Faculty of Medicine

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Author: search.filters.author.Rankovic, Ivan

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    Upper gastrointestinal bleeding from primary aortoesophageal fistula in a patient with aneurism of the thoracoabdominal aorta: Case report and literature review
    (Wiley, 2024-08)
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    Andov, Mishel
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    Kolev, Aleksandar
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    Bundovski, Kristijan
    Upper gastrointestinal bleeding due to primary aortoesophageal fistula is a rare clinical condition burdened with high mortality rate. However, the outcomes are closely related to the level of clinical awareness, the complementary and multidisciplinary approach during the diagnostic workup, and the selected treatment option. We present an atypical case of an aneurysm of the thoracoabdominal aorta complicated with primary aortoesophageal fistula (AEF). A 55‐year‐old male with no previous diseases, presented with prolonged and intense back pain and upper gastrointestinal bleeding. The gastroscopy detected an unusual culprit lesion in the distal esophagus resembling an esophageal wall defect, and the computed tomography revealed an aneurysm of the thoracoabdominal aorta, remarkable surrounding hematoma, and active contrast extravasation. Despite the urgent surgical repair, a lethal outcome occurred. AEF patients require high clinical awareness and complementary multidisciplinary approach in order to provide a rapid diagnosis and optimal treatment.
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    RUPTURED HEPATIC ARTERY ANEURYSM SUCCESSFULLY TREATED WITH DUAL-LAYER STENT ENDOVASCULAR TREATMENT: CASE REPORT AND LITERATURE REVIEW
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2024)
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    Spontaneous rupture of a hepatic artery aneurysm into the peritoneal cavity is a serious life-threatening complication related to hemodynamic instability and high mortality rate. We present a case of a hepatic artery aneurysm complicated with intraperitoneal bleeding and successfully treated with endovascular stent insertion. A 78-year-old male patient was admitted to a tertiary care center due to an abdominal pain and a large amount of free fluid in the peritoneal cavity. The diagnostic paracentesis confirmed hemoperitoneum. The CT scan revealed an aneurysm of the common hepatic artery that was successfully treated with an insertion of a dual-layered carotid stent. Endovascular stent insertion of a ruptured aneurysm of the common hepatic artery is an effective therapeutic procedure that can provide a definitive curative treatment in some patients.
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    The Role of Endothelial Dysfunction in the Pathogenesis of Pregnancy-Related Pathological Conditions: A Review
    (Walter de Gruyter GmbH, 2023-07)
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    Milivojevic, Vladimir
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    Rankovic, Ivan
    In the recent decades, endothelial dysfunction (ED) has been recognized as a significant contributing factor in the pathogenesis of many pathological conditions. In interaction with atherosclerosis, hypercholesterolemia, and hypertension, ED plays a crucial role in the pathogenesis of coronary artery disease, chronic renal disease, and microvascular complications in diabetes mellitus. Although ED plays a significant role in the pathogenesis of several pregnancy-related disorders such as preeclampsia, HELLP syndrome, fetal growth restriction, and gestational diabetes mellitus, the exact pathogenetic mechanisms are still a matter of debate. The increased prevalence of these entities in patients with preexisting vascular diseases highlights the essential pathological role of the preexisting ED in these patients. The abnormal uteroplacental circulation and the release of soluble factors from the ischemic placenta into the maternal bloodstream are the main causes of the maternal ED underlying the characteristic preeclamptic phenotype. Besides the increased risk for maternal and fetal poor outcomes, the preexisting ED also increases the risk of development of future cardiovascular diseases in these patients. This study aimed to look deeper into the role of ED in the pathogenesis of several pregnancy-related hypertensive and liver diseases. Hopefully, it could contribute to improvement of the awareness, knowledge, and management of these conditions and also to the reduction of the adverse outcomes and additional long-term cardiovascular complications.