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1

Acute coronary syndrome in a 100-year-old woman treated successfully with primary percutaneous coronary angioplasty  

PubMed Central

We present a case of a 100-year-old woman living alone with ST-elevation myocardial infarction acute coronary syndrome of the infero-lateral wall treated with percutaneous coronary intervention. Coronary angiography revealed critical 99% stenosis in the marginal branch of the circumflex artery and insignificant lesions in other arteries. Two bare metal stents were implanted successfully in the same session. The patient was discharged home in good general condition, able to live and function independently. PMID:24570714

Beckowski, Maciej; Szwed, Hanna; Ciszewski, Andrzej

2013-01-01

2

Successful treatment of primary cardiac lymphoma causing ST-elevation myocardial infarction by percutaneous coronary intervention combined with chemotherapy.  

PubMed

A 76-year-old immunocompetent woman presented to our hospital with general fatigue. Her blood pressure was 60/40?mm?Hg and pulse rate was 110?bpm. An electrocardiogram showed ST-elevation in the II, III and aVF leads with complete atrioventricular block. An echocardiogram and CT revealed pericardial effusion and a 6?cm solid tumour lying anterior to the heart. The right coronary artery (RCA) ran through the centre of the tumour, which bulged into the right atrium for 35?mm and vibrated. Emergent coronary angiography revealed 99% stenosis with delay at the proximal RCA; however, intravascular ultrasound showed no atheromatous changes, and the RCA was compressed by the extravascular mass. Successful coronary stenting improved the coronary flow. The following day, a biopsy was performed via thoracotomy without any events, the results of which showed diffuse-type large B-cell lymphoma histologically. Chemotherapy gradually reduced the tumour size, and the patient became stable haemodynamically. PMID:25404253

Nagatomo, Daisuke; Oyama, Jun-Ichi; Yoshihara, Mari; Node, Koichi

2014-01-01

3

Successful Percutaneous Transluminal Angioplasty and Stenting in Acute Mesenteric Ischemia  

SciTech Connect

Acute mesenteric ischemia (AMI) is a life-threatening emergency. The complications are high by the time of diagnosis in most cases and therefore only few data on primary percutaneous intervention with percutaneous transluminal angioplasty (PTA) and stenting in AMI are available. We present the case of an 84-year-old woman who presented to our emergency department complaining of an acute worsening of pre-existing abdominal periumbilical pain, nausea, vomiting, and diarrhea. She had previously undergone percutaneous transluminal embolectomy for an acute occlusion of the left common femoral artery. Due to suspicion of intestinal infarction, conventional angiography of the aorta and the superior mesenteric artery (SMA) was performed and confirmed a proximal occlusion of the SMA. Percutaneous SMA recanalization with balloon dilation and subsequent stent implantation was carried out successfully. The abdominal symptoms subsided after this procedure. In AMI that is diagnosed early, endovascular stenting should be considered as an alternative treatment to the surgical approach that avoids the need for surgical bowel resection.

Gartenschlaeger, Soeren [Charite University Medical Care in Berlin, Virchow Campus Hospital, Department of Radiology (Germany)], E-mail: soeren.gartenschlaeger@charite.de; Bender, Siegfried; Maeurer, Juergen [Klinikum Frankfurt (Oder) GmbH, Academic Teaching Hospital of Charite University Medical Care, Institute for Imaging Diagnostics (Germany); Schroeder, Ralf J. [Charite University Medical Care in Berlin, Virchow Campus Hospital, Department of Radiology (Germany)

2008-03-15

4

Early discharge after primary percutaneous coronary intervention  

Microsoft Academic Search

The length of hospital stay after a successful percutaneous coronary intervention (PCI) for acute myocardial infarction is subject of debate. Patients should not be kept in hospital longer than strictly needed in terms of safety, psycho-social reasons, adequate mobilisation and patient comfort. In many tertiary centres with a busy PCI program insufficient bed capacity is an ongoing concern. Moreover, it

Gerrit J Laarman; Maurits T Dirksen

2010-01-01

5

In-hospital daily insulin dose predicts long-term adverse outcome in patients with diabetes with ST-elevation myocardial infarction treated with successful primary percutaneous angioplasty  

PubMed Central

Introduction Early initiation of reperfusion therapy including primary percutaneous coronary revascularization (PPCI) has been recognized as a crucial factor determining clinical outcomes in the acute phase of myocardial infarction. In unstable patients with type 2 diabetes mellitus (T2D) the clear benefit from PPCI was proven. We aim to evaluate the prognostic value of factors describing glycometabolic state on admission in patients with T2D undergoing PPCI in acute ST-elevation myocardial infarction (STEMI). Material and methods Prospective analysis of clinical and laboratory variables (mean daily short acting exogenous insulin dose (DID), admission blood glucose, glycated hemoglobin (HbA1c), microalbuminuria) was performed in 112 consecutive patients with T2D with STEMI who underwent PPCI. Women comprised 58% of the group. Results Insulin dosing was targeted to obtain a mean daily glucose level < 7.8 mmol/l. During 12-month follow-up 33 (29.5%) major adverse cardiac events (major adverse cardiac events (MACE) consisting of death, reinfarction, and repeated target vessel revascularization) were reported. Microalbuminuria was present in 68 (60.5%) patients. The mean HbA1c level was 7.9%. In the multivariate logistic regression model only DID > 44 IU remained an independent risk factor for MACE (p = 0.02, OR = 5.2). Conclusions In patients with diabetes with STEMI treated with PPCI, simple measurement of DID during hospitalization can add valuable prognostic information about the future risk of MACE.

Peruga, Jan Z.; Kasprzak, Jaroslaw D.; Bendinger, Tomasz; Plewka, Michal; Drozdz, Jaroslaw; Drzewoski, Jozef; Krzeminska-Pakula, Maria

2014-01-01

6

Thrombus aspiration during primary percutaneous coronary intervention.  

PubMed

The main goal of primary percutaneous coronary intervention (PPCI) is to achieve not only restoration of flow in the epicardial coronary artery, but also reperfusion at the level of myocardial tissue. Distal embolization is a possible complication of PPCI; in these patients, a microvascular injury occurs, which finally leads to a lack of myocardial reperfusion. Thrombus aspiration during PPCI has been proposed to prevent embolization. Several different thrombectomy devices have been demonstrated to be well tolerated and effective in improving surrogate markers of myocardial reperfusion; furthermore, in a few studies, the use of thrombectomy was associated with an improvement of clinical outcome. Because study results appeared largely inconsistent, especially about clinical outcome data, several meta-analyses have been carried out, showing that thrombectomy is able to improve markers of myocardial reperfusion and that manual thrombectomy is associated with better results in terms of myocardial reperfusion and clinical outcome, compared with embolic protection or mechanical thrombectomy devices, probably due to its easy and time-sparing use with low rate of complication. Literature data, based mainly on the Thrombus Aspiration During Primary Percutaneous Coronary Intervention (TAPAS) trial, indicate a favourable effect on outcome of routine manual thrombectomy strategy and the recent European Society of Cardiology (ESC) and European Association for Cardio-Thoracic Surgery (EACTS) guidelines on myocardial revascularization recommend thrombus aspiration during PPCI. However, data on long-term clinical outcome are still inconsistent and no trials have been, at the present time, designed to assess hard endpoint. In this review, we have carefully analysed literature data on thrombectomy during PPCI, taking into account the most recent studies and the last meta-analyses; study results have been compared to verify if either a routine or a selective use of thrombectomy should be adopted and to assess whether the use of thrombectomy may finally improve clinical outcome. PMID:21986489

Picchi, Andrea; Limbruno, Ugo

2012-01-01

7

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. PMID:19699864

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

8

Effectiveness of primary percutaneous coronary interventions for stent thrombosis.  

PubMed

There are very few (and conflicting) data about the effectiveness of primary percutaneous coronary interventions (PCIs) for stent thrombosis (ST) treatment. We sought to evaluate the prevalence, efficacy, and outcomes of primary PCI in patients with ST-elevation acute myocardial infarction (STEMI) due to ST in 2,464 consecutive patients treated by primary PCI. ST was the cause of STEMI in 67 patients (3%). Patients with ST showed a lower rate of significant collateral circulation (0% vs 6%, p = 0.034) and a higher peak creatine kinase value (2,678 +/- 3,221 vs 2,375 +/- 2,189 U/L, p = 0.003) compared with the other 2,397 patients with STEMI. PCI was successful in 64 patients (96%) in the ST group and consisted of additional stenting (78%) or only balloon angioplasty (22%). Abciximab and rheolytic thrombectomy were used in 75% and 31% of patients, respectively. Procedure (39 +/- 26 vs 32 +/- 19 minutes, p = 0.0001) and fluoroscopy (13 +/- 10 vs 10 +/- 8 minutes, p = 0.0001) times were longer, and contrast medium amount (221 +/- 89 vs 194 +/- 103 ml, p = 0.034) larger in patients with ST compared with patients with de novo STEMI. Six-month death (12% vs 8%, p = 0.216) and nonfatal reinfarction (10% vs 1%, p = 0.0001) rates were higher in patients with ST compared with those without. At 6-month angiographic follow-up (n = 1,843 of 2,269), the restenosis/reocclusion rate was 54% versus 17% (p = 0.0001) in patients with and without ST. In conclusion, the prevalence of primary PCI for ST is low. Additional stenting with or without thrombectomy is effective in restoring vessel patency in patients with ST, but restenosis and reocclusion are frequent. ST treated with successful PCI is associated with a large infarct and poor outcome. PMID:19327415

Parodi, Guido; Memisha, Gentian; Bellandi, Benedetta; Valenti, Renato; Migliorini, Angela; Carrabba, Nazario; Vergara, Ruben; Antoniucci, David

2009-04-01

9

Primary Percutaneous Coronary Intervention in a Patient with Haemophilia A  

PubMed Central

Haemophilia A is a rare genetic condition leading to coagulation factor VIII deficiency and thus predisposing to bleeding diathesis. Due to advances in treatment, life expectancy of haemophilia A sufferers is increasing, and the incidence and prevalence of coronary artery disease are rising. There have been many reported cases of acute myocardial infarction in such patients, who subsequently undergo elective percutaneous coronary intervention. We present the case of a 55-year-old gentleman presenting with an acute anterior full-thickness myocardial infarction who required emergency primary percutaneous coronary intervention. PMID:24454390

Reddy, S. Ashwin; Hoole, Stephen P.; Besser, Martin W.

2013-01-01

10

Primary Childhood School Success Scale.  

ERIC Educational Resources Information Center

The purpose of this research study was to build and pilot a psychometric instrument, the Primary Childhood School Success Scale (PCSSS), to identify behaviors needed for children to be successful in first grade. Fifty-two teacher responses were collected. The instrument had a reliability coefficient (Alpha) of 0.95, a mean of 13.26, and a variance…

Seagraves, Margaret C.

11

Primary succession in Mount Pinatubo  

PubMed Central

Vegetation structure on the east flank of Mount Pinatubo was investigated to determine the inventory of species at 15 y post-eruption, then to ascertain environmental variables that have influenced the early patterns of primary succession. Unconstrained and constrained ordination methods were used to determine the influence of spatial, elevation, and substrate patterns on vegetation. Vegetation was assigned to one of 3 habitat types. Scours were eroded flat surfaces, terraces were perched flat surfaces, and talus piles were created along the canyon edges as mass waste events. The influence of habitat type on vegetation was multifaceted because they represent different conditions and different histories. The talus piles have preferential access to colonists from the vegetation on the canyon walls above and a more benign microclimate than the exposed terrace and scour sites. Scoured sites on the valley floor exhibited the least vegetation cover, as these substrates had the least mature surfaces and the most restricted capacity for root exploration. Perched terraces exhibited greater plant dominance than did the other habitats in the early stages of succession because of the ubiquitous appearance of Parasponia rugosa as initial colonists on these relatively flat surfaces. Polynomial canonical correspondence analysis was more closely aligned with the pattern of vegetation than linear canonical correspondence analysis, and therefore more closely approximated accurate descriptions of correlations among site ordination positions and measured variables. These results confirm that a variety of statistical approaches can clarify applications for restoration ecology following landslide and volcanic disturbances or agriculture and forestry anthropogenic disturbances in the lowland tropics. PMID:24505499

Marler, Thomas E; del Moral, Roger

2013-01-01

12

Transradial percutaneous coronary interventions: indications, success rates & clinical outcome.  

PubMed

Before ten years, radial artery was discovered as a useful vascular access site for percutaneous coronary procedures. It has the advantage of reduced access site complications but is associated with specific technical challenges in comparison with the transfemoral approach. Although earlier data from a meta-analysis indicated higher procedure failure rates with radial--as compared to femoral access (7.2 vs. 2.4%), more recent data from prospective multicenter studies and large meta analysis showed significantly better outcomes with radial access versus femoral access in contemporary, real-world clinical settings of percutaneous cardiovascular procedures (e.g. PREVAIL-, PRESTO-ACS-studies). This includes also challenging coronary procedures in acute coronary syndromes (NSTEMI and STEMI) where the radial access was associated with fewer bleeding complications leading to better long-term outcomes. Transradial procedure failures can sometimes be due to variation in radial artery anatomy (e.g. vessel diameter, anomalous branching patterns, tortuosity) or risk factors for radial spasms (e.g. smoking, anxiety, vessel diameter, age, gender). Postprocedural radial occlusions (0.6-1.2%) seems strongly be related to these anatomical variances, which possibly may be reduced by the use of smaller catheter, however 5 French lumen diameter guiding catheter include limitations regarding treating options in complex coronary lesion. In conclusion, the transradial access for coronary angiography and interventions is not only to enhance patients comfort, but shows significant better long-term results due to less bleeding complications as compared to the femoral access. PMID:21275296

Dahm, Johannes B; van Buuren, Frank

2010-01-01

13

Successful percutaneous treatment of anomalous left coronary artery from pulmonary artery  

Microsoft Academic Search

Anomalous origin of the left main coronary artery from the pulmonary artery (ALCAPA) is an uncommon congenital condition seen in the adult population, with most patients developing symptoms in infancy.We describe successful closure of an ALCAPA in an adult using a percutaneous transcatheter approach in a patient with evidence of anterior wall ischemia believed to be the consequence of myocardial

N. Collins; J. Colman; L. Benson; M. Hansen; N. Merchant; E. Horlick

2007-01-01

14

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

15

Safety and Technical Success of Percutaneous Left Main Coronary Artery Stenting  

PubMed Central

Objective: Critical stenosis of left main coronary artery (LMCA) has always remained a challenge for interventional cardiologists. Conventionally Coronary Artery Bypass Grafting (CABG) is done for these patients but recently Percutaneous Coronary Intervention (PCI) is also being tried more frequently, but data of PCI is scarce in this regard. Our objective was to determine the safety and technical success rate of percutaneous left main coronary artery stenting. Methods: This was 12 month follow up study conducted at Pakistan Institute of Medical Sciences (PIMS), Islamabad from 11th Jan 2012 to 11th Jan 2013. All symptomatic patients who underwent coronary angiogram at PIMS and were found to have either isolated LMCA disease or coexisting osteal Left Anterior Descending (LAD) artery disease were potentially eligible for the study. Patients who had previous surgical treatment for coronary artery disease and those with renal dysfunction requiring dialysis were excluded. Patients were counselled in detail regarding the pros and cons of PCI versus CABG.Those who opted for PCI were included in the study. All these patients were treated with percutaneous left main coronary artery stenting with or without osteal LAD stenting. Results: Seventy two patients had LMCA disease during angiogram. Fifteen patients opted for CABG. Four patients did not meet the inclusion criteria, whereas 53 patients were finally enrolled. Mean age of patients were 55.45±10.275 years. Twenty nine patients were with acute coronary syndrome and 22 presented with unstable angina.PCI with stenting was technically successful in all patients. One patient died three months after PCI, there was no other mortality. Conclusion: Our study showed that Percutaneous Coronary Intervention (PCI) to LMS has good technical success rate; the safety of the procedure is also acceptable. PMID:25097507

Ali, Liaqat; Malik, Shahid Nawaz; Khalid, Abdullah Bin; Sultan, Mehboob; Sadiq, Nadeem

2014-01-01

16

Transradial access for primary percutaneous coronary intervention: the next standard of care?  

Microsoft Academic Search

ObjectivePrimary percutaneous coronary intervention (PPCI) has been acknowledged by the most recent European guidelines to be the preferred treatment for ST elevation myocardial infarction (STEMI). Patients undergoing PPCI are expected to receive a broad spectrum of anticoagulants and antiplatelet agents, which increases the risk of bleedings, in most cases, at the site of vascular access. The burden of bleeding complications

Giovanni Amoroso; Ferdinand Kiemeneij

2010-01-01

17

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

18

Feasibility of the Radial Artery as a Vascular Access Route in Performing Primary Percutaneous Coronary Intervention  

PubMed Central

We aimed to evaluate the feasibility of transradial primary percutaneous coronary intervention (PCI) in patients with ST elevation myocardial infarction (STEMI) by comparing the procedural results and complications with those of transfemoral intervention. From April 1997 to October 2004, we enrolled 352 consecutive cases of STEMI who underwent primary PCI. The femoral route was used in 132 cases (TFI group) and the radial route was used in 220 cases (TRI group). Cases with Killips class IV, a negative Allen test or a non-palpable radial artery were excluded from our study. Baseline clinical and angiographic profiles were comparable in both groups. Vascular access time was 3.8 ± 3.5 min in the TFI group and 3.6 ± 3.1 min in the TRI group, and cath room to reperfusion time was 25 ± 11 min in the TRI group and 26 ± 13 min in the TRI group. The procedural success rate was 89% in the TFI group and 88% in the TRI group. Crossover occurred in 9 cases (4%) due to approaching vessel tortuosity in the TRI group. Major access site complications occurred in 7 cases (5%) in the TFI group, and there were no complications in the TRI group (p < 0.001). Although radial occlusion occurred in 5 cases of the TRI group, there was no evidence of hand ischemia. The total hospital stay was significantly shorter in TRI group than in TFI group. In conclusion, use of the radial artery might be a potential vascular access route in performing primary PCI in selected cases. PMID:16127775

Kim, Jang-Young; Jung, Hyun-Sook; Ko, Ji-Yeon; Yoo, Byung-Su; Hwang, Sung-Oh; Lee, Seung-Hwan; Choe, Kyung-Hoon

2005-01-01

19

In-hospital outcomes after primary percutaneous coronary intervention according to left ventricular ejection fraction  

PubMed Central

BACKGROUND The primary objective of primary percutaneous coronary intervention (pPCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) is not only to restore the blood flow in the infarct-related artery, but also to save the patients’ quality and duration of their life. Since left ventricular ejection fraction (LVEF) is a known predictor of clinical outcomes in STEMI patients, the possible association between characteristics of a large group of patients who undergo pPCI with LVEF and death was evaluated. METHODS This prospective cohort study included 304 patients who had undergone pPCI between 2009 and 2011. The association between LVEF and in-hospital outcomes of patients was assessed. RESULTS LVEF ? 25%, 25% < LVEF < 50%, and LVEF ? 50% were presented in 23 (7.6%), 150 (49.3%), and 128 (42.1%) of the patients, respectively. Three patients (0.01%) died before echocardiography. There was no significant difference among aforementioned three groups regarding baseline characteristics, except age (P = 0.012) and sex (P = 0.016). Cumulative number of cardiogenic shock and death were 7 (2.3%) and 22 (7.2%), respectively; with significant differences between three LVEF groups. Age more than 70 years old, pulmonary edema, systolic blood pressure < 100 mm Hg, shock, post-PCI thrombolysis in myocardial infarction (MI) flow grade, corrected thrombolysis in MI frame count, angiographic success and ST-segment resolution showed significant association with death (P < 0.050). CONCLUSION This study not only demonstrates that LVEF ? 50% is associated with a higher incidence of in-hospital adverse events, but also identifies characteristics that are strongly correlated with the risk of LVEF ? 50% and death after pPCI.

Vakili, Hossein; Sadeghi, Roxana; Rezapoor, Parisa; Gachkar, Latif

2014-01-01

20

Postconditioning during primary percutaneous coronary intervention: A review and meta-analysis  

Microsoft Academic Search

BackgroundMyocardial postconditioning (POC), defined as intermittent interruptions of blood flow at the onset of reperfusion after sustained ischemia, may attenuate reperfusion injury. In order to weigh the current evidence linking POC to reduction of myocardial infarct size in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI), we performed a systematic review and meta-analysis of the

Peter Riis Hansen; Helene Thibault; Jawdat Abdulla

2010-01-01

21

Primary treatment of chondroblastoma with percutaneous radio-frequency heat ablation: report of three cases.  

PubMed

Chondroblastomas are benign cartilaginous lesions; however, intervention is necessary to stop progression and alleviate pain. The authors evaluated three patients in whom minimally invasive percutaneous radio-frequency heat ablation was used to treat pathologically proven chondroblastoma to determine whether this treatment demonstrated long-term success. The authors found that this approach may be an effective alternative to surgical intervention in some cases. PMID:11687691

Erickson, J K; Rosenthal, D I; Zaleske, D J; Gebhardt, M C; Cates, J M

2001-11-01

22

Real-time Image Fusion for Successful Percutaneous Radiofrequency Ablation of Hepatocellular Carcinoma.  

PubMed

Percutaneous radiofrequency ablation (RFA) is an established nonsurgical curative treatment for hepatocellular carcinoma (HCC). Because of its efficiency and safety, sonography is the most commonly used imaging modality when performing RFA. However, the presence of HCC nodules that are inconspicuous when using conventional sonography is a major drawback of RFA and limits its feasibility as a treatment for HCC. However, a new technology has been developed that synthesizes high-resolution multiplanar reconstruction images using 3-dimensional data and is combined with a position-tracking system using magnetic navigation. With this technology, real-time sonograms can be fused with corresponding computed tomographic, magnetic resonance imaging, or even sonographic volume data; this process is known as real-time image fusion. In this article, we describe this novel imaging method as a useful tool for successful RFA treatment of HCC. PMID:25336489

Toshikuni, Nobuyuki; Tsutsumi, Mikihiro; Takuma, Yoshitaka; Arisawa, Tomiyasu

2014-11-01

23

Dissection and re-entry techniques and longer-term outcomes following successful percutaneous coronary intervention of chronic total occlusion.  

PubMed

New techniques involving dissection of the subintimal space and re-entry into the true lumen increase success rates in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). However, their long-term safety and efficacy were unknown. This study included a series of consecutive patients who underwent CTO PCI. All patients who did not present events were contacted 12 to 18 months after their PCI. The combined incidence of cardiac death, myocardial infarction, ischemia-driven target-vessel revascularization (TVR), or reocclusion was assessed as our primary outcome. From January 2010 to January 2013, of 212 CTOs treated in our CTO program, 192 (91%) were successfully opened (in 179 patients). Follow-up data were available for 187 CTOs (97.4%), with 82 (44%) that were opened with dissection re-entry and 105 (56%) with conventional wire escalation techniques. At a median follow-up of 398 days, the primary outcome occurred in 18 of 179 CTOs treated (10.7%), driven by TVR. No patient died from cardiac causes. Eleven CTOs (15.2%) treated with dissection re-entry versus 7 CTOs (7.3%) treated with wire escalation presented with the primary outcome (p = 0.17). With multivariate adjustment, dissection re-entry techniques had no significant impact on outcomes. However, treatment of an in-stent occlusion was independently associated with TVR (hazards ratio >6.0, p <0.001). In conclusion, dissection re-entry techniques have minimal impact on long-term outcomes after CTO PCI, which are favorable in most patients. However, treatment of an in-stent occlusion and use of sirolimus-eluting stent were predictors of subsequent adverse outcomes. PMID:25242364

Rinfret, Stéphane; Ribeiro, Henrique Barbosa; Nguyen, Can Manh; Nombela-Franco, Luis; Ureña, Marina; Rodés-Cabau, Josep

2014-11-01

24

Effect of Radial-to-Femoral Access Crossover on Adverse Outcomes in Primary Percutaneous Coronary Intervention.  

PubMed

We aimed to describe the impact of the vascular access used when patients are treated with primary percutaneous coronary intervention (PPCI) and to assess whether this translates into differences in angiographic outcomes. Patients with ST-elevation myocardial infarction who underwent PPCI were divided into 3 groups: successful radial access (RA), successful femoral access (FA), and Crossover (failed RA with need for bailout FA) groups. Vascular access-related time (VART) was defined as the delay in PPCI that can be attributed to vascular access-related issues. Study end point was the final corrected Thrombolysis In Myocardial Infarction frame count. Multivariable analysis was used to identify predictors of RA failure (RAF: FA + Crossover). We included 241 patients (RA, n = 172; FA, n = 49; Crossover, n = 20). Mean VART was longer in Crossover (10.3 [8.8 to 12.4] minutes), relative to RA (4.1 [3.2 to 5.5] minutes) and FA (4.6 [3.4 to 8.4] minutes, p <0.001). A similar situation was found for time-to-first device (Crossover 22.5 [20.3 to 32.0], RA 15.0 [12.0 to 19.8]; FA 17.9 [13.5 to 22.3] minutes, p <0.001) and total procedure time (Crossover 60.3 [51.6 to 71.5], RA 46.8 [38.1 to 59.7], FA 52.3 [41.9 to 74.7] minutes, p <0.001). No differences in corrected Thrombolysis In Myocardial Infarction frame count were observed (Crossover 26 [18 to 32] frames, RA 24 [18 to 32] frames, FA 25 [16 to 34] frames, p = 0.625). Killip class IV (odds ratio [OR] 3.628, 95% confidence interval [CI] 1.098 to 11.981, p = 0.035), cardiopulmonary resuscitation before arrival (OR 3.572, 95% CI 1.028 to 12.407, p = 0.045), and glomerular filtration rate (OR 0.861, 95% CI 0.758 to 0.978, p = 0.021) were independent predictors of RA failure. In conclusion, in the setting of PPCI, radial-to-FA crossover can lead to VART delays that do not affect angiographic outcomes, in comparison with successful RA. PMID:25260813

Azzalini, Lorenzo; Khan, Razi; Al-Hawwas, Malek; Hatem, Raja; Fortier, Annik; L'Allier, Philippe L; Ly, Hung Q

2014-10-15

25

Diabetes Mellitus and Glucose as Predictors of Mortality in Primary Coronary Percutaneous Intervention  

PubMed Central

Background Diabetes mellitus and admission blood glucose are important risk factors for mortality in ST segment elevation myocardial infarction patients, but their relative and individual role remains on debate. Objective To analyze the influence of diabetes mellitus and admission blood glucose on the mortality of ST segment elevation myocardial infarction patients submitted to primary coronary percutaneous intervention. Methods Prospective cohort study including every ST segment elevation myocardial infarction patient submitted to primary coronary percutaneous intervention in a tertiary cardiology center from December 2010 to May 2012. We collected clinical, angiographic and laboratory data during hospital stay, and performed a clinical follow-up 30 days after the ST segment elevation myocardial infarction. We adjusted the multivariate analysis of the studied risk factors using the variables from the GRACE score. Results Among the 740 patients included, reported diabetes mellitus prevalence was 18%. On the univariate analysis, both diabetes mellitus and admission blood glucose were predictors of death in 30 days. However, after adjusting for potential confounders in the multivariate analysis, the diabetes mellitus relative risk was no longer significant (relative risk: 2.41, 95% confidence interval: 0.76 - 7.59; p-value: 0.13), whereas admission blood glucose remained and independent predictor of death in 30 days (relative risk: 1.05, 95% confidence interval: 1.02 - 1.09; p-value ? 0.01). Conclusion In ST segment elevation myocardial infarction patients submitted to primary coronary percutaneous intervention, the admission blood glucose was a more accurate and robust independent predictor of death than the previous diagnosis of diabetes. This reinforces the important role of inflammation on the outcomes of this group of patients. PMID:25352506

David, Renato Budzyn; Almeida, Eduardo Dytz; Cruz, Larissa Vargas; Sebben, Juliana Canedo; Feijo, Ivan Petry; Schmidt, Karine Elisa Schwarzer; Avena, Luisa Martins; Gottschall, Carlos Antonio Mascia; de Quadros, Alexandre Schaan

2014-01-01

26

Cytological Sampling Versus Forceps Biopsy During Percutaneous Transhepatic Biliary Drainage and Analysis of Factors Predicting Success  

SciTech Connect

Purpose: To assess the accuracy of cytological sampling and forceps biopsy in obstructing biliary lesions and to identify factors predictive of success. Methods: Consecutive patients (n = 119) with suspected malignant inoperable obstructive jaundice treated with percutaneous transhepatic biliary drainage during 7 years were included (60 male; mean age 72.5 years). All patients underwent forceps biopsy plus cytological sampling by washing the forceps device in cytological solution. Patient history, procedural and pathological records, and clinical follow-up were reviewed. Statistical analysis included chi-square test and multivariate regression analysis. Results: Histological diagnosis after forceps biopsy was more successful than cytology: Sensitivity was 78 versus 61%, and negative predictive value was 30 versus 19%. Cytology results were never positive when the forceps biopsy was negative. The cytological sample was negative and forceps sample positive in 2 cases of cholangiocarcinoma, 16 cases of pancreatic carcinoma, and 1 case of benign disease. Diagnostic accuracy was predicted by low bilirubin (p < 0.001), aspartate transaminase (p < 0.05), and white cell count (p {<=} 0.05). Conclusions: This technique is safe and effective and is recommended for histological diagnosis during PTBD in patients with inoperable malignant biliary strictures. Diagnostic yield is greater when bilirubin levels are low and there is no sepsis; histological diagnosis by way of forceps biopsy renders cytological sampling unnecessary.

Tapping, C. R.; Byass, O. R.; Cast, J. E. I., E-mail: james.cast@hey.nhs.uk [Hull Royal Infirmary, Department of Radiology (United Kingdom)

2012-08-15

27

Spontaneous Hemoperitoneum due to Rupture of Uterine Varicose Veins during Labor Successfully Treated by Percutaneous Embolization.  

PubMed

Hemoperitoneum during pregnancy is a rare but potentially lethal clinical condition. Improvements in antenatal and intrapartum care, especially in surgical and anesthetic techniques, have reduced maternal mortality; perinatal mortality remains very high (31%). Treatment is based on the systemic correction of hypovolemia and immediate surgery via laparotomy or laparoscopy in cases in the first trimester of pregnancy for hemostatic purposes. Sometimes, hysterectomy is needed. A 35-year-old Asiatic primigravid woman at 37 weeks' gestation with otherwise uneventful pregnancy came to the hospital referring abrupt-onset lumbar and abdominal pain. A bleeding uterine superficial varicocele of about 7?cm was found on the left uterine horn during Caesarean section. Interventional radiologic embolization of both uterine arteries was successfully performed. Posterior evolution of the patient was favorable. Percutaneous vascular embolization of the uterine arteries is an effective alternative treatment for many obstetrical and gynecological causes of bleeding. The main advantage of this technique is the low rate of serious complications and the preservation of reproductive function. To our knowledge, this is the first case of spontaneous intrapartum hemoperitoneum treated with this technique. An early diagnosis and a rapid indication of this therapeutic option are essential. Hemodynamic stability is needed to decide this conservative management. PMID:25114819

Díaz-Murillo, Rebeca; Tobías-González, Pablo; López-Magallón, Sara; Magdaleno-Dans, Fernando; Bartha, José L

2014-01-01

28

Effects of Glycoprotein IIb\\/IIIa Receptor Inhibition with Tirofiban on Minor Myocardial Damage in Angiographically Successful Percutaneous Coronary Angioplasty  

Microsoft Academic Search

Aim: The aim of the study was to evaluate the effects of glycoprotein (GP) IIb\\/IIIa inhibition on minor myocardial injury characterized by cardiac troponin I (cTn-I) and cardiac troponin T (cTn-T) elevation after elective successful percutaneous coronary intervention (PCI). Methods: The study consisted of 119 consecutive patients scheduled for elective coronary balloon angioplasty with or without stent implantation. Sixty-three patients

Ertan Okmen; Arda Sanli; Huseyin Uyarel; Sennur Dayi; Zeynep Tartan; Nese Cam

2004-01-01

29

Cardiac arrest during percutaneous coronary intervention in a patient 'resistant' to clopidogrel - successful 50-minute mechanical chest compression  

PubMed Central

We report a case of 72-year-old female patient with end-stage chronic kidney disease, undergoing percutaneous coronary intervention (PCI) that resulted in a cardiac arrest caused by a thrombus mediated flow limitation in the left coronary artery. With mechanical cardiopulmonary resuscitation (CPR) PCI of the left main artery was performed successfully during 50 min cardiac arrest. The patient was discharged from the hospital without compromising cardiac function and neurological deficits. PMID:24570760

Szymkiewicz, Pawel; Sciborski, Krzysztof; Orda, Alina; Karolko, Bozena; Jonkisz, Anna; Lebioda, Arleta; Mysiak, Andrzej

2013-01-01

30

Pseudoaneurysm After Spontaneous Rupture of Renal Angiomyolipoma in Tuberous Sclerosis: Successful Treatment with Percutaneous Thrombin Injection  

SciTech Connect

We report a case of a large perinephric pseudoaneurysm due to spontaneous rupture of renal angiomyolipoma, occluded by percutaneous thrombin injection under ultrasound guidance in a young woman affected by tuberous sclerosis.

Corso, Rocco, E-mail: roccocorso@jumpy.it; Carrafiello, Gianpaolo; Rampoldi, Antonio [Niguarda 'Ca Granda' Hospital, Department of Diagnostic and Interventional Radiology (Italy); Leni, Davide [University of Milan, Institute of Radiology (Italy); Ticca, Cristiana [Niguarda 'Ca Granda' Hospital, Department of Diagnostic and Interventional Radiology (Italy); Vercelli, Ruggero [University of Milan, Institute of Radiology (Italy); Vanzulli, Angelo [Niguarda 'Ca Granda' Hospital, Department of Diagnostic and Interventional Radiology (Italy)

2005-04-15

31

Successful disintegration, dissolution and drainage of intracholedochal hematoma by percutaneous transhepatic intervention  

PubMed Central

Hemobilia is a rare biliary complication of liver transplantation. The predominant cause of hemobilia is iatrogenic, and it is often associated with traumatic operations, such as percutaneous liver intervention, endoscopic retrograde cholangiopancreatography, cholecystectomy, biliary tract surgery, and liver transplantation. Percutaneous transhepatic cholangiography and liver biopsy are two major causes of hemobilia in liver transplant recipients. Hemobilia may also be caused by coagulation defects. It can form intracholedochal hematomas, causing obstructive jaundice. Herein we describe a patient with an intracholedochal hematoma resulting in significant obstructive jaundice after liver transplantation for fulminant hepatic failure. Previous studies have shown that percutaneous transhepatic manipulation is a major cause of hemobilia after liver transplantation, but in our case, percutaneous transhepatic intervention was used to relieve the biliary obstruction and dissolve the biliary clot, with a good outcome. PMID:23323019

Qin, Jian-Jie; Xia, Yong-Xiang; Lv, Ling; Wang, Zhao-Jing; Zhang, Feng; Wang, Xue-Hao; Sun, Bei-Cheng

2012-01-01

32

Risk stratification for ST segment elevation myocardial infarction in the era of primary percutaneous coronary intervention.  

PubMed

Acute coronary syndromes presenting with ST elevation are usually treated with emergency reperfusion/revascularisation therapy. In contrast current evidence and national guidelines recommend risk stratification for non ST segment elevation myocardial infarction (NSTEMI) with the decision on revascularisation dependent on perceived clinical risk. Risk stratification for STEMI has no recommendation. Statistical risk scoring techniques in NSTEMI have been demonstrated to improve outcomes however their uptake has been poor perhaps due to questions over their discrimination and concern for application to individuals who may not have been adequately represented in clinical trials. STEMI is perceived to carry sufficient risk to warrant emergency coronary intervention [by primary percutaneous coronary intervention (PPCI)] even if this results in a delay to reperfusion with immediate thrombolysis. Immediate thrombolysis may be as effective in patients presenting early, or at low risk, but physicians are poor at assessing clinical and procedural risks and currently are not required to consider this. Inadequate data on risk stratification in STEMI inhibits the option of immediate fibrinolysis, which may be cost-effective. Currently the mode of reperfusion for STEMI defaults to emergency angiography and percutaneous coronary intervention ignoring alternative strategies. This review article examines the current risk scores and evidence base for risk stratification for STEMI patients. The requirements for an ideal STEMI risk score are discussed. PMID:25228966

Brogan, Richard A; Malkin, Christopher J; Batin, Phillip D; Simms, Alexander D; McLenachan, James M; Gale, Christopher P

2014-08-26

33

Risk stratification for ST segment elevation myocardial infarction in the era of primary percutaneous coronary intervention  

PubMed Central

Acute coronary syndromes presenting with ST elevation are usually treated with emergency reperfusion/revascularisation therapy. In contrast current evidence and national guidelines recommend risk stratification for non ST segment elevation myocardial infarction (NSTEMI) with the decision on revascularisation dependent on perceived clinical risk. Risk stratification for STEMI has no recommendation. Statistical risk scoring techniques in NSTEMI have been demonstrated to improve outcomes however their uptake has been poor perhaps due to questions over their discrimination and concern for application to individuals who may not have been adequately represented in clinical trials. STEMI is perceived to carry sufficient risk to warrant emergency coronary intervention [by primary percutaneous coronary intervention (PPCI)] even if this results in a delay to reperfusion with immediate thrombolysis. Immediate thrombolysis may be as effective in patients presenting early, or at low risk, but physicians are poor at assessing clinical and procedural risks and currently are not required to consider this. Inadequate data on risk stratification in STEMI inhibits the option of immediate fibrinolysis, which may be cost-effective. Currently the mode of reperfusion for STEMI defaults to emergency angiography and percutaneous coronary intervention ignoring alternative strategies. This review article examines the current risk scores and evidence base for risk stratification for STEMI patients. The requirements for an ideal STEMI risk score are discussed. PMID:25228966

Brogan, Richard A; Malkin, Christopher J; Batin, Phillip D; Simms, Alexander D; McLenachan, James M; Gale, Christopher P

2014-01-01

34

Percutaneous Drainage of Pyogenic Liver Abscesses  

Microsoft Academic Search

This report summarizes the results of percutaneous catheter drainage in 23 cases of primary or secondary pyogenic liver abscess. The overall success rate was 76%. Only three (60%) of five cases of secondary abscess (infected hematoma or infected tumor) were cured with catheter drainage, but 11 (91%) of the last 12 primary pyogenic abscesses were drained successfully. Six patients with

Randall D. Johnson; Peter A. Mueller; Steven L. Dawson; Rodney J. Butch; Joseph F. Sirneone; Jack Wittenberg

35

Successful early percutaneous closure of acute ventricular septal rupture complicating acute myocardial infarction with Amplatzer ventricular septal occluder.  

PubMed

Acute ventricular septal rupture - ventricular septal defect (VSD) following acute myocardial infarction remains a critical condition. We present an 80 year-old patient with an acute VSD following an acute inferior myocardial infarction. Percutaneous VSD closure with an Amplatzer ventricular septal occluder (AVSO) was performed successfully, two days after initial admission. In-hospital follow-up was uneventful. We speculate that percutaneous VSD closure with an AVSO can be an alternative to surgical correction for these patients. Despite the impressive result, this innovative approach needs further investigation and refinements before it can be recommended as the treatment of choice for acute ischemic VSD. (Cardiol J 2007; 14: 411-414). PMID:18651494

Waci?ski, Piotr; Bilodeau, Luc; Ibrahim, Reda

2007-01-01

36

Association between Peak Neutrophil Count, Clopidogrel Loading Dose, and Left Ventricular Systolic Function in Patients with Primary Percutaneous Coronary Intervention  

PubMed Central

Inflammation plays an important role in plaque development and left ventricular remodeling during acute myocardial infarction (AMI). Clopidogrel may exhibit some anti-inflammatory properties and high loading dose of clopidogrel results in improved clinical outcomes in patients with AMI. 357 patients who received successful primary percutaneous coronary intervention from January 2008 to March 2011 in Peking University Third Hospital were included in this study. Different loading dose of clopidogrel (300?mg, 450?mg, or 600?mg) was given at the discretion of the clinician. Neutrophils reached their peak values on the first day after AMI. Higher levels of peak neutrophil and lower left ventricular ejection fraction (LVEF) were found in patients of low clopidogrel loading dose group (300?mg or 450?mg). After adjusting for the related confounders, a logistic regression model showed that low clopidogrel loading dose remained an independent predictor of low LVEF (LVEF ? 50%) [OR: 1.97, 95% CI: 1.03–3.79, P = 0.04]. Low clopidogrel loading dose was associated with higher peak neutrophil count and poor left ventricular systolic function, suggesting an important role of clopidogrel loading dose in the improvement of left ventricular function and high loading dose may exhibit better anti-inflammatory properties. PMID:25147436

Wang, Xinyu; Yu, Haiyi; Li, Zhaoping; Li, Liuning; Zhang, Youyi; Gao, Wei

2014-01-01

37

Factors responsible for successful primary closure in bladder exstrophy  

Microsoft Academic Search

To assess the important factors for successful primary closure in staged reconstruction of bladder exstrophy, 25 patients\\u000a (18 males, 7 females) underwent primary bladder closure during the years 1993–1997. Twenty-one were more than 72?h old; all\\u000a of these underwent bilateral posterior iliac osteotomies followed by primary bladder closure during the same anesthetic. Bladder\\u000a closure was done in a double layer.

Laxmikant S. Kasat; S. S. Borwankar

2000-01-01

38

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

39

Early discharge after primary percutaneous coronary intervention for ST-elevation myocardial infarction  

PubMed Central

Background: To assess safety of early discharge following primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI). Methods and results: Retrospective analysis of prospectively collected data of 2448 STEMI patients treated with PPCI surviving to hospital discharge. Post-discharge all-cause mortality was reported at 1, 7, and 30 days and long-term follow up. A total of 1542 patients (63.0%) were discharged within 2 days of admission (early discharge group) and 906 patients (37.0%) after 2 days (late discharge group). In both groups, no deaths were recorded 1 day post discharge. The early and late discharge group mortality figures for 7 days were 0 and 4 patients (0.04%) and between 7 and 30 days were 11 (0.7%) and 11 patients (1.2%), respectively. During a mean follow up of 584 days, 178 patients (7.3%) died: 67 in the early discharge group (4.3%) and 111 in the late discharge group (12.3%). Conclusions: This exploratory, observational study demonstrates that discharging low-risk STEMI patients within 2 days following PPCI is safe. For providers of health care, early discharge can help to allay the cost of providing a 24-hour PPCI service and adds to the recognized benefits arising from PPCI. PMID:24222838

Noman, Awsan; Schechter, Clyde; Balasubramaniam, Karthik; Das, Rajiv

2013-01-01

40

Gender comparisons in cardiogenic shock during ST elevation myocardial infarction treated by primary percutaneous coronary intervention.  

