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1

Successful primary percutaneous coronary intervention in the first trimester of pregnancy.  

PubMed

A 28-year-old patient, medical nurse, in 10th week of her second pregnancy suffered ventricular fibrillation just after entering the waiting room of the emergency department. After she was successfully defibrillated, electrocardiography revealed a large acute anteroseptolateral ST elevation myocardial infarction. Urgent coronarography was done (premedication with 300 mg of aspirin and 600 mg of clopidogrel) with 90 min door-to-balloon time. Proximal left anterior descending occlusion was found, primary percutaneous coronary intervention was done using Amazonia CroCo 3.0/12 bare-metal stent, and Thrombolysis in Myocardial Infarction III flow was achieved. During the procedure, the patient was wrapped in lead apron. Because of postresuscitational agitation, procedure was done in intravenous anesthesia. The revealed risk factors were smoking and hypercholesterolemia. PAI-1 gene 4G/4G genotype and Apo E gene E2/E4 genotype were also found. Estimated X-ray dosage that fetus received during the procedure was 0.45 mSv, which is less than the upper safe limit in pregnancy. All drugs given to our patient (clopidogrel, aspirin, ivabradine, bisoprolol, anesthetics, low-molecular-weight heparin, and unfractionated heparin) have B or C Food and Drug Administration Pregnancy Category. Fetal ultrasonography showed normal fetal growth, and, after consultation with our team, the patient decided to maintain the pregnancy. Before discharge echocardiography showed left ventricle of normal size with anteroseptolateral hypokinesia, small apical aneurysm, left ventricular ejection fraction of 40-45%, and diastolic dysfunction grade II, without pulmonary hypertension. At the 36th week of pregnancy, the patient was hospitalized and closely monitored; clopidogrel and aspirin were discontinued, and low-molecular-weight heparin was administered. She gave birth to a normal boy by vaginal delivery with epidural anesthesia and without any complication. PMID:21351227

Babic, Zdravko; Gabric, Ivo Darko; Pintaric, Hrvoje

2011-01-04

2

Prognostic significance of serum creatinine concentration for in-hospital mortality in patients with acute myocardial infarction who underwent successful primary percutaneous coronary intervention (from the Heart Institute of Japan Acute Myocardial Infarction [HIJAMI] Registry)  

Microsoft Academic Search

This study evaluated the impact of serum creatinine levels on in-hospital mortality in 1,359 consecutive patients with acute myocardial infarction (from a Japanese prospective multicenter registry) who underwent successful primary percutaneous coronary intervention (PCI). Even in the patients who underwent successful primary PCI, the in-hospital mortality of patients with mild (1.2 ? creatinine

Jun-ichi Yamaguchi; Hiroshi Kasanuki; Yasuhiro Ishii; Masahiro Yagi; Hiroshi Ogawa; Shin-ya Fujii; Hiroshi Koganei; Hisayuki Okada; Hirotaka Kimura; Toshinobu Horie; Kazuo Haze; Tetsuya Sumiyoshi; Takashi Honda

2004-01-01

3

Percutaneous interventional reconstruction of the iliac arteries: primary and long-term success rate in selected TASC C and D lesions  

Microsoft Academic Search

We report the primary and long-term outcome of patients with selected TransAtlantic Inter-Society Consensus (TASC) C or D lesions of the iliac arteries after percutaneous interventional reconstruction. Between 1999 and 2001, 89 patients with peripheral arterial disease categorized as TASC C (n=37) and D (n=52) underwent percutaneous interventional reconstruction and stent implantation. Patients were followed for 1–62 months (mean 36

Jörn O. Balzer; Verena Gastinger; Ralf Ritter; Christopher Herzog; Martin G. Mack; Thomas Schmitz-Rixen; Thomas J. Vogl

2006-01-01

4

Successful percutaneous angioplasty after failed femorodistal bypass.  

PubMed

Although balloon angioplasty for the management of failing bypass grafts has been well documented, little mention has been made of its use in treating the occlusive lesion within the native artery after a failed bypass graft. We report our experience with five patients in whom successful balloon angioplasty was carried out subsequent to failure of a femoral popliteal bypass graft. Increasingly aggressive percutaneous therapy of arterial occlusive disease may now be expanded to include a unique group of patients with chronically failed bypass grafts and occlusive disease within the native artery conducive to percutaneous transluminal angioplasty. This group of patients would previously have been relegated to repeat bypass grafts with its inherently inferior patency and recognized added technical demands. Percutaneous balloon angioplasty appears to be a plausible alternative in selected cases for repeat lower extremity revascularization. PMID:2145958

Harris, R W; Andros, G; Oblath, R W; Salles-Cunha, S X; Dulawa, L B

1990-09-01

5

Primary percutaneous coronary intervention in a patient with dextrocardia.  

PubMed

The case of a 40-year-old male with dextrocardia who presented with ST Elevated Myocardial Infarction (STEMI) is reported. Coronary angiogram was performed after due manipulation and then successful primary percutaneous coronary intervention (PCI) of Left anterior descending (LAD) coronary artery was done. His 9 months follow up primary PCI in a patient with angiogram revealed patent stent in proximal LAD. There are very few published case reports of this rare congenital anomaly addressing technical details of successful primary PCI with dextrocardia. PMID:23862265

Khan, Naveed-Ullah; Farman, Muhammad Tariq; Ashraf, Tariq

2012-08-01

6

Accepted TCT challenging case: common femoral artery perforation after primary percutaneous coronary intervention successfully treated with a novel transcatheter "thrombin-blood patch" injection technique.  

PubMed

Severe vascular access complications are infrequent, yet potentially life-threatening, conditions related to percutaneous procedures approached via the femoral artery. Surgical vascular repair of such complications are associated with high rates of morbimortality due to advanced cardiovascular disease. Endovascular repair of the injured vessel appears to be the treatment of choice for patients who cannot tolerate vascular reconstruction and bleeding due to severe cardiovascular disease. We report a case that illustrates the feasibility of a novel technique: transcatheter "thrombin-blood patch" injection to access perforated arteries. PMID:21061252

Maluenda, Gabriel; Waksman, Ron; Bernardo, Nelson L

2012-02-21

7

Success in Primary School. Success in Schools  

ERIC Educational Resources Information Center

A quality education system is not measured solely by national test scores, but by whether all students are successful in primary school. This simply stated goal is surprisingly difficult to achieve where substantial numbers of children are at risk of failing to complete a primary education. This paper explores the challenges and the diverse…

Academy for Educational Development, 2010

2010-01-01

8

Percutaneous coronary intervention in the Occluded Artery Trial: Procedural success, hazard, and outcomes over 5 years  

PubMed Central

Background The Occluded Artery Trial (OAT) was a 2,201-patient randomized clinical trial comparing routine stent-based percutaneous coronary intervention (PCI) versus optimal medical therapy alone in stable myocardial infarction (MI) survivors with persistent infarct-related artery occlusion identified day 3 to 28 post MI. Intent-to-treat analysis showed no difference between strategies with respect to the incidence of new class IV congestive heart failure, MI, or death. The influence of PCI failure, procedural hazard, and crossover on trial results has not been reported. Methods Study angiograms were analyzed and adjudicated centrally. Factors associated with PCI failure were examined. Time-to-event analysis using the OAT primary outcome was performed by PCI success status. Landmark analysis (up to and beyond 30 days) partitioned early hazard versus late outcome according to treatment received. Results Percutaneous coronary intervention was adjudicated successful in >87%. Percutaneous coronary intervention failure rates were similar in US and non-US sites, and did not significantly influence outcome at 60 months (hazard ratio for success vs fail 0.79, 99% CI 0.45–1.40, P = .29). Partitioning of early procedural hazard revealed no late benefit for PCI (hazard ratio for PCI success vs medical therapy alone 1.06, 99% CI 0.75–1.50, P = .66). Conclusions Percutaneous coronary intervention failure and complication rates in the OAT were low. Neither PCI failure nor early procedural hazard substantively influenced the primary trial results.

Buller, Christopher E.; Rankin, Jamie M.; Carere, Ronald G.; Buszman, Pawel E.; Pfisterer, Matthias E.; Dzavik, Vladimir; Thomas, Boban; Forman, Sandra; Ruzyllo, Witold; Mancini, G.B. John; Michalis, Lampros K.; Abreu, Pedro F.; Lamas, Gervasio A.; Hochman, Judith S.

2010-01-01

9

Primary percutaneous coronary intervention in patients with acute myocardial infarction.  

PubMed

This article examines the development of primary percutaneous coronary intervention (PPCI) for the treatment of acute ST-segment elevation myocardial infarction in the UK. It discusses the evidence related to PPCI, the technological advances to improve accessibility to this treatment and the nursing care of a patient undergoing this procedure. PMID:17016998

Tough, J

10

Functional and structural correlates of persistent ST elevation after acute myocardial infarction successfully treated by percutaneous coronary intervention  

Microsoft Academic Search

Background:In the thrombolytic era, persistence of ST-segment elevation was considered a marker of left ventricular (LV) aneurysm. ST-segment elevation may still be found persistently raised after successful primary percutaneous coronary intervention (PCI). Echocardiographic correlates of this finding, however, are still poorly known.Methods and results:82 consecutive patients with first ST-segment elevation myocardial infarction and successful PCI were divided into patients with

Leonarda Galiuto; Sabrina Barchetta; Serena Paladini; Gaetano Lanza; Antonio G Rebuzzi; Mario Marzilli; Filippo Crea

2007-01-01

11

Successful percutaneous transluminal coronary angioplasty for acute myocardial infarction in von Willebrand's disease.  

PubMed

An elderly woman with mild von Willebrand's disease presented with acute myocardial infarction. Percutaneous transluminal coronary angioplasty, to mechanically disrupt the thrombus without anticoagulation, was successfully undertaken. Haemostatic cover was also avoided. PMID:12410656

James, P R; de Belder, A J; Kenny, M W

2002-11-01

12

Long-Term Clinical Follow-Up After Successful Repeat Percutaneous Intervention for Stent Restenosis  

Microsoft Academic Search

Objectives. This study evaluated the long-term clinical outcome of successful repeat percutaneous intervention after in-stent restenosis.Background. Recurrence of symptoms and angiographic restenosis after stent implantation are observed in 15% to 35% of cases. Repeat percutaneous treatment for in-stent restenosis has been shown to be safe, with high immediate success, but little is known about the long-term clinical outcome.Methods. Clinical follow-up

Bernhard Reimers; Issam Moussa; Tatsuro Akiyama; Gina Tucci; Massimo Ferraro; Giovanni Martini; Simonetta Blengino; Carlo DI Mario; Antonio Colombo

1997-01-01

13

Primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction: changing patterns of vascular access, radial versus femoral artery  

Microsoft Academic Search

Objective:To examine the safety and efficacy of emergency transradial primary percutaneous coronary intervention for ST-elevation myocardial infarction.Design:Single-centre observational study with prospective data collection.Setting:A regional cardiac centre, United Kingdom.Patients:1051 consecutive patients admitted with ST-elevation myocardial infarction, without cardiogenic shock, between November 2004 and October 2008.Interventions:Percutaneous coronary interventions by radial and femoral accessMain outcome measures:The primary outcome measures were procedural success, major

S L Hetherington; Z Adam; R Morley; M A de Belder; J A Hall; D F Muir; A G C Sutton; N Swanson; R A Wright

2009-01-01

14

Successful Primary School Libraries in Challenging Circumstances  

Microsoft Academic Search

This article describes a research project, funded by Booktrust, into factors which contribute to successful primary school libraries. The research involved six case studies of primary school libraries which had proved successful in challenging circumstances. Such challenges might include lack of space, poor resourcing or deprived school catchment areas.Evidence was collected through visits, during which semi-structured interviews were conducted with

Helen Greenwood; Claire Creaser; Sally Maynard

2010-01-01

15

Acute Profound Thrombocytopenia after Using Abciximab for No-Reflow during Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction  

PubMed Central

Glycoprotein IIb/IIIa antagonists are well established for their effectiveness in improving clinical outcomes in acute coronary syndrome patients undergoing percutaneous coronary intervention. Acute profound thrombocytopenia is a rare complication of abciximab. We present a case which was managed successfully for the rare complication of acute profound thrombocytopenia after using abciximab and an intra-aortic balloon pump for the treatment of a no-reflow phenomenon and consecutive cardiogenic shock during primary percutaneous coronary intervention.

Park, Soonyoung; Lee, Jooyoung; Lee, Sang Yeub; Bae, Jang-Whan; Hwang, Kyung-Kuk; Kim, Dong-Woon; Cho, Myeong-Chan

2013-01-01

16

Primary and Secondary Succession in America's Forests  

NSDL National Science Digital Library

From PBS-American Field Guide, this website offers high school educators a multimedia lesson plan on Primary and Secondary Succession in Americas Forests. Hyperlinked video clips introduce students to several different North American Forests while learning about concepts associated with succession in both natural and disturbed environments.

2001-01-01

17

A case of refractory chylous ascites after nephrectomy successfully treated with percutaneous obliteration using adhesive glue.  

PubMed

Here we report a case of uncontrollable chylous ascites that developed after nephrectomy and was successfully treated with percutaneous obliteration of the lymphocele-like extravasation using ethiodized oil during lymphangiography. Under computed tomographic and fluoroscopic guidance, an N-butyl cyanoacrylate-ethiodized oil mixture was used with metallic coils to obliterate the extralymphatic leakage site. The volume of intraperitoneal drainage decreased steadily over the next 5 days, and the tube was removed. Percutaneous obliteration can be characterized as filling of the leakage site from outside the lymph vessel with no flow disruption, which contrasts with the conventional embolization approach via the cisterna chyli. PMID:23065489

Itou, Chihiro; Koizumi, Jun; Myojin, Kazunori; Yamashita, Tomohiro; Mori, Naoko; Imai, Yutaka

2012-10-13

18

Successful percutaneous coil occlusion of a large pulmonary arteriovenous malformation.  

PubMed

Pulmonary arteriovenous malformation is one of the rarest congenital anomalies of cardiovascular system. We present a case of 30-year-old female with a large pulmonary arteriovenous malformation (PAVM) arising from the right lower pulmonary artery and draining to the left atrium. She underwent successful embolization using three detachable Cook coils. PMID:15530285

Jameel, Al-Ata; Arfi, Amin Muhammed; Ayman, M S; Nasser, Mahdi; Amjad, Kouatli; Iskandar, Al-Githmi

2004-11-01

19

[Successive application of percutaneous endoscopic gastrostomy with jejunal extension and percutaneous endoscopic jejunostomy in a case of multiple system atrophy].  

PubMed

A 75-year-old man with multiple system atrophy received percutaneous endoscopic gastrostomy (PEG) because of dysphagia. But recurrent aspiration pneumonia occurred after PEG nutrition, which was due to gastroesophageal reflux. As he had floppy epiglottis, orally inserted endoscopic procedure caused upper airway obstruction, which required transient non-invasive positive-pressure ventilator (NIPPV) treatment. He underwent transgastrostomal jejunal tube (PEG-J) replacement under the nasal endoscopic guidance successfully, but tube was patent only for 5-months. Thereafter, endoscopic jejunostomy (PEJ) via gastric stoma was performed on NIPPV safely, and the patient is now stable. For the management of nutrition in the advanced stage of neurodegenerative disease patients, PEJ is one of useful choice. PMID:19618848

Ogawa, Tomoko; Oodaira, Hironori; Suzuki, Yutaka; Hashimoto, Ritsuo; Kato, Hiroyuki

2009-06-01

20

Successful Therapy of Ventricular Rupture by Percutaneous Intrapericardial Instillation of Fibrin Glue: A Case Report  

PubMed Central

Rupture of the ventricular myocardium is an often lethal complication after myocardial infarction. Due to the dramatic hemodynamics and the short time frame between ventricular rupture and surgical closure of the defect, additional therapeutic strategies are needed. Here we report the successful therapy of ventricular rupture by percutaneous intrapericardial instillation of fibrin glue in a 72-year-old male patient with postinfarct angina secondary to anterior myocardial infarction.

Bode, Christoph

2013-01-01

21

Successful percutaneous treatment of gluteal claudication secondary to isolated bilateral hypogastric stenoses.  

PubMed

We report an unusual case of bilateral buttock claudication at ambulation of less than two blocks in a 57-year-old man with normal lower-extremity segmental pressure on noninvasive exercise testing. He was found to have bilateral high-grade internal iliac artery stenoses on arteriography. Both sides were successfully treated in a staged fashion via a contralateral approach with percutaneous transluminal angioplasty and a balloon-expandable stent, with complete symptom resolution. A clinical vascular examination with normal findings of the common iliac, external iliac, and common and superficial femoral arteries eliminates significant vascular obstruction as a cause of claudication. However, internal iliac occlusive disease may be suspected when symptoms are limited to the gluteal musculature and other causes are eliminated. Percutaneous interventions can be of diagnostic and therapeutic value. PMID:16414405

Chaer, Rabih A; Faries, Peter L; Lin, Stephanie; Dayal, Rajeev; McKinsey, James F; Kent, K Craig

2006-01-01

22

[A case of emphysematous pyelonephritis successfully treated by multiple CT-guided percutaneous drainage procedures].  

PubMed

A case of emphysematous pyelonephritis successfully treated by multiple, computed tomography (CT)- guided, percutaneous drainage procedures. A 63-year-old female with complaints of high-grade fever and vomiting was transferred to our hospital with leukocytosis and hyperglycemia. CT revealed a gas shadow widespread not only in the left renal parenchyma but also in the retroperitoneal space with extension to the right pararenal space. Under a diagnosis of emphysematous pyelonephritis, CT-guided percutaneous drainage was performed immediately, and a drainage catheter was placed in the retroperitoneal space. However, because a single drainage with medical management was not completely effective, a second drainage procedure was performed. She recovered, and the catheters were removed after four months. A left perinephric abscess and cutaneous fistula formation were localized and almost completely resolved after one year. PMID:23995531

Matsuura, Hiroshi; Kanai, Masahiro; Tochigi, Hiromi

2013-08-01

23

Primary percutaneous coronary intervention in nonagenarians: six-month outcomes from a single-center registry.  

PubMed

Little is known about the efficacy and medium-term outcomes of primary percutaneous coronary intervention (PCI) in very old patients. We evaluated in-hospital and 6-month outcomes in a retrospective cohort of nonagenarian patients presenting at our hospital with ST-segment elevation myocardial infarction (STEMI) and treated by primary PCI from January 2003 to May 2012. During this period, primary PCI was performed in 1598 consecutive patients; twenty-seven patients (age, 92.5 ± 2.5 years) were enrolled in the study. Four patients (15%) were in advanced Killip class at presentation. STEMI location was anterior in 44%. Patients received aspirin, 300 mg clopidogrel loading dose, and heparin. Abciximab was given to 41% of patients. Coronary angiography showed multivessel disease in 52% of patients. Pain-to-balloon and door-to-balloon times were 375.0 ± 410.2 minutes and 107.3 ± 47.6 minutes, respectively. Intra-aortic balloon pump was implanted in 1 patient. An average of 1.3 ± 0.7 stents (95% bare-metal stents) were implanted per patient. Procedural success rate, defined as Thrombolysis in Myocardial Infarction (TIMI) flow grade ? 2 and residual stenosis <20%, was 89%. Hospital mortality was 18.5%. TIMI major bleeding and acute renal failure, defined as an absolute increase of 0.5 mg/dL serum creatinine, occurred in 7% and 22% of patients, respectively. Overall 6-month survival rate was 67%. Our data suggest that primary PCI can be performed in nonagenarian patients with high success rate and with an acceptable bleeding risk, even when aggressive antithrombotic drugs, such as glycoprotein IIb/IIIa inhibitors, are given. PMID:23645049

Rigattieri, Stefano; Cera, Maria; Sciahbasi, Alessandro; Di Russo, Cristian; Fedele, Silvio; Ferraiuolo, Giuseppe; Altamura, Giuliano; Pugliese, Francesco Rocco; Loschiavo, Paolo

2013-05-01

24

Acute heart failure in patients with acute myocardial infarction treated with primary percutaneous coronary intervention  

Microsoft Academic Search

Background: Scanty data exist about the relation between acute heart failure (HF) and acute myocardial infarction (AMI). Aim: To assess the impact of HF on outcome in AMI patients treated with primary percutaneous coronary intervention (PCI). Methods and results: Out of 2089 AMI patients, 82% did not present HF, 17% presented HF on admission and 1% developed HF after hospitalisation.

Giovanni M. Santoro; Nazario Carrabba; Angela Migliorini; Guido Parodi; Renato Valenti

25

Failure and Success of Percutaneous Angioplasty in a Hypertensive Child with Bilateral Renal Artery Stenosis  

SciTech Connect

We describe the clinical course of a 5-year-old girl with severe arterial hypertension that was uncontrollable with antihypertensive medication. Renal angiography revealed bilateral renal artery stenoses. Because percutaneous transluminal renal angioplasty (PTRA) failed to dilate the stenotic lesions, a renal artery bypass grafting in both renal arteries was performed. The patient remained normotensive for 7 months, and after that the arterial pressure increased again. Digital subtraction angiography demonstrated stenosis at the peripheral and central anastomosis of the vein graft that was used for revascularization of the left kidney. PTRA was decided on and successful patency was achieved. The patient has now been normotensive for a period of 5 years.

Giavroglou, Constantinos; Tsifountoudis, Ioannis, E-mail: jtsif@mycosmos.g [Aristotle University of Thessaloniki, Department of Radiology, AHEPA Hospital (Greece); Boutzetis, Theodoros [Aristotle University of Thessaloniki, Second Pediatric Clinic, AHEPA Hospital (Greece); Kiskinis, Dimitrios [Aristotle University of Thessaloniki, First Surgery Clinic, AHEPA Hospital (Greece)

2009-01-15

26

Primary epiploic appendagitis and successful outpatient management  

PubMed Central

Summary Background Primary epiploic appendagitis (PEA) is a rare cause of abdominal acute or subacute complaints. Diagnosis of PEA is made with ultrasonography (US) or when computed tomography (CT) reveals a characteristic lesion. Case Report We report on two patients with PEA. In one patient PEA was first seen with US and confirmed with contrast enhanced CT, and in the second patient CT without contrast enhancement demonstrated PEA. In both patients an outpatient recovery with conservative non-surgical treatment is described. Conclusions Medical personnel should be aware of this rare disease, which mimics many other intra-abdominal acute and subacute conditions. A correct diagnosis of PEA with imaging procedures enables conservative and successful outpatient management avoiding unnecessary surgical intervention and additional costs.

Schnedl, Wolfgang J.; Krause, Robert; Wallner-Liebmann, Sandra J.; Tafeit, Erwin; Mangge, Harald; Tillich, Manfred

2012-01-01

27

Clinical and Angiographic Predictors of ST-Segment Recovery After Primary Percutaneous Coronary Intervention  

Microsoft Academic Search

Important determinants of incomplete ST-segment recovery in patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) have been incompletely characterized. Early risk stratification could identify patients with STEMI and incomplete ST-segment recovery who may benefit from adjunctive therapy. For the present study, we analyzed 12-lead electrocardiograms from 2,124 patients with STEMI who underwent primary PCI at

Niels J. W. Verouden; Joost D. E. Haeck; Wichert J. Kuijt; Martijn Meuwissen; Karel T. Koch; José P. S. Henriques; Jan Baan; Marije M. Vis; Jan J. Piek; Jan G. P. Tijssen; Robbert J. de Winter

2010-01-01

28

Chemoembolisation combined with percutaneous radiofrequency ablation in the treatment of primary angiosarcoma of the liver.  

PubMed

Angiosarcoma of the liver is a rare disease; however, it ranks as the third most common primary liver malignancy. Diagnosis is difficult and prognosis is very poor. After the onset of clinical symptoms, the disease often progresses rapidly, decreasing the chances of curative treatment. We report the case of an 83-year-old male patient who presented with postprandial fullness. Upper abdominal ultrasound showed a hypervascular mass in segment 6 of the liver. The results of anatomopathological examination and immunohistochemistry were compatible with the diagnosis of primary angiosarcoma of the liver. Patient refused surgery (haepatectomy), and treatment was then initiated with transarterial chemoembolisation, followed by percutaneous radiofrequency ablation. The patient is currently cured based on clinical and radiological evidence. This case report is the first in the literature to describe the combined use of transarterial chemoembolisation with percutaneous radiofrequency ablation in the treatment of primary angiosarcoma of the liver. PMID:23704445

Nunes, Thiago Franchi; Barbosa, Fabio Colagrossi Paes; Miiji, Luciana Nakao Odashiro; de Souza, Luiz Gustavo Orlandi

2013-05-22

29

Non-endoscopic removal of radiologically placed percutaneous primary gastrostomy tubes: a new technique  

Microsoft Academic Search

Purpose. To present a new technique for non-endoscopic removal of radiologically inserted primary percutaneous gastrostomy tubes (PGT)\\u000a and to assess the utility and safety of this technique in the pediatric population. Materials and methods. Over a 9-year period 172 children (80 F, 92 M) mean age 10 years (range 0.29–24 years) underwent removal of radiologically\\u000a placed PGTs in the Radiology

A. M. Cahill; Robin D. Kaye; Charles R. Fitz; Richard B. Towbin

2001-01-01

30

Predictors of success in percutaneous transluminal coronary angioplasty of chronic total occlusions.  

PubMed

Earlier studies have indicated that percutaneous transluminal coronary angioplasty (PTCA) of chronic total occlusions has a low success rate. To determine success rate and assess clinical and angiographic variables associated with success and complications, 57 total occlusions in 56 patients undergoing PTCA were analyzed. The clinical duration of occlusion was 51 +/- 86 days. Success (less than 50% residual stenosis) was achieved at 40 of 57 (70%) dilatation sites. Of these 57 total occlusions, 5 were attempted within 24 hours of acute myocardial infarction, 35 between 1 day and 8 weeks of clinical occlusion, 13 greater than 8 weeks and 4 were of unknown duration. Success rates were 4 of 5, 25 of 35, 9 of 13 and 2 of 4, respectively, in each group (difference not significant, comparison of all time groups). Of the 9 narrowings with a successful PTCA for an occlusion greater than 8 weeks, the mean duration of occlusion was 93 +/- 41 days (range 60 to 180). None of the attempted dilatations of occlusions with a clinical duration of greater than 180 days (n = 3) was successful. None of the clinical or angiographic variables (including tortuosity, length of occlusion gap, distance of the occlusion from the vessel origin, thrombus, lesion calcium, collaterals, prior myocardial infarction, vessel dilated or diffuse disease) impacted on success rate (difference not significant for all). No patient died, had a Q-wave infarction, required emergency coronary artery bypass grafting or underwent repeat PTCA within 7 days of the procedure. Non-Q-wave infarction occurred in 2 of 56 patients (4%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2589190

LaVeau, P J; Remetz, M S; Cabin, H S; Hennecken, J F; McConnell, S H; Rosen, R E; Cleman, M W

1989-12-01

31

Triple Versus Dual Antiplatelet Therapy in Patients With Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention  

Microsoft Academic Search

Background—Whether triple antiplatelet therapy is superior or similar to dual antiplatelet therapy in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention in the era of drug-eluting stents remains unclear. Methods and Results—A total of 4203 ST-segment elevation myocardial infarction patients who underwent primary percutaneous coronary intervention with drug-eluting stents were analyzed retrospectively in the Korean Acute

Kang-Yin Chen; Seung-Woon Rha; Yong-Jian Li; Kanhaiya L. Poddar; Zhe Jin; Yoshiyasu Minami; Lin Wang; Eung Ju Kim; Chang Gyu Park; Hong Seog Seo; Dong Joo Oh; Myung Ho Jeong; Young Keun Ahn; Taek Jong Hong; Young Jo Kim; Seung Ho Hur; In Whan Seong; Jei Keon Chae; Myeong Chan Cho; Jang Ho Bae; Dong Hoon Choi; Yang Soo Jang; In Ho Chae; Chong Jin Kim; Jung Han Yoon; Wook Sung Chung; Ki Bae Seung; Seung Jung Park

2010-01-01

32

Early detection of restenosis after successful percutaneous transluminal coronary angioplasty by exercise-redistribution Thallium scintigraphy  

Microsoft Academic Search

The value of exercise testing and thallium scintigraphy in predicting recurrence of angina pectoris and restenosis after a primary successful transluminal coronary angioplasty (PTCA) was prospectively evaluated. In 89 patients, a symptom-limited exercise electrocardiogram (ECG) and thallium scintigraphy were performed 4 weeks after they had undergone successful PTCA. Thereafter, the patients were followed for 6.4 +\\/- 2.5 months (mean +\\/-

William Wijns; Patrick W. Serruys; Johan H. C. Reiber; Feyter de P. J; Marcel van den Brand; Maarten L. Simoons; Paul G. Hugenholtz

1985-01-01

33

Lessons from primary succession for restoration of severely damaged habitats  

Microsoft Academic Search

Questions: How can studies of primary plant succession increase the effectiveness of restoration activities? Can restoration methods be improved to contribute to our understanding of succession? Results: Successional studies benefit restoration in six areas: site amelioration, development of community struc- ture, nutrient dynamics, species life history traits, species interactions, and modeling of transitions and trajectories. Primary succession provides valuable lessons

Lawrence R. Walker

34

Cardiac troponin T, creatine kinase, and its isoform release after successful percutaneous transluminal coronary angioplasty with or without stenting  

Microsoft Academic Search

Background Cardiac troponin T is a sensitive and specific marker for the detection of minor myocardial injury. However, it has been rarely used to monitor myocardial injury after coronary stenting. The purpose of the study was to measure troponin T after apparently successful percutaneous transluminal coronary angioplasty (PTCA) with or without coronary stenting and to compare its result with serum

Kou-Gi Shyu; Pei-Liang Kuan; Jun-Jack Cheng; Chi-Ren Hung

1998-01-01

35

Successful percutaneous transcatheter patent foramen ovale closure through the right internal jugular vein using a steerable catheter.  

PubMed

Percutaneous transcatheter closure of a patent foramen ovale (PFO) remains challenging when femoral venous approach is not available. We describe the successful closure of a PFO using the right internal jugular venous approach and a deflectable catheter delivery system in a patient with a PFO, recurrent stroke, and an inferior vena cava filter. © 2013 Wiley Periodicals, Inc. PMID:23413211

Hascoet, Sebastien; Fraisse, Alain; Elbaz, Meyer

2013-03-22

36

Successful percutaneous recanalization of thrombosed major aortopulmonary collateral artery in palliated tetralogy of fallot with pulmonary atresia.  

PubMed

We report the case of a 25-year-old male with palliated tetralogy of Fallot and pulmonary atresia presenting with thrombotic occlusion of a major aortopulmonary collateral artery to the right lung. Percutaneous intervention was successful in recanalizing this vessel, resulting in symptomatic improvement. PMID:22967228

Caruana, Maryanne; Cullen, Shay; Mullen, Michael

2012-09-12

37

Impact of Atrioventricular Compliance on Clinical Outcome of Patients Undergoing Successful Percutaneous Balloon Mitral Valvuloplasty.  

PubMed

OBJECTIVE: We aimed to assess the impact of atrioventricular compliance (Cn) on the clinical outcome, after successful percutaneous balloon mitral valvuloplasty (PBMV). METHODS AND RESULTS: Using Doppler echocardiography Cn was estimated from the equation that has been previously validated. Mitral valve area (MVA), tricuspid annular plane systolic excursion (TAPSE), pulmonary artery pressure (PAP), and degree of tricuspid regurgitation (TR) severity were evaluated before, immediately, and every 6 months with a median duration of 32 months after successful PBMV in 150 consecutive patients. An immediate drop in PAP and significant improvement of right ventricle (RV) function was observed after PBMV. Cn was negatively correlated pre and post-PBMV, with the degree of pulmonary artery systolic pressure (PAPs), TAPSE (P < 0.0001). Patients with Cn ? 3.75 mL/mmHg had higher incidence of adverse outcome (developing atrial fibrillation [AF], worsening RV function, progressive left atrial dilation, and redo intervention). Multivariate regression analysis showed that the Cn was the strongest independent predictor of PAPs and RV function before and after successful PBMV (P < 0.0001). Cn ? 3.75 mL/mmHg was the cutoff value for prediction of clinical events at follow-up. CONCLUSIONS: Atrioventricular compliance was significantly lower in patients with mitral stenosis (MS) with unfavorable outcome after successful PBMV. The RV function and pulmonary hypertension were significantly correlated with the degree of Cn. This suggests a significant role of Cn in patients with MS, providing a good insight for intervention and utilizing Cn as a noninvasive hemodynamic index for risk stratification and proper timing for intervention in patients with MS. PMID:23742164

Mahfouz, Ragab A; Elawady, Waled; Hossein, Ekhlas; Yosri, Ahmad

2013-06-01

38

Percutaneous laser-assisted recanalization of long chronic iliac artery occlusions: primary and mid-term results  

Microsoft Academic Search

We report the primary and mid-term outcome of patients with long chronic iliac artery occlusions after percutaneous excimer-laser-assisted interventional recanalization. Between 2000 and 2001, 43 patients with 46 chronic occlusions of either the common iliac artery (n=27), the external iliac artery ( n=13) or both (n=3) underwent laser-assisted percutaneous transluminal angioplasty and implantation of stents. The average length of the

Jörn O. Balzer; Verena Gastinger; Axel Thalhammer; Ralf G. Ritter; Edelgard Lindhoff-Last; Thomas Schmitz-Rixen; Thomas J. Vogl

2006-01-01

39

Successful laparoscopic management of primary omental pregnancy.  

PubMed

Omental pregnancy is an extremely rare type of ectopic pregnancy. We present a case in which a 26-year-old woman was admitted to the emergency room with abdominal pain. She was diagnosed with a ruptured ectopic pregnancy after a positive urinary pregnancy test and transvaginal ultrasound. Laparoscopic surgery showed intact pelvic organs and an ectopic mass on the omentum. The patient was treated successfully with laparoscopic partial omentectomy, and pathologic examination confirmed an omental pregnancy. As evidenced by this case, laparoscopy can be useful to diagnose and treat unusually located ectopic pregnancies. PMID:19434418

Seol, Hyun-Joo; Kim, Tak; Lee, Seon-Kyung

2009-05-12

40

Primary Percutaneous Coronary Angioplasty for Acute Myocardial Infarction at a Rural Area Hospital A Great Difference from the Ideal  

Microsoft Academic Search

Background: Primary percutaneous coronary intervention (PCI) is recommended as a standard treatment for acute ST-elevation myocardial infarction (STEMI). We sought to understand how this treatment is implemented in a rural area. Methods: We reviewed charts of acute STEMI patients admitted between February 2001 and October 2005 to Tzu Chi Da Lin General Hospital and managed with primary PCI. We collected

Chih-Wei Chen; Chih-Ta Lin; Tin-Kwang Lin; Bin-Chen Chen; Chin-Lon Lin

2007-01-01

41

Successful management of massive intraoperative pulmonary fat embolism with percutaneous cardiopulmonary support.  

PubMed

We report a patient who sustained catastrophic pulmonary fat embolism, during open reduction, internal fixation (ORIF) of fracture femur. In our opinion, the use of percutaneous cardiopulmonary support with (PCPS), saved the patient from certain death. PMID:19742250

Sarkar, Suman; Mandal, Krutisundar; Bhattacharya, Prithwis

2008-07-01

42

Intracoronary versus intravenous abciximab in ST-segment elevation myocardial infarction: rationale and design of the CICERO trial in patients undergoing primary percutaneous coronary intervention with thrombus aspiration  

Microsoft Academic Search

ABSTRACT: BACKGROUND: Administration of abciximab during primary percutaneous coronary intervention is an effective adjunctive therapy in the treatment of patients with ST-segment elevation myocardial infarction. Recent small-scaled studies have suggested that intracoronary administration of abciximab during primary percutaneous coronary intervention is superior to conventional intravenous administration. This study has been designed to investigate whether intracoronary bolus administration of abciximab is

Youlan L Gu; Marieke L Fokkema; Marthe A Kampinga; Bart JGL de Smet; Eng S Tan; Ad FM van den Heuvel; Felix Zijlstra

2009-01-01

43

"Tubeless" percutaneous surgery: a new advance in the technique of percutaneous renal surgery.  

PubMed

We describe our modification of the technique of traditional percutaneous renal surgery called "tubeless" percutaneous renal surgery. Fifty patients have now undergone percutaneous renal procedures without the use of a postoperative nephrostomy tube consisting of percutaneous nephrolithotripsy, percutaneous endopyelotomy, and both percutaneous stone extraction and endopyelotomy in the same setting. Our current modification of standard percutaneous surgical technique includes the placement of an internal ureteral catheter with primary closure of the access site using hemostatic skin sutures. The study group was compared to a control group of 50 patients who were age, sex and procedure matched who had undergone standard percutaneous renal procedures previously with routine placement of postoperative nephrostomy tubes. The incidence of complications, analgesia requirements, length of hospitalization, time of return to normal activities, and cost of treatment were compared between the two groups. All tubeless percutaneous procedures were successfully performed without significant complications. The initial 15 patients had postoperative renal ultrasounds demonstrating no urinoma. Hospital stay, analgesia requirements, and the patient's ability to return to normal activities were statistically significantly decreased in the patient group studied. The cost of a "tubeless" procedure was $1,638 compared with $3,750 (129% greater) for traditional percutaneous surgery (cost saving of $2,112/case). Tubeless percutaneous renal surgery is a safe procedure and offers advantages over the routine placement of a nephrostomy tube. The hospitalization period, analgesia requirements, return to normal activities, and cost are significantly less with this new technique. PMID:9170218

Candela, J; Davidoff, R; Gerspach, J; Bellman, G C

1997-01-01

44

[Prospective register of primary percutaneous coronary interventions in patients with acute myocardial infarction].  

PubMed

The present study has evaluated the immediate angiographic results of primary percutaneous interventions (PCI) in patients with acute myocardial infarction, as well as hospital and 6-month clinical outcomes. The analysis covered a total of 265 patients (females (23%) and males (77%)); their mean age was 57+/-11 years. The mean time before the first balloon dilatation during PCI was 278+/-135 minutes after the development of the pain syndrome or 109+/-94 minutes after hospital admission. PCI proved to be effective in 96% of the patients, as evidenced by angiography. TIMI 3 blood flow was achieved in 83% of cases during PCI. After primary PCI, hospital mortality was 98.9% and 95% survived 6 months. At 6-month follow-up, 22% patients had positive exercise tests, recurrent angina pectoris and/or more than 50% luminal stenosis of the infarct-related artery. Control angiography made less than 6 months later showed 11% restenosis. This prospective study has demonstrated the high immediate and long effectiveness and safety of primary interventions in acute myocardial infarction. PMID:18561398

Sozykin, A V; Shirokov, R O; Merkulov, E V; Zhamgyrchiev, Sh T; Samko, A N

45

Successful surgical excision of primary right atrial angiosarcoma  

Microsoft Academic Search

Primary cardiac angiosarcoma is a rare and aggressive tumor with a high incidence of metastatic spread (up to 89%) at the\\u000a time of diagnosis, which restricts the indication for surgical resection to a small number of patients. We report the case\\u000a of a 50-year old Caucasian woman with non-metastatic primary right atrial angiosarcoma, who underwent successful surgical\\u000a excision of the

Wobbe Bouma; Chris PH Lexis; Tineke P Willems; Albert JH Suurmeijer; Iwan CC van der Horst; Tjark Ebels; Massimo A Mariani

2011-01-01

46

Early detection of restenosis after successful percutaneous transluminal coronary angioplasty by exercise-redistribution thallium scintigraphy  

SciTech Connect

The value of exercise testing and thallium scintigraphy in predicting recurrence of angina pectoris and restenosis after a primary successful transluminal coronary angioplasty (PTCA) was prospectively evaluated. In 89 patients, a symptom-limited exercise electrocardiogram (ECG) and thallium scintigraphy were performed 4 weeks after they had undergone successful PTCA. Thereafter, the patients were followed for 6.4 +/- 2.5 months (mean +/- standard deviation) or until recurrence of angina. They all underwent a repeat coronary angiography at 6 months or earlier if symptoms recurred. PTCA was considered successful if the patients had no symptoms and if the stenosis was reduced to less than 50% of the luminal diameter. Restenosis was defined as an increase of the stenosis to more than 50% luminal diameter. The ability of the thallium scintigram (presence of a reversible defect) to predict recurrence of angina was 66%, vs 38% for the exercise ECG (ST-segment depression or angina at peak workload). Restenosis was predicted in 74% of patients by thallium scintigraphy, but only in 50% of patients by the exercise ECG. Thus, thallium scintigraphy was highly predictive but the exercise ECG was not (p less than 0.005). These results suggest that restenosis had occurred to some extent already at 4 weeks after the PTCA in most patients in whom it was going to occur.

Wijns, W.; Serruys, P.W.; Reiber, J.H.; de Feyter, P.J.; van den Brand, M.; Simoons, M.L.; Hugenholtz, P.G.

1985-02-01

47

Outcome of primary percutaneous intervention in patients with infarct-related coronary artery ectasia.  

PubMed

Data related to the incidence and clinical outcome of acute myocardial infarction (AMI) in patients with preexisting coronary artery ectasia (CAE) are limited. We assessed whether infarct-related artery ectasia (EIRA) indicates an untoward clinical outcome in patients with AMI undergoing primary percutaneous coronary intervention (pPCI). Consecutive patients (n = 643) who presented with AMI and were treated with pPCI were analyzed retrospectively; 31 patients (4.8%) had EIRA. Patients who had EIRA were significantly younger and had higher incidence of hypertension, previous stroke, smoking, inferior wall AMI, and Killip score >1. Infarct-related artery ectasia was more frequent in the right coronary artery (RCA). Impaired epicardial arterial flow, thrombus burden score of infarct-related artery (IRA), impaired Thrombolysis in Myocardial Infarction (TIMI) Myocardial Perfusion Grade, and distal embolization were significantly higher whereas ST-segment resolution and collateral vascular development were significantly lower in patients with EIRA. Infarct-related artery ectasia was an independent predictor of adverse outcome (odds ratio: 0.197; 95% confidence interval [CI]: 0.062-0.633; P = .006). PMID:20395236

Erden, Ismail; Erden, Emine Cakcak; Ozhan, Hakan; Karabulut, Ahmet; Ordu, Serkan; Yazici, Mehmet

2010-04-14

48

[A case of hepatic encephalopathy successfully treated by antegrade glycerin enema through percutaneous endoscopic cecostomy].  

PubMed

A 76-year-old man with liver cirrhosis, a chronic defecation disorder and a refractory hepatic encephalopathy was hospitalized for the hepatic encephalopathy. The encephalopathy quickly improved upon treatment, but a high level of serum ammonia persisted. We inserted a percutaneous endoscopic cecostomy at the cecum and an antegrade glycerin enema through it to treat the chronic defecation disorder, which was a deteriorative factor of the hepatic encephalopathy. After the aforementioned procedure, the chronic defecation disorder improved and the serum ammonia level dramatically decreased. The patient continued the antegrade glycerin enema at home, and serum ammonia values remained low in comparison to levels measured prior to the administration of treatment. The subject has not experienced a recurrence of hepatic encephalopathy. PMID:18176043

Tomikashi, Koichi; Nomura, Yuh; Miyawaki, Kiichiro; Shimada, Ayumi; Kanemitsu, Daisuke; Takashima, Hidetaka; Abe, Mitsumasa

2008-01-01

49

The prognostic significance of a fragmented QRS complex after primary percutaneous coronary intervention.  

PubMed

Fragmented QRS (fQRS) may occur due to non-homogeneous activation of ischemic ventricles. We want to investigate the prognostic significance of a fQRS complex in a patient who had undergone primary percutaneous coronary intervention (PCI). Eighty-five patients with no history of coronary artery disease who underwent primary PCI were included in the study. Of these patients, 34 who were found to have a fQRS at the 48th hour after primary PCI were defined as group 1, and 51 who were found not to have a fQRS were defined as group 2. Both groups were monitored for adverse cardiac events. At 6.6 ± 2.3 months of follow-up, major adverse cardiac events (MACE) was found significantly higher in the fQRS group [group 1:10 (29.4%) vs. group 2:3 (5.9%); p:0.003]. In multivariate Cox regression analysis; the duration of chest pain (HR:1.02, CI:1.004-1.05; p = 0.03) and fQRS at 48th hour (HR 7.16, CI 3.17-20.11; p = 0.006) were predictors of MACE. In the group 2, event-free survival rate was found significantly higher; however, Q wave and QRS distortion were found to be insignificant with regard to demonstrating event-free survival. Compared to both Q wave and QRS distortion, fQRS showed high sensitivity and specificity in demonstrating MACE (sensitivity 0.77; specificity 0.67; AUC 0.71 (0.57-0.86); p 0.01). fQRS had 73% sensitivity and 49% specificity and Q wave had 58% sensitivity and 85% specificity for demonstrating the presence of scar on myocardial perfusion scintigraphy with ROC curve analysis. The presence of a fQRS at the 48th hour is a significant predictor of MACE in patients with ST elevation myocardial infarction who have undergone primary PCI. (ClinicalTrials.gov number: NCT01136837). PMID:21344317

Ari, Hasan; Cetinkaya, Seçkin; Ari, Selma; Koca, Vedat; Bozat, Tahsin

2011-02-23

50

Timing, setting and incidence of cardiovascular complications in patients with acute myocardial infarction submitted to primary percutaneous coronary intervention  

PubMed Central

BACKGROUND At the Istituto di Clinica Medica Generale e Cardiologia (Florence, Italy), the widespread use of percutaneous coronary intervention (PCI) has markedly changed the hospital course of patients with acute myocardial infarction (AMI). These patients are typically transferred to the coronary care unit (CCU) only after primary PCI, whereas during the thrombolytic era, patients were first admitted to CCU before reperfusion. OBJECTIVES AND METHODS The incidence, timing and setting of complications from symptom onset to hospital discharge in 689 consecutive AMI patients undergoing PCI were evaluated. RESULTS Ventricular fibrillation occurred in 11% of patients, and most episodes (94.7%) occurred before or during PCI. Of all patients, 6.3% developed complete atrioventricular block (CAVB), and in 86.3% of these cases, the CAVB occurred before or during PCI; in 94.5%, a CAVB resolution occurred in the catheterization laboratory (CL). Thirty-one patients (4.5%) had impending shock on admission to the CL. Cardiogenic shock developed in 29 patients (4.2%), mostly in the prehospital phase or in the CL. Only four patients (less than 1%) developed cardiogenic shock later during their hospital course. Similarly, circulatory and ventilatory support, as well as temporary pacing and cardiac defibrillation, were used mostly in the prehospital phase or in the CL. During the CCU stay, 45 patients (6.5%) had hemorrhagic or vascular complications, and the incidence of post-PCI ischemia and early reocclusion of the culprit vessel were low (2.1% and 0.6%, respectively). Thus, cardiac complications usually associated with AMI were observed mainly before hospital admission or in the CL during the reopening of the target vessel. These complications were rarely observed after a successful PCI. CONCLUSIONS For AMI patients, the CL is not only the site of PCI, it is also where most life-threatening cardiac complications are observed and treated.

Giglioli, Cristina; Margheri, Massimo; Valente, Serafina; Comeglio, Marco; Lazzeri, Chiara; Chechi, Tania; Armentano, Corinna; Romano, Salvatore Mario; Falai, Massimiliano; Gensini, Gian Franco

2006-01-01

51

PreDischarge Exercise Test for Evaluation of Patients with Complete or Incomplete Revascularization following Primary Percutaneous Coronary Intervention: A DANAMI-2 Sub-Study  

Microsoft Academic Search

Objectives: It is unclear whether the completeness of revascularization impacts on the prognostic value of an exercise test after primary percutaneous coronary intervention (PCI). Methods: The DANAMI-2 trial included patients with ST elevation acute myocardial infarction randomized to primary PCI or fibrinolysis. Of the 790 patients randomized to primary PCI, 572 performed an exercise test. Prospectively, 310 patients were classified

Nana Valeur; Peter Clemmensen; Peer Grande; Kristian Wachtell; Kari Saunamäki

2008-01-01

52

Successful treatment of de Quervain tenosynovitis with ultrasound-guided percutaneous needle tenotomy and platelet-rich plasma injection: a case presentation.  

PubMed

De Quervain tenosynovitis is a disorder of the tendons of the first dorsal compartment of the wrist that causes pain and functional disability, which may be refractory to conservative treatments. We present a case of ultrasound-guided percutaneous needle tenotomy and platelet-rich plasma injection for the successful treatment of de Quervain tenosynovitis. PMID:23701981

Peck, Evan; Ely, Erin

2013-05-01

53

Sacral radiculopathy due to cement leakage from percutaneous sacroplasty, successfully treated with surgical decompression.  

PubMed

Percutaneous sacroplasty is a procedure adapted from vertebroplasty, which is designed to ameliorate the painful morbidity associated with sacral insufficiency fractures without the invasiveness of open surgery. Early estimates of efficacy, according to several case reports and small series, appear promising, but the procedure is not without risk. Several cases of radiculopathy due to nerve root compression by extravasated polymethylmethacrylate (PMMA) have been reported. The authors present a case of radiculopathy caused by cement leakage from sacroplasty, treated with surgical decompression of the compromised nerve root. The patient presented with left S-1 radiculopathy and was found on CT to have a left S-1 nerve root completely encased in PMMA over a portion of its length. The patient underwent sacral laminectomy with the removal of PMMA and experienced pain relief and the return of function postoperatively. Surgical removal of PMMA extravasated during sacroplasty is feasible and should be considered when nerve root compression or canal stenosis causes pain or neurological deficit refractory to conservative therapy. PMID:23521686

Barber, Sean M; Livingston, Andrew D; Cech, David A

2013-03-22

54

Population dynamics along a primary succession gradient: do alpine species fit into demographic succession theory?  

PubMed Central

Background and Aims Understanding processes and mechanisms governing changes in plant species along primary successions has been of major importance in ecology. However, to date hardly any studies have focused on the complete life cycle of species along a successional gradient, comparing pioneer, early and late-successional species. In this study it is hypothesized that pioneer species should initially have a population growth rate, ?, greater than one with high fecundity rates, and declining growth rates when they are replaced by late-successional species. Populations of late-successional species should also start, at the mid-successional stage (when pioneer species are declining), with growth rates greater than one and arrive at rates equal to one at the late successional stage, mainly due to higher survival rates that allow these species to persist for a long time. Methods The demography of pioneer- (Saxifraga aizoides), early (Artemisia genipi) and late-successional species (Anthyllis vulneraria ssp. alpicola) was investigated together with that of a ubiquitous species (Poa alpina) along the Rotmoos glacier foreland (2300–2400 m a.s.l., Central Alps, Austria) over 3 years. A matrix modelling approach was used to compare the main demographic parameters. Elasticity values were plotted in a demographic triangle using fecundity, individual growth and survival as vital rates contributing to the population growth rates. Key Results The results largely confirmed the predictions for population growth rates during succession. However, high survival rates of larger adults characterized all species, regardless of where they were growing along the succession. At the pioneer site, high mortality rates of seedlings, plantlets and young individuals were recorded. Fecundity was found to be of minor relevance everywhere, but it was nevertheless sufficient to increase or maintain the population sizes. Conclusions Demographically, all the species over all sites behaved like late-successional or climax species in secondary successions, mainly relying on survival of adult individuals. Survival serves as a buffer against temporal variation right from the beginning of the primary succession, indicating a major difference between primary and secondary succession.

Marcante, Silvia; Winkler, Eckart; Erschbamer, Brigitta

2009-01-01

55

Percutaneous sacroplasty.  

PubMed

The recognition of sacral insufficiency fractures continues to be poor, and diagnosis is often delayed resulting in significant morbidity. Percutaneous sacroplasty is an image guided procedure that is safe and potentially effective for treating the pain and disability related to these fractures. Several cohort studies reviewed here report successful outcomes using this procedure, with patients experiencing nearly full pain relief immediately and longitudinally. As with the well proven results from percutaneous vertebral augmentation within the thoracic and lumbar spine, sacroplasty reduces the cost associated with bed rest and physical therapy and allows patients to return to activities of daily living sooner than with conservative therapy. PMID:22003050

Gupta, Amar C; Yoo, Albert J; Stone, Jeffrey; Barr, John C; Brook, Allan; Tutton, Sean; Ortiz, Orlando; Hirsch, Ariel E; Larvie, Mykol; Frey, Michael E; Jayaraman, Mahesh V; Hirsch, Joshua A

2011-10-15

56

Recurrent cardiac tamponade following unusual micro leak after successful closure of the primary leak.  

PubMed

Although uncommon, coronary artery perforation is one of the most dreadful complications of percutaneous coronary intervention, which requires prompt, aggressive, and effective management. Perforations induced by coronary guidewires are usually located in the distal part of a coronary artery and commonly managed with embolization. This is an unusual case report of guidewire-induced coronary perforation with recurrent cardiac tamponade, which was managed successfully by coil embolization of both ipsilateral and contralateral coronary arteries via transradial approach. PMID:22388314

Baruah, Dibya Kumar; Lakshmi, Adi; Chandrashekaran, Vidya

2012-03-01

57

Percutaneous Mitoxantrone Injection for Primary and Secondary Liver Tumors: Preliminary Results  

SciTech Connect

Purpose: To determine the effects of percutaneous intratumoral chemotherapy with mitoxantrone (PIM) in the palliative treatment of malignant liver lesions. Methods: We treated 15 progressive lesions in nine patients in whom either previous therapy failed or serious complications developed as a result. Seven lesions were metastatic and eight were due to foci of hepatocellular carcinoma. Under computed tomography (CT) guidance, we percutaneously injected 10-20 mg of mitoxantrone mixed with 0.5 ml of contrast medium into the tumor, performing one to three treatments at intervals of 1 month. Results: There were no complications. The morphologic responses of the tumors after treatment were: minor response in one case, no change in 11 cases, progressive disease in three cases. Mitoxantrone induced tumor necrosis with no viable cancer tissue in eight of 11 biopsies. Recurrence was observed in nine of the treated lesions 2-9 months after treatment. New lesions were observed in five of nine patients 1-9 months after treatment. Conclusion: In patients with malignant liver lesions with no other therapeutic possibilities, minimally invasive intratumoral mitoxantrone injection was carried out safely with good tumor delivery of chemotherapy, and tumor necrosis was demonstrated at biopsy. We feel this approach warrants further investigation.

Farres, Maria Teresa; Baere, Thierry de; Lagrange, Christine [Department of Interventional Radiology, Institut Gustave Roussy, 39 rue Camille Desmoulins, F-94805 Villejuif (France); Ramirez, Luis [Laboratoire de Pharmacotoxicologie et Pharmacogenetique, Institut Gustave Roussy, 39 rue Camille Desmoulins, F-94805 Villejuif (France); Rougier, Phillipe; Munck, Jean-Nicolas [Department of Medicine, Institut Gustave Roussy, 39 rue Camille Desmoulins, F-94805 Villejuif (France); Roche, Alain [Department of Interventional Radiology, Institut Gustave Roussy, 39 rue Camille Desmoulins, F-94805 Villejuif (France)

1998-09-15

58

30 Comparison of bivalirudin vs abciximab vs “unfractionated heparin only” for primary percutaneous coronary intervention in a high-volume centre  

Microsoft Academic Search

IntroductionPrimary percutaneous coronary intervention (PPCI) has been established as a standard therapy for ST elevation myocardial infarction (STEMI). In addition to thrombectomy and unfractionated heparin (UFH), thrombus burden in STEMI may require use of more potent antithrombotic agents. Bivalirudin is shown to be superior to abciximab in reducing the net adverse clinical events and major bleeding in STEMI in the

R Showkathali; J Davies; N Malik; W Taggu; J Sayer; R Aggarwal; P Kelly

2011-01-01

59

Assessment and Learning in the Primary School. Successful Teaching Series.  

ERIC Educational Resources Information Center

Noting that improving the quality of learning in primary schools and preparing children for a long, complex life in the twenty-first century requires the highest quality of teaching and professional training, this book is part of a series to improve teachers' skills in the classroom. The book is intended to offer primary school teachers a means of…

Wragg, E. C.

