.

Telehealth has brought doctors back into the house virtually via smartphone, computer and tablet screens. Now several health tests that used to require a trip to a doctor’s office or lab are also being done from the comfort of home. Others are on the cusp of being approved.

You can buy some tests off the shelf at your local pharmacy. Others may require a prescription from your physician, who can then monitor certain conditions from afar.

Health-related tests of one kind or another aren’t entirely new, of course. Women have been able to take home pregnancy tests for decades. Diabetics can prick their finger with a needle to test glucose levels or wear a continuous glucose monitor. Some people share their DNA through 23andMe to screen for hereditary conditions.

COVID makes home testing routine

Millions have grown accustomed to home diagnostics by sticking a swab up their noses, however unpleasant, to test for COVID-19.

“The pandemic definitely changed a lot of people’s opinions of testing at home,” says virologist Mary Rodgers, principal scientist for diagnostics at Abbott, the North Chicago–based health care company behind the BinaxNOW-branded COVID tests.

Nearly half of adults ages 50 to 80 surveyed in July 2022 as part of the University of Michigan’s National Poll on Healthy Aging have purchased at least one at-home medical test. More than 4 in 5 expressed an interest in using them in the future.

“The people who tend to need these sorts of tests more are probably older people. But I think a lot of this is going to be driven by younger people, [who have] an expectation of convenience probably in a way that we never did,” says David Pride, M.D., professor of pathology and the director of microbiology at UC San Diego.

Your smartphone will play a role

The latest generation of home tests may combine sophisticated sensors and artificial intelligence (AI) analysis, often in sync with a smartphone or smartwatch. These digital health tests cover a wide swath of concerns, as you can see from the following products, many of which were exhibited at the January 2023 CES tech fest in Las Vegas.

• Monitoring urine. Withings has launched U-Scan, which the French company markets as the world’s first at-home, hands-free urine lab. To use it, you urinate onto a pebble-shaped, 3½-inch-diameter rechargeable reader that sits in your toilet bowl.

U-Scan has interchangeable cartridges that can analyze various biomarkers. Among the first are a cartridge to help women track hormonal fluctuations in their cycles, and another that measures nutritional balance around vitamin C, ketones and hydration. Data syncs up via Wi-Fi with a smartphone app. Low-energy radar sensors embedded within the U-Scan reader help it identify your urine as distinct from, say, a family member’s.

U-Scan is slated to go on sale in Europe for €500 (about $535) around midyear but hasn’t yet received regulatory approval from the U.S. Food and Drug Administration.

Healthy.io’s Minuteful Kidney test also uses urine to uncover increased risk for chronic kidney disease in its early stages and avert damage that can lead to a kidney transplant or dialysis. The Tel Aviv–based company received FDA clearance last year for its home test kit, which uses a smartphone app to deliver immediate results.

• Identifying respiratory viruses. Opteev Technologies in Baltimore has developed a battery-powered, multiple-use handheld breath analyzer test called ViraWarn that the company says can detect all COVID variants, as well as respiratory syncytial virus (RSV) and influenza, in less than 60 seconds.

You blow into this electronic device twice. A carbon filter captures larger particles in your breath. Virus particles pass through. A flashing red light signifies a positive result, though the test won’t tell you what you have; a green light indicates a negative.

ViraWarn comes with a removable mouthpiece and replaceable sensor cartridges. It is in clinical trials and will require FDA approval.

• Checking arteries. The Pulse monitor from Conneqt in Newport Beach, California, promises to do more than the typical cuff-based blood pressure machine. It can capture a patient’s central pulse pressure, which is used to identify damage to the brain, heart and kidneys. Among other features, it can also measure augmentation pressure, a marker that indicates how stiff a person’s arteries are.

Overview

A vascular ring is a heart problem present at birth. That means it's a congenital heart defect. In this condition, part of the body's main artery or its branches form a ring around the windpipe, the food swallowing tube or both.

• The body's main artery is called the aorta. The condition affects the part of the aorta called the aortic arch.
• The food swallowing tube leads from the mouth to the stomach. It's called the esophagus.
• The windpipe is also called the trachea.

A vascular ring may be complete or incomplete.

• A complete vascular ring forms a ring around both the esophagus and trachea.
• An incomplete vascular ring doesn't go all the way around the esophagus or trachea.

