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Sample records for adjunctive balloon angioplasty

  1. Intravascular Ultrasound Imaging of Peripheral Arteries as an Adjunct to Balloon Angioplasty and Atherectomy

    SciTech Connect

    Korogi, Yukunori; Hirai, Toshinori; Takahashi, Mutsumasa

    1996-11-15

    This article reviews many of the applications of intravascular ultrasound (US) imaging for peripheral arterial diseases. In vitro studies demonstrate an excellent correlation between ultrasound measurements of lumen and plaque crossectional area compared with histologic sections. In vivo clinical studies reveal the enhanced diagnostic capabilities of this technology compared with angiography. Intravascular US imaging can provide valuable information on the degree, eccentricity, and histologic type of stenosis before intervention, and on the morphological changes in the arterial wall and the extent of excision after intervention. Intravascular US may also serve as a superior index for gauging the diameter of balloon, stent, laser probe, and/or atherectomy catheter appropriate for a proposed intervention. Significant new insights into the mechanisms of balloon angioplasty and atherectomy have been established by intravascular US findings. Intravascular US imaging has been shown to be a more accurate method than angiography for determining the cross-sectional area of the arterial lumen, and for assessing severity of stenosis. Quantitative assessment of the luminal cross-sectional area after the balloon dilatation should be more accurate than angiography as intimal tears or dissections produced by the dilatation may not be accurately evaluated with angiography. At the present time, intravascular US is still a controversial imaging technique. Outcome studies are currently being organized to assess the clinical value and cost effectiveness of intravascular ultrasound in the context of these interventional procedures.

  2. Intravascular ultrasound imaging of peripheral arteries as an adjunct to balloon angioplasty and atherectomy.

    PubMed

    Korogi, Y; Hirai, T; Takahashi, M

    1996-01-01

    This article reviews many of the applications of intravascular ultrasound (US) imaging for peripheral arterial diseases. In vitro studies demonstrate an excellent correlation between ultrasound measurements of lumen and plaque cross-sectional area compared with histologic sections. In vivo clinical studies reveal the enhanced diagnostic capabilities of this technology compared with angiography. Intravascular US imaging can provide valuable information on the degree, eccentricity, and histologic type of stenosis before intervention, and on the morphological changes in the arterial wall and the extent of excision after intervention. Intravascular US may also serve as a superior index for gauging the diameter of balloon, stent, laser probe, and/or atherectomy catheter appropriate for a proposed intervention. Significant new insights into the mechanisms of balloon angioplasty and atherectomy have been established by intravascular US findings. Intravascular US imaging has been shown to be a more accurate method than angiography for determining the cross-sectional area of the arterial lumen, and for assessing severity of stenosis. Quantitative assessment of the luminal cross-sectional area after the balloon dilatation should be more accurate than angiography as intimal tears or dissections produced by the dilatation may not be accurately evaluated with angiography. At the present time, intravascular US is still a controversial imaging technique. Outcome studies are currently being organized to assess the clinical value and cost effectiveness of intravascular ultrasound in the context of these interventional procedures. PMID:8653738

  3. Balloon catheter coronary angioplasty

    SciTech Connect

    Angelini, P.

    1987-01-01

    The author has produced a reference and teaching book on balloon angioplasty. Because it borders in surgery and is performed on an awake patient without circulatory assistance, it is a complex and demanding procedure that requires thorough knowledge before it is attempted. The text is divided into seven sections. The first section describes coronary anatomy and pathophysiology, defines the objectives and mechanisms of the procedure and lists four possible physiologic results. The next section describes equipment in the catheterization laboratory, catheters, guidewires and required personnel. The following section is on the procedure itself and includes a discussion of examination, testing, technique and follow-up. The fourth section details possible complications that can occur during the procedure, such as coronary spasms, occlusion, thrombosis, perforations and ruptures, and also discusses cardiac surgery after failed angioplasty. The fifth section details complex or unusual cases that can occur. The sixth and seventh sections discuss radiation, alternative procedures and the future of angioplasty.

  4. Coronary artery balloon angioplasty - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100160.htm Coronary artery balloon angioplasty - series To use the sharing features ... out of 9 Normal anatomy Overview The coronary arteries supply blood to the heart muscle. The right ...

  5. Balloon angioplasty - short segment

    MedlinePlus Videos and Cool Tools

    Angioplasty is a procedure to open narrowed or blocked arteries caused by deposits of plaque. If the blockage is not major, ... passage for the blood to flow through. Typically, a device called a stent is placed within the ...

  6. Tandem balloon catheter for coronary angioplasty.

    PubMed

    Finci, L; Meier, B; Steffenino, G; Rutishauser, W

    1986-01-01

    The Tandem balloon catheter is a triple lumen steerable catheter for coronary angioplasty with two separately inflatable balloons of different diameters. Indications and results of 26 consecutive patients treated with a Tandem balloon catheter are reviewed. Adequate distal pressure measurements were obtained in 71% of the cases. In ten patients, the Tandem balloon catheter was selected for two stenoses in different segments of the same coronary artery. Angioplasty was successful for all lesions in five and for at least the strategic lesions in five patients (in one only after changing to a single-balloon catheter). In the seven patients with stenoses in two different coronary arteries of various calibers, angioplasty was successful for both vessels in three and for one vessel in four patients. In the six patients with a very tight stenosis, where the Tandem balloon catheter was selected to predilate with the small balloon, the procedure was technically successful in all, but there was a myocardial infarction in one patient. In the three patients with a chronic total occlusion, where the stiffness of the Tandem balloon was the reason for selection, one recanalization was successful. The Tandem balloon catheter provides a handy tool for complex coronary angioplasty. It offers comparable ease in manipulation and pressure transmission and may save time, money, and radiation exposure by avoiding catheter exchanges. PMID:2949848

  7. Restenosis After Balloon Angioplasty for Cerebral Vasospasm

    SciTech Connect

    Sedat, J. Chau, Y.; Popolo, M.; Gindre, S.; Rami, L.; Orban, J. C.

    2009-03-15

    Transluminal balloon dilatation for symptomatic vasospasm after subarachnoid hemorrhage is effective, and clinical studies have shown that it achieves long-lasting dilatation of spastic cerebral arteries. Delayed arterial renarrowing has not been reported. Here we report the case of a 58-year-old woman who presented asymptomatic and permanent restenosis after angioplasty for cerebral vasospasm.

  8. Thermoelastic analysis of high-pressure angioplasty balloons.

    PubMed

    Eaton-Evans, J; Dulieu-Barton, J M; Little, E; Brown, I

    2006-04-01

    Failures in angioplasty balloons are investigated using typical destructive techniques. The material properties of moulded balloons are derived from tensile tests and used to establish the reasons for failure of the balloons. Thermoelastic stress analysis is used to determine the stress distribution in the balloons, and a means of interpreting the data to derive actual stresses is described. The departure from linear elastic behaviour in the angioplasty balloons is identified using thermoelastic analysis. The results from the thermoelastic analysis are discussed and compared with those from the destructive tests, and the thermoelastic technique is shown to be a potential new means for non-destructive analysis of angioplasty balloons. PMID:16808075

  9. Paget-Schroetter Syndrome Treated with Cutting-Balloon Angioplasty

    SciTech Connect

    Gosling, J.; Nayeemuddin, M.; Cowling, M.; Pherwani, A.; Asquith, J.

    2012-06-15

    Here, a case of Paget-Schroetter Syndrome in a 25-year-old guitar player is reported. After thrombolysis, conventional angioplasty failed to dilate the underlying subclavian stenosis both before and after first-rib excision with scalenus anterior and medius division. For the third attempt at angioplasty, a cutting balloon was used, which immediately produced a good result. Venography at 4-year follow-up showed no restenosis and no functional deficit. This case report demonstrates that cutting-balloon angioplasty may be considered when conventional balloon fails and may have greater durability than conventional balloon angioplasty in the treatment of Paget-Schroetter syndrome.

  10. Paget-Schroetter syndrome treated with cutting-balloon angioplasty.

    PubMed

    Gosling, J; Nayeemuddin, M; Cowling, M; Pherwani, A; Asquith, J

    2012-06-01

    Here, a case of Paget-Schroetter Syndrome in a 25-year-old guitar player is reported. After thrombolysis, conventional angioplasty failed to dilate the underlying subclavian stenosis both before and after first-rib excision with scalenus anterior and medius division. For the third attempt at angioplasty, a cutting balloon was used, which immediately produced a good result. Venography at 4-year follow-up showed no restenosis and no functional deficit. This case report demonstrates that cutting-balloon angioplasty may be considered when conventional balloon fails and may have greater durability than conventional balloon angioplasty in the treatment of Paget-Schroetter syndrome. PMID:21845509

  11. Rotational atherectomy or balloon angioplasty in the treatment of intra-stent restenosis: BARASTER multicenter registry.

    PubMed

    Goldberg, S L; Berger, P; Cohen, D J; Shawl, F; Buchbinder, M; Fortuna, R; O'Neill, W; Leon, M; Braden, G A; Teirstein, P S; Reisman, M; Bailey, S R; Dauerman, H L; Bowers, T; Mehran, R; Colombo, A

    2000-12-01

    The BARASTER registry was formed to evaluate the initial success and long-term results of rotational atherectomy in the management of in-stent restenosis. Rotational atherectomy was used in 197 cases of in-stent restenosis: 46 with stand-alone rotational atherectomy or at most 1 atmosphere of balloon inflation (Rota strategy), and 151 with rotational atherectomy and adjunctive balloon angioplasty <1 atmosphere (Combination strategy). These were compared with 107 episodes of in-stent restenosis treated with balloon angioplasty alone. In this observational study, the use of Combination therapy was associated with a slightly higher initial success rate (95% vs. 87% with the Rota strategy and 89% with Balloons, P = 0.08). There was a reduction in one year clinical outcomes (death, myocardial infarction or target lesion revascularization) in the combination group (38% vs. 60% with Rota and 52% with balloons, P = 0.02). These data support a benefit of the strategy of debulking with rotational atherectomy followed by adjunctive balloon angioplasty, in the management of in-stent restenosis. PMID:11108670

  12. Does Coronary Stenting Following Balloon Angioplasty Improve Myocardial Fractional Flow Reserve?

    SciTech Connect

    Takeuchi, Masaaki; Himeno, Etsuro

    1998-11-15

    Purpose: Suboptimal distal coronary flow reserve after successful balloon angioplasty has been attributed to angiographically unrecognized inadequate lumen expansion, and adjunct coronary stenting has been shown to improve coronary flow reserve. The aim of this study was to investigate whether myocardial fractional flow reserve (FFRmyo) would increase further after coronary stenting compared with balloon angioplasty alone in the same patient group. Methods: FFRmyo and quantitative coronary angiography were obtained before and after pre-stent balloon dilation, and again after stent placement in 11 patients (7 left anterior descending artery, 3 right coronary artery and 1 left circumflex artery). FFRmyo was calculated as the ratio of Pd/Pa during intracoronary adenosine 5'-triphosphate (50 {mu}g and 20 {mu}g in the left and right coronary arteries, respectively)-induced maximum hyperemia, where Pd represents mean distal coronary pressure measured by a 2.1 Fr infusion catheter and Pa represents mean aortic pressure measured by the guiding catheter. Results: Percent diameter stenosis significantly decreased after balloon angioplasty (74% {+-} 15% vs 37% {+-} 17%, p < 0.001), and decreased further after stent placement (18% {+-} 10%, p < 0.001 vs baseline and balloon angioplasty). FFRmyo after coronary stenting (0.85 {+-} 0.09) was significantly higher than that at baseline (0.51 {+-} 0.16, p < 0.001) and after balloon angioplasty (0.77 {+-} 0.11, p < 0.05). There was a significant correlation between angiographic variables and FFRmyo. The increase in lumen dimensions after coronary stenting was followed by a further significant improvement of FFRmyo. Conclusion: These results suggest that coronary stenting may provide a more favorable functional status and lumen geometry of residual coronary stenosis compared with balloon angioplasty alone.

  13. Intravascular ultrasound imaging following balloon angioplasty.

    PubMed

    Tobis, J M; Mahon, D J; Moriuchi, M; Honye, J; McRae, M

    1991-01-01

    Despite its long history and reliability, contrast angiography has several inherent limitations. Because it is a two-dimensional projection image of the lumen contour, the wall thickness cannot be measured and the plaque itself is not visualized. This results in an underestimation of the amount of atherosclerotic disease by angiography. An assessment of atherosclerosis could be improved by an imaging modality: (1) that has an inherent larger magnification than angiography and (2) that directly visualizes the plaque. Intravascular ultrasound fulfils these criteria. This presentation will provide evidence that intravascular ultrasound may prove complimentary or even superior to angiography as an imaging modality. Intravascular ultrasound demonstrates excellent representations of lumen and plaque morphology of in vitro specimens compared with histology. There is very close intraobserver and interobserver variability of measurements made from intravascular ultrasound images. Phantom studies of stenoses in a tube model demonstrate that angiography can misrepresent the severity of stenosis when the lumen contour is irregular and not a typical ellipse, whereas intravascular ultrasound reproduces the cross-sectional morphology more accurately since it images the artery from within. In vitro studies of the atherosclerotic plaque tissue characteristics compare closely with the echo representation of fibrosis, calcification, and lipid material. In addition, in vitro studies of balloon angioplasty demonstrate that intravascular ultrasound accurately represents the changes in the structure of artery segments following balloon dilatation. PMID:1833473

  14. Comparison of angioscopic findings between coronary balloon and laser angioplasty

    NASA Astrophysics Data System (ADS)

    Larrazet, Fabrice S.; Dupouy, Patrick J.; Dubois-Rande, Jean Luc; Hirosaka, Akira; Kvasnicka, Jan; Geschwind, Herbert J.

    1994-07-01

    Percutaneous intracoronary angioscopy was used to study the morphological changes occurring in coronary arteries after balloon or laser angioplasty. Angioscopy is thought to provide details on the coronary vessel lumen and the inner wall. Coronary lesion were studied in 44 patients with a 4.5 F Imagecath angioscope before and after each interventional procedure. Balloon and laser angioplasty were performed on 21 (group I) and 23 patients (group II), respectively. There was no difference in age, sex, or angiographic lesion appearance before the procedure between the two groups. Circumferential visualization of the target lesion was successfully completed in 17 group I patients and 19 group II patients. A larger lumen than that observed at control was seen in all 17 dilatation patients and in 13 of the 19 laser patients. Tissue remnants were observed in all balloon and laser patients. Laser irradiation resulted in characteristic sharp edged craters. Dissection was identified in 2 of 19 before versus 9 of 19 patients after balloon angioplasty (p<0.05) and in 0 of 23 before versus 4 of 23 patients after laser angioplasty. Subintimal hemorrhage was observed in 3 of 19 before versus 11 of 19 patients after balloon angioplasty (p<0.05) and in 2 of 23 before versus 4 of 23 patients after laser angioplasty. The frequency of hemorrhage was higher in the post balloon group than in the post laser group (11 of 19 versus 4 of 23, respectively, p<0.02). Angioscopy provides valuable information on lesion morphology after coronary interventions. Balloon dilation results in a high rate of dissection and subintimal hemorrhage. Laser angioplasty is able to ablate obstructing tissue and results in a lower rate of subintimal hemorrhage than balloon dilatation.

  15. Cutting Balloon Angioplasty Versus Standard Balloon Angioplasty for Failing Infra-inguinal Vein Grafts: Comparative Study of Short- and Mid-Term Primary Patency Rates

    SciTech Connect

    Vikram, Raghunandan; Ross, Rose A.; Bhat, Rajesh; Griffiths, Gareth D.; Stonebridge, Peter A.; Houston, J. Graeme; Chakraverty, S.

    2007-07-15

    Purpose. To evaluate the results of a recent change in practice in our institution using cutting balloon angioplasty instead of standard balloon angioplasty as the primary treatment for failing infra-inguinal vein bypass grafts. Methods. In this nonrandomized cohort study with a historical control, failing infra-inguinal vein grafts were identified at duplex surveillance or clinical examination. Patients had confirmatory arteriography and balloon angioplasty at the same attendance. Interventions proximal or distal to the graft itself and prosthetic grafts were not included. Patients were entered into a duplex graft surveillance program. Initial assessment of technical success was duplex or improvement 4-6 weeks after the primary angioplasty. Results. Twenty-seven consecutive patients were treated with standard balloon angioplasty, then 11 consecutive patients were treated with cutting balloon angioplasty. Initial technical success was 74% for the standard balloon versus 82% for the cutting balloon. The primary patency rate at 6 months was 16/26 (62%) for standard balloon angioplasty and 8/10 (80%) for cutting balloon angioplasty (p = 0.44). The primary patency rate at 12 months was 9/25 (36%) for standard balloon angioplasty and 5/10 (50%) for cutting balloon angioplasty (p = 0.47). Conclusion. The use of cutting balloons for primary angioplasty of infra-inguinal vein grafts offers no definite advantage over standard balloon angioplasty in this institution or compared with patency rates after standard balloon angioplasty reported elsewhere. Larger multicenter studies would be required to demonstrate whether there was any real difference between the two techniques.

  16. Reaction to injury following balloon angioplasty and intravascular stent placement in the canine femoral artery.

    PubMed

    Salam, T A; Taylor, B; Suggs, W D; Hanson, S R; Lumsden, A B

    1994-05-01

    Intravascular stents are used clinically as an adjunct to coronary and iliac angioplasty. This study was performed to evaluate the thrombogenicity and intimal hyperplasia incited by stents deployed in non-injured and in balloon-injured femoral arteries in the canine model. Medinvent stents (4 mm) were placed in the femoral arteries bilaterally in five mongrel dogs via cut down. This was preceded by balloon catheter angioplasty of the stent site on one side. Platelet deposition was measured at 30, 60, and 90 minutes and at 24 and 48 hours after stent placement, using gamma camera imaging of Indium111 platelets. The animals were killed after 2 months using a pressure perfusion technique, and the stents harvested. All vessels were patent at the time of harvest. Neointimal thickness was measured by computer image analysis. Platelet deposition was significantly increased on the angioplastied side compared to the non-angioplastied side at 60 minutes (5.67 x 10(9) +/- 1.4 versus 2.17 x 10(9) +/- 0.5 platelets/cm; P < 0.05), at 90 minutes (8.13 x 10(9) +/- 1.8 versus 2.33 x 10(9) +/- 0.6 platelets/cm; P < 0.05), and at 24 hours (stent-to-blood ratio = 15.86 +/- 6.3 versus 3.75 +/- 1.5; P < 0.05). Neointimal thickness was also significantly greater on the side of combined angioplasty and stent placement (0.45 +/- 0.21 mm versus 0.33 +/- 0.09 mm; P < 0.05). These results demonstrate that placement of intravascular stents in normal arteries is associated with a certain degree of thrombogenicity and formation of neointimal hyperplasia. Combining balloon angioplasty with stent placement significantly augments both thrombogenicity and production of intimal hyperplasia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8161086

  17. Balloon Angioplasty Optimization: Should We Measure Balloon Volume As Well As Pressure?

    SciTech Connect

    Shehab, M.; Michalis, L. K.; Rees, M. R.

    2008-01-15

    Purpose. To investigate the influence that measurement of balloon volume as a controlled variable in addition to balloon pressure has on the outcome of balloon angioplasty in an experimental model. Methods. One hundred and three segments of explanted normal porcine carotid arteries were obtained. Five were used as controls, and the remaining 98 were subjected to balloon angioplasty with simultaneous measurement of balloon volume and pressure. These arteries were randomized into two groups. In one group the endpoint of the angioplasty was determined by balloon pressure (pressure-limited group, PLG) and in the other group by balloon volume (volume-limited group, VLG). Pressure/volume curves for each procedure were constructed by continuous measurement of both parameters by a purpose-designed computer-controlled inflation device. The diameter of each arterial segment was measured by intravascular ultrasound (IVUS) and the ratio of the inflated balloon to arterial diameter calculated. Arterial appearances after angioplasty were recorded using IVUS. Results. The balloon volumes measured at the endpoint of angioplasty were significantly smaller in the PLG compared with the VLG (p < 0.001). Three types of pressure/volume curves were identified: A, B, and C. In the type A curves, IVUS identified fissures in 28% (17/60) and the examination was normal in 72% (43/60). In the type B curves, IVUS identified fissures in 44% (4/9), dissections in 22% (2/9), and the examination was normal in 33% (3/9). In the type C curves, IVUS identified fissures in 44% (4/9) and dissection in 56% (5/9) with no normal examinations. In undamaged arterial segments a very high correlation was achieved between balloon volume and the balloon/artery ratio (Pearson correlation = -0.979, R{sup 2} = 0.957, p < 0.0001, n = 27). Conclusion. The measurement of pressure and volume during angioplasty enabled the construction of pressure/volume curves that showed deviations from the curves obtained in air. The

  18. Hugging balloons: coronary angioplasty of oversized vessels with side-by-side balloons.

    PubMed

    Teirstein, P S; Johnson, W L; Rutherford, B D; Hartzler, G O

    1988-01-01

    Angioplasty of large (greater than 4.0-mm) saphenous vein grafts using the largest available (4.0-mm) balloon catheters may result in inadequate graft dilatation. To avoid leaving a significant residual stenosis, two balloon catheters can be inflated side by side across the stenosis. Herein, we report two cases where this "hugging balloon" technique was used to achieve wide graft patency. PMID:2970301

  19. Effectiveness of the hugging balloon technique in coronary angioplasty for a heavy, encircling, calcified coronary lesion.

    PubMed

    Ahn, Min Soo; Yoon, Junghan; Lee, Jun Won; Lee, Kyoung Hoon; Kim, Jang Young; Yoo, Byung Su; Lee, Seung Hwan; Choe, Kyung Hoon

    2009-11-01

    We report our experience in coronary angioplasty and intravascular ultrasonography (IVUS) on a heavy, encircling, calcified lesion that was not dilated with the use of a cutting balloon and a non-compliant balloon. The angioplasty was successfully performed with a simple and inexpensive hugging balloon technique. PMID:19997547

  20. Applicability of laser to assist coronary balloon angioplasty.

    PubMed

    Lee, G; Chan, M C; Ikeda, R M; Rink, J L; Dukich, J; Peterson, L; Lee, K K; Reis, R L; Mason, D T

    1985-12-01

    Severe atherosclerotic obstructed coronary artery disease (CAD) may preclude passage of a balloon catheter for transluminal coronary angioplasty (TCA). Since lasers have been shown to effectively vaporize CAD plaque, the initial application of laser to effect a lumen large enough to accommodate the angioplasty catheter for further dilatation was explored. Eleven postmortem human CAD segments which did not permit passage of a 1.33 mm shaft diameter angioplasty catheter were studied. Argon laser radiation (14 to 90 J) transmitted via 400 micron core diameter quartz fiber onto the stenotic channel of 0.58 mm created a vaporized lumen of 1.77 mm (mean increase of 1.31 +/- 0.25 mm, p less than 0.001). The laser procedure allowed the balloon angioplasty catheter to be pushed into the stenosis. TCA was then performed (7 atm, 45 seconds) and expanded the channel to 2.12 mm (additional mean increase of 0.38 +/- 0.07 mm, p less than 0.001). In terms of percent luminal narrowing, laser radiation reduced obstruction from 80% to 45% (mean difference of -38.7 +/- 4.6%, p less than 0.001), and TCA caused a further decrease to 37% (mean difference of -9.3 +/- 1.9%, p less than 0.001). Thus, in tight atherosclerotic lesions, the laser may be useful in creating an initial opening enabling the placement of the balloon angioplasty catheter which, in turn, can further dilate the lased stenotic coronary lumen. PMID:2933943

  1. Balloon valvuloplasty and angioplasty in congenital heart disease.

    PubMed Central

    Miller, G A

    1985-01-01

    Balloon dilatation valvuloplasty was performed in 16 patients with pulmonary valve stenosis aged 10 days to 17 years. Gradients were reduced in all but two patients and were less than or equal to 20 mm Hg after the procedure in all but these two and one other. Unsatisfactory initial results in these three patients were attributed to the use of too small a balloon in one patient (gradient subsequently abolished at repeat valvuloplasty), to a dysplastic valve in a neonate, and to the fact that there had been a previous surgical valvotomy with scar tissue formation in one patient. The good result was retained in six of seven patients followed up at three to six months. In one the gradient, having been reduced from 60 to 18 mm Hg, had risen to 35 mm Hg. Repeat valvuloplasty was technically impossible in this patient, but in two others residual gradients of 24 and 22 mm Hg were reduced to 4 and 8 mm Hg respectively by repeat valvuloplasty. Balloon dilatation angioplasty was successful in dilating a severe stenosis at the lower limb of an atrial baffle (previous correction of complete transposition) and in dilating supravalvar stenosis of the pulmonary artery resulting from previous banding and debanding. Thus balloon pulmonary valvuloplasty, though still a new technique, appears to be the treatment of choice in patients with typical pulmonary stenosis and thin mobile valves. Patients with dysplastic valves may be less suitable candidates for the procedure. Balloon angioplasty is likely to have other applications, including the treatment of postoperative stenotic lesions. Images PMID:2931093

  2. Modeling plaque fissuring and dissection during balloon angioplasty intervention.

    PubMed

    Gasser, T Christian; Holzapfel, Gerhard A

    2007-05-01

    Balloon angioplasty intervention is traumatic to arterial tissue. Fracture mechanisms such as plaque fissuring and/or dissection occur and constitute major contributions to the lumen enlargement. However, these types of mechanically-based traumatization of arterial tissue are also contributing factors to both acute procedural complications and chronic restenosis of the treatment site. We propose physical and finite element models, which are generally useable to trace fissuring and/or dissection in atherosclerotic plaques during balloon angioplasty interventions. The arterial wall is described as an anisotropic, heterogeneous, highly deformable, nearly incompressible body, whereas tissue failure is captured by a strong discontinuity kinematics and a novel cohesive zone model. The numerical implementation is based on the partition of unity finite element method and the interface element method. The later is used to link together meshes of the different tissue components. The balloon angioplasty-based failure mechanisms are numerically studied in 3D by means of an atherosclerotic-prone human external iliac artery, with a type V lesion. Image-based 3D geometry is generated and tissue-specific material properties are considered. Numerical results show that in a primary phase the plaque fissures at both shoulders of the fibrous cap and stops at the lamina elastica interna. In a secondary phase, local dissections between the intima and the media develop at the fibrous cap location with the smallest thickness. The predicted results indicate that plaque fissuring and dissection cause localized mechanical trauma, but prevent the main portion of the stenosis from high stress, and hence from continuous tissue damage. PMID:17385047

  3. Arteriovenous fistula at the site of balloon dilatation complicating femoropopliteal angioplasty

    SciTech Connect

    Malcolm, Paul N.; King, David H.; Crabbe, Ray W.; Taylor, Peter R.; Reidy, John F.

    1997-01-15

    We describe an arteriovenous fistula (AVF) at the site of balloon dilatation immediately after percutaneous transluminal angioplasty (PTA) of the femoropopliteal artery. This occurred during an otherwise uncomplicated angioplasty with a good clinical result. The AVF closed spontaneously within 2 months as monitored by color duplex ultrasound. This uncommon complication of PTA is not widely recognized.

  4. MedlinePlus: Angioplasty

    MedlinePlus

    ... Angioplasty updates by email What's this? GO GO MEDICAL ENCYCLOPEDIA Angioplasty and stent - heart - discharge Angioplasty and stent placement - heart Balloon angioplasty - short segment Coronary artery balloon angioplasty - slideshow ...

  5. Long term outcome and cost-effectiveness of stenting versus balloon angioplasty for acute myocardial infarction

    PubMed Central

    Suryapranata, H; Ottervanger, J; Nibbering, E; van't, H; Hoorntje, J; de Boer, M J; Al, M; Zijlstra, F

    2001-01-01

    OBJECTIVE—To investigate the long term clinical outcome and cost-effectiveness of stenting compared with balloon angioplasty in patients with acute myocardial infarction.
METHODS—Patients with acute myocardial infarction were randomly allocated to primary stenting (112) or balloon angioplasty (115). The primary end point was the cumulative first event rate of death, non-fatal reinfarction, or target vessel revascularisation. Secondary end points were restenosis at six months and the cost-effectiveness at follow up.
RESULTS—After 24 months, the combined clinical end point of death/reinfarction was 4% after stenting and 11% after balloon angioplasty (p = 0.04). Subsequent target vessel revascularisation was necessary in 15 patients (13%) after stenting and in 39 (34%) after balloon angioplasty (p < 0.001). The cumulative cardiac event-free survival rate was also higher after stenting (84% v 62%, p < 0.001). The angiographic restenosis rate after stenting was less than after balloon angioplasty (12% v 34%, p < 0.001). Despite the higher initial costs of stenting (Dfl 21 484 v Dfl 18 625, p < 0.001), the cumulative costs at 24 months were comparable with those of balloon angioplasty (Dfl 31 423 v Dfl 32 933, p = 0.83).
CONCLUSIONS—Compared with balloon angioplasty, primary stenting for acute myocardial infarction results in a better long term clinical outcome without increased cost.


Keywords: stenting; angioplasty; myocardial infarction; cost-benefit analysis PMID:11359749

  6. Stenting of a renal artery stenosis achieves better relief of the obstructive lesion than balloon angioplasty.

    PubMed

    Dorros, G; Prince, C; Mathiak, L

    1993-07-01

    A balloon-expandable (Palmaz-Schatz) stainless steel stent was utilized following balloon angioplasty (PTRA) to determine if the obstructive lesion, using quantitative methods (automated measuring the diameter stenosis, and transstenotic peak systolic and mean pressure gradients), was significantly further reduced or abolished. Hemodynamic transstenotic gradient and stenoses measurements were made during 21 renal artery stenting procedures; prior and following PTRA, and subsequent to stent deployment. The stent sizes placed in the renal arteries were 5 mm (19%), 6 mm (67%), and 7 mm (14%). The results were as follows: [table: see text] The balloon-expandable (Palmaz-Schatz) stent significantly further reduced, and in fact effectively abolished, the obstructive renal artery lesion in comparison to balloon angioplasty (PTRA). The stent's effectiveness with regard lesion recurrence, maintenance, and preservation of renal function; cure or improved management of hypertension; and survival will be determined by careful clinic follow-up. PMID:8402841

  7. Cardiac release of chemoattractants after ischaemia induced by coronary balloon angioplasty.

    PubMed Central

    Neumann, F J; Richardt, G; Schneider, M; Ott, I; Haupt, H M; Tillmanns, H; Schömig, A; Rauch, B

    1993-01-01

    OBJECTIVE--To investigate the release of chemoattractants after myocardial ischaemia during balloon angioplasty. DESIGN--Sampling of femoral arterial and coronary sinus blood before and immediately after the first balloon inflation during angioplasty. In a study group of 16 patients the balloon was kept expanded for two minutes, whereas in a control group of eight patients the first balloon inflation was brief (< 10 s). MAIN OUTCOME MEASURES--Chemotaxis of neutrophils from healthy donors towards patient plasma (Boyden chamber), superoxide anion production by normal neutrophils after incubation with patient plasma (cytochrome C reduction). RESULTS--In the study group, coronary sinus plasma after balloon deflation was more chemoattractive to normal neutrophils (median relative increase 24% (quartiles: 4%, 45%), p = 0.008) and induced a higher superoxide anion production in normal neutrophils (44% (10%, 97%), p = 0.013) than arterial plasma. Concomitantly, the degree of activation of patient neutrophils was increased in coronary sinus blood compared with arterial blood, as shown by an increased proportion of neutrophils reducing nitro-blue tetrazolium (21% (9%, 38%), p = 0.006) and a decreased neutrophil filter-ability (-16%(-3%, -40%), p = 0.003) in coronary sinus blood. In the study group before balloon inflation and in the control group before and after balloon inflation differences between arterial and coronary sinus blood were not significant. Signs of ischaemia (lactate release, ST segment changes) were only detected in the study group. CONCLUSION--After transient myocardial ischaemia during balloon angioplasty there is a local release of chemoattractants, associated with neutrophil activation. PMID:8037995

  8. Cutting-Balloon Angioplasty Versus Balloon Angioplasty as Treatment for Short Atherosclerotic Lesions in the Superficial Femoral Artery: Randomized Controlled Trial

    SciTech Connect

    Poncyljusz, Wojciech Falkowski, Aleksander; Safranow, Krzysztof Rac, Monika; Zawierucha, Dariusz

    2013-12-15

    Purpose: To evaluate the treatments of a short-segment atherosclerotic stenosis in the superficial femoral arteries with the cutting balloon angioplasty (CBA) versus conventional balloon angioplasty [percutaneous transluminal angioplasty (PTA)] in a randomized controlled trial. Material and Methods: The study group comprised 60 patients (33 men, 27 women; average age 64 years) with a short ({<=}5 cm) focal SFA de novo atherosclerotic stenosis associated with a history of intermittent claudication or rest pain. The primary end point of this study was the rate of binary restenosis in the treated segment 12 months after the intervention. All patients were evenly randomized to either the PTA or CBA treatment arms. Follow-up angiograms and ankle-brachial index (ABI) measurements were performed after 12 months. The evaluation of the restenosis rates and factors influencing its occurrence were calculated by logistic regression analysis. Results: In the intention-to-treat analysis, restenosis rates after 2-month follow-up were 9 of 30 (30 %) in the PTA group and 4 of 30 (13 %) in the CBA group (p = 0.117). In the actual treatment analysis, after exclusion of patients who required nitinol stent placement for a suboptimal result after angioplasty alone (5 patients in the PTA group and none in the CBA group), restenosis rates were 9 of 25 (36 %) and 4 of 30 (13 %), respectively (p = 0.049). In the intention-to-treat analysis there were also significant differences in ABI values between the PTA and CBA groups at 0.77 {+-} 0.11 versus 0.82 {+-} 0.12, respectively (p = 0.039), at 12 months. Conclusion: Based on the presented results of the trial, CBA seems to be a safer and more effective than PTA for treatment of short atherosclerotic lesions in the superior femoral artery.

  9. Use of mechanical devices for distal hemoperfusion during balloon catheter coronary angioplasty.

    PubMed

    Heibig, J; Angelini, P; Leachman, D R; Beall, M M; Beall, A C

    1988-01-01

    Previous attempts to protect the dependent myocardium during balloon catheter coronary angioplasty in animals and humans have had generally unsatisfactory results. This paper summarizes the authors' experience in investigating commercially available mechanical pumps for distal coronary hemoperfusion during balloon angioplasty. Both roller and piston pumps can attain adequate distal perfusion without significant side effects in the majority of patients. Our goal was to suppress angina for at least 5 min to prolong balloon inflation in awake patients. Minor T-wave changes without concomitant angina pectoris can be expected when the distal coronary bed is perfused with hypothermic blood. Side branch occlusion by the inflated balloon prevents effective protection of the corresponding part of the dependent myocardium during distal hemoperfusion, which may result in persistent angina and ST-T changes uncorrected by increasing the hemoperfusion rate. Distal coronary diffuse spasm, rare and transient, was the only immediate complication of this procedure. It is suggested that intense local wall stimulation could occur with a higher flow rate (jet effect). Improved balloon catheter pressure/flow characteristics and on-line continuous mechanical pumps should soon make distal coronary hemoperfusion through balloon catheters an accepted clinical technique. PMID:2973837

  10. Cutting-Balloon Angioplasty in Transplant Renal Artery Stenosis as First-Line Treatment in the Early Postoperative Period

    SciTech Connect

    Ucar, Adem; Yahyayev, Aghakishi; Bakkaloglu, Huseyin; Agayev, Ayaz; Aydin, Ali Emin; Rozanes, Izzet

    2011-02-15

    Percutaneous transluminal angioplasty has been successfully used for the treatment of transplant renal artery stenosis (RAS). Cutting-balloon angioplasty (CBA) is being used as a second option in pressure-resistant stenosis. It is thought that CBA is less traumatic and therefore restenosis occurs less frequently than in conventional angioplasty. This case report describes the unusual use of a cutting balloon in transplant RAS as a first option in the early postoperative period. Long-term follow-up data are also presented.

  11. [Angioscopic evaluation of the immediate result of coronary angioplasty in relation to balloon inflation time].

    PubMed

    Eltchaninoff, H; Cribier, A; Koning, R; Jolly, N; Baala, B; Farid, N; Letac, B

    1994-06-01

    The aim of this study was to assess the effects of coronary angioplasty on the intima with respect to the duration of balloon inflation by percutaneous angioplasty. Twenty-seven patients were randomized according to the total duration of balloon inflation: Group I "standard" duration (total duration < or = 3 min, N = 13) and Group II: prolonged duration (total duration > or = 12 min, N = 14); the type and distribution of the lesions were comparable in the two groups. The results of angioplasty were evaluated immediately after dilatation by angiography and angioscopy. Angioscopy was performed without failure or complications with perfect definition of the images in all cases. Angioscopy showed 1) intimal tears, 2) thrombi, 3) longitudinal dissections. A classification in three grades was used taking the apparent gravity of the lesions into consideration. The mean duration of balloon inflation in Group I was 205 +/- 45 s and 958 +/- 129 s in Group II. The residual stenosis was 36 +/- 8% in Group I and 26 +/- 10% in Group II (p < 0.05). Angioscopy showed the frequency of intimal tears to be twice greater in Group I (9 cases) than in Group II (4 cases) (p = 0.05). Intravascular thrombi were observed in 13 cases, 6 in Group I and 7 in Group II. One case of longitudinal dissection was observed in each group: only one of these two cases was detected at angiography. The authors conclude that repeated and prolonged balloon inflations improve the immediate results of angioplasty with less residual stenosis at angiography and a lower incidence of intimal tears at angioscopy. PMID:7702414

  12. Characterization of Pebax angioplasty balloon surfaces with AFM, SEM, TEM, and SAXS.

    PubMed

    Warner, Jacob A; Forsyth, Bruce; Zhou, Fang; Myers, Jason; Frethem, Chris; Haugstad, Greg

    2016-04-01

    In the medical device industry, angioplasty balloons have been widely used in the less invasive treatment of heart disease by expanding and relieving clogged structures in various arterial segments. However, new applications using thin coatings on the balloon surface have been explored to enhance therapeutic value in the delivery of pharmaceuticals (drug-elution) or control thermal energy output (RF ablation). In this study, angioplasty balloon materials comprised of poly(ether-block-amide) (Pebax) were investigated via atomic force microscopy (AFM), transmission electron microscopy (TEM), scanning electron microscopy (SEM), and small-angle X-ray scattering (SAXS) to characterize physical properties at the balloon surface that may affect coating adhesion. The soft segment of this Pebax 1074 material is polyethylene oxide (PEO) and the hard segment is nylon-12. The morphology of the hard segments of this block co-polymer are found via AFM stiffness measurements to be (40 ± 20) nm by (300 ± 150) nm and are oriented parallel to the surface of the balloon. SAXS measurements found the lamellar spacing to be (18.5 ± 0.5) nm, and demonstrate a preferential orientation in agreement with TEM and AFM measurements. Fixation of this balloon in resin, followed by cryo-sectioning is shown to provide a novel manner in which to investigate surface characteristics on the balloon such as material or coating thickness as well as uniformity in comparison to the bulk structure. These outputs were deemed critical to improve overall balloon processing such as molding and surface treatment options for robust designs toward better procedural outcomes targeting new therapeutic areas. PMID:25891789

  13. Balloon Angioplasty - The Legacy of Andreas Grüntzig, M.D. (1939-1985).

    PubMed

    Barton, Matthias; Grüntzig, Johannes; Husmann, Marc; Rösch, Josef

    2014-01-01

    In 1974, at the Medical Policlinic of the University of Zürich, German-born physician-scientist Andreas Grüntzig (1939-1985) for the first time applied a balloon-tipped catheter to re-open a severely stenosed femoral artery, a procedure, which he initially called "percutaneous transluminal dilatation". Balloon angioplasty as a therapy of atherosclerotic vascular disease, for which Grüntzig and Charles T. Dotter (1920-1985) received a nomination for the Nobel Prize in Physiology or Medicine in 1978, became one of the most successful examples of translational medicine in the twentieth century. Known today as percutaneous transluminal angioplasty (PTA) in peripheral arteries or percutaneous transluminal coronary angioplasty (PTCA) or percutaneous coronary intervention (PCI) in coronary arteries, balloon angioplasty has become the method of choice to treat patients with acute myocardial infarction or occluded leg arteries. On the occasion of the 40(th) anniversary of balloon angioplasty, we summarize Grüntzig's life and career in Germany, Switzerland, and the United States and also review the developments in vascular medicine from the 1890s to the 1980s, including Dotter's first accidental angioplasty in 1963. The work of pioneers of catheterization, including Pedro L. Fariñas in Cuba, André F. Cournand in France, Werner Forssmann, Werner Porstmann and Eberhard Zeitler in Germany, António Egas Moniz and Reynaldo dos Santos in Portugal, Sven-Ivar Seldinger in Sweden, and Barney Brooks, Thomas J. Fogarty, Melvin P. Judkins, Richard K. Myler, Dickinson W. Richards, and F. Mason Sones in the United States, is discussed. We also present quotes by Grüntzig and excerpts from his unfinished autobiography, statements of Grüntzig's former colleagues and contemporary witnesses, and have included hitherto unpublished historic photographs and links to archive recordings and historic materials. This year, on June 25, 2014, Andreas Grüntzig would have celebrated his 75(th

  14. Preliminary results utilizing a new percutaneous transluminal coronary angioplasty balloon catheter.

    PubMed

    Talley, J D; Joseph, A; Kupersmith, J

    1990-06-01

    We report our initial experience with a new percutaneous transluminal coronary angioplasty (PTCA) balloon catheter and compare it to a similar over-the-wire system in a retrospective, nonrandomized fashion. There was no statistical difference in pre-PTCA angiographic indices and post-PTCA angiographic and clinical success rates between the two groups. There was a trend toward a decrease in length of fluoroscopy (P = .08) and a significant decrease in the amount of contrast utilized (P = .007) with the new balloon catheter. Several new construction features of the new catheter account for this improvement and are discussed. The long-term success of this balloon catheter remains to be investigated. PMID:2354509

  15. Detection of platelet deposition at the site of peripheral balloon angioplasty using indium-111 platelet scintigraphy

    SciTech Connect

    Pope, C.F.; Ezekowitz, M.D.; Smith, E.O.; Rapoport, S.; Glickman, M.; Sostman, H.D.; Zaret, B.L.

    1985-02-01

    Restenosis after balloon angioplasty may be mediated through platelet deposition at the site of arterial dilatation. The purpose of this study was to determine whether platelet deposition at the site of dilatation could be detected using indium-111 platelet scintigraphy. Fifteen patients, aged 60 +/- 9 years, with iliac or femoral (n . 12), renal artery (n . 2) or distal aortic (n . 1) stenoses were studied. All patients received intravenous heparin at the time of dilatation. Labeled platelets containing 471 +/- 65 muCi indium-111 were injected 0.25 to 4 hours after dilatation and 1 to 24 hours after imaging. In 11 of 12 patients with iliac and femoral dilatations, focal uptake was demonstrated at the angioplasty site. In 4 patients (2 patients with renal, 1 patient with iliofemoral, and 1 with distal aortic stenoses), uptake at the dilatation sites was not detected. This preliminary study indicates that despite intravenous heparin, platelets accumulate at sites of balloon dilatation. Platelet scintigraphy may be useful in predicting sites of future narrowing after angioplasty and may be used to test the efficacy of antiplatelet therapy in retarding restenosis.

  16. A model for optical and thermal analysis of laser balloon angioplasty.

    PubMed

    Cheong, W F; Welch, A J

    1989-12-01

    Laser balloon angioplasty is modeled using an infinitely long cylinder possessing axisymmetry. The balloon surface is assumed to be uniformly irradiated by diffuse light at 1060 nm delivered from within the inner balloon core. The diffusion approximation to the radiative transport equation is solved for a single layer of homogeneous medium enclosing the transparent fluid-filled balloon. The computed light fluence rate (W.cm-2) just beneath the tissue surface is 4.7 times the primary irradiance, owing to scattering and secondary irradiance from the "integrating cylinder" effect of backscattered light into the inner core. The transient temperature response of the heated tissue is then calculated using an implicit finite difference solution of the heat conduction equation for concentric layers of varying thermal properties. Finally, the extent of damage is analyzed using the Arrhenius rate process model. Changes in optical and thermal properties with temperature and thermal phase transitions have been omitted in all our analyses. Irradiances which decrease with time can produce a "temperature plateau" for a longer time period than a constant irradiance of equal total energy output. This may be clinically important. Flexible boundary conditions at the balloon interface permit simulation of a "hot contact surface," such as a black balloon absorbing all incident laser power. In this situation, the computed surface damage is consistently higher than that obtained by LBA of equivalent energy output. PMID:2532617

  17. Comparison of activation process of platelets and neutrophils after coronary stent implantation versus balloon angioplasty for stable angina pectoris.

    PubMed

    Inoue, T; Sohma, R; Miyazaki, T; Iwasaki, Y; Yaguchi, I; Morooka, S

    2000-11-15

    The pathophysiologic features of stent-induced cellular responses of platelets and leukocytes have not been established. This study was designed to clinically investigate the activation of platelets and neutrophils after coronary stenting and to identify its effects on the long-term results of coronary stents. Forty-eight consecutive patients with left anterior descending coronary artery disease indicating coronary intervention were randomly assigned to either a balloon angioplasty group or a coronary stent group. Flow cytometric analysis demonstrated that the transcardiac gradient (the value of coronary sinus blood minus the value of peripheral blood) of platelet surface expression of CD62P (p < 0.001) and CD63 (p < 0.01) increased immediately after coronary stenting, but increased less significantly immediately after balloon angioplasty (CD62P, p < 0.01; CD63, p < 0.05). These increases were persistently observed after coronary stenting but transiently after balloon angioplasty alone during a 48-hour observation period after the procedures. The gradient for neutrophil surface expression of CD11b increased, and that of CD62 L decreased 48 hours after coronary stenting (CD11b, p < 0.001; CD62 L, p < 0.05), but these changes showed less significance 48 hours after balloon angioplasty alone (CD11b, p < 0.05; CD62 L, p = NS). The gradients 48 hours after the procedures for both CD62P (r = 0.39, p < 0.05) and CD11b (r = 0.44, p < 0.01) were independently correlated with the late loss in the stent group, whereas the correlation was seen only for CD11b (r = 0.38, p < 0.05) in the balloon angioplasty group. Both platelet and neutrophil activation was greater after coronary stenting than after balloon angioplasty. Cellular interactions between platelets and neutrophils may be related to the progression of neointimal proliferation leading to restenosis after coronary stent implantation. PMID:11074199

  18. Safety and Efficacy of Transluminal Balloon Angioplasty Using a Compliant Balloon for Severe Cerebral Vasospasm after an Aneurysmal Subarachnoid Hemorrhage

    PubMed Central

    Choi, Beom Jin; Lee, Jae Il; Ko, Jun Kyeung; Park, Hwa Seung; Choi, Chang Hwa

    2011-01-01

    Objective Vasospasm of cerebral vessels remains a major source of morbidity and mortality after an aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study was to evaluate the safety and efficacy of transluminal balloon angioplasty (TBA) for SAH-induced vasospasm. Methods Eleven patients with an angiographically confirmed significant vasospasm (>50% vessel narrowing and clinical deterioration) were studied. A total of 54 vessel segments with significant vasospasm were treated by TBA. Digital subtraction angiography was used to confirm the presence of vasospasm, and TBA was performed to dilate vasospastic arteries. Medical and angiographic reports were reviewed to determine technical efficacy and for procedural complications. Results TBA using Hyper-Glide or Hyper-Form balloons (MicroTherapeutics, Irvine, CA) was successfully accomplished in 88.9% vasospastic segments (48 of 54), namely, in the distal internal carotid artery (100%, n=7), the middle cerebral artery (100%), including the M1 (n=10), M2 (n=10), and M3 segments (n=4), in the vertebral artery (100%, n=2), basilar artery (100%, n=1), and in the anterior cerebral artery (ACA), including the A1 (66%), A2 (66%), and A3 segments (100%). Vessel diameters significantly increased after TBA. There were no cases of vessel rupture or thromboembolic complications. GCS at one day after TBA showed an improvement in all patients except one. Conclusion This study suggests that TBA using Hyper-Glide or Hyper-Form balloons is a safe and effective treatment for subarachnoid hemorrhage-induced cerebral vasospasm. PMID:21556235

  19. Differential glomerular filtration rate in diagnosis of renovascular hypertension and follow-up of balloon angioplasty

    SciTech Connect

    Lamki, L.; Spence, J.D.; MacDonald, A.C.; Roulston, M.

    1986-03-01

    Two hundred nine hypertensive patients with high stimulated plasma renin levels were screened for renovascular hypertension using Tc-99m DTPA renal scintigraphy. Differential glomerular filtration rate (Diff-GFR) was obtained by integrating the area under the background-subtracted renogram of each kidney between 1 and 3 minutes. 50 patients who also had undergone selective renal angiography were divided into four groups according to Diff-GFR contribution by one of the kidneys. If one kidney contributed 45-50% of total GFR, this was regarded as normal. A Diff-GFR of less than 45% was very considered to be very suggestive of renovascular hypertension in the appropriate clinical setting, while a Diff-GFR of less than 20% indicated that the renal artery might not be amenable to successful balloon angioplasty. Diff-GFR following balloon angioplasty closely reflected the early clinical response of the patients--and in some cases progressive Diff-GFR improvement was observed several months later. Diff-GFR as a scintigraphic criterion for renovascular hypertension has a sensitivity of 93%, specificity of 74%, and accuracy of 85%.

  20. THE CORONARY ARTERY HISTOPATHOLOGIC RESPONSE TO ANGIOPLASTY BALLOON INJURY IN A SWINE MODEL IS GENDER- AND HORMONAL-DEPENDENT

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The effects of gender and exogenous estrogen on the histopathologic response of the left anterior descending coronary artery (LAD) to angioplasty balloon over-inflation were examined in this study. In addition, we sought to develop an animal model to predict adequately the effects of cardiovascular ...