60

A survey of primary percutaneous coronary intervention for patients with ST segment elevation myocardial infarction in Canadian hospitals  

PubMed Central

BACKGROUND: Historically, access to primary percutaneous coronary intervention (PCI) for the treatment of patients with ST segment elevation myocardial infarction (STEMI) has been limited in Canada. Recent studies have identified innovative strategies to improve timely access and reduce reperfusion time. Accordingly, the contemporary use of primary PCI treatment in Canada was ascertained. METHODS: A cross-sectional survey of all 38 Canadian hospitals that were capable of performing PCI procedures was conducted from June 2007 to November 2007. The survey focused on the practice of primary PCI for patients with STEMI and whether the hospitals had implemented internal strategies to reduce ‘door-to-balloon’ times. Analyses were performed at the level of geographical regions. RESULTS: Overall, 71% of PCI hospitals (27 of 38) provided around-the-clock primary PCI for patients with STEMI, but the proportion of PCI hospitals offering this service varied widely, from 33% to 100% across regions. All Canadian PCI hospitals provided around-the-clock rescue PCI treatment to STEMI patients who had failed fibrinolytic therapy. In terms of strategies that are associated with reduced reperfusion time, it was observed that only 42% of PCI hospitals (16 of 38) provided feedback on door-to-balloon time to the emergency department and to the cardiac catheterization laboratories within one week of the primary PCI procedure. Overall, 24% of the hospitals had not adopted any of the four identified strategies to improve door-to-balloon time. CONCLUSION: Although the majority of Canadian hospitals with PCI capability provide around-the-clock primary PCI for patients with STEMI, significant variations in this practice exist across the country. Canadian PCI hospitals have not consistently adopted strategies that are associated with improved door-to-balloon time.

Ko, Dennis T; Donovan, Linda R; Huynh, Thao; Rinfret, Stephane; So, Derek Y; Love, Michael P; Galbraith, Diane; Tu, Jack V

2008-01-01

61

Times to Treatment in Transfer Patients Undergoing Primary Percutaneous Coronary Intervention in the United States: National Registry of Myocardial Infarction (NRMI)-3\\/4 Analysis  

Microsoft Academic Search

Background—Treatment delays in patients with ST-segment-elevation myocardial infarction (STEMI) transferred for primary percutaneous coronary intervention (PCI) may decrease the advantage of this strategy over on-site fibrinolytic therapy that has been demonstrated in recent clinical trials. Accordingly, we sought to describe patterns of times to treatment in patients undergoing interhospital transfer for primary PCI in the United States. Methods and Results—We

Brahmajee K. Nallamothu; Eric R. Bates; Jeph Herrin

2005-01-01

62

Data feedback reduces door-to-balloon time in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention  

Microsoft Academic Search

Current guidelines recommend a goal of door-to-balloon (D2B) time < 90 min for patients undergoing primary percutaneous coronary\\u000a intervention (PCI) for ST-elevation myocardial infarction (STEMI). We aim to prospectively determine the effect of data feedback\\u000a on D2B time and its seven individual components in primary PCI. From December 7, 2007, to June 2, 2009, 116 consecutive patients\\u000a with STEMI who received PCI within

Jeng-Feng Lin; Shun-Yi Hsu; Semon Wu; Chiau-Suong Liau; Heng-Chia Chang; Chih-Jen Liu; Hsuan-Li Huang; Yao-Tsan Ho; Shu-Li Weng; Yu-Lin Ko

2011-01-01

63

Histopathological Features of Aspirated Thrombi after Primary Percutaneous Coronary Intervention in Patients with ST-Elevation Myocardial Infarction  

PubMed Central

Background Plaque disruption with superimposed thrombus is the predominant mechanism responsible for the onset of acute coronary syndromes. Studies have shown that plaque disruption and thrombotic occlusion are frequently separated in time. We established the histopathological characteristics of material aspirated during primary percutaneous coronary intervention (PCI) in a large consecutive ST-elevation myocardial infarction (STEMI) population. Methodology/Principal Findings Thrombus aspiration during primary PCI was performed in 1,362 STEMI patients. Thrombus age was classified as fresh (<1 day), lytic (1–5 days), or organized (>5 day). Further, the presence of plaque was documented. The histopathological findings were related to the clinical, angiographic, and procedural characteristics. Material could be aspirated in 1,009 patients (74%). Components of plaque were found in 395 of these patients (39%). Fresh thrombus was found in 577 of 959 patients (60%) compared to 382 patients (40%) with lytic or organized thrombi. Distal embolization was present in 21% of patients with lytic thrombus compared to 12% and 15% of patients with fresh or organized thrombus. Conclusions/Significance Material could be obtained in 74% of STEMI patients treated with thrombus aspiration during primary PCI. In 40% of patients thrombus age is older than 24 h, indicating that plaque disruption and thrombus formation occur significantly earlier than the onset of symptoms in many patients.

Kramer, Miranda C.; van der Wal, Allard C.; Koch, Karel T.; Rittersma, Saskia Z.; Li, Xiaofei; Ploegmakers, Hanneke P.; Henriques, Jose P.; van der Schaaf, Rene J.; Baan, Jan; Vis, Marije M.; Meesterman, Martin G.; Piek, Jan J.; Tijssen, Jan G.; de Winter, Robbert J.

2009-01-01

64

Successful treatment of a chronic post-traumatic 5-year-old osteoporotic vertebral compression fracture by percutaneous vertebroplasty  

Microsoft Academic Search

Osteoporotic vertebral compression fracture (VCF) is a frequently encountered clinical problem associated with chronic pain and disability. Conservative treatment in the form of bed rest, pain control and bracing may create a vicious circle, in which reduced activity leads to further reduction in bone density and fracture risk. Percutaneous vertebroplasty (PVP) is an accepted treatment modality for osteoporotic vertebral body

F G Irani; J P MORALES; T SABHARWAL; R DOURADO; A GANGI

2005-01-01

65

Percutaneous Nephroscopic Surgery  

PubMed Central

With the development of techniques for percutaneous access and equipment to disintegrate calculi, percutaneous nephroscopic surgery is currently used by many urologists and is the procedure of choice for the removal of large renal calculi and the management of diverticula, intrarenal strictures, and urothelial cancer. Although it is more invasive than shock wave lithotripsy and retrograde ureteroscopic surgery, percutaneous nephroscopic surgery has been successfully performed with high efficiency and low morbidity in difficult renal anatomies and patient conditions. These advantages of minimal invasiveness were rapidly perceived and applied to the management of ureteropelvic junction obstruction, calyceal diverticulum, infundibular stenosis, and urothelial cancer. The basic principle of endopyelotomy is a full-thickness incision of the narrow segment followed by prolonged stenting and drainage to allow regeneration of an adequate caliber ureter. The preferred technique for a calyceal diverticulum continues to be debated. Excellent long-term success has been reported with percutaneous, ureteroscopic, and laparoscopic techniques. Each approach is based on the location and size of the diverticulum. So far, percutaneous ablation of the calyceal diverticulum is the most established minimally invasive technique. Infundibular stenosis is an acquired condition usually associated with inflammation or stones. Reported series of percutaneously treated infundibular stenosis are few. In contrast with a calyceal diverticulum, infundibular stenosis is a more difficult entity to treat with only a 50-76% success rate by percutaneous techniques. Currently, percutaneous nephroscopic resection of transitional cell carcinoma in the renal calyx can be applied in indicated cases.

2010-01-01

66

Primary Students' Success on the Structured Number Line  

ERIC Educational Resources Information Center

Number lines are part of people's everyday life and are frequently used in primary mathematics as instructional aids, in texts, and for assessment purposes on mathematics tests. There are two types of number lines; (1) structured number lines, which are the focus of this paper; and (2) empty number lines. Structured number lines represent…

Diezmann, Carmel M.; Lowrie, Tom; Sugars, Lindy A.

2010-01-01

67

Immunoglobulin Replacement Therapy in Primary Antibody Deficiency Diseases – Maximizing Success  

Microsoft Academic Search

Antibody or humoral immunodeficiencies comprise the largest group of primary immunodeficiency diseases. Since the first description of patients with low gammaglobulin levels more than four decades ago, a great wealth of information has been accumulated. Especially in the last several years, the application of molecular and genetic techniques has unraveled many of these disorders, identifying disorders of B cell development,

Anne Durandy; Volker Wahn; Steve Petteway; Erwin W. Gelfand

2005-01-01

68

Successful Percutaneous Retrieval of an Inferior Vena Cava Filter Migrating to the Right Ventricle in a Bariatric Patient  

SciTech Connect

The use of an inferior vena cava filter has an important role in the management of patients who are at high risk for development of pulmonary embolism. Migration is a rare but known complication of inferior vena cava filter placement. We herein describe a case of a prophylactic retrievable vena cava filter migrating to the right ventricle in a bariatric patient. The filter was retrieved percutaneously by transjugular approach and the patient did well postoperatively. A review of the current literature is given.

Veerapong, Jula [University of Chicago Hospitals, Department of General Surgery (United States); Wahlgren, Carl Magnus, E-mail: carl.wahlgren@karolinska.s [University of Chicago Hospitals, Section of Vascular Surgery, Department of Surgery (United States); Jolly, Neeraj [University of Chicago Hospitals, Section of Interventional Cardiology, Department of Medicine (United States); Bassiouny, Hisham [University of Chicago Hospitals, Section of Vascular Surgery, Department of Surgery (United States)

2008-07-15

69

Successful thoracoscopic sympathectomy for primary erythromelalgia in the upper extremities  

Microsoft Academic Search

Erythromelalgia is known as a rare syndrome of unknown etiology, characterized by redness with burning pain, edema associated\\u000a with increased skin temperature in the upper and\\/or lower extremities. Various treatments such as drug therapies and sympathetic\\u000a blockade were reported. We report two cases including a 57-year-old woman and a 64-year-old woman, showing the successful\\u000a clinical outcome by bilateral thoracoscopic sympathectomy.

Yuki Nakajima; Kiyoshi Koizumi; Tomomi Hirata; Kyoji Hirai; Atsuhiro Sakamoto; Kazuo Shimizu

2004-01-01

70

Methanogen communities along a primary succession transect of mire ecosystems.  

PubMed

Peat accumulating mires are important sources of the greenhouse gas methane. Methane emissions and methanogenic Archaea communities have been shown to differ between fens and bogs, implying that mire succession includes an ecological succession in methanogen communities. We investigated methane production and the methanogen communities along a chronosequence of mires (ca. 100-2,500 years), which consisted of five sites (1-5) located on the land-uplift coast of the Gulf of Bothnia. Methane production was measured in a laboratory incubation experiment. Methanogen communities were determined by amplification of a methyl coenzyme M-reductase (mcr) gene marker and analyzed by terminal-restriction fragment length polymorphism. The terminal-restriction fragment length polymorphism fingerprinting resulted in 15 terminal restriction fragments. The ordination configuration of the terminal restriction fragments data, using nonmetric multidimensional scaling, showed a clear gradient in the methanogen community structure along the mire chronosequence. In addition, fingerprint patterns of samples from the water table level and 40 cm below differed from one another in the bog site (site 5). Methane production was negligible in the three youngest fen sites (sites 1-3) and showed the highest rates in the oligotrophic fen site (site 4). Successful PCR amplification using mcr gene primers revealed the presence of a methanogen community in all five sites along the study transect. PMID:16420630

Merilä, Päivi; Galand, Pierre E; Fritze, Hannu; Tuittila, Eeva-Stiina; Kukko-Oja, Kari; Laine, Jukka; Yrjälä, Kim

2006-02-01

71

Nicorandil in Patients with Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis  

PubMed Central

Background Nicorandil, as an adjunctive therapy with primary percutaneous coronary intervention (PCI), had controversial benefits in cardioprotection in patients with acute myocardial infarction (AMI). Methods and Results We performed a systematic review of randomized controlled trials (RCTs) comparing treatment with nicorandil prior to reperfusion therapy with control (placebo or no nicorandil) in patients who suffered from AMI and performed primary PCI. PubMed, EMBASE and CENTRAL databases and other sources were searched without language and publication restriction. 14 trials involving 1680 patients were included into this meta-analysis. Nicorandil significantly reduced the incidence of thrombolysis in myocardial infarction (TIMI) flow grade ?2 (risk ratio [RR], 0.57; 95% confidence interval [CI]: 0.42 to 0.79), the Timi frame count (TFC) (mean difference [MD], -5.19; 95% CI: -7.13 to -3.26), increased left ventricular ejection fraction (LVEF) (%) (MD, 3.08; 95% CI: 0.79 to 5.36), and reduced the incidence of ventricular arrhythmia (RR, 0.53; 95% CI: 0.37 to 0.76) and congestive heart failure (CHF) (RR, 0.41; 95% CI: 0.22 to 0.75). No difference in the pear creatine kinase (CK) value (MD, -290.19; 95% CI: -793.75 to 213.36) or cardiac death (RR, 0.39; 95% CI: 0.09 to 1.67) was observed. Conclusions Nicorandil prior to reperfusion is associated with improvement of coronary reflow as well as suppression of ventricular arrhythmia, and further improves left ventricular function in patients who suffered from AMI and underwent primary PCI. But the definite clinical benefits of nicorandil were not found, which may be due to the small sample size of the selected studies.

Xie, Haojun; Zhou, Zhongjiang

2013-01-01

72

Primary localized cutaneous nodular amyloidosis successfully treated with cyclophosphamide.  

PubMed

Primary localized cutaneous nodular amyloidosis (PLCNA) is a rare subtype of localized cutaneous amyloidosis and can be associated with various connective tissue disorders. It can be difficult to treat and past therapies include surgical excision, dermabrasion, electrodessication and curettage, cryotherapy and laser therapy. We present a case of a middle-aged woman with PLCNA associated with CREST (calcinosis, Raynaud phenomenon, oesophageal motility disorders, sclerodactyly and telangiectasia) syndrome and Sjögren's syndrome responding to cyclophosphamide with no new amyloid deposits and resolution of skin ulceration after many years of resistance to drug therapy. It is important to monitor these patients for progression into systemic amyloidosis. PMID:23373889

Tong, Philip L; Walker, William A; Glancy, Ross J; Cooney, Julian P; Gebauer, Kurt

2011-05-31

73

Shared learning for primary health care teams: a success story.  

PubMed

This paper sets out an educational model for shared learning for professionals working in primary health care teams (PHCTs). It presents an outline of an experiential educational programme using a simulated learning exercise based on a genogram. Multidisciplinary programmes are inherently problematic and tend to be ad hoc in their choice of educational theory. It was therefore our intention to discover the educational principles and theory that underpinned our innovative educational experience and to offer some fundamental criteria for the planning of future shared learning sessions in PHCTs. The process chosen to make the theory explicit was, 'reflecting on a critical incident' (Reed & Proctor 1993, Tripp 1993). PMID:9277164

Howkins, E; Allison, A

1997-06-01

74

The Relationship between Hemoglobin A1c and Major Adverse Cardiac Events in Nondiabetic Acute Myocardial Infarction Patients Underwent Primary Percutaneous Coronary Intervention  

Microsoft Academic Search

Background and Objectives:Hyperglycemia on hospital admission is a known important risk factor in patients with acute myocardial infarction. The purpose of this study was to investigate the relation between the level of he- moglobin A1c (HbA1c) and major adverse cardiac events (MACE) in non-diabetic acute myocardial infarction patients who underwent primary percutaneous coronary intervention (PCI). Subjects and Methods:Of the 105

Yeon Sang Lee; Myung Ho Jeong; Kye Hun Kim; Dong Goo Kang; Kyung Ho Yun; Sang Hyun Lee; Sang Yup Lim; Seo Na Hong; Hyung Wook Park; Young Joon Hong; Ju Han Kim; Weon Kim; Young Keun Ahn; Jeong Gwan Cho; Jong Chun Park

75

Impact of Insulin-Requiring diabetes mellitus on effectiveness of reperfusion and outcome of patients undergoing primary percutaneous coronary intervention for acute myocardial infarction  

Microsoft Academic Search

The relation between diabetes mellitus (DM) and outcome was assessed in a series of 1,061 patients with acute myocardial infarction (AMI) who underwent primary percutaneous coronary intervention (PCI). The efficacy of reperfusion was assessed by ST-segment resolution analysis. Of 1,061 patients, 166 had DM (15.6%), and 84 had insulin-requiring DM (51% of DM patients). The 6-month mortality rate was 26%

David Antoniucci; Renato Valenti; Angela Migliorini; Guido Parodi; Guia Moschi; Gentian Memisha; Giovanni Maria Santoro; Giampaolo Cerisano

2004-01-01

76

Comparison of Primary Percutaneous Coronary Intervention and Fibrinolytic Therapy in ST-Segment-Elevation Myocardial Infarction Bayesian Hierarchical Meta-Analyses of Randomized Controlled Trials and Observational Studies  

Microsoft Academic Search

Background—Published meta-analyses comparing primary percutaneous coronary intervention with fibrinolytic therapy in patients with ST-segment-elevation myocardial infarction include only randomized controlled trials (RCTs). We aim to obviate the limited applicability of RCTs to real-world settings by undertaking meta-analyses of both RCTs and observational studies. Methods and Results—We included all RCTs and observational studies, without language restriction, published up to May 1,

Thao Huynh; Stephane Perron; Jennifer O'Loughlin; Lawrence Joseph; Michel Labrecque; Jack V. Tu; Pierre Théroux

77

Effects of nitrogen deposition on soil and vegetation in primary succession stages in inland drift sands  

Microsoft Academic Search

Background and aims Primary succession was studied in acid inland drift sands. Main research questions were: 1) How do vegetation and soil change during succession? 2) How are soil parameters and species abundance affected by atmospheric nitrogen deposition? Methods One hundred sixty-five plots were selected in 21 drift sands throughout The Netherlands, divided over eight succession stages from bare sand

L. B. Sparrius; J. Sevink; A. M. Kooijman

2012-01-01

78

SYNTAX Score Predicts the Left Ventricle Thrombus Development in Patients Undergoing Primary Percutaneous Coronary Intervention for First Anterior Myocardial Infarction.  

PubMed

Objectives: The aim of this study is to investigate the relationship between left ventricular thrombus (LVT) developments and the SYNTAX score (SS) in patients undergoing primary percutaneous coronary intervention (PPCI) for first anterior wall ST-segment elevation myocardial infarction (STEMI). Methods: We enrolled 160 patients. All participants were evaluated by serial transthoracic echocardiography. Baseline clinical, echocardiographic, and procedural features of PPCI were analyzed to find predictors of LVT development. Results: The LVT was detected in 32 (20%) patients. Left ventricular ejection fraction (LVEF) and SS-I were found to be independent predictors of LVT development. Receiver-operating characteristic curve analysis revealed a cutoff value >19.5 for SS-I (area under the curve: 0.697, 95% confidence interval 0.620-0.767, P < .001) with a specificity of 45.3% and a sensitivity of 84.3%. Conclusion: High SS which was obtained through diagnostic angiogram of PPCI may be associated with LVT development in patients with first anterior wall STEMI. PMID:23434922

Gökdeniz, Tayyar; Boyaci, Faruk; Hatem, Engin; Aslan, Ahmet Oguz; Aykan, Ahmet Çagri; Gül, Ilker; Turan, Turhan; Kalaycioglu, Ezgi; Celik, Sükrü

2013-02-22

79

The role of von Willebrand factor and ADAMTS13 in the no-reflow phenomenon: after primary percutaneous coronary intervention.  

PubMed

We prospectively studied the correlations between plasma levels of von Willebrand factor and its cleaving protease--a disintegrin and metalloproteinase with thrombospondin type I motif, member 13 (ADAMTS13)--in 126 patients who did or did not develop no-reflow phenomenon after primary percutaneous intervention for acute ST-segment-elevation myocardial infarction. Quantitative plasma levels of von Willebrand factor and ADAMTS13 were measured by immunoturbidometric assay.Angiographic no-reflow was observed in 46 (37%) of the 126 patients. At admission, plasma levels of von Willebrand factor were significantly higher in the no-reflow group (P < 0.001), but levels of ADAMTS13 at admission were similar in the 2 groups (P = 0.143). At logistic regression, after adjustment for serum creatinine, left ventricular ejection fraction, high-sensitivity C-reactive protein, and N-terminal pro B-type natriuretic peptide, plasma von Willebrand factor level at admission (? 5,531 mU/mL) was still the predictive factor for the no-reflow phenomenon. The area under the receiver operating characteristics curve was 0.785.Our results suggest that high von Willebrand factor level is related to the no-reflow phenomenon in such a way that it might be a predictor of the phenomenon. PMID:22163125

Zhao, Bilian; Li, Jian; Luo, Xinping; Zhou, Qing; Chen, Hua; Shi, Haiming

2011-01-01

80

Percutaneous transluminal angioplasty of the lower extremities by the vascular surgeon.  

PubMed

As vascular surgeons, we performed 376 percutaneous transluminal angioplasties as follows: aorta and iliac arteries (148), infrainguinal arteries (191), and bypass grafts (21). Sixteen procedures were attempted but not completed. Neodymium-yttrium-aluminum-garnet laser thermoprobe was successfully used prior to balloon dilatations in 49 procedures. In contrast to our experience with operative intervention, percutaneous transluminal angioplasty was performed more frequently for claudication (75%), nondiabetics (72%), and women (45%). Median age was 71 years. Percutaneous transluminal angioplasty either preceded or followed proximal or distal open reconstruction in 58 extremities. Primary patency rates for iliac percutaneous transluminal angioplasties were: 94% at one month, 93% at six months, and 88% at one year. For infrainguinal percutaneous transluminal angioplasties they were 95%, 82%, and 70% at 1, 6, and 12 months, respectively. Repeat percutaneous transluminal angioplasty increased the one-year patency rates to 92% and 86% for iliac and infrainguinal percutaneous transluminal angioplasties, respectively. Preliminary data indicate that the six-month secondary patency rates were 82% for laser-assisted percutaneous transluminal angioplasty and 65% for percutaneous transluminal angioplasty of distal bypass grafts. The implementation of balloon angioplasty was facilitated by our 21 years of experience with arteriography. Percutaneous transluminal angioplasty has become a valuable adjunct to the practice of vascular surgery by expanding the therapeutic options for managing peripheral vascular occlusive disease. PMID:1831647

Harris, R W; Dulawa, L B; Andros, G; Oblath, R W; Salles-Cunha, S X; Apyan, R L

1991-07-01

81

Hypercoagulation Assessed by Thromboelastography is Neither Related to Infarct Size nor to Clinical Outcome After Primary Percutaneous Coronary Intervention.  

PubMed

Objectives: We investigated the relationship between coagulation assessed by thromboelastography (TEG) and myocardial damage in ST-segment elevation myocardial infarction (STEMI). Methods: We measured platelet activity with TEG-maximum amplitude (TEG-MA) in 233 patients undergoing urgent percutaneous coronary intervention (PCI). Infarct size and myocardial salvage index were evaluated using cardiac magnetic resonance, and the relation of these parameters to posttreatment coagulation was examined retrospectively. Adverse events were adjudicated and related to the coagulation status during the index event. Results: Hypercoagulation was found in 82 (35.2%) patients and was neither correlated to infarct size nor correlated to myocardial salvage index (P = .28 and .65, respectively) or clinical adverse events. Patients who experienced an adverse event during follow-up had a slightly higher TEG-MA value than patients with an event-free follow-up, but this was not statistically significant (68.1 vs 67.3, P = .44). Conclusions: The TEG-MA does not appear to be a sensitive predictor of reperfusion success and prognosis in urgent PCI for STEMI. PMID:23613040

Paarup Dridi, Nadia; Lønborg, Jacob T; Radu, Maria D; Clemmensen, Peter; Engstrøm, Thomas; Kelbæk, Henning; Jørgensen, Erik; Helqvist, Steffen; Saunamäki, Kari; Christensen, Troels H; Baeres, Florian M M; Johansson, Pär I; Holmvang, Lene

2013-05-01

82

Percutaneous Transluminal Revascularization following an Angiotensin Receptor Blocker: Successful Treatment for Flash Pulmonary Edema and Hyponatremic Hypertensive Syndrome  

PubMed Central

Either flash pulmonary edema or hyponatremic hypertensive syndrome has been described in renal artery stenosis. However, coexistence of these two disorders has never been previously reported. We describe a patient who presented with flash pulmonary edema and hyponatremic hypertensive syndrome associated with bilateral renal artery disease (one complete occlusion, one highly critical renal artery stenosis, the equivalent of unilateral stenosis of a solitary functioning kidney). His blood pressure, hyponatremia, and symptoms of acute heart failure were much improved by an angiotensin receptor blocker. After the procedure of percutaneous transluminal revascularization, his stenotic kidney function and serum sodium levels were completely restored.

Shao, Leping; Gao, Yanxia; Xu, Yan; Lang, Yanhua

2012-01-01

83

Key aspects for successful immunoglobulin therapy of primary immunodeficiencies  

PubMed Central

Immunoglobulin (Ig) therapy is the mainstay for treatment in the majority of primary immune deficiencies. While B cell defects are the predominant conditions in man, other diseases in which T cell dysfunction is severe also require antibody replacement. In many medical practices the phenotypic overlap between immune deficiency and symptoms of asthma leads to both missed opportunities for diagnosing immune defects and inappropriate Ig treatment of asthmatic patients with normal B cell function. As steroid therapy can lower serum IgG levels, this finding alone is an insufficient indicator for Ig replacement. In the past 3 decades, there has a gradual increase in recommended and commonly used doses of parenteral immune globulin, often based on both IgG trough levels and clinical responses. Special attention to Ig doses is needed for growing children, in cases of weight loss or gain, pregnancy and for subjects in whom more rapid consumption of Ig is likely, including febrile patients or those with gastrointestinal or lung disease. While acute bacterial infections are much less common in Ig-treated subjects, a number of reports note continued evidence of inflammatory complications. Monitoring patients over time includes, at minimum, physical examination, blood counts and chemistry screening tests and IgG trough levels, at 6–12-month intervals. Other monitoring tools include spirometry and at wider intervals with those with lung disease, carbon monoxide diffusion capacity and chest computed tomography scans. With careful selection of patients and adequate therapy, an improved quality of life is possible.

Cunningham-Rundles, C

2011-01-01

84

Microvascular obstruction after primary percutaneous coronary intervention: pathogenesis, diagnosis and prognostic significance.  

PubMed

The primary goal in reopening an infarct-related artery is the restoration of myocardial tissue-level perfusion. In a variable proportion of patients with ST-elevation myocardial infarction, however, microcirculatory impairment may persist after epicardial coronary artery recanalization. This phenomenon is known as microvascular obstruction (MVO). Ischemic injury, reperfusion injury, and distal embolization along with the individual response to each of these mechanisms are variably involved in the pathogenesis of MVO in the single patient. Importantly, MVO is associated with a worse prognosis both at short- and long-term follow-up. MVO can be assessed in the cath-lab by simple angiographic indexes, such as Thrombolysis in Myocardial Infarction grade score and Myocardial Blush Grade, or by invasive measures of coronary flow pattern. Imaging techniques, such as myocardial contrast echocardiography or cardiac magnetic resonance, and ST-segment resolution on standard electrocardiogram are used in the days following reperfusion with the patient in the coronary care unit. In this article, we review the available data regarding pathogenesis, diagnosis and the prognostic significance of MVO after primary percurtaneous coronary intervention in ST-elevation myocardial infarction patients, with a brief highlighting on the crucial role of its prevention and its early detection. PMID:23506502

Niccoli, Giampaolo; Cosentino, Nicola; Minelli, Silvia; Cataneo, Leonardo; Crea, Filippo

2013-03-01

85

Relationship of admission hematological indexes with myocardial reperfusion abnormalities in acute ST segment elevation myocardial infarction patients treated with primary percutaneous coronary interventions  

PubMed Central

BACKGROUND: Elevated values of mean platelet volume (MPV) and elevated white blood cell (WBC) count are predictors of an unfavourable outcome among survivors of ST segment elevation myocardial infarction (STEMI). However, their relationship with reperfusion abnormalities is less clear. OBJECTIVE: To evaluate the value of admission MPV and WBC count in predicting impaired reperfusion in patients with acute STEMI who are treated with primary percutaneous coronary intervention (PCI). METHODS: Blood samples were obtained on admission from 368 STEMI patients who underwent successful PCI. According to the 60th minute ST segment resolution ratio, patients were divided into impaired reperfusion and reperfusion groups. RESULTS: Impaired reperfusion was detected in 40% of study patients. Patients in the impaired reperfusion group had a higher admission MPV (9.8±1.3 fL versus 8.6±1.0 fL; P<0.001) and a higher WBC count (14.4±5.5×109/L versus 12.1±3.8×109/L; P<0.001) compared with the patients in the reperfusion group. In regression analysis, MPV (OR 2.21, 95% CI 1.69 to 2.91; P<0.001) and WBC count (OR 1.08, 95% CI 1.02 to 1.15; P=0.01) were found to be independently associated with impaired reperfusion. The best cut-off value of MPV for predicting impaired reperfusion was determined to be 9.05 fL, with a sensitivity of 74% and a specificity of 73%. CONCLUSIONS: The results indicate that leukocytes and platelets have a role in the mediation of reperfusion injury. In patients with STEMI who are undergoing PCI, admission MPV may be valuable in discriminating a higher-risk patient subgroup and thus, may help in deciding the need for adjunctive therapy to improve the outcome.

Maden, Orhan; Kacmaz, Fehmi; Selcuk, Hatice; Selcuk, Mehmet T; Aksu, Tolga; Tufekcioglu, Omac; Senen, Emir K; Balbay, Yucel; Ilkay, Erdogan

2009-01-01

86

Access to primary percutaneous coronary intervention for ST-segment elevation myocardial infarction in Canada: a geographic analysis  

PubMed Central

Background Primary percutaneous coronary intervention (PCI) is preferred over fibrinolysis for the treatment of ST-segment elevation myocardial infarction (STEMI). In the United States, nearly 80% of people aged 18 years and older have access to a PCI facility within 60 minutes. We conducted this study to evaluate the areas in Canada and the proportion of the population aged 40 years and older with access to a PCI facility within 60, 90 and 120 minutes. Methods We used geographic information systems to estimate travel times by ground transport to PCI facilities across Canada. Time to dispatch, time to patient and time at the scene were considered in the overall access times. Using 2006 Canadian census data, we extracted the number of adults aged 40 years and older who lived in areas with access to a PCI facility within 60, 90 and 120 minutes. We also examined the effect on these estimates of the hypothetical addition of new PCI facilities in underserved areas. Results Only a small proportion of the country’s geographic area was within 60 minutes of a PCI facility. Despite this, 63.9% of Canadians aged 40 and older had such access. This proportion varied widely across provinces, from a low of 15.8% in New Brunswick to a high of 72.6% in Ontario. The hypothetical addition of a single facility to each of 4 selected provinces could increase the proportion by 3.2% to 4.3%, depending on the province. About 470 000 adults would gain access in such a scenario of new facilities. Interpretation We found that nearly two-thirds of Canada’s population aged 40 years and older had timely access to PCI facilities. The proportion varied widely across the country. Such information can inform the development of regionalized STEMI care models.

Patel, Alka B; Tu, Jack V; Waters, Nigel M; Ko, Dennis T; Eisenberg, Mark J; Huynh, Thao; Rinfret, Stephane; Knudtson, Merril L; Ghali, William A

2010-01-01

87

Determinants and patterns of utilization of primary percutaneous coronary intervention across 12 European countries: 2003-2008.  

PubMed

BACKGROUND: Important differences exist between European countries in the degree of implementation of primary percutaneous coronary intervention (PPCI) for patients with ST-elevation myocardial infarction (STEMI). To investigate whether health care-associated economic and demographic country-level characteristics were associated with differences in utilization of PPCI, we aimed to examine 5-year trends in the implementation of PPCI for STEMI across 12 EU countries. METHODS: An ecological study of aggregated data from national and international registries. Main outcome was the number of PPCI per 1,000,000 population, collected annually for the years 2003 to 2008. Impact of year on PPCI implementation was modeled using linear regression and mixed effects models used to quantify associations between PPCI use and country-level parameters. RESULTS: The annual growth in utilization of PPCI was 1.11 (1.03,1.20) per million. Country-level utilization rates varied from 0.82 (95% CI 0.52, 1.30) to 1.38 (95% CI 1.15, 1.64) per million per year. Number of physicians per 100,000 population, number of nurses and midwifes per 100,000 population, number of acute care beds per 100,000 population, population density per km(2), and proportion of population under 50years old were associated with PPCI utilization. CONCLUSIONS: All 12 EU countries demonstrated evidence of PPCI implementation from 2003 to 2008. However, there was substantial variation in the use and rate of uptake of PPCI between countries. Differences in utilization rates of PPCI are associated with supply factors, such as numbers of beds and physicians, rather than healthcare economic characteristics. Further studies are needed to explore the influence of patient-level factors. PMID:23608389

Laut, Kristina Grønborg; Gale, Christopher Peter; Lash, Timothy L; Kristensen, Steen Dalby

2013-04-19

88

Successful treatment of intraoperative heart failure caused by ampulla cardiomyopathy by intra-aortic balloon pumping and percutaneous cardiopulmonary support: report of a case.  

PubMed

An 82-year-old woman underwent total gastrectomy for advanced gastric cancer with invasion to the lower esophagus. Her blood pressure dropped alarmingly during the operation, which was performed via the transabdominal and left-side transthoracic approach. Using echocardiography, we diagnosed intraoperative-onset reversible heart failure caused by ampulla cardiomyopathy. Because the infusion of catecholamines is associated with secondary heart failure, we gave her calcium antagonists and nicorandil, then started intra-aortic balloon pumping (IABP) and the percutaneous cardiopulmonary support system (PCPS). On postoperative day (POD) 7, the IABP and PCPS were removed and on POD 12, she was extubated successfully. The patient was discharged on POD 54 and has remained well. The factors predisposing her to ampulla cardiomyopathy were left-side thoracotomy, hypoxia caused by one-lung ventilation, and the infusion of high-dose catecholamines. Prompt diagnosis and timely treatment of the heart failure with IABP and PCPS prevented any further complications. PMID:16175470

Yabuuchi, Shin-ichi; Miura, Koh; Shiiba, Ken-ichi; Shibata, Chikashi; Ishii, Seiichi; Mizoi, Takayuki; Ejima, Yutaka; Horinouchi, Takashi; Iwabuchi, Kaoru; Oda, Katsuhiko; Unno, Michiaki; Morita, Rina; Nagaya, Koichi; Nitta, Yoshio; Matsuno, Seiki; Sasaki, Iwao

2005-01-01

89

Relationships among Preservice Primary Mathematics Teachers' Gender, Academic Success and Spatial Ability  

ERIC Educational Resources Information Center

|The aim of this work is to investigate relationships among pre-service primary mathematics teachers' gender, academic success and spatial ability. The study was conducted in Izmir with 193 pre-service primary mathematics teachers of Dokuz Eylul University. In the work, spatial ability test, which consists of two main sub-tests measuring spatial…

Turgut, Melih; Yilmaz, Suha

2012-01-01

90

Success rate of formocresol pulpotomy in primary molars restored with stainless steel crown vs amalgam  

Microsoft Academic Search

Purpose: The purpose of this retrospective study was to compare the success rates of formocresol pulpotomy in primary molars restored with stainless steel crowns (SSC) to those restored with amalgam (AM). Methods: Radiographs of pulpotomized primary molars restored with SSC or AM in the principal author's pediatric dentist practice were evaluated and defined as a \\

Gideon Holan; Anna B. Fuks

2002-01-01

91

Strategies for and Successes with Promoting Social Integration in Primary Schools in Canada and China  

ERIC Educational Resources Information Center

|This study examined social integration in 11 primary schools in Canada and 19 primary schools in China as reported by teachers in terms of the strategies employed to promote social integration and success in achieving social integration. Structured interviews were conducted with 64 Canadian and 52 Chinese general education teachers. The results…

Dyson, Lily

2012-01-01

92

The relationship of coronary flow to neutrophil/lymphocyte ratio in patients undergoing primary percutaneous coronary intervention  

PubMed Central

Purpose It has been known that inflammatory mechanisms play an important role in the coronary artery disease. Our aim in this study was to investigate the relationship between the neutrophil/lymphocyte (N/L) ratio and coronary flow velocity after primary percutaneous coronary intervention (PCI) in patients presenting with ST-segment elevation myocardial infarction (STEMI). Methods Two hundred and ten patients who had undergone primary PCI were included. The coronary flow velocities were evaluated using the recorded PCI procedures by Thrombolysis in Myocardial Infarction (TIMI) flow grades and corrected TIMI frame counts (cTFC) values. A value of >40 for the final cTFC was accepted as an index of insufficient coronary blood flow. The white blood cell subtypes and counts were determined in the blood samples obtained at the clinics. Results In 165 (78%) of the investigated patients, reperfusion was found to be sufficient (Group I) while in 45 (22%) of them (Group II) insufficient reperfusion was observed (Group II). In-hospital mortality was 7.2% (n=12) in Group I, whereas it was 17.7% (n=8) in Group II (P=0.033). Similarly, one-year mortality was higher in Group II (26.6%, n=12) than in Group I (13.3%, n=22) (P=0.031). N/L ratio was determined to be higher in Group I than in Group II (8.3±6.1 vs. 6.2±5.0; P=0.034). Also, N/L ratio was found as an independent predictor of severe no-reflow development (TIMI 0-1) and of one-year mortality (P=0.01 and P=0.047, respectively). Conclusions N/L ratio has been found to be an independent indicator for no-reflow development in patients who have undergone PCI for acute STEMI. This simple and low-cost parameter can provide useful information for the relevant risk evaluation in these patients.

Yuksel, Serkan; Gulel, Okan; Erbay, Ali Riza; Meric, Murat; Zengin, Halit; Museyibov, Muhtar; Yasar, Erdogan; Demircan, Sabri

2013-01-01

93

Successful use of a new Amplatzer® Vascular plug for percutaneous closure of a large aortopulmonary collateral artery in a pulmonary atresia with ventricular septal defect prior to complete repair  

Microsoft Academic Search

We report the case of a 14 year-old girl with a pulmonary atresia with VSD and multiple aortopulmonary collaterals who underwent a successful complementary occlusion of a large collateral vessel using an Amplatzer® vascular plug after a previously failed attempt of occlusion with a coil. The percutaneous procedure, performed from the femoral artery before the complete surgical repair, provided an immediate

C. Tissot; E. da Cruz; M. Beghetti; Y. Aggoun

2007-01-01

94

Impact of Pulmonary Artery Stiffness on Right Ventricular Function and Tricuspid Regurgitation after Successful Percutaneous Balloon Mitral Valvuloplasty: The Importance of Early Intervention.  

PubMed

Aims: We assessed impact of pulmonary artery stiffness (PAS) on the long-term right ventricular (RV) function and tricuspid regurgitation (TR) changes after percutaneous balloon mitral valvuloplasty (PBMV). Methods and Results: Using Doppler echocardiography, PAS was calculated by dividing maximal frequency shift of pulmonary flow by the acceleration time, and mitral area, RV function, and degree of TR severity were evaluated before, immediately after, 6 months, and 12 months after successful PBMV in 81 consecutive patients. Compared with control subjects patients with mitral stenosis (MS) had significant higher PAS (P < 0.001). The PAS was significantly lower in patients with progressive RV function improvement and regression of TR (P < 0.001). PAS was significantly correlated with the degree of pulmonary artery systolic pressure (PASP), tricuspid annular plane systolic excursion (TAPSE), and E/E'm ratio (P < 0.0001, <0.0001, and < 0.001, respectively). Multivariate regression analysis showed that the PAS is an independent predictor of TR regression and sustained RV functional improvement after successful PBMV (P < 0.0001). Conclusions: The changes in RV function and TR after successful PBMV were significantly correlated with the degree of PAS. Despite a sustained increase in mitral valve area, some patients showed no regression of TR, and progressive RV dysfunction suggests a significant role of PAS on RV function and the degree of TR regression in patients with MS suggests that PBMV must be performed early, utilizing PAS as a noninvasive parameter for proper timing for PBMV. PMID:22897621

Mahfouz, Ragab A

2012-08-17

95

Current considerations in direct percutaneous endoscopic jejunostomy  

PubMed Central

BACKGROUND: Direct percutaneous endoscopic jejunostomy (DPEJ) is a well-known approach to deliver postpyloric enteral nutritional support to individuals who cannot tolerate gastric feeding. However, it is technically difficult, and some case series have reported significant procedural failure rates. The present article describes current indications, successes and complications of DPEJ placement METHODS: A MEDLINE database search was performed to identify relevant articles using the key words “direct percutaneous endoscopic jejunostomy”, “percutaneous endoscopic gastrostomy”, and “percutaneous endoscopic gastrostomy with a jejunal extension tube”. Additional articles were identified by a manual search of the references cited in the key articles obtained in the primary search. RESULTS: DPEJ is gradually becoming more common in the treatment of patients who cannot tolerate gastric feeding. Differences in patient selection and technique modifications may contribute to the various success rates reported. Failure is most often due to inadequate transillumination or gastroduodenal obstruction. Currently, there are limited data to evaluate the safety and effectiveness of DPEJ. CONCLUSION: The clinical use of DPEJ is increasing. With appropriate care and expertise, DPEJ may prove to be reliable and safe.

Zhu, Yanfei; Shi, Liping; Tang, Hao; Tao, Guoqing

2012-01-01

96

The contrast medium volume to estimated glomerular filtration rate ratio as a predictor of contrast-induced nephropathy after primary percutaneous coronary intervention  

Microsoft Academic Search

Background  Contrast-induced nephropathy (CIN) is a serious complication in percutaneous coronary intervention (PCI) patients, which may\\u000a be related to the contrast dose used during cardiac catheterization.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We prospectively investigated 277 consecutive consenting patients with acute ST-segment elevation myocardial infarction (STEMI)\\u000a who were given primary PCI, and we calculated their ratio of volume of contrast media to estimated glomerular filtration rate\\u000a (V\\/eGFR).

Yong Liu; Ning Tan; Ying-Ling Zhou; Peng-Cheng He; Jian-Fang Luo; Ji-Yan Chen

97

Direct Primary or Secondary Percutaneous Ureteral Stenting: What Is the Most Compliant Option in Patients with Malignant Ureteral Obstructions?  

SciTech Connect

The objective of this study was to analyze three ureteral stenting techniques in patients with malignant ureteral obstructions, considering the indications, techniques, procedural costs, and complications. In the period between June 2003 and June 2006, 45 patients with bilateral malignant ureteral obstructions were evaluated (24 males, 21 females; average age, 68.3; range, 42-87). All of the patients were treated with ureteral stenting: 30 (mild strictures) with direct stenting (insertion of the stent without predilation), 30 (moderate/severe strictures) with primary stenting (insertion of the stent after predilation in a one-stage procedure), and 30 (mild/moderate/severe strictures with infection) with secondary stenting (insertion of the stent after predilation and 2-3 days after nephrostomy). The incidence of complications and procedural costs were compared by a statistical analysis. The primary technical success rate was 98.89%. We did not observe any major complications. The minor complication rate was 11.1%. The incidence of complications for the various techniques was not statistically significantly. The statistical analysis of costs demonstrated that the average cost of secondary stenting ( Euro 637; SD, Euro 115) was significantly higher than that of procedures which involved direct or primary stenting ( Euro 560; SD, Euro 108). We conclude that one-step stenting (direct or primary) is a valid option to secondary stenting in correctly selected patients, owing to the fact that when the procedure is performed by expert interventional radiologists there are high technical success rates, low complication rates, and a reduction in costs.

Carrafiello, Gianpaolo, E-mail: gcarraf@tin.it; Lagana, Domenico; Lumia, Domenico; Giorgianni, Andrea; Mangini, Monica; Santoro, Domenico [University of Insubria, Radiology Department (Italy); Cuffari, Salvatore [University of Insubria, Anesthesia Department (Italy); Marconi, Alberto [University of Insubria, Urology Department (Italy); Novario, Raffaele [University of Insubria, Physical Medicine Department (Italy); Fugazzola, Carlo [University of Insubria, Radiology Department (Italy)

2007-09-15

98

Rationale and design of EXPLORE: a randomized, prospective, multicenter trial investigating the impact of recanalization of a chronic total occlusion on left ventricular function in patients after primary percutaneous coronary intervention for acute ST-elevation myocardial infarction  

PubMed Central

Background In the setting of primary percutaneous coronary intervention, patients with a chronic total occlusion in a non-infarct related artery were recently identified as a high-risk subgroup. It is unclear whether ST-elevation myocardial infarction patients with a chronic total occlusion in a non-infarct related artery should undergo additional percutaneous coronary intervention of the chronic total occlusion on top of optimal medical therapy shortly after primary percutaneous coronary intervention. Possible beneficial effects include reduction in adverse left ventricular remodeling and preservation of global left ventricular function and improved clinical outcome during future coronary events. Methods/Design The Evaluating Xience V and left ventricular function in Percutaneous coronary intervention on occLusiOns afteR ST-Elevation myocardial infarction (EXPLORE) trial is a randomized, prospective, multicenter, two-arm trial with blinded evaluation of endpoints. Three hundred patients after primary percutaneous coronary intervention for ST-elevation myocardial infarction with a chronic total occlusion in a non-infarct related artery are randomized to either elective percutaneous coronary intervention of the chronic total occlusion within seven days or standard medical treatment. When assigned to the invasive arm, an everolimus-eluting coronary stent is used. Primary endpoints are left ventricular ejection fraction and left ventricular end-diastolic volume assessed by cardiac Magnetic Resonance Imaging at four months. Clinical follow-up will continue until five years. Discussion The ongoing EXPLORE trial is the first randomized clinical trial powered to investigate whether recanalization of a chronic total occlusion in a non-infarct related artery after primary percutaneous coronary intervention for ST-elevation myocardial infarction results in a better preserved residual left ventricular ejection fraction, reduced end-diastolic volume and enhanced clinical outcome. Trial registration trialregister.nl NTR1108.

2010-01-01

99

Reconstruction of an interrupted primary beach plain succession using a Geographical Information System  

Microsoft Academic Search

This study reports on a primary succession on a beach plain on the Dutch Wadden island of Schiermonnikoog. Vegetation succession\\u000a started in 1959 when a sand dike was constructed to prevent structural erosion of the area by storm floods. Since then the\\u000a sandy beach behind the dike has been protected from the direct influence of the North Sea. Heavy storms

A. van der Veen; A. P. Grootjans; J. de Jong; J. Rozema

1997-01-01

100

Embolization of Bleeding Stomal Varices by Direct Percutaneous Approach  

SciTech Connect

Stomal varices can occur in patients with stoma in the presence of portal hypertension. Suture ligation, sclerotherapy, angiographic embolization, stoma revision, beta blockade, portosystemic shunt, and liver transplantation have been described as therapeutic options for bleeding stomal varices. We report the case of a 21-year-old patient with primary sclerosing cholangitis and colectomy with ileostomy for ulcerative colitis, where stomal variceal bleeding was successfully treated by direct percutaneous embolization. We consider percutaneous embolization to be an effective way of treating acute stomal bleeding in decompensated patients while awaiting decisions regarding shunt procedures or liver transplantation.

Arulraj, Ramakrishnan, E-mail: arulraas@yahoo.com [Queen Elizabeth Hospital, Liver Unit (United Kingdom); Mangat, Kamarjit S., E-mail: Kamarjit.mangat@uhb.nhs.uk [Queen Elizabeth Hospital, Department of Radiology (United Kingdom); Tripathi, Dhiraj, E-mail: d.tripathi@bham.ac.uk [Queen Elizabeth Hospital, Liver Unit (United Kingdom)

2011-02-15

101

Percutaneous antegrade transarterial treatment of iatrogenic radial arteriovenous fistula.  

PubMed

Site of access vascular complications is infrequent after transradial interventions. We report the case of a 66-year-old man referred to our hospital because of right forearm swelling, oedema and pain with functional forearm disability, 1 year after a transradial primary percutaneous coronary intervention (PCI). The diagnostic and procedural issues are discussed. This is the first description of a successful and well-tolerated radial arteriovenous fistula (AVF) treatment by means of percutaneous antegrade approach with the use of a short introducer and a biocompatible covered stent. PMID:21532499

Summaria, Francesco; Romagnoli, Enrico; Preziosi, Paolo

2012-01-01

102

Relative efficacy of bivalirudin versus heparin monotherapy in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention: a network meta-analysis  

PubMed Central

In the absence of head-to-head clinical data, the objective of this study was to indirectly compare the efficacy and safety of a bivalirudin-based anticoagulation strategy with that of heparin monotherapy in patients with ST-elevation myocardial infarction (STEMI) intended for primary percutaneous coronary intervention. A systematic literature review was performed to identify randomized controlled trials to build a network of bivalirudin and heparin monotherapy strategies in STEMI patients using heparin, with glycoprotein IIb/IIIa inhibitor as a common reference strategy. At 30 days, the bivalirudin-based strategy was expected to result in lower mortality rates than heparin monotherapy (odds ratio [OR], 0.55; credible limit [CrL], 0.32–0.95). This relationship was sustained at 1 year. At 30 days, the risk for stroke (OR, 0.88; CrL, 0.37–2.13), myocardial infarction (OR, 0.79; CrL, 0.40–1.55), and thrombolysis in myocardial infarction major and minor bleedings (OR, 0.66; CrL, 0.45–0.98) tended to be numerically reduced with bivalirudin in comparison with heparin monotherapy. For patients with STEMI intended for primary percutaneous coronary intervention, bivalirudin is associated with lower mortality rates in comparison with heparin monotherapy. This study suggests that bivalirudin is more effective and safer than heparin monotherapy and should therefore be preferred over heparin monotherapy.

Kinnaird, Tim; Medic, Goran; Casella, Gianni; Schiele, Francois; Kaul, Upendra; Radke, Peter W; Eijgelshoven, Indra; Bergman, Gert; Chew, Derek P

2013-01-01

103

Season of Birth and School Success in the Early Years of Primary Education  

ERIC Educational Resources Information Center

|Several studies have reported significant relationships between children's season of birth and measures of their academic success (i.e., the "season of birth effect"). Whereas most of these studies were cross-sectional, the current study uses growth curve modelling to analyse longitudinal data on 3,187 children in Flemish primary education. The…

Verachtert, Pieter; De Fraine, Bieke; Onghena, Patrick; Ghesquiere, Pol

2010-01-01

104

Some Ecological Characteristics of the Primary Trophic Level of a Secondary Succession  

Microsoft Academic Search

Simultaneous studies have been made of the macroscopic organisms of a series of sites in a secondary succession to determine the extent to which the bionomic strategies of the organisms and the features of the communities show consistent patterns or trends. In the estimation of primary productivity allowance was made for turnover. Although standing crop and litter biomass increased through

T. R. E. Southwood; V. K. Brown; P. M. Reader; E. Mason

1988-01-01

105

Synthesized Comprehension Instruction in Primary Classrooms: A Story of Successes and Challenges  

Microsoft Academic Search

This 8-month qualitative study investigated 3 primary classrooms' implementation of a synthesized approach to comprehension instruction that incorporated vocabulary development, cognitive strategies, and responsive engagement. Three themes emerged, including successes and challenges in (a) the implementation of the separate components of the synthesis approach, (b) the gradual release of responsibility, and (c) the classroom logistics involved in the implementation of

Katherine A. Dougherty Stahl

2009-01-01

106

Season of Birth and School Success in the Early Years of Primary Education  

ERIC Educational Resources Information Center

Several studies have reported significant relationships between children's season of birth and measures of their academic success (i.e., the "season of birth effect"). Whereas most of these studies were cross-sectional, the current study uses growth curve modelling to analyse longitudinal data on 3,187 children in Flemish primary education. The…

Verachtert, Pieter; De Fraine, Bieke; Onghena, Patrick; Ghesquiere, Pol

2010-01-01

107

Successful ?en bloc resection of primary hepatocellular carcinoma directly invading the stomach and pancreas  

Microsoft Academic Search

Multivisceral surgical resection for cure was success- fully performed in a 70-year-old man suffering from a primary hepatocellular carcinoma (HCC) associated with direct invasion to the stomach and pancreas. The patient presented with gastric outlet obstruction, upper abdominal pain and a history of chronic liver disease due to hepatitis B virus (HBV) infection. Upper gastro- intestinal (GI) endoscopy revealed an

Dimitris P Korkolis; Chrysanthi Aggeli; George D; George D Plataniotis; Emmanuel Gontikakis; Helen Zerbinis; Nikitas Papantoniou; Dimitris Xinopoulos; Nikiforos Apostolikas; Perikles P Vassilopoulos

2009-01-01

108

Successful percutaneous coronary intervention in a patient with combined deficiency of FV and FVIII due to novel compound heterozygous mutations in LMAN1.  

PubMed

Percutaneous coronary intervention (PCI) in patients with congenital coagulation factor deficiencies presents a unique challenge. They are not only at increased risk of perioperative bleeding but can also suffer thrombosis of the stent as preventive anticoagulation and antiplatelet therapy is difficult. Several cases of successful PCI have been described in patients with haemophilia A and B, but there are no reports in patients with combined coagulation factor deficiencies. We used PCI to treat the coronary artery disease in a patient with the combined deficiency of factor V and factor VIII (F5F8D) and analysed the molecular basis of the disorder for this patient. A 68-year-old patient was admitted for urgent PCI with bare metal stent placement after the diagnosis of the F5F8D. Peripheral blood DNA was extracted for the sequence analysis of LMAN1 and MCFD2 genes. Mutations in LMAN1 was confirmed by molecular cloning of the PCR product and resequencing of the resulting clones. The patient underwent successful PCI with good long-term outcome. Our patient tolerated anticoagulation therapy well, with unfractionated heparin, and double antiplatelet therapy while he was initially supported with fresh frozen plasma and recombinant FVIII. Molecular analysis revealed that the patient carries unusual compound heterozygous frameshift mutations on the same microsatellite repeat region in exon 8 of LMAN1, one of which is a novel mutation (c.912delA). Our results suggest that patients with F5F8D can safely undergo PCI for coronary artery disease, with the treatment individualized to the specific patient. PMID:23557496

Patel, A J; Liu, H-H; Lager, R A; Malkovska, V; Zhang, B

2013-04-05

109

Percutaneous vertebroplasty or kyphoplasty.  

PubMed

Percutaneous vertebral augmentation techniques performed with vertebroplasty or kyphoplasty are safe and effective for the treatment of osteoporotic vertebral compression fractures, primary or secondary spine tumors, and selected traumatic fractures. This article compares the procedures and outlines their advantages and disadvantages. It concludes that vertebroplasty should be performed in most cases, but kyphoplasty is preferable in selected cases. PMID:20609898

Anselmetti, G C; Muto, M; Guglielmi, Giuseppe; Masala, S

2010-05-01

110

PBS-American Field Guide: Primary and Secondary Succession in America's Forests  

NSDL National Science Digital Library

From PBS-American Field Guide, this website offers high school educators a multimedia lesson plan on Primary and Secondary Succession in America's Forests. The lesson plan utilizes hyperlinked video clips to introduce students "to several different North American Forests while learning about concepts associated with succession in both natural and disturbed environments." The site contains descriptions of two 30-minute, in-class activities, as well as a slightly longer outdoor observation activity. The concise activity descriptions include needed Materials, Objectives, Teaching Instructions, and Discussion Questions. A few corresponding National Content Standards are also listed.

111

Evaluation of the Restoration Success of Endodontic Therapy of the Primary Molars  

PubMed Central

Objectives: The aim of this study was to evaluate the clinical and radiographic success rates of pulpotomized primary molar teeth restored with a compomer material with using United States Public Health Service (USPHS) criteria. Methods: In 173 primary molars of 156 child patients, aged within 4–9 years (mean age: 6.1±1.4 years), conventional pulpotomy treatment were performed. The teeth treated using calcium hydroxide, formocresol or ferric sulphate. After pulpotomy procedure, teeth were restored with compomer material. The teeth were evaluated as clinically and radiographically during a period of 12–24 months. Both of success of pulpotomy treatment and also restorative material (compomer material) were evaluated during follow-up period. The data were assessed with chi-square test. Results: At the end of the first year, 45% of initial treated teeth were checked, but only 18% were checked at the end of the second year. The first year success rates in the groups treated with CH, FC, and FS were 87.5%, 95%, and 79%, respectively, and, as the number of controllable patients was lower, the success rates on available teeth were determined to be 88.3% and 80%, respectively, according to the materials at the end of the second year. Restorations having been made, they were analyzed in accordance with USPHS criteria. Conclusions: At the end of the first year, 67.5% of compomer restorations were detected to be original and healthy and at the end of the second year, 57% were deemed healthy. No statistically significant relationships were found between marginal adaptation, secondary caries and pulpotomy success (chi-square test, P>.05). Among the three groups, there is no significant difference in terms of success. The least successful age group was defined as 4–6 years.

Kirzioglu, Zuhal; Gungor, Ozge Erken; Ciftci, Z. Zahit

2011-01-01

112

Successful treatment of persistent hypoxemia by nasal suctioning in a neonate with primary ciliary dyskinesia.  