PubMed

Among patients hospitalized with acute myocardial infarction (AMI), cardiogenic shock (CS) is the leading cause of death, complicating up to 10% of admissions. Introduction of early revascularization strategies and mechanical ventricular support have seen short-term mortality associated with CS fall from 70% to 80% in the 1970s to approximately 50% to 60% in the 1990s. Previous studies reported a higher incidence of CS after AMI in women (11.6% vs 8.3%). The aims of this study were to determine hospital mortality outcomes and gender differences following primary percutaneous coronary intervention (PPCI) in the setting of CS. Data were collected prospectively among all patients undergoing PPCI for AMI at a large UK tertiary cardiac center between April 2008 and October 2011. A sample of 2,864 patients (women: 844 [29.5%]) underwent PPCI, of which 141 (4.9%) had a confirmed diagnosis of CS. Eighty-one of 2,019 [4.0%] male patients (mean age: 64.2 years) and 60 of 844 [7.1%]) female patients (mean age: 69.9 years) with CS underwent PPCI (p <0.001). The overall hospital mortality was 35.5% with no gender difference (male: 35.8% vs female: 35%, p >0.99). In conclusion, this analysis demonstrates that in the contemporary PPCI era, there is a reduction in the incidence of CS with reduced hospital mortality rates and no gender difference. The absence of a gender difference is remarkable because higher proportions of women presented with CS and were older than their male counterparts. Long-term follow-up data are required to determine if this difference is sustained. PMID:23711807

Kunadian, Vijay; Qiu, Weiliang; Bawamia, Bilal; Veerasamy, Murugu; Jamieson, Sheila; Zaman, Azfar

2013-09-01

41

Inadvertent left aorto-coronary dissection following percutaneous coronary intervention treated successfully by bail-out left main coronary artery stenting  

PubMed Central

Left main coronary artery (LMCA) dissection occurs very rarely following percutaneous coronary intervention (PCI). It caused major consequences with no flow in coronary artery and requires immediate surgical or percutaneous intervention. We are reporting a case of 42-year-male patient who presented with effort angina. Coronary angiogram revealed significant stenosis in left anterior descending (LAD) and left circumflex (LCX) coronary artery. During removal of angioplasty balloon and guide wire after successfully stenting in LAD and balloon angioplasty in LCX, guiding catheter induced dissection of LMCA was happened. Subsequently, LMCA was stented; kissing balloon dilatation was done at carina & TIMI III flow re-established. PMID:24027361

Badnur, Srinivas C.; Nagesh, Chamrajnagar Mahadevappa; Patra, Soumya; Reddy, Babu; Manjunath, Cholenahally Nanjappa

2013-01-01

42

Successful Percutaneous Coil Embolization of a Ruptured Internal Iliac Artery Aneurysm Remnant after Abdominal Aortic Aneurysm Repair via the Deep Iliac Circumflex Artery  

PubMed Central

Here, we describe a case of an 83-year-old man treated with percutaneous IIA coil embolization for an enlarging remnant IIA aneurysm. CT scans revealed a contained rupture and persistent flow in the right IIA with the enlargement. We selected percutaneous embolization via the deep iliac circumflex artery, that was communicating with the superior gluteal artery and the IIA. Coil embolization of the arteries supplying the IIA aneurysm was successfully performed with 12 embolization coils placed in the IIA and its branches. The absence of blood flow and shrinkage of the aneurysm were confirmed by CT three months after embolization. PMID:24719671

2014-01-01

43

Paclitaxel-eluting versus uncoated stents in primary percutaneous coronary intervention  

Microsoft Academic Search

BACKGROUND: Drug-eluting coronary-artery stents have been shown to decrease restenosis and therefore the likelihood that additional procedures will be required after percutaneous coronary intervention (PCI). We evaluated the use of a drug-eluting stent in patients undergoing PCI for acute myocardial infarction with ST-segment elevation. METHODS: We randomly assigned 619 patients presenting with an acute myocardial infarction with ST-segment elevation to

Gerrit J. Laarman; Maarten J. Suttorp; Maurits T. Dirksen; Loek van Heerebeek; Ferdinand Kiemeneij; Ton Slagboom; L. Ron van der Wieken; Jan G. P. Tijssen; Benno J. Rensing; Mark Patterson

2006-01-01

44

Successful percutaneous treatment for massive hemorrhage due to infectious pseudoaneurysm in the abdominal wall after percutaneous endoscopic gastrostomy: a case report  

PubMed Central

Background Percutaneous endoscopic gastrostomy (PEG) is often performed for alimentation and to prevent weight loss in patients with feeding problems due to central neurologic diseases such as cerebral infarction or intracranial hemorrhage. Although infection at the skin site after PEG placement is a typical late complication of PEG, a ruptured infectious pseudoaneurysm caused massive bleeding adjacent to the tract is rare. Prompt treatment is required to avoid the hemorrhage shock, however surgical ligation is difficult to obtain the arrest of bleeding in damaged skin due to the infection. Case presentation A 70-year-old male was bedridden due a cerebral infarction suffered 1 year previously. APEG was placed because of feeding problems, and a push-type, 20-Fr gastrostomy tube was inserted through the anterior abdominal wall. On day 16 after PEG placement, the patient had massive bleeding from the PEG site due to the rupture of infectious pseudoaneurysm and developed a decreased level of consciousness and hypotension. Treatment by percutaneous direct injection of a mixture of n-butyl-cyanoacrylate (NBCA)-lipiodol was performed and achieved good hemostasis is obtained. Conclusions A rare case of an infectious pseudoaneurysm that developed in the abdominal wall and caused massive bleeding at a PEG placement site was described. Percutaneous injection of a mixture of n-butyl-cyanoacrylate (NBCA)-lipiodol under ultrasound guidance is an effective treatment in this case. PMID:24915936

2014-01-01

45

Study of the possible medical and medication explanatory factors of angiographic outcomes in patients with acute ST elevation myocardial infarction undergoing primary percutaneous intervention  

PubMed Central

Background: Myocardial blush grade (MBG), thrombolysis in myocardial infarction (TIMI) and corrected TIMI frame count (cTFC) are indices of successful angiographic reperfusion. This study sought to determine the predictors of angiographically successful reperfusion including demographic, clinical and angiographic factors in patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). Materials and Methods: A cross-sectional study of patients with a confirmed diagnosis of STEMI undergoing pPCI was designed. Eligible patients referring to a university heart center were enrolled in the study from March 2012 to December 2012. Successful epicardial reperfusion was defned as TIMI flow grade 3 or cTFC<= 28 frames and successful myocardial reperfusion as MBG 2 or 3. Results: The study population consisted of 100 patients, including 74 males and 26 females, with mean ± standard deviation age of 58.27 ± 11.60 years. Achieving open microvasculature (MBG 2/3) was positively associated with a history of nitrate intake (P = 0.03) and history of calcium channel blocker (CCB) intake (P = 0.005). Hyperglycemia was inversely associated with achieving a final cTFC ? 28 frames (r = ?0.32, P = 0.001). Conclusions: Our findings suggest that patients with a history of nitrate and CCB intake had a higher likelihood of successful PCI. In addition, patients with a higher blood glucose level on admission may have a reduced rate of reperfusion success. Future studies with a larger sample size are recommended to investigate the significant relationships observed in this study. PMID:25250300

Eshraghi, Azadeh; Talasaz, Azita Hajhossein; Salamzadeh, Jamshid; Bahremand, Mostafa; Salarifar, Mojtaba; Nozari, Yones; Jenab, Yaser; Boroumand, Mohammad Ali; Vaseghi, Golnaz; Eshraghi, Nazanin

2014-01-01

46

Integrating primary care with occupational health services: a success story.  

PubMed

This article describes the process used by a large U.S. manufacturing company to successfully integrate full-service primary care centers at two locations. The company believed that by providing employees with health promotion and disease prevention services, including screening, early diagnosis, and uncomplicated illness treatment, its health care costs could be significantly reduced while saving employees money. To accurately demonstrate the cost-effectiveness of adding primary care to existing occupational health services, a thorough financial analysis projected the return on investment (ROI) of the program. Decisions were made about center size, the scope of services, and staffing. A critical part of the ROI analysis involved evaluating employee health claim data to identify the actual cost of health care services for each center and the projected costs if the services were provided on-site. The pilot initiative included constructing two on-site health center facilities staffed with primary care physicians, nurse practitioners, physical therapists, and other health care professionals. Key outcome metrics from the pilot clinics exceeded goals in three of four categories. In addition, clinic use after 12 months far exceeded benchmarks for similar clinics. Most importantly, the pilot clinics were operating with a positive cash flow within the first year and demonstrated an increasingly positive ROI. PMID:21188796

Griffith, Karen; Strasser, Patricia B

2010-12-01

47

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. PMID:19273477

Marcante, Silvia; Winkler, Eckart; Erschbamer, Brigitta

2009-01-01

48

[Percutaneous aortic valve replacement. A multidisciplinary approach. The key to success].  

PubMed

Recently transcatheter aortic valve implantation (TAVI) has been offered to selected patients and results have been good. In Europe, for example, TAVI is an established, evidence-based, alternative to open aortic valve replacement for patients with aortic stenosis in whom conventional cardiac surgery would pose a high risk. Studies in the United States demonstrated that, in patients with severe aortic stenosis who are not candidates for surgery, TAVI using the Edwards SAPIEN valve resulted in significantly lower mortality than standard treatment. However, TAVI was associated with a nonsignificantly higher incidence of stroke and major vascular complications compared to standard aortic valve replacement. Moreover, when strokes and transient ischemic attacks were considered together, there was a significant benefit in favor of surgery at both 30 days and 1 year (P=.04). Clearly, optimal patient selection is critical for the success of TAVI. In addition, it has been shown that the adoption of a multidisciplinary approach improves outcomes in complex procedures like these. To ensure successful outcomes with TAVI, a multidisciplinary heart valve team must collaborate at all stages of the program: during screening, during and after the procedure, and throughout follow-up. In particular, patients should be screened for inclusion in a TAVI program by a member of the multidisciplinary team, and not by an external individual specialist. Moreover, the selection of candidates for treatment should involve consultation between the different disciplines (i.e. between cardiologists, surgeons, imaging specialists, anesthesiologists, pulmonologist, and other specialists, if necessary). PMID:22921172

Palacios, Igor F

2012-07-01

49

Percutaneous vertebroplasty.  

PubMed

Percutaneous vertebroplasty (PV) is a safe and effective treatment for relieving pain in patients complaining of severe back pain induced by osteoporotic or neoplastic compression fractures. The success rate exceeds 90% and the complication rate is lower than 1%. Most of the complications are transient. The classic indication for PV is severe, persistent, and incapacitating focal back pain not responding to standard medical therapy and related to one or more collapsed vertebral bodies of 4 to 12 weeks duration. PMID:14651089

Mathis, J M

2003-01-01

50

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  

PubMed Central

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 more effective than intravenous bolus administration in improving myocardial perfusion in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention with thrombus aspiration. Methods/Design The Comparison of IntraCoronary versus intravenous abciximab administration during Emergency Reperfusion Of ST-segment elevation myocardial infarction (CICERO) trial is a single-center, prospective, randomized open-label trial with blinded evaluation of endpoints. A total of 530 patients with STEMI undergoing primary percutaneous coronary intervention are randomly assigned to either an intracoronary or intravenous bolus of weight-adjusted abciximab. The primary end point is the incidence of >70% ST-segment elevation resolution. Secondary end points consist of post-procedural residual ST-segment deviation, myocardial blush grade, distal embolization, enzymatic infarct size, in-hospital bleeding, and clinical outcome at 30 days and 1 year. Discussion The CICERO trial is the first clinical trial to date to verify the effect of intracoronary versus intravenous administration of abciximab on myocardial perfusion in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention with thrombus aspiration. Trial registration ClinicalTrials.gov NCT00927615 PMID:19785725

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

2009-01-01

51

45 Should primary percutaneous coronary intervention be the routine reperfusion strategy in octogenarians and non-agenarians presenting with ST elevation myocardial infarction?  

Microsoft Academic Search

IntroductionPrimary percutaneous coronary intervention (PPCI) has been established as standard therapy for ST elevation myocardial infarction (STEMI). Very few trials have looked at the outcome of PPCI in elderly patients. Even in trials which claimed to have looked at PPCI in elderly patients such as SENIOR PAMI (Grines, 2005) and TRIANA (Bueno, 2009) the minimum age for inclusion was 70

R Showkathali; E Boston-Griffiths; J Davies; G Clesham; J Sayer; P Kelly; R Aggarwal

2011-01-01

52

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

53

"Call 911" STEMI protocol to reduce delays in transfer of patients from non primary percutaneous coronary intervention referral Centers.  

PubMed

Primary percutaneous coronary intervention (PPCI) is the preferred method of reperfusion for ST-segment elevation myocardial infarction (STEMI), if it can be performed in a timely manner by an experienced interventional cardiologist at a high volume STEMI Receiving Center. However, an estimated 50% of STEMI patients present to STEMI Referral Centers without PPCI capability. Transfer of STEMI patients for PPCI has been shown to improve outcomes as compared with fibrinolysis given at the presenting hospital. Nonetheless, transfer of STEMI patients for PPCI has not been used extensively in the United States and is associated with markedly prolonged transfer times. This study demonstrates that rapid transfer of STEMI patients from community hospitals without PPCI capability to a STEMI Receiving Center is both safe and feasible using a standardized protocol with an integrated transfer system. PMID:20802263

Baruch, Terrence; Rock, Alisa; Koenig, William J; Rokos, Ivan; French, William J

2010-09-01

54

Primary succession in Mount Pinatubo: Habitat availability and ordination analysis.  

PubMed

Vegetation structure on the east flank of Mount Pinatubo was investigated to determine the inventory of species at 15 y post-eruption, then to ascertain environmental variables that have influenced the early patterns of primary succession. Unconstrained and constrained ordination methods were used to determine the influence of spatial, elevation, and substrate patterns on vegetation. Vegetation was assigned to one of 3 habitat types. Scours were eroded flat surfaces, terraces were perched flat surfaces, and talus piles were created along the canyon edges as mass waste events. The influence of habitat type on vegetation was multifaceted because they represent different conditions and different histories. The talus piles have preferential access to colonists from the vegetation on the canyon walls above and a more benign microclimate than the exposed terrace and scour sites. Scoured sites on the valley floor exhibited the least vegetation cover, as these substrates had the least mature surfaces and the most restricted capacity for root exploration. Perched terraces exhibited greater plant dominance than did the other habitats in the early stages of succession because of the ubiquitous appearance of Parasponia rugosa as initial colonists on these relatively flat surfaces. Polynomial canonical correspondence analysis was more closely aligned with the pattern of vegetation than linear canonical correspondence analysis, and therefore more closely approximated accurate descriptions of correlations among site ordination positions and measured variables. These results confirm that a variety of statistical approaches can clarify applications for restoration ecology following landslide and volcanic disturbances or agriculture and forestry anthropogenic disturbances in the lowland tropics. PMID:24505499

Marler, Thomas E; Del Moral, Roger

2013-11-01

55

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. PMID:20495691

2010-01-01

56

Percutaneous arthrodesis.  

PubMed

It has been generally accepted that residual cartilage and subchondral bone has to be removed in order to get bony fusion in arthrodeses. In 1998 we reported successful fusion of 11 rheumatoid ankles, all treated with percutaneous fixation only. In at least one of these ankle joint there was cartilage left. This was confirmed by arthrotomy in order to remove an osteophyte, which hindered dorsiflexion. More than 25 rheumatoid patients with functional alignment in the ankle joint have subsequently been operated on with the percutaneous technique, and so far we have had only one failure. Patients with rheumatoid arthritis are known to sometimes fuse at least their subtalar joints spontaneously, and the destructive effect of the synovitis on the cartilage could contribute to fusion when using the percutaneous technique. In a rabbit study we therefore tested the hypothesis that even a normal joint can fuse merely by percutaneous fixation. The patella was fixated to the femur with lag screw technique without removal of cartilage, and in 5 of 6 arthrodeses with stable fixation bony fusion followed. Depletion of synovial fluid seemed to be the mechanism behind cartilage disappearance. The stability of the fixation achieved at arthrodesis surgery is an important factor in determining success or failure. Dowel arthrodesis without additional fixation proved to be deleterious. A good fit of the bone surfaces appears necessary. In the ankle joint, it would be technically demanding to retain the arch-shaped geometry of the joint after resection of the cartilage. Normally the joint surfaces are resected to produce flat osteotomy surfaces that are thus easier to fit together, encouraging healing to occur. On the other hand it is considered an advantage to preserve as much subchondral bone as possible, as the strong subchondral bone plate can contribute to the stability of the arthrodesis. Ankle arthrodesis can be successfully performed in patients with rheumatoid arthritis by percutaneous screw fixation without resection of the joint surfaces. This procedure has two advantages: first, it is less surgically traumatic, second, both the arch-shaped geometry and the subchondral bone are preserved, and thus both could contribute to the postoperative stability of the construct. Intuitively, preservation of the arch-shape should increase rotational stability. The results of our experimental sawbone study indicate that the arch shape and the subchondral bone should be preserved when ankle arthrodesis is performed. The importance of this is likely to increase in weak rheumatoid bone. In a finite element study the initial stability provided by two different methods of joint preparation and different screw configurations in ankle arthrodesis, was compared. Better initial stability is predicted for ankle arthrodesis when joint contours are preserved rather than resected. Overall, inserting the two screws at a 30-degree angle with respect to the long axis of the tibia and crossing them above the fusion site improved stability for both joint preparation techniques. The question rose as to whether patients with osteoarthritis could also be operated on solely by percutaneous fixation technique. The first metatarsophalangeal joint in patients with hallux rigidus was chosen as an appropriate joint to test the percutaneous technique. In this small series we have shown that it is possible to achieve bony fusion with a percutaneous technique in an osteoarthrotic joint in humans, but failed to say anything about the fusion rate. PMID:12640890

Lauge-Pedersen, Henrik

2003-02-01

57

Percutaneous bone lesion ablation.  

PubMed

Benign tumors and metastatic bone lesions can be treated by ablation techniques performed either alone or in combination with other percutaneous techniques. Ablation techniques include ethanol or acetic acid injection and thermal ablation by means of energy deposition [including laser, radiofrequency, microwave, cryoablation, radiofrequency ionization and magnetic resonance (MR)-guided high-intensity focused ultrasound (HIFU)]. Goal definition of the therapy is crucial: ablation techniques can be proposed as curative treatments in benign bone tumors or oligometastatic disease (<3 lesions). Alternatively, these techniques can be proposed as palliative treatments aiming at reduction of pain, local control of the disease and tumor decompression. Depending on the lesion's location ablation can be combined with cementation with or without further metallic augmentation; local tumor control can be enhanced by combining ablation with transarterial bland embolization or chemoembolization. Thermal ablation of bone and soft tissues is characterized by high success and relatively low rates of potential complications, mainly iatrogenic thermal damage of surrounding sensitive structures. Successful thermal ablation requires a sufficient ablation volume and thermal protection of the surrounding vulnerable structures. This article will describe the general principles governing ablation and the mechanism of action for each technique and in addition will review the literature about safety and effectiveness of percutaneous imaging-guided ablation for benign and malignant (primary and metastatic) lesions. PMID:24894924

Filippiadis, Dimitrios K; Tutton, Sean; Kelekis, Alexis

2014-07-01

58

Assessment of Myocardial Reperfusion by Intravenous Myocardial Contrast Echocardiography and Coronary Flow Reserve After Primary Percutaneous Transluminal Coronary Angiography in Patients With Acute Myocardial Infarction  

Microsoft Academic Search

Background—This study investigated whether the extent of perfusion defect determined by intravenous myocardial contrast echocardiography (MCE) in patients with acute myocardial infarction (AMI) treated by primary percutaneous transluminal coronary angioplasty (PTCA) relates to coronary flow reserve (CRF) for assessment of myocardial reperfusion and is predictive for left ventricular recovery. Methods and Results—Twenty-five patients with first AMI underwent intravenous MCE with

Wolfgang Lepper; Rainer Hoffmann; Otto Kamp; Andreas Franke; Carel C. de Cock; Harald P. Kuhl; Gertjan T. Sieswerda; Jurgen vom Dahl; Uwe Janssens; Paolo Voci; Cees A. Visser; Peter Hanrath

2010-01-01

59

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

60

Corrected thrombolysis in myocardial infarction frame count and ejection fraction in patients undergoing primary percutaneous coronary intervention for myocardial infarction  

PubMed Central

BACKGROUND This study aimed to assess the associations between corrected thrombolysis in myocardial infarction frame count (CTFC) of the infarct-related artery (IRA) and ejection fraction (EF) after three-six months in patients who underwent primary percutaneous coronary intervention (PPCI) for ST segment elevation myocardial infarction (STEMI). METHODS CTFC was determined by a digital system for 78 patients. EF was measured through Simpson’s method upon discharge and three-six months later. The subjects were divided into two groups of CTFC ? 20 (n = 54) and CTFC > 20 (n = 24). Association between CTFC and EF were then specified. RESULTS CTFC ? 20 and CTFC > 20 were present in 69.2% and 30.8% of the patients, respectively. There was no significant difference between the two groups regarding baseline characteristics. EF at the time of discharge was 42.1% ± 10.2% and 43.5% ± 11.4% in groups with CTFC ? 20 and > 20, respectively. There was no significant association between EF at discharge and CTFC (P = 0.611). After three months, EF changed to 49.6% ± 8.7% and 41.6 ± 12.4% in the groups with CTFC ? 20 and CTFC > 20, respectively. Three months after PPCI, EF and CTFC had a significant relation (P = 0.007). Cumulative number and percentage of shock and death were 3 (3.8%) and 2 (2.6%), respectively. CONCLUSION Lower CTFC of the infarct-related artery in patients undergoing PPCI for STEMI was associated with higher left ventricular ejection fraction after three months. PMID:23690813

Vakili, Hossein; Sadeghi, Roxana; Tabkhi, Mahdiyeh; Safi, Morteza

2013-01-01

61

Coronary flow of the infarct artery assessed by transthoracic Doppler after primary percutaneous coronary intervention predicts final infarct size.  

PubMed

Coronary microcirculatory function after primary percutaneous coronary intervention (pPCI) in patients with acute myocardial infarction is important determinant of infarct size (IS). Our aim was to investigate the utility of coronary flow reserve (CFR) and diastolic deceleration time (DDT) of the infarct artery (IRA) assessed by transthoracic Doppler echocardiography after pPCI for final IS prediction. In 59 patients, on the 2nd day after pPCI for acute anterior myocardial infarction, transthoracic Doppler analysis of IRA blood flow was done including measurements of CFR, baseline DDT and DDT during adenosine infusion (DDT adeno). Killip class, myocardial blush grade, resolution of ST segment elevation, peak creatine kinase-myocardial band and conventional echocardiographic parameters were determined. Single-photon emission computed tomography myocardial perfusion imaging was done 6 weeks later to define final IS (percentage of myocardium with fixed perfusion abnormality). IS significantly correlated with CFR (r = -0.686, p < 0.01), DDT (r = -0.727, p < 0.01), and DDT adeno (r = -0.780, p < 0.01). CFR and DDT adeno in multivariate analysis remained independent IS predictors after adjustment for other covariates and offered incremental prognostic value in models based on conventional clinical, angiographic, electrocardiographic and enzymatic variables. In predicting large infarction (IS > 20 %), the best cut-off for CFR was <1.73 (sensitivity 65 %, specificity 96 %) and for DDT adeno ?720 ms (sensitivity 81 %, specificity 96 %). CFR and DDT during adenosine are independent and powerful early predictors of final IS offering incremental prognostic information over conventional parameters of myocardial and microvascular damage and tissue reperfusion. PMID:25108390

Trifunovic, Danijela; Sobic-Saranovic, Dragana; Beleslin, Branko; Stankovic, Sanja; Marinkovic, Jelena; Orlic, Dejan; Vujisic-Tesic, Bosiljka; Petrovic, Milan; Nedeljkovic, Ivana; Banovic, Marko; Djukanovic, Nina; Petrovic, Olga; Petrovic, Marija; Stepanovic, Jelena; Djordjevic-Dikic, Ana; Tesic, Milorad; Ostojic, Miodrag

2014-12-01

62

-Primary succession on Mount St. Helens -223 Journal of Vegetation Science 4: 223-234, 1993  

E-print Network

- Primary succession on Mount St. Helens - 223 Journal of Vegetation Science 4: 223-234, 1993 © IAVS; Opulus Press Uppsala. Printed in Sweden Early primary succession on the volcano Mount St. Helens del Moral, Roger1* & Wood, David M.2 1Department of Botany, KB-15, University of Washington, Seattle

del Moral, Roger

63

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  

Microsoft Academic Search

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

René J van der Schaaf; Bimmer E Claessen; Loes P Hoebers; Niels J Verouden; Jacques J Koolen; Maarten J Suttorp; Emanuele Barbato; Matthijs Bax; Bradley H Strauss; Göran K Olivecrona; Vegard Tuseth; Dietmar Glogar; Truls Råmunddal; Jan G Tijssen; Jan J Piek; José PS Henriques

2010-01-01

64

Vegetation–environment interactions in a sub-arctic primary succession  

Microsoft Academic Search

Biological modification of the physical environment is a characteristic feature of primary succession that is of particular\\u000a importance in stressful, high-latitude habitats. However, the degree of spatiotemporal variability in biotic reaction is poorly\\u000a understood. This is a significant gap in our knowledge of primary succession, as spatiotemporal variability in biotic reaction\\u000a may be linked to divergent development during succession. The

Nick Cutler

2011-01-01

65

[A successful surgical treatment of dissecting thoracoabdominal aortic aneurysm using a heparin coated percutaneous cardiopulmonary support system].  

PubMed

A 52-year-old man with dissecting thoracoabdominal aortic aneurysm (impending rupture) involving the celiac, superior mesenteric and renal arteries underwent graft replacement of the thoracoabdominal aorta with reconstruction of all visceral branches and intercostal arteries (Th11,12) with the aid of femoro-femoral bypass. The bypass was performed using a heparin coated percutaneous cardiopulmonary support system with low doses of heparin, maintaining activated coagulation time at about 300 seconds. During the reconstruction of the major visceral branches, the branches were separately cannulated from inside the aorta, and perfused selectively via partial extracorporeal circulation. The intercostal arteries were reconstructed segmentally to minimize the duration of ischemia. During the repair of the intercostal arteries, Fogarty balloon catheters were inserted into the intercostal arteries to prevent back bleeding and ischemia. The patient had a satisfactory postoperative course. PMID:9213320

Tanaka, H; Yanagiya, A; Kazui, T

1997-05-01

66

Role of primary stability for successful osseointegration of dental implants: Factors of influence and evaluation  

PubMed Central

A secure implant primary (mechanical) stability is positively associated with a successful implant integration and long-term successful clinical outcome. Therefore, it is essential to assess the initial stability at different time-points to ensure a successful osseointegration. The present study critically reviews the factors that may play a role in achieving a successful initial stability in dental implants. Databases were searched from 1983 up to and including October 2013 using different combinations of various keywords. Bone quality and quantity, implant geometry, and surgical technique adopted may significantly influence primary stability and overall success rate of dental implants. PMID:24381734

Ahmed, Hameeda Bashir; Crespi, Roberto; Romanos, Georgios E.

2013-01-01

67

Percutaneous management of multiple liver abscesses  

SciTech Connect

Percutaneous catheter drainage is now an accepted technique in the management of hepatic and other intraabdominal abscesses. Most abscesses accepted by the radiologist for drainage are unilocular with a safe percutaneous approach. This report demonstrates that even multiple hepatic abscesses may be successfully managed by percutaneous drainage. The use of computed tomography (CT) for diagnosis and sonography for safe puncture guidance is discussed.

Greenwood, L.H.; Collins, T.L.; Yrizarry, J.M.

1982-08-01

68

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

69

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

70

Angiographic and Clinical Impact of Successful Manual Thrombus Aspiration in Diabetic Patients Undergoing Primary PCI  

PubMed Central

Background. Diabetes mellitus is associated with worse angiographic and clinical outcomes after percutaneous coronary intervention (PCI). Aim. To investigate the impact of manual thrombus aspiration on in-stent restenosis (ISR) and clinical outcome in patients treated by bare-metal stent (BMS) implantation for ST-segment elevation myocardial infarction (STEMI). Methods. 100 diabetic patients were prospectively enrolled. They were randomly assigned to undergo either standard primary PCI (group A, 50 patients) or PCI with thrombus aspiration using Export catheter (group B, 50 patients). The primary endpoint was the rate of eight-month ISR. The secondary endpoint included follow-up for major adverse cardiac events (MACE). Results. Mean age of the study cohort was 59.86 ± 8.3 years, with 64 (64%) being males. Baseline characteristics did not differ between both groups. Eight-month angiogram showed that group B patients had significantly less late lumen loss (0.17 ± 0.35 versus 0.60 ± 0.42?mm, P < 0.001), with lower incidence of ISR (4% versus 16.6%, P < 0.001). There was a trend towards lower rate of MACE in the same group of patients. Conclusion. In diabetic patients undergoing primary PCI, manual thrombus aspiration (compared with standard PCI) was associated with better ISR rate after BMS implantation. PMID:24804102

2014-01-01

71

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. PMID:24124401

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

2013-01-01

72

Successful nutritional support for a dysphagic patient with massive cirrhotic ascites and intrathoracic stomach using percutaneous endoscopic gastrostomy (PEG).  

PubMed

Although massive cirrhotic ascites is generally considered a contraindication for the placement of percutaneous endoscopic gastrostomy (PEG), such patients are usually poorly nourished. Preceding paracentesis of ascites is one method for controlling ascites and allowing the safe placement of PEG, but it often results in overuse of albumin. Preceding peritoneal-venous (P-V) shunting can avoid excessive use of albumin, but this introduces the risk of infectious contamination. We encountered an 88-y-old woman with massive cirrhotic ascites, a giant esophageal hernia with dislocation of the proximal stomach into the mediastinum, hypertrophy of the lateral segment of the liver, and malnutrition who had suffered from appetite loss and a swallowing disorder for 4 mo. She underwent PEG using a staged sequential introduction method using a Funada-style gastric wall fixation kit as follows: 1) full stretching and pushing out of the stomach from the mediastinum into the peritoneal cavity by deep insertion and a turning-over procedure of the endoscope, 2) full distention by air to adhere the gastric wall to the peritoneal wall without migration of the colon, 3) four-point square fixation under gastroenterological endoscopy without migration of the visceral organ, and 4) puncture of the needle introducer of the PEG tube in the center of the fixations under repeated gastroenterological endoscopy 3 d after the fixation. She underwent P-V shunting under local anesthesia on the 28th day after placement of PEG and enteral nutrition. Her case shows that we can achieve proper enteral nutritional support even for patients with massive cirrhotic ascites. PMID:25280427

Moriwaki, Yoshihiro; Otani, Jun; Okuda, Junzo; Niwano, Toshiyuki; Sawada, Yoshiyuki; Nitta, Tachiko; Ohshima, Chiaki

2014-01-01

73

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

74

Modern languages in the primary curriculum: are we creating conditions for success?  

Microsoft Academic Search

As the 2010 deadline for implementation of the National Languages Strategy in primary schools approaches, how effective is the current national strategy likely to be in embedding modern languages successfully into the primary curriculum? Have lessons been learnt from the last – and ultimately failed – attempt to introduce languages into the curriculum, or are we merely repeating the same flawed process? This paper

Angela McLachlan

2009-01-01

75

Effects of Baseline Coronary Occlusion and Diabetes Mellitus in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.  

PubMed

Several studies have highlighted the prognostic role of preprocedural Thrombolysis In Myocardial Infarction (TIMI) flow in the infarct-related artery (IRA) in patients with ST-segment elevation myocardial infarction (STEMI). However, the impact of preprocedural IRA occlusion in patients with diabetes with STEMI has been insufficiently studied. The aim of this study was to evaluate the effects of baseline IRA occlusion and diabetic status in patients with STEMI who underwent primary percutaneous coronary intervention by using data from a pooled analysis of randomized trials comparing intracoronary with intravenous abciximab bolus administration. A total of 3,046 patients with STEMI who underwent primary percutaneous coronary intervention were included. Diabetes was present in 578 patients (19%). The primary outcome was mortality after a median follow-up period of 375 days. Secondary end points were reinfarction and stent thrombosis. In patients without diabetes, IRA occlusion versus no occlusion was not associated with increased rates of mortality (4.3% vs 2.7%, p = 0.051) and reinfarction (3.3% vs 2.5%, p = 0.33). Patients with diabetes with IRA occlusion compared with those without occlusion showed higher rates of mortality (10.6% vs 4.6%, p = 0.01) and reinfarction (5.6% vs 2.1%, p = 0.03). Baseline IRA occlusion increased the rate of stent thrombosis in the nondiabetic (2.1% vs 1.0%, p = 0.04) and diabetic (3.2% vs 0.8%, p = 0.05) cohorts. Interaction analysis demonstrated that the risk for death and reinfarction was significantly increased when diabetes and IRA occlusion occurred concomitantly. In conclusion, patients with STEMI with diabetes and baseline IRA occlusion had disproportionately higher rates of death and reinfarction. Preprocedural IRA occlusion increased the risk for stent thrombosis, irrespective of diabetic status. PMID:25193670

Piccolo, Raffaele; Galasso, Gennaro; Iversen, Allan Zeeberg; Eitel, Ingo; Dominguez-Rodriguez, Alberto; Gu, Youlan L; de Smet, Bart J G L; Mahmoud, Karim D; Abreu-Gonzalez, Pedro; Trimarco, Bruno; Thiele, Holger; Piscione, Federico

2014-10-15

76

Efficacy of early intensive rosuvastatin therapy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (ROSEMARY Study).  

PubMed

The purpose of the study was to investigate whether early high-dose potent statin therapy in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention can reduce infarct size compared with conventional low-dose statin therapy. In a randomized placebo-controlled multicenter trial, 185 patients were assigned either to an early high-dose rosuvastatin group (n = 92, rosuvastatin 40 mg before treatment plus maintenance for 7 days) or to a conventional low-dose rosuvastatin group (n = 93, placebo before treatment plus rosuvastatin 10-mg maintenance for 7 days). Serial cardiac magnetic resonance imaging (MRI) was performed during the acute (3 to 7 days) and chronic (3 months) phases. The primary end point was relative infarct volume assessed by MRI at 3 months. Baseline characteristics were similar between the 2 groups, except hypertension, which was more prevalent in the high-dose group. Serial MRI data were available for 121 patients (high-dose group n = 54 and low-dose group n = 67). The relative infarct volumes in the acute (23.0 ± 9.5% vs 20.5 ± 11.7%, p = 0.208) and chronic (15.9 ± 8.3% vs 15.8 ± 9.7%, p = 0.943) phases were not different between the groups. No differences between groups were observed for periprocedural microvascular circulation evaluated by Thrombolysis In Myocardial Infarction flow grade, myocardial blush grade, ST-segment resolution, microvascular obstruction on cardiac MRI, or clinical outcomes. In conclusion, early high-dose rosuvastatin therapy in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention did not improve periprocedural myocardial perfusion or reduce infarct volume measured by MRI compared with the conventional low-dose rosuvastatin regimen. PMID:24831577

Ko, Young-Guk; Won, Hoyoun; Shin, Dong-Ho; Kim, Jung-Sun; Kim, Byeong-Keuk; Choi, Donghoon; Hong, Myeong-Ki; Bae, Jang-Ho; Lee, Sahng; Lim, Do-Sun; Jang, Yangsoo

2014-07-01

77

The primary percutaneous coronary intervention for acute anterior myocardial infarction in a middle-aged male patient with bilateral coronary artery to pulmonary artery fistulas.  

PubMed

A 38-year-old man admitted to emergency department with 2 h of typical substernal chest pain, shortness of breath and nausea. The ECG revealed sinus rhythm with a 3 mm ST elevation in precordial leads V1-V6. The coronary angiography revealed acute total occlusion in left anterior descending artery (LAD) with normal circumflex and right coronary artery (RCA) along with bilateral fistulas arising from the proximal LAD and ostial RCA draining into the main pulmonary artery. Therefore, primary percutaneous coronary intervention and bare metal stent implantation was performed to culprit LAD lesion. The electrocardiographically gated 64-slice multidetector-row CT showed two large, tortuous abnormal vessels which arose from the both ostial part of the RCA and LAD draining into the main pulmonary artery. We report an unusual case of bilateral coronary artery to pulmonary artery fistulas leading to acute anterior myocardial infarction in a middle-aged male patient. PMID:23152179

Altay, Servet; Cakmak, Huseyin Altug; Velibey, Yalcin; Erer, Betul

2012-01-01

78

Successful resection of a giant primary liposarcoma of the posterior mediastinum.  

PubMed

Primary liposarcomas of the mediastinum are extremely rare neoplasms, comprising less than 1% of all mediastinal tumors. These tumors occur most commonly in the lower extremities (75%) and less frequently in the retroperitoneum. We present a case involving a successful radical resection of a large myxoid liposarcoma and its recurrence, both located in the posterior mediastinum. PMID:17473663

Marulli, Giuseppe; Rea, Federico; Feltracco, Paolo; Calabrese, Fiorella; Giacometti, Cinzia; Rizzardi, Giovanna; Vincenzo, Luigi; Sartori, Francesco

2007-05-01

79

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

80

Primary succession of aquatic macrophytes in experimental ditches in relation to nutrient input  

Microsoft Academic Search

In four experimental ditches, receiving four different levels of external nutrient input, ranging from as low as possible to a very high external loading rate, the development of the species composition of the aquatic macrophyte communities was monitored during a period of 3.5 years (May 1989–October 1992). The rate of primary succession was positively related to the level of external

R. Portielje; R. M. M. Roijackers

1995-01-01

81

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

E-print Network

Spatial factors affecting primary succession on the Muddy River Lahar, Mount St. Helens, Washington eruption of Mount St. Helens, Washington spawned a massive lahar that now supports a mosaic of vegeta- tion hundred and fifty one 200-m2 plots. We classified these plots into nine community types (CTs) that were

del Moral, Roger

82

Responses to rapid warming at Termination 1a at Gerzensee (Central Europe): Primary succession, albedo, soils,  

E-print Network

Responses to rapid warming at Termination 1a at Gerzensee (Central Europe): Primary succession a Institute of Plant Sciences and Oeschger Centre for Climate Change Research, University of Bern, Switzerland 030 Besançon, France k ETH Zurich, Institute of Plant Sciences, LFW C55.2, Universitaetsstrasse 2, CH

Gilli, Adrian

83

Coronary artery calcification as a new predictor of non-target lesion revascularization during the chronic phase after successful percutaneous coronary intervention.  

PubMed

In the drug-eluting stent era, the outcome of patients undergoing percutaneous coronary intervention (PCI) has remarkably improved. Nevertheless, non-target lesion revascularization (non-TLR) is often performed even after successful PCI and optimized medical therapy. This study aimed to determine the predictor of non-TLR. In all, 125 consecutive patients with stable angina pectoris underwent intravascular ultrasound (IVUS)-guided PCI and were followed up for 3.3 ± 0.5 years. We performed oral glucose-tolerance tests in patients with no history of known diabetes mellitus (DM) to investigate glucose tolerance. To evaluate the severity of coronary artery calcification (CAC), we calculated CAC score by multiplying the arc (degree) with the length (mm) of the superficial calcium deposit detected by IVUS. Fourteen patients underwent non-TLR (non-TLR group); the remaining 111 did not (reference group). Glycosylated hemoglobin (HbA1c; %) and prevalence of known DM were similar in both groups, but the non-TLR group had higher fasting blood glucose (103 ± 16 vs. 94 ± 11 mg/dl, p = 0.04) and blood glucose (196 ± 60 vs. 149 ± 48 ?U/ml, p = 0.01) and insulin at 2 h (184 ± 241 vs. 67 ± 49 ?U/ml, p < 0.01) than did the reference group. CAC score was significantly higher in the non-TLR group (788 ± 585 vs. 403 ± 466, p = 0.01). Multiple logistic analysis indicated that CAC score is an independent predictor of non-TLR (p = 0.008). Non-TLR-free rate was significantly higher for patients with CAC score ?400 than for those with CAC score <400 (p = 0.01). Non-TLR is associated with abnormal glucose tolerance and CAC score; CAC score is an independent predictor of non-TLR. Secondary prevention is especially important in patients with high CAC scores. PMID:24906449

Honda, Yohsuke; Toyama, Takuji; Miyaishi, Yusuke; Kan, Hakuken; Kawaguchi, Ren; Adachi, Hitoshi; Hoshizaki, Hiroshi; Oshima, Shigeru

2014-10-01

84

Protective effects of anisodamine on renal function in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.  

PubMed

ST-segment elevation myocardial infarction (STEMI) is the most severe type of heart attack, and primary percutaneous coronary intervention (PCI) is the first line treatment for STEMI. However, these patients are at higher risk of contrast-induced nephropathy (CIN), which increases the length of hospital stay and mortality rate. Anisodamine, an alkaloid extracted from a Chinese herb, has been shown to exert protective effects on the renal function. The aim of this study was to investigate the protective effect of anisodamine on CIN in STEMI patients undergoing primary PCI. A total of 126 consecutive STEMI patients were randomly assigned to receive anisodamine (n=60) or placebo (control, n=66) from admission to 24 hours after PCI. The serum creatinine (SCr) concentrations, estimated glomerular filtration rate (eGFR) and incidence of CIN were measured on admission, and 24, 48 and 72 hours after PCI between the two groups. We found that the renal function of all patients after PCI underwent a course from injury to recovery. The incidence of CIN was 5.0%, 8.3%, and 6.7% at 24, 48 and 72 hours, respectively, after primary PCI in anisodamine group, while in control group it was 16.7%, 22.7%, and 19.7%, respectively. The incidence of CIN in anisodamine group was lower than that in control group during 72 hours after PCI (all P<0.05). In conclusion, intravenous infusion of anisodamine before and after primary PCI may reduce the occurrence of CIN in STEMI patients undergoing primary PCI, without serious side effects. PMID:21597242

Wang, Yanbo; Fu, Xianghua; Wang, Xuechao; Jia, Xinwei; Gu, Xinshun; Zhang, Jing; Su, Jianling; Hao, Guozhen; Jiang, Yunfa; Fan, Weize; Wu, Weili; Li, Shiqiang

2011-01-01

85

Predictors of coronary artery aneurysm after stent implantation in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention.  

PubMed

The clinical and angiographic predictors of coronary artery aneurysm (CAA) formation in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) are not clear. This study aims to assess the predictors of CAA formation after primary PCI. 3,428 patients who underwent PCI for STEMI were enrolled. The average period of follow-up was mean 48 months (range 35-56 months) after PCI. During this time, 1,304 patients were underwent follow-up coronary angiography. CAA was detected in 21 patients (1.6 %). CAA occurred at the segment of stent implantation in all patients. The clinical and angiographic data were compared between patients with CAA group (n = 21) and without CAA group (n = 1,283). Patients who developed CAA had longer reperfusion time, higher high-sensitiviy C-reactive protein (hs-CRP) levels and neutrophil to lymphocyte ratio than those who had without CAA. Angiographically, CAA developed proximally located lesions and lesion length was significantly greater in patients with CAA than without CAA. Statin and beta-blocker discontinuation were found higher in stent-associated CAA. Every 1 mg/l increase in hs-CRP and implantation of drug eluting stent (DES) were independent predictor of CAA formation after STEMI. Baseline elevated inflammation status and DES implantation in the setting of STEMI may predict the CAA formation. PMID:25053515

Karabay, Can Yucel; Kocabay, Gonenc; Guler, Ahmet; Oduncu, Vecih; Akgun, Taylan; Kalayci, Arzu; K?l?cgedik, Alev; Tasar, Onur; Kalkan, Sedat; Erkol, Ayhan; Izgi, Akin; Esen, Ali Metin; Kirma, Cevat

2014-12-01

86

Comparison between Intracoronary Abciximab and Intravenous Eptifibatide Administration during Primary Percutaneous Coronary Intervention of Acute ST-Segment Elevation Myocardial Infarction  

PubMed Central

Background: Administration of glycoprotein IIb/IIIa inhibitors is an effective adjunctive treatment strategy during primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI). Recent data suggest that an intracoronary administration of these drugs can increase the efficacy of PPCI. This study was done to find any potential difference in terms of efficacy of administering intracoronary Abciximab vs. intravenous Eptifibatide in primary PPCI. Methods: A total of 40 STEMI patients who underwent PPCI within 12 hours of symptom onset were randomized to either an intracoronary Abciximab (0.25 ?g/kg) bolus or two boluses of intravenous Eptifibatide (0.180 ?g/kg) each 10 minutes. The primary end points were enzymatic infarct size, myocardial reperfusion measured as ST-segment resolution (STR), and post-procedural thrombolysis in myocardial infarction (TIMI) grade flow of the infarct-related artery. The secondary end points were intra-procedural adverse effect (arrhythmia) and no-reflow phenomenon, in-hospital mortality, reinfarction, hemorrhage, and post-procedural global systolic function. Results: Post-procedural TIMI grade 3 flow was achieved in 95% and 90% of the intracoronary Abciximab and intravenous Eptifibatide groups, respectively (p value = 0.61). The infarct size, as assessed by the area under the curve of creatine phosphokinase-MB in the first 48 hours after PPCI (?mol/L/hr), was similar between the intracoronary Abciximab and intravenous Eptifibatide groups: 6591 (interquartile range [IQR], 3006.0 to 11112.0) versus 7,294 (IQR, 3795.5 to 11803.5); p value = 0.59. Complete STR was achieved in 55% and 45% of the intracoronary Abciximab and intravenous Eptifibatide groups, respectively (p value = 0.87). No deaths, urgent revascularizations, reinfarctions, or TIMI major bleeding events were observed in either group. Conclusion: The intracoronary administration of Abciximab was not superior to the intravenous administration of Eptifibatide in the STEMI patients who underwent primary PCI. PMID:24396362

Namazi, Mohammad Hasan; Safi, Morteza; Vakili, Hosein; Saadat, Habibollah; Karimi, Esfandiar; Bagheri, Ramin Khameneh

2013-01-01

87

Prognostic Value of Early Acute Kidney Injury After Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction.  

PubMed

The pattern and prognostic impact of "early" acute kidney injury (AKI) after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction have not been well established. From November 2005 to November 2011, 971 post-myocardial infarction patients who underwent primary PCI were analyzed. Early AKI was defined using absolute change in serum creatinine (SCr; SCr <24 hours after primary PCI minus admission SCr) as follows: no early AKI (SCr change <0.3 mg/dl), mild early AKI (SCr change 0.3 to <0.5 mg/dl), moderate early AKI (SCr change 0.5 to <1.0 mg/dl), and severe early AKI (SCr change ?1.0 mg/dl). One-year major adverse cardiac events were defined as death, nonfatal myocardial infarction, and revascularizations. Overall, 9.6% had early AKI, including 5.7% with mild, 2.5% with moderate, and 1.4% with severe early AKI. Diabetes mellitus (odds ratio 1.84, p = 0.042), the left ventricular ejection fraction (odds ratio 0.97, p = 0.042), and hemoglobin levels (odds ratio 0.84, p = 0.039) were independently associated with early AKI. Early AKI (adjusted hazard ratio 2.80, p = 0.005) was an independent predictor of 1-year major adverse cardiac events. The adjusted hazard ratios of 1-year major adverse cardiac events from the lowest (reference) to the highest quartile of early AKI were as follows: 1, 2.87 (p = 0.012), 3.22 (p = 0.021), and 5.83 (p = 0.004), respectively. In conclusion, early dynamic change in renal function after primary PCI can sensitively predict worse outcomes. PMID:25159240

Kim, Jae Hee; Lee, Jang Hoon; Jang, Se Yong; Park, Sun Hee; Bae, Myung Hwan; Yang, Dong Heon; Park, Hun Sik; Cho, Yongkeun; Chae, Shung Chull

2014-10-15

88

Effect of High Dose Rosuvastatin Loading before Primary Percutaneous Coronary Intervention on Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction  

PubMed Central

Background and Objectives High dose rosuvastatin loading before percutaneous coronary interventions (PCI) reduces the myocardial damage and the incidence of adverse cardiac events in patients with stable angina and acute coronary syndrome. However, no studies are present yet about rosuvastatin loading in patients with ST-segment elevation myocardial infarction (STEMI) in a primary PCI setting. Subjects and Methods A total of 475 patients who underwent primary PCI for STEMI were studied. The study population was divided into two groups with 208 patients in the statin group=40 mg rosuvastatin loading before primary PCI and 267 patients in the control group=no statin pretreatment. At median 3 days after PCI a single-photon emission computed tomography (SPECT) was performed with technetium 99m tetrofosmin For this study were compared infarct size, corrected Thrombolysis in Myocardial Infarction (TIMI) frame count and the myocardial blush grade (MBG) between the both groups. Results Baseline clinical and procedural characteristics were similar between the groups. Infarct size, as assessed by SPECT, was significantly smaller (19.0±15.9% vs. 22.9±16.5%, p=0.009) in the statin group than in the control group. Patients of the statin group showed a lower corrected TIMI frame count (28.2±19.3 vs. 32.6±21.4, p=0.020), and higher MBG (2.49±0.76 vs. 2.23±0.96, p=0.001) than the patients of the control group. The multivariate analysis revealed that rosuvastatin loading {odds ratio (OR) 0.61}, pain to balloon time (OR 2.05), anterior myocardial infarction (OR 3.89) and final the MBG (OR 2.93) were independent predictors of a large infarct size. Conclusion A high dose rosuvastatin loading before the primary PCI reduced the infarct size by microvascular myocardial perfusion improvement. PMID:24653736

Kim, Ji Won; Kim, Eun Kyoung; Kim, Yong Cheol; Joe, Dai-Yeol; Ko, Jum Suk; Rhee, Sang Jae; Lee, Eun Mi; Yoo, Nam Jin; Kim, Nam-Ho; Oh, Seok Kyu; Jeong, Jin-Won

2014-01-01

89

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

2013-03-01

90

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. PMID:22589580

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

2011-01-01

91

Dispersal and establishment both limit colonization during primary succession on a glacier foreland  

Microsoft Academic Search

Plant colonization can be limited by lack of seeds or by factors that reduce establishment. The role of seed limitation in\\u000a community assembly is being increasingly recognized, but in early primary succession, establishment failure is still considered\\u000a more important. We studied the factors limiting colonization on the foreland of Coleman Glacier, Washington, USA, to determine\\u000a the importance of seed and

Chad C. Jones; Roger del Moral

2009-01-01

92

Does Seed Dispersal Limit Initiation of Primary Succession in Desert Playas?  