  1. Critical appraisal of paclitaxel balloon angioplasty for femoral–popliteal arterial disease

    PubMed Central

    Herten, Monika; Torsello, Giovanni B; Schönefeld, Eva; Stahlhoff, Stefan

    2016-01-01

    Peripheral arterial disease, particularly critical limb ischemia, is an area with urgent need for optimized therapies because, to date, vascular interventions often have limited life spans. In spite of initial encouraging technical success after femoropopliteal percutaneous transluminal angioplasty or stenting, postprocedural restenosis remains the major problem. The challenging idea behind the drug-coated balloon (DCB) concept is the biological modification of the injury response after balloon dilatation. Antiproliferative drugs administered via DCBs or drug-eluting stents are able to suppress neointimal hyperplasia, the main cause of restenosis. This article reviews the results of DCB treatments of femoropopliteal and infrapopliteal lesions in comparison to standard angioplasty with uncoated balloons. A systematic literature search was performed in 1) medical journals (ie, MEDLINE), 2) international registers for clinical studies (ie, www.clinicaltrials.gov), and 3) abstracts of scientific sessions. Several controlled randomized trials with follow-up periods of up to 5 years demonstrated the efficacy of paclitaxel –DCB technology. However, calcified lesions seem to affect the efficacy of DCB. Combinations of preconditioning methods with DCBs showed promising results. Although the mechanical abrasion of calcium via atherectomy or laser ablation showed favorable periprocedural results, the long-term impact on restenosis and clinical outcome has to be demonstrated. Major advantages of the DCBs are the rapid delivery of drug at uniform concentrations with a single dose, their efficacy in areas wherein stents have been contraindicated until now (ie, bifurcation, ostial lesions), and in leaving no stent scaffold behind. Reinterventions are easier to perform because DCBs leave no metal behind. Various combinations of DCBs with other treatment modalities may prove to be viable options in future. The follow-up results of clinical studies will evaluate the long

  2. Critical appraisal of paclitaxel balloon angioplasty for femoral-popliteal arterial disease.

    PubMed

    Herten, Monika; Torsello, Giovanni B; Schönefeld, Eva; Stahlhoff, Stefan

    2016-01-01

    Peripheral arterial disease, particularly critical limb ischemia, is an area with urgent need for optimized therapies because, to date, vascular interventions often have limited life spans. In spite of initial encouraging technical success after femoropopliteal percutaneous transluminal angioplasty or stenting, postprocedural restenosis remains the major problem. The challenging idea behind the drug-coated balloon (DCB) concept is the biological modification of the injury response after balloon dilatation. Antiproliferative drugs administered via DCBs or drug-eluting stents are able to suppress neointimal hyperplasia, the main cause of restenosis. This article reviews the results of DCB treatments of femoropopliteal and infrapopliteal lesions in comparison to standard angioplasty with uncoated balloons. A systematic literature search was performed in 1) medical journals (ie, MEDLINE), 2) international registers for clinical studies (ie, www.clinicaltrials.gov), and 3) abstracts of scientific sessions. Several controlled randomized trials with follow-up periods of up to 5 years demonstrated the efficacy of paclitaxel -DCB technology. However, calcified lesions seem to affect the efficacy of DCB. Combinations of preconditioning methods with DCBs showed promising results. Although the mechanical abrasion of calcium via atherectomy or laser ablation showed favorable periprocedural results, the long-term impact on restenosis and clinical outcome has to be demonstrated. Major advantages of the DCBs are the rapid delivery of drug at uniform concentrations with a single dose, their efficacy in areas wherein stents have been contraindicated until now (ie, bifurcation, ostial lesions), and in leaving no stent scaffold behind. Reinterventions are easier to perform because DCBs leave no metal behind. Various combinations of DCBs with other treatment modalities may prove to be viable options in future. The follow-up results of clinical studies will evaluate the long-term impact

  3. Comparison of Paclitaxel-Coated Balloon Treatment and Plain Old Balloon Angioplasty for De Novo Coronary Lesions

    PubMed Central

    Her, Ae-Young; Ann, Soe Hee; Singh, Gillian Balbir; Kim, Yong Hoon; Yoo, Sang-Yong; Garg, Scot; Koo, Bon-Kwon

    2016-01-01

    Purpose This study compared the angiographic outcomes of paclitaxel-coated balloon (PCB) versus plain old balloon angioplasty (POBA) treatment for de novo coronary artery lesions. At present, there is no available data comparing the efficacy of PCB versus POBA for the treatment of de novo coronary lesions. Materials and Methods This multicenter retrospective observational study enrolled patients with de novo coronary lesions with a reference vessel diameter between 2.5 mm and 3.0 mm and lesion length ≤24 mm who were successfully treated with PCB or POBA. Angiographic measurements and quantitative coronary analysis were performed before and after the procedure, and at 9 months follow-up. Results A total of 72 patients (49 receiving PCB and 23 receiving POBA) were enrolled in this study. Late luminal loss was -0.12±0.30 mm in the PCB group and 0.25±0.50 mm in the POBA group (p<0.001). There was a higher percentage of binary restenosis (diameter stenosis ≥50%) in POBA, compared to PCB (30.4%, n=7 vs. 4.1%, n=2, p<0.001). Target vessel revascularization was higher in the POBA group (13.0%, n=3 vs. 0%, p=0.033). Conclusion PCB treatment of de novo coronary lesions showed better 9-month angiographic outcomes than POBA treatment alone. PMID:26847284

  4. Transauricular balloon angioplasty in rabbit thoracic aorta: a novel model of experimental restenosis

    PubMed Central

    2014-01-01

    Background The aim of this study was to demonstrate a percutaneous transauricular method of balloon angioplasty in high-cholesterol fed rabbits, as an innovative atherosclerosis model. Methods Twenty male New Zealand rabbits were randomly divided into two groups of ten animals, as follows: atherogenic diet plus balloon angioplasty (group A) and atherogenic diet alone (group B). Balloon angioplasty was performed in the descending thoracic aorta through percutaneous catheterization of the auricular artery. Eight additional animals fed regular diet were served as long term control. At the end of 9 week period, rabbits were euthanized and thoracic aortas were isolated for histological, immunohistochemical and biochemical analysis. Results Atherogenic diet induced severe hypercholesterolemia in both group A and B (2802 ± 188.59 and 4423 ± 493.39 mg/dl respectively) compared to the control animals (55.5 ± 11.82 mg/dl; P < 0.001). Group A atherosclerotic lesions appeared to be more advanced histologically (20% type IV and 80% type V) compared to group B lesions (50% type III and 50% type IV). Group A compared to group B atherosclerotic lesions demonstrated similar percentage of macrophages (79.5 ± 9.56% versus 84 ± 12.2%; P = 0.869), more smooth muscle cells (61 ± 14.10% versus 40.5 ± 17.07; P = 0.027), increased intima/media ratio (1.20 ± 0.50 versus 0.62 ± 0.13; P = 0.015) despite the similar degree of intimal hyperplasia (9768 ± 1826.79 μm2 versus 12205 ± 8789.23 μm2; P = 0.796), and further significant lumen deterioration (23722 ± 4508.11 versus 41967 ± 20344.61 μm2; P = 0.05) and total vessel area reduction (42350 ± 5819.70 versus 73190 ± 38902.79 μm2; P = 0.022). Group A and B animals revealed similar nitrated protein percentage (P = NS), but significantly higher protein nitration compared to control group (P < 0.01; P < 0.01, respectively

  5. Primary Cutting Balloon Angioplasty for Treatment of Venous Stenoses in Native Hemodialysis Fistulas: Long-Term Results from Three Centers

    SciTech Connect

    Bhat, Rajesh McBride, Kieran; Chakraverty, Sam; Vikram, Raghunandan; Severn, Alison

    2007-11-15

    Aim. To evaluate the technical success and patency rates following primary cutting balloon angioplasty for venous stenoses in native dialysis fistulas. Methods. Forty-one patients (26 men, 15 women; age range 26-82 years, average age 59 years) underwent 50 (repeat procedures in 9 patients) primary cutting balloon (PCB) angioplasty procedures in three institutions by three primary operators. The indication was primary stenosis in 21 patients, recurrent lesions in 15, and immature fistulas in 5. A PCB was used alone in 17 cases, but was followed by a larger standard balloon in 33 cases. Follow-up included ultrasound, flow analysis and urea reduction ratio, and ranged from 2 to 30 months (mean 14 months). Results. The technical success rate was 98%. All procedures were relatively painless. Two PCBs burst and 4 leaked, but without causing any morbidity. Nineteen fistulas were still working at last follow-up. Primary patency rates at 6, 12, and 24 months using Kaplan-Meier analysis were 88%, 73%, and 34%, respectively, and the primary assisted patencies were 90%, 75%, and 50%, respectively. Conclusion. PCB angioplasty has high technical success and low complication rates. The long-term patency rates are favorable for PCB angioplasty and compare favorably with other series.

  6. Efficacy of Local Molsidomine Delivery from a Hydrogel-Coated Angioplasty Balloon Catheter in the Atherosclerotic Porcine Model

    SciTech Connect

    Rolland, Pierre H.; Mekkaoui, Choukri; Palassi, Maria; Friggi, Alain; Moulin, Guy; Piquet, Philippe; Bartoli, Jean-Michel

    2003-02-15

    Purpose: To evaluate the therapeutic effects of local molsidomine delivery via a hydrogel-coated angioplasty balloon catheter during overstretch angioplasty in atheroscleroticswine iliac vessels. Molsidomine is retained in the arterial wall after local delivery for more than 72 hr and is slowly metabolized intolinsidomine, releasing nitric oxide (NO). Methods: A hydrogel-coated angioplasty balloon catheter was used to both deliver drug locally (150 mg molsidomine or placebo in the contralateral vessel) and dilate iliac vessels in nine Pietrin pigs that had been on an atherogenic diet for 5 months. Animals were killed at 3 hr(n = 2), 24 hr (n = 3) and 3 months(n = 3) after treatment. Iliac arteries were examined for wall pulsatility, histomorphometry, cell proliferation and platelet aggregation. Results: No significant therapeutic effects were detected 3 hr after treatment. At 24 hr, wall pulsatility,thrombo resistance and vascular cell homeostasis were significantly restored in the molsidomine-treated versus placebo group. At 3 months,molsidomine inhibited restenotic lesion development, except in scarred areas of histologically detectable adventitial/medial dissection. Conclusion: Local delivery of concentrated molsidomine from a hydrogel-coated angioplasty balloon catheter resulted in early NO-dependent vasodilation/stress normalization and antithrombotic and antiproliferative effects. In the medium term, molsidomine inhibited restenosis in the absence of vessel dissection.

  7. Site-targeted acoustic contrast agent detects molecular expression of tissue factor after balloon angioplasty

    NASA Astrophysics Data System (ADS)

    Hall, Christopher S.; Abendschein, Dana R.; Scherrer, David E.; Scott, Michael J.; Marsh, Jon N.; Wickline, Samuel A.; Lanza, Gregory M.

    2000-04-01

    Complex molecular signaling heralds the early stages of pathologies such as angiogenesis, inflammation, and cellular responses to mechanically damaged coronary arteries after balloon angioplasty. In previous studies, we have demonstrated acoustic enhancement of blood clot morphology with the use of a nongaseous, ligand-targeted acoustic nanoparticle emulsion delivered to areas of thrombosis both in vitro and in vivo. In this paper, we characterize the early expression of tissue factor which contributes to subsequent arterial restenosis. Tissue factor is a 42kd glycoprotein responsible for blood coagulation but also plays a well-described role in cancer metastasis, angiogenesis, and vascular restenosis. This study was designed to determine whether the targeted contrast agent could localize tissue factor expressed within the wall of balloon-injured arteries. Both carotid arteries of five pigs (20 kg) were injured using an 8 X 20 mm angioplasty balloon. The carotids were treated in situ with a perfluorocarbon nanoparticle emulsion covalently complexed to either specific anti-tissue factor polyclonal F(ab) fragments (treatment) or non-specific IgG F(ab) fragments (control). Intravascular ultrasound (30 MHz) images of the arteries were obtained before and after exposure to the emulsions. Tissue- factor targeted ultrasonic contrast agent acoustically enhanced the subintima and media at the site of balloon- induced injury compared with control contrast arteries (p less than 0.05). Immunohistochemical staining confirmed the presence of increased tissue factor at the sites of acoustic enhancement. Binding of the targeted agents was demonstrated in vitro by scanning electron microscope images of cultured smooth muscle cells that constitutively express tissue factor. This study demonstrates the concept of molecular imaging and localization of carotid arteries' tissue factor in vivo using a new, nanoparticulate emulsion. Enhancement of the visualization of the molecular

  8. Cutting-balloon angioplasty before drug-eluting stent implantation for the treatment of severely calcified coronary lesions

    PubMed Central

    Tang, Zhe; Bai, Jing; Su, Shao-Ping; Wang, Yu; Liu, Mo-Han; Bai, Qi-Cai; Tian, Jin-Wen; Xue, Qiao; Gao, Lei; An, Chun-Xiu; Liu, Xiao-Juan

    2014-01-01

    Background Severely calcified coronary lesions respond poorly to balloon angioplasty, resulting in incomplete and asymmetrical stent expansion. Therefore, adequate plaque modification prior to drug-eluting stent (DES) implantation is the key for calcified lesion treatment. This study was to evaluate the safety and efficacy of cutting balloon angioplasty for severely calcified coronary lesions. Methods Ninety-two consecutive patients with severely calcified lesions (defined as calcium arc ≥ 180° calcium length ratio ≥ 0.5) treated with balloon dilatation before DES implantation were randomly divided into two groups based on the balloon type: 45 patients in the conventional balloon angioplasty (BA) group and 47 patients in the cutting balloon angioplasty (CB) group. Seven cases in BA group did not satisfactorily achieve dilatation and were transferred into the CB group. Intravascular ultrasound (IVUS) was performed before balloon dilatation and after stent implantation to obtain qualitative and quantitative lesion characteristics and evaluate the stent, including minimum lumen cross-sectional area (CSA), calcified arc and length, minimum stent CSA, stent apposition, stent symmetry, stent expansion, vessel dissection, and branch vessel jail. In-hospital, 1-month, and 6-month major adverse cardiac events (MACE) were reported. Results There were no statistical differences in clinical characteristics between the two groups, including calcium arc (222.2° ± 22.2° vs. 235.0° ± 22.1°, P = 0.570), calcium length ratio (0.67 ± 0.06 vs. 0.77 ± 0.05, P = 0.130), and minimum lumen CSA before PCI (2.59 ± 0.08 mm2 vs. 2.52 ± 0.08 mm2, P = 0.550). After stent implantation, the final minimum stent CSA (6.26 ± 0.40 mm2 vs. 5.03 ± 0.33 mm2; P = 0.031) and acute lumen gain (3.74 ± 0.38 mm2 vs. 2.44 ± 0.29 mm2, P = 0.015) were significantly larger in the CB group than that of the BA group. There were not statistically differences in stent expansion, stent symmetry

  9. Cutting Balloon Angioplasty of Bilateral Renal Artery Stenosis Due to Takayasu Arteritis in a 5-Year-Old Child with Midterm Follow-Up

    SciTech Connect

    Gumus, Burcak Cevik, Halime; Vuran, Can; Omay, Oguz; Kocyigit, Ozgen Ilgaz; Turkoz, Riza

    2010-04-15

    The aim of this report is to demonstrate the successful endovascular treatment of bilateral renal artery stenosis due to Takayasu arteritis by cutting balloon angioplasty in a 5-year-old child with mid-term follow-up.

  10. Association Between Disruption of Fibrin Sheaths Using Percutaneous Transluminal Angioplasty Balloons and Late Onset of Central Venous Stenosis

    SciTech Connect

    Ni, Nina Mojibian, Hamid; Pollak, Jeffrey; Tal, Michael

    2011-02-15

    To compare the rates of central venous stenosis in patients undergoing hemodialysis who underwent disruption of fibrin sheath with percutaneous transluminal angioplasty balloons and those who underwent over-the-wire catheter exchange. This study is a retrospective review of 209 percutaneous transluminal angioplasty balloon disruption and 1304 over-the-wire catheter exchange procedures performed in 753 patients. Approval from the Human Investigations Committee was obtained for this study. Up to 10-year follow-up was performed. A {chi}{sup 2} test was used to compare the rates of central venous stenosis after balloon disruption versus catheter exchange. A t-test was used to compare time to central venous stenosis development. Of the 753 patients in the study, 127 patients underwent balloon disruption of fibrin sheath and 626 had catheter exchange. Within the balloon disruption group, 18 (14.2%) of 127 patients subsequently developed central venous stenosis, compared with 44 (7.0%) of 626 in the catheter exchange group (P < 0.01, {chi}{sup 2} test). Time to central venous stenosis development was approximately 3 years in both groups and not significantly different (1371 and 1010 days, P = 0.20). A total of 25.2% of patients in the balloon disruption group had four or more subsequent catheter exchanges, versus 12.6% in the catheter exchange group (P < 0.01, {chi}{sup 2} test). In conclusions, there is a possible association between percutaneous transluminal angioplasty balloon disruption of fibrin sheath and late-onset central venous stenosis. Because venography was not routinely performed in catheter exchange patients, future randomized studies are necessary to confirm these findings.

  11. Cryoplasty Versus Conventional Balloon Angioplasty of the Femoropopliteal Artery in Diabetic Patients: Long-Term Results from a Prospective Randomized Single-Center Controlled Trial

    SciTech Connect

    Spiliopoulos, Stavros Katsanos, Konstantinos; Karnabatidis, Dimitris; Diamantopoulos, Athanasios; Kagadis, George C.; Christeas, Nikolaos; Siablis, Dimitris

    2010-10-15

    The purpose of this study was to investigate the immediate and long-term results of cryoplasty versus conventional balloon angioplasty in the femoropopliteal artery of diabetic patients. Fifty diabetic patients (41 men, mean age 68 years) were randomized to cryoplasty (group CRYO; 24 patients with 31 lesions) or conventional balloon angioplasty (group COBA; 26 patients with 34 lesions) of the femoropopliteal artery. Technical success was defined as <30% residual stenosis without any adjunctive stenting. Primary end points included technical success, primary patency, binary in-lesion restenosis (>50%), and freedom from target lesion recanalization. Cox proportional hazards regression analysis was performed to adjust for confounding factors of heterogeneity. In total, 61.3% (19 of 31) in group CRYO and 52.9% (18 of 34) in group COBA were de novo lesions. More than 70% of the lesions were Transatlantic Inter-Society Consensus (TASC) B and C in both groups, and 41.4% of the patients in group CRYO and 38.7% in group COBA suffered from critical limb ischemia. Immediate technical success rate was 58.0% in group CRYO versus 64.0% in group COBA (p = 0.29). According to 3-year Kaplan-Meier estimates, there were no significant differences with regard to patient survival (86.8% in group CRYO vs. 87.0% in group COBA, p = 0.54) and limb salvage (95.8 vs. 92.1% in groups CRYO and COBA, respectively, p = 0.60). There was a nonsignificant trend of increased binary restenosis in group CRYO (hazard ratio [HR] 1.3; 95% CI 0.6-2.6, p = 0.45). Primary patency was significantly lower in group CRYO compared with group COBA (HR 2.2; 95% CI 1.1-4.3, p = 0.02). Significantly more repeat intervention events because of recurrent symptoms were required in group CRYO (HR 2.5; 95% CI 1.2-5.3, p = 0.01). Cryoplasty was associated with lower primary patency and more clinically driven repeat procedures after long-term follow-up compared with conventional balloon angioplasty.

  12. Does the method of transluminal coronary revascularisation influence re-stenosis? Balloon angioplasty, atherectomy and stents compared.

    PubMed

    Foley, D P; Keane, D; Serruys, P W

    1995-01-01

    Luminal renarrowing after successful coronary angioplasty is now recognised as a continuously distributed process which is determined largely by the extent of luminal increase achieved at angioplasty. In this study an alternative analytical approach is applied to determine whether luminal renarrowing following coronary intervention is related to the mechanism of luminal increase (ie by balloon, by atherectomy, by a self-expanding stainless steel mesh stent, or by a balloon-expandable tantalum coil stent). The results confirm the known proportional relationship between luminal renarrowing during follow-up and luminal improvement at intervention, regardless of the device used. However, significant differences were observed between the devices, which may reflect device-specific characteristics of the hyperplastic response to vessel injury and may have clinical implications. PMID:7742199

  13. Balloon Angioplasty – The Legacy of Andreas Grüntzig, M.D. (1939–1985)

    PubMed Central

    Barton, Matthias; Grüntzig, Johannes; Husmann, Marc; Rösch, Josef

    2014-01-01

    In 1974, at the Medical Policlinic of the University of Zürich, German-born physician-scientist Andreas Grüntzig (1939–1985) for the first time applied a balloon-tipped catheter to re-open a severely stenosed femoral artery, a procedure, which he initially called “percutaneous transluminal dilatation”. Balloon angioplasty as a therapy of atherosclerotic vascular disease, for which Grüntzig and Charles T. Dotter (1920–1985) received a nomination for the Nobel Prize in Physiology or Medicine in 1978, became one of the most successful examples of translational medicine in the twentieth century. Known today as percutaneous transluminal angioplasty (PTA) in peripheral arteries or percutaneous transluminal coronary angioplasty (PTCA) or percutaneous coronary intervention (PCI) in coronary arteries, balloon angioplasty has become the method of choice to treat patients with acute myocardial infarction or occluded leg arteries. On the occasion of the 40th anniversary of balloon angioplasty, we summarize Grüntzig’s life and career in Germany, Switzerland, and the United States and also review the developments in vascular medicine from the 1890s to the 1980s, including Dotter’s first accidental angioplasty in 1963. The work of pioneers of catheterization, including Pedro L. Fariñas in Cuba, André F. Cournand in France, Werner Forssmann, Werner Porstmann and Eberhard Zeitler in Germany, António Egas Moniz and Reynaldo dos Santos in Portugal, Sven-Ivar Seldinger in Sweden, and Barney Brooks, Thomas J. Fogarty, Melvin P. Judkins, Richard K. Myler, Dickinson W. Richards, and F. Mason Sones in the United States, is discussed. We also present quotes by Grüntzig and excerpts from his unfinished autobiography, statements of Grüntzig’s former colleagues and contemporary witnesses, and have included hitherto unpublished historic photographs and links to archive recordings and historic materials. This year, on June 25, 2014, Andreas Grüntzig would have celebrated

  14. Randomized Trial of the SMART Stent versus Balloon Angioplasty in Long Superficial Femoral Artery Lesions: The SUPER Study

    SciTech Connect

    Chalmers, Nicholas; Walker, Paul T.; Belli, Anna-Maria; Thorpe, Anthony P.; Sidhu, Paul S.; Robinson, Graham; Ransbeeck, Mariella van

    2013-04-15

    To determine whether primary stenting reduces the rate of restenosis compared with balloon angioplasty alone in the endovascular treatment of long superficial femoral artery lesions; and to assess the effect of treatment on quality of life. A total of 150 patients with superior femoral artery occlusion or severe stenosis of 5-22 cm length from 17 UK centers were randomized to either primary stenting with the SMART stent or balloon angioplasty (i.e., percutaneous transluminal angioplasty, PTA). Bailout stent placement was permitted in case of inadequate result from PTA. The primary end point was restenosis measured by duplex ultrasound at 1 year. Quality-of-life assessments were performed by the EuroQol (EQ)-5D questionnaire. Mean lesion length was 123.0 mm in the stent group and 116.8 mm in the PTA group. A total of 140 (93.3 %) of 150 had total occlusions. At 12 months' follow-up, restenosis measured by Duplex ultrasound was not significantly different between the stent and PTA groups by intention-to-treat or as-treated analyses: 47.2 versus 43.5 % (p = 0.84) and 40.8 versus 46.7 % (p = 0.68), respectively. There were fewer target lesion revascularizations in patients randomized to stenting, but this did not reach statistical significance (12.5 vs. 20.8 %, p = 0.26). There was no difference in the rate of amputation. Patients in both groups reported improved quality of life. Primary stenting of long lesions in predominantly occluded superficial femoral arteries does not reduce the rate of binary restenosis compared with balloon angioplasty and bailout stenting. Both treatment strategies conferred a meaningful and sustained improvement to the quality of life of patients with severe superficial femoral artery disease.

  15. Efficacy of cardiac rehabilitation after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension

    PubMed Central

    Fukui, Shigefumi; Ogo, Takeshi; Takaki, Hiroshi; Ueda, Jin; Tsuji, Akihiro; Morita, Yoshiaki; Kumasaka, Reon; Arakawa, Tetsuo; Nakanishi, Michio; Fukuda, Tetsuya; Yasuda, Satoshi; Ogawa, Hisao; Nakanishi, Norifumi; Goto, Yoichi

    2016-01-01

    Objective To determine safety and efficacy of cardiac rehabilitation (CR) initiated immediately following balloon pulmonary angioplasty (BPA) in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) who presented with continuing exercise intolerance and symptoms on effort even after a course of BPA; 2–8 sessions/patient. Methods Forty-one consecutive patients with inoperable CTEPH who underwent their final BPA with improved resting mean pulmonary arterial pressure of 24.7±5.5 mm Hg and who suffered remaining exercise intolerance were prospectively studied. Participants were divided into two groups just after the final BPA (6.8±2.3 days): patients with (CR group, n=17) or without (non-CR group, n=24) participation in a 12-week CR of 1-week inhospital training followed by an 11-week outpatient programme. Cardiopulmonary exercise testing, haemodynamics, and quality of life (QOL) were assessed before and after CR. Results No significant between-group differences were found for any baseline characteristics. At week 12, peak oxygen uptake (VO2), per cent predicted peak VO2 (70.7±9.4% to 78.2±12.8%, p<0.01), peak workload, and oxygen pulse significantly improved in the CR group compared with the non-CR group, with a tendency towards improvement in mental health-related QOL. Quadriceps strength and heart failure (HF) symptoms (WHO functional class, 2.2–1.8, p=0.01) significantly improved within the CR group. During the CR, no patient experienced adverse events or deterioration of right-sided HF or haemodynamics as confirmed via catheterisation. Conclusions The combination of BPA and subsequent CR is a new treatment strategy for inoperable CTEPH to improve exercise capacity to near-normal levels and HF symptoms, with a good safety profile. PMID:27220694

  16. Influence of plaque morphology on the mechanism of luminal enlargement after directional coronary atherectomy and balloon angioplasty.

    PubMed Central

    Marsico, F.; Kubica, J.; De Servi, S.; Angoli, L.; Bramucci, E.; Costante, A. M.; Specchia, G.

    1995-01-01

    OBJECTIVE--To relate the mechanism of luminal gain after directional atherectomy and balloon angioplasty to the morphological characteristics of the coronary lesions, assessed by intravascular ultrasound imaging. DESIGN--Intravascular ultrasound imaging was performed before and after the revascularisation procedure to assess the contribution of wall stretching and plaque reduction in luminal gain. SUBJECTS--32 patients undergoing balloon angioplasty and 29 undergoing directional coronary atherectomy. MAIN RESULTS--The main luminal area in vessels treated by balloon angioplasty increased from 1.51 (SD 0.30) to 3.91 (1.09) mm2 (P < 0.0001) with a concomitant increase in total vessel area from 11.44 (2.73) to 13.07 (2.83) mm2 (P < 0.0001). Therefore stretching of the vessel wall accounted for 68% of the luminal gain while plaque reduction accounted for the remaining 32%. This mechanism ranged from 45% in non-calcific plaques to 81% in echogenic plaques. The main luminal area in vessels treated by directional atherectomy increased from 1.49 (0.32) to 4.68 (1.73) mm2 (P < 0.0001), with a concomitant increase of total vessel area from 13.61 (4.67) to 15.2 (4.04) mm2 (P = 0.006). Thus stretching of the vessel wall accounted for 49% of the luminal area gain and plaque reduction for the remaining 51%. The presence of calcium influenced the relative contribution of these two mechanisms to the final luminal gain after directional atherectomy, since in calcific plaques stretching of the vessel wall accounted for only 9% of the luminal gain as compared to 56% in non-calcific plaques. After balloon angioplasty there was greater evidence of coronary dissections (32% v 3% after directional atherectomy, P < 0.01) and plaque fissure (60% v 0%, P < 0.01). Plaque fissure was more frequently seen in echolucent and concentric lesions, whereas dissections prevailed in echogenic and eccentric lesions. CONCLUSIONS--Intravascular ultrasound imaging may allow the assessment of acute changes

  17. MR-guided balloon angioplasty of stenosed aorta: in vivo evaluation using near-standard instruments and a passive tracking technique.

    PubMed

    Godart, F; Beregi, J P; Nicol, L; Occelli, B; Vincentelli, A; Daanen, V; Rey, C; Rousseau, J

    2000-10-01

    The purpose of this study was to assess the feasibility of magnetic resonance (MR)-guided balloon angioplasty of a stenosed aorta on an open low-field magnet using a passive tracking technique. Visualization of vessels and position of instruments were realized by using a fast low-angle shot (FLASH) sequence. Catheters and guidewire were prepared for susceptibility-based MR visualization. Standard balloon catheters were inflated with diluted gadolinium, and nitinol guidewires were modified by incorporation of iron oxide markers into their walls. After validation on a flow phantom, balloon angioplasty was performed on an in vivo model of arterial stenosis. Creation of abdominal aorta stenosis was realized in five piglets. MR-guided balloon angioplasty of the aorta was performed with success in all but one. In one of them, stent implantation was achieved in the descending aorta. Balloon angioplasty using a passive tracking technique is a simple concept that can be realized with near-standard instruments and any MR imaging system. This represents an advance toward MR-guided vascular interventions in the future. PMID:11042648

  18. Inadvertent intracoronary stent extraction 10 months after implantation complicating cutting balloon angioplasty for in-stent restenosis

    SciTech Connect

    Almeda, Francis Q.; Billhardt, Roger A

    2003-09-01

    We report the case of an unusual complication for Cutting Balloon Angioplasty (CBA) during treatment for instent restenosis (ISR), which resulted in inadvertent intracoronary stent extraction 10 months after implantation. In this case report, CBA was utilized to treat an ISR lesion in the distal right coronary artery (RCA). Due to difficulty in withdrawing the cutting balloon into the guide after treatment of the lesion, the entire system (guide, cutting balloon, and guidewire) was removed as a unit from the body. Upon examination of the system, the previously placed stent in the distal RCA was attached to the microtomes of the cutting balloon. Although the precise mechanisms for stent extraction in this case remain speculative, the initial stent used in the distal RCA may have been undersized, and this may have played a major role in this complication. Although there is limited data regarding the optimal strategy to treat the site of the inadvertent stent extraction, we opted to re-stent the area with a properly-sized coronary stent. Following the intervention, there was no residual stenosis with TIMI 3 flow through the vessel. The patient remained asymptomatic and a serum troponin drawn 18 hours after the procedure was normal, and he was discharged the next day. The interventionist must be vigilant about this rare but serious complication when applying CBA in the treatment of ISR, particularly when an undersized or underdeployed stent is suspected.

  19. Clinical impact and risk stratification of balloon angioplasty for femoropopliteal disease in nitinol stenting era: Retrospective multicenter study using propensity score matching analysis

    PubMed Central

    Tsuchiya, Taketsugu; Takamura, Takaaki; Soga, Yoshimitsu; Iida, Osamu; Hirano, Keisuke; Suzuki, Kenji; Yamaoka, Terutoshi; Miyashita, Yusuke; Kitayama, Michihiko; Kajinami, Koji

    2016-01-01

    Objective: Nitinol stenting could bring the better outcome in endovascular therapy for femoropopliteal disease. However, it might be expected that recent marked advances in both device technology and operator technique had led to improved efficacy of balloon angioplasty even in this segment. The aims of this study were to evaluate the clinical impact of balloon angioplasty for femoropopliteal disease and make risk stratification clear by propensity score matching analysis. Methods: Based on the multicenter retrospective data, 2758 patients (balloon angioplasty: 729 patients and nitinol stenting: 2029 patients), those who underwent endovascular therapy for femoropopliteal disease, were analyzed. Results: The propensity score matching procedure extracted a total of 572 cases per group, and the primary patency rate of balloon angioplasty and nitinol stenting groups after matching was significantly the same (77.2% vs 82.7% at 1 year; 62.2% vs 64.3% at 3 years; 47.8% vs 54.3% at 5 years). In multivariate Cox hazard regression analysis, significant predictors for primary patency were diabetes mellitus, regular dialysis, cilostazol use, chronic total occlusion, and intra-vascular ultra-sonography use. The strategy of balloon angioplasty was not evaluated as a significant predictor for the primary patency. After risk stratification using five items (diabetes mellitus, regular dialysis, no use of intra-vascular ultra-sonography, chronic total occlusion, and no use of cilostazol: the DDICC score), the estimated primary patency rates of each group (low, DDICC score 0–2; moderate, DDICC score 3; high risk, DDICC score 4–5) were 88.6%, 78.3%, and 63.5% at 1 year; 75.2%, 60.7%, and 39.8% at 3 years; and 66.0%, 47.1%, and 26.3% at 5 years (p < 0.0001). The primary patency rate of balloon angioplasty and nitinol stenting groups was significantly the same in each risk stratification. Conclusion: This study suggests that balloon angioplasty does not have

  20. Absence of Bacteria on Coronary Angioplasty Balloons from Unselected Patients: Results with Use of a High Sensitivity Polymerase Chain Reaction Assay

    PubMed Central

    Hansen, Gorm Mørk; Nilsson, Martin; Nielsen, Claus Henrik; Holmstrup, Palle; Helqvist, Steffen; Tolker-Nielsen, Tim; Givskov, Michael; Hansen, Peter Riis

    2015-01-01

    Periodontitis is a chronic, bacterially-induced inflammatory disease of the tooth-supporting tissues, which may result in transient bacteremia and a systemic inflammatory response. Periodontitis is associated with coronary artery disease independently of established cardiovascular risk factors, and translocation of bacteria from the oral cavity to the coronary arteries may play a role in the development of coronary artery disease. Very few studies have used angioplasty balloons for in vivo sampling from diseased coronary arteries, and with varying results. Therefore, the aim of this study was to assess if bacterial DNA from primarily oral bacteria could be detected on coronary angioplasty balloons by use of an optimized sampling process combined with an internally validated sensitive polymerase chain reaction (PCR) assay. Coronary angioplasty balloons and control samples from a total of 45 unselected patients with stable angina, unstable angina/non-ST elevation myocardial infarction, and ST-elevation myocardial infarction (n = 15 in each group) were collected and analyzed using a PCR assay with high sensitivity and specificity for 16S rRNA genes of the oral microbiome. Despite elimination of extraction and purification steps, and demonstration of sensitivity levels of 25–125 colony forming units (CFU), we did not detect bacterial DNA from any of the coronary angioplasty balloons. A subsequent questionnaire indicated that the prevalence of periodontitis in the study cohort was at least 39.5%. Although coronary angioplasty balloons are unlikely to be useful for detection of bacteria with current PCR techniques in unselected patients with coronary artery disease, more studies are warranted to determine the extent to which bacteria contribute to atherosclerosis and its clinical manifestations and whether the presence of bacteria in the arteries is a transient phenomenon. PMID:26695491

  1. Absence of Bacteria on Coronary Angioplasty Balloons from Unselected Patients: Results with Use of a High Sensitivity Polymerase Chain Reaction Assay.

    PubMed

    Hansen, Gorm Mørk; Nilsson, Martin; Nielsen, Claus Henrik; Holmstrup, Palle; Helqvist, Steffen; Tolker-Nielsen, Tim; Givskov, Michael; Hansen, Peter Riis

    2015-01-01

    Periodontitis is a chronic, bacterially-induced inflammatory disease of the tooth-supporting tissues, which may result in transient bacteremia and a systemic inflammatory response. Periodontitis is associated with coronary artery disease independently of established cardiovascular risk factors, and translocation of bacteria from the oral cavity to the coronary arteries may play a role in the development of coronary artery disease. Very few studies have used angioplasty balloons for in vivo sampling from diseased coronary arteries, and with varying results. Therefore, the aim of this study was to assess if bacterial DNA from primarily oral bacteria could be detected on coronary angioplasty balloons by use of an optimized sampling process combined with an internally validated sensitive polymerase chain reaction (PCR) assay. Coronary angioplasty balloons and control samples from a total of 45 unselected patients with stable angina, unstable angina/non-ST elevation myocardial infarction, and ST-elevation myocardial infarction (n = 15 in each group) were collected and analyzed using a PCR assay with high sensitivity and specificity for 16S rRNA genes of the oral microbiome. Despite elimination of extraction and purification steps, and demonstration of sensitivity levels of 25-125 colony forming units (CFU), we did not detect bacterial DNA from any of the coronary angioplasty balloons. A subsequent questionnaire indicated that the prevalence of periodontitis in the study cohort was at least 39.5%. Although coronary angioplasty balloons are unlikely to be useful for detection of bacteria with current PCR techniques in unselected patients with coronary artery disease, more studies are warranted to determine the extent to which bacteria contribute to atherosclerosis and its clinical manifestations and whether the presence of bacteria in the arteries is a transient phenomenon. PMID:26695491

  2. Stent underexpansion in angiographic guided percutaneous coronary intervention, despite adjunctive balloon post-dilatation, in drug eluting stent era

    PubMed Central

    Taherioun, Mehrdad; Namazi, Mohammad Hassan; Safi, Morteza; Saadat, Habibolah; Vakili, Hossein; Alipour-Parsa, Saeed; Rajabi-Moghadam, Hasan; Pedari, Shamsedin

    2014-01-01

    BACKGROUND Stent underexpansion is the most powerful predictor of long-term stent patency and clinical outcome. The purpose of this study was to evaluate the incidence and predictors of stent underexpansion despite adjunctive post-dilatation with non-compliant balloon. METHODS After elective coronary stent implantation and adjunctive post-dilatation with non-compliant balloon and optimal angiographic result confirmed by the operator, intravascular ultrasound (IVUS) was performed for all the treated lesions. If the treated lesions fulfilled the IVUS criteria, they are considered as the optimal stent group; if not, they are considered as the suboptimal group. RESULTS From 50 patients enrolled in this study 39 (78%) had optimal stent deployment and 11 (22%) had suboptimal stent deployment. In the suboptimal group 7 (14%) had underexpansion, 2 (4%) malposition, and 2 (4%) had asymmetry. There were no stent edge dissections detected by IVUS. We did not find any correlation between lesion calcification, ostial lesions, stent length, and stent underexpansion. Stent diameter ≤ 2.75 mm had a strong correlation with stent underexpansion. CONCLUSION Despite adjunctive post-dilatation with noncompliant balloon, using a relatively small stent diameter was a strong predictor for underexpansion. IVUS guided percutaneous coronary intervention (PCI) may be considered for drug eluting stent (DES) implantation in relatively small vessels. PMID:24963308

  3. Elastic Recoil after Balloon Angioplasty in Hemodialysis Accesses: Does It Actually Occur and Is It Clinically Relevant?

    PubMed

    Rajan, Dheeraj K; Sidhu, Arshdeep; Noel-Lamy, Maxime; Mahajan, Ashish; Simons, Martin E; Sniderman, Kenneth W; Jaskolka, Jeffrey; Tan, Kong Teng

    2016-06-01

    Purpose To qualify and quantify elastic recoil and determine its effect on access patency. Materials and Methods Research ethics board approval was obtained and all patients signed an informed consent form. This was a prospective, nonrandomized study of mature accesses that underwent balloon percutaneous transluminal angioplasty (PTA) between January 2009 and December 2012. After PTA, completion fistulography was performed at 0-, 5-, 10-, and 15-minute intervals. From Digital Imaging and Communications in Medicine images, percentage of lesion stenosis before and after PTA was measured at each time point. A total of 76 patients (44 men, 32 women; mean age, 59.6 years) were enrolled and underwent 154 PTAs in 56 grafts and 98 fistulas. Venous elastic recoil was defined as recurrent luminal narrowing greater than 50% within 15 minutes after full effacement of the stenosis by the angioplasty balloon. Data collected included sex, age, access type and location, lesion location, length, and time to next intervention. Access patency was estimated by using Kaplan-Meier survival method, association of variables with the risk of loss of patency was assessed by using a Cox proportional hazards model, and a multiple variable model was examined by considering all variables. Results Technical success of PTA with less than 30% residual stenosis was 78%. By 15 minutes, 15.6% (24 of 154) of treated lesions recurrently narrowed by more than 50%, with a majority observed at 5 minutes (15 of 24). Technical failure of PTA was predictive of elastic recoil (P < .001), as was cephalic arch stenosis in fistulas (P = .047) and autogenous fistulas (P = .04). Elastic recoil, when it did occur, did not influence patency. Six-month primary patency was 34.8% in grafts and 47.1% in fistulas. Conclusion Venous elastic recoil after PTA of stenoses in hemodialysis access circuits is common, but its occurrence does not influence access primary patency after PTA. (©) RSNA, 2015. PMID:26694051

  4. The Role of 'Cutting' Balloon Angioplasty for the Treatment of Short Femoral Bifurcation Steno-Obstructive Disease

    SciTech Connect

    Cotroneo, Antonio Raffaele; Iezzi, Roberto

    2010-10-15

    This study was designed to report our experience with 'cutting' balloon angioplasty (CBA) for the treatment of short femoral bifurcation arterial stenosis. Between March 2005 and September 2007, 18 consecutive patients who were high-risk for surgery with critical limb ischemia or severe lifestyle-limiting claudication underwent 'cutting' balloon angioplasty (4-6 mm diameter/15-20-mm length) for the treatment of 27 focal (<3 cm) severe fibro-calcified stenosis of the common femoral artery (n = 14) and/or the proximal part of the superficial femoral artery (n = 6) or profunda femoris (n = 7). Baseline patient demographic data, pre- and post-procedural patient clinical data, and procedural results were recorded. Follow-up consisted of clinical check-up and color duplex ultrasonography (CDU) examination 1, 3, 6, 12, and 18 months after the procedure. All endovascular treatments were successfully performed with clinical success obtained for all patients. No complications occurred during all treatments and no patient required surgical conversion or placement of a stent because of recoil, dissection, or arterial tears. No acute vessel closure was registered. During a mean follow-up of 9.4 (range, 6-18) months, endovascular treatment (CBA) was performed for restenosis/occlusion of seven lesions (25.9%) in four patients, whereas surgical treatment (endarterectomy with patch) for restenosis/occlusion of three lesions (11.1%) was performed in two patients with a consequent reintervention rate of 37%. Primary and secondary patency rates were 84.6 and 88.4% at 6 months and 57.9 and 79.6% at 12 months, respectively. No major limb amputation was performed, with a 12-month limb salvage rate of 88.9%. CBA seems to be a valuable tool for the endovascular treatment of focal femoral bifurcation stenotic lesions for patients who are poor candidates for surgery.

  5. Insertion of Self-Expandable Nitinol Stents Without Previous Balloon Angioplasty Reduces Restenosis Compared with PTA Prior to Stenting

    SciTech Connect

    Harnek, Jan; Zoucas, Evita; Stenram, Unne; Cwikiel, Wojciech

    2002-10-15

    Purpose: To compare the development of intimal hyperplasia after deployment of a self-expanding nitinol stent with and without previous percutaneous transluminal balloon angioplasty (PTA), with the results after PTA alone. Methods: In nine healthy pigs, the iliac arteries were divided into three groups: group 1 (n = 6 arteries) was treated with PTA; group 2 n 6)with insertion of self-expanding stents after PTA; and group 3 (n = 6) with stent insertion without previous PTA. After 8 weeks the vessels were examined with intravascular ultrasonography,histologic examination and morphometric analysis. Results: Although the injury index in group 1 (0.17{+-} 0.57) was lower (p <0.05) than in group 2 (0.26 {+-} 0.06) and group 3 (0.26 {+-} 0.08), PTA-treated arteries showed significantly (p <0.05) reduced mean luminal gain (0.53 {+-} 2.84) compared with arteries treated with PTA prior to stenting (2.58 {+-} 1.38) and compared with stenting alone (4.65 {+-}5.34). Stenting after PTA resulted in a higher (p<0.05) restenosis index (2.63 {+-} 1.06) compared with stenting without PTA (1.35 {+-} 0.59). Group 2 also had a significantly thicker intimap <0.05) and 83% and 74% higher intima/mediaratio (p <0.05) compared with groups 1 and 3, respectively. Conclusion: Insertion of a self-expandable nitinol stent without previous PTA results in less intimalhyperplasia than if PTA is performed prior to stenting, suggesting that direct stenting can be used in angioplasty sessions with a favorable outcome.

  6. Local delivery of dexamethasone for prevention of neointimal proliferation in a rat model of balloon angioplasty.

    PubMed Central

    Villa, A E; Guzman, L A; Chen, W; Golomb, G; Levy, R J; Topol, E J

    1994-01-01

    A periadventitial polymer system is an alternative local drug delivery technique to obtain and maintain high tissue levels of the drug at the site of vascular injury. To determine if local periadventitial delivery of dexamethasone decreases neointimal proliferation after balloon vascular injury, in three groups of Sprague-Dawley rats, 5% dexamethasone, 0.5% dexamethasone, and placebo silicone polymers were implanted around the left common carotid artery after balloon injury. In a fourth group, placebo polymers were implanted without balloon injury. Dexamethasone serum and tissue levels after polymer implantation were significantly higher in the 5% dexamethasone group compared with the 0.5% dexamethasone group. There was no neointima formation in any of the arterial segments covered with placebo polymers for 3 wk, but without balloon injury. In the arterial segments covered by the 5 and 0.5% dexamethasone polymers, there was a 76 and 75% reduction in intima/media ratios, respectively, compared with the placebo group (5% dexamethasone, 0.26 +/- 0.04; 0.5% dexamethasone, 0.27 +/- 0.03; placebo, 1.09 +/- 0.16, respectively; P < 0.0001). These results suggest that: (a) silicone polymers wrapped around the common carotid arteries for 3 wk did not, without balloon injury, stimulate neointimal proliferation in the rat model; (b) the activity of the drug-eluting polymer for suppressing intimal proliferation was chiefly, but not exclusively, site specific; and (c) transadventitial local delivery of dexamethasone at two different doses markedly inhibits neointimal proliferation after balloon vascular injury. Images PMID:8132764

  7. Differences in Endothelial Injury After Balloon Angioplasty, Insertion of Balloon-Expanded Stents or Release of Self-Expanding Stents: An Electron Microscopic Experimental Study

    SciTech Connect

    Harnek, Jan; Zoucas, Evita; Carlemalm, Erik; Cwikiel, Wojciech

    1999-01-15

    Purpose: To evaluate which of six different commonly available stents inserted into an artery without percutaneous transluminal angioplasty (PTA) causes the least endothelial damage. To compare the degree of endothelial injury after insertion of such a stent with injury caused by PTA. Methods: Twelve healthy pigs were used in the experiments. In the first part of the study six different types of stents were inserted into the common iliac arteries. In the second part of the study self-expanding stents with large spaces between the wires were used. PTA was performed in the contralateral iliac artery. The pigs were killed immediately after the procedure and resected specimens examined after fixation, using scanning electron microscopy. Results: All procedures but two were accomplished successfully. More endothelium was preserved after insertion of self-expanding stents with large spaces between the wires, compared with stents with small spaces and balloon-expanded stents. After insertion of self-expanding stents with large spaces, 50.1% {+-} 16.4% of the endothelium remained intact, compared with only 5.6% {+-} 7.7% after PTA. The difference was statistically significant (p < 0.001). Conclusion: Self-expanding stents with large spaces between the wires, inserted without PTA, cause less damage to the endothelium than other stents and significantly less damage than PTA.

  8. Post-Dilatation Intravascular Brachytherapy Trials on Hypercholesterolemic Rabbits Using {sup 32}P-Phosphate Solutions in Angioplasty Balloons

    SciTech Connect

    Walichiewicz, Piotr Wilczek, Krzysztof; Petelenz, Barbara; Jachec, Wojciech; Jochem, Jerzy; Tomasik, Andrzej; Bilski, Pawel; Gaca, Pawel; Banaszczuk, Joanna; Ihnatowicz, Jerzy; Wodniecki, Jan

    2004-01-15

    Response of peripheral arteries to post-dilatation intravascular brachytherapy (IVBT) using {sup 32}P liquid sources was studied in a rabbit model. The applied sources were angioplasty balloons filled with aqueous solutions of Na{sub 2}H{sup 32}PO{sub 4}, NaCl and iodinated contrast. Dose distribution was calibrated by thermoluminescence dosimetry. The uncertainty of in vitro determinations of the activity-dose dependence was {+-} 15-30%. The animal experiments were performed on rabbits with induced hypercholesterolemia. The {sup 32}P sources were introduced into a randomly chosen (left or right) iliac artery, immediately after balloon injury. Due to the low specific activity of the applied sources, the estimated 7-49 Gy doses on the internal artery surface required 30-100 min irradiations. A symmetric, balloon-occluded but non-irradiated artery of the same animal served as control. Radiation effects were evaluated by comparing the thicknesses of various components of irradiated versus untreated artery walls of each animal. The treatment was well tolerated by the animals. The effects of various dose ranges could be distinguished although differences in individual biological reactions were large. Only the 49 Gy dose at 'zero' distance (16 Gy at 1.0 mm from the balloon surface) reduced hypertrophy in every active layer of the artery wall. The cross-sectional intimal thicknesses after 7, 12, 38 and 49 Gy doses were 0.277, 0.219, 0.357 and 0.196 mm{sup 2} respectively, versus 0.114, 0.155, 0.421 and 0.256 mm{sup 2} in controls (p < 0.05). The lowest radiation dose on the intima induced the opposite effect. Edge intimal hyperplasia was not avoided, which agrees with other reports. The edge restenosis and the variability of individual response to identical treatment conditions must be considered as limitations of the post-dilatation IVBT method. Only application of highest irradiation doses was effective. The irradiation dose should be planned and calculated for

  9. Coronary artery rupture during balloon angioplasty, rescued with localized thrombin injection and coil embolization.

    PubMed

    Fischell, Tim A; Carter, Andrew J; Ashraf, Kamal; Birdsall, Joseph; Smoker, Sandy

    2006-08-01

    Distal intracoronary thrombin injection has been used successfully to seal very small, guidewire related, coronary artery perforations during percutaneous coronary intervention. This case report expands upon this therapeutic approach, by describing the use of high dose distal thrombin injection for the successful (non-surgical) management of balloon-induced coronary artery rupture, with an intrapericardial leak. PMID:16819769

  10. Drug-Coated Balloon Versus Standard Percutaneous Transluminal Angioplasty for the Treatment of Superficial Femoral and Popliteal Peripheral Artery Disease

    PubMed Central

    Tepe, Gunnar; Schneider, Peter; Brodmann, Marianne; Krishnan, Prakash; Micari, Antonio; Metzger, Christopher; Scheinert, Dierk; Zeller, Thomas; Cohen, David J.; Snead, David B.; Alexander, Beaux; Landini, Mario; Jaff, Michael R.

    2015-01-01

    Background— Drug-coated balloons (DCBs) have shown promise in improving the outcomes for patients with peripheral artery disease. We compared a paclitaxel-coated balloon with percutaneous transluminal angioplasty (PTA) for the treatment of symptomatic superficial femoral and popliteal artery disease. Methods and Results— The IN.PACT SFA Trial is a prospective, multicenter, single-blinded, randomized trial in which 331 patients with intermittent claudication or ischemic rest pain attributable to superficial femoral and popliteal peripheral artery disease were randomly assigned in a 2:1 ratio to treatment with DCB or PTA. The primary efficacy end point was primary patency, defined as freedom from restenosis or clinically driven target lesion revascularization at 12 months. Baseline characteristics were similar between the 2 groups. Mean lesion length and the percentage of total occlusions for the DCB and PTA arms were 8.94±4.89 and 8.81±5.12 cm (P=0.82) and 25.8% and 19.5% (P=0.22), respectively. DCB resulted in higher primary patency versus PTA (82.2% versus 52.4%; P<0.001). The rate of clinically driven target lesion revascularization was 2.4% in the DCB arm in comparison with 20.6% in the PTA arm (P<0.001). There was a low rate of vessel thrombosis in both arms (1.4% after DCB and 3.7% after PTA [P=0.10]). There were no device- or procedure-related deaths and no major amputations. Conclusions— In this prospective, multicenter, randomized trial, DCB was superior to PTA and had a favorable safety profile for the treatment of patients with symptomatic femoropopliteal peripheral artery disease. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique Identifiers: NCT01175850 and NCT01566461. PMID:25472980

  11. Successful balloon pulmonary angioplasty with gadolinium contrast media for a patient with chronic thromboembolic pulmonary hypertension and iodine allergy

    PubMed Central

    Nakamura, Tomohisa; Ogo, Takeshi; Tsuji, Akihiro; Fukui, Shigefumi; Fukuda, Tetsuya; Tahara, Nobuhiro; Fukumoto, Yoshihiro; Yasuda, Satoshi; Ogawa, Hisao; Nakanishi, Norifumi

    2016-01-01

    A 28-year-old male was referred to our hospital with dyspnea. He was diagnosed as having chronic thromboembolic pulmonary hypertension, and a pulmonary endarterectomy (PEA) was performed. However, exertional dyspnea remained because of residual pulmonary hypertension; therefore, the patient was re-admitted to our hospital 1 year after PEA. We performed computed tomography and pulmonary angiography and found web and band lesions in the distal pulmonary artery with a high pulmonary artery pressure. Although further management was complicated because the patient had an anaphylactic shock to iodine-based contrast media, we eventually completed five sessions of balloon pulmonary angioplasty (BPA) using gadolinium contrast medium. His symptoms and hemodynamics dramatically improved after a series of BPA. After 15 months, mean pulmonary arterial pressure reduced from 67 mmHg to 20 mmHg, and subjective symptoms improved from stage Ⅳ to I as per the WHO classification system. BPA is a potential procedure for residual pulmonary hypertension after PEA and could be safely performed using gadolinium contrast medium for patients with iodine allergy. PMID:27141436

  12. Laser Angioplasty

    NASA Technical Reports Server (NTRS)

    1990-01-01

    The principal method of dealing with coronary artery blockage is bypass surgery. A non-surgical alternative available to some patients is balloon angioplasty. For several years, medical researchers have been exploring another alternative that would help a wider circle of patients than the balloon treatment and entail less risk than bypass surgery. A research group is on the verge of an exciting development: laser angioplasty with a 'cool' type of laser, called an excimer laser, that does not damage blood vessel walls and offers non-surgical cleansing of clogged arteries with extraordinary precision. The system is the Dymer 200+ Excimer Laser Angioplasty System, developed by Advanced Intraventional Systems. Used in human clinical tests since 1987, the system is the first fully integrated 'cool' laser capable of generating the requisite laser energy and delivering the energy to target arteries. Thirteen research hospitals in the U.S. have purchased Dymer 200+ systems and used them in clinical trials in 121 peripheral and 555 coronary artery cases. The success rate in opening blocked coronary arteries is 85 percent, with fewer complications than in balloon angioplasty. Food and Drug Administration approval for the system is hoped for in the latter part of 1990. * Advanced Intraventional Systems became Spectranetics in 1994 and discontinued the product.