PubMed

Primary ciliary dyskinesia (PCD) is a genetic disorder that manifests clinically with chronic sinopulmonary and otologic disease. Despite the majority of patients presenting with respiratory symptoms in the neonatal period, the diagnosis is often delayed until several years of age. We report the case of a 5-day-old male who was diagnosed with PCD by electron microscopic evaluation of cilia obtained from nasal brush biopsy. This case also demonstrated the successful treatment of persistent hypoxemia with frequent nasal suctioning. PMID:24027700

Molchan, Sonia L; Hsu, Daniel P

2012-04-01

113

Spatial factors affecting primary succession on the Muddy River Lahar, Mount St. Helens, Washington  

Microsoft Academic Search

Primary succession is controlled by a combination of landscape and habitat factors whose actions may be stochastic or deterministic.\\u000a The 1980 eruption of Mount St. Helens, Washington spawned a massive lahar that now supports a mosaic of vegetation. Our goals\\u000a were to describe vegetation patterns after 28 growing seasons, determine the factors associated with these patterns, and to\\u000a contrast the

R. del Moral; J. E. Sandler; C. P. Muerdter

2009-01-01

114

Recurrent abscess after primary successful endo-sponge treatment of anastomotic leakage following rectal surgery  

PubMed Central

AIM: To assess long-term efficacy of initially successful endo-sponge assisted therapy. METHODS: Between 2006 and 2009, consecutive patients who had undergone primary successful endo-sponge treatment of anastomotic leakage following rectal cancer surgery were enrolled in the study. Patients were recruited from 6 surgical departments in Vienna. Clinical and oncologic outcomes were assessed through routine endoscopic and radiologic follow-up examination. RESULTS: Twenty patients (7 female, 13 male) were included. The indications for endo-sponge treatment were anastomotic leakage (n = 17) and insufficiency of a rectal stump after Hartmann’s procedure (n = 3). All patients were primarily operated for rectal cancer. The overall mortality rate was 25%. The median follow-up duration was 17 mo (range 1.5-29.8 mo). Five patients (25%) developed a recurrent abscess. Median time between last day of endo-sponge therapy and occurrence of recurrent abscess was 255 d (range 21-733 d). One of these patients was treated by computed tomography-guided drainage and in 3 patients Hartmann’s procedure had to be performed. Two patients (10%) developed a local tumor recurrence and subsequently died. CONCLUSION: Despite successful primary outcome, patients who receive endo-sponge therapy should be closely monitored in the first 2 years, since recurrence might occur.

Riss, Stefan; Stift, Anton; Kienbacher, Caroline; Dauser, Bernhard; Haunold, Ingrid; Kriwanek, Stefan; Radlsboek, Wolfgang; Bergmann, Michael

2010-01-01

115

Percutaneous balloon pulmonary valvuloplasty.  

PubMed Central

Percutaneous pulmonary valvuloplasty was performed in 27 patients with congenital pulmonary valve stenosis. A fall in the transvalve gradient of at least 15 mm Hg occurred in 22 patients. In five there was little change in the severity of the stenosis; in three of these the pulmonary valve was dysplastic. None of the successfully treated patients had a dysplastic valve. The two other failures, early in the series, were probably due to inadequate balloon size. In one patient the procedure was performed twice, with a successful result from the second dilatation with a larger balloon. Follow up studies in a further six patients showed no evidence of restenosis in those who had been successfully treated and no late improvement in the remainder. There were no important complications. Percutaneous pulmonary valvuloplasty should be the initial treatment for congenital pulmonary valve stenosis, although when the valve is dysplastic the result is less likely to be satisfactory. Images

Tynan, M; Baker, E J; Rohmer, J; Jones, O D; Reidy, J F; Joseph, M C; Ottenkamp, J

1985-01-01

116

Effect of prolonged Bivalirudin infusion on ST-segment resolution following primary percutaneous coronary intervention (from the PROBI VIRI 2 study).  

PubMed

Bivalirudin is widely used as an anticoagulant during percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction. However, an increase in acute stent thrombosis rates has been found in the HORIZONS-AMI trial. A prolonged infusion after PCI has been shown to be a safe and effective tool in patients undergoing urgent or elective PCI in the PROBI VIRI study. We examined the effects of prolonged drug infusion after primary PCI. From databases of 5 high-volume centers we compared a group of patients treated with a 4-hour prolonged infusion after PCI to 2 groups treated with a peri-PCI infusion and heparin plus abciximab. The primary study end point was >70% ST-segment resolution within 90 minutes after PCI; secondary end points were partial (>50%) ST-segment resolution within 90 minutes and intrahospital major and minor bleedings on the Acuity scale. The study population consisted of 264 patients undergoing primary PCI who were pretreated with aspirin and clopidogrel. The 3 study groups did not differ significantly by baseline characteristics. The primary end point was achieved in 69.8%, 48.8%, and 69.6% of patients in the prolonged bivalirudin, bivalirudin, and heparin/abciximab groups, respectively (p = 0.048 for prolonged vs standard infusion, p = 0.98 for prolonged infusion vs abciximab). Major bleedings and other secondary study end points were not significantly different among study groups. In conclusion, a strategy of prolonged bivalirudin infusion after primary PCI seems equivalent to a strategy with heparin plus abciximab, with an improvement in standard infusion in obtaining early microvascular reperfusion. PMID:21855837

Cortese, Bernardo; Limbruno, Ugo; Severi, Silva; De Matteis, Sara; Diehl, Livia; Pitì, Antonio

2011-08-17

117

Catheter thrombosis during primary percutaneous coronary intervention for acute ST elevation myocardial infarction despite subcutaneous low-molecular-weight heparin, acetylsalicylic acid, clopidogrel and abciximab pretreatment  

PubMed Central

BACKGROUND Subcutaneous enoxaparin is increasingly employed as the antithrombin of choice in non-ST elevation myocardial infarction and in conjunction with various fibrinolytic regimens in acute ST elevation myocardial infarction (STEMI). Few data exist describing the use of subcutaneous or intravenous enoxaparin as an anticoagulant in the highly thrombotic setting of primary percutaneous coronary intervention (PCI) for STEMI. METHODS The Which Early ST Elevation Therapy (WEST) study compared fibrinolysis (with and without early cardiac catheterization) with primary PCI in a setting that expedited both strategies on first medical contact. Patients assigned primary PCI are administered acetylsalicylic acid 325 mg, clopidogrel 300 mg and subcutaneous enoxaparin 1 mg/kg before transport to a PCI centre. Of 36 initial patients treated with primary PCI, three patients had procedures that were complicated by extensive thrombosis within coronary catheters and on PCI equipment. RESULTS Index cases were men aged 43 to 68 years who presented with confirmed STEMI and angiographically proven acute total or subtotal occlusion of a major epicardial coronary segment. During PCI, performed 76 min to 102 min following enoxaparin administration, a clot developed within the guide catheter or on the coronary guidewires and balloon catheter shafts, thus necessitating the replacement of all PCI equipment. In one case, there was evidence of continued intracoronary clot propagation and embolization. CONCLUSION A single, conventional, weight-adjusted dose of subcutaneous enoxaparin before expedited primary PCI for STEMI may not provide a reliable antithrombotic effect. Supplementary intravenous enoxaparin is now strongly recommended within the WEST study, and a substudy evaluating pre- and postprocedural antifactor Xa activity has been initiated.

Buller, Christopher E; Pate, Gordon E; Armstrong, Paul W; O'Neill, Blair J; Webb, John G; Gallo, Richard; Welsh, Robert C

2006-01-01

118

Aortocoronary bypass graft fistula after surgical treatment of circumflex coronary artery fistula: a unique variation of a rare condition successfully treated with percutaneous embolization.  

PubMed

Multiple coronary artery fistulae are rare, complications can be life-threatening, and with large or symptomatic fistulae, intervention is mandatory. Both surgical and percutaneous interventions are well-described. We believe this is the first report of the embolization of an acquired fistula following initial surgical treatment of multiple congenital fistulae. PMID:19903688

White, Ralph W; Sivananthan, Mohan U; Kay, Philip H

2009-11-10

119

Complete versus culprit-only revascularization during primary percutaneous coronary intervention in ST-elevation myocardial infarction patients with multivessel disease: a meta-analysis.  

PubMed

Complete versus culprit-only revascularization in acute ST-elevation myocardial infarction (STEMI) patients with multivessel disease is controversial. Current guidelines recommend treatment of the culprit artery alone during the primary procedure. However, with improvements in stent technique and with the use of new antiplatelet drugs (GP IIb/IIIa inhibitors), complete revascularization (CR) at an early stage is attracting increasing attention. We conducted an English language search on Medline (PubMed database), Embase, and the Cochrane databases between January 1966 and January 2011, as well as a search on the China National Knowledge Internet (1979-January 2011), and the Chinese Biomedical Literature Database (1978-January 2011). Randomized controlled trials (RCTs) or non-RCTs that compared the two strategies in patients with STEMI and multivessel disease (MVD) during primary percutaneous coronary intervention (PCI) were included. Thirteen articles were selected, 8240 patients in the CR group and 51,998 in the culprit-only revascularization group. CR was associated with an increased short-term mortality [odds ratio (OR) = 1.39, 95% confidence interval (CI) = (1.26, 1.53)], a long-term mortality [OR = 1.35, 95% CI = (1.09, 1.67)], and an increased risk of renal failure [OR (95% CI) = 1.24 (1.11, 1.38)] in patients with STEMI and MVD at the primary procedure. In addition, CR did not reduce the rate of short-term major adverse cardiac events [OR (95% CI) = 1.52 (0.88, 2.61)] and remyocardial infarction [OR = 0.57, 95% CI = (0.25, 1.29)]. However, CR was associated with a marked reduction in the rate of revascularization [OR = 0.45, 95% CI = (0.27, 0.74)]. This analysis of current available data demonstrates that CR during primary PCI can put those patients with STEMI and MVD at risk. To clarify this issue, large RCTs are needed. PMID:23465417

Lu, Cong; Huang, Hao; Li, Jing; Zhao, Jianxun; Zhang, Qing; Zeng, Zhi; Chen, Yucheng

2012-11-21

120

Successful Triple Immuno - Enzymatic Method Employing Primary Antibodies from Same Species and Same Immunoglobulin Subclass  

PubMed Central

Protocols for immunohistochemical (IHC) detection of multiple antigens in the same tissue sections have been developed using primary antibodies directly conjugated to different enzymes or fluorochromes, or ones that have been raised in different species, or from different immunoglobulin (Ig) classes or subclasses. For antibodies lacking such dissimilarities, very few proposals have been published with varying degrees of generalizability. In this report we present a successful triple IHC protocol engaging three unconjugated monoclonal primary antibodies raised in the same species and of the same Ig subclass. Compared to other methods, our results showed that denaturation of the preceding reaction complex by microwave heating, combined with additional suppression of enzyme activity, enabled the detection of all three reactions by using the same detection system, with no cross reaction observed. Moreover, expression patterns of each of the three antigens in the triple stained sections, was found to be similar to the pattern observed when single staining was performed. Unlike previous reports, no damage of targeted antigens or tissues did occur following this protocol. Furthermore, the contrast of the colors employed was investigated by computerized color deconvolution, and the three reactions products were successfully separated into three individual images that could be used for further objective quantification.

Osman, T.A.; ?ijordsbakken, G.; Costea, D.E.; Johannessen, A.C.

2013-01-01

121

Successful triple immunoenzymatic method employing primary antibodies from same species and same immunoglobulin subclass.  

PubMed

Protocols for immunohistochemical (IHC) detection of multiple antigens in the same tissue sections have been developed using primary antibodies directly conjugated to different enzymes or fluorochromes, or ones that have been raised in different species, or from different immunoglobulin (Ig) classes or subclasses. For antibodies lacking such dissimilarities, very few proposals have been published with varying degrees of generalizability. In this report we present a successful triple IHC protocol engaging three unconjugated monoclonal primary antibodies raised in the same species and of the same Ig subclass. Compared to other methods, our results showed that denaturation of the preceding reaction complex by microwave heating, combined with additional suppression of enzyme activity, enabled the detection of all three reactions by using the same detection system, with no cross reaction observed. Moreover, expression patterns of each of the three antigens in the triple stained sections, was found to be similar to the pattern observed when single staining was performed. Unlike previous reports, no damage of targeted antigens or tissues did occur following this protocol. Furthermore, the contrast of the colors employed was investigated by computerized color deconvolution, and the three reactions products were successfully separated into three individual images that could be used for further objective quantification. PMID:24085271

Osman, T A; Oijordsbakken, G; Costea, D E; Johannessen, A C

2013-09-16

122

[Dynamics of biomass and net primary productivity in succession of south subtropical forests in southwest Guangdong].  

PubMed

Coniferous forest (Pinus massoniana community), pine-borad leaved mixed forest (Pinus massoniana + Castanopsis kawakamii + Schima superba + Liquidambar formosana) and evergreen broad-leaved forest (Ixonanthes chinensis + Artocarpus styacifolius + Ormosia glaberrima + Cryptocarya concinna) are the three main communities representing 3 major stages in a secondary succession series in Heishiding Nature Reserve, Guangdong Province. Their biomass and net primary productivity (NPP) were studied by using harvest method (for trees and lianas) and clear cut method (for shrub and herb). The biomass and NPP were 246.697 t.hm-2 and 14.715 t.hm-2.yr-1 for the coniferous forest, 287.367 t.hm-2 and 17.179 t.hm-2.yr-1 for the pine-broad leaved mixed forest, and 357.976 t.hm-2 and 18.730 t.hm-2 yr-1 for the evergreen broad-leaved forest, respectively. These results indicated that these three stages were very close in the succession process, and that coniferous forest and mixed forest were more mature, while broad-leaved forest was relatively young. Therefore, under the conditions of no or only minor disturbance, their biomass and NPP showed an increasing trend with the succession of the forest communities in Heishiding. PMID:15031902

Yang, Qingpei; Li, Mingguang; Wang, Bosun; Li, Renwei; Wang, Changwei

2003-12-01

123

Percutaneous pyelolysis.  

PubMed

Pelvi-ureteric junction obstruction has been treated in 3 patients using a percutaneous modification of the Davis intubated ureterostomy technique. A 10-French tube is introduced into the obstructed upper ureter through a percutaneous nephrostomy puncture. Full thickness incision of the upper ureter and pelvi-ureteric junction is then carried out using a standard endoscopic urethrotome. The splint tube and diverting proximal nephrostomy remain in situ for 1 month. Good drainage was established in 2 cases following de-tubing. Further cases are under study. PMID:6852083

Wickham, J E; Kellet, M J

1983-01-01

124

Transfer Times and Outcomes in ST-Elevations Myocardial Infarction Patients Undergoing Inter-Hospital Transfer for Primary Percutaneous Coronary Intervention: APEX-AMI Insights  

PubMed Central

Background Transfer delays for primary percutaneous coronary intervention (PPCI) may increase mortality in patients with ST-segment elevation myocardial infarction (STEMI). We examined the association between door 1 to door 2 (D1D2) time, a measure capturing the entire transfer process, and outcomes in patients undergoing inter-hospital transfer for primary PCI. Methods and Results We evaluated the relationship between D1D2 time and the 90 day incidence of death, shock, and heart failure in the sub-set of 2075 (36.1%) of 5745 patients who underwent inter-hospital transfer for PPCI in the APEX-AMI trial. There was no significant difference in the 90 day incidence of death, shock, and heart failure between the transferred and the non-transferred groups (10.3% vs 10.2%, p=0.89). The median difference in symptom to balloon time between the two groups was 45 minutes (229 vs 184, p<0.001). The primary outcome per 30 minute delay was higher for patients with a D1D2 time ? 150 minutes (HR 1.19: 95% Confidence Interval [CI], 1.06 to 1.33 p=0.004) but not for D1D2 times > 150 minutes (HR, 0.99: 95% CI, 0.96 to 1.02; p=0.496). The association between longer D1D2 time and worsening outcome was no longer statistically significant after multivariable adjustment. Conclusion Longer transfer times were associated with higher rate of death, shock, and heart failure among patients undergoing inter-hospital transfer from PPCI, although this difference did not persist after adjusting for baseline characteristics. Clinical Trial Registration Information URL: www.clincaltrials.gov, Unique Identifier: NCT00091637

van Diepen, Sean; Widimsky, Petr; Lopes, Renato D.; White, Kyle R; Weaver, W. Douglas; Van de Werf, Frans; Ardissino, Diego; van't Hof, Arnoud W. J.; Armstrong, Paul W.; Granger, Christopher B.

2012-01-01

125

Clinical Outcome, and Survival Between Primary Percutaneous Coronary Intervention Versus Fibrinolysis in Patients Older Than 60 Years with Acute Myocardial Infarction  

PubMed Central

Objective: The aim of the present study was to compare the short-term and 6-month clinical outcome, and survival in patients older than 60 years with ST-elevation myocardial infarction randomized to either primary percutaneous coronary intervention (PPCI) or thrombolysis. Materials and Methods: 82 patients with STEMI older than 60 years were randomized to either primary PCI or thrombolysis from September 2006 to August 2008. Angiograms were reviewed by two interventionalists not involved in the study. Patients randomized to primary PCI received Aspirin and 600 mg Clopidogrel. Heparin was administered in conjunction with PCI. Patients randomized to thrombolysis received Aspirin followed by streptokinase infusion for one hour. Rescue PCI was considered if there was ongoing pain and ST-segment resolution was <50% at 90 min. after initiation of thrombolysis or chest pain recurred with ST-segment elevation within 24 hours. All patients were followed up for 6 months. End points were reinfarction and cardiac death using competing-risks regression estimation. Results: The mean time from hospital admission to start of streptokinase infusion was 31 ± 15 min and door to balloon time was 70 ± 25 min. There was no significant difference between the groups in the number of deaths and reinfarctions at 6 months. As expected, the fibrinolysis group had a higher rate of revascularization and heart failure. Conclusion: The higher rates of heart failure and need for revascularization in the fibrinolysis group reinforces benefits of PPCI in patients older than 60 years. PPCI in those who are 60 years and above with AMI is safe and cost effective.

Falsoleiman, H.; Fatehi, G. H.; Dehghani, M; Shakeri, M. T.; Bayani, Baktash; Ahmadi, Mostafa; Rohani, Atoosheh

2012-01-01

126

Is Lower Pole Caliceal Anatomy Predictive of Extracorporeal Shock Wave Lithotripsy Success for Primary Lower Pole Kidney Stones?  

Microsoft Academic Search

PurposeThe management of lower pole kidney stones is controversial. We examined whether lower pole caliceal anatomy could predict the success of extracorporeal shock wave lithotripsy of primary lower pole kidney stones 20 mm. or less.

CARSTEN M. SORENSEN; PARAMJIT S. CHANDHOKE

2002-01-01

127

Successful percutaneous coronary intervention in a case of acute aortic dissection complicated with malperfusion of the left main coronary artery after replacement of the ascending aorta.  

PubMed

A 75-year-old female was admitted to our hospital with sudden back pain and right leg ischemia. Computed tomography showed acute type A aortic dissection with the occlusion of the right common iliac artery. The patient was treated with ascending aorta replacement and femoro-femoral bypass. Three hours after the operation, the patient went into a sudden shock. Electrocardiogram showed ventricular tachycardia and ventricular fibrillation. Percutaneous cardio-pulmonary support was administered and coronary arteriogram (CAG) was proceeded for evaluation of the coronary arteries. Although CAG revealed normal coronary arteries, intravascular ultrasound showed mobile intimal flap at left main coronary artery trunk, suggesting dissection of the coronary artery. Percutaneous coronary intervention of the left main coronary artery trunk was performed. The patient recovered from shock and was discharged from the hospital without any major complication. PMID:22566246

Hori, Daijiro; Noguchi, Kenichiro; Yamaguchi, Atsushi; Adachi, Hideo

2012-05-08

128

Effect of no-reflow during primary percutaneous coronary intervention for acute myocardial infarction on six-month mortality.  

PubMed

No-reflow is a frequent event during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI), and it may affect cardiac prognosis. We evaluated the occurrence of no-reflow as a predictor of outcomes in patients who underwent PCI for AMI. We prospectively collected data from 599 consecutive patients who underwent stent-based PCI for ST-elevation AMI by identifying those with no-reflow (Thrombosis In Myocardial Infarction [TIMI] grade <3 flow at completion of the procedure) and analyzing their baseline characteristics and clinical outcomes. Patients with no-reflow (n = 40, 6.7%) were older (67 +/- 13 vs 60 +/- 13 years, p = 0.002) and had longer ischemic times (5.5 +/- 3.7 vs 4.4 +/- 3.0 hours, p = 0.04) with more TIMI grade 0/1 flow at presentation (90% vs 64%, p = 0.001). No-reflow occurred mostly (73%) after stenting and often required intra-aortic balloon pump counterpulsation (30% vs 4.3%, p <0.001). Peak creatine kinase level was higher in patients with no-reflow (2,700 +/- 1,900 vs 2,000 +/- 1,800, p = 0.03) and more often associated with moderate or severe left ventricular dysfunction (68% vs 45%, p = 0.006) and increased 6-month mortality (12.5% vs 4.3%, p = 0.04). By multivariate analysis, no-reflow was an independent predictor of long-term mortality (odds ratio 3.4, p = 0.02). In addition, renal failure (odds ratio 4.39, p = 0.0025) and preprocedure TIMI grade 0/1 flow (odds ratio 2.1, p = 0.003) were independent predictors of no-reflow. In conclusion, the association of no-reflow with longer ischemic time and worse initial TIMI flow may indicate the presence of highly organized thrombus burden with higher propensity for distal embolization. Regardless of its mechanism, no-reflow was an independent predictor of increased mortality. PMID:17293180

Brosh, David; Assali, Abid R; Mager, Aviv; Porter, Avital; Hasdai, David; Teplitsky, Igal; Rechavia, Eldad; Fuchs, Shmuel; Battler, Alexander; Kornowski, Ran

2006-12-20

129

Clinical significance of no-reflow phenomenon observed on angiography after successful treatment of acute myocardial infarction with percutaneous transluminal coronary angioplasty  

Microsoft Academic Search

The clinical significance of the angiographic no-reflow phenomenon was evaluated in 93 patients with acute myocardial infarction treated by percutaneous transluminal coronary angioplasty (PTCA). On the basis of the post-PTCA angiograms, patients were divided into three groups: normal angiogram (group 1, n=65), slight no-reflow (group 2, n = 13), and severe no-reflow (group 3, n = 15). Regional wall motion

Itsuro Morishima; Takahito Sone; Shinji Mokuno; Shin Taga; Akemi Shimauchi; Yoshitaka Oki; Junichiro Kondo; Hideyuki Tsuboi; Hiromi Sassa

1995-01-01

130

Sequential thallium-201 myocardial perfusion studies after successful percutaneous transluminal coronary artery angioplasty: delayed resolution of exercise-induced scintigraphic abnormalities  

Microsoft Academic Search

To characterize the sequential changes of myocardial perfusion scintigraphy in patients with coronary artery disease (CAD) after complete revascularization, 43 patients underwent exercise thallium-201 (²°¹Tl) myocardial perfusion scintigraphy before and at 9 +\\/- 5 days, 3.3 +\\/- 0.6, and 6.8 +\\/- 1.2 months after percutaneous transluminal coronary angioplasty (PTCA). Only patients with single-vessel CAD, without previous myocardial infarction, and without

D. E. Manyari; M. Knudtson; R. Kloiber; D. Roth

1988-01-01

131

Pexelizumab, an AntiC5 Complement Antibody, as Adjunctive Therapy to Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction The COMplement inhibition in Myocardial infarction treated with Angioplasty (COMMA) Trial  

Microsoft Academic Search

Background—Complement, activated during myocardial ischemia and reperfusion, causes myocardial damage through multiple processes. The COMplement inhibition in Myocardial infarction treated with Angioplasty (COMMA) trial was performed to determine the effect of pexelizumab, a C5 complement inhibitor, on infarct size in patients with ST-segment- elevation myocardial infarction (MI) undergoing primary percutaneous coronary intervention. Methods and Results—In COMMA, 960 patients with MI

Christopher B. Granger; Kenneth W. Mahaffey; W. Douglas Weaver; Pierre Theroux; Judith S. Hochman; Thomas G. Filloon; Scott Rollins; Thomas G. Todaro; Jose C. Nicolau; Witold Ruzyllo; Paul W. Armstrong

2010-01-01

132

Primary synovial sarcoma of the lung successfully resected under temporary bypass.  

PubMed

A 48-year old man presented with chest pain and haemoptysis. Chest computed tomography showed a 60-mm mass in the left upper lobe of the lung, adjacent to the distal aortic arch. Bronchoscopic cytology revealed the presence of malignant cells and, in the absence of evidence of distant metastasis, a thoracotomy was performed. Although the tumour was firmly adherent to the distal aortic arch, under temporary bypass from the left subclavian artery to the descending aorta, it was successfully resected en bloc with the section of the aorta attached to it. The tumour was diagnosed as a primary synovial sarcoma of the lung on the basis of histopathological findings and fluorescent chromogenic in situ hybridization, showing SS18 gene rearrangement. PMID:23760220

Ichimura, Hideo; Kikuchi, Shinji; Ozawa, Yuichiro; Matsuzaki, Kanji

2013-06-11

133

Successful use of bisphosphonate and calcimimetic in neonatal severe primary hyperparathyroidism.  

PubMed

Neonatal primary hyperparathyroidism (NPHT) is associated with an inactivating homozygous mutation of the calcium sensing receptor (CaSR). The CaSR is expressed most abundantly in the parathyroid glands and the kidney and regulates calcium homeostasis through its ability to modulate parathormone secretion and renal calcium reabsorption. NPHT leads to life threatening hypercalcemia, nephrocalcinosis, bone demineralization, and neurologic disabilities. Surgery is the treatment of choice. While waiting for surgery, bisphosphonates offer a good alternative to deal with hypercalcemia. Cinacalcet is a class II calcimimetic that increases CaSR affinity for calcium, leading to parathormone suppression and increased calcium renal excretion. At present, there is little evidence as to whether cinacalcet could improve the function of mutant CaSR in NPHT. We report a case of NPHT, treated successfully with bisphosphonates and cinacalcet after surgery failure. To our knowledge, it is the first time cinacalcet has been used for NPHT. PMID:22331334

Wilhelm-Bals, Alexandra; Parvex, Paloma; Magdelaine, Corinne; Girardin, Eric

2012-02-13

134

Baseline von Willebrand factor plasma levels and no-reflow phenomenon after primary percutaneous coronary intervention for ST segment elevation myocardial infarction.  

PubMed

No-reflow phenomenon is associated with a poor prognosis and its underlying mechanisms are still poorly understood. von Willebrand Factor (vWF) is a central molecule in haemostasis which plays an important role in acute coronary syndromes. However its possible role in no-reflow has not been assessed prior to this study. Quantitative baseline vWF plasma antigen was measured by immunoturbidometric assay in 54 consecutive patients with a first ST segment elevation acute myocardial infarction, treated by primary percutaneous coronary intervention within 12 h of symptom onset. Definitions of no-reflow were (1) angiographic: final TIMI flow ?2 or final TIMI flow 3 with a myocardial blush grade <2; (2) electrocardiographic: lack of ST segment resolution (?50% reduction of ST segment elevation at 90 min). Angiographic and electrocardiographic no-reflow was observed in 32 (59%) and 30 (56%) patients, respectively (only 9 patients had both type of no-reflow). Plasma levels of vWF were significantly higher in patients with angiographic no-reflow but not in those with electrocardiographic no-reflow. Also, vWF was the most powerful independent predictors of angiographic no-reflow (OR 3.8, 95% CI 1.1-12.9, p=0.033). Our results provide new insights into no-reflow pathophysiology with appealing therapeutic implications. PMID:19732980

Sgueglia, Gregory Angelo; Niccoli, Giampaolo; Spaziani, Cristina; Cosentino, Nicola; Russo, Eleonora; Andreotti, Felicita; Lanza, Gaetano Antonio; Landolfi, Raffaele; Crea, Filippo

2009-09-03

135

A Study on the Playing of Computer Games, Class Success and Attitudes of Parents to Primary School Students  

ERIC Educational Resources Information Center

|This study is a descriptive study based on the screening model, and was conducted in order to inquire the effect of games and the relation between gender and class success variables and game preferences in primary school students. The universe of the study was the primary schools in city center in Province of Burdur and the sample group of the…

Pepe, Kadir

2011-01-01

136

Successful Use of a Primary Care Practice-Specialty Collaboration in the Care of an Adolescent With Chronic Fatigue Syndrome  

Microsoft Academic Search

We report on the successful collaborative care of an adolescent with chronic fatigue syndrome between a primary care pediatrician and an academic chronic fatigue syndrome specialist located in different cities. Regular telephone and e-mail communication and clearly defined patient-care roles allowed for timely management of symptoms and marked clinical improvement. We discuss ways to improve the collaboration of primary care

Dennis Z. Kuo; Tina L. Cheng; Peter C. Rowe

2010-01-01

137

Percutaneous Gastrostomy for Decompression in Patients with Advanced Gynecologic Malignancies  

Microsoft Academic Search

The objective of this study was to evaluate the use of percutaneous decompression gastrostomy in patients with gynecologic malignancies. Decompression gastrostomy tubes were inserted percutaneously in patients with recurrent gynecologic malignancies and small bowel obstruction or fistulae. The technique was evaluated for successful gastric decompression, acute and long-term complications, and palliation of symptoms. Twenty patients underwent placement of percutaneous gastrostomy

MARY JADHONCUNNINGHAM; CHERYL BROMBERG; DANIEL C. KREDENTSER; MARK B. COLLINS; JOHN H. MALFETANO

1995-01-01

138

Interaction of chronic total occlusion and chronic kidney disease in patients undergoing primary percutaneous coronary intervention for acute ST-elevation myocardial infarction.  

PubMed

Chronic total occlusion (CTO) in a non-infarct-related artery and chronic kidney failure (CKD) are associated with worse outcomes after primary percutaneous coronary intervention (PCI). The aim of this study was to investigate the interaction of CTO and CKD in patients who underwent primary PCI for acute ST-segment elevation myocardial infarction (STEMI). Patients with STEMIs with or without CKD, defined as an estimated glomerular filtration rate <60 ml/min/1.73 m(2), were categorized into those with single-vessel disease and those with multivessel disease with or without CTO. The primary outcomes were the incidence of 30-day and 1-year mortality. Among 1,873 consecutive patients with STEMIs included between 2006 and 2011, 336 (18%) had CKD. The prevalence of CTO in a non-infarct-related artery was 13% in patients with CKD compared with 7% in those without CKD (p = 0.0003). There was a significant interaction between CKD and CTO on 30-day mortality (p = 0.018) and 1-year mortality (p = 0.013). Independent predictors of late mortality in patients with CKD were previous myocardial infarction (hazard ratio [HR] 1.71, 95% confidence interval [CI] 1.01 to 2.79), age >75 years (HR 1.86, 95% CI 1.19 to 2.95), a left ventricular ejection fraction after primary PCI <40% (HR 2.20, 95% CI 1.36 to 3.63), left main culprit artery (HR 4.46, 95% CI 1.64 to 10.25), and shock (HR 7.44, 95% CI 4.56 to 12.31), but multivessel disease with CTO was not a predictor. In contrast, multivessel disease with CTO was an independent predictor of mortality in patients without CKD (HR 3.30, 95% CI 1.70 to 6.17). In conclusion, in patients with STEMIs who underwent primary PCI, with preexisting CKD, the prevalence of CTO in a non-infarct-related artery was twice as great. In these patients, the clinical impact of CTO seems to be overshadowed by the presence of CKD. PMID:23601580

Bataille, Yoann; Plourde, Guillaume; Machaalany, Jimmy; Abdelaal, Eltigani; Déry, Jean-Pierre; Larose, Eric; Déry, Ugo; Noël, Bernard; Barbeau, Gérald; Roy, Louis; Costerousse, Olivier; Bertrand, Olivier F

2013-04-18

139

VPS 45-associated primary infantile myelofibrosis - Successful treatment with hematopoietic stem cell transplantation.  

PubMed

PMF of infancy is a recently described autosomal recessive disorder presenting with severe bone marrow failure, accelerated neutrophil apoptosis, and significant platelet dysfunction, caused by a mutation in the VPS45 gene. In this study, we update our group of patients with PMF, highlighting different aspects of this disease, and evaluating the effectiveness of HSCT for the treatment of this disorder. Update of clinical data, hematological features, molecular studies, treatment and final outcome of four children diagnosed with VPS 45-associated PMF of infancy. The patients described had clinical and hematological findings consistent with MF. Molecular studies showed that all patients were homozygous for the Thr224Asn mutation in the VPS 45 gene. HSCT was carried out in three patients and was successful in two. VPS 45-associated MF is a novel primary immune deficiency that can be successfully corrected by HSCT if applied early in the course of disease using appropriate conditioning. The diagnosis of VPS 45-associated PMF should be considered in all children presenting with SCN with subsequent development of pancytopenia. Long-term follow-up of these patients is necessary to identify extra-hematological manifestations of VPS45 deficiency. PMID:24164830

Stepensky, Polina; Simanovsky, Natalia; Averbuch, Diana; Gross, Menachem; Yanir, Asaf; Mevorach, Dror; Elpeleg, Orly; Weintraub, Michael

2013-12-01

140

The development of mire vegetation and water table in primary succession  

NASA Astrophysics Data System (ADS)

Mires are globally important carbon storage and an essential element of northern nature. They are associated with high watertable levels and accumulation of peat. During the mire primary succession, the plant community changes from the early sedge and shore plant dominated communities towards the Sphagnum moss dominated bog communities. Different successional stages of aapamires can be found in the land uplift area in the Finnish coast of the Gulf of Bothnia . From this landscape (64°45´N, 24°42´E) we selected a set of undisturbed mires varying in their terrestrial age to form a successional transect from the early stages near the coast to the more ombrothrophic stages in the inlands. We collected macrofossil and modern vegetation data from the transect to compare the preceding communities to the communities found today in the transect. The comparison will be made using multivariate analysis methods. The water table and vegetation of the mire transect will be calibrated with the paleodata to get data of the past levels of water table. The questions we wanted to examine were: Can the successional stages in the mire transect be found in the macrofossil data? How has the water table changed during the succession? Are the changes in plant communities and water table rapid or do they evolve gradually? Is there a trend in the mire succession that can be seen in both the hollow and hummock surfaces of the mire. The preliminary results of the study indicate that the fen-bog transition seems to be very rapid at least in the older parts of the transect. Before the transition there was a clear peak in Eriophorum vaginatum abundance.

Miettinen, Antti; Väliranta, Minna; Tuittila, Eeva-Stiina

2010-05-01

141

A Direct Comparison of Intravenous Enoxaparin With Unfractionated Heparin in Primary Percutaneous Coronary Intervention (from the ATOLL Trial).  

PubMed

Intravenous enoxaparin did not reduce significantly the primary end point (p = 0.06) compared with unfractionated heparin (UFH) in the randomized Acute Myocardial Infarction Treated with primary angioplasty and intravenous enoxaparin Or unfractionated heparin to Lower ischemic and bleeding events at short- and Long-term follow-up (ATOLL) trial. We present the results of the prespecified per-protocol analysis excluding patients who did not receive the treatment allocated by randomization or received both enoxaparin and UFH. We evaluated all-cause mortality, complication of myocardial infarction, procedural failure, or major bleeding (primary end point) and all-cause mortality, recurrent acute coronary syndrome, or urgent revascularization (main secondary end point). Baseline and procedural characteristics were well balanced between the 2 treatment groups. Of 910 randomized patients, 795 patients (87.4%) were treated according to the protocol with consistent anticoagulation using intravenous enoxaparin (n = 400) or UFH (n = 395). Enoxaparin reduced significantly the rates of the primary end point (relative risk [RR] 0.76, 95% confidence interval [CI] 0.62 to 0.94, p = 0.012) and the main secondary end point (RR 0.37, 95% CI 0.22 to 0.63, p <0.0001). There was less major bleeding with enoxaparin (RR 0.46, 95% CI 0.21 to 1.01, p = 0.050) contributing to the significant improvement of the net clinical benefit (RR 0.46, 95% CI 0.3 to 0.74, p = 0.0002). All-cause mortality was also reduced with enoxaparin (RR 0.36, 95% CI 0.18 to 0.74, p = 0.003). In conclusion, in the per-protocol analysis of the ATOLL trial, pertinent to >87% of the study population, enoxaparin was superior to UFH in reducing ischemic end points and mortality. PMID:24012033

Collet, Jean-Philippe; Huber, Kurt; Cohen, Marc; Zeymer, Uwe; Goldstein, Patrick; Pollack, Charles; Silvain, Johanne; Henry, Patrick; Varenne, Olivier; Carrié, Didier; Coste, Pierre; Angioi, Michael; Le Breton, Hervé; Cayla, Guillaume; Elhadad, Simon; Teiger, Emmanuel; Filippi, Emmanuelle; Aout, Mounir; Vicaut, Eric; Montalescot, Gilles

2013-09-05

142

High-dose glucose-insulin-potassium has hemodynamic benefits and can improve cardiac remodeling in acute myocardial infarction treated with primary percutaneous coronary intervention: From a randomized controlled study  

PubMed Central

Objective: To evaluate the effects of high-dose glucose–insulin–potassium (GIK) solution on hemodynamics and cardiac remodeling in patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI). Patients and Methods: We observed the changes in the hemodynamic parameters in 26 patients with AMI. All patients received primary PCI before entering the study. All patients in the study were randomized into the GIK group (n = 14) or the control group (n = 12). Patients in the GIK group received high-dose GIK solution (25% glucose, 80 mmol/L KCl and 50 IU/L insulin; 1.5 ml/kg/h) over 24 h. Patients in the control group received standard therapy. We monitored the hemodynamic parameters at baseline and after 6 h, 12 h, 18 h and 24 h, respectively. Then, we followed-up the cardiac function with echocardiography after 7 days, 1 month and 6 months. Results: The basic clinical data was similar between the groups. Primary PCI was performed successfully in 25 patients. The two groups were indistinguishable in all factors measured. GIK solution did not have a deleterious effect on the hemodynamic parameters. The pulmonary capillary wedge pressure increased during the first 12-h period and then decreased smoothly (F = 3.75, P = 0.02). The trends were similar between the two groups. The system vascular resistance index (SVRI) and pulmonary vascular resistance index (PVRI) decreased during the first 12 h in the GIK group but increased in the control group. The GIK solution significantly influenced SVRI (F = 4.71, P = 0.02). GIK solution improved the cardiac function measured by stroke volume (F = 4.11, P = 0.03) and cardiac index (F = 4.40, P = 0.02). In the 6-month follow-up, GIK improved cardiac remodeling (left ventricular diastolic diameter: 49.2 ± 2.89 vs. 53.9 ± 2.48, P < 0.001; left ventricular systolic diameter: 32.9 ± 2.24 vs. 35.9 ± 2.78, P < 0.01). Conclusion: High-dose GIK solution had no adverse effects on the hemodynamics in AMI patients treated with primary PCI. It can improve cardiac function by lowering SVRI. In the 6-month follow-up, it improved cardiac remodeling.

Li, Yanhui; Zhang, Lin; Zhang, Lei; Zhang, Haiyong; Zhang, Nianzhong; Yang, Zhongsu; Gao, Mingming; Yang, Xinchun; Cui, Liang

2010-01-01

143

Ultrasound-guided percutaneous renal biopsy-induced accessory renal artery bleeding in an amyloidosis patient  

PubMed Central

Abstract Ultrasound-guided percutaneous renal biopsy is an important technique for diagnosis of glomerular diseases, and the biopsy-induced life-threatening bleeding rarely happens. Primary systemic amyloidosis is a rare disease which may lead to organ dysfunction including arterial stiffness. The accessory renal artery is a kind of renal vascular variation which goes into the renal parenchyma directly or via the renal hilum. Here we reported a rare case of percutaneous renal biopsy-induced accessory renal artery life-threatening bleeding in a renal amyloidosis patient, and our experience of successful rescue in this patient. Virtual Slides http://www.diagnosticpathology.diagnomx.eu/vs/1524207344817819

2012-01-01

144

Safety and efficacy of adjuvant glycoprotein IIb/IIIa inhibitors during primary percutaneous coronary intervention performed from the radial approach for acute ST segment elevation myocardial infarction.  

PubMed

The use of glycoprotein IIb/IIIa receptor inhibitors (GPIs) in high-risk patients with acute coronary syndromes has been associated with reductions in ischemic events but increases in bleeding complications. The role of GPIs in patients who undergo primary percutaneous coronary intervention (PCI) by the transradial approach (TRA) is not well studied. The aim of this post hoc analysis from the randomized prospective Acute Myocardial Infarction Treated With Primary Angioplasty and Intravenous Enoxaparin or Unfractionated Heparin to Lower Ischemic and Bleeding Events at Short- and Long-Term Follow-Up (ATOLL) trial was to assess the safety and efficacy of GPIs in primary PCI performed using the TRA. A total of 910 patients were enrolled in ATOLL; 522 patients (67%) underwent PCI using the TRA. Two comparative analyses were performed. First, patients who underwent PCI using the TRA who received GPIs were compared with those who did not receive GPIs. Second, patients who underwent PCI using the TRA who received GPIs were compared with those who underwent PCI using a nonradial route and received GPIs. Composite end points of net clinical benefit, ischemic outcomes, and safety consisting of bleeding and transfusion at 1 month were analyzed. A propensity score was constructed, and weight adjustment were made for variables, including but not limited to age, weight, gender, renal function, concomitant use of other medications, Killip class, and medical history, when analyzing the end points. There was no significant difference in net clinical benefit or ischemic outcomes between either TRA patients with versus without GPIs or TRA patients with GPIs versus non-TRA patients with GPIs. Additionally, there were significantly fewer major bleeding events and blood transfusions in TRA patients with GPIs compared with non-TRA patients with GPIs. In conclusion, the addition of GPIs in the setting of primary PCI using the TRA was not associated with bleeding liability. The use of GPIs with TRA was associated with safer outcomes than using GPIs with a nontransradial approach. This study was limited in that it was a nonrandomized retrospective analysis. PMID:23528027

Iqbal, Zafar; Cohen, Marc; Pollack, Charles; Goldstein, Patrick; Zeymer, Uwe; Huber, Kurt; Barthelemy, Olivier; Cayla, Guillaume; Aout, Mounir; Vicaut, Eric; Montalescot, Gilles

2013-03-22

145

Impact of TIMI 3 patency before primary percutaneous coronary intervention for ST-elevation myocardial infarction on clinical outcome: results from the ASSENT-4 PCI study  

PubMed Central

Background: Early restoration of blood flow of the infarct-related artery is associated with an improved outcome in patients with ST-elevation myocardial infarction (STEMI). Previous studies have shown a low mortality in patients with TIMI 3 flow before primary percutaneous coronary intervention (PCI). Most likely these patients had spontaneous recanalization of the infarct vessel and might constitute a low-risk subgroup. The purpose of the present analysis was to investigate whether TIMI 3 flow obtained with fibrinolysis before PCI is associated with a clinical outcome comparable to that in patients with spontaneous TIMI 3 flow. Methods: Patients with STEMI <6 hours enrolled in the ASSENT-4 PCI study were randomized to facilitated PCI with tenecteplase or primary PCI. For this analysis, patients were divided into three groups according to the TIMI flow of the infarct vessel before PCI: TIMI 0/1, TIMI 2, and TIMI 3. Results: From a total of 1617 patients, 861 had TIMI 0/1, 279 had TIMI 2, and 477 TIMI 3 flow. The rates of TIMI 3 flow after PCI were 84.6, 89.7, and 95.6%, respectively. Complete ST resolution was observed most often in the TIMI 3 flow group (47.5, 53.6, and 58.6%). The incidence of cardiogenic shock (6.2, 5.5, and 3.6%) and 90-day mortality (6.1, 4.7, and 4.0%) were lowest in the group with TIMI 3 patency before PCI, respectively. The rate of TIMI 3 flow before PCI was higher in the facilitated PCI group than in the primary PCI group (43.9 vs. 15.2%). The 90-day mortality in patients with TIMI 3 before PCI was identical in the facilitated and the primary PCI groups (14/353, 4.0% vs. 5/124, 4.0%). Conclusion: In this post-hoc analysis of ASSENT-4 PCI, TIMI grade 3 flow in the infarct-related artery before PCI, occurring either spontaneously or obtained by fibrinolysis, is associated with a higher TIMI patency after PCI, better improved ST resolution and a trend towards a favourable clinical outcome after 90 days.

Huber, Kurt; Fu, Yuling; Ross, Allan; Granger, Christopher; Goldstein, Patrick; van de Werf, Frans; Armstrong, Paul

2012-01-01

146

Impact of multivessel coronary artery disease and noninfarct-related artery revascularization on outcome of patients with ST-elevation myocardial infarction transferred for primary percutaneous coronary intervention (from the EUROTRANSFER Registry).  

PubMed

The aim of the study was to assess the impact of multivessel coronary artery disease (MVD) and noninfarct-related artery (non-IRA) revascularization during index percutaneous coronary intervention (PCI) on outcomes of patients with ST-segment elevation myocardial infarction (STEMI). Data on 1,598 of 1,650 patients with complete angiographic data, with >or=1 significantly stenosed epicardial coronary artery, and without previous coronary artery bypass grafting were retrieved from the EUROTRANSFER Registry database. Patients with 1-, 2-, and 3-vessel disease made up 48.5%, 32.0%, and 19.5% of the registry population, respectively. Patients with MVD were less likely to achieve final Thrombolysis In Myocardial Infarction grade 3 flow (1- vs 2- vs 3-vessel disease, 93.6% vs 89.3% vs 87.9%, respectively, p = 0.003) and ST-segment resolution >50% within 60 minutes after PCI (1- vs 2- vs 3-vessel disease, 80.9% vs 77.5% vs 69.3%, respectively, p <0.001). They were also at higher risk of death during 1-year follow-up (1- vs 2- vs 3-vessel disease, 4.9% vs 7.4% vs 13.5%, respectively, p <0.001), and MVD was identified as an independent predictor of 1-year death. In 70 patients (9%) non-IRA PCI was performed during index PCI. These patients were at higher risk of 30-day and 1-year death compared to patients without non-IRA PCI, but this difference in mortality was no longer significant after adjustment for covariates. In conclusion, patients with MVD have decreased epicardial and myocardial reperfusion success and had worse prognosis after primary PCI for STEMI compared to patients with 1-vessel disease. In this large multicenter registry, non-IRA PCI during the index procedure was performed in 9% of patients with MVD and it was associated with increased 1-year mortality. PMID:20643243

Dziewierz, Artur; Siudak, Zbigniew; Rakowski, Tomasz; Zasada, Wojciech; Dubiel, Jacek S; Dudek, Dariusz

2010-06-18

147

Usefulness of the SYNTAX score to predict "no reflow" in patients treated with primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.  

PubMed

The no-reflow phenomenon has been shown to have a significant effect on clinical outcomes in patients with acute ST-segment elevation myocardial infarction. Angiographic features incorporated in the SYNTAX Score (SXScore) obtained on diagnostic angiography during primary percutaneous coronary intervention (PPCI) may be associated with the occurrence of myocardial no-reflow. The aim of this study was to assess the ability of the SXScore to predict no-reflow during PPCI. The SXScore was applied to 669 consecutive patients presenting with acute ST-segment elevation myocardial infarction from November 2006 to February 2008. Angiographic analysis of the PPCI procedure was used to determine no-reflow. The median SXScore was 16 (range 9.5 to 23). No-reflow occurred in 77 patients (12%). On univariate logistic regression analysis, the SXScore showed a strong association (for each 10-unit increase in SXScore, odds ratio 1.42, 95% confidence interval 1.16 to 1.76, p <0.001). On multivariate logistic regression in a model including clinical variables, SXScore was an independent predictor of no-reflow (odds ratio 1.29, 95% confidence interval 1.02 to 1.63, p <0.001). Classification and regression tree analysis identified SXScore >21 as the best cutoff, with patients having double the risk for no-reflow compared to those with SXScore ?21 (events 9% vs 18%, p = 0.006). In conclusion, the SXScore obtained in the diagnostic phase of PPCI for acute ST-segment elevation myocardial infarction can identify patients at risk for developing no-reflow. PMID:22177003

Magro, Michael; Nauta, Sjoerd T; Simsek, Cihan; Boersma, Eric; van der Heide, Elco; Regar, Evelyn; van Domburg, Ron T; Zijlstra, Felix; Serruys, Patrick W; van Geuns, Robert Jan

2011-12-15

148

Long-term prognostic benefit of field triage and direct transfer of patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention.  

PubMed

Direct transfer (DT) to the catheterization laboratory has been demonstrated to reduce delays in primary percutaneous coronary intervention (PPCI). However, data with regard to its effect on long-term mortality are sparse. The aim of this study was to investigate the effect of DT on long-term mortality in patients with ST-segment elevation myocardial infarctions treated with PPCI. A cohort study was conducted of 1,859 patients (mean age 63.1 ± 13 years, 80.2% men) who underwent PPCI from May 2005 to December 2010. From the whole series, 425 patients (23%) were admitted by DT and 1,434 (77%) by emergency departments. DT patients were younger (mean age 61 ± 12 vs 64 ± 12 years, p = 0.017), were more frequently men (86% vs 76%, p = 0.001), and had a higher proportion of abciximab use (77% vs 64%, p <0.0001). The DT group had a shorter median contact-to-balloon time (105 vs 122 minutes, p <0.0001) and a shorter time to treatment (185 vs 255 minutes, p <0.0001) compared with the emergency department group. Thirty-day and long-term mortality (median follow-up 2.4 years, interquartile range 1.6 to 3.2) were lower in the DT group (3% vs 6%, p = 0.049, and 9.4% vs 14.4%, p = 0.008, respectively). An adjusted Cox regression analysis proved that the DT group had an improved prognosis during follow-up (hazard ratio 0.71, 95% confidence interval 0.50 to 0.99). In conclusion, DT of patients with ST-segment elevation myocardial infarctions for PPCI was associated with fewer delays and improved survival. This benefit was maintained after long follow-up. This strategy should be emphasized in all networks of ST-segment elevation myocardial infarction care. PMID:23499276

Estévez-Loureiro, Rodrigo; Calviño-Santos, Ramón; López-Sainz, Angela; Vázquez-Rodríguez, José Manuel; Soler-Martín, María Rita; Prada-Delgado, Oscar; Barge-Caballero, Eduardo; Salgado-Fernández, Jorge; Aldama-López, Guillermo; Piñón-Esteban, Pablo; Flores-Ríos, Xacobe; Barreiro-Díaz, María; Varela-Portas, Jacobo; Freire-Tellado, Miguel; García-Guimaraes, Marcos; Vázquez-González, Nicolás; Castro-Beiras, Alfonso

2013-03-14

149

Successful management of multiple permanent pacemaker complications - infection, 13 year old silent lead perforation and exteriorisation following failed percutaneous extraction, superior vena cava obstruction, tricuspid valve endocarditis, pulmonary embolism and prosthetic tricuspid valve thrombosis  

PubMed Central

A 59 year old man underwent mechanical tricuspid valve replacement and removal of pacemaker generator along with 4 pacemaker leads for pacemaker endocarditis and superior vena cava obstruction after an earlier percutaneous extraction had to be abandoned, 13 years ago, due to cardiac arrest, accompanied by silent, unsuspected right atrial perforation and exteriorisation of lead. Postoperative course was complicated by tricuspid valve thrombosis and secondary pulmonary embolism requiring TPA thrombolysis which was instantly successful. A review of literature of pacemaker endocarditis and tricuspid thrombosis along with the relevant management strategies is presented. We believe this case report is unusual on account of non operative management of right atrial lead perforation following an unsuccessful attempt at percutaneous removal of right sided infected pacemaker leads and the incidental discovery of the perforated lead 13 years later at sternotomy, presentation of pacemaker endocarditis with a massive load of vegetations along the entire pacemaker lead tract in superior vena cava, right atrial endocardium, tricuspid valve and right ventricular endocardium, leading to a functional and structural SVC obstruction, requirement of an unusually large dose of warfarin postoperatively occasioned, in all probability, by antibiotic drug interactions, presentation of tricuspid prosthetic valve thrombosis uniquely as vasovagal syncope and isolated hypoxia and near instantaneous resolution of tricuspid prosthetic valve thrombosis with Alteplase thrombolysis.

Kaul, Pankaj; Adluri, Krishna; Javangula, Kalyana; Baig, Wasir

2009-01-01

150

Contemporary Analysis of Incidence and Outcomes of Stent Thrombosis Presenting as ST Elevation Myocardial Infarction in a Primary Percutaneous Coronary Intervention Cohort.  

PubMed

There are limited data about the effectiveness of primary percutaneous coronary intervention (PPCI) for stent thrombosis treatment. We aimed to evaluate the prevalence and outcomes of PPCI in patients with ST elevation acute myocardial infarction (STEMI) due to stent thrombosis, and comparing the outcomes with patients treated for de novo coronary thrombosis. This was an observational cohort study of 2,935 patients who underwent PPCI from 2003 to 2011 with follow-up for a median of 3.0 years (interquartile range 1.2 to 4.6). The primary end point was the first major adverse cardiac event (MACE) defined as death, nonfatal myocardial infarction, stroke, or target vessel revascularization. Stent thrombosis overall accounted for 6.6% (194 of 2,935) of all STEMIs with a proportion that increased over time (3.3% in 2004 to 9.4% in 2011). A total of 34.5% were early, 30.9% late stent thrombosis, and 34.5% were very late stent thrombosis. Indications for the original intervention were elective in 27.8%, after acute coronary syndrome (non-STEMI or unstable angina) in 21.1%, and after PPCI in 51.1%. Patients with stent thrombosis had higher rates of hypertension, hypercholesterolemia, diabetes, renal dysfunction, and previous myocardial infarction or coronary artery bypass surgery compared with patients with native artery occlusion. MACE rates were higher in patients with stent thrombosis compared with patients with native artery occlusions (40.9%, 95% confidence interval [CI] 31.1 to 50.6 vs 15.1%, 95% CI 12.5 to 18.3; p <0.0001). The poor outcome of stent thrombosis was particularly associated with early and late stent thromboses. Very late stent thrombosis appears to be a relatively less serious event, with similar outcomes to native vessel thromboses (MACE very late stent thrombosis 16.5%, 95% CI 8.2 to 28.6 vs native 15.1%, 95% CI 12.5 to 18.3, p = 0.245). In conclusion, stent thrombosis accounts for an increasing proportion of STEMI and is associated with worse outcomes compared with native artery occlusion. PMID:24012030

Jones, Daniel A; Gallagher, Sean; Rathod, Krishnaraj S; Akhtar, Mohammed; Knight, Charles J; Rothman, Martin T; Kapur, Akhil; Mathur, Anthony; Jain, Ajay K; Timmis, Adam D; Smith, Elliot J; Wragg, Andrew

2013-09-05

151

Cooperative primary-secondary transmission using superposition coding and successive interference cancellation  

Microsoft Academic Search

In a collaborative primary-secondary transmission system, a secondary transmitter (ST) working as a relay is allowed to transmit its own signal superimposed on the primary signal only if it does not intervene the primary transmission. The spectrum room for the secondary usage is thanks to the link gain achieved by the relaying. At the secondary receiver (SR), it also receives

Taewon Kim; Dongwoo Kim

2012-01-01

152

Intracoronary fixed dose of nitroprusside via thrombus aspiration catheter for the prevention of the no-reflow phenomenon following primary percutaneous coronary intervention in acute myocardial infarction  

PubMed Central

Previous studies have shown that intracoronary (IC) nitroprusside (NTP) injection is a safe and effective strategy for the treatment of no-reflow (NR) during percutaneous coronary intervention (PCI). The present study tested the hypothesis that, on the basis of thrombus aspiration for the treatment of ST-segment elevation myocardial infarction (STEMI), the selective IC administration of a fixed dose of NTP (100 ?g) plus tirofiban is a safe and superior treatment method compared with the IC administration of tirofiban alone for the prevention of NR during primary PCI. A total of 162 consecutive patients with STEMI, who underwent primary PCI within 12 h of onset, were randomly assigned to two groups: Group A, IC administration of a fixed dose of NTP (100 ?g) plus tirofiban (10 ?g/kg) and group B, IC administration of tirofiban (10 ?g/kg) alone (n=80 and n=82, respectively). The drugs were selectively injected into the infarct-related artery (IRA) via a thrombus aspiration catheter advanced into the IRA. The primary end-point was post-procedural corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC). The proportion of complete (>70%) ST-segment resolution (STR); the TIMI myocardial perfusion grade (TMPG) 2–3 ratio following PCI; the peak value of creatine kinase (CK)-MB; the TIMI flow grade; the incidence of major adverse cardiac events (MACEs) and the left ventricular ejection fraction (LVEF) after 6 months of follow-up were observed as the secondary end-points. There were no significant differences in the baseline clinical and angiographic characteristics between the two groups. Compared with group B, group A had i) a lower CTFC (23±7 versus 29±11, P=0.000); ii) a higher proportion of complete STR (72.5 versus 55.9%, P=0.040); iii) an enhanced TMPG 2–3 ratio (71.3 versus 53.7%, P=0.030) and iv) a lower peak CK-MB value (170±56 versus 210±48 U/l, P=0.010). There were no statistically significant differences in the final TIMI grade-3 flow between the two groups (92.5 versus 91.5% for groups A and B, respectively; P=0.956). The LVEF at 6 months was higher in group A than group B (63±9 versus 53±11%, respectively; P=0.001); however, the incidence of MACEs was not statistically different between the two groups, although there was a trend indicating improvement in group A (log rank ?2=0.953, P=0.489). The selective IC administration of a fixed dose of NTP (100 ?g) plus tirofiban via a thrombus aspiration catheter advanced into the IRA is a safe and superior treatment method compared with tirofiban alone in patients with STEMI undergoing primary PCI. This novel therapeutic strategy improves the myocardial level perfusion, in addition to reducing the infarct size. Furthermore, it may improve the postoperative clinical prognosis following PCI.