Surgery is usually needed to treat a vascular ring.

© Provided by Mayo Clinic Vascular ring

Symptoms

Some people with a vascular ring don't have symptoms. Sometimes symptoms aren't noticed until later in life. If a vascular ring presses against the trachea and esophagus, it can lead to breathing and digestive problems.

Symptoms of a vascular ring may include:

• Frequent respiratory infections.
• Wheezing.
• Coughing.
• Trouble swallowing.
• Difficulty feeding.
• Vomiting.

Some people born with a vascular ring also may have other heart problems at birth. Specific symptoms depend on the type of heart problems present.

Diagnosis

A health care provider does a physical exam and asks questions about the symptoms. Tests done to diagnose a vascular ring may include:

• Imaging tests. A chest X-ray can show changes in the windpipe that might suggest a vascular ring. The test also can show which side of the body the aortic arch is on.

  Other imaging tests may include an echocardiogram, a CT angiogram or an MRI scan. Health care providers also may use these tests to plan treatment.

• Barium swallow. This test involves swallowing a substance called barium. X-rays are taken to see how the substance moves from the mouth to the stomach. The test can show changes in the structure of the esophagus that may be caused by vascular rings.
• Upper endoscopy. A long, flexible tube with a camera is used to examine the esophagus. The device is called an endoscope. The health care provider inserts it through the mouth and into the throat. A tiny camera at the tip sends images to a video monitor.
• Bronchoscopy. In this test, a health care provider inserts a small, flexible tube through the mouth or nose into the lungs. A light and a small camera attached to the tube allow the provider to see inside the windpipe and the lungs' airways. This test can show if a vascular ring is pushing against the trachea.

Treatment

Surgery is usually done to treat a vascular ring that presses against the trachea or esophagus. Surgery also helps prevent complications.

During surgery, the health care provider splits the vascular ring to stop the blood vessel from pressing against the windpipe and food pipe. The surgery may be done as open-heart surgery or as a minimally invasive approach.

The specific type of surgery depends on the type of heart problems present.

People born with a vascular ring need regular health checkups for life to prevent complications.

©2023 Mayo Foundation for Medical Education and Research (MRMER). All rights reserved.

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Feb 18, 2023 (The Expresswire) -- [144 Insights] Top “Vascular Stents Market” Size 2023 Key players Profiled in the Report are [, Medtronic Plc, Abbott Laboratories, Boston Scientific Corporation, Biotronik Se and Co. Kg, B. Braun Melsungen Ag, Terumo Corporation, Microport Scientific Corporation, Meril Life Sciences Pvt. Ltd., Vascular Concepts Limited, C.R. Bard, Inc., W.L. Gore and Associates, Inc., Endologix, Inc., Lombard Medical, Translumina Gmbh, Jotec Gmbh,] most important, influential, or successful companies, brands, or individuals within a Vascular Stents market 2023 to 2026.

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Vascular dementia is a general term describing problems with reasoning, planning, judgment, memory and other thought processes caused by brain damage from impaired blood flow to your brain.

There's no specific test that can confirm vascular dementia. Instead, health care professionals make a judgment based on any medical history for stroke or disorders of the heart and blood vessels, and results of tests that can clarify the diagnosis.

Symptoms

Vascular dementia symptoms vary, depending on the part of your brain where blood flow is impaired. Symptoms often overlap with those of other types of dementia, especially Alzheimer's disease. But unlike Alzheimer's disease, the most significant symptoms of vascular dementia tend to involve speed of thinking and problem-solving rather than memory loss.

Vascular dementia signs and symptoms include:

• Confusion
• Trouble paying attention and concentrating
• Reduced ability to organize thoughts or actions
• Decline in ability to analyze a situation, develop an effective plan and communicate that plan to others
• Slowed thinking
• Difficulty with organization
• Difficulty deciding what to do next
• Problems with memory
• Restlessness and agitation
• Unsteady gait
• Sudden or frequent urge to urinate or inability to control passing urine
• Depression or apathy

Causes

Vascular dementia results from conditions that damage your brain's blood vessels, reducing their ability to supply your brain with the amounts of nutrition and oxygen it needs to perform thought processes effectively.