  13. Difference between Outcome of Left Circumflex Artery and Right Coronary Artery Related Acute Inferior Wall Myocardial Infarction in Patients Undergoing Adjunctive Angioplasty after Fibrinolysis

    PubMed Central

    Sohrabi, Bahram; Separham, Ahmad; Madadi, Reza; Toufan, Mehrnoush; Mohammadi, Nasibeh; Aslanabadi, Naser; Kazemi, Babak

    2014-01-01

    Introduction: Prognostic differences between anterior and inferior wall Myocardial Infarction (MI) has been extensively investigated, but there is limited information about similar comparison between inferior wall MI caused by right coronary artery (RCA) and left circumflex artery (LCX) occlusion. The aim of present study was to compare prognostic differences between LCX- and RCA-related acute inferior wall ST-segment elevation MI (STEMI) treated by routine adjunctive angioplasty after receiving thrombolytic therapy (TLT). Methods: Between March 2012 and June 2013 one hundred fifty consecutive patients with acute inferior wall STEMI were studied. Patients were divided into two groups according to the infarct related artery (LCX vs. RCA). All patients underwent routine adjunctive angioplasty after TLT during the index hospitalization and clinical characteristics and outcomes were compared. Results: RCA and LCX arteries were occluded in 97 (64.7%) and 53 (35.3%) of patients, respectively. Two groups were similar in baseline characteristics except multiple-vessel disease was more prevalent with LCX occlusion (p= 0.008). There was a higher cardiac enzyme release (p< 0.001), more significant mitral regurgitation (MR) (p= 0.015), and lower left ventricular ejection fraction (LVEF) (p= 0.01) in patients with LCX occlusion. Multivariate analysis showed cTn-I release, occurrence of MR, and lower LVEF as independent factors leading to poor outcome. Conclusions: There were higher cTn-I release, MR occurrence, and lower LVEF in LCX-related acute inferior wall STEMI, all associated with poor outcome. Therefore, patients with ECG finding in favour of LCX occlusion should be considered as high risk and an invasive approach should be planned. PMID:25031825

  14. Excimer laser coronary angioplasty: relative risk analysis of clinical results

    NASA Astrophysics Data System (ADS)

    Bittl, John A.

    1992-08-01

    Reports of successful use of excimer laser coronary angioplasty for complex coronary artery disease abound, yet firm indications for its use have not been defined. We attempted to treat 858 coronary stenoses in 764 consecutive patients (mean age 61 years; range 32 - 91 years; 75% men; 76% with Class III or IV angina) with excimer laser angioplasty at 308 nm. Successful treatment was achieved in 86% of patients, as indicated by angioplasty, we used relative risk analysis. This showed that certain angiographic features, such as lesions at a vessel bifurcation (odds ratio, OR equals 0.46; 95% confidence interval 0.23, 0.88; P equals 0.017;) or in a tortuous segment (OR equals 0.54; 95% CI equals 0.34, 0.88; P equals 0.041), have decreased likelihood of clinical success. On the other hand, ostial stenoses (OR equals 1.06; 95% CI equals 0.44, 2.56, P equals 0.903) and saphenous vein graft lesions (OR equals 2.17; 95% CI equals 0.98, 4.82; P equals 0.051) have acceptable success rates. Diffuse disease (> 20 mm), total occlusions and calcified lesions were treated as successfully as all other lesion types. Successful treatment with excimer laser coronary angioplasty was also achieved in almost all patients (15/16) who had a prior unsuccessful attempt at balloon angioplasty in the lesion was crossed with a guidewire yet resists either balloon catheter passage or full dilatation. Follow-up angiography was obtained in 70% of eligible patients. Angiographic restenosis, defined by > 50% stenosis, was seen in 60% of patients. Relative risk analysis showed an increased risk of restenosis when adjunctive balloon angioplasty was not used (OR equals 1.68; 95% CI equals 1.02, 2.28; P equals 0.039). Other variables known to affect the outcome of balloon angioplasty, such as lesion length or stenosis in degenerated saphenous vein bypass graft, did not influence the

  15. Vasculitis resulting from a superficial femoral artery angioplasty with a paclitaxel-eluting balloon.

    PubMed

    Thomas, Shannon D; McDonald, Robert R A; Varcoe, Ramon L

    2014-02-01

    Drug-eluting balloons (DEBs) coated with the antiproliferative agent paclitaxel may improve primary patency by reducing recurrent luminal stenosis. A proportion of the active drug and excipient coating are known to embolize distally, but until now, there have been no reports of adverse events resulting from their use. We report an unusual case of a painful nodular, biopsy specimen-proven vasculitic rash that afflicted the ipsilateral lower limb of a patient after superficial femoral artery treatment with a DEB. This adverse event may have implications for the use of DEB in this and other vascular territories. PMID:23642919

  16. Surgical treatment of acute myocardial ischaemia related to coronary angioplasty with special reference to use of perfusion balloon catheter and long-term outcome.

    PubMed

    Heikkinen, L; Virtanen, K; Heikkila, J; Verkkala, K; Salo, J; Jarvinen, A

    1997-04-01

    Twenty of 569 consecutive patients (3.5%) undergoing percutaneous transluminal coronary angioplasty required emergency coronary artery bypass grafting for acute closure of the dilated vessel. In seven patients an intracoronary autoperfusion balloon catheter was inserted to ensure antegrade blood flow across the injured zone of the coronary artery. The time needed for completion of the bypass grafts ranged from 100 to 399 minutes (mean 180 minutes). An average of 1.9 coronary artery bypasses was inserted. In total, 11 of the 20 patients (55%) developed new Q waves and had elevated CK-MB levels. However, the myocardial infarction rate was only 14% in those with a perfusion balloon catheter as against 77% in those without one. The insertion of a ball-out catheter permitted greater utilization of the internal mammary artery as a bypass graft. Angiographic follow-up was conducted after a mean of 28 months (19 patients). The patency rate of the bypass grafts placed in the emergency setting was relatively good (91%). Thallium tomography revealed a scar of variable size in all 17 patients studied and a reversible exercise perfusion defect requiring coronary reangioplasty in three patients. In conclusion, the insertion of a perfusion balloon catheter after abrupt coronary occlusion during coronary angioplasty solved the problems of acute myocardial ischemia and markedly lowered the definite myocardial infarction rate. This technique ensures favourable haemodynamic conditions for emergency myocardial revascularization. PMID:9201117

  17. Utility of birefringence changes due to collagen thermal denaturation rate process analysis: vessel wall temperature estimation for new short term heating balloon angioplasty

    NASA Astrophysics Data System (ADS)

    Kaneko, Kenji; Shimazaki, Natsumi; Gotoh, Maya; Nakatani, Eriko; Arai, Tsunenori

    2007-02-01

    Our photo thermal reaction heating architecture balloon realizes less than 10 s short term heating that can soften vessel wall collagen without damaging surrounding tissue thermally. New thermal balloon angioplasty, photo-thermo dynamic balloon angioplasty (PTDBA) has experimentally shown sufficient opening with 2 atm low pressure dilation and prevention of chronic phase restenosis and acute phase thrombus in vivo. Even though PTDBA has high therapeutic potential, the most efficient heating condition is still under study, because relationship of treatment and thermal dose to vessel wall is not clarified yet. To study and set the most efficient heating condition, we have been working on establishment of temperature history estimation method from our previous experimental results. Heating target of PTDBA, collagen, thermally denatures following rate process. Denaturation is able to be quantified with measured collagen birefringence value. To express the denaturation with equation of rate process, the following ex vivo experiments were performed. Porcine extracted carotid artery was soaked in two different temperature saline baths to enforce constant temperature heating. Higher temperature bath was set to 40 to 80 degree Celsius and soaking duration was 5 to 40 s. Samples were observed by a polarizing microscope and a scanning electron microscope. The birefringence was measured by polarizing microscopic system using Brace-Koehler compensator 1/30 wavelength. The measured birefringence showed temperature dependency and quite fit with the rate process equation. We think vessel wall temperature is able to be estimated using the birefringence changes due to thermal denaturation.

  18. Focused force angioplasty Theory and application

    SciTech Connect

    Solar, Ronald J.; Ischinger, Thomas A

    2003-03-01

    Focused force angioplasty is a technique in which the forces resulting from inflating an angioplasty balloon in a stenosis are concentrated and focused at one or more locations within the stenosis. While the technique has been shown to be useful in resolving resistant stenoses, its real value may be in minimizing the vascular trauma associated with balloon angioplasty and subsequently improving the outcome.

  19. Common Iliac Artery Thrombosis following Pelvic Surgery Resulting in Kidney Allograft Failure Successfully Treated by Percutaneous Transluminal Angioplasty with Balloon-Expandable Covered Stent

    PubMed Central

    Golla, Maheswara S.; Acharjee, Subasit; Jaber, Bertrand L.; Garcia, Lawrence A.

    2015-01-01

    We report the case of a 66-year-old woman who developed acute kidney allograft failure due to thrombotic occlusion of the common iliac artery after hysterectomy requiring emergent allograft rescue. She underwent percutaneous transluminal angioplasty with endovascular balloon expandable covered stent graft placement in the right common iliac artery. Although there are a handful of case reports of acute limb ischemia secondary to acute common iliac artery thrombosis, this is the first case reported in the literature resulting in successful kidney allograft rescue following pelvic surgery. PMID:26355669

  20. Acute embolic occlusion of the right common iliac artery after revision total hip arthroplasty treated with catheter-directed thrombolysis and balloon angioplasty: A case report

    PubMed Central

    Yang, Hongqi; Chen, Song; Chen, Li; Li, Yuefeng; Chai, Yasheng; Wei, Ping; Xu, Shunchi; Liu, Tangyou; Liu, Feng; Zhang, Zhuo

    2015-01-01

    Methods: A 63-year-old woman with atrial fibrillation presented clinical symptoms and signs of acute ischemia in the right lower extremity on the 17th postoperative day after revision total hip arthroplasty of the left hip for aseptic loosening of femoral component. Aspirin was discontinued 7 days before surgery. Both computed tomography angiography and digital subtraction angiography demonstrated complete occlusion of the right common iliac artery. An emergency catheter-directed thrombolysis with urokinase combined with balloon angioplasty was performed to obtain complete patency of the right common iliac artery. Results: The patient received anticoagulation and antiplatelet therapy postoperatively and was fine at the 2-year follow-up. Conclusions: This case demonstrated that catheter-directed thrombolysis combined with balloon angioplasty could be an efficacious, minimally invasive approach for the treatment of acute embolic occlusion of the common iliac artery. Preoperative anticoagulation for patients undergoing total hip arthroplasty with long-term use of aspirin for atrial fibrillation needs further investigation.

  1. Temporary Arterial Balloon Occlusion as an Adjunct to Yttrium-90 Radioembolization

    SciTech Connect

    Hagspiel, Klaus D.; Nambiar, Ashwin; Hagspiel, Lauren M.; Ahmad, Ehab Ali; Bozlar, Ugur

    2013-06-15

    Purpose. This study was designed to describe the technique of arterial occlusion using a temporary occlusion balloon system as an alternative to coil occlusion during Yttrium-90 radioembolization of hepatic tumors. Methods. Review of charts, angiography, and follow-up imaging studies of consecutive patients undergoing oncological embolization procedures in which a HyperForm system (ev3 Neurovascular, Irvine, CA) was used. Intraprocedural target vessel occlusion and patency of the target vessel on follow-up were recorded. Clinical data and Bremsstrahlung scans were reviewed for evidence of nontarget embolization. Results. Four radioembolization procedures were performed in three patients (all female, age 48-54 (mean 52) years). Five arteries were temporarily occluded (three gastroduodenal arteries, one right gastric artery, and one cystic artery). All radioembolization procedures were successfully completed. Follow-up imaging (either digital subtraction angiography (DSA) or computed tomography angiography (CTA)) was available for all patients between 28-454 (mean 183) days following the procedure, demonstrating all five vessels to be patent. No clinical or imaging evidence for nontarget embolization was found. Conclusions. Temporary balloon occlusion of small and medium-sized arteries during radioembolization allows safe therapy with preserved postprocedural vessel patency on early and midterm follow-up.

  2. Restoration of Failed Renal Graft Function After Successful Angioplasty of Pressure-Resistant Renal Artery Stenosis Using a Cutting Balloon: A Case Report

    SciTech Connect

    Peregrin, J. H.; Buergelova, M.

    2009-05-15

    This study is the report of a 37-year-old male with a transplanted kidney from a 3.5-year-old donor: the graft had two arteries transplanted with an aortic patch to an external iliac artery. Four months after transplantation, the graft function deteriorated, together with the development of hypertension. Stenosis of both graft arteries was detected and the patient was referred for angioplasty. The angiographic result was suboptimal, nevertheless, the graft function improved and was more or less stable (serum creatinine, 160-200 {mu}mol/l) for 4 years, along with persistently difficult-to-control hypertension. Five years after transplantation, the graft function deteriorated again and severe graft artery restenosis was detected. The restenosis did not respond to dilatation, graft function failed, hypertension decompensated, and left ventricular failure developed. The patient required dialysis. A cutting balloon angioplasty opened the artery, and kidney function was restored after a few days: the serum creatinine level dropped to 140-160 {mu}mol/l, and the glomerular filtration rate (creatinine clearance) to 0.65 ml/min/1.73 m{sup 2}. The graft function has now been stable for more than 2 years, however, the hypertension is still difficult to control.

  3. Rescue balloon pulmonary angioplasty under veno-arterial extracorporeal membrane oxygenation in a patient with acute exacerbation of chronic thromboembolic pulmonary hypertension.

    PubMed

    Nakamura, Makiko; Sunagawa, Osahiko; Tsuchiya, Hiroyuki; Miyara, Takafumi; Taba, Yoji; Touma, Takashi; Munakata, Hiroshi; Kugai, Tadao; Okita, Yutaka

    2015-01-01

    We describe a case of a 41-year-old woman with acute exacerbation of chronic thromboembolic pulmonary hypertension (CTEPH) complicated by rapidly progressive respiratory failure and right heart failure with cardiogenic shock. A computed tomography (CT) showed thrombi in the right main pulmonary artery and bilateral peripheral pulmonary arteries, and echocardiography showed right ventricular dilatation and tricuspid regurgitation, with an estimated pressure gradient of 80 mmHg. The patient was initially diagnosed with acute pulmonary thromboembolism, and thrombolytic therapy was administered. Her condition subsequently deteriorated, however, necessitating mechanical ventilation and veno-arterial extracorporeal membrane oxygenation (VA-ECMO). We performed emergency catheter-directed thrombectomy and thrombus aspiration. Pulmonary hypertension (PH) temporarily improved, but subsequently worsened, and the patient was diagnosed with CTEPH. Pulmonary endarterectomy (PEA) was performed. After PEA, we were unable to wean the patient off VA-ECMO, and rescue balloon pulmonary angioplasty (BPA) to the middle and inferior lobe branches of the right lung was performed. Five days after BPA, the patient was removed from VA-ECMO and on the 57th day of hospitalization, she was weaned off the ventilator. The patient was discharged after 139 days of hospitalization. Rescue BPA represents a useful intervention for improving PH and weaning off VA-ECMO in a patient with acute exacerbation of CTEPH. PMID:25742948

  4. IN.PACT Amphirion paclitaxel eluting balloon versus standard percutaneous transluminal angioplasty for infrapopliteal revascularization of critical limb ischemia: rationale and protocol for an ongoing randomized controlled trial

    PubMed Central

    2014-01-01

    Background The effectiveness and durability of endovascular revascularization therapies for chronic critical limb ischemia (CLI) are challenged by the extensive burden of infrapopliteal arterial disease and lesion-related characteristics (e.g., severe calcification, chronic total occlusions), which frequently result in poor clinical outcomes. While infrapopliteal vessel patency directly affects pain relief and wound healing, sustained patency and extravascular care both contribute to the ultimate “patient-centric” outcomes of functional limb preservation, mobility and quality of life (QoL). Methods/Design IN.PACT DEEP is a 2:1 randomized controlled trial designed to assess the efficacy and safety of infrapopliteal arterial revascularization between the IN.PACT Amphirion™ paclitaxel drug-eluting balloon (IA-DEB) and standard balloon angioplasty (PTA) in patients with Rutherford Class 4-5-6 CLI. Discussion This multicenter trial has enrolled 358 patients at 13 European centers with independent angiographic core lab adjudication of the primary efficacy endpoint of target lesion late luminal loss (LLL) and clinically driven target lesion revascularization (TLR) in major amputation-free surviving patients through 12-months. An independent wound core lab will evaluate all ischemic wounds to assess the extent of healing and time to healing at 1, 6, and 12 months. A QoL questionnaire including a pain scale will assess changes from baseline scores through 12 months. A Clinical Events Committee and Data Safety Monitoring Board will adjudicate the composite primary safety endpoints of all-cause death, major amputation, and clinically driven TLR at 6 months and other trial endpoints and supervise patient safety throughout the study. All patients will be followed for 5 years. A literature review is presented of the current status of endovascular treatment of CLI with drug-eluting balloon and standard PTA. The rationale and design of the IN.PACT DEEP Trial are

  5. The efficacy and safety of drug-eluting balloons for the treatment of in-stent restenosis as compared with drug-eluting stents and with conventional balloon angioplasty

    PubMed Central

    Oh, Pyung Chun; Suh, Soon Yong; Kang, Woong Chol; Lee, Kyounghoon; Han, Seung Hwan; Ahn, Taehoon; Shin, Eak Kyun

    2016-01-01

    Background/Aims: Treatment of coronary in-stent restenosis (ISR) is still associated with a high incidence of recurrence. We aimed to compare the efficacy and safety of drug-eluting balloons (DEB) for the treatment of ISR as compared with conventional balloon angioplasty (BA) and drug-eluting stents (DES). Methods: Between January 2006 and May 2012 a total of 177 patients (188 lesions, 64.1 ± 11.7 years old) who underwent percutaneous coronary intervention for ISR were retrospectively enrolled. Clinical outcomes were compared between patients treated with DEB (n = 58, 32.8%), conventional BA (n = 65, 36.7%), or DES (n = 54, 30.5%). The primary end point was a major adverse cardiac event (MACE), defined as a composite of cardiac death, myocardial infarction, and target lesion revascularization(TLR). Results: Baseline characteristics were not different except for a history of previous MI, which was more frequent in patients treated by conventional BA or DES than in patients treated by DEB (40.0% vs. 48.1% vs. 17.2%, respectively, p = 0.002). The total incidences of MACEs were 10.7%, 7.4%, and 15.4% in patients treated by DEB, DES, or conventional BA, respectively (p > 0.05). TLR was more frequent in patients treated by conventional BA than in patients treated by DEB or DES, but this was not statistically significant (10.8% vs. 6.9% vs. 3.7%, p > 0.05 between all group pairs, respectively). Conclusions: This study showed that percutaneous coronary intervention using DEB might be a feasible alternative to conventional BA or DES implantation for treatment of coronary ISR. Further large-scaled, randomized study assessing long-term clinical and angiographic outcomes will be needed. PMID:26951915

  6. Thermal compression and molding of atherosclerotic vascular tissue with use of radiofrequency energy: implications for radiofrequency balloon angioplasty

    SciTech Connect

    Lee, B.I.; Becker, G.J.; Waller, B.F.; Barry, K.J.; Connolly, R.J.; Kaplan, J.; Shapiro, A.R.; Nardella, P.C.

    1989-04-01

    The combined delivery of pressure and thermal energy may effectively remodel intraluminal atherosclerotic plaque and fuse intimal tears. To test these hypotheses with use of a non-laser thermal energy source, radiofrequency energy was delivered to postmortem human atherosclerotic vessels from a metal hot-tip catheter, block-mounted bipolar electrodes and from a prototype radiofrequency balloon catheter. Sixty-two radiofrequency doses delivered from a metal electrode tip produced dose-dependent ablation of atherosclerotic plaque, ranging from clean and shallow craters with histologic evidence of thermal compression at doses less than 40 J to tissue charring and vaporization at higher (greater than 80 J) doses. Lesion dimensions ranged between 3.14 and 3.79 mm in diameter and 0.20 and 0.47 mm in depth. Tissue perforation was not observed. To test the potential for radiofrequency fusion of intimal tears, 5 atm of pressure and 200 J radiofrequency energy were delivered from block-mounted bipolar electrodes to 48 segments of human atherosclerotic aorta, which had been manually separated into intima-media and media-adventitial layers. Significantly stronger tissue fusion resulted (28.5 +/- 3.3 g) with radiofrequency compared with that with pressure alone (4.8 +/- 0.26 g; p less than 0.0001). A prototype radiofrequency balloon catheter was used to deliver 3 atm of balloon pressure with or without 200 J radiofrequency energy to 20 postmortem human atherosclerotic arterial segments. In 10 of 10 radiofrequency-treated vessels, thermal molding of both normal and atherosclerotic vessel wall segments resulted with increased luminal diameter and histologic evidence of medial myocyte damage.

  7. Myxomavirus Anti-Inflammatory Chemokine Binding Protein Reduces the Increased Plaque Growth Induced by Chronic Porphyromonas gingivalis Oral Infection after Balloon Angioplasty Aortic Injury in Mice

    PubMed Central

    Lucas, Alexandra R.; Verma, Raj K.; Dai, Erbin; Liu, Liying; Chen, Hao; Kesavalu, Sheela; Rivera, Mercedes; Velsko, Irina; Ambadapadi, Sriram; Chukkapalli, Sasanka; Kesavalu, Lakshmyya

    2014-01-01

    Thrombotic occlusion of inflammatory plaque in coronary arteries causes myocardial infarction. Treatment with emergent balloon angioplasty (BA) and stent implant improves survival, but restenosis (regrowth) can occur. Periodontal bacteremia is closely associated with inflammation and native arterial atherosclerosis, with potential to increase restenosis. Two virus-derived anti-inflammatory proteins, M-T7 and Serp-1, reduce inflammation and plaque growth after BA and transplant in animal models through separate pathways. M-T7 is a broad spectrum C, CC and CXC chemokine-binding protein. Serp-1 is a serine protease inhibitor (serpin) inhibiting thrombotic and thrombolytic pathways. Serp-1 also reduces arterial inflammation and improves survival in a mouse herpes virus (MHV68) model of lethal vasculitis. In addition, Serp-1 demonstrated safety and efficacy in patients with unstable coronary disease and stent implant, reducing markers of myocardial damage. We investigate here the effects of Porphyromonas gingivalis, a periodontal pathogen, on restenosis after BA and the effects of blocking chemokine and protease pathways with M-T7 and Serp-1. ApoE−/− mice had aortic BA and oral P. gingivalis infection. Arterial plaque growth was examined at 24 weeks with and without anti-inflammatory protein treatment. Dental plaques from mice infected with P. gingivalis tested positive for infection. Neither Serp-1 nor M-T7 treatment reduced infection, but IgG antibody levels in mice treated with Serp-1 and M-T7 were reduced. P. gingivalis significantly increased monocyte invasion and arterial plaque growth after BA (P<0.025). Monocyte invasion and plaque growth were blocked by M-T7 treatment (P<0.023), whereas Serp-1 produced only a trend toward reductions. Both proteins modified expression of TLR4 and MyD88. In conclusion, aortic plaque growth in ApoE−/− mice increased after angioplasty in mice with chronic oral P. gingivalis infection. Blockade of chemokines, but not serine

  8. Angioplasty and stent placement - peripheral arteries - discharge

    MedlinePlus

    ... Supplements Videos & Tools Español You Are Here: Home → ... the sharing features on this page, please enable JavaScript. You had procedure that used a balloon catheter to open a narrowed vessel (angioplasty) that ...

  9. Laser angioplasty for cardiovascular disease

    NASA Astrophysics Data System (ADS)

    Okada, Masayoshi

    2005-07-01

    Recently, endovascular interventions such as balloon angioplasty, atherectomy and the stenting method, except for conventional surgery have been clinically employed for the patients with atheromatous plaques of the peripheral- and the coronary arteries, because the number of patients with arteriosclerosis is now increasing in the worldwide. Among these procedures, restenoses after endovascular interventions have been remarkably disclosed in 20-40 % of the patients who underwent percutaneous coronary interventions. Thus, there are still some problems in keeping long-term patency by means of endovascular techniques such as balloon angioplasty and atherectomy (1, 2). For reduction of these problems , laser angioplasty using Argon laser was applied experimentally and clinically. Based on excellent experimental studies, laser was employed for 115 patients with stenotic ,or obstructive lesions occluding more thasn 75 % of the peripheral and the coronary arteries angiographycally.

  10. Renal Branch Artery Occlusion in a 13-Year-Old Hypertensive Girl: Initial Treatment and Treatment of Recurrent Stenosis by Balloon Angioplasty

    SciTech Connect

    Konez, Orhan; Burrows, Patricia E.; Harmon, William E.

    2001-09-15

    A 13-year-old girl who recently developed hypertension was diagnosed to have an occluded right renal branch artery and was treated successfully with percutaneous transluminal angioplasty (PTA). To our knowledge, PTA has not been reported as a treatment for totally occluded renal branch arteries, and there is no data available regarding the success rate and possible complications.

  11. Coronary Angioplasty

    MedlinePlus

    ... page from the NHLBI on Twitter. What Is Percutaneous Coronary Intervention? Español Percutaneous (per-ku-TA-ne-us) coronary intervention (PCI), commonly known as coronary angioplasty (AN-jee- ...

  12. Angioplasty and stent placement -- peripheral arteries

    MedlinePlus

    Percutaneous transluminal angioplasty - peripheral artery; PTA - peripheral artery; Angioplasty - peripheral arteries; Iliac artery -angioplasty; Femoral artery - angioplasty; Popliteal artery - angioplasty; Tibial artery - angioplasty; Peroneal artery - ...

  13. Ultrasonic angioplasty

    NASA Astrophysics Data System (ADS)

    Siegel, Robert J.

    1990-08-01

    Over the past 3 years we have developed a percutaneous ultrasonic angioplasty device and recently applied it in human peripheral arteries. This paper describes some of the background preceding the development of intravascular ultrasound for arterial recanalization. The chronology of our development of ultrasonic angioplasty is discussed from in vitro studies on atherosclerotic plaque to in vivo studies in canine models with differing types of arterial occlusions (thrombotic fibrotic calcific-atherosclerotic) and to initial human application. SPIE Vol. 1321 Modern Technologies Applied to Medical Practice (1989) / 69

  14. Percutaneous intravascular US as adjunct to catheter-based interventions: preliminary experience in patients with peripheral vascular disease.

    PubMed

    Isner, J M; Rosenfield, K; Losordo, D W; Kelly, S; Palefski, P; Langevin, R E; Razvi, S; Pastore, J O; Kosowsky, B D

    1990-04-01

    Catheter-based ultrasound (US) transducers may be introduced into the vascular system to record high-resolution images of the vessel wall and lumen. The potential advantages and existing liabilities of percutaneous intravascular US as an adjunct to transluminal vascular recanalization were investigated. A 6.6-F braided, polyethylene catheter enclosing a rotary drive shaft with a single-element, 20-MHz transducer at the distal tip was used in 17 patients undergoing percutaneous transluminal (balloon) angioplasty (PTA) alone (10 patients), PTA with implantation of an endovascular stent (two patients), atherectomy alone (two patients), or laser angioplasty with PTA and/or atherectomy (three patients). The arteries treated and examined included the common iliac in five patients, the external iliac in two, the superficial femoral in nine, and a vein graft-arterial anastomosis in one. In 14 cases PTA was employed as sole or adjunctive therapy; plaque cracks were clearly delineated with intravascular US in all 14 (100%) and dissections were observed in 11 (78%). Plaque-arterial wall disruption was less prominent in the arteries treated with mechanical atherectomy. The results of laser angioplasty reflected the adjunctive modality employed. After stent implantation, serial intravascular US documented effacement of PTA-induced plaque cracks and/or dissections. Intravascular US also aided in the quantitative assessment of luminal cross-sectional areas after the procedures (19.0-51.8 mm2). The observations recorded in this preliminary group of 17 patients illustrate the potential utility of intravascular US as an adjunct to conventional angiography in patients undergoing percutaneous revascularization. PMID:2138342

  15. A comparison of balloon angioplasty of native coarctation versus surgical repair for short segment coarctation associated with ventricular septal defect—a single-center retrospective review of 92 cases

    PubMed Central

    Zhang, Huifeng; Ye, Ming; Chen, Gang; Liu, Fang; Wu, Lin

    2016-01-01

    Background The hybrid technique combining balloon angioplasty for discrete coarctation (CoA) and surgical repair of a ventricular septal defect (VSD) is a novel treatment for patients with aortic CoA and VSD, but the efficacy of this approach is unknown. Methods We performed a retrospective analysis of 92 patients with short segment CoA and VSD who underwent complete repair between January 2004 and July 2014 in our center. Patients were divided into two groups according to the surgical approach employed: hybrid procedure (group A, n=39) and traditional midline surgical repair (group B, n=53). Baseline, perioperative, and outcome data were compared between the two groups. Results Three early deaths occurred in group B, whereas none occurred in group A. Compared to those in group B, patients in group A experienced a shorter aortic clamp duration (28.1±6.7 vs. 43.2±9.2 minutes, P<0.001), shorter cardiopulmonary bypass (CPB) duration (52.9±10.7 vs. 86.2±23.8 minutes, P<0.001), shorter ventilator time (47.0 vs. 73.7 hours, P=0.002), and shorter intensive care unit stay (6.2 vs. 9.1 days, P=0.019). The risks for aortic re-CoA and re-intervention did not differ significantly between the groups within five years (P=0.40 and 0.65, respectively). Conclusions The hybrid technique was associated with better periprocedural outcomes for patients with short-segment CoA and VSD. The incidences of aortic re-CoA and re-intervention were comparable between the hybrid technique and surgical groups over a mid-term follow-up. PMID:27621858

  16. Angioplasty and stent placement - heart

    MedlinePlus

    ... angioplasty; Coronary artery angioplasty; Percutaneous transluminal coronary angioplasty; Heart artery dilatation ... to carefully guide the catheter up into your heart and arteries. Dye will be injected into your ...

  17. Adjunct Accounting

    ERIC Educational Resources Information Center

    Lesesne, Cherise

    2012-01-01

    With colleges and universities recruiting more adjunct professors, schools have been able to reduce the costly expenses of large salary and benefit packages that are typically associated with full-time employees. Yet, schools have started to re-evaluate their use of adjunct professors in order to comply with the Affordable Care Act (ACA), dubbed…

  18. Holmium:YAG laser angioplasty: treatment of acute myocardial infarction

    NASA Astrophysics Data System (ADS)

    Topaz, On

    1993-06-01

    We report our clinical experience with a group of 14 patients who presented with acute myocardial infarction. A holmium:YAG laser was applied to the infarct-related artery. This laser emits 250 - 600 mJ per pulse, with a pulse length of 250 microseconds and repetition rate of 5 Hz. Potential benefits of acute thrombolysis by lasers include the absence of systemic lytic state; a shortened thrombus clearing time relative to using thrombolytics; safe removal of the intracoronary thrombus and facilitation of adjunct balloon angioplasty. Potential clinical difficulties include targeting the obstructive clot and plaque, creation of debris and distal emboli and laser-tissue damage. It is conceivable that holmium:YAG laser can be a successful thrombolytic device as its wave length (2.1 microns) coincides with strong water absorption peaks. Since it is common to find an atherosclerotic plaque located under or distal to the thrombotic occlusion, this laser can also be applied for plaque ablation, and the patient presenting with acute myocardial infarction can clearly benefit from the combined function of this laser system.

  19. [Uncommon indications for coronary angioplasty].

    PubMed

    Vojácek, J; Krupicka, P; Aschermann, M; Holm, F; Humhal, J

    1993-07-01

    During the period between March 16, 1989 and October 7, 1992 at the Second Medical Clinic of the First Medical Faculty, Charles University Prague a total of 173 coronary angioplasties were performed. With expanding experience and greater availability of controllable super thin conductors and balloon catheters with a small profile, gradually the indication criteria of coronary angioplasty were extended. In 93.1% of patients simple balloon dilatation of a significant stenosis of the coronary arteries was performed and in 6.9% before dilatation in addition an attempt of recanalization of a chronic occlusion of the coronary artery was made. In 74% of the patients one coronary stenosis was dilated, in 16.7% several stenoses, in 1.2% of the patients a covered stenosis of the trunk of the left coronary was dilated and in the same number an aortocoronary bypass was performed. Even in the group of patients where only one coronary stenosis was dilated the type B coronary affection according to the classification ACC/AHA predominated and the same applied to the entire group of patients. PMID:8372458

  20. A new catheter system for coronary angioplasty.

    PubMed

    Simpson, J B; Baim, D S; Robert, E W; Harrison, D C

    1982-04-01

    A new catheter system has been designed for percutaneous transluminal coronary angioplasty. An independently movable, flexible-tipped guide wire within the balloon dilation catheter facilitates selection of the involved vessel. This guide wire can be passed slowly and carefully beyond the coronary stenosis, permitting safe advancement of the balloon catheter. After testing in animal and cadaver hearts, this system was used in 53 patients (56 stenoses) with single vessel coronary artery disease, with an overall primary success rate of 64 percent. In the last 41 of these 56 cases, use of a balloon catheter with a smaller deflated diameter increased the success rate to 73 percent. In patients with lesions of the left anterior descending coronary artery, the success rate was 89 percent. Three (6 percent) of the 53 patients had complications during coronary arterial dilation that necessitated emergency coronary arterial bypass graft surgery. There were no procedure-related or late cardiac deaths. During the mean follow-up period of 8 months (range 1 to 21), there were one late death (of noncardiac causes) and no late myocardial infarctions. Clinical status was persistently improved in 31 of the 36 patients who had successful dilation. The remaining five patients experienced restenosis at the angioplasty site and return of angina pectoris within 3 months of dilation. Two of these patients had repeat coronary angioplasty with restoration of asymptomatic status, and three had elective coronary bypass graft surgery. PMID:6461241

  1. Coronary artery balloon angioplasty - series (image)

    MedlinePlus

    ... of patients and may eliminate the need for coronary artery bypass surgery. The outcome is relief from chest pain ... of the narrowing is not accomplished, heart surgery (coronary artery bypass graft surgery, also called a CABG) may be ...

  2. Laser angioplasty with lensed fibers and a holmium:YAG laser in iliac artery occlusions

    NASA Astrophysics Data System (ADS)

    White, Christopher J.; Ramee, Stephen R.; Mesa, Juan E.; Collins, Tyrone J.; Kotmel, Robert; Godfrey, Maureen A.

    1991-05-01

    Holmium-YAG (2.1 (mu) ) laser recanalization was attempted in 10 totally occluded miniature swine iliac arteries using a lensed fiber delivery system. The iliac artery occlusions were created in a Yucatan miniature swine model of atherosclerosis by means of a high cholesterol diet and balloon endothelial denudation. In order to increase the spot size, a spherical silica lens was attached to the distal end of a 300 micrometers core diameter silica optical fiber. The holmium-YAG laser was operated in the free-running mode with 250 microsecond(s) ec pulses at 4 Hz. The energy delivered was 225 mJ per pulse for the 1.0 mm lensed fiber and 200 mJ per pulse for the 1.3 mm lensed fiber. Laser energy was delivered in 2 to 5 second bursts. Successful recanalization was achieved in all 10 arteries attempted without perforation of the arterial wall. The average length of the occlusions was 5.0 +/- 1.8 cm. Following successful laser recanalization significant stenoses (>50%) remained in all of the arteries as judged by angiography. In conclusion, the lensed fibers coupled to the pulsed holmium-YAG laser were safe and effective in recanalizing these difficult lesions in relatively straight iliac arteries. There is potential clinical utility for this system as an adjunct to balloon angioplasty in patients with lesions which are unable to be crossed with guidewires.

  3. Adjunct Professorships

    ERIC Educational Resources Information Center

    Goldman, Jay P.

    2011-01-01

    Colleges of education have come to rely heavily on superintendents to teach graduate-level classes in educational administration. While no national organization tracks this phenomenon, anecdotal evidence points to widespread and perhaps growing involvement in the adjunct ranks. While the majority reported being assigned to teach semester-long…

  4. Therapeutic adjuncts for immediate transfer to the catheterization laboratory in patients with acute coronary syndromes.

    PubMed

    Kereiakes, D J; Young, J; Broderick, T M; Shimshak, T M; Abbottsmith, C W

    2000-12-28

    Early coronary intervention in patients with non-ST-segment elevation myocardial infarction (MI) and unstable angina may be made safer and more efficacious with concomitant therapies, including glycoprotein IIb/IIIa inhibitors and low-molecular-weight heparins. Stent placement has been shown to improve procedural success and reduce major in-hospital complications when compared with balloon angioplasty alone in patients with unstable angina. However, unstable angina remains a major hazard for adverse coronary events in long-term follow-up after elective stent placement. The currently available glycoprotein IIb/IIIa inhibitors-eptifibatide, tirofiban, and abciximab--have each been shown to reduce ischemic events before percutaneous coronary intervention when administered to patients presenting with non-ST-segment elevation acute coronary syndromes in large clinical trials. The adjunctive role of low-molecular-weight heparins in this scenario has been largely unexplored. Enoxaparin, when given before angiography or percutaneous coronary intervention, has been shown to be superior to unfractionated heparin in preventing major coronary events. In this review, an algorithm for treatment of non-ST-segment elevation acute coronary syndromes is presented and the current role of these newer adjunctive pharmacotherapies is explored. In the future, combinations of these agents may prove to be most beneficial in patients undergoing early percutaneous coronary intervention. PMID:11206013

  5. Isolated acute occlusion of a large right ventricular branch of the right coronary artery following coronary balloon angioplasty. The only true 'model' to study ECG changes in acute, isolated right ventricular infarction.

    PubMed

    van der Bolt, C L; Vermeersch, P H; Plokker, H W

    1996-02-01

    An isolated right ventricular infarction occurs rarely and data on its electrocardiographic appearance and underlying angiographically proven cause are scarce. The electrocardiographic response of acute right ventricular ischaemia is often obscured by the coexisting forces of the ischaemic mass of the inferior wall of the left ventricle when the right coronary artery itself becomes occluded. Percutaneous transluminal coronary angioplasty of the right coronary artery may cause an isolated occlusion of a right ventricular branch. We encountered this phenomenon in nine patients. In all, it led to acute isolated right ventricular ischaemia with ST elevations in the right precordial leads (V1-V3, V3R and V4R) on the electrocardiogram. We conclude that the ECG pattern of pure right ventricular ischaemia can be seen when an isolated occlusion of a large right ventricular branch occurs, for example as a complication of percutaneous transluminal coronary angioplasty. PMID:8732378

  6. Percutaneous transluminal angioplasty: radiological-pathological correlation

    SciTech Connect

    Saffitz, J.E.; Totty, W.G.; McClennan, B.L.; Gilula, L.A.

    1981-12-01

    Radiological and pathological assessment of the degree and extent of arterial injury caused by balloon angioplasty was performed in 20 renal arteries obtained at autopsy. Intact arteries were studied angiographically before and after dilatation and then examined histologically. Both normal and diseased arteries were subjected to varying degrees of dilatation. Damage ranged from minimal inimal disruption to major tears of the muscular media. Equivalent dilatory force created greater damage in the distal (muscular) than in the proximal (elastic) portion of the renal artery. There was no evidence of plaque remodling or compression.

  7. Angioplasty and stent placement - carotid artery

    MedlinePlus

    Carotid angioplasty and stenting; CAS; Angioplasty - carotid artery; Carotid artery stenosis - angioplasty; ... Carotid angioplasty and stenting (CAS) is done using a small surgical cut. Your surgeon will make a surgical cut in your groin after using some ...

  8. Angioplasty and Vascular Stenting

    MedlinePlus

    ... the narrowed vein is also needed. narrowing in dialysis fistula or grafts. When there is decreased flow ... the graft or fistula making it inadequate for dialysis, angioplasty is generally the first line of treatment. ...

  9. Nd:YAG iliac and femoropopliteal laser angioplasty: results with large probes as "sole therapy".

    PubMed

    Rosenthal, D; Wheeler, W G; Seagraves, A; Erdoes, L; Lamis, P A; Jones, M; Clark, M D; Pallos, L L

    1991-01-01

    Laser assisted balloon angioplasty with a laser heated metallic capped fiberoptic catheter may be effective in the treatment of femoral and iliac artery occlusive disease. In order to avoid the inherent trauma of balloon angioplasty, yet at the same time "debulk" atheroma, 75 patients underwent laser angioplasty of the superficial femoral and iliac arteries as "sole therapy". Laser angioplasty was performed using an Nd:YAG laser coupled to a 600 micron fiber and a 3.5 mm probe (22-28 watts), 4.2 mm or 5.0 probe (32-40 watts). Fifty-nine patients had laser angioplasty for claudication and 16 for limb salvage. The initial angiographic success rate was 84% (41/49) (lesion length 2-14 cm) for the superficial femoral and 69% (18/26) (lesion length 2-14 cm) for the iliac arteries. In follow-up extending to 21 months (mean 14.4 months) 73% (30/41) of the superficial femoral artery and 76% (14/18) of the initially recanalized iliac arteries remain patent. When initial failures are included, this represents an overall intermediate-term patency rate of 52% (32/49) for superficial femoral and 49% (14/26) for iliac arteries respectively. By avoiding the disruptive effect on the arterial wall architecture caused by balloon angioplasty, while at the same time ablating and vaporizing more atheromatous material with larger laser probes, the long-term patency rates of laser angioplasty as "sole therapy" may prove to be superior to those of laser assisted balloon angioplasty. PMID:2019619

  10. What Is Coronary Angioplasty?

    MedlinePlus

    ... In many patients a collapsed wire mesh tube (stent), mounted on a special balloon, is moved over ... As the balloon is inflated, it opens the stent against the artery walls. The stent locks in ...

  11. Primary Angioplasty for the Treatment of Acute ST-Segment Elevated Myocardial Infarction

    PubMed Central

    2004-01-01

    Executive Summary One of the longest running debates in cardiology is about the best reperfusion therapy for patients with evolving acute myocardial infarction (MI). Percutaneous transluminal coronary angioplasty (ANGIOPLASTY) is a surgical treatment to reopen a blocked coronary artery to restore blood flow. It is a type of percutaneous (through-the-skin) coronary intervention (PCI) also known as balloon angioplasty. When performed on patients with acute myocardial infarction, it is called primary angioplasty. Primary angioplasty is an alternative to thrombolysis, clot-dissolving drug therapy, for patients with acute MI associated with ST-segment elevation (STEMI), a change recorded with an electrocardiogram (ECG) during chest pain. This review of the clinical benefits and policy implications of primary angioplasty was requested by the Ontario Health Technology Advisory Committee and prompted by the recent publication of a randomized controlled trial (RCT) in the New England Journal of Medicine (1) that compared referred primary angioplasty with on-site thrombolysis. The Medical Advisory Secretariat reviewed the literature comparing primary angioplasty with thrombolysis and other therapies (pre-hospital thrombolysis and facilitated angioplasty, the latter approach consisting of thrombolysis followed by primary angioplasty irrespective of response to thrombolysis) for acute STEMI. There have been many RCTs and meta-analyses of these RCTs comparing primary angioplasty with thrombolysis and these were the subject of this analysis. Results showed a statistically significant reduction in mortality, reinfarction, and stroke for patients receiving primary angioplasty. Although the individual trials did not show significant improvements in mortality alone, they did show it for the outcomes of nonfatal reinfarction and stroke, and for an end point combining mortality, reinfarction, and stroke. However, researchers have raised concerns about these studies. A main concern

  12. Percutaneous Mural Fenestration and Angioplasty for the Treatment of a Refractory Hemodialysis-Related Venous Stenosis

    SciTech Connect

    Denison, Gregory L. Funaki, Brian

    2006-12-15

    Venous stenoses are the leading cause of dialysis graft and mature dialysis fistula malfunction. We report a simple, inexpensive technique for treating stenoses that are refractory to conventional balloon angioplasty and present a case in which this technique was successfully applied.

  13. Advances in interventional cardiology: beyond the balloon.

    PubMed

    Nickolaus, M J; Chambers, C E; Ettinger, S M; Gilchrist, I C; Kozak, M

    2000-12-01

    The world of interventional cardiology has changed dramatically since the advent of balloon angioplasty. New therapies have evolved over the past decade as knowledge of the pathophysiology of heart disease has increased. Nurses who have an understanding of this pathophysiology will be better equipped to manage and educate their patients, teaching them about current and future interventional therapies. This article reviews the pathophysiology of heart disease, current interventional therapies, and the future directions for interventional cardiology nursing practice. PMID:11072277

  14. Digital coronary roadmapping as an aid for performing coronary angioplasty.

    PubMed

    Tobis, J; Johnston, W D; Montelli, S; Henderson, E; Roeck, W; Bauer, B; Nalcioglu, O; Henry, W

    1985-08-01

    In an attempt to improve visualization of the position of the guidewire and dilatation balloon during coronary angioplasty, a method was developed called digital coronary roadmapping. With this method a digitally acquired coronary angiogram is interlaced with the live fluoroscopic image of the guidewire and balloon catheter. The digital coronary angiogram is superimposed at the same magnification and radiologic projection as the live fluoroscopic image onto the video monitor above the catheterization table. The digital roadmap image thus provides immediate feedback to the angiographer to assist in directing the guidewire into the appropriate coronary artery branch and to help in placement of the balloon so that it straddles the site of stenosis. PMID:3161319

  15. [Percutaneous coronary Excimer laser angioplasty in patients with coronary heart disease].

    PubMed

    Karsch, K R; Haase, K K; Mauser, M; Ickrath, O; Voelker, W; Baumbach, A; Seipel, L

    1990-07-01

    To verify the efficacy and safety of percutaneous coronary excimer laser angioplasty in patients with coronary artery disease a prospective study was conducted in 60 patients. The application of laser light was possible in 55 of the 60 patients. A novel 1.4-mm diameter catheter with 20 quartz fibers of 100-microns diameter, each arranged concentrically around a central lumen suitable for an 0.014-inch flexible guide wire was used. The light source was a commercial excimer laser emitting energy at a wavelength of 308 nm, with a pulse duration of 60 ns. The laser was operated at 20 Hz; mean energy transmission was 30 +/- 5 mJ/mm2. In 23 of the 55 patients treated with excimer laser energy the qualitative angiographic results were sufficient. In 32 patients additional balloon angioplasty was necessary, either because of an insufficient result or due to vessel closure after laser ablation. In 47 of the 55 patients control angiography was performed within the 6-month follow-up period. Rate of restenosis was higher in patients treated with laser ablation and subsequent balloon angioplasty (16 of 28) than in patients treated with laser ablation alone (6 of 19). Results of the 6-month observation period suggest that 1) coronary excimer laser angioplasty in combination with subsequent balloon angioplasty results in a considerable increase of the restenosis rate; 2) the exclusive use of laser ablation also results in a restenosis rate comparable to balloon angioplasty alone; and 3) the impact of this new method using improved application systems and higher energy transmission has to be determined in further studies. PMID:2399764

  16. Percutaneous transluminal coronary angioplasty (PTCA)

    MedlinePlus Videos and Cool Tools

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

  17. Spontaneous Coronary Dissection: "Live Flash" Optical Coherence Tomography Guided Angioplasty.

    PubMed

    Bento, Angela Pimenta; Fernandes, Renato Gil Dos Santos Pinto; Neves, David Cintra Henriques Silva; Patrício, Lino Manuel Ribeiro; de Aguiar, José Eduardo Chambel

    2016-01-01

    Optical Coherence tomography (OCT) is a light-based imaging modality which shows tremendous potential in the setting of coronary imaging. Spontaneous coronary artery dissection (SCAD) is an infrequent cause of acute coronary syndrome (ACS). The diagnosis of SCAD is made mainly with invasive coronary angiography, although adjunctive imaging modalities such as computed tomography angiography, IVUS, and OCT may increase the diagnostic yield. The authors describe a clinical case of a young woman admitted with the diagnosis of ACS. The ACS was caused by SCAD detected in the coronary angiography and the angioplasty was guided by OCT. OCT use in the setting of SCAD has been already described and the true innovation in this case was this unique use of OCT. The guidance of angioplasty with live and short images was very useful as it allowed clearly identifying the position of the guidewires at any given moment without the use of prohibitive amounts of contrast. PMID:26989520

  18. Recombinant Human Elastase Alters the Compliance of Atherosclerotic Tibial Arteries After Ex Vivo Angioplasty

    PubMed Central

    Bingham, Karen; Moss, Emma; Gottlieb, Daniel P.; Wong, Marco D.; Bland, Kimberly S.; Franano, F. Nicholas

    2016-01-01

    Purpose: This study was designed to determine whether vonapanitase (formerly PRT-201), a recombinant human elastase, treatment can fragment the protein elastin in elastic fibers and cause dilation of atherosclerotic human peripheral arteries subjected to ex vivo balloon angioplasty. Materials and Methods: Seven patients undergoing lower limb amputation for peripheral artery disease or who died and donated their bodies to science donated 11 tibial arteries (5 anterior, 6 posterior) for this study. All arteries were atherosclerotic by visual inspection. The arteries underwent ex vivo balloon angioplasty and thereafter were cut into rings and studied on wire myographs where the rings were stretched and tension was recorded. After treatment with vonapanitase 2 mg/mL or vehicle control, myography was repeated and the rings were then subject to elastin content measurement using a desmosine radioimmunoassay and elastic fiber visualization by histology. The wire myography data were used to derive compliance, stress-strain, and incremental elastic modulus curves. Results: Vonapanitase treatment reduced elastin (desmosine) content by 60% and decreased elastic fiber histologic staining. Vonapanitase-treated rings experienced less tension at any level of stretch and as a result had shifts in the compliance and stress-strain curves relative to vehicle-treated rings. Vonapanitase treatment did not alter the incremental elastic modulus curve. Conclusions: Vonapanitase treatment of atherosclerotic human peripheral arteries after ex vivo balloon angioplasty fragmented elastin in elastic fibers, decreased tension in the rings at any level of stretch, and altered the compliance and stress-strain curves in a manner predicting arterial dilation in vivo. Based on this result, local treatment of balloon angioplasty sites may increase blood vessel diameter and thereby improve the success of balloon angioplasty in peripheral artery disease. PMID:26745001

  19. Balloons Revisited

    ERIC Educational Resources Information Center

    Jeskova, Z.; Featonby, D.; Fekova, V.