ZHAO, YU-JUN; FU, XIANG-HUA; MA, XIAO-XIAO; WANG, DONG-YING; DONG, QIU-LI; WANG, YAN-BO; LI, WEI; XING, KUN; GU, XIN-SHUN; JIANG, YUN-FA

2013-01-01

153

Percutaneous Ablation of Adrenal Tumors  

PubMed Central

Adrenal tumors comprise a broad spectrum of benign and malignant neoplasms, and include functional adrenal adenomas, pheochromocytomas, primary adrenocortical carcinoma and adrenal metastases. Percutaneous ablative approaches that have been described and used in the treatment of adrenal tumors include percutaneous radiofrequency ablation (RFA), cryoablation, microwave ablation and chemical ablation. Local tumor ablation in the adrenal gland presents unique challenges, secondary to the adrenal gland’s unique anatomic and physiologic features. The results of clinical series employing percutaneous ablative techniques in the treatment of adrenal tumors are reviewed in this article. Clinical and technical considerations unique to ablation in the adrenal gland are presented, including approaches commonly used in our practices, and risks and potential complications are discussed.

Venkatesan, Aradhana M.; Locklin, Julia; Dupuy, Damian E.; Wood, Bradford J.

2010-01-01

154

Clinical Experience With Primary Percutaneous Transluminal Coronary Angioplasty Compared With Alteplase (Recombinant Tissue-Type Plasminogen Activator) in Patients With Acute Myocardial Infarction 1 1 The National Registry of Myocardial Infarction is supported by a grant from Genentech, Inc., South San Francisco, California  

Microsoft Academic Search

Objectives. We sought to compare outcomes after primary percutaneous transluminal coronary angioplasty (PTCA) or thrombolytic therapy for acute myocardial infarction (MI).Background. Primary PTCA and thrombolytic therapy are alternative means of achieving reperfusion in patients with acute MI. The Second National Registry of Myocardial Infarction (NRMI-2) offers an opportunity to study the clinical experience with these modalities in a large patient

Alan J Tiefenbrunn; Nisha C Chandra; William J French; Joel M Gore; William J Rogers

1998-01-01

155

Nitrogen availability and nitrification during succession: Primary, secondary, and old-field seres  

Microsoft Academic Search

Suggestions that nutrient cycles become more strongly regulated and that nitrification is progressively inhibited in the course of ecological succession have stimulated numerous field measurements. Results of these are inconsistent; in some cases nitrogen turnover and nitrification decrease during succession, while in others both increase substantially.

Peter M. Vitousek; Pamela A. Matson; KEITH VAN CLEVE

1989-01-01

156

Biodiversity, abundance, and activity of nitrogen-fixing bacteria during primary succession on a copper mine tailings.  

PubMed

Microorganisms are important in soil development, inputs and biogeochemical cycling of nutrients and organic matter during early stages of ecosystem development, but little is known about their diversity, distribution, and function in relation to the chemical and physical changes associated with the progress of succession. In this study, we characterized the community structure and activity of nitrogen-fixing microbes during primary succession on a copper tailings. Terminal fragment length polymorphism (T-RFLP) and clone sequencing of nifH genes indicated that different N(2) -fixing communities developed under primary succession. Phylogenetic analysis revealed a diversity of nifH sequences that were mostly novel, and many of these could be assigned to the taxonomic divisions Proteobacteria, Cyanobacteria, and Firmicutes. Members of the Cyanobacteria, mostly affiliated with Nostocales or not closely related to any known organisms, were detected exclusively in the biological soil crusts and represented a substantial fraction of the respective diazotrophic communities. Quantitative PCR (and statistical analyses) revealed that, overall, copy number of nifH sequences increased with progressing succession and correlated with changes in physiochemical properties (including elementary elements such as carbon and nitrogen) and the recorded nitrogenase activities of the tailings. Our study provides an initial insight into the biodiversity and community structure evolution of N(2) -fixing microorganisms in ecological succession of mine tailings. PMID:22066852

Huang, Li-Nan; Tang, Feng-Zao; Song, Yong-Sheng; Wan, Cai-Yun; Wang, Sheng-Long; Liu, Wei-Qiu; Shu, Wen-Sheng

2011-08-25

157

Sequential thallium-201 myocardial perfusion studies after successful percutaneous transluminal coronary artery angioplasty: delayed resolution of exercise-induced scintigraphic abnormalities  

SciTech Connect

To characterize the sequential changes of myocardial perfusion scintigraphy in patients with coronary artery disease (CAD) after complete revascularization, 43 patients underwent exercise thallium-201 (/sup 201/Tl) myocardial perfusion scintigraphy before and at 9 +/- 5 days, 3.3 +/- 0.6, and 6.8 +/- 1.2 months after percutaneous transluminal coronary angioplasty (PTCA). Only patients with single-vessel CAD, without previous myocardial infarction, and without evidence of restenosis at 6 to 9 months after PTCA were included. Perfusion scans were analyzed blindly with the use of a new quantitative method to define regional myocardial perfusion in the topographic distribution of each coronary artery, which was shown to be reproducible (r = .94 or higher and SEE of 7% or less, between repeated measures by one and two operators). At 4 to 18 days after PTCA, the mean treadmill walking time increased by 123 +/- 42 sec, mean exercise-induced ST segment depression decreased by 0.6 +/- 0.3 mm, group maximal heart rate increased by 20 +/- 9 beats/min, and group systolic blood pressure at peak exercise increased by 24 +/- 10 mm Hg, compared with pre-PTCA values (p less than .001). However, no group differences were noted in these variables between the three post-PTCA stages. Myocardial perfusion in the distribution of the affected (dilated) coronary artery, on the other hand, improved progressively. In the 45 degree left anterior oblique view for instance, myocardial perfusion increased at 9 days after PTCA (from 68 +/- 24% before PTCA to 91 +/- 9%, p less than .001) and at 3.3 months after PTCA (101 +/- 8%, p less than .05 vs 9 days after PTCA), but no further significant changes were seen at 6.8 months after PTCA (102 +/- 8%). Similar changes were noted in the other two views. No relationship between minor complications during PTCA and delayed improvement on the /sup 201/Tl was observed.

Manyari, D.E.; Knudtson, M.; Kloiber, R.; Roth, D.

1988-01-01

158

Soil nitrogen transformations along a primary succession transect on the land-uplift coast in western Finland  

Microsoft Academic Search

We monitored net and gross N transformations in the organic layer along a primary successional transect (alder\\/rowan, birch, birch\\/spruce, spruce I and spruce II) typical for the land-uplift coast in Western Finland. The relationships between N transformations, vegetation succession and organic matter quality (i.e. concentration of dissolved forms of N, C\\/N ratio, moisture and acidity) were then evaluated. Net N

Päivi Merilä; Aino Smolander; Rauni Strömmer

2002-01-01

159

Palliative Care Partnership: a successful model of primary\\/secondary integration  

Microsoft Academic Search

The health reforms of the 1990s and early 21st century have seen unheralded change in the delivery of health services in New Zealand, and the concept of integration of primary and specialist or secondary services into a seamless health delivery service is one of the key planks of national and regional healthcare planning in New Zealand. 1,2 This paper reports

Bruce Stewart; Simon Allan; Barry Keane; Bridget Marshall; Jane Ayling; Tai Luxford

2006-01-01

160

Fertilizer application during primary succession changes the structure of plant and herbivore communities  

Microsoft Academic Search

Fertilization of secondary successional communities generally increases biomass but reduces diversity; its impact on primary successional communities is less well understood. Following applications of a balanced fertilizer to naturally established vegetation on slate quarry waste, effects on tree growth, ground flora species and foliar invertebrates were monitored over two years. Fertilization increased tree growth, with stem basal area increasing by

Edwin C. Rowe; John R. Healey; Gareth Edwards-Jones; Joanna Hills; Mererid Howells; David L. Jones

2006-01-01

161

[Current options for percutaneous endoscopic access to the digestive tract].  

PubMed

Four patients, aged 67, 52, 56 and 64 years, respectively, undergoing percutaneous colostomy or jejunostomy are presented to illustrate current options for percutaneous endoscopic access to the digestive tract. The first patient had Parkinson's disease and required percutaneous jejunostomy for continuous post-pyloric administration of medication. The second patient had impaired gastric emptying due to gastric graft-versus-host disease following bone marrow transplantation. He was successfully treated with percutaneous jejunostomy, which was removed 2 years later after full recovery. The third patient had severe constipation due to the use ofmorphinomimetic analgesics. She received percutaneous caecostomy for colonic lavage and desufflation. The fourth patient had combined constipation and sphincteric insufficiency. Although the percutaneous endoscopic colostomy was clinically successful, the catheter had to be removed due to local pain and abscess formation. PMID:18788674

Römkens, T E H; de Jong, D J; Kristinsson, J O; Wanten, G J

2008-08-23

162

Facilitating Primary Head Teacher Succession in England: The Role of the School Business Manager  

ERIC Educational Resources Information Center

|School leadership is significant for student learning, but increased workload and complexity are believed to be in part responsible for the difficulties internationally in managing succession, with experienced leaders leaving the profession prematurely and potential future leaders reluctant to take on the role. This article draws on a national…

Woods, Charlotte; Armstrong, Paul; Pearson, Diana

2012-01-01

163

Facilitating primary head teacher succession in England: the role of the School Business Manager  

Microsoft Academic Search

School leadership is significant for student learning, but increased workload and complexity are believed to be in part responsible for the difficulties internationally in managing succession, with experienced leaders leaving the profession prematurely and potential future leaders reluctant to take on the role. This article draws on a national government-funded programme of inter-school collaborations in England. Focusing on data from

Charlotte Woods; Paul Armstrong; Diana Pearson

2012-01-01

164

Some ecological observations on a permanent pond in southern England: Primary production and planktonic seasonal succession  

Microsoft Academic Search

A one year study of a 0.9 hectare permanent alkaline pond (mean depth lm) in southern England has shown that phytoplankton productivity was highest during fall and spring. Hourly rates of photosynthesis ranged from almost zero in the winter to a peak of 475 mgC\\/m3\\/h in the fall. Daily gross primary productivity per unit area varied from 0.1–2.5 gC\\/m2\\/d. The

Anthony R. Russo

1978-01-01

165

Primary mucinous carcinoma of the periocular region: successful management with local resections over 30 years.  

PubMed

Primary mucinous carcinoma of the skin is a rare malignant neoplasm, often with periocular involvement, believed to originate from eccrine sweat glands. It is slow growing and locally destructive, at times forming tumour satellites. We present a case with six local recurrences treated with surgical resections over a period of 30 years. We have not been able to find longer follow-up in the literature, and believe this case may offer insight into the management of these uniquely indolent malignancies. PMID:23417934

Burris, Christopher Keith; Rajan, K D Anand; Iliff, Nicholas T

2013-02-15

166

Successful treatment of a child with a primary intracranial rhabdomyosarcoma with chemotherapy and radiation therapy  

Microsoft Academic Search

Primary rhabdomyosarcoma of the central nervous system (CNS) is rare in both adults and children (Taratuto et al. (1985) Acta Neuropathol (Berl) 66(2):98–104). The outcome in the majority of cases is poor, and many cases are associated with\\u000a early mortality (Celli et al. (1998) J Neurooncol 36(3):259–267). There are very few cases reported in the literature of survival beyond 2 years after

Gregory Michael Taylor Guilcher; Glenda Hendson; Karen Goddard; Paul Steinbok; Mason Bond

2008-01-01

167

Primary immigration and succession of soil organisms on reclaimed opencast coal mining areas in eastern Germany  

Microsoft Academic Search

Immigration to and colonisation of recultivated opencast coal mining areas by soil organisms were investigated in eastern Germany during the period 1996–1998 in freshly exposed substrates (immigration test) and two up to 46-year-old afforested mine soils (stage-dependent succession). The results indicate that immigration by air is characteristic for protists, soil microarthropods and spiders, while active locomotion is more important for

Manfred Wanner; Wolfram Dunger

2002-01-01

168

Primary undifferentiated spindle-cell sarcoma of sella turcica: successful treatment with adjuvant temozolomide.  

PubMed

Sellar tumours in adults are most commonly pituitary adenomas. Primary spindle cell sarcoma of the sella turcica without a prior history of cranial radiation is extremely rare. We report a case of a large sellar mass with suprasellar and cavernous sinus extension in a geriatric male patient who presented with complete left oculomotor nerve palsy and panhypopituitarism. The patient underwent partial resection of the sellar mass through transcranial route. The pathology of the mass revealed a poorly differentiated spindle cell neoplasm most consistent with a sarcoma. Postoperatively, the size of the residual sellar mass decreased significantly following six cycles of external beam radiation in conjunction with temozolomide. PMID:23715844

Sareen, Pooja; Chhabra, Lovely; Trivedi, Nitin

2013-05-27

169

Stanozolol treatment for successful prevention of attacks of severe primary cryofibrinogenemia.  

PubMed

Severe essential cryofibrinogenemia is rare in childhood, and both the diagnosis and the management are challenging for pediatricians. An 11-year-old male, who had already lost two digits following cold exposure, was referred after multiple visits to various hospitals and subsequently diagnosed as primary cryofibrinogenemia. His history revealed unresponsiveness to calcium channel blockers, acetyl salicylic acid, pentoxifylline, dextran, and steroids. Stanozolol (2 mg/day, orally) prophylaxis was initiated and no new skin lesions developed following starting this treatment. Some of the newly formed lesions at the onset of stanozolol healed. PMID:20209649

Unal, Sule; Kara, Fehime; Ozen, Seza; Orhan, Diclehan; Tuncer, Murat; Gumruk, Fatma

2010-07-15

170

Primary systemic carnitine deficiency under successful therapy: clinical, biochemical, ultrahistochemical and renal clearance studies.  

PubMed

Systemic carnitine deficiency is an often fatal, but treatable metabolic disorder which should be considered in any child with repeated episodes of a Reye-like syndrome or a cardiomyopathy. A 4-year-old girl with a typical history and clinical findings was successfully treated with oral carnitine. Despite low liver carnitine, ketogenesis upon fasting was normal. Normal muscle function under therapy was associated with unchanged low muscle carnitine levels. Improvement of mitochondrial structure and function was demonstrated by controlled ultrahistochemical studies. A renal carnitine leak, evident from renal clearance studies, may contribute to the pathogenesis of systemic carnitine deficiency. PMID:3995808

von Petrykowski, W; Ketelsen, U P; Schmidt-Sommerfield, E; Penn, D; Sawicka, E; Struck, E; Lehnert, W; Haap, K; Strassburg, H M

171

Salvage of Immature Arteriovenous Fistulas with Percutaneous Transluminal Angioplasty  

SciTech Connect

The purpose of this study was to assess the value of percutaneous transluminal angioplasty (PTA) for the salvage of arteriovenous fistulas (AVFs) that fail to mature. From November 1998 to February 2003, 19 patients who were treated with PTA due to immature forearm AVFs were selected. Fistulography and PTA were performed via a retrograde transvenous approach after direct puncture of the fistular vein. Technical success was defined as less than a 30% residual stenosis, whereas clinical success was defined as the ability to perform at least one session of normal hemodialysis after PTA. Findings of fistulograms, success rates of PTA, and patency rates were evaluated. On initial fistulograms, stenoses were observed in all cases and 68% (13/19) of the stenoses were located in the perianastomotic area of these immature AVFs. The initial technical success rate was 84% (16/19). Technical failures comprised two patients with diffuse narrowing and segmental thrombosis of the cephalic veins and one case of elastic recoil of the anastomotic site stenosis after PTA. Two patients were immediately lost on follow-up. The remaining 14 cases underwent successful hemodialysis 0 to 33 (mean = 15) days after PTA, showing 74% (14/19) clinical success. Although accessory branch veins were noted in most cases (74%, 14/19), leaving them alone did not affect the maturation of AVFs following PTA. There was no significant procedural or late complication. Primary and secondary patency rates at 1 year were 61 and 82%, respectively. For those AVFs that failed to mature, there were stenoses along their vascular courses as underlying causes. For the percutaneous procedure, the retrograde transvenous approach was a reasonable one. As PTA is effective and quick for the salvation of immature AVFs, it can be considered a primary method for salvaging these immature AVFs.

Shin, Sung Wook; Do, Young Soo, E-mail: ysdo@smc.samsung.co.kr; Choo, Sung Wook; Lieu, Wei Chiang; Choo, In-Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiology (Korea, Republic of)

2005-05-15

172

Incidence and Treatment of Elastic Recoil Occurring in the 15 Minutes Following Successful Percutaneous Transluminal Coronary Angioplasty * * This study was supported by a Training in Cardiovascular Research Grant, NIH 5-T32 HL07360-17, a Texas Affiliate Grant-In-Aid from the American Heart Association, NIH Grant R01HL53225-01 from the National Heart, Lung, and Blood Institute, NIH Ischemic SCOR Grant HL17669, and the Harry S. Moss Heart Fund  

Microsoft Academic Search

This study was performed (1) to assess the incidence and magnitude of elastic recoil occurring within 15 minutes of successful coronary angioplasty, and (2) to determine the effect of subsequent additional balloon inflations on coronary luminal diameter in patients displaying substantial recoil. The coronary angiograms of 50 consecutive patients who underwent a successful percutaneous transluminal coronary angioplasty were analyzed using

William C. Daniel; Mark J. Pirwitz; John E. Willard; Richard A. Lange; L. David Hillis; Charles Landau

1996-01-01

173

Primary succession of Acrididae (Orthoptera): Differences in displacement capacities in early and late colonizers of new habitats  

NASA Astrophysics Data System (ADS)

Rehabilitated mine sites are suitable environments for the study of primary ecological succession. Following the monitoring of Plant and Orthoptera communities for 4 years on 7 sites in the Limousin region (France), covering 9 years of rehabilitation, three grasshopper seres were defined. It is expected that these seres are conditioned by both displacement capacities and reproductive characteristics. This study compares by field experiments the jumping flights and walking speed of the most abundant Caelifera belonging to the defined seres. A strong link emerged between the successional stages, the distances covered by jumping flights and sexual dimorphism. Walking speed is poorly related to the successional stage. We show that the high density of some species, as observed in the medium stage of succession, significantly reduces the walking distance of late colonisers, suggesting a mechanism that reduces further colonisation.

Picaud, F.; Petit, D. P.

2007-07-01

174

Percutaneous transluminal angioplasty of radiation-induced arterial stenoses  

SciTech Connect

A case of atherosclerosis resulting from previous irradiation was successfully treated using percutaneous transluminal angioplasty for recanalization of the vessel. Irradiation may result in extensive perivascular fibrosis around an area of arterial narrowing; percutaneous transluminal angioplasty appears to be the method of choice for treatment of such lesions.

Guthaner, D.F. (Stanford Univ. School of Medicine, CA); Schmitz, L.

1982-07-01

175

Primary school children in a large-scale OSCE: Recipe for disaster or formula for success?  

PubMed

Background: Many medical schools have moved to large end-of-year Objective Structured Clinical Examinations (OSCEs) in which it is difficult to involve children as patients. It is nevertheless important to assess student competencies in clinical examination of children. Methods: We set up a partnership with a local primary school, where children aged 8-11 years have assisted with our OSCE annually from 2007 to 2012. Approximately 30 children attend each exam, and are distributed between 14 simultaneous stations, each part of a 20-station circuit. Approximately 280 candidates complete the same paediatric station (e.g. cardiovascular examination) in one morning. Evaluation: A total of 160 children took part in the exams over this period, and of 129 (80.6%) who filled a questionnaire: 99.2% agreed that they 'had enjoyed taking part in the exam'; 100% 'thought it was a good experience'; and 96.1% 'thought that it was well organised'. Parent and teacher feedback has been overwhelmingly positive. Conclusion: We conclude that it is feasible to involve school children in a large-scale OSCE. A school - medical school partnership is mutually beneficial, improving assessment of important paediatric clinical skills, while providing a positive experience for children who participate. PMID:23848302

Darling, Jonathan C; Bardgett, Rebecca J M

2013-07-12

176

Meta-analysis comparing efficacy and safety of first generation drug-eluting stents to bare-metal stents in patients with diabetes mellitus undergoing primary percutaneous coronary intervention.  

PubMed

Several concerns have emerged regarding the higher risk for stent thrombosis (ST) after drug-eluting stent (DES) implantation, especially in the setting of ST-segment elevation myocardial infarction (STEMI). Few data have been reported so far in patients with diabetes mellitus, which is associated with high rates of target vessel revascularization after bare-metal stent (BMS) implantation but also higher rates of ST after DES implantation. Therefore, the aim of this study was to perform a meta-analysis of individual patients' data to evaluate the long-term safety and effectiveness of DES compared with BMS in patients with diabetes who undergo primary percutaneous coronary intervention for STEMI. Published reports were scanned by formal searches of electronic databases (MEDLINE and CENTRAL). All completed randomized trials of DES for STEMI were examined. No language restrictions were enforced. Individual patients' data were obtained from 11 of 13 trials, including a total of 972 patients with diabetes (616 [63.4%] randomized to DES and 356 [36.6%] to BMS). At long-term follow-up (median 1,095 days, interquartile range 1,087 to 1,460), DES significantly reduced the occurrence of target vessel revascularization (hazard ratio 0.42, 95% confidence interval 0.29 to 0.59, p <0.0001), without any significant difference in terms of mortality, late reinfarction, and ST (>1 year) with DES. In conclusion, this meta-analysis, based on individual patients' data from 11 randomized trials, showed that among patients with diabetes with STEMIs who undergo primary percutaneous coronary intervention, sirolimus-eluting stents and paclitaxel-eluting stents, compared with BMS, are associated with a significant reduction in target vessel revascularization at long-term follow-up, without any apparent concern in terms of mortality, despite the trend toward higher rates of reinfarction and ST. PMID:23490029

De Luca, Giuseppe; Dirksen, Maurits T; Spaulding, Christian; Kelbæk, Henning; Schalij, Martin; Thuesen, Leif; van der Hoeven, Bas; Vink, Marteen A; Kaiser, Christopher; Musto, Carmine; Chechi, Tania; Spaziani, Gaia; Diaz de la Llera, Luis Salvador; Pasceri, Vincenzo; Di Lorenzo, Emilio; Violini, Roberto; Suryapranata, Harry; Stone, Gregg W

2013-03-12

177

Successful GP intervention with frequent attenders in primary care: randomised controlled trial  

PubMed Central

Background Frequent attenders to GP clinics can place an unnecessary burden on primary care. Interventions to reduce frequent attendance have had mixed results. Aim To assess the effectiveness of a GP intervention to reduce frequent-attender consultations. Design of study Randomised controlled trial with frequent attenders divided into an intervention group and two control groups (one control group was seen by GPs also providing care to patients undergoing the intervention). Setting A health centre in southern Spain. Method Six GPs and 209 randomly-selected frequent attenders participated. Three GPs were randomly allocated to perform the new intervention: of the 137 frequent attenders registered with these three GPs, 66 were randomly allocated to receive the intervention (IG) and 71 to a usual care control group (CG2). The other three GPs offered usual care to the other 72 frequent attenders (CG1). The main outcome measure was the total number of consultations 1 year post-intervention. Baseline measurements were recorded of sociodemographic characteristics, provider–user interface, chronic illnesses, and psychosocial variables. GPs allocated to the new intervention received 15 hours' training which incorporated biopsychosocial, organisational, and relational approaches. After 1 year of follow-up frequent attenders were contacted. An intention-to-treat analysis was used. Results A multilevel model was built with three factors: time, patient, and doctor. After adjusting for covariates, the mean number of visits at 1 year in IG was 13.10 (95% confidence interval [CI] = 11.39 to 14.94); in the CG1 group was 19.37 (95% CI = 17.31 to 21.55); and in the CG2 group this was 16.72 (95% CI =14.84 to 18.72). Conclusion The new intervention with GPs resulted in a significant and relevant reduction in frequent-attender consultations. Although further trials are needed, this intervention is recommended to GPs interested in reducing consultations by their frequent attenders.

Bellon, Juan Angel; Rodriguez-Bayon, Antonina; de Dios Luna, Juan; Torres-Gonzalez, Francisco

2008-01-01

178

Temporal evolution and functional outcome of no reflow: sustained and spontaneously reversible patterns following successful coronary recanalisation  

Microsoft Academic Search

Objective: To identify in humans the temporal patterns of no reflow and their functional implications.Methods: 24 patients with first acute myocardial infarction and successful coronary recanalisation by recombinant tissue-type plasminogen activator (n = 15) or primary percutaneous transluminal coronary angioplasty (n = 9) were studied by myocardial contrast echocardiography within 24 hours of recanalisation and at one month’s follow up.

L Galiuto; A Lombardo; A Maseri; L Santoro; I Porto; D Cianflone; A G Rebuzzi; F Crea

2003-01-01

179

Percutaneous nephrolithotomy in early pregnancy.  

PubMed

Most cases of urolithiasis in pregnancy are managed conservatively either with ureteric stents or percutaneous nephrostomy tubes, which need to be changed at regular intervals. Definitive management of the stone is usually delayed till after delivery. We describe a patient who presented with pyonephrosis in the fifth week of gestation, due to a stone obstructing the right ureteropelvic junction. This was managed by insertion of a nephrostomy tube. She declined nephrostomy tube/stent changes during the rest of her pregnancy and requested termination as an alternative. She successfully underwent percutaneous nephrolithotomy in the 14th week of pregnancy, with radiation exposure strictly localised to the kidney for 6 s. A healthy male baby was delivered at term. PMID:15372856

Shah, A; Chandak, P; Tiptaft, R; Glass, J; Dasgupta, P

2004-08-01

180

Tubeless percutaneous nephrolithotomy  

PubMed Central

Introduction and Objective: Placement of a percutaneous nephrostomy tube for drainage has been an integral part of the standard percutaneous nephrolithotomy (PCNL) procedure. However, in recent years, the procedure has been modified to what has been called ‘tubeless’ PCNL, in which nephrostomy tube is replaced with internal drainage provided by a double-J stent or a ureteral catheter. The objective of this article is to review the evidence-based literature on ‘nephrostomy-free’ or ‘tubeless’ PCNL to compare the safety, effectiveness, feasibility, and advantages of tubeless PCNL over standard PCNL. Materials and Methods: We performed a MEDLINE database search to retrieve all published articles relating to ‘tubeless’ PCNL. Cross-references from retrieved articles as well as articles from urology journals not indexed in MEDLINE, were also retrieved. Results: The majority of the studies have shown ‘tubeless’ PCNL to be a safe and economical procedure, with reduced postoperative pain and morbidity and shorter hospital stay. tubeless PCNL has been found to be safe and effective even in patients with multiple stones, complex staghorn stones, concurrent ureteropelvic junction obstruction, and various degrees of hydronephrosis. The technique has been successful in obese patients, children, and in patients with recurrent stones after open surgery. Conclusion: Tubeless PCNL can be used with a favorable outcome in selected patients (stone burden <3 cm, single tract access, no significant residual stones, no significant perforation, minimal bleeding, and no requirement for a secondary procedure), with the potential advantages of decreased postoperative pain, analgesia requirement, and hospital stay. However, for extended indications, like supine PCNL, multiple, complex and staghorn stones, and concurrent PUJ obstruction, the evidence is insufficient and should come from prospective randomized trials.

Agrawal, Madhu Sudan; Agrawal, Mayank

2010-01-01

181

Comparison of Thrombolysis Followed by Broad Use of Percutaneous Coronary Intervention With Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Acute Myocardial Infarction Data From the French Registry on Acute ST-Elevation Myocardial Infarction (FAST-MI)  

Microsoft Academic Search

Background—Intravenous thrombolysis remains a widely used treatment for ST-elevation myocardial infarction; however, it carries a higher risk of reinfarction than primary PCI (PPCI). There are few data comparing PPCI with thrombolysis followed by routine angiography and PCI. The purpose of the present study was to assess contemporary outcomes in ST-elevation myocardial infarction patients, with specific emphasis on comparing a pharmacoinvasive

Nicolas Danchin; Pierre Coste; Jean Ferrières; Philippe-Gabriel Steg; Yves Cottin; Didier Blanchard; Loïc Belle; Bernard Ritz; Gilbert Kirkorian; Michael Angioi; Philippe Sans; Bernard Charbonnier; Hélène Eltchaninoff; Pascal Guéret; Khalife Khalife; Philippe Asseman; Jacques Puel; Patrick Goldstein; Jean-Pierre Cambou; Tabassome Simon

2011-01-01

182

Additive prognostic value of the SYNTAX score over GRACE, TIMI, ZWOLLE, CADILLAC and PAMI risk scores in patients with acute ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention.  

PubMed

This study evaluated additive prognostic value of the SYNTAX score over GRACE, TIMI, ZWOLLE, CADILLAC and PAMI risk scores in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). All six scores were calculated in 209 consecutive STEMI patients undergoing pPCI. Primary end-point was the major adverse cardiovascular event (MACE--composite of cardiovascular mortality, non-fatal myocardial infarction and stroke); secondary end point was cardiovascular mortality. Patients were stratified according to the SYNTAX score tertiles (?12; between 12 and 19.5; >19.5). The median follow-up was 20 months. Rates of MACE and cardiovascular mortality were highest in the upper tertile of the SYNTAX score (p < 0.001 and p = 0.003, respectively). SYNTAX score was independent multivariable predictor of MACE and cardiovascular mortality when added to GRACE, TIMI, ZWOLLE, and PAMI risk scores. However, the SYNTAX score did not improve the Cox regression models of MACE and cardiovascular mortality when added to the CADILLAC score. The SYNTAX score has predictive value for MACE and cardiovascular mortality in patients with STEMI undergoing primary PCI. Furthermore, SYNTAX score improves prognostic performance of well-established GRACE, TIMI, ZWOLLE and PAMI clinical scores, but not the CADILLAC risk score. Therefore, long-term survival in patients after STEMI depends less on detailed angiographical characterization of coronary lesions, but more on clinical characteristics, myocardial function and basic angiographic findings as provided by the CADILLAC score. PMID:23443340

Brkovic, Voin; Dobric, Milan; Beleslin, Branko; Giga, Vojislav; Vukcevic, Vladan; Stojkovic, Sinisa; Stankovic, Goran; Nedeljkovic, Milan A; Orlic, Dejan; Tomasevic, Miloje; Stepanovic, Jelena; Ostojic, Miodrag

2013-02-27

183

Coupling of Primary Producers, Detritus, Decomposer Organisms and Nitrogen Availability during Secondary Succession: Progress Report for Period September 28, 1987-September 27, 1988.  

National Technical Information Service (NTIS)

Secondary succession is a consequence of the interactions among primary producers, decomposers, detritus, and abiotic components of the system over time. This study focuses on the interrelationships among above- and below-ground processes involved in semi...

E. F. Redente

1988-01-01

184

Percutaneous transvenous embolisation of iatrogenic vertebral arteriovenous fistula  

Microsoft Academic Search

Two patients presented with vertebral arteriovenous fistulae following unintentional puncture of the vertebral artery. A percutaneous transvenous approach was used in both cases and the fistula was successfully embolised with microcoils. A complete cure was achieved in both patients.

S. Fukao; N. Hashimoto; K. Kazekawa; Y. Kaku

1995-01-01

185

Percutaneous nephrolithotomy.  

PubMed

A new method of removing calculi from the renal collecting system, in which the large and traumatic incision in the loin currently used is unnecessary, was attempted in 31 patients. Small dilators were introduced over a guide wire through a nephrostomy tube into the renal pelvis and a catheter inserted. The track was dilated in stages and two days later the nephrostomy tube was removed and a cystoscope introduced into the interior of the kidney. A stone basket was introduced down the operating channel of the cystoscope and maneuvered to secure the stone; the cystoscope, stone basket, and stone were then removed. The procedure failed in 11 of the 31 patients, in five because the needle could not be placed accurately initially and in six because the stone could not be removed despite the establishment of a nephrostomy track. In the remaining 20 patients the procedure was successful. This procedure is far less traumatic than the conventional operation. With the development of a flexible nephroscope and an ultrasonic stone disintegrator it will be possible also to remove larger stones and stones in the peripheral calices using this method. PMID:6796170

Wickham, J E; Kellet, M J

1981-12-12

186

Percutaneous Transluminal Angioplasty of Peripheral Bypass Stenoses  

Microsoft Academic Search

Purpose: To assess the success of percutaneous transluminal angioplasty (PTA) in treating peripheral bypass stenoses. Methods: Patients who received a femoropopliteal or femorocrural bypass graft for limb ischemia were included in a duplex surveillance program. If duplex ultrasound revealed a short (<2 cm) severe (peak systolic velocity ratio {>=} 4.5) stenosis, patients were scheduled for arteriography and PTA. Fifty-eight peripheral

Arjan W. J. Hoksbergen; Dink A. Legemate; Jim A. Reekers; Dirk T. Ubbink; Michael J. H. M. Jacobs

1999-01-01

187

Microcatheter Use for Difficult Percutaneous Biliary Procedures  

SciTech Connect

Percutaneous biliary drainage procedures in patients with nondilated ducts are demanding, resulting in lower success rates than in patients with bile duct dilatation. Pertinent clinical settings include patients with iatrogenic bile leaks, diffuse cholangiocarcinomas, and sclerosing cholangitis. We describe a method to facilitate these procedures with the combined use of a 2.7-Fr microcatheter and a 0.018-in. hydrophilic wire.

Brountzos, Elias N., E-mail: ebrountz@med.uoa.gr; Kelekis, Alexis D.; Ptohis, Nikolaos; Kotsioumba, Ioanna [Athens University Medical School, Attikon University Hospital, Second Department of Radiology (Greece); Misiakos, Evangelos [Athens University, Medical School, Attikon University Hospital, Third Department of Surgery (Greece); Perros, George [Athens University, Medical School, Attikon University Hospital, Fourth Department of Surgery (Greece); Gouliamos, Athanasios D. [Athens University Medical School, Attikon University Hospital, Second Department of Radiology (Greece)

2008-09-15

188

Syphilitic Coronary Artery Ostial Stenosis Resulting in Acute Myocardial Infarction Treated by Percutaneous Coronary Intervention  

PubMed Central

Cardiovascular abnormalities are well-known manifestations of tertiary syphilis infections which although not frequent, are still causes of morbidity and mortality. A less common manifestation of syphilitic aortitis is coronary artery ostial narrowing related to aortic wall thickening. We report a case of a 46-year-old male admitted due to acute anterior ST elevation myocardial infarction submitted to primary percutaneous coronary intervention successfully. Coronary angiography showed a suboccluded ostial lesion of left main coronary artery. VDRL was titrated to 1/512. The patient was discharged with treatment including benzathine penicillin. Previous case reports of acute myocardial infarction in association with syphilitic coronary artery ostial stenosis have been reported, but the fact that the patient was treated by percutaneous coronary intervention is unique in this case.

Nakazone, Marcelo A.; Machado, Mauricio N.; Barbosa, Raphael B.; Santos, Marcio A.; Maia, Lilia N.

2010-01-01

189

Percutaneous Nephrostomy: Technical Aspects and Indications  

PubMed Central

First described in 1955 by Goodwin et al as a minimally invasive treatment for urinary obstruction causing marked hydronephrosis, percutaneous nephrostomy (PCN) placement quickly found use in a wide variety of clinical indications in both dilated and nondilated systems. Although the advancement of modern endourological techniques has led to a decline in the indications for primary nephrostomy placement, PCNs still play an important role in the treatment of multiple urologic conditions. In this article, the indications, placement, and postprocedure management of percutaneous nephrostomy drainage are described.

Dagli, Mandeep; Ramchandani, Parvati

2011-01-01

190

Percutaneous nephrolithotomy: Current concepts  

PubMed Central

Percutaneous nephrolithotomy (PNL) is the procedure of choice for large renal stones. Since its introduction in 1976, many aspects of the operative technique and the endoscopic equipments have had constant evolution, increasing the success rates of the procedure. We performed a literature search using Entrez Pubmed from January 2000 to July 2007 concerning PNL and many aspects related to all steps of the procedure. We could verify that PNL in supine position has been proved as an acceptable option, but more worldwide experience is necessary. Urologists must be trained to gain their own renal tract access. Minipercutaneous PNL still needs equipments improvements for better results. Tubeless PNL is increasing in popularity and different tract sealants have been studied. Medical prevention is proved to be effective against stone recurrence and should be always used after PNL. Although the evolution of the technique in the last 20 years, urologists must continue to improve their skills and develop new technologies to offer to the patients more and more a safe and effective option to treat large renal stones.

Vicentini, Fabio C.; Gomes, Cristiano Mendes; Danilovic, Alexandre; Neto, Elias A. Chedid; Mazzucchi, Eduardo; Srougi, Miguel

2009-01-01

191

Successful production of the engineering development unit (EDU) primary mirror segment and flight unit tertiary mirror for JWST  

NASA Astrophysics Data System (ADS)

During 2009, Tinsley finished most of the Configuration 1 pre-cryo test Computer Controlled Optical Surfacing (CCOS) operations on the James Webb Space Telescope primary mirror segments and in mid-2009 we began the Configuration 2 post-cryo test CCOS operations. After completing the grinding and polishing operations, including final figuring to a cryo-null target, we delivered the finished Engineering Development Unit (EDU) to Ball Aerospace Technology Corporation on 4 December 2009. Achieving fabrication and metrology conditions to meet the specifications for this off-axis ~1.5 m hexagonal point-to-point segmented mirror required special methods. Achieving repeatable and accurate interferometric alignment of the off-axis aspherical mirror surface and stable thermal gradient control of the beryllium substructure during tests required rigorous component and system-level validation. Final optical wavefront measurements over the various spatial frequency ranges have demonstrated that all of the requirements are met. This success has validated our processes of fabrication and metrology and allows us to proceed with the production of the 18 flight mirror segments. The first finished flight mirror, the Tertiary Mirror, was shipped to BATC on 24 February, 2010. Performance of that mirror is reported here also.

Arneson, Andrea; Alongi, Chris; Bernier, Rob; Boese, Ed; Daniel, Jay; Dettmann, Lee; Garfield, Robert; Glatzel, Holger; Kincade, John; Johnson, Patrick; Lee, Allen; Magruder, Adam; Patel, Ankit; Seilonen, Martin; Surges, Gary; Bergeland, Mark; Brown, Robert J.; Gallagher, Benjamin; McKay, Andrew; Cohen, Lester M.

2010-07-01

192

The Association Between Levels of Tissue Inhibitor of Metalloproteinase-1 with Acute Heart Failure and Left Ventricular Dysfunction in Patients with ST Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention  

PubMed Central

Aims: Tissue inhibitors of metalloproteinase (TIMPs) bind to active matrix metalloproteinase (MMPs), and thereby inhibit their proteolytic activity. We investigated the role of polymorphisms in the gene for TIMP-1 and serum levels of TIMP-1 in association with postmyocardial infarction (MI), left ventricular (LV) dysfunction, and symptoms of acute heart failure (AHF) in patients treated with primary percutaneous coronary intervention. Methods: In total, 556 patients with STEMI were evaluated. Levels of TIMP-1 were measured at admission and 24?h after MI onset. The TIMP-1 exon 5 SNP rs4898 (F124F with T>C) located at X chromosome was assayed. Results: TIMP-1 levels were higher for men with AHF as well as for men with LV dysfunction (ejection fraction [EF]<40%). According to multivariate analysis, the TIMP-1 level was a factor with an independent negative relationship to EF and AHF in men. An independent relationship between exon 5 TIMP-1 gene polymorphism and EF, AHF or TIMP-1 level was not documented. Conclusion: These results provide evidence that a higher level of circulating TIMP-1 is independently associated with worse EF and AHF.

Goldbergova, Monika Pavkova; Jarkovsky, Jiri; Kala, Petr; Poloczek, Martin; Manousek, Jan; Kluz, Krystyna; Kubkova, Lenka; Littnerova, Simona; Tesak, Martin; Toman, Ondrej; Pavek, Nikolas; Cermakova, Zdenka; Tomandl, Josef; Vasku, Anna; Spinar, Jindrich

2012-01-01

193

MEASUREMENT OF BIO-IMPEDANCE WITH A SMART NEEDLE TO CONFIRM PERCUTANEOUS KIDNEY ACCESS  

Microsoft Academic Search

Purpose: The traditional method of percutaneous renal access requires freehand needle place- ment guided by C-arm fluoroscopy, ultrasonography, or computerized tomography. This ap- proach provides limited objective means for verifying successful access. We developed an imped- ance based percutaneous Smart Needle system and successfully used it to confirm collecting system access in ex vivo porcine kidneys. Materials and Methods: The

DAVID J. HERNANDEZ; VLADIMIR A. SINKOV; WILLIAM W. ROBERTS; MOHAMAD E. ALLAF; ALEXANDRU PATRICIU; THOMAS W. JARRETT; LOUIS R. KAVOUSSI; DAN STOIANOVICI

2001-01-01

194

Percutaneous Radiofrequency Ablation of Lung Tumors in Contact with the Aorta: Dangerous and Difficult but Efficient: A Report of Two Cases  

SciTech Connect

Percutaneous imaging-guided tumor ablation is a widely accepted method for the treatment of primary and secondary lung tumors. Although it is generally feasible and effective for local tumor control, some conditions may affect its feasibility and effectiveness. Herein the authors report their experience with two patients with lung malignancies contiguous to the aorta who were successfully treated with radiofrequency ablation, even though it initially appeared highly risky due to the possible fatal complications.

Thanos, Loukas, E-mail: loutharad@yahoo.co ['Sotiria' General Hospital of Chest Diseases, Computed Tomography and Interventional Radiology Department (Greece); Mylona, Sofia; Giannoulakos, Nikolaos [Red Cross General Hospital of Athens, Radiology Department (Greece); Ptohis, Nikolaos ['Sotiria' General Hospital of Chest Diseases, Computed Tomography and Interventional Radiology Department (Greece); Galani, Panagiota; Pomoni, Maria [Red Cross General Hospital of Athens, Radiology Department (Greece)

2008-11-15

195

Percutaneous coronary intervention with anomalous origin of right coronary artery: case reports and literature review  

PubMed Central

Percutaneous coronary intervention (PCI) in an anomalous right coronary artery (RCA) can be technically difficult because selective cannulation of the vessel may not be easy. We thereby present two cases with unstable angina pectoris of anomalous originated RCA. The PCI were successfully performed in two patients with a special guiding wire manipulating skill which we called “gone with the flow” combined with balloon anchoring technology, providing excellent angiographic visualization and sound guide support for stent delivery throughout the procedure without severe cardiovascular adverse effects. Our primary data suggested that PCI for geriatric patients with an anomalous origin of RCA accompanied by severe atherosclerotic lesions might also be a safe, available, and feasible strategy.

Hong, Li-Feng; Luo, Song-Hui; Li, Jian-Jun

2013-01-01

196

Percutaneous Endovascular Treatment of Chronic Iliac Artery Occlusion  

SciTech Connect

Purpose: To evaluate the clinical and radiological long-term results of recanalization of chronic occluded iliac arteries with balloon angioplasty and stent placement.Methods: Sixty-nine occluded iliac arteries (mean length 8.1 cm; range 4-16 cm) in 67 patients were treated by percutaneous transluminal angioplasty and stent placement. Evaluations included clinical assesment according to Fontaine stages, Doppler examinations with ankle-brachial index (ABI) and bilateral lower extremity arteriograms. Wallstent and Cragg vascular stents were inserted for iliac artery recanalization under local anesthesia. Follow-up lasted 1-83 months (mean 29.5 months).Results: Technical success rate was 97.1% (67 of 69). The mean ABI increased from 0.46 to 0.85 within 30 days after treatment and was 0.83 at the most recent follow-up. Mean hospitalization time was 2 days and major complications included arterial thrombosis (3%), arterial rupture (3%) and distal embolization (1%). During follow-up 6% stenosis and 9% thrombosis of the stents were observed. Clinical improvement occurred in 92% of patients. Primary and secondary patency rates were 75% and 95%, respectively.Conclusion: The long-term patency rates and clinical benefits suggest that percutaneous endovascular revascularization with metallic stents is a safe and effective treatment for patients with chronic iliac artery occlusion.

Carnevale, F. C. [Institute of Radiology, University of Sao Paulo, Department of Interventional Radiology (Brazil)], E-mail: fcarnevale@uol.com.br; De Blas, Mariano; Merino, Santiago; Egana, Jose M. [Hospital De Guipuzcoa, Department of Radiology (Spain); Caldas, Jose G.M.P. [Institute of Radiology, University of Sao Paulo, Department of Interventional Radiology (Brazil)

2004-09-15

197

Percutaneous endoscopic gastrostomy  

Microsoft Academic Search

Percutaneous endoscopic gastrostomy (PEG) is one of the most commonly used methods for nutritional support in patients who\\u000a are unable to take food orally. Traditional surgical gastrostomy, percutaneous radiologic gastrostomy, and laparoscopic gastrostomy\\u000a are the alternatives. The most common indication is neurogenic dysphagia followed by obstructive causes such as head and neck\\u000a tumors. Ethically justified and clinically comprehensive guidelines should

Rasim Gencosmanoglu

2004-01-01

198

Updates on Percutaneous Radiologic Gastrostomy/Gastrojejunostomy and Jejunostomy  

PubMed Central

Gastrostomy placement for nutritional support for patients with inadequate oral intake has been attempted using surgical, endoscopic, and, more recently, percutaneous radiologically guided methods. Surgical gastrostomy has been superseded by both endoscopic and radiologic gastrostomy. We describe herein the indications, contraindications, patient preparations, techniques, complications, and aftercare with regard to radiologic gastrostomy. In addition, we discuss the available tube types and their perceived advantages. There remain some controversies regarding gastropexy performance and primary percutaneous gastrojejunostomy. Percutaneous jejunostomy is indicated for patients whose stomach is inaccessible for gastrostomy placement or for those who have had a previous gastrectomy.

Park, Auh-Whan

2010-01-01

199

Percutaneous Management of Abscess and Fistula Following Pancreaticoduodenectomy  

SciTech Connect

Purpose: To evaluate the efficacy of percutaneous drainage of fluid collections following pancreaticoduodenectomy (Whipple's procedure). Methods: We performed a retrospective review of 19 patients referred to our service with fluid collections following pancreaticoduodenectomy. The presence of associated enteric or biliary fistulas, the route(s) of access for image-guided drainage, the incidence of positive bacterial cultures, and the duration and success of percutaneous management were recorded. Results: Fistulous communication to the jejunum in the region of the pancreatico-jejunal anastomosis was demonstrable in all 19 patients by gentle contrast injection into drainage tubes. Three patients had concurrent biliary fistulas. In 18 of 19 patients, fluid samples yielded positive bacterial cultures. Successful percutaneous evacuation of fluid was achieved in 17 of 19 patients (89%). The mean duration of drainage was 31 days. Conclusion: Percutaneous drainage of abscess following pancreaticoduodenectomy is effective in virtually all patients despite the coexistence of enteric and biliary fistulas.

AAssar, O. Sami; LaBerge, Jeanne M.; Gordon, Roy L.; Wilson, Mark W.; Mulvihill, Sean J.; Way, Lawrence W.; Kerlan, Robert K. [Department of Radiology, Box 0252, UCSF Medical Center, 505 Parnassus Avenue, San Francisco CA 94143-0252 (United States)

1999-01-15

200

Ectopic Varices in the Gastrointestinal Tract: Short- and Long-Term Outcomes of Percutaneous Therapy  

SciTech Connect

To evaluate the results of percutaneous management of ectopic varices, a retrospective review was carried out of 14 patients (9 men, 5 women; mean age 58 years) who between 1992 and 2001 underwent interventional radiological techniques for management of bleeding ectopic varices. A history of prior abdominal surgery was present in 12 of 14 patients. The interval between the surgery and percutaneous intervention ranged from 2 to 38 years. Transhepatic portal venography confirmed ectopic varices to be the source of portal hypertension-related gastrointestinal bleeding. Embolization of the ectopic varices was performed by a transhepatic approach with coil embolization of the veins draining into the ectopic varices. Transjugular intrahepatic portosystemic shunt (TIPS) was performed in the standard fashion. Eighteen procedures (12 primary coil embolizations, 1 primary TIPS, 2 re-embolizations, 3 secondary TIPS) were performed in 13 patients. One patient was not a candidate for percutaneous treatment. All interventions but one (re-embolization) were technically successful. In 2 of 18 interventions, re-bleeding occurred within 72 hr (both embolization patients). Recurrent bleeding (23 days to 27 months after initial intervention) was identified in 9 procedures (8 coil embolizations, 1 TIPS due to biliary fistula). One patient had TIPS revision because of ultrasound surveillance findings. New encephalopathy developed in 2 of 4 TIPS patients. Percutaneous coil embolization is a simple and safe treatment for bleeding ectopic varices; however, recurrent bleeding is frequent and reintervention often required. TIPS can offer good control of bleeding at the expense of a more complex procedure and associated risk of encephalopathy.

Macedo, Thanila A., E-mail: macedo.thanila@mayo.edu; Andrews, James C. [Mayo Clinic and Foundation, Department of Radiology (United States); Kamath, Patrick S. [Mayo Clinic and Foundation, Division of Gastroenterology and Hepatology (United States)

2005-04-15

201

Ultrasonic-Guided Percutaneous Injection of Pancreatic Pseudoaneurysm with Thrombin  

SciTech Connect

Pancreatic pseudoaneurysm is a relatively uncommon complication of chronic pancreatitis, with an associated high mortality if rupture or hemorrhage occurs. We present a case of pancreatic pseudoaneurysm complicating pancreatitis which was successfully treated by direct percutaneous injection of thrombin into the aneurysmal sac. Follow-up at 8 weeks did not demonstrate recurrence. This case indicates that percutaneous thrombin injection offers effective treatment of visceral arterial pseudoaneurysms.

Sparrow, Patrick, E-mail: patsparrow@doctors.net.uk; Asquith, John; Chalmers, Nick [Manchester RoyalInfirmary, Oxford Road, Manchester M13 9WL, Department of Radiology (United Kingdom)

2003-06-15

202

Donor-gifted allograft urolithiasis: early percutaneous management  

Microsoft Academic Search

Objectives. To describe our successful early management of donor-gifted nephrolithiasis by percutaneous nephrolithotomy. Donor-gifted nephrolithiasis is a rare and frustrating complication of renal transplantation. In the past, initial conservative management with relief of obstruction and shock wave lithotripsy has been recommended.Methods. We treated 3 cases of donor-gifted cadaveric kidney transplant stones by a percutaneous approach 1 to 2 months postoperatively.

Hsueh-Fu Lu; Bijan Shekarriz; Marshall L Stoller

2002-01-01

203

The identification, development, succession and retention of leadership talent in contextually different primary schools: a case study located within the English West Midlands  

Microsoft Academic Search

This article explores head teacher and middle leader perceptions of leadership talent identification, development, succession and retention in 12 contextually different urban primary schools. The schools are located within a single local education authority in the English West Midlands. The study is constructed to inform the research agenda in the face of a looming leadership recruitment and retention crisis in

Christopher Rhodes; Mark Brundrett

2006-01-01

204

The Identification, Development, Succession and Retention of Leadership Talent in Contextually Different Primary Schools: A Case Study Located within the English West Midlands  

ERIC Educational Resources Information Center

This article explores head teacher and middle leader perceptions of leadership talent identification, development, succession and retention in 12 contextually different urban primary schools. The schools are located within a single local education authority in the English West Midlands. The study is constructed to inform the research agenda in the…

Rhodes, Christopher; Brundrett, Mark

2006-01-01

205

Effects of arbuscular mycorrhizal fungi and soil developmental stages on herbaceous plants growing in the early stage of primary succession on Mount Fuji  

Microsoft Academic Search

A pot culture experiment was conducted to examine the effects of arbuscular mycorrhizal (AM) fungi and soil developmental stages on the growth and nutrient absorption of pioneer plants growing in the early stage of primary succession on Mt. Fuji. Four herbaceous plants, Polygonum cuspidatum (Polygonaceae), Miscanthus oligostachyus (Gramineae), Aster ageratoides var. ovatus (Compositae), and Hedysarum vicioides (Leguminosae), were grown from

Masaaki Fujiyoshi; Atsushi Kagawa; Takayuki Nakatsubo; Takehiro Masuzawa

2006-01-01

206

An Investigation into the Need for Effective Leadership Mechanisms in the Management of a Successful Inclusive Programme in the Primary School System  

ERIC Educational Resources Information Center

|This research project aims to highlight the need for effective leadership mechanisms to be put in place for the management of a successful inclusive program in the Primary School System in Barbados. The outcomes of the research findings show evidence of the need for strong instructional leadership by the principals in order to implement workable…

McClean, Wilma A.

2007-01-01

207

Coupling of primary producers, detritus, decomposer organisms and nitrogen availability during secondary succession: Progress report for period September 28, 1987September 27, 1988  

Microsoft Academic Search

Secondary succession is a consequence of the interactions among primary producers, decomposers, detritus and abiotic components of the system over time. This study focuses on the interrelationships among above- and below-ground processes involved in semiarid ecosystem development. We found that the addition of nitrogen and phosphorus significantly reduced the production of perennial species while significantly increasing the production of annual

Redente

1988-01-01

208

Dynamics of soil organic matter in primary and secondary forest succession on sandy soils in The Netherlands: An application of the ROMUL model  

Microsoft Academic Search

We applied the simulation model ROMUL of soil organic matter dynamics in order to analyse and predict forest soil organic matter (SOM) changes following stand growth and also to identify gaps of data and modelling problems. SOM build-up was analysed (a) from bare sand to forest soil during a primary succession in Scots pine forest and (b) on mature forest

M. A. Nadporozhskayaa; G. M. J. Mohren; O. G. Chertov; A. S. Komarov; A. V. Mikhailov

2006-01-01

209

Effect of Family Supported Pre-Reading Training Program Given to Children in Preschool Education Period on Reading Success in Primary School  

ERIC Educational Resources Information Center

In this study, the effect of Family Supported Pre-Reading Program developed for 6 year olds attending nursery school on children's reading success in the future was examined. In order to fulfill this aim, reading skills of 25 primary school first-grade pupils who participated Family Supported Pre-Reading Program were compared with another 25…

Buyuktaskapu, Sema

2012-01-01

210

Intracoronary versus intravenous high-dose bolus plus maintenance administration of tirofiban in patients undergoing primary percutaneous coronary intervention for acute ST elevation myocardial infarction.  

