BackgroundSubclavian artery stenosis (SAS) is narrowing of the subclavian artery most commonly caused by atherosclerosis. It serves as a marker for cerebrovascular and myocardial ischemic events.MethodsA retrospective cohort study was conducted to determine the association of treatment via combination therapy (antiplatelet drug plus either by-pass surgery or percutaneous transluminal angioplasty (PTA) with or without stent implantation) versus antiplatelet drug therapy alone on cardiovascular events and all-cause mortality in Marshfield Clinic patients diagnosed with symptomatic SAS from January 1, 1995 to December 31, 2009.ResultsOf the total 2153 cases, 100 patients were identified as eligible to be included in the study. Of these 100 patients that met inclusion criteria, 30 underwent combination therapy while 70 were managed only with drug treatment. A median length of follow-up was 8.45 years. Adverse cardiovascular events occurred in 5/30 (17%) of combination therapy patients compared to 28/70 (40%) of antiplatelet drug therapy only patients (p = 0.0355). Accordingly, all-cause mortality was higher (47%) in the antiplatelet drug therapy only group than the combination therapy group (13%) [hazard ratio = 3.45, p = 0.0218].ConclusionsPreliminary findings in this pilot data set suggest that combination therapy (medications plus either surgical or interventional repair) of subclavian artery stenosis is associated with less cardiovascular adverse events and higher survival rates. However, prospective randomized studies with larger number of patients are needed to validate these findings.

We present in this report a case of an infant girl who was born with natal teeth along with an ulcerated rapidly involuting congenital hemangioma (RICH) on her thigh. RICH is a benign vascular tumor that is more common than other congenital hemangioma subtypes. Natal teeth are a birth anomaly that occurs in isolated form or in association with different syndromes like Ellis-van Creveld, Pierre Robin, Soto and Hallerman-Streiff. We have performed an intensive literature search to determine if there is a link between natal teeth and RICH, but no article has described any association thus far. It remains unclear whether this is a mere coincidence or whether there are common genetic factors that play a role in benign tumor growth and eruption of premature teeth. Further reports on the co-occurrence may shed light on possible common risk factors contributing to natal teeth and congenital hemangioma.

Background: Subclavian artery stenosis (SAS) is narrowing of the subclavian artery most commonly caused by atherosclerosis. It serves as a marker for cerebrovascular and myocardial ischemic events. Methods: A retrospective cohort study was conducted to determine the association of treatment via combination therapy (antiplatelet drug plus either by-pass surgery or percutaneous transluminal angioplasty (PTA) with or without stent implantation) versus antiplatelet drug therapy alone on cardiovascular events and all-cause mortality in Marshfield Clinic patients diagnosed with symptomatic SAS from January 1, 1995 to December 31, 2009. Results: Of the total 2153 cases, 100 patients were identified as eligible to be included in the study. Of these 100 patients that meet inclusion criteria, 30 underwent combination therapy while 70 were managed only with pharmacological drug treatment. Adverse cardiovascular events occurred in 5/30 (17%) of combination therapy patients compared to 28/70 (40%) of antiplatelet drug therapy only patients (p = 0.0355). Accordingly, all-cause mortality was higher (47%) in the antiplatelet drug therapy only group than the combination therapy group (13%) [hazard ratio = 3.45, p = 0.0218]. Conclusions: Preliminary findings in this pilot data set suggest that combination therapy (medications plus either surgical or interventional repair) of subclavian artery stenosis is associated with less cardiovascular adverse events and higher survival rates, benefits that extend beyond the target vessel. Prospective randomized studies with larger number of patients are needed to validate these findings.