    2012-01-01

    Whilst everyone is familiar with the process of blowing up a balloon, few of us have gone further to quantify the actual pressures involved at different stages in the inflation process. This paper seeks to describe experiments to fill some of those gaps and examine some of the apparently anomalous behaviour of connected balloons. (Contains 12…

  20. Balloons for Science.

    ERIC Educational Resources Information Center

    Lally, Vincent E.

    1982-01-01

    Discusses the nature and use of scientific balloons. Topics addressed include: (1) types of balloons; (2) lifting gases; (3) polyethylene balloons; (4) duration of balloon flight; and (5) use of balloons in scientific research. (JN)

  1. Factors contributing to perforations resulting from laser coronary angioplasty: observations in an intact human postmortem preparation of intraoperative laser coronary angioplasty.

    PubMed

    Isner, J M; Donaldson, R F; Funai, J T; Deckelbaum, L I; Pandian, N G; Clarke, R H; Konstam, M A; Salem, D N; Bernstein, J S

    1985-09-01

    This investigation was designed to assess the potential use of laser coronary angioplasty as an intraoperative adjunct in the surgical treatment of ischemic heart disease. Among 17 postmortem hearts, simulated laser coronary angioplasty was performed at 53 sites with a No. 4F guiding catheter and 240 micron (200 micron core) quartz optical fiber. Perforation complicated laser coronary angioplasty in 33 (62%) of the 53 attempts. Most (n = 29) perforations were thermal; four were purely mechanical. Perforation sites were characterized by extensive calcific deposits (21 of 33 cases [64%] ) and the origin of a side branch (13 of 33 [39%] ). Excessive tortuosity of the extramural coronary artery contributed to arterial perforation in four cases, and precluded attempts to perform laser coronary angioplasty in two other cases. In 19 of the 53 attempts to perform laser coronary angioplasty, a high-frequency two-dimensional echocardiographic probe was used to image the coronary artery during antegrade manipulation of the optical fiber/guiding catheter and laser irradiation of the target arterial stenosis. Although perforation nevertheless occurred in 11 (58%) of 19 sites, only one mechanical perforation resulted; the remaining 10 were thermal. Characteristics of the perforation sites in this group were similar to those noted for the group as a whole. Experience with this model of laser coronary angioplasty indicates that even when access problems associated with percutaneous laser coronary angioplasty are obviated by a simulated intraoperative approach, perforation of the underlying coronary arterial wall continues to represent the "rate-limiting" complication of laser coronary angioplasty. Most perforations occurred in relation to calcific deposits, branch points, and tortuous coronary segments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3161660

  2. Laser welding of balloon catheters

    NASA Astrophysics Data System (ADS)

    Flanagan, Aidan J.

    2003-03-01

    The balloon catheter is one of the principal instruments of non-invasive vascular surgery. It is used most commonly for angioplasty (and in recent years for delivering stents) at a multitude of different sites in the body from small arteries in the heart to the bilary duct. It is composed of a polymer balloon that is attached to a polymer shaft at two points called the distal and proximal bonds. The diverse utility of balloon catheters means a large range of component sizes and materials are used during production; this leads to a complexity of bonding methods and technology. The proximal and distal bonds have been conventionally made using cyanoacrylate or UV curing glue, however with performance requirements of bond strength, flexibility, profile, and manufacturing costs these bonds are increasingly being made by welding using laser, RF, and Hot Jaw methods. This paper describes laser welding of distal and proximal balloon bonds and details beam delivery, bonding mechanisms, bond shaping, laser types, and wavelength choice.

  3. Laser angioplasty of totally occluded arteries of the limb

    NASA Astrophysics Data System (ADS)

    Szopinski, Piotr; Hara, Marek; Noszczyk, Wojciech

    1996-03-01

    The authors summarize their experience in the use of Nd-YAG laser in chronic occlusion of lower limb arteries. Percutaneous transluminal laser angioplasty (PTLA) with laser-heated metal and sapphire tips were used as an adjuvant to conventional balloon angioplasty. In cases of reocclusions, endovascular stents were implanted. Laser recanalization was performed in 46 arteries (iliac, superficial femoral, and popliteal). Indications for the procedure were: limb salvage, claudication below 100 m, and temporal or rest pain. Initial clinical and hemodynamic improvement was observed in 37 (80%) patients. Four perforations occurred without clinical sequel. The one-year cumulative clinical patency was 27 (58%) of the 46 lesions. PTLA may be appropriate for high-risk patients, who are unsuitable for surgical reconstruction because of the concomitant diseases. The combination of laser recanalization and implantation of vascular stents may be a promising method in the management of limb ischemia.

  4. Instability of Reference Diameter in the Evaluation of Stenosis After Coronary Angioplasty: Percent Diameter Stenosis Overestimates Dilative Effects Due to Reference Diameter Reduction

    SciTech Connect

    Hirami, Ryouichi; Iwasaki, Kohichiro; Kusachi, Shozo; Murakami, Takashi; Hina, Kazuyoshi; Matano, Shigeru; Murakami, Masaaki; Kita, Toshimasa; Sakakibara, Noburu; Tsuji, Takao

    2000-03-15

    Purpose: To examine changes in the reference segment luminal diameter after coronary angioplasty.Methods: Sixty-one patients with stable angina pectoris or old myocardial infarction were examined. Coronary angiograms were recorded before coronary angioplasty (pre-angioplasty) and immediately after (post-angioplasty), as well as 3 months after. Artery diameters were measured on cine-film using quantitative coronary angiographic analysis.Results: The diameters of the proximal segment not involved in the balloon inflation and segments in the other artery did not change significantly after angioplasty, but the reference segment diameter significantly decreased (4.7%). More than 10% luminal reduction was observed in seven patients (11%) and more than 5% reduction was observed in 25 patients (41%). More than 5% underestimation of the stenosis was observed in 22 patients (36%) when the post-angioplasty reference diameter was used as the reference diameter, compared with when the pre-angioplasty measurement was used and more than 10% underestimation was observed in five patients (8%).Conclusion: This study indicated that evaluation by percent diameter stenosis, with the reference diameter from immediately after angioplasty, overestimates the dilative effects of coronary angioplasty, and that it is thus better to evaluate the efficacy of angioplasty using the absolute diameter in addition to percent luminal stenosis.

  5. Use of Reactor-Produced Radioisotopes for Prevention Restenosis After Angioplasty

    SciTech Connect

    Knapp, F.F.; Pipes, D.W.

    1999-12-21

    Coronary heart disease leads to myocardial infarction and is a major cause of death in the US. Myocardial infarctions result from atherosclerotic plaque deposits in the coronary arteries, reducing blood flow through these arteries which supply oxygen and nutrients to the heart muscle. The two major approaches for restoring adequate blood flow are coronary bypass graft surgery and coronary angioplasty. Angioplasty is a routinely used clinical procedure, where a deflated balloon attached to the end of a long catheter is inserted into an artery in the leg and then advanced through the aorta into the blocked regions of the coronary arteries. After positioning in the occluded region of the artery, the balloon is inflated with a pressurized saline solution which opens the artery restoring blood flow by pressing the atherosclerotic plaque into the vessel wall. Angioplasty is a widely performed procedure with the coronary arteries and is a much less expensive alternative to coronary bypass surgery. The best patients for angioplasty are those with single occlusions and this method is preferred over bypass grafting because of the significantly reduced expense. The reformation of plaque deposits in arteries (restenosis) following angioplasty, however, is a major clinical problem encountered in as high as 40 percent of patients. Because reduction of health care costs is a major national priority, development of effective new preventative methods for restenoses is an important national priority.

  6. Overview Of Angioplasty: Need For Imaging And Sensing

    NASA Astrophysics Data System (ADS)

    Borst, Cornelius; Rienks, Rienk; Verdaasdonk, Rudolph M.

    1989-08-01

    Balloon angioplasty is a well established non-surgical treatment of ischemic vascular disease. Balloon dilatation increases the lumen in a stenosed artery by overstretching the wall and fracturing the atherosclerotic plaque. Fluoroscopy is adequate to guide the proper placement of guide wire and balloon catheter. Fluoroscopy largely fails, however, when a different recanalization strategy is choosen to address the major problems associated with balloon dilatation. In the past few years, more than twenty different recanalization catheters have been developed that physically remove obstructing plaque. In the femoral artery, both mechanical and thermal methods appear to be quite successful in traversing total occlusions in spite of 'blind' guidance by fluoroscopy. However, subsequent balloon dilatation is often needed. The femoral artery is large and runs a fairly straight course. Perforation of the femoral artery is a minor complication. In the coronary arteries, in contrast, the novel angioplasty methods have met with variable success. These arteries are small, tortuous and move continuously. The anatomy and composition of the plaque is complex and the remainder of the diseased wall may be thin. In the coronary arteries, the margin between recanalization and perforation is small. The latter is a potentially fatal complication. Thus, there is a great need for a catheter that is capable of high resolution imaging and tissue identification in obstructed arteries of small caliber. Intra-arterial echo imaging, possibly combined with laser fluorescence spectroscopy, seems a promising approach. The design of a catheter that combines these powerful diagnostic features with steerability, flexibility and controlled ablation is now the major engineering challenge in interventional cardiology.

  7. Ballooning Interest.

    ERIC Educational Resources Information Center

    Mebane, Robert C.; Rector, Bronwyn

    1991-01-01

    Presents activities that utilize balloons to encourage students to explore questions related to scientific concepts. Concepts explored include light, heat, charged ions, polarization, and the sense of smell. (MDH)

  8. Adjunct Faculty Handbook.

    ERIC Educational Resources Information Center

    Thompson, Merle O'Rourke

    This handbook for Northern Virginia Community College (NVCC) adjunct faculty presents a variety of information designed for adjunct lecturers in English. Three short introductory sections focus on general information, helpful hints, and the use of office machines. The body of the handbook contains the following sections: (1) Services, including…

  9. Percutaneous Transhepatic Use of a Cutting Balloon in the Treatment of a Benign Common Bile Duct Stricture

    SciTech Connect

    Kakani, Nirmal K.; Puckett, Mark; Cooper, Martin; Watkinson, Anthony

    2006-06-15

    Benign biliary strictures (BBS) are difficult to treat. The majority of them are treated either endoscopically or using percutaneous techniques either with stents or conventional angioplasty balloons. To our knowledge we present the first case of use of a cutting balloon in the treatment of BBS through a percutaneous approach.

  10. Tool/tissues interaction modeling for transluminal angioplasty simulation.

    PubMed

    Le Fol, T; Haigron, P; Lucas, A

    2007-01-01

    In this paper, a simulation environment is described for balloon dilation during percutaneous transluminal angioplasty. It means simulating tool/tissues interactions involved in the inflation of a balloon by considering patient specific data. In this context, three main behaviors have been identified: soft tissues, crush completely under the effect of the balloon, calcified plaques, do not admit any deformation but could move in deformable structures and blood vessel wall and organs, try to find their original forms. A deformable soft tissue model is proposed, based on the Enhanced ChainMail method to take into account tissues deformation during dilatation. We improved the original ChainMail method with a "forbidden zone" step to facilitate tool/tissues interactions. The simulation was implemented using five key steps: 1) initialization of balloon parameters; 2) definition of the data structure; 3) dilatation of the balloon and displacement approximation; 4) final position estimation by an elastic relaxation; and 5) interpolation step for visualization. Preliminary results obtained from patient CT data are reported. PMID:18002311

  11. [Role of laser angioplasty in the management of peripheral arteriopathies. Report of 79 cases].

    PubMed

    Henry, M; Beron, R; Chastel, A; Voiriot, P

    1990-01-01

    From May 1988 to November 1989, 79 of the 341 patients admitted to our center requiring angioplasty for peripheral artery disease were treated by laser angioplasty (LA) associated with secondary dilatation. Laser angioplasty was performed with and Nd-YAG laser coupled by an optical fiber to 1.8, 2.2 and 3 mm sapphires. The population studied included 64 men and 15 women (mean age: 66 years). Functional outcome before LA was class II in 85% of cases (n = 67) and class III and IV respectively in 10 (13%) and 2 patients. Laser angioplasty was the primary indication in 61 patients (77%) with a femoropopliteal (n = 53), iliac (n = 7) or axillary (n = 1) arterial obstruction. Laser angioplasty was the secondary indication in stenoses which could not be negotiated by a guide or balloon (23%; n = 18). Laser angioplasty led to repermeabilization of arterial occlusions in 82% of cases. The best results were obtained for short occlusions of less than 3 cm (n = 5; 100%) and for femoropopliteal lesions (n = 60; 85%). Stenoses were revascularized in all cases. Complementary dilatation was performed at the same time in all revascularized patients. Forty-seven revascularized patients were followed up 3 to 6 months after LA. Results were good in 36 cases (77%); restenosis occurred in 7 cases (15%); and reocclusion in 4 cases (8%). It was possible to treat all restenoses percutaneously (dilatation: n = 5; extruder: n = 1; stent: n = 1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2286812

  12. Percutaneous peripheral laser angioplasty with a pulsed Nd:YAG laser and sapphire tips

    NASA Astrophysics Data System (ADS)

    Kvasnicka, Jan; Stanek, Frantisek; Boudik, Frantisek; Kubecek, Vaclav; Krivanek, Jiri; Keclik, Richard; Prochazkova, Helena; Hamal, Karel

    1990-07-01

    Percutaneous transluminal laser angioplasty with a pulsed Nd:YAG laser (1,064 nm wavelength, 100 jig pulse duration, up to 0.4 J per pulse, 10 Hz repetition rate) coupled to optical fibers with sapphire tips of 1.8, 2.2 and 2.9 mm diameter was performed in 17 chronic occlusions of iliac, femoral, popliteal and fibular arteries in 15 patients. Clinically the procedure was successful in 14 cases. The probe formed a primary channel of at least 2.0 mm width which was further dilated by conventional balloon catheter. Ankle/brachial systolic pressure index (ABPI) increased from 0.46 0.13 to 0.84 0.21 after the procedure. Two failures were due to an extensive dissection which occurred after balloon angioplasty and resulted in an early reocclusion. In the remaining case a balloon catheter could not be introduced through the 30 cm long primary channel which reoccluded shortly after the recanalization. The initial patency rate was 82 % and in 5 patients followed for more then 6 months the ABPI showed only a minor decrease. These first results are encouraging and it is likely that this method could become an important alternative to conventional balloon angioplasty.

  13. Angioplasty and stent - heart - discharge

    MedlinePlus

    ... discharge; PTCA - discharge; Percutaneous transluminal coronary angioplasty - discharge; Heart artery dilatation - discharge ... the blood vessels that supply blood to your heart. You may have had a heart attack or ...

  14. Coronary angioplasty guidewire technology.

    PubMed

    McDermott, E A

    1987-01-01

    The technology of coronary guide wires has advanced rapidly since Simpson and Robert performed the first angioplasty with a movable guidewire system in 1981. The technology involved in engineering guidewires encompasses three areas: (1) selection of materials, (2) design of the configuration, and (3) development of the construction process to fabricate the guidewire. Each of these areas must be considered concurrently; that is, the functional effects of manufacturing a wire must be considered along with material selection and configuration design. Another critical area is functional testing to ensure safe and effective performance of the guidewire in the clinical setting and to confirm its functional limits. Research is directed continually toward advancing existing guidewire technology to improve functional performance and develop more efficient manufacturing processes. Additionally under development are new guidewire devices incorporating microsensors and fiberoptics to provide real-time feedback. Advances in technology require miniaturization of guidewire components and application of new materials and processes to manufacture new designs. PMID:2964145

  15. Balloon Sculpture

    ERIC Educational Resources Information Center

    Warwick, James F.

    1976-01-01

    For the adventurous teacher and student there is an alternative to the often messy mixing, pouring, casting, cutting, scoring and sanding of plaster of Paris for casting or sculptural projects. Balloon sculpture, devised, designed and shown here by a sculptor/teacher, is an eye appealing sculptural form and holds a strong interest for students.…

  16. Cosmic Balloons

    ERIC Educational Resources Information Center

    El Abed, Mohamed

    2014-01-01

    A team of French high-school students sent a weather balloon into the upper atmosphere to recreate Viktor Hess's historical experiment that demonstrated the existence of ionizing radiation from the sky--later called cosmic radiation. This discovery earned him the Nobel Prize for Physics in 1936.

  17. Cosmic balloons

    NASA Astrophysics Data System (ADS)

    El Abed, Mohamed

    2014-11-01

    A team of French high-school students sent a weather balloon into the upper atmosphere to recreate Viktor Hess’s historical experiment that demonstrated the existence of ionizing radiation from the sky—later called cosmic radiation. This discovery earned him the Nobel Prize for Physics in 1936.

  18. Angioplasty - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Angioplasty URL of this page: https://medlineplus.gov/languages/angioplasty.html Other topics A-Z A B ...

  19. Angioplasty - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Angioplasty URL of this page: https://www.nlm.nih.gov/medlineplus/languages/angioplasty.html Other topics A-Z A B ...

  20. Arterial healing response after angioplasty and its contributions to restenosis

    NASA Astrophysics Data System (ADS)

    Borst, Cornelius; van Erven, Lieselotte; Velema, Evelyn; Post, Mark J.

    1992-08-01

    Balloon angioplasty of coronary obstructions is limited by a 40% angiographic restenosis rate six months after the intervention. Myointimal hyperplasia is a major contributor to restenosis. In 77 normal rabbits we examined the question whether severe thermal interventional injury to the iliac artery wall would result in less myointimal hyperplasia than severe mechanical injury induced by balloon dilation. Eight weeks after percutaneous injury by electrical spark erosion, the metal laser probe, cw Nd:YAG laser energy through the sapphire contact probe, 90 degree(s)C RF heated balloon dilation, or standard balloon dilation the neointima thickness measured up to 380 micrometers . When thermally and mechanically damaged walls were compared, myointimal hyperplasia was similar. We conclude that in the normal rabbit the arterial wall healing response after any injury is neointima formation which is the vessel wall's expression of the general pattern of wound healing. It is inferred that alternative modes of injury in new recanalization techniques will lead to induced restenosis rates.

  1. Percutaneous Angioplasty of the Sole Patent Cerebral Artery in Two Patients with Takayasu’s Aortoarteritis

    PubMed Central

    Varghese, Kiron; Adhyapak, Srilakshmi M.

    2016-01-01

    We report two female patients with Takayasu’s aortoarteritis, who presented with symptoms of cerebral ischemia due to critical stenosis of the sole patent cerebral artery. Both had occlusion of both vertebral arteries and one carotid artery with critical stenosis of the other carotid artery and presented with hemiparesis contralateral to the patent but stenosed cerebral artery. They also had transient ischemic attacks attributable to the culprit vessel. In the first patient, balloon angioplasty alone was not successful, and hence, a self-expanding stent was deployed in the right common carotid artery. In the second patient, successful balloon angioplasty was performed for the left common carotid artery. Distal protection devices were not used, and neither patient experienced any periprocedural neurological event. Clinical follow-up at six months revealed no significant cerebral events. PMID:27042151

  2. Influence of elastic recoil on restenosis after successful coronary angioplasty in unstable angina pectoris.

    PubMed

    Ardissino, D; Di Somma, S; Kubica, J; Barberis, P; Merlini, P A; Eleuteri, E; De Servi, S; Bramucci, E; Specchia, G; Montemartini, C

    1993-03-15

    The elastic behavior of the dilated coronary vessel has been reported to affect the immediate results of coronary angioplasty. To determine whether elastic recoil may also influence the long-term restenosis process, 98 consecutive patients with unstable angina and 1-vessel disease were studied. An automated coronary quantitative program was used for the assessment of balloon and coronary luminal diameters. Elastic recoil was defined as the percent reduction between minimal balloon diameter at the highest inflation pressure and minimal lesion diameter immediately after coronary angioplasty. Follow-up coronary arteriography was performed 8 to 12 months after the procedure in all patients. The mean elastic recoil averaged 17.7 +/- 16% and was correlated to the degree of residual stenosis immediately after coronary angioplasty (r = 0.64; p < 0.001). Restenosis, defined as > 50% diameter stenosis at follow-up, developed in 53 patients (54%). There was no correlation between the degree of elastic recoil and the changes in minimal lesion diameter observed during follow-up, whereas a positive correlation between the amount of elastic recoil and the incidence of restenosis was documented (r = 0.84; p < 0.05). Thus, the elastic properties of the dilated vessel do not influence the active process of restenosis. However, because elastic recoil negatively influences the initial results of angioplasty, it is more likely that further reductions in lumen diameter during follow-up can reach a threshold of obstruction considered critical for a binary definition of restenosis. PMID:8447261

  3. Remodelling of the Superior Caval Vein After Angioplasty in an Infant with Superior Caval Vein Syndrome

    SciTech Connect

    Mert, Murat Saltik, Levent; Gunay, Ilhan

    2004-08-15

    An 8-month old girl was presented with superior caval vein syndrome early after cardiac surgery. Angiography showed severe stenosis of the superior caval vein with 50 mmHg pressure gradient. Following balloon angioplasty, the pressure gradient was reduced to 7 mmHg with some residual stenosis of the superior caval vein. When the patient was reevaluated 5 months after the procedure, angiography revealed a normal diameter of the superior caval vein without a pressure gradient.

  4. Suppression of Neointimal Hyperplasia Following Angioplasty-Induced Vascular Injury in Pigs Infected with Swinepox Virus

    PubMed Central

    Shimamura, Takeshi; Jeng, David; Lucas, Alexandra; Essani, Karim

    2012-01-01

    Many patients suffering from angina pectoris are treated with percutaneous coronary intervention (PCI) and quickly develop angiographic renarrowing, or restenosis, at the site of PCI treatment. Restenosis is thought to arise from the combinatorial activation of thrombotic and inflammatory responses. The inflammatory response responsible for restenosis is also thought to involve the activation of a cascade of serine proteases and its subsequent regulation. Poxviruses are known to possess a variety of immunomodulatory strategies, some of which target serine proteases, cytokines, and chemokines. To this end we evaluated whether systemic species-specific swinepox virus (SPV) infection could induce sufficient host-immune modulation to promote an anti-inflammatory and anti-proliferative effect, thereby preventing restenosis. Two groups of domestic feeder pigs were used - the first group was experimentally infected with SPV (n= 11) and the second group served as an uninfected control (n= 5). A week after infection, the pigs were anesthetized and percutaneous transluminal coronary angioplasty (PTCA) was performed in the left anterior descending coronary artery using X-ray fluoroscopy to visualize the balloon and record angiograms. Three weeks post infection, the pigs were euthanized and balloon angioplasty injured arteries were harvested and examined. We observed a statistically significant reduction of restenosis in SPV-infected pigs (p = 0.05) compared to control pigs and conclude that systemic swinepox virus infection causes sufficient host immune suppression to significantly reduce restenosis in pigs after balloon angioplasty injury. PMID:23136622

  5. Balloons and Science Kit.

    ERIC Educational Resources Information Center

    Balloon Council, Washington, DC.

    This document provides background information on balloons including: (1) the history of balloons; (2) balloon manufacturing; (3) biodegradability; (4) the fate of latex balloons; and (5) the effect of balloons on the rainforest and sea mammals. Also included as part of this instructional kit are four fun experiments that allow students to…

  6. Endovascular Stenting for Unsuccessful Angioplasty of the Aorta in Aortoarteritis

    SciTech Connect

    Tyagi, Sanjay; Kaul, Upkar A.; Arora, Ramesh

    1999-11-15

    Purpose: The efficacy and safety of endovascular stent implantation to correct dissection or a suboptimal result after percutaneous transluminal angioplasty (PTA) was evaluated in patients suffering from aortic stenosis due to aortoarteritis. Methods: Twelve children and young adults [aged (mean {+-} SD) 18.2 {+-} 8.7 years] underwent stent implantation after PTA of the aorta, seven for obstructive dissection, four for ineffective balloon dilatation, and one for recurrent restenosis. Nine patients underwent implantation of self-expandable stents and three received balloon-expandable Palmaz stents. Results: Stent implantation could be successfully performed in all 12 patients. After stent implantation, the peak systolic pressure gradient decreased from 91 {+-} 33.5 mmHg to 12.4 {+-} 12.5 mmHg (p < 0.001). The diameter of the stenosed segment increased from 4.6 {+-} 0.8 mm to 11.1 {+-} 1.9 mm (p < 0.001). The dissection was completely covered in all seven patients with dissection. Except for epigastric pain with vomiting in one patient, there was no complication. On follow-up, over 12-57 months (mean 26.8 {+-} 10.8 months), 11 patients (91.6%) had marked improvement in their blood pressure. Patients with congestive heart failure and claudication also showed improvement. Repeat catheterization in five patients, between 6-30 months (mean 16.8 {+-} 9.1 months) after stent implantation, showed sustained improvement in four and a fusiform, long segment, intrastent restenosis after 30 months in one child. The stenosis was safely redilated. Conclusion: Endovascular aortic stent implantation is safe and provides good immediate relief in patients with unsatisfactory results after balloon angioplasty. Improvement is sustained in most patients on intermediate-term follow-up.

  7. Drug-eluting balloon catheters for lower limb peripheral arterial disease: the evidence to date

    PubMed Central

    Barkat, Mohamed; Torella, Francesco; Antoniou, George A

    2016-01-01

    A significant proportion of patients with severe lower limb peripheral arterial disease require revascularization. Over the past decade, an endovascular-first approach even for complex disease has gained widespread use among vascular specialists. An important limitation of percutaneous transluminal balloon angioplasty or stenting remains the occurrence of restenosis. Drug-coated balloons have emerged as an exciting technology developed to overcome the limitations of standard balloon angioplasty and stenting. Drug-eluting devices inhibit neointimal growth of vascular smooth muscle cells with the potential of preventing restenosis. This review provides a synopsis of the up-to-date evidence on the role of drug-coated balloons in the treatment of lower limb peripheral arterial disease. Bibliographic searches were conducted using MEDLINE, EMBASE, and the Cochrane Library electronic database. Eleven randomized clinical trials, two systematic reviews, and a published registry providing the best available evidence were identified. Current evidence suggests that angioplasty with drug-coated balloon is reliable, safe, and efficient in increasing patency rates and reducing target lesion revascularization and restenosis. However, it remains unknown whether these improved results can translate into beneficial clinical outcomes, as current randomized clinical trials have failed to demonstrate a significant benefit in limb salvage and mortality. Further randomized trials focusing on clinical and functional outcomes of drug-eluting balloons and on cost versus clinical benefit are required. PMID:27274265

  8. The Entrepreneurial Adjunct

    ERIC Educational Resources Information Center

    Hess, John

    2004-01-01

    Increasingly, the higher education community is witnessing what the author calls the "entrepreneurial adjunct phenomenon": a kind of merchandising of the needs, concerns, and activities of faculty with short-term, often part-time, appointments that depend on factors like enrollment, budget, and program changes. These faculty members are called any…

  9. Peripheral Applications of Drug-Coated Balloons: Past, Present and Future

    SciTech Connect

    Krokidis, Miltiadis Spiliopoulos, Stavros Katsanos, Konstantinos Sabharwal, Tarun

    2013-04-15

    Drug-coated balloon (DCB) technologies represent the latest and hottest development in the field of endovascular treatment of peripheral arterial disease. Initial experience with paclitaxel-coated balloon use in the femoral artery has demonstrated lower mid-term restenosis and superior mid-term clinical outcomes in terms of improved wound healing and reduced repeat angioplasty rates compared with standard balloon angioplasty. Many companies are presently developing and/or improving DCB catheters and therefore ongoing, technical improvements of the already existing platforms, new drugs, and innovative carriers are expected. The ongoing basic research studies and various multicenter randomized, controlled trials that are currently in progress will offer valuable scientific insights regarding the long-term effectiveness and other crucial issues, such as efficacy in various vascular beds, optimal balloon dosage, and post angioplasty antiplatelet therapy. Future applications of these devices also could include in-stent restenosis, anastomotic stenosis of surgical bypass, and benign stenoses of the central venous system. The authors envision that DCB angioplasty will evolve to a major paradigm shift in the endovascular treatment of occlusive vascular diseases.

  10. Ballooning Then...and Ballooning Now.

    ERIC Educational Resources Information Center

    Journal of Aerospace Education, 1978

    1978-01-01

    Describes the history of hot-air balloon travel, starting with its French origins and continuing through to the 1978 national championship. An address for Balloon Federation of America membership is included. (MA)

  11. Adjuncts to opioid therapy.

    PubMed

    Goldstein, Frederick J

    2002-09-01

    Administration of opioids to alleviate moderate to severe acute pain and chronic cancer pain is an established management process. However, advancements in clinical pharmacologic research have shown that opioids are also effective in chronic noncancerous pain. Many patients properly treated for prolonged periods with opioids develop tolerance and subsequently, physical dependence. This process is not necessarily harmful to the patient and will not cause the patient to develop an addiction (properly defined as psychologic dependence). For many patients who have been on opioid therapy for months or years, analgesic effectiveness tragically becomes less. In addition, opioid-induced constipation can be severe and cause pain; patients do not develop tolerance to this adverse reaction. Therefore, such issues become a management problem and require additional intervention. Currently, many different classes of drugs can serve as effective adjuncts to opioids for treatment of pain. Adding adjunctive medication to opioid therapy improves pain management primarily by nonopioid mechanisms of action. Clinical outcomes of such combinations include greater analgesia and attenuation of opioid-induced adverse reactions such as nausea and vomiting, constipation, sedation, and respiratory depression. Adjuncts include acetaminophen, antiarrhythmics, anticonvulsants, antidepressants, antipsychotics, baclofen, benzodiazepines, capsaicin, calcium channel blockers, clonidine hydrochloride, central nervous system stimulants, corticosteroids, local anesthetics, N-methyl-D-aspartate receptor antagonists, nonsteroidal antiinflammatory drugs, pentoxifylline, and scopolamine. Some adjuncts (eg, acetaminophen) are routinely used today, whereas others (eg, nifedipine [calcium channel blocker]) are used on a limited basis but have great potential for more widespread application. All professionals (eg, nurses, pharmacists, physicians, physicians' assistants, social workers, members of the clergy

  12. Ultrasonic resonant modes of piezoelectric balloons under internal pressure.

    PubMed

    Denham, Lori Vidal; Rice, David A

    2012-09-01

    Properties of a piezoelectric polymeric angioplasty balloon that may decrease the problems of acute closure and restenosis are evaluated in this study. Polyvinylidene difluoride (PVDF), a piezoelectric and pyroelectric polymer, has sufficient strength to serve as a standard angioplasty balloon as well as functioning as an ultrasonic transmitter and/or receiver. These properties enable potential therapeutic applications using ultrasound such as plaque ablation and sonotherapy as well as vulnerable plaque diagnosis using thermography. This study investigates the resonant structure of the PVDF balloon catheter in the frequency range 5-100 kHz. Vibrations of the piezoelectric balloon are modeled using cylindrical shell theory and compared with the observed modal frequencies of PVDF cylinders with and without internal pressure. Modal frequencies are determined by measuring the near-field pressure response of the PVDF cylinders using a high frequency microphone. A rich nodal structure is observed between 5 and 100 kHz with peak relative amplitudes measured between 42 and 45 kHz. Higher order modes for cylinders with 9 μm and 28 μm wall thickness increase in frequency as the internal pressure is increased. Experimental measurements confirm theoretical models that predict both pressure-dependent and pressure-independent resonant frequencies. Frequencies of pressure-dependent modes are calculated within 2.2% of measured values at high pressure. PMID:22978865

  13. Three years of clinical experiences on excimer laser angioplasty

    NASA Astrophysics Data System (ADS)

    Viligiardi, Riccardo; Galiberti, Sandra; Pini, Roberto; Salimbeni, Renzo

    1992-03-01

    We report here the experience of our multidisciplinary group that has been working since 1986 on excimer laser angioplasty. After having selected the excimer laser between the available sources because of the negligible lesions left on the residual tissue, we had the purpose to develop a suitable laser and catheter system. Neglecting here all the preliminary studies, we outline only a typical phenomenon related to the energy delivery and useful for the comprehension of the recanalization process. The energy emitted by every single fiber determines, under a certain threshold, independent recanalized channels in the plaque with residual flaps. At a higher energy level the overposition of the lobes, due to the intrinsic divergence, up to the recanalization in a single large channel. In our opinion this condition is crucial in the design of the catheters to obtain an optical instead of a mechanical recanalization. The biological experimentation conducted during the preliminary tests on human hearts obtained from transplants or cadavers, convinced us that the correct goal to pursue was unique laser angioplasty without the need for further balloon dilation.

  14. Influences on vascular wall smooth muscle cells with novel short-duration thermal angioplasty

    NASA Astrophysics Data System (ADS)

    Kunio, M.; Shimazaki, N.; Arai, T.; Sakurada, M.

    2012-02-01

    We investigated the influences on smooth muscle cells after our novel short-duration thermal angioplasty, Photo-thermo Dynamic Balloon Angioplasty (PTDBA), to reveal the mechanism that can suppress neo-intimal hyperplasia after PTDBA. We obtained the sufficient arterial dilatations by short-duration heating (<=15 s, <70°C) and low dilatation pressure (<0.4 MPa) without arterial injuries in our previous in vivo studies. Smooth muscle cells, which play most important role in chronic treatment effects, were heated during PTDBA and stretch-fixed after PTDBA. The dead cell rate by heating, estimated by Arrhenius equation with A=2.5x1016 s-1 and Ea=1.17×105 J mol-1, was 15.7+/-2.2% after PTDBA. The measured deformation rate of smooth muscle cells' nuclei was 1.6+/-0.1 after PTDBA in vivo. We found that the expression of smooth muscle cells' growth factor after PTDBA was inhibited 0.52 fold compared to that after the conventional balloon angioplasty in vivo. The measured neo-intimal hyperplasia occupancy rate was less than 20% after PTDBA in vivo. We prospect that the inhibition of the growth factor's expression by stretch-fixing may result to suppress the neo-intimal hyperplasia. In addition, the decrease of smooth muscle cells' density in the vessel media by heating might be another reason for the neo-intimal hyperplasia suppression.

  15. Spontaneous Coronary Dissection: “Live Flash” Optical Coherence Tomography Guided Angioplasty

    PubMed Central

    Bento, Angela Pimenta; Fernandes, Renato Gil dos Santos Pinto; Neves, David Cintra Henriques Silva; Patrício, Lino Manuel Ribeiro; de Aguiar, José Eduardo Chambel

    2016-01-01

    Optical Coherence tomography (OCT) is a light-based imaging modality which shows tremendous potential in the setting of coronary imaging. Spontaneous coronary artery dissection (SCAD) is an infrequent cause of acute coronary syndrome (ACS). The diagnosis of SCAD is made mainly with invasive coronary angiography, although adjunctive imaging modalities such as computed tomography angiography, IVUS, and OCT may increase the diagnostic yield. The authors describe a clinical case of a young woman admitted with the diagnosis of ACS. The ACS was caused by SCAD detected in the coronary angiography and the angioplasty was guided by OCT. OCT use in the setting of SCAD has been already described and the true innovation in this case was this unique use of OCT. The guidance of angioplasty with live and short images was very useful as it allowed clearly identifying the position of the guidewires at any given moment without the use of prohibitive amounts of contrast. PMID:26989520

  16. Vertebral artery origin angioplasty and primary stenting: safety and restenosis rates in a prospective series

    PubMed Central

    Cloud, G; Crawley, F; Clifton, A; McCabe, D; Brown, M; Markus, H

    2003-01-01

    Objectives: To report a single centre ongoing experience of endovascular treatment for atherosclerotic vertebral artery origin stenosis in a series of symptomatic patients, with follow up imaging to determine the incidence of restenosis. Methods: 14 patients with vertebral artery origin stenosis on catheter angiography were treated. Angioplasty without stenting was undertaken in the first four patients, all of whom had follow up catheter angiography at one year. Subsequently, patients were treated by primary stenting and followed up with colour Doppler ultrasound examination. Results: The procedure was technically successful in all treated arteries, with no immediate complications. The degree of stenosis was reduced from (mean (SD)) 73 (18)% before treatment to 21 (26)% immediately after treatment in the angioplasty alone group (p = 0.059). In the primary stenting patients, the severity of stenosis was reduced from 82 (8)% to 13 (13)% immediately after treatment (p < 0.001). Restenosis to 70% or greater occurred at one year in all four patients initially treated by angioplasty without stenting. One patient subsequently developed further symptoms and was retreated by stenting. One of the 10 patients treated by primary stenting developed restenosis. None of the remaining patients had further posterior circulation ischaemic symptoms during a mean follow up period of 33.6 months (range 1 to 72 months). Conclusions: Restenosis occurs often after vertebral artery origin balloon angioplasty without stenting but is uncommon after stenting. Primary stenting is therefore recommended to maintain patency at this site, and had a low complication rate in this series. PMID:12700299

  17. Heme oxygenase-1 alleviates cigarette smoke-induced restenosis after vascular angioplasty by attenuating inflammation in rat model.

    PubMed

    Ni, Leng; Wang, Zhanqi; Yang, Genhuan; Li, Tianjia; Liu, Xinnong; Liu, Changwei

    2016-03-14

    Cigarette smoke is not only a profound independent risk factor of atherosclerosis, but also aggravates restenosis after vascular angioplasty. Heme oxygenase-1 (HO-1) is an endogenous antioxidant and cytoprotective enzyme. In this study, we investigated whether HO-1 upregulating by hemin, a potent HO-1 inducer, can protect against cigarette smoke-induced restenosis in rat's carotid arteries after balloon injury. Results showed that cigarette smoke exposure aggravated stenosis of the lumen, promoted infiltration of inflammatory cells, and induced expression of inflammatory cytokines and adhesion molecules after balloon-induced carotid artery injury. HO-1 upregulating by hemin treatment reduced these effects of cigarette smoke, whereas the beneficial effects were abolished in the presence of Zincprotoporphyrin IX, an HO-1 inhibitor. To conclude, hemin has potential therapeutic applications in the restenosis prevention after the smokers' vascular angioplasty. PMID:26809138

  18. Drug-Coated Balloons for Infrainguinal Peripheral Artery Disease.

    PubMed

    Sethi, Sanjum S; Lee, Michael S

    2016-07-01

    Revascularization of infrainguinal peripheral artery disease has traditionally been accomplished via percutaneous transluminal angioplasty. However, long-term results have been hampered by high rates of restenosis. Along with the advent of stents, paclitaxel-coated balloons are an emerging therapeutic option for the invasive management of infrainguinal peripheral artery disease. Paclitaxel has been successful in inhibiting neointimal hyperplasia, the main mechanism for in-stent restenosis. Technological advances have facilitated the development of paclitaxel-coated balloons, which show promise in early trials for femoropopliteal stenosis relative to uncoated balloons. For infrapopliteal stenoses, the data remain scant and conflicted. Therefore, large-scale randomized clinical trials with long-term follow-up evaluating safety and effectiveness between various strategies need to be performed to determine the optimal invasive management strategy for infrainguinal peripheral artery disease. PMID:27342205

  19. Drug-coated balloons are replacing the need for nitinol stents in the superficial femoral artery.

    PubMed

    Kitrou, Panagiotis; Karnabatidis, Dimitrios; Katsanos, Konstantinos

    2016-08-01

    Amassed evidence from several randomized controlled trials and high quality meta-analyses clearly support the primary use of paclitaxel-coated balloons (PCB) in the superficial femoral artery over traditional plain balloon angioplasty or primary bare nitinol stenting with significantly lower vascular restenosis, less need for repeat procedures, improved quality of life and potential cost savings for the healthcare system. Stents may be reserved for bail-out in case of a suboptimal dilatation result, and for selected more complex lesions, or in case of critical limb ischemia in order to eliminate vessel recoil and maximize immediate hemodynamic gain. Debulking atherectomy remains unproven, but holds a lot of promise in particular in combination with PCBs, in order to improve compliance of the vessel wall by plaque removal, allow for a better angioplasty result and optimize drug transfer and bioavailability. The present overview summarizes and discusses current evidence about femoropopliteal PCB angioplasty compared to the historical standard of plain old balloon angioplasty and bare nitinol stents. Available evidence is appraised in the context of clinically meaningful results, relevant unresolved issues are highlighted, and future trends are discussed. PMID:27128105

  20. Angioplasty or Stenting in Adult Coarctation of the Aorta? A Retrospective Single Center Analysis Over a Decade

    SciTech Connect

    Macdonald, Sumaira Thomas, Steven M.; Cleveland, Trevor J.; Gaines, Peter A.

    2003-08-15

    For over 11 years, endovascular treatment by angioplasty (PTA) alone or stenting of adult coarctation at a single center was evaluated. We retrospectively reviewed 28 consecutive patients (31 interventions), median age 25 years, treated between 1991 and 2002, 20 of whom had native coarctation. Thirteen patients had PTA alone (16 procedures) (10 'kissing balloon' angioplasty comprising 12 interventions, and 3 single balloon angioplasty comprising 4 interventions) and 15 patients were stented(15 procedures), including 6 secondary and 9 primary stents. There were no procedural or 30-day complications. For the whole group, the median follow-up was 6.6 years (range 1-10 years). In the PTA group, median follow-up was 9 years (range 3-10) and in the stenting group it was 3 years (range 1-5). There were 9 restenoses in the PTA group (6 after 'kissing balloons' and 3 after single balloon) comprising 56% of the angioplasties (9/16 procedures). There was 1 restenosis in the stenting group diagnosed at computed tomography (CT). The patient was clinically well. For the whole group there were significant reductions in systolic blood pressure (BP) (p 0.0003), diastolic BP (p = 0.004) and number of drugs per patient (p = 0.045) at latest follow-up post-treatment. Five patients discontinued therapy.Analysis of the groups revealed that the reduction of systolic and diastolic BP and number of drugs did not reach statistical significance in the PTA group but were significant in the stent group. The endovascular management of adult coarctation is safe. Stents may be more effective than PTA alone but longer-term follow-up of stents is required.

  1. Septic endarteritis following percutaneous transluminal coronary angioplasty.

    PubMed

    Kardaras, F G; Kardara, D F; Rontogiani, D P; Mpourazanis, I A; Flessas, L P

    1995-01-01

    We report a case of bacterial arteritis of the external iliac artery complicated by mycotic aneurysm following coronary angioplasty. To our knowledge, this is the first reported instance of arterial wall infection caused by coronary angioplasty at a distance from the insertion site equal to the length of the sheath. PMID:7728855

  2. Caught in the Adjunct Trap

    ERIC Educational Resources Information Center

    Hose, Linda; Ford, E. J.

    2014-01-01

    Based on personal experiences garnered through years of adjunct instruction, the authors explore the challenges associated with working in academia without the guarantees of a long-term contract or tenure. Further, adjuncts are desperate to accept any position that is remunerative and this willingness undermines contract negotiation leverage of…

  3. NASA Balloon Technology Developments

    NASA Technical Reports Server (NTRS)

    Fairbrother, D. A.

    2004-01-01

    The National Aeronautics and Space Administration (NASA) Balloon Program has been, and will continue to be, committed to improving the capabilities of balloons to support science missions. Fundamental to vehicle improvement is a program of technology development that will enable improved flight performance throughout the next decade. The program s technology thrust areas include: materials, vehicle design & development, structural analysis, operations & support systems, performance modeling and planetary balloons. Building on the foundations of the 18-year research and development program, a technology roadmap has been generated which identifies specific areas of interest to NASA and the vision of future developments. The major components of the roadmap are: vehicle systems, balloon-craft systems, operational and safety support systems, and planetary vehicles. Current technology activities include nanocomposite balloon films, a new balloon designed to lift 3600 kgs to 36 km, a balloon rotation rate study and Mars pumpkin balloon investigations. The technology roadmap, as well as specific projects and recent advancements, will be presented.

  4. Scientific ballooning in Japan

    NASA Astrophysics Data System (ADS)

    Makino, Fumiyoshi

    Activities in scientific ballooning in Japan during 1998-1999 are reported. The total number of scientific balloons flown in Japan in 1998 and 1999 was sixteen, eight flights in each year. The scientific objectives were observations of high energy cosmic electrons, air samplings at various altitudes, monitoring of atmospheric ozone density, Galactic infrared observations, and test flights of new type balloons. Balloon expeditions were conducted in Antarctica by the National Institute of Polar Research, in Russia, in Canada and in India in collaboration with foreign countries' institutes to investigate cosmic rays, Galactic infrared radiation, and Earth's atmosphere. There were three flights in Antarctica, four flights in Russia, three flights in Canada and two flights in India. Four test balloons were flown for balloon technology, which included pumpkin-type super-pressure balloon and a balloon made with ultra-thin polyethylene film of 3.4 μm thickness.

  5. Sinuplasty (Balloon Catheter Dilation)

    MedlinePlus

    ... development of the balloon dilating catheter and its adaptation to sinus surgery. In the 1980s, the field ... used in endoscopic sinus surgery. It is the adaptation or application of minimally-invasive balloon technology to ...

  6. Early results of pulsed dye laser angioplasty with integral ball-tips in long femoral occlusions

    NASA Astrophysics Data System (ADS)

    Murray, Alan; Mitchell, David C.; Wood, Richard F. M.

    1990-07-01

    A Pulsed Dye laser together with specifically designed integral ball-tipped optical fibres have been used for the primary recanalisation of femoropopliteal vascular disease in 25 limbs of 23 patients. All patients had complete occlusions of the vessels ranging from 8-49cms in length (mean 22cms), having presented with critical ischaemia (18) or severe claudication warranting operative intervention (5). Pedal ulceration was present in 8 limbs and digital gangrene in 4. The laser produced visible light at 480nm in lOOmJ/lus pulses, at a frequency of 10-20Hz. The energy delivery device comprised a smooth atraumatic ball-tip constructed from the glass of the optical fibre, which was loaded retrogradely into a standard balloon angioplasty catheter. The device was introduced through a common femoral artery cutdown. Angiographic recanalisation was achieved in 22 of the 25 limbs with a mean energy of 280J(range 68-727J) and in each case the channel created by the laser fibre was augmented by balloon angioplasty. Technical failure occurred in three cases, caused by a wall dissection, persistent side-branch entry and incomplete lesion penetration respectively. Eighteen of procedures (72%) were clinically successful with marked symptomatic improvement. Of the four angiographic successful but clinical failures, acute occlusion within 48 hours occurred in 2 diabetic patients with very poor run-off and distal gangrene. The third case failed acutely due to a technically inadequate balloon dilatation and the fourth patient failed to improve symptomatically due to widespread with segmental tibial vessel disease below a successful recanalisation. Over a mean follow-up period of 7 months, three patients died of myocardial infarction. Twelve of the 23 patients (52%) remain well with patent vessels. These early results demonstrate the efficacy of pulsed dye laser angioplasty using ball-tipped optical fibres.

  7. NASA balloon technology developments

    NASA Astrophysics Data System (ADS)

    Fairbrother, D. A.

    The National Aeronautics and Space Administration (NASA) Balloon Program has been, and will continue to be, committed to improving the capabilities of balloons to support science missions. Fundamental to vehicle improvement is a program of technology development that will enable improved flight performance throughout the next decade. The program's technology thrust areas include: materials, vehicle design & development, structural analysis, operations & support systems, performance modeling and planetary balloons. Building on the foundations of the 18-year research and development program, a technology roadmap has been generated which identifies specific areas of interest to NASA and the vision of future developments. The major components of the roadmap are: vehicle systems, ballooncraft systems, operational and safety support systems, and planetary vehicles. Current technology activities include nanocomposite balloon films, a new balloon designed to lift 3600 kgs to 36 km, a balloon rotation rate study and Mars pumpkin balloon investigations. The technology roadmap, as well as specific projects and recent advancements, will be presented.

  8. Below-the-ankle Angioplasty and Stenting for Limb Salvage: Anatomical Considerations and Long-term Outcomes

    SciTech Connect

    Katsanos, Konstantinos Diamantopoulos, Athanasios; Spiliopoulos, Stavros; Karnabatidis, Dimitris; Siablis, Dimitris

    2013-08-01

    PurposeTo report the long-term angiographic and clinical results in a series of below-the-ankle (BTA) angioplasty procedures and to present some biomechanical issues related to the unique anatomical geometry of the ankle.MethodsWe performed a retrospective analysis of BTA angioplasty procedures. Clinical end points included technical success, patient mortality, salvage of the treated foot, and repeat target lesion revascularization. Imaging end points included primary patency, binary restenosis of the target lesion at the 50 % threshold, and stent integrity (stent fracture, deformation, or collapse). Univariate subgroup analysis was performed.ResultsIn total, 40 limbs in 37 patients (age 73.5 {+-} 8.2 years) with critical limb ischemia were included and 42 inframalleolar lesions (4.2 {+-} 1.4 cm) were analyzed. Technical success was achieved in 95.2 % (40 of 42). Provisional stent placement was performed in 45.2 % (19 of 42). Two patients died, and two major amputations occurred up to 3 years. At 1 year, overall primary vessel patency was 50.4 {+-} 9.1 %, lesion binary restenosis rate was 64.1 {+-} 8.3 %, and repeat intervention-free survival was 93.6 {+-} 4.3 % according to life table analysis of all treated lesions. Pairwise subgroup analysis showed that BTA self-expanding stents were associated with significantly higher restenosis and poorer primary patency compared to plain balloon angioplasty or sirolimus-eluting balloon-expandable stents. Significant deformation and/or fracture of balloon-expandable stents placed BTA were identified in five of 11. Dynamic imaging showed that the dorsalis pedis artery is kinked during foot dorsiflexion, whereas the distal posterior tibial artery is kinked during plantar flexion of the foot.ConclusionBTA angioplasty for critical limb ischemia treatment is safe and feasible with satisfactory long-term results. BTA stent placement must be reserved for bailout indications.

  9. Sleep Apnea Tied to Complications After Angioplasty

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_159391.html Sleep Apnea Tied to Complications After Angioplasty Nightly breathing ... 15, 2016 WEDNESDAY, June 15, 2016 (HealthDay News) -- Sleep apnea may increase the risk of serious complications ...

  10. Sleep Apnea Tied to Complications After Angioplasty

    MedlinePlus

    ... nlm.nih.gov/medlineplus/news/fullstory_159391.html Sleep Apnea Tied to Complications After Angioplasty Nightly breathing ... 15, 2016 WEDNESDAY, June 15, 2016 (HealthDay News) -- Sleep apnea may increase the risk of serious complications ...

  11. NASA Balloon Technology Activities

    NASA Astrophysics Data System (ADS)

    Fairbrother, D. A.

    The National Aeronautics and Space Administration NASA Balloon Program technology development efforts are fundamental to improving the capabilities of the balloon systems better understanding of the flight dynamics and to support the science missions throughout the next decade Building on the foundations of the 20-year research and development program a technology roadmap has been generated which identifies specific areas of interest to NASA and the vision of future developments The major components of the roadmap are vehicle systems ballooncraft systems operational and safety support systems and planetary vehicles Within each of these major components technologies are targeted that will provide both better understanding and foster advancements The Program s technology thrust areas are directed both in broad efforts that touch on a number of the major components as well as specific tasks that address elements within a specific component Advances in vehicle systems have focused on producing better balloon designs This is being attempted through the use of improved inputs into the balloon design process Central to this is an increasing the understanding of materials used to fabricate balloons Testing techniques have been improved with better bi-axial characterization of the balloon materials More realistic radiative properties of the balloon films and components have also been made Analytical assessments of the balloon designs are also key in improving balloon designs These analytical assessments have been accomplished using improving

  12. Weather Balloon Ascent Rate

    NASA Astrophysics Data System (ADS)

    Denny, Mark

    2016-05-01

    The physics of a weather balloon is analyzed. The surprising aspect of the motion of these balloons is that they ascend to great altitudes (typically 35 km) at a more or less constant rate. Such behavior is not surprising near the ground—say for a helium-filled party balloon rising from street level to the top of the Empire State building—but it is unexpected for a balloon that rises to altitudes where the air is rarefied. We show from elementary physical laws why the ascent rate is approximately constant.

