Introduction: Percutaneous transluminal angioplasty (PTA) is one of the treatment options for stenotic and obstructive lesions of the subclavian artery. Aim: To evaluate initial and long-term results of percutaneous transluminal angioplasty of subclavian artery lesions. Methods: During period February 2016 to December 2017, 26 patients (12 men and 14 women) with significant subclavian artery stenosis and occlusion were admitted and underwent PTA. All patients were symptomatic. All PTA procedures were performed with the patient under local anesthesia, through the femoral artery (n=22), brachial artery (n=4), or combined route (n=6). In 7 patients, we performed direct stenting, while in the other 15 patients we performed predilatation before stent implantation. The follow-up protocol consisted of regular clinical examinations in 1, 3, 6 and 12 months post-procedural, and annually thereafter with duplex ultrasound monitoring. Results: Initial technical success was achieved in 22 of 26 procedures (84.61%), 100% in stenotic lesions and 55.5 % in total occlusions. Fourth of nine occlusions could not be recanalized by PTA. These patients were managed surgically. The 30-day mortality rate was 0% for the entire group. No patients required reintervention for recurrence of symptoms and the stents remain patent at period of 12 months post-procedural. Conclusion: The minimal invasive technique, the markedly lower complication rate, the high long-term patency, patient’s comfort and the decreased hospital stay have made endovascular repair the primary choice of treatment in the majority of cases, especially in patients with stenotic lesions and high-risk patients. We consider PTA of subclavian artery stenotic/obstructive lesions should be the first therapeutic option.

Although kidney transplantation is by far the best method of renal replacement therapy, organ receiver is still not spared of eventual toxic consequences of drugs that are in charge of keeping the transplanted kidney functional. Both calcineurin inhibitors, of which tacrolimus more often, occasionally lead to neurotoxic side effects, mostly mild and reversible and dose-dependent in nature, but they can also be very severe or even fatal. It is very important to be aware of possible neurotoxic effects, to confirm them radiologically, and to prevent or reduce drug effects on nervous system. Sometimes the reduction of dose or substitution with another drug with similar mechanism effect is sufficient to terminate the neurotoxic effects of the drug and still not jeopardize the function of transplanted organ.

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We investigated the insulin-like growth factor 1 (IGF-1)/growth hormone (GH) axis in patients with ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI). This was a prospective study that was carried out in 2010. The study included an analysis of levels of GH, insulin, IGF-1, and its binding protein (IGFBP-3) in 43 patients with STEMI, 30 patients with NSTEMI, and 30 healthy individuals (control group). Blood samples for all analyses were taken within 24 h of admission. We found lower IGF-1 and IGFBP-3 levels and higher GH, C-reactive protein, glucose, and glycol glycosylated hemoglobin (HbA1c) levels in both STEMI and NSTEMI patients compared with controls. Insulin levels and the insulin resistance index did not differ between NSTEMI patients and controls. A significant difference in GH values was observed between the STEMI and NSTEMI groups (P < 0.05). The increased GH levels in the STEMI compared with the NSTEMI group are consistent with a stronger inflammatory response in patients with STEMI.a Medians with values of lower and upper quartiles in parentheses, respectively, followed by P value according to t-test (for normally distributed parameters) or Mann-Whitney analysis.GH in STEMI and NSTEMI Dizdarević -Hudić et al. 61

&lt;p&gt;&lt;strong&gt;Aim&lt;/strong&gt; &lt;br /&gt;To determine risk factors responsible for developing postoperative complications after the thoracic aorta reconstructive surgery.&lt;br /&gt;&lt;strong&gt;Methods&lt;/strong&gt; &lt;br /&gt;Medical records of 100 patients, who had undergone elective or emergency thoracic aorta reconstructive surgery at the&lt;br /&gt;Clinic for Cardiovascular Surgery, University Clinical Center Tuzla, were analysed. Intraoperative data as cross-clamp time (CCT), duration of cardiopulmonary bypass (CPBT) and hypothermic circulatory arrest time (HCAT) were evaluated. Univariate analysis was used to show risk factors for developing postoperative cardiac, respiratory, surgical and renal complications.&lt;br /&gt;&lt;strong&gt;Results&lt;/strong&gt; &lt;br /&gt;Between May 2019 and April 2021, 48 Bentall procedures (BP), 23 ascending aortic replacements (AAR), 20 BP and coronary artery bypass grafting (CABG) and 9 aortic valve replacements (AVR) with AAR were performed. Incidence of postoperative complications in the elective and emergency groups was as follows: respiratory 20% vs 38% (p=0.049), cardiac 18% vs 70% (p=0.015), renal 16% vs 48% (p=0.027) and surgical 4% vs 6% (p&amp;gt;0.05). Intrahospital 30 days morbidity was 44% with mortality rate of 13%. The results showed that CPBT&amp;gt;180 minutes was a risk factor for respiratory (p=0.034), cardiac (p=0.020) and renal (p=0.027) postoperative complications after acute type A aortic&lt;br /&gt;dissection surgery.&lt;br /&gt;&lt;strong&gt;Conclusion&lt;/strong&gt; &lt;br /&gt;CPBT &amp;gt; 180 min is a risk factor for postoperative development of respiratory, cardiac and renal complications. Postoperative cardiac and renal complications were associated with longer HCAT.&lt;/p&gt;