Microsoft Academic Search

To investigate the initiation of primary succession in a cold-desert playa-dune complex, we studied the large-scale (2000 m) seed (diaspore) dispersal patterns at Mono Lake, California. Seeds of seven of the ten species reaching the barren playa had wind-dispersal adaptations. Rates of dispersal (numbers of seeds per square metre per day) were as much as three orders of magnitude lower

Kevin P. Fort; James H. Richards

1998-01-01

93

[A case of primary erythromelalgia successfully treated with high-dose intravenous immunoglobulin therapy].  

PubMed

Erythromelalgia is a rare condition characterized by constant or paroxysmal burning pain, erythema, and the elevation of skin temperature in the extremities. Recently, the impairment of C-fiber function due to autoimmune system involvement is considered as the primary cause of erythromelalgia. However, a successful treatment has yet not been established. We report a case of a 39-year-old woman with primary erythromelalgia accompanied by high cerebrospinal fluid protein concentration and axonal neuropathy. She received various antiepileptic and anti-inflammatory drugs, but failed to improve. She finally underwent high-dose intravenous immunoglobulin therapy, which dramatically improved her symptoms and normalized cerebrospinal fluid protein concentration. This result demonstrates the effectiveness of high-dose intravenous immunoglobulin therapy for the treatment of primary erythromelalgia and the possibility of autoimmune system involvement. PMID:24523317

Kuroda, Takeshi; Sugimoto, Azusa; Ishigaki, Seiichirou; Murakami, Hidetomo; Kawamura, Mitsuru

2014-02-01

94

Effect of Preinfarction Angina Pectoris on Long-term Survival in Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention.  

PubMed

The influence of preinfarction angina pectoris (AP) on long-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI) remains controversial. In 5,429 patients with acute myocardial infarction (AMI) enrolled in the Coronary Revascularization Demonstrating Outcome Study in Kyoto AMI Registry, the present study population consisted of 3,476 patients with STEMI who underwent primary PCI within 24 hours of symptom onset and in whom the data on preinfarction AP were available. Preinfarction AP defined as AP occurring within 48 hours of hospital arrival was present in 675 patients (19.4%). Patients with preinfarction AP was younger and more often had anterior AMI and longer total ischemic time, whereas they less often had history of heart failure, atrial fibrillation, and shock presentation. The infarct size estimated by peak creatinine phosphokinase was significantly smaller in patients with than in patients without preinfarction AP (median [interquartile range] 2,141 [965 to 3,867] IU/L vs 2,462 [1,257 to 4,495] IU/L, p <0.001). The cumulative 5-year incidence of death was significantly lower in patients with preinfarction AP (12.4% vs 20.7%, p <0.001) with median follow-up interval of 1,845 days. After adjusting for confounders, preinfarction AP was independently associated with a lower risk for death (hazard ratio 0.69, 95% confidence interval 0.54 to 0.86, p = 0.001). The lower risk for 5-year mortality in patients with preinfarction AP was consistently observed across subgroups stratified by total ischemic time, initial Thrombolysis In Myocardial Infarction flow grade, hemodynamic status, infarct location, and diabetes mellitus. In conclusion, preinfarction AP was independently associated with lower 5-year mortality in patients with STEMI who underwent primary PCI. PMID:25159235

Taniguchi, Tomohiko; Shiomi, Hiroki; Toyota, Toshiaki; Morimoto, Takeshi; Akao, Masaharu; Nakatsuma, Kenji; Ono, Koh; Makiyama, Takeru; Shizuta, Satoshi; Furukawa, Yutaka; Nakagawa, Yoshihisa; Ando, Kenji; Kadota, Kazushige; Horie, Minoru; Kimura, Takeshi

2014-10-15

95

Intracoronary Compared to Intravenous Abciximab in Patients with ST Segment Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention Reduces Mortality, Target Vessel Revascularization and Reinfarction after 1 Year  

Microsoft Academic Search

Objectives: Administration of the glycoprotein IIb\\/IIIa inhibitor abciximab to patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) improves outcome. Data have suggested that an intracoronary (IC) bolus might be superior to the standard intravenous (IV) administration. We have previously reported reduced short-term mortality and need for target vessel revascularization (TVR) with the IC route.

Allan Zeeberg Iversen; Soeren Galatius; Ulrik Abildgaard; Anders Galloe; Peter Riis Hansen; Sune Pedersen; Thomas Engstroem; Jan Skov Jensen

2011-01-01

96

-Early primary succession on Mount St. Helens -107 Journal of Vegetation Science 6: 107-120, 1995  

E-print Network

slope of Mount St. Helens was sampled with 141 circular 100-m2 plots to describe vegetation- Early primary succession on Mount St. Helens - 107 Journal of Vegetation Science 6: 107-120, 1995 © IAVS; Opulus Press Uppsala. Printed in Sweden Early primary succession on Mount St. Helens, Washington

del Moral, Roger

97

Impact of admission blood glucose levels on prognosis of elderly patients with ST elevation myocardial infarction treated by primary percutaneous coronary intervention  

PubMed Central

Objective Admission hyperglycemia in acute myocardial infarction (MI) is related with increased in-hospital and long term mortality and major cardiac adverse events. We aimed to investigate how admission hyperglycemia affects the short and long term outcomes in elderly patients (> 65 years) after primary percutaneous coronary intervention for ST elevation myocardial infarction. Methods We retrospectively analyzed 677 consecutive elderly patients (mean age 72.2 ± 5.4). Patients were divided into two groups according to admission blood glucose levels. Group 1: low glucose group (LLG), glucose < 168 mg/dL; and Group 2: high glucose group (HGG), glucose > 168 mg/dL. Results In-hospital, long term mortality and in-hospital major adverse cardiac events were higher in the high admission blood glucose group (P < 0.001). Multivariate regression analysis showed: Killip > 1, post-thrombolysis in MI < 3 and admission blood glucose levels were independent predictors of in-hospital adverse cardiac events (P < 0.001). Conclusions Admission hyperglycemia in elderly patients presented with ST elevation myocardial infarction is an independent predictor of in-hospital major adverse cardiac events and is associated with in-hospital and long term mortality. PMID:24454322

Ekmekci, Ahmet; Uluganyan, Mahmut; Tufan, Fatif; Uyarel, Huseyin; Karaca, Gurkan; Kul, Seref; Gungor, Bar?s; Ertas, Gokhan; Erer, Betul; Sayar, Nurten; Gul, Mehmet; Eren, Mehmet

2013-01-01

98

A Comparative Pharmacodynamic Study of Ticagrelor versus Clopidogrel and Ticagrelor in Patients Undergoing Primary Percutaneous Coronary Intervention: The CAPITAL RELOAD Study  

PubMed Central

Background In patients undergoing primary percutaneous coronary intervention (PPCI) ticagrelor is superior to clopidogrel in reducing cardiovascular events. This study sought to evaluate the effect of clopidogrel pretreatment on the pharmacodynamics of ticagrelor in patients undergoing PPCI. Methods We measured platelet reactivity using the VerifyNow P2Y12 assay at baseline, 1, 2, 4, 6, 12, 24, and 48 hours following ticagrelor bolus in patients previously loaded with clopidogrel (C+T) and in thienopyridine-naive patients (T) referred to our centre for PPCI. Results In total, 52 consecutive eligible patients with ST-elevation myocardial infarction (STEMI) were enrolled (27 C+T and 25 T). Baseline characteristics and mean baseline platelet reactivity units (PRUs) were similar between the groups. The primary endpoint, the proportion of patients achieving a PRU<208 at 2 hours, was more frequently achieved in the C+T group compared to T treatment (76.0% vs 44.4%, p?=?0.026). Notably, C+T therapy resulted in fewer patients with high platelet reactivity at 1 hour (56.0% vs. 14.8%), 4 hours (100.0% vs. 61.5%) and 6 hours (100.0% vs. 64%, p<0.01 for all comparisons). Furthermore, C+T therapy was associated with lower PRU values from 2 to 48 hours. Conclusions In patients referred for PPCI, ticagrelor bolus following clopidogrel resulted in more rapid and profound platelet inhibition, demonstrating a positive pharmacodynamic interaction. Further study is needed to determine if this pharmacodynamic effect translates into reduced clinical events. PMID:24651043

Pourdjabbar, Ali; Simard, Trevor; Ramirez, F. Daniel; Moudgil, Rohit; Blondeau, Melissa; Labinaz, Marino; Dick, Alexander; Glover, Christopher; Froeschl, Michael; Marquis, Jean-Francois; So, Derek Y. F.; Le May, Michel R.

2014-01-01

99

Successful emergency coronary artery bypass grafting after use of a percutaneous cardiopulmonary support system in a patient with cardiopulmonary arrest secondary to acute myocardial infarction  

Microsoft Academic Search

A 37-year-old woman was taken to a hospital because of sudden chest pain. She lapsed into shock, and the ECG indicated acute\\u000a myocardial infarction. The ECG later showed ventricular fibrillation, and the patient was given cardiac massage while being\\u000a transported to our hospital, where she was resuscitated with a percutaneous cardiopulmonary support system. Emergency coronary\\u000a angiography revealed 99% stenosis of

Tadaaki Koyama; Takaaki Mochizuki; Norimasa Mitsui; Akira Marui

1998-01-01

100

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

101

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

2013-06-15

102

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. PMID:24085271

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

2013-01-01

103

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; Øijordsbakken, G; Costea, D E; Johannessen, A C

2013-01-01

104

Successful Treatment of Primary Central Nervous System Lymphoma without Irradiation in Children: Single Center Experience  

PubMed Central

Primary CNS lymphoma (PCNSL) is a very uncommon disease in children, and usually treated by chemotherapy, combined with focal or craniospinal radiotherapy (RT). However, adverse effects of RT are a concern. We evaluated the outcomes of childhood PCNSL, treated with systemic and intrathecal chemotherapy, but without RT. For fifteen years, six patients among 175 of non-Hodgkin lymphoma were diagnosed as PCNSL in Seoul National University Children's Hospital and we analyzed their medical records retrospectively. Their male:female ratio was 5:1, and median age was 10.1 yr. The primary sites were the sellar area in three patients, parietal area in one, cerebellum in one, and multiple areas in one. Their pathologic diagnoses were diffuse large B-cell lymphoma in three patients, Burkitt lymphoma in two, and undifferentiated B-cell lymphoma in one. Five were treated with the LMB96 treatment protocol, and one was treated with the CCG-106B protocol. None had RT as a first-line treatment. One patient had a local relapse and received RT and salvage chemotherapy, without success. No patient had treatment-related mortality. Their estimated 5-yr event-free and overall survival rates were both 83.3%. In conclusion, PCNSL is a rare disease in childhood, but successfully treated by chemotherapy without RT. PMID:23166421

Yoon, Jong Hyung; Kang, Hyoung Jin; Kim, Hyery; Lee, Ji Won; Park, June Dong; Park, Kyung Duk; Ahn, Hyo Seop

2012-01-01

105

Predictors of success in selective laser trabeculoplasty for primary open angle glaucoma in Chinese  

PubMed Central

Purpose To determine the predictors of success for adjuvant selective laser trabeculoplasty (SLT) in Chinese primary open angle glaucoma (POAG) patients. Methods This prospective study recruited Chinese subjects with unilateral or bilateral POAG currently taking medication to reduce intraocular pressure (IOP). All subjects received a single session of 360° SLT treatment and continued their medications for 1 month. SLT success was defined as IOP reduction ?20% at 1 month. The following covariates were analyzed in both groups via univariate and multivariate analyses: age, sex, lens status, initial IOPs, post-SLT IOPs, number and type of medications, SLT shots and energy, and pre-SLT investigations. Results In 51 eyes of 33 POAG subjects, the success rate of SLT was 47.1%. Certain groups of patients were associated with greater success using univariate analysis. These groups included the following: older age (coefficient =0.1; OR: 1.1; P=0.0003), a higher pre-SLT IOP (coefficient =0.3; OR: 1.3; P=0.0005), using four types of antiglaucoma medication (coefficient =2.1; OR: 8.4; P=0.005), a greater degree of spherical equivalent (coefficient =2.1; OR: 8.4; P=0.005), and the use of a topical carbonic anhydrase inhibitor (coefficient =1.7; OR: 6.0; P=0.003). None of the covariates were significant using multivariate analysis. Conclusion Older age, a higher pretreatment IOP, using multiple antiglaucoma medications especially topical carbonic anhydrase inhibitor, and higher refractive errors were associated with greater SLT success.

Lee, Jacky WY; Liu, Catherine CL; Chan, Jonathan CH; Wong, Raymond LM; Wong, Ian YH; Lai, Jimmy SM

2014-01-01

106

Successful treatment of fetal bilateral primary chylothorax--report of the two cases.  

PubMed

Primary fetal chylothorax is an uncommon complication, associated with high perinatal morbidity and mortality. In our report, we describe two cases of fetal bilateral primary chylothorax successfully treated with pleuro-amniotic shunting. In both cases, ultrasound scans showed bilateral, hypoechoic fluid in the pleural space without any associated structural malformations and features of infection and aneuploidy Laboratory analysis of pleural fluids revealed 79% and 92% of lymphocytes, respectively confirming chylothorax in both fetuses. In the first case, pleuro-amniotic shunts were successfully inserted at 31 weeks and 6 days of gestation. Ultrasound scan after two weeks showed expansion of the left lung and lack of fluid in both pleural cavities. At 39 weeks of gestation, a 2660 g baby boy was delivered by cesarean section (Apgar score: 9). The child did not require surgical intervention and was discharged home on day 16 of life. In the second case, the insertion of shunts (at 24 weeks and 6 days of gestation) also significantly reduced the amount of the fluid in the pleural cavities, but one shunt had to be surgically removed after birth. At 30 weeks and 2 days of gestation, a cesarean section was performed due to maternal cholestasis. A female weighing 7400 g was delivered (Apgar score: 7). The chest X-ray revealed only a small amount of fluid in the left pleural cavity The infant was discharged on postnatal day 26, in good condition and with body weight of 2150 g. Pleuro-amniotic shunt insertion is a method of choice in the treatment of confirmed primary fetal chylothorax. PMID:25322545

Nowakowska, Dorota; Gaj, Zuzanna; Grzesiak, Mariusz; Gulczy?ska, Ewa; Wilczy?ski, Jan

2014-09-01

107

Bryophyte-cyanobacteria associations during primary succession in recently Deglaciated areas of Tierra del Fuego (Chile).  

PubMed

Bryophyte establishment represents a positive feedback process that enhances soil development in newly exposed terrain. Further, biological nitrogen (N) fixation by cyanobacteria in association with mosses can be an important supply of N to terrestrial ecosystems, however the role of these associations during post-glacial primary succession is not yet fully understood. Here, we analyzed chronosequences in front of two receding glaciers with contrasting climatic conditions (wetter vs drier) at Cordillera Darwin (Tierra del Fuego) and found that most mosses had the capacity to support an epiphytic flora of cyanobacteria and exhibited high rates of N2 fixation. Pioneer moss-cyanobacteria associations showed the highest N2 fixation rates (4.60 and 4.96 µg N g-1 bryo. d-1) very early after glacier retreat (4 and 7 years) which may help accelerate soil development under wetter conditions. In drier climate, N2 fixation on bryophyte-cyanobacteria associations was also high (0.94 and 1.42 µg N g-1 bryo. d-1) but peaked at intermediate-aged sites (26 and 66 years). N2 fixation capacity on bryophytes was primarily driven by epiphytic cyanobacteria abundance rather than community composition. Most liverworts showed low colonization and N2 fixation rates, and mosses did not exhibit consistent differences across life forms and habitat (saxicolous vs terricolous). We also found a clear relationship between cyanobacteria genera and the stages of ecological succession, but no relationship was found with host species identity. Glacier forelands in Tierra del Fuego show fast rates of soil transformation which imply large quantities of N inputs. Our results highlight the potential contribution of bryophyte-cyanobacteria associations to N accumulation during post-glacial primary succession and further describe the factors that drive N2-fixation rates in post-glacial areas with very low N deposition. PMID:24819926

Arróniz-Crespo, María; Pérez-Ortega, Sergio; De Los Ríos, Asunción; Green, T G Allan; Ochoa-Hueso, Raúl; Casermeiro, Miguel Ángel; de la Cruz, María Teresa; Pintado, Ana; Palacios, David; Rozzi, Ricardo; Tysklind, Niklas; Sancho, Leopoldo G

2014-01-01

108

Bryophyte-Cyanobacteria Associations during Primary Succession in Recently Deglaciated Areas of Tierra del Fuego (Chile)  

PubMed Central

Bryophyte establishment represents a positive feedback process that enhances soil development in newly exposed terrain. Further, biological nitrogen (N) fixation by cyanobacteria in association with mosses can be an important supply of N to terrestrial ecosystems, however the role of these associations during post-glacial primary succession is not yet fully understood. Here, we analyzed chronosequences in front of two receding glaciers with contrasting climatic conditions (wetter vs drier) at Cordillera Darwin (Tierra del Fuego) and found that most mosses had the capacity to support an epiphytic flora of cyanobacteria and exhibited high rates of N2 fixation. Pioneer moss-cyanobacteria associations showed the highest N2 fixation rates (4.60 and 4.96 µg N g?1 bryo. d?1) very early after glacier retreat (4 and 7 years) which may help accelerate soil development under wetter conditions. In drier climate, N2 fixation on bryophyte-cyanobacteria associations was also high (0.94 and 1.42 µg N g?1 bryo. d?1) but peaked at intermediate-aged sites (26 and 66 years). N2 fixation capacity on bryophytes was primarily driven by epiphytic cyanobacteria abundance rather than community composition. Most liverworts showed low colonization and N2 fixation rates, and mosses did not exhibit consistent differences across life forms and habitat (saxicolous vs terricolous). We also found a clear relationship between cyanobacteria genera and the stages of ecological succession, but no relationship was found with host species identity. Glacier forelands in Tierra del Fuego show fast rates of soil transformation which imply large quantities of N inputs. Our results highlight the potential contribution of bryophyte-cyanobacteria associations to N accumulation during post-glacial primary succession and further describe the factors that drive N2-fixation rates in post-glacial areas with very low N deposition. PMID:24819926

Arroniz-Crespo, Maria; Perez-Ortega, Sergio; De los Rios, Asuncion; Green, T. G. Allan; Ochoa-Hueso, Raul; Casermeiro, Miguel Angel; de la Cruz, Maria Teresa; Pintado, Ana; Palacios, David; Rozzi, Ricardo; Tysklind, Niklas; Sancho, Leopoldo G.

2014-01-01

109

Percutaneous ablation of bone tumors.  

PubMed

Percutaneous ablation (radiofrequency or cryotherapy) of bone tumors is most often performed for palliative purposes. Many studies have shown that percutaneous ablation of a painful bone metastasis can significantly and sustainably reduce symptoms. It is therefore an alternative to radiotherapy and to long-term opiates. Percutaneous ablation can also be performed for curative purposes. In this situation, its efficacy has however only been studied to a very small extent (apart from radiofrequency ablation of osteoid osteomas in which the success rate is almost 100%). In our experience, the success rate after radiofrequency ablation of a bone metastasis is 75% if it is less than 3cm in diameter and fall significantly over this (to 40%, P=0.04). This treatment can therefore be justified in oligometastatic patients whose disease is progressing slowly. Its benefit on survival has however not been assessed in this selected population. Whether it is performed for palliative or curative reasons, percutaneous ablation should ideally be followed by an injection of cement if the metastasis being treated is lytic and located in a bone, which is subject to mechanical forces. The aim of consolidating cementoplasty is to counterbalance the additional risk of fracture due to destruction of the percutaneously ablated bone. PMID:25017149

Deschamps, F; Farouil, G; de Baere, T

2014-01-01

110

[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

111

Impact of renal insufficiency on mortality in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention  

PubMed Central

Background Chronic kidney disease is associated with increased risk of mortality. We examined the impact of moderate and severe renal insufficiency (RI) on short- and long-term mortality among unselected patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). Methods From January 1, 2002 to December 31, 2010 all patients with STEMI treated with primary PCI were identified. The hazard ratio (HR) for death was estimated using a Cox regression model, controlling for potential confounders. RI was defined as creatinine clearance (CrCl)?primary PCI, moderate and severe RI were associated with increased risk of mortality. PMID:24506974

2014-01-01

112

Usefulness of the platelet-to-lymphocyte ratio in predicting angiographic reflow after primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction.  

PubMed

Impaired coronary flow after primary percutaneous coronary intervention (PPCI) is associated with short- and long-term morbidity and mortality in patients with acute ST-segment elevation myocardial infarction (STEMI). Recent studies have demonstrated that platelet-to-lymphocyte ratio (PLR) is associated with adverse cardiovascular outcomes. The aim of this study was to assess the relation between admission PLR and angiographic reflow after PPCI. A total of 520 patients with acute STEMI (age 60 ± 13 years; 74% men) occurring within 12 hours of the onset of symptoms who underwent PPCI were enrolled. The PLR and other laboratory parameters were measured before PPCI. The patients were divided into 2 groups based on the postintervention Thrombolysis in Myocardial Infarction (TIMI) flow grade: normal-reflow group (defined as postintervention TIMI grade 3 flow) and none-reflow group (consisted of both patients with angiographic no-reflow defined as postintervention TIMI grades 0 to 1 flow and slow flow defined as postintervention TIMI grade 2 flow). There were 117 patients (22.5%) in the none-reflow group (age 68 ± 13 years and 77% men) and 403 patients in the normal-reflow group (age 58 ± 12 years and 63% men). The none-reflow group had significantly higher PLR compared with the normal-reflow group (219 ± 79 vs 115 ± 59, p <0.001). In logistic regression analysis, PLR (odds ratio 1.818, 95% confidence interval 1.713 to 1.980, p <0.001) and total stent length (OR 1.052, confidence interval 1.019 to 1.086, p = 0.002) were independent predictors of none-reflow after PPCI. In conclusion, preintervention PLR is a strong and independent predictor of slow flow/no-reflow after PPCI in patients with acute STEMI. PMID:24948493

Kurtul, Alparslan; Yarlioglues, Mikail; Murat, Sani Namik; Ergun, Gokhan; Duran, Mustafa; Kasapkara, Haci Ahmet; Demircelik, Muhammed Bora; Cetin, Mustafa; Ocek, Adil Hakan

2014-08-01

113

Incidence and predictors of early left ventricular thrombus after ST-elevation myocardial infarction in the contemporary era of primary percutaneous coronary intervention.  

PubMed

The aim of this study was to define the incidence of left ventricular thrombus (LVT) and its predictors in the contemporary era of primary percutaneous intervention (pPCI) and contrast echocardiography. We retrospectively analyzed 1,059 patients presenting with ST-elevation myocardial infarction (STEMI) to our tertiary cardiac center and treated with pPCI. Preprocedural pharmacology and procedural technique (including access route, the use of drug-eluting stents, and thrombectomy) were at the operators' discretion. Transthoracic echocardiography was performed before discharge; echo contrast agent was used when appropriate. LVT was detected in 42 subjects (4%). There were no significant differences in baseline demographics or pre-PCI clinical features between the 2 groups. Post-treatment, mean ejection fraction (EF) in patients with LVT was 35±8.4% and in those without LVT was 47±10%, p<0.001. Thirty-seven patients (88%) in the LVT group presented with an anterior STEMI versus 471 patients (42%) in the without LVT group (p<0.001). Apical akinesis was noted in all patients with LVT irrespective of the principal location of the MI. Multivariate analysis predictors of LVT were reduced EF, anterior site of MI, and the use of platelet glycoprotein IIb/IIIa inhibitors. After diagnosis of LVT, patients were treated with warfarin for 3 to 6 months. No significant difference in mortality was detectable at discharge between the 2 groups. In conclusion, in the contemporary era of pPCI, the incidence of LVT in patients with STEMI is significantly lower than that of the previous (thrombolysis) literature. The early presence of LVT is more likely in patients with anterior STEMI (involving the apex) and reduced EF. PMID:24485697

Gianstefani, Silvia; Douiri, Abdel; Delithanasis, Ioannis; Rogers, Toby; Sen, Arup; Kalra, Sundeep; Charangwa, Langton; Reiken, Joseph; Monaghan, Mark; MacCarthy, Philip

2014-04-01

114

Incidence, determinants, and prognostic value of reverse left ventricular remodelling after primary percutaneous coronary intervention: results of the Acute Myocardial Infarction Contrast Imaging (AMICI) multicenter study  

PubMed Central

Aims Few data are available on the extent and prognostic value of reverse left ventricular remodelling (r-LVR) after ST-elevation acute myocardial infarction (STEMI). We sought to evaluate incidence, major determinants, and long-term clinical significance of r-LVR in a group of STEMI patients treated with primary percutaneous coronary intervention (PPCI). In particular, the role of preserved microvascular flow within the infarct zone in inducing r-LVR has been investigated. Methods and results Serial echocardiograms (2DE) and myocardial contrast study were obtained within 24 h of coronary recanalization (T1) and at pre-discharge (T2) in 110 reperfused STEMI patients. Follow-up 2DE was scheduled after 6 months (T3). Two-year clinical follow-up was obtained. Reverse remodelling was defined as a reduction >10% in LV end-systolic volume (LVESV) at 6 months follow-up. r-LVR occurred in 39% of study population. At multivariable analysis, independent predictors of r-LVR were an effective microvascular reflow within the infarct zone, the in-hospital improvement of myocardial perfusion, an initial large LVESV, and a short time to reperfusion. Cox analysis identified r-LVR as the only independent predictor of 2-year event-free survival. Combined events rate was significantly higher among patients without compared to those with r-LVR (log-rank test P < 0.05). Conclusion r-LVR frequently occurs in STEMI patients treated with PPCI and it is an important predictor of favourable long-term outcome. A preserved microvascular perfusion within the infarct zone is the major determinant of r-LVR. PMID:19098019

Funaro, Stefania; La Torre, Giuseppe; Madonna, Mariapina; Galiuto, Leonarda; Scara, Antonio; Labbadia, Alessandra; Canali, Emanuele; Mattatelli, Antonella; Fedele, Francesco; Alessandrini, Francesco; Crea, Filippo; Agati, Luciano

2009-01-01

115

Aspiration thrombectomy in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention (from the Acute Coronary Syndrome Israeli Survey 2010).  

PubMed

We assessed the impact of aspiration thrombectomy (AT) in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention (PPCI) on major adverse cardiac events at 30 days and 1-year mortality in 517 consecutive patients who were included in the prospective, nationwide, multicenter, observational Acute Coronary Syndrome Israeli Survey in 2010. Two hundred seventeen patients (42%) underwent AT (AT-PPCI) and 300 patients conventional (C) PPCI. Both groups had similar infarct-related artery distribution and ostial or proximal culprit lesion. Patients in AT-PPCI versus C-PPCI had lower systolic blood pressure and worse Killip class on admission, more frequent Thrombolysis In Myocardial Infarction flow 0 or 1 before PPCI (80% vs 56%), less frequent restoration of flow after indwelling a guidewire in the infarct-related artery (32% vs 52%), and more use of IIb/IIIa glycoprotein inhibitors (69% vs 49%), respectively (p ?0.05 for all comparisons). Thirty-day major adverse cardiac events was similar in the AT-PPCI and C-PPCI groups, 10.6% versus 9.7%, p = 0.73; adjusted odds ratio 0.97, 95% confidence interval 0.45 to 2.10, p = 0.95. One-year mortality was lower in the AT-PPCI versus C-PPCI group, 3.7% versus 6.7%, p = 0.13; adjusted hazard ratio 0.31, 95% confidence interval 0.10 to 0.96, p = 0.042. In conclusion, this study of consecutive patients with ST elevation myocardial infarction undergoing PPCI demonstrates that AT was an independent predictor of reduced 1-year mortality. PMID:24423897

Moriel, Mady; Matetzky, Shlomi; Segev, Amit; Medina, Aaron; Kornowski, Ran; Danenberg, Haim; Gavrielov-Yusim, Natalie; Goldenberg, Ilan; Tzivoni, Dan; Gottlieb, Shmuel

2014-03-01

116

[Percutaneous transcatheter embolization of deep visceral pseudoaneurysms].  

PubMed

The authors present their experience with the percutaneous embolization of 13 splanchnic aneurysms and pseudoaneurysms (2 pseudoaneurysms of gastroduodenal artery, 3 of the hepatic artery, 7 renal pseudoaneurysms, 1 aneurysm of the splenic artery). In 9 of 13 cases the lesions were iatrogenic. Embolizing devices and techniques are described. Percutaneous embolization was successful in 12 of 13 cases, and useless in 1 case of renal pseudoaneurysm. In the 12 successfully treated cases the lesions were still occluded in the follow-up period. Transcatheter percutaneous embolization is the elective treatment in splanchnic aneurysms and pseudoaneurysms; surgery must be performed only when embolization fails. PMID:1502360

Grosso, M; Spalluto, F; Anselmetti, G C; Faissola, B; Fava, C

1992-06-01

117

Primary synovial sarcoma of the lung successfully resected under temporary bypass  

PubMed Central

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

2013-01-01

118

Percutaneous needle nephrostomy  

PubMed Central

Percutaneous nephrostomy is a simple technique for temporary drainage of an obstructed kidney. Under local anaesthesia a ureteric catheter is passed through a Vim–Silverman needle into the renal pelvis and is connected to a drainage bag. Seven cases (six successful) in which this method was used are described and the indications are discussed. It has been free from complications, is acceptable to patients, and is felt to represent a useful addition to the methods available for the treatment of obstruction of the upper urinary tract. ImagesFig. 4Fig. 1Fig. 2 PMID:5359921

Ogg, C. S.; Saxton, H. M.; Cameron, J. S.

1969-01-01

119

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

120

Ectomycorrhizal ecology under primary succession on coastal sand dunes: interactions involving Pinus contorta, suilloid fungi and deer  

Microsoft Academic Search

Summary • Ectomycorrhizal fungi (EMF) are critical for pine establishment under primary succession. The species of EMF supporting primary successional pine seedlings on coastal sand dunes and mechanisms for their establishment were investigated. • Fungi were identified from ectomycorrhizal roots using molecular techniques. Field seedlings were collected from forested and nonforested zones. Laboratory seedlings were grown in soils collected from

Sara Ashkannejhad; Thomas R. Horton

2006-01-01

121

Intracranial primary dural diffuse large B-cell lymphoma successfully treated with chemotherapy  

PubMed Central

Diffuse large B-cell lymphoma (DLBCL) presented as a primary dural lesion is an extremely rare entity, which may be misdiagnosed as meningioma. Patients with symptomatic meningioma are usually treated with tumor resection. The five previously described cases of intracranial dural DLBCL were treated with surgery followed by chemotherapy and/or radiotherapy, with a favorable outcome, but with potential sequels. We reported the first case of DLBCL, presented as a primary dural lesion, successfully treated with chemotherapy only in a 52-year-old woman presented in October 2011 with rapidly progressive headaches, nausea and vomiting. Magnetic resonance imaging of the brain and head computed tomography showed a lesion en plaque in the right parieto-occipital region, tracking the dura matter, and osteolytic lesions. The patient underwent an open tumor biopsy, and the diagnosis of DLBCL was established. The patient received dexamethasone, cisplatin and cytarabine (DHAP) followed by methotrexate plus cytarabine, and obtained a durable complete response. Thus, intracranial dural DLBCL must be considered in differential diagnosis of meningeal lesions, particularly when a rapid progression of symptoms and osteolytic lesions are present, because an early diagnosis and rapid initiation of treatment, even though with chemotherapy, is associated with favorable outcome. PMID:24600506

Brito, Angelo Borsarelli Carvalho; Reis, Fabiano; de Souza, Carmino Antonio; Vassallo, Jose; Lima, Carmen Silvia Passos

2014-01-01

122

Development of a primary-care tool to assess treatment success in COPD: consensus report from a closed meeting of respiratory and primary-care specialists  

Microsoft Academic Search

A 1-day meeting, attended by invited respiratory and primary-care specialists all of whom had an international profile and a specific interest in Chronic Obstructive Pulmonary Disease (COPD), considered specific research recommendations from the Global Initiative in Obstructive Lung Disease (GOLD) workshop report. Attendees discussed developing a tool to complement spirometry and help primary-care physicians assess treatment success in patients with

Jim Reid; David Price; Thys van der Molen; Bruno Housset; José Jardim; Paul Jones; Peter Kardos; Jean-François Muir; Pierluigi Paggiaro; Stephen Rennard; Emiel Wouters

2004-01-01

123

Safety and efficacy of thrombectomy in patients undergoing primary percutaneous coronary intervention for Acute ST elevation MI: A Meta-Analysis of Randomized Controlled Trials  

PubMed Central

Background Clinical trials comparing thrombectomy devices with conventional percutaneous coronary interventions (PCI) in patients with acute ST elevation myocardial infarction (STEMI) have produced conflicting results. The objective of our study was to systematically evaluate currently available data comparing thrombectomy followed by PCI with conventional PCI alone in patients with acute STEMI. Methods Seventeen randomized trials (n = 3,909 patients) of thrombectomy versus PCI were included in this meta-analysis. We calculated the summary odds ratios for mortality, stroke, post procedural myocardial blush grade (MBG), thrombolysis in myocardial infarction (TIMI) grade flow, and post procedural ST segment resolution (STR) using random-effects and fixed-effects models. Results There was no difference in risk of 30-day mortality (44/1914 vs. 50/1907, OR 0.84, 95% CI 0.54-1.29, P = 0.42) among patients randomized to thrombectomy, compared with conventional PCI. Thrombectomy was associated with a significantly greater likelihood of TIMI 3 flow (1616/1826 vs. 1533/1806, OR 1.41, P = 0.007), MBG 3 (730/1526 vs. 486/1513, OR 2.42, P < 0.001), STR (923/1500 vs. 715/1494, OR 2.30, P < 0.001), and with a higher risk of stroke (14/1403 vs. 3/1413, OR 2.88, 95% CI 1.06-7.85, P = 0.04). Outcomes differed significantly between different device classes with a trend towards lower mortality with manual aspiration thrombectomy (MAT) (21/949 vs.36/953, OR 0.59, 95% CI 0.35-1.01, P = 0.05), whereas mechanical devices showed a trend towards higher mortality (20/416 vs.10/418, OR 2.07, 95% CI 0.95-4.48, P = 0.07). Conclusions Thrombectomy devices appear to improve markers of myocardial perfusion in patients undergoing primary PCI, with no difference in overall 30-day mortality but an increased likelihood of stroke. The clinical benefits of thrombectomy appear to be influenced by the device type with a trend towards survival benefit with MAT and worsening outcome with mechanical devices. PMID:20187958

2010-01-01

124

Does seed dispersal limit initiation of primary succession in desert playas?  

PubMed

To investigate the initiation of primary succession in a cold-desert playa-dune complex, we studied the large-scale (2000 m) seed (diaspore) dispersal patterns at Mono Lake, California. Seeds of seven of the ten species reaching the barren playa had wind-dispersal adaptations. Rates of dispersal (numbers of seeds per square metre per day) were as much as three orders of magnitude lower on the playa than in the diverse dune vegetation. However, seed input appeared sufficient to reach potential safe sites on the playa, with a peak input of 66 ± 8 total seeds·m·d. The smooth playa surface, the virtual absence of aboveground barriers, and the high windspeed environment promote the long-distance dispersal of seeds (at least 1300 m for Chrysothamnus spp. and at least 700 m for Sarcobatus vermiculatus). The large spatial scale of sampling revealed a relatively high seed input onto the playa by the dominant pioneer species S. vermiculatus, despite the low abundance of parent vegetation in this region. All of these results implicate low rates of seed entrapment as an obstacle to establishment on this desert playa, rather than a lack of seed input. PMID:21680332

Fort, K P; Richards, J H

1998-12-01

125

Mycorrhizal fungal growth responds to soil characteristics, but not host plant identity, during a primary lacustrine dune succession.  

PubMed

Soil factors and host plant identity can both affect the growth and functioning of mycorrhizal fungi. Both components change during primary succession, but it is unknown if their relative importance to mycorrhizas also changes. This research tested how soil type and host plant differences among primary successional stages determine the growth and plant effects of arbuscular mycorrhizal (AM) fungal communities. Mycorrhizal fungal community, plant identity, and soil conditions were manipulated among three stages of a lacustrine sand dune successional series in a fully factorial greenhouse experiment. Late succession AM fungi produced more arbuscules and soil hyphae when grown in late succession soils, although the community was from the same narrow phylogenetic group as those in intermediate succession. AM fungal growth did not differ between host species, and plant growth was similarly unaffected by different AM fungal communities. These results indicate that though ecological filtering and/or adaptation of AM fungi occurs during this primary dune succession, it more strongly reflects matching between fungi and soils, rather than interactions between fungi and host plants. Thus, AM fungal performance during this succession may not depend directly on the sequence of plant community succession. PMID:24141906

Sikes, Benjamin A; Maherali, Hafiz; Klironomos, John N

2014-04-01

126

Percutaneous interventional catheter therapy for lesions of the chest and lungs.  

PubMed

Percutaneous, nonsurgical interventions using angiographic catheter techniques and radiologic guidance were used in the management of seven cases of various lesions of the chest and lungs. Successful catheter therapy included the embolization of a large, acquired, postinflammatory vascular malformation causing massive hemoptysis and a cavernous hemangioma of the chest wall. Sixteen pulmonary arteriovenous fistulas (one patient), an iatrogenic internal mammary artery-to-innominate vein fistula, and a persistent, postbiopsy bronchopleural fistula were successfully closed. Percutaneous drainage of a pyogenic lung abscess and the nonoperative retrieval of an intravascular foreign body that had embolized to the left pulmonary artery were also successfully achieved. Performed under local anesthesia with minimal morbidity, stress, and risk, interventional catheter therapy is remarkably cost-effective. Primary chest physicians are encouraged to consider this mode of therapy whenever applicable. PMID:7039984

Keller, F S; Rösch, J; Barker, A F; Dotter, C T

1982-04-01

127

Percutaneous Abscess Drainage  

MedlinePLUS

Percutaneous Abscess Drainage • Overview An abscess is an infected fluid collection within the body. In general, people who have an abscess ... long as it is deemed safe, percutaneous abscess drainage offers a minimally invasive therapy that can be ...

128

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

129

Primary succession trajectories on a barren plain, Mount St. Helens, Roger del Moral, Jason M. Saura & Jennifer N. Emenegger  

E-print Network

Plain of Mount St. Helens, Washington, USA (461120 4200 N, 1221080 2700 W, ele- vation 1360 mPrimary succession trajectories on a barren plain, Mount St. Helens, Washington Roger del Moral, Jason M. Saura & Jennifer N. Emenegger Abstract Questions: Have predictable relationships between

del Moral, Roger

130

Different Impact of Diabetes Mellitus on In-Hospital and 1-Year Mortality in Patients with Acute Myocardial Infarction Who Underwent Successful Percutaneous Coronary Intervention: Results from the Korean Acute Myocardial Infarction Registry  

PubMed Central

Background/Aims The aim of this study was to evaluate the impact of diabetes mellitus (DM) on in-hospital and 1-year mortality in patients who suffered acute myocardial infarction (AMI) and underwent successful percutaneous coronary intervention (PCI). Methods Among 5,074 consecutive patients from the Korea AMI Registry with successful revascularization between November 2005 and June 2007, 1,412 patients had a history of DM. Results The DM group had a higher mean age prevalence of history of hypertension, dyslipidemia, ischemic heart disease, high Killip class, and diagnoses as non-ST elevation MI than the non-DM group. Left ventricular ejection fraction (LVEF) and creatinine clearance were lower in the DM group, which also had a significantly higher incidence of in-hospital and 1-year mortality of hospital survivors (4.6% vs. 2.8%, p = 0.002; 5.0% vs. 2.5%, p < 0.001). A multivariate analysis revealed that independent predictors of in-hospital mortality were Killip class IV or III at admission, use of angiotensin converting enzyme inhibitors or angiotensin-II receptor blockers, LVEF, creatinine clearance, and a diagnosis of ST-elevated MI but not DM. However, a multivariate Cox regression analysis showed that DM was an independent predictor of 1-year mortality (hazard ratio, 1.504; 95% confidence interval, 1.032 to 2.191). Conclusions DM has a higher association with 1-year mortality than in-hospital mortality in patients with AMI who underwent successful PCI. Therefore, even when patients with AMI and DM undergo successful PCI, they may require further intensive treatment and continuous attention. PMID:22707890

Park, Keun-Ho; Jeong, Myung Ho; Chae, Shung Chull; Hur, Seung Ho; Kim, Young Jo; Seong, In Whan; Chae, Jei Keon; Hong, Taek Jong; Cho, Myeong Chan; Bae, Jang Ho; Rha, Seung Woon; Jang, Yang Soo

2012-01-01

131

Supine percutaneous nephrolithotomy: con.  

PubMed

Advocates of supine percutaneous nephrolithotomy (PCNL) consider several theoretical advantages for this procedure. Despite the potential advantages of the supine PCNL, the majority of urologists have remained reluctant to perform this technique. This reluctance may be related to successful outcomes of prone PCNL and technical difficulties associated with supine PCNL. Feasibility of supine PCNL has been shown in different series and the current evidence, although limited and not fully organized, implies the application of this technique for patients with simple stones who are at high anesthesiological risk. However, there is no convincing evidence to support performing supine PCNL in morbidly obese patients and those with complex and multiple stones. Further randomized clinical trials of large sample size and high methodological quality are required to recommend extensive application of supine PCNL as an alternative to prone PCNL. PMID:22090043

Lashay, Alireza; Amini, Erfan; Ahanian, Ali; Ozhand, Ardalan; Nikkar, Mohammad Masoud; Sharifi, Seyed Hossein Hosseini

2011-01-01

132

A Case of Primary Subglottic Malignant Melanoma with a Successful Surgical Treatment  

PubMed Central

Primary subglottic malignant melanoma is a very rare and underdiagnosed neoplasm. We are reporting a case of primary malignant melanoma of subglottic mucosa in a 78-year-old woman who presented to our hospital with shortness of breath and hoarseness of voice. Laryngoscopy and excisional biopsy along with immunoreactivity to S-100 and human melanoma black-45 (HMB-45) confirmed the diagnosis. The patient was treated with laryngectomy followed by radiotherapy. Five years following surgical treatment, she continues to be asymptomatic. To our knowledge, there is only one reported case of primary malignant melanoma of subglottic mucosa in the medical literatures. PMID:24995141

Goldblatt, Curtis; Stark, Owen; Masciotra, Nicholas

2014-01-01

133

Percutaneous Transluminal Angioplasty of Peripheral Bypass Stenoses  

SciTech Connect

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 bypass stenoses in 39 grafts in 37 patients were treated with PTA. The cumulative primary patency of treated stenoses was calculated. Results: During the first year after PTA 31 (53%) treated lesions remained patent, 15 (26%) lesions restenosed at a median interval of 5.0 (range 1-12) months and 4 (7%) bypasses occluded. The cumulative primary patency of 58 treated graft stenoses at 1 year was 60% [95% confidence interval (CI) 46%-74%] and 55% (95% CI 41%-70%) at 2 years. Graft body stenoses showed a better 2-year cumulative primary patency (86%; 95% CI 68%-100%) compared with juxta-anastomotic lesions (45%; 95% CI 29%-62%; p < 0.05). Conclusion: PTA is justifiable as the initial treatment of peripheral bypass stenoses. Nevertheless, the restenosis rate is rather high, especially in juxta-anastomotic lesions. Continuation of duplex surveillance after PTA and timely reintervention is recommended.

Hoksbergen, Arjan W.J.; Legemate, Dink A. [Department of Vascular Surgery, G1-244, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Reekers, Jim A. [Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Ubbink, Dirk T.; Jacobs, Michael J.H.M. [Department of Vascular Surgery, G1-244, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

1999-07-15

134

Removal of a Trapped Endoscopic Catheter from the Gallbladder via Percutaneous Transhepatic Cholecystostomy: Technical Innovation  

SciTech Connect

Background. Percutaneous cholecystostomy is used for a variety of clinical problems. Methods. Percutaneous cholecystostomy was utilized in a novel setting to resolve a problematic endoscopic situation. Observations. Percutaneous cholecystostomy permitted successful removal of a broken and trapped endoscopic biliary catheter, in addition to helping treat cholecystitis. Conclusion. Another valuable use of percutaneous cholecystostomy is demonstrated, as well as emphasizing the importance of the interplay between endoscopists and interventional radiologists.