  13. GHOST balloons around Antarctica

    NASA Technical Reports Server (NTRS)

    Stearns, Charles R.

    1988-01-01

    The GHOST balloon position as a function of time data shows that the atmospheric circulation around the Antarctic Continent at the 100 mb and 200 mb levels is complex. The GHOST balloons supposedly follow the horizontal trajectory of the air at the balloon level. The position of GHOST balloon 98Q for a three month period in 1968 is shown. The balloon moved to within 2 deg of the South Pole on 1 October 1968 and then by 9 December 1968 was 35 deg from the South Pole and close to its position on 1 September 1968. The balloon generally moved from west to east but on two occasions moved in the opposite direction for a few days. The latitude of GHOST balloons 98Q and 149Z which was at 200 mb is given. Both balloons tended to get closer to the South Pole in September and October. Other GHOST balloons at the same pressure and time period may not indicate similar behavior.

  14. Kestrel balloon launch system

    SciTech Connect

    Newman, M.J.

    1991-10-01

    Kestrel is a high-altitude, Helium-gas-filled-balloon system used to launch scientific payloads in winds up to 20 knots, from small platforms or ships, anywhere over land or water, with a minimal crew and be able to hold in standby conditions. Its major components consist of two balloons (a tow balloon and a main balloon), the main deployment system, helium measurement system, a parachute recovery unit, and the scientific payload package. The main scope of the launch system was to eliminate the problems of being dependent of launching on long airfield runways, low wind conditions, and long launch preparation time. These objectives were clearly met with Kestrel 3.

  15. Outpatient angioplasty: 4-year experience in one practice.

    PubMed Central

    Payne, S. P.; Stanton, A.; Travers, P.; Glenn, D.; Hanel, K. C.

    1997-01-01

    Angioplasty is often performed as an inpatient procedure after preliminary angiography. In order to increase efficiency and patient comfort we introduced a policy of performing angioplasty for chronic leg ischaemia as an outpatient whenever possible, using duplex scanning to select suitable lesions. This paper examines the safety and feasibility of this policy over a 4-year period. We prospectively assessed 168 consecutive cases which were planned for outpatient angioplasty from a total of 190 cases undergoing angioplasty and found full agreement between duplex scanning and angiography in 92%. Six patients (4%) developed complications of angioplasty requiring admission and another five were admitted for unexpected organisational reasons. Thus, the complication rate of outpatient angioplasty was 4%. All complications were noted at the time of angioplasty with no unexpected readmissions. Angioplasty for leg ischaemia is feasible and safe to perform as an outpatient using duplex scanning to select appropriate cases. PMID:9326123

  16. Cryoplasty Versus Conventional Angioplasty in Femoropopliteal Arterial Recanalization: 3-Year Analysis of Reintervention-Free Survival by Treatment Received

    SciTech Connect

    Diaz, Maria Lourdes; Urtasun, Fermin Barberena, Javier; Aranzadi, Carlos; Guillen-Grima, Francisco; Bilbao, Jose Ignacio

    2011-10-15

    Purpose: To compare long-term efficacy of cryoplasty therapy versus conventional angioplasty in the treatment of peripheral arterial atherosclerotic stenosis on the basis of our 3-year clinical experience. Materials and Methods: From January 2006 to December 2008, a total of 155 patients with 192 lesions of the femoropopliteal sector were randomized to receive either cryoplasty or conventional balloon angioplasty. The primary study end point was lesion target patency. Follow-up with clinical evaluation of patient's symptoms, ankle-brachial index, and Doppler ultrasound was scheduled at 1, 6, 9, 12, 24, and 36 months. Results: For the cryoplasty group (n = 86), technical immediate success was achieved in 74.4% of lesions. Rate of significant dissection was 13.5% and rate of stent placement of 22%. In the long term, target lesion patency rate at 6 months was 59.4%, with rates of 55.9, 52.6, and 49.1% at 1, 2, and 3 years, respectively. For the conventional angioplasty group (n = 69), the immediate technical success rate was 83.7%. Rate of significant dissection was 19%, and rate of stent placement was 72.9%. Patency rates at 6 months and at 1, 2, and 3 years were 71.5, 61.2, 60, and 56%, respectively. Conclusion: Compared with conventional angioplasty, cryoplasty showed good immediate success rates with lower stent placement rates. During the 3-year follow-up, patency rates tended to equalize between the two modalities.

  17. Percutaneous peripheral excimer laser angioplasty: immediate success rate and short-term outcome

    NASA Astrophysics Data System (ADS)

    Visona, Adriana; Liessi, Guido; Bonanome, Andrea; Lusiani, Luigi; Miserocchi, Luigi; Pagnan, Antonio

    1991-05-01

    Excimer Laser Angioplasty was attempted in 47 patients (36 males, 11 females, mean age 62+/- 7 years, range 39-77 years), affected by peripheral vascular disease. Thirty-seven patients had a total occlusion of the superficial femoral artery, 3 of the iliac artery and 1 of the popliteal artery; 6 patients showed a subocclusive stenosis of the superficial femoral artery. Occlusions and subocclusive stenoses were classified by length: < 10 cm (28 cases), > 10 cm (19 cases). A commercial excimer laser (Technolas Max-10) was used at the Xenon- Chloride wavelength of 308 nm. The laser operated at 60 ns pulse length and at 20-40 Hz repetition rate. Applied energy fluence was 20 mJ/pulse. The energy was delivered through a multifiber catheter, which combines 12 (7F) or 18 (9F) fibers (260 micron diameter each), concentrically arranged. Balloon dilatation was associated to complete the procedure in 38 cases. The treated arteries were successfully recanalized in 41 out of 47 patients (87%). Hemodynamic improvement was confirmed by a significant increase of ankle/brachial systolic pressure index (from 0.60+/- 0.17 to 0.79+/- 0.20, p < 0.005). Failure to recanalize arterial occlusion occurred in 6 cases, and was due to dissection in 3 patients and inability to cross the final segment of a long occlusion in 3 patients. The success rate was higher for lesions < 10 cm in length. Early reocclusion was observed in 7 patients and was associated with poor run-off. The cumulative patency rate at 1 month was 90.7%. Preliminary results are encouraging. More suitable catheters and better selection of patients should improve the efficacy of laser angioplasty and should allow to perform laser procedures without combining balloon angioplasty.

  18. QT interval dispersion changes according to the vessel involved during percutaneous coronary angioplasty.

    PubMed Central

    Kilic, Harun; Atalar, Enver; Necla, Ozer; Ovunc, Kenan; Aksoyek, Serdar; Ozmen, Ferhan

    2007-01-01

    Increased QT dispersion (QTd) is a noninvasive marker of an electrophysiologic abnormality associated with high mortality in coronary artery disease. The purposes of this study were to measure changes in QTd and ST-segment changes immediately before, during and after intracoronary balloon inflation and to determine whether the coronary artery vessel involved and/or the duration of inflation affect(s) QTd. A total of 45 patients (32 men, 13 women, mean age 58 +/- 11 years) who were referred for elective percutaneous transluminal coronary angioplasty were included. The mean QT interval dispersions for all patients before the inflation, during the balloon inflation at 60 sec and after the balloon deflation at 5 min were 68 +/- 13 ms, 82 +/- 16 ms and 71 +/- 13 ms, respectively. There was no significant difference between baseline and 5 min after deflation. The increase in QTd during the balloon inflation was significant (p<0.01). There was no significant QTd change in patients with left circumflex artery (Cx) lesions during inflation and after deflation compared with baseline. The differences were statistically significant only in patients with left anterior descending (LAD) lesions and right coronary artery (RCA) lesions at 60 sec during balloon inflation (p=0.001 vs. p=0.04). Acute reversible myocardial ischemia induced by balloon inflation causes an increase in QTd limited to the LAD and RCA vessels. Therefore, when using QTd as a marker of myocardial repolarization abnormality due to acute reversible ischemia, the involved coronary artery vessel must be taken into account. PMID:17722670

  19. Percutaneous angioscopy after excimer laser angioplasty

    NASA Astrophysics Data System (ADS)

    Nakamura, Fumitaka; Kvasnicka, Jan; Geschwind, Herbert J.; Uchida, Yasumi

    1992-08-01

    Angioscopy has proved to provide more detailed information on lesion morphology before and after interventional procedures than angiography. Therefore, to evaluate the effects of laser angioplasty, angioscopy was performed in five patients with peripheral or coronary vascular disease who underwent excimer laser angioplasty. The excimer laser was operated at 308 nm, 135 nsec, 25 Hz, and 40 - 60 mJ/mm2 and was coupled into multifiber wire-guided catheters of 1.4 to 2.0 mm diameter for coronary lesions and 2.2 mm for peripheral lesions. There were three coronary (one left anterior descending, one circumflex, one right coronary artery) and two peripheral (one common iliac artery, one superficial femoral artery) lesions. Angioscopy was successfully performed before and after laser ablation without any complications in all five lesions. The characteristics of angioscopic findings after excimer laser angioplasty consisted of flaps, fractures of plaques, and abundant tissue remnants. There was no apparent thermal injury. Recanalized channels were small and irregular. These results indicate that (1) angioscopy is effective and safe for evaluation of lesion morphology after laser angioplasty, (2) laser ablation does not result in thermal injury, and (3) irregular channels after recanalization and abundant tissue remnants may explain the suboptimal results after laser angioplasty.

  20. Video-assisted thoracoscopic bronchoplasty/pulmonary arterial angioplasty.

    PubMed

    Xu, Xin; Huang, Jun; Pan, Hui; Chen, Hanzhang; He, Jianxing

    2016-03-01

    Thoracoscopic bronchoplasty combined with pulmonary arterial angioplasty can be particularly challenging. In the past, it was often done by using a conventional incision or hybrid video-assisted small incision. In recent years, anecdotal articles have described the application of thoracoscopic bronchoplasty/pulmonary arterial angioplasty. This chapter will describe the details associated with thoracoscopic bronchoplasty/pulmonary arterial angioplasty. PMID:27076953

  1. Video-assisted thoracoscopic bronchoplasty/pulmonary arterial angioplasty

    PubMed Central

    Xu, Xin; Huang, Jun; Pan, Hui; Chen, Hanzhang

    2016-01-01

    Thoracoscopic bronchoplasty combined with pulmonary arterial angioplasty can be particularly challenging. In the past, it was often done by using a conventional incision or hybrid video-assisted small incision. In recent years, anecdotal articles have described the application of thoracoscopic bronchoplasty/pulmonary arterial angioplasty. This chapter will describe the details associated with thoracoscopic bronchoplasty/pulmonary arterial angioplasty. PMID:27076953

  2. Clefting in pumpkin balloons

    NASA Astrophysics Data System (ADS)

    Baginski, F.; Schur, W.

    NASA's effort to develop a large payload, high altitude, long duration balloon, the Ultra Long Duration Balloon, focuses on a pumpkin shape super-pressure design. It has been observed that a pumpkin balloon may be unable to pressurize into the desired cyclically symmetric equilibrium configuration, settling into a distorted, undesired stable state instead. Hoop stress considerations in the pumpkin design leads to choosing the lowest possible bulge radius, while robust deployment is favored by a large bulge radius. Some qualitative understanding of design aspects on undesired equilibria in pumpkin balloons has been obtained via small-scale balloon testing. Poorly deploying balloons have clefts, but most gores away from the cleft deploy uniformly. In this paper, we present models for pumpkin balloons with clefts. Long term success of the pumpkin balloon for NASA requires a thorough understanding of the phenomenon of multiple stable equilibria and means for quantitative assessment of measures that prevent their occurrence. This paper attempts to determine numerical thresholds of design parameters that distinguish between properly deploying designs and improperly deploying designs by analytically investigating designs in the vicinity of criticality. Design elements which may trigger the onset undesired equilibria and remedial measures that ensure deployment are discussed.

  3. The Japanese Balloon Program

    NASA Astrophysics Data System (ADS)

    Nishimura, J.

    The Japanese scientific ballooning program has been organized by ISAS since the institute was founded in mid 1960s. Since then, the balloon group of ISAS has been engaged in the development of the balloon technologies and scientific observations in collaboration with scientists and engineers in other universities and organizations. Here, I describe several subjects of recent activities, the details of some items will also be reported in the separate papers in this meeting.Preparation of a new mobile receiving station.

  4. Balloons of made of the EVAL (Ethylene-Vinyl-Alcohol) films. EVAL film has specific Infra-red absorption bands, and is expected to be useful for saving the ballast for a long duration flight.
  5. A high altitude balloon with thin polyethylene films achieving at an altitude of above 50km. Further improvement of this type of balloons is continued by inventing how to extrude thin films less than 5 microns of thickness.
  6. Recent achievement of Antarctica Flights under the collaboration of ISAS and National Polar Institute.
  7. Other new efforts to long duration flights such as satellite link boomerang balloon systems and others.
  8. New balloon borne scientific instrumentation for observations of high energy electrons and Anti-protons in cosmic-rays.
  9. The Great Balloon Controversy.

    ERIC Educational Resources Information Center

    Chase, Valerie

    1989-01-01

    Discusses the harmful effects of balloon launches and the dumping of plastic debris into oceans. Cites several examples of plastic materials being discovered inside the bodies of sick and/or dead marine animals. Offers alternative activities to releasing balloons into the atmosphere. (RT)

  10. Modelling Hot Air Balloons.

    ERIC Educational Resources Information Center

    Brimicombe, M. W.

    1991-01-01

    A macroscopic way of modeling hot air balloons using a Newtonian approach is presented. Misleading examples using a car tire and the concept of hot air rising are discussed. Pressure gradient changes in the atmosphere are used to explain how hot air balloons work. (KR)

  11. Qualifying Adjuncts Academic Worth and the Justification of Adjunct Work

    ERIC Educational Resources Information Center

    Pagnucco, Nicholas D.

    2012-01-01

    This dissertation studies the organization of adjunct instruction within Departments of English and Mathematics at three colleges--a public research university, a private masters granting teaching college, and a public community college. Four questions lie at the core of this project. First, what higher principles and standards of evaluation (i.e.…

  12. The place of rotablator for treatment of in-stent restenosis.

    PubMed

    Reith, S; Radke, P W; Volk, O; vom Dahl, J; Klues, H G

    2000-12-01

    In-stent restenosis (ISR) is still a growing problem in interventional cardiology due to the increasing number of stent implantations. Various treatment modalities are available at present. As a non ablative strategy balloon angioplasty is the strategy of choice for focal ISR, while ablative techniques such as directional coronary atherectomy, Excimer laser coronary angioplasty and rotational atherectomy are used preferentially in diffuse restenosis processes. These debulking techniques are optimized by peri-interventional use of intravascular ultrasound and adjunctive balloon angioplasty. Study data comparing different interventional approaches, usually with adjunct balloon angioplasty, have not proven an optimal treatment modality for ISR yet. PMID:11244517

  13. [Subintimal angioplasty and diabetic foot revascularisation].

    PubMed

    Pierret, Charles; Tourtier, Jean-Pierre; Bordier, Lise; Blin, Emmanuel; Duverger, Vincent

    2011-01-01

    Diabetic wounds foot are responsible for 5-10% minor or major amputation in France. In fact, amputation risk of lower limbs is 15-30% higher for diabetic patients. University of Texas classification (UT) is the reference for diabetic foot wound. It distinguish non ischemic and ischemic wound with more amputation. If ischaemia is combined, revascularization may be considered for salvage of the limb. Some revascularization techniques are well known: as surgical by-pass, angioplasty with or without stent, or hybrid procedures with the both. Subintimal angioplasty is a more recent endovascular technique, in assessment for old patients who are believed to be unsuitable candidates for conventional by-pass or angioplasty. PMID:20980123

  14. Successful Percutaneous Transluminal Angioplasty and Stenting in Acute Mesenteric Ischemia

    SciTech Connect

    Gartenschlaeger, Soeren Bender, Siegfried; Maeurer, Juergen; Schroeder, Ralf J.

    2008-03-15

    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.

  15. Alloplastic adjuncts in breast reconstruction

    PubMed Central

    Cabalag, Miguel S.; Rostek, Marie; Miller, George S.; Chae, Michael P.; Quinn, Tam; Rozen, Warren M.

    2016-01-01

    Background There has been an increasing role of acellular dermal matrices (ADMs) and synthetic meshes in both single- and two-stage implant/expander breast reconstruction. Numerous alloplastic adjuncts exist, and these vary in material type, processing, storage, surgical preparation, level of sterility, available sizes and cost. However, there is little published data on most, posing a significant challenge to the reconstructive surgeon trying to compare and select the most suitable product. The aims of this systematic review were to identify, summarize and evaluate the outcomes of studies describing the use of alloplastic adjuncts for post-mastectomy breast reconstruction. The secondary aims were to determine their cost-effectiveness and analyze outcomes in patients who also underwent radiotherapy. Methods Using the PRSIMA 2009 statement, a systematic review was conducted to find articles reporting on the outcomes on the use of alloplastic adjuncts in post-mastectomy breast reconstruction. Multiple databases were searched independently by three authors (Cabalag MS, Miller GS and Chae MP), including: Ovid MEDLINE (1950 to present), Embase (1980 to 2015), PubMed and Cochrane Database of Systematic Reviews. Results Current published literature on available alloplastic adjuncts are predominantly centered on ADMs, both allogeneic and xenogeneic, with few outcome studies available for synthetic meshes. Outcomes on the 89 articles, which met the inclusion criteria, were summarized and analyzed. The reported outcomes on alloplastic adjunct-assisted breast reconstruction were varied, with most data available on the use of ADMs, particularly AlloDerm® (LifeCell, Branchburg, New Jersey, USA). The use of ADMs in single-stage direct-to-implant breast reconstruction resulted in lower complication rates (infection, seroma, implant loss and late revision), and was more cost effective when compared to non-ADM, two-stage reconstruction. The majority of studies demonstrated

  16. Balloon Design Software

    NASA Technical Reports Server (NTRS)

    Farley, Rodger

    2007-01-01

    PlanetaryBalloon Version 5.0 is a software package for the design of meridionally lobed planetary balloons. It operates in a Windows environment, and programming was done in Visual Basic 6. By including the effects of circular lobes with load tapes, skin mass, hoop and meridional stress, and elasticity in the structural elements, a more accurate balloon shape of practical construction can be determined as well as the room-temperature cut pattern for the gore shapes. The computer algorithm is formulated for sizing meridionally lobed balloons for any generalized atmosphere or planet. This also covers zero-pressure, over-pressure, and super-pressure balloons. Low circumferential loads with meridionally reinforced load tapes will produce shapes close to what are known as the "natural shape." The software allows for the design of constant angle, constant radius, or constant hoop stress balloons. It uses the desired payload capacity for given atmospheric conditions and determines the required volume, allowing users to design exactly to their requirements. The formulations are generalized to use any lift gas (or mixture of gases), any atmosphere, or any planet as described by the local acceleration of gravity. PlanetaryBalloon software has a comprehensive user manual that covers features ranging from, but not limited to, buoyancy and super-pressure, convenient design equations, shape formulation, and orthotropic stress/strain.

  17. Adjunct Control in Telugu and Assamese

    ERIC Educational Resources Information Center

    Haddad, Youssef A.

    2007-01-01

    My study explores Adjunct Control in two South Asian languages, Telugu (Dravidian) and Assamese (Indo-Aryan), within the Minimalist Program of syntactic theory. Adjunct Control is a relation of obligatory co-referentiality between two subjects, one in the matrix clause and one in an adjunct/subordinate clause of the same structure. Telugu and…

  18. What are the potential limitations of drug coated balloons and possible ways to overcome.

    PubMed

    Werk, Michael

    2016-02-01

    In several independent randomized clinical studies, it has been shown that drug-coated balloons (DCBs) cause persistent clinically meaningful and statistically significant inhibition of restenosis in femoropopliteal arteries in comparison to percutaneous transluminal angioplasty with uncoated balloon catheters. The potential benefits of delivering an antiproliferative drug into the vessel wall using a balloon as transporter are manifold: 1) widespread applicability: balloon angioplasty is suitable for use in a wide range of lesions. The use of DCBs is technically less demanding and offers greater flexibility compared with stenting techniques. 2) Maintaining options: minimizing the use of durable implants is providing more options for following and complementary revascularization procedures; 3) proven efficacy: consistent, positive outcomes across studies and key subgroups have been demonstrated from the first preclinical studies to ongoing clinical trials. Beside the enthusiasm carried along with this novel technique and questioning if DCBs will become standard-of-care-therapy for the superficial femoral artery, the potential limitations have to be discussed. PMID:26771723

  19. Laser-driven short-duration heating angioplasty: chronic artery lumen patency and histology in porcine iliac artery

    NASA Astrophysics Data System (ADS)

    Shimazaki, Natsumi; Kunio, Mie; Naruse, Sho; Arai, Tsunenori; Sakurada, Masami

    2012-02-01

    We proposed a short-duration heating balloon angioplasty. We designed a prototype short-duration heating balloon catheter that can heat artery media to 60-70°C within 15-25 s with a combination of laser-driven heat generation and continuous fluid irrigation in the balloon. The purpose of this study was to investigate chronic artery lumen patency as well as histological alteration of artery wall after the short-duration heating balloon dilatation with porcine healthy iliac artery. The short-term heating balloon dilated sites were angiographically patent in acute (1 hour) and in chronic phases (1 and 4 weeks). One week after the dilatation, smooth muscle cells (SMCs) density in the artery media measured from H&E-stained specimens was approx. 20% lower than that in the reference artery. One and four weeks after the dilatations, normal structure of artery adventitia was maintained without any incidence of thermal injury. Normal lamellar structure of the artery media was also maintained. We found that the localized heating restricted to artery media by the short-duration heating could maintain adventitial function and artery normal structure in chronic phase.

  20. Ballooning Interest in Science.

    ERIC Educational Resources Information Center

    Kim, Hy

    1992-01-01

    Presents an activity in which students construct model hot air balloons to introduce the concepts of convection current, the principles of Charles' gas law, and three-dimensional geometric shapes. Provides construction and launching instructions. (MDH)

  21. The Descending Helium Balloon

    ERIC Educational Resources Information Center

    Helseth, Lars Egil

    2014-01-01

    I describe a simple and fascinating experiment wherein helium leaks out of a rubber balloon, thereby causing it to descend. An estimate of the volumetric leakage rate is made by measuring its rate of descent.

  22. NASA Now: Balloon Research

    NASA Video Gallery

    In this NASA Now program, Debbie Fairbrother discusses two types of high-altitude balloons that NASA is using to test scientific instruments and spacecraft. She also talks about the Ideal Gas Law a...

  23. Arterio-Ureteric Fistula Following Iliac Angioplasty

    SciTech Connect

    Aarvold, Alexander; Wales, Lucy Papadakos, Nikolaos; Munneke, Graham; Loftus, Ian; Thompson, Matt

    2008-07-15

    Arterio-ureteric fistulae are rare but can be associated with significant morbidity and mortality. We describe a novel case in which an arterio-ureteric fistula occurred as a complication following external iliac artery angioplasty and stenting, in a patient who had undergone previous pelvic surgery, radiotherapy, ureteric stenting, and urinary diversion surgery. Prompt recognition enabled successful endovascular management using a covered stent.

  24. Temporary Percutaneous Aortic Balloon Occlusion to Enhance Fluid Resuscitation Prior to Definitive Embolization of Post-Traumatic Liver Hemorrhage

    SciTech Connect

    Matsuoka, Shin; Uchiyama, Katsuhiro; Shima, Hideki; Ohishi, Sonomi; Nojiri, Yoko; Ogata, Hitoshi

    2001-07-15

    We successfully stabilized severe hemorrhagic shock following traumatic liver injury by percutaneous transcarotid supraceliac aortic occlusion with a 5 Fr balloon catheter. Then we were able to perform transfemoral embolization therapy of the hepatic arterial bleeding source. Transient aortic occlusion using a balloon catheter appears to be a useful adjunct in select cases where stabilization of the patient is necessary to allow successful selective embolization of the bleeding source.

  25. Visualizing balloon stresses

    NASA Astrophysics Data System (ADS)

    Winker, James A.

    1994-02-01

    In a structure as indeterminate as a partially inflalted balloon it is very difficult to determine either the stress at any given point or a stress pattern over an area. Finite element analysis for this purpose is under development, but this will not likely bear fruit for years. This paper describes a process using desktop computers to convert actual experimental stress data into graphic, visual displays. The results provide valuable insight into the nature of balloon stresses.

  1. Determination of balloon drag

    NASA Technical Reports Server (NTRS)

    Conrad, George R.; Robbins, Edward J.

    1991-01-01

    The evolution of an empirical drag relationship that has stimulated rethinking regarding the physics of balloon drag phenomena is discussed. Combined parasitic drag from all sources in the balloon system are estimated to constitute less than 10 percent of the total system drag. It is shown that the difference between flight-determined drag coefficients and those based on the spherical assumption should be related to the square of the Froude number.

  2. New developments in the clinical use of drug-coated balloon catheters in peripheral arterial disease

    PubMed Central

    Naghi, Jesse; Yalvac, Ethan A; Pourdjabbar, Ali; Ang, Lawrence; Bahadorani, John; Reeves, Ryan R; Mahmud, Ehtisham; Patel, Mitul

    2016-01-01

    Peripheral arterial disease (PAD) involving the lower extremity is a major source of morbidity and mortality. Clinical manifestations of PAD span the spectrum from lifestyle limiting claudication to ulceration and gangrene leading to amputation. Advancements including balloon angioplasty, self-expanding stents, drug-eluting stents, and atherectomy have resulted in high technical success rates for endovascular therapy in patients with PAD. However, these advances have been limited by somewhat high rates of clinical restenosis and clinically driven target lesion revascularization. The recent introduction of drug-coated balloon technology shows promise in limiting neointimal hyperplasia induced by vascular injury after endovascular therapies. This review summarizes the contemporary clinical data in the emerging area of drug-coated balloons. PMID:27418859

  3. Percutaneous coronary excimer laser angioplasty in patients with stable and unstable angina pectoris. Acute results and incidence of restenosis during 6-month follow-up.

    PubMed

    Karsch, K R; Haase, K K; Voelker, W; Baumbach, A; Mauser, M; Seipel, L

    1990-06-01

    A clinical study was conducted to evaluate the efficacy and safety of percutaneous coronary excimer laser angioplasty in 60 patients with coronary artery disease. Forty-nine patients had stable exertional angina, and 11 patients had unstable angina despite medical therapy. A novel 1.4-mm diameter catheter with 20 quartz fibers of 100-microns diameter each arranged concentrically around a central lumen suitable for a 0.014-in. flexible guide wire was coupled to an excimer laser. A commercial excimer laser emitting energy at a wavelength of 308 nm with a pulse duration of 60 nsec was used. The laser was operated at 20 Hz. Mean energy transmission was 30 +/- 5 mJ/mm2. In five of the 60 patients, laser angioplasty was not attempted. In 23 patients with laser ablation alone, percent stenosis decreased from 76 +/- 14% before to 27 +/- 17% after ablation and was 34 +/- 15% at the early follow-up angiogram. In 32 patients, additional balloon angioplasty was performed because of vessel closure after laser ablation in 11 and an insufficient qualitative result in 21 patients. Of the 11 patients with unstable angina, one patient died due to vessel closure 3 hours after intervention, and two patients developed a myocardial infarction. In 22 of 47 patients with late follow-up angiography, restenosis within the 6-month follow-up period occurred. Rate of restenosis was higher in patients treated with laser ablation and balloon angioplasty (16 of 28) than in patients treated with laser ablation alone (six of 19). These results suggest that coronary excimer laser angioplasty for ablation of obstructive lesions is feasible and safe in patients with stable angina. However, development of new catheter systems is necessary for an improved success rate. PMID:2344680

  4. Adjunctive therapies for Kawasaki disease.

    PubMed

    Campbell, Anita J; Burns, Jane C

    2016-07-01

    Kawasaki disease (KD) is the most common cause of acquired heart disease in children in developed countries.(1,2) The primary goal of treatment is to prevent coronary artery aneurysms (CAA). Between 10 and 20% of KD patients are resistant to treatment with intravenous immunoglobulin (IVIG) and have an almost nine-fold increased risk of developing CAA.(3) In addition, approximately 80-90% of patients who go on to develop CAA have abnormal coronary artery dimensions on their first echocardiogram and can therefore be identified as high-risk patients. These two subsets of KD patients are candidates for adjunctive therapy, in addition to IVIG. Understanding the mechanism of action of IVIG may provide insight into IVIG resistance and guidance for choosing adjunctive therapies in KD. Therapeutic options in the treatment of refractory KD and patients with early CAA include additional IVIG, glucocorticoids, tumor necrosis factor inhibitors, calcineurin inhibitors and interleukin-1 (IL-1) blockers.(3-10) Animal studies suggest that the anti-inflammatory properties of statins may also be beneficial in blocking CAA progression.(6) It is unlikely that these therapies will be studied in large, randomized controlled trials in the future due to required sample size and funding constraints. Thus, data from the research laboratory may be helpful in guiding selection of the most promising adjunctive therapies. PMID:27241708

  5. The 'MAP strategy' (Maximum aspiration of atherothrombus and adjunctive glycoprotein IIb/IIIa inhibitor utilization combined with prolonged inflation of balloon/stent) for preventing no-reflow in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention: A retrospective analysis of seventy-one cases.

    PubMed

    Potdar, Anil; Sharma, Satyavan

    2015-12-01

    'No-reflow' phenomenon is a common occurrence in percutaneous coronary intervention (PCI). A three-component 'MAP strategy' was designed to prevent no-reflow by addressing both intralesional and intraluminal thrombus in patients with ST-segment elevation myocardial infarction (STEMI). In this analysis, we observed Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 or 2 in all patients, with no incidence of no-reflow. Myocardial blush grade (MBG) 3 or 2 was observed in most (87.32%) patients. Left ventricular ejection fraction (LVEF) was improved, without any incidence of death up to 9-month follow-up. All patients safely tolerated the strategy-driven prolonged, 35-s inflation of the balloon/stent. PMID:26995430

  6. [Coronary angioplasty in elderly patients].

    PubMed

    Liistro, Francesco; Colombo, Antonio

    2002-01-01

    the two different strategies (5-year survival rate: 85.7% for the coronary artery bypass grafting group vs 81.4% for the percutaneous revascularization group) with a clear benefit in favor of surgery only in diabetic patients. The only constant difference is the need of a repeat intervention which is significantly higher for the percutaneous approach. Furthermore, the introduction of newer percutaneous devices suitable for the recanalization of totally occluded coronary arteries could increase the completeness of the revascularization achieved with the percutaneous approach with a positive effect on the long-term outcome. These considerations could be "out of time" if the results obtained with the use of drug-eluting stents observed in selected patient populations will be confirmed in larger trials and in routine clinical practice. Whereas the advantages of the percutaneous versus the surgical approach in the elderly have not been fully clarified in patients with stable or unstable angina, primary angioplasty appears to be a very promising strategy in old patients with acute myocardial infarction. The improved clinical success with percutaneous revascularization in the elderly (acute mortality in patients > 85 years: 28.4% reperfused vs 38.5% not reperfused; p = 0.001) has to be related to the use of stents and to IIb/IIIa antagonists. In conclusion, when an old patient needs myocardial revascularization, the percutaneous approach should, in our opinion, be considered the treatment of choice in subjects either with stable or unstable angina and in those with acute myocardial infarction. At present, surgical revascularization provides better results in diabetic patients. The advent of drug-eluting stents may change many of the current limitations of percutaneous revascularization and further expand the use of this strategy. PMID:11899566

  7. Scientific ballooning opportunities

    NASA Astrophysics Data System (ADS)

    Peacock, D.

    The National Science Foundation and the National Aeronautics and Space Administration are exploring the, possibilities of a joint balloon program in Antarctica. Over the years there have been many successful small balloons launched from Antarctica for research on topics such as meteorology, atmospheric chemistry, magnetospheric physics, and astrophysics. Recently, a large balloon (and payload) was successfully launched from McMurdo.In response to this growing interest, NSF hosted a 1-day workshop on Scientific Ballooning in Antarctica on March 27. This was well received, as evidenced by the attendance of some 40-50 scientists. At a follow-up meeting on June 14, 1988, attended by P. Wilkness, Division Director, Polar Programs, NSF, and S. Shawhan, Division Director, Space Physics, NASA, it was decided to solicit community input in the form of brief letters (one or two pages). Therefore if you have aspirations for balloon activities in Antarctica within the next few years, please send a brief description of your plans, including scientific objectives, time frame, launch site(s), logistical requirements, budget estimates (excluding logistics), and special needs, if any. Send this material to J . Lynch, Program Manager, Polar Atmospheric Sciences, Division of Polar Programs, National Science Foundation, 1800 G St., N.W., Washington, DC 20550. Send a copy to S. Shawhan, Director, Space Physics Division, NASA Headquarters, Washington, DC 20546.

  8. Experimental analysis of sapphire contact probes for Nd-YAG laser angioplasty.

    PubMed

    Ashley, S; Brooks, S G; Gehani, A A; Kester, R C; Rees, M R

    1990-06-01

    Laser angioplasty may offer percutaneous recanalization of occluded vessels where conventional guidewire and balloon techniques fail. Metal laser thermal angioplasty probes may, however, cause excessive thermal damage due to high tip temperatures (greater than 400.C). Therefore, contact probes made from artificial sapphire crystal designed for general laser surgery are currently being evaluated for use in laser angioplasty with continuous wave Nd-YAG energy. The sapphire modifies the laser energy in various ways, and this paper examines the physical characteristics of five types of rounded sapphire probe (SMTR, MTR, MTRL, OS, LT) and how these properties are affected by clinical usage. The laser beam profile emitted by these probes demonstrates a focal spot 1-2 mm in front of the tip. However, the forward transmission of Nd-YAG energy through the sapphires varied (SMTR, 85%; MTR, 83%; MTRL, 75%; OS, 54%; LT, 69%). Probe heating occurs owing to energy absorption within the sapphire. The surface temperature of the sapphires was measured in air by infrared thermography and the hottest region within the probes localized by an isothermographic technique. At energy settings used clinically (20 J, 10 watts for 2 s) the SMTR, MTR, and MTRL probes exhibited higher temperature rises (94-112.C) than the OS and LT probes (30.C), and heating was localized to the front surface of the former probes. Peak sapphire temperatures remained lower than those of metal probes even at higher energies. After clinical use, the MTR probe demonstrated reduced transmission, beam defocusing, and increased heating, due to surface pitting. Thus, recanalization with sapphire probes occurs by a combination of photothermal and contact thermal effects that are localized to the probe tip and may reduce the degree of thermal injury associated with metal probes. Understanding these basic properties is important to the application and development of contact probes for laser recanalization. PMID:2142867

  9. Stability of lobed balloons

    NASA Astrophysics Data System (ADS)

    Pagitz, M.; Xu, Y.; Pellegrino, S.

    This paper presents a computational study of the stability of simple lobed balloon structures. The particular structure that is investigated is a stack of pumpkin-shaped envelopes with a common axis of symmetry, and hence forming a kind of lobed cylinder. The number of the pumpkin envelopes is one of the variables that is investigated; a number of shape imperfections are also considered. This lobed cylinder is an axi-symmetric, idealised version of the lobed pumpkin balloons that have occasionally deployed into anomalous, clefted configurations. By studying in detail the behaviour of lobed cylinder we are able to draw some preliminary conclusions about general features of the behaviour of lobed pumpkin balloons.

  10. Universal stratospheric balloon gradiometer

    NASA Astrophysics Data System (ADS)

    Tsvetkov, Yury; Filippov, Sergey; Brekhov, Oleg; Nikolaev, Nikolay

    The study of the interior structure of the Earth and laws of its evolution is one of the most difficult problems of natural science. Among the geophysical fields the anomaly magnetic field is one of the most informational in questions of the Earth’s crust structure. Many important parameters of an environment are expedient for measuring at lower altitudes, than satellite ones. So, one of the alternatives is stratospheric balloon survey. The balloon flight altitudes cover the range from 20 to 50 km. At such altitudes there are steady zone air flows due to which the balloon flight trajectories can be of any direction, including round-the-world (round-the-pole). For investigation of Earth's magnetic field one of the examples of such sounding system have been designed, developed and maintained at IZMIRAN and MAI during already about 25 years. This system consists of three instrumental containers uniformly placed along a vertical 6 km line. Up today this set has been used only for geomagnetic purposes. So we describe this system on example of the measuring of the geomagnetic field gradient. System allows measuring a module and vertical gradient of the geomagnetic field along the whole flight trajectory and so one’s name is - stratospheric balloon magnetic gradiometer (SMBG). The GPS-receivers, located in each instrumental container, fix the flight coordinates to within several tens meters. Process of SBMG deployment, feature of the exit of rope from the magazine at the moment of balloon launching has been studied. Used magazine is cellular type. The hodograph of the measuring base of SBMG and the technique of correction of the deviations of the measuring base from the vertical line (introduction of the amendments for the deviation) during the flight have been investigated. It is shown that estimation of the normal level of values of the vertical gradient of the geomagnetic field is determined by the accuracy of determining the length of the measuring base SBMG

  11. Balloon gondola diagnostics package

    NASA Technical Reports Server (NTRS)

    Cantor, K. M.

    1986-01-01

    In order to define a new gondola structural specification and to quantify the balloon termination environment, NASA developed a balloon gondola diagnostics package (GDP). This addition to the balloon flight train is comprised of a large array of electronic sensors employed to define the forces and accelerations imposed on a gondola during the termination event. These sensors include the following: a load cell, a three-axis accelerometer, two three-axis rate gyros, two magnetometers, and a two axis inclinometer. A transceiver couple allows the data to be telemetered across any in-line rotator to the gondola-mounted memory system. The GDP is commanded 'ON' just prior to parachute deployment in order to record the entire event.

  12. [A Case of Vertebral Artery Stenosis Presenting with Progressing Stroke and Treated by Percutaneous Transluminal Angioplasty].

    PubMed

    Hayashi, Kentaro; Matsuo, Yoshitaka; Toyoda, Keisuke; Hayashi, Yukishige; Shirakawa, Kiyoshi; Kaminogo, Makio

    2016-05-01

    A 75-year-old man with a history of diabetes mellitus and hypertension was suffered from dizziness and vomiting and brought to the near-by hospital. MRI showed cerebellar infarction due to right vertebral artery stenosis. Despite best medical treatment, the infarction progressed day by day and he was transferred to our hospital five days later. Neurological examination showed mild disturbance of consciousness and right hemiparesis. Right vertebral angiography revealed high-grade stenosis accompanied with atherosclerosis at the V3-V4 portion. Percutaneous transluminal angioplasty(PTA)was performed with 2.5mm×14mm balloon with 6 atm dilation. Postoperative course was uneventful and no further stroke occurred after the treatment. PTA was effective for vertebral artery stenosis manifested with progressing stroke. The indication of stent placement for the cerebral artery should be prudent. PMID:27166843

  13. Intravascular Ultrasound and Histology in In Vitro Assessment of Iliac Artery Angioplasty

    SciTech Connect

    Lankeren, Winnifred van; Gussenhoven, Elma J.; Qureshi, Akeel; Lugt, Aad van der

    1999-01-15

    Purpose: Intravascular ultrasound (IVUS) was used to assess in vitro the morphologic and quantitative effects of balloon angioplasty (PTA) of the iliac artery. Methods: Forty human iliac arteries ({>=} 30% area stenosis) were studied with IVUS in vitro before and after PTA and the findings were validated with histology. Results: The sensitivity of IVUS for dissection was 74% and for media rupture 59%. The incidence of vascular damage was higher when the whole segment was analyzed rather than the target site alone. Dissections occurred at the thinnest region of the plaque, unrelated to plaque calcification. Following PTA, quantitative changes at the target site were greater compared with the overall data derived from all cross-sections. The increase in lumen area was caused solely by an increase in vessel area. Conclusions: IVUS is sensitive in detecting dissections, which occurred irrespective of calcification at the thinnest region of the plaque. The increase in lumen area after PTA was caused by stretching of the vessel.

  14. Adjunctive Psychotherapy for Bipolar Disorder

    PubMed Central

    Miklowitz, David J.

    2008-01-01

    Objective Psychotherapy has long been recommended as adjunctive to pharmacotherapy for bipolar disorder, but it is unclear which interventions are effective for which patients, over what intervals, and for what domains of outcome. This article reviews randomized trials of adjunctive psychotherapy for bipolar disorder. Method Eighteen trials of individual and group psychoeducation, systematic care, family therapy, interpersonal therapy, and cognitive-behavioral therapy are described. Relevant outcome variables include time to recovery, recurrence, duration of episodes, symptom severity, and psychosocial functioning. Results The effects of the treatment modalities varied according to the clinical condition of patients at the time of random assignment and the polarity of symptoms at follow-up. Family therapy, interpersonal therapy, and systematic care appeared to be most effective in preventing recurrences when initiated after an acute episode, whereas cognitive-behavioral therapy and group psychoeducation appeared to be most effective when initiated during a period of recovery. Individual psychoeducational and systematic care programs were more effective for manic than depressive symptoms, whereas family therapy and cognitive-behavioral therapy were more effective for depressive than manic symptoms. Conclusions Adjunctive psychotherapy enhances the symptomatic and functional outcomes of bipolar disorder over 2-year periods. The various modalities differ in content, structure, and associated mediating mechanisms. Treatments that emphasize medication adherence and early recognition of mood symptoms have stronger effects on mania, whereas treatments that emphasize cognitive and interpersonal coping strategies have stronger effects on depression. The placement of psychotherapy within chronic care algorithms and its role as a preventative agent in the early stages of the disorder deserve investigation. PMID:18794208

  15. BARREL Team Launching 20 Balloons

    NASA Video Gallery

    A movie made by the NASA-Funded Balloon Array for Radiation belt Relativistic Electron Losses, or BARREL, team on their work launching 20 balloons in Antarctica during the Dec. 2013/Jan. 2014 campa...

  16. Launching Garbage-Bag Balloons.

    ERIC Educational Resources Information Center

    Kim, Hy

    1997-01-01

    Presents a modification of a procedure for making and launching hot air balloons made out of garbage bags. Student instructions for balloon construction, launching instructions, and scale diagrams are included. (DDR)

  17. Fiberoptic study on the effects of transluminal angioplasty in experimental occlusive arterial thrombosis.

    PubMed

    Tomaru, T; Uchida, Y; Sugimoto, T

    1988-02-01

    Percutaneous transluminal coronary angioplasty has been proposed as definitive therapy for coronary recanalization of occluded coronary arteries in patients with acute myocardial infarction (AMI). The effects of transluminal angioplasty (TA) on experimental occlusive canine arterial thrombi that closely simulated the clinical condition was examined by a fiberoptic method. Experimental arterial thrombosis was produced by endothelial denudation and induction of luminal stenosis. Eighteen dogs that showed total occlusion of the iliac artery with thrombi were evaluated. Seven dogs (group A) with 6-hour-old thrombi received 20,000 IU/kg intravenous urokinase (UK) but did not show recanalization. TA was performed with a Gruentzig or Simpson-Robert balloon catheter and its effect was evaluated by a vascular fibroscope. Eight dogs (group B) with 6-hour-old thrombi underwent primary TA. After TA, less than 50% luminal obstruction with residual thrombi was visualized in five dogs (71%) of group A and four dogs (50%) of group B. Residual thrombi showed a doughnut-like or globular type shape and consisted of dense fibrin networks and compact platelet aggregates. All dogs in group B received 20,000 IU/kg intravenous UK after TA, but most of them showed progression of thrombus size despite UK infusion. In conclusion, the results suggest (1) that TA is effective in recanalization of an occluded artery with aged thrombus that is resistant to thrombolytic therapy and (2) that vascular fiberscope is a useful method for evaluation of the effects of TA on occlusive arterial thrombus. PMID:2963513

  18. Primary success and one-year followup of percutaneous peripheral excimer laser angioplasty

    NASA Astrophysics Data System (ADS)

    Visona, Adriana; Liessi, Guido; Miserocchi, Luigi; Bonanome, Andrea; Lusiani, Luigi; Breggion, Giovanni; Pagnan, Antonio

    1992-08-01

    Excimer laser angioplasty was performed in 59 patients (44 males and 17 females, mean age 63 +/- 9 years, range 39 - 77) affected by peripheral vascular disease. Fifty patients had a total occlusion of the superficial femoral artery, three of the iliac artery, and one of the popliteal artery; seven patients showed a subocclusive stenosis of the superficial femoral artery. A commercial excimer laser (Technolas Max-10) was used at the Xenon-Chloride wavelength of 308 nm. The laser operated at 120 ns pulse length and at 20 Hz repetition rate. Applied energy fluence was 20 mJ/pulse. The energy was delivered through a multifiber catheter, which combines 12 (7F) or 18 (9F) fibers (260 micron diameter each), concentrically arranged. Balloon dilatation was associated in 51 patients. Successful recanalization was obtained in 59 out of 61 patients (97%). Failure to recanalize the occluded arteries occurred in two cases, and was due to dissection. Early thrombosis and reocclusion (within 48 hours) was observed in five patients. The cumulative patency rate was 56% at one year. On the basis of these results, excimer laser assisted angioplasty seems a feasible and safe procedure. However, this technique did not solve the restenosis problem. A wide application of excimer laser as a stand alone approach can be foreseen for treatment of peripheral vascular disease.

  19. Balloon-Borne Polarimetry

    NASA Astrophysics Data System (ADS)

    Rust, D. M.; Murphy, G.; Strohbehn, K.; Keller, C. U.

    1996-03-01

    For about two weeks in 1995, the balloon-borne Flare Genesis Experiment will continuously observe the Sun well above the turbulent, image-blurring layers of the Earth's atmosphere. The polarization-free 80 cm telescope will supply images to a liquid-crystal based vector magnetograph, which will measure magnetic features at a resolution of 0.2 arcsec. An electrically tunable lithium-niobate Fabry-Perot provides a spectral resolution of about 0.015 nm. In a follow-up series of Antarctic balloon flights, the Flare Genesis Experiment (FGE) will provide unprecedented details about sunspots, flares, magnetic elements, filaments, and the quiet solar atmosphere.

  20. Balloon borne Infrared Surveys

    NASA Astrophysics Data System (ADS)

    Lubin, Philip M.

    2015-08-01

    We report on modeling of a balloon borne mission to survey the 1-5 micron region with sensitivity close to the zodiacal light limits in portions of this band. Such a survey is compelling for numerous science programs and is complimentary to the upcoming Euclid, WFIRST and other orbital missions. Balloons borne missions offer much lower cost access and rapid technological implementation but with much less exposure time and increased backgrounds. For some science missions the complimentary nature of these is extremely useful. .

  1. Effect of gradual computerized angioplasty on outcomes of patients undergoing coronary stenting.

    PubMed

    Leibowitz, David; Lotan, Chaim; Katz, Iony; Nassar, Hisham; Boguslavsky, Larissa; Mosseri, Morris; Jabara, Refat; Varshitzsky, Boris; Danenberg, Haim; Weiss, A Teddy

    2009-07-15

    Mechanical trauma caused by percutaneous coronary intervention is a major factor contributing to subsequent cardiac events, restenosis, and the need for target lesion revascularization (TLR). To minimize this trauma, we developed a Computerized Angioplasty Pressure Sensor and Inflator Device (CAPSID) for gradual inflation. The objective of the present prospective randomized study was to examine whether the use of this novel device reduced TLR, as well as cardiac events, in patients undergoing stenting. Patients undergoing coronary stenting were eligible and randomized to receive CAPSID or standard manual percutaneous coronary intervention. In the CAPSID group, slow, gradual balloon inflation was performed using a personal computer. Patients with acute ST-elevation myocardial infarction or the need for percutaneous coronary intervention for total occlusions, left main disease, and vein grafts were excluded. Clinical follow-up for major adverse cardiac events, including death, acute myocardial infarction, and TLR, was performed at 12 months. A total of 310 patients were enrolled in the study. No significant differences were found in the clinical characteristics between the CAPSID and control groups. At 1 year of follow-up, the CAPSID group had had a significantly lower rate of major adverse cardiac events (8% vs 18%, p <0.01) driven by significantly lower rates of acute myocardial infarction (1% vs 7%, p <0.01) and TLR (5% vs 12%, p <0.05). In conclusion, gradual computerized balloon inflation using CAPSID as a platform for angioplasty and stenting significantly reduced TLR and major adverse cardiac events at 1 year in patients undergoing coronary stenting. The use of this novel device may improve outcomes in patients undergoing coronary stenting. PMID:19576351

  2. JACEE long duration balloon flights

    SciTech Connect

    Burnett, T.; Iwai, J.; Lord, J.J.; Strausz, S.; Wilkes, R.J. ); Dake, S.; Oda, H. ); Miyamura, O. ); Fuki, M. ); Jones, W.V. ); Gregory, J.; Hayashi, T.; Takahashi, U. ); Tominaga,

    1989-01-01

    JACEE balloon-borne emulsion chamber detectors are used to observe the spectra and interactions of cosmic ray protons and nuclei in the energy range 1-100A TeV. Experience with long duration mid-latitude balloon flights and characteristics of the detector system that make it ideal for planned Antarctic balloon flights are discussed. 5 refs., 2 figs.

  3. Adjunct Info: A Journal for Managers of Adjunct and Part-Time Faculty, 1994-97.

    ERIC Educational Resources Information Center

    Greive, Donald, Ed.

    1997-01-01

    This document consists of the twelve issues of the quarterly journal "Adjunct Info" during the three-year period 1994-1997. Individual issues contain articles, editorials, columns, teaching tips, and suggested resources related to management of adjunct and part-time faculty. Major articles include: "A Message to Managers: From an Adjunct" (June…

  4. Adjunct Mentoring, a Vital Responsibility in a Changing Educational Climate: The Lesley University Adjunct Mentoring Program

    ERIC Educational Resources Information Center

    Ziegler, Carol A.; Reiff, Marianne

    2006-01-01

    Lesley University in Cambridge, Massachusetts, USA, has established an adjunct mentoring process in response to its growing number of adjunct faculty. Lesley's adjunct corps serves in Lesley programs offered both on and off campus. The primary goals of the mentoring program are to support excellence in teaching, and to engage in mentoring that…

  5. Particle Astrophysics Using Balloons

    NASA Astrophysics Data System (ADS)

    Seo, E. S.

    Cosmic rays, energetic particles coming from outer space, bring us information about the physical processes that accelerate particles to relativistic energies, about the effects of those particles in driving dynamical processes in our Galaxy, and about the distribution of matter and fields in interstellar space. Cosmic rays were discovered in the early twentieth century using a balloon-borne electroscope. Balloons are currently being used for answering fundamental questions about the cosmos: (1) Is the Universe symmetric, and if so where is the antimatter? (2) What is the dark matter? (3) How do cosmic rays get their enormous energies? (4) Can the entire energy spectrum of cosmic rays result from a single acceleration mechanism? (5) Are supernovae really the sources of cosmic rays? (6) What is the history of cosmic rays in the Galaxy? (7) What is the origin of the "knee" in the cosmic ray energy spectrum? etc. The status of results from past balloon-borne measurements and expected results from ongoing and planned future balloon-borne particle astrophysics experiments will be reviewed.

  6. Scientific balloons: historical remarks.

    NASA Astrophysics Data System (ADS)

    Ubertini, P.