Common conditions that may lead to vascular dementia include:

• Stroke blocking a brain artery: Strokes that block a brain artery usually cause a range of symptoms that may include vascular dementia. But some strokes don't cause any noticeable symptoms. These silent strokes still increase dementia risk. With both silent and apparent strokes, the risk of vascular dementia increases with the number of strokes that occur over time. One type of vascular dementia involving many strokes is called multi-infarct dementia.
• Brain hemorrhage: This condition often is caused by high blood pressure weakening a blood vessel, leading to bleeding into the brain and causing damage. Another cause can be buildup of protein in small blood vessels that occurs with aging and weakens them over time.
• Narrowed or chronically damaged brain blood vessels: Conditions that narrow or inflict long-term damage on your brain's blood vessels also can lead to vascular dementia. These conditions include the wear and tear associated with aging, high blood pressure, diabetes and abnormal aging of blood vessels.

Risk factors

In general, the risk factors for vascular dementia are the same as those for heart disease and stroke.

Risk factors for vascular dementia include:

• Increasing age: Your risk of vascular dementia rises as you grow older. The disorder is rare before 65, and the risk rises substantially by your 90s.
• History of heart attack, stroke or transient ischemia: If you've had a heart attack, you may be at increased risk of having blood vessel problems in your brain. The brain damage that occurs with a stroke or transient ischemia episode may increase your risk of developing dementia.
• Abnormal aging of blood vessels, or atherosclerosis: This condition occurs when deposits of cholesterol and other substances build up in your arteries and narrow your blood vessels. Atherosclerosis can increase your risk of vascular dementia by reducing the flow of blood that nourishes your brain.
• High cholesterol: Elevated levels of low-density lipoprotein, or LDL or "bad," cholesterol, are associated with an increased risk of vascular dementia.
• High blood pressure: High blood pressure puts extra stress on blood vessels everywhere in your body, including your brain. This increases the risk of vascular problems in the brain.
• Diabetes: High glucose levels from diabetes can damage blood vessels throughout your body. Damage in brain blood vessels can increase your risk of stroke and vascular dementia.
• Smoking: Smoking directly damages your blood vessels, increasing your risk of atherosclerosis and other circulatory diseases, including vascular dementia.
• Obesity: Being overweight is a well-known risk factor for vascular diseases in general and so presumably increases your risk of vascular dementia.
• Atrial fibrillation: In this abnormal heart rhythm, the upper chambers of your heart begin to beat rapidly and irregularly, out of coordination with your heart's lower chambers. Atrial fibrillation increases your risk of stroke because it causes blood clots to form in the heart that can break off and go to the brain blood vessels.

Treatment

Treatment often focuses on managing the health conditions and risk factors that contribute to vascular dementia. Controlling conditions that affect the underlying health of your heart and blood vessels can slow the rate at which vascular dementia worsens and prevent further decline.

Depending on your individual situation, your health care professional may prescribe medications to:

• Lower your blood pressure.
• Reduce your cholesterol level.
• Prevent your blood from clotting and keep your arteries clear.
• Help control your blood sugar if you have diabetes.

Prevention

The health of your brain's blood vessels is closely linked to your overall heart health. Taking these steps to keep your heart healthy also can reduce your risk of vascular dementia:

• Maintain a healthy blood pressure.
• Prevent or control diabetes.
• Quit smoking.
• Get regular exercise.
• Keep your cholesterol in check.

Blood vessel replacements (vascular grafts) are used today for hemodialysis blood access, trauma repair and cardiovascular reconstruction. The first synthetic vascular grafts (blood vessel replacements) were developed just after World War II and were fabricated from materials such as parachute cloth, stitched on home sewing machines. By the 1970s, commercial vascular grafts were introduced, made primarily from Dacron fabric or expanded Teflon (ePTFE).

These larger diameter (>5mm) grafts work satisfactorily for replacing or repairing large blood vessels. However, there are many needs where small diameter vascular grafts (SDVG) would be beneficial. For example, there are about 1 million leg amputations worldwide, mostly due to clogged blood vessels.

Synthetic blood vessel grafts in small sizes most often fail in this demanding, low-flow anatomical site. Also, surgeons would be pleased to have synthetic grafts suitable for heart bypass surgery, but no SDVG will work in this site. The FDA has never approved vascular grafts with diameters smaller than 5 mm. Why after 70+ years have vascular grafts not advanced in performance? There have been almost 50,000 technical papers published on vascular grafts, many proposing novel designs and novel biomaterials. So, research is ongoing—yet there is no cohesive theory to drive SDVG development.