Stay, Rourke M.; Sonnenberg, Eric van [Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Departments of Radiology (United States)], E-mail: evansonnenberg@yahoo.com; Goodacre, Brian W. [Victoria General Hospital, Department of Radiology (Canada); Ozkan, Orhan S. [University of Ankara, Department of Radiology (Turkey); Wittich, Gerhard R. [Bay Shore Medical Center, Department of Radiology (United States)

2006-12-15

135

Percutaneous Cyanoacrylate Glue Injection into the Renal Pseudoaneurysm to Control Intractable Hematuria After Percutaneous Nephrolithotomy  

SciTech Connect

We report a case of a 43-year-old man who developed intractable hematuria after percutaneous nephrolithotomy. Angiography detected a pseudoaneurysm arising from the lower polar artery; however, embolization could not be performed because of unfavorable vascular anatomy. A percutaneous thrombin injection under ultrasound guidance initially controlled the bleeding, but hematuria subsequently recurred as a result of recanalization of the aneurysm. The case was successfully managed with ultrasound- and fluoroscopic-guided direct injection of cyanoacrylate glue into the pseudoaneurysm.

Lal, Anupam, E-mail: dralal@rediffmail.com; Kumar, Ajay; Prakash, Mahesh; Singhal, Manphool [Post Graduate Institute of Medical Education and Research (PGIMER), Department of Radiodiagnosis and Imaging (India); Agarwal, Mayank Mohan; Sarkar, Debansu [Post Graduate Institute of Medical Education and Research (PGIMER), Department of Urology (India); Khandelwal, Niranjan [Post Graduate Institute of Medical Education and Research (PGIMER), Department of Radiodiagnosis and Imaging (India)

2009-07-15

136

Percutaneous Ablation of Hepatic Tumors  

PubMed Central

The liver is a common site of both primary and secondary malignancy resulting in significant morbidity and mortality. Careful patient evaluation and triage allows for optimal utilization of all oncologic therapies, including radiation, systemic chemotherapy, surgery, transarterial therapies, and ablation. Although the role of interventional oncologists in the management of hepatic malignancies continues to evolve, the use of percutaneous ablation therapies has proven to be an effective and minimally invasive modality for treatment. Percutaneous ablation therapies have diversified from direct ethanol injection to multiple modalities including radiofrequency ablation (RFA), cryoablation, acetic acid injection, laser ablation, microwave ablation, high-intensity focused ultrasound, and irreversible electroporation. RFA is the most commonly utilized modality for hepatic interventions and has proven efficacy in both hepatocellular carcinoma and colorectal carcinoma metastases. Although tumor size remains a challenge, combination therapies and new device innovations continue to allow for improved ablation zones and more durable results. PMID:22550364

McCarley, James R.; Soulen, Michael C.

2010-01-01

137

A Case of Successful Remission of Extensive Primary Gastric Diffuse Large B Cell Lymphoma: Radiologic, Endoscopic and Pathologic Evidence  

PubMed Central

Though rare amongst stomach neoplasms, primary gastric diffuse large B cell lymphoma is one of the commonest extranodal non-Hodgkin lymphomas. If left untreated, it can have a devastating progression and life-threatening consequences. We present the case of a successfully treated large antral ulcer confirmed to be large B cell lymphoma as evidenced by radiologic, endoscopic and histopathologic findings. A brief discussion about the types of gastric lymphoma, their Helicobacter pylori relation and therapeutic modalities follows. PMID:24847196

Bismar, Mike M.; Alasadi, Mazen; Hendawy, Bassem S.; Waness, Abdelkarim

2014-01-01

138

Accumulation of nitrogen and organic matter during primary succession of Leymus arenarius dunes on the volcanic island Surtsey, Iceland  

NASA Astrophysics Data System (ADS)

The volcanic island of Surtsey has been a natural laboratory where the primary succession of flora and fauna has been monitored, since it emerged from the N-Atlantic Ocean in 1963. We quantified the accumulation rates of nitrogen (N) and soil organic matter (SOM) in a 37 year long chronosequence of Leymus arenarius dunes in order to illuminate the spatiotemporal patterns in their build-up in primary succession. The Leymus dune area, volume and height grew exponentially over time. Aboveground plant biomass, cover or number of shoots per unit area did not change significantly with time, but root biomass accumulated with time, giving a root-shoot ratio of 19. The dunes accumulated on average 6.6 kg N ha-1 year-1, which was 3.5 times more than is received annually by atmospheric deposition. The extensive root system of Leymus seems to effectively retain and accumulate large part of the annual N deposition, not only deposition directly on the dunes but also from the adjacent unvegetated areas. SOM per unit area increased exponentially with dune age, but the accumulation of roots, aboveground biomass and SOM was more strongly linked to soil N than time: 1 g m-2 increase in soil N led on the average to 6 kg C m-2 increase in biomass and SOM. The Leymus dunes, where most of the N has been accumulated, will therefore probably act as hot-spots for further primary succession of flora and fauna on the tephra sands of Surtsey.

Stefansdottir, G.; Aradottir, A. L.; Sigurdsson, B. D.

2014-05-01

139

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

140

Interference Characteristics and Success Probability at the Primary User in a Cognitive Radio Network  

E-print Network

) devices in the ultra high frequency (UHF) television (TV) bands under the condition that they do not cause harmful interference to the operation of the primary users [1], [2]. This paper assesses the effect harmful interference at the PU. Using the concepts of stochastic geometry, we study the characteristics

Boyer, Edmond

141

Case management by nurses in primary care: analysis of 73 'success stories'  

Microsoft Academic Search

BACKGROUND: There is interest as to whether case management reduces unplanned patient admission to hospital. However, very little is known about how the intervention is delivered and what the most salient outcome measures are. DESIGN: Qualitative study embedded in a wider evaluation. SETTING: Primary health care. METHOD: Analysis of case manager case reports in a service innovation evaluation study. RESULTS:

G. Elwyn; M. Williams; C. Roberts; R. G. Newcombe; J. Vincent

2008-01-01

142

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. PMID:20535280

Agrawal, Madhu Sudan; Agrawal, Mayank

2010-01-01

143

Predicting Success on a Bachelor of Arts Primary Education Degree Course  

ERIC Educational Resources Information Center

Background: Successfully selecting students for undergraduate courses and for teaching is notoriously difficult. Traditionally, in England, A level grades and interviews have been used in conjunction with a variety of other approaches. Purpose: This paper examines the predictive validity of students' A level grades and of scores from a structured…

Barmby, Patrick; Bolden, David; Higgins, Steve; Tymms, Peter

2012-01-01

144

Ecosystem properties and microbial community changes in primary succession on a glacier forefront  

Microsoft Academic Search

We studied microbial community composition in a primary successional chronosequence on the forefront of Lyman Glacier, Washington,\\u000a United States. We sampled microbial communities in soil from nonvegetated areas and under the canopies of mycorrhizal and\\u000a nonmycorrhizal plants from 20- to 80-year-old zones along the successional gradient. Three independent measures of microbial\\u000a biomass were used: substrate-induced respiration (SIR), phospholipid fatty acid

Rauni Ohtonen; Hannu Fritze; Taina Pennanen; Ari Jumpponen; Jim Trappe

1999-01-01

145

Gopher mounds decrease nutrient cycling rates and increase adjacent vegetation in volcanic primary succession.  

PubMed

Fossorial mammals may affect nutrient dynamics and vegetation in recently initiated primary successional ecosystems differently than in more developed systems because of strong C and N limitation to primary productivity and microbial communities. We investigated northern pocket gopher (Thomomys talpoides) effects on soil nutrient dynamics, soil physical properties, and plant communities on surfaces created by Mount St. Helens' 1980 eruption. For comparison to later successional systems, we summarized published studies on gopher effects on soil C and N and plant communities. In 2010, 18 years after gopher colonization, we found that gophers were active in ~2.5 % of the study area and formed ~328 mounds ha(-1). Mounds exhibited decreased species density compared to undisturbed areas, while plant abundance on mound margins increased 77 %. Plant burial increased total soil carbon (TC) by 13 % and nitrogen (TN) by 11 %, compared to undisturbed soils. Mound crusts decreased water infiltration, likely explaining the lack of detectable increases in rates of NO3-N, NH4-N or PO4-P leaching out of the rooting zone or in CO2 flux rates. We concluded that plant burial and reduced infiltration on gopher mounds may accelerate soil carbon accumulation, facilitate vegetation development at mound edges through resource concentration and competitive release, and increase small-scale heterogeneity of soils and communities across substantial sections of the primary successional landscape. Our review indicated that increases in TC, TN and plant density at mound margins contrasted with later successional systems, likely due to differences in physical effects and microbial resources between primary successional and older systems. PMID:25260998

Yurkewycz, Raymond P; Bishop, John G; Crisafulli, Charles M; Harrison, John A; Gill, Richard A

2014-12-01

146

Primary cutaneous anaplastic large cell lymphoma successfully treated with local thermotherapy using pocket hand warmers.  

PubMed

Apart from for cutaneous deep fungal or mycobacterial infections, thermotherapy has been used for various malignant tumors. We report a case of primary cutaneous anaplastic large cell lymphoma, which responded quite well to topical thermotherapy using chemical pocket hand warmers. The treatment resulted in an immediate tumor regression without recurrence. This method is simple and might be a useful tool against solitary cutaneous lymphoma, especially of elderly patients with poor performance status or with various systemic complications. PMID:19120772

Honma, Masaru; Hashimoto, Makoto; Iwasaki, Takeshi; Iinuma, Shin; Takahashi, Hidetoshi; Ishida-Yamamoto, Akemi; Iizuka, Hajime

2008-11-01

147

The Impact of SYNTAX Score of Non-Infarct-Related Artery on Long- Term Outcome among Patients with Acute ST Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention  

PubMed Central

Objective We investigated the impact of the severity of stenosis in a non-infarct-related artery (IRA) on the long-term prognosis of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods Three hundred one consecutive patients (age: 59.7 ± 13.2 years, 85.5% men) underwent primary PCI during 2009–2012. Receiver operating characteristic curve analysis found the optimal cutoff for non-IRA SYNTAX score (SS) to be 2.5. We divided the patients into two groups according to this cutoff value. Results By multivariable analysis, non-IRA SS (?2.5) was an independent predictor of major adverse cardiac events (hazard ratio [HR]: 2.15, 95% confidence interval [CI]: 1.21–3.79, P ?=? 0.008) and all-cause mortality (HR: 3.49, 95% CI: 1.13–10.8, P ?=? 0.03). However, the prediction of cardiovascular mortality had only borderline significance (HR: 3.29, 95% CI: 0.90–12.08, P ?=? 0.07). Conclusion STEMI patients treated with primary PCI and moderate to severe non-IRA stenosis (SS ?2.5) have more subsequent cardiac events. Those populations should be treated with more aggressive preventive and medical management. PMID:25303079

Su, Min-I; Tsai, Cheng-Ting; Yeh, Hung-I; Chen, Chun-Yen

2014-01-01

148

Successful Multimodal Therapies for a Primary Atypical Teratoid\\/Rhabdoid Tumor in the Cervical Spine  

Microsoft Academic Search

Atypical teratoid\\/rhabdoid tumor (AT\\/RT) occurring in the central nervous system is a high-grade malignant tumor, and its prognosis is poor for patients younger than 3 years of age. In this article, we present a case of infant AT\\/RT in the cervical spine and its successful treatment by intensive chemotherapy. The patient, a 1.75-year-old girl, developed an acute, progressive tetraparesis. MRI

Shunsuke Yano; Kazutoshi Hida; Hiroyuki Kobayashi; Yoshinobu Iwasaki

2008-01-01

149

Early results after percutaneous transluminal coronary angioplasty in 400 patients.  

PubMed Central

In a consecutive series of 400 patients treated by percutaneous transluminal coronary angioplasty 212 had single vessel disease, 142 had multivessel disease with only one vessel dilated, and 46 had multivessel dilatation. In addition sequential stenoses were dilated in the same vessel in all groups. There was no mortality among patients with single vessel disease. Success rates varied from 83% to 90% according to the artery in which angioplasty was attempted. Urgent surgery was required by 3.8%. Primary success was lower (74%) in the presence of multivessel disease and complications were more frequent, with four deaths (2.8%). In 46 patients with multivessel disease in whom all important lesions were dilated during the same procedure the overall primary success rate was 76% and within the last year of the study it was 91%. One (2%) patient died and three (7%) required urgent surgery. Twelve (86%) out of 14 stenosed vein grafts were successfully dilated and eight (53%) chronically occluded vessels were re-opened; in both groups there were no deaths, no infarctions, and no need for urgent surgery. In all groups symptoms improved greatly and predischarge exercise tests showed that there was no reversible ischaemia in 94% of patients with single vessel disease or in 65% of patients with incomplete revascularisation. Six months after the procedure 95% of the patients had improved symptomatically and 80% had normal exercise tests after one year. Percutaneous transluminal coronary angioplasty is the method of choice in single vessel disease and its use also results in a high proportion of other patients becoming symptom free. Complication rates are low and for selected patients results that are equivalent to those of cardiac surgery are obtained. PMID:2942161

Sowton, E; Timmis, A D; Crick, J C; Griffin, B; Yates, A K; Deverall, P

1986-01-01

150

A "low and slow" approach to successful medical treatment of primary cardiac lymphoma  

PubMed Central

Primary cardiac lymphomas (PCL) are very rare lymphoid malignancies that originate in the heart or pericardium. Their clinical diagnosis is often difficult, as they infrequently present with signs and symptoms consistent with cardiopulmonary conditions. Typically when B symptoms develop, (fever, weight loss, fatigue common in lymphoid malignancies), progressive heart failure will ensue. Antineoplastic treatment of PCL carries the risk of rapid tumor destruction, causing significant cardiovascular complications including life threatening arrhythmias, pericardial effusion or ventricular septal rupture. While chemotherapy is recommended to treat PCL, prognosis and response to therapy are impacted by the cardiovascular complications. In this instance, a low intensity initiation of chemotherapy followed by the standard full-dose regimen was able to achieve complete remission without cardiovascular complications. Patient monitoring in the Cardiac Intensive Care Unit (CICU) while undergoing initial cycles of chemotherapy may further offer the opportunity to institute lifesaving treatment when encountering the aforementioned cardiovascular complications. PMID:25009797

Shah, Khanjan

2014-01-01

151

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

152

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

153

From empower to green dot : successful strategies and lessons learned in developing comprehensive sexual violence primary prevention programming.  

PubMed

This case study describes Kentucky's partnership with the Centers for Disease Control and Prevention (CDC) EMPOWER (Enhancing and Making Programs Work to End Rape) program to enhance the mission and services of existing rape crisis centers to include comprehensive primary prevention programming to reduce rates of sexual violence perpetration. The planning process and the successful implementation of a statewide, 5-year, randomized control trial study of a bystander prevention program (Green Dot), and its evaluation are described. Lessons learned in generating new questions, seeking funding, building relationships and capacity, and disseminating knowledge are presented. PMID:25261438

Cook-Craig, Patricia G; Millspaugh, Phyllis H; Recktenwald, Eileen A; Kelly, Natalie C; Hegge, Lea M; Coker, Ann L; Pletcher, Tisha S

2014-10-01

154

Outcomes of patients treated with triple antithrombotic therapy after primary percutaneous coronary intervention for ST-elevation myocardial infarction (from the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction [HORIZONS-AMI] trial).  

PubMed

In the setting of ST-segment elevation myocardial infarction (STEMI), patients at high risk of systemic emboli who undergo primary percutaneous coronary intervention (PCI) using stents might require triple antithrombotic therapy (a combination of aspirin, thienopyridine, and vitamin K antagonist [VKA]). The risks and benefits of such therapy in the setting of STEMI have been incompletely characterized. We, therefore, assessed the outcomes of patients who received triple therapy after primary PCI in the large-scale, contemporary Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction [HORIZONS-AMI] trial. Among the 3,320 patients triaged to primary PCI, 126 (3.8%) were prescribed triple therapy and 3,194 (96.2%) were prescribed dual antiplatelet therapy. The most frequent indications for VKA treatment were a severely reduced left ventricular ejection fraction with a large akinetic area, atrial fibrillation (23.8% each), and mural thrombus (23.0%). The assignment to triple therapy was associated with older age, female gender, rhythm disturbances, Killip class > 1 on admission, lower left ventricular ejection fraction, left anterior descending artery territory infarcts, and Final Thrombolysis In Myocardial Infarction flow grade < 3. Patients treated with triple versus dual therapy had comparable short- and long-term ischemic outcomes but had significantly increased rates of major bleeding during the index hospitalization (17.1% vs 6.5%, p < 0.0001), resulting in premature VKA discontinuation in 14.3% of those patients. In conclusion, in the setting of STEMI treated with primary PCI, the combination of aspirin, thienopyridine, and VKA results in an excess of bleeding complications and premature discontinuation of VKA. The risk of adding oral anticoagulation to patients admitted for STEMI should be carefully considered before choosing drug-eluting or bare metal stents. PMID:22196778

Nikolsky, Eugenia; Mehran, Roxana; Dangas, George D; Yu, Jennifer; Parise, Helen; Xu, Ke; Pocock, Stuart J; Stone, Gregg W

2012-03-15

155

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. PMID:18482486

Bellón, Juan Ángel; Rodríguez-Bayón, Antonina; de Dios Luna, Juan; Torres-González, Francisco

2008-01-01

156

Successful treatment of a primary gastric T-cell lymphoma lacking the human T-cell leukemia virus type 1.  

PubMed

Primary gastric lymphomas generally are of B-cell lineage. Among the previously reported cases of exceptional primary gastric T-cell lymphomas, most demonstrate evidence of human T-cell leukemia virus type 1 (HTLV-1) infection with a poor prognosis. The present study is a report of a rare case of primary gastric T-cell lymphoma without HTLV-1 which could be successfully treated with surgical resection and adjuvant chemotherapy. The patient was a 50-year-old Japanese male who presented with epigastric pain. Clinical examination showed no lymphadenopathy or skin changes. Radiographic and endoscopic examinations revealed an ill-demarcated ulcerative lesion in the stomach, and a biopsy specimen confirmed high-grade lymphoma. Total gastrectomy with regional lymph node dissection was performed. Histological examination of the gastric lesion revealed a malignant lymphoma, diffuse large cell type, with lymph nodal involvement. On immunohistochemistry, tumor cells were positive for CD3, CD4 and CD30, but negative for CD8, CD20 and CD56, implying a T-cell nature. Following surgery, the patient received 8 cycles of chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisolone/CHOP). To date the patient has been free of recurrence for 86 months without further treatment. Review of previously reported cases of primary gastric T-cell lymphoma indicates that the prognosis is better without than with HTLV-1. We conclude that primary gastric T-cell lymphomas without HTLV-1 should be managed in the same way as the more common diffuse large B-cell type gastric lymphomas. PMID:20583449

Yachida, Shinichi; Sasako, Mitsuru; Tobinai, Kensei; Matsuno, Yoshihiro; Shimoda, Tadakazu

2010-01-01

157

Accumulation of nitrogen and organic matter during primary succession of Leymus arenarius dunes on the volcanic island Surtsey, Iceland  

NASA Astrophysics Data System (ADS)

Initial soil development and enhanced nutrient retention are often important underlying environmental factors during primary succession. We quantified the accumulation rates of nitrogen (N) and soil organic matter (SOM) in a 37-year-long chronosequence of Leymus arenarius dunes on the pristine volcanic island Surtsey in order to illuminate the spatiotemporal patterns in their build-up. The Leymus dune area, volume and height grew exponentially over time. Aboveground plant biomass, cover or number of shoots per unit area did not change significantly with time, but root biomass accumulated with time, giving a root / shoot ratio of 19. The dunes accumulated on average 6.6 kg N ha-1 year-1, which was 3.5 times more than is received annually by atmospheric deposition. The extensive root system of Leymus seems to effectively retain and accumulate a large part of the annual N deposition, not only deposition directly on the dunes but also from the adjacent unvegetated areas. SOM per unit area increased exponentially with dune age, but the accumulation of roots, aboveground biomass and SOM was more strongly linked to soil N than time: a 1 g m-2 increase in soil N led on average to a 6 kg C m-2 increase in biomass and SOM. The Leymus dunes, where most of the N has been accumulated, will therefore probably act as hot spots for further primary succession of flora and fauna on the tephra sands of Surtsey.

Stefansdottir, G.; Aradottir, A. L.; Sigurdsson, B. D.

2014-10-01

158

Metachronous renal vein and artery injure after percutaneous nephrostolithotomy  

PubMed Central

Background Percutaneous nephrostolithotomy is important approach for kidney stones removal. A percutaneous nephrostomy drainage tube placement is an effective method to stop venous bleeding. Occasionally, the catheter can pierce into the renal parenchyma, and migrate into the renal vein even to the vena cava. Case presentation A 66-year-old woman underwent a percutaneous nephrostolithotomy for kidney staghorn stone complicating severe bleeding. A computed tomography angiography showed the percutaneous nephrostomy drainage tube inside the renal vein. The percutaneous nephrostomy drainage tube was withdrawn 3 cm back to the renal parenchyma/sinus/pelvis in stages with the surgical team on standby. Seven days later, the patient developed severe hematuria. Computed tomography angiography demonstrated the pseudoaneurysm located near the percutaneous nephrostomy drainage tube. Pseudoaneurysm is embolized successfully. Conclusion Our case shows intravenous misplacement of the nephrostomy tube and subsequent pseudoaneurysm after percutaneous nephrostolithotomy. To our knowledge, this seems to be the first documentation of major bleeding from the injury to both renal vein and artery. The percutaneous nephrostomy drainage tube can be withdrawn back to the renal parenchyma/sinus/pelvis in stages with the surgical team on standby, and the withdrawn distance may vary according to patient and catheter position. PMID:24304827

2013-01-01

159

Intracardiac echocardiography for percutaneous closure of atrial septal defects: initial experiences in Japan.  

PubMed

Transcatheter closure of secundum atrial septal defect (ASD) has been widely performed as a less invasive alternative to surgery with zero mortality so far in Japan. In the US and Europe, intracardiac echocardiography (ICE) has replaced transesophageal echocardiography (TEE) as a primary imaging tool during percutaneous ASD closure. However, the experience of ICE in ASD closure is limited in Japan. Consecutive 51 patients underwent percutaneous ASD closure with ICE guidance. Clinical results were compared to those of 41 patients who underwent ASD closure with TEE guidance. Pediatric patients and patients with multiple ASDs who were expected to need multiple devices were excluded. Success rate was similar in both groups (ICE 96.1 %, TEE 92.7 %). Catheterization laboratory time was significantly shortened with ICE than with TEE (131 vs. 155 min, p = 0.0003). There were no complications related to the use of ICE. ICE-guided ASD closure is feasible in most adult patients. ICE is superior to TEE in shortening catheterization laboratory time and eliminating general anesthesia, and can potentially replace TEE as the primary image guide during percutaneous ASD closure. PMID:23709325

Shimizu, Sayaka; Kawamura, Akio; Arai, Takahide; Ohno, Yohei; Mogi, Satoshi; Kodaira, Masaki; Anzai, Atsushi; Kawakami, Takashi; Kanazawa, Hideaki; Hayashida, Kentaro; Yuasa, Shinsuke; Maekawa, Yuichiro; Fukuda, Keiichi

2013-10-01

160

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

161

Percutaneous drainage and sclerotherapy as definitive treatment of renal lymphangiomatosis  

PubMed Central

We report the technique and outcome of percutaneous drainage and sclerotherapy as primary treatment of renal lymphangiomatosis. Between January and May 2009, two patients presenting with symptomatic renal lymphangiomatosis were treated in our department by a minimally invasive modality combining percutaneous drainage with repeated sclerotherapy. We retrospectively analysed recurrence, complications and patient satisfaction. In this limited case series, percutaneous drainage and repeated sclerotherapy proved to be safe and effective for treating renal lymphangiomatosis. This procedure provides a minimally invasive option for selected patients, potentially avoiding a surgical procedure and any risk of complications. PMID:22396381

Valerio, Massimo; Meuwly, Jean-Yves; Tawadros, Cecile; Jichlinski, Patrice

2012-01-01

162

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. PMID:22971139

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

163

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

164

Participation in the SUCCESS-A Trial Improves Intensity and Quality of Care for Patients with Primary Breast Cancer  

PubMed Central

The SUCCESS-A trial is a prospective, multicenter, phase III clinical trial for high-risk primary breast cancer. It compares disease-free survival after randomization in patients treated with fluorouracil, epirubicin and cyclophosphamide followed by 3 cycles of docetaxel (FEC-D) with that of patients treated with 3 cycles of FEC followed by 3 cycles of gemcitabine and docetaxel (FEC-DG). After a second randomization patients were treated with zoledronate for 2 or 5 years. A total of 251 centers took part in the trial and 3754 patients were recruited over a period of 18 months which ended in March 2007. In a questionnaire-based survey we investigated the impact of enrollment in the trial on patient care, the choice of chemotherapy protocol and access to current oncologic information as well as overall satisfaction in the respective centers. Analysis of the 78 questionnaires returned showed that 40?% of the centers had never previously enrolled patients with these indications in clinical studies. Prior to participating in the study, 4?% of the centers prescribed CMF or other protocols in patients with high-primary breast cancer risk, 46?% administered anthracycline-based chemotherapy and 50?% gave taxane-based chemotherapy. Around half of the participating centers noted that intensity of care and overall quality of care became even better and that access to breast cancer-specific information improved through participation in the trial. After their experience with the SUCCESS-A trial, all of the centers stated that they were prepared to enroll patients in clinical phase III trials again in the future. These data indicate that both patients and physicians benefit from clinical trials, as enrollment improves treatment strategies and individual patient care, irrespective of study endpoints. PMID:24771886

Andergassen, U.; Kasprowicz, N. S.; Hepp, P.; Schindlbeck, C.; Harbeck, N.; Kiechle, M.; Sommer, H.; Beckmann, M. W.; Friese, K.; Janni, W.; Rack, B.; Scholz, C.

2013-01-01

165

N-P Co-Limitation of Primary Production and Response of Arthropods to N and P in Early Primary Succession on Mount St. Helens Volcano  

PubMed Central

Background The effect of low nutrient availability on plant-consumer interactions during early succession is poorly understood. The low productivity and complexity of primary successional communities are expected to limit diversity and abundance of arthropods, but few studies have examined arthropod responses to enhanced nutrient supply in this context. We investigated the effects of nitrogen (N) and phosphorus (P) addition on plant productivity and arthropod abundance on 24-yr-old soils at Mount St. Helens volcano. Methodology/Principal Findings We measured the relative abundance of eight arthropod orders and five families in plots that received N, P, or no nutrients for 3–5 years. We also measured plant % cover, leaf %N, and plant diversity. Vegetation responded rapidly to N addition but showed a lagged response to P that, combined with evidence of increased N fixation, suggested P-limitation to N availability. After 3 yrs of fertilization, orthopterans (primarily Anabrus simplex (Tettigoniidae) and Melanoplus spp (Acrididae)) showed a striking attraction to P addition plots, while no other taxa responded to fertilization. After 5 yrs of fertilization, orthopteran density in the same plots increased 80%–130% with P addition and 40% with N. Using structural equation modeling, we show that in year 3 orthopteran abundance was associated with a P-mediated increase in plant cover (or correlated increases in resource quality), whereas in year 5 orthopteran density was not related to cover, diversity or plant %N, but rather to unmeasured effects of P, such as its influence on other aspects of resource quality. Conclusions/Significance The marked surprising response to P by orthopterans, combined with a previous observation of P-limitation in lepidopteran herbivores at these sites, suggests that P-mediated effects of food quantity or quality are critical to insect herbivores in this N-P co-limited primary successional system. Our results also support a previous suggestion that the availability of N in these soils is P-limited. PMID:21049006

Bishop, John G.; O'Hara, Niamh B.; Titus, Jonathan H.; Apple, Jennifer L.; Gill, Richard A.; Wynn, Louise

2010-01-01

166

Anticoagulant therapy during primary percutaneous coronary intervention for acute myocardial infarction: a meta-analysis of randomized trials in the era of stents and P2Y12 inhibitors  

PubMed Central

Objectives To investigate the relative benefits of unfractionated heparin, low molecular weight heparin(LMWH), fondaparinux, and bivalirudin as treatment options for patients with ST segment elevation myocardial infarction undergoing percutaneous coronary intervention (PCI). Design Mixed treatment comparison and direct comparison meta-analysis of randomized trials in the era of stents and P2Y12 inhibitors. Data sources and study selection A search of Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) for randomized trials comparing unfractionated heparin plus glycoprotein IIb/IIIa inhibitor(GpIIb/IIIa inhibitor), unfractionated heparin, bivalirudin, fondaparinux, or LMWH plus GpIIb/IIIa inhibitor for patients undergoing primary PCI. Outcomes The primary efficacy outcome was short term (in hospital or within 30 days) major adverse cardiovascular event; the primary safety outcome was short term major bleeding. Results We identified 22 randomized trials that enrolled 22?434 patients. In the mixed treatment comparison models, when compared with unfractionated heparin plus GpIIb/IIIa inhibitor, unfractionated heparin was associated with a higher risk of major adverse cardiovascular events (relative risk 1.49 (95% confidence interval 1.21 to 1.84), as were bivalirudin (relative risk 1.34 (1.01 to 1.78)) and fondaparinux (1.78 (1.01 to 3.14)). LMWH plus GpIIb/IIIa inhibitor showed highest treatment efficacy, followed (in order) by unfractionated heparin plus GpIIb/IIIa inhibitor, bivalirudin, unfractionated heparin, and fondaparinux. Bivalirudin was associated with lower major bleeding risk compared with unfractionated heparin plus GpIIb/IIIa inhibitor (relative risk 0.47 (0.30 to 0.74)) or unfractionated heparin (0.58 (0.37 to 0.90)). Bivalirudin, followed by unfractionated heparin, LMWH plus GpIIb/IIIa inhibitor, unfractionated heparin plus GpIIb/IIIa inhibitor, and fondaparinux were the hierarchy for treatment safety. Results were similar in direct comparison meta-analyses: bivalirudin was associated with a 39%, 44%, and 65% higher risk of myocardial infarction, urgent revascularization, and stent thrombosis respectively when compared with unfractionated heparin with or without GpIIb/IIIa inhibitor. However, bivalirudin was associated with a 48% lower risk of major bleeding compared with unfractionated heparin plus GpIIb/IIIa inhibitor and 32% lower compared with unfractionated heparin alone. Conclusions In patients undergoing primary PCI, unfractionated heparin plus GpIIb/IIIa inhibitor and LMWH plus GpIIb/IIIa inhibitor were most efficacious, with the lowest rate of major adverse cardiovascular events, whereas bivalirudin was safest, with the lowest bleeding. These relationships should be considered in selecting anticoagulant therapies in patients undergoing primary PCI. PMID:25389143

Toklu, Bora; Kotwal, Anupam; Volodarskiy, Alexander; Sharma, Sahil; Kirtane, Ajay J; Feit, Frederick

2014-01-01

167

Ectomycorrhizal ecology under primary succession on coastal sand dunes: interactions involving Pinus contorta, suilloid fungi and deer.  

PubMed

Ectomycorrhizal fungi (EMF) are critical for pine establishment under primary succession. The species of EMF supporting primary successional pine seedlings on coastal sand dunes and mechanisms for their establishment were investigated. Fungi were identified from ectomycorrhizal roots using molecular techniques. Field seedlings were collected from forested and nonforested zones. Laboratory seedlings were grown in soils collected from the same zones, and in sterile soils inoculated with fresh and 1-yr-old dry deer fecal pellets. Suilloid fungi were frequently observed on all seedlings. A diverse group of fungi was available to seedlings in forested zones. A less diverse group of fungi was available to field seedlings in nonforested zones and all laboratory bioassay seedlings. Deer fecal inoculant yielded an average of two EMF per seedling. Both Suillus and Rhizopogon species dominated seedlings inoculated with fresh deer feces, but only Rhizopogon species dominated seedlings inoculated with 1-yr-old feces. Suilloid fungi are dispersed by deer, produce resistant spore banks and are the principle fungi supporting seedlings on the sand dunes. PMID:16411937

Ashkannejhad, Sara; Horton, Thomas R

2006-01-01

168

-The role of refugia and dispersal in primary succession on Mount St. Helens, Washington -637 Journal of Vegetation Science 14: 637-644, 2003  

E-print Network

- The role of refugia and dispersal in primary succession on Mount St. Helens, Washington - 637 blast devastated Mount St. Helens in 1980, but forest understory species survived in some north- slope of community assembly. We investigated how refugia influenced succession, because even minor isolation (m

del Moral, Roger

169

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

170

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

171

Percutaneous osteoplasty in treatment of bone lymphangiomatosis  

PubMed Central

Primary bone lymphangiomatosis is a disease of unknown etiology that can cause lytic lesions in long bones, the pelvis, the spinal column and the cranium. We are presenting the case of a woman with localized bone lymphangiomatosis in the left knee. The authors believe this is the first case in which percutaneous osteoplasty was used in long bones for the treatment of bone lesions resulting from this disease showing good clinical results. PMID:24133314

Mifsut, Damián; Renovell, Pablo; Gomar, Francisco; Saravia, Marcos

2013-01-01

172

Intracoronary compared to intravenous Abciximab and high-dose bolus compared to standard dose in patients with ST-segment elevation myocardial infarction undergoing transradial primary percutaneous coronary intervention: a two-by-two factorial placebo-controlled randomized study.  

PubMed

Platelet aggregation inhibition (PAI) of > or =95% has been associated with improved outcomes after percutaneous coronary intervention (PCI) and glycoprotein IIb/IIIa inhibitor treatment. A greater thrombotic burden in acute ST-segment elevation myocardial infarction (STEMI) might require higher doses and/or intracoronary delivery of glycoprotein IIb/IIIa inhibitors to achieve optimal PAI. Using a 2 x 2 factorial placebo-controlled design, 105 patients with STEMI who had been referred for primary PCI within 6 hours of symptom onset were randomized to intracoronary (IC) or intravenous (IV) delivery of an abciximab bolus at a standard dose (0.25 mg/kg) or high dose (> or =0.30 mg/kg) of abciximab. The primary end point was PAI measured at 10 minutes after the bolus of abciximab. Secondary end points included the acute and 6-month outcomes using angiographic parameters, cardiac biomarkers, cardiovascular magnetic resonance imaging, and clinical end points. At 10 minutes after the bolus, the proportion of patients with > or =95% PAI was not different between the IC and IV groups (53% vs 54%, p = 1.00) nor between the high-dose and standard-dose bolus groups (56% vs 51%, p = 0.70). Acutely, the angiographic myocardial blush grades, peak release of cardiac biomarkers, necrosis size, myocardial perfusion, and no reflow as assessed by magnetic resonance imaging, and clinical end points were similar between the groups and did not suggest a benefit for IC compared to IV or high-dose versus standard-dose bolus of abciximab. No increase occurred in bleeding complications with the high-dose bolus or IC delivery. The clinical, angiographic and cardiac magnetic resonance imaging outcomes at 6 and 12 months were similar between the 4 groups. In conclusion, in patients with STEMI presenting with symptom onset <6 hours and undergoing transradial primary PCI, PAI remained suboptimal, despite a higher dose bolus of abciximab. A higher dose bolus or IC delivery of abciximab bolus was not associated with improved acute or late results compared to the standard IV dosing and administration. PMID:20494655

Bertrand, Olivier F; Rodés-Cabau, Josep; Larose, Eric; Rinfret, Stéphane; Gaudreault, Valérie; Proulx, Guy; Barbeau, Gérald; Déry, Jean-Pierre; Gleeton, Onil; Manh-Nguyen, Can; Noël, Bernard; Roy, Louis; Costerousse, Olivier; De Larochellière, Robert

2010-06-01

173

Percutaneous distal perfusion of the lower extremity following femoral cannulation for venoarterial ECMO in a small child  

PubMed Central

Femoral cannulation in pediatric patients requiring extracorporeal membrane oxygenation (ECMO) is commonly associated with distal limb ischemia. Authors have previously reported successful lower limb perfusion using various open techniques to cannulate a distal lower extremity artery at the time of initial ECMO cannulation. These procedures include open femoral artery antegrade cannulation and distal posterior tibial artery retrograde cannulation in older children and adults. Such approaches require ample vessel diameters that can accommodate an arteriotomy and catheter insertion, and therefore are of limited utility in smaller children. We hypothesized that following femoral artery cannulation for ECMO, a percutaneous technique of distal limb perfusion might offer unique advantages when treating lower extremity ischemia in small pediatric patients. We report a technique for percutaneous antegrade cannulation in a 4 year old patient shortly following her primary cannulation for venoarterial ECMO via the femoral artery. PMID:19231552

Haley, Mary Jo; Fisher, Jason C.; Ruiz-Elizalde, Alejandro R.; Stolar, Charles J.H.; Morrissey, Nicholas J.; Middlesworth, William

2011-01-01

174

Impact of multiple balloon inflations during primary percutaneous coronary intervention on infarct size and long-term clinical outcomes in ST-segment elevation myocardial infarction: real-world postconditioning.  

PubMed

Interrupting myocardial reperfusion with intermittent episodes of ischemia (i.e., postconditioning) during primary percutaneous coronary intervention (PPCI) has been suggested to protect myocardium in ST-segment elevation myocardial infarction (STEMI). Nevertheless, trials provide inconsistent results and any advantage in long-term outcomes remains elusive. Using a retrospective study design, we evaluated the impact of balloon inflations during PPCI on enzymatic infarct size (IS) and long-term outcomes. We included 634 first-time STEMI patients undergoing PPCI with an occluded infarct-related artery and adequate reperfusion thereafter and divided these into: patients receiving 1-3 inflations in the infarct-related artery [considered minimum for patency/stent placement (controls); n = 398] versus ?4 [average cycles in clinical protocols (postconditioning analogue); n = 236]. IS, assessed by peak creatine kinase, was lower in the postconditioning analogue group compared with controls [median (interquartile range) 1,287 (770-2,498) vs. 1,626 (811-3,057) UI/L; p = 0.02], corresponding to a 21 % IS reduction. This effect may be more pronounced in women, patients without diabetes/hypercholesterolemia, patients presenting within 3-6 h or with first balloon re-occlusion ?1 min. No differences were observed in 4-year mortality or MACCE between groups. Four or more inflations during PPCI reduced enzymatic IS in STEMI patients under well-defined conditions, but did not translate into improved long-term outcomes in the present study. Large-scale randomized trials following strict postconditioning protocols are needed to clarify this effect. PMID:24481769

Yetgin, Tuncay; Magro, Michael; Manintveld, Olivier C; Nauta, Sjoerd T; Cheng, Jin M; den Uil, Corstiaan A; Simsek, Cihan; Hersbach, Ferry; van Domburg, Ron T; Boersma, Eric; Serruys, Patrick W; Duncker, Dirk J; van Geuns, Robert-Jan M; Zijlstra, Felix

2014-03-01

175

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

176

Relationship between ST-segment resolution and anterior infarct size after primary percutaneous coronary intervention: analysis from the INFUSE-AMI trial  

PubMed Central

Aims: ST-segment resolution (STR) after reperfusion therapy has been shown to correlate with prognosis in patients with ST-segment elevation myocardial infarction (STEMI). We investigated whether acute ECG measurements also correlate with ultimate infarct size. Methods and Results: The INFUSE-AMI trial randomized 452 patients with anterior STEMI to intracoronary bolus abciximab vs. no abciximab, and to thrombus aspiration vs. no aspiration. Infarct size as percentage of total LV mass was calculated by cardiac magnetic resonance imaging (MRI) 30 days post intervention. Five ECG methods were analysed for their ability to predict MRI infarct mass: (1) summed STR across all infarct-related ECG leads (?STR); (2) STR in the single lead with maximum baseline ST-segment elevation (maxSTR); (3) summed residual ST-segment elevation across all infarct-related leads at 60 min post intervention (?ST residual); (4) maximum residual ST-segment elevation in the worst single lead at 60 min post intervention (maxST residual); (5) number of new significant Q-waves (Qwave) at 60 min. All ECG methods strongly correlated with 30-day MRI infarct mass (all p<0.003). Simpler ECG measurements such as maxSTresidual and Qwave were as predictive as more complex measurements. A subset analysis of 158 patients who had microvascular obstruction (MVO) determined by MRI 5 days post intervention also showed strong correlations of MVO with the ECG measures. Conclusions: ST-segment and Q-wave changes after primary PCI in anterior STEMI strongly correlated with 30-day infarct size by MRI. In particular, maxST residual and Qwave at 60 min are simple ECG parameters that offer rapid analysis for prognostication. PMID:24562806

Brener, Sorin J; Maehara, Akiko; Witzenbichler, Bernard; Biviano, Angelo; Godlewski, Jacek; Parise, Helen; Dambrink, Jan-Henk; Mehran, Roxana; Gibson, C Michael; Stone, Gregg W

2014-01-01

177

Percutaneous Transhepatic Cholangiography  

Microsoft Academic Search

This is an evaluation of percutaneous transhepatic cholangiography, a technique of over eight years' standing, previously considered by many authorities as both unrewarding and dangerous. The value and risks of the procedure have been examined in 20 patients with obstructive jaundice of uncertain origin and in one further patient with a post-cholecystectomy syndrome. The presence and the nature of extrahepatic

Michael Atkinson; Margaret G. Happey; Francis G. Smiddy

1960-01-01

178

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

179

Comparison of treatment of renal calculi by open surgery, percutaneous nephrolithotomy, and extracorporeal shockwave lithotripsy.  

PubMed Central

This study was designed to compare different methods of treating renal calculi in order to establish which was the most cost effective and successful. Of 1052 patients with renal calculi, 350 underwent open surgery, 350 percutaneous nephrolithotomy, 328 extracorporeal shockwave lithotripsy (ESWL), and 24 both percutaneous nephrolithotomy and ESWL. Treatment was defined as successful if stones were eliminated or reduced to less than 2 mm after three months. Success was achieved in 273 (78%) patients after open surgery, 289 (83%) after percutaneous nephrolithotomy, 301 (92%) after ESWL, and 15 (62%) after percutaneous nephrolithotomy and ESWL. Comparative total costs to the NHS were estimated as 3500 pounds for open surgery, 1861 pounds for percutaneous nephrolithotomy, 1789 pounds for ESWL, and 3210 pounds for both ESWL and nephrolithotomy. ESWL caused no blood loss and little morbidity and is the cheapest and quickest way of returning patients to normal life. PMID:3083922

Charig, C R; Webb, D R; Payne, S R; Wickham, J E

1986-01-01

180

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

181

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

182

SMALL-SCALE SPATIOTEMPORAL DYNAMICS OF PLANT COVER DURING THE INITIAL PHASE OF PRIMARY SUCCESSION IN AN ABANDONED ORE-WASHERY SEDIMENTATION BASIN  

Microsoft Academic Search

Permanent plots and repeated mapping of the initial primary succession in the abandoned sedimentation basin in Chvaletice (E Bohemia, Czech Republic) demonstrated plant cover dynamics of colonizing species living in an extreme environment. The analysis used autocorrelation and cross-correlation (Mo- ran's I) over lags in space and time (13 years long period). Short-lived and long- lived (clonal) plants exhibit complementary

Pavel Kováfi

2005-01-01

183

Latest Data Show Strong Fertility Center Offers Region's Best IVF Success Rates! The Society for Assisted Reproductive Technology (SART), the primary organization of  

E-print Network

Latest Data Show Strong Fertility Center Offers Region's Best IVF Success Rates! The Society for Assisted Reproductive Technology (SART), the primary organization of professionals dedicated to the practice of assisted reproductive technologies (ART) in the United States, annually collects and publishes

Goldman, Steven A.

184

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

185

[Results of percutaneous transluminal angioplasty].  

PubMed

Percutaneous transluminal angioplasty (PTA) can be subdivided into three epochs: 1. from its inception by Dotter and Judkins up to the first coronary artery stenosis dilatation with the Grüntzig balloon catheter system; 2. from the introduction of coronary stenosis dilatation by Grüntzig up to its unequivocal acceptance; 3. the period of influence of low-risk coronary dilatation on peripheral angioplasty and the search for techniques to compliment or obviate the need for balloon dilatation. The Grüntzig double-lumen balloon catheter system contributed to the lower rate of complications and higher success rate. The clinical acceptance appeared greater for the coronary arteries since, in contrast to the peripheral vascular system, the indication for treatment is established by the physician performing the dilatation. PTA implies percutaneous puncture of a vessel with Seldinger technique and introduction of devices such as guidewires, Dotter or Grüntzig catheters among others, catheters with fiberglass for laser conduction and instruments for fractionating, drilling and cutting. The goal of PTA is to completely or partially eliminate, without surgery, intraluminal vascular narrowing in the presence of peripheral arterial disease in stage II, III or IV. Prerequisite to the use of PTA are: 1. adequate fluoroscopic and angiographic facilities; 2. adequate instrumentation; 3. experience with at least 200 procedures; 4. knowledge of the pathophysiology and adjunctive treatment; 5. knowledge of the treatment of complications; 6. cooperation with a vascular surgery service. A number of factors may influence the results of treatment. Adjunctive medical treatment: the use of platelet aggregation inhibitors and heparin influences the rate of early rethrombosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2522077

Zeitler, E; Feng, G; Oldendorf, M; Richter, E I; Ritter, W; Seyferth, W

1989-02-01

186

Use of 99m Tc-sestamibi gated SPECT to assess the influence of anterograde flow before primary coronary angioplasty on tissue salvage and functional recovery in acute myocardial infarction  

Microsoft Academic Search

Purpose Preserved thrombolysis in myocardial infarction (TIMI) flow before percutaneous coronary intervention (PCI) in acute myocardial infarction is related to improved outcome. Gated single-photon emission computed tomography (SPECT) allows the simultaneous assessment of left ventricular perfusion and function. We evaluated the initial risk area and subsequent evolution of perfusion and function according to TIMI flow before successful primary PCI. Methods

Mario Leoncini; Francesco Bellandi; Roberto Sciagrà; Mauro Maioli; Anna Toso; Stelvio Sestini; Angela Coppola; Alberto Mennuti; Roberto Piero Dabizzi; Alberto Pupi

2004-01-01

187

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

188

Percutaneous Sclerotherapy Using Acetic Acid After Failure of Alcohol Ablation in an Intra-abdominal Lymphangioma  

SciTech Connect

We report a case of percutaneous sclerotherapy using acetic acid in a 22-year-old woman with an intra-abdominal cystic lymphangioma who was not successfully treated with ethanol despite multiple trials.