    The paper is an overview of the Human attempt to fly, from the myth of Daedalus and his son Icarus to the first "aerostatic" experiment by Joseph-Michel and Jaques-Etienne Montgolfier. Then, via a jump of about 200 years, we arrive to the era of the modern stratospheric ballooning that, from the beginning of the last century, have provided a unique flight opportunity for aerospace experiments. In particular, the Italian scientific community has employed stratospheric balloons since the '50s for cosmic rays and high energy astrophysical experiments with initial launches performed from Cagliari Helmas Airport (Sardinia). More recently an almost ideal location was found in the area of Trapani-Milo (Sicily, Italy), were an old abandoned airport was refurbished to be used as a new launch site that became operative at the beginning of the '70s. Finally, we suggest a short reminiscence of the first transatlantic experiment carried out on August 1975 in collaboration between SAS-CNR (Italy) and NSBF-NASA (USA). The reason why the Long Duration Balloon has been recently re-oriented in a different direction is analysed and future perspectives discussed. Finally, the spirit of the balloon launch performed by the Groups lead by Edoardo Amaldi, Livio Scarsi and other Italian pioneers, with payloads looking like "refrigerators" weighting a few tens of kg is intact and the wide participation to the present Workshop is the clear demonstration.

  7. Flow Past a Descending Balloon

    NASA Technical Reports Server (NTRS)

    Baginski, Frank

    2001-01-01

    In this report, we present our findings related to aerodynamic loading of partially inflated balloon shapes. This report will consider aerodynamic loading of partially inflated inextensible natural shape balloons and some relevant problems in potential flow. For the axisymmetric modeling, we modified our Balloon Design Shape Program (BDSP) to handle axisymmetric inextensible ascent shapes with aerodynamic loading. For a few simple examples of two dimensional potential flows, we used the Matlab PDE Toolbox. In addition, we propose a model for aerodynamic loading of strained energy minimizing balloon shapes with lobes. Numerical solutions are presented for partially inflated strained balloon shapes with lobes and no aerodynamic loading.

  8. Percutaneous transluminal angioplasty of radiation-induced arterial stenoses

    SciTech Connect

    Guthaner, D.F.; Schmitz, L.

    1982-07-01

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

  9. Athletic Trainers' Knowledge Regarding Airway Adjuncts

    ERIC Educational Resources Information Center

    Edler, Jessica R.; Eberman, Lindsey E.; Kahanov, Leamor; Roman, Christopher; Mata, Heather Lynne

    2015-01-01

    Context: Research suggests that knowledge gaps regarding the appropriate use of airway adjuncts exist among various health care practitioners, and that knowledge is especially limited within athletic training. Objective: To determine the relationship between perceived knowledge (PK) and actual knowledge (AK) of airway adjunct use and the…

  10. Starting a job as adjunct clinical instructor.

    PubMed

    Koharchik, Linda; Jakub, Karen

    2014-08-01

    This article is the second in a new quarterly series on the roles of adjunct clinical faculty and preceptors, who teach nursing students to apply knowledge in clinical settings. Topics will include the preparation of clinical instructors and preceptors for these roles, the student evaluation process, and overcoming challenges that can come with teaching in the clinical field and with adjunct teaching. PMID:25075704

  11. The Associate Program for Adjunct Instructors.

    ERIC Educational Resources Information Center

    Gerda, Joe; And Others

    At the College of the Canyons in California, the majority of faculty are adjunct instructors, many of whom have had little formal background in teaching. In an effort to support these faculty and to assure the quality of instruction, the Associate Program for Adjunct Instructors was instituted. The program emphasizes the development and evaluation…

  12. Precursors and adjuncts of a lunar base

    NASA Technical Reports Server (NTRS)

    Burke, J. D.

    1988-01-01

    The automated, teleoperated, robotic and human-tended subsystems which will precede and accompany a lunar base program are discussed. The information about lunar conditions that can be provided by such precursors and adjuncts is addressed. The use of precursors and adjuncts for communications and navigation, for safety and survival, for lunar archives, and for entertainment and leisure is examined.

  13. Early and Long-Term Results of Subclavian Angioplasty in Aortoarteritis (Takayasu Disease): Comparison with Atherosclerosis

    SciTech Connect

    Tyagi, Sanjay; Verma, Puneet K.; Gambhir, Daljeet S.; Kaul, Upkar A.; Saha, Renuka; Arora, Ramesh

    1998-05-15

    Purpose: To compare the early andlong-term outcomes of subclavian artery angioplasty in patients with aortoarteritis and atherosclerosis. Methods: Sixty-one subclavian artery angioplasties were performed in 55 consecutive patients with aortoarteritis (n= 32) and atherosclerosis (n= 23) between 1986 and 1995. An arch aortogram followed by a selective subclavian artery angiogram was done to profile the site and extent of the lesion, its relation to the vertebral artery, and the distal circulation. Percutaneous transluminal angioplasty (PTA) was performed via the femoral route for 56 stenotic lesions and 5 total occlusions. Results: PTA was successful in 52 (92.8%) stenotic lesions and 3 (60%) total occlusions. Three patients (5.4%) had complications, that could be effectively managed nonsurgically. Compared with atherosclerosis, patients with aortoarteritis were younger (27.4 {+-} 9.3 years vs 54.5 {+-} 10.5 years; p < 0.001), more often female (75% vs 17.4%; p < 0.001), gangrene was uncommon (0% vs 17.4%; p < 0.05), and diffuse involvement was seen more often (43.8% vs 4.4%; p < 0.001). The luminal diameter stenoses were similar before PTA (88.6 {+-} 9.7% vs 89.0 {+-} 9.1%; p= NS). Higher balloon inflation pressure was required to dilate the lesions of aortoarteritis (9.9 {+-} 4.6 ATM vs 5.5 {+-} 1.0 ATM; p < 0.001). This group had more residual stenosis (15.5 {+-} 12.4% vs 8.3 {+-} 9.4%; p < 0.05) after PTA. There were no neurological sequelae, even in PTA of prevertebral lesions. On 3-120 months (mean 43.3 {+-} 28.9 months) follow-up of 40 patients, restenosis was more often observed in patients with aortoarteritis, particularly in those with diffuse arterial narrowing. These lesions could be effectively redilated. Clinical symptoms showed marked improvement after successful angioplasty. Conclusion: Subclavian PTA is safe and can be performed as effectively in aortoarteritis as in atherosclerosis, with good long-term results. Long-term follow-up shows that it

  14. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients

    PubMed Central

    Cho, Hee Young; Park, Yong Won; Kim, Young Han; Jung, Inkyung; Kwon, Ja-Young

    2015-01-01

    Purpose The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation. Methods We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL. Results Sixty-four patients (46.7%) required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1%) had placenta previa totalis. The overall success rate was 75% (48/64) for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all p<0.05). The drainage amount over 1 hour was 500 mL (20–1200 mL) in the balloon failure group and 60 mL (5–500 mL) in the balloon success group (p<0.01). Conclusion Intrauterine tamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance. PMID:26263014

  15. Transhepatic Venous Approach for Balloon-assisted Cervical Collateral Venous Access

    SciTech Connect

    Eyheremendy, Eduardo P.; Malizia, Patricio; Sierre, Sergio

    2011-12-15

    Central venous catheter placement is indicated in many situations, and an increasing number of patients require temporary and long-term central catheters. Frequently, patients who have undergone multiple central veins catheterizations develop complete and diffuse venous occlusion, and this constitutes a difficult-to-manage clinical problem. We report a case of a 20-year-old patient who was referred to our department for central venous line placement who manifested bilateral femoral, jugular, and subclavian veins occlusion. A central venous catheter was implanted through a cervical collateral vein, targeting on and puncturing an angioplasty balloon, and advanced into the collateral vein through a transhepatic venous access.

  16. High plasma coenzyme Q10 concentration is correlated with good left ventricular performance after primary angioplasty in patients with acute myocardial infarction.

    PubMed

    Huang, Ching-Hui; Kuo, Chen-Ling; Huang, Ching-Shan; Tseng, Wan-Min; Lian, Ie Bin; Chang, Chia-Chu; Liu, Chin-San

    2016-08-01

    Exogenous administration of coenzyme Q10 (CoQ10) has been shown in experimental models to have a protective effect against ischemia-reperfusion injury. However, it is unclear whether follow-up plasma CoQ10 concentration is prognostic of left ventricular (LV) performance after primary balloon angioplasty in patients with acute ST segment elevation myocardial infarction (STEMI).We prospectively recruited 55 patients with STEMI who were treated with primary coronary balloon angioplasty. Plasma CoQ10 concentrations were measured before primary angioplasty (baseline) and 3 days, 7 days, and 1 month after STEMI using high-performance liquid chromatography. Echocardiography was performed at baseline and at 6-month follow-up. The control group comprised 54 healthy age- and sex-matched volunteers.Serial circulating CoQ10 concentrations significantly decreased with time in the STEMI group. The LV ejection fraction at 6-month follow-up positively correlated with the 1-month plasma CoQ10 tertile. Higher plasma CoQ10 concentrations at 1 month were associated with favorable LV remodeling and systolic function 6 months after STEMI. Multiple linear regression analysis showed that changes in CoQ10 concentrations at 1-month follow-up were predictive of LV systolic function 6 months after STEMI. Changes in CoQ10 concentrations correlated negatively with baseline oxidized low-density lipoprotein and fibrinogen concentrations and correlated positively with leukocyte mitochondrial copy number at baseline.Patients with STEMI who had higher plasma CoQ10 concentrations 1 month after primary angioplasty had better LV performance at 6-month follow-up. In addition, higher plasma CoQ10 concentration was associated with lower grade inflammatory and oxidative stress status. Therefore, plasma CoQ10 concentration may serve as a novel prognostic biomarker of LV systolic function after revascularization therapy for acute myocardial infarction. PMID:27495100

  17. High plasma coenzyme Q10 concentration is correlated with good left ventricular performance after primary angioplasty in patients with acute myocardial infarction

    PubMed Central

    Huang, Ching-Hui; Kuo, Chen-Ling; Huang, Ching-Shan; Tseng, Wan-Min; Lian, Ie Bin; Chang, Chia-Chu; Liu, Chin-San

    2016-01-01

    Abstract Exogenous administration of coenzyme Q10 (CoQ10) has been shown in experimental models to have a protective effect against ischemia–reperfusion injury. However, it is unclear whether follow-up plasma CoQ10 concentration is prognostic of left ventricular (LV) performance after primary balloon angioplasty in patients with acute ST segment elevation myocardial infarction (STEMI). We prospectively recruited 55 patients with STEMI who were treated with primary coronary balloon angioplasty. Plasma CoQ10 concentrations were measured before primary angioplasty (baseline) and 3 days, 7 days, and 1 month after STEMI using high-performance liquid chromatography. Echocardiography was performed at baseline and at 6-month follow-up. The control group comprised 54 healthy age- and sex-matched volunteers. Serial circulating CoQ10 concentrations significantly decreased with time in the STEMI group. The LV ejection fraction at 6-month follow-up positively correlated with the 1-month plasma CoQ10 tertile. Higher plasma CoQ10 concentrations at 1 month were associated with favorable LV remodeling and systolic function 6 months after STEMI. Multiple linear regression analysis showed that changes in CoQ10 concentrations at 1-month follow-up were predictive of LV systolic function 6 months after STEMI. Changes in CoQ10 concentrations correlated negatively with baseline oxidized low-density lipoprotein and fibrinogen concentrations and correlated positively with leukocyte mitochondrial copy number at baseline. Patients with STEMI who had higher plasma CoQ10 concentrations 1 month after primary angioplasty had better LV performance at 6-month follow-up. In addition, higher plasma CoQ10 concentration was associated with lower grade inflammatory and oxidative stress status. Therefore, plasma CoQ10 concentration may serve as a novel prognostic biomarker of LV systolic function after revascularization therapy for acute myocardial infarction. PMID:27495100

  18. Primary Infrainguinal Subintimal Angioplasty in Diabetic Patients

    SciTech Connect

    Bargellini, Irene Petruzzi, Pasquale; Scatena, Alessia; Cioni, Roberto; Cicorelli, Antonio; Vignali, Claudio; Rizzo, Loredana; Piaggesi, Alberto; Bartolozzi, Carlo

    2008-07-15

    The aim of this study was to prospectively evaluate technical and clinical results of infrainguinal subintimal angioplasty in a series of diabetic patients with limb-threatening ischemia. From July 2003 to December 2007, 60 consecutive diabetic patients (M/F = 41/19; mean age, 69.4 {+-} 9.4 years) with Fontaine stage IV critical limb ischemia, not suitable for surgical recanalization, underwent primary infrainguinal subintimal angioplasty. The technical success, perioperative morbidity and mortality, and clinical success (defined by ulcer healing) were evaluated. Kaplan-Meier life-table analysis was obtained for cumulative clinical success, limb salvage, and survival rates. The procedure was technically successful in 55 of 60 (91.7%) patients; in 5 cases we were not able to achieve a reentry. Periprocedural mortality was 5% (3 patients); three patients (5%) required major amputation periprocedurally. Mean follow-up was 23 months (range, 0-48 months). On an intention-to-treat basis, the limb salvage rate was 93.3% (56/60 patients); ulcer healing was observed in 45 of 60 (75%) patients and it was significantly (p < 0.05) associated with serum creatinine and HbA1c levels, diabetes duration, and infrapopliteal recanalization. One- and three-year cumulative survival rates were 91.5% and 83.1%, respectively; serum creatinine levels, patient age, and clinical success were significant predictors of survival. In conclusion, infrainguinal primary subintimal angioplasty is a safe and effective treatment in diabetic patients with limb-threatening ischemia not suitable for surgical recanalization. This procedure is aimed to create a 'temporary bypass' that facilitates ulcer healing.

  19. Prevention of Intracranial In-stent Restenoses: Predilatation with a Drug Eluting Balloon, Followed by the Deployment of a Self-Expanding Stent

    SciTech Connect

    Vajda, Zsolt Guethe, Thomas Perez, Marta Aguilar Kurre, Wiebke; Schmid, Elisabeth Baezner, Hansjoerg; Henkes, Hans

    2013-04-15

    Stenting in intracranial atherosclerotic disease (ICAD) is increasingly debated, due to issues of procedural safety, technical efficacy, and in-stent recurrent stenoses (ISR). In the present study, feasibility, safety, and efficacy of angioplasty using a drug-eluting balloon (DEB) followed by the implantation of a self-expanding stent (Enterprise) were evaluated for the treatment of ICAD lesions. Fifty-two patients (median age: 71 years; range: 54-86 years; male/female ratio 37:15) underwent stenting of high-grade ICAD lesions between February 2010 and November 2011 in a single center. Angioplasty using a paclitaxel coated SeQuent Please (B. Braun, Germany) or DIOR (Eurocor, Germany) coronary PTCA balloon, followed by the implantation of a self-expanding stent (Enterprise, Codman, USA) was performed in 54 lesions. Angiographic and clinical follow-up was performed at 6 and 12 weeks, 6 and 12 months, and yearly thereafter. Technical success rate, periprocedural complications, occurrence of recurrent ischemic symptoms, and the development of an ISR were analyzed. Angioplasty using a DEB followed by stent implantation was successfully performed in 44 (81 %) cases. DEB insertion failed in 19 % of the cases and angioplasty was finally performed using a conventional PTCA balloon. The combined procedure related permanent neurologic morbidity and mortality rate (stroke, ICH, and subarachnoid hemorrhage) at 30 days and beyond was 5 %. Angiographic and clinical follow-up were obtained in 33 (61 %) lesions in 32 patients. Recurrent stenosis was seen in one (3 %) lesion. Angioplasty and stenting using a DEB is safe and yields encouragingly low ISR rates. Further technical developments to improve lesion accessibility are, nevertheless, mandatory.

  20. [Percutaneous transluminal angioplasty in aortic coarctation. The short- and median-term results].

    PubMed

    Ledesma Velasco, M; Acosta Valdes, J L; Munayer Calderón, J; Salgado Escobar, J L; Arias Monroy, L; Soberanis Torruco, C N

    1991-01-01

    Percutaneous transluminal angioplasty (PTA) was performed in 34 patients with aortic coarctation (Ao Co). One of them with coarctation after surgical correction, the rest were native Ao Co. We used one balloon in 28 patients and two balloons simultaneously in 6. They were separated in three groups according to the degree of aortic arc hypoplasia. Group I (mild to moderate hypoplasia N = 9) the gradient dropped 39% with angiographic improvement of 48% during the follow-up (m = 13.1 months). Three cases with restenosis, 2 were satisfactory dilated and one was sent to surgery. In Group II (severe hypoplasia N = 4) the gradient dropped 31% with angiographic improvement of 30% (follow-up 16.3 months). Two cases with recoarctation were sent to surgery. In Group III (without hypoplasia N = 21) we obtained dropped of gradient of 71% with angiographic improvement of 60% (follow-up 18.5 months). Two cases were redilated successfully. The complications were: cerebral hemorrhage with death due to hypertensive crisis, (1) cerebral embolism, (1) thrombosis in the puncture site 1 and small aneurysm in dilated zone. (1) We think PTA is a good choice to conventional surgery with low rate of morbidity-mortality. The results depend basically on the anatomic type of coarctation and degree of aortic arch hypoplasia. PMID:1828657

  1. Vega balloon meteorological measurements

    NASA Technical Reports Server (NTRS)

    Crisp, D.; Ingersoll, A. P.; Hildebrand, C. E.; Preston, R. A.

    1990-01-01

    The Vega balloons obtained in situ measurements of pressure, temperature, vertical winds, cloud density, ambient illumination, and the frequency of lightning during their flights in the Venus middle cloud layer. The Vega measurements were used to develop a comprehensive description of the meteorology of the Venus middle cloud layer. The Vega measurements provide the following picture: large horizontal temperature gradients near the equator, vigorous convection, and weather conditions that can change dramatically on time scales as short as one hour.

  2. Current treatment of ST elevation acute myocardial infarction in Japan: door-to-balloon time and total ischemic time from the J-AMI registry.

    PubMed

    Nakamura, Masato; Yamagishi, Masakazu; Ueno, Takafumi; Hara, Kazuhiro; Ishiwata, Sugao; Itoh, Tomonori; Hamanaka, Ichiro; Wakatsuki, Tetsuzo; Wakatsuki, Tetuszo; Sugano, Teruyasu; Kawai, Kazuya; Kimura, Takeshi

    2013-01-01

    The door-to-balloon time and total ischemic time are important predictors of the outcome in patients with ST elevation myocardial infarction (STEMI) receiving primary angioplasty, but the current situation in Japan is unknown. The Japan Acute Myocardial Infarction registry is a prospective observational study of 2,030 consecutive STEMI patients admitted to 213 Japanese institutions. The time from symptom onset to hospital arrival, door-to-balloon time, and in-hospital outcome were assessed. Data were compared between patients treated during regular hours or after hours. Percutaneous coronary angioplasty was done in 97.2 % of the patients, using drug-eluting stents in 30 % and bare metal stents in 63 % of the treated cases. The median symptom onset-to-door time (25th and 75th percentiles) was 135 min (64-305 min), median door-to-balloon time was 42 min (28-66 min), and mean procedural time was 98 ± 51 min. The on-call catheterization team performed 48.5 % of the procedures. There was no significant difference of door-to-balloon time between the patients treated after hours and those treated during regular hours. The cardiac mortality rate was 3.2 %, and it increased with longer door-to-balloon times (P = 0.03). The relationship between total ischemic time and cardiac mortality showed 2 peaks, with a trough at 5 h. Median door-to-balloon time was <90 min and was not longer in after hours cases. These findings suggest that Japanese institutions can provide primary angioplasty within an acceptable time frame. PMID:22983884

  3. Optimum designs for superpressure balloons

    NASA Astrophysics Data System (ADS)

    Smith, M. S.; Rainwater, E. L.

    2004-01-01

    The elastica shape is now well known to be the best basic shape for superpressure balloon design. This shape, also known as the pumpkin, or natural shape for balloons, has been well understood since the early 1900s when it was applied to the determination of the shape of descending parachutes. The elastica shape was also investigated in the 1950s when high strength films were used to produce superpressure cylinder balloons. The need for uniform stress distribution in shells of early superpressure balloons led to a long period of the development of spherical superpressure balloons. Not until the late 1970s was the elastica shape revisited for the purpose of the producing superpressure balloons. This paper will review various development efforts in the field of superpressure design and will elaborate on the current state-of-the-art with suggestions for future developments.

  4. Popping a balloon with spaghetti

    NASA Astrophysics Data System (ADS)

    Planinšič, Gorazd; Etkina, Eugenia

    2015-05-01

    Imagine a balloon sitting on a tabletop. The balloon is free to move. You take one uncooked spaghetti noodle. Can you pop the balloon with this spaghetti? If you try, you will quickly see that you cannot [Fig. 1(a)]. You might think that the reason for the failure is the movement of the balloon. As it is not supported by anything, it moves away the moment you touch it with the spaghetti. But you also observe that the noodle breaks. Are these the explanations of your lack of success? To test both explanations of the balloon popping failure, the movement of the balloon (E1) and breaking of the spaghetti noodle (E2), we will perform testing experiments.

  5. Magnetic Particle / Magnetic Resonance Imaging: In-Vitro MPI-Guided Real Time Catheter Tracking and 4D Angioplasty Using a Road Map and Blood Pool Tracer Approach

    PubMed Central

    Jung, Caroline; Kaul, Michael Gerhard; Werner, Franziska; Them, Kolja; Reimer, Rudolph; Nielsen, Peter; vom Scheidt, Annika; Adam, Gerhard; Knopp, Tobias; Ittrich, Harald

    2016-01-01

    Purpose In-vitro evaluation of the feasibility of 4D real time tracking of endovascular devices and stenosis treatment with a magnetic particle imaging (MPI) / magnetic resonance imaging (MRI) road map approach and an MPI-guided approach using a blood pool tracer. Materials and Methods A guide wire and angioplasty-catheter were labeled with a thin layer of magnetic lacquer. For real time MPI a custom made software framework was developed. A stenotic vessel phantom filled with saline or superparamagnetic iron oxide nanoparticles (MM4) was equipped with bimodal fiducial markers for co-registration in preclinical 7T MRI and MPI. In-vitro angioplasty was performed inflating the balloon with saline or MM4. MPI data were acquired using a field of view of 37.3×37.3×18.6 mm3 and a frame rate of 46 volumes/sec. Analysis of the magnetic lacquer-marks on the devices were performed with electron microscopy, atomic absorption spectrometry and micro-computed tomography. Results Magnetic marks allowed for MPI/MRI guidance of interventional devices. Bimodal fiducial markers enable MPI/MRI image fusion for MRI based roadmapping. MRI roadmapping and the blood pool tracer approach facilitate MPI real time monitoring of in-vitro angioplasty. Successful angioplasty was verified with MPI and MRI. Magnetic marks consist of micrometer sized ferromagnetic plates mainly composed of iron and iron oxide. Conclusions 4D real time MP imaging, tracking and guiding of endovascular instruments and in-vitro angioplasty is feasible. In addition to an approach that requires a blood pool tracer, MRI based roadmapping might emerge as a promising tool for radiation free 4D MPI-guided interventions. PMID:27249022

  6. Adjunctive analgesic therapy in veterinary medicine.

    PubMed

    Lamont, Leigh A

    2008-11-01

    Adjunctive analgesic therapies are interventions for pain that involve agents or techniques other than the traditional analgesics (opioids, nonsteroidal anti-inflammatory drugs, and local anesthetics). Adjunctive therapies may be pharmacologic or nonpharmacologic in nature. The focus of this article is on pharmacologic interventions with potential utility as adjunctive analgesics in veterinary medicine. Pharmacology of selected agents, including medetomidine, ketamine, amantadine, gabapentin, systemic lidocaine, and pamidronate, is discussed in addition to evidence for their safety and efficacy and guidelines for their use in veterinary patients. PMID:18954680

  7. Use of Rhenium-188 Liquid-Filled Balloons for Inhibition of Coronary Restenosis After PTCA - A New Opportunity for Nuclear Medicine

    SciTech Connect

    Knapp, F.F., Jr.; Spencer, R.H.; Stabin, M.

    1999-05-13

    Although the use of ionizing radiation for the treatment of benign lesions such as keloids has been available for nearly one hundred years, only recently have the cost effective benefits of such technology for the inhibition of arterial restenosis following controlled vessel damage from balloon angioplasty been fully realized. In particular, the use of balloons filled with solutions of beta-emitting radioisotopes for vessel irradiation provide the benefit of uniform vessel irradiation. Use of such contained ("unsealed") sources is expected to represent a new opportunity for nuclear medicine physicians working in conjunction with interventional cardiologists to provide this new approach for restenosis therapy.

  8. Cleft formation in pumpkin balloons

    NASA Astrophysics Data System (ADS)

    Baginski, Frank E.; Brakke, Kenneth A.; Schur, Willi W.

    NASA’s development of a large payload, high altitude, long duration balloon, the Ultra Long Duration Balloon, centers on a pumpkin shape super-pressure design. Under certain circumstances, it has been observed that a pumpkin balloon may be unable to pressurize into the desired cyclically symmetric equilibrium configuration, settling into a distorted, undesired state instead. Success of the pumpkin balloon for NASA requires a thorough understanding of the phenomenon of multiple stable equilibria and developing of means for the quantitative assessment of design measures that prevent the occurrence of undesired equilibrium. In this paper, we will use the concept of stability to classify cyclically symmetric equilibrium states at full inflation and pressurization. Our mathematical model for a strained equilibrium balloon, when applied to a shape that mimics the Phase IV-A balloon of Flight 517, predicts instability at float. Launched in Spring 2003, this pumpkin balloon failed to deploy properly. Observations on pumpkin shape type super-pressure balloons that date back to the 1980s suggest that within a narrowly defined design class of pumpkin shape super-pressure balloons where individual designs are fully described by the number of gores ng and by a single measure of the bulging gore shape, the designs tend to become more vulnerable with the growing number of gores and with the diminishing size of the bulge radius rB Weight efficiency considerations favor a small bulge radius, while robust deployment into the desired cyclically symmetrical configuration becomes more likely with an increased bulge radius. In an effort to quantify this dependency, we will explore the stability of a family of balloon shapes parametrized by (ng, rB) which includes a design that is very similar, but not identical, to the balloon of Flight 517. In addition, we carry out a number of simulations that demonstrate other aspects related to multiple equilibria of pumpkin balloons.

  9. Breakthrough in Mars balloon technology

    NASA Astrophysics Data System (ADS)

    Kerzhanovich, V. V.; Cutts, J. A.; Cooper, H. W.; Hall, J. L.; McDonald, B. A.; Pauken, M. T.; White, C. V.; Yavrouian, A. H.; Castano, A.; Cathey, H. M.; Fairbrother, D. A.; Smith, I. S.; Shreves, C. M.; Lachenmeier, T.; Rainwater, E.; Smith, M.

    2004-01-01

    Two prototypes of Mars superpressure balloons were flight tested for aerial deployment and inflation in the Earth's stratosphere in June, 2002. One was an 11.3 m diameter by 6.8 m high pumpkin balloon constructed from polyethylene film and Zylon (PBO) tendons, the second was a 10 m diameter spherical balloon constructed from 12 μm thick Mylar film. Aerial deployment and inflation occurred under parachute descent at 34 km altitude, mimicing the dynamic pressure environment expected during an actual Mars balloon mission. Two on-board video cameras were used on each flight to provide real-time upward and downward views of the flight train. Atmospheric pressure and temperature were also recorded. Both prototypes successfully deployed from their storage container during parachute descent at approximately 40 m/s. The pumpkin balloon also successfully inflated with a 440 g charge of helium gas injected over a 1.5-min period. Since the helium inflation system was deliberately retained after inflation in this test, the pumpkin balloon continued to fall to the ocean where it was recovered for post-flight analysis. The less robust spherical balloon achieved only a partial (~70%) inflation before a structural failure occurred in the balloon film resulting in the loss of the vehicle. This structural failure was diagnosed to result from the vigorous oscillatory motion of the partially inflated balloon, possibly compounded by contact between the balloon film and an instrumentation box above it on the flight train. These two flights together represent significant progress in the development of Mars superpressure balloon technology and pave the way for future flight tests that will include post-deployment flight of the prototype balloons at a stable altitude.

  10. Primary coronary angioplasty in patients with acute myocardial infarction.

    PubMed Central

    Popma, J J; Chuang, Y C; Satler, L F; Kleiber, B; Leon, M B

    1994-01-01

    In some patients with acute myocardial infarction, thrombolytic therapy may be limited by its failure to reperfuse the occluded artery, by recurrent ischemia (despite initially successful reperfusion), and by major hemorrhagic complications. Primary coronary angioplasty may circumvent these limitations. This article reviews the results of primary angioplasty reported in patients with myocardial infarction and makes recommendations for its use. The review includes pertinent articles found in the English language literature from July 1987 to July 1993 on MEDLINE. Nonrandomized series of primary angioplasty in acute myocardial infarction have demonstrated high procedural success rates (86% to 99%) and infrequent recurrent ischemia (4%). Two randomized trials comparing primary angioplasty and thrombolytic therapy have shown that primary angioplasty results in lower mortality, less recurrent ischemia, shorter length of hospital stay, and improved left ventricular function. Two other randomized studies have shown little benefit from primary angioplasty on myocardial salvage, recurrent ischemia, or ventricular function. One major limitation of primary angioplasty is that it requires 24-hour availability of a catheterization laboratory and experienced surgical personnel. Primary angioplasty may be the preferred approach in patients with extensive myocardial infarction who have immediate (< 120 min) access to a cardiac catheterization laboratory with experienced personnel. Patients having 1) contraindications to thrombolytic therapy, 2) cardiogenic shock, 3) prior coronary bypass surgery, or 4) "stuttering" onset of pain may also benefit from primary angioplasty. Poor candidates for this procedure are those with a small myocardial infarction, those in whom undue delays in access to a cardiac catheterization facility would be expected, or those with complex coronary anatomy, including left main coronary artery disease. PMID:8061539

  11. Application of new balloon catheters in the treatment of congenital heart defects

    PubMed Central

    Fiszer, Roland; Szkutnik, Małgorzata; Smerdziński, Sebastian; Chodór, Beata; Białkowski, Jacek

    2016-01-01

    Introduction Balloon angioplasty (BAP) and aortic or pulmonary balloon valvuloplasty (BAV, BPV) are well-established treatment options in congenital heart defects. Recently, significant technological progress has been made and new catheters have been implemented in clinical practice. Aim To analyze the results of BAP, BAV and BPV with the new balloon catheter Valver and its second generation Valver II, which the company Balton (Poland) launched and developed. These catheters have not been clinically evaluated yet. Material and methods We performed 64 interventions with Valver I and Valver II. With Valver I the following procedures were performed: 17 BPV (including 9 in tetralogy of Fallot – TOF), 10 BAV and 27 BAP in coarctations of the aorta (CoA) – including 9 native and 18 after surgery. With Valver II ten interventions were done – 3 BPV, 2 pulmonary supravalvular BAP (after switch operations), 2 BAP of recoarctations and 3 other BAP. Age of the patients ranged from a few days to 40 years. Results All procedures were completed successfully, without rupture of any balloon catheters. The pressure gradient drop was statistically significant in all groups: BPV in isolated pulmonary valvular stenosis 28.1 mm Hg (mean), BPV in TOF 18.7 mm Hg, BAV 32.8 mm Hg, BAP in native CoA 15.4 mm Hg and in recoarctations 18.6 mm Hg. In 3 cases during rapid deflation of Valver I, wrinkles of the balloons made it impossible to insert the whole balloon into the vascular sheath (all were removed surgically from the groin). No such complication occured with Valver II. Conclusions Valver balloon catheters are an effective treatment modality in different valvular and vascular stenoses. PMID:27625686

  12. Microgravity Experiment System Using Balloon

    NASA Astrophysics Data System (ADS)

    Sawai, Shujiro; Hashimoto, Tatsuaki; Sawai, Shujiro; Sakai, Shin'ichiro; Bando, Nobutaka; Kobayashi, Hiroaki; Fujita, Kazuhisa; Inatomi, Yuko; Ishikawa, Takehiko; Yoshimitsu, Tetsuo; Saito, Yoshitaka

    Balloon based system to conduct microgravity experiment was developed. This system consists of high altitude balloon, Microgravity Operation Unit for Scientific Experiment (MOUSE), and Balloon based Operation Vehicle (BOV). BOV drops from the balloon. But due to the residual air drag, BOV do not fall freely. So, MOUSE floats freely inside BOV body. BOV itself is controlled not to collide to MOUSE, and it makes the residual gravity negligible inside MOUSE. Authors have conducted the flight campaign twice to show the feasibility of this microgravity experiment system.

  13. Next Generation Balloon Performance Model

    NASA Astrophysics Data System (ADS)

    Pankine, A.; Nock, K.; Heun, M.; Schlaifer, S.

    Global Aerospace Corporation is developing a new trajectory and performance modeling tool for Earth and Planetary Balloons, called Navajo. This tool will advance the state of the art for balloon performance models and assist NASA and commercial balloon designers, campaign and mission planners, and flight operations staff by providing high-accuracy vertical and horizontal trajectory predictions. Nothing like Navajo currently exists. The Navajo design integrates environment, balloon (or Lighter Than Air - LTA), gondola (for ballast and communications), and trajectory control system submodels to provide rapid and exhaustive evaluation of vertical and horizontal balloon and LTA vehicle trajectories. The concept utilizes an extensible computer application architecture to permit definit ion of additional flight system components and environments. The Navajo architecture decouples the balloon performance and environment models so that users can swap balloon and environment models easily and assess the capabilities of new balloon technologies in a variety of environments. The Navajo design provides integrated capabilities for safety analysis for Earth balloon trajectories, and utilize improved thermal models. We report on our progress towards the development of Navajo.

  14. Venous Recanalization by Metallic Stents After Failure of Balloon Angioplasty or Surgery: Four-Year Experience

    SciTech Connect

    Nazarian, Gwen K.; Austin, William R.; Wegryn, Scott A.; Bjarnason, Haraldur; Stackhouse, Daniel J.; Castaneda-Zuniga, Wilfrido R.; Hunter, David W.

    1996-04-15

    Purpose: This retrospective study describes our updated experience in treating venous stenoses and occlusions with metallic endovascular stents. Methods: Gianturco, Palmaz, and Wallstent stents were placed in 55 patients over a 4-year period. Stent sites included the subclavian veins (9), innominate veins (3), superior vena cava (4), inferior vena cava (3), iliac veins (29), femoral veins (5), and portal veins (6). The most common indications for stent placement were malignant stenoses and chronic pelvic venous occlusions. Venoplasty and/or urokinase were used as ancillary therapy. Patients were anticoagulated for 3-6 months. Follow-up included clinical assessment and duplex ultrasound. Results: Lifetable analysis shows 59%, 63%, and 72% primary, primary assisted, and secondary 1-year patency rates, respectively. The 4-year primary patency rates were the same. Duration of patency depended on the venous site. Death was a complication of stent placement in 2 patients and 12 patients died within 6 months after stent placement from primary disease progression. Although early failures were more common in stents placed across occlusions than stenoses, 1-year secondary patency rates were comparable. Primary patency rates were only slightly lower in patients with malignant obstruction than in patients with benign disease. Conclusion: Endovascular stent placement provides a nonsurgical alternative for reestablishment of venous flow and symptomatic relief in patients with benign as well as malignant venous obstruction.

  15. An Orientation Program for Clinical Adjunct Faculty.

    PubMed

    Rice, Gwendolyn

    2016-01-01

    Having highly competent clinical faculty in an institution of higher learning is a prerequisite for graduating safe nurses in the future. The purpose of this project was to increase each clinical nurse's knowledge and skills for the new role of clinical adjunct nursing faculty. Successful implementation of this program will help promote consistency in effective job performance of clinical adjunct faculty and facilitate achievement of the projected goals and outcomes. This orientation program was presented in a one day face-to-face encounter with twelve (12) adjunct faculty members, tenured and others on the tenured track. These faculty members were hired by City Colleges of Chicago (CCC) School of Nursing Program at the Malcolm X College. Presentations were given by attendees with a lesson plan. Pre-test, post-test and evaluation forms were presented and it was agreed that an orientation program should be developed and presented to all newly hired clinical adjunct nursing faculty at CCC. PMID:26930766

  16. Tricuspid balloon valvuloplasty: a more simplified approach using inoue balloon.

    PubMed

    Patel, T M; Dani, S I; Shah, S C; Patel, T K

    1996-01-01

    We report a more simplified technique of the balloon tricuspid valvuloplasty using inoue balloon set in a patient suffering from severe rheumatic tricuspid stenosis. We believe that this technique may be useful in a difficult case of tricuspid valvuloplasty. PMID:8770490

  17. Ballooning Comes of Age: Make Your Own Balloon.

    ERIC Educational Resources Information Center

    Eckford, Jim

    1983-01-01

    Provides instructions for building a working model of a hot-air balloon, offering suggestions for a successful flight. Indicates that children can be involved in the projects, for example, by filling in colors in the panels of a balloon drawing. (JN)

  18. 32 CFR 728.93 - Chart of adjuncts.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Chart of adjuncts. 728.93 Section 728.93... FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Adjuncts to Medical Care § 728.93 Chart of adjuncts. The following chart and footnotes provide information relative to adjuncts which may be...

  19. Telescope Systems for Balloon-Borne Research

    NASA Technical Reports Server (NTRS)

    Swift, C. (Editor); Witteborn, F. C. (Editor); Shipley, A. (Editor)

    1974-01-01

    The proceedings of a conference on the use of balloons for scientific research are presented. The subjects discussed include the following: (1) astronomical observations with balloon-borne telescopes, (2) orientable, stabilized balloon-borne gondola for around-the-world flights, (3) ultraviolet stellar spectrophotometry from a balloon platform, (4) infrared telescope for balloon-borne infrared astronomy, and (5) stabilization, pointing, and command control of balloon-borne telescopes.

  20. Clopidogrel Responsiveness in Patients Undergoing Peripheral Angioplasty

    SciTech Connect

    Pastromas, Georgios Spiliopoulos, Stavros Katsanos, Konstantinos Diamantopoulos, Athanasios Kitrou, Panagiotis Karnabatidis, Dimitrios Siablis, Dimitrios

    2013-12-15

    Purpose: To investigate the incidence and clinical significance of platelet responsiveness in patients receiving clopidogrel after peripheral angioplasty procedures. Materials and Methods: This prospective study included patients receiving antiplatelet therapy with clopidogrel 75 mg after infrainguinal angioplasty or stenting and who presented to our department during routine follow-up. Clopidogrel responsiveness was tested using the VerifyNow P2Y12 Assay. Patients with residual platelet reactivity units (PRU) {>=} 235 were considered as nonresponders (NR group NR), whereas patients with PRU < 235 were considered as normal (responders [group R]). Primary end points were incidence of resistance to clopidogrel and target limb reintervention (TLR)-free survival, whereas secondary end points included limb salvage rates and the identification of any independent predictors influencing clinical outcomes. Results: In total, 113 consecutive patients (mean age 69 {+-} 8 years) with 139 limbs were enrolled. After clopidogrel responsiveness analysis, 61 patients (53.9 %) with 73 limbs (52.5 %) were assigned to group R and 52 patients (46.1 %) with 66 limbs (47.5 %) to group NR. Mean follow-up interval was 27.7 {+-} 22.9 months (range 3-95). Diabetes mellitus, critical limb ischemia, and renal disease were associated with clopidogrel resistance (Fisher's exact test; p < 0.05). According to Kaplan-Meier analysis, TLR-free survival was significantly superior in group R compared with group NR (20.7 vs. 1.9 %, respectively, at 7-year follow-up; p = 0.001), whereas resistance to clopidogrel was identified as the only independent predictor of decreased TLR-free survival (hazard rate 0.536, 95 % confidence interval 0.31-0.90; p = 0.01). Cumulative TLR rate was significantly increased in group NR compared with group R (71.2 % [52 of 73] vs. 31.8 % [21 of 66], respectively; p < 0.001). Limb salvage was similar in both groups. Conclusion: Clopidogrel resistance was related with

  1. Aerodynamics of a Party Balloon

    ERIC Educational Resources Information Center

    Cross, Rod

    2007-01-01

    It is well-known that a party balloon can be made to fly erratically across a room, but it can also be used for quantitative measurements of other aspects of aerodynamics. Since a balloon is light and has a large surface area, even relatively weak aerodynamic forces can be readily demonstrated or measured in the classroom. Accurate measurements…

  2. A Methane Balloon Inflation Chamber

    ERIC Educational Resources Information Center

    Czerwinski, Curtis J.; Cordes, Tanya J.; Franek, Joe

    2005-01-01

    The various equipments, procedure and hazards in constructing the device for inflating a methane balloon using a standard methane outlet in a laboratory are described. This device is fast, safe, inexpensive, and easy to use as compared to a hydrogen gas cylinder for inflating balloons.

  3. Scientific Balloons for Venus Exploration

    NASA Astrophysics Data System (ADS)

    Cutts, James; Yavrouian, Andre; Nott, Julian; Baines, Kevin; Limaye, Sanjay; Wilson, Colin; Kerzhanovich, Viktor; Voss, Paul; Hall, Jeffery

    Almost 30 years ago, two balloons were successfully deployed into the atmosphere of Venus as an element of the VeGa - Venus Halley mission conducted by the Soviet Union. As interest in further Venus exploration grows among the established planetary exploration agencies - in Europe, Japan, Russia and the United States, use of balloons is emerging as an essential part of that investigative program. Venus balloons have been proposed in NASA’s Discovery program and ESA’s cosmic vision program and are a key element in NASA’s strategic plan for Venus exploration. At JPL, the focus for the last decade has been on the development of a 7m diameter superpressure pressure(twice that of VeGa) capable of carrying a 100 kg payload (14 times that of VeGA balloons), operating for more than 30 days (15 times the 2 day flight duration of the VeGa balloons) and transmitting up to 20 Mbit of data (300 times that of VeGa balloons). This new generation of balloons must tolerate day night transitions on Venus as well as extended exposure to the sulfuric acid environment. These constant altitude balloons operating at an altitude of about 55 km on Venus where temperatures are benign can also deploy sondes to sound the atmosphere beneath the probe and deliver deep sondes equipped to survive and operate down to the surface. The technology for these balloons is now maturing rapidly and we are now looking forward to the prospects for altitude control balloons that can cycle repeatedly through the Venus cloud region. One concept, which has been used for tropospheric profiling in Antarctica, is the pumped-helium balloon, with heritage to the anchor balloon, and would be best adapted for flight above the 55 km level. Phase change balloons, which use the atmosphere as a heat engine, can be used to investigate the lower cloud region down to 30 km. Progress in components for high temperature operation may also enable investigation of the deep atmosphere of Venus with metal-based balloons.

  4. Nationwide Eclipse Ballooning Project

    NASA Astrophysics Data System (ADS)

    Colman Des Jardins, Angela; Berk Knighton, W.; Larimer, Randal; Mayer-Gawlik, Shane; Fowler, Jennifer; Harmon, Christina; Koehler, Christopher; Guzik, Gregory; Flaten, James; Nolby, Caitlin; Granger, Douglas; Stewart, Michael

    2016-05-01

    The purpose of the Nationwide Eclipse Ballooning Project is to make the most of the 2017 rare eclipse event in four main areas: public engagement, workforce development, partnership development, and science. The Project is focused on two efforts, both student-led: online live video of the eclipse from the edge of space and the study of the atmospheric response to the eclipse. These efforts, however, involving more than 60 teams across the US, are challenging in many ways. Therefore, the Project is leveraging the NASA Space Grant and NOAA atmospheric science communities to make it a success. The first and primary topic of this poster is the NASA Space Grant supported online live video effort. College and high school students on 48 teams from 31 states will conduct high altitude balloon flights from 15-20 locations across the 8/21/2017 total eclipse path, sending live video and images from near space to a national website. Video and images of a total solar eclipse from near space are fascinating and rare. It’s never been done live and certainly not in a network of coverage across a continent. In addition to the live video to the web, these teams are engaged in several other science experiments as secondary payloads. We also briefly highlight the eclipse atmospheric science effort, where about a dozen teams will launch over one hundred radiosondes from across the 2017 path, recording an unprecedented atmospheric data sample. Collected data will include temperature, density, wind, humidity, and ozone measurements.

  5. The Venus Balloon Project

    NASA Technical Reports Server (NTRS)

    Stelzried, C. T.; Preston, R. A.; Hildebrand, C. E.; Wilcher, J. H.; Ellis, J.

    1986-01-01

    On June 11 and 15, 1985, two instrumental balloons were released from the Soviet VEGA 1 and VEGA 2 spacecraft and deployed in the atmosphere of Venus. The VEGA probes flew by the planet on their way to a rendezvous with comet Halley in March 1986. Drifting with the wind at altitudes of 54 km, the balloons traveled one-third of the way around the planet during their 46-hour lifetimes. Sensors on-board the gondolas made periodic measurements of pressure, temperature, vertical wind velocity, cloud particle density, ambient light level, and frequency of lightning. The data were transmitted to Earth and received at the Deep Space Network (DSN) 64-m stations and at several large antennas in the USSR. Approximately 95 percent of the telemetry data were successfully decoded at the DSN complexes and in the Soviet Union, and were provided to the international science team for analysis. Very Long Baseline Interferometry (VLBI) data were acquired by 20 radio observatories around the world for the purpose of monitoring the Venus winds. The DSN 64-m subnet was part of a 15-station VLBI network organized by the Centre National d'Etudes Spatiales (CNES) of France. In addition, five antennas of the Soviet network participated. VLBI data from the CNES network are currently being processed at the Jet Propulsion Laboratory.

  6. Free boundary ballooning mode representation

    SciTech Connect

    Zheng, L. J.

    2012-10-15

    A new type of ballooning mode invariance is found in this paper. Application of this invariance is shown to be able to reduce the two-dimensional problem of free boundary high n modes, such as the peeling-ballooning modes, to a one-dimensional problem. Here, n is toroidal mode number. In contrast to the conventional ballooning representation, which requires the translational invariance of the Fourier components of the perturbations, the new invariance reflects that the independent solutions of the high n mode equations are translationally invariant from one radial interval surrounding a single singular surface to the other intervals. The conventional ballooning mode invariance breaks down at the vicinity of plasma edge, since the Fourier components with rational surfaces in vacuum region are completely different from those with rational surfaces in plasma region. But, the new type of invariance remains valid. This overcomes the limitation of the conventional ballooning mode representation for studying free boundary modes.

  7. Feasibility of Angioplasty and Stenting for Abdominal Aortic Lesions Adjacent to Previously Stented Visceral Artery Lesions in Patients with Takayasu Arteritis

    SciTech Connect

    Joseph, George George, Paul V.; Pati, Purendra Kumar; Chandy, Sunil Thomas

    2007-04-15

    Two young female patients with Takayasu arteritis presented with symptomatic long-segment abdominal aortic stenosis in the vicinity of previously deployed celiac and renal artery stents that projected markedly into the narrowed aortic lumen. Crushing or distortion of the visceral artery stents during aortic angioplasty was avoided by performing simultaneous or alternating balloon dilatations in the aorta and in the visceral artery stents. Consequently, the visceral artery stents remained patent and shortened longitudinally, allowing unhindered deployment of Wallstents in the adjacent aorta and abolition of a pressure gradient across the aortic lesions. Access to side branches covered by the Wallstent was obtained without difficulty, enabling the performance of balloon dilatation in multiple side branches and ostial stent deployment in a renal artery. These techniques could increase the scope of endovascular therapy in the treatment of patients with Takayasu arteritis.

  8. Mars Balloon Flight Test Results

    NASA Technical Reports Server (NTRS)

    Hall, Jeffery L.; Pauken, Michael T.; Kerzhanovich, Viktor V.; Walsh, Gerald J.; Kulczycki, Eric A.; Fairbrother, Debora; Shreves, Chris; Lachenmeier, Tim

    2009-01-01

    This paper describes a set of four Earth atmosphere flight test experiments on prototype helium superpressure balloons designed for Mars. Three of the experiments explored the problem of aerial deployment and inflation, using the cold, low density environment of the Earth's stratosphere at an altitude of 30-32 km as a proxy for the Martian atmosphere. Auxiliary carrier balloons were used in three of these test flights to lift the Mars balloon prototype and its supporting system from the ground to the stratosphere where the experiment was conducted. In each case, deployment and helium inflation was initiated after starting a parachute descent of the payload at 5 Pa dynamic pressure, thereby mimicking the conditions expected at Mars after atmospheric entry and high speed parachute deceleration. Upward and downward looking video cameras provided real time images from the flights, with additional data provided by onboard temperature, pressure and GPS sensors. One test of a 660 cc pumpkin balloon was highly successful, achieving deployment, inflation and separation of the balloon from the flight train at the end of inflation; however, some damage was incurred on the balloon during this process. Two flight tests of 12 m diameter spherical Mylar balloons were not successful, although some lessons were learned based on the failure analyses. The final flight experiment consisted of a ground-launched 12 m diameter spherical Mylar balloon that ascended to the designed 30.3 km altitude and successfully floated for 9.5 hours through full noontime daylight and into darkness, after which the telemetry system ran out of electrical power and tracking was lost. The altitude excursions for this last flight were +/-75 m peak to peak, indicating that the balloon was essentially leak free and functioning correctly. This provides substantial confidence that this balloon design will fly for days or weeks at Mars if it can be deployed and inflated without damage.

  9. Excimer laser coronary angioplasty: experience with a prototype multifibre catheter in patients with stable angina pectoris.

    PubMed

    Kochs, M; Haerer, W; Eggeling, T; Hoeher, M; Schmidt, A; Hombach, V

    1992-03-01

    Percutaneous excimer laser coronary angioplasty (ELCA) was performed in a first group of 20 patients with stable angina pectoris caused by significant coronary stenosis, and long-term follow-up was evaluated. Prototype 4 to 5.5 French multifibre catheters with 18-20 quartz fibres of 100 microns diameter, concentrically arranged around a central lumen for taking up a guide wire, were coupled to a commercial XeCl excimer laser. Energy was delivered at a wavelength of 308 nm with a pulse duration of 60 or 120 ns. Operating at a repetition rate of 20 Hz, mean energy transmission was 13.4 +/- 6.8 mJ per pulse. In all but one patient the lesion could be passed by the catheter. Percent diameter stenosis decreased from 77.1 +/- 10.8% to 53.1 +/- 11.8% after ELCA. Complications were frequently observed, intracoronary thrombus formation in eight instances, dissection in six patients and spasm in five cases, causing total vessel occlusion in five procedures. All complications could be managed efficaciously by thrombolytic and vasodilating drugs and/or balloon angioplasty. Subsequent PTCA was performed in case of complication or insufficient stenosis reduction after ELCA in 18 patients with adequate results (residual stenosis, 28.5 +/- 10.2%). Long-term follow-up angiography, which could be performed in 16 of 19 laser treatments, demonstrated significant restenosis in only three patients. Our preliminary results suggest that, using ELCA, ablation of atherosclerotic lesions is feasible in most cases. However, compared with PTCA, stenosis reduction is significantly less, and the acute complication rate is much higher. Thus, further improvements of the catheter system are necessary in order to realize the advantages of excimer laser ablation, which can be demonstrated by experimental studies. PMID:1597220

  10. Adjunct processors in embedded medical imaging systems

    NASA Astrophysics Data System (ADS)

    Trepanier, Marc; Goddard, Iain

    2002-05-01

    Adjunct processors have traditionally been used for certain tasks in medical imaging systems. Often based on application-specific integrated circuits (ASICs), these processors formed X-ray image-processing pipelines or constituted the backprojectors in computed tomography (CT) systems. We examine appropriate functions to perform with adjunct processing and draw some conclusions about system design trade-offs. These trade-offs have traditionally focused on the required performance and flexibility of individual system components, with increasing emphasis on time-to-market impact. Typically, front-end processing close to the sensor has the most intensive processing requirements. However, the performance capabilities of each level are dynamic and the system architect must keep abreast of the current capabilities of all options to remain competitive. Designers are searching for the most efficient implementation of their particular system requirements. We cite algorithm characteristics that point to effective solutions by adjunct processors. We have developed a field- programmable gate array (FPGA) adjunct-processor solution for a Cone-Beam Reconstruction (CBR) algorithm that offers significant performance improvements over a general-purpose processor implementation. The same hardware could efficiently perform other image processing functions such as two-dimensional (2D) convolution. The potential performance, price, operating power, and flexibility advantages of an FPGA adjunct processor over an ASIC, DSP or general-purpose processing solutions are compelling.