PubMed

We aimed to examine whether intracoronary high-dose bolus of tirofiban plus maintenance would result in improved clinical outcome in STEMI patients undergoing primary PCI in this pilot trial. A total of 56 patients were enrolled to receive either intracoronary high-dose bolus plus maintenance (n = 34) or intravenous high-dose bolus plus maintenance (n = 22) of tirofiban. Pre and post intervention TIMI flow grades, myocardial blush grades, peak CKMB and troponin levels, time to peak CKMB and troponin, time to 50% ST resolution and major composite adverse cardiac event rates at 30 days were recorded. Although incidence of major adverse cardiac events was not different, post intervention TIMI flow and TIMI blush grades, peak CKMB and troponin levels, and time to peak CKMB and time to peak troponin were significantly different, favoring intracoronary strategy. In conclusion, this regimen improved myocardial reperfusion and coronary flow, and reduced myocardial necrosis, but failed to improve clinical outcomes at 30 days. PMID:22252901

Candemir, Basar; Kilickap, Mustafa; Ozcan, Ozgur Ulas; Kaya, Cansin Tulunay; Gerede, Menekse; Ozdemir, Aydan Ongun; Ozdol, Cagdas; Kumbasar, Deniz; Erol, Cetin

2012-07-01

211

ASTER and Ground Observations of Vegetation Primary Succession and Habitat Development near Retreating Glaciers in Alaska and Nepal  

NASA Astrophysics Data System (ADS)

Like active volcanoes, glaciers are among the most dynamic components of the Earth's solid surface. All of the main surface processes active in these areas have an ability to suddenly remake or "resurface" the landscape, effectively wiping the land clean of vegetation and habitats, and creating new land surface and aqueous niches for life to colonize and develop anew. This biological and geomorphological resurfacing may remove the soil or replace it with inorganic debris layers. The topographical, hydrological, and particle size-frequency characteristics of resurfaced deglaciated landscapes typically create a high density of distinctive, juxtaposed niches where differing plant communities may become established over time. The result is commonly a high floral and faunal diversity and fecundity of life habitats. The new diverse landscape continues to evolve rapidly as ice-cored moraines thaw, lakes drain or fill in with sediment, as fluvial dissection erodes moraine ridges, as deltaic sedimentation shifts, and other processes (coupled with primary succession) take place in rapid sequence. In addition, climate dynamics which may have caused the glaciers to retreat may continue. We will briefly explore two distinctive glacial environments-(1) the maritime Copper River corridor through the Chugach Mountains (Alaska), Allen Glacier, and the river's delta; and (2) Nepal's alpine Khumbu valley and Imja Glacier. We will provide an example showing how ASTER multispectral and stereo-derived elevation data, with some basic field-based constraints and observations, can be used to make automatic maps of certain habitats, including that of the Tibetan snowcock. We will examine geomorphic and climatic domains where plant communities are becoming established in the decades after glacier retreat and how these link to the snowcock habitat and range. Snowcock species have previously been considered to have evolved in close association with glacial and tectonic history of South and Central Asia (B. An et al., 2009, Molecular Phylogenetics and Evolution 50: 526-533; R. Luzhang et al., 2010, Animal Biology 60: 449-465). The new maps and some observations of the snowcock's habits, ecological relationships to other species and landscapes, and physiological limitations support that basic model. Our new data and mapping carries some profound implications for past, present, and future coevolution of these birds and glaciers. Using insights derived from ASTER remote sensing based habitat mapping, we will explore some specific processes that may drive snowcock habitat, population, and genetic dynamics. Although the ecological fabric differs from one region to another, some basic insights from the Himalayan Khumbu valley may be applied to the Chugach Range.

Kargel, J. S.; Leonard, G. J.; Furfaro, R.

2011-12-01

212

[Minimally invasive percutaneous nephrolitholapaxy (MIP)].  

PubMed

Minimally invasive percutaneous nephrolithopaxy (MIP) was developed to combine the excellent stone-free rates of the conventional percutaneous nephrolithopaxy (PCNL) technique with the low morbidity of the miniaturized PCNL (Mini-Perc) and, at the same time, achieve a high level of patient comfort. The procedure is characterized not only by the diameter of the miniaturized 18-Fr Amplatz sheath that was adopted from the Mini-Perc but also by the following features: ultrasound-guided puncture of the kidney; single-step dilatation of the access tract; ballistic lithotripsy; a low-pressure irrigation system together with stone retraction by irrigation with a specially designed nephroscope sheath, for the so-called vacuum cleaner effect; and a sealed and tubeless access tract with primary closure of the channel independent of hemorrhage and without a second-look procedure.The results of the first 57 patients demonstrate primary stone-free rates of 92.9% with operating times averaging 62 (25-123) min. Severe complications, such as sepsis or bleeding requiring blood transfusion, did not occur. The high and predictable stone-free rate and a low morbidity comparable to that of ureteroscopy and extracorporeal shock-wave lithotripsy make MIP an attractive option for patients and urologists. The "vacuum cleaner effect" with quick removal of stone fragments reduces operating time and prevents new stone formation by avoiding residual fragments. The direct and primary closure of the access tract increases patient comfort and is justified by the reintervention rate of less than 8% in the presented cohort.The lack of a need for second-look nephroscopies, the vacuum cleaner effect, improved patient comfort without nephrostomy tubes, as well as surgery times comparable to that of traditional PCNL demonstrate a consequent evolution of the Mini-Perc. MIP therefore represents a promising and future-oriented module in modern stone therapy. PMID:18709351

Nagele, U; Schilling, D; Anastasiadis, A G; Walcher, U; Sievert, K D; Merseburger, A S; Kuczyk, M; Stenzl, A

2008-09-01

213

[Percutaneous vertebroplasty: methods, indications, results].  

PubMed

Percutaneous vertebroplasty (PVP) is a radiologically guided therapeutic procedure, which consists of percutaneous injection of a liquid polymer (bone cement) into a destroyed vertebral body. PVP was invented in 1984, in France, first for treating vertebral body haemangioma. Since its introduction the indications have been expanded progressively and today PVP is indicated mainly for treatment of vertebral haemangioma, malignant vertebral tumor and osteoporotic vertebral compression fracture. The unique advantage of this technique is that besides the stabilization of the vertebral body--and partly in connection with this--it affords prompt and lasting pain relief. Based on published data the success rate of the procedure is 80-100% with a complication rate of 1-10%. Thus, PVP is a valuable minimally invasive tool, providing immediate pain relief and early mobility in carefully selected patients. However, further work is needed to define the benefits of PVP compared to the standard treatment. The purpose of this paper is to demonstrate the technique by analyzing scientific reports published to date and summarizing the first author's own experience gained at the University Hospital of Geneva, Department of Neuroradiology, Switzerland. PMID:12674801

Baráth, Krisztina; Martin, Jean-Baptiste; Fasel, H Jean; Tokunaga, Koji; Szikora, István; Martos, János; Nyáry, István; Rüfenacht, A Daniel

2002-11-01

214

Total Percutaneous Aortic Repair: Midterm Outcomes  

SciTech Connect

The purpose of this study was to examine the immediate and midterm outcomes of percutaneous endovascular repair of thoracic and abdominal aortic pathology. Between December 2003 and June 2005, 21 patients (mean age: 60.4 {+-} 17.1 years; 15 males, 6 females) underwent endovascular stent-graft insertion for thoracic (n = 13) or abdominal aortic (n = 8) pathology. Preprocedural computed tomographic angiography (CTA) was performed to assess the suitability of aorto-iliac and common femoral artery (CFA) anatomy, including the degree of CFA calcification, for total percutaneous aortic stent-graft repair. Percutaneous access was used for the introduction of 18- to 26-Fr delivery devices. A 'preclose' closure technique using two Perclose suture devices (Perclose A-T; Abbott Vascular) was used in all cases. Data were prospectively collected. Each CFA puncture site was assessed via clinical examination and CTA at 1, 6, and 12 months, followed by annual review thereafter. Minimum follow-up was 36 months. Outcome measures evaluated were rates of technical success, conversion to open surgical repair, complications, and late incidence of arterial stenosis at the site of Perclose suture deployment. A total of 58 Perclose devices were used to close 29 femoral arteriotomies. Outer diameters of stent-graft delivery devices used were 18 Fr (n = 5), 20 Fr (n = 3), 22 Fr (n = 4), 24 Fr (n = 15), and 26 Fr (n = 2). Percutaneous closure was successful in 96.6% (28/29) of arteriotomies. Conversion to surgical repair was required at one access site (3.4%). Mean follow-up was 50 {+-} 8 months. No late complications were observed. By CT criteria, no patient developed a >50% reduction in CFA caliber at the site of Perclose deployment during the study period. In conclusion, percutaneous aortic stent-graft insertion can be safely performed, with a low risk of both immediate and midterm access-related complications.

Bent, Clare L., E-mail: clare.bent@bartsandthelondon.nhs.uk; Fotiadis, Nikolas; Renfrew, Ian [Barts and The London NHS Trust, Department of Diagnostic Imaging (United Kingdom); Walsh, Michael; Brohi, Karim [Barts and The London NHS Trust, Department of Vascular Surgery and Trauma Surgery (United Kingdom); Kyriakides, Constantinos [Barts and The London NHS Trust, Department of Vascular Surgery and Queen Mary's School of Medicine and Dentistry (United Kingdom); Matson, Matthew, E-mail: Matthew.matson@bartsandthelondon.nhs.u [Barts and The London NHS Trust, Department of Diagnostic Imaging (United Kingdom)

2009-05-15

215

Breast Cancer Follow-Up: Strategies for Successful Collaboration between Cancer Care Specialists and Primary Care Providers  

Microsoft Academic Search

Nurse practitioners working in family or primary care often need to incorporate specialty care knowledge into their practice. Knowledge of breast cancer staging, treatment, common side effects, and possible long-term sequelae is critically important for primary care nurse practitioners caring for women with a history of breast cancer. The unique considerations of breast cancer staging, treatment, and long-term effects are

Mary Ann Zalewski; Susan Beikman; Shannon Ferrari; Kathleen Slavish; Margaret Rosenzweig

2010-01-01

216

Usefulness of monocyte chemoattractant protein-1 to predict no-reflow and three-year mortality in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.  

PubMed

Although monocyte chemoattractant protein-1 (MCP-1) levels are increased in patients with ST-segment elevation myocardial infarction, the prognostic value of MCP-1 in primary percutaneous coronary intervention (pPCI) is not clear. The goal of the present study was to investigate the association of MCP-1 levels with myocardial perfusion and prognosis in patients with ST-segment elevation myocardial infarction undergoing pPCI. Consecutive pPCI patients (n = 192) were assigned to tertiles according to their admission serum MCP-1 levels. Angiographic no-reflow, Thrombolysis In Myocardial Infarction flow grade, myocardial blush grade, and ST-segment resolution were assessed. Mortality and major adverse cardiac events were evaluated during hospitalization and at the 3-year clinical follow-up visit. Failure of ST resolution was associated with greater admission MCP-1 levels. The risk of no-reflow (Thrombolysis In Myocardial Infarction flow ?2 or Thrombolysis In Myocardial Infarction flow 3 with final myocardial blush grade ?2 after pPCI and ST resolution <30%) increased as the admission MCP-1 increased. The 3-year mortality increased as the MCP-1 level increased (8% vs 22% vs 28% for the 3 tertiles, p <0.01). Multivariate logistic regression analysis demonstrated that MCP-1 levels at admission are a significant independent correlate of 3-year mortality in patients with no-reflow as detected by myocardial blush grade. A receiver operating characteristics analysis identified an optimum cut point of ?254 pg/ml, which was associated with a negative predictive value of 95% in association with 1-year mortality. In conclusion, the plasma MCP-1 levels at admission are independently associated with the development of no-reflow and 3-year mortality in patients with ST-segment elevation myocardial infarction undergoing pPCI. PMID:23601576

Buyukkaya, Eyup; Poyraz, Fatih; Karakas, Mehmet F; Kurt, Mustafa; Akcay, Adnan B; Akpinar, Ibrahim; Motor, Sedat; Turak, Osman; Ozturk, Oktay H; Sen, Nihat; Akpek, Mahmut; Kaya, Mehmet G; Gibson, C Michael

2013-04-18

217

Usefulness of minimum stent cross sectional area as a predictor of angiographic restenosis after primary percutaneous coronary intervention in acute myocardial infarction (from the HORIZONS-AMI Trial IVUS substudy).  

PubMed

HORIZONS-AMI was a prospective dual-arm randomized trial of different antithrombotic regimens and stent types in patients with ST-segment elevation myocardial infarction. A formal intravascular ultrasound (IVUS) substudy enrolled 464 patients with baseline and 13-month follow-up at 36 centers. Of them, 318 patients with 355 lesions were evaluated for this study. Angiographic restenosis occurred in 45 of 355 lesions (12.7%). Bare-metal stent use (45.5% vs 21.2%, p <0.001) and diabetes mellitus (29.5% vs 10.9%, p <0.001) were more prevalent in patients with versus without restenosis. Postprocedure IVUS minimum lumen area (5.6 mm(2), 5.0 to 6.1, vs 6.7 mm(2), 6.5 to 6.9, p <0.001), minimum stent area (5.7 mm(2), 5.1 to 6.3, vs 6.9 mm(2), 6.6 to 7.1, p <0.001), and reference average lumen area (7.7 mm(2), 6.8 to 8.6, vs 9.7 mm(2), 9.3 to 10.1, p <0.001) were smaller in restenotic versus nonrestenotic lesions. By multivariable analysis, minimum stent area was an independent predictor of angiographic restenosis (odds ratio 0.75, 95% confidence interval 0.61 to 0.93, p = 0.009) in addition to diabetes, bare-metal stent use, and longer stent length. Attenuated plaque behind the stent struts had a trend to predict less binary restenosis (p = 0.07). In conclusion, a smaller IVUS minimum stent area was an independent predictor of angiographic restenosis after primary percutaneous intervention in patients with ST-segment elevation myocardial infarction, similar to patients with stable coronary artery disease. PMID:22118823

Choi, So-Yeon; Maehara, Akiko; Cristea, Ecaterina; Witzenbichler, Bernhard; Guagliumi, Giulio; Brodie, Bruce; Kellett, Mirle A; Dressler, Ovidiu; Lansky, Alexandra J; Parise, Helen; Mehran, Roxana; Mintz, Gary S; Stone, Gregg W

2011-11-24

218

Percutaneous transluminal angioplasty of peripheral bypass stenoses  

Microsoft Academic Search

Purpose: To assess the success of percutaneous transluminal angioplasty (PTA) in treating peripheral bypass stenoses.\\u000a \\u000a \\u000a Methods: Patients who received a femoropopliteal or femorocrural bypass graft for limb ischemia were included in a duplex surveillance\\u000a program. If duplex ultrasound revealed a short (<2 cm) severe (peak systolic velocity ratio ?4.5) stenosis, patients were\\u000a scheduled for arteriography and PTA. Fifty-eight peripheral bypass

Arjan W. J. Hoksbergen; Dink A. Legemate; Jim A. Reekers; Dirk T. Ubbink; Michael J. H. M. Jacobs

1999-01-01

219

Percutaneous lumbar disc decompression.  

PubMed

Chronic low back pain is a major social, economic, and healthcare issue in the United States. Various techniques are utilized in managing discogenic pain, with or without disc herniation. Percutaneous techniques are rapidly replacing traditional open surgery in operations requiring discectomy, decompression, and fusion. The percutaneous access to the disc was first used in the 1950s to biopsy the disc with needles. Percutaneous access to the disc using endoscopic techniques was developed in the 1970s. Technical advances in the use of intradiscal therapies led to the development of intradiscal electrothermal annuloplasty (IDET), DISC Nucleoplasty, and DeKompressor, along with laser-assisted, endoscopic, and Nucleotome disc decompressions. The indications for percutaneous lumbar disc decompression include low back and lower extremity pain caused by a symptomatic disc. Internal disc disruptions and disc herniations are common causes of low back and/or lower extremity pain which may become chronic, if not diagnosed and treated. Annular tears lead to migration of the nuclear material and deranged internal architecture. In the chronically damaged intervertebral disc, leakage of nuclear material from annular tears can initiate, promote, and continue the inflammatory process and delay or stop recovery of vital remaining intradiscal tissue. The most often stated goal of central nuclear decompression is to lower the pressure in the nucleus and to allow room for the herniated fragment to implode inward. Provocative discography prior to percutaneous lumbar disc decompression is recommended. Percutaneous disc decompression may result in a small number of complications but occasionally, these could be serious. PMID:16703975

Singh, Vijay; Derby, Richard

2006-04-01

220

Severe primary postpartum hemorrhage due to genital tract laceration after operative vaginal delivery: successful treatment with transcatheter arterial embolization  

Microsoft Academic Search

The purpose of this study was to report our experience in the management of severe primary postpartum hemorrhage due to genital\\u000a tract laceration following operative vaginal delivery with forceps using pelvic transcatheter arterial embolization (TAE).\\u000a Ten women (mean age, 31.9 years) with severe primary postpartum hemorrhage due to genital tract laceration after operative\\u000a delivery with forceps were treated with TAE. TAE

Yann Fargeaudou; Philippe Soyer; Olivier Morel; Marc Sirol; Olivier le Dref; Mourad Boudiaf; Henri Dahan; Roland Rymer

2009-01-01

221

Intra-Arterial Hepatic Chemotherapy: A Comparison of Percutaneous Versus Surgical Implantation of Port-Catheters  

SciTech Connect

Purpose: To compare retrospectively the safety and efficacy of percutaneous and surgical implantations of port-catheters for intra-arterial hepatic chemotherapy (IAHC). Materials and Methods: Between January 2004 and December 2008, 126 consecutive patients (mean age 58 years) suffering from liver colorectal metastases were referred for intra-arterial hepatic chemotherapy (IAHC). Port-catheters were percutaneously implanted (P) through femoral access with the patient under conscious sedation when no other surgery was planned or were surgically implanted (S) when laparotomy was performed for another purpose. We report the implantation success rate, primary functionality, functionality after revision, and complications of IAHC. Results: The success rates of implantation were 97% (n = 65 of 67) for P and 98% (n = 58 of 59) for S. One hundred eleven patients received IAHC in our institution (n = 56P and n = 55S). Primary functionality was the same for P and S (4.80 vs. 4.82 courses), but functionality after revision was significantly higher for P (9.18 vs. 5.95 courses, p = 0.004) than for S. Forty-five complications occurred during 516 courses for P and 28 complications occurred during 331 courses for S. The rates of discontinuation of IAHC linked to complications of the port-catheters were 21% (n = 12 of 56) for P and 34% (n = 19 of 55) for S. Conclusion: Overall, significantly better functionality and similar complication rates occurred after P versus S port-catheters.

Deschamps, F., E-mail: frederic.deschamps@igr.fr [Gustave Roussy Institut, Department of Interventional Radiology (France); Elias, D., E-mail: elias@igr.fr; Goere, D., E-mail: goere@igr.fr [Gustave Roussy Institut, Department of Surgery (France); Malka, D., E-mail: malka@igr.fr; Ducreux, M., E-mail: ducreux@igr.fr; Boige, V., E-mail: boige@igr.fr [Gustave Roussy Institut, Department of Medical Oncology (France); Auperin, A., E-mail: auperin@igr.fr [Gustave Roussy Institut, Department of Statistics (France); Baere, T. de, E-mail: debaere@igr.fr [Gustave Roussy Institut, Department of Interventional Radiology (France)

2011-10-15

222

Successful low-dose azathioprine for myasthenia gravis despite hepatopathy from primary sclerosing cholangitis: a case report  

PubMed Central

Introduction Although myasthenia gravis is frequently associated with other disorders, it has not been reported together with primary sclerosing cholangitis, complicating the administration of liver-toxic immunosuppressive therapy. Case presentation A 73-year-old Caucasian woman with a history of arterial hypertension, thyroid dysfunction, glaucoma, right-sided ptosis and later generalized weakness, was diagnosed with myasthenia gravis. Additionally, primary sclerosing cholangitis was detected, initially prohibiting the administration of immunosuppressants. Despite treatment with steroids and pyridostigmine she repeatedly experienced myasthenic crises. After the fifth crisis and after antibody titers had reached levels > 100 nmol/L during two years of follow-up, it was decided to restart azathioprine. Interestingly, low-dose azathioprine (1.5 mg/kg/day) was well tolerated, had a positive clinical and immunological effect and did not worsen primary sclerosing cholangitis. Conclusion Myasthenia gravis may occur together with primary sclerosing cholangitis in the same patient. Mild immunosuppression with azathioprine is feasible and effective in such a patient, without worsening myasthenia gravis or primary sclerosing cholangitis.

2010-01-01

223

Cryptogenic stroke after percutaneous closure of an atrial septal defect.  

PubMed

We present the case of a patient who underwent a percutaneous secundum atrial septal defect (ASD II) closure with an undersized septal occluder device. One week and one month later she experienced two transient ischemic attacks. Three-dimensional transesophageal echocardiography (TEE) revealed a residual patent foramen ovale (PFO) with a positive Valsalva bubble test. She underwent a second procedure under the 3D TEE guidance and the PFO was successfully closed percutaneously using a PFO occluder device that was attached to the ASD device. Accurate ASD and PFO morphology assessment and appropriate device selection are the key factors in the success of percutaneous closure. 3D TEE is an innovative diagnostic technique, providing a complete description of the cardiac defect and improving spatial orientation. Real-time 3D TEE is the appropriate guidance for successful and accurate positioning of the device. PMID:22484783

Dardas, Petros S; Ninios, Vlasis; Mezilis, Nikos; Theofilogiannakos, Efstratios K; Tsikaderis, Dimitris; Thanopoulos, Vassilis

2012-03-01

224

Percutaneous Implantation of a Catheter with Subcutaneous Reservoir for Intraarterial Regional Chemotherapy: Technique and Preliminary Results  

SciTech Connect

Purpose: We present the technique and the preliminary results of percutaneous implantation of intraarterial catheters connected to a subcutaneous infusion reservoir for prolonged regional chemotherapy of hepatic and extrahepatic tumors.Methods: Two hundred patients with primary or secondary hepatic neoplasms, pelvic, pancreatic, renal, lingual, and breast cancer underwent the procedure. The access was the left axillary artery (188 patients) and the femoral artery (12 patients). The catheter tip was placed in the hepatic (170 patients), hypogastric (18), splenic (4), internal thoracic (2), gastroduodenal (3), renal (2) or the external carotid artery (1). The catheter was connected to a subcutaneous reservoir and filled with heparin; chemotherapeutic infusion was subsequently started.Results: One hundred percent immediate technical success was obtained. Forty-three of 200 (21.5%) patients had a complication: 29 patients had a catheter dislodgment, nine had arterial thrombosis, three had a pseudoaneurysm of the left axillary artery and two had a port pocket hematoma. Most complications (37/43, 86%) were treated percutaneously without interruption of chemotherapy. In only six cases (3% of the total population) was chemotherapy discontinued due to the complication itself. The mean duration of catheter patency was 7.2 months.Conclusion: Percutaneous placement of an intraarterial catheter is feasible and causes less discomfort to the patient than the surgical approach. The technique has an acceptable complication rate (21.5%), similar to that for surgical implantation (17.8%), with the advantage that in most cases the complications can be resolved percutaneously. This technique represents an alternative to surgical implantation in the treatment of liver metastases from colorectal cancer and opens new therapeutic possibilities for the local prolonged treatment of other kinds of tumor, though its clinical efficacy must be assessed in selected trials.

Grosso, Maurizio [Department of Radiology, Santa Croce Hospital, Via Coppino 26, I-12100 Cuneo (Italy); Zanon, Claudio [Division of Surgical Oncology, San Giovanni Battista Hospital, Corso Dogliotti 14, I-10126 Turin (Italy); Mancini, Andrea; Garruso, Matteo; Gazzera, Carlo; Anselmetti, Giovanni Carlo; Veglia, Simona; Gandini, Giovanni [Department of Radiology, University of Turin, Via Genova 3, I-10126 Turin (Italy)

2000-03-15

225

Spatially structured herbivory and primary succession at Mount St Helens: field surveys and experimental growth studies suggest a role for nutrients  

Microsoft Academic Search

The 1980 eruption ofMount St Helens (Washington, U.S.A.) created a 60-km2 region ofprimary successional habitat. Since colonising in 1981, the spatial spread ofthe legume Lupinus lepidus at Mount St Helens, Washington, U.S.A., has afforded intriguing opportunities to study the effect of trophic dynamics on primary succession. 2. Insect herbivory on this lupine has exhibited striking spatial structure for over a

WILLIAM F. F AGAN; J OHN

2004-01-01

226

Percutaneous cecostomy in the management of organic fecal incontinence in children  

PubMed Central

AIM: To assess the effectiveness and safety of imaging-guided percutaneous cecostomy in the management of pediatric patients with organic fecal incontinence. METHODS: Twenty three cecostomies were performed on 21 children with organic fecal incontinence (13 males, 8 females), aged from 5 to 16 years (mean 9.5 years). Thirteen patients had neurogenic fecal incontinence and 8 patients had anorectal anomalies. Procedures were performed under general anesthesia and fluoroscopic guidance. Effectiveness and complication data were obtained for at least 1 year after the procedure. RESULTS: Cecostomy was successful in 20 patients (primary technical success rate 95%). Cecostomy failed in one patient due to tube breakage (secondary technical success rate 100%). The tubes were in situ for an average of 18 mo (range 12-23 mo). Eighteen patients (87%) expressed satisfaction with the procedures. Resolution of soiling was achieved in all patients with neurogenic fecal incontinence (100%) and in 5 of 8 patients with anorectal anomalies (62.5%). Eleven patients (52%) experienced minor problems. No major complications were noted. CONCLUSION: Percutaneous cecostomy improves the quality of life in children with organic fecal incontinence. A satisfactory outcome is more prevalent in patients with neurogenic fecal incontinence than anorectal anomalies.

Donkol, Ragab Hani; Al-Nammi, Ahmed

2010-01-01

227

Isolated Spontaneous Dissection of the Common Iliac Artery: Percutaneous Stent Placement in Two Patients  

SciTech Connect

Isolated spontaneous dissection of the common iliac artery (CIA) is a rare entity. Two patients with this condition were successfully treated by percutaneous stent placement. We emphasize the feasibility of nonsurgical management by percutaneous stent placement for isolated spontaneous dissection of the CIA.

Kwak, Hyo-Sung; Han, Young-Min, E-mail: ymhan@chonbuk.ac.kr; Chung, Gyung-Ho [Chonbuk National University Medical School, Department of Diagnostic Radiology (Korea, Republic of); Yu, Hee Chul; Jeong, Yeon-Jun [Chonbuk National University Medical School, Department of Surgery (Korea, Republic of)

2006-10-15

228

Percutaneous Extraction of Transvenous Defibrillator Leads Using the VascoExtor Pacing Lead Removal System  

Microsoft Academic Search

In the implantable cardioverter defibrillator era the necessity for lead removal is not negligible. A specially designed extraction lead system for percutaneous removal of such leads is lacking, in contrast to the existing pacing lead extraction systems. We report the successful percutaneous extraction of four implantable cardioverter defibrillator leads in three patients because of lead malfunction using a novel pacemaker

Vassilios Pericles Vassilikos; Themos Nikolaos Maounis; John Chiladakis; Dennis Vassilios Cokkinos; Antonis Stavros Manolis

1999-01-01

229

Bright and Beautiful: High achieving girls, ambivalent femininities, and the feminization of success in the primary school  

Microsoft Academic Search

This paper refocuses attention on and problematizes girls’ experiences of school achievement and the construction of schoolgirl femininities. In particular, it centres on the relatively neglected experiences and identity work of high achieving primary school girls. Drawing upon ethnographic data (observations, interviews, and pupil diaries) from a broader study of girls’ and boys’ perceptions and experiences of schoolwork and achievement

Emma Renold; Alexandra Allan

2006-01-01

230

Opening Doors to Success in Multilingual Classrooms: Bilingualism, Codeswitching and the Professional Identities of Ethnic Minority Primary Teachers  

ERIC Educational Resources Information Center

|In England, government initiatives to recruit more ethnic minority teachers into mainstream schools have met with only limited success. One important reason for this may be that the factors that contribute to their distinctive professional skills and identities, and their potential to help raise the achievements of ethnic minority pupils, are not…

Conteh, Jean

2007-01-01

231

Imaging in percutaneous ablation for atrial fibrillation.  

PubMed

Percutaneous ablation for electrical disconnection of the arrhythmogenic foci using various forms of energy has become a well-established technique for treating atrial fibrillation (AF). Success rate in preventing recurrence of AF episodes is high although associated with a significant incidence of pulmonary vein (PV) stenosis and other rare complications. Clinical workup of AF patients includes imaging before and after ablative treatment using different noninvasive and invasive techniques such as conventional angiography, transoesophageal and intracardiac echocardiography, computed tomography (CT) and magnetic resonance imaging (MRI), which offer different information with variable diagnostic accuracy. Evaluation before percutaneous ablation involves assessment of PVs (PV pattern, branching pattern, orientation and ostial size) to facilitate position and size of catheters and reduce procedure time as well as examining the left atrium (presence of thrombi, dimensions and volumes). Imaging after the percutaneous ablation is important for assessment of overall success of the procedure and revealing potential complications. Therefore, imaging methods enable depiction of PVs and the anatomy of surrounding structures essential for preprocedural management and early detection of PV stenosis and other ablation-related procedures, as well as long-term follow-up of these patients. PMID:16715238

Maksimovi?, Ruzica; Dill, Thorsten; Risti?, Arsen D; Seferovi?, Petar M

2006-05-20

232

Soil microbial activity and community structure along a primary succession transect on the land-uplift coast in western Finland  

Microsoft Academic Search

We investigated the changes in basal respiration (BASAL), microbial biomass as substrate-induced respiration (SIR) and their ratio (qCO2) in the organic layer along a primary successional transect (alder\\/rowan, birch, birch\\/spruce, spruce I and spruce II) typical of the land-uplift coast in western Finland. PLFA analysis was used to detect concurrent successional changes in microbial community structure. Along the transect the

Päivi Merilä; Rauni Strömmer; Hannu Fritze

2002-01-01

233

Successful Remodeling and Endovascular Repair of a Ruptured Type B Chronic Aortic Dissection 12 Years after Primary Surgery.  

PubMed

A 70-year-old woman with a medical history of descending aorta replacement for chronic type B aortic dissection 12 years prior was admitted to our hospital with sudden back pain and hemoptysis. The patient was diagnosed with ruptured residual dissected thoracic aortic aneurysm and underwent emergent endovascular treatment. Two TAG thoracic endoprosthesis of different sizes were used to accommodate the discrepancy in size of the true lumen, resulting in a successful closure of the entry tear and hemostasis, without any damage to the intima. Computed tomography performed 3 months after surgery revealed successful remodeling of the remaining aorta. Thoracic endovascular aortic replacement may be considered as an option in the treatment of chronic dissected aortic aneurysm, achieving not only entry closure but possibly remodeling, as well. PMID:23518626

Hori, Daijiro; Yuri, Koichi; Nishi, Satoshi; Matsumoto, Harunobu; Yamaguchi, Atsushi; Adachi, Hideo

2013-03-22

234

Percutaneous Valvular Leak Repair  

Microsoft Academic Search

Percutaneous closure of paravalvular leaks has been reported in patients who are poor operative candidates. Transesophageal\\u000a echocardiography (TEE) currently plays an important role in procedures of this kind. TEE provides essential information regarding\\u000a the characteristics of the dehiscence, periprosthetic regurgitation severity, during the intervention, procedure-related complications,\\u000a immediate result of the procedure, and long-term follow-up. Also, three-dimensional TEE enables us to

Miguel Angel García-Fernandez; Marcelino Cortés; Eulogio García

2010-01-01

235

Percutaneous dissolution of gallstones.  

PubMed

Contact dissolution with MTBE is an effective and safe method to treat symptomatic patients with cholesterol gallstones. Personnel, time, and safety factors have limited widespread use of the procedure. With current competing methods to treat gallstones, it is likely that MTBE use will be reserved for those patients who elect percutaneous therapy due to fear of surgery or anesthesia and in those elderly patients who are compromised by underlying medical conditions. PMID:1925663

vanSonnenberg, E; D'Agostino, H B; Hofmann, A F; Sanchez, R B; Goodacre, B B; Esch, O; Casola, G

1991-07-01

236

Percutaneous Bone Tumors Management  

Microsoft Academic Search

\\u000a Image-guided tumor management is a minimally invasive treatment for localized bone tumors. Compared to other modalities, minimally\\u000a invasive procedures require fewer resources, less time, recovery, and cost, and often reduced morbidity and mortality. Many\\u000a percutaneous techniques are available. Some aim to treat pain and consolidate bone, i.e. cementoplasty. Others ablate or reduce\\u000a the tumor, i.e. chemical and thermal ablation techniques.

Afshin Gangi; Xavier Buy

237

Percutaneous transluminal coronary angioplasty (PTCA)  

MedlinePLUS Videos and Cool Tools

Percutaneous transluminal coronary angioplasty (PTCA) is a minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle. The procedure ...

238

[Percutaneous lumber nucleoplasty].  

PubMed

Low-back pain is one of the most common causes for seeking professional medical assistance and the most frequent cause of absence from work. It is not rare that the intervertebral discs are the etiological factor. Degenerated discs with internal disruptions may cause axial back pain whereas protrusion or herniation of a disc may result in radicular pain. Open surgical procedures targeting the intervertebral discs are carried out frequently for years. But especially because of its lack of superiority over the conventional therapies in the long-term and the risk of development of failed back surgery syndrome, the investigators are forced to develop minimally invasive techniques of disc decompression. In the last two decades, better understanding of the spinal anatomy, function and pain generating mechanisms along with the technological achievements, has accelerated the development of many modalities for the treatment of low back pain. Chemonucleolysis, automated percutaneous lumbar discectomy (APLD), intradiscal laser discectomy, intradiscal electrothermal therapy (IDET) and most recently percutaneous nucleoplasty are the minimally invasive techniques developed for this aim. Percutaneous nucleoplasty is a minimally invasive technique which uses radiofrequency energy to ablate the nucleus pulposus in a controlled manner for disc decompression. The current data about this new technique is insufficient yet, but the preliminary reports indicate that the technique is relatively safe and the outcomes are encouraging. PMID:15977089

Erdine, Serdar; Ozyalçin, Nuri Süleyman; Cimen, Ali

2005-04-01

239

Percutaneous Endovascular Treatment of Hepatic Artery Stenosis in Adult and Pediatric Patients After Liver Transplantation  

SciTech Connect

The purpose of this study was to evaluate the efficacy of percutaneous endovascular techniques for the treatment of hepatic artery stenosis (HAS) occurring after liver transplantation (LT) in adult and pediatrics patients. From February 2003 to March 2009, 25 patients (15 adults and 10 children) whose developed HAS after LT were referred to our interventional radiology unit. Technical success was achieved in 96% (24 of 25) of patients. Percutaneous transluminal angioplasty (PTA) was performed in 13 patients (7 children), and stenting was performed in 11 patients (2 children). After the procedure, all patients were followed-up with liver function tests, Doppler ultrasound, and/or computed tomography. Mean follow-up was 15.8 months (range 5 days to 58 months). Acute hepatic artery thrombosis occurred immediately after stent deployment in 2 patients and was successfully treated with local thrombolysis. One patient developed severe HA spasm, which reverted after 24 h. After the procedure, mean trans-stenotic pressure gradient decreased from 30.5 to 6.2 mmHg. Kaplan-Meyer curve of HA primary patency was 77% at 1 and 2 years. During the follow-up period, 5 patients (20%) had recurrent stenosis, and 2 patients (8.3%) had late thrombosis. Two of 7 patients with stenosis/thrombosis underwent surgical revascularization (n = 1) and liver retransplantation (n = 1). Six (25%) patients died during follow-up, but overall mortality was not significantly different when comparing patients having patent hepatic arteries with those having recurrent stenosis/thrombosis. There were no significant differences in recurrent stenosis/thrombosis and mortality comparing patients treated by PTA versus stenting and comparing adult versus pediatric status. Percutaneous interventional treatment of HAS in LT recipients is safe and effective and decreases the need for surgical revascularization and liver retransplantation. However, the beneficial effects for survival are not clear, probably because the clinical complexity of many of these cases.

Maruzzelli, Luigi; Miraglia, Roberto, E-mail: rmiraglia@ismett.edu; Caruso, Settimo; Milazzo, Mariapina; Mamone, Giuseppe [Mediterranean Institute for Transplantation and Advanced Specialized Therapies, (ISMETT), Department of Diagnostic and Interventional Radiology (Italy); Gruttadauria, Salvatore; Spada, Marco [University of Pittsburgh Medical Center (United States); Luca, Angelo [Mediterranean Institute for Transplantation and Advanced Specialized Therapies, (ISMETT), Department of Diagnostic and Interventional Radiology (Italy); Gridelli, Bruno [University of Pittsburgh Medical Center (United States)

2010-12-15

240

In-hospital time to treatment of patients with acute ST elevation myocardial infarction treated with primary angioplasty: determinants and outcome. Results from the registry of percutaneous coronary interventions in acute myocardial infarction of the Arbeitsgemeinschaft Leitender Kardiologischer Krankenhaus?rzte  

PubMed Central

Objective: To determine the predictors of time between presentation and primary angioplasty and the influence of this delay time on in-hospital mortality in clinical practice. Design: Analysis of data from the registry of percutaneous coronary interventions in acute myocardial infarction of the Arbeitsgemeinschaft Leitender Kardiologischer Krankenhausärzte (ALKK). Patients: Data of 4815 patients registered at 80 hospitals between 1994 and 2000 were analysed. Results: Mean age of the patients was 61.4 (12.5) years. Cardiogenic shock was present in 14.1%. Mean time from admission to primary angioplasty (“door to angiography” time) was 83 (122) minutes. Logistic regression analysis showed the presence of a bundle branch block (odds ratio (OR) 1.95, 95% confidence interval (CI) 1.15 to 3.29), prior coronary artery bypass grafting (OR 1.67, 95% CI 1.08 to 2.59), pre-hospital delay > 3 hours (OR 1.61, 95% CI 1.37 to 1.89), and female sex (OR 1.21, 95% CI 1.01 to 1.45) to be independently associated with longer door to angiography times, whereas a higher hospital volume of performing primary angioplasty (OR 0.53, 95% CI 0.46 to 0.62) and the year of the investigation (OR 0.96, 95% CI 0.92 to 1.00) were independently associated with shorter door to angiography times. Independent predictors of in-hospital mortality were cardiogenic shock (41.6% v 4.0% without cardiogenic shock, p < 0.0001), technical success (29.2% with TIMI (thrombolysis in myocardial infarction) flow < 3 v 6.5% with TIMI flow 3, p < 0.0001), age (16.5% ? 70 years v 6.6% < 70, p < 0.0001), three vessel disease (16.5% v 6.8% with < 3 vessel disease, p < 0.0001), anterior location of infarction (12% v 7.4% without anterior infarction, p < 0.0001), year of inclusion (adjusted OR 0.92 per year, p ?=? 0.011), and volume of primary angioplasty at the hospital (11% for < 20 angioplasty procedures/year v 8.3% for ? 20/year, p ?=? 0.027) but not the door to angiography time (adjusted OR 1.14 per tertile, p ?=? 0.397). Conclusions: In current clinical practice in Germany median door to angiography time is quite short (83 (122) minutes). Some patients and hospital factors are independently associated with a longer door to angiography time. Within the observed short in-hospital delays door to angiography time did not influence in-hospital mortality. However, efforts to keep them as short as possible should be continued.

Zahn, R; Vogt, A; Zeymer, U; Gitt, A K; Seidl, K; Gottwik, M; Weber, M A; Niederer, W; Modl, B; Engel, H-J; Tebbe, U; Senges, J

2005-01-01

241

Mycorrhiza-plant colonization patterns on a subalpine glacier forefront as a model system of primary succession.  

PubMed

Lyman glacier in the North Cascades Mountains of Washington has a subalpine forefront characterized by a well-developed terminal moraine, inconspicuous successional moraines, fluting, and outwash. These deposits were depleted of symbiotic fungi when first exposed but colonized by them over time after exposure. Four major groups of plant species in this system are (1) mycorrhiza-independent or facultative mycotrophic, (2) dependent on arbuscular mycorrhizae (AM) (3) dependent on ericoid mycorrhiza (ERM) or ectomycorrhizae (EM), and (4) colonized by dark-septate (DS) endophytes. We hypothesized that availability of mycorrhizal propagules was related to the success of mycorrhiza-dependent plants in colonizing new substrates in naturally evolved ecosystems. To test this hypothesis roots samples of 66 plant species were examined for mycorrhizal colonization. The plants were sampled from communities at increasing distances from the glacier terminus to compare the newest communities with successively older ones. Long established, secondary successional dry meadow communities adjacent to the glacier forefront, and nearby high alpine communities were sampled for comparison. DS were common on most plant species on the forefront. Nonmycorrhizal plants predominated in the earlier successional sites, whereas the proportion of mycorrhizal plants generally increased with age of community. AM were present, mostly at low levels, and nearly absent in two sites of the forefront. ERM were present in all species of Ericaceae sampled, and EM in all species of Pinaceae and Salicaceae. Roots of plants in the long established meadow and heath communities adjacent to the forefront and the high alpine community all had one or another of the colonization types, with DS and AM predominating. PMID:15772815

Cázares, Efrén; Trappe, James M; Jumpponen, Ari

2005-03-17

242

The scintigraphic index spleen/liver at 30 minutes predicts the success of splenectomy in persistent and chronic primary immune thrombocytopenia.  

PubMed

Splenectomy is considered the second-line of treatment in patients with chronic primary immune thrombocytopenia (ITP) in whom glucocorticoids have failed. Some patients do not respond to splenectomy or they have postoperative complications. Based on our previous experience using kinetic and scintigraphic parameters, we did a retrospective study with the aim of comparing all these parameters as a means of predicting the success of splenectomy in persistent and chronic primary ITP. Forty-one consecutive patients with chronic primary ITP refractory to prednisone, who had been splenectomized, were included in the study. The response to splenectomy was assessed by evaluating bleeding and platelet counts before and at different times after surgery. A complete platelet kinetic study was performed before the splenectomy using autologous (111) In-labeled platelets. The scintigraphic parameters measured included different indices between spleen/heart, liver/hearth, and spleen/liver. Thirty-six patients gave a complete response after splenectomy and five patients did not respond. A statistically significant difference between both groups was found with initial platelet recovery and with some scintigraphic indices which also showed a variable prediction value for the success of splenectomy. Among these indices, the spleen/liver at 30 minutes demonstrated a predictive value with a 100% of sensitivity and a 100% of specificity. Conclusion: some platelet kinetic parameters and scintigraphic indices, in particular the spleen/liver at 30 minutes, were useful to predict the outcome of splenectomy in persistent and chronic primary ITP and, therefore, they should be taken into account when deciding whether or not to perform a splenectomy. PMID:21948335

Roca, Manel; Muñiz-Diaz, Eduardo; Mora, Jaume; Romero-Zayas, Inmaculada; Ramón, Olga; Roig, Inmaculada; Pujol-Moix, Núria

2011-09-21

243

Stent Treatment of Obstructing Dissection After Percutaneous Transluminal Angioplasty of Aortic Stenosis Caused by Nonspecific Aortitis  

SciTech Connect

We report the follow-up of a patient with nonspecific aortitis (Takayasu's disease) in whom a self-expanding stent was used to successfully treat an obstructing dissection after percutaneous transluminal angioplasty of a descending thoracic stenosis.

Sharma, Sanjiv; Sharma, Sanjay [Department of Cardiovascular Radiology, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi 110029 (India); Bahl, Vinay K. [Department of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi 110029 (India); Rajani, Mira [Department of Cardiovascular Radiology, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi 110029 (India)

1997-09-15

244

Percutaneous Transluminal Coronary Angioplasty: Efficacy, Cost and Effects of Prospective Payment.  

National Technical Information Service (NTIS)

Percutaneous transluminal coronary angioplasty (PTCA) is a safe and effective technology for treating selected patients with coronary artery disease, and when performed successfully it is a cost-saving technology compared to coronary bypass surgery. Succe...

N. R. Powe

1985-01-01

245

Percutaneous Retrieval of Chronic Intravascular Foreign Bodies  

SciTech Connect

To evaluate the feasibility of intravascular retrieval of chronic foreign bodies, we retrospectively reviewed an 8 year experience (1993-2001) of percutaneous retrieval of chronically retained intravascular foreign bodies (n = 6). In 6 of 6 cases (4 catheter fragments, 2 guidewires), 5-90 days elapsed before retrieval via the femoral or internal jugular vein. Under fluoroscopy, we determined the foreign body's course, position and size. A guidewire was advanced through a multipurpose catheter to the foreign body. The multipurpose catheter was replaced with a gooseneck snare catheter and the snare advanced to grasp and remove the foreign body. Percutaneous retrieval was successful in all 6 cases. One patient experienced mild hemoptysis, which resolved within 24 hr of observation. No patient experienced long-term sequelae. Given the potential life-threatening complications from intravascular foreign bodies and the low complication rate from percutaneous retrieval, we recommend extraction of the foreign body even if it is asymptomatic in the chronic setting (> 24 hr)

Savage, Clare [University of Texas Medical Branch, Galveston, Texas, Department of Surgery (United States); Ozkan, Orhan S.; Walser, Eric M. [University of Texas Medical Branch, Galveston, Texas, Department of Radiology (United States); Wang Dongfang; Zwischenberger, Joseph B. [University of Texas Medical Branch, Galveston, Texas, Department of Surgery (United States)], E-mail: jzwische@utmb.edu

2003-09-15

246

Successful pregnancy after the treatment of primary amenorrhea in a patient with non-classical congenital adrenal hyperplasia.  

PubMed

We describe a case of non-classical congenital adrenal hyperplasia (NCCAH) due to 21-hydroxylase deficiency in a 30-year-old Japanese woman who achieved pregnancy after treatment of primary amenorrhea. Hirsutism and clitoromegaly were present. Ultrasound examination showed polycystic appearance of the ovary. Luteinizing hormone-releasing hormone (LH-RH) test resulted in exaggerated LH response, showing a polycystic ovary syndrome (PCOS) pattern. The diagnosis was based on the elevated intial levels of 17-hydroxyprogesterone (55?ng/mL) and dihydroepiandosterone (7780?ng/mL). The first withdrawal bleeding occurred within 6?weeks after treatment with hydrocortisone (20?mg/day) combined with conjugated estrogens (1.25?mg/day) and medroxyprogesterone acetate (10?mg/day), which were continued for five courses. The bleeding remained cyclic every 28?days with maintenance doses of hydrocortisone. Subsequently, ovulation was induced using clomiphene citrate (100?mg/day). Pregnancy was achieved at the second attempt of ovulation induction and was within 10?months after initial presentation. Continuing hydrocortisone, the patient delivered a healthy baby at term. PMID:22672538

Purwana, Indri N; Kanasaki, Haruhiko; Oride, Aki; Miyazaki, Kohji

2012-06-04

247

Percutaneous nephrolithotomy in older children  

Microsoft Academic Search

Purpose: The aim of this study was to evaluate the safety and efficacy of percutaneous nephrolithotomy (PCNL) in pediatric patients, older than 8 years, without any technical and instrumental modifications. Methods: The authors retrospectively evaluated the data of 16 percutaneously treated kidneys of 14 patients with a mean age of 11 years (range, 8 to 17). The mean stone burden

Ahmet ?ahin; Serdar Tekgül; Erim Erdem; Sinan Ekici; Metin Hasçiçek; Sezer Kendi

2000-01-01

248

Percutaneous coil occlusion of ascending aorta to pulmonary artery shunts.  

PubMed

Two patients with pulmonary atresia and intact ventricular septum each underwent early palliative surgery with a pulmonary valvotomy and an ascending aorta to pulmonary artery shunt. Adequate right ventricular growth and relief of pulmonary stenosis rendered the shunts unnecessary. The shunts were successfully occluded percutaneously with Gianturco coils. PMID:9631986

Lane, G K; Lucas, V W; Sklansky, M S; Kashani, I A; Rothman, A

1998-06-01

249

Ultrasonography guided percutaneous radiofrequency ablation for hepatic cavernous hemangioma  

Microsoft Academic Search

AIM: Hepatic cavernous hemangioma (HCH) is the most common benign tumor of the liver and its management is still controversial. Recent success in situ radiofrequency ablation of hepatic malignancies has led us to consider using this technique in patients with HCH. This study was to assess the efficacy, safety, and complications of percutaneous radiofrequency ablation (PRFA) under ultrasonography guidance in

Yan Cui; Li-Yan Zhou; Man-Ku Dong; Ping Wang; Min Ji; Xiao-Ou Li; Chang-Wei Chen; Zi-Pei Liu; Yong-Jie Xu; Hong-Wen Zhang

2003-01-01

250

Percutaneous treatment of symptomatic central venous stenosis angioplasty  

Microsoft Academic Search

ObjectivesThe increased use of central venous access primarily for hemodialysis has led to a significant increase in clinically relevant central venous occlusive disease (CVOD). The magnitude of and the optimal therapy for CVOD are not clearly established. The purpose of this study is to define the problem of CVOD and determine the success of percutaneous therapy for relieving symptoms and

L. Richard Sprouse II; Christopher J Lesar; George H Meier III; F. Noel Parent; Richard J Demasi; Robert G Gayle; Michael J Marcinzyck; Marc H Glickman; Raseh M Shah; C. Scott McEnroe; Martin A Fogle; Gordon K Stokes; John O Colonna

2004-01-01

251

Percutaneous plate arthrodesis in small animals.  

PubMed

Arthrodesis is an elective surgical procedure designed to eliminate articular pain and dysfunction by deliberate osseous fusion. A percutaneous approach can be used to perform tarsal and carpal arthrodeses in dogs and cats. Intraoperative imaging facilitates cartilage debridement performed with a burr inserted through stab incisions. The plate is introduced through an epiperiosteal tunnel and secured with screws inserted through the skin insertion incisions. Additional screws can be placed through separate stab incisions. The primary advantage of this technique is a decreased risk of soft tissue complications such as plantar necrosis or wound dehiscence. Preliminary clinical results are promising. PMID:23040310

Pozzi, Antonio; Lewis, Daniel D; Hudson, Caleb C; Kim, Stanley E

2012-09-01

252

[Temporal variations of soil microbial biomass and enzyme activities during the secondary succession of primary broadleaved-Pinuskoraiensis forests in Changbai Mountains of Northeast].  

PubMed

By the method of space-for-time Substitution, and taking the matured (>200 years old) and over-matured (>200 years old) primary broadleaved-Pinus koraiensis forests and, their secondary forests at different succession stages (20-, 30-, 50-, 80-, and 100 years old Betula platphylla forests) in Changbai Mountains of Northeast China as test objects, this paper studied the temporal variations of soil organic carbon, soil microbial biomass, and soil enzyme activities during the secondary succession of primary broadleaved-Pinus koraiensis forests in the Mountains. Under the 20- and 80 years old B. platphylla forests, the soil organic carbon content in humus layer was the highest (154.8 and 154.3 g.kg-1, respectively); while under the matured and over-matured primary broad-leaved-Pinus koraiensis forests, this organic carbon content was relatively low, being 141. 8 and 133. 4 g.kg , respectively. The soil microbial biomass carbon and microbial quotient and the activities of soil cellulase, peroxidase, acid phosphatase, and cellobiase under the 50- and 80 years old B. platphylla forests were the highest, but the activity of soil polyphenol oxidase was the lowest, which revealed that under middle-aged and matured B. platphylla forests, soil organic carbon had a faster turnover rate, and was probably in a stronger accumulation phase. Statistical analysis showed that the soil microbial biomass carbon had significant positive correlations with the soil organic carbon, total nitrogen, and available phosphorus (r = 0.943, 0. 963, and 0.953, respectively; PMID:23705380

Hu, Song; Zhang, Ying; Shi, Rong-Jiu; Han, Si-Qin; Li, Hui; Xu, Hui

2013-02-01

253

Percutaneous closure of tricuspid paravalvular leak.  

PubMed

While transcatheter closure of mitral and aortic paravalvular leaks has been well-described, there are no prior reports of such procedures for prosthetic tricuspid valves. We describe our experience with percutaneous closure of a tricuspid paravalvular leak in a 34-year-old patient with a history of tricuspid atresia. He had previously undergone repair with placement of a right atrium-to-right ventricle conduit and most recently, placement of a bio-prosthetic tricuspid valve. He subsequently developed significant tricuspid paravalvular leak with symptoms of severe right heart failure. His clinical status was improved following successful transcatheter closure of the defect. © 2013 Wiley Periodicals, Inc. PMID:23554068

Turner, Mariel E; Lai, Wyman W; Vincent, Julie A

2013-04-18

254

Direct Percutaneous Embolization of Bleeding Stomal Varices  

SciTech Connect

Stomal variceal bleeding can develop in patients with underlying cirrhosis and portal hypertension. Most patients are best treated with transjugular intrahepatic portosystemic shunt (TIPS) creation because this addresses the underlying problem of portal hypertension. However, some patients are not good candidates for TIPS creation because they have end-stage liver disease or encephalopathy. We describe such a patient who presented with recurrent bleeding stomal varices, which was successfully treated with percutaneous coil embolization. The patient had bleeding-free survival for 1 month before death from unrelated causes.

Naidu, Sailen G., E-mail: naidu.sailen@mayo.ed [Mayo Clinic Arizona, Mayo Clinic Hospital, Department of Radiology, Division of Interventional Radiology (United States); Castle, Erik P. [Mayo Clinic Arizona, Mayo Clinic Hospital, Department of Urology (United States); Kriegshauser, J. Scott; Huettl, Eric A. [Mayo Clinic Arizona, Mayo Clinic Hospital, Department of Radiology, Division of Interventional Radiology (United States)

2010-02-15

255

Atlantoaxial Joint Synovial Cyst: Diagnosis and Percutaneous Treatment  

SciTech Connect

Synovial cysts at the atlantoaxial level are found uncommonly. Lumbar symptomatic cases are treated by percutaneous cyst aspiration with or without corticoid injection or by surgical resection, but synovial cysts at the C1-C2 level are usually treated by surgery. We report here a 92-year-old woman with a retro-odontoid synovial cyst producing spinal cord compression that was treated by percutaneous aspiration of the cyst under CT guidance. To our knowledge, this is the first reported case of an atlantoaxial synovial cyst successfully treated with a minimally invasive procedure.

Velan, Osvaldo, E-mail: osvaldo.velan@hospitalitaliano.org.a [Hospital Italiano de Buenos Aires, Department of Radiology (Argentina); Rabadan, Alejandra, E-mail: alejandra.rabadan@hospitalitaliano.org.a [Hospital Italiano de Buenos Aires, Department of Neurosurgery (Argentina); Paganini, Lisandro, E-mail: lisandro.paganini@hospitalitaliano.org.a [Hospital Italiano de Buenos Aires, Department of Radiology (Argentina); Langhi, Luciano, E-mail: luciano.langhi@hospitalitaliano.org.a [Hospital Italiano de Buenos Aires, Department of Neurosurgery (Argentina)

2008-11-15

256

Percutaneous peripheral nerve stimulation.  

PubMed

Since its inception in the 1970s, peripheral neuromodulation has become an increasingly common procedure to treat chronic neuropathic disorders. Historically, peripheral nerve stimulation (PNS) originated with the placement of large surface cuff electrodes, which was refined by the introduction of functional nerve mapping with circumferential electrical stimulation. This substantially improved the targeting of sensory fascicles. Surgical placement of spinal cord stimulation (SCS) 'button type' paddle electrodes was replaced when the introduction of percutaneous cylindrical SCS electrodes expanded the spectrum of PNS applications and improved the ability to target afferent sensory fibers as well as reducing the complication rate. To further refine functional mapping for the placement of these percutaneous electrodes, radiofrequency needle probes have more recently been employed to elicit paresthesias in awake patients to map the pain generators and guide treatment. In this chapter, we provide a description of the development and basic mechanisms of peripheral nerve stimulation, as well as a more detailed description of the two most commonly employed forms of peripheral nerve stimulation: occipital nerve stimulation for occipital neuralgia, and subcutaneous peripheral nerve field stimulation to stimulate free nerve endings within the subcutaneous tissue when the pain is limited to a small, well-localized area. The closely related ideas of internal and external targeted subcutaneous stimulation are also discussed. PMID:21422775

Aló, Kenneth M; Abramova, Marina V; Richter, Erich O

2011-03-21

257

Percutaneous Iliac Screws for Minimally Invasive Spinal Deformity Surgery  

PubMed Central

Introduction. Adult spinal deformity (ASD) surgeries carry significant morbidity, and this has led many surgeons to apply minimally invasive surgery (MIS) techniques to reduce the blood loss, infections, and other peri-operative complications. A spectrum of techniques for MIS correction of ASD has thus evolved, most recently the application of percutaneous iliac screws. Methods. Over an 18 months 10 patients with thoracolumbar scoliosis underwent MIS surgery. The mean age was 73 years (70% females). Patients were treated with multi-level facet osteotomies and interbody fusion using expandable cages followed by percutaneous screw fixation. Percutaneous iliac screws were placed bilaterally using the obturator outlet view to target the ischial body. Results. All patients were successfully instrumented without conversion to an open technique. Mean operative time was 302 minutes and the mean blood loss was 480?cc, with no intraoperative complications. A total of 20 screws were placed successfully as judged by CT scanning to confirm no bony violations. Complications included: two asymptomatic medial breaches at T10 and L5, and one patient requiring delayed epidural hematoma evacuation. Conclusions. Percutaneous iliac screws can be placed safely in patients with ASD. This MIS technique allows for successful caudal anchoring to stress-shield the sacrum and L5-S1 fusion site in long-segment constructs.

Wang, Michael Y.