Park, Sang Woo [Konkuk University Hospital, Konkuk University School of Medicine, Department of Diagnostic Radiology (Korea, Republic of)], E-mail: psw0224@kku.ac.kr; Cha, In Ho; Kim, Kyeong Ah; Hong, Suk Joo; Park, Cheol Min; Chung, Hwan Hoon [Department of Diagnostic Radiology, Korea University School of Medicine (Korea, Republic of)

2004-09-15

189

Percutaneous Nephrolithotomy in Early Pregnancy  

Microsoft Academic Search

We report on an 11-weeks pregnant woman, who under went a percutaneous nephrolithotomy without the use of X-rays during the procedure due to 8-mm left upper ureteric stone. In the available literature, we didn’t find any reported case about percutaneous stone removal without the use of X-rays.

Csaba Tóth; György Tóth; Attila Varga; Tibor Flaskó; Morshed A. Salah

2005-01-01

190

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. PMID:21059205

2010-01-01

191

Percutaneous Transosseous Embolization of Internal Iliac Artery Aneurysm Type II Endoleak: Report of Two Cases  

SciTech Connect

This report describes two cases of successful treatment of an internal iliac artery aneurysm (IIAA) type II endoleak utilizing a percutaneous transosseous access that could not be treated using an endovascular or standard percutaneous approach. A direct percutaneous approach through bone was chosen to avoid vital structures and the surrounding bowel. The procedure was successful and required minimal fluoroscopy time compared with other treatment options. We believe this procedure is an alternative to some of the more complex and technically challenging means of treating this lesion.

Gemmete, Joseph J., E-mail: gemmete@umich.edu; Arabi, Mohammad; Cwikiel, Wojciech B. [University of Michigan Health System, Department of Radiology (United States)

2011-02-15

192

Barriers to the successful practice of chronic kidney diseases at the primary health care level; a systematic review  

PubMed Central

Background: Chronic kidney disease (CKD), a major global public health problem, has been recognized as one of the eleven important causes of death. This review explores a wide range of barriers related to patients and health systems involved in controlling the prevalence of CKD at the primary health care level. Patients and Method: Electronic databases including PubMed/Medline, Cumulative Index to Nursing and Allied Health (CINAHL), Entrez, British Medical Journal (BMJ), EBSCO host, Cochrane and Google scholar were searched for the data published from 2000 to 2010 using MeSH terms such as ‘chronic kidney diseases’, ‘renal transplantation’, ‘complications’, ‘health care services’, ‘acute renal failure’. After screening 587 abstracts, a total of 10 studies were selected for systematic review. Developed countries such as the United Kingdom, the USA and other European countries were reviewed in order to identify the barriers associated with CKD practice at the primary health care level. The reasons for the failure of services at the primary health care level were categorized. A pre-defined protocol was used for data extraction and content appraisal. Results: At the primary health care level, the major barriers associated with CKD include the late referral of patients to nephrologists, old age, presence of several co-morbidities, lack of education and awareness among ethnic minorities, difficulty in communication between primary health care professionals, and the shortage of multi-disciplinary care team at dialysis centers. Additionally, factors such as drug-drug interaction during treatment, lack of anemia-management during dialysis, hypertension, and depression in CKD patients also act as important barriers in CKD care at the primary health care level. Conclusion: The knowledge and awareness about CKD management is lacking. Therefore, educational intervention is essential for patients as well medical personnel. Also, a multidisciplinary care team is essential for the complex management of CKD due to associated co-morbidities. PMID:25340171

Junaid Nazar, Chaudhary Muhammad; Kindratt, Tiffany Billmeier; Ahmad, Syed Muhammad Ahtizaz; Ahmed, Manzoor; Anderson, John

2014-01-01

193

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. PMID:16020592

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

194

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

195

A NOVEL MECHANICAL TRANSMISSION APPLIED TO PERCUTANEOUS RENAL ACCESS  

E-print Network

) procedure duration, (3) patient safety, (4) sterility, and (5) surgeon radiation exposure. After extensive surgery significantly reduce patient morbidity and recovery time. However, percutaneous needle access can an active robot for similar purposes. Although these systems successfully address issues of image

Whitcomb, Louis L.

196

Percutaneous Bipolar Radiofrequency Microdebridement for Recalcitrant Proximal Plantar Fasciosis  

Microsoft Academic Search

Success rates for traditional methods of surgical intervention for chronic plantar fasciosis are low, and associated with high rates of complications and long recovery times. The purpose of this prospective case series was to assess the effectiveness of percutaneous bipolar radiofrequency microfasciotomy for the treatment of recalcitrant proximal plantar fasciosis in 21 patients. The mean preoperative American Orthopaedic Foot &

Matthew D. Sorensen; Christopher F. Hyer; Terrence M. Philbin

2011-01-01

197

Bright and Beautiful: High Achieving Girls, Ambivalent Femininities, and the Feminization of Success in the Primary School  

ERIC Educational Resources Information Center

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…

Renold, Emma; Allan, Alexandra

2006-01-01

198

Investigating Fresh Water--Some Ideas That Have Been Used Successfully in Primary Schools in the ACT.  

ERIC Educational Resources Information Center

Outlines some strategies used in primary schools in the Australian Capital Territory (ACT) to teach science. Teachers wanting to investigate freshwater conducted experiments and drew concepts for reuse, recycling, and conservation. Presents two case studies using these activities to show how this theme can be used to introduce and consolidate a…

Shoring, Nola

2003-01-01

199

Percutaneous coronary intervention in a patient with single coronary artery  

PubMed Central

Coronary artery anomalies are found in 1–5% of all coronary angiograms. Single coronary artery is a rare congenital anomaly. The prevalence of the anomaly is 0.024–0.066% of the general population and percutaneous coronary intervention in this anomaly is performed infrequently. The highest incidence of this condition is reported from India. We report a case of a 55 year old patient of anterior wall ST elevation myocardial infarction with L1 group of single coronary artery who underwent successful angioplasty and stenting to left anterior descending artery. The unique features and inherent risks of percutaneous coronary intervention to single coronary artery are discussed. PMID:24973852

Mishra, T.K.; Mishra, C.K.; Das, B.

2014-01-01

200

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

201

Atlantoaxial joint synovial cyst: diagnosis and percutaneous treatment.  

PubMed

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. PMID:18437457

Velán, Osvaldo; Rabadán, Alejandra; Paganini, Lisandro; Langhi, Luciano

2008-01-01

202

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

203

Percutaneous balloon dilatation in congenital mitral stenosis.  

PubMed Central

A three year old girl with severe congenital mitral stenosis was successfully treated by percutaneous balloon dilatation of the mitral valve. Cardiac catheterisation and cross sectional and Doppler echocardiography indicated that the orifice of the mitral valve had doubled in area. A small atrial septal defect was found at follow up cardiac catheterisation and angiography. Balloon dilatation of the mitral valve is a reasonable alternative to surgical treatment for typical congenital mitral stenosis even in young children. Images Fig 1 Fig 2 PMID:3593619

Alday, L E; Juaneda, E

1987-01-01

204

Monoplanar access technique for percutaneous nephrolithotomy.  

PubMed

Percutaneous renal access is the most important step in percutaneous nephrolithotomy (PNL), and the adequacy of access directly affects the success and complication rates of this procedure. We use a monoplanar access technique that is different from biplanar method in that we utilize only fluoroscopic projections maintained on a vertical plane. The aim of this study is to evaluate the effects of this monoplanar access technique on operative outcomes. From October 2009 to December 2011, a total of 200 patients who had renal stones and underwent monoplanar PNL which done by the same surgical team were included in this study. Patient and procedure-related factors were recorded, as well as perioperation and postoperation variables such as operation time, puncture time, fluoroscopy screening time, complication rates, success rates, and duration of hospitalization. The average patient age at the time of procedure was 30.32 years. Mean operation and puncture time were 79.8 and 0.83 min, respectively. Stone-free rate was 80.5 % in postoperative day 1. After additional procedures such as shock wave lithotripsy (SWL), ureterorenoscopy and re-PNL final success rate was 98 % at third month including patients with clinically insignificant residual fragments. There were no severe complications except one patient in whom adjacent organ injury (colon) was observed. Monoplanar access is a safe and effective technique in PNL procedure. Furthermore less puncture time is an advantage of this technique. PMID:23564416

Hatipoglu, Nam?k Kemal; Bodakci, Mehmet Nuri; Penbegül, Necmettin; Bozkurt, Ya?ar; Sancaktutar, Ahmet Ali; Atar, Murat; Söylemez, Haluk

2013-06-01

205

Psychosocial Factors Associated with Successful Transition into HIV Case Management for those without Primary Care in an Urban Area  

Microsoft Academic Search

The purpose of this study was to identify the psychosocial factors which influence transitioning HIV positive clients without\\u000a primary medical care to a case management agency within 6 weeks by a city brokerage agency. People living with HIV who reported\\u000a being in a social support group and those who requested assistance with meeting their basic needs were significantly more\\u000a likely to

Derek Johnson; Marcia Polansky; Marlene Matosky; Michelle Teti

2010-01-01

206

Percutaneous trans-hepatic bilateral biliary stenting in Bismuth IV malignant obstruction  

PubMed Central

AIM: To investigate the clinical efficiency of percutaneous trans-hepatic bilateral biliary metallic stenting for the management of Bismuth IV malignant obstructive disease. METHODS: Our hospital’s database was searched for all patients suffering from the inoperable malignant biliary obstruction Bismuth IV, and treated with percutaneous bilateral trans-hepatic placement of self-expandable nitinol stents. The indication for percutaneous stenting was an inoperable, malignant, symptomatic, biliary obstruction. An un-correctable coagulation disorder was the only absolute contra-indication for treatment. Bismuth grading was performed using magnetic resonance cholangiopancreatography. Computed tomography evaluation of the lesion and the dilatation status of the biliary tree was always performed prior to the procedure. All procedures were performed under conscious sedation. A single trans-hepatic track technique was preferred (T-configuration stenting) and a second, contra-lateral trans-hepatic track (Y-configuration stenting) was used only in cases of inability to access the contra-lateral lobe using a single track technique. The study’s primary endpoints were clinical success, defined as a decrease in bilirubin levels within 10 d and patient survival rates. Secondary endpoints included peri-procedural complications, primary and secondary patency rates. RESULTS: A total of 35 patients (18 female, 51.4%) with a mean age 69 ± 13 years (range 33-88) were included in the study. The procedures were performed between March 2000 and June 2008 and mean time follow-up was 13.5 ± 22.0 mo (range 0-96). The underlying malignant disease was cholangiocarcinoma (n = 10), hepatocellular carcinoma (n = 9), pancreatic carcinoma (n = 5), gastric cancer (n = 2), bile duct tumor (n = 2), colorectal cancer (n = 2), gallbladder carcinoma (n = 2), lung cancer (n = 1), breast cancer (n = 1) or non-Hodgkin lymphoma (n = 1). In all cases, various self-expandable bare metal stents with diameters ranging from 7 to 10 mm were used. Stents were placed in Y-configuration in 24/35 cases (68.6%) using two stents in 12/24 patients and three stents in 12/24 cases (50%). A T-configuration stent placement was performed in 11/35 patients (31.4%), using two stents in 4/11 cases (36.4%) and three stents in 7/11 cases (63.6%). Follow-up was available in all patients (35/35). Patient survival ranged from 0 to 1763 d and the mean survival time was 168 d. Clinical success rate was 77.1% (27/35 cases), and peri-procedural mortality rate was 5.7% (2/35 patients). Biliary re-obstruction due to stent occlusion occurred in 25.7% of the cases (9/35 patients), while in 7/11 (63.6%) one additional percutaneous re-intervention due to stent occlusion resulting in clinical relapse of symptomatology was successfully performed. In the remaining 4/11 patients (36.4%) more than 1 additional reintervention was performed. The median decrease of total serum bilirubin was 60.5% and occurred in 81.8% of the cases (27/33 patients). The median primary and secondary patency was 105 (range 0-719) and 181 d (range 5-1763), respectively. According to the Kaplan-Meyer survival analysis, the estimated survival rate was 73.5%, 47.1% and 26.1% at 1, 6 and 12 mo respectively, while the 8-year survival rate was 4.9%. Major and minor complication rates were 5.7% (2/35 patients) and 17.1% (6/35 patients), respectively. CONCLUSION: Percutaneous bilateral biliary stenting is a safe and clinically effective palliative approach in patients suffering from Bismuth IV malignant obstruction. PMID:23556043

Karnabatidis, Dimitrios; Spiliopoulos, Stavros; Katsakiori, Paraskevi; Romanos, Odissefs; Katsanos, Konstantinos; Siablis, Dimitrios

2013-01-01

207

Biotechnological reduction of sulfide in an industrial primary wastewater treatment system: A sustainable and successful case study  

SciTech Connect

The leather industry is an important export-oriented industry in India, with more than 3,000 tanneries located in different clusters. Sodium sulfide, a toxic chemical, is used in large quantities to remove hair and excess flesh from hides and skins. Most of the sodium sulfide used in the process is discharged as waste in the effluent, which causes serious environmental problems. Reduction of sulfide in the effluent is generally achieved by means of chemicals in the pretreatment system, which involves aerobic mixing using large amounts of chemicals and high energy, and generating large volumes of sludge. A simple biotechnological system that uses the residual biosludge from the secondary settling tank was developed, and the commercial-scale application established that more than 90% of the sulfide could be reduced in the primary treatment system. In addition to the reduction of sulfide, foul smells, BOD and COD are reduced to a considerable level. 3 refs., 2 figs., 1 tab.

Rajamani, S. [Central Leather Research Institute, Madras (India)

1996-12-31

208

A Survival Analysis of Patients with Malignant Biliary Strictures Treated by Percutaneous Metallic Stenting  

SciTech Connect

Background. Percutaneous metal stenting is an accepted palliative treatment for malignant biliary obstruction. Nevertheless, factors predicting survival are not known. Methods. Seventy-six patients with inoperable malignant biliary obstruction were treated with percutaneous placement of metallic stents. Twenty patients had non-hilar lesions. Fifty-six patients had hilar lesions classified as Bismuth type I (n = 15 patients), type II (n = 26), type III (n = 12), or type IV (n = 3 patients). Technical and clinical success rates, complications, and long-term outcome were recorded. Clinical success rates, patency, and survival rates were compared in patients treated with complete (n = 41) versus partial (n = 35) liver parenchyma drainage. Survival was calculated and analyzed for potential predictors such as the tumor type, the extent of the disease, the level of obstruction, and the post-intervention bilirubin levels. Results. Stenting was technically successful in all patients (unilateral drainage in 70 patients, bilateral drainage in 6 patients) with an overall significant reduction of the post-intervention bilirubin levels (p < 0.001), resulting in a clinical success rate of 97.3%. Clinical success rates were similar in patients treated with whole-liver drainage versus partial liver drainage. Minor and major complications occurred in 8% and 15% of patients, respectively. Mean overall primary stent patency was 120 days, while the restenosis rate was 12%. Mean overall secondary stent patency was 242.2 days. Patency rates were similar in patients with complete versus partial liver drainage. Mean overall survival was 142.3 days. Survival was similar in the complete and partial drainage groups. The post-intervention serum bilirubin level was an independent predictor of survival (p < 0.001). A cut-off point in post-stenting bilirubin levels of 4 mg/dl dichotomized patients with good versus poor prognosis. Patient age and Bismuth IV lesions were also independent predictors of survival. Conclusions. Percutaneous metallic biliary stenting provides good palliation of malignant jaundice. Partial liver drainage achieved results as good as those after complete liver drainage. A serum bilirubin level of less than 4 mg/dl after stenting is the most important independent predictor of survival, while increasing age and Bismuth IV lesions represent dismal prognostic factors.

Brountzos, Elias N., E-mail: ebrountz@cc.uoa.gr; Ptochis, Nikolaos; Panagiotou, Irene; Malagari, Katerina [Athens University School of Medicine, Attikon University Hospital, 2nd Department of Radiology (Greece); Tzavara, Chara [Athens University School of Medicine, Department of Hygiene and Epidemiology (Greece); Kelekis, Dimitrios [Athens University School of Medicine, Attikon University Hospital, 2nd Department of Radiology (Greece)

2007-02-15

209

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

210

Hemosuccus pancreaticus secondary to intraductal rupture of a primary splenic artery aneurysm: diagnosis by ERCP and successful management by interventional radiology.  

PubMed

This report describes the case of a 65-year-old man with a prolonged history of gastrointestinal bleeding of unknown origin. During a 2-year period, he underwent 28 endoscopic procedures, three angiographies with or without heparin provocation, a nuclear scan, and abdominal magnetic resonance imaging, none of which were diagnostic. A blind ileocecal resection was also carried out. A diagnosis of hemosuccus pancreaticus secondary to a ruptured primary splenic artery aneurysm was obtained by endoscopic retrograde cholangiopancreatography, and successful interventional radiographic embolization of the splenic artery aneurysm was conducted. During a 17-month follow-up period, no relapse of gastrointestinal bleeding was observed. PMID:15100954

Hasaj, O; Di Stasi, C; Perri, V; Tringali, A; Costamagna, G

2004-05-01

211

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

212

Academic success across the transition from primary to secondary schooling among lower-income adolescents: understanding the effects of family resources and gender.  

PubMed

Successful academic performance during adolescence is a key predictor of lifetime achievement, including occupational and social success. The present study investigated the important transition from primary to secondary schooling during early adolescence, when academic performance among youth often declines. The goal of the study was to understand how risk factors, specifically lower family resources and male gender, threaten academic success following this "critical transition" in schooling. The study involved a longitudinal examination of the predictors of academic performance in grades 7-8 among 127 (56 % girls) French-speaking Quebec (Canada) adolescents from lower-income backgrounds. As hypothesized based on transition theory, hierarchical regression analyses showed that supportive parenting and specific academic, social and behavioral competencies (including spelling ability, social skills, and lower levels of attention problems) predicted success across this transition among at-risk youth. Multiple-mediation procedures demonstrated that the set of compensatory factors fully mediated the negative impact of lower family resources on academic success in grades 7-8. Unique mediators (social skills, spelling ability, supportive parenting) also were identified. In addition, the "gender gap" in performance across the transition could be attributed statistically to differences between boys and girls in specific competencies observed prior to the transition, as well as differential parenting (i.e., support from mother) towards girls and boys. The present results contribute to our understanding of the processes by which established risk factors, such as low family income and gender impact development and academic performance during early adolescence. These "transitional" processes and subsequent academic performance may have consequences across adolescence and beyond, with an impact on lifetime patterns of achievement and occupational success. PMID:23904002

Serbin, Lisa A; Stack, Dale M; Kingdon, Danielle

2013-09-01

213

Alternative Treatment for Bleeding Peristomal Varices: Percutaneous Parastomal Embolization  

SciTech Connect

Purpose: To describe how peristomal varices can be successfully embolized via a percutaneous parastomal approach. Methods: The medical records of patients who underwent this procedure between December 1, 2000, and May 31, 2008, were retrospectively reviewed. Procedural details were recorded. Median fluoroscopy time and bleeding-free interval were calculated. Results: Seven patients underwent eight parastomal embolizations. The technical success rate was 88 % (one failure). All embolizations were performed with coils combined with a sclerosant, another embolizing agent, or both. Of the seven successful parastomal embolizations, there were three cases of recurrent bleeding; the median time to rebleeding was 45 days (range 26-313 days). The remaining four patients did not develop recurrent bleeding during the follow-up period; their median bleeding-free interval was 131 days (range 40-659 days). Conclusion: This case review demonstrated that percutaneous parastomal embolization is a feasible technique to treat bleeding peristomal varices.

Pabon-Ramos, Waleska M., E-mail: waly.pr@duke.edu [Duke University Hospital, Department of Radiology (United States); Niemeyer, Matthew M. [Washington University Medical Center, Mallinckrodt Institute of Radiology (United States)] [Washington University Medical Center, Mallinckrodt Institute of Radiology (United States); Dasika, Narasimham L., E-mail: narasimh@med.umich.edu [University of Michigan Health System, Department of Radiology (United States)

2013-10-15

214

Image-guided percutaneous ablation of bone and soft tissue tumors.  

PubMed

Image-guided percutaneous ablation of bone and soft tissue tumors is an effective minimally invasive alternative to conventional therapies, such as surgery and external beam radiotherapy. Proven applications include treatment of benign primary bone tumors, particularly osteoid osteoma, as well as palliation of painful bone metastases. Use of percutaneous ablation in combination with cementoplasty can provide stabilization of metastases at risk for fracture. Local control of oligometastatic disease and treatment of desmoid tumors are emerging applications. PMID:22550367

Kurup, A Nicholas; Callstrom, Matthew R

2010-09-01

215

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

216

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. PMID:24082382

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

2013-01-01

217

Seasonal succession of net primary productivity, particulate organic carbon export, and autotrophic community composition in the eastern Bering Sea  

NASA Astrophysics Data System (ADS)

Seasonal patterns in the partitioning of phytoplankton carbon during receding sea ice conditions in the eastern Bering Sea water column are presented using rates of 14C net primary productivity (NPP), phototrophic plankton carbon content, and POC export fluxes from shelf and slope waters in the spring (March 30-May 6) and summer (July 3-30) of 2008. At ice-covered and marginal ice zone (MIZ) stations on the inner and middle shelf in spring, NPP averaged 76±93 mmol C m-2 d-1, and in ice-free waters on the outer shelf NPP averaged 102±137 mmol C m-2 d-1. In summer, rates of NPP were more uniform across the entire shelf and averaged 43±23 mmol C m-2 d-1 over the entire shelf. A concomitant shift was observed in the phototrophic pico-, nano-, and microplankton community in the chlorophyll maximum, from a diatom dominated system (80±12% autotrophic C) in ice covered and MIZ waters in spring, to a microflagellate dominated system (71±31% autotrophic C) in summer. Sediment trap POC fluxes near the 1% PAR depth in ice-free slope waters increased by 70% from spring to summer, from 10±7 mmol C m-2 d-1 to 17±5 mmol C m-2 d-1, respectively. Over the shelf, under-ice trap fluxes at 20 m were higher, averaging 43±17 mmol C m-2 d-1. POC export over the shelf and slope estimated from 234Th deficits averaged 11±5 mmol C m-2 d-1 in spring and 10±2 mmol C m-2 d-1 in summer. Average e-ratios calculated on a station-by-station basis decreased by ˜30% from spring to summer, from 0.46±0.48 in ice-covered and MIZ waters, to 0.33±0.26 in summer, though the high uncertainty prevents a statistical differentiation of these data.

Moran, S. B.; Lomas, M. W.; Kelly, R. P.; Gradinger, R.; Iken, K.; Mathis, J. T.

2012-06-01

218

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

219

Percutaneous radiofrequency upper thoracic sympathectomy.  

PubMed

Between June 1979 and May 1994, I performed 148 unilateral or bilateral sympathectomies on 247 limbs in 110 patients using a percutaneous radiofrequency technique, usually on an outpatient surgery basis. Patient ages ranged from 10 to 81 years, with 45 male and 65 female patients. Four patients had unsuccessfully undergone prior open surgical sympathectomy. Patients suffered from hyperhidrosis, vascular occlusion, Raynaud's disease or other chronic vasculopathies, painful causalgia or reflex sympathetic dystrophy, or Prinzmetal's angina. The sympathectomy technique has evolved over this 15-year period and is currently in its third phase. Changes in the procedure were based on anatomic and clinical/radiographic correlations and careful patient follow-up. Current modifications have reduced the frequency of both early and late failures. The present technique (Phase III) relies on neuroleptanalgesia with superficial local anesthesia only and does not require general anesthesia, intubation, or lung collapse. Two 18-gauge radiofrequency TIC needle electrodes (Radionics, Burlington, MA) are used. A series of three lesions is rostrocaudally made at each of the ganglion sites selected in an attempt to destroy the entire fusiform ganglion. Lesion sites are targeted by C-arm fluoroscopy and electrical stimulation, which produces a threshold of sensory awareness of > 1.0 V. Lesion effectiveness is monitored by bilateral finger plethysmography and hand skin temperature measurement. With the Phase III technique, the sympathetic activity in 96% of operated limbs after 2 years and in 91% of operated limbs after 3 years continues to be completely or largely interrupted. By comparison, I achieved similar success in 83 and 72% operated limbs with the Phase I technique and in 77 and 71% with the Phase II technique. Symptomatic pneumothorax, in six patients, has been the only serious complication. When necessary, a subsequent operation can easily be performed and is effective. PMID:8692390

Wilkinson, H A

1996-04-01

220

Difficulties with access in percutaneous renal surgery  

PubMed Central

Percutaneous renal surgery provides a minimally invasive approach to the kidney for stone extraction in a number of different clinical scenarios. Certain clinical cases present inherent challenges to percutaneous access to the kidney. Herein, we present scenarios in which obtaining and/or maintaining percutaneous access is difficult along with techniques to overcome the challenges commonly encountered. Also, complications associated with these challenging percutaneous renal surgeries are discussed. PMID:21869906

Rais-Bahrami, Soroush; Friedlander, Justin I.; Duty, Brian D.; Okeke, Zeph; Smith, Arthur D.

2011-01-01

221

Safe percutaneous suprapubic catheterisation  

PubMed Central

INTRODUCTION We describe our technique of percutaneous suprapubic catheter insertion with special reference to steps that help to avoid common complications of haematuria and catheter misplacement. METHODS The procedure is performed using a stainless steel reusable trocar under local infiltrative anaesthesia, usually at the bedside. After clinical confirmation of a full bladder, the trocar is advanced into the bladder through a skin incision. Once the bladder is entered, the obturator is removed and the assistant inserts a Foley catheter followed by rapid balloon inflation. Slight traction is applied to the catheter for about five minutes. Patients with previous lower abdominal surgery, an inadequately distended bladder or acute pelvic trauma do not undergo suprapubic catheterisation using this method. RESULTS The procedure was performed in 72 men (mean age: 42.4 years, range: 18–78 years) with urinary retention with a palpable bladder. The average duration of the procedure was less than five minutes. No complications were noted in any of the patients. CONCLUSIONS Trocar suprapubic catheter insertion is a safe and effective bedside procedure for emergency bladder drainage and can be performed by resident surgeons. The common complications associated with the procedure can be avoided with a few careful steps. PMID:23131233

Goyal, NK; Goel, A; Sankhwar, SN

2012-01-01

222

[Percutaneous pulmonary valvuloplasty].  

PubMed

Five patients (aged between 11 and 59 years) with valvular pulmonary artery stenosis and pressure gradients between 60 and 143 mm Hg underwent percutaneous transluminal balloon valvuloplasty. Selection of the appropriate balloon size was based on the measurement of the dimension of the value anulus as a determinant from the angiogram. Balloon catheters were used with a diameter of 18 to 20 mm. After placement in the stenotic valve the balloon was filled with diluted contrast material for 10-20 s. The balloon indention by the stenotic valve disappeared suddenly during expansion with one to three atmospheres. The pressure gradient in individual patients decreased from 60 to 25, from 143 to 60, 100 to 55, 143 to 60, and 60 to 37 mm Hg, in the mean from 101 to 52 mm Hg. All patients were discharged two to four days after the procedure. During follow-up with recatheterization after three to nine months (four patients) the gradients decreased as compared to the value immediately after valvuloplasty. The exercise capacity increased in all patients. No complications were observed. Balloon valvuloplasty of pulmonary valvular stenosis seems to be an alternative to the operative procedure. PMID:2937221

Bussmann, W D; Sievert, H; Reifart, N; Kober, G; Satter, P; Kaltenbach, M

1985-12-01

223

Percutaneous CT-guided curettage of osteoid osteoma with histological confirmation: a retrospective study and review of the literature  

PubMed Central

Osteoid osteoma is a benign bone tumour usually occurring in young individuals (10–30 years). It presents with intense pain (typically nocturnal), which can be alleviated by salicylates. Treatment consists of surgical excision or destroying the nidus and it is curative. In the past, surgery was performed in an “open” fashion and the nidus had to be removed with a bone block. This extensive type of surgery could be associated with some rates of both failure and complication. There is growing evidence to suggest that percutaneous CT-guided removal or destruction of the nidus is a good alternative and it is indeed gaining worldwide popularity. We present a series of 18 consecutive patients with osteoid osteoma of the pelvis, femur, and tibia, treated percutaneously under CT guidance. Removal of the nidus was performed using a 4.5-mm cannulated drill and a cannulated curette of our own design. Tissue samples for histological evaluation were obtained in the same way. The mean follow-up time was 29 months. Sixteen patients were initially cured. The procedure had to be repeated in two patients and was eventually successful (primary and secondary success rates 88 and 100% respectively). The diagnosis was histologically confirmed in 14 cases out of 18 (77%). In four cases no histological confirmation of osteoid osteoma could be achieved. There were only two minor complications, one case of femoral neuropraxia and one case of skin abrasion. Percutaneous CT-guided removal seems to be efficient and safe for the treatment of osteoid osteoma. The use of a cannulated drill and a cannulated curette facilitates efficient removal of the tumour and procurement of tissue for diagnosis. PMID:16474938

Garniack, Alexander; Morag, Benyamina; Palti, Ram; Salai, Moshe

2006-01-01

224

Image-guided percutaneous splenic interventions.  

PubMed

In the spleen, image-guided interventional procedures such as biopsy and catheter drainage have not been widely performed because of the perceived increased risk of complications. The ability of image-guided biopsy to allow tissue diagnosis of a focal splenic mass without the need for splenectomy is the driving force behind use of this procedure in oncology patients. The literature on image-guided splenic biopsy suggests that the highest biopsy yield is achieved with core biopsy and the lowest complication rate is achieved with fine-needle aspiration. Image-guided catheter drainage is an effective alternative to splenectomy for management of infected splenic collections. In clinical practice, image-guided splenic biopsy, fluid aspiration, and catheter drainage have high success rates. Image-guided alcohol ablation is effective in treatment of splenic cysts. The literature on splenic radiofrequency ablation (RFA) is sparse; therefore, further studies are needed to determine the role of RFA in management of splenic neoplasms and hypersplenism. Image-guided percutaneous thrombin injection can be used to treat splenic artery pseudoaneurysms. Awareness of the correct interventional techniques and their limitations is important for safe performance of image-guided percutaneous splenic interventions. PMID:22411947

Singh, Ajay K; Shankar, Sridhar; Gervais, Debra A; Hahn, Peter F; Mueller, Peter R

2012-01-01

225

Can the need for colectomy after computed tomography-guided percutaneous drainage for diverticular abscess be predicted?  

PubMed

The primary aim of this study was to define predictors of computed tomography (CT)-guided percutaneous abscess drainage treatment failure in complicated diverticulitis. A 10-year retrospective analysis of inpatients seen in surgical consultation for diverticular abscess management subsequently referred for CT-guided percutaneous drainage (PD) was conducted. The clinical courses of patients undergoing a technically successful PD were categorized into three groups: 1) no colectomy; 2) elective colectomy; and 3) nonelective colectomy. Forty study patients were identified. Thirteen (33%) of the 40 patients required a nonelective colectomy, 20 patients (50%) underwent elective resection, and seven patients (18%) have been managed nonoperatively with no recurrent diverticulitis for a median of 46.8 months (range, 3.2 to 84.3 months). Forward logistic regression identified the presence of immunosuppression or renal insufficiency (creatinine 1.5 mg/dL or greater) as factors independently associated with failure of PD and need for nonelective colectomy. No clinical, laboratory, or radiologic variables were predictive of long-term nonoperative success. Although PD allows for the resolution of intra-abdominal sepsis for most cases of diverticulitis complicated by an abscess, a substantial proportion progress to nonelective colectomy, emphasizing the need for clinical vigilance in follow-up. PMID:24160790

Felder, Seth I; Barmparas, Galinos; Lynn, Juliane; Murrell, Zuri; Margulies, Daniel R; Fleshner, Phillip

2013-10-01

226

Single-Institution Results of Image-Guided Nonplugged Percutaneous Versus Transjugular Liver Biopsy  

SciTech Connect

Purpose: To retrospectively review patients who underwent transjugular and image-guided percutaneous biopsy and compare the relative risk of ascites, thrombocytopenia, and coagulopathy. Materials and Methods: From August 2001 through February 2006, a total of 238 liver biopsies were performed. The radiologist reviewed all patient referrals for transjugular biopsy. These patients either underwent transjugular biopsy or were reassigned to percutaneous biopsy (crossover group). Patients referred to percutaneous image-guided liver biopsy underwent this same procedure. Biopsies were considered successful if a tissue diagnosis could be made from the samples obtained. Results: A total of 36 transjugular biopsies were performed with 3 total (8.3%) and 1 major (2.8%) complications. A total of 171 percutaneous biopsies were performed with 10 (5.8%) total and 3 (1.8%) major complications. The crossover group showed a total of 4 (12.9%) complications with 1 (3.2%) major complication. Sample adequacy was 91.9% for transjugular and 99.5% for percutaneous biopsy. Conclusion: Both transjugular and percutaneous liver biopsy techniques are efficacious and safe. Contraindications such as thrombocytopenia, coagulopathy, and ascites are indicators of greater complications but are not necessarily prevented by transjugular biopsy. Percutaneous biopsy more frequently yields a diagnostic specimen than transjugular biopsy.

Hardman, Rulon L., E-mail: hardmanr@uthscsa.edu [University of Texas Health Science Center San Antonio (United States); Perrich, Kiley D.; Silas, Anne M. [Dartmouth-Hitchcock Medical Center, Division of Vascular and Interventional Radiology (United States)

2011-04-15

227

Design and Testing of a Percutaneously Implantable Fetal Pacemaker  

PubMed Central

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

2012-01-01

228

Percutaneous Management of Postoperative Duodenal Stump Leakage with Foley Catheter  

SciTech Connect

Purpose: This study was designed to evaluate retrospectively the safety and efficacy of the percutaneous management of duodenal stump leakage with a Foley catheter after subtotal gastrectomy. Methods: Ten consecutive patients (M:F = 9:1, median age: 64 years) were included in this retrospective study. The duodenal stump leakages were diagnosed in all the patients within a median of 10 days (range, 6-20). At first, the patients underwent percutaneous drainage on the day of or the day after confirmation of the presence of duodenal stump leakage, and then the Foley catheters were replaced at a median of 9 days (range, 6-38) after the percutaneous drainage. Results: Foley catheters were placed successfully in the duodenal lumen of all the patients under a fluoroscopic guide. No complication was observed during and after the procedures in all the patients. All of the patients started a regular diet 1 day after the Foley catheter placement. The patients were discharged at a median of 7 days (range, 5-14) after the Foley catheter placement. The catheters were removed in an outpatient clinic 10-58 days (median, 28) after the Foley catheter placement. Conclusions: Fluoroscopy-guided percutaneous Foley catheter placement may be a safe and effective treatment option for postoperative duodenal stump leakage and may allow for shorter hospital stays, earlier oral intake, and more effective control of leakage sites.

Oh, Jung Suk, E-mail: oj-cumc@daum.net; Lee, Hae Giu, E-mail: hgleehfh@catholic.ac.kr; Chun, Ho Jong; Choi, Byung Gil [Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology (Korea, Republic of)] [Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology (Korea, Republic of); Lee, Sang Hoon; Hahn, Seong Tai [Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology (Korea, Republic of)] [Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology (Korea, Republic of); Ohm, Joon Young [Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology (Korea, Republic of)] [Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology (Korea, Republic of)

2013-10-15

229

Percutaneous Sclerotherapy of Cystic Lesions  

PubMed Central

With modern cross-sectional imaging techniques, cystic lesions are very common and usually incidental findings, especially if small. However, when cysts enlarge, become infected, bleed, or undergo torsion, they can be symptomatic, and percutaneous drainage can be effective in the management. When cysts recur after aspiration, which is often the case for hepatic and renal cysts, cyst sclerosis or surgical unroofing may be required. This article describes the indications for and technical aspects of percutaneous sclerotherapy of cystic lesions of multiple organ systems. PMID:24293802

Cheng, Danny; Amin, Parag; Ha, Thuong Van

2012-01-01

230

Percutaneous treatments for trigeminal neuralgia.  

PubMed

Trigeminal neuralgia (TN) is a neurologic disorder, defined by paroxysmal electric shocklike painful attacks in 1 or more trigeminal nerve branches. Treatment of TN is diverse and includes minimally invasive percutaneous techniques, which consist of balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation. Although all 3 techniques are generally safe, efficient, and effective, a clear consensus has not been reached regarding their specific indications and degree of efficacy. The aim of this article is to describe the percutaneous treatments available for TN and outline their characteristics, technique, indications and efficacy. PMID:25240662

Missios, Symeon; Mohammadi, Alireza M; Barnett, Gene H

2014-10-01

231

Percutaneous release of trigger fingers.  

PubMed

Open surgery has been indicated as the surgical treatment for trigger finger for many years; however, minimally invasive techniques are replacing conventional methods. Minimally invasive techniques enable early recovery of the patient with minimal damage to soft tissues. The authors’ study showed that levels of effectiveness of open surgical and percutaneous methods were superior to those of the conservative method using corticosteroid based on the cure and reappearance rates of the trigger. Percutaneous pulley release for treating trigger finger is a safe, effective, and minimally invasive surgical alternative. PMID:24286741

Sato, Edson Sasahara; dos Santos, João Baptista Gomes; Belloti, João Carlos; Albertoni, Walter Manna; Faloppa, Flavio

2014-02-01

232

Percutaneous Portosystemic Shunts: TIPS and Beyond.  

PubMed

Percutaneous interventions for portal hypertension have been available since the 1990s. Over time, improved technology-including covered stent grafts-and clinical understanding has expanded the available procedures for percutaneous portal decompression. While transjugular intrahepatic portosystemic shunt creation is the most commonly cited percutaneous intervention, direct intrahepatic portocaval shunt and percutaneous mesocaval shunt creation are important alternatives with specific advantages and applications. This article reviews contemporary, minimally invasive interventional approaches to percutaneous portosystemic shunt creation in terms of procedure rationale, patient selection, interventional technique, and technical outcomes. PMID:25177082

Casadaban, Leigh C; Gaba, Ron C

2014-09-01

233

Abundance of narG, nirS, nirK, and nosZ Genes of Denitrifying Bacteria during Primary Successions of a Glacier Foreland  

PubMed Central

Quantitative PCR of denitrification genes encoding the nitrate, nitrite, and nitrous oxide reductases was used to study denitrifiers across a glacier foreland. Environmental samples collected at different distances from a receding glacier contained amounts of 16S rRNA target molecules ranging from 4.9 × 105 to 8.9 × 105 copies per nanogram of DNA but smaller amounts of narG, nirK, and nosZ target molecules. Thus, numbers of narG, nirK, nirS, and nosZ copies per nanogram of DNA ranged from 2.1 × 103 to 2.6 × 104, 7.4 × 102 to 1.4 × 103, 2.5 × 102 to 6.4 × 103, and 1.2 × 103 to 5.5 × 103, respectively. The densities of 16S rRNA genes per gram of soil increased with progressing soil development. The densities as well as relative abundances of different denitrification genes provide evidence that different denitrifier communities develop under primary succession: higher percentages of narG and nirS versus 16S rRNA genes were observed in the early stage of primary succession, while the percentages of nirK and nosZ genes showed no significant increase or decrease with soil age. Statistical analyses revealed that the amount of organic substances was the most important factor in the abundance of eubacteria as well as of nirK and nosZ communities, and copy numbers of these two genes were the most important drivers changing the denitrifying community along the chronosequence. This study yields an initial insight into the ecology of bacteria carrying genes for the denitrification pathway in a newly developing alpine environment. PMID:16957216

Kandeler, Ellen; Deiglmayr, Kathrin; Tscherko, Dagmar; Bru, David; Philippot, Laurent

2006-01-01

234

Percutaneous stenting of interrupted aortic arch to treat compressive myelopathy.  

PubMed

Neurological complications of coarctation of aorta include spontaneous SAH, intracerebral hemorrhage, and cerebral abscess. Interrupted aortic arch (IAA) present as compressive myelopathy is not known. We describe an adult male presenting to neurology department with progressive paraparesis and was detected to have IAA with intraspinal collaterals causing compressive myelopathy. He was successfully treated with percutaneous stenting of IAA with dramatic improvement in paraparesis. © 2014 Wiley Periodicals, Inc. PMID:24458503

Moorthy, Nagaraja; Ananthakrishna, Rajiv; Nanjappa, Manjunath C

2014-11-01

235

Percutaneous transluminal alcohol septal myocardial ablation after aortic valve replacement  

NASA Technical Reports Server (NTRS)

When left ventricular outflow tract obstruction develops after aortic valve replacement, few treatment choices have been available until now. We present a patient with prior aortic valve replacement who developed left ventricle outflow tract obstruction that was successfully treated with a percutaneous transcoronary myocardial septal alcohol ablation. This technique is a useful tool for the treatment of obstructive hypertrophic cardiomyopathy, especially in those patients with prior heart surgery. Copyright 2001 Wiley-Liss, Inc.

Sitges, M.; Kapadia, S.; Rubin, D. N.; Thomas, J. D.; Tuzcu, M. E.; Lever, H. M.

2001-01-01

236

Transradial versus transfemoral approach for percutaneous coronary procedures  

Microsoft Academic Search

Selective coronary angiography was originally performed through open brachial arteriotomy. Thereafter, the percutaneous Seldinger\\u000a technique and the use of preformed Judkins-type catheters popularized the femoral approach. More recently, after the first\\u000a report of successful coronary angiography by the transradial approach in 1989, the radial artery has been increasingly used\\u000a as an alternative access site. The main advantage offered by the

Elena Franchi; Paolo Marino; Giuseppe G. Biondi-Zoccai; Giuseppe De Luca; Corrado Vassanelli; Pierfrancesco Agostoni

2009-01-01

237

[Results of percutaneous coronary angioplasty in patients with stable and unstable angina].  

PubMed

Percutaneous coronary angioplasty is very well known percutaneous revascularization procedure. Results of the percutaneous coronary angioplasty vary according to the stage of ischemic heart disease. The aim of our study was to evaluate and to compare the results of percutaneous coronary angioplasty in patients with stable and unstable angina. We analyzed data from 1148 patients in both groups. The extent of atherosclerosis was significantly higher in unstable angina group, however there was no significant difference in procedural as well in in-hospital outcomes between two groups. Success rate was 86% in unstable angina group and 83.3% in stable angina group. Major adverse cardiac events occurred in 1.48% patients with no difference in both groups. Left ventricular ejection fraction and end-diastolic diameter improved more in unstable angina group. PMID:15079114

Unikas, Ram?nas; Vaicekavicius, Edvardas; Navickas, Ram?nas; Jarusevicius, Gediminas; Janavicius, Arnoldas; Audickas, Dainius; Grinius, Virgilijus

2004-01-01

238

Temporal-Spatial Variation and Controls of Soil Respiration in Different Primary Succession Stages on Glacier Forehead in Gongga Mountain, China  

PubMed Central

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. Q10 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-Q10 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

2012-01-01

239

Effects of seabird nitrogen input on biomass and carbon accumulation after 50 years of primary succession on a young volcanic island, Surtsey  

NASA Astrophysics Data System (ADS)

What happens during primary succession after the first colonizers have occupied a pristine surface largely depends on how they ameliorate living conditions for other species. For vascular plants the onset of soil development and associated increase in nutrient (mainly nitrogen, N) and water availability is especially important. Here, we report the relation between N accumulation and biomass- and ecosystem carbon (C) stocks in a 50 year old volcanic island, Surtsey, in Iceland, where N stocks are still exceptionally low. However, 27 year old seagull colony on the island provided nutrient-enriched areas, which enabled us to assess the relationship between N stock and biomass- and ecosystem C stocks across a much larger range in N stock. Further, we compared areas on shallow and deep tephra sands as we expected that deep-rooted systems would be more efficient in retaining N. The sparsely vegetated area outside the colony was more efficient in N retention than we expected and had accumulated 0.7 kg N ha-1 yr-1, which was ca. 60% of the estimated N input rate from wet deposition. The seagulls have added, on average, 47 kg N ha-1 yr-1, which induced a shift from belowground to aboveground in ecosystem N and C stocks and doubled the ecosystem "N use efficiency", determined as the ratio of biomass and C storage per unit N input. Soil depth did not significantly affect total N stocks, which suggests a high N retention potential. Both total ecosystem biomass and C stocks were strongly correlated with N stock inside the colony, which indicated the important role of N during the first steps of primary succession. Inside the colony, the ecosystem biomass C stocks (17-27 kg C ha-1) had reached normal values for grasslands, while the soil organic carbon stocks (SOC; 4-10 kg C ha-1) were only a fraction of normal grassland values. Thus, it will take a long time until the SOC stock reaches equilibrium with the current primary production; during which conditions for new colonists may change.

Leblans, N. I. W.; Sigurdsson, B. D.; Roefs, P.; Thuys, R.; Magnússon, B.; Janssens, I. A.

2014-05-01

240

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

241

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 PMID:4788917

Evison, Gordon; McNulty, Myles; Thomson, Colin

1973-01-01

242

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

243

Percutaneous Management of Caliceal Diverticuli  

PubMed Central

Abstract Background and Purpose Caliceal diverticula are rare congenital abnormalities that can become symptomatic if associated with a calculus or infection. We review percutaneous management of caliceal diverticula. Methods Pathogenesis, clinical evaluation, management options, and recommended follow-up for symptomatic caliceal diverticula are reviewed. We present our single-stage and prepercutaneous nephrolithotomy opacification techniques for the management of caliceal diverticula. This involves complete extraction of all stone particles and ablation of the diverticular cavity without infundibular identification or dilation. Comparison of outcomes between our current ablative technique and our previous dilation technique is evaluated. Results Percutaneous management of caliceal diverticula offers the highest symptomatic relief and stone-free rate of available management options. We identified 106 patients with caliceal diverticula who were treated with a percutaneous approach. Review of 85 of these patients demonstrated that most procedures can be performed with a small nephrostomy tube in place for 24 hours and an overnight hospital stay. Minimal complication and stone recurrence rates were observed. Patients treated with caliceal diverticular ablation experienced a shorter hospital stay, fewer complications, and a higher stone-free status than those patients who were treated with dilation of the diverticular infundibulum. Conclusions Percutaneous management of caliceal diverticula using cavity ablation is a minimally invasive technique that offers long-term symptomatic relief with minimal complications. PMID:19814580

Krambeck, Amy E.