  11. Stability of Lobed Balloons

    NASA Technical Reports Server (NTRS)

    Ball, Danny (Technical Monitor); Pagitz, M.; Pellegrino, Xu S.

    2004-01-01

    This paper presents a computational study of the stability of simple lobed balloon structures. Two approaches are presented, one based on a wrinkled material model and one based on a variable Poisson s ratio model that eliminates compressive stresses iteratively. The first approach is used to investigate the stability of both a single isotensoid and a stack of four isotensoids, for perturbations of in.nitesimally small amplitude. It is found that both structures are stable for global deformation modes, but unstable for local modes at su.ciently large pressure. Both structures are stable if an isotropic model is assumed. The second approach is used to investigate the stability of the isotensoid stack for large shape perturbations, taking into account contact between di.erent surfaces. For this structure a distorted, stable configuration is found. It is also found that the volume enclosed by this con.guration is smaller than that enclosed by the undistorted structure.

  12. Angioplasty of forearm arteries as a finger salvage procedure for patient with end-stage renal failure.

    PubMed

    Law, Yuk; Chan, Yiu Che; Cheng, Stephen Wing-Keung

    2016-01-01

    Due to the relatively low metabolic demand and extensive collaterals of the upper limb, peripheral arterial disease seldom leads to tissue loss, except in patients with end-stage renal failure (ESRF), rheumatologic diseases, Raynaud's disease, frostbites, or distal emboli. We report a case of a 51-year-old lady with ESRF who presented to our tertiary referral vascular center with infected gangrene of her right ring finger. Duplex ultrasound showed that her forearm arteries were severely diseased. Digital subtraction angiogram showed severe multilevel stenoses/occlusions in her forearm radial and ulnar arteries. These lesions were successfully angioplastized with 2 mm × 25 mm angioplasty balloon. Completion angiogram showed good radiological results with some post-dilatation spasm which improved with intra-arterial glyceryl trinitrate. The sepsis improved after revascularization, and the distal phalanx was allowed to self-demarcate with dressings and autoamputate with good clinical results. Our case illustrated that even in delayed setting, patients could still benefit from specialist vascular care with a combination of expert care and angioplasty of forearm arteries, with successful salvage of her finger. PMID:27143949

  13. Angioplasty of forearm arteries as a finger salvage procedure for patient with end-stage renal failure

    PubMed Central

    Law, Yuk; Chan, Yiu Che; Cheng, Stephen Wing-Keung

    2016-01-01

    Due to the relatively low metabolic demand and extensive collaterals of the upper limb, peripheral arterial disease seldom leads to tissue loss, except in patients with end-stage renal failure (ESRF), rheumatologic diseases, Raynaud’s disease, frostbites, or distal emboli. We report a case of a 51-year-old lady with ESRF who presented to our tertiary referral vascular center with infected gangrene of her right ring finger. Duplex ultrasound showed that her forearm arteries were severely diseased. Digital subtraction angiogram showed severe multilevel stenoses/occlusions in her forearm radial and ulnar arteries. These lesions were successfully angioplastized with 2 mm × 25 mm angioplasty balloon. Completion angiogram showed good radiological results with some post-dilatation spasm which improved with intra-arterial glyceryl trinitrate. The sepsis improved after revascularization, and the distal phalanx was allowed to self-demarcate with dressings and autoamputate with good clinical results. Our case illustrated that even in delayed setting, patients could still benefit from specialist vascular care with a combination of expert care and angioplasty of forearm arteries, with successful salvage of her finger. PMID:27143949

  14. Percutaneous Transluminal Angioplasty of Hepatic Artery Stenosis in Patients After Orthotopic Liver Transplantation: Mid-term Results

    SciTech Connect

    Jarmila, Lastovickova Jan, Peregrin

    2011-12-15

    Purpose: This study was designed to present our experience with percutaneous treatment of hepatic artery stenosis in orthotopic liver transplant patients and to evaluate the efficacy, technical outcomes, and mid-term clinical results of the procedure. Methods: Twenty-two percutaneous transluminal angioplasties (PTAs) were performed in 19 liver transplant recipients at our institution between 1998 and 2010. Stents were placed into the hepatic/celiac artery in 16 PTAs, but balloon dilatation alone was performed in 6 because of the anatomical condition of the vessel. PTA/stenting was indicated in 17 patients because of elevated liver enzymes; 2 patients were asymptomatic. The objective of treating stenosis was prevention of long-term complications, including thrombosis. Results: Technical success was achieved in all patients. There was only one complication: dissection of the treated artery without any subsequent adverse effects. In all patients, elevated liver enzyme levels improved after treatment. No restenosis was observed in any patient during a mean follow-up of 2.6 years (1 month to 5.5 years). Conclusions: Percutaneous angioplasty/stent placement is a safe method for the treatment of hepatic artery stenosis after orthotopic liver transplantation, with a high technical success rate and promising mid-term results.

  15. Hot-Air Ballooning in Physics Teaching.

    ERIC Educational Resources Information Center

    Haugland, Ole Anton

    1991-01-01

    Describes the modern hot-air balloon and the physics of ballooning. Proposes that students construct their own hot-air balloon and presents an experiment calculating the time needed for a balloon to rise to the ceiling of a gymnasium. (MDH)

  16. Randomised comparison of coronary stenting with and without balloon predilatation in selected patients

    PubMed Central

    Le Breton, H; Boschat, J; Commeau, P; Brunel, P; Gilard, M; Breut, C; Bar, O; Geslin, P; Tirouvanziam, A; Maillard, L; Moquet, B; Barragan, P; Dupouy, P; Grollier, G; Berland, J; Druelles, P; Rihani, R; Huret, B; Leclercq, C; Bedossa, M

    2001-01-01

    BACKGROUND—The SWIBAP (stent without balloon predilatation) prospective randomised trial was designed to compare direct coronary stenting with stenting preceded by lesion predilatation with an angioplasty balloon.
OBJECTIVE—To determine the feasibility and safety of direct stenting in non-complex coronary lesions in a prospective study.
PATIENTS AND DESIGN—All patients < 76 years of age scheduled to undergo angioplasty of a non-complex, non-calcified lesion in a coronary artery of > 3.0 mm, who granted their informed consent, were randomised into the trial. In group I, the stent was placed without balloon predilatation, while in group II stent implantation was preceded by balloon predilatation. The primary end point was the angiographic result according to procedure assigned by randomisation. An intravascular ultrasound substudy was performed in 60 patients.
RESULTS—Stent implantation was successful without predilatation in 192 of the 197 group I patients (97.5%), and with predilatation in 197 of the 199 group II patients (99%) (NS). No in-hospital stent thrombosis or death occurred. Overall procedural times, fluoroscopy times, and volumes of contrast agent given (mean (SD)) in group I v group II were 23.50 (13.54) min v 27.96 (15.23) min (p = 0.002), 6.04 (4.13) min v 6.67 (3.65) min (NS), and 135 (65) ml v 157 (62) ml (p < 0.001), respectively. No major adverse cardiovascular events had occurred by 30 days.
CONCLUSIONS—The feasibility and safety of direct stenting of selected and non-complex coronary lesions is confirmed. This technique was as successful as the conventional approach and was associated with a minor reduction in fluoroscopic exposure and procedure time and the administration of less contrast agent.


Keywords: coronary artery angioplasty; stent; coronary artery ultrasound PMID:11514483

  17. Structure variations of pumpkin balloon

    NASA Astrophysics Data System (ADS)

    Yajima, N.; Izutsu, N.; Honda, H.

    A robed pumpkin balloon by 3-D gore design concept is recognized as a basic form for a super -pressure balloon. This paper deals with an extension of this design concept for other large pressurized membrane structures, such as a stratospheric airship and a balloon of which volume is controllable. The structural modifications are performed by means of additional ropes or poles. When the original pumpkin shape is modified for those systems, superior characteristics of 3-D gore design, those are large bulges with a small local radius and unidirectional film tension, should be maintained. Improved design methods which are adequate for the above subjects will be discussed in detail.

  18. Post-marketing surveillance in the published medical and grey literature for percutaneous transluminal coronary angioplasty catheters: a systematic review

    PubMed Central

    2013-01-01

    Background Post-marketing surveillance (PMS) may identify rare serious incidents or adverse events due to the long-term use of a medical device, which was not captured in the pre-market process. Percutaneous transluminal coronary angioplasty (PTCA) is a non-surgical procedure that uses a balloon-tipped catheter to enlarge a narrowed artery. In 2011, 1,942 adverse event reports related to the use of PTCA catheters were submitted to the FDA by the manufacturers, an increase from the 883 reported in 2008. The primary research objective is to conduct a systematic review of the published and grey literature published between 2007 and 2012 for the frequency of incidents, adverse events and malfunctions associated with the use of PTCA catheters in patients with coronary artery disease (CAD). Grey literature has not been commercially published. Methods We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and PubMed for medical literature on PMS for PTCA catheters in patients with CAD published between January 2007 and July 2012. We also searched the grey literature. Results This review included 11 studies. The in-hospital adverse events reported were individual cases of myocardial infarction and hematoma. In studies of patients with coronary perforation, more patients with balloon angioplasty were identified compared with patients who required stenting. Conclusions Our systematic review illustrates that the volume and quality of PMS studies associated with the use of PTCA catheters in patients with CAD are low in the published and grey literature, and may not be useful sources of information for decisions on safety. In most studies, the objectives were not to monitor the long-term safety of the use of PTCA catheters in clinical practice. Future studies can explore the strengths and limitations of PMS databases administered by regulatory authorities. PMID:24112460

  19. Development of novel short-term heating angioplasty: diameter and elasticity change of vascular wall ex vivo

    NASA Astrophysics Data System (ADS)

    Shimazaki, Natsumi; Kaneko, Kenji; Nakatani, Eriko; Arai, Tsunenori

    2007-02-01

    In order to investigate the optimum operation parameters on novel short-term heating (<15s, approx. 70 °C) balloon, named Photo-thermo dynamic balloon (PTDB), we studied diameter and elasticity change of vascular wall after dilatation ex vivo. We have been studying to develop the PTDB angioplasty in which we demonstrated sufficient vascular dilatation with lower pressure by heat- induced denaturation of arterial collagen. And we have also demonstrated the suppression of intimal hyperplasia in animal experiments. We need to understand the PTDB dilatation mechanism to determine the optimum operation parameters. The prototype PTDB with diameter of 3mm was used in our experiments. The internal diameters of extracted fresh porcine carotid arteries at pre- and post- PTDB dilatation were measured. Balloon parameters were follows; pressure P=2atm, peak temperature in balloon T=60-80 °C, and heating duration t=4-30s. Morphological change in the media of dilated artery with PTDB were microscopically examined with Weigert staining. Elastic properties were carried out by stress-strain measurements with calculation of young's modulus. We found that PTDB dilatation provided the effect to prevent elastic recoil. We explained that the reason of this effect might be arrangement of micro- structure in the media, i.e., heat-denatured collagen fibers sustained the elastic recoil due to rubbery elastin fibers. The arterial elasticity was not significant different after PTDB dilatation. It was suggested that there could be no compliance mismatch after PTDB dilatation in physiological range. We found that a part of PTDB dilatation mechanism, in which the vascular wall structure played an important role. The optimum operation parameters for PTDB might be determined in consideration of collagen denaturation progress and arterial composition.

  20. Adjuncts to colonic cleansing before colonoscopy.

    PubMed

    Park, Sanghoon; Lim, Yun Jeong

    2014-03-21

    Pre-procedural cleansing of the bowel can maximize the effectiveness and efficiency of colonoscopy. Yet, efficacy of the current gold standard colonic preparation method - high-volume oral administration of purgative agents 12-24 h prior to the procedure - is limited by several factors, such as patient compliance (due to poor palatability and inconvenience of the dosing regimen) and risks of complications (due to drug interactions or intolerance). Attempts to resolve these limitations have included providing adjunctive agents and methods to promote the colonic cleansing ability of the principal purgative agent, with the aim of lessening unpleasant side effects (such as bloating) and reducing the large ingested volume requirement. Several promising adjunctive agents are bisacodyl, magnesium citrate, senna, simethicone, metoclopramide, and prokinetics, and each are being investigated for their potential. This review provides an up to date summary of the reported investigations into the potencies and weaknesses of the key adjuncts currently being applied in clinic as supplements to the traditional bowel preparation agents. While the comparative analysis of these adjuncts showed that no single agent or method has yet achieved the goal of completely overcoming the limitations of the current gold standard preparation method, they at least provide endoscopists with an array of alternatives to help improve the suboptimal efficacy of the main cleansing solutions when used alone. To aid in this clinical endeavor, a subjective grade was assigned to each adjunct to indicate its practical value. In addition, the systematic review of the currently available agents and methods provides insight into the features of each that may be overcome or exploited to create novel drugs and strategies that may become adopted as effective bowel cleansing adjuncts or alternatives. PMID:24659864

  1. Feasibility Study of Eval Balloons

    NASA Astrophysics Data System (ADS)

    Saito, Yoshitaka; Kamioka, Eiji; Toriumi, Michihiko; Matsuzaka, Yukihiko; Namiki, Michiyoshi; Izutsu, Naoki; Ohta, Shigco; Yamagami, Takamasa; Nishimura, Jun; Matsushima, Kiyoho

    For a new balloon material, we have been studying the properties of an EVAL (Ethylene-Vinyl-ALcohol) film during a part of few years. The EVAL film is a product of Kurare Plastic Company, and has mechanical properties similar to that of a Mylar film. Besides this strong mechanical strength. we found that the EVAL film has several characteristics which seems to be suitable for the balloon material. Those are:

  2. Sandwiched EVAL films laminated by polyethylene films can be heat-sealed,
  3. Gas leakage through the EVAL film is extremely low, and for Helium gas, it is almost 100 times less than that of a Mylar film.
  4. The EVAL film is transparent in the optical band. while it efficiently absorbs the infrared radiation from the earth.In 1997, we have carried out a test flight from the Sanriku Balloon Center using a small balloon with a volume of 1000 m3. The balloon reached an altitude of 22 km successfully and showed a maximum burst pressure of 2.1 g/cm2.In this paper, basic properties of the EVAL film and performance of the test balloon are described

  5. Mechanical and acoustic analysis in ultrasonic angioplasty

    NASA Astrophysics Data System (ADS)

    Detwiler, Paul W.; Watkins, James F.; Rose, Eric A.; Ratner, A.; Vu, Louis P.; Severinsky, J. Y.; Rosenschein, Uri

    1991-05-01

    The goal of this study was to investigate the relationship between ultrasonic tissue ablation and passive mechanical elasticity. Experience with ultrasonic angioplasty in experimental settings (in-vivo and in-vitro) together with clinical experience in peripheral vascular disease is reported. A model composed exclusively of a hydroxyproline ballistic gelatin matrix showed a negative correlation between material elasticity and the rate of ultrasonic ablation. This model provided a means of studying the effects of collagen content on ablation, exclusive of other biologic components. Ballistic gelatin ablation (mg/sec) was found to increase logarithmically with decreasing protein concentration over the range studied (20.00 to 1.25%). Ablation as a function of gelatin elasticity behaved in a similar manner. Temperature of the material ablated was also demonstrated to affect the rate of ablation. We conclude that the previously reported differences in ablation between thrombi and blood vessel are predictable based on the large difference in their mechanical elasticity, and that this difference provides a wide margin of safety.

  6. Angioplasty and Stenting for Intracranial Stenosis

    PubMed Central

    IZUMI, Takashi; IMAMURA, Hirotoshi; SAKAI, Nobuyuki; MIYACHI, Shigeru

    2014-01-01

    Of the patients enrolled in the Japanese Registry of Neuroendovascular Therapy (JR-NET), a surveillance study in Japanese, 1133 patients who underwent intracranial percutaneous transluminal angioplasty (PTA)/stenting for intracranial stenosis during the period from 2005 to 2009 were investigated. A technical success was achieved in 98.3% of the patients, and 70.5% and 7.5% had a residual stenosis of < 30% and ≥ 50%, respectively. The incidence of ischemic complications and hemorrhagic complications was as low as 7.7% and 2.5%, respectively, but tended to increase in patients who underwent stenting. While a significant correlation with ischemic complications was observed in previously untreated patients and patients who underwent stenting followed by post-dilatation, a significant correlation with hemorrhagic complications was observed in patients who received emergency treatment and those treated between 24 hours and 14 days of the onset. Flexible intracranial stents are expected to contribute to improvement in the treatment outcome. PMID:24390191

  7. [Coronary arterial rupture during percutaneous transluminal coronary angioplasty: a case report].

    PubMed

    Hsu, Y S; Tamai, H; Odawara, K; Yamagata, T; Ueda, K; Tomita, T; Koya, M; Motohara, S; Uehata, H

    1990-01-01

    A case who developed rupture in a diagonal branch of the left anterior descending coronary artery (LAD) during percutaneous transluminal coronary angioplasty (PTCA) is reported here. The present case was 80-year-old man with severe focal stenosis of the LAD at its junction with a diagonal branch. PTCA for the LAD lesion was successfully performed, but occlusion of the diagonal branch developed later. A subsequent ECG showed elevation of an ST segment in a VL, and PTCA for the diagonal branch was attempted. A 018 Hi-torque floppy guide wire was introduced into the occluded diagonal branch, and its dilatation was attempted using a 2 mm Simpson-Robert catheter. During a maximal pressure of 120 psi, a deformity was found at the distal end of the balloon. Post-PTCA angiograms showed rupture of the diagonal arterial branch, and mild to moderate pericardial effusion was observed by echocardiography. The patient experienced transient hypotension (60 mmHg at systolic), but his condition gradually stabilized after the administration of only a pressor medication. Neither pericardiocentesis nor emergency surgery was performed. The next day, follow-up angiograms showed diagonal branch occlusion at the proximal portion of the rupture site. His clinical course was satisfactory with spontaneous resolution of pericardial effusion and mild elevation of his cardiac enzymes (CPK = 243IU). In this case, it was concluded that the cause of coronary arterial rupture was the difference in diameters of the coronary artery (1 mm) and the balloon catheter (2 mm). This was the first rupture case experienced among 750 PTCA sites (0.13%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2104423

  8. Outward Bound as an Adjunct to Therapy.

    ERIC Educational Resources Information Center

    Chase, Nelson K.

    The Colorado Outward Bound School (COBS) provides successful adjunct programs for special populations undergoing therapy at the Adventure Home (Boulder, CO), the Juvenile Justice Program and the St. Luke's Hospital Alcoholism Recovery Unit (Denver, CO), and the Dartmouth-Hitchcock Medical Center Department of Psychiatry (Hanover, NH). The goals of…

  9. Effective Leadership of Online Adjunct Faculty

    ERIC Educational Resources Information Center

    Tipple, Robert

    2010-01-01

    Post secondary education leaders and administrators are currently facing two separate but inter-related trends: the growth in online education, and the significant increase in adjunct (part-time) faculty. In order to maximize the educational quality and institutional effectiveness, education leaders must develop an approach that levers the…

  10. THE EFFECTIVENESS OF ADJUNCT AUTO-INSTRUCTION.

    ERIC Educational Resources Information Center

    KINZER, JOHN R.; WORCESTER, DEAN A.

    THE QUESTION OF PRIMARY CONCERN IN FOUR STUDIES WAS IMMEDIATE FEEDBACK IN ADJUNCT AUTOINSTRUCTIONAL EXERCISES (LEARNING EXERCISES DEFINED AS THOSE DESIGNED TO TAKE ADVANTAGE OF THE STRUCTURE INHERENT IN SUBJECT MATTER). IN A CONTROLLED SITUATION, DIFFERENT FEEDBACK DELAYS (IMMEDIATE, 1-HOUR DELAY, 2-DAY DELAY, AND 1-WEEK DELAY) WERE TESTED. OTHER…

  11. Adjuncts: Solutions for a Mistreated Majority

    ERIC Educational Resources Information Center

    Louis, Deborah

    2009-01-01

    According to best estimates, some 800,000 faculty members, close to two-thirds of the total nationwide, are adjunct, "contingent," or "lecturer." The severity of their plight, rapidly worsening in today's economic crisis, intersects the interrelated domains of human rights, fair employment, and the future of higher education. In those areas where…

  12. Early coronary angioplasty for acute myocardial infarction complicated by cardiogenic shock: have novel therapies led to better results?

    PubMed

    Moreno, R; Garcia, E; Abeytua, M; Soriano, J; Acosta, J; Perez De Isla, L; Lopez De Sa, E; Rubio, R; Lopez-Sendon, J

    2000-12-01

    Patients with acute myocardial infarction (MI) and cardiogenic shock constitute a very high risk subset despite an aggressive management. The objective of this study was to evaluate if the results of early coronary angioplasty in patients with acute myocardial infarction and cardiogenic shock have changed over the last years, and to address which role the recent adjuvant therapies have played in this evolution. From 1991 to April 1999, 94 patients with acute MI and cardiogenic shock were treated with coronary angioplasty within the first 12 hours from the onset of symptoms. Temporal changes of the utilization of adjuvant therapies and operators experience were studied over these years, as well as their impact on the angiographic results and in-hospital outcome. Over the years, a progressive and significant increase on the use of coronary stents and c7E3Fab was observed, as well as an increased number of primary angioplasties performed per month. The proportion of patients treated with intraaortic balloon pump did not changed significantly over the years. An angiographic successful result (< 50% residual stenosis and TIMI flow 2 or 3) and a final TIMI grade 3 flow were obtained in 76 (80.9%) and 61 (64.9%) patients, respectively. The angiographic success rate progressively increased over the years, from 72.3% in patients treated before 1994 to 94.1% in those admitted in 1998Eth 1999 (p for trend 0.0409). The proportion of patients with a final TIMI grade 3 flow also grew progressively over the years: from 36.4% before 1994 to 76.5% after 1997 (p for trend 0. 0209). The overall in-hospital mortality rate was 63.8% (60 patients), and there was no significant change in mortality rate over the years. Therefore, apart from the growing operators experience, we have observed an incremental change in the use of coronary stents and c7E3 Fab (abciximab) in patients with acute myocardial infarction and cardiogenic shock treated with early coronary angioplasty. All these

  13. Drug-Coated Balloon Venoplasty for In-Stent Restenosis in a Patient With Recurrent Pulmonary Vein Stenosis Post Ablation for Atrial Fibrillation: Initial Experience With a New Treatment Technique.

    PubMed

    Rosenberg, Jonathan; Fisher, Westby G; Guerrero, Mayra; Smart, Steve; Levisay, Justin; Feldman, Ted; Salinger, Michael

    2016-05-01

    Pulmonary vein stenosis (PVS) is an uncommon but serious complication following radiofrequency ablation for atrial fibrillation. Occurrence of this complication has risen with increased rates of ablation procedures, with >50,000 AF ablation procedures performed per year, and can occur within weeks to months post procedure. Currently, the main therapies for PVS include percutaneous interventions with balloon angioplasty and stenting, but these treatments are complicated by a high rate of restenosis. The optimal treatment for recurrent pulmonary vein in-stent restenosis has not been determined. We describe the novel use of a paclitaxel drug-coated balloon for the treatment of in-stent restenosis of the pulmonary veins. PMID:27145055

  14. Early hospital discharge after direct angioplasty for acute myocardial infarction.

    PubMed

    Hanlon, J T; Combs, D T; McLellan, B A; Railsback, L; Haugen, S

    1995-07-01

    To determine the feasibility and safety of early hospital discharge after myocardial infarction, we reviewed a 3-yr experience with direct angioplasty: 204 patients had direct angioplasty with in-hospital mortality of 3.4%. Of these patients, 125 were discharged < 5 days after infarction and 98% of these were available for 30-day follow-up. There was one early death (0.8% mortality), two early readmissions without complications, and three late readmissions. Thus early hospital discharge a mean of 3.4 days after infarction can be achieved in > 60% of patients undergoing direct angioplasty with no significant early complications and excellent 30-day survival (99.2%). PMID:7553817

  15. [Ultrasound coronary angioplasty: state of the art and new clinical aspects].

    PubMed

    Rosenschein, U; Budde-Schwartzman, B

    1997-12-01

    stable angina or AMI were treated by ultrasound angioplasty. Residual stenosis after ultrasound treatment was 71%, after balloon dilation reduced to 34%. In the 6-month follow-up angiograms showed no major adverse effect or restenosis. Our experience with coronary ultrasound thrombolysis (CUT) is based on the analysis of 33 patients' data in the feasibility (Table 1) plus multicenter phase of the ACUTE trial (Analysis of Coronary Ultrasound Thrombolysis Endpoints) (Figure 3). Our patients were exclusively treated for AMI by ultrasound angioplasty and afterwards by PTCA if required (Figure 4). The average final percent stenosis was 20% (Figure 5). The main efficacy parameters, device success and angiographic success rates were 100%, clinical success rate was 91.7% (Figure 6 and Table 2). The adverse clinical events of CUT are limited--at least in our studies--to reocclusion of infarct-related artery and ischemia and could be reversed by additional PTCA. No adverse clinical side effects were observed during sonication of the coronary tree. Final angiography revealed residual stenosis of 20% without morphological signs. These excellent results suggest that bioselectivity of ultrasound together with the developed skills of the catheter system induces rapid and selective thrombolysis with no need to cross the target lesion before sonication. But what is the better solution for thrombosis and which for plaque disruption? The development of transluminal balloon catheter really modified therapeutic approach to obstructive coronary and peripheral arterial disease but it is still accompanied by a high rate of abrupt closure, AMI and death. Although the use of intravenous thrombolytic agents is well established in the treatment of AMI and these agents are widely used, a large patient collective remains (up to 33% and more) in whom their use is inadvisable due to recent stroke, surgery, trauma or other contraindications. (ABSTRACT TRUNCATED) PMID:9483436

  16. Adjuncts in Social Work Programs: Good Practice or Unethical?

    ERIC Educational Resources Information Center

    Pearlman, Catherine A.

    2013-01-01

    Social work education programs rely heavily on adjunct instructors, as do most academic institutions. This article adds to existing literature on adjuncts by focusing on the unique issues in social work education, using social work values and ethics as a focus. The benefits and detriments for adjuncts, programs, and students in schools of social…

  17. Desire for Professional Development among Adjunct Business Faculty

    ERIC Educational Resources Information Center

    Backhaus, Kristin

    2009-01-01

    This study provides a foundation for further work about motivation for training and the world of contingent employment in higher education and beyond for adjunct faculty. This sample of adjunct business faculty shows there is much to be learned about why adjunct faculty choose to work in higher education and how they view their own professional…

  18. Adjunct Faculty Organizational Sense of Belonging and Affective Organizational Commitment

    ERIC Educational Resources Information Center

    Merriman, Constance L.

    2010-01-01

    In recent years all public higher education institutions have increased their reliance on adjunct faculty. Adjuncts provide expertise in key areas, are available at times that meet the needs of the changing student demographic, and cover an increasing number of introductory courses. It has been suggested that adjunct faculty may be more weakly…

  19. Ablation of chronic total occlusions using kilohertz-frequency mechanical vibrations in minimally invasive angioplasty procedures.

    PubMed

    McGuinness, G B; Wylie, M P; Gavin, G P

    2010-01-01

    Certain minimally invasive cardiology procedures, such as balloon angioplasty and stent implantation, critically require that the site of an arterial blockage be crossed by an intraluminal guidewire. Plaques resulting in near or totally occluded arteries are known as chronic total occlusions, and crossing them with conventional guidewires is a significant challenge. Among the most promising proposed solutions is the delivery of high-power, low-frequency ultrasonic vibrations to the occlusion site via an intraluminal wire waveguide. The vibrating distal tip of the ultrasound wire waveguide is used to transmit energy to the surrounding plaques, tissues, and fluids to ablate or weaken atherosclerotic plaque. Potential mechanisms of interaction with the plaque and adjacent fluids identified in the literature include: (i) direct contact with the waveguide distal tip, (ii) subcavitational acoustic fluid pressure fluctuations, (iii) cavitation, and (iv) acoustic streaming. We summarize developments in this area over more than two decades, describing experimental methods for device performance characterization, preclinical tests, early clinical investigations, and, later, full clinical trials. The article also reviews theoretical foundations and numerical models suitable for device design and analysis. Finally, important issues for future research and for the development of this technology will be considered. PMID:21303322

  20. Haemodynamic observations during percutaneous transluminal coronary angioplasty in the presence of synchronised diastolic coronary sinus retroperfusion.

    PubMed Central

    Beatt, K J; Serruys, P W; de Feyter, P; van den Brand, M; Verdouw, P D; Hugenholtz, P G

    1988-01-01

    Animal studies have demonstrated that synchronised coronary sinus retroperfusion with arterial blood can provide effective perfusion of ischaemic myocardium. Preliminary clinical studies have shown that the technique can also be used with safety in human beings, and in the present study its effectiveness was assessed in three patients undergoing repeated coronary artery occlusions during percutaneous transluminal coronary angioplasty. Arterial blood was removed via an 8F catheter positioned in the femoral artery and delivered by a retroperfusion pumping system to a 7F retroperfusion balloon catheter positioned in the anterior cardiac vein. Ischaemia-related indices were monitored both before and during coronary sinus retroperfusion. These indices included high fidelity left ventricular pressure recordings and pressure derived indices (including velocities of isovolumic contraction and relaxation), as well as electrocardiographic changes and symptoms. Analysis of these variables showed that the ischaemic changes induced during coronary artery occlusion were not prevented by this type of coronary sinus retroperfusion. There was no major complication in any of the patients. It may be that adaptation of the technique or the use of alternative end points will establish a benefit, but further modifications of the delivery system are necessary for effective clinical use. Images Fig 1 PMID:2963657

  21. Aspirin inhibition of platelet deposition at angioplasty sites: demonstration by platelet scintigraphy

    SciTech Connect

    Cuningham, D.A.; Kumar, B.; Siegel, B.A.; Gilula, L.A.; Totty, W.G.; Welch, M.J.

    1984-05-01

    In-111 platelet scintigraphy was used to evaluate the effects of prior aspirin administration on the accumulation of In-111-labeled autologous platelets at sites of arterial injury resulting from iliac, femoral, or popliteal transluminal angioplasty in a nonrandomized study of 17 men. The degree of platelet localization at angioplasty sites was significantly less in nine men who had received aspirin in varying doses within the 4 days before angioplasty than in eight men who had not received aspirin for at least two weeks. The results suggest that aspirin treatment before angioplasty limits the early platelet deposition at the angioplasty site in men.

  22. The case for angioplasty in patients with symptomatic intracranial atherosclerosis.

    PubMed

    McTaggart, Ryan A; Marks, Michael P

    2014-01-01

    Intracranial atherosclerotic disease (ICAD) is likely the most common cause of stroke worldwide and remains highly morbid even with highly monitored medical therapy. Recent results of the SAMMPRIS trial, which randomized patients to stenting plus aggressive medical management versus aggressive medical management alone have shown that additional treatment of intracranial atherosclerotic lesions with the Wingspan stent is inferior to aggressive medical management alone. In light of these results, there has been renewed interest in angioplasty alone to treat symptomatic ICAD. This article will briefly review the natural history of ICAD and discuss the possible future for endovascular treatment of ICAD with primary intracranial angioplasty in appropriately selected patients. PMID:24782816

  23. The Case for Angioplasty in Patients with Symptomatic Intracranial Atherosclerosis

    PubMed Central

    McTaggart, Ryan A.; Marks, Michael P.

    2014-01-01

    Intracranial atherosclerotic disease (ICAD) is likely the most common cause of stroke worldwide and remains highly morbid even with highly monitored medical therapy. Recent results of the SAMMPRIS trial, which randomized patients to stenting plus aggressive medical management versus aggressive medical management alone have shown that additional treatment of intracranial atherosclerotic lesions with the Wingspan stent is inferior to aggressive medical management alone. In light of these results, there has been renewed interest in angioplasty alone to treat symptomatic ICAD. This article will briefly review the natural history of ICAD and discuss the possible future for endovascular treatment of ICAD with primary intracranial angioplasty in appropriately selected patients. PMID:24782816

  1. Superior caval venous syndrome after atrial switch procedure: relief of complete venous obstruction by gradual angioplasty and placement of stents.

    PubMed

    Michel-Behnke, I; Hagel, K J; Bauer, J; Schranz, D

    1998-10-01

    Superior caval venous syndrome is one of the late problems known to occur after Mustard repair of complete transposition. Reoperation may leave residual stenosis, and carries substantial risk for the patient. It is now feasible to use intravascular stents to overcome systemic venous baffle obstructions, and such an approach is probably more effective. The purpose of our study therefore, was to assess immediate and medium term results of inserting stents subsequent to gradual balloon enlargement of acquired atresia of the intraatrial baffle in patients who had undergone an atrial switch operation. We investigated five patients with complete obstruction of the superior caval venous pathway at perforation of the atretic segment was achieved using a guide wire technique. The procedure was successful in all patients. Gradual angioplasty was performed and intravascular stents were implanted. The pressure in the superior caval vein dropped to normal values, symptoms improved, and the patency of the newly created venoatrial communication was proven at mid-term follow-up. Thus critical obstructions at the superior caval venous pathway after the Mustard procedure can be reopened by interventional catheterization. Implantation of balloon-expandable intravascular stents is safe and effective in the acute relief of the obstructions, but careful long-term follow-up is mandatory. PMID:9855097

  2. The challenge to balloon science

    NASA Astrophysics Data System (ADS)

    Jones, W. Vernon

    A thorough review of the NASA balloon program in 1995 confirmed both the inherent importance of balloon science investigations and their value for developing technology for future space missions. A follow-on study in 1996 looked into restructuring the entire suborbital program, in order to find more efficient and effective ways of doing business. These studies were mandated by the adverse impact of NASA's declining budgets and work force constraints on all aspects of space research. The challenge is to accomplish more with less. The balloon program began stepping up to this challenge several years ago with the advent of 10 - 20 day long-duration flights in Antarctica. We must now push ahead with enhanced flight capabilities and with new science instrument technologies, as we forge alliances with other modes of low-cost access to space. Specifically, the development of sealed superpressure balloons could extend flight duration by another order of magnitude, to about 100 days, making ballooning even more competitive with space missions.

  3. Structure variations of pumpkin balloon

    NASA Astrophysics Data System (ADS)

    Yajima, N.; Izutsu, N.; Honda, H.

    2004-01-01

    A lobed pumpkin balloon by 3-D gore design concept is recognized as a basic form for a super-pressure balloon. This paper deals with extensions of this design concept for other large pressurized membrane structures, such as a stratospheric airship and a balloon of which volume is controllable. The structural modifications are performed by means of additional ropes, belts or a strut. When the original pumpkin shape is modified by these systems, the superior characteristics of the 3-D gore design, incorporating large bulges with a small local radius and unidirectional film tension, should be maintained. Improved design methods which are adequate for the above subjects will be discussed in detail. Application for ground structures are also mentioned.

  4. Balloon Exoplanet Nulling Interferometer (BENI)

    NASA Technical Reports Server (NTRS)

    Lyon, Richard G.; Clampin, Mark; Woodruff, Robert A.; Vasudevan, Gopal; Ford, Holland; Petro, Larry; Herman, Jay; Rinehart, Stephen; Carpenter, Kenneth; Marzouk, Joe

    2009-01-01

    We evaluate the feasibility of using a balloon-borne nulling interferometer to detect and characterize exosolar planets and debris disks. The existing instrument consists of a 3-telescope Fizeau imaging interferometer with 3 fast steering mirrors and 3 delay lines operating at 800 Hz for closed-loop control of wavefront errors and fine pointing. A compact visible nulling interferometer is under development which when coupled to the imaging interferometer would in-principle allow deep suppression of starlight. We have conducted atmospheric simulations of the environment above 100,000 feet and believe balloons are a feasible path forward towards detection and characterization of a limited set of exoplanets and their debris disks. Herein we will discuss the BENI instrument, the balloon environment and the feasibility of such as mission.

  5. Tensile set behavior of Foley catheter balloons.

    PubMed

    Joseph, R; Ramesh, P; Sivakumar, R

    1999-01-01

    The removal of indwelling urinary balloon catheters from patients is usually associated with many problems. The problems such as balloon deflation failure; encrustations on balloons, eyes, and lumen; and catheter associated infections are widely discussed in the literature. The tensile set exhibited by the catheter balloon material could also play a role and further complicate the removal process. This article addresses this issue by comparing the tensile set behavior of the balloon material from three commercially available Foley catheters. The balloon materials were subjected to aging in synthetic urine at 37 degrees C for 28 days to simulate clinical conditions. The deflation time of catheter balloons aged in similar conditions were also measured. It was found that different brands of catheters exhibited statistically significant differences in their properties. The tensile set data of the aged samples could be correlated with the deflation time of the balloons. The clinical significance of the tensile set is also highlighted. PMID:10029146

  6. NASA Aeronautics Showcased at Balloon Fiesta

    NASA Video Gallery

    Visitors at the 2010 International Balloon Fiesta in Albuquerque, N.M., got visual stimulation from hundreds of colorful hot-air balloons soaring skyward, but also learned about NASA's aeronautics ...

  7. Yellow Balloon in a Briar Patch.

    ERIC Educational Resources Information Center

    Cooper, Frank; Fitzmaurice, Robert W.

    1978-01-01

    As part of a meteorology unit, sixth grade science students launched helium balloons with attached return postcards. This article describes Weather Service monitoring of the balloons and postcard return results. (MA)

  8. Status of the NASA Balloon Program

    NASA Technical Reports Server (NTRS)

    Needleman, H. C.; Nock, R. S.; Bawcom, D. W.

    1993-01-01

    The NASA Balloon Program (BP) is examined in an overview of design philosophy, R&D activities, flight testing, and the development of a long-duration balloon for Antarctic use. The Balloon Recovery Program was developed to qualify the use of existing films and to design improved materials and seals. Balloon flights are described for studying the supernova SN1987a, and systems were developed to enhance balloon campaigns including mobile launch vehicles and tracking/data-acquisition systems. The technical approach to long-duration ballooning is reviewed which allows the use of payloads of up to 1350 kg for two to three weeks. The BP is responsible for the development of several candidate polyethylene balloon films as well as design/performance standards for candidate balloons. Specific progress is noted in reliability and in R&D with respect to optimization of structural design, resin blending, and extrusion.

  9. The EUSO-Balloon pathfinder

    NASA Astrophysics Data System (ADS)

    Adams, J. H.; Ahmad, S.; Albert, J.-N.; Allard, D.; Anchordoqui, L.; Andreev, V.; Anzalone, A.; Arai, Y.; Asano, K.; Ave Pernas, M.; Baragatti, P.; Barrillon, P.; Batsch, T.; Bayer, J.; Bechini, R.; Belenguer, T.; Bellotti, R.; Belov, K.; Berlind, A. A.; Bertaina, M.; Biermann, P. L.; Biktemerova, S.; Blaksley, C.; Blanc, N.; Błȩcki, J.; Blin-Bondil, S.; Blümer, J.; Bobik, P.; Bogomilov, M.; Bonamente, M.; Briggs, M. S.; Briz, S.; Bruno, A.; Cafagna, F.; Campana, D.; Capdevielle, J.-N.; Caruso, R.; Casolino, M.; Cassardo, C.; Castellinic, G.; Catalano, C.; Catalano, G.; Cellino, A.; Chikawa, M.; Christl, M. J.; Cline, D.; Connaughton, V.; Conti, L.; Cordero, G.; Crawford, H. J.; Cremonini, R.; Csorna, S.; Dagoret-Campagne, S.; de Castro, A. J.; De Donato, C.; de la Taille, C.; De Santis, C.; del Peral, L.; Dell'Oro, A.; De Simone, N.; Di Martino, M.; Distratis, G.; Dulucq, F.; Dupieux, M.; Ebersoldt, A.; Ebisuzaki, T.; Engel, R.; Falk, S.; Fang, K.; Fenu, F.; Fernández-Gómez, I.; Ferrarese, S.; Finco, D.; Flamini, M.; Fornaro, C.; Franceschi, A.; Fujimoto, J.; Fukushima, M.; Galeotti, P.; Garipov, G.; Geary, J.; Gelmini, G.; Giraudo, G.; Gonchar, M.; González Alvarado, C.; Gorodetzky, P.; Guarino, F.; Guzmán, A.; Hachisu, Y.; Harlov, B.; Haungs, A.; Hernández Carretero, J.; Higashide, K.; Ikeda, D.; Ikeda, H.; Inoue, N.; Inoue, S.; Insolia, A.; Isgrò, F.; Itow, Y.; Joven, E.; Judd, E. G.; Jung, A.; Kajino, F.; Kajino, T.; Kaneko, I.; Karadzhov, Y.; Karczmarczyk, J.; Karus, M.; Katahira, K.; Kawai, K.; Kawasaki, Y.; Keilhauer, B.; Khrenov, B. A.; Kim, J.-S.; Kim, S.-W.; Kim, S.-W.; Kleifges, M.; Klimov, P. A.; Kolev, D.; Kreykenbohm, I.; Kudela, K.; Kurihara, Y.; Kusenko, A.; Kuznetsov, E.; Lacombe, M.; Lachaud, C.; Lee, J.; Licandro, J.; Lim, H.; López, F.; Maccarone, M. C.; Mannheim, K.; Maravilla, D.; Marcelli, L.; Marini, A.; Martinez, O.; Masciantonio, G.; Mase, K.; Matev, R.; Medina-Tanco, G.; Mernik, T.; Miyamoto, H.; Miyazaki, Y.; Mizumoto, Y.; Modestino, G.; Monaco, A.; Monnier-Ragaigne, D.; Morales de los Ríos, J. A.; Moretto, C.; Morozenko, V. S.; Mot, B.; Murakami, T.; Murakami, M. Nagano; Nagata, M.; Nagataki, S.; Nakamura, T.; Napolitano, T.; Naumov, D.; Nava, R.; Neronov, A.; Nomoto, K.; Nonaka, T.; Ogawa, T.; Ogio, S.; Ohmori, H.; Olinto, A. V.; Orleański, P.; Osteria, G.; Panasyuk, M. I.; Parizot, E.; Park, I. H.; Park, H. W.; Pastircak, B.; Patzak, T.; Paul, T.; Pennypacker, C.; Perez Cano, S.; Peter, T.; Picozza, P.; Pierog, T.; Piotrowski, L. W.; Piraino, S.; Plebaniak, Z.; Pollini, A.; Prat, P.; Prévôt, G.; Prieto, H.; Putis, M.; Reardon, P.; Reyes, M.; Ricci, M.; Rodríguez, I.; Rodríguez Frías, M. D.; Ronga, F.; Roth, M.; Rothkaehl, H.; Roudil, G.; Rusinov, I.; Rybczyński, M.; Sabau, M. D.; Sáez-Cano, G.; Sagawa, H.; Saito, A.; Sakaki, N.; Sakata, M.; Salazar, H.; Sánchez, S.; Santangelo, A.; Santiago Crúz, L.; Sanz Palomino, M.; Saprykin, O.; Sarazin, F.; Sato, H.; Sato, M.; Schanz, T.; Schieler, H.; Scotti, V.; Segreto, A.; Selmane, S.; Semikoz, D.; Serra, M.; Sharakin, S.; Shibata, T.; Shimizu, H. M.; Shinozaki, K.; Shirahama, T.; Siemieniec-Oziȩbło, G.; Silva López, H. H.; Sledd, J.; Słomińska, K.; Sobey, A.; Sugiyama, T.; Supanitsky, D.; Suzuki, M.; Szabelska, B.; Szabelski, J.; Tajima, F.; Tajima, N.; Tajima, T.; Takahashi, Y.; Takami, H.; Takeda, M.; Takizawa, Y.; Tenzer, C.; Tibolla, O.; Tkachev, L.; Tokuno, H.; Tomida, T.; Tone, N.; Toscano, S.; Trillaud, F.; Tsenov, R.; Tsunesada, Y.; Tsuno, K.; Tymieniecka, T.; Uchihori, Y.; Unger, M.; Vaduvescu, O.; Valdés-Galicia, J. F.; Vallania, P.; Valore, L.; Vankova, G.; Vigorito, C.; Villaseñor, L.; von Ballmoos, P.; Wada, S.; Watanabe, J.; Watanabe, S.; Watts, J.; Weber, M.; Weiler, T. J.; Wibig, T.; Wiencke, L.; Wille, M.; Wilms, J.; Włodarczyk, Z.; Yamamoto, T.; Yamamoto, Y.; Yang, J.; Yano, H.; Yashin, I. V.; Yonetoku, D.; Yoshida, K.; Yoshida, S.; Young, R.; Zotov, M. Yu.; Zuccaro Marchi, A.

    2015-11-01

    EUSO-Balloon is a pathfinder for JEM-EUSO, the Extreme Universe Space Observatory which is to be hosted on-board the International Space Station. As JEM-EUSO is designed to observe Ultra-High Energy Cosmic Rays (UHECR)-induced Extensive Air Showers (EAS) by detecting their ultraviolet light tracks "from above", EUSO-Balloon is a nadir-pointing UV telescope too. With its Fresnel Optics and Photo-Detector Module, the instrument monitors a 50 km2 ground surface area in a wavelength band of 290-430 nm, collecting series of images at a rate of 400,000 frames/sec. The objectives of the balloon demonstrator are threefold: a) perform a full end-to-end test of a JEM-EUSO prototype consisting of all the main subsystems of the space experiment, b) measure the effective terrestrial UV background, with a spatial and temporal resolution relevant for JEM-EUSO. c) detect tracks of ultraviolet light from near space for the first time. The latter is a milestone in the development of UHECR science, paving the way for any future space-based UHECR observatory. On August 25, 2014, EUSO-Balloon was launched from Timmins Stratospheric Balloon Base (Ontario, Canada) by the balloon division of the French Space Agency CNES. From a float altitude of 38 km, the instrument operated during the entire astronomical night, observing UV-light from a variety of ground-covers and from hundreds of simulated EASs, produced by flashers and a laser during a two-hour helicopter under-flight.

  10. Cooling balloons with liquid nitrogen

    NASA Astrophysics Data System (ADS)

    Moreno, A. J.; Ferrari, H.; Bekeris, V.

    2010-12-01

    We present an undergraduate level experiment in which the radius of a rubber balloon is measured as it is cooled with liquid nitrogen. For balloons filled with simple gases that condense at liquid nitrogen temperatures, we found that the volume decreases linearly with time. We compared our measurements with a simplified model based on elementary kinetic theory and thermodynamics that explains this behavior. Students are encouraged to test the validity of the model by repeating the experiment using gas mixtures and gases that do not condense at liquid nitrogen temperatures.

  11. Interference in the processing of adjunct control.

    PubMed

    Parker, Dan; Lago, Sol; Phillips, Colin

    2015-01-01

    Recent research on the memory operations used in language comprehension has revealed a selective profile of interference effects during memory retrieval. Dependencies such as subject-verb agreement show strong facilitatory interference effects from structurally inappropriate but feature-matching distractors, leading to illusions of grammaticality (Pearlmutter et al., 1999; Wagers et al., 2009; Dillon et al., 2013). In contrast, dependencies involving reflexive anaphors are generally immune to interference effects (Sturt, 2003; Xiang et al., 2009; Dillon et al., 2013). This contrast has led to the proposal that all anaphors that are subject to structural constraints are immune to facilitatory interference. Here we use an animacy manipulation to examine whether adjunct control dependencies, which involve an interpreted anaphoric relation between a null subject and its licensor, are also immune to facilitatory interference effects. Our results show reliable facilitatory interference in the processing of adjunct control dependencies, which challenges the generalization that anaphoric dependencies as a class are immune to such effects. To account for the contrast between adjunct control and reflexive dependencies, we suggest that variability within anaphora could reflect either an inherent primacy of animacy cues in retrieval processes, or differential degrees of match between potential licensors and the retrieval probe. PMID:26441723

  12. Interference in the processing of adjunct control

    PubMed Central

    Parker, Dan; Lago, Sol; Phillips, Colin

    2015-01-01

    Recent research on the memory operations used in language comprehension has revealed a selective profile of interference effects during memory retrieval. Dependencies such as subject–verb agreement show strong facilitatory interference effects from structurally inappropriate but feature-matching distractors, leading to illusions of grammaticality (Pearlmutter et al., 1999; Wagers et al., 2009; Dillon et al., 2013). In contrast, dependencies involving reflexive anaphors are generally immune to interference effects (Sturt, 2003; Xiang et al., 2009; Dillon et al., 2013). This contrast has led to the proposal that all anaphors that are subject to structural constraints are immune to facilitatory interference. Here we use an animacy manipulation to examine whether adjunct control dependencies, which involve an interpreted anaphoric relation between a null subject and its licensor, are also immune to facilitatory interference effects. Our results show reliable facilitatory interference in the processing of adjunct control dependencies, which challenges the generalization that anaphoric dependencies as a class are immune to such effects. To account for the contrast between adjunct control and reflexive dependencies, we suggest that variability within anaphora could reflect either an inherent primacy of animacy cues in retrieval processes, or differential degrees of match between potential licensors and the retrieval probe. PMID:26441723

  13. Carotid Artery Stenosis with Acute Ischemic Stroke: Stenting versus Angioplasty

    PubMed Central

    Villwock, Mark R.; Padalino, David J.; Deshaies, Eric M.

    2015-01-01

    Background When a patient with carotid artery stenosis presents emergently with acute ischemic stroke, the optimum treatment plan is not clearly defined. If intervention is warranted, and open surgery is prohibitive, endovascular revascularization may be performed. The use of stents places the patient at additional risk due to their thrombogenic potential. The intent of this study was to compare outcomes following endovascular approaches (angioplasty alone vs. stent) in the setting of acute stroke. Methods We extracted a population from the National Inpatient Sample (2012) and the Nationwide Inpatient Sample (2003–2011) composed of patients with carotid artery stenosis with infarction that were admitted nonelectively and received endovascular revascularization. Patients treated with mechanical thrombectomy or thrombolysis were excluded. Categorical variables were compared between treatment groups with Chi-squared tests. Binary logistic regression was performed to evaluate mortality and iatrogenic stroke while controlling for age, case severity, and comorbidity burden. Results About 6,333 admissions met our criteria. A majority were treated via stenting (89%, n = 5,608). The angioplasty-alone group had significantly higher mortality (9.0% vs. 3.8%, p < 0.001) and iatrogenic stroke rate (3.9% vs. 1.9%, p < 0.001) than the stent group. The adjusted odds ratios of mortality and iatrogenic stroke for patients treated with angioplasty alone were 1.953 (p < 0.001) and 1.451 (p = 0.105), respectively, in comparison to patients treated with carotid stenting. Conclusion Multivariate analysis found the risk of mortality to be elevated following angioplasty alone. This may represent selection bias, but it also may indicate that symptomatic patients with stroke suffer from severe stenosis and unstable plaques that would benefit from stent placement. These results would caution angioplasty alone as an arm of a future randomized trial involving this severely burdened patient

  14. Simulating clefts in pumpkin balloons

    NASA Astrophysics Data System (ADS)

    Baginski, Frank; Brakke, Kenneth

    2010-02-01

    The geometry of a large axisymmetric balloon with positive differential pressure, such as a sphere, leads to very high film stresses. These stresses can be significantly reduced by using a tendon re-enforced lobed pumpkin-like shape. A number of schemes have been proposed to achieve a cyclically symmetric pumpkin shape, including the constant bulge angle (CBA) design, the constant bulge radius (CBR) design, CBA/CBR hybrids, and NASA’s recent constant stress (CS) design. Utilizing a hybrid CBA/CBR pumpkin design, Flight 555-NT in June 2006 formed an S-cleft and was unable to fully deploy. In order to better understand the S-cleft phenomenon, a series of inflation tests involving four 27-m diameter 200-gore pumpkin balloons were conducted in 2007. One of the test vehicles was a 1/3-scale mockup of the Flight 555-NT balloon. Using an inflation procedure intended to mimic ascent, the 1/3-scale mockup developed an S-cleft feature strikingly similar to the one observed in Flight 555-NT. Our analysis of the 1/3-scale mockup found it to be unstable. We compute asymmetric equilibrium configurations of this balloon, including shapes with an S-cleft feature.