2012-01-01

258

Percutaneous iliac screws for minimally invasive spinal deformity surgery.  

PubMed

Introduction. Adult spinal deformity (ASD) surgeries carry significant morbidity, and this has led many surgeons to apply minimally invasive surgery (MIS) techniques to reduce the blood loss, infections, and other peri-operative complications. A spectrum of techniques for MIS correction of ASD has thus evolved, most recently the application of percutaneous iliac screws. Methods. Over an 18 months 10 patients with thoracolumbar scoliosis underwent MIS surgery. The mean age was 73 years (70% females). Patients were treated with multi-level facet osteotomies and interbody fusion using expandable cages followed by percutaneous screw fixation. Percutaneous iliac screws were placed bilaterally using the obturator outlet view to target the ischial body. Results. All patients were successfully instrumented without conversion to an open technique. Mean operative time was 302 minutes and the mean blood loss was 480?cc, with no intraoperative complications. A total of 20 screws were placed successfully as judged by CT scanning to confirm no bony violations. Complications included: two asymptomatic medial breaches at T10 and L5, and one patient requiring delayed epidural hematoma evacuation. Conclusions. Percutaneous iliac screws can be placed safely in patients with ASD. This MIS technique allows for successful caudal anchoring to stress-shield the sacrum and L5-S1 fusion site in long-segment constructs. PMID:22900162

Wang, Michael Y

2012-07-29

259

The management of liver hydatid cysts by percutaneous drainage  

PubMed Central

Objective To investigate the effect of percutaneous drainage on liver hydatid cysts. Design A retrospective case study. Setting Department of Surgery, Selçuk University, Konya, Turkey. Patients Forty-five patients with 83 liver hydatid cysts (types I and II according to the classification of Gharbi and colleagues) followed up for a mean of 30 months (range from 14 to 36 months). Intervention The cysts were drained percutaneously with ultrasonographic guidance and then irrigated with 0.05% silver nitrate solution through a fine needle. Albendazole was administered 48 hours before percutaneous drainage and for 2 months after the procedure to prevent the implantation of spilled scolices. Main outcome measures Complications of the procedure, decrease in size of the cyst cavity, recurrence and dissemination of the cysts. Results All the cysts were treated successfully by percutaneous drainage. Anaphylactic shock developed in 1 (2.2 %) patient, and mild allergic reactions were observed in 2 (4.4 %) patients during the interventional procedure. Follow-up ultrasonography and CT demonstrated a statistically significant (p < 0.01) decrease in the mean cyst size. Recurrence and dissemination were not observed during the follow-up period. Conclusion Percutaneous fine-needle aspiration and drainage is effective for managing cystic liver hydatid disease in selected cases.

Aygun, Ersan; Sahin, Mustafa; Odev, Kemal; Vatansev, Celalettin; Aksoy, Faruk; Paksoy, Yahya; Kartal, Adil; Karahan, Omer

2001-01-01

260

The value of artificial pleural effusion for percutaneous microwave ablation of liver tumour in the hepatic dome: A retrospective case-control study.  

PubMed

Abstract Purpose: The aim of this study was to evaluate the feasibility, safety, and efficiency of percutaneous microwave ablation (MWA) with artificial pleural effusion for liver tumours located in the hepatic dome. Materials and methods: A total of 112 sessions of artificial pleural effusion performed on 102 liver tumour patients were summarised and analysed at our hospital. Among them, 31 hepatocellular carcinoma patients treated by percutaneous MWA were selected as the artificial pleural effusion group. The control group without artificial pleural effusion was matched with tumour size, tumour location and the histological grades of differentiation. The primary technique effectiveness rate, local tumour progression rate and tumour-free survival rate were compared. Results: Artificial pleural effusion was achieved successfully in 110 of 112 sessions (98.2%), which helped to improve the visibility in 98.8% (82/83) and acquire safe puncture path in 96.3% (26/27). There were no statistical differences between the artificial pleural effusion group and the control group in the primary technique effectiveness rate (p?=?1.000), the 1-, 2-, and 3-year local tumour progression rates (p?=?0.669), and the 1-, 2-, and 3-year tumour-free survival rates (p?=?0.979). Conclusions: Percutaneous MWA with artificial pleural effusion could be a feasible, safe, and effective technique for liver tumours located in the hepatic dome. PMID:24102395

Zhang, Dezhi; Liang, Ping; Yu, Xiaoling; Cheng, Zhigang; Han, Zhiyu; Yu, Jie; Liu, Fangyi

2013-11-01

261

Clinical efficacy and scintigraphic evaluation of post-coronary bypass patients undergoing percutaneous transluminal coronary angioplasty for recurrent angina pectoris  

SciTech Connect

The efficacy of percutaneous transluminal angioplasty in improving recurrent anginal symptoms and myocardial perfusion after coronary artery bypass graft surgery was assessed prospectively in 55 patients, of whom 50 had an initial angiographic and clinical success. Although 80% of those successfully dilated were initially free of angina at 23 +/- 11 months of follow-up, one half of these patients had recurrent angina. Although only 48% of the patient cohort had complete relief of angina, 94% had less angina than before dilatation and 86% were able to decrease antianginal medications. Fifteen patients with persistent or recurrent angina had from one to five repeat dilatations. After angioplasty, lung thallium uptake, the extent of abnormal scan segments, and the magnitude of redistribution in dilated lesions were significantly reduced (n = 24 patients). Redistribution defects were seen in 38% of patients on postangioplasty scans. All were associated with subsequent angina. Of various clinical, angiographic, exercise, and thallium-201 scan variables, only the presence of delayed redistribution was an independent predictor of recurrent angina. Restenosis was the most common underlying cause for this exercise-induced perfusion defect. Thus percutaneous coronary angioplasty performed as primary therapy for recurrent angina after bypass surgery is moderately successful in long-term follow-up for the amelioration of symptoms and enhancement of regional myocardial perfusion.

Reed, D.C.; Beller, G.A.; Nygaard, T.W.; Tedesco, C.; Watson, D.D.; Burwell, L.R.

1989-01-01

262

Percutaneous Tennis Elbow Release Under Local Anaesthesia  

PubMed Central

Introduction: When the non-operative treatment of tennis elbow fails to improve the symptoms a surgical procedure can be performed. Many different techniques are available. The percutaneous release of the common extensor origin was first presented by Loose at a meeting in 1962. Despite the simplicity of the operation and its effectiveness in relieving pain with minimal scarring this procedure is still not widely accepted. This study presents the long-term results of percutaneous tennis elbow release in patients when conservative measures including local steroid injections have failed to relieve the symptoms. Patients and Methods: Percutaneous release of the extensor origin was performed in 24 consecutive patients (seven male and seventeen female), providing 30 elbows for this study. The age of the patients ranged from 26 to 71 years with mean age of 55 years. The technique involved a day case procedure in the operating theatre using local anaesthesia without the need for a tourniquet. The lateral elbow was infiltrated with 5mls 1% lignocaine and 5mls 0.5% bupivicaine with 1:200,000 adrenaline. All operations were performed by the senior author. The patients were assessed post operatively by using DASH (disabilities of arm, shoulder and hand) score and Oxford elbow scores. The mean follow up period was 36 months (1-71months). Results: Twenty one patients returned the DASH and Oxford elbow questionnaires. Four patients were lost in the follow up. The post operative outcome was good to excellent in most patients. Eighty seven percent of patients had complete pain relief. The mean post-op DASH score was 8.47 (range 0 to 42.9) and the mean Oxford elbow score was 42.8 (range 16 to 48). There were no complications reported. All the patients returned to their normal jobs, hobbies such as gardening, horse riding and playing musical instruments. Conclusion: In our experience Percutaneous release of the epicondylar muscles for humeral epicondylitis has a high rate of success, is relatively simple to perform, is done as a day case procedure and has been without complications. Percutaneous release is a viable treatment option after failed conservative management of tennis elbow.

Nazar, MA; Lipscombe, S; Morapudi, S; Tuvo, G; Kebrle, R; Marlow, W; Waseem, M

2012-01-01

263

Percutaneous Gastrostomy in Patients Who Fail or Are Unsuitable for Endoscopic Gastrostomy  

SciTech Connect

Purpose: Percutaneous endoscopic gastrostomy (PEG) is not possible or fails in some patients. We aimed to categorize the reasons for PEG failure, to study the success of percutaneous radiologic gastrostomy (PRG) in these patients, and to highlight the associated technical difficulties and complications.Methods: Forty-two patients (28 men, 14 women; mean age 60 years, range 18-93 years) in whom PEG failed or was not possible, underwent PRG. PEG failure or unsuitability was due to upper gastrointestinal tract obstruction or other pathology precluding PEG in 15 of the 42 patients, suboptimal transillumination in 22 of 42 patients, and advanced cardiorespiratory decompensation precluding endoscopy in five of 42 patients. T-fastener gastropexy was used in all patients and 14-18 Fr catheters were inserted.Results: PRG was successful in 41 of 42 patients (98%). CT guidance was required in four patients with altered upper gastrointestinal anatomy. PRG failed in one patient despite CT guidance. In the 16 patients with high subcostal stomachs who failed PEG because of inadequate transillumination, intercostal tube placement was required in three and cephalad angulation under the costal margin in six patients. Major complications included inadvertent placement of the tube in the peritoneal cavity. There was one case of hemorrhage at the gastrostomy site requiring transfusion and one case of superficial gastrostomy site infection requiring tube removal. Minor complications included superficial wound infection in six patients, successfully treated with routine wound toilette.Conclusion: We conclude that PRG is a safe, well-tolerated and successful method of gastrostomy and gastrojejunostomy insertion in the technically difficult group of patients who have undergone an unsuccessful PEG. In many such cases optimal clinical evaluation will suggest primary referral for PRG as the preferred option.

Thornton, Frank J.; Varghese, Jose C.; Haslam, Philip J.; McGrath, Frank P.; Keeling, Frank; Lee, Michael J. [Department of Radiology, Beaumont Hospital and Royal College of Surgeons in Ireland Medical School, Beaumont Road, Dublin 9 (Ireland)

2000-07-15

264

Primary Self-Expandable Nitinol Stent Placement in Focal Lesions of Infrarenal Abdominal Aorta: Long Term Results  

SciTech Connect

Purpose. To evaluate the technical and clinical success, safety and long term results of percutaneous transluminal angioplasty/self-expandable nitinol stent placement of infrarenal abdominal aorta focal lesions. Materials and Methods. Eighteen patients underwent PTA of focal atherosclerotic occlusive disease of distal abdominal aorta. Two symptomatic occlusions and 16 stenoses in 10 male and 8 female patients (mean age 68.2 years) were treated with primary self-expandable nitinol stent placement. Results. Primary self-expandable nitinol stent placement was technically successful in all 18 procedures; clinical success was achieved in 100% of patients. No complications associated with the procedure occurred. During the 49.4 months of mean follow up (range 3-96, 4 months) all treated aortic segments remained patent. Conclusions. Endovascular treatment (primary self-expandable nitinol stent placement) of focal atherosclerotic lesions of distal abdominal aorta is a safe method with excellent primary technical and clinical success rates and favourable Long term results.

Lastovickova, Jarmila, E-mail: jala@medicon.cz; Peregrin, Jan H. [Institute for Clinical and Experimental Medicine, Department of Diagnostic and Interventional Radiology (Czech Republic)

2008-01-15

265

Percutaneous Radiologic Gastrostomy: A 12-Year Series  

PubMed Central

Background/Aims Interventional radiologists have played a main role in the technical evolution of gastrostomy, from the first surgical/endoscopical approaches to percutaneous interventional procedures. This study evaluated the results obtained in a 12-year series. Methods During the period December 1996 to December 2008, 254 new consecutive gastrostomies and 275 replacement procedures were performed in selected patients. All of the cases were treated by a T-fastener gastropexy and tube placement. The procedures were assessed by analyzing indications, patient selection, duration of the procedures, and mortality. Results All 254 first gastrostomies were successful; replacement procedures were also successfully performed. One (0.2%) patient with severe neurologic disorders died after the procedure without signs of procedure-related complications, and seven (1.3%) major complications occurred (four duodenal lesions with peritoneal leakage, two gastric bleedings, and one gastric lesion). Minor complications were easily managed; three tube ruptures were resolved. Conclusions This long-term series and follow-up showed that a group of interventional radiologist can effectively provide gastrostomy placement and long-term tube management. Percutaneous gastrostomy is less invasive than other approaches and it satisfies the needs even of high-risk patients.

Castellazzi, Giorgio; De Iuliis, Alessandro; Rizzo, Laura

2010-01-01

266

Coupling of primary producers, detritus, decomposer organisms and nitrogen availability during secondary succession: Progress report for period September 28, 1987-September 27, 1988  

SciTech Connect

Secondary succession is a consequence of the interactions among primary producers, decomposers, detritus and abiotic components of the system over time. This study focuses on the interrelationships among above- and below-ground processes involved in semiarid ecosystem development. We found that the addition of nitrogen and phosphorus significantly reduced the production of perennial species while significantly increasing the production of annual and biennial plants. Three years of N addition have altered plant community composition, slowed the rate of secondary succession, and reduced the fungal component, of the microbial community. Early- and late-successional plant species differ in their maintenance of rhizosphere microbial communities. Under nutrient-limited conditions, early-successional species maintain larger microbial biomasses than late-successional species. This strategy may cause early-successional species to be less competitive than late-successional species under nutrient poor conditions because of the need for a greater amount of carbon to be released by early-successional species to maintain a rhizosphere community. Using P/N ratios we have demonstrated that mycorrhizal grasses in the field have enriched relative P nutrition. 52 refs., 2 figs., 3 tabs.

Redente, E.F.

1988-06-01

267

Delayed Union of a Sacral Fracture: Percutaneous Navigated Autologous Cancellous Bone Grafting and Screw Fixation  

SciTech Connect

Delayed or non-union of a sacral fracture is a serious clinical condition that may include chronic pain, sitting discomfort, gait disturbances, neurological problems, and inability to work. It is also a difficult reconstruction problem. Late correction of the deformity is technically more demanding than the primary treatment of acute pelvic injuries. Open reduction, internal fixation (ORIF), excision of scar tissue, and bone grafting often in a multi-step approach are considered to be the treatment of choice in delayed unions of the pelvic ring. This procedure implies the risk of neurological and vascular injuries, infection, repeated failure of union, incomplete correction of the deformity, and incomplete pain relief as the most important complications. We report a new approach for minimally invasive treatment of a delayed union of the sacrum without vertical displacement. A patient who suffered a Malgaigne fracture (Tile C1.3) was initially treated with closed reduction and percutaneous screw fixation (CRPF) of the posterior pelvic ring under CT navigation and plating of the anterior pelvic ring. Three months after surgery he presented with increasing hip pain caused by a delayed union of the sacral fracture. The lesion was successfully treated percutaneously in a single step procedure using CT navigation for drilling of the delayed union, autologous bone grafting, and screw fixation.

Huegli, R. W. [University Hospital, Basel, Department of Radiology (Switzerland)], E-mail: rhuegli@uhbs.ch; Messmer, P. [University Hospital, Zuerich, Division of Trauma Surgery (Switzerland); Jacob, A. L.; Regazzoni, P. [University Hospital, Basel, Department of Surgery, Trauma Unit (Switzerland); Styger, S. [University Hospital, Basel, Department of Radiology (Switzerland); Gross, T. [University Hospital, Basel, Department of Surgery, Trauma Unit (Switzerland)

2003-09-15

268

Percutaneous Nephrolithotomy in Children  

PubMed Central

The surgical management of pediatric stone disease has evolved significantly over the last three decades. Prior to the introduction of shockwave lithotripsy (SWL) in the 1980s, open lithotomy was the lone therapy for children with upper tract calculi. Since then, SWL has been the procedure of choice in most pediatric centers for children with large renal calculi. While other therapies such as percutaneous nephrolithotomy (PNL) were also being advanced around the same time, PNL was generally seen as a suitable therapy in adults because of the concerns for damage in the developing kidney. However, recent advances in endoscopic instrumentation and renal access techniques have led to an increase in its use in the pediatric population, particularly in those children with large upper tract stones. This paper is a review of the literature focusing on the indications, techniques, results, and complications of PNL in children with renal calculi.

DeMarco, Romano T.

2011-01-01

269

[Percutaneous endoscopic gastrostomy (PEG)].  

PubMed

Percutaneous endoscopic gastrostomy (PEG), although a standard method for long-time enteral nutrition, still leaves uncertainty about details in indication, technique and complications. Based on own experiences (approximately 1000 PEG's and 170 EPJ's in the last 10 years) these topics are discussed. As new indications the PEG for decompression in chronic intestinal obstruction and the questionable relative contraindications ascites, peritoneal carcinosis and Morbus Crohn are discussed. The common thread-pull through-technique is recommended in a slightly modified variation, according to direct puncture techniques of small intestine: the cannulas inserted in the intestine are fixed by an endoscopic alligator forceps, thus facilitating precise puncture and raising safety for the patient due to avoidance of dislocation. As complications local infections, implantation metastases and the buried bumper syndrome have to be mentioned and avoided. Alternative methods for PEG and different exchange systems for more comfort for the patients are discussed finally. PMID:12071092

Grund, K E

2002-05-15

270

Ultrasound-guided percutaneous galactography.  

PubMed

We present a new percutaneous ultrasound-guided galactography technique that may be used in patients in whom the conventional technique fails and breast ultrasonography show dilated ducts. PMID:8270666

Rissanen, T; Typpö, T; Tikkakoski, T; Turunen, J; Myllymäki, T; Suramo, I

1993-10-01

271

Temporal-spatial variation and controls of soil respiration in different primary succession stages on glacier forehead in Gongga Mountain, China.  

PubMed

Soil respiration (SR) is an important process in the global carbon cycle. It is difficult to estimate SR emission accurately because of its temporal and spatial variability. Primary forest succession on Glacier forehead provides the ideal environment for examining the temporal-spatial variation and controlling factors of SR. However, relevant studies on SR are relatively scarce, and variations, as well as controlling factors, remain uncertain in this kind of region. In this study, we used a static chamber system to measure SR in six sites which represent different stages of forest succession on forehead of a temperate glacier in Gongga Mountain, China. Our results showed that there was substantial temporal (coefficient of variation (CV) ranged from 39.3% to 73.9%) and spatial (CV ranged from 12.3% to 88.6%) variation in SR. Soil temperature (ST) at 5 cm depth was the major controlling factor of temporal variation in all six sites. Spatial variation in SR was mainly caused by differences in plant biomass and Total N among the six sites. Moreover, soil moisture (SM), microbial biomass carbon (MBC), soil organic carbon (SOC), pH and bulk density could influence SR by directly or indirectly affecting plant biomass and Total N. Q(10) values (ranged from 2.1 to 4.7) increased along the forest succession, and the mean value (3.3) was larger than that of temperate ecosystems, which indicated a general tendency towards higher-Q(10) in colder ecosystems than in warmer ecosystems. Our findings provided valuable information for understanding temporal-spatial variation and controlling factors of SR. PMID:22879950

Luo, Ji; Chen, Youchao; Wu, Yanhong; Shi, Peili; She, Jia; Zhou, Peng

2012-08-06

272

Percutaneous Management of Occlusive Arterial Disease Associated with Vasculitis: A Single Center Experience  

SciTech Connect

The purpose of this study was to evaluate the safety and effectiveness of percutaneous transluminal angioplasty for occlusive arterial disease associated with vasculitis. Eleven patients(10 women, 1 man; ages 35-82 years) with the diagnosis of vasculitis of the large vessels underwent interventional treatment during intraarterial angiography. The causes included giant cell arteritis(n = 8) and Takayasu arteritis (n = 3).Thirty-three occlusive lesions (including brachiocephalic and renalarteries, and arteries of upper and lower extremities) were treated with balloon angioplasty and/or stent placement. Follow-up included clinical examination, angiography, and color duplex ultrasound.Technical success was 100% (25/25) for stenoses and 50% (4/8) for occlusive lesions, representing all lesions combined from different anatomic locations. Dissection (n = 3) and arterial rupture with retroperitoneal hematoma (n = 1) was found in three patients. During follow-up (mean 12 months), restenoses(n = 8) and re-restenoses (n = 1)occurred in 8 vascular areas. Three of these lesions were treated with repeated PTA (n = 4). The cumulative primary clinical success rate was 67.6%, cumulative secondary success rate 74.4%, and cumulative tertiary success rate 75.9%. Interventional therapy in systemic vasculitis provides promising results in technical success rates and followup. Angioplasty may result in arterial injury, but the rate of complications is low.

Both, M.; Jahnke, T. [Department of Radiology, Christian-Albrechts-University of Kiel, Kiel(Germany); Reinhold-Keller, E. [Department of Rheumatology, University of Luebeck, Rheumaklinik Bad Bramstedt (Germany); Reuter, M.; Grimm, J.; Biederer, J.; Brossmann, J. [Department of Radiology, Christian-Albrechts-University of Kiel, Kiel (Germany); Gross, W.L. [Department of Rheumatology, University of Luebeck, Rheumaklinik Bad Bramstedt (Germany); Heller, M.; Mueller-Huelsbeck, S. [Department of Radiology, Christian-Albrechts-University of Kiel, Kiel (Germany)

2003-02-15

273

Percutaneous Versus Surgical Tracheostomy  

PubMed Central

Objective To compare surgical (SgT) and percutaneous (PcT) tracheostomies. Background Percutaneous tracheostomy has been said to provide numerous advantages over classical SgT. Methods A prospective randomized trial with a double-blind evaluation was used to compare SgT and PcT. SgT and PcT were performed according to established techniques (n = 70). The procedure was performed at the bedside in the intensive care unit in 21 cases (30%). The outcome measures were divided into procedure-related variables, perioperative complications, and postoperative complications. The procedure-related variables (location, duration, and difficulty) were evaluated by the surgeon. The perioperative and postoperative complications were divided into serious, intermediate, and minor. Perioperative and early postoperative (14 days) complications were evaluated daily by an intensive care unit nurse blinded to the technique used. Long-term postoperative complications were evaluated 3 months after decannulation by a surgeon blinded to the surgical technique. Results There were no major complications in either group. Most variables studied were not statistically different between the PcT and SgT groups. The only variables to reach statistical significance were the size of the incision (smaller with PcT, p < 0.0001), minor perioperative complications (greater with PcT, p = 0.02), and difficult cannula changes (greater with PcT; p < 0.05). Among nonsignificant differences, difficult procedures and false passages were more frequent with PcT, whereas long-term unesthetic scars were more frequent with SgT. Conclusions Both techniques are associated with a low rate of serious or intermediate complications when performed by experienced surgeons. There were more minor perioperative complications with PcT and more minor long-term complications with SgT.

Gysin, Claudine; Dulguerov, Pavel; Guyot, Jean-Philippe; Perneger, Thomas V.; Abajo, Blanca; Chevrolet, Jean-Claude

1999-01-01

274

Image-guided percutaneous radiofrequency ablation for osteoid osteomas.  

PubMed

The authors present a retrospective analysis of the technical and clinical successes, complications, and clinical follow-up of image-guided percutaneous radiofrequency (RF) ablation of osteoid osteomas. Nine patients with osteoid osteomas underwent image-guided localization of osteoid osteomas. Outpatient percutaneous therapy (13 procedures) was performed under general anesthesia after image-guided localization of the nidus. Initial technical success was achieved in seven of nine patients. Two initial technical and clinical failures occurred early in this experience because of failure to adequately enter the nidus with use of fluoroscopic imaging alone. Clinical success was achieved in eight of nine patients. No major immediate or delayed complications were observed. PMID:12631644

Venbrux, Anthony C; Montague, Brian J; Murphy, Kieran P J; Bobonis, Lauren A; Washington, Stanley B; Soltes, Amy P; Frassica, Frank J

2003-03-01

275

Occlusion of an Intraosseous Arteriovenous Malformation With Percutaneous Injection of Polymethylmethacrylate  

SciTech Connect

Primary intraosseous arteriovenous malformations are rare. Many minimally invasive procedures can be considered preoperative steps and/or definitive treatment. The case reported regards a young woman with a voluminous arteriovenous extratroncular infiltrating malformation of the humerus. She underwent several treatments, but none of them was completely occlusive. The last treatment consisted of direct percutaneous puncture of the intraosseous alteration and injection of polymethylmethacrylate (PMMA), which is normally used in percutaneous vertebroplasty. We obtained complete occlusion of the humerus lytic lesion. To the best of our knowledge, this represents the first case of intraosseous AVM treated by percutaneous injection of PMMA.

Ierardi, Anna Maria, E-mail: amierardi@yahoo.it [S. Giuseppe Hospital, Department of Radiology (Italy); Mangini, Monica, E-mail: monica.mangini@tin.it [University Hospital of Insubria, Department of Radiology (Italy); Vaghi, Massimo, E-mail: vaghim@yahoo.it [U. O. Department of Vascular Surgery, A. O. G. Salvini (Italy); Cazzulani, Alberto, E-mail: cazzulanialberto@tiscali.it [A. O. G. Salvini, Department of Radiology (Italy); Mattassi, Raul, E-mail: rmattassi@yahoo.it [U. O. Department of Vascular Surgery, A. O. G. Salvini (Italy); Carrafiello, Gianpaolo, E-mail: gcarraf@tin.it [University Hospital of Insubria, Department of Radiology (Italy)

2011-02-15

276

An Overview of Image-Guided Percutaneous Ablation of Renal Tumors  

PubMed Central

Although nephron-sparing surgery remains the gold standard treatment for small renal tumors, minimally invasive image-guided percutaneous ablation is becoming a viable alternative to operative resection. Percutaneous radiofrequency ablation (RFA) and cryoablation show high technical success rates, a relatively low incidence of residual or recurrent tumor, and competitive rates of patient survival. In this review, an overview of the current status of image-guided percutaneous ablation of renal tumors is presented, with a focus on procedure indications and patient selection, technical aspects of ablation procedures, and treatment outcomes and patient follow-up.

Maybody, Majid

2010-01-01

277

Percutaneous transluminal renal angioplasty in aortoarteritis.  

PubMed

Percutaneous transluminal renal angioplasty (PTRA) was performed in 26 patients with aortoarteritis, including unilateral renal artery stenosis in ten patients, bilateral renal artery stenosis in 16 patients. The total of 37 stenotic artery were performed by PTRA. Among them, 30 stenosis (81.1 per cent) were technically successful, three stenosis (8.1 per cent) were technically improved, and four stenosis were resistant to dilatation. The blood pressure responses were observed after PTRA, including cured in 17 patients (65.4 per cent), improved in five patients (19.2 per cent), failed in four patients (15.4 per cent). Sixteen patients after successful angioplasty were followed-up from 6 months to 15 years (average 5.4 years). The blood pressure was still normal in 12 patients (75 per cent). The blood pressure gradually increased may be due to restenosis in four patients (25 per cent). PMID:9951821

Deyu, Z; Lisheng, L; Ruping, D; Haiying, W; Guozhang, L

1998-10-01

278

Delay of dialysis in end-stage renal failure: Prospective study on percutaneous renal artery interventions  

Microsoft Academic Search

Delay of dialysis in end-stage renal failure: Prospective study on percutaneous renal artery interventions.BackgroundRenal artery stenosis (RAS) is a cause of end-stage renal failure. We studied the effect of percutaneous renal artery intervention (PRI) in patients with advanced, progressive disease at risk for renal failure, hypothesizing a beneficial effect.MethodsThirty-nine primary and 14 secondary PRIs were performed on 28 patients with

S. Korsakas; M. G. Mohaupt; H. P. Dinkel; F. Mahler; D. D. Do; J. Voegele; I. Baumgartner

2004-01-01

279

Femoral artery percutaneous revascularization for patients with critical limb ischemia: outcomes compared to patients with claudication over 2.5 years.  

PubMed

Patients with critical limb ischemia have higher rates of death and amputation after revascularization compared to patients with intermittent claudication. However, the differences in patency after percutaneous revascularization of the superficial femoral artery are uncertain and impact the long-term risk of amputation and function in critical limb ischemia. We identified 171 limbs from 136 consecutive patients who had angioplasty and/or stenting for super?cial femoral artery stenoses or occlusions from July 2003 through June 2007. Patients were followed for primary and secondary patency, death and amputation up to 2.5 years, and 111 claudicants were retrospectively compared to the 25 patients with critical limb ischemia. Successful percutaneous revascularization occurred in 128 of 142 limbs (90%) with claudication versus 25 of 29 limbs (86%) with critical limb ischemia (p = 0.51). Overall secondary patency at 2.5 years was 91% for claudication and 88% for critical limb ischemia. In Cox proportional hazards models, percutaneous revascularization for critical limb ischemia had similar long-term primary patency (adjusted hazard ratio = 1.1, 95% CI = 0.4, 2.6; p = 0.89) and secondary patency (adjusted hazard ratio = 1.1, 95% CI = 0.2, 6.0; p = 0.95) to revascularization for claudication. Patients with critical limb ischemia had higher mortality and death rates compared to claudicants, with prior statin use associated with less death (p = 0.034) and amputation (p = 0.010), and prior clopidogrel use associated with less amputation (p = 0.034). In conclusion, percutaneous superficial femoral artery revascularization is associated with similar long-term durability in both groups. Intensive treatment of atherosclerosis risk factors and surveillance for restenosis likely contribute to improving the long-term outcomes of both manifestations of peripheral artery disease. PMID:22496125

Todoran, Thomas M; Connors, Gerard; Engelson, Brian A; Sobieszczyk, Piotr S; Eisenhauer, Andrew C; Kinlay, Scott

2012-04-11

280

Retrograde Percutaneous Closure of a Ventricular Septal Defect after Myectomy for Hypertrophic Obstructive Cardiomyopathy  

PubMed Central

In patients with hypertrophic obstructive cardiomyopathy, hemodynamically significant ventricular septal defect after septal myectomy is a rare sequela that warrants closure. Percutaneous closure provides a safer alternative to repeated sternotomy, which is associated with significant morbidity and mortality rates. We report a possibly unique case of successful retrograde percutaneous closure, with an AMPLATZER Muscular VSD Occluder, of an iatrogenic ventricular septal defect consequent to surgical therapy for hypertrophic obstructive cardiomyopathy.

Singh, Vikas; Badheka, Apurva O.; Bokhari, Syed S.; Ghersin, Eduard; Clark, Pedro Martinez; O'Neill, William W.

2013-01-01

281

Percutaneous Drainge and Ileocolectomy for Spontaneous Intraabdominal Abscess in Crohn’s Disease  

Microsoft Academic Search

Background  Historical studies have shown that percutaneous drainage alone for intraabdominal abscess secondary to Crohn’s disease is\\u000a successful in avoiding surgery in only approximately 50% of patients. Failure, however, can require urgent surgery and is\\u000a then associated with increased morbidity, extended hospital stays, and increased risk for stoma creation. Because of this,\\u000a our current protocol is initial percutaneous drainage of the

Lisa S. Poritz; Walter A. Koltun

2007-01-01

282

Direct Percutaneous Jejunostomy-An Underutilized Interventional Technique?  

SciTech Connect

Our aim in this study was to report our single-center experience with direct percutaneous jejunostomy over a 4-year period with regard to technical success rate, immediate and late complications, and patient tolerance of the procedure. Institutional records of 22 consecutive patients who underwent radiological insertion of a percutaneous jejunostomy for a variety of indications were reviewed. The proximal jejunum was punctured under either fluoroscopic or ultrasonic guidance, and following placement of retention sutures, a 10- to 12-Fr catheter inserted. There was a 100% technical success rate in placement involving a total of seven operators. The indications for placement were prior gastric resection, newly diagnosed resectable esophageal or gastric carcinoma, unresectable gastric carcinoma with outlet obstruction, and palliative drainage of bowel obstruction. Mean duration of follow-up was 100 days, and catheter placement 57.7 days. There were six minor early complications, consisting of loss of two retention anchors requiring repuncture, three cases of localized excessive postprocedural pain, and one failed relief of symptoms of small bowel obstruction. Four tubes developed late complications (two blocked, one catheter cracked, and one inadvertently pulled out). Three of the four were successfully replaced through the existing tracts. One patient subsequently developed a minor skin infection, while another developed late pericatheter leakage from ascites. We conclude that direct percutaneous jejunostomy is a valuable treatment modality applicable to a number of clinical scenarios, with a high technical success rate and low serious complication rate.

Sparrow, Patrick, E-mail: patsparrow@doctors.net.uk; David, Elizabeth; Pugash, Robyn [Sunnybrook Health Sciences Centre, Department of Vascular and Interventional Radiology (Canada)

2008-03-15

283

Percutaneous transhepatic dissolution of gallbladder stones.  

PubMed

The method of percutaneous transhepatic dissolution with methyl tert-butyl ether (MTBE) has been used at the Zagreb Clinical Hospital Department of Medicine since 1989. From December 1989 until December 1991, 69 patients, 51 (74%) females and 18 (26%) males, with symptomatic and cholesterol gallbladder stones were hospitalised at the Department. All patients preferred percutaneous transhepatic dissolution to surgical treatment of gallbladder stones. The gallbladder was successfully punctured and the catheter placed into the gallbladder lumen in 63 (91%) patients, whereas complete dissolution was achieved in 59 (85.5%) patients. In 21 (33.9%) of these 59 patients, after completed dissolution computer-processed roentgenograms and ultrasonic scan of the gallbladder revealed residual particles of debris sized up to 2 mm. Six patients in whom puncture, i.e. the placement of the catheter into the lumen was unsuccessful, were electively operated on the following day without any complications. The mean duration of hospitalisation for 63 patients was 4.5 days. PMID:1509785

Salamon, V; Simunic, S; Radanovic, B

1992-07-01

284

[Percutaneous tracheotomy following single tracheal dilatation. Experience in 74 patients].  

PubMed

In the method described by Ciaglia et al., the trachea is cannulated transcutaneously below the cricoid cartilage under bronchoscopic observation. For this purpose, a Seldinger wire with seven graduated dilatators is used for successive tracheal dilatation to 36 CH and insertion of an indwelling tracheal cannula. The disadvantage of this procedure is the time-consuming successive insertion of seven bougies and the repeated risk of injury to the dorsal tracheal wall. Percutaneous cannulization sets are expensive and cannot be re-sterilized. We developed a re-sterilizable, single-step bougienage device and tested the procedure successfully without any complications in 74 patients. PMID:10663004

Wolfgarten, B; July, M

2000-01-01

285

Design and testing of a percutaneously implantable fetal pacemaker.  

PubMed

We are developing a cardiac pacemaker with a small, cylindrical shape that permits percutaneous implantation into a fetus to treat complete heart block and consequent hydrops fetalis, which can otherwise be fatal. The device uses off-the-shelf components including a rechargeable lithium cell and a highly efficient relaxation oscillator encapsulated in epoxy and glass. A corkscrew electrode made from activated iridium can be screwed into the myocardium, followed by release of the pacemaker and a short, flexible lead entirely within the chest of the fetus to avoid dislodgement from fetal movement. Acute tests in adult rabbits demonstrated the range of electrical parameters required for successful pacing and the feasibility of successfully implanting the device percutaneously under ultrasonic imaging guidance. The lithium cell can be recharged inductively as needed, as indicated by a small decline in the pulsing rate. PMID:22855119

Loeb, Gerald E; Zhou, Li; Zheng, Kaihui; Nicholson, Adriana; Peck, Raymond A; Krishnan, Anjana; Silka, Michael; Pruetz, Jay; Chmait, Ramen; Bar-Cohen, Yaniv

2012-08-02

286

Preoperative percutaneous localisation of parathyroid tumours: a preliminary report.  

PubMed Central

Uncomplicated bilateral percutaneous subclavian venous sampling for parathormone estimation was performed preoperatively in 10 patients with primary hyperparathyroidism. In 7 cases there was correlation of the higher parathormone level with the side of the parathyroid tumour subsequently found at operation. In conjunction with the "Tibblin strategy of unilateral parathyroidectomy" (1) a dual approach is suggested that may provide a simple, accurate method of treating patients with hyperparathyroidism.

Dennison, A.; Ball, M.; Dudley, N.

1985-01-01

287

Preoperative percutaneous localisation of parathyroid tumours: a preliminary report.  

PubMed

Uncomplicated bilateral percutaneous subclavian venous sampling for parathormone estimation was performed preoperatively in 10 patients with primary hyperparathyroidism. In 7 cases there was correlation of the higher parathormone level with the side of the parathyroid tumour subsequently found at operation. In conjunction with the "Tibblin strategy of unilateral parathyroidectomy" (1) a dual approach is suggested that may provide a simple, accurate method of treating patients with hyperparathyroidism. PMID:4051421

Dennison, A; Ball, M; Dudley, N

1985-09-01

288

Splenic Injury During Percutaneous Nephrolithotomy  

PubMed Central

Background: Injury to the spleen is a recognized complication during percutaneous renal access due to the close anatomical relationship of the spleen and the left kidney. However, transsplenic renal access is a rare complication of percutaneous nephrolithotomy and can also result in considerable morbidity, often requiring emergent splenectomy. Methods: We present our experience with splenic injury during percutaneous nephrolithotomy managed conservatively with the use of a collagen-thrombin hemostatic sealant (D-Stat; Vascular Solutions, Inc., Minneapolis, MN) after delayed removal of the nephrostomy tubes. Results: The patient had an uneventful recovery and was discharged home on postoperative day 6. Conclusion: In select hemodynamically stable patients, nonoperative management with the adjunctive use of hemostatic sealants may be considered.

Thomas, Anil A.; Pierce, Gregory; Walsh, R. Matthew; Sands, Mark

2009-01-01

289

Percutaneous endoscopic gastrostomy in the open abdomen patient.  

PubMed

Nutrition support of critically ill patients is an integral element to their multimodal care. We describe the placement of a percutaneous endoscopic gastrostomy (PEG) for long-term enteral access in a patient with an open abdomen. To our knowledge, this is the third successfully reported case that demonstrates the viability of PEG in this uncommon population. In critically ill and malnourished surgical patients with contraindications for immediate abdominal closure, PEG should be strongly considered as a procedure for enteral feedings. PMID:23114265

Fei, Jeffrey Zhaoke; Demuro, Jonas P

2012-10-31

290

Totally Tubeless Outpatient Percutaneous Nephrolithotomy: Initial Case Report  

PubMed Central

We report the first case of totally tubeless outpatient percutaneous nephrolithotomy (PCNL). Our patient was discharged home safely less than 4 hours following uncomplicated PCNL with no nephrostomy tube, ureteral stent, or urethral catheter. Follow-up the next day in clinic confirmed that the procedure was successful, as the patient was clinically well and stone free. To our knowledge, this is the first case report of totally tubeless (no nephrostomy, no ureteral stent) PCNL performed on a truly outpatient basis.

Beiko, Darren; Samant, Meghana; McGregor, Thomas B.

2009-01-01

291

Negative results - Vascular general Graft repair of tracheo-innominate artery fistula following percutaneous tracheostomy  

Microsoft Academic Search

Tracheo-innominate fistula (TIF) is a rare complication following percutaneous dilatational tracheostomy (PDT), occurring in F1% of cases. It usually develops three days to six weeks after the procedure and is fatal in the majority of cases, even after successful initial repair. We present a successfully treated case of TIF using a Goretex graft to replace the severely destroyed segment of

Hassan Jamal-Eddine; Adel K. Ayed; Ahmed Al-Moosa; Nael Al-Sarraf

2010-01-01

292

Lasers in percutaneous renal procedures  

Microsoft Academic Search

Introduction  Since the invention of lasers in 1960, they have been increasingly used in medicine. In this review paper, the types of lasers\\u000a used in urology, in addition to their applications to percutaneous renal surgery will be reviewed. Specifically, use of lasers\\u000a in the percutaneous management of renal stones, upper tract transitional cell carcinoma and stricture will be reviewed.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and

Nadya M. Cinman; Sero Andonian; Arthur D. Smith

2010-01-01

293

Geographic variation and physician specialization in the use of percutaneous biopsy for breast cancer diagnosis  

PubMed Central

Background Preoperative diagnosis of breast cancer is a standard of care. We conducted a population-based study to determine the factors associated with the use of percutaneous needle biopsy to diagnose breast cancer in Ontario. Methods We identified a total of 3644 women who underwent breast tissue sampling (percutaneous needle biopsy or surgical excision) that yielded a diagnosis of cancer between Apr. 1, 2002, and Dec. 31, 2002, and for whom we were able to obtain complete data. We performed univariate and multivariate analyses to examine the association between a number of variables and the use of percutaneous biopsy or surgery for diagnosis and the performance of biopsy with or without image guidance. The variables were age, local health integration network (LHIN), income quintile, urban or rural residence, access to a primary care provider, prior mammogram, prior regular screening mammography, screen-initiated biopsy, and surgeon and radiologist specialization in breast disease. Results A total of 2374 women (65%) underwent percutaneous biopsy to diagnose breast cancer. The use of percutaneous biopsy varied from 22% to 81% among LHINs. On multivariate analysis, no patient variables were associated with the use of percutaneous biopsy for diagnosis. Only the LHIN and surgeon and radiologist specialization were predictive of whether a woman received a percutaneous biopsy. These 2 variables, along with income quintile and screen-initiated biopsy, were associated with the use of image-guided biopsy as the method of choice. Conclusion Geographic variation in the use of percutaneous biopsy, particularly image-guided biopsy, for the diagnosis of breast cancer exists across Ontario. The frequency of such biopsies may be a useful quality indicator. Strategies to improve uptake of organized evidence-based care may increase the use of percutaneous biopsy.

Holloway, Claire M.B.; Saskin, Refik; Paszat, Lawrence

2008-01-01

294

[Percutaneous transhepatic litholysis--indications, results, risks].  

PubMed

A total of 170 patients with symptomatic cholesterol stones in the gallbladder were scheduled for percutaneous transhepatic dissolution with MTBE. Puncture was successful in 167/170 patients; stones dissolved in 161/167. The treatment of solitary stones averaged 3.9 hours, whereas multiple stones required 9.6 hours. The mean hospitalisation time was 3.6 days. After litholysis 1/3 of the patients had sludge in the gallbladder; most of them were free of residue after treatment for 3 months with UDC/CDC. Complications included hemobilia in 2/167, perforation in 1/167 and bile leakage in 7/167 (5 had surgery). PMID:1983517

Hellstern, A; Leuschner, U; Gatzen, M

1990-01-01

295

The role of percutaneous nephrostomy in the management of obstructing candidiasis of the urinary tract in infants.  

PubMed

We report on 5 neonates with obstructive urinary tract candidiasis in whom percutaneous nephrostomy had a major role in management. The advantages of percutaneous nephrostomy in this setting include prompt drainage of the obstructed renal pelvis or ureter, direct access to obtain specimens from the renal pelvis to confirm the diagnosis, direct irrigation of the fungus balls with amphotericin B and an access route for fragmentation of fungus balls by guide wire manipulation. In 3 cases percutaneous placement of the nephrostomy tube was successful in obtaining and maintaining access to the renal pelvis, while in 2 surgical intervention was required because of problems maintaining placement of the percutaneous catheters. Percutaneous nephrostomy with antegrade amphotericin B irrigation, coupled with systemic antifungal therapy, is the mainstay of treatment. The usefulness of ultrasonography in the early diagnosis of renal candidiasis also is emphasized. PMID:3398131

Bartone, F F; Hurwitz, R S; Rojas, E L; Steinberg, E; Franceschini, R

1988-08-01

296

The value of percutaneous cholangiography  

PubMed Central

Percutaneous cholangiograms performed on fifty patients in a district general hospital have been reviewed, and the advantages and limitations of the examination are described. The investigation is considered to have sufficient diagnostic value to warrant its inclusion in the diagnostic armamentarium of every general radiological department. ImagesFig. 1Fig. 2Fig. 3Fig. 4

Evison, Gordon; McNulty, Myles; Thomson, Colin

1973-01-01

297

Percutaneous endoscopic gastrostomy tube replacement.  

PubMed

Percutaneous endoscopic gastrostomy (PEG) is undertaken in order to provide long-term nutrition in patients with dysphagia. Over time, the PEG tubes will deteriorate and will need to be replaced. We describe a method of replacement which is cost-effective and which does not require repetition of the endoscopy. PMID:22080482

Khaliq, Abdul

2011-11-11

298

Percutaneous Penetration Enhancers: An Overview  

Microsoft Academic Search

Transdermal drug delivery is the controlled release of drugs through the skin to obtain therapeutic levels systematically. Several technological advances have been made in the recent decades to enhance percutaneous drug penetration. This overview focuses on the physical, biochemical, and chemical means of penetration enhancement, as well as the classification and mechanisms of chemical penetration enhancers, their application in transdermal

H.-Y. Thong; H. Zhai; H. I. Maibach

2007-01-01

299

Jejunal Variceal Bleeding Successfully Treated with Percutaneous Coil Embolization  

PubMed Central

A 52-yr-old male with alcoholic liver cirrhosis was hospitalized for hematochezia. He had undergone small-bowel resection due to trauma 15 yr previously. Esophagogastroduodenoscopy showed grade 1 esophageal varices without bleeding. No bleeding lesion was seen on colonoscopy, but capsule endoscopy showed suspicious bleeding from angiodysplasia in the small bowel. After 2 weeks of conservative treatment, the hematochezia stopped. However, 1 week later, the patient was re-admitted with hematochezia and a hemoglobin level of 5.5 g/dL. Capsule endoscopy was performed again and showed active bleeding in the mid-jejunum. Abdominal computed tomography revealed a varix in the jejunal branch of the superior mesenteric vein. A direct portogram performed via the transhepatic route showed portosystemic collaterals at the distal jejunum. The patient underwent coil embolization of the superior mesenteric vein just above the portosystemic collaterals and was subsequently discharged without re-bleeding. At 8 months after discharge, his condition has remained stable, without further bleeding episodes.

Koo, So My; Jang, Jae Young; Lee, Tae Hee; Jeon, Seong Ran; Kim, Hyun Gun; Kim, Jin Oh; Kim, Yong Jae

2012-01-01

300

Percutaneous Endoluminal Bypass of Iliac Aneurysms with a Covered Stent  

SciTech Connect

To evaluate the feasibility of percutaneous treatment of iliac aneurysms, a covered stent was inserted in nine men suffering from common iliac artery aneurysms (six cases), external iliac aneurysms (one case), or pseudoaneurysms (two cases). Placement of the stent was successful in all patients. In one patient, an endoprosthesis thrombosed after 15 days, but was successfully treated by thrombolysis and additional stent placement. At the follow-up examinations (mean period 22 months) all stent-grafts had remained patent. No late leakage or stenosis was observed.

Ruebben, Alexander; Tettoni, Serena; Muratore, Pierluigi; Rossato, Dennis; Savio, Daniele; Rabbia, Claudio [Radiologia del Pronto Soccorso, Servizio di Angioradiologia, Azienda Ospedaliera San Giovanni Battista, Corso Bramante 88, I-10126 Turin (Italy)

1998-07-15

301

Vascular injuries after percutaneous renal procedures: treatment by transcatheter embolization.  

PubMed

Percutaneous renal procedures have become the standard technique for diagnosis and treatment of a number of renal pathologies. Hemorrhage and vascular lesions are the most serious complications. We report our experience with 15 patients treated by hyperselective vascular embolization. Fifteen patients (10 men and 5 women; mean age 55 years) had severe perioperative hemorrhage after percutaneous renal procedures, due to arterial renal major injury. All patients underwent duplex US, CT, and renal arteriography demonstrating the presence of arteriovenous fistulas (n=2), renal hematoma (n=3), pseudoaneurysms (n=3), and hematoma with pseudoaneurysm (n=7). Four patients showed transient renal dysfunction, with an increase in serum creatinine levels. One patient had a solitary transplanted kidney. Hyperselective arterial embolization was performed successfully by means of coils (n=14), associated with gelfoam in 4 cases; homologous blood clot was used in 1 patient. No major complications occurred, and renal function rapidly normalized in the 4 patients with transient renal failure. Imaging follow-up confirmed the successful devascularization of the lesion. Renal arterial hemorrhage following percutaneous procedures is a rare but severe complication. Hyperselective renal artery embolization, with particles and/or coils, represents the first-choice treatment option, being safe and effective in stopping the bleeding. PMID:14625782

Vignali, Claudio; Lonzi, Simone; Bargellini, Irene; Cioni, Roberto; Petruzzi, Pasquale; Caramella, Davide; Bartolozzi, Carlo

2003-11-19

302

Emergency percutaneous treatment in surgical bile duct injury.  

PubMed

The aim of this study is to evaluate the efficacy of emergency percutaneous treatment in patients with surgical bile duct injury (SBDI). From May 2004 to May 2007, 11 patients (five men, six women; age range 26-80 years; mean age 58 years) with a critical clinical picture (severe jaundice, bile peritonitis, septic state) due to SBDI secondary to surgical or laparoscopic procedures were treated by percutaneous procedures. We performed four ultrasound-guided percutaneous drainages, four external-internal biliary drainages, one bilioplasty, and two plastic biliary stenting after 2 weeks of external-internal biliary drainage placement. All procedures had 100% technical success with no complications. The clinical emergencies resolved in 3-4 days in 100% of cases. All patients had a benign clinical course, and reoperation was avoided in 100% of cases. Interventional radiological procedures are effective in the emergency management of SBDI since they are minimally invasive and have a high success rate and a low incidence of complications compared to the more complex and dangerous surgical or laparoscopic options. PMID:18463906

Carrafiello, Gianpaolo; Laganà, Domenico; Dizonno, Massimiliano; Ianniello, Andrea; Cotta, Elisa; Dionigi, Gianlorenzo; Dionigi, Renzo; Fugazzola, Carlo

2008-05-08

303

[Endoscopic percutaneous gastrostomy with gastropexy: a safe technical choice].  

PubMed

Percutaneous endoscopic gastrostomy is an interesting method of providing enteral nutrition or gastric decompression in patients who are candidates for operative gastrostomy or nasoenteric tube feeding. We report our experience with percutaneous endoscopic gastrostomy with gastropexy (Introducer T-Fastener) in 41 patients. This method uses a technique in which the anterior gastric wall is non-surgically sutured to the anterior abdominal wall before catheter insertion. This technique was successful in all patients, including one subject with a Billroth II hemigastrectomy. Enteral nutrition was started in all cases within 24 hours of the end of the procedure. The medium enteral nutrition period to date is 482.5 days. There were no deaths related to the procedure and no patients had major specific abdominal complications requiring urgent surgical repair. Eight patients complained of minor specific complications which were successfully resolved in all cases with simple conservative procedures and/or therapies. These results indicate that the Introducer T-Fastener method for performing percutaneous endoscopic gastrostomy is rapid, safe, and inexpensive. PMID:11723896

Paganelli, M T; Antonini, G; Correnti, F S; Mercati, U

304

The prognosis of periprocedural myocardial infarction after percutaneous coronary interventions.  

PubMed

An increase of biomarkers of myocardial necrosis is observed frequently after percutaneous coronary interventions (PCI) even when the procedure seems angiographically successful and otherwise uncomplicated. The recently updated Universal Definition of Myocardial infarction (MI) arbitrarily defined periprocedural MI (type 4a) by elevation of cardiac troponin (cTn) values >5 × the upper reference limit (URL) in patients with normal baseline values or a rise of cTn values >20% if the baseline values are elevated, together with either angina or new ECG changes or angiographic loss of patency of a coronary artery or a side branch or persistent slow or no-flow or embolization, or imaging demonstration of new loss of viable myocardium. Most frequent causes of such event are side-branch closure and/or plaque microembolization. The present review is focused on the prognostic implication of periprocedural necrosis. The risk related to a PCI-induced MI is significantly lower as compared to a spontaneous event where a similar increase of biomarkers is detected. Moreover, although an association between CK-MB elevations and adverse prognosis after PCI has been documented, existing data do not support the statement that an isolated elevation of troponins after PCI is associated with an adverse prognosis after PCI; increased troponin levels before PCI seem far more predictive of future events than a peri-procedural itself. Caution should be paid in the interpretation of clinical trials using type 4a MI as a primary endpoint. Nevertheless, patients with periprocedural myocardial damage should be treated as a higher-risk cohort, carefully monitored and receive an intensified secondary prevention program. PMID:23164601

Zimarino, Marco; Affinito, Vincenzo

2012-11-17

305

Percutaneous Therapy of Ureteral Obstructions and Leak After Renal Transplantation: Long-Term Results  

SciTech Connect

The purpose of this study was to evaluate the long-term outcome of percutaneous therapy of ureteral complications after renal transplantation. Between January 2000 and June 2006 we percutaneously treated 26 renal transplant patients with ureteral obstruction (n=19) and leak (n=7). Obstructions were classified as early (<2 months after transplantation) or late (>2 months). Patients with leak were treated with nephro-ureteral catheter placement and subsequent double-J stenting. Balloon dilatation, stent placement, and basket extraction were used to treat ureteral obstructions. Patients were followed with ultrasonography. No major procedure-related complication occurred. The mean follow-up time was 34.3 months (range: 6 to 74 months). Initial clinical success was achieved in all 19 patients with obstruction and 6 of 7 patients with leak. Four of 9 early obstructions and 4 of 10 late obstructions recurred during the follow-up. All recurrences were initially managed again with percutaneous methods, including cutting balloon technique and metallic stent placement. Although there was no recurrence in patients with successfully treated leak, stricture was seen at the previous leak site in two patients. These strictures were also successfully managed percutaneously. We conclude that in the treatment of ureteral obstruction and leak following renal transplantation, percutaneous therapy is an effective alternative to surgery. However, further interventions are usually needed to maintain long-term patency.

Aytekin, Cueneyt, E-mail: cuneytaytekin@hotmail.com; Boyvat, Fatih; Harman, Ali; Ozyer, Umut [Faculty of Medicine, Baskent University, Department of Radiology (Turkey); Colak, Turan [Baskent University, Department of Nephrology, Faculty of Medicine (Turkey); Haberal, Mehmet [Baskent University, Department of Surgery, Faculty of Medicine (Turkey)

2007-11-15

306

Congenital Splenic Cyst Treated with Percutaneous Sclerosis Using Alcohol  

SciTech Connect

We report a case of successful percutaneous treatment of a congenital splenic cyst using alcohol as the sclerosing agent. A 14-year-old female adolescent presented with a nonsymptomatic cystic mass located in the spleen that was believed to be congenital. After ultrasonography, a drainage catheter was placed in the cavity. About 250 ml of serous liquid was extracted and sent for microbiologic and pathologic studies to rule out an infectious or malignant origin. Immediately afterwards, complete drainage and local sclerotherapy with alcohol was performed. This therapy was repeated 8 days later, after having observed 60 ml of fluid in the drainage bag. One year after treatment the cyst has practically disappeared. We believe that treatment of splenic cyst with percutaneous puncture, ethanolization, and drainage is a valid option and it does not rule out surgery if the conservative treatment fails.

Anon, Ramon [Clinical University Hospital, University of Valencia, Department of Gastroenterology (Spain)], E-mail: ranon@comv.es; Guijarro, Jorge [Clinical University Hospital, University of Valencia, Department of Interventional Radiology (Spain); Amoros, Cirilo [Clinical University Hospital, University of Valencia, Department of Gastroenterology (Spain); Gil, Joaquin [Clinical University Hospital, University of Valencia, Department of Interventional Radiology (Spain); Bosca, Marta M. [Clinical University Hospital, University of Valencia, Department of Gastroenterology (Spain); Palmero, Julio [Clinical University Hospital, University of Valencia, Department of Interventional Radiology (Spain); Benages, Adolfo [Clinical University Hospital, University of Valencia, Department of Gastroenterology (Spain)

2006-08-15

307

Complication of a percutaneous endoscopic gastrostomy tube causing duodenal ischemia.  

PubMed

A 33-year-old woman with a percutaneous endoscopic gastrostomy tube was admitted with bilious vomiting, 1 month after her feeding tube was replaced by a temporary Foley catheter. A computed tomography scan of her abdomen revealed a 4.5 cm by 7.5 cm fluid-filled structure in the distal duodenum surrounding the Foley feeding tube. Approximately 100 mL of fluid was aspirated from the Foley's balloon port. We hypothesized that the Foley catheter was flushed inappropriately through the balloon port, causing an iatrogenic ischemic duodenal injury. Conservative management was successful in the intensive care unit. This case highlights an unusual complication of percutaneous endoscopic gastrostomy tubes. In addition, it emphasizes the temporary nature of Foley catheters as replacement gastrostomy tubes, and the importance of training in the handling of feeding tubes. PMID:17277666

Martel, Guillaume; Lingas, Rania I; Gutauskas, Andrea; Clark, Heather D

2006-12-01

308

Spontaneous left main dissection treated by percutaneous coronary intervention.  