2009-01-01

244

Primary renal MALToma: A rare differential diagnosis for a recurrent renal mass after primary ablative therapy  

PubMed Central

We report a case of primary renal lymphoma of mucosa-associated lymphoid tissue in an 82-year-old woman. She presented with a history of renal mass previously treated with kidney percutaneous cryoablation at another centre. PMID:25024802

Vedovo, Francesca; Pavan, Nicola; Liguori, Giovanni; Siracusano, Salvatore; Bussani, Rossana; Trombetta, Carlo

2014-01-01

245

Implementing a successful tuberculosis programme within primary care services in a conflict area using the stop TB strategy: Afghanistan case study  

PubMed Central

Introduction Afghanistan has faced health consequences of war including those due to displacement of populations, breakdown of health and social services, and increased risks of disease transmission for over three decades. Yet it was able to restructure its National Tuberculosis Control Programme (NTP), integrate tuberculosis treatment into primary health care and achieve most of its targets by the year 2011. What were the processes that enabled the programme to achieve its targets? More importantly, what were the underpinning factors that made this success possible? We addressed these important questions through a case study. Case description We adopted a processes and outcomes framework for this study, which began with examining the change in key programme indicators, followed by backwards tracing of the processes and underlying factors, responsible for this change. Methods included review of the published and grey literature along with in-depth interviews of 15 key informants involved with the care of tuberculosis patients in Afghanistan. Discussion and evaluation TB incidence and mortality per 100,000 decreased from 325 and 92 to 189 and 39 respectively, while case notification and treatment success improved during the decade under study. Efficient programme structures were enabled through high political commitment from the Government, strong leadership from the programme, effective partnership and coordination among stakeholders, and adequate technical and financial support from the development partners. Conclusions The NTP Afghanistan is an example that public health programmes can be effectively implemented in fragile states. High political commitment and strong local leadership are essential factors for such programmes. To ensure long-term effectiveness of the NTP, the international support should be withdrawn in a phased manner, coupled with a sequential increase in resources allocated to the NTP by the Government of Afghanistan. PMID:24507446

2014-01-01

246

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

247

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

248

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

249

Preliminary clinical trial in percutaneous nephrolithotomy using a real-time navigation system for percutaneous kidney access  

NASA Astrophysics Data System (ADS)

Background: Precise needle puncture of renal calyces is a challenging and essential step for successful percutaneous nephrolithotomy. This work tests and evaluates, through a clinical trial, a real-time navigation system to plan and guide percutaneous kidney puncture. Methods: A novel system, entitled i3DPuncture, was developed to aid surgeons in establishing the desired puncture site and the best virtual puncture trajectory, by gathering and processing data from a tracked needle with optical passive markers. In order to navigate and superimpose the needle to a preoperative volume, the patient, 3D image data and tracker system were previously registered intraoperatively using seven points that were strategically chosen based on rigid bone structures and nearby kidney area. In addition, relevant anatomical structures for surgical navigation were automatically segmented using a multi-organ segmentation algorithm that clusters volumes based on statistical properties and minimum description length criterion. For each cluster, a rendering transfer function enhanced the visualization of different organs and surrounding tissues. Results: One puncture attempt was sufficient to achieve a successful kidney puncture. The puncture took 265 seconds, and 32 seconds were necessary to plan the puncture trajectory. The virtual puncture path was followed correctively until the needle tip reached the desired kidney calyceal. Conclusions: This new solution provided spatial information regarding the needle inside the body and the possibility to visualize surrounding organs. It may offer a promising and innovative solution for percutaneous punctures.

Rodrigues, Pedro L.; Moreira, António H. J.; Rodrigues, Nuno F.; Pinho, A. C. M.; Fonseca, Jaime C.; Lima, Estevão.; Vilaça, João. L.

2014-03-01

250

Percutaneous Transumbilical Portal Vein Embolization in a Patient with a Ruptured Hepatocellular Carcinoma Supplied by the Portal Vein  

SciTech Connect

We describe a case of a ruptured hepatocellular carcinoma supplied by the portal vein that was successfully treated with portal vein embolization via a percutaneous transumbilical approach. A contrast material-enhanced computed tomographic (CT) scan showed the presence of a large hypervascular tumor on portal venous phase as well as right hepatic vein thrombosis and hemoperitoneum that prevented portal vein embolization by the use of the percutaneous and transjugular transhepatic approach. The use of percutaneous transumbilical portal vein embolization can be an alternative option in this situation.

Kim, Soo Chin; Kim, Hyo-Cheol, E-mail: angiointervention@gmail.com; Chung, Jin Wook; Jae, Hwan Jun; Park, Jae Hyung [Seoul National University College of Medicine, Department of Radiology (Korea, Republic of)

2011-02-15

251

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 PMID:22012904

Wood, Bradford J.; Gervais, Debra A.

2011-01-01

252

Percutaneous vertebroplasty in tumoral osteolysis  

Microsoft Academic Search

Percutaneous vertebroplasty is a minimally invasive, radiologically guided procedure in which bone cement is injected into\\u000a structurally weakened or destructed vertebrae in order to achieve additional biomechanical stability. In addition to treating\\u000a osteoporotic vertebral fractures, this technique gains popularity to relieve pain by stabilizing vertebrae compromised by,\\u000a for example, metastases, aggressive hemangiomas or multiple myeloma that are at risk of

T. F. Jakobs; C. Trumm; M. Reiser; R. T. Hoffmann

2007-01-01

253

Percutaneous closure of complex paravalvular aortic root pseudoaneurysm and aorta-cavitary fistulas  

PubMed Central

Native aortic valve or its prosthetic valve endocarditis can extend to the adjacent periannular areas and erode into nearby cardiac chambers, leading to pseudoaneurysm and aorta-cavitary fistulas respectively. The later usually leads to acute cardiac failure and hemodynamic instability requiring an urgent surgical intervention. However rarely this might pass unnoticed and the patient might present later with cardiac murmur. Percutaneous device closure of aortic pseudoaneurysm, ruptured sinus of Valsalva aneurysm, aorta-pulmonary window, paravalvular leaks, and aorta-cavitary fistula have been reported. We present a 59-year-old female who developed a large aortic root pseudoaneurysm with biventricular communication aorta-cavitary fistulas presenting late following aortic prosthetic valve endocarditis. She underwent successful percutaneous device closure of her pseudoaneurysm and aorta-cavitary fistulas using two Amplatzer Duct Occluders. This case illustrates a challenging combination of aortic root pseudoaneurysm and biventricular aorta-cavitary fistulas that was successfully treated with percutaneous procedure. PMID:24973845

Al-Maskari, Salim; Panduranga, Prashanth; Al-Farqani, Abdullah; Thomas, Eapen; Velliath, John

2014-01-01

254

The Use of Below-Knee Percutaneous Transluminal Angioplasty in Arterial Occlusive Disease Causing Chronic Critical Limb Ischemia  

SciTech Connect

Purpose: To determine the efficacy, safety and long-term results of crural artery percutaneous transluminal angioplasty (PTA) in limbs with chronic critical limb ischemia (CLI). Methods: Patients undergoing crural artery PTA due to CLI were followed at regular clinic visits with ankle brachial pressure index (ABPI) measurements. PTA of the crural arteries was attempted either alone (n= 39) or in combination with PTA of the superficial and/or popliteal artery (n= 55) in 86 limbs (82 patients and 94 procedures) presenting with CLI. The ages of patients ranged from 37 to 94 years (mean 72 years). The indications for PTA were rest pain in 10 and ulcer/gangrene in 84 limbs.Results: A technically successful PTA with at least one crural level was achieved in 88% of cases (n= 83). Cumulative primary clinical success rates at 6, 12, 24, and 36 months were 55%, 51%, 36%, and 36%, respectively. Cumulative secondary clinical success and limb salvage rates at 36 months were 44% and 72%, respectively. Conclusion: PTA of the crural arteries might be considered the primary choice of treatment in patients with CLI and distal lesions with localized stenosis or segmental short occlusions.

Loefberg, Ann-Marie; Loerelius, Lars-Erik [Department of Diagnostic Radiology, University Hospital, S-75185 Uppsala (Sweden); Karacagil, Sadettin; Westman, Bo; Almgren, Bo; Berqgvist, David [Department of Surgery, University Hospital, S-75185 Uppsala (Sweden)

1996-09-15

255

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

256

Long-term outcome of percutaneous transluminal angioplasty in chronic haemodialysis patients with peripheral arterial disease  

Microsoft Academic Search

Background. Chronic haemodialysis patients are at an in- creased risk of peripheral artery disease (PAD). Although percutaneous transluminal angioplasty (PTA) has become a widely used therapeutic intervention for PAD, its out- come in haemodialysis patients remains poorly understood. The aim of this study was to clarify the long-term outcome of PTA as a primary treatment for PAD in haemodialysis patients.

Yoshitaka Kumada; T oru Aoyama; Hideki Ishii; Miho Tanaka; Yoshihiro Kawamura; Hiroshi Takahashi; Takanobu Toriyama; Yukio Yuzawa; Syoichi Maruyama; Seiichi Matsuo; Toyoaki Murohara

2008-01-01

257

Percutaneous radiofrequency treatment of osteoid osteoma  

Microsoft Academic Search

Osteoid osteoma is a small osteogenic tumor usually found in the lower extremity of children and young adults. Although these lesions are benign and rarely progress, they present distinctive pain symptoms that frequently require medical intervention. This article reviews surgical, medical, and percutaneous techniques for treatment of osteoid osteoma, emphasizing the value of percutaneous radiofrequency treatment.

Martin Torriani; Daniel I. Rosenthal

2002-01-01

258

Retrograde method for percutaneous access to kidney.  

PubMed

A technique is described for gaining percutaneous access to the kidney by puncturing from inside out using a retrograde catheter and a sharpened stainless steel stylet. The method allows precise placement of a percutaneous tract in the nondilated upper urinary tract. PMID:6649221

Lawson, R K; Murphy, J B; Taylor, A J; Jacobs, S C

1983-12-01

259

Percutaneous aspiration of fluid for management of peritonitis in space  

NASA Technical Reports Server (NTRS)

BACKGROUND: As a medical emergency that can affect even well-screened, healthy individuals, peritonitis developing during a long-duration space exploration mission may dictate deviation from traditional clinical practice due to the absence of otherwise indicated surgical capabilities. Medical management can treat many intra-abdominal processes, but treatment failures are inevitable. In these circumstances, percutaneous aspiration under sonographic guidance could provide a "rescue" strategy. Hypothesis: Sonographically guided percutaneous aspiration of intra-peritoneal fluid can be performed in microgravity. METHODS: Investigations were conducted in the microgravity environment of NASA's KC-135 research aircraft (0 G). The subjects were anesthetized female Yorkshire pigs weighing 50 kg. The procedures were rehearsed in a terrestrial animal lab (1 G). Colored saline (500 mL) was introduced through an intra-peritoneal catheter during flight. A high-definition ultrasound system (HDI-5000, ATL, Bothell, WA) was used to guide a 16-gauge needle into the peritoneal cavity to aspirate fluid. RESULTS: Intra-peritoneal fluid collections were easily identified, distinct from surrounding viscera, and on occasion became more obvious during weightless conditions. Subjectively, with adequate restraint of the subject and operators, the procedure was no more demanding than during the 1-G rehearsals. CONCLUSIONS: Sonographically guided percutaneous aspiration of intra-peritoneal fluid collections is feasible in weightlessness. Treatment of intra-abdominal inflammatory conditions in spaceflight might rely on pharmacological options, backed by sonographically guided percutaneous aspiration for the "rescue" of treatment failures. While this risk mitigation strategy cannot guarantee success, it may be the most practical option given severe resource limitations.

Kirkpatrick, A. W.; Nicolaou, S.; Campbell, M. R.; Sargsyan, A. E.; Dulchavsky, S. A.; Melton, S.; Beck, G.; Dawson, D. L.; Billica, R. D.; Johnston, S. L.; Hamilton, D. R.

2002-01-01

260

Percutaneous Recanalization of Coronary Chronic Total Occlusions: Current Devices and Specialized Wire Crossing Techniques  

PubMed Central

Treatment of coronary chronic total occlusions (CTOs) remains a challenging obstacle, posing a considerable barrier to achieving successful complete revascularization. By nature of their complexity, percutaneous CTO interventions are associated with lower rates of procedural success, higher complication rates, greater radiation exposure and longer procedure times compared with non-CTO interventions. In the last few years, development in guidewires, devices and the emergence of new techniques from Japanese centers resulted in higher success rates in the hands of experienced operators. The impact of drug eluting stents on restenosis has improved long-term outcomes after successful recanalization. Successful revascularization is associated with improved long-term survival, reduced symptoms, improved left ventricular function and reduced need for coronary bypass surgery. This paper reviews the current devices and specialized crossing techniques of percutaneous intervention to relieve CTOs. PMID:20514329

2010-01-01

261

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

262

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

263

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

264

Clinical failure after percutaneous transluminal angioplasty of the superficial femoral and popliteal arteries  

Microsoft Academic Search

Objective: Anatomic patency after percutaneous transluminal angioplasty (PTA) of the superficial femoral and popliteal arteries does not guarantee clinical success. The aim of this report is to determine the causes of clinical failure after PTA. Methods: The records of all patients who have undergone PTA of the femoropopliteal arterial segment by our vascular group were retrospectively reviewed. Only patients with

Laura A Karch; Mark A Mattos; John P Henretta; Robert B McLafferty; Don E Ramsey; Kim J Hodgson

2000-01-01

265

Percutaneous Ultrasound-Guided Thrombin Injection as First-Line Treatment of Pancreatic Pseudoaneurysm  

SciTech Connect

Pancreatic pseudoaneurysms are a rare but potentially fatal complication of pancreatitis. Surgical intervention and transcatheter embolization are not always feasible therapeutic options. In this report we present a case of a pseudoaneurysm secondary to pancreatitis which, despite being angiographically invisible, was successfully embolized with a single ultrasound-guided percutaneous injection of thrombin.

McErlean, Aoife; Looby, Seamus; Lee, Michael J. [Beaumont Hospital, Department of Radiology (Ireland)], E-mail: mlee@rcsi.ie

2007-06-15

266

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

267

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

268

Percutaneous Endoscopic Retrieval and Replacement of a Knitted (Ultraflex) Biliary Stent  

SciTech Connect

A knitted (Ultraflex) biliary stent became obstructed after 5 months causing recurrent jaundice in a 92-year-old man with pancreatic cancer. The obstructed stent was successfully removed percutaneously by retrieval forceps under guidance by an 8.4 Fr fiberoptic biliary endoscope. A new stent was placed. No complications were encountered.

Sawada, Satoshi [Department of Radiology, University Hospital of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-01 (Japan); Kobayashi, Masami [Department of Radiology, Tottori University Hospital, 36-1 Nishimachi, Yonago 683 (Japan); Tanigawa, Noboru; Okuda, Yoshikazu; Mishima, Kazuya; Ohmura, Naoto; Kobayashi, Midori [Department of Radiology, University Hospital of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-01 (Japan)

1997-09-15

269

Percutaneous transluminal angioplasty (PTA) of supra-aortic arteries especially the internal carotid artery  

Microsoft Academic Search

We present our experience with 105 patients in whom percutaneous transluminal angioplasty was performed in 112 stenosed or occluded supra-aortic arteries. Symptoms of cerebrovascular and\\/or vertebrobasilar insufficiency were present in 104 of the 105 patients. The angioplasty was successful in 35 stenoses of the internal carotid artery, 2 stenoses of the common carotid artery, 1 stenosis of the external carotid

R. Kachel; St. Basche; I. Heerklotz; K. Grossmann; S. Endler

1991-01-01

270

[Transradial percutaneous approach for cardiac catheterization in patients with previous brachial artery cutdown].  

PubMed

The percutaneous punction of the radial artery for catheterization procedures has gained acceptance lately. This was a consequence of achieving results similar to the femoral approach, with the benefits of a lower rate of complications and increased comfort for the patients post procedure. Recently it has gained an additional impulse with the better prognosis obtained in acute coronary syndromes. In this trial we have evaluated if the feasibility, results and advantages related with the use of the radial artery percutaneous approach to perform catheterization procedures, continues when used in patients who have had a previous brachial artery cutdown. Out of a total of 1356 percutaneous radial accesses, 53 were in patients with previous brachial artery cutdown. Through this access 71 catheterization procedures were performed, achieving access success in 96.2% (51/53) of the punctions. Once the access success was obtained, 93.6% (44/47) of the diagnostic procedures and 100% (24/24) of the therapeutics procedures were successful. During hospitalization, in this group of patients, no major adverse cardiac events occurred and there was a 1.4% (1/71) rate of minor events. At seven days follow up, no new complications were recorded. Although this is a small group, we believe that it is enough to show that percutaneous punctions of the radial artery to perform catheterization procedures, in patients with previous brachial artery cutdown, are feasible, allowing high access and procedure success rates, with a low frequency of complications. PMID:23335700

Magariños, Eduardo; Solioz, Germán; Cermesoni, Gabriel; Koretzky, Martín; Carnevalini, Mariana; González, Daniel

2013-01-01

271

[The percutaneous absorption of diclofenac].  

PubMed

The percutaneous absorption of diclofenac diethylammonium 1.16% (w/w) in a combination of emulsion cream and gel (Voltaren Emulgel) and of diclofenac sodium 1% (w/w) in a cream formulation (Voltaren cream) was investigated in guinea-pig, rabbit and man. The percutaneous absorption of diclofenac sodium in guinea-pig was 3 to 6% of the dose when the cream formulation in doses of 320, 100 or 40 mg was applied on 10 cm2 of occluded skin and left in place for 6 h. The transdermal delivery of 14C-labelled diclofenac yielded plateau plasma concentrations of radiotracer from 1.5 h after application until removal of the residual cream. Subsequently the steady state drug depots in the skin and muscle tissue were depleted promptly. During daily administration the steady state levels in the muscle tissue in proximity to the application site were about 3 times higher than in distant muscle tissue. By topical application on knee joints of rabbits diclofenac penetrated into the patellar ligament, the adipose corpus and the synovial fluid. In man the percutaneous absorption was 6% of the dose when the Emulgel formulation was spread by 5 mg/cm2 and left for 12 h on non-occluded skin. The pattern of metabolites of diclofenac in human urine was the same after topical and oral administration. In man, upon daily topical administration of 3 times 2.5 g cream formulation (10 mg/cm2) the diclofenac steady state plasma levels were 20 to 40 nmol/l.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3768079

Riess, W; Schmid, K; Botta, L; Kobayashi, K; Moppert, J; Schneider, W; Sioufi, A; Strusberg, A; Tomasi, M

1986-07-01

272

Recommendations on percutaneous coronary intervention for the reperfusion of acute ST elevation myocardial infarction  

PubMed Central

Little information is currently available from the various societies of cardiology on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Since primary PCI is the main method of reperfusion in AMI in many centres, and since of all cardiac emergencies AMI represents the most urgent situation for PCI, recommendations based on scientific evidence and expert experience would be useful for centres practising primary PCI, or those looking to establish a primary PCI programme. To this aim, a task force for primary PCI in AMI was formed to develop a set of recommendations to complement and assist clinical judgment. This paper represents the product of their recommendations. PMID:15145901

Montalescot, G; Andersen, H R; Antoniucci, D; Betriu, A; de Boer, M J; Grip, L; Neumann, F J; Rothman, M T

2004-01-01

273

The contribution of spawning Pacific-salmon to nitrogen fertility and vegetation nutrition during riparian primary succession on an expansive floodplain of a large river.  

E-print Network

?? Floodplain vegetation communities are mosaics of succession stages caused by erosion/redeposition as river channels migrate throughout their floodplains. Typically, plants colonizing alluvial deposits are… (more)

Morris, Michael Roger

2008-01-01

274

Percutaneous Transcatheter Ethanol Sclerotherapy and Catheter Drainage of Postoperative Pelvic Lymphoceles  

SciTech Connect

The aim of this study is to investigate the efficacy and long-term results of percutaneous transcatheter ethanol sclerotherapy (PTES) for postoperative pelvic lymphocele treatment. Fifty-two patients who were referred for lymphocele treatment were included in this study. Sixty lymphoceles of 52 patients were treated by percutaneous treatment with or without ethanol sclerotherapy. Lymphoceles developed in 47 and 5 patients, who underwent gynecologic malignancy operation (31 ovarian cancer, 6 cervix cancer, 10 endometrial cancer) and renal transplantation, respectively. Lymphoceles were catheterized by ultrasonography and fluoroscopy guidance using the Seldinger technique. Lymphoceles smaller than 150 mL underwent single-session ethanol sclerotherapy and the others were treated by multiple-session ethanol scleortherapy. In 10 patients, percutaneous ethanol sclerotherapy could not be performed and they were treated only by percutaneous catheter drainage. The mean lymphocele volume was 329 mL (15-2900 mL). The mean catheterization duration was 11.8 days (1-60 days). The mean follow up time was 25.8 months (2-64 months). The initial treatment was successful in 46 out of 50 (91%) lymphoceles treated with PTES and 7 out of 10 (70%) lymphoceles treated with percutaneous catheter drainage. Minor complications (secondary infection and catheter dislodgement) were noted in seven (11.6%) patients. Recurrence developed in four and three patients who were treated by PTES and percutaneous catheter drainage, respectively. Five of these patients were treated with PTES without further recurrence. Percutaneous transcatheter ethanol sclerotherapy is an effective and reliable method for the treatment of postoperative lymphoceles.

Akhan, Okan, E-mail: musturayk@yahoo.com; Karcaaltincaba, Musturay; Ozmen, Mustafa N.; Akinci, Devrim [Hacettepe University School of Medicine, Department of Radiology (Turkey); Karcaaltincaba, Deniz; Ayhan, Ali [Hacettepe University School of Medicine, Department of Obstetrics and Gynecology (Turkey)

2007-04-15

275

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

276

Single antiplatelet therapy after percutaneous coronary intervention in patients allergic to aspirin.  

PubMed

Dual antiplatelet therapy including aspirin and a P2Y12 ADP receptor antagonist is given after percutaneous coronary intervention to avoid catastrophic complication of stent thrombosis. Dual antiplatelet therapy is associated with increased bleeding risk and may not be tolerated by many patients. This article presents the patients, which had to be given single antiplatelet therapy after percutaneous coronary intervention and discusses the possible factors responsible for the success of single antiplatelet therapy strategy in these patients, in the current era of newer antiplatelet agents and coronary stents. PMID:24880912

Agarwal, Sanjeev Kumar

2014-01-01

277

Current status of percutaneous coronary intervention of chronic total occlusion  

PubMed Central

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

2012-01-01

278

Ultrasound-guided radiofrequency thermal ablation of liver tumors: Percutaneous, laparoscopic, and open surgical approaches  

Microsoft Academic Search

Only 10% to 20% of patients with primary and colorectal metastatic liver tumors are candidates for curative surgical resection.\\u000a Even after curative treatment, tumors recur commonly in the liver. As a less invasive therapy, radiofrequency thermal ablation\\u000a (RFA) of primary, metastatic, and recurrent liver tumors was performed under percutaneous, laparoscopic, or open intraoperative\\u000a ultrasound guidance. The safety and local control

Junji Machi; Shinji Uchida; Kenneth Sumida; Whitney M. L. Limm; Scott A. Hundahl; Andrew J. Oishi; Nancy L. Furumoto; Robert H. Oishi

2001-01-01

279

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

280

Minimally invasive percutaneous cystostomy with ureteroscopic pneumatic lithotripsy for calculus in bladder diverticula  

PubMed Central

The aim of this study was to investigate the effectiveness of minimally invasive percutaneous cystostomy with ureteroscopic pneumatic lithotripsy for treating calculus in bladder diverticula. Percutaneous cystostomy with ureteroscopic pneumatic lithotripsy was performed on six elderly male patients with calculi in bladder diverticula, who could not be treated with transurethral ureteroscopic lithotripsy. The stones were successfully removed from all patients, with no complications such as bladder perforation, rupture, urethritis or cystitis. The surgery time was 15–60 min, with an average time of 32 min. Postoperative ultrasound or X-ray examination showed no stone residues and the bladder stoma healed well. No recurrent stones were detected in the follow-up of 3–24 months (average, 16 months). Minimally invasive percutaneous cystostomy with ureteroscopic pneumatic lithotripsy is a safe, efficient and easy treatment for calculus in bladder diverticula. This method provides a new clinical approach for lithotripsy and we suggest that it is worthy of wider use. PMID:23837044

GU, SI-PING; YOU, ZHI-YUAN; HUANG, YUNTENG; LU, YI-JIN; HE, CAOHUI; CAI, XIAO-DONG; ZHOU, XIAO-MING

2013-01-01

281

Percutaneous Cholecystostomy for Patients with Acute Cholecystitis and an Increased Surgical Risk  

SciTech Connect

Purpose: To evaluate percutaneous cholecystostomy in patients with acute cholecystitis and an increased surgical risk. Methods: Thirty-three patients with acute cholecystitis (calculous, n= 22; acalculous, n= 11) underwent percutaneous cholecystostomy by means of a transhepatic (n= 21) or transperitoneal (n= 12) access route. Clinical and laboratory parameters were retrospectively studied to determine the benefit from cholecystostomy. Results: All procedures were technically successful. Twenty-two (67%) patients improved clinically within 48 hr; showing a significant decrease in body temperature (n= 13), normalization of the white blood cell count (n= 3), or both (n= 6). There were 6 (18%) minor/moderate complications (transhepatic access, n= 3; transperitoneal access, n= 3). Further treatment for patients with calculous cholecystitis was cholecystectomy (n= 9) and percutaneous and endoscopic stone removal (n= 8). Further treatment for patients with acalculous cholecystitis was cholecystectomy (n= 2) and gallbladder ablation (n= 2). There were 4 deaths (12%) either in hospital or within 30 days of drainage; none of the deaths was procedure-related. Conclusions: Percutaneous cholecystostomy is a safe and effective procedure for patients with acute cholecystitis. For most patients with acalculous cholecystitis percutaneous cholecystostomy may be considered a definitive therapy. In calculous disease this treatment is often only temporizing and a definitive surgical, endoscopic, or radiologic treatment becomes necessary.

Overhagen, Hans van; Meyers, Hjalmar [Department of Radiology, University Hospital Dijkzigt, Dr. Molewaterplein 40, NL-3015 GD Rotterdam (Netherlands); Tilanus, Hugo W.; Jeekel, Johannes [Department of Surgery, University Hospital Dijkzigt, Dr. Molewaterplein 40, NL-3015 Rotterdam (Netherlands); Lameris, Johan S. [Department of Radiology, University Hospital Dijkzigt, Dr. Molewaterplein 40, NL-3015 GD Rotterdam (Netherlands)

1996-03-15

282

A novel vacuum assisted closure therapy model for use with percutaneous devices.  

PubMed

Long-term maintenance of a dermal barrier around a percutaneous prosthetic device remains a common clinical problem. A technique known as Negative Pressure Wound Therapy (NPWT) uses negative pressure to facilitate healing of impaired and complex soft tissue wounds. However, the combination of using negative pressure with percutaneous prosthetic devices has not been investigated. The goal of this study was to develop a methodology to apply negative pressure to the tissues surrounding a percutaneous device in an animal model; no tissue healing outcomes are presented. Specifically, four hairless rats received percutaneous porous coated titanium devices implanted on the dorsum and were bandaged with a semi occlusive film dressing. Two of these animals received NPWT; two animals received no NPWT and served as baseline controls. Over a 28-day period, both the number of dressing changes required between the two groups as well as the pressures were monitored. Negative pressures were successfully applied to the periprosthetic tissues in a clinically relevant range with a manageable number of dressing changes. This study provides a method for establishing, maintaining, and quantifying controlled negative pressures to the tissues surrounding percutaneous devices using a small animal model. PMID:24685323

Cook, Saranne J; Nichols, Francesca R; Brunker, Lucille B; Bachus, Kent N

2014-06-01

283

Percutaneous nephrolithotomy directly through an angiomyolipoma.  

PubMed

We present a patient with tuberous sclerosis and bilateral angiomyolipomas with a right partial staghorn calculi in which the calculi was managed with a percutaneous nephrolithotomy. Despite the inherent risk of hemorrhage with a percutaneous approach compounded by the fact that this was done directly through a tumor, we were able to render the patient stone free with no intraoperative bleeding, complications, or the need for postoperative blood transfusion. To our knowledge, this is the first reported case of percutaneous nephrolithotomy directly through a renal angiomyolipoma. PMID:7985324

Kropp, B P; Dabagia, M D; Scott, J W; Lingeman, J E

1994-12-01

284

Comparison of cockcroft-gault and modification of diet in renal disease formulas as predictors of cardiovascular outcomes in patients with myocardial infarction treated with primary percutaneous coronary intervention.  

PubMed

We prospectively assessed the value of estimated glomerular filtration rate (eGFR) by the Modification of Diet in Renal Disease (MDRD) and Cockcroft-Gault (C-G) equations in predicting inhospital adverse outcomes after primary coronary intervention for acute ST-segment elevation myocardial infarction. We classified 647 patients into 3 categories according to eGFR, <60, 60 to 90, and >90 mL/min/1.73 m(2). The eGFRC-G classified 17 patients in the >90 mL/min/1.73 m(2) subgroup and 6 and 11 patients in the 60 to 90 and <60 mL/min/1.73 m(2) subgroups, respectively. In multivariate analysis, patients with eGFRC-G < 60 mL/min/1.73 m(2) had 19.5-fold (95% confidence interval [CI] 1.55-178) higher mortality risk and 5.48-fold (95% CI 1.75-24.21) higher major adverse cardiac events risk compared to patients with eGFRC-G >90 mL/min/1.73 m(2) (P = .01 and P = .01, respectively); the eGFRMDRD was not predictive. Although the MDRD equation more accurately estimates GFR in certain populations, the CG formula may be a better predictor of adverse events. PMID:24101712

Ekmekci, Ahmet; Uluganyan, Mahmut; Gungor, Baris; Tufan, Fatih; Cekirdekci, Elif Iclal; Ozcan, Kazim Serhan; Erer, Hatice Betul; Orhan, Ahmet; Osmanov, Damir; Bozbay, Mehmet; Cicek, Gokhan; Sayar, Nurten; Eren, Mehmet

2014-10-01

285

Histologic assessment of biliary obstruction with different percutaneous endoluminal techniques  

PubMed Central

Background Despite the sophisticated cross sectional image techniques currently available, a number of biliary stenosis or obstructions remain of an uncertain nature. In these pathological conditions, an "intrinsic" parietal alteration is the cause of biliary obstruction and it is very difficult to differentiate benign from malignant lesions using cross-sectional imaging procedures alone. We evaluated the efficacy of different endoluminal techniques to achieve a definitive pathological diagnosis in these situations. Methods Eighty patients underwent brushing, and or biopsy of the biliary tree through an existing transhepatic biliary drainage route. A subcoort of 12 patients needed balloon-dilatation of the bile duct and the material covering the balloon surface was also sent for pathological examination (balloon surface sampling). Pathological results were compared with surgical findings or with long-term clinical and instrumental follow-ups. Success rates, sensitivity, specificity, accuracy, confidential intervals, positive predictive value and negative predictive value of the three percutaneous techniques in differentiating benign from malignant disease were assessed. The agreement coefficient of biopsy and brushing with final diagnosis was calculated using the Cohen's "K" value. Results Fifty-six patients had malignant strictures confirmed by surgery, histology, and by clinical follow-ups. Success rates of brushing, balloon surface sampling, and biopsy were 90.7, 100, and 100%, respectively. The comparative efficacy of brushing, balloon-surface sampling, and biopsy resulted as follows: sensitivity of 47.8, 87.5, and 92.1%, respectively; specificity of 100% for all the techniques; accuracy of 69.2, 91.7 and 93.6%, Positive Predictive Value of 100% for all the procedures and Negative Predictive Value of 55, 80, and 75%, respectively. Conclusions Percutaneous endoluminal biopsy is more accurate and sensitive than percutaneous bile duct brushing in the detection of malignant diseases (p < 0.01). PMID:15329152

Rossi, Michele; Cantisani, Vito; Salvatori, Filippo Maria; Rebonato, Alberto; Greco, Laura; Giglio, Luigi; Guido, Giampiero; Pagliara, Elisa; David, Vincenzo

2004-01-01

286

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

287

Development of Percutaneous Energy Transmission Systems.  

National Technical Information Service (NTIS)

Development of a Percutaneous Access Device (PAD) over the initial 9-month period is documented. The authors hope to develop a PAD satisfying long-performance criteria, i.e. freedom from infection, extrusion, and marsupialization by meeting two requiement...

A. Kantrowitz, P. S. Freed, A. A. Ciarkowski, F. L. Vaughan, J. I. VeShancey

1979-01-01

288

An unusual complication following radiological percutaneous gastrostomy  

E-print Network

with complications. Clinicians should have a high index of suspicion about malrotation when performing procedures like percutaneous gastrostomy and radiologically guided entrostomy. If there is an index of suspicion they should be screened prior to the procedure....

Veenith, Tonny; Bhagwat, Manasi; Bailey, Andrew

2008-08-12

289

Percutaneous umbilical cord blood sampling - series (image)  

MedlinePLUS

... your doctor may recommend percutaneous umbilical cord blood sampling (PUBS), which is performed at 18 weeks' gestation. ... it connects to the umbilical cord determine which method your doctor uses. If the placenta is attached ...

290

Animal models for percutaneous absorption.  

PubMed

Animal models are important tools to predict human in vivo percutaneous absorption/penetration. Monkey, pig, rat, rabbit, guinea pig, hairless rodents, such as hairless rat, hairless mouse, hairless guinea pig and hairless dog, are among the most used animals for this purpose. Each animal model has its own advantages and weakness or limitation. To better correlate animal data with human skin absorption, we need to be familiar with each animal model's characteristics as well as experimental method and condition. We reviewed the original papers published after 1993 that described permeability of both animal skin and human skin. It showed that monkey, pig and hairless guinea pig are more predictive of human skin absorption/penetration and common laboratory animals, such as rat, rabbit, guinea pig, generally overestimate human skin absorption/penetration. Copyright © 2014 John Wiley & Sons, Ltd. PMID:25345378

Jung, Eui Chang; Maibach, Howard I

2015-01-01

291

Percutaneous absorption of uranium compounds.  

PubMed

Percutaneous absorption of soluble and insoluble uranium compounds has been induced in order to obtain information on penetration routes and the tissue injury produced by uranium salts. The high electron density of uranium provided a reliable way to visualize, by electron microscopy, the precise localization of the heavy compounds within the tissues. Few minutes after topical application of uranyl nitrate, dense deposits of uranium were observed at the epidermal barrier level. A few hours later, dense deposits were seen filling the intercellular spaces and were also scattered in the cytoplasm and nucleus. Mortality and body weight measurements indicated the high toxicity of uranyl nitrate and ammonium uranyl tricarbonate; uranyl acetate and ammonium diuranate were less toxic. As no penetration was achieved after uranium dioxide, no variations were detected on these parameters. PMID:6832127

de Rey, B M; Lanfranchi, H E; Cabrini, R L

1983-04-01

292

Percutaneous treatment of bone tumors by radiofrequency thermal ablation.  

PubMed

We present our experience of the treatment of bone tumors with radiofrequency thermal ablation (RFTA). Over the past 4 years, we have treated 26 cases (22 benign and 4 malignant) using CT-guided RFTA. RFTA was the sole treatment in 19 cases and was combined with percutaneous cementation during the same session in the remaining seven cases. Our approach to the tumors was simplified, using a single point of entrance for both RFTA and percutaneous osteoplasty. In the benign cases, clinical success was defined as resolution of pain within 1 month of the procedure and no recurrence during the follow-up period. It was achieved in 19 out of the 21 patients in which curative treatment was attempted. The two non-resolved cases were a patient with osteoid osteoma who developed a symptomatic bone infarct after a symptom-free period of 2 months and another with femoral diaphysis osteoblastoma who suffered a pathological fracture after 8 months without symptoms. The procedure was considered clinically successful in the five cases (4 malign and 1 benign) in which palliative treatment was attempted, because there was a mean (±SD) reduction in visual analogue scale (VAS) pain score from 9.0±0.4 before the procedure to <4 during the follow-up period. PMID:19586734

Ruiz Santiago, Fernando; Castellano García, María del Mar; Guzmán Álvarez, Luis; Martínez Montes, Jose Luis; Ruiz García, Manuel; Tristán Fernández, Juan Miguel

2011-01-01

293

Percutaneous cardiopulmonary support of video-assisted metastasectomy for a patient with lung cancer following pneumonectomy.  

PubMed

We describe herein a case of a 68-year-old woman with primary lung cancer who had undergone induction chemoradiotherapy and then a right pneumonectomy for non-small cell cancer (adenocarcinoma). Twenty-one months later, the cancer had metastasized to the brain, which was treated with 2-knife radiosurgery. She had been well for up to 32 months; however, the chest radiography and chest computed tomography (CT) demonstrated a nodule in the left upper lobe of the lung that was gradually growing. We preformed a partial resection of the left upper lobe by video-assisted thoracic surgery (VATS) under percutaneous cardiopulmonary support (PCPS), considering the oxygenation requirement of the patient. PCPS was applied via venoarterial (V-A) bypass, and the hemodynamic status of the patient was mostly stable. The postoperative course was uneventful, and the patient has no evidence of metastatic lung cancer, 10 months postoperatively, indicating that the minimally invasive VATS under PCPS was successful and safe. Although few reports have been described and some key questions remain unanswered, the method appears to be promising. PMID:21587128

Suzuki, Toshiaki; Akiba, Tadashi; Hiramatsu, Miyako; Matsudaira, Hideki; Hirano, Jun; Odaka, Makoto; Morikawa, Toshiaki

2011-01-01

294

Poor Single-Mother College Students' Views on the Effect of Some Primary Sociological and Psychological Belief Factors on Their Academic Success.  

ERIC Educational Resources Information Center

A study using structured interviews assessed views of 46 poor single-mother college students concerning factors in their academic success. The study identified four social support factors (support of other students, family, faculty, and university services) and four psychological belief factors (personal ambition, effort/discipline, prior…

Van Stone, Nadine; And Others

1994-01-01

295

[Therapeutic approach in patients undergoing percutaneous coronary interventions].  

PubMed

While the performance of percutaneous coronary interventions remains the domain of interventional cardiologists, the management of these patients before, during, and after the procedure is in the domain of general cardiologists, internists and primary care physicians. Therefore, for optimal patient care it is crucial that all engaged physicians should understand the procedural risks, complications and optimal treatment strategy before, during and after the procedure. Before a percutanous coronary intervention, patients with known allergies to iodinated contrast dye should be pretreated with oral corticosteroids and H1-receptor blockers. Diabetic patients as well as patients with renal failure need special care. Hydration is crucial for patients with renal insufficiency in order to minimise the risk of contrast nephropathy. Metformin therapy should be discontinued before the procedure in patients with renal failure in order to avoid lactic acidosis, and it should be reinstituted after the procedure only when normal serum creatine level is confirmed. Double antiplatelet therapy (aspirin plus clopidogrel) should be initiated at least six hours before the procedure. While aspirin therapy after the procedure is life long, the duration of clopidogrel therapy depends on the type of implanted stent (in patients with bare stents implanted clopidogrel should be taken at least 3 - 4 weeks post procedural, and in patients with drug-eluting stents implanted clopidogrel should be taken at least 6 - 12 months after the procedure due to in-stent restenosis prevention). Patients who experience typical anginal pain in a period of one to eight month after percutaneous coronary revascularization are likely to have restenosis, and they should be reevaluated with stress echocardiography and/or repeated coronary angiography. PMID:19902784

Mijailovi?, Zdravko M; Staji?, Zoran; Jevti?, Miodrag; Aleksandri?, Srdan; Matunovi?, Radomir; Tavciovski, Dragan

2009-01-01

296

Successful booster antibody response up to 54 months after single primary vaccination with virosome-formulated, aluminum-free hepatitis A vaccine.  

PubMed

This study demonstrates that a booster dose of the virosome-formulated, aluminum-free hepatitis A vaccine Epaxal (Berna Biotech) is highly immunogenic in subjects who received a single primary dose of this vaccine 18-54 months earlier. There were no significant differences in geometric mean antibody titers (GMTs) among subjects who received the booster dose 18-29 months (GMT, 2330 mIU/mL), 30-41 months (GMT, 2395 mIU/mL), or 42-54 months (GMT, 2432 mIU/mL) after primary vaccination, indicating that delays in the administration of booster vaccination do not lead to a loss of immunogenicity. PMID:14557982

Beck, Bernhard R; Hatz, Christoph; Brönnimann, Rainer; Herzog, Christian

2003-11-01

297

Percutaneous plating of distal tibial fractures in children and adolescents.  

PubMed

Fractures of the tibia and fibula are among the most common injuries involving the lower extremities in children and adolescents. Although most can be treated nonoperatively, with satisfactory long-term results, some fractures require surgical stabilization. The increasing experience in adults with minimally invasive plate osteosynthesis for the treatment of complex fractures of the lower extremity has supported the treatment of selected distal tibia fractures in older children and adolescents. This article details the surgical technique for plating of the distal tibia using the percutaneous approach and assesses the results and complications in a pediatric series. We retrospectively reviewed 11 consecutive patients with open physes who had undergone percutaneous plating of a distal tibial fracture between January 2008 and January 2012. All patients were monitored clinically and radiographically until fracture union. Complications related to treatment, such as malunion, delayed union, nonunion, infection, and the need for subsequent surgical treatment, were recorded. Eleven patients (11 tibial fractures) were treated with minimally invasive plate osteosynthesis. The average follow-up period was 22 months (range, 12-48 months). Fractures healed with an average time to union of 9.4 weeks (range, 8-16 weeks). There were no cases of delayed union or nonunion. No clinically evident neurovascular complications were observed. One patient had a superficial infection, treated successfully by oral antibiotics. There were no cases of rotational deformity or leg-length discrepancy at the final follow-up. Because of its biologic advantages and stable fixation that allows early mobilization, percutaneous plating seems a reasonable treatment option for selected distal tibial fractures in children and adolescents. Level of evidence: Level IV therapeutic study - Case series. PMID:24500423

Masquijo, Julio J

2014-05-01

298

Why a successful task substitution in glaucoma care could not be transferred from a hospital setting to a primary care setting: a qualitative study  

PubMed Central

Background Healthcare systems are challenged by a demand that exceeds available resources. One policy to meet this challenge is task substitution-transferring tasks to other professions and settings. Our study aimed to explore stakeholders’ perceived feasibility of transferring hospital-based monitoring of stable glaucoma patients to primary care optometrists. Methods A case study was undertaken in the Rotterdam Eye Hospital (REH) using semi-structured interviews and document reviews. They were inductively analysed using three implementation related theoretical perspectives: sociological theories on professionalism, management theories, and applied political analysis. Results Currently it is not feasible to use primary care optometrists as substitutes for optometrists and ophthalmic technicians working in a hospital-based glaucoma follow-up unit (GFU). Respondents’ narratives revealed that: the glaucoma specialists’ sense of urgency for task substitution outside the hospital diminished after establishing a GFU that satisfied their professionalization needs; the return on investments were unclear; and reluctant key stakeholders with strong power positions blocked implementation. The window of opportunity that existed for task substitution in person and setting in 1999 closed with the institutionalization of the GFU. Conclusions Transferring the monitoring of stable glaucoma patients to primary care optometrists in Rotterdam did not seem feasible. The main reasons were the lack of agreement on professional boundaries and work domains, the institutionalization of the GFU in the REH, and the absence of an appropriate reimbursement system. Policy makers considering substituting tasks to other professionals should carefully think about the implementation process, especially in a two-step implementation process (substitution in person and in setting) such as this case. Involving the substituting professionals early on to ensure all stakeholders see the change as a normal step in the professionalization of the substituting professionals is essential, as is implementing the task substitution within the window of opportunity. PMID:23351180

2013-01-01

299

Percutaneous Introducibility of the Expandable Vascular Sheath System and Injury Potential of Balloon-Assisted Thrombectomy: Preliminary In Vivo Results  

SciTech Connect

Purpose: To test the percutaneous introducibility of the expandable vascular sheath (EVS) system and the safety of percutaneous balloon-assisted thrombectomy. Methods: The EVS was inserted directly (n= 9) or through a 9.5 Fr regular vascular introducer sheath (n= 9) into the femoral arteries and veins and carotid arteries in four dogs (18-21 kg). Balloon-assisted thrombectomies were simulated in iliac arteries. Histologic examinations were done at sites of funnel deployment immediately (n= 4) and 25 days (n= 8) after the intervention. Results: The EVS was successfully introduced into six of nine vessels by a direct percutaneous approach. Balloon-assisted thrombectomy using the EVS device caused localized intimal denudation, disruption of the internal elastic lamina, and mild hemorrhages into the media; one arterial dissection at the site of funnel deployment was seen. All indirect insertions and funnel deployments were successful. Twenty-five days after the experiments, intimal hyperplasia was noted in all cases. Conclusion: Percutaneous balloon-assisted thrombectomy may cause mild vascular injuries. Direct percutaneous introduction of the EVS device cannot be recommended yet.