In a perspective article published in the journal BME Frontiers, a new hypothesis is formulated that may reveal a path to the desired SDVG. After reviewing historical precedents and the pros and cons of many vascular graft approaches, the article proposes that we must emulate the structure and behavior of the natural, living artery.

Key elements of a next generation SDVG will be a living, functioning endothelial cell lining, a blood vessel network within the walls of the graft (a "pseudo vasa vasorum") and biomechanics to match the elasticity of the natural artery being replaced. Importantly, the graft cannot trigger the foreign body reaction (FBR) that leads to a fibrotic scar capsule with low vascularity and activated macrophages.

Most of our accepted biomaterials today (Teflon, Dacron, for example) trigger this FBR. The FBR reaction, if mild, is accepted by medical device regulatory agencies. However, the case is made that the FBR is really a manifestation of chronic inflammation—an ongoing, unending attack against the biomaterial.

The biomaterial essentially never truly heals in the body. Thus, so-called biocompatible biomaterials are perhaps not so biocompatible! This ongoing inflammation inhibits the formation of a healthy endothelial cell layer and the rigid foreign body capsule prevents the normal flexing pulsation of an implanted graft. Grafts showing the FBR are poised to fail because they do not have a healthy, living endothelial lining and their non-flexing walls and capsule contracture reduce blood flow and produce flow disturbances which lead to thrombosis.

Fortunately, there are new biomaterials being developed that inhibit the FBR and show reconstructive, regenerative healing. The central hypothesis of the paper suggests that these types of new materials can lead to successful vascular grafts that more closely emulate the performance of the natural artery. A number of vascular graft approaches based upon engineering natural tissues show this regenerative healing and are being explored in the lab and clinic.

These have promise, but there is a concern about long-term durability due to the body's mechanisms to digest older tissue. Also, there are new biomaterials such as a porous structure with 40 micron interconnected pores that heals in a non-fibrotic, vascularized manner. These new vascular graft approaches offer the possibility of SDVG that heal in a reconstructive manner and function much like the natural vessel they are intended to replace.

Provided by BMEF (BME Frontiers)

If you’re confounded by the constant and seemingly contradictory studies proclaiming that caffeine is either a benefit or a bust for your heart, you’re not alone.

But while medical professionals acknowledge that drawing conclusions can be difficult, they urge consumers to take the dueling research with a grain of salt (or sugar) and use common sense with their coffee intake.

“There’s a lot of confusion and uncertainty out there,” said Dr. Will Baker, a cardiologist with UCHealth Heart and Vascular Clinics in Steamboat Springs and Craig. “While the evidence is mixed, in general, there is no strong evidence that caffeine is bad for you. It’s probably fine, and possibly even beneficial, if you limit it to about one or a few cups per day.”

The problem with studies that tout the advantages of eating or drinking certain foods is that they are observational in nature and draw conclusions from surveying the habits of large groups of people over a certain length of time, he said. A myriad of variables could alter the results.

A more valid approach would include two test groups – one that drank coffee and one that drank a placebo that tasted like coffee. After a certain length of time, researchers could study the link between various health-related issues and caffeine. These types of studies are limited regarding coffee.

“Lacking a study like that, it’s pretty hard to sort out a true cause and effect,” Baker said.

Not all coffee is created equal

Most of the studies that have been reported are limited to filtered coffee. Unfiltered coffee like espresso, French press or boiled ground-type coffee may be a different story.

Unfiltered coffee has higher levels of chemicals including cholesterol-raising diterpenes. These chemical compounds are diluted in filtered coffee since it goes through a paper filter, and they can increase the level of LDL cholesterol, also known as “bad cholesterol.” LDL cholesterol levels are associated with a higher risk for heart attacks and strokes.

One solution does not fit all

In addition to different types of coffee, people will react to coffee and presumably caffeine differently, depending upon their body’s metabolism. Baker wants people to pay attention to their caffeine intake and its effects on their mood, sleep habits, body rhythms, alertness and overall feeling of wellness. It is also possible that other substances in coffee may be beneficial, such as antioxidants.

“There’s a lot of individual variability in how people will respond,” Baker said. “There’s also a degree of tolerance as people habituate to the effects of caffeine over time, so how much coffee you consume regularly can affect your response.”