PubMed

Spontaneous coronary artery dissection is a rare cause of acute coronary events or sudden cardiac death. The clinical presentation is highly variable and prognosis varies widely, depending mainly on how rapidly it is diagnosed. Prompt treatment is also essential, and includes medical management, percutaneous coronary intervention and surgical revascularization. We describe the case of a young woman presenting with spontaneous coronary artery dissection of the left main coronary artery, first diagnosed as coronary thrombus, who underwent successful percutaneous coronary stenting. This report highlights the need to include spontaneous coronary artery dissection in differential diagnosis of chest pain in young women and that distinguishing between coronary thrombus and coronary artery dissection is not always straightforward. To our knowledge this is the fourth case of left main stenting in a patient with spontaneous coronary artery dissection described in the literature. PMID:23809628

Sousa, Alexandra; Lopes, Ricardo; Silva, João Carlos; Maciel, M Júlia

2013-06-25

309

Percutaneous Transsplenic Access to the Portal Vein for Management of Vascular Complication in Patients with Chronic Liver Disease  

SciTech Connect

Purpose: To evaluate the safety and feasibility of percutaneous transsplenic access to the portal vein for management of vascular complication in patients with chronic liver diseases. Methods: Between Sept 2009 and April 2011, percutaneous transsplenic access to the portal vein was attempted in nine patients with chronic liver disease. Splenic vein puncture was performed under ultrasonographic guidance with a Chiba needle, followed by introduction of a 4 to 9F sheath. Four patients with hematemesis or hematochezia underwent variceal embolization. Another two patients underwent portosystemic shunt embolization in order to improve portal venous blood flow. Portal vein recanalization was attempted in three patients with a transplanted liver. The percutaneous transsplenic access site was closed using coils and glue. Results: Percutaneous transsplenic splenic vein catheterization was performed successfully in all patients. Gastric or jejunal varix embolization with glue and lipiodol mixture was performed successfully in four patients. In two patients with a massive portosystemic shunt, embolization of the shunting vessel with a vascular plug, microcoils, glue, and lipiodol mixture was achieved successfully. Portal vein recanalization was attempted in three patients with a transplanted liver; however, only one patient was treated successfully. Complete closure of the percutaneous transsplenic tract was achieved using coils and glue without bleeding complication in all patients. Conclusion: Percutaneous transsplenic access to the portal vein can be an alternative route for portography and further endovascular management in patients for whom conventional approaches are difficult or impossible.

Chu, Hee Ho; Kim, Hyo-Cheol, E-mail: angiointervention@gmail.com; Jae, Hwan Jun [Seoul National University College of Medicine, Seoul National University Medical Research Center, Seoul National University Hospital, Department of Radiology, Institute of Radiation Medicine, Clinical Research Institute (Korea, Republic of); Yi, Nam-Joon; Lee, Kwang-Woong; Suh, Kyung-Suk [Seoul National University College of Medicine and Seoul National University Hospital, Department of Surgery (Korea, Republic of); Chung, Jin Wook; Park, Jae Hyung [Seoul National University College of Medicine, Seoul National University Medical Research Center, Seoul National University Hospital, Department of Radiology, Institute of Radiation Medicine, Clinical Research Institute (Korea, Republic of)

2012-12-15

310

Percutaneous Ablation in the Kidney  

PubMed Central

Percutaneous ablation in the kidney is now performed as a standard therapeutic nephron-sparing option in patients who are poor candidates for resection. Its increasing use has been largely prompted by the rising incidental detection of renal cell carcinomas with cross-sectional imaging and the need to preserve renal function in patients with comorbid conditions, multiple renal cell carcinomas, and/or heritable renal cancer syndromes. Clinical studies to date indicate that radiofrequency ablation and cryoablation are effective therapies with acceptable short- to intermediate-term outcomes and with a low risk in the appropriate setting, with attention to pre-, peri-, and postprocedural detail. The results following percutaneous radiofrequency ablation and cryoablation in the treatment of renal cell carcinoma are reviewed in this article, including those of several larger scale studies of ablation of T1a tumors. Clinical and technical considerations unique to ablation in the kidney are presented, and potential complications are discussed. © RSNA, 2011

Wood, Bradford J.; Gervais, Debra A.

2011-01-01

311

Morbidity after percutaneous liver biopsy.  

PubMed Central

The safety of percutaneous liver biopsy with a 1.2 mm Menghini needle in infants aged one year or less was investigated. One hundred and eighty four procedures performed from 1975 to 1985 were reviewed. There were no deaths or major complications within 48 hours associated with the procedure. In five instances specific complications occurred: a drop in haemoglobin concentration (three), transient hypotension (one), and haematoma at the biopsy site (one). The result of liver biopsy was diagnostic in 83% of cases, compatible with unspecified metabolic disease in 8%, and normal or not diagnostic in 9%. This study suggests that percutaneous liver biopsy can be performed with relative safety in small infants if coagulation is normal and there are no major contraindications, and the results yield important diagnostic information which cannot be obtained using less invasive procedures.

Lichtman, S; Guzman, C; Moore, D; Weber, J L; Roberts, E A

1987-01-01

312

Clinical review: Percutaneous dilatational tracheostomy  

Microsoft Academic Search

As the number of critically ill patients requiring tracheotomy for prolonged ventilation has increased, the demand for a procedural\\u000a alternative to the surgical tracheostomy (ST) has also emerged. Since its introduction, percutaneous dilatational tracheostomies\\u000a (PDT) have gained increasing popularity. The most commonly cited advantages are the ease of the familiar technique and the\\u000a ability to perform the procedure at the

Mariam A Al-Ansari; Mohammed H Hijazi

2005-01-01

313

Percutaneous valved stent repair of a failed homograft: implications for the Ross procedure.  

PubMed

A case of percutaneous pulmonary valve implantation following a failed homograft in the pulmonary position is reported. A 16-year-old boy developed infective endocarditis of his pulmonary homograft, which was implanted four years earlier during a Ross procedure for congenital aortic stenosis. Following successful medical therapy, the boy was symptomatic due to pulmonary stenosis and regurgitation. A 22 mm Melody valve (Medtronic, USA) was successfully implanted percutaneously. His symptoms resolved and he was discharged home one day after the procedure. Echocardiography at the six-month follow-up demonstrated a normally functioning pulmonary valve. Percutaneous pulmonary valve replacement may make the Ross procedure a more attractive option for patients with aortic stenosis, particularly in the pediatric population. PMID:18685750

Pretorius, Victor; Jones, Alan; Taylor, Dylan; Coe, Yashu; Ross, David B

2008-08-01

314

Percutaneous extraction of transvenous defibrillator leads using the VascoExtor pacing lead removal system.  

PubMed

In the implantable cardioverter defibrillator era the necessity for lead removal is not negligible. A specially designed extraction lead system for percutaneous removal of such leads is lacking, in contrast to the existing pacing lead extraction systems. We report the successful percutaneous extraction of four implantable cardioverter defibrillator leads in three patients because of lead malfunction using a novel pacemaker lead extraction system, the VascoExtor (VascoMed) system. Three leads were successfully removed in two patients using traction with special locking stylets from the superior approach. One lead was removed using the system's additional extraction tools through the femoral approach. There were no complications. This preliminary experience shows that the VascoExtor (VascoMed) pacemaker lead extraction system can also be used in implantable cardioverter defibrillator lead extraction safely and effectively. In addition to the locking stylets, adjunct percutaneous extraction tools may be needed in some cases. PMID:10490481

Vassilikos, V P; Maounis, T N; Chiladakis, J; Cokkinos, D V; Manolis, A S

1999-10-01

315

Clinical Relevance of the Primary Findings of the MTA: Success Rates Based on Severity of ADHD and ODD Symptoms at the End of Treatment  

Microsoft Academic Search

ObjectivesTo develop a categorical outcome measure related to clinical decisions and to perform secondary analyses to supplement the primary analyses of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit\\/Hyperactivity Disorder (MTA).

JAMES M. SWANSON; HELENA C. KRAEMER; STEPHEN P. HINSHAW; L. EUGENE ARNOLD; C. KEITH CONNERS; HOWARD B. ABIKOFF; WALTER CLEVENGER; MARK DAVIES; GLEN R. ELLIOTT; LAURENCE L. GREENHILL; LILY HECHTMAN; BETSY HOZA; PETER S. JENSEN; JOHN S. MARCH; JEFFREY H. NEWCORN; ELIZABETH B. OWENS; WILLIAM E. PELHAM; ELLEN SCHILLER; JOANNE B. SEVERE; STEVE SIMPSON; BENEDETTO VITIELLO; KAREN WELLS; TIMOTHY WIGAL; MIN WU

2001-01-01

316

PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG): RETROSPECTIVE ANALYSIS OF A 7-YEAR CLINICAL EXPERIENCE  

PubMed Central

Aims: Since its description in 1980, percutaneous endoscopic gastrostomy has become the modality of choice for providing enteral access to patients who require long-term enteral nutrition. This study aimed to evaluate current indications and complications associated with PEG feeding. Methods: We conducted a retrospective analysis of all patients who referred to our endoscopic unit of the Department of Gastroenterology and Hepatology of the Medical Center University of Sarajevo for PEG tube placement over a period of 7 years. Medical records of 359 patients dealing with PEG tube placement were reviewed to assess indications, technical success, complications and the need for repeat procedures. Results: The indications for enteral feeding tube placement were malignancy in 44% (n=158), of which 61% (n=97) patients were suffering of head and neck cancer and 39% (n=61) of other malignancy. Central nervous disease was the indication in 48.7 % (n=175) of patients. Cerebrovascular accidents (CVA) accounted for 20% (n=73), head injury for 16% (n=59) and cerebral palsy for 11% (n=38). In 6.13% (n=22) of patients minor complications occur which included wound infection (0.8%), inadvertent PEG removal (2.5%) and tube blockage (1.1%). 11 patients experienced major complications including hemorrhage, tube migration and perforation. There were no deaths related to PEG procedure placement and the overall 30-day mortality rate due to primary disease was 15.8%. Oral feeding was resumed in 23% of the patients and the tube was removed subsequently after 6 -12 months. Conclusions: Percutaneous endoscopic gastrostomy is a save and minimally invasive endoscopic procedure associated with a low morbidity (9.2%) rate, easy to follow-up and to replace when blockage occurs. Over a seven-year period we noticed an increase of 63% in PEG placement at our department.

Vanis, Nenad; Saray, Aida; Gornjakovic, Srdjan; Mesihovic, Rusmir

2012-01-01

317

Angiographic and clinical characteristics associated with increased in-hospital mortality in elderly patients with acute myocardial infarction undergoing percutaneous intervention (a pooled analysis of the primary angioplasty in myocardial infarction trials)  

Microsoft Academic Search

Advanced age is associated with increased mortality in acute myocardial infarction (AMI) but the mechanism remains unclear. We performed a pooled analysis of 3,032 patients from the Primary Angioplasty in Myocardial Infarction (PAMI)-2, Stent-PAMI, and PAMI-No Surgery On Site trials to determine which clinical, hemodynamic, and angiographic characteristics in the elderly were associated with in-hospital death. There were 452 patients

Vincent S DeGeare; Gregg W Stone; Lorelei Grines; Bruce R Brodie; David A Cox; Eulogio Garcia; Thomas P Wharton; Judith A Boura; William W O’Neill; Cindy L Grines

2000-01-01

318

An Implantable Left Atrial Pressure Sensor Lead Designed for Percutaneous Extraction Using Standard Techniques  

PubMed Central

Background An implantable left atrial pressure (LAP) monitoring system for guiding the management of patients with advanced heart failure has the potential to require extraction, particularly in the setting of infection. The LAP sensor lead was designed to be suitable for ease of percutaneous extraction using standard techniques for extracting pacemaker and defibrillator leads. The clinical experience, to date, with percutaneous extraction of the LAP sensor lead is presented. Methods A total of 82 patients underwent successful implantation of the LAP sensor lead using transseptal catheterization. Five patients of the 82 patients during a cumulative follow-up period of 267 patient-years (median of 2.9 years/patient) underwent percutaneous extraction using manual traction with a locking stylet and/or an excimer laser sheath to bore through adhesions. The distal fixation anchors of the LAP sensor lead are designed to fold forward during extraction so that the sensor module can easily separate from the interatrial septum. Results Percutaneous extraction of the LAP sensor lead was accomplished successfully in all five patients with no embolic events, vascular tears, perforations, or other complications requiring surgical intervention. Manual traction alone was sufficient to detach the LAP sensor lead from the interatrial septum in all cases. Use of the excimer laser sheath was needed in selected cases to bore through scar tissue within the venous insertion site, but not within the heart. Conclusions The extraction of the LAP sensor lead was accomplished safely using standard techniques and equipment for percutaneously extracting pacemaker and defibrillator leads.

PRETORIUS, VICTOR; BIRGERSDOTTER-GREEN, ULRIKA; HEYWOOD, J THOMAS; HAFELFINGER, WERNER; GUTFINGER, DAN E; EIGLER, NEAL L; LOVE, CHARLES J; ABRAHAM, WILLIAM T

2013-01-01

319

Human Thrombin Injection for the Percutaneous Treatment of Iatrogenic Pseudoaneurysms  

SciTech Connect

Purpose: Thrombin injection is becoming well established for the percutaneous management of iatrogenic pseudoaneurysms. All the published series to date use bovine thrombin,and there have been reports of adverse immunologic effects following its use. Our study aimed to assess the efficacy of human thrombin injection for pseudoaneurysm occlusion. Methods:Fourteen patients with iatrogenic pseudoaneurysms underwent a color Doppler ultrasound examination to assess their suitability for percutaneous human thrombin injection. Human thrombin 1000 IU was then injected into the pseudoaneurysm sac under sterile conditions and with ultrasound guidance. A further color Doppler ultrasound examination was performed 24 hr later to confirm occlusion. Results: All 14 pseudoaneurysms were successfully occluded by human thrombin injection. In two cases a second injection of thrombin was required,but there were no other complications, and all pseudoaneurysms remained occluded at 24 hr. Conclusion: Ultrasound-guided human thrombin injection is simple to perform, effective and safe. We recommend that human thrombin becomes the agent of choice for percutaneous injection into iatrogenic pseudoaneurysms.

Elford, Julian [Department of Radiology, DerrifordHospital, Plymouth PL6 8DH (United Kingdom); Burrell, Christopher [Department of Cardiology, DerrifordHospital, Plymouth PL6 8DH (United Kingdom); Freeman, Simon; Roobottom, Carl [Department of Radiology, DerrifordHospital, Plymouth PL6 8DH (United Kingdom)

2002-03-15

320

Outcomes of percutaneous pinning in treatment of distal radius fractures.  

PubMed

Distal radius fractures are among the most common bone fractures all over the world. Close reduction and fixation by percutaneous pinning is a less invasive method comparing with other open surgeries. This study aims at evaluating the functional outcome of this treatment in distal radius fractures. In this prospective study, 50 patients with distal radius fractures underwent percutaneous pinning during a 16 month period in Tabriz Shohada Hospital. Follow-up for 3 months was possible in 48 (96%) patients. Possible complications (such as infection, nonunion, pin loosening and pain), functional outcomes (including range of motion, grip and pinch strengths) and radiological outcome were documented in intervals during follow-up. Forty eight patient, 22 males and 27 females with a mean age of 47.1 +/- 13.7 (19-80) years were enrolled. Local pain, infection and pin loosening were documented in 14.6, 16.7 and 2.1% of cases, respectively. Based on radiological reports, unacceptable palmar tilt, articular step, radial inclination and radial shortening were present in 6.3, 0, 2.1 and 6.3% of cases, respectively three months post-operation. The clinical outcomes according to Cooney's modification of the Green and O'Brien scheme were as excellent, good, fair and poor in 52.1, 31.3, 10.4 and 6.3% of cases, respectively. According to these results, closed reduction and percutaneous pinning of distal radius fractures is a rather successful method with minor complications. PMID:21848063

Sadighi, A; Bazavar, M; Moradi, A; Eftekharsadat, B

2010-07-15

321

Percutaneous ethanol treatment of hepatocellular carcinoma (HCC): large volumes for large tumors  

Microsoft Academic Search

We report on the use of large ethanol volumes for percutaneous treatment of primary hepatocellular carcinomas > 40 mm in diameter (mean: 57.6 mm) in 29 patients, according to Child's classification. Absolute sterile ethanol (20–50 ml) was injected at each of the five to 10 sessions, for a cumulative volume ranging from 43 to 300 ml (mean: 180 ml). Twelve

Christophe Bastid; Camille Azar; José Sahel

1996-01-01

322

ORIGINAL RESEARCH Outcomes of Patients Receiving Long-Term Corticosteroid Therapy Who Undergo Percutaneous Vertebroplasty  

Microsoft Academic Search

BACKGROUND AND PURPOSE: The purpose of this study was to determine the efficacy and rate of complications in patients undergoing percutaneous vertebroplasty (PVP) for vertebral compression fractures as a result of secondary osteoporosis caused by long-term corticosteroid use compared with patients with primary osteoporosis treated with PVP. MATERIALS AND METHODS: A retrospective review of all patients undergoing PVP was conducted

C. A. Koch; K. F. Layton; D. F. Kallmes

323

Percutaneous Radiofrequency Ablation of Nodal Metastases  

SciTech Connect

We report our experience with percutaneous image-guided radiofrequency (RF) ablation to treat isolated nodal metastases. Four patients underwent image-guided percutaneous RF ablation of metastatic disease involving retrocrural nodes,retroperitoneal nodes, or pelvic nodes. Coagulation necrosis was achieved in all cases.

Gervais, Debra A.; Arellano, Ronald S.; Mueller, Peter R. [Department of Radiology, Massachusetts GeneralHospital, White 270, Boston, MA 02114 (United States)

2002-12-15

324

Percutaneous Endovascular Treatment of Hepatic Artery Stenosis in Adult and Pediatric Patients After Liver Transplantation  

Microsoft Academic Search

The purpose of this study was to evaluate the efficacy of percutaneous endovascular techniques for the treatment of hepatic artery stenosis (HAS) occurring after liver transplantation (LT) in adult and pediatrics patients. From February 2003 to March 2009, 25 patients (15 adults and 10 children) whose developed HAS after LT were referred to our interventional radiology unit. Technical success was

Luigi Maruzzelli; Roberto Miraglia; Settimo Caruso; Mariapina Milazzo; Giuseppe Mamone; Salvatore Gruttadauria; Marco Spada; Angelo Luca; Bruno Gridelli

2010-01-01

325

Retrieval of Cement Embolus from Inferior Vena Cava After Percutaneous Vertebroplasty  

SciTech Connect

Percutaneous vertebroplasty is an accepted treatment for painful vertebral compression fractures caused by osteoporosis and malignant disease. Venous leakage of cement and pulmonary cement embolism have been reported complications. We describe a paravertebral venous cement leak resulting in the deposition of a cement cast in the inferior vena cava and successful retrieval of the cement embolus.

Athreya, S., E-mail: sathreya@stjoes.c [St. Joseph's Healthcare, Department of Radiology (Canada); Mathias, N. [Gartnavel General Hospital, Department of Radiology (United Kingdom); Rogers, P. [Gartnavel General Hospital, Department of Surgery (United Kingdom); Edwards, R. [Gartnavel General Hospital, Department of Radiology (United Kingdom)

2009-07-15

326

Retrieval of Cement Embolus from Inferior Vena Cava After Percutaneous Vertebroplasty  

Microsoft Academic Search

Percutaneous vertebroplasty is an accepted treatment for painful vertebral compression fractures caused by osteoporosis and malignant disease. Venous leakage of cement and pulmonary cement embolism have been reported complications. We describe a paravertebral venous cement leak resulting in the deposition of a cement cast in the inferior vena cava and successful retrieval of the cement embolus.

S. Athreya; N. Mathias; P. Rogers; R. Edwards

2009-01-01

327

Sclerotic Vertebral Metastases: Pain Palliation Using Percutaneous Image-Guided Cryoablation  

SciTech Connect

Cryoablative therapies have been proposed to palliate pain from soft-tissue or osteolytic bone tumors. A case of a patient with painful thoracic and sacral spine sclerotic metastases successfully treated by image-guided percutaneous cryoablation with the aid of insulation techniques and thermosensors is reported in this case report.

Costa de Freitas, Ricardo Miguel, E-mail: ricardomcfreitas@gmail.com; Menezes, Marcos Roberto de [Instituto do Cancer do Estado de Sao Paulo, Department of Radiology (Brazil); Cerri, Giovanni Guido [Sirio Libanes Hospital, Department of Radiology (Brazil); Gangi, Afshin [Strasbourg University Hospital, Department of Radiology (France)

2011-02-15

328

CT-Guided Percutaneous Thrombin Injection for Treatment of an Inferior Pancreaticoduodenal Artery Pseudoaneurysm  

SciTech Connect

We present a case of an inferior pancreaticoduodenal artery pseudoaneurysm treated by computed tomography (CT)-guided percutaneous injection of thrombin. As far as we are aware, we present the first documented case of successful long-term (9 months) follow-up with no evidence of recurrence.

Williams, Marc [Bristol Royal Infirmary, Department of Surgery (United Kingdom); Alderson, Derek [Bristol Royal Infirmary, Department of Clinical Radiology (United Kingdom); Virjee, Jim; Callaway, Mark [Bristol Royal Infirmary, Department of Surgery (United Kingdom)], E-mail: Mark.callaway@ubht.swest.nhs.uk

2006-08-15

329

Percutaneous transluminal angioplasty for carotid artery stenosis in Takayasu arteritis: Persistent benefit over 10 years  

SciTech Connect

A 66-year-old man was admitted to our hospital with right hemiplegia due to a cerebral infarction associated with Takayasu arteritis. We successfully performed percutaneous transluminal angioplasty for stenoses of the innominate and right common carotid arteries. Improvement of the stenotic lesions persisted over 10 years.

Murakami, Ryuji; Korogi, Yukunori; Matsuno, Yasuji; Matsukawa, Tetsuya; Hirai, Toshinori; Takahashi, Mutsumasa [Kumamoto University School of Medicine, Department of Radiology (Japan)

1997-05-15

330

Prospective randomized comparison of two different sized percutaneous endoscopically placed gastrostomy tubes  

Microsoft Academic Search

We performed a prospective randomised study of two different sized percutaneous endoscopicgastrostomy (PEG) tubes to determine if tube size influenced the incidence of PEG-related complications. Patients were given prophylactic cefuroxime, if not already on antibiotics at the time of PEG insertion. Fifty-two PEGs were successfully placed, 26 in each group. Most patients who required a PEG had suffered a cerebrovascular

H. D. Duncan; M. J. Bray; S. A. Kapadia; T. E. Bowling; S. J. Cole; S. M. Gabe; E. R. Walters; D. B. A. Silk

1996-01-01

331

Percutaneous transhepatic cholangiography in the investigation of the persistent postoperative bile leak  

Microsoft Academic Search

Percutaneous transhepatic cholangiography (PTHC) is now a widely available, inexpensive investigation with a low incidence of complications, especially in the nonobstructed system, and a high success rate. Its role in the management of obstructive jaundice is well established but it is only infrequently performed in the investigation of persistent bile leakage following biliary tract surgery. Four cases are reported in

Caroline M. Kissin; Alan Grundy

1987-01-01

332

Risk factors of developing new symptomatic vertebral compression fractures after percutaneous vertebroplasty in osteoporotic patients  

Microsoft Academic Search

Percutaneous vertebroplasty (PVP) is an efficient procedure to treat pain due to osteoporotic vertebral compression fractures (OVCFs). However, some patient populations experience recurrent vertebral fracture after initial successful procedure. There are a lot of literatures about the effectiveness of this procedure but few concerning the development of recurrent, new compression fracture. This is a retrospective review of all PVPs performed

Wan Soo Lee; Kyeong Hoon Sung; Hyun Tae Jeong; Youn Sang Sung; Yong In Hyun; Jae Young Choi; Kyu Seok Lee; Chul Su Ok; Young Woo Choi

2006-01-01

333

Management of lithiasis in pelvic kidney through laparoscopy-guided percutaneous transperitoneal nephrolithotripsy  

Microsoft Academic Search

We report the case of a patient with pain and an abdominal palpable mass whose tests showed a left pelvic kidney with a 1.5-cm stone in the renal pelvis. We describe the successful management through videolaparoscopy-guided percutaneous transperitoneal nephrolithotripsy, stressing that this method is a therapeutic option in such cases.

Alesse R. dos Santos; Delson C. B. Rocha Filho; Luis C. F. Tajra

2004-01-01

334

Percutaneous transluminal angioplasty in a patient with vasospasm due to staphylococcal meningitis.  

PubMed

Arterial large vessel vasculopathy is an unusual complication of bacterial meningitis in adults that may result in cerebral ischemia and severe neurological sequelae. Previous therapy has included antimicrobials with no specific vascular interventions. The authors report their experience with a patient with bacterial meningitis who developed a vasculopathy with neurological deficits. Percutaneous intracranial intervention was used successfully with anatomical and functional improvement. PMID:22577745

Buechner, David; Gelfand, Michael S; Cleveland, Kerry O

2012-05-11

335

Percutaneous Endovascular Stent-Graft for Iliac Pseudoaneurysm Following Lumbar Discectomy  

SciTech Connect

In a 24-year-old woman, an iliac pseudoaneurysm following lumbar discectomy was successfully treated by percutaneous placement of a self-expanding stent-graft. A postprocedural angiogram demonstrated complete exclusion of the pseudoaneurysm without leakage of contrast agent.

Hong, Seong J.; Oh, Joo H.; Yoon, Yup [Department of Diagnostic Radiology, College of Medicine, Kyung Hee University, 1, Hoekidong, Dongdaemunku, Seoul 130-702 (Korea, Republic of)

2000-11-15

336

Evaluation of minimally invasive percutaneous CT-controlled ventriculostomy in patients with severe head trauma  

Microsoft Academic Search

Evaluation of percutaneous CT-controlled ventriculostomy (PCV) in patients with severe traumatic brain injury to measure intracranial pressure as a component of early clinical care. A consecutive series of 52 interventions with PCV was prospectively analyzed with regard to technical success, procedural time, time from the initial cranial computed tomography (CCT) until procedure and transfer to the intensive care unit (ICU).

M. Krötz; U. Linsenmaier; K. G. Kanz; K. J. Pfeifer; W. Mutschler; M. Reiser

2004-01-01

337

Prevention of restenosis by lovastatin after successful coronary angioplasty  

Microsoft Academic Search

Prevention of restenosis after successful percutaneous transluminal coronary angioplasty (PTCA) remains a major challenge. To determine whether lovastatin could prevent restenosis, between December 1987 and July 1988, a total of 157 patients undergoing successful PTCA were randomly and prospectively assigned to the lovastatin group or a control group. Seventy-nine patients received lovastatin (20 mg daily if the serum cholesterol level

R. Sahni; A. R. Maniet; G. Voci; V. S. Banka

1991-01-01

338

Practice guidelines for ultrasound-guided percutaneous microwave ablation for hepatic malignancy.  

PubMed

Primary liver cancer and liver metastases are among the most frequent malignancies worldwide, with an increasing number of new cases and deaths every year. Traditional surgery is only suitable for a limited proportion of patients and imaging-guided percutaneous thermal ablation has achieved optimistic results for management of hepatic malignancy. This synopsis outlines the first clinical practice guidelines for ultrasound-guided percutaneous microwave ablation therapy for hepatic malignancy, which was created by a joint task force of the Society of Chinese Interventional Ultrasound. The guidelines aim at standardizing the microwave ablation procedure and therapeutic efficacy assessment, as well as proposing the criteria for the treatment candidates. PMID:24023485

Liang, Ping; Yu, Jie; Lu, Ming-De; Dong, Bao-Wei; Yu, Xiao-Ling; Zhou, Xiao-Dong; Hu, Bing; Xie, Ming-Xing; Cheng, Wen; He, Wen; Jia, Jian-Wen; Lu, Guo-Rong

2013-09-01

339

Current status of percutaneous vertebroplasty and percutaneous kyphoplasty - a review  

PubMed Central

Percutaneous vertebroplasty (PV) and kyphoplasty (PK) are the 2 vertebral augmentation procedures that have emerged as minimally invasive surgical options to treat painful vertebral compression fractures (VCF) during the last 2 decades. VCF may either be osteoporotic or tumor-associated. Two hundred million women are affected by osteoporosis globally. Vertebral fracture may result in acute pain around the fracture site, loss of vertebral height due to vertebral collapse, spinal instability, and kyphotic deformity. The main goal of the PV and PK procedures is to give immediate pain relief to patients and restore the vertebral height lost due to fracture. In percutaneous vertebroplasty, bone cement is injected through a minimal incision into the fractured site. Kyphoplasty involves insertion of a balloon into the fractured site, followed by inflation-deflation to create a cavity into which the filler material is injected, and the balloon is taken out prior to cement injection. This literature review presents a qualitative overview on the current status of vertebral augmentation procedures, especially PV and PK, and compares the efficacy and safety of these 2 procedures. The review consists of a brief history of the development of these 2 techniques, a discussion on the current research on the bone cement, clinical outcome of the 2 procedures, and it also sheds light on ongoing and future research to maximize the efficacy and safety of vertebral augmentation procedures.

Yimin, Yang; Zhiwei, Ren; Wei, Ma; Jha, Rajiv

2013-01-01

340

Current status of percutaneous coronary intervention of chronic total occlusion.  

PubMed

This paper describes the current status of percutaneous coronary intervention (PCI) for totally occluded coronary arteries. Chronic total occlusion is associated with 10%-20% of all PCI procedures. Results show that opening an occluded vessel, especially one supplying a considerable area of myocardium, may be beneficial for a patient's angina relief and heart function. We describe the devices used currently in re-canalization such as new wires, microcatheters (including Tonus and Cosair) and intravascular ultrasound guidance. Different techniques to improve the success rate and reduce complications are discussed in detail. PMID:22843178

Ge, Jun-bo

2012-08-01

341

Percutaneous Transluminal Angioplasty in Peripheral Vascular Disease: A Review  

PubMed Central

Percutaneous transluminal angioplasty is a relatively new technique employed in the treatment of stenoses or occlusions of peripheral arteries. While the longterm success rates have yet to be determined, short-term results have been excellent. The procedure has greatest value in the dilatation of localized lesions, avoiding surgery and its attendant risks. However, PTA and surgery are complementary, not competing, modes of therapy. PTA complements the traditional therapy of peripheral vascular disease, which remains reconstructive surgery. ImagesFig. 7Fig. 8Fig. 9Fig. 10Fig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6

Louis, Eugene L. St.; Provan, John L.; Gray, Robin R.; Grosman, Harvey; Ameli, F. Michael; Elliott, David S.

1982-01-01

342

Percutaneous Left Atrial Appendage Closure Using a PFO Closure Device.  

PubMed

Percutaneous left atrial appendage (LAA) occlusion is commonly performed using umbrella-shaped devices. However, the utility of such devices is highly dependent on the underlying anatomy of the appendage. For the first time, we report the use of an Occlutech PFO closure device to successfully occlude a left atrial appendage that possessed a circumferential ridge at its mouth. PFO closure devices would also be suitable for the occlusion of left atrial appendages when an incomplete surgical closure results in a circumferential ridge. PMID:23702289

Kanthan, Ajita; Looi, Khang-Li; Mottram, Philip; Harper, Richard; Bittinger, Logan; Alison, Jeffery F

2013-05-20

343

Replacement of Mushroom Cage Gastrostomy Tube Using a Modified Technique to Allow Percutaneous Replacement with an Endoscopic Tube in Patients with Amyotrophic Lateral Sclerosis  

SciTech Connect

Radiologic inserted gastrostomy (RIG) is the preferred method in our institution for enteral feeding in amyotrophic lateral sclerosis (ALS). Skin-level primary-placed mushroom cage gastrostomy tubes become tight with weight gain. We describe a minimally invasive radiologic technique for replacing mushroom gastrostomy tubes with endoscopic mushroom cage tubes in ALS. All patients with ALS who underwent replacement of a RIG tube were included. Patients were selected for a modified replacement when the tube length of the primary placed RIG tube was insufficient to allow like-for-like replacement. Replacement was performed under local anesthetic and fluoroscopic guidance according to a preset technique, with modification of an endoscopic mushroom cage gastrostomy tube to allow percutaneous placement. Assessment of the success, safety, and durability of the modified technique was undertaken. Over a 60-month period, 104 primary placement mushroom cage tubes in ALS were performed. A total of 20 (19.2%) of 104 patients had a replacement tube positioned, 10 (9.6%) of 104 with the modified technique (male n = 4, female n = 6, mean age 65.5 years, range 48-85 years). All tubes were successfully replaced using this modified technique, with two minor complications (superficial wound infection and minor hemorrhage). The mean length of time of tube durability was 158.5 days (range 6-471 days), with all but one patient dying with a functional tube in place. We have devised a modification to allow percutaneous replacement of mushroom cage gastrostomy feeding tubes with minimal compromise to ALS patients. This technique allows tube replacement under local anesthetic, without the need for sedation, an important consideration in ALS.

Ammar, Thoraya [King's College Hospital, Department of Radiology (United Kingdom); Rio, Alan [King's College Hospital, Department of Dietetics (United Kingdom); Ampong, Mary Ann [King's College Hospital, Department of Neurosciences (United Kingdom); Sidhu, Paul S., E-mail: paulsidhu@nhs.ne [King's College Hospital, Department of Radiology (United Kingdom)

2010-06-15

344

Replacement of mushroom cage gastrostomy tube using a modified technique to allow percutaneous replacement with an endoscopic tube in patients with amyotrophic lateral sclerosis.  

PubMed

Radiologic inserted gastrostomy (RIG) is the preferred method in our institution for enteral feeding in amyotrophic lateral sclerosis (ALS). Skin-level primary-placed mushroom cage gastrostomy tubes become tight with weight gain. We describe a minimally invasive radiologic technique for replacing mushroom gastrostomy tubes with endoscopic mushroom cage tubes in ALS. All patients with ALS who underwent replacement of a RIG tube were included. Patients were selected for a modified replacement when the tube length of the primary placed RIG tube was insufficient to allow like-for-like replacement. Replacement was performed under local anesthetic and fluoroscopic guidance according to a preset technique, with modification of an endoscopic mushroom cage gastrostomy tube to allow percutaneous placement. Assessment of the success, safety, and durability of the modified technique was undertaken. Over a 60-month period, 104 primary placement mushroom cage tubes in ALS were performed. A total of 20 (19.2%) of 104 patients had a replacement tube positioned, 10 (9.6%) of 104 with the modified technique (male n = 4, female n = 6, mean age 65.5 years, range 48-85 years). All tubes were successfully replaced using this modified technique, with two minor complications (superficial wound infection and minor hemorrhage). The mean length of time of tube durability was 158.5 days (range 6-471 days), with all but one patient dying with a functional tube in place. We have devised a modification to allow percutaneous replacement of mushroom cage gastrostomy feeding tubes with minimal compromise to ALS patients. This technique allows tube replacement under local anesthetic, without the need for sedation, an important consideration in ALS. PMID:19937022

Ammar, Thoraya; Rio, Alan; Ampong, Mary Ann; Sidhu, Paul S

2009-11-24

345

Osteoid osteoma of the midfoot: percutaneous radiofrequency treatment in 2 cases.  

PubMed

Osteoid osteoma should be considered as a potential diagnosis in cases of chronic midfoot pain in younger individuals. If proper precautions are taken, percutaneous radiofrequency ablation may be considered a safe and efficient alternative to surgical resection in the treatment of osteoid osteomas, even in the small bones of the midfoot. We report on 2 cases of osteoid osteoma, 1 in the lateral cuneiform, and the other at the base of the second metatarsal, that were successfully treated with percutaneous radiofrequency ablation. Preoperative imaging studies, procedure technique, and clinical outcome are presented. PMID:21397525

Le Corroller, Thomas; Champsaur, Pierre

2011-03-11

346

MitraClip: a novel percutaneous approach to mitral valve repair  

PubMed Central

As life expectancy increases, valvular heart disease is becoming more common. Management of heart disease and primarily valvular heart disease is expected to represent a significant proportion of healthcare provided to the elderly population. Recent years have brought a progression of surgical treatments toward less invasive strategies. This has given rise to percutaneous approaches for the correction of valvular heart disease. Percutaneous mitral valve repair using the MitraClip system (Abbott Vascular, Santa Clara, CA, USA) creates a double orifice and has been successfully used in selected patients with mitral regurgitation. We review the rationale, procedural aspects, and clinical data thus far available for the MitraClip approach to mitral regurgitation.

Jilaihawi, Hasan; Hussaini, Asma; Kar, Saibal

2011-01-01

347

Percutaneous Transhepatic Cutting Balloon Papillotomy for Removal of Common Bile Duct Stones  

SciTech Connect

We report the case of a 66-year-old female who presented with jaundice secondary to recurrent adenocarcinoma of the gallbladder and several common bile duct stones. Percutaneous papillary dilatation was planned to remove the common bile duct stones. Papilla was dilated through the percutaneous approach with an 8-mm peripheral cutting balloon instead of a standard balloon. All the stones were pushed successfully into the duodenum with a saline flush. No complications were encountered. Use of a peripheral cutting balloon for dilatation of the papilla seems to be safe and effective because it has the advantage of controlled incision and dilatation of the target at low pressures.

Oguzkurt, Levent, E-mail: loguzkurt@yahoo.com; Ozkan, Ugur; Gumus, Burcak [Baskent University Faculty of Medicine, Department of Radiology (Turkey)

2009-09-15

348

Percutaneous mechanical thrombectomy of superior mesenteric artery embolism  

PubMed Central

Background The present series present three consecutive cases of successful percutaneous mechanical embolectomy in acute superior mesenteric artery ischemia. Superior mesenteric artery embolism is a rare abdominal emergency that commonly leads to bowel infarction and has a very high mortality rate. Prompt recognition and treatment are crucial for successful outcome. Endovascular therapeutic approach in patients with acute SMA embolism in median portion of its stem is proposed. Case reports. Three male patients had experienced a sudden abdominal pain and acute superior mesenteric artery embolism in median portion of its stem was revealed on computed tomography angiography. No signs of intestinal infarction were present. The decision for endovascular treatment was made in concordance with the surgeons. In one patient 6 French gauge Rotarex® device was used while in others 6 French gauge Aspirex® device were used. All patients experienced sudden relief of pain after the procedure with no signs of intestinal infarction. Minor procedural complication – rupture of a smaller branch of SMA during Aspirex® treatment was successfully managed by coiling while transient paralytic ileus presented in one patient resolved spontaneously. All three patients remained symptom-free with patent superior mesenteric artery during the follow-up period. Conclusions Percutaneous mechanical thrombectomy seems to be a rapid and effective treatment of acute superior mesenteric artery embolism in median portion of its stem in absence of bowel necrosis. Follow-up of our patients showed excellent short- and long-term results.

Kuhelj, Dimitrij; Kavcic, Pavel; Popovic, Peter

2013-01-01

349

Modified Radiology-Guided Percutaneous Gastrostomy (MRPG) for Patients with Complete Obstruction of the Upper Digestive Tract and Who are without Endoscopic or Nasogastric Access  

PubMed Central

Objective We wanted to report on our experience with modified radiology-guided percutaneous gastrostomy (MRPG) without endoscopic or nasogastric access for treating patients with complete obstruction of the upper digestive tract. Materials and Methods Fourteen oncology patients (13 had hypopharyngeal cancer and 1 had upper esophageal cancer) with complete obstruction of the upper digestive tract were recruited. Conventional percutaneous endoscopic gastrostomy (PEG) and radiologic (fluoroscopy-guided) percutaneous gastrostomy (RPG) were not feasible in all the patients. An MRPG technique (with a combination of ultrasound, an air enema and fluoroscopic guidance) was performed in these patients. Results We achieved successfully percutaneous gastrostomy using the modified technique in all patients without any major or minor complications after the procedure. Conclusion A modified radiology-guided percutaneous gastrostomy technique can be safely performed in patients who failed to receive conventional PEG or RPG due to the absence of nasogastric access in the completely obstructed upper digestive tract.

Chan, Siu-Cheung; Liu, Kar-Wai; Liao, Chun-Ta; Lee, Tsung-Shih; Ng, Shu-Hang

2011-01-01

350

Effectiveness of percutaneous closure of patent foramen ovale for hypoxemia.  

PubMed

The aim of this study was to evaluate the ability of percutaneous patent foramen ovale (PFO) closure to improve systemic hypoxemia. Although PFO-mediated right-to-left shunt (RTLS) is associated with hypoxemia, the ability of percutaneous closure to ameliorate hypoxemia is unknown. Between 2004 and 2009, 97 patients who underwent PFO closure for systemic hypoxemia and dyspnea that was disproportionate to underlying lung disease were included for evaluation. All patients exhibited PFO-mediated RTLS as determined by agitated saline echocardiography. Procedural success was defined as implantation of a device without major complications and mild or no residual shunt at 6 months. Clinical success was defined as a composite of an improvement in New York Heart Association (NYHA) functional class, reduction of dyspnea symptoms, or decreased oxygen requirement. Procedural success was achieved in 96 of 97 (99%), and clinical success was achieved in 68 of 97 (70%). The presence of any moderate or severe interatrial shunt by agitated saline study (odds ratio [OR] = 4.7; p <0.024), NYHA class at referral (OR = 2.9; p <0.0087), and 10-year increase in age (OR = 1.8; p <0.0017) increased likelihood of clinical success. In contrast, a pulmonary comorbidity (OR = 0.18; p <0.005) and male gender (OR = 0.30; p <0.017) decreased the likelihood of success. In conclusion, based on the largest single-center experience of patients referred for PFO closure for systemic hypoxemia, PFO closure was a mechanically effective procedure with an associated improvement in echocardiographic evidence of RTLS, NYHA functional class, and oxygen requirement. PMID:23871675

Fenster, Brett E; Nguyen, Bryant H; Buckner, J Kern; Freeman, Andrew M; Carroll, John D

2013-07-19

351

Visualization of Discrete Microinfarction After Percutaneous Coronary Intervention Associated With Mild Creatine Kinase-MB Elevation  

Microsoft Academic Search

Background—Mild elevations in creatine kinase-MB (CK-MB) are common after successful percutaneous coronary interventions and are associated with future adverse cardiac events. The mechanism for CK-MB release remains unclear. A new contrast-enhanced MRI technique allows direct visualization of myonecrosis. Methods and Results—Fourteen patients without prior infarction underwent cine and contrast-enhanced MRI after successful coronary stenting; 9 patients had procedure-related CK-MB elevation,

Mark J. Ricciardi; Edwin Wu; Charles J. Davidson; Kelly M. Choi; Francis J. Klocke; Robert O. Bonow; Robert M. Judd; Raymond J. Kim

2010-01-01

352

Percutaneous Retrieval of Misplaced Intravascular Foreign Objects with the Dormia Basket: An Effective Solution  

SciTech Connect

Purpose. We report our experience of the retrieval of intravascular foreign body objects by the percutaneous use of the Gemini Dormia basket. Methods. Over a period of 2 years we attempted the percutaneous removal of intravascular foreign bodies in 26 patients. Twenty-six foreign bodies were removed: 8 intravascular stents, 4 embolization coils, 9 guidewires, 1 pacemaker lead, and 4 catheter fragments. The percutaneous retrieval was achieved with a combination of guide catheters and the Gemini Dormia basket. Results. Percutaneous retrieval was successful in 25 of 26 patients (96.2%). It was possible to remove all the intravascular foreign bodies with a combination of guide catheters and the Dormia basket. No complication occurred during the procedure, and no long-term complications were registered during the follow-up period, which ranged from 6 months to 32 months (mean 22.4 months overall). Conclusion. Percutaneous retrieval is an effective and safe technique that should be the first choice for removal of an intravascular foreign body.

Sheth, Rahul [Sir H.N. Hospital, Department of Interventional Radiology (India)], E-mail: rahulsheth1@gmail.com; Someshwar, Vimal [Lilavati Hospital, Department of Interventional Radiology (India); Warawdekar, Gireesh [Holy Family Hospital, Department of Interventional Radiology (India)

2007-02-15

353

Percutaneous Radiologic, Surgical Endoscopic, and Percutaneous Endoscopic Gastrostomy\\/Gastrojejunostomy: Comparative Study and Cost Analysis  

Microsoft Academic Search

Purpose: To compare the results and costs of three different means of achieving direct percutaneous gastroenteric access.\\u000a \\u000a \\u000a Methods: Three groups of patients received the following procedures: fluoroscopically guided percutaneous gastrostomy\\/gastrojejunostomy\\u000a (FPG, n= 42); percutaneous endoscopic gastrostomy\\/gastrojejunostomy (PEG, n= 45); and surgical endoscopic gastrostomy\\/gastrojejunostomy (SEG, n= 34). Retrospective review of the medical records was performed to evaluate indications for the procedure,

Jeffrey M. Barkmeier; Scott O. Trerotola; Eric A. Wiebke; Stuart Sherman; Veronica J. Harris; John J. Snidow; Matthew S. Johnson; Wendy J. Rogers; Xiao-Hua Zhou

1998-01-01

354

Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation.  

PubMed

Percutaneous disc decompression procedures have been performed in the past. Various percutaneous techniques such as percutaneous discectomy, laser discectomy, and nucleoplasty have been successful. Our prospective study was directly to evaluate the results of percutaneous cervical nucleoplasty (PCN) surgery for cervical disc herniation, and illustrate the effectiveness of PCN in symptomatic patients who had cervical herniated discs. From July of 2002 to June of 2005, 126 consecutive patients with contained cervical disc herniations have presented at the authors' clinic and treated by PCN. The patients' gender distribution for PCN was 65 male, 61 female. The age of patients ranged from 34 to 66 years (mean 51.9 +/- 10.2 years). The levels of involvement were 21 cases at C3-4, 30 cases at C4-5, 40 cases at C5-6, and 35 cases at C6-7. The clinical outcomes, pain reduction and the segment stability were all recorded during this study. A clinical outcome was quantified by the Macnab standard and using VAS. The angular displacement (AD) > or =11 degrees or horizontal displacement (HD) > or =3 mm was considered to be radiographically unstable. In the results of this study, puncture of the needle into the disc space was accurately performed under X-ray guidance in all cases. There was one case where the Perc-D Spine Wand had broken in the disc space during the procedure. The partial Perc-D Spine Wand, which had broken in the disc space could not be removed by the percutaneous cervical discectomy and thus remained there. There were no recurrent cases or complications in our series. Macnab standard results were excellent in 62 cases, good in 41 cases and fair in 23 cases. The rate of excellent and good was 83.73%. The VAS scores demonstrated statistically significant improvement in PCN at the 2-week, 1, 3, 6, and 12-month follow-up visits when compared to preoperational values (P < 0.01). There were no cases of instability following the PCN procedure. There was no significant difference in stability either preoperatively or postoperatively (P > 0.05). Our findings confirm that PCN for the treatment of cervical disc herniation results in a good outcome without any tampering of the stability of the cervical spine. Hence, PCN as a procedure is safe, minimally invasive, less traumatic, requiring less time with an excellent clinical outcome. PCN should be performed for those patients who fail conservative medical management including medication, physical therapy, behavioral management, psychotherapy, and who are unwilling to undergo a more invasive technique such as spinal surgery. PMID:18830638

Li, Jian; Yan, Deng-lu; Zhang, Zai-Heng

2008-10-01

355

Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation  

PubMed Central

Percutaneous disc decompression procedures have been performed in the past. Various percutaneous techniques such as percutaneous discectomy, laser discectomy, and nucleoplasty have been successful. Our prospective study was directly to evaluate the results of percutaneous cervical nucleoplasty (PCN) surgery for cervical disc herniation, and illustrate the effectiveness of PCN in symptomatic patients who had cervical herniated discs. From July of 2002 to June of 2005, 126 consecutive patients with contained cervical disc herniations have presented at the authors’ clinic and treated by PCN. The patients’ gender distribution for PCN was 65 male, 61 female. The age of patients ranged from 34 to 66 years (mean 51.9 ± 10.2 years). The levels of involvement were 21 cases at C3–4, 30 cases at C4–5, 40 cases at C5–6, and 35 cases at C6–7. The clinical outcomes, pain reduction and the segment stability were all recorded during this study. A clinical outcome was quantified by the Macnab standard and using VAS. The angular displacement (AD) ?11° or horizontal displacement (HD) ?3 mm was considered to be radiographically unstable. In the results of this study, puncture of the needle into the disc space was accurately performed under X-ray guidance in all cases. There was one case where the Perc-D Spine Wand had broken in the disc space during the procedure. The partial Perc-D Spine Wand, which had broken in the disc space could not be removed by the percutaneous cervical discectomy and thus remained there. There were no recurrent cases or complications in our series. Macnab standard results were excellent in 62 cases, good in 41 cases and fair in 23 cases. The rate of excellent and good was 83.73%. The VAS scores demonstrated statistically significant improvement in PCN at the 2-week, 1, 3, 6, and 12-month follow-up visits when compared to preoperational values (P < 0.01). There were no cases of instability following the PCN procedure. There was no significant difference in stability either preoperatively or postoperatively (P > 0.05). Our findings confirm that PCN for the treatment of cervical disc herniation results in a good outcome without any tampering of the stability of the cervical spine. Hence, PCN as a procedure is safe, minimally invasive, less traumatic, requiring less time with an excellent clinical outcome. PCN should be performed for those patients who fail conservative medical management including medication, physical therapy, behavioral management, psychotherapy, and who are unwilling to undergo a more invasive technique such as spinal surgery.

Li, Jian; Zhang, Zai-Heng

2008-01-01

356

[Percutaneous approaches in valvular heart diseases].  

PubMed

Valvular heart diseases still continue to be an important health problem. Surgical replacement of cardiac valves keeps a widely used treatment method for the present. However, the efficiency of minimal invasive and percutaneous methods targeted to repair and replacement of the diseased valves has been searched for nowadays. The first clinical experiences and early stage outcomes on the applicability of these methods are encouraging. Nevertheless, it should be kept in mind that percutaneous valvular interventions are at their development stages. Long term confidence and efficiency studies of these treatment modalities are needed. The present review emphasizes the studies on percutaneous techniques initiated in the treatment of valvular heart diseases. PMID:19581156

Aydin, Mustafa; Cetiner, Mehmet Ali

2009-07-01

357

Measuring organizational and individual factors thought to influence the success of quality improvement in primary care: a systematic review of instruments  

PubMed Central

Background Continuous quality improvement (CQI) methods are widely used in healthcare; however, the effectiveness of the methods is variable, and evidence about the extent to which contextual and other factors modify effects is limited. Investigating the relationship between these factors and CQI outcomes poses challenges for those evaluating CQI, among the most complex of which relate to the measurement of modifying factors. We aimed to provide guidance to support the selection of measurement instruments by systematically collating, categorising, and reviewing quantitative self-report instruments. Methods Data sources: We searched MEDLINE, PsycINFO, and Health and Psychosocial Instruments, reference lists of systematic reviews, and citations and references of the main report of instruments. Study selection: The scope of the review was determined by a conceptual framework developed to capture factors relevant to evaluating CQI in primary care (the InQuIRe framework). Papers reporting development or use of an instrument measuring a construct encompassed by the framework were included. Data extracted included instrument purpose; theoretical basis, constructs measured and definitions; development methods and assessment of measurement properties. Analysis and synthesis: We used qualitative analysis of instrument content and our initial framework to develop a taxonomy for summarising and comparing instruments. Instrument content was categorised using the taxonomy, illustrating coverage of the InQuIRe framework. Methods of development and evidence of measurement properties were reviewed for instruments with potential for use in primary care. Results We identified 186 potentially relevant instruments, 152 of which were analysed to develop the taxonomy. Eighty-four instruments measured constructs relevant to primary care, with content measuring CQI implementation and use (19 instruments), organizational context (51 instruments), and individual factors (21 instruments). Forty-one instruments were included for full review. Development methods were often pragmatic, rather than systematic and theory-based, and evidence supporting measurement properties was limited. Conclusions Many instruments are available for evaluating CQI, but most require further use and testing to establish their measurement properties. Further development and use of these measures in evaluations should increase the contribution made by individual studies to our understanding of CQI and enhance our ability to synthesise evidence for informing policy and practice.

2012-01-01

358

Pioneer dwarf willow may facilitate tree succession by providing late colonizers with compatible ectomycorrhizal fungi in a primary successional volcanic desert.  

PubMed

To advance understanding of the contribution of ectomycorrhizal (ECM) fungi to tree successional processes, natural establishment patterns of secondary colonizing hosts and their ECM fungal communities were investigated with special reference to pioneer hosts. In the volcanic desert on Mount Fuji, Japan, vegetation is sparsely distributed, resembling islands in a sea of scoria. Of 509 vegetation islands in the research area, 161 contained Salix reinii (Salix), the first colonizing ECM host species. The spatial coincidence between secondary colonizing timber species and Salix was analysed, and ECM fungal communities were studied using molecular identification methods. I found 39 and 26 individuals of Betula ermanii and Larix kaempferi, respectively. Without exception, these individuals were all accompanied by Salix. The ECM fungal communities of these timber species showed high similarity to that of Salix and were dominated by generalists that were compatible with two or more plant families. In this desert, available ECM propagules are limited. Pioneer Salix may contribute to tree succession by providing adjacent late colonizers with compatible ECM fungal symbionts. PMID:16771994

Nara, Kazuhide

2006-01-01

359

Percutaneous valve repair and replacement techniques  

PubMed Central

Valvular heart disease is a significant cause of morbidity and mortality. Rates increase with age and the prevalence will increase as the population ages. Several factors have led to an interest in expanding percutaneous valve repair and replacement techniques to more lesions in more patients. This review explores current percutaneous valve repair and replacement techniques in mitral stenosis, mitral regurgitation, aortic stenosis and aortic regurgitation in adults, outlines the future directions, and discusses some technique?related issues.

Munt, B; Webb, J

2006-01-01

360

Similar Success Rates with Bivalirudin and Unfractionated Heparin in Bare-Metal Stent Implantation  

SciTech Connect

Background. Unfractionated heparin (UFH) is the traditional agent utilized during percutaneous peripheral interventions (PPIs) despite its well-known limitations. Bivalirudin, a thrombin-specific anticoagulant, overcomes many of the limitations of UFH and has consistently demonstrated comparable efficacy with significantly fewer bleeding complications. The purpose of this study was to compare procedural success in patients undergoing bare-metal stent implantation for atherosclerotic blockage of the renal, iliac, and femoral arteries and receiving either bivalirudin (0.75 mg/kg bolus/1.75 mg/kg/hr infusion) or UFH (50-70 U/kg/hr bolus) as the primary anticoagulant. Methods. This study was an open-label, nonrandomized retrospective registry with the primary endpoint of procedural success. Secondary endpoints included incidence of: death, myocardial infarction (MI), urgent revascularization, amputation, and major and minor bleeding. Results. One hundred and five consecutive patients were enrolled (bivalirudin = 53; heparin = 52). Baseline demographics were comparable between groups. Patients were pretreated with clopidogrel (approx. 71%) and aspirin (approx. 79%). Procedural success was achieved in 97% and 96% of patients in the bivalirudin- and heparin-treated groups, respectively. Event rates were low and similar between groups. Conclusion. Bivalirudin maintained an equal rate of procedural success in this cohort without sacrificing patient safety. Results of this study add to the growing body of evidence supporting the safety and efficacy of bivalirudin as a possible substitute for UFH in anticoagulation during peripheral vascular bare-metal stent implantation.

Hallak, Omar [Centers for Clinical Science Research, CAMC Institute (United States); Shams, S. Ali [Charleston Area Medical Center, Department of Internal Medicine (United States); Broce, Mike; Lavigne, P. Scott; Lucas, B. Daniel; Elhabyan, Abdul-Karim; Reyes, Bernardo J. [Centers for Clinical Science Research, CAMC Institute (United States)], E-mail: bernardo.reyes@camc.org

2007-09-15

361

Treatment of osteoid osteoma with CT-guided percutaneous radiofrequency thermoablation.  