Brossmann, Joachim [Klinik fuer Diagnostische Radiologie, Christian-Albrechts-Universitaet Kiel, Arnold Heller Strasse 9, D-24105 Kiel (Germany); Haghighi, Parviz [Department of Pathology and Laboratory Medicine, VA Medical Center, 3350 Lojolla Village Drive, San Diego, CA 92161 (United States); Bookstein, Joseph J. [Department of Radiology, University of California, 225 W. Dickinson St., San Diego, CA 91203 (United States)

1999-01-15

300

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. PMID:23526482

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

301

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. PMID:23449657

Cambron, S.C.; McIntyre, J.J.; Guerin, S.J.; Li, Z.; Pastel, D.A.

2013-01-01

302

Percutaneous minimally invasive treatment of malignant biliary strictures: current status.  

PubMed

The concept of percutaneous management of malignant biliary obstruction has not significantly changed in the last two decades and is based on the successful drainage of bile toward the duodenum, which normalizes liver function and prevents the development of cholangitis and sepsis. However, patient survival has changed slightly in the last two decades due to the advance of the diagnostic methods, chemo-radiotherapy protocols, and minimally invasive local control of the disease. Bare metal stents have not improved; however, newly developed covered biliary stents have been designed, and there is now evidence supporting their use in the clinical practice. However, other novel devices that may potentially offer benefit to patients with malignant biliary obstruction have been developed, such as drug-eluting biliary stents and intraductal ablation devices, and first feasibility trials have been published that offer encouraging results. These new technological developments, in combination with increased patient survival, bring new exciting data in this constantly developing area. The purpose of this review article is to investigate the latest published evidence on percutaneous minimal invasive palliation of malignant biliary disease and to delineate current trends. PMID:23851920

Krokidis, Miltiadis; Hatzidakis, Adam

2014-04-01

303

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. PMID:23241168

2012-01-01

304

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

305

Arthroscopically assisted percutaneous fixation of displaced midclavicular fracture using a Knowles pin.  

PubMed

Clavicle fractures are common traumatic injuries of the shoulder girdle, with surgery being the recommended treatment for some displaced midshaft fractures. Open surgery is widely used; however, the primary concerns of this procedure include cosmetic problems and incisional complications, such as wound dehiscence, infection, numbness, and sensitivity. A new arthroscopically assisted technique was developed, in which the Knowles pin was used for percutaneous fixation to treat the displaced midclavicular fracture. This technique is an attractive alternative treatment option for midclavicular fractures. PMID:23179454

Lin, Cheng-Li; Jou, I-Ming; Huang, Ming-Tung; Lin, Chii-Jeng; Su, Wei-Ren

2014-02-01

306

Outpatient percutaneous heel cord lengthening in children.  

PubMed

Outpatient percutaneous tendo Achillis lengthening is a quick, complication-free, inexpensive approach to a common pediatric orthopedic problem. The procedure is a known alternative to conventional open procedures, but it is not widely used. This study outlines the advantage of the percutaneous procedure performed in outpatient surgery with the patient under a general anesthetic. Fifty-five patients were operated on between December 1980 and March 1984. Overall results were excellent, with 97% improvement in gait. There were no infections. Percutaneous heel cord lengthening in children is a safe and simple operation, yielding results equal to those of open procedures. The advantage of outpatient surgery adds a further positive dimension to this procedure. PMID:3584437

Moreau, M J; Lake, D M

1987-01-01

307

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

308

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

309

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

310

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

311

Usefulness of nisoldipine for prevention of restenosis after percutaneous transluminal coronary angioplasty (results of the NICOLE study)  

Microsoft Academic Search

The NIsoldipine in COronary artery disease in LEuven (NICOLE) study investigates (1) whether nisoldipine, a dihydropyridine calcium antagonist, reduces the progression of minor coronary arterial lesions in the long term, and (2) whether it reduces the restenosis rate after successful percutaneous transluminal coronary angioplasty (PTCA). The NICOLE study is a single-center, randomized, double-blind trial in 826 patients, who underwent a

Joseph A Dens; Walter J Desmet; Patrick Coussement; Ivan K De Scheerder; Konstantinos Kostopoulos; Pitsanu Kerdsinchai; Chumpol Supanantaroek; Jan H Piessens

2001-01-01

312

Percutaneous Cryotherapy of Vascular Malformation: Initial Experience  

SciTech Connect

The present report describes a case of percutaneous cryotherapy in a 36-year-old woman with a large and painful pectoral venous malformation. Cryoablation was performed in a single session for this 9-cm mass with 24 h hospitalisation. At 2- and 6-month follow-up, the pain had completely disappeared, and magnetic resonance imaging demonstrated a significant decrease in size. Percutaneous cryoablation shows promise as a feasible and apparently safe method for local control in patients with symptomatic venous vascular malformations.

Cornelis, F., E-mail: francoiscornelis@hotmail.com [Institut Bergonie, Department of Radiology (France); Neuville, A. [Institut Bergonie, Department of Pathology (France); Labreze, C. [Pellegrin Hospital, Department of Pediatric Dermatology (France); Kind, M. [Institut Bergonie, Department of Radiology (France); Bui, B. [Institut Bergonie, Department of Oncology (France); Midy, D. [Pellegrin Hospital, Department of Vascular Surgery (France); Palussiere, J. [Institut Bergonie, Department of Radiology (France); Grenier, N. [Pellegrin Hospital, Department of Radiology (France)

2013-06-15

313

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

314

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

315

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

316

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

317

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

318

Percutaneous transhepatic sclerotherapy with embolization of the drainage vein for a gastric varix  

PubMed Central

We experienced a case with a gastric varix that did not have a catheterizable main drainage vein and had multiple afferent veins. For this case we successfully performed percutaneous transhepatic sclerotherapy using the following procedure. After the drainage vein was embolized by metallic coils and n-butyl cyanoacrylate from a microcatheter that was advanced through the gastric varix, 5% ethanolamine oleate-iopamidol was infused into the gastric varix from one main afferent vein under balloon occlusion. PMID:25298873

Yamagami, Takuji; Miura, Hiroshi; Okuda, Kotaro

2014-01-01

319

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

320

The impact of accreditation of primary healthcare centers: successes, challenges and policy implications as perceived by healthcare providers and directors in Lebanon  

PubMed Central

Background In 2009, the Lebanese Ministry of Public Health (MOPH) launched the Primary Healthcare (PHC) accreditation program to improve quality across the continuum of care. The MOPH, with the support of Accreditation Canada, conducted the accreditation survey in 25 PHC centers in 2012. This paper aims to gain a better understanding of the impact of accreditation on quality of care as perceived by PHC staff members and directors; how accreditation affected staff and patient satisfaction; key enablers, challenges and strategies to improve implementation of accreditation in PHC. Methods The study was conducted in 25 PHC centers using a cross-sectional mixed methods approach; all staff members were surveyed using a self-administered questionnaire whereas semi-structured interviews were conducted with directors. Results The scales measuring Management and Leadership had the highest mean score followed by Accreditation Impact, Human Resource Utilization, and Customer Satisfaction. Regression analysis showed that Strategic Quality Planning, Customer Satisfaction and Staff Involvement were associated with a perception of higher Quality Results. Directors emphasized the benefits of accreditation with regards to documentation, reinforcement of quality standards, strengthened relationships between PHC centers and multiple stakeholders and improved staff and patient satisfaction. Challenges encountered included limited financial resources, poor infrastructure, and staff shortages. Conclusions To better respond to population health needs, accreditation is an important first step towards improving the quality of PHC delivery arrangement system. While there is a need to expand the implementation of accreditation to cover all PHC centers in Lebanon, considerations should be given to strengthening their financial arrangements as well. PMID:24568632

2014-01-01

321

Successful renal transplantation in a patient with systemic sarcoidosis and renal failure due to focal glomerulosclerosis.  

PubMed

In 1987, a patient presented with pulmonary sarcoidosis and progressive renal failure. Percutaneous renal biopsy showed focal glomerular sclerosis (FGS). Over the subsequent 4-year period, her renal failure progressed to require hemodialysis. During this time, her pulmonary sarcoidosis was treated with daily corticosteroid therapy and she remained in clinical remission. The patient received a one-haplotype-identical living-related renal transplant from her mother. The patient is now 25 months posttransplant with a serum creatinine of 106 mumol/L (1.2 mg/dL). Her sarcoidosis continues to be in clinical remission. In this report, we review the rare association of a primary glomerular lesion causing renal failure in patients with sarcoidosis. In addition, we detail the first successful renal transplant in such a patient. PMID:1585940

Hakaim, A G; Stilmant, M M; Kauffman, J; Schmitt, G; Joshi, P; Carpinito, G; Cho, S I

1992-05-01

322

Multiple atrial septal defects and patent ductus arteriosus: successful outcome using two Amplatzer septal occluders and Gianturco coils.  

PubMed

We report on a case of successful percutaneous closure of two atrial septal defects and a persistent ductus arteriosus using two Amplatzer septal occluders and a Gianturco coil in a 9-year-old child. PMID:9829882

Pedra, C A; Fontes-Pedra, S R; Esteves, C A; Assef, J; Fontes, V F; Hijazi, Z M

1998-11-01

323

Percutaneous balloon pulmonary valvuloplasty: A modified over-the-wire Inoue balloon technique for difficult right ventricular anatomy  

PubMed Central

Percutaneous balloon pulmonary valvuloplasty (BPV) is the mainstay of treatment for significant pulmonary stenosis with doming leaflets. Various techniques have been described in the literature including the use of Inoue Percutaneous Transseptal Mitral Commissurotomy (PTMC) catheter with standard 0.025? guidewire. But if right ventricular anatomy is not suitable, 0.025? guidewire doesn't provide enough support to track the Inoue PTMC catheter. Here, we report a case of successful BPV using a novel technique of slenderizing the Inoue Percutaneous Transseptal Mitral Commissurotomy (PTMC) catheter over an Amplatz superstiff 0.035? guidewire. This technique may be useful during BPV in difficult right ventricular inflow and outflow tract anatomy in patients with congenital pulmonary valve stenosis. PMID:24814118

Deora, Surender; Vyas, Chirayu; Shah, Sanjay; Patel, Tejas

2014-01-01

324

Interval Biliary Stent Placement Via Percutaneous Ultrasound Guided Cholecystostomy: Another Approach to Palliative Treatment in Malignant Biliary Tract Obstruction  

SciTech Connect

Percutaneous cholecystostomy is a minimally invasive procedure for providing gallbladder decompression, often in critically ill patients. It can be used in malignant biliary obstruction following failed endoscopic retrograde cholangiopancreatography when the intrahepatic ducts are not dilated or when stent insertion is not possible via the bile ducts. In properly selected patients, percutaneous cholecystostomy in obstructive jaundice is a simple, safe, and rapid option for biliary decompression, thus avoiding the morbidity and mortality involved with percutaneous transhepatic biliary stenting. Subsequent use of a percutaneous cholecystostomy for definitive biliary stent placement is an attractive concept and leaves patients with no external drain. To the best of our knowledge, it has only been described on three previous occasions in the published literature, on each occasion forced by surgical or technical considerations. Traditionally, anatomic/technical considerations and the risk of bile leak have precluded such an approach, but improvements in catheter design and manufacture may now make it more feasible. We report a case of successful interval metal stent placement via percutaneous cholecystostomy which was preplanned and achieved excellent palliation for the patient. The pros and cons of the procedure and approach are discussed.

Harding, James, E-mail: drjames.harding@btinternet.com; Mortimer, Alex [North Bristol NHS Trust, Frenchay Hospital, Department of Radiology (United Kingdom); Kelly, Michael [North Bristol NHS Trust, Frenchay Hospital, Department of General Surgery (United Kingdom); Loveday, Eric [North Bristol NHS Trust, Frenchay Hospital, Department of Radiology (United Kingdom)

2010-12-15

325

Development of a Percutaneous Energy Transmission System.  

National Technical Information Service (NTIS)

The goal of this project is development of a percutaneous access device (PAD) which satisfies long-term performance criteria. To achieve this goal, epidermal cell proliferation is to be controlled and the tissue-PAD seal protected from strain. Recognizing...

A. Kantrowitz, P. S. Freed, T. Wasfie, J. Polanski, F. L. Vaughn

1982-01-01

326

Ultrasonically-aided percutaneous orbital aspiration.  

PubMed

Ultrasonography is the most effective diagnostic modality for locating and delimiting cystic orbital lesions, and may often provide an accurate tissue diagnosis. A case is presented demonstrating the ability of ultrasonography to aid in the percutaneous aspiration of selected orbital cystic lesions. PMID:523057

Skalka, H W; Callahan, M A

1979-11-01

327

Use of fibrin glue in percutaneous nephrolithotomy  

Microsoft Academic Search

ObjectivesTo report our experience with the use of fibrin glue during tubeless percutaneous nephrolithotomy. We addressed the safety of this approach and evaluated its use for any clinical benefit with respect to length of hospital stay, bleeding, analgesic usage, and urinary extravasation.

Albert A Mikhail; John S Kaptein; Gary C Bellman

2003-01-01

328

Percutaneous Transluminal Angioplasty of the Subclavian  

Microsoft Academic Search

We studied the long-term results of percutaneous transluminal angioplasty of the subclavian artery in treating stenosis (43 patients) or occlusion (nine patients). In all 52 patients, the blood pressure before treatment in the arm on the involved side was at least 30 mm Hg lower than that in the opposite arm. Thirty-nine patients (75%) had symptoms of vertebrobasilar insufficiency (dizziness,

Andrija Hebrang; Josip Maskovic; Berislav Toma

329

Percutaneous needle treatment of liver tumors  

E-print Network

· Percutaneous needle treatment of liver tumors · Target multiple tumors through a single incisionmm x 90mm x 260mm · Autoclavable I. Free Space III. Bovine Liver · Precurved concentric nitinol tubes.80 Bovine Liver (mm) 3.32 ± 2.66 II. Ethanol Solution Future Work · Human trials with manual unit · Fully

Webster III, Robert James

330

Percutaneous drilling for chronic heel pain  

Microsoft Academic Search

The authors report a retrospective study involving 25 feet in 21 patients who underwent percutaneous drilling for chronic heel pain. Patients with increased activity of the heel were considered for surgical treatment if there was increased uptake on the delayed bone scans. The average follow-up was 21 months (range, 6 to 30 months). All patients were treated in day surgery

Stefano Santini; Arturo Rebeccato; Roberto Schiavon; Livio Nogarin

2003-01-01

331

Response of Nonmidline Pain to Percutaneous Vertebroplasty  

Microsoft Academic Search

OBJECTIVE. The purpose of this study was to determine the prevalence of nonmidline symptoms in patients undergoing percutaneous vertebroplasty and the response of these symp- toms to vertebroplasty. MATERIALS AND METHODS. This is a retrospective study performed through exami- nation of patient records, baseline questionnaires, demographic sheets, follow-up questionnaires, reports from telephone follow-up, and pain location diagrams completed before and

Jill E. Gibson; Thomas K. Pilgram; Louis A. Gilula; Gibson JE; Pilgram TK; Gilula LA

332

Percutaneous Treatment of Pyocystis in Patients with Autosomal Dominant Polycystic Kidney Disease  

SciTech Connect

The course of autosomal dominant polycystic kidney disease (ADPKD) is frequently complicated by infection of a cyst within a polycystic kidney, which is a diagnostic and therapeutic dilemma damaging the clinical course of patients. The aim of this study was to demonstrate the safety and efficacy of percutaneous drainage in management of infected cysts in ADPKD patients. Between May 2003 and December 2006, percutaneous drainage was performed in 16 infected renal cysts of four kidneys in three patients (two females, one male), with a mean age of 57.3 years. Cyst dimensions, total amount of drained cyst fluid, catheterization duration, isolated microorganisms, and follow-up duration were recorded. Technical, clinical success rates were 100%; the complication rate was 0%. Diameters of cysts ranged between 3 and 8 cm. Average volume of drained fluid and average duration of catheterization for one cyst were 226 ml and 9.8 days. No recurrence was encountered but one patient (no. 3), who had pyocystis in the right kidney and was treated with catheterization, referred with left flank pain due to pyocystis in her left kidney 3 months later. Follow-up durations were 35, 47, and 11 months for patients 1, 2, and 3, respectively. For patient 3, follow-up duration for the second procedure was 7 months. We conclude that percutaneous drainage with antibiotic therapy should be the initial method in management of infected cysts in ADPKD patients, with high success and low complication rates.

Akinci, Devrim, E-mail: akincid@yahoo.com; Turkbey, Baris, E-mail: bturkbey@yahoo.co [Hacettepe University School of Medicine, Department of Radiology (Turkey); Yilmaz, Rahmi [Hacettepe University School of Medicine, Department of Nephrology (Turkey); Akpinar, Erhan; Ozmen, Mustafa N.; Akhan, Okan [Hacettepe University School of Medicine, Department of Radiology (Turkey)

2008-09-15

333

Percutaneous transhepatic cholangiography in the investigation of the persistent postoperative bile leak.  

PubMed

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 which the superior demonstration of biliary anatomy provided by PTHC allowed successful identification of the site of postoperative biliary leakage. We compared PTHC with other diagnostic imaging techniques available and conclude that it is a safe, accurate, and reliable technique. PMID:3596138

Kissin, C M; Grundy, A

1987-01-01

334

Ultrasound-Guided Percutaneous Drainage of Neonatal Pyometrocolpos Under Local Anesthesia  

SciTech Connect

Hydrometrocolpos is an uncommon congenital disorder with cystic dilatation of the vagina and uterus that occurs as a result of accumulated secretions from the reproductive tract due to distal genital tract obstruction. Secondary infection may also occur, resulting in pyometrocolpos, a potentially lethal disease. Immediate drainage of the cystic mass in patients determined to have pyometrocolpos is required to prevent or treat uropathy and septicemia until definitive corrective surgery can be performed. We report an unusual cause of obstructive uropathy in three infants: pyometrocolpos due to lower genital tract atresia. Ultrasound-guided percutaneous drainage of the pyometrocolpos resulted in dramatically improved clinical and laboratory findings in these patients. Ultrasound-guided percutaneous drainage under local anesthesia is a simple, minimally invasive, safe, and effective procedure that facilitates later successful corrective surgery and avoids the need for more complex drainage procedures.

Algin, Oktay, E-mail: droktayalgin@gmail.com [Atatuerk Training and Research Hospital, Department of Radiology (Turkey); Erdogan, Cuneyt [Uludag University Medical Faculty, Department of Radiology (Turkey); Kilic, Nizamettin [Uludag University Medical Faculty, Department of Pediatric Surgery (Turkey)

2011-02-15

335

Percutaneous Endoscopic Colostomy: A New Technique for the Treatment of Recurrent Sigmoid Volvulus  

PubMed Central

Sigmoid volvulus is a common cause of large bowel obstruction in western countries and Africa. It accounts for 25% of the patients admitted to the hospital for large bowel obstruction. The acute management of sigmoid volvulus is sigmoidoscopic decompression. However, the recurrence rate can be as high as 60% in some series. Recurrent sigmoid volvulus in elderly patients who are not fit for definitive surgery is difficult to manage. The percutaneous endoscopic placement of two percutaneous endoscopic colostomy tube placement is a simple and relatively safe procedure. The two tubes should be left open to act as vents for the colon from over-distending. In our opinion, this aspect is key to its success as it keeps the sigmoid colon deflated until adhesions form between the colon and the abdominal wall. PMID:20339184

Al-Alawi, Ibrahim K.

2010-01-01

336

[Right patent ductus arteriosus with an ipsilateral aortic arch: percutaneous closure with amplatzer devices].  

PubMed

The association of a right aortic arch with an ipsilateral patent ductus arteriosus is rare, especially when there are no other intracardiac anomalies. We report three female patients aged 26, 35 and 9 years with this combination in whom previous attempts at surgical closure by thoracotomy and sternotomy were unsuccessful and who subsequently underwent successful percutaneous closure of the defects using Amplatzer devices. In two patients, although angiography demonstrated the presence of type-A patent ductus arteriosus, it was not possible to determine the minimum diameter accurately and it was necessary to measure it using a sizing balloon. An Amplatzer duct occluder was used in two patients and an Amplatzer muscular ventricular septal defect occluder, in the other. In all patients, full closure was confirmed in the catheterization laboratory and the patients were discharged on the same day with no complications. Percutaneous closure of a right patent ductus arteriosus associated with a right aortic arch is feasible, safe and effective. PMID:17394880

Santiago, Justo; Acuña, Manuel; Arispe, Elizabeth; Camargo, Ronaldo; Neves, Juliana; Arnoni, Daniel; Fontes, Valmir F; Pedra, Carlos A

2007-03-01

337

Right patent ductus arteriosus with an ipsilateral aortic arch: percutaneous closure with amplatzer devices.  

PubMed

The association of a right aortic arch with an ipsilateral patent ductus arteriosus is rare, especially when 3 are no other intracardiac anomalies. We report three female patients aged 26, 35, and 9 years with this combination in whom previous attempts at surgical closure by thoracotomy and sternotomy were unsuccessful and who subsequently underwent successful percutaneous closure of the defects using Amplatzer devices. In 2 patients, although angiography demonstrated the presence of type-A patent ductus arteriosus, it was not possible to determine the minimum diameter accurately and it was necessary to measure it using a sizing balloon. An Amplatzer duct occluder was used in 2 patients and an Amplatzer muscular ventricular septal defect occluder in the other. In all patients, full closure was confirmed in the catheterization laboratory and the patients were discharged on the same day with no complications. Percutaneous closure of a right patent ductus arteriosus associated with a right aortic arch is feasible, safe and effective. PMID:24774528

Santiago, Justo; Acuña, Manuel; Arispe, Elizabeth; Camargo, Ronaldo; Neves, Juliana; Arnoni, Daniel; Fontes, Valmir F; Pedra, Carlos A C

2007-01-01

338

Ultrasound-guided percutaneous drainage of neonatal pyometrocolpos under local anesthesia.  

PubMed

Hydrometrocolpos is an uncommon congenital disorder with cystic dilatation of the vagina and uterus that occurs as a result of accumulated secretions from the reproductive tract due to distal genital tract obstruction. Secondary infection may also occur, resulting in pyometrocolpos, a potentially lethal disease. Immediate drainage of the cystic mass in patients determined to have pyometrocolpos is required to prevent or treat uropathy and septicemia until definitive corrective surgery can be performed. We report an unusual cause of obstructive uropathy in three infants: pyometrocolpos due to lower genital tract atresia. Ultrasound-guided percutaneous drainage of the pyometrocolpos resulted in dramatically improved clinical and laboratory findings in these patients. Ultrasound-guided percutaneous drainage under local anesthesia is a simple, minimally invasive, safe, and effective procedure that facilitates later successful corrective surgery and avoids the need for more complex drainage procedures. PMID:20130873

Algin, Oktay; Erdogan, Cuneyt; Kilic, Nizamettin

2011-02-01

339

The significance of atypical lobular hyperplasia at percutaneous breast biopsy.  

PubMed

Atypical lobular hyperplasia (ALH) is occasionally found in specimens obtained by percutaneous stereotactic vacuum-assisted breast biopsy for microcalcifications. Since malignancy is often found at surgical excision when atypical ductal hyperplasia is found at percutaneous biopsy, we reviewed our pathologic findings from surgery for ALH at percutaneous biopsy. This was a retrospective review of all percutaneous breast biopsy specimens for mammographic microcalcifications obtained from a single institution over a 30-month period. The pathologic findings from percutaneous biopsy were correlated with the radiologic appearance and the pathology from surgical excision. ALH was found in 13 of 766 (1.7%) stereotactic vacuum-assisted core needle biopsies performed for mammographic microcalcifications. Subsequent surgery in six patients revealed ductal carcinoma in situ (DCIS) in two patients and one case of invasive ductal carcinoma. Surgical excision is indicated for areas with ALH discovered by percutaneous biopsy for mammographic microcalcifications. PMID:12558664

Dmytrasz, Karen; Tartter, Paul Ian; Mizrachy, Howard; Chinitz, Lynn; Rosenbaum Smith, Sharon; Estabrook, Alison

2003-01-01

340

Use of novel 6 French intra-aortic balloon pump catheter for patients undergoing percutaneous coronary intervention.  

PubMed

This study aimed to evaluate the feasibility and safety of a new 6 French (6 Fr) intra-aortic balloon pumping (IABP) catheter for patients undergoing percutaneous coronary intervention (PCI). Sixty-nine consecutive patients who received a 6 Fr IABP catheter were retrospectively evaluated. Patients with height <162 cm were primary selected for the 6 Fr IABP catheter treatment because of limited balloon size (30 ml). These catheters were also used for patients for whom the femoral approach was contraindicated. The mean age of the patients was 76.9 years. The average height and body weight were 156.7 cm and 56.0 kg, respectively. The 6 Fr IABP catheters were successfully inserted in all 69 patients, including four patients treated via the brachial artery. No patient developed limb ischemia. Poor helium inflation due to kinking of the catheter shaft occurred in one patient and helium leakage in one patient. The other 67 patients were well supported, and no patient required the 6 Fr catheter to be exchanged with a larger balloon catheter. The current study demonstrates that using this novel and currently, the thinnest IABP catheter is feasible and safe for small-sized patients undergoing PCI and seems promising for reduction in vascular complications. Brachial insertion is also possible using the 6 Fr IABP catheter; this may solve access site limitations observed with existing conventional IABP catheters. PMID:23851454

Yamada, Takeshi; Mizuguchi, Yukio; Sakamoto, Shingo; Taniguchi, Norimasa; Nakajima, Shunsuke; Takahashi, Akihiko

2013-01-01

341

Percutaneous coronary intervention: recommendations for good practice and training  

PubMed Central

Cardiologists undertaking percutaneous coronary intervention (PCI) are excited by the combination of patient and physician satisfaction and technological advance occurring on the background of the necessary manual dexterity. Progress and applicability of percutaneous techniques since their inception in 1977 have been remarkable; a sound evidence base coupled with the enthusiasm and ingenuity of the medical device industry has resulted in a sea change in the treatment of coronary heart disease (CHD), which continues to evolve at breakneck speed. This is the third set of guidelines produced by the British Cardiovascular Intervention Society and the British Cardiac Society.1,2 Following the last set of guidelines published in 2000, we have seen PCI activity in the UK increase from 33 652 to 62 780 (87% in four years) such that the PCI to coronary artery bypass grafting ratio has increased to 2.5:1. The impact of drug eluting stents has been profound, and the Department of Health is investigating the feasibility of primary PCI for acute myocardial infarction. Nevertheless, the changes in the structure of National Health Service funding are likely to focus our attention on cost effective treatments and will require physician engagement and sensitive handling if we are to continue the rapid and appropriate growth in our chosen field.3 It is important with this burgeoning development now occurring on a broad front (in both regional centres and district general hospitals) that we maintain our vigilance on audit and outcome measures so that standards are maintained for both operators and institutions alike. This set of guidelines includes new sections on training, informed consent, and a core evidence base, which we hope you will find useful and informative. Keith D Dawkins: President, British Cardiovascular Intervention Society (2000–2004) Huon H Gray: President, British Cardiac Society (2003–2005) PMID:16365340

Dawkins, K; Gershlick, T; de Belder, M; Chauhan, A; Venn, G; Schofield, P; Smith, D; Watkins, J; Gray, H; Joint, W

2005-01-01

342

Paradoxical air embolism during percutaneous nephrolithotomy: a case report.  

PubMed

Air embolism is a rare complication of percutaneous nephrolithotomy. Patent foramen ovale, which is necessary in fetal circulation, is a potential route for emboli arising from the venous system to enter the systemic arterial circulation, resulting in paradoxical air embolism syndrome. A case of paradoxical air embolism during percutaneous nephrolithotomy is presented. To our knowledge, this is the first report of paradoxical air embolism associated with patent foramen ovale during percutaneous nephrolithotomy. PMID:18162725

Song, Seung Hun; Hong, Bumsik; Park, Hyung Keun; Park, Taehan

2007-12-01

343

Percutaneous closure of patent foramen ovale: impact of device design on safety and efficacy  

PubMed Central

Objective: To compare the safety and efficacy of percutaneous closure of patent foramen ovale (PFO) with the Amplatzer PFO occluder (Amplatzer) or the PFO STAR device (STAR) in patients with presumed paradoxical embolism. Methods: Implantation characteristics, procedural complications, residual shunt, and recurrence of thromboembolic events were recorded prospectively in 100 consecutive patients undergoing percutaneous PFO closure with the STAR (n ?=? 50) or Amplatzer (n ?=? 50) devices between 1998 and 2001. The study was not randomised. Device implantation was successful in all cases. Results: There were more procedural complications in the STAR than in the Amplatzer group (8/50 v 1/50, p ?=? 0.01). More than one device placement attempt was an independent predictor of procedural complications (odds ratio (OR) 8.5, 95% confidence interval (CI) 1.3 to 55.8; p ?=? 0.03). A residual shunt six months after PFO closure, assessed by transoesophageal contrast echocardiography, occurred more often in the STAR than the Amplatzer group (17/50 v 3/50, p ?=? 0.004), and was predicted in the STAR group by the use of a device with a 5 mm as opposed to a 3 mm disc connector (OR 6.1, 95% CI 1.1 to 34.0; p ?=? 0.04). The actuarial risk of recurrent thromboembolic events after 3.5 years was 16.8% (95% CI 7.6% to 34.6%) in the STAR and 2.7% (95% CI 0.4% to 17.7%) in the Amplatzer group after three years (p ?=? 0.08). Conclusions: Percutaneous PFO closure with the Amplatzer PFO occluder had fewer procedural complications and was more likely to be complete than with the STAR device. These findings underline the importance of device design for successful percutaneous PFO closure. PMID:14729794

Schwerzmann, M; Windecker, S; Wahl, A; Mehta, H; Nedeltchev, K; Mattle, H; Seiler, C; Meier, B

2004-01-01

344

Percutaneous Transhepatic Removal of Bile Duct Stones: Results of 261 Patients  

SciTech Connect

Purpose: To determine the effectiveness of percutaneous transhepatic removal of bile duct stones when the procedure of endoscopic therapy fails for reasons of anatomical anomalies or is rejected by the patient. Methods: Between April 2001 and May 2010, 261 patients (138 male patients and 123 female patients; age range, 14-92 years; mean age, 64.6 years) with bile duct stones (common bile duct [CBD] stones = 248 patients and hepatolithiasis = 13 patients) were included in the study. Percutaneous transhepatic cholangiography was performed, and stones were identified. Percutaneous transhepatic balloon dilation of the papilla of Vater was performed. Then stones were pushed out into the duodenum with a Fogarty balloon catheter. If the stone diameter was larger than 15 mm, then basket lithotripsy was performed before balloon dilation. Results: Overall success rate was 95.7%. The procedure was successful in 97.5% of patients with CBD stones and in 61.5% of patients with hepatolithiasis. A total of 18 major complications (6.8%), including cholangitis (n = 7), subcapsular biloma (n = 4), subcapsular hematoma (n = 1), subcapsular abscess (n = 1), bile peritonitis (n = 1), duodenal perforation (n = 1), CBD perforation (n = 1), gastroduodenal artery pseudoaneurysm (n = 1), and right hepatic artery transection (n = 1), were observed after the procedure. There was no mortality. Conclusion: Our experience suggests that percutaneous transhepatic stone expulsion into the duodenum through the papilla is an effective and safe approach in the nonoperative management of the bile duct stones. It is a feasible alternative to surgery when endoscopic extraction fails or is rejected by the patient.

Ozcan, Nevzat, E-mail: nevzatcan@yahoo.com; Kahriman, Guven, E-mail: guvenkahriman@hotmail.com; Mavili, Ertugrul, E-mail: ertmavili@yahoo.com [Erciyes University, Department of Radiology, Medical Faculty (Turkey)

2012-08-15

345

Percutaneous Transhepatic Removal of Bile Duct Stones: Results of 261 Patients  

SciTech Connect

Purpose: To determine the effectiveness of percutaneous transhepatic removal of bile duct stones when the procedure of endoscopic therapy fails for reasons of anatomical anomalies or is rejected by the patient. Methods: Between April 2001 and May 2010, 261 patients (138 male patients and 123 female patients; age range, 14-92 years; mean age, 64.6 years) with bile duct stones (common bile duct [CBD] stones = 248 patients and hepatolithiasis = 13 patients) were included in the study. First, percutaneous transhepatic cholangiography was performed and stones were identified. Percutaneous transhepatic balloon dilation of the papilla of Vater was performed. Then stones were pushed out into the duodenum with a Fogarty balloon catheter. If the stone diameter was larger than 15 mm, then basket lithotripsy was performed before balloon dilation. Results: Overall success rate was 95.7%. The procedure was successful in 97.5% of patients with CBD stones and in 61.5% of patients with hepatolithiasis. A total of 18 (6.8%) major complications, including cholangitis (n = 7), subcapsular biloma (n = 4), subcapsular hematoma (n = 1), subcapsular abscess (n = 1), bile peritonitis (n = 1), duodenal perforation (n = 1), CBD perforation (n = 1), gastroduodenal artery pseudoaneurysm (n = 1), and right hepatic artery transection (n = 1), were seen after the procedure. There was no mortality. Conclusion: Our experience suggests that percutaneous transhepatic stone expulsion into the duodenum through the papilla is an effective and safe approach in the nonoperative management of the bile duct stones. It is a feasible alternative to surgery when endoscopic extraction fails or is rejected by the patient.

Ozcan, Nevzat, E-mail: nevzatcan@yahoo.com; Kahriman, Guven, E-mail: guvenkahriman@hotmail.com; Mavili, Ertugrul, E-mail: ertmavili@yahoo.com [Erciyes University, Department of Radiology, Medical Faculty, Gevher Nesibe Hospital (Turkey)

2012-06-15

346

Percutaneous endoscopic decompression for lumbar spinal stenosis.  

PubMed

Percutaneous endoscopic lumbar discectomy has become a representative minimally invasive spine surgery for lumbar disc herniation. Due to the remarkable evolution in the techniques available, the paradigm of spinal endoscopy is shifting from treatments of soft disc herniation to those of lumbar spinal stenosis. Lumbar spinal stenosis can be classified into three categories according to pathological zone as follows: central stenosis, lateral recess stenosis and foraminal stenosis. Moreover, percutaneous endoscopic decompression (PED) techniques may vary according to the type of lumbar stenosis, including interlaminar PED, transforaminal PED and endoscopic lumbar foraminotomy. However, these techniques are continuously evolving. In the near future, PED for lumbar stenosis may be an efficient alternative to conventional open lumbar decompression surgery. PMID:25033889

Ahn, Yong

2014-11-01

347

How we do it: emergency percutaneous tracheostomy: a case series.  

PubMed

Emergency percutaneous tracheostomy is a safe alternative method for providing a definitive airway in an emergency, in trained hands. A general anaesthetic is not required allowing the procedure to be performed outside of the operating theatre. All of the necessary instruments to perform the percutaneous tracheostomy are pre-packaged in one kit. With experience the percutaneous tracheostomy can be performed without a bronchoscopy. Percutaneous tracheostomy can be utilised in a variety of emergency clinical situations requiring rapid access to the airway. PMID:15373874

Clarke, J; Jaffery, A

2004-10-01

348

Gastrointestinal complications following percutaneous coronary intervention (PCI)  

Microsoft Academic Search

IntroductionPercutaneous Coronary Intervention (PCI) is widely used in the emergency and elective setting. If drug-eluting stents are deployed, dual antiplatelet therapy must continue for 12 months. Antiplatelet agents are a recognised cause of overt and occult gastrointestinal (GI) bleeding. The aim of this study was to determine the rate of GI complications following PCI in a tertiary cardiothoracic centre.MethodsA cohort

G E Dolman; C M Wijayasekara; J R F Cummings

2011-01-01

349

Percutaneous treatment of hydatid cysts (Echinococcus Granulosus)  

Microsoft Academic Search

A new method called PAIR (Puncture-Aspiration of cyst contents—Injection of hypertonic saline solution—Reaspiration) was used\\u000a as a percutaneous treatment of hydatid cysts. In 37 patients, 120 cysts were punctured. All patients had not been considered\\u000a surgical candidates. The cysts were localized in the liver, peritoneum, spleen, kidneys, muscles, and bones. In 70% of patients,\\u000a good results were obtained. Recurrence occurred

Moncef Gargouri; Nejet Ben Amor; Ferid Ben Chehida; Azza Hammou; Hassen A. Gharbi; Mohamed Ben Cheikh; Hefdi Kchouk; Kamel Ayachi; Jean Yves Golvan

1990-01-01

350

Percutaneous plating for unstable tibial fractures  

Microsoft Academic Search

.  ?Twenty-four unstable tibial fractures were stabilized with a narrow limited contact-dynamic compression plate inserted using\\u000a a percutaneous plating technique under fluoroscopic guidance. The major indication for this technique was a tibial fracture\\u000a for which intramedullary nailing would be difficult. There were 16 proximal or distal metaphyseal fractures and 5 segmental\\u000a fractures in adults and 3 mid-shaft fractures in adolescents who

Chang-Wug Oh; Byung-Chul Park; Hee-Soo Kyung; Sung-Jung Kim; Hee-Soo Kim; Seong-Man Lee; Joo-Chul Ihn

2003-01-01

351

Cost Determinants of Percutaneous and Surgical Interventions for Treatment of Intermittent Claudication from the Perspective of the Hospital  

SciTech Connect

Purpose. To identify pretreatment predictors of procedural costs in percutaneous and surgical interventions for intermittent claudication due to aortoiliac and/or femoropopliteal disease. Methods. A retrospective study was conducted in 97 consecutive patients who underwent percutaneous or surgical interventions over 15 months at a tertiary care center. Nineteen clinical predictive variables were collected at baseline. Procedural costs (outcome) were assessed from the perspective of the hospital by direct calculation, not based on ratios of costs-to-charges. A multivariable regression model was built to identify significant cost predictors. Follow-up information was obtained to provide multidimensional assessment of clinical outcome, including technical success (arteriographic score) and clinical result (changes in ankle-brachial pressure index; cumulative patency, mortality, and complication rates). Results. The linear regression model shows that procedural costs per patient are 25% lower in percutaneous patients (versus surgical), 42% lower for patients without rest pain than for those with, 28% lower if treated lesions are unilateral (versus bilateral), 12% lower if the treated lesion is stenotic rather than occlusive, 34% higher in sedentary patients, and 11% higher in patients with a history of cardiac disease. After a mean clinical follow-up >2 years, between-group differences between percutaneous and surgical patients were small and of limited significance in all dimensions of clinical outcome. Conclusion. Predictors of clinical outcome are different from predictors of costs, and one should include both types of variables in the decision-making process. The choice of percutaneous versus surgical strategy, the presence of rest pain, and the bilaterality of the culprit lesions were the main pretreatment determinants of procedural costs. When possible choices of treatment strategy overlap, percutaneous treatment should provide an acceptable result that is less expensive (although not equal to surgery)

Janne d'Othee, Bertrand [Massachusetts General Hospital, Harvard Medical School, Department of Radiology, Cardiovascular Imaging and Intervention (United States)], E-mail: bjannedothee@partners.org; Morris, Michael F. [Banner Good Samaritan Hospital (United States); Powell, Richard J. [Dartmouth-Hitchcock Medical Center, Department of Surgery (United States); Bettmann, Michael A. [Wake Forest University Baptist Medical Center, Medical Center Boulevard, Department of Radiological Science (United States)

2008-01-15

352

Chaparral Succession1 Richard J. Vogl2  

E-print Network

in this manuscript. Rather, certain highlights of plant succession will be again presented and re the controlling factors and dynamics of succession. Chaparral vs. Classical Succession Classical plant succession with subshrubs followed by woody plants. Growth that resembles the early stages of classical primary succession

Standiford, Richard B.

353

Percutaneous mechanical thrombectomy for treatment of acute femoropopliteal bypass occlusion  

PubMed Central

Acute and subacute ischemia of the legs in acute and subacute femoropopliteal bypass occlusion is a dramatic situation that endangers the survival of the limbs, depending on the severity of the ischemia. Different therapy options like percutaneous mechanical thrombectomy procedures, which include rotational thrombectomy, have become available in recent years, in addition to local lysis and surgical thrombectomy. Surgical thrombectomy using the Fogarty catheter technique, in particular, shows an increased incidence of perioperative complications but only small technical success rates in randomized trials. On the other hand, local lysis is associated with increased costs due to resource-consuming measures, such as intensive monitoring and repeat angiographies, in addition to bleeding complications. In the past, further development of the Straub Rotarex® system as an endovascular therapy option has demonstrated good success leading to amputation-free survival in multiple studies. At the same time, a low rate of complications with use has been documented. Most examinations have been conducted in the thigh. To date, there are little investigational data on its use in acutely and subacutely occluded femoropopliteal bypasses. In this paper, the current study-based significance of the Rotarex system for this indication is analyzed based on the existing literature and the authors’ own experiences with 22 patients. PMID:22661895

Lichtenberg, Michael; Kaunicke, Matthias; Hailer, Birgit

2012-01-01

354

Successful Treatment with a Covered Stent and 6-Year Follow-Up of Biliary Complication After Liver Transplantation  

SciTech Connect

The role of covered stent in the management of biliary complications is not yet defined in liver transplant recipients. This Case Report presents a patient with anastomotic stricture and leakage with biloma treated with a covered stent 32 months following liver transplantation. Signs of in-stent restenosis developed 52 months following covered stent placement, which was resolved by balloon dilation. There were no complications during the interventions. The latest follow-up, at 69 months following primary and 19 months following secondary percutaneous intervention, shows a patent covered stent without any clinical or morphological sign of further restenosis. The clinical success with long-term follow-up data suggests that covered stent implantation can be a rational, minimally invasive option for simultaneous treatment of bile duct stenosis and bile leak following liver transplantation in selected cases.

Doros, Attila, E-mail: dorattila@yahoo.com; Nemeth, Andrea; Deak, Akos Pal; Hartmann, Erika; Gerlei, Zsuzsa; Fazakas, Janos; Kobori, Laszlo [Semmelweis University, Department of Transplantation and Surgery (Hungary)

2010-04-15

355

Percutaneous Valve Replacement: Significance of Different Delivery Systems In Vitro and In Vivo  

SciTech Connect

Background and purpose. Percutaneous heart valve replacement is an exciting growing field in cardiovascular medicine yet still with some major problems. Only sophisticated improvement of the instruments could make it a real alternative to conventional surgery. Therefore, the aim of this study was to evaluate different delivery devices for percutaneous heart valve replacement in vitro and in vivo. Methods. A catheter prototype designed by our group, and two commercially available devices for the delivery of esophageal stents and aortic endoprostheses, were tested. After in vitro experiments, an ovine animal model of transfemoral pulmonary valve implantation was established using biological valved self-expanding stents. Only the delivery device for aortic endografts (Medtronic, Talent, Santa Rosa, CA, USA) allowed fast in vitro procedures without material fatigue. This device was chosen for the in vivo tests. Results. Technical success was achieved in 9 of 10 animals (90%). One animal died after perforation of the ventricular wall. Orthotopic pulmonary placement was performed in 6 animals and intentional supravalvular valved stent placement in 3 animals. Conclusions. An adequate in vitro model for this evolving field of interventional heart valve replacement is presented. Furthermore, the present study pinpoints the key characteristics that are mandatory for a delivery system in percutaneous pulmonary valve implantation. With regard to the delivery device's ductility observed during this 'venous' study, an approach to transfemoral aortic valve implantation seems feasible.

Attmann, Tim; Lutter, Georg, E-mail: lutter@kielheart.uni-kiel.de; Quaden, Rene [Christian Albrechts University of Kiel, Department of Cardiovascular Surgery, School of Medicine (Germany); Jahnke, Thomas [Christian Albrechts University of Kiel, Department of Radiology, School of Medicine (Germany); Rumberg, Kristin; Cremer, Jochen [Christian Albrechts University of Kiel, Department of Cardiovascular Surgery, School of Medicine (Germany); Muller-Hulsbeck, Stefan [Christian Albrechts University of Kiel, Department of Radiology, School of Medicine (Germany)

2006-06-15

356

CT-guided percutaneous drilling is a safe and reliable method of treating osteoid osteomas.  