Baker said patients arrive at his office after suffering a heart attack or experiencing heart irregularities like atrial fibrillation, which is a type of heart arrhythmia where the heart beats irregularly or too fast or too slow, and announce they are cutting caffeine cold turkey.

For some, it might make a difference. For others, it won’t.

“Some will go ahead and stop drinking coffee and their heart palpitations go away,” said Baker. “For others, cutting out caffeine doesn’t make a difference, so again, people respond in different ways.”

Be careful what you order

A bigger worry to him than a cup or two of joe for his patients are other selections available at a coffee shop or in a grocery store aisle.

Beverages such as caffeinated energy drinks, soft drinks and even some teas can contain up to five times as much caffeine as coffee. And then there are calorie-laded “coffee” options with a little caffeine and a host of dairy products and sugar that can pack as many calories as a milkshake.

“These energy drinks are often loaded with large amounts of caffeine or other stimulants, while some of the coffee drinks are laden with sugar and other substances with little or no nutritional value,” he said.

Baker said some of the best advice he dispenses comes back to what your mother and grandma may have extolled: Don’t do anything to excess.

“I’ve never told anyone to stop drinking coffee,” he said. “So go ahead and enjoy your caffeine, but like anything, just do it in moderation, and pay attention to how it affects you.”

Mary Gay Broderick writes for UCHealth. She can be reached at marygaybroderick@comcast.net.

An esteemed surgeon has launched a new private vascular health clinic.

L&P Vascular will be based in Rossett, between Wrexham and Chester, and offer consultation and surgical procedures for people with conditions that affect the arteries, veins, and the lymphatic system, including varicose veins.

With more than 30 years’ experience in the UK and Hungarian health services, director Laszlo Papp is a well-known name in the sector having obtained the European Qualification in Vascular Surgery (FEBVS) two decades ago.

He is also one of only 12 Professors of Vascular Surgery in Europe to hold a Gold Examiner award from the FEBVS (Fellow of the European Board for Vascular Surgery) and was a visiting professor at Yale University in the US.

Laszlo said the practice will complement existing NHS services and offer people the chance to avoid lengthy waiting times given that more than 400 people in North Wales alone are on the list to be treated for varicose veins.

“Our main focus will be consultation and treatment of varicose veins, but we are also able to support people with a range of conditions affecting the arteries and lymphatic system,” he said.

“The waiting times can be quite lengthy for these issues – often several years, depending on how serious it is – but we would expect to be able to see people within a matter of weeks or months.

“There is a huge demand for this service so it’s an interesting and exceptionally busy time to begin this next chapter in my professional life.”

L&P Vascular is a private practice that will be sited at the award-winning Pure Perfection Clinic on Chester Road.

Featuring innovative medical technology and ultrasound scanning equipment, it will use a variety of procedures and methods to treat varicose veins – swollen and enlarged veins which tend to appear on the legs and feet, often twisted and bulging, causing pain and discomfort and even ulceration of the leg.

However, with research revealing more than 30% of the UK will develop varicose veins in their lifetime – and women are more likely to do so than men – people are urged to look out for other symptoms including itchy, sore skin over the veins, swollen legs, and hard tender lumps.

Laszlo revealed in the majority of cases keyhole surgery takes 40 minutes if one leg is treated to 1.5-2 hours if a more extensive treatment is needed or two legs are treated on the same occasion. The majority of patients will be able to walk in and walk out after a short period of rest and recovery.

Other services he will provide include Doppler tests for arterial disease, radiofrequency ablation treatment, and foam sclerotherapy and injection sclerotherapy of varicose veins.

“If varicose veins are causing long-term complications that could lead to a blood clot or leg ulcer. Offering our services means the patient will not have to wait as long for treatment as they would have via their local health board,” he said.

“But in most cases the issue is cosmetic or causing minor discomfort, so the wait is years rather than months.”

Laszlo added:

“To be able to open the clinic in such a perfect location is a great thrill for me; we have already had a lot of interest from not only North Wales but Cheshire, Wirral and into the North West so it’s an exciting time.”

Sara Cheeney, Director of Pure Perfection Clinic, added:

“We are delighted for Laszlo and for L&P Vascular to be based here, offering private clients another high-quality, much-needed medical service in this region.”

For more information, call 01244 917259 or email [email protected].