PubMed

Osteoid osteoma is a benign bone tumor with a male predominance occurring mainly in children and young adults. The most common symptom is intermittent pain that worsens at night and is at least partially relieved by nonsteroidal anti-inflammatory drugs. The purpose of this study was to assess the long-term effectiveness of computed tomography-guided percutaneous radiofrequency thermoablation in patients with a minimum follow-up of 2 years. Twenty patients with osteoid osteoma (15 men and 5 women) with a mean age of 20.7 years (range, 4-61 years; 12 patients aged 20 years or younger) underwent computed tomography-guided percutaneous radiofrequency thermoablation. Lesion sites were the femur (n=9), tibia (n=7), pelvis (n=1), talus (n=1), cuneiform bone (n=1), and humerus (n=1). Mean follow-up was 44 months (range, 3-106 months). Pain relief was significant in 95% of patients; it disappeared within 24 hours in 14 patients, within 3 days in 4, and within 7 days in 1. The patient with persistent symptoms underwent another percutaneous radiofrequency thermoablation procedure that was successful. The difference between pre- and postoperative pain was significant (P ? .01). No recurrences occurred. Computed tomography-guided percutaneous radiofrequency thermoablation is a safe, minimally invasive, and economical procedure with high technical and clinical success rates, and it effectively and durably enhances quality of life. PMID:23672909

de Palma, Luigi; Candelari, Roberto; Antico, Ettore; Politano, Rocco; Luniew, Eugenio; Giordanengo, Maurizio; Di Giansante, Silvio; Marinelli, Mario; Paci, Enrico

2013-05-01

362

Percutaneous ultrasound-guided thermal ablation for intrahepatic cholangiocarcinoma  

PubMed Central

Objective The objective of this study was to evaluate the treatment efficacy and overall survival (OS) of percutaneous ultrasound-guided thermal ablation by means of microwave ablation or radiofrequency ablation for intrahepatic cholangiocarcinoma (ICC). Methods 18 patients with 25 ICC nodules underwent ultrasound-guided thermal ablation with curative intention. 8 patients were primary cases and 10 were recurrent cases after curative resection. The local treatment response, complications and survivals were analysed. Results Complete ablation was achieved in 23 (92.0%, 23/25) nodules (diameter, 0.7–4.3 cm; mean, 2.5±0.9 cm) and incomplete ablation was found in 2 (8.0%, 2/25) larger tumours (6.4 and 6.9 cm in diameter). No death associated with the treatment was found. The major complication rate was 5.5% (1/18). The follow-up periods ranged from 1.3 to 86.2 months (mean, 20.5±26.3 months; median, 8.7 months). OS rates for all patients at 6, 12, 36 and 60 months were 66.7%, 36.3%, 30.3% and 30.3%, respectively. By univariate analysis, the patient source (primary or recurrent case) was found to be a significant prognostic factor for OS rates (p=0.001). The patient source (p=0.001) and the number of nodules (p=0.038) were found to be significant prognostic factors for recurrence-free survival. OS rates for the primary ICC at 6, 12, 36 and 60 months were 87.5%, 75.0%, 62.5% and 62.5%, respectively. Conclusion Percutaneous ultrasound-guided thermal ablation is a safe and effective therapeutic technique for ICC. Acceptable survival can be achieved in primary ICCs, whereas the prognosis of recurrent ICCs is relatively poor.

Xu, H-X; Wang, Y; Lu, M-D; Liu, L-N

2012-01-01

363

Evaluation of poly(ethylene oxide)–poly(propylene oxide)–poly(ethylene oxide) (PEO–PPO–PEO) gels as a release vehicle for percutaneous fentanyl  

Microsoft Academic Search

The primary objective of this study was to investigate the feasibility of PEO–PPO–PEO copolymer gel as a release vehicle for percutaneous administration of fentanyl in vitro and in vivo. A cellulose membrane and nude mouse skin with series concentrations of PEO–PPO–PEO block copolymers were used to examine the sustained-release pattern and permeation of fentanyl. The in vivo percutaneous absorption was

Jiahorng Liaw; Yen-Chao Lin

2000-01-01

364

Percutaneous balloon mitral valvotomy during pregnancy.  

PubMed

Rheumatic mitral valve stenosis continues to be the most frequently encountered clinically significant valvular abnormality in pregnant women. We retrospectively studied the fetal outcomes of patients with severe rheumatic Mitral Valve Stenosis (MS) admitted to hospital with heart failure and underwent Percutaneous Balloon Mitral Valvotomy (PBMV) during pregnancy. We identified all of the pregnant cases with rheumatic MS from February 1st 1994 till February 1st 2011 who underwent PBMV from medical records in the tertiary referral center of Madani Heart Hospital in Tabriz, Iran. Follow up was done by phone call and office visit. During this period 24 pregnant patients with mean ages of 29.45 +/- 5.05 (19-38) had undergone PBMV for severe MS. Fourteen patients could not be reached and were lost to follow-up. PBMV had been performed during second trimester of pregnancy in 20 cases (83.3%) and during third trimester in 4 patients (16.6%). The success rate of PBMV was 100%. Pulmonary artery pressure reduced from 58.88 +/- 21.97 to 38.50 +/- 8.87 (p < 0.05), peak and mean transmitral valve gradient reduced 25.20 +/- 9.71 to 11.03 +/- 3.61 (p < 0.0001), 14.18 +/- 7.60 to 5.00 +/- 1.39 (p = 0.004), respectively. We conducted follow up in 10 patients with good fetal outcome in all except in 2 infants who died during follow up with intractable heart failure. Twenty patients were in normal sinus rhythm at the time of procedure (83.3%) and 4 of them (16.7%) had arterial fibrillation. PBMV during pregnancy could be recommended as a relatively safe procedure for mother and fetus. PMID:24171270

Salehi, Rezvanie; Aslanabadi, Naser; Taghavi, Simin; Pourafkari, Leili; Imani, Shahla; Goldust, Mohamad

2013-02-15

365

Lumbar Facet Joint Synovial Cysts: Does T2 Signal Intensity Predict Outcomes after Percutaneous Rupture?  

PubMed Central

BACKGROUND AND PURPOSE Lumbar facet synovial cysts are a cause of back pain and radiculopathy with facet joint degeneration, the most common cause for cyst formation. Typically, LFSCs are T2 hyperintense on MR imaging, but the signal intensity is variable. Treatment options include percutaneous rupture and surgical resection. This study evaluates the relationship between LFSC signal intensity on MR imaging and outcomes as it relates to percutaneous rupture success and need for subsequent surgery. MATERIALS AND METHODS A retrospective review of 110 patients who underwent CT fluoroscopic-guided rupture of symptomatic LFSCs was performed. The LFSCs were characterized by their T2 signal intensity on MR imaging and divided into 3 groups: high, intermediate, and low T2 signal intensity. The rates of successful cyst rupture and need for subsequent surgery were recorded. RESULTS Percutaneous LFSC rupture was technically successful in 87% of all cases. Cyst rupture was successful in 89% and 90% of high and intermediate signal intensity cysts, respectively, and in 65% of low signal intensity cysts (P = .017, .030). High signal intensity cysts had lower postprocedural surgical rates (29%) when compared with intermediate and low signal cyst as a group (P = .045). CONCLUSIONS T2 hyperintense and intermediate signal intensity LFSCs are easier to rupture, perhaps because the cysts contain a higher proportion of fluid and are less gelatinous or calcified than T2 hypointense cysts. Patients with T2 hyperintense LFSCs are less likely to need surgery.

Cambron, S.C.; McIntyre, J.J.; Guerin, S.J.; Li, Z.; Pastel, D.A.

2013-01-01

366

Project Success.  

ERIC Educational Resources Information Center

This report reviews the remedial education program--Project Success--at the Urban Education Center, City Colleges of Chicago (Illinois). The major features of the program are outlined and its operation and evaluation are discussed. Student performance and characteristics are then tabularly compared, based on their groupings as "successful" (final…

Baehr, Rufus F.

367

Percutaneous Transluminal Angioplasty for Obstructive Lesions of the Aortic Arch.  

National Technical Information Service (NTIS)

Percutaneous transluminal angioplasty (PTA) is the percutaneous, fluoroscopically guided use of balloon-tipped catheters to remove or relieve stenotic or occlusive lesions of the vascular system. Since its introduction in 1964, PTA has been widely used to...

M. Erlichman

1984-01-01

368

Percutaneous Transluminal Angioplasty for Obstructive Lesions of Arteriovenous Dialysis Fistulas.  

National Technical Information Service (NTIS)

Percutaneous transluminal angioplasty (PTA) is the percutaneous, fluoroscopically guided use of balloon-tipped catheters to remove or relieve stenotic or occlusive lesions of the vascular system. Since its introduction in 1964, PTA has been widely used to...

M. Erlichman

1984-01-01

369

Percutaneous Ultrasound Procedures for the Treatment of Kidney Stones.  

National Technical Information Service (NTIS)

Percutaneous lithotripsy has achieved widespread diffusion throughout the medical community and is described by many authors as the manipulative treatment of choice in an increasing number of patients with renal stones. Appropriate use of percutaneous lit...

J. R. Farrell

1985-01-01

370

Fragmented Pigtail Percutaneous Nephrostomy Tubes: Etiology and Management  

PubMed Central

Purpose To review our experience with the management of fragmented and retained pigtail percutaneous nephrostomy (PCN) tubes and to explore the reasons for the fragmentation. Materials and Methods We retrospectively reviewed our institute database from January 2006 to December 2011 for patients who had undergone retrieval of fragmented PCN tubes. We assessed the preoperative factors, operative technique, and post-operative outcomes. Results A total of seven patients (4 males and 3 females) had been diagnosed with fragmented PCN tubes. The mean age of the patients was 41.5 years. Of the seven patients, five required antegrade instrumentation by way of a percutaneous tract to remove the foreign body, mostly along with stone retrieval. One patient underwent ureterorenoscopy and pneumolithotripsy for a ureteric stone along with ureteroscopic removal of the PCN fragment. Another patient underwent nephrectomy of the kidney containing the PCN fragment because it had become nonfunctioning. All patients were free of stones and symptoms on follow-up. Conclusions A prolonged waiting period for definitive surgery, urinary infection, and associated stone disease are significant factors causing fragmentation of PCN tubes. Proper insertion techniques, regular timed changes of the PCN tube, appropriate care of the PCN tube, and early surgery for underlying stone disease are required to avoid this complication. Patients with retained PCN tubes can be managed effectively with antegrade or retrograde endoscopic techniques while definitive management of the primary pathology is carried out, without any additional morbidity.

Ganesamoni, Raguram; Nanjappa, Bhuvanesh; Sharma, Varun

2012-01-01

371

Neurologic Complications in Percutaneous Nephrolithotomy  

PubMed Central

Purpose Percutaneous nephrolithotomy (PCNL) has been the preferred procedure for the removal of large renal stones in Iran since 1990. Recently, we encountered a series of devastating neurologic complications during PCNL, including paraplegia and hemiplegia. There are several reports of neurologic complications following PCNL owing to paradoxical air emboli, but there are no reports of paraplegia following PCNL. Materials and Methods We retrospectively reviewed the medical records of patients who had undergone PCNL in 13 different endourologic centers and retrieved data related to neurologic complications after PCNL, including coma, paraplegia, hemiplegia, and quadriplegia. Results The total number of PCNL procedures in these 13 centers was 30,666. Among these procedures, 11 cases were complicated by neurologic events, and four of these cases experienced paraplegia. All events happened with the patient in the prone position with the use of general anesthesia and in the presence of air injection. There were no reports of neurologic complications in PCNL procedures performed with the patient under general anesthesia and in the prone position and with contrast injection. Conclusions It can be assumed that using room air to opacify the collecting system played a major role in the occurrence of these complications. Likewise, the prone position and general anesthesia may predispose to these events in the presence of air injection.

Basiri, Abbas; Soltani, Mohammad Hossein; Kamranmanesh, Mohammadreza; Tabibi, Ali; Mohsen Ziaee, Seyed Amir; Nouralizadeh, Akbar; Sharifiaghdas, Farzaneh; Poorzamani, Mahtab; Gharaei, Babak; Ozhand, Ardalan; Lashay, Alireza; Ahanian, Ali; Aminsharifi, Alireza; Sichani, Mehrdad Mohammadi; Asl-Zare, Mohammad; Ali Beigi, Faramarz Mohammad; Najjaran, Vahid; Abedinzadeh, Mehdi

2013-01-01

372

Percutaneous Tumor Ablation with Radiofrequency  

PubMed Central

BACKGROUND Radiofrequency thermal ablation (RFA) is a new minimally invasive treatment for localized cancer. Minimally invasive surgical options require less resources, time, recovery, and cost, and often offer reduced morbidity and mortality, compared with more invasive methods. To be useful, image-guided, minimally invasive, local treatments will have to meet those expectations without sacrificing efficacy. METHODS Image-guided, local cancer treatment relies on the assumption that local disease control may improve survival. Recent developments in ablative techniques are being applied to patients with inoperable, small, or solitary liver tumors, recurrent metachronous hereditary renal cell carcinoma, and neoplasms in the bone, lung, breast, and adrenal gland. RESULTS Recent refinements in ablation technology enable large tumor volumes to be treated with image-guided needle placement, either percutaneously, laparoscopically, or with open surgery. Local disease control potentially could result in improved survival, or enhanced operability. CONCLUSIONS Consensus indications in oncology are ill-defined, despite widespread proliferation of the technology. A brief review is presented of the current status of image-guided tumor ablation therapy. More rigorous scientific review, long-term follow-up, and randomized prospective trials are needed to help define the role of RFA in oncology.

Wood, Bradford J.; Ramkaransingh, Jeffrey R.; Fojo, Tito; Walther, McClellan M.; Libutti, Stephen K.

2008-01-01

373

Gated SPECT Evaluation of the Relationship Between Admission Troponin I, Myocardial Salvage, and Functional Recovery in Acute Myocardial Infarction Treated by Abciximab and Early Primary Angioplasty  

Microsoft Academic Search

Using gated SPECT, we evaluated the relationship between admission troponin I, risk area, and myocardial salvage in pa- tients with a first myocardial infarction treated with abciximab and primary percutaneous coronary intervention within 6 h. Methods: In 43 patients, 99mTc-sestamibi was injected before primary percutaneous coronary intervention. Gated SPECT was acquired immediately thereafter and was repeated 7 and 30 d

Mario Leoncini; Francesco Bellandi; Mauro Maioli; Anna Toso; Angela Coppola; Stelvio Sestini; Alberto Mennuti; Roberto Piero Dabizzi; Alberto Pupi

374

Percutaneous Method of Management of Simple Bone Cyst  

PubMed Central

Introduction. Simple bone cyst or unicameral bone cysts are benign osteolytic lesions seen in metadiaphysis of long bones in growing children. Various treatment modalities with variable outcomes have been described in the literature. The case report illustrates the surgical technique of minimally invasive method of treatment. Case Study. A 14-year-old boy was diagnosed as active simple bone cyst proximal humerus with pathological fracture. The patient was treated by minimally invasive percutaneous curettage with titanium elastic nail (TENS) and allogenic bone grafting mixed with bone marrow under image intensifier guidance. Results. Pathological fracture was healed and allograft filled in the cavity was well taken up. The patient achieved full range of motion with successful outcome. Conclusion. Minimally invasive percutaneous method using elastic intramedullary nail gives benefit of curettage cyst decompression and stabilization of fracture. Allogenic bone graft fills the cavity and healing of lesion by osteointegration. This method may be considered with advantage of minimally invasive technique in treatment of benign cystic lesions of bone, and the level of evidence was therapeutic level V.

Lakhwani, O. P.

2013-01-01

375

Feasibility and safety of infracolic fluoroscopically guided percutaneous radiologic gastrostomy.  

PubMed

We study the feasibility and safety of infracolic fluoroscopically guided percutaneous gastrostomy when patient anatomy prevents conventional supracolic puncture. From September 2004 to April 2007, 508 gastrostomy and gastrojejunostomy catheters were inserted in a single institution, and in six patients, the position of the transverse colon prevented conventional supracolic puncture. All were male, with a mean age of 57 years. Four patients had head and neck cancer and two had neurologic conditions. With fluoroscopic guidance, a 14-F gastrostomy tube was inserted with T-fastener gastropexy caudal to the colon. The medical records of patients treated with this technique were reviewed for demographics, indication, technique, complications, function of gastrostomy, timing of removal of the gastrostomy, and subsequent hospital admissions. All procedures were technically successful and there was no procedure-related morbidity or mortality. The mean follow-up was 16 months (range, 7-25 months) and the mean duration of therapy was 7 months. Five patients had their gastrostomy removed after clinical improvement and one of these patients had a gastrostomy reinserted cephalic to the colon after recurrence of head and neck cancer. Two patients died of disease progression and one still had the gastrostomy in position. No patient was subsequently admitted for a complication of the technique or catheter malfunction. In conclusion, infracolic percutaneous radiologic gastrostomy with gastropexy is feasible in patients without an access route cephalic to the transverse colon. PMID:18192478

Cantwell, Colin P; Gervais, Debra A; Hahn, Peter F; Mueller, Peter R

2008-01-01

376

Advances in percutaneous treatment of mitral regurgitation.  

PubMed

Percutaneous techniques for the treatment of mitral regurgitation have aroused much interest in recent years. Percutaneous mitral annuloplasty can be performed indirectly by using devices implanted in the coronary sinus or directly by using a retrograde approach. However, as yet, the results of these techniques are scarce and some devices have a high complications rate. The most frequent percutaneous mitral valve repair technique consists of mitral leaflet plication by implanting 1 or more percutaneous clips (MitraClip) in an imitation of the Alfieri surgical technique. Clinical experience with this device is broader than that with any other. The MitraClip device is associated with improved mitral regurgitation in a high percentage of carefully-selected patients. However, the single randomized study performed to date (EVEREST) showed its efficacy to be less than that of surgical repair and we await the results of new randomized studies that should clarify which patient-type can benefit most from this technique. Other left ventricular remodeling devices, tendinous cord implantation, and leaflet ablation are currently undergoing preclinical development or first-in-human experimentation. Finally, the development of biological prostheses for percutaneous mitral valve replacement is at an early stage. Many promising experiments at the preclinical phase and initial experiments in humans will very probably multiply in the near future. However, the true role of this technique in treating mitral valve disease will have to be evaluated in appropriately designed randomized controlled studies. Full English text available from:www.revespcardiol.org/en. PMID:23755868

Nombela-Franco, Luis; Urena, Marina; Ribeiro, Henrique Barbosa; Rodés-Cabau, Josep

2013-06-04

377

Percutaneous a1 Pulley Release Vs Steroid Injection for Trigger Digit: the Results of a Prospective, Randomized Trial  

Microsoft Academic Search

This study compared the results of percutaneous A1 pulley release and steroid injection in 105 trigger digits in 95 patients. The patients were randomly assigned to either surgery (43 patients, 46 digits) or steroid injection (52 patients, 59 digits). The results were assessed at 1 and 6 months and the measurements included rate of recurrence (primary outcome measure), pain on

A. Zyluk; G. Jagielski

2011-01-01

378

Delayed percutaneous transluminal coronary angioplasty after acute myocardial infarction  

Microsoft Academic Search

The value of delayed percutaneous transluminal coronary angioplasty (>12 h from admission or after thrombolytic therapy) following acute myocardial infarction is controversial. We compared the short- and long-term prognosis of 1940 consecutive patients after acute myocardial infarction, of whom 188 underwent delayed percutaneous transluminal coronary angioplasty. Delayed percutaneous transluminal coronary angioplasty was more frequently done in patients treated with thrombolysis

Avraham Caspi; Shmuel Gottlieb; Solomon Behar

1998-01-01

379

Percutaneous Vertebroplasty for Metastatic Involvement of the Axis  

Microsoft Academic Search

BACKGROUND AND PURPOSE: Percutaneous vertebroplasty in the upper cervical spine is a challenging procedure, and little is known about its therapeutic outcome. The purpose of this study was to assess the risks and benefits of percutaneous vertebroplasty for metastatic involvement of the axis. METHODS: From January 1994 to August 2004, 12 patients (mean age, 52.3 years) under- went percutaneous vertebroplasty

Francisco Mont; Jean-Noel Vallee; Evelyne Cormier; Remy Guillevin; Hector Barragan; Betty Jean; Jacques Chiras

380

Use of percutaneous endoscopy to place syringopleural or cystoperitoneal cerebrospinal fluid shunts: technical note.  

PubMed

The authors describe a technique for percutaneous endoscopic shunt placement to treat clinically symptomatic spinal cysts. Seven patients underwent the procedure--five with syringomyelia, one with a symptomatic perineurial cyst, and one with a large arachnoid cyst. In all patients the shunt was successfully placed, and clinical improvement occurred in six. In four patients the entire procedure was performed endoscopically, whereas in three conversion to an open surgical exposure was required for safe access of a syrinx cavity. Overall, however, the pleural or peritoneal catheter was successfully placed endoscopically in all seven patients. There were two cases of postoperative positional headaches of which one required valve revision. In one case the catheter migrated and required repositioning. Percutaneous endoscopic shunt placement appears feasible in appropriately selected patients. PMID:15871494

Guest, James D; Silbert, Lisa; Casas, Carlos E

2005-04-01

381

Percutaneous Laser Disc Decompression (PLDD): Experience and Results From Multiple Centers and 19,880 Procedures  

NASA Astrophysics Data System (ADS)

In mid-February 1986, Peter Ascher and Daniel Choy performed the first Percutaneous Laser Disc Decompression (PLDD) at the Neurosurgical Department, University of Graz, Graz, Austria. It was planned to deliver 1000 joules with a Nd:YAG laser to a herniated L4-5 disc causing sciatica. At 600 joules the procedure was terminated because the pain was gone. Since then, PLDD has spread all over the world, with procedures being performed in the entire spine except for T1-T4 because these discs do not permit percutaneous access with a needle. The success rate has ranged from 70 to 89%, and the complication rate, chiefly discitis, from 0.3 to 1.0%. When successful, return to normal work averages one week. Long term follow-up to 23 years yields a recurrence rate of 4-5%.

Paolo Tassi, Gian; Choy, Daniel S. J.; Hellinger, Johannes; Hellinger, Stefan; Lee, Sang-Ho

2010-05-01

382

Percutaneous ultrasound-guided thrombin injection of a post-traumatic pancreatic pseudoaneurysm in a pediatric patient.  

PubMed

Non-operative management for blunt injuries to the proximal pancreas has become increasingly common. A bleeding pseudoaneurysm in the setting of a traumatic pancreatic pseudocyst presents a morbid operation. We present the case of a 15-year old with a grade V pancreatic injury that developed a bleeding pseudoaneurysm successfully treated with percutaneous ultrasound-guided thrombin injection. PMID:21969234

Kennedy, Raelene D; Clapp, Allison J; Potter, D Dean; McKusick, Michael A; Petersen, Bret T; Friese, Jeremy L

2011-10-04

383

CT-guided percutaneous aspiration of Tarlov cyst as a useful diagnostic procedure prior to operative intervention  

Microsoft Academic Search

Summary Tarlov or perineural cysts are lesions of the nerve root most often found in the sacral region. Several authors recommend surgical treatment of symptomatic Tarlov cysts. However, successful surgical treatment is dependent on appropriate patient selection. In this article, we report three cases of a sacral perineural cyst, causing sciatic pain, and emphasize the usefulness of CT-guided percutaneous aspiration

J.-Y. Lee; P. Impekoven; W. Stenzel; M. Löhr; R.-I. Ernestus; N. Klug

2004-01-01

384

Percutaneous transluminal angioplasty for the treatment of limb threatening ischemia: Do the results justify an attempt before bypass grafting?  

Microsoft Academic Search

Purpose: Results of percutaneous transluminal angioplasty (PTA) in selected cases have been reported to be equal or superior to those of arterial bypass graft surgery, with a lower morbidity and mortality. We performed PTA of stenotic or occlusive lesions in patients with limb-threatening ischemia, hoping to improve our overall success and decrease morbidity in this group of patients. The results

Richard E. Parsons; William D. Suggs; James J. Lee; Luis A. Sanchez; Ross T. Lyon; Frank J. Veith

1998-01-01

385

Primary intrathoracic malignant fibrous histiocytoma and angiosarcoma.  

PubMed

Primary intrathoracic malignant fibrous histiocytoma and angiosarcoma are rare sarcomas constituting less than 0.2% of lung cancers. The typical imaging appearance is a large, well-circumscribed, non-cavitating, non-calcified, peripheral lung mass without hilar or mediastinal lymphadenopathy. Bronchoscopy and percutaneous needle aspiration are of limited value in differential diagnosis, and thoracotomy is warranted for definitive diagnosis. PMID:10901861

Pui, M H; Yu, S P; Chen, J D

1999-02-01

386

Acute gastric volvulus treated with laparoscopic reduction and percutaneous endoscopic gastrostomy  

PubMed Central

Acute gastric volvulus requires emergency surgery, and a laparoscopic approach for both acute and chronic gastric volvulus was reported recently to give good results. The case of a 50-year-old patient with acute primary gastric volvulus who was treated by laparoscopic reduction and percutaneous endoscopic gastrostomy is described here. This approach seems to be feasible and safe for not only chronic gastric volvulus, but also acute gastric volvulus.

Jeong, Sang-Ho; Ha, Chang-Youn; Choi, Sang-Kyung; Hong, Soon-Chan; Jung, Eun-Jung; Ju, Young-Tae; Jeong, Chi-Young; Ha, Woo-Song

2013-01-01

387

Treatment planning for permanent and temporary percutaneous implants with custom made templates.  

PubMed

Nine patients who were presented at MSKCC with primary or recurrent pelvic or head and neck tumors and for whom surgery or further external radiation were excluded, were treated with percutaneous permanent or temporary implants, with individual pre-treatment planning and custom made templates. The tumor dose distributions achieved were as good as for implants performed at the time of surgical exploration. No serious complications have been encountered. PMID:2912944

Osian, A D; Anderson, L L; Linares, L A; Nori, D; Hilaris, B S

1989-01-01

388

Percutaneous radiofrequency ablation of lung tumors with expandable needle electrodes: current status  

Microsoft Academic Search

Percutaneous radiofrequency thermal ablation (RFA) has been used to treat primary and secondary liver tumors under ultrasound,\\u000a computed tomography (CT), or magnetic resonance imaging (MRI) guidance for the past decade [Park et al., Radiol Clin North\\u000a Am 38:545–561, 2000; Siperstein and Gotomirski, Cancer J 6:S293–S301, 2000; Kelekis et al., Eur Radiol 13:1100–1105, 2003]. RFA is a low-cost, minimally invasive treatment

A. D. Kelekis; L. Thanos; S. Mylona; N. Ptohis; K. Malagari; A. Nikita; J. Christodoulidou; N. Kelekis

2006-01-01

389

Successful Concepts  

Cancer.gov

Successful Concepts Study Rationale Condition to be studied is common and of great enough severity in the proposed study population to justify an intervention Focus background rationale on mechanism(s) likely to be relevant Is Intervention likely

390

Percutaneous vertebral augmentation: vertebroplasty, kyphoplasty and skyphoplasty.  

PubMed

Percutaneous vertebroplasty is a safe, inexpensive, and effective interventional vertebral augmentation technique that provides pain relief and stabilization in carefully selected patients with severe back pain due to vertebral compression. Complications from percutaneous vertebroplasty can be devastating, but are rare and avoidable with application of a meticulous technique. Percutaneous vertebroplasty has a role in the management pathway of patients presenting with painful vertebral compression fractures. Kyphoplasty uses a balloon tamp with the aim of restoring vertebral body height, improving kyphotic deformity, and creating a cavity into which bone cement is injected. Kyphoplasty is as effective and safe as vertebroplasty in treatment of painful vertebral compression fractures. Skyphoplasty, a modification of kyphoplasty, is a promising new technique. PMID:18707964

Peh, Wilfred C G; Munk, Peter L; Rashid, Faisal; Gilula, Louis A

2008-05-01

391

Percutaneous Holmium Laser Fulguration of Calyceal Diverticula  

PubMed Central

Introduction. Calyceal diverticular stones are uncommon findings that represent a challenge in their treatment, due to the technical difficulty in accessing the diverticulum, and the high risk of their recurrence. Current percutaneous technique for calyceal diverticular stones involves establishing a renal access, clearing the stone, and fulguration of the diverticular lining with a roller-ball cautery electrode using hypotonic irrigation solution such as sterile water or glycine solution which may be associated with the absorption of hypotonic fluids with its inherent electrolyte disturbances. Case Report. In this paper, we present for the first time percutaneous holmium laser fulguration of calyceal diverticula in 2 patients using normal saline. Their immediate postoperative sodium was unchanged and their follow-up imaging showed absence of stones. Both patients remain asymptomatic at 30 months post-operatively. Conclusion. This demonstrates that holmium laser is a safe alternative method to fulgurate the calyceal diverticulum after clearing the stone percutaneously.

Alwaal, Amjad; Azhar, Raed A.; Andonian, Sero

2012-01-01

392

The percutaneous stabilisation of the sacroiliac joint with hollow modular anchorage screws: a prospective outcome study.  

PubMed

PURPOSE: The use of percutaneous iliosacral screw fixation as a treatment of sacroiliac joint pain has been reported to be successful. This study was a prospective single surgeon series to evaluate the short-term outcomes of patients who underwent percutaneous sacroiliac joint stabilisation. METHODS: Between July 2004 and February 2011, 73 patients underwent percutaneous sacroiliac joint fusion in our unit. All patients completed a short form (SF)-36 questionnaire, visual analogue pain score and Majeed scoring questionnaire prior to treatment and at last follow-up. RESULTS: 55 patients (9 male and 46 female) completed follow-up. The average follow-up period was for 36.18 months (range 12-84). The mean preoperative SF-36 scores were 26.59 for physical health and 40.38 for mental health. The mean postoperative SF-36 scores were 42.93 for physical health and 52.77 for mental health. The mean visual analogue pain scores were 8.1 preoperative and 4.5 postoperative. The mean pelvic specific scoring were 36.9 preoperative and 64.78 postoperative. We noted that patients who had previous instrumented spinal surgery did significantly worse than those who had not. We had two nerve root-related complications. CONCLUSION: We conclude that in selected patient group who respond positively to CT-guided injection, a percutaneous SI joint stabilisation is beneficial in effecting pain relief and functional improvement. PMID:23686478

Mason, Lyndon W; Chopra, Iqroop; Mohanty, Khitish

2013-05-18

393

Outcomes of percutaneous femoral cannulation for venoarterial extracorporeal membrane oxygenation support  

PubMed Central

Introduction: We report and examine the outcomes of emergency venoarterial extracorporeal membrane oxygenation (ECMO) support initiated via percutaneous cannulation of the femoral vessels. Patients and methods: Fifteen patients undergoing percutaneous venoarterial ECMO under emergency circumstances between January 2009 and July 2011 were identified. The implantation technique employed the Seldinger’s technique for both arterial and venous cannulae. Whenever possible antegrade perfusion of the ipsilateral lower limb was performed through percutaneous catheterization of the superficial femoral artery (SFA). Results: ECMO support was indicated mainly for cardiac arrest (n=9, 60%) or cardiogenic shock (n=4, 27%), while two (13%) patients required ECMO support for acute respiratory failure. In five (33%) patients, ECMO was implanted during cardiopulmonary resuscitation manoeuvres. ECMO support was maintained for a mean of 4.9 days. Eight patients (53%) were successfully weaned from the device. Thirty-day mortality was 53%. Seven patients (47%) suffered early complications, namely two wound infections, one thrombosis of the venous cannula, one erroneous implantation of the arterial cannula into the femoral vein, one local dissection of the femoral artery, one retroperitoneal bleeding and one acute limb ischaemia. No long-term vascular complications were noted. Conclusion: Percutaneous femoral cannulation for ECMO support remains a prompt approach for establishing extracorporeal circulatory support in acute cardiopulmonary failure when conditions for performing femoral vessel cut down are not optimal. However, vascular complications are frequent and carry a significant morbidity and mortality.

Roussel, Arnaud; Alkhoder, Soleiman; Radu, Costin; Raffoul, Richard; Alshammari, Mezher; Montravers, Philippe; Wolff, Michel; Nataf, Patrick

2012-01-01

394

Thermal Protection During Percutaneous Thermal Ablation Procedures: Interest of Carbon Dioxide Dissection and Temperature Monitoring  

SciTech Connect

Percutaneous image-guided thermal ablation of tumor is widely used, and thermal injury to collateral structures is a known complication of this technique. To avoid thermal damage to surrounding structures, several protection techniques have been reported. We report the use of a simple and effective protective technique combining carbon dioxide dissection and thermocouple: CO{sub 2} displaces the nontarget structures, and its low thermal conductivity provides excellent insulation; insertion of a thermocouple in contact with vulnerable structures achieves continuous thermal monitoring. We performed percutaneous thermal ablation of 37 tumors in 35 patients (4 laser, 10 radiofrequency, and 23 cryoablations) with protection of adjacent vulnerable structures by using CO{sub 2} dissection combined with continuous thermal monitoring with thermocouple. Tumor locations were various (19 intra-abdominal tumors including 4 livers and 9 kidneys, 18 musculoskeletal tumors including 11 spinal tumors). CO{sub 2} volume ranged from 10 ml (epidural space) to 1500 ml (abdominal). Repeated insufflations were performed if necessary, depending on the information given by the thermocouple and imaging control. Dissection with optimal thermal protection was achieved in all cases except two patients where adherences (one postoperative, one arachnoiditis) blocked proper gaseous distribution. No complication referred to this technique was noted. This safe, cost-effective, and simple method increases the safety and the success rate of percutaneous thermal ablation procedures. It also offers the potential to increase the number of tumors that can be treated via a percutaneous approach.

Buy, Xavier; Tok, Chung-Hong; Szwarc, Daniel; Bierry, Guillaume; Gangi, Afshin, E-mail: gangi@rad6.u-strasbg.f [University Hospital of Strasbourg, Department of Radiology B (France)

2009-05-15

395

Percutaneous Endovascular Treatment of Hepatic Artery Stenosis in Adult and Pediatric Patients After Liver Transplantation  

Microsoft Academic Search

The purpose of this study was to evaluate the efficacy of percutaneous endovascular techniques for the treatment of hepatic\\u000a artery stenosis (HAS) occurring after liver transplantation (LT) in adult and pediatrics patients. From February 2003 to March\\u000a 2009, 25 patients (15 adults and 10 children) whose developed HAS after LT were referred to our interventional radiology unit.\\u000a Technical success was

Luigi Maruzzelli; Roberto Miraglia; Settimo Caruso; Mariapina Milazzo; Giuseppe Mamone; Salvatore Gruttadauria; Marco Spada; Angelo Luca; Bruno Gridelli

2010-01-01

396

Retrieval of Cement Embolus from Inferior Vena Cava After Percutaneous Vertebroplasty  

Microsoft Academic Search

Percutaneous vertebroplasty is an accepted treatment for painful vertebral compression fractures caused by osteoporosis and\\u000a malignant disease. Venous leakage of cement and pulmonary cement embolism have been reported complications. We describe a\\u000a paravertebral venous cement leak resulting in the deposition of a cement cast in the inferior vena cava and successful retrieval\\u000a of the cement embolus.

S. Athreya; N. Mathias; P. Rogers; R. Edwards

2009-01-01

397

Are Patients With Renal Failure Good Candidates for Percutaneous Coronary Revascularization in the New Device Era?  

Microsoft Academic Search

Background—Patients with end-stage renal disease undergoing conventional balloon angioplasty have reduced procedural success and increased complication rates. This study was designed to determine the immediate and long-term outcomes of patients with varying degrees of renal failure undergoing percutaneous coronary intervention in the current device era. Methods and Results—We compared the immediate and long-term outcomes of 362 renal failure patients (creatinine

Mark H. Rubenstein; Lari C. Harrell; Boris V. Sheynberg; Heribert Schunkert; Hasan Bazari; Igor F. Palacios

398

Percutaneous Injection Therapy for a Peripheral Pulmonary Artery Pseudoaneurysm After Failed Transcatheter Coil Embolization  

SciTech Connect

Coil embolization to occlude the feeding artery of a pseudoaneurysm is an effective treatment to control hemoptysis. However, a feeding artery of the pseudoaneurysm may not be identified at pulmonary angiography, resulting in a failure to obtain embolization. We describe here two cases of a Rasmussen aneurysm that was successfully treated with percutaneous injection of thrombin (case 1) and N-butyl cyanoacrylate (case 2) under ultrasonographic and fluoroscopic guidance after failed transcatheter coil embolization.

Lee, Kyungwoo [Gyeongsang National University Hospital, Department of Emergency Medicine (Korea, Republic of); Shin, Taebeom, E-mail: tbshinkr@yahoo.co.k [Gyeongsang National University Hospital, Department of Diagnostic Radiology (Korea, Republic of); Choi, Jinsu; Kim, Younghwan [Kemyeong University Hospital, Department of Diagnostic Radiology (Korea, Republic of)

2008-09-15

399

Percutaneous embolization of a high-flow pancreatic transplant arteriovenous fistula  

SciTech Connect

Percutaneous endovascular techniques were used to treat an arteriovenous fistula (AVF) associated with pancreatic transplantation. A pancreatic transplant superior mesenteric artery-to-superior mesenteric-vein AVF was successfully embolized while flow to the pancreas transplant was preserved. The embolization was aided by the use of Guglielmi detachable coils and a detachable balloon. No complications were encountered. At 23 months follow-up, the patient is doing well with no recurrence.

Angle, J. Fritz; Matsumoto, Alan H. [University of Virginia, Health Science Center, Department of Radiology (United States); McGraw, J. Kevin [St. Vincent Medical Center, Department of Radiology (United States); Hagspiel, Klaus D.; Spinosa, David J. [University of Virginia, Health Science Center, Department of Radiology (United States); McCullough, Christopher S. [St. Vincent Medical Center, Department of Radiology (United States)

1999-03-15

400

Percutaneous Embolization of a High-Flow Pancreatic Transplant Arteriovenous Fistula  

SciTech Connect

Percutaneous endovascular techniques were used to treat an arteriovenous fistula (AVF) associated with pancreatic transplantation. A pancreatic transplant superior mesenteric artery-to-superior mesenteric-vein AVF was successfully embolized while flow to the pancreas transplant was preserved. The embolization was aided by the use of Guglielmi detachable coils and a detachable balloon. No complications were encountered. At 23 months follow-up, the patient is doing well with no recurrence.

Angle, J. Fritz; Matsumoto, Alan H. [Department of Radiology, Box 170, University of Virginia, Health Sciences Center, Charlottesville, VA 22908 (United States); McGraw, J. Kevin [Department of Radiology, St. Vincent Medical Center, 2213 Cherry Street, Toledo, OH 43608 (United States); Hagspiel, Klaus D.; Spinosa, David J. [Department of Radiology, Box 170, University of Virginia, Health Sciences Center, Charlottesville, VA 22908 (United States); McCullough, Christopher S. [Department of Radiology, St. Vincent Medical Center, 2213 Cherry Street, Toledo, OH 43608 (United States)

1998-03-15

401

Percutaneous CT-Guided Treatment of Osteochondritis Dissecans of the Sacroiliac Joint  

SciTech Connect

Osteochondritis dissecans (OCD) is a joint disorder that affects the articular cartilage and subchondral bone, most commonly at the knee. OCD of the sacroiliac joint is extremely rare. Management of OCD remains controversial, and surgery is often needed, especially when conservative treatment fails. We present a rare case of OCD involving the left sacroiliac joint successfully treated by percutaneous computed tomography-guided retrograde drilling and debridement.

Becce, Fabio, E-mail: fabio.becce@chuv.ch [University of Lausanne, Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (Switzerland); Mouhsine, Elyazid [Clinique Hirslanden Bois-Cerf, Department of Orthopaedic Surgery (Switzerland); Mosimann, Pascal John; Anaye, Anass [University of Lausanne, Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (Switzerland); Letovanec, Igor [University Institute of Pathology, Centre Hospitalier Universitaire Vaudois (Switzerland); Theumann, Nicolas [University of Lausanne, Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (Switzerland)

2012-08-15

402

Percutaneous Repair of Radial Artery Pseudoaneurysm in a Hemodialysis Patient Using Sonographically Guided Thrombin Injection  

SciTech Connect

We report a case of a radial artery pseudoaneurysm complicating an incorrect puncture of a Brescia-Cimino hemodialysis fistula that was treated with percutaneous ultrasound-guided thrombin injection. The pseudoaneurysm recurred after the initial successful thrombin injection. With a second injection we obtained permanent pseudoaneurysm occlusion. Our case illustrates that this procedure is an effective treatment in this type of arteriovenous fistula complication. We compare this case with the only similar one we could find in the literature.

Corso, Rocco, E-mail: roccocorso@jumpy.it; Rampoldi, Antonio [Niguarda 'Ca Granda' Hospital, Department of Diagnostic and Interventional Radiology (Italy); Vercelli, Ruggero; Leni, Davide [University of Milan, Institute of Radiology (Italy); Vanzulli, Angelo [Niguarda 'Ca Granda' Hospital, Department of Diagnostic and Interventional Radiology (Italy)

2006-02-15

403

Percutaneous transluminal renal angioplasty: Initial results and long-term follow-up in 202 patients  

Microsoft Academic Search

Percutaneous transluminal renal angioplasty was performed in 202 patients with 250 stenoses. The procedure was successful\\u000a in 201 of 250 (83%). Results were better for postostial atherosclerotic lesions (94%), fibromuscular lesions (83%), and transplant\\u000a kidneys (71%) than for ostial atherosclerotic lesions (29%). Of all the patients, 61% had reduced blood pressures following\\u000a the procedure, with cure (diastolic blood pressure ?90

A. L. Baert; G. Wilms; A. Amery; J. Vermylen; R. Suy

1990-01-01

404

Creatine kinase-MB fraction elevation after percutaneous coronary intervention in patients with chronic renal failure  

Microsoft Academic Search

We evaluated the short- and long-term clinical outcomes of 326 consecutive patients with chronic renal failure, not on dialysis, who had creatine kinase (CK)-myocardial band (MB) fraction elevation after successful percutaneous coronary intervention in a native coronary artery. Based on peak CK-MB levels measured after intervention, patients were divided into 3 groups: no elevation (group 1, n = 184), 1

Luis Gruberg; Roxana Mehran; Ron Waksman; George Dangas; Shmuel Fuchs; Hongsheng Wu; Kenneth M Kent; Augusto D Pichard; Lowell F Satler; Gregg W Stone; Martin B Leon

2001-01-01

405

Percutaneous Reduction and Internal Fixation of the Lisfranc Fracture-Dislocation  

Microsoft Academic Search

\\u000a The success of minimally invasive percutaneous reduction and fixation of tarsometatarsal or Lisfranc injuries lies in understanding\\u000a the appropriate injury pattern for this method of treatment. The eponym Lisfranc dislocation is derived from injuries sustained to cavalry troops in the Napoleonic era. These were associated with significant vascular\\u000a and soft tissue injury, as they were treated with an amputation through

Anish R. Kadakia; Mark S. Myerson

406

Renal effects of percutaneous stone removal  

SciTech Connect

Preoperative and postoperative renography with 99mTechnetium-diethylene-triamine pentaacetic acid was performed on 33 patients who were free of renal scarring, infection, and obstruction and who underwent percutaneous renal stone removal. Although there was a transient decrease in renal function postoperatively in some patients, statistically significant reductions in renal function occurred only in 1 patient with an arteriovenous malformation that was embolized and in 1 patient who had a postoperative ureteropelvic junction stricture. The creation of more than one nephrostomy tract did not affect the results. In the absence of serious complications, percutaneous nephrostomy does not have a significant effect on renal function.

Eshghi, M.; Schiff, R.G.; Smith, A.D.

1989-02-01

407

Immunohistochemical identification of primary peritoneal serous cystadenocarcinoma mimicking advanced colorectal carcinoma: a case report  

Microsoft Academic Search

Primary peritoneal cystadenocarcinoma is a rare tumor of similar histogenic origin as primary ovarian carcinoma. We present a case of primary peritoneal serous cystadenocarcinoma mimicking advanced colorectal cancer in a 68 yr-old African American female. Radiology, endoscopy and cytology yielded only inconclusive findings. Immunohistochemical analysis of percutaneously obtained ascitic fluid provided a correct diagnosis of primary peritoneal cystadenocarcinoma. The discovery

Wesley B von Riedenauer; Sumbul A Janjua; David S Kwon; Ziying Zhang; Vic Velanovich

2007-01-01

408

Percutaneous Radiofrequency Ablation for Treatment of Recurrent Retroperitoneal Liposarcoma  

SciTech Connect

Percutaneous CT-guided radiofrequency ablation (RFA) is becoming more and more established in the treatment of various neoplasms, including retroperitoneal tumors of the kidneys and the adrenal glands. We report the case of RFA in a patient suffering from the third relapse of a retroperitoneal liposarcoma in the left psoas muscle. After repeated surgical resection and supportive radiation therapy of a primary retroperitoneal liposarcoma and two surgically treated recurrences, including replacement of the ureter by a fraction of the ileum, there was no option for further surgery. Thus, we considered RFA as the most suitable treatment option. Monopolar RFA was performed in a single session with a 2-cm umbrella-shaped LeVeen probe. During a 27-month follow-up period the patient remained free of tumor.

Keil, Sebastian, E-mail: keil@rad.rwth-aachen.de; Bruners, Philipp [RWTH Aachen University, Department of Diagnostic Radiology, University Hospital (Germany); Brehmer, Bernhard [RWTH Aachen University, Department of Urology, University Hospital (Germany); Mahnken, Andreas Horst [RWTH Aachen University, Department of Diagnostic Radiology, University Hospital (Germany)

2008-07-15

409

Segmental Artery Injury Following Percutaneous Vertebroplasty Using Extrapedicular Approach  

PubMed Central

We performed a percutaneous vertebroplasty at the compressed L2 vertebral body of a 73-year-old female using a left-sided unilateral extrapedicular approach. She complained severe radiating pain and a tingling sensation in her left leg two hours after the vertebroplasty. Spinal computed tomographic scan showed a large retroperitoneal hematoma, and a subsequent spinal angiography revealed a left L2 segmental artery injury. Bleeding was successfully controlled by endovascular embolization. Recently, extrapedicular approaches have been attempted, allowing for the avoidance of facet and pedicle injury with only a unilateral approach. With this approach, however, the needle punctures the vertebral body directly. Therefore, this procedure carries the potential risk of a spinal segmental artery.

Cho, Yong Jun

2011-01-01

410

Brachial Artery Access for Percutaneous Renal Artery Interventions  

SciTech Connect

Purpose: To evaluate the suitability of transbrachial access for endovascular renal artery interventions. Methods: During 37 consecutive endovascular renal artery interventions, the transbrachial approach was used on nine patients (mean age 63 years; range 41-76 years) for 11 renal artery procedures on native kidneys and one percutaneous transluminal angioplasty (PTA) on a transplanted kidney. The reason for using transbrachial access was a steep aorta-renal angle in five, and severe aorta-iliac atherosclerosis in the remaining patients. In addition to the intervention catheter in the left brachial artery, an additional nonselective catheter for controlling the procedure was inserted transfemorally (six patients) or via the contralateral brachial artery. Results: Eleven interventions (six PTAs, five stents) were successfully completed. The one failure resulted from impenetrable subclavian artery stenosis. The only major complication was a brachial artery pseudoaneurysm requiring surgical treatment. Conclusion: Transbrachial access is an effective and relatively safe technique for renal artery interventions when transfemoral access is not possible.

Kaukanen, Erkki T.; Manninen, Hannu I.; Matsi, Pekka J.; Soeder, Heini K. [Department of Clinical Radiology, Kuopio University Hospital, SF-70211 Kuopio (Finland)

1997-09-15

411

Palliative Percutaneous Jejunal Stent for Patients with Short Bowel Syndrome  

PubMed Central

Gastrointestinal obstruction is a common preterminal event in patients with gastric and pancreatic cancer who often undergo palliative bypass surgery. Although endoscopic palliation with self-expandable metallic stents has emerged as a safe and effective alternative to surgery, experience with this technique remains limited. In particular, a proximal jejunal obstruction requires more technical expertise than a duodenal obstruction. Palliative treatment modalities include both surgical and nonsurgical approaches. In this report, we describe the successful placement of self-expandable metallic stents at the proximal jejunum using a combination of percutaneous endoscopic, intraoperative, and transstomal stenting. Usually endoscopy is not indicated in cases of proximal jejunal obstruction, but some cases may require palliative endoscopy instead of bypass operation.

Takayama, Satoru; Ochi, Yasuo; Yasuda, Akira; Sakamoto, Masaki; Takahashi, Hideki; Akamo, Yoshimi; Takeyama, Hiromitsu

2009-01-01

412

[Primary hyperparathyroidism].  

PubMed

Primary hyperparathyroidism is frequently an incidental finding in asymptomatic patients. Often the diagnosis of primary hyperparathyroidism is made in evaluation for osteoporosis, rarely in the context of hypercalcemic crisis, myopathy, kidney stones, nephrocalcinosis, and osteitis fibrosa. The most frequent cause for primary hyperparathyroidism is benign parathyroid adenoma, reminders have hyperplasia. Primary hyperparathyroidism is defined as hypercalcemia with inappropriately high parathyroid hormone levels. Surgery is the definitive treatment for patients with symptomatic primary hyperparathyroidism and asymptomatic patients, who meet one of the following criteria: serum calcium>0.25 mmol/L (1.0 mg/dl) above the accepted normal reference range, renal failure (GFR<60 ml/min) and presence of osteoporosis (T-score<-2.5 or fracture). Parathyroidectomy should be performed by an experienced surgeon. As an alternative in inoperable patients or preoperatively in severe hypercalcemia cinacalcet successfully reduces calcium levels. In asymptomatic patients not meeting the above mentioned criteria serum calcium and creatinin levels should be measured once a year and DXA every two years, since 30% of the patients with asymptomatic primary hyperparathyroidism are progressive. PMID:21656491

Suter-Widmer, Isabelle; Kraenzlin, Marius E; Meier, Christian

2011-06-01

413

[Successful aging].  

PubMed

Age: an annoying burden or a priceless gain? The ancient physicians differentiated between senium and senectus to describe old age. In modern-day terminology, the former corresponds to the deficit model, the latter to the competence model of old age. Its success or failure is dependent on biological, psychological, social and mental determinants. In the first part, these four determinants will be compared from the perspectives of competence and deficit, success and failure. The second part will outline selected meaningful aspects of the art of living that are relevant for successful ageing, namely, an awareness for the transient nature of life, attention to life, conciliation with oneself, F. Nietzsche's higher state of health, attention to god and humor. PMID:14640023

Nager, F

2003-10-29

414

Palliative use of percutaneous endoscopic gastrostomy and percutaneous endoscopic cecostomy tubes.  

PubMed

Percutaneous endoscopic gastrostomy (PEG) tubes are most commonly placed for feeding purposes with the intention of maintenance or improvement in nutritional status; however, they may also be used in a palliative role in patients who have terminal illnesses for feeding or decompression. Percutaneous endoscopic cecostomy (PEC) tubes can be used to decompress malignant and functional bowel disorders with accepted morbidity and mortality. This article reviews the use of PEG and PEC tubes for palliative use. PMID:17967383

Holm, Adrian N; Baron, Todd H

2007-10-01

415

Percutaneous endoscopic gastrostomy feeding in patients with cystic fibrosis  

PubMed Central

Background—Malnutrition is a common management problem in patients with cystic fibrosis (CF). Various approaches to supplemental nutrition by both parenteral and enteral routes have been used. ?Aim—To analyse the efficacy and acceptability of supplemental overnight feeding using a percutaneous endoscopic gastrostomy (PEG) in patients with CF. ?Patients—53 patients with CF (43 adults; age >17 years) with severe pulmonary disease. ?Methods—The technical success and complications of PEG insertion were documented together with changes in nutritional and pulmonary status of the cohort. ?Results—PEG tubes were successfully inserted in all patients, with immediate complications (respiratory depression) in two (4%) and late complications in 13 (25%). Feeding was well tolerated by 50/51 (98%) of the cohort during a mean (SEM) follow up of 14.5 (2.1) months. The adult cohort had a significant increase in weight and body mass index at six months which was maintained at 12 months. Serum albumin concentration remained stable at six months but had fallen by 12 months, although the differences were not statistically significant. These results were reflected in the paediatric cohort. Pulmonary function in those followed up for one year had apparently stabilised, but the number of admissions to hospital over the year before and the year after PEG did not change. Half of the cohort were accepted for heart-lung/lung transplantation, the improvement in nutritional status being a prerequisite for this. ?Conclusion—Supplemental PEG tube feeding is well tolerated and results in a significant improvement in nutritional status and an apparent stabilisation of pulmonary function in severely malnourished CF patients with advanced pulmonary disease. ?? Keywords: cystic fibrosis; malnutrition; enteral nutrition; percutaneous endoscopic gastrostomy

Williams, S; Ashworth, F; McAlweenie, A; Poole, S; Hodson, M; Westaby, D

1999-01-01

416

Cone-Beam Computed Tomography-Guided Percutaneous Radiologic Gastrostomy  

SciTech Connect

The purpose of this study was to investigate the feasibility of a flat-detector C-arm-guided radiographic technique (cone-beam computed tomography [CBCT]) for percutaneous radiologic gastrostomy (PRG) insertion. Eighteen patients (13 men and 5 women; mean age 62 years) in whom percutaneous endoscopic gastrostomy (PEG) had failed underwent CBCT-guided PRG insertion. PEG failure or unsuitability was caused by upper gastrointestinal tract obstruction in all cases. Indications for gastrostomy were esophageal and head and neck malignancies, respectively. Before the PRG procedure, initial C-arm CBCT scans were acquired. Three- and 2-dimensional soft-tissue reconstructions of the epigastrium region were generated on a dedicated workstation. Subsequently, gastropexy was performed with T-fasteners after CBCT-guided puncture of the stomach bubble, followed by insertion of an 14F balloon-retained catheter through a peel-away introducer. Puncture of the stomach bubble and PRG insertion was technically successful in all patients without alteration of the epigastric region. There was no malpositioning of the tube or other major periprocedural complications. In 2 patients, minor complications occurred during the first 30 days of follow-up (PRG malfunction: n = 1; slight infection: n = 1). Late complications, which were mainly tube disturbances, were observed in 2 patients. The mean follow-up time was 212 days. CBCT-guided PRG is a safe, well-tolerated, and successful method of gastrostomy insertion in patients in whom endoscopic gastrostomy is not feasible. CBCT provides detailed imaging of the soft tissue and surrounding structures of the epigastric region in one diagnostic tour and thus significantly improves the planning of PRG procedures.

Moehlenbruch, Markus; Nelles, Michael; Thomas, Daniel; Willinek, Winfried [University Hospital Bonn, Department of Radiology (Germany); Gerstner, Andreas [University of Bonn, Department of Otolaryngology, Head and Neck Surgery (Germany); Schild, Hans H.; Wilhelm, Kai, E-mail: wilhelm@uni-bonn.d [University Hospital Bonn, Department of Radiology (Germany)

2010-04-15

417

Systematic primary angioplasty in octogenarian and older patients  

Microsoft Academic Search

Background There are conflicting data about the efficacy of aggressive treatment and early intervention among high-risk patients with acute myocardial infarction (AMI), such as elderly patients. This study sought to determine the short- and long-term outcome of octogenarian and older patients after primary percutaneous transluminal coronary angioplasty (PTCA). Methods In our tertiary referral center a program of primary PTCA was

David Antoniucci; Renato Valenti; Giovanni M. Santoro; Leonardo Bolognese; Guia Moschi; Maurizio Trapani; Enrico Taddeucci; Pier Filippo Fazzini

1999-01-01

418

Imaging of primary and secondary renal lymphoma.  

PubMed

OBJECTIVE. This article reviews the CT and MRI patterns of primary and secondary renal lymphomas and discusses the role of percutaneous biopsy in diagnosis and management. CONCLUSION. Renal lymphoma has a variable imaging spectrum and may mimic renal cell carcinoma. An awareness of the typical and atypical imaging features of both primary and secondary renal lymphomas can help the radiologist to suggest these diagnoses and recommend biopsy when appropriate. PMID:24147501

Ganeshan, Dhakshinamoorthy; Iyer, Revathy; Devine, Catherine; Bhosale, Priya; Paulson, Erik

2013-11-01

419

Percutaneous Endovascular Repair of Abdominal Aortic Aneurysm with Coexisting Horseshoe Kidney: Technical Aspects and Review of the Literature  

PubMed Central

Surgical repair of abdominal aortic aneurysms (AAAs) with coexisting horseshoe kidney (HSK) is technically challenging because of complex anatomy. Endovascular repair has emerged as a common approach to AAA repair and represents a valid alternative in selected patients with AAA and concomitant congenital renal anomalies. We report a case of successful percutaneous endovascular repair in a patient with coexistent AAA and HSK. Careful preoperative planning is essential in successful endovascular management of abdominal aneurysms in these patients.

Tan, Tze-Woei; Farber, Alik

2011-01-01

420

Successive Discounts  

NSDL National Science Digital Library

This lesson uses the example of successive discounts at a retail store to demonstrate numeric, algebraic, and graphical representations of compositions of mathematical functions. Students will get the opportunity to determine equivalent expressions for compositions of functions. The material includes a student activity sheet and example questions. The lesson is intended for grades 9-12 and should require 1 class period to complete.

2010-12-17