PubMed

Computed tomography (CT)-guided percutaneous drilling is an alternative for osteoid osteoma treatment. This study aims to evaluate the remodeling of the drill orifice. The success rate and complications were also recorded and compared with other treatment methods. Fifteen patients with an average age of fourteen years (ranging from 4 to 25) submitted to CT-guided percutaneous drilling between 2003 and 2009 were retrospectively analyzed according to clinical and radiological criteria. Fourteen cases showed complete alleviation of pain one week after surgery. No relapse was detected even in the subject who continued complaining of pain. All patients were treated with a day-hospital regimen and were discharged with partial weight bearing. Total weight bearing was allowed after one month, and sports were allowed after consolidation, which occurred in all but one case after the third month. One patient, who did not follow our medical advice, returned to sports activities after two weeks and experienced a fracture as a result. Atrophy of the vastus lateralis muscle developed after the procedure in another patient. Our case series suggests that this method is reliable and safe. The level of complexity is comparable with other minimally invasive percutaneous procedures. The cost is low because there is no need to buy probes or other equipment. The negative points include weakening of the bone and the logistical problem of assembling the orthopedic surgeon, radiologist, and anesthesiologist in the tomography room. PMID:23519705

Engel, Edgard Eduard; Gava, Nelson Fabrício; Nogueira-Barbosa, Marcello Henrique; Botter, Filipe Almeida

2013-12-01

357

Percutaneous intervention in peripheral artery disease improves calf muscle phosphocreatine recovery kinetics: A pilot study  

PubMed Central

We hypothesized that percutaneous intervention in the affected lower extremity artery would improve calf muscle perfusion and cellular metabolism in patients with claudication and peripheral artery disease (PAD) as measured by magnetic resonance imaging (MRI) and spectroscopy (MRS). Ten patients with symptomatic PAD (mean ± SD: age 57 ± 9 years; ankle–brachial index (ABI) 0.62 ± 0.17; seven males) were studied 2 months before and 10 months after lower extremity percutaneous intervention. Calf muscle phosphocreatine recovery time constant (PCr) in the revascularized leg was measured by 31P MRS immediately after symptom-limited exercise on a 1.5-T scanner. Calf muscle perfusion was measured using first-pass gadolinium-enhanced MRI at peak exercise. A 6-minute walk and treadmill test were performed. The PCr recovery time constant improved significantly following intervention (91 ± 33 s to 52 ± 34 s, p < 0.003). Rest ABI also improved (0.62 ± 0.17 to 0.93 ± 0.25, p < 0.003). There was no difference in MRI-measured tissue perfusion or exercise parameters, although the study was underpowered for these endpoints. In conclusion, in this pilot study, successful large vessel percutaneous intervention in patients with symptomatic claudication, results in improved ABI and calf muscle phosphocreatine recovery kinetics. PMID:22363013

West, Amy M; Anderson, Justin D; Epstein, Frederick H; Meyer, Craig H; Hagspiel, Klaus D; Berr, Stuart S; Harthun, Nancy L; Weltman, Arthur L; Annex, Brian H; Kramer, Christopher M

2012-01-01

358

Percutaneous Ablation of Peripheral Pseudoaneurysms Using Thrombin: A Simple and Effective Solution  

SciTech Connect

Purpose: To assess the effectiveness of tissue adhesive and thrombin solution in the percutaneous ablation of peripheral artery pseudoaneurysms.Methods: Twenty-five pseudoaneurysms were treated over a 33-month period; all had failed ultrasound-guided compression. Tissue adhesive or thrombin solution was injected percutaneously, with needle tip position and changes within the aneurysm confirmed with color Doppler ultrasound. In 19 cases we utilized a protective balloon inflated across the aneurysm neck prior to the injection of tissue adhesive and in six cases used thrombin injection alone. Seven patients were anticoagulated. Patients were followed up after the procedure.Results: All 25 aneurysms were treated successfully; two patients required a return visit and there were no immediate complications or peripheral emboli detected. One patient developed a contralateral pseudoaneurysm.Conclusions: The percutaneous injection of pseudoaneurysms is a safe, a traumatic, and effective treatment for femoral artery pseudoaneurysms in the peripheral circulation. There are significant advantages over ultrasound-guided compression or surgical repair.

Owen, Richard J.T.; Haslam, Philip J.; Elliott, Simon T.; Rose, John D.G.; Loose, Henry W. [Department of Clinical Radiology, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN (United Kingdom)

2000-11-15

359

Percutaneous Transhepatic Portography for the Treatment of Early Portal Vein Thrombosis After Surgery  

SciTech Connect

We treated three cases of early portal vein thrombosis (PVT) by minimally invasive percutaneous transhepatic portography. All patients developed PVT within 30 days of major hepatic surgery (one case each of orthotopic liver transplantation, splenectomy in a previous liver transplant recipient, and right extended hepatectomy with resection and reconstruction of the left branch of the portal vein for tumor infiltration). In all cases minimally invasive percutaneous transhepatic portography was adopted to treat this complication by mechanical fragmentation and pharmacological lysis of the thrombus. A vascular stent was also positioned in the two cases in which the thrombosis was related to a surgical technical problem. Mechanical fragmentation of the thrombus with contemporaneous local urokinase administration resulted in complete removal of the clot and allowed restoration of normal blood flow to the liver after a median follow-up of 37 months. PVT is an uncommon but severe complication after major surgery or liver transplantation. Surgical thrombectomy, with or without reconstruction of the portal vein, and retransplantation are characterized by important surgical morbidity and mortality. Based on our experience, minimally invasive percutaneous transhepatic portography should be considered an option toward successful recanalization of early PVT after major liver surgery including transplantation. Balloon dilatation and placement of a vascular stent could help to decrease the risk of recurrent thrombosis when a defective surgical technique is the reason for the thrombosis.

Adani, Gian Luigi, E-mail: adanigl@hotmail.com; Baccarani, Umberto; Risaliti, Andrea [University Hospital of Udine, Department of Surgery and Transplantation (Italy); Sponza, Massimo; Gasparini, Daniele [University Hospital of Udine, Department of Interventional Radiology (Italy); Bresadola, Fabrizio; Anna, Dino de; Bresadola, Vittorio [University Hospital of Udine, Department of Surgery and Transplantation (Italy)

2007-11-15

360

Revisional Percutaneous Full Endoscopic Disc Surgery for Recurrent Herniation of Previous Open Lumbar Discectomy  

PubMed Central

Study Design A retrospective study. Purpose To determine the feasibility and effectiveness of revisional percutaneous full endoscopic discectomy for recurrent herniation after conventional open disc surgery. Overview of the Literature Repeated open discectomy with or without fusion has been the most common procedure for recurrent lumbar disc herniation. Percutaneous endoscopic lumbar discectomy for recurrent herniation has been thought of as an impossible procedure. Despite good results with open revisional surgery, major problems may be caused by injuries to the posterior stabilized structures. Our team did revisional full endoscopic lumbar disc surgery on the basis of our experience doing primary full endoscopic disc surgery. Methods Between February 2004 and August 2009 a total of 41 patients in our hospital underwent revisional percutaneous endoscopic lumbar discectomy using a YESS endoscopic system and a micro-osteotome (designed by the authors). Indications for surgery were recurrent disc herniation following conventional open discectomy; with compression of the nerve root revealed by Gadolinium-enhanced magnetic resonance imaging; corresponding radiating pain which was not alleviated after conservative management over 6 weeks. Patients with severe neurologic deficits and isolated back pain were excluded. Results The mean follow-up period was 16 months (range, 13 to 42 months). The visual analog scale for pain in the leg and back showed significant post-treatment improvement (p < 0.001). Based on a modified version of MacNab's criteria, 90.2% showed excellent or good outcomes. There was no measurable blood loss. There were two cases of recurrence of and four cases with complications. Conclusions Percutaneous full-endoscopic revisional disc surgery without additional structural damage is feasible and effective in terms of there being less chance of fusion and bleeding. This technique can be an alternative to conventional repeated discectomy. PMID:21386940

Chang, Ho-Guen; Rhee, Nam Kyou; Lim, Kwahn Sue

2011-01-01

361

Predicting Infected Bile Among Patients Undergoing Percutaneous Cholecystostomy  

Microsoft Academic Search

Purpose: Patients may not achieve a clinical benefit after percutaneous cholecystostomy due to the inherent difficulty in identifying patients who truly have infected gallbladders. We attempted to identify imaging and biochemical parameters which would help to predict which patients have infected gallbladders. Methods: A retrospective review was performed of 52 patients undergoing percutaneous cholecystostomy for clinical suspicion of acute cholecystitis

Shannon L. Beardsley; Richard D. Shlansky-Goldberg; Aalpen Patel; David B. Freiman; Michael C. Soulen; S. William Stavropoulos; Timothy W. I. Clark

2005-01-01

362

Renal lymphangiomatosis during pregnancy: management with percutaneous drainage.  

PubMed

We report a unique case of exacerbation of renal lymphangiomatosis during pregnancy which was managed percutaneously until delivery. Renal lymphangiomatosis is a very rare benign disorder that might cause abdominal pain and rarely hypertension and hematuria. Surgical treatment options may result in nephrectomy. Percutaneous drainage of symptomatic renal lymphangiomas should be viewed as an efficient therapeutic option particularly when surgery is contraindicated. PMID:11194914

Ozmen, M; Deren, O; Akata, D; Akhan, O; Ozen, H; Durukan, T

2001-01-01

363

Interventional Radiology Robot for CT and MRI Guided Percutaneous Interventions  

E-print Network

Interventional Radiology Robot for CT and MRI Guided Percutaneous Interventions Nikolai Hungr1 introduces a new patient-mounted CT and MRI guided interventional radiology robot for percutaneous needle: Interventional radiology, Robotics, CT, MRI, Image guided, Ultrasonic motors, Magnetic resonance compatibility

Paris-Sud XI, Université de

364

Endoscopic percutaneous drainage of a renal echinococcal cyst during percutaneous nephrolithotomy.  

PubMed

In Morocco, hydatid disease is endemic and constitutes a major problem of public health. Renal echinococcal cyst ranks third after pulmonary and hepatic locations. We report a case of renal echinococcal cyst diagnosed during percutaneous nephrolithotomy which was treated endoscopically. To our knowledge, this situation has not been reported previously in the literature. PMID:9611359

el Khader, K; Koutani, A; el Mamoun, M; Ibn Attya, A; Hachimi, M; Lakrissa, A

1998-03-01

365

Percutaneous Endoscopic Holmium Laser Lithotripsy for Management of Complicated Biliary Calculi  

PubMed Central

Background and Objectives: Advances in endoscopic techniques have transformed the management of urolithiasis. We sought to evaluate the role of such urological interventions for the treatment of complex biliary calculi. Methods: We conducted a retrospective review of all patients (n=9) undergoing percutaneous holmium laser lithotripsy for complicated biliary calculi over a 4-year period (12/2003 to 12/2007). All previously failed standard techniques include ERCP with sphincterotomy (n=6), PTHC (n=7), or both of these. Access to the biliary system was obtained via an existing percutaneous transhepatic catheter or T-tube tracts. Endoscopic holmium laser lithotripsy was performed via a flexible cystoscope or ureteroscope. Stone clearance was confirmed intra- and postoperatively. A percutaneous transhepatic drain was left indwelling for follow-up imaging. Results: Mean patient age was 65.6 years (range, 38 to 92). Total stone burden ranged from 1.7 cm to 5 cm. All 9 patients had stones located in the CBD, with 2 patients also having additional stones within the hepatic ducts. All 9 patients (100%) were visually stone-free after one endoscopic procedure. No major perioperative complications occurred. Mean length of stay was 2.4 days. At a mean radiological follow-up of 5.4 months (range, 0.5 to 21), no stone recurrence was noted. Conclusions: Percutaneous endoscopic holmium laser lithotripsy is a minimally invasive alternative to open salvage surgery for complex biliary calculi refractory to standard approaches. This treatment is both safe and efficacious. Success depends on a multidisciplinary approach. PMID:19660213

Healy, Kelly; Chamsuddin, Abbas; Spivey, James; Martin, Louis; Nieh, Peter

2009-01-01

366

Graft Loss Due to Percutaneous Sclerotherapy of a Lymphocele Using Acetic Acid After Renal Transplantation  

SciTech Connect

Development of lymphoceles after renal transplantation is a well-described complication that occurs in up to 40% of recipients. The gold standard approach for the treatment of symptomatic cases is not well defined yet. Management options include simple aspiration, marsupialization by a laparotomy or laparoscopy, and percutaneous sclerotherapy using different chemical agents. Those approaches can be associated, and they depend on type, dimension, and localization of the lymphocele. Percutaneous sclerotherapy is considered to be less invasive than the surgical approach; it can be used safely and effectively, with low morbidity, in huge, rapidly accumulating lymphoceles. Moreover, this approach is highly successful, and the complication rate is acceptable; the major drawback is a recurrence rate close to 20%. We herewith report a renal transplant case in which the patient developed a symptomatic lymphocele that was initially treated by ultrasound-guided percutaneous sclerotherapy with ethanol and thereafter using acetic acid for early recurrence. A few hours after injection of acetic acid in the lymphatic cavity, the patient started to complain of acute pain localized to the renal graft and fever. An ultrasound of the abdomen revealed thrombosis of the renal vein and artery. The patient was immediately taken to the operating room, where the diagnosis of vascular thrombosis was confirmed and the graft was urgently explanted. In conclusion, we strongly suggest avoiding the use of acetic acid as a slerosating agent for the percutaneous treatment of post-renal transplant lymphocele because, based on our experience, it could be complicated by vascular thrombosis of the kidney, ending in graft loss.

Adani, Gian Luigi, E-mail: adanigl@hotmail.com; Baccarani, Umberto; Bresadola, Vittorio; Lorenzin, Dario [University School of Medicine, Department of Surgery and Transplantation (Italy); Montanaro, Domenico [AOSMM, Sauta Maria della Misericordia Hospital, Division of Nephrology (Italy); Risaliti, Andrea; Terrosu, Giovanni [University School of Medicine, Department of Surgery and Transplantation (Italy); Sponza, Massimo [AOSMM, Sauta Maria della Misericordia Hospital, Department of Radiology (Italy); Bresadola, Fabrizio [University School of Medicine, Department of Surgery and Transplantation (Italy)

2005-12-15

367

Percutaneous Resolution of Lumbar Facet Joint Cysts as an Alternative Treatment to Surgery: A Meta-Analysis  

PubMed Central

Purpose A comprehensive review of the literature in order to analyze data about the success rate of percutaneous resolution of the lumbar facet joint cysts as a conservative management strategy. Methods A systematic search for relevant articles published during 1980 to May 2014 was performed in several electronic databases by using the specific MeSH terms and keywords. Most relevant data was captured and pooled for the meta-analysis to achieve overall effect size of treatment along with 95% confidence intervals. Results 29 studies were included in the meta-analysis. Follow-up duration as mean ± sd (range) was 16±10.2 (5 days to 5.7 years). Overall the satisfactory results (after short- or long-term follow-up) were achieved in 55.8 [49.5, 62.08] % (pooled mean and 95% CI) of the 544 patients subjected to percutaneous lumbar facet joint cyst resolution procedures. 38.67 [33.3, 43.95] % of this population underwent surgery subsequently to achieve durable relief. There existed no linear relationship between the increasing average duration of follow-up period of individual studies and percent satisfaction from the percutaneous resolutions procedure. Conclusion Results shows that the percutaneous cyst resolution procedures have potential to be an alternative to surgical interventions but identification of suitable subjects requires further research. PMID:25389771

Shuang, Feng; Hou, Shu-Xun; Zhu, Jia-Liang; Ren, Dong-Feng; Cao, Zheng; Tang, Jia-Guang

2014-01-01

368

Abciximab and early adjunctive percutaneous coronary intervention are associated with improved ST-segment resolution after thrombolysis: Observations from the TIMI 14 Trial  

Microsoft Academic Search

Background Percutaneous coronary intervention (PCI) improves clinical outcomes in selected patients with failed thrombolysis but has not been proven to benefit patients who achieve a patent infarct-related artery. Even after successful epicardial reperfusion, myocardial perfusion may be inadequate. We sought to evaluate whether a strategy that uses a reperfusion regimen containing abciximab and a reduced-dose thrombolytic agent (combination therapy), followed

James A. de Lemos; C. Michael Gibson; Elliott M. Antman; Sabina A. Murphy; David A. Morrow; Kristin C. Schuhwerk; Marc Schweiger; Patrick Coussement; Frans Van de Werf; Eugene Braunwald

2001-01-01

369

Adjunctive Therapy with an Antithrombotic Drug Can Prevent Reocclusion and Induce Residual Thrombus Reduction After Percutaneous Transcatheter Angioplasty of the Thrombotic Lesions  

Microsoft Academic Search

Acute reocclusion after successful angioplasty is a severe complication. The preventive effects of heparin, the synthetic antithrombin, argtroban, and the defibrinogenating agent batroxobin on reocclusion after balloon angioplasty of thrombotic occlusions were evaluated in canine iliac arteries. After the 2-hour-old thrombus was evaluated by angiography and angioscopy, percutaneous transcatheter angioplasty (PTA) was performed on the thrombotic stenosis. We used one

Hiroaki Kawano; Takanobu Tomaru; Masao Omata; Ryozo Okada; Yasumi Uchida

1997-01-01

370

Project Success.  

ERIC Educational Resources Information Center

Project Success consists of after-school, weekend, and summer educational programs geared toward minority and disadvantaged students to increase their numbers seeking postsecondary education from the Meadville, Pennsylvania area. The project is funded primarily through the Edinboro University of Pennsylvania, whose administration is committed to…

Meredith, Larry D.

371

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

372

Orthopedic surgical analyzer for percutaneous vertebroplasty  

NASA Astrophysics Data System (ADS)

Since the spine is one of the most complex joint structures in the human body, its surgical treatment requires careful planning and high degree of precision to avoid any unwanted neurological compromises. In addition, comprehensive biomechanical analysis can be very helpful because the spine is subject to a variety of load. In case for the osteoporotic spine in which the structural integrity has been compromised, it brings out the double challenges for a surgeon both clinically and biomechanically. Thus, we have been developing an integrated medical image system that is capable of doing the both. This system is called orthopedic surgical analyzer and it combines the clinical results from image-guided examination and the biomechanical data from finite element analysis. In order to demonstrate its feasibility, this system was applied to percutaneous vertebroplasty. Percutaneous vertebroplasty is a surgical procedure that has been recently introduced for the treatment of compression fracture of the osteoporotic vertebrae. It involves puncturing vertebrae and filling with polymethylmethacrylate (PMMA). Recent studies have shown that the procedure could provide structural reinforcement for the osteoporotic vertebrae while being minimally invasive and safe with immediate pain relief. However, treatment failures due to excessive PMMA volume injection have been reported as one of complications. It is believed that control of PMMA volume is one of the most critical factors that can reduce the incidence of complications. Since the degree of the osteoporosis can influence the porosity of the cancellous bone in the vertebral body, the injection volume can be different from patient to patient. In this study, the optimal volume of PMMA injection for vertebroplasty was predicted based on the image analysis of a given patient. In addition, biomechanical effects due to the changes in PMMA volume and bone mineral density (BMD) level were investigated by constructing clinically relevant finite element models. In conclusion, we were able to demonstrate the feasibility of our orthopedic surgical analyzer in a case for percutaneous vertebroplasty.

Tack, Gye Rae; Choi, Hyung Guen; Lim, Do H.; Lee, Sung J.

2001-05-01

373

Percutaneous acetabuloplasty for metastatic acetabular lesions  

PubMed Central

Background Osteolytic metastases around the acetabulum are frequent in tumour patients, and may cause intense and drug-resistant pain of the hip. These lesions also cause structural weakening of the pelvis, limping, and poor quality of life. Percutaneous acetabuloplasty is a mini-invasive procedure for the management of metastatic lesions due to carcinoma of the acetabulum performed in patients who cannot tolerate major surgery, or in patients towards whom radiotherapy had already proved ineffective. Methods We report a retrospective study in 25 such patients (30 acetabuli) who were evaluated before and after percutaneous acetabuloplasty, with regard to pain, mobility of the hip joint, use of analgesics, by means of evaluation forms: Visual Analog Scale, Harris Hip Score, Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC), Eastern Cooperative Oncology Group (ECOG). The results obtained were analysed using the ?2 Test and Fisher's exact test. Significance was sent at P < 0.05. Results Marked clinical improvement was observed in all patients during the first six post-operative months, with gradual a worsening thereafter from deterioration of their general condition. Complete pain relief was achieved in 15 of our 25 (59%) of patients, and pain reduction was achieved in the remaining 10 (41%) patients. The mean duration of pain relief was 7.3 months. Pain recurred in three patients (12%) between 2 weeks to 3 months. No major complications occurred. There was transient local pain in most cases, and 2 cases of venous injection of cement without clinical consequences. Conclusion Percutaneous acetabuloplasty is effective in improving the quality of life of patients with osteolytic bone tumours, even though the improvement is observed during the first 6 months only. It can be an effective aid to chemo- and radiotherapy in the management of acetabular metastases. PMID:18457594

Maccauro, Giulio; Liuzza, Francesco; Scaramuzzo, Laura; Milani, Alessandro; Muratori, Francesco; Rossi, Barbara; Waide, Victor; Logroscino, Giandomenico; Logroscino, Carlo A; Maffulli, Nicola

2008-01-01

374

Iliofemoral Deep Vein Thrombosis: Conventional Therapy Versus Lysis and Percutaneous Transluminal Angioplasty and Stenting  

PubMed Central

Objective To compare conventional treatment (heparin and warfarin) of iliofemoral venous thrombosis with multimodality treatment (lysis and stenting). Summary Background Data Several studies have reported on conventional therapy for iliofemoral venous thrombosis with disappointing results. However, more recent studies have reported better results with multimodality treatment. Methods Fifty-one consecutive patients with extensive iliofemoral venous thrombosis were treated during a 10-year period. If there were no contraindications, patients were given the option to choose between conventional therapy (group 1) and multimodality therapy (group 2). The multimodality treatment strategy included catheter-directed lysis followed by percutaneous transluminal balloon angioplasty (PTA) and stenting for residual iliac stenoses. All patients underwent routine venous duplex imaging at 30 days, 3 months, 6 months, and every 6 months thereafter. Results There were 33 patients in group 1 and 18 patients in group 2. Demographic and clinical characteristics were comparable for both groups. Initial lysis was achieved in 16 of 18 patients (89%) in group 2. Ten of 18 patients in group 2 had residual stenosis after lysis (8 primary and 2 secondary to malignancy), and they were treated with PTA/stenting with an initial success rate of 90%. Two patients in group 1 (6%) had a symptomatic pulmonary embolism (none in group 2). At 30 days, venous patency and symptom resolution were achieved in 1 of 33 patients (3%) in group 1 versus 15 of 18 (83%) in group 2. Kaplan-Meier analysis showed primary iliofemoral venous patency rates at 1, 3, and 5 years of 24%, 18%, and 18% and 83%, 69%, and 69% for groups 1 and 2, respectively. Long-term symptom resolution was achieved in 10 of 33 patients (30%) in group 1 versus 14 of 18 (78%) in group 2. Kaplan-Meier life table analysis showed similar survival rates at 1, 3, and 5 years of 100%, 93%, and 85% for group 1 and 100%, 93%, and 81% for group 2. Conclusions Lysis/stenting treatment was more effective than conventional treatment in patients with iliofemoral vein thrombosis. PMID:11371733

AbuRahma, Ali F.; Perkins, Samuel E.; Wulu, John T.; Ng, Hong K.

2001-01-01

375

[Fundamental features on percutaneous cardiopulmonary support].  

PubMed

The fundamental features on percutaneous cardiopulmonary support (PCPS) were reviewed. The number of PCPS installation in Japan has been increasing especially in the area of emergency medicine and cardiology. All-in-one package for PCPS system is becoming a mainstream in clinical practice. It is considered to be crucial to understand the details in characteristics and pitfalls on respective products. The results of nation-wide questionnaire indicate that the detailed criteria for PCPS usage in clinical practice appear to be variable among facilities in Japan;therefore, the formulation of guideline and educational system for PCPS installation is required. PMID:25138934

Hayatsu, Yukihiro; Saiki, Yoshikatsu

2014-07-01

376

Percutaneous renal puncture: requirements and preliminary results  

E-print Network

This paper introduces the principles of computer assisted percutaneous renal puncture, that would provide the surgeon with an accurate pre-operative 3D planning on CT images and, after a rigid registration with space-localized echographic data, would help him to perform the puncture through an intuitive 2D/3D interface. The whole development stage relied on both CT and US images of a healthy subject. We carried out millimetric registrations on real data, then guidance experiments on a kidney phantom showed encouraging results.

Leroy, A; Payan, Y; Richard, F; Chartier-Kastler, E; Troccaz, J; Leroy, Antoine; Mozer, Pierre; Payan, Yohan; Chartier-Kastler, Emmanuel; Troccaz, Jocelyne

2002-01-01

377

Outcome of percutaneous continuous drainage of psoas abscess: A clinically guided technique  

PubMed Central

Background: Percutaneous aspiration of abscesses under ultrasonography (USG) and computer tomography (CT) scan has been well described. With recurrence rate reported as high as 66%. The open drainage and percutaneous continuous drainage (PCD) has reduced the recurrence rate. The disadvantage of PCD under CT is radiation hazard and problems of asepsis. Hence a technique of clinically guided percutaneous continuous drainage of the psoas abscess without real-time imaging overcomes these problems. We describe clinically guided PCD of psoas abscess and its outcome. Materials and Methods: Twenty-nine patients with dorsolumbar spondylodiscitis without gross neural deficit with psoas abscess of size >5 cm were selected for PCD. It was done as a day care procedure under local anesthesia. Sequentially, aspiration followed by guide pin-guided trocar and catheter insertion was done without image guidance. Culture sensitivity was done and chemotherapy initiated and catheter kept till the drainage was <10 ml for 48 hours. Outcome assessment was done with relief of pain, successful abscess drainage and ODI (Oswestry Disability Index) score at 2 years. Results: PCD was successful in all cases. Back and radicular pain improved in all cases. Average procedure time was 24.30 minutes, drain output was 234.40 ml, and the drainage duration was 7.90 days. One patient required surgical stabilisation due to progression of the spondylodiscitis resulting in instability inspite of successful drainage of abscess. Problems with the procedure were noticed in six patients. Multiple attempts (n = 2), persistent discharge (n = 1) for 2 weeks, blocked catheter (n = 2) and catheter pull out (n = 1) occurred with no effect on the outcome. The average ODI score improved from 62.47 to 5.51 at 2 years. Conclusions: Clinically guided PCD is an efficient, safe and easy procedure in drainage of psoas abscess. PMID:24600066

Dave, Bharat R; Kurupati, Ranganatha Babu; Shah, Dipak; Degulamadi, Devanand; Borgohain, Nitu; Krishnan, Ajay

2014-01-01

378

Percutaneous Stent-Graft Repair of Anastomotic Pseudoaneurysms following Vascular Bypass Procedures: A Report of Two Cases  

PubMed Central

Anastomotic pseudoaneurysms are common entities following vascular bypass procedures and, if left untreated, serious complications such as thromboses, infection, and rupture can frequently occur. Therefore, attempts to employ various methods of repair have been utilized in treating anastomotic pseudoaneurysms to maximize operational success and future risk reduction. Herein, the authors report two cases of anastomotic pseudoaneurysms which were repaired percutaneously utilizing a combination of strategies such as careful preoperational image planning, multiple commercially available devices, and secondary embolization techniques. PMID:23365781

Rundback, John; Haug, James; Herman, Kevin; Manno, Joseph; Cerda, Martin

2013-01-01

379

Percutaneous Placement of Self-Expandable Metallic Stents in Patients with Obstructive Jaundice Secondary to Metastatic Gastric Cancer after Gastrectomy  

PubMed Central

Objective To evaluate the outcomes of patients undergoing percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy. Materials and Methods Fifty patients (mean age, 62.4 years; range, 27-86 years) who underwent percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy were included. The technical success rate, clinical success rate, complication rate, stent patency, patient survival and factors associated with stent patency were being evaluated. Results The median interval between the gastrectomy and stent placement was 23.1 months (range, 3.9-94.6 months). The 50 patients received a total of 65 stents without any major procedure-related complications. Technical success was achieved in all patients. The mean total serum bilirubin level, which had been 7.19 mg/dL ± 6.8 before stent insertion, decreased to 4.58 mg/dL ± 5.4 during the first week of follow-up (p < 0.001). Clinical success was achieved in 42 patients (84%). Percutaneous transhepatic biliary drainage catheters were removed from 45 patients (90%). Infectious complications were noted in two patients (4%), and stent malfunction occurred in seven patients (14%). The median stent patency was 233 ± 99 days, and the median patient survival was 179 ± 83 days. Total serum bilirubin level after stenting was an independent factor for stent patency (p = 0.009). Conclusion Percutaneous transhepatic placement of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy is a technically feasible and clinically effective palliative procedure. PMID:24043974

Hong, Hyun Pyo; Cha, In-Ho; Yu, Jung Rim; Mok, Young Jae; Oh, Joo Hyeong; Kwon, Se Hwan; Kim, Sam Soo; Kim, Seung Kwon

2013-01-01

380

CT-guided percutaneous aspiration of Tarlov cyst as a useful diagnostic procedure prior to operative intervention.  

PubMed

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 as an important diagnostic and prognostic procedure prior to definitive operative treatment. PMID:15197609

Lee, J-Y; Impekoven, P; Stenzel, W; Löhr, M; Ernestus, R-I; Klug, N

2004-07-01

381

Left anterior descending artery percutaneous coronary intervention via the left internal mammary artery in a 54-year-old type 1 diabetic woman: a case report  

PubMed Central

Data on the treatment of left anterior descending artery (LAD) stenosis involving or localized distally to left internal mammary artery anastomosis are scarce and not homogeneous. Both surgery (CABG) and percutaneous interventions (PCI) have been attempted, but the most effective treatment has not yet been established. We report a case of a 54-year-old woman suffering from chronic, stable angina and diabetes type 1 successfully treated with percutaneous angioplasty of LAD via the left internal mammary artery with drug-eluting stent implantation with excellent short-term results. PMID:24570698

Kasprzak, Jaroslaw

2013-01-01

382

Massive Pulmonary Embolism: Percutaneous Emergency Treatment Using an Aspirex Thrombectomy Catheter  

SciTech Connect

Massive pulmonary embolism (PE) is a life-threatening condition with a high early mortality rate caused by acute right ventricular failure and cardiogenic shock. A 51-year-old woman with a massive PE and contraindication for thrombolytic therapy was treated with percutaneous mechanical thrombectomy using an Aspirex 11F catheter (Straub Medical AG, Wangs, Switzerland). The procedure was successfully performed and showed a good immediate angiographic result. The patient made a full recovery from the acute episode and was discharged on heparin treatment. Our case report indicates that in patients with contraindications to systemic thrombolysis, catheter thrombectomy may constitute a life-saving intervention for massive PE.

Popovic, Peter, E-mail: peter.popovic@kclj.s [University Medical Centre Ljubljana, Institute of Radiology (Slovenia); Bunc, Matjaz [University Medical Centre Ljubljana, Clinical Department for Cardiology (Slovenia)

2010-10-15

383

Impotence due to External Iliac Steal Syndrome: Treatment with Percutaneous Transluminal Angioplasty and Stent Placement  

PubMed Central

We report a case of erectile dysfunction caused by external iliac artery occlusion, associated with pelvic steal syndrome; bilateral internal iliac arteries were patent. The patient stated that he had experienced erectile dysfunction at similar times along with claudication, but he did not mention it before angiography. He expressed that the erectile dysfunction did not last long and that he felt completely okay after the interventional procedure, in addition to his claudication. Successful treatment of the occlusion, by percutaneous transluminal angioplasty and stent implantation, helped resolve erectile dysfunction completely and treat the steal syndrome. PMID:23323034

Oguzkurt, Levent; Kaya, Bilal; Tekbas, Guven; Ozkan, Ugur

2013-01-01

384

Impotence due to external iliac steal syndrome: treatment with percutaneous transluminal angioplasty and stent placement.  

PubMed

We report a case of erectile dysfunction caused by external iliac artery occlusion, associated with pelvic steal syndrome; bilateral internal iliac arteries were patent. The patient stated that he had experienced erectile dysfunction at similar times along with claudication, but he did not mention it before angiography. He expressed that the erectile dysfunction did not last long and that he felt completely okay after the interventional procedure, in addition to his claudication. Successful treatment of the occlusion, by percutaneous transluminal angioplasty and stent implantation, helped resolve erectile dysfunction completely and treat the steal syndrome. PMID:23323034

Gür, Serkan; Oguzkurt, Levent; Kaya, Bilal; Tekbas, Güven; Ozkan, Ugur

2013-01-01

385

Outpatient percutaneous coronary intervention: Ready for prime time?  

PubMed Central

Outpatient practice after percutaneous coronary intervention (PCI) is gaining momentum due to constantly optimizing results. Furthermore, the availability of limited beds to handle the large volume of coronary interventions also promotes outpatient practice. The present report relates the current experience with same-day discharge and defines persisting challenges in promoting accelerated in-hospital turnover. Since the mid-1990s, there have been several reports on same-day discharge following uncomplicated procedures. Overall, the success of outpatient PCI practice is based on a few technological and pharmacological advances. First, the systematic use of stents and potent antiplatelet agents have revolutionized the acute success rates of PCI by virtually eliminating the risks of acute vessel closure within the first 24 h following a successful procedure. Second, the miniaturization of catheter sizes has also simplified access site management, accelerated ambulation time and limited the risks of puncture site bleeding. In this regard, the transradial approach initially described in Canada and later popularized in Europe has transformed the acute care of patients after PCI. Today, however, the practice of transradial PCI still varies largely from country to country. From the literature review, it appears that after a short period of observation (4 h to 6 h), the majority of eligible patients who have undergone uncomplicated coronary stenting can be discharged on the same day. Whereas implementation of same-day discharge to referring centres is simple, home discharge requires the development of structured outpatient programs with dedicated resources to assist the patient and family with short-term logistics, to provide reassurance, to serve as a ‘safety net’ and, lastly, to promote medication compliance and cardiovascular risk factor management. Further studies are required to better define the cost-minimization effects of outpatient PCI practice, as well as patient perception of fast-track PCI. It is proposed that outpatient PCI will likely continue to expand over the next decade. PMID:17932589

Bertrand, Olivier F; Larose, Eric; De Larochelliere, Robert; Proulx, Guy; Nguyen, Can Manh; Dery, Jean-Pierre; Gleeton, Onil; Barbeau, Gerald; Noel, Bernard; Rouleau, Jacques; Boudreault, Jean-Roch; Roy, Louis; Rodes-Cabau, Josep

2007-01-01

386

Transradial percutaneous coronary interventions in acute coronary syndrome.  

PubMed

Transradial access (TRA) is becoming increasingly used worldwide for percutaneous coronary intervention (PCI) after acute coronary syndromes (ACS). TRA compared with transfemoral access has been noted to improve clinical outcomes in clinical trials and large registry cohort studies. However, much of the benefits of TRA PCI are noted in patients with ST elevation myocardial infarction (STEMI) undergoing primary PCI, where TRA PCI has been associated with reductions in major bleeding events and potentially lower short- and long-term mortality rates. Although much less data exist for TRA PCI in unstable angina and/or non-ST elevation myocardial infarction, similar reductions in bleeding and mortality have not been consistently described. Differences in outcome benefit with TRA PCI among various ACS subtypes may be attributable to the potentially increased inherent risk of periprocedural bleeding in STEMI compared with unstable angina and/or non-ST elevation myocardial infarction. Pre- and intra-procedural factors associated with STEMI treatment, such as use of pharmacoinvasive therapy and aggressive antithrombotic regimens likely increase bleeding risk in patients. In conclusion, this review describes the evidence for TRA PCI across the spectrum of ACS and highlights why differences in clinical benefit may exist among ACS subtypes. PMID:24925803

Khan, Razi; Ly, Hung Q

2014-07-01

387

Standardizing the reporting of percutaneous nephrolithotomy complications  

PubMed Central

Accurate reporting of complications is an essential component to critical appraisal and innovation in surgery and specifically with percutaneous nephrolithotomy (PCNL). We review the evolution of complication reporting for PCNL and suggest future directions for innovation. A selective review was carried out using Pubmed. Key search terms and their combinations included percutaneous, anatrophic, nephrolithotomy, PCNL, complications, Clavien, Martin score, bleeding, bowel injury, perforation, fever, sepsis. The references from relevant papers and reviews as well as AUA and EAU guidelines were also scanned for inclusion. PCNL has become the procedure of choice for large renal stones owing to decreased morbidity over alternative procedures. Both common and rare complications have been described in large case series, small randomized controlled trials, and case reports in an unstandardized form. Although these reports have provided an informative starting point, a standardized complication reporting methodology is necessary to enable appropriate comparisons between institutions, time periods, or innovations in technique. The Clavien-Dindo grading system has become widely accepted in urology and has facilitated the study of PCNL complications. Future research should focus on adaptions of this system to render it more comprehensive and applicable to PCNL. PMID:24497689

Voilette, Philippe D.; Denstedt, John D.

2014-01-01

388

Statin treatment before percutaneous cononary intervention  

PubMed Central

Treatment with 3-hydroxy-3-methyl glutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) improves short-and-long term prognosis in high-risk patients with stable coronary artery disease and in those with acute coronary syndrome and their use is strongly recommended for secondary prevention. Moreover, recent data suggest that statin pre-treatment is associated with a better short- and long-term outcome in patients undergoing percutaneous coronary intervention. Current guidelines for coronary revascularization recommend the use of high-dose of statins before percutaneous coronary intervention to reduce the risk of periprocedural myocardial infarction in statin naïve patients (class IIa A) and in those on chronic statin therapy (class IIa B). However, the beneficial clinical effects elicited by statins in patients undergoing coronary angioplasty may arise not only from a cardiac protection against periprocedural myocardial injury but also from a renal protection against acute kidney injury caused by iodinated contrast media. Actually, statins exert multiple non-lipid lowering (pleiotropic) effects, including improved endothelial function, reduced inflammatory and immuno-modulatory processes, oxidative stress and platelet adhesion, that may contribute to both cardio- and nephro-protection even in the short-term. PMID:23825770

Toso, Anna; Maioli, Mauro; Tropeano, Francesco; Bellandi, Francesco

2013-01-01

389

Statin treatment before percutaneous cononary intervention.  

PubMed

Treatment with 3-hydroxy-3-methyl glutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) improves short-and-long term prognosis in high-risk patients with stable coronary artery disease and in those with acute coronary syndrome and their use is strongly recommended for secondary prevention. Moreover, recent data suggest that statin pre-treatment is associated with a better short- and long-term outcome in patients undergoing percutaneous coronary intervention. Current guidelines for coronary revascularization recommend the use of high-dose of statins before percutaneous coronary intervention to reduce the risk of periprocedural myocardial infarction in statin naïve patients (class IIa A) and in those on chronic statin therapy (class IIa B). However, the beneficial clinical effects elicited by statins in patients undergoing coronary angioplasty may arise not only from a cardiac protection against periprocedural myocardial injury but also from a renal protection against acute kidney injury caused by iodinated contrast media. Actually, statins exert multiple non-lipid lowering (pleiotropic) effects, including improved endothelial function, reduced inflammatory and immuno-modulatory processes, oxidative stress and platelet adhesion, that may contribute to both cardio- and nephro-protection even in the short-term. PMID:23825770

Leoncini, Mario; Toso, Anna; Maioli, Mauro; Tropeano, Francesco; Bellandi, Francesco

2013-06-01

390

Percutaneous calcaneoplasty in displaced intraarticular calcaneal fractures.  

PubMed

The ideal treatment for displaced intraarticular calcaneal fractures is still under debate. Open reduction and internal fixation is the most popular surgical procedure; however, wound complications, hardware failure and infection remain a major concern. The aim of this study was to evaluate the results of a new minimally-invasive surgical procedure: closed reduction technique combined with balloon-assisted fracture augmentation with cement or calcium phosphate (minimally-invasive percutaneous calcaneoplasty). We retrospectively reviewed 11 patients that sustained Sander's type II and III calcaneal fractures treated in our institution from January 2008 to June 2010. The same approach and technique was utilized in all cases. Conventional X-rays and CT scan have been performed pre- and post-operatively. The average follow-up was 24 months. The American Orthopaedic Foot and Ankle Society ankle/hindfoot score has been utilized for clinical evaluation and Bohler's angle to assess bone reduction. All cases obtained bony union in 2/3 months, with average Bohler's angle of 22.97° (from 14.21° to 32.83°). No skin complications or adverse reactions were observed, with only one patient complaining of residual pain in the hindfoot. Minimally-invasive percutaneous calcaneoplasty can represent an alternative to open reduction internal fixation in the treatment of calcaneal fractures, allowing stable reduction without plating, early function recovery and short hospital stay. PMID:23744105

Biggi, Francesco; Di Fabio, Stefano; D'Antimo, Corrado; Isoni, Francesco; Salfi, Cosimo; Trevisani, Silvia

2013-12-01

391

[Percutaneous tracheostomy in the ventilated patient].  

PubMed

The medical indications of tracheostomy comprise the alleviation of upper airway obstruction; the prevention of laryngeal and upper airway damage due to prolonged translaryngeal intubation in patients subjected to prolonged mechanical ventilation; and the facilitation of airway access for the removal of secretions. Since 1985, percutaneous tracheostomy (PT) has gained widespread acceptance as a method for creating a surgical airway in patients requiring long-term mechanical ventilation. Since then, several comparative trials of PT and surgical tracheostomy have been conducted, and new techniques for PT have been developed. The use of percutaneous dilatation techniques under bronchoscopic control are now increasingly popular throughout the world. Tracheostomy should be performed as soon as the need for prolonged intubation is identified. However a validated model for the prediction of prolonged mechanical ventilation is not available, and the timing of tracheostomy should be individualized. The present review analyzes the state of the art of PT in mechanically ventilated patients--this being regarded by many as the technique of choice in performing tracheostomy in critically ill patients. PMID:23347906

Añón, J M; Araujo, J B; Escuela, M P; González-Higueras, E

2014-04-01

392

Efficacy of percutaneous versus intradermal BCG in the prevention of tuberculosis in South African infants: randomised trial  

PubMed Central

Objective To compare the incidence of tuberculosis over two years in infants vaccinated at birth with intradermal BCG or with percutaneous BCG. Design Randomised trial. Setting South Africa. Participants 11?680 newborn infants. Interventions Infants were randomised by week of birth to receive Tokyo 172 BCG vaccine through the percutaneous route (n=5775) or intradermal route (n=5905) within 24 hours of birth and followed up for two years. Main outcome measures The primary outcome measure was documented Mycobacterium tuberculosis infection or radiological and clinical evidence of tuberculosis disease. Secondary outcome measures were rates of adverse events, all cause and tuberculosis specific admissions to hospital, and mortality. Results The difference in the cumulative incidence of definite, probable, and possible tuberculosis between the intradermal group and the percutaneous group, as defined using study definitions based on microbiological, radiological, and clinical findings was ?0.36% (95.5% confidence interval ?1.27% to 0.54%). No significant differences were found between the routes in the cumulative incidence of tuberculosis using a range of equivalence of “within 25%.” Additionally, no significant differences were found between the routes in the cumulative incidence of adverse events (risk ratio 0.98, 95% confidence interval 0.91 to 1.06), including deaths (1.19, 0.89 to 1.58). Conclusion Equivalence was found between intradermal BCG vaccine and percutaneous BCG in the incidence of tuberculosis in South African infants vaccinated at birth and followed up for two years. The World Health Organization should consider revising its policy of preferential intradermal vaccination to allow national immunisation programmes to choose percutaneous vaccination if that is more practical. Trial registration ClinicalTrials.gov NCT00242047. PMID:19008268

2008-01-01

393

Percutaneous ethanol injection therapy for autonomously functioning thyroid nodule.  

PubMed

Four patients with solitary autonomously functioning thyroid nodule (AFTN; 2 toxic and 2 subclinically toxic) received ultrasonography (US)-guided percutaneous ethanol injection therapy (PEIT). The pretreatment scintigraphic appearance of the nodule was hot, and radioactivity in the extranodular tissue was completely suppressed throughout. Ninety-nine percent ethanol was slowly injected under US guidance. As a rule, the injection was performed in fractionated sessions and the treatment was repeated until the total amount of ethanol exceeded the baseline nodular volume. The therapy was successful. Complete remission of hyperthyroidism was observed among the patients with toxic nodule. The basal level of TSH and its response to TRH injection was normalized in the patients with subclinically toxic nodule. Posttreatment scintigrams revealed that the extranodular tissue recovered and radioactivity in the hot nodule had noticeably decreased. The rate of reduction in the nodular volume was more than 80% in all. There was no recurrence or development of hypothyroidism during a follow up of 10 to 23 months. The main side effect was mild and transient pain and/or a burning sensation at injection. No severe or permanent complications occurred. Although the number of our cases was small, the results suggest that PEIT is a useful program in treating AFTN. PMID:8800445

Nakada, K; Katoh, C; Kanegae, K; Tsukamoto, E; Itoh, K; Tamaki, N

1996-05-01

394

Perk Station - Percutaneous Surgery Training and Performance Measurement Platform  

PubMed Central

Motivation Image-guided percutaneous (through the skin) needle-based surgery has become part of routine clinical practice in performing procedures such as biopsies, injections and therapeutic implants. A novice physician typically performs needle interventions under the supervision of a senior physician; a slow and inherently subjective training process that lacks objective, quantitative assessment of the surgical skill and performance[S1]. Shortening the learning curve and increasing procedural consistency are important factors in assuring high-quality medical care. Methods This paper describes a laboratory validation system, called Perk Station, for standardized training and performance measurement under different assistance techniques for needle-based surgical guidance systems. The initial goal of the Perk Station is to assess and compare different techniques: 2D image overlay, biplane laser guide, laser protractor and conventional freehand. The main focus of this manuscript is the planning and guidance software system developed on the 3D Slicer platform, a free, open source software package designed for visualization and analysis of medical image data. Results The prototype Perk Station has been successfully developed, the associated needle insertion phantoms were built, and the graphical user interface was fully implemented. The system was inaugurated in undergraduate teaching and a wide array of outreach activities. Initial results, experiences, ongoing activities and future plans are reported. PMID:19539446

Vikal, Siddharth; U-Thainual, Paweena; Carrino, John A.; Iordachita, Iulian; Fischer, Gregory S.; Fichtinger, Gabor

2009-01-01

395

Percutaneous endoscopic transapical aortic valve implantation: three experimental transcatheter models.  

PubMed

We sought to demonstrate the feasibility of an endoscopic approach to transapical aortic valve implantation (AVI), avoiding the morbidity of a thoracotomy incision. Using an experimental pig model, we performed three different approaches to transapical AVI, using a standard minithoracotomy (n=4), a robotic approach using the da Vinci telemanipulator (n=4) and an endoscopic approach using a port and camera access (n=4). The feasibility of the different techniques, exposure of the left ventricular apex, postoperative blood loss and total operative time were evaluated. Left ventricular apical exposure, 'purse-string' suture control and 33-F introducer access were successfully performed and confirmed videoscopically, fluoroscopically and at a post mortem in all 12 animals. The haemodynamics were stable in all animals. Mean intraoperative and postoperative (two-hour) blood losses were 88 and 65 ml with minithoracotomy, and 228 and 138 ml with the robotic and 130 and 43 ml with the endoscopic technique (P=0.26, P=0.14, respectively). There was no significant change in perioperative haematocrit (P=0.53). The mean total operative times were 1.4, 3.9 and 1.1 h (P=0.06), respectively. Percutaneous endoscopic and robotic transapical AVI are both feasible and can be performed in a timely manner with reasonable perioperative blood loss. Future research will focus on identifying optimal candidates for surgery based upon preoperative thoracic imaging. PMID:21700598

Chu, Michael W A; Falk, Volkmar; Mohr, Friedrich W; Walther, Thomas