  15. Global electrodynamics from superpressure balloons

    NASA Technical Reports Server (NTRS)

    Holzworth, R. H.; Hu, H.

    1995-01-01

    Electric field and conductivity measurements in the stratosphere between November 1992 and March 1993 have been made using superpressure balloons in the southern hemisphere. Over 400 payload-days of data have been made during a record setting experiment called ELBBO (Extended Life Balloon Borne Observatories). This experiment resulted in 4 flights aloft simultaneously for over 2 months including one flight which lasted over 4 months. Electrodynamical coupling between the atmosphere and ionosphere is studied using the measured electric fields, and a simple empirical model of the stratospheric conductivity. Altitude profiles of conductivity have been obtained from several superpressure balloon flights using the large end-of-flight altitude swings on the last few days of each flight (as the balloon begins to loose superpressure). Coupling between the fields and atmospheric inertial waves has been observed. Effects and dynamics of the global circuit suggest that standard models are missing significant phenomena. Large scale ionospheric convection activity has been studied from the polar cap to the middle latitudes. Cusp latitude fields have been continuously measured for many days in a row.

  16. Balloon atmospheric propagation experiment measurements

    NASA Technical Reports Server (NTRS)

    Minott, P. O.

    1973-01-01

    High altitude balloon measurements on laser beam fading during propagation through turbulent atmosphere show that a correlation between fading strength and stellar scintillation magnitudes exists. Graphs for stellar scintillation as a function of receiver aperture are used to predict fading bit error rates for neodymium-yag laser communication system.

  17. Stability of the pumpkin balloon

    NASA Astrophysics Data System (ADS)

    Baginski, Frank

    A large axisymmetric balloon with positive differential pressure, e.g., a sphere, leads to high film stresses. These can be significantly reduced by using a lobed pumpkin-like shape re-enforced with tendons. A number of schemes have been proposed to achieve a cyclically symmetric pumpkin-shape at full inflation, including the constant bulge angle (CBA) design and the constant bulge radius (CBR) design. The authors and others have carried out stability studies of CBA and CBR designs and found instabilities under various conditions. While stability seems to be a good indicator of deployment problems for large balloons under normal ascent conditions, one cannot conclude that a stable design will deploy reliably. Nevertheless, stability analysis allows one to quantify certain deployment characteristics. Ongoing research by NASA's Balloon Program Office utilizes a new design approach developed by Rodger Farley, NASA/GSFC, that takes into account film and tendon strain. We refer to such a balloon as a constant stress (CS) pumpkin design. In June 2006, the Flight 555-NT balloon (based on a hybrid CBR/CBA design) developed an S-cleft and did not deploy. In order to understand the S-cleft phenomena and study a number of aspects related to the CS-design, a series of inflation tests were conducted at TCOM, Elizabeth City, NC in 2007. The test vehicles were 27 meter diameter pumpkins distinguished by their respective equatorial bulge angles (BA). For example, BA98 indicates an equatorial bulge angle of 98° . BA90, BA55, and BA00 are similarly defined. BA98 was essentially a one-third scale version of of the Flight 555 balloon (i.e., 12 micron film instead of 38.1 micron, mini-tendons, etc.). BA90 and BA55 were Farley CS-designs. BA00 was derived from the BA55 design so that a flat chord spanned adjacent tendons. In this paper, we will carry out stability studies of BA98, BA90, BA55, and BA00. We discuss the deployment problem of pumpkin balloons in light of 2007 inflation

  18. Evaluation of a New Balloon Catheter for Difficult Calcified Lesions in Infrainguinal Arterial Disease: Outcome of a Multicenter Registry

    SciTech Connect

    Spaargaren, G. J.; Lee, M. J.; Reekers, J. A.; Overhagen, H. van; Schultze Kool, L. J.; Hoogeveen, Y. L.

    2009-01-15

    The purpose of this study was to assess the technical performance and immediate procedure outcome of a new balloon catheter in the treatment of calcified lesions in infrainguinal arterial disease. Seventy-five patients with infrainguinal arterial disease were prospectively entered into the registry. The catheter (ReeKross Clearstream, Ireland) is a 5- to 6-Fr balloon catheter with a rigid shaft intended for enhanced pushability. Only technical procedural outcome was recorded. Treated calcified lesions (range: 5-30 cm), assessed angiographically, were located in the superficial femoral, popliteal, and crural arteries. In 67 patients the lesion was an occlusion. Guidewire passage occurred subintimally in 68 patients. In 24 patients a standard balloon catheter was chosen as first treatment catheter: 5 failed to cross the lesion, 8 balloons ruptured, and in 11 patients there was an inadequate dilatation result. In only one of the five patients did subsequent use of the ReeKross catheter also fail in lesion crossing. The ReeKross was successful as secondary catheter in the other 23 cases. In 50 patients the ReeKross was used as primary catheter. In total the ReeKross crossed the lesions in 74 patients. After passage and dilatation with this catheter in 73 patients (1 failed true-lumen reentry), 19 had >30% residual lesions, of which 11 were not treated and 8 were successfully stented. No ReeKross balloons ruptured. We conclude that in the treatment of difficult calcified lesions in arterial stenotic or occlusive disease, the choice of a high-pushability angioplasty catheter, with more calcification-resistant balloon characteristics, like the ReeKross, warrants consideration.

  19. Results of a Peripheral Cutting Balloon Prospective Multicenter European Registry in Hemodialysis Vascular Access

    SciTech Connect

    Peregrin, Jan H. Rocek, Miloslav

    2007-04-15

    Purpose. To report initial experience with the Peripheral Cutting Balloon (PCB) in treatment of failing hemodialysis shunts. Methods. A total of 190 patients (95 men, 95 women; average age 64.4 {+-} 11.9 years, range 32-87 years) who were treated with the PCB for pressure-resistant stenosis, restenosis or failed percutaneous transluminal angioplasty (PTA) in the venous limb of an arteriovenous shunt were followed in seven European centers using a simple registry. The group consisted of 109 de novo lesions (57%) and 79 restenotic lesions (43%). Results. Technical success was achieved in 88.9% of cases. Primary patency was as follows (the results for whole group and simultaneous results for de novo lesions and restenoses are presented): 1 month (140 patients followed): 94%, 98%, and 93%; 3 months (116 patients followed): 93%, 98%, and 92%; 6 months (40 patients followed): 85%, 92%, and 79%; 12 months (27 patients followed): 74%, 87%, and 48%. No complication occurred. Patients experienced an equal or lower level of pain during the procedure compared with conventional PTA. Conclusion. The PCB proved to be successful in dilating pressure-resistant stenoses. We cannot conclude whether PCB angioplasty can lower the restenosis rate in hemodialysis access lesions, but the long-term patency for de novo lesions is high. A further randomized study is advisable.

  20. A Challenge to the Highest Balloon Altitude

    NASA Astrophysics Data System (ADS)

    Saito, Yoshitaka; Akita, Daisuke; Fuke, Hideyuki; Iijima, Issei; Izutsu, Naoki; Kato, Yoichi; Kawada, Jiro; Matsuzaka, Yukihiko; Mizuta, Eiichi; Namiki, Michiyoshi; Nonaka, Naoki; Ohta, Shigeo; Sato, Takatoshi; Seo, Motoharu; Takada, Atsushi; Tamura, Keisuke; Toriumi, Michihiko; Yamagami, Takamasa; Yamada, Kazuhiko; Yoshida, Tetsuya; Matsushima, Kiyoho; Tanaka, Shigeki

    Development of a balloon to fly at higher altitudes is one of the most attractive challenges in scientific balloon technologies. After reaching the highest record setting balloon altitude of 53.0 km using the 3.4 µm film in 2002, a thinner balloon film with a thickness of 2.8 µm using a higher density resin was developed. In 2004, a 5,000 m3 balloon with the film was successfully launched, however, 60,000 m3 balloons launched in 2005, 2006, and 2007, were broken during the ascending phase. The problem was suspected to be due to the properties of the film including the uniformity and the strength, neither of which can be estimated by the conventional tensile test. Thus, we checked the strength of the film with large sample, the bi-axial tensile test properties, the creep properties, and the viscoelasticity, comparing with these to the other thick balloon films. In this conference, we are going to report our new test procedure of the balloon film, results of our current and a new 2.8 µm balloon film, and our future plan to launch the highest altitude balloon.

  1. A Mars 2011 Balloon Mission Trade Study

    NASA Astrophysics Data System (ADS)

    Smith, I.; Lew, T.; Perry, W.

    Mars Scouts are competitively selected PI-led missions to further Mars exploration in ways that satisfy NASA s overall objectives but are not currently in the planned line of missions The current 2006 Announcement of Opportunity AO for Mars Scouts has just closed The goal of this SwRI study was to develop a new balloon mission concept to where it could be credibly proposed for the AO The balloon system was defined in the study as consisting of two parts the balloon flight system BFS and the balloon deployment inflation system DIS The BFS includes the balloon envelope accessory hardware and gondola The balloon includes the envelope seams end fittings load core inflation tube diffusers payload tether shock attenuator and separation hardware The DIS includes the balloon container deployment hardware sequencer tankage gas and control hardware Trade studies were performed to better define the mission design space These studies included 1 effect of varied atmospheric thermal loads 2 effect of varying latitudes 3 effect of payload mass for varying altitudes 4 effect of radiative material properties on balloon size mass 5 effect of material areal densities on balloon size mass and 6 effect of inflation gas on system masses Results of the balloon trade study for the Mars 2011 mission opportunity will be presented

  2. Scientific ballooning payload termination loads

    NASA Astrophysics Data System (ADS)

    Robbins, E.

    1993-02-01

    NASA's high altitude balloon borne scientific payloads are typically suspended from a deployed flat circular parachute. At flight termination, the recovery train is pyrotechnically separated at the parachute apex and balloon nadir interface. The release of elastic energy stored in the parachute at zero initial virtical velocity in the rarefied atmosphere produces high canopy opening forces that subject the gondola to potentially damaging shock loads. Data from terminations occuring at altitudes to 40 km with payloads up to 2500 kg on parachutes up to 40 m in diameter are presented. Measured loads are markedly larger than encountered via packed parachute deployment for similar canopy loadings. Canopy inflation is significantly surpressed in the early stages and then accelerated during final blossoming. Data interpretation and behavioral phenomena are discussed along with proposed shock attenuation techniques.

  3. Scientific ballooning payload termination loads

    NASA Technical Reports Server (NTRS)

    Robbins, E.

    1993-01-01

    NASA's high altitude balloon borne scientific payloads are typically suspended from a deployed flat circular parachute. At flight termination, the recovery train is pyrotechnically separated at the parachute apex and balloon nadir interface. The release of elastic energy stored in the parachute at zero initial vertical velocity in the rarefied atmosphere produces high canopy opening forces that subject the gondola to potentially damaging shock loads. Data from terminations occurring at altitudes to 40 km with payloads up to 2500 kg on parachutes up to 40 m in diameter are presented. Measured loads are markedly larger than encountered via packed parachute deployment for similar canopy loadings. Canopy inflation is significantly suppressed in the early stages and then accelerated during final blossoming. Data interpretation and behavioral phenomena are discussed along with proposed shock attenuation techniques.

  4. High Altitude Ozone Research Balloon

    NASA Technical Reports Server (NTRS)

    Cauthen, Timothy A.; Daniel, Leslie A.; Herrick, Sally C.; Rock, Stacey G.; Varias, Michael A.

    1990-01-01

    In order to create a mission model of the high altitude ozone research balloon (HAORB) several options for flight preparation, altitude control, flight termination, and payload recovery were considered. After the optimal launch date and location for two separate HAORB flights were calculated, a method for reducing the heat transfer from solar and infrared radiation was designed and analytically tested. This provided the most important advantage of the HAORB over conventional balloons, i.e., its improved flight duration. Comparisons of different parachute configurations were made, and a design best suited for the HAORB's needs was determined to provide for payload recovery after flight termination. In an effort to avoid possible payload damage, a landing system was also developed.

  5. Adjunctive treatment in septic shock: What's next?

    PubMed

    Annane, Djillali

    2016-04-01

    Sepsis is a leading cause of death and long-term sequels worldwide. For more than a decade, the scientific community is providing physicians, patients and policy makers with regularly updated guidelines. There is some evidence that implementation of the Surviving Sepsis Campaign guidelines is associated with improved patients outcomes. Though there were major advances in the understanding of sepsis, the management of sepsis mainly relies on anti-infective treatments and restoration of cardiovascular and respiratory function according to quantitative protocolized care. Except some hormonal interventions such as insulin to maintain blood glucose levels of less than 180mg/dL and low doses of corticosteroids and vasopressin in highly selected patients, there is no adjunct therapy for the routine management of sepsis. Recent years have shown some interest in revolutionary concepts such as selective beta-1 receptor antagonists or interventions to boost the immune system. These provocative approaches yielded promising results in various experimental models of sepsis and in preliminary data in humans. The current narrative review summarized some of the numerous adjunct therapies that are currently being investigated in sepsis. PMID:27085987

  6. 'Transcollateral' Renal Angioplasty for a Completely Occluded Renal Artery

    SciTech Connect

    Chandra, Subash; Chadha, Davinder S. Swamy, Ajay

    2011-02-15

    Percutaneous transluminal renal angioplasty with stenting has been effective in the control of hypertension, renal function, and pulmonary edema caused by atherosclerotic renal artery stenosis. However, the role of the procedure has not been fully established in the context of chronic total occlusion of renal artery. We report the successful use of this procedure in 57-year-old male patient who reported for evaluation of a recent episode of accelerated hypertension. A renal angiogram in this patient showed ostial stenosis of the right renal artery, which was filling by way of the collateral artery. Renal angioplasty for chronic total occlusion of right renal artery was successfully performed in a retrograde fashion through a collateral artery, thereby leading to improvement of renal function and blood pressure control.

  7. Balloon-borne transform spectroscopy

    NASA Technical Reports Server (NTRS)

    Traub, W. A.

    1976-01-01

    The design and construction of a high-resolution far-infrared Fourier-transform spectrometer for use on the Smithsonian balloon-borne one-meter telescope is described. The instrument will operate at a resolution of about 0.1 kayser in the region from 25 to 150 microns. It will be used to obtain spectra of Jupiter, Venus, Orion, and other H II and molecular cloud regions, as well as the terrestrial stratosphere.

  8. Early Results with the Use of Heparin-bonded Stent Graft to Rescue Failed Angioplasty of Chronic Femoropopliteal Occlusive Lesions: TASC D Lesions Have a Poor Outcome

    SciTech Connect

    Kuhan, Ganesh Abisi, Said; Braithwaite, Bruce D.; MacSweeney, Shane T. R.; Whitaker, Simon C.; Habib, Said B.

    2012-10-15

    Purpose: To evaluate early patency rate of the heparin-bonded stent grafts in atherosclerotic long femoropopliteal occlusive disease, and to identify factors that affect outcome. Methods: Heparin-bonded Viabahn stent grafts were placed in 33 limbs in 33 patients during 2009-2010. The stents were deployed to rescue failed conventional balloon angioplasty. Mean age was 69 (range 44-88) years, and 67 % (22 of 33) were men. Most procedures (21 of 33, 64 %) were performed for critical limb ischemia (33 % for rest pain, 30 % tissue loss). Kaplan-Meier plots and Cox regression analysis were used to identify significant risk factors. Results: The average length of lesions treated was 25 {+-} 10 cm, and they were predominantly TASC (Transatlantic Intersociety Consensus) D (n = 13) and C (n = 17) lesions. The median primary patency was 5.0 months (95 % confidence interval 1.22-8.77). The mean secondary patency was 8.6 months (95 % confidence interval 6.82-10.42). Subsequently, 4 patients underwent bypass surgery and 5 patients underwent major amputation. One patient died. There were 5 in-stent or edge-stent stenoses. Cox multivariate regression analysis identified TASC D lesions to be a significant risk factor for early occlusion (p = 0.035). Conclusion: TASC D lesions of femoropopliteal occlusions have poor patency rates with the use of heparin-bonded stent grafts after failed conventional angioplasty. Alternative options should be considered for these patients.

  9. Viscoelastic behaviour of pumpkin balloons

    NASA Astrophysics Data System (ADS)

    Gerngross, T.; Xu, Y.; Pellegrino, S.

    2008-11-01

    The lobes of the NASA ULDB pumpkin-shaped super-pressure balloons are made of a thin polymeric film that shows considerable time-dependent behaviour. A nonlinear viscoelastic model based on experimental measurements has been recently established for this film. This paper presents a simulation of the viscoelastic behaviour of ULDB balloons with the finite element software ABAQUS. First, the standard viscoelastic modelling capabilities available in ABAQUS are examined, but are found of limited accuracy even for the case of simple uniaxial creep tests on ULDB films. Then, a nonlinear viscoelastic constitutive model is implemented by means of a user-defined subroutine. This approach is verified by means of biaxial creep experiments on pressurized cylinders and is found to be accurate provided that the film anisotropy is also included in the model. A preliminary set of predictions for a single lobe of a ULDB is presented at the end of the paper. It indicates that time-dependent effects in a balloon structure can lead to significant stress redistribution and large increases in the transverse strains in the lobes.

  10. Balloon tracer for atmospheric pollutants

    SciTech Connect

    Lichfield, E.W.; Ivey, M.D.; Zak, B.D.; Church, H.W.

    1985-01-01

    An operational prototype of the Balloon Tracer was developed and described. This prototype was designed to be capable of meeting all of the desired specifications for the Balloon Tracer. Its buoyancy adjustment subsystem is shown. Three Gilian instrument pumps operating in parallel provide a flow of about 12 litres per minute, depending upon backpressure. The miniature Klippard mechanical valves are actuated by a servo mechanism which only requires power when the state of the valves is being changed. The balloon itself for the operational prototype is just under 3 meters in diameter. A block diagram of the operational prototype payload measures ambient pressure, temperature, and humidity obtained from AIR which outputs its data in ASCII format. The vertical anemometer, which has a measured starting speed of under 2 cm/s, makes use of a Gill styrofoam propeller and a Spaulding Instruments rotation sendor. The command decoder is built around a chip developed originally for remote control television tuners. The command receiver operating on 13.8035 MHz was developed and built by Hock Engineering. The Argos transmitter is a Telonics platform transmitter terminal. The heart of the control system is an Intel 8052AH BASIC microcomputer with both random access and read only memory.

  11. Spectroscopic feedback in laser lithotripsy and laser angioplasty

    NASA Astrophysics Data System (ADS)

    Jiang, Zhi X.; King, Terence A.; Shah, T.; Watson, Graham M.

    1992-08-01

    The feasibility of new forms of monitoring the fragmentation and ablation process through the plasma feedback signals in laser lithotripsy and laser angioplasty has been investigated. In laser lithotripsy it has been found that shock wave feedback monitoring is not as reliable as the plasma emission feedback monitoring. The plasma emission spectra indicate clearly plasma formation on calculi or calcified plaque, while an audible signal can be observed on targets such as dark tissue, catheter, and blood. This technique was successful in ex-vivo experiments in which calculi were inserted into pigs' ureter and then fragmented. Spectra were obtained in vivo indicating calcium abundance in calculi and the feasibility of real-time stone composition analysis. Ex-vivo gallstone fragmentation was also performed successfully under plasma spectra feedback monitoring. In laser angioplasty, in vitro experiments have shown a discriminative effect at laser pulse energies of 40 mJ or greater. Strong plasma spectra can only be observed from calcified plaque and not from normal artery tissue or fibrous plaque. The threshold for plasma formation on calcified plaque increases in blood compared to that in saline while the spectral structure becomes more specific. This study shows promising prospects for the technique in both laser lithotripsy and laser angioplasty.

  12. Transluminal coronary angioplasty in the treatment of silent ischemia

    SciTech Connect

    Bergin, P.; Myler, R.K.; Shaw, R.E.; Stertzer, S.H.; Clark, D.A.; Ryan, C.; Murphy, M.C.

    1988-01-01

    Fifty-four asymptomatic patients with positive thallium exercise tests underwent coronary angiography followed by coronary angioplasty (PTCA), as the primary therapy for silent ischemia. The procedure was technically successful in 89% of these patients. Emergency bypass graft surgery was necessary in 2 (3.6%) and q-wave myocardial infarction occurred in 1 (1.8%) of these. All fifty-four patients have been followed for a mean of 35 months since angioplasty. Of the 48 patients with initially successful PTCA, 12 had either clinical restenosis (9/14 or 19%) or a new lesion (3/48 or 6%) during follow-up, which required a repeat PTCA. At the longest follow-up, 46 (85%) had been successfully treated with on or more PTCA procedures. Two patients (3.6%) had sustained late q-wave myocardial infarction and two additional patients reported angina pectoris. There were no deaths. Angioplasty as a primary therapy for silent ischemia appears efficacious, with success and restenosis rates comparable to those in the symptomatic population. Event-free survival is improved, compared with natural history data for patients with silent ischemia from other studies. Prudent risk/benefit analysis may help to define subgroups most likely to benefit from this intervention.

  13. The Primary Patency of Percutaneous Transluminal Angioplasty in Hemodialysis Patients With Vascular Access Failure

    PubMed Central

    Kim, Woo Shin; Pyun, Wook Bum

    2011-01-01

    Background and Objectives Dysfunction of arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) contributes significantly to morbidity and hospitalization in the dialysis population. We evaluated the primary patency of AVFs following percutaneous transluminal angioplasty (PTA) in haemodialysis patients. Subjects and Methods We performed 231 interventions in 118 patients with a mean age of 62.1±12.9 years. We performed 122 interventions in 53 AVG patients (44.9%), and 109 interventions in 65 AVF patients (55.1%). If there was thrombosis of the vascular access, urokinase was administered and/or thrombus aspiration was performed. The stent was inserted when balloon dilatation did not expand sufficiently or elastic recoil occurred. Results For the 118 patients, the median patency time was 10.45±10.29 months at 92 months of follow-up. The primary patencies for stenotic AVFs at 6, 12, 24, 36, 48, and 60 months were 63.4%, 41.4%, 17.0%, 9.7%, 7.3%, and 2.4%, respectively. The primary patencies for AVGs at 6, 12, 24, and 36 months were 36.9%, 19.5%, 10.8%, 2.1%, respectively, and were obtained by means of the Kaplan-Meier analysis (log rank=6.42, p<0.05). The median patency time was 11.0 months and 4.45 months in the non-thrombus and thrombus groups, respectively. The complication rate was 1.73% (4/231); two cases of pseudoaneurysms and two cases of extravasation were detected. All therapy failures (5/231) occurred in thrombotic lesions of AVGs and were treated surgically. Conclusion PTA is an efficacious method for the correction of stenosis of AVFs for hemodialysis, thus prolonging the patency of the fistulas. PMID:22022326

  14. 14 CFR 101.39 - Balloon position reports.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...) AIR TRAFFIC AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND UNMANNED FREE BALLOONS Unmanned Free Balloons § 101.39 Balloon position reports. (a) Each person operating an unmanned... hour before beginning descent, each person operating an unmanned free balloon shall forward to...

  15. 14 CFR 101.39 - Balloon position reports.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) AIR TRAFFIC AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND UNMANNED FREE BALLOONS Unmanned Free Balloons § 101.39 Balloon position reports. (a) Each person operating an unmanned... hour before beginning descent, each person operating an unmanned free balloon shall forward to...

  16. 14 CFR 101.39 - Balloon position reports.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) AIR TRAFFIC AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND UNMANNED FREE BALLOONS Unmanned Free Balloons § 101.39 Balloon position reports. (a) Each person operating an unmanned... hour before beginning descent, each person operating an unmanned free balloon shall forward to...

  17. 14 CFR 101.39 - Balloon position reports.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) AIR TRAFFIC AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND UNMANNED FREE BALLOONS Unmanned Free Balloons § 101.39 Balloon position reports. (a) Each person operating an unmanned... hour before beginning descent, each person operating an unmanned free balloon shall forward to...

  18. 14 CFR 101.39 - Balloon position reports.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...) AIR TRAFFIC AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND UNMANNED FREE BALLOONS Unmanned Free Balloons § 101.39 Balloon position reports. (a) Each person operating an unmanned... hour before beginning descent, each person operating an unmanned free balloon shall forward to...

  19. Biodegradable inflatable balloons for tissue separation.

    PubMed

    Basu, Arijit; Haim-Zada, Moran; Domb, Abraham J

    2016-10-01

    Confining radiation to a specific region (during radiation therapy) minimizes damage to surrounding tissues. Biodegradable inflatable balloons (bio-balloons) were developed. The device protects the normal tissues by increasing the gap between radiation source and critical structures. The radiation fades away while passing through the inflated balloon preventing the surrounding tissues from harmful radiation. These bio-balloons have also found clinical use to treat massive rotator cuff tear. This review summarizes the chemistry, engineering, and clinical development of these biomedical devices. These balloons are made of biodegradable polymers folded into the edge of a trocar and inserted between the tissues to be separated, and inflated by normal saline in the site of the application. The inserted balloon protects the tissues from radiation or mechanical stress. They remain inflated on site for two months and are finally eliminated within 12 months. PMID:27521613

  20. Ultraviolet stellar spectrophotometry from a balloon platform

    NASA Technical Reports Server (NTRS)

    Kondo, Y.; Wells, C.

    1974-01-01

    A 40 centimeter diameter aperture, balloon-borne telescope and ultraviolet spectrometer is described and selected scientific results are briefly reviewed. The general configuration of the 0.4 angstrom resolution instrument is shown and the utilization of servo-controlled secondary mirror, image dissector detector, and special mirror coatings are discussed. An outlook for astronomical research in the mid-ultraviolet from balloon-borne telescopes is presented together with future development plans for JSC's balloon-borne payload.

  1. Psychotherapeutic and Adjunctive Pharmacologic Approaches to Treating Posttraumatic Stress Disorder

    PubMed Central

    Nisenoff, Carolina D.

    2008-01-01

    Posttraumatic stress disorder (PTSD) is a potentially disabling illness that affects millions of people worldwide and can be very difficult to treat, especially the sleep disturbances often associated with this disorder. Successful treatment focuses on psychotherapy, and medications may be useful adjuncts. This article gives examples of successful therapeutic approaches and adjunctive medication use in PTSD. PMID:19727267

  2. A Philosopher Stirs up the World of Adjuncts

    ERIC Educational Resources Information Center

    June, Audrey Williams

    2008-01-01

    Keith Hoeller is an adjunct professor. He teaches philosophy for a living at Green River Community College, just outside Seattle. He has also spent much of the last two decades ruminating about the bigger picture for those at his level of the professorial pecking order. Over the years, Hoeller has lobbied relentlessly for adjunct-friendly…

  3. Adjunct Classes: Organizing Resources for High Risk Students.

    ERIC Educational Resources Information Center

    Harding, Ida B.

    The University of Wisconsin at Eau Claire has attempted to solve the problem of underprepared freshmen by offering adjunct classes to freshman level content courses. Currently ten adjunct classes in seven departments are taught and are used to integrate the teaching of learning and study skills into the teaching of the regular course content. Two…

  4. Uses and Abuses of Adjunct Faculty in Higher Education.

    ERIC Educational Resources Information Center

    Twigg, Helen Parramore

    The extensive use of adjunct and temporary faculty to teach basic general education courses at community colleges can be professionally harmful to both tenured and adjunct faculty. Part-time faculty are guaranteed no health insurance, raises, promotions, nor voice in the decisions that affect them. Their plight affects all faculty in many ways,…

  5. Managing Adjunct & Part-Time Faculty for the New Millennium.

    ERIC Educational Resources Information Center

    Greive, Donald E., Ed.; Worden, Catherine A., Ed.

    The contributions in this book address issues related to the management of part-time and adjunct college faculty members, including the impact of new technology, and provide information necessary for effective management in the future. The chapters are: (1) "A Vision of the Future--From the CEO" (Roy A. Church); (2) "Managing Adjunct and Part-Time…

  6. Mentoring New Adjunct Faculty to Teach Science Laboratories

    ERIC Educational Resources Information Center

    Anderson, Delia Castro

    2007-01-01

    The author discusses mentoring and training strategies that enhance adjunct faculty members' teaching effectiveness in undergraduate science laboratories and foster a sense of common enterprise within the institutional environment. These strategies include the preparation of an "Adjunct Faculty Handbook", mentoring and peer-support programs, and…

  7. Absorption spectrometer balloon flight and iodine investigations

    NASA Technical Reports Server (NTRS)

    1970-01-01

    A high altitude balloon flight experiment to determine the technical feasibility of employing absorption spectroscopy to measure SO2 and NO2 gases in the earth's atmosphere from above the atmospheric ozone layer is discussed. In addition to the balloon experiment the contract includes a ground-based survey of natural I emissions from geological sources and studies of the feasibility of mapping I2 from spacecraft. This report is divided into three major sections as follows: (1) the planning engineering and execution of the balloon experiment, (2) data reduction and analysis of the balloon data, and (3) the results of the I2 phase of the contract.

  8. Innovative Balloon Buoyancy Techniques for Atmospheric Exploration

    NASA Technical Reports Server (NTRS)

    Jones, J.

    2000-01-01

    Until quite recently, the only practical means to control balloon buoyancy, and thus altitude, required consuming large amounts of fuel or the limited venting of helium balloons and/or dropping of ballast. With recent discoveries at JPL, novel long-life, balloon buoyancy techniques have been discovered that for the first time allow balloons to float in the primarily hydrogen atmospheres of Jupiter, Saturn, Uranus, and Neptune (using ambient fill-gas), and by using renewable energy sources, allow multiple controlled landings on Venus (using atmospheric temperature differences), Mars (solar heat), Titan (RTG heat), and Earth (planet radiant heat).

  9. Scientific Ballooning Activities and Recent Developments in Technology and Instrumentation of the TIFR Balloon Facility, Hyderabad

    NASA Astrophysics Data System (ADS)

    Buduru, Suneel Kumar

    2016-07-01

    The Balloon Facility of Tata Institute of Fundamental Research (TIFR-BF) is a unique center of expertise working throughout the year to design, fabricate and launch scientific balloons mainly for space astronomy, atmospheric science and engineering experiments. Recently TIFR-BF extended its support to new user scientists for conducting balloon launches for biological and middle atmospheric sciences. For the first time two balloon launches conducted for sending live lab rats to upper stratosphere and provided launch support for different balloon campaigns such as Tropical Tropopause Dynamics (TTD) to study water vapour content in upper tropospheric and lower stratospheric regions over Hyderabad and the other balloon campaign to study the Asian Tropopause Aerosol Layer (BATAL) during the Indian summer monsoon season. BATAL is the first campaign to conduct balloon launches during active (South-West) monsoon season using zero pressure balloons of different volumes. TIFR-BF also provided zero pressure and sounding balloon support to various research institutes and organizations in India and for several international space projects. In this paper, we present details on our increased capability of balloon fabrication for carrying heavier payloads, development of high strength balloon load tapes and recent developments of flight control and safety systems. A summary of the various flights conducted in two years will be presented along with the future ballooning plans.

  10. Laser turbinectomy as an adjunct to rhinoseptoplasty.

    PubMed

    Selkin, S G

    1985-07-01

    One hundred two inferior turbinectomies were done with the carbon dioxide laser as an adjunct to rhinoseptoplasty. Indications for surgery were airway obstruction on one or both sides not relieved by medical means (42 cases), patient inability to tolerate medication (36 cases), and patient unwillingness to continue to receive medication for prolonged periods (24 cases) in patients unhappy with their appearance. Pathologic processes included allergic rhinitis (34 cases), vasomotor rhinitis (28 cases), and rhinitis medicamentosum (40 cases). A newly designed suction speculum provided easy access to the internal nose and protected the alar rim and the face from laser energy. Only a few minutes of extra operating time were required. Relief of obstruction was comparable to that obtained from cryosurgery, submucous resection of the turbinate, and partial turbinectomy. Intraoperative and postoperative bleeding was less with laser turbinectomy than with any other means. PMID:4015497

  11. Scintimammography as an Adjunctive Breast Imaging Technology

    PubMed Central

    2007-01-01

    Executive Summary Objective X-ray mammography (XMM) represents the most useful screening tool in breast cancer detection, especially for patients over 50. Unfortunately, XMM is not reliable in the assessment of dense breast tissue found in approximately 25% of women younger than 50 years of age, or in differentiating scar tissue from a tumor. Currently, ultrasound (US) is being used as an adjunct to XMM, with the purpose of improving sensitivity and specificity of XMM in breast cancer detection. In an attempt to reduce the biopsy rate resulting from false positive tests, other adjunctive technologies are being explored, including scintimammography (SMM). A number of papers in the current literature suggest the high value of SMM in breast cancer detection. This evaluation addresses the clinical indications for and effectiveness of SMM in the diagnosis of breast cancer. The Technology SMM is a nuclear medicine imaging technique that uses radionuclides and has the ability to image malignant breast tumors. SMM requires the administration of a gamma-ray emitting radiopharmaceutical to the patient, and a camera for imaging the lesion. The most commonly used radiopharmaceutical for SMM is TC-99m-methoxy isobutyl isonitrile MIBI. Review Strategy In the 2003 Medical Advisory Secretariat assessment of SMM in the diagnosis of breast cancer, a structured search was used to identify English-language studies published between 1992 and October 2002. A meta-analysis was then conducted of the literature which compared the diagnostic value of SMM with US as the second line imaging technique. An updated search strategy was developed in order to identify all studies published from October 2002 to January 2007. Summary of Findings The results of the meta-analysis showed that SMM is as effective as US in differentiating benign and malignant breast lesions. However, there may be a role for SMM as a third line adjunctive technique in the evaluation of breast abnormalities, in particular

  12. Paclitaxel-Coated Balloons: Review of a Promising Interventional Approach to Preventing Restenosis in Femoropopliteal Arteries.

    PubMed

    Teleb, Mohamed; Wardi, Miraie; Gosavi, Sucheta; Said, Sarmad; Mukherjee, Debabrata

    2016-06-01

    Peripheral arterial disease (PAD), a major cause of morbidity and mortality worldwide, is characterized by intermittent claudication and is associated with chronic diseases such as diabetes and hypertension. The goal of treatment is to address the underlying cause and to modify risk factors. Although medical management is the first-line treatment of PAD, some individuals may have severe symptoms and require revascularization with percutaneous transluminal angioplasty with or without stent placement or surgery. Interventional approaches may, however, be associated with high prevalence of restenosis and subsequent complications such as critical limb ischemia and amputation. Drug-eluting balloons (DEBs) are a new interventional technology with the primary goal of preventing restenosis. We review the clinical trials and studies that assessed the efficacy and safety profile of DEB and will focus on the restenosis rate in femoropopliteal arteries including target lesion revascularization (TLR) and late lumen lesion (LLL) using different modalities of intervention such as stents and DEB. Average data collected from the trials reported included restenosis rate of 25%, 0.3 mm LLL, and 14% reduction in TLR with DEB versus uncoated balloons. Below the knee (BTK) only intervention studies were excluded from this review as endovascular approach is usually reserved for critical limb ischemia for BTK disease. Interventional approach to treat PAD with DEB appears to be a promising technology. Additional larger studies are needed to further define safety, efficacy, and longer term outcome with this novel technology. PMID:27231422

  13. Drug-eluting balloon: Initial experience in patients with in-stent restenosis (ISR)

    PubMed Central

    Swamy, A.J.; Kumar, Anil; Keshavamurthy, G.; Chadha, D.S.

    2014-01-01

    Background In-stent restenosis is the most important limitation of modern coronary angioplasty. Drug-eluting stents solve this problem but at the cost of late stent thrombosis and longer duration of dual-antiplatelet therapy. Drug-eluting balloon (DEB) technology is now available and offers an attractive option for treatment of restenosis. Methods A cohort of 20 patients with in-stent restenosis after stenting were treated with a drug-eluting balloon and were followed up clinically and angiographically for 6 months. Results and conclusion Procedural success was achieved in all patients. 6 month clinical follow-up was available for all and 6 month angiographic follow up for 17 patients. On 6 month follow-up, 5 of the 20 patients had recurrence of angina and 4 patients had angiographic restenosis (2 focal, 2 diffuse). The mean Canadian Cardiovascular Society angina score improved significantly from 3.1 to 1.1. DEB offers a novel method of treatment for patients with in-stent restenosis with a good safety and efficacy profile. PMID:25378777

  14. 75 FR 77673 - National Environmental Policy Act: Scientific Balloon Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-13

    ... SPACE ADMINISTRATION National Environmental Policy Act: Scientific Balloon Program AGENCY: National... Finding of No Significant Impact (FONSI) with respect to its proposed increase in scientific balloon launches at the Columbia Scientific Balloon Facility (CSBF). CSBF would launch up to 10...

  15. All Adjuncts Are Not Created Equal: An Exploratory Study of Teaching and Professional Needs of Online Adjuncts

    ERIC Educational Resources Information Center

    Bedford, Laurie; Miller, Heather

    2013-01-01

    Online education programs continue to rely on a significant contingent of adjunct faculty to meet the instructional needs of the students. Discourse relating to this situation primarily focuses on the extent to which adjuncts are able to ensure the rigor and quality of instruction as well as the ability of the organization to attract, retain, and…

  16. Assessment of the "long sheath" technique for percutaneous aortic balloon valvuloplasty.

    PubMed

    Plante, S; Beatt, K J; van den Brand, M; Di Mario, C; Meier, B; Serruys, P W

    1990-02-01

    A 100 cm-long 16.5 F valvuloplasty catheter introducer was assessed as an adjunct for percutaneous transluminal aortic valvuloplasty (PTAV) via the femoral artery in 31 patients with severe aortic stenosis. Observed improvements in peak systolic gradient (81.6 +/- 29.9 mm Hg vs. 35.5 +/- 16.0 mm Hg, P less than 0.000001) and aortic valve area (0.6 +/- 0.4 cm2 vs. 1.0 +/- 0.6 cm2, P less than 0.00001) were similar to those achieved in a control group (C) of 17 patients in which no femoral sheath was used. However, a shorter procedure duration (211 +/- 81 min vs. 117 +/- 30 min, P less than 0.001) and a reduced rate of vascular complications at the femoral puncture site (41% vs. 6.5%) were observed in patients in whom the long sheath (LS) technique was used. The frequency of other PTAV-related complications was comparable (C = 35%, LS = 29%, P = n.s.). Other technical advantages of this device are: 1) prevention of looping and bending of the balloon catheter in tortuous vessels and easy positioning of the balloon across the aortic orifice provided by the LS trackability, 2) stabilisation of the balloon during inflation, 3) monitoring of supravalvular aortic pressure provided by the side-arm of the LS and reliable measurement of systolic gradient, and 4) the ability to perform aortograms without the need of another catheter in the ascending aorta. Thus, in our experience, the long sheath technique is a valuable adjunct for PTAV. PMID:2306775

  17. Observations from a constant-altitude stratospheric balloon

    NASA Technical Reports Server (NTRS)

    Mollo-Christensen, Erik; Vermillion, Charles H.; Chan, Paul H.; Mcbrien, Gary E.; Ward, William; Coronado, Patrick

    1991-01-01

    The paper describes a constant-altitude stratospheric balloon system, called Earthwinds, designed for high-altitude atmospheric observations. Special attention is given to the balloon's variable ballast system for altitude control; reactions of the balloon system to air motions in a stratified atmosphere; instruments for locating the balloon position, controlling the altitude, and making observations of atmospheric movements; balloon dynamics; and the atmospheric phenomena that will be observed by the balloon instruments.

  18. Derivatives of the local ballooning growth rate with respect to surface label, field line label, and ballooning parameter

    SciTech Connect

    Hudson, S.R.

    2006-04-15

    Expressions for the derivative of the local ballooning growth rate with respect to surface label, field line label, and ballooning-parameter are presented. Such expressions lead to increased computational efficiency for ballooning stability applications.

  19. 21 CFR 874.4100 - Epistaxis balloon.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Epistaxis balloon. 874.4100 Section 874.4100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4100 Epistaxis balloon. (a)...

  20. 21 CFR 874.4100 - Epistaxis balloon.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Epistaxis balloon. 874.4100 Section 874.4100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4100 Epistaxis balloon. (a)...

  1. 21 CFR 874.4100 - Epistaxis balloon.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Epistaxis balloon. 874.4100 Section 874.4100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4100 Epistaxis balloon. (a)...

  2. 21 CFR 874.4100 - Epistaxis balloon.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Epistaxis balloon. 874.4100 Section 874.4100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4100 Epistaxis balloon. (a)...

  3. 21 CFR 874.4100 - Epistaxis balloon.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Epistaxis balloon. 874.4100 Section 874.4100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4100 Epistaxis balloon. (a)...

  4. The United Kingdom rocket and balloon program

    NASA Astrophysics Data System (ADS)

    Delury, J. T.

    1980-06-01

    The United Kingdom civilian scientific balloon and rocket program for 1979, 1980, 1981 are summarized and the areas of scientific interest for the period 1981 to 1985 are mentioned. Ten balloons up to 40 cu m to be launched from the USA or Australia and launches of up to ten 7.5 in. diameter Petrel rockets are planned.

  5. Transient midventricular ballooning syndrome: a new variant.

    PubMed

    Hurst, R Todd; Askew, J Wells; Reuss, Christina S; Lee, Richard W; Sweeney, John P; Fortuin, F David; Oh, Jae K; Tajik, A Jamil

    2006-08-01

    We describe a new variant of transient left ventricular (LV) ballooning in North American Caucasian patients in which only the midventricle is affected. The patients described in this case series initially presented with emotional or physical stress and had similarities to transient apical ballooning syndrome; however, this variant is unique in that the transient ballooning involves the midventricle with hypercontractility of the apical and basal segments. The presentation, clinical features, and transient nature of the reported cases in this series are similar to transient LV apical ballooning and suggest a shared pathophysiologic etiology. Sparing of the apical segment with involvement of midventricle only supports etiologies not related to an epicardial coronary artery distribution. Although the pathophysiologic mechanism of the transient ventricular ballooning syndromes and other cases of catecholamine-associated transient ventricular dysfunction are not well understood, the emergence of this new variant raises further questions in the understanding of the "brain-heart" relationship. PMID:16875987

  6. Early Cosmic Ray Research with Balloons

    NASA Astrophysics Data System (ADS)

    Walter, Michael

    2013-06-01

    The discovery of cosmic rays by Victor Hess during a balloon flight in 1912 at an altitude of 5350 m would not have been possible without the more than one hundred years development of scientific ballooning. The discovery of hot air and hydrogen balloons and their first flights in Europe is shortly described. Scientific ballooning was mainly connected with activities of meteorologists. It was also the geologist and meteorologist Franz Linke, who probably observed first indications of a penetrating radiation whose intensity seemed to increase with the altitude. Karl Bergwitz and Albert Gockel were the first physicists studying the penetrating radiation during balloon flights. The main part of the article deals with the discovery of the extraterrestrial radiation by V. Hess and the confirmation by Werner Kolhörster.

  7. Promising role of drug-coated balloons in the tibial vessels?

    PubMed

    Langhoff, Ralf; Behne, Andrea; Buschmann, Eva

    2016-10-01

    In order to assess the role of drug-coated balloons (DCB) in below-the-knee (BTK) artery interventions, we analyzed randomized trials which compare coated to non-coated balloons and additionally a direct comparison of drug-eluting stents (DES) with DCB. As angioplasty with non-coated balloons is per guideline-recommendation still standard of care for below-the-knee artery endovascular treatment, we focused on the direct comparison of efficacy and clinical outcome data of both treatment modalities. Data from peer reviewed and published trials were consulted. For each single study, primary and secondary endpoints were reported and compared. Three single-center, non-core lab adjudicated trials showed encouraging data which suggests that DCB in BTK arteries effectively inhibit the risk of early restenosis, but the pivotal, prospectively randomized, multicenter, core lab adjudicated trials failed to match with these result. Limitations of DEB treatment and trials in BTK arteries had been reported, hence a technical evaluation of possible side effects of DCB treatment and of trial design was taken into account. On the basis of the results available, the distinguishing findings of drug eluting effects in the femoropopliteal region cannot be transferred to BTK arteries. Refinement of the existing DCB technology and of future trial design should be considered. To adjudicate on DCB technology applied for BTK treatment is premature and it is mandatory to be kept under evaluation, because the potential benefit, with respect to the compelling results in the femoropoliteal arteries, could be huge to improve endovascular BTK and especially CLI treatment. PMID:27465390

  8. Incremental prognostic value of stress echocardiography as an adjunct to exercise electrocardiography after uncomplicated myocardial infarction

    PubMed Central

    Bigi, R; Desideri, A; Galati, A; Bax, J; Coletta, C; Fiorentini, C; Fioretti, P

    2001-01-01

    OBJECTIVE—To assess the prognostic value of stress echocardiography as an adjunct to exercise electrocardiography in patients with uncomplicated acute myocardial infarction.
DESIGN—496 patients underwent a maximum exercise ECG and pharmacological stress echocardiography (406 dobutamine and 90 dipyridamole) within 15 days of uncomplicated acute myocardial infarction and were followed for a mean of 25 months (range 1-74 months) for reinfarction, unstable angina, and cardiac death. Patients undergoing revascularisation were omitted.
RESULTS—Exercise ECG was positive in 162 patients (32.6%) and low threshold positive (< 100 W) in 91 (18%). Stress echocardiography was positive in 239 patients (48%) (194 with dobutamine and 45 with dipyridamole stress). The agreement between the two tests was 63% (κ = 0.24, 95% confidence interval 0.15 to 0.33). Sixty nine spontaneous events occurred (14 cardiac deaths, 26 reinfarctions, and 29 with unstable angina requiring hospital admission), and 126 patients underwent revascularisation (39 coronary angioplasty and 87 bypass surgery). By receiver operating characteristic curve analysis, stress echocardiography provided incremental prognostic information compared with clinical data. A low threshold positive exercise ECG was associated with a worse outcome, but there was a fivefold increase in risk in patients with positive stress echocardiography who also had a high threshold (> 100 W) positive exercise ECG. Event-free survival of patients with both tests positive was significantly less than in patients with only one positive test or with both tests negative.
CONCLUSIONS—Stress echocardiography provides additional prognostic information after uncomplicated acute myocardial infarction, but the greatest gain is found in patients with a high threshold positive exercise ECG.


Keywords: risk stratification; myocardial infarction; stress echocardiography; exercise stress testing PMID:11250968

  9. Cerebrospinal Fluid Enhancement on Fluid Attenuated Inversion Recovery Images After Carotid Artery Stenting with Neuroprotective Balloon Occlusions: Hemodynamic Instability and Blood-Brain Barrier Disruption

    SciTech Connect

    Ogami, Ryo Nakahara, Toshinori; Hamasaki, Osamu; Araki, Hayato; Kurisu, Kaoru

    2011-10-15

    Purpose: A rare complication of carotid artery stenting (CAS), prolonged reversible neurological symptoms with delayed cerebrospinal fluid (CSF) space enhancement on fluid attenuated inversion recovery (FLAIR) images, is associated with blood-brain barrier (BBB) disruption. We prospectively identified patients who showed CSF space enhancement on FLAIR images. Methods: Nineteen patients-5 acute-phase and 14 scheduled-underwent 21 CAS procedures. Balloon catheters were navigated across stenoses, angioplasty was performed using a neuroprotective balloon, and stents were placed with after dilation under distal balloon protection. CSF space hyperintensity or obscuration on FLAIR after versus before CAS indicated CSF space enhancement. Correlations with clinical factors were examined. Results: CSF space was enhanced on FLAIR in 12 (57.1%) cases. Postprocedural CSF space enhancement was significantly related to age, stenosis rate, acute-stage procedure, and total occlusion time. All acute-stage CAS patients showed delayed enhancement. Only age was associated with delayed CSF space enhancement in scheduled CAS patients. Conclusions: Ischemic intolerance for severe carotid artery stenosis and temporary neuroprotective balloon occlusion, causing reperfusion injury, seem to be the main factors that underlie BBB disruption with delayed CSF space enhancement shortly after CAS, rather than sudden poststenting hemodynamic change. Our results suggest that factors related to hemodynamic instability or ischemic intolerance seem to be associated with post-CAS BBB vulnerability. Patients at risk for hemodynamic instability or with ischemic intolerance, which decrease BBB integrity, require careful management to prevent intracranial hemorrhagic and other post-CAS complications.

  10. Design of a cost-effective, hemodynamically adjustable model for resuscitative endovascular balloon occlusion of the aorta (REBOA) simulation.

    PubMed

    Keller, Benjamin A; Salcedo, Edgardo S; Williams, Timothy K; Neff, Lucas P; Carden, Anthony J; Li, Yiran; Gotlib, Oren; Tran, Nam K; Galante, Joseph M

    2016-09-01

    Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct technique for salvaging patients with noncompressible torso hemorrhage. Current REBOA training paradigms require large animals, virtual reality simulators, or human cadavers for acquisition of skills. These training strategies are expensive and resource intensive, which may prevent widespread dissemination of REBOA. We have developed a low-cost, near-physiologic, pulsatile REBOA simulator by connecting an anatomic vascular circuit constructed out of latex and polyvinyl chloride tubing to a commercially available pump. This pulsatile simulator is capable of generating cardiac outputs ranging from 1.7 to 6.8 L/min with corresponding arterial blood pressures of 54 to 226/14 to 121 mmHg. The simulator accommodates a 12 French introducer sheath and a CODA balloon catheter. Upon balloon inflation, the arterial waveform distal to the occlusion flattens, distal pulsation within the simulator is lost, and systolic blood pressures proximal to the balloon catheter increase by up to 62 mmHg. Further development and validation of this simulator will allow for refinement, reduction, and replacement of large animal models, costly virtual reality simulators, and perfused cadavers for training purposes. This will ultimately facilitate the low-cost, high-fidelity REBOA simulation needed for the widespread dissemination of this life-saving technique. PMID:27270855

  11. [Macroscopic and pathohistological investigation of endarterial plaque after intraoperative balloon dilatation of the carotid artery during carotid endarterectomy].

    PubMed

    Nishida, M; Shima, T; Okada, Y; Yamane, K; Hatayama, T; Yamanaka, C; Toyota, A; Nishida, T

    1998-12-01

    the intima and no increase in lumen size. Preoperative ultrasonography showed hyperechoic finding and postoperative pathohistological findings showed severe fibrosis and calcification, which were thought to have interrupted balloon dilatation. There have been small numbers of reports about pathohistological presentation after percutaneous transluminal angioplasty (PTA), because it is very difficult to take a specimen after PTA. In this report we were able to present the necessity of preoperative investigations by angiography, ultrasonography, and 3D-CT. PMID:9883446

  12. Adjunctation and Scalar Product in the Dirac Equation - I

    NASA Astrophysics Data System (ADS)

    Dima, M.

    2016-02-01

    The Bargmann-Pauli adjunctator (hermitiser) of {C}{l}_{_{1,3}}(C) is derived in a representation independent way, circumventing the early derivations (Pauli, Ann. inst. Henri Poincaré 6, 109 and 121 1936) using representation-dependent arguments. Relations for the adjunctator's transformation with the scalar product and space generator set are given. The S U(2) adjunctator is shown to determine the {C}{l}_{_{1,3}}(C) adjunctator. Part-II of the paper will approach the problem of the two scalar products used in Dirac theory - an unphysical situation of "piece-wise physics" with erroneous results. The adequate usage of scalar product - via calibration - will be presented, in particular under boosts, yielding the known covariant transformations of physical quantities.

  13. Technological adjuncts to increase adherence to therapy: a review.

    PubMed

    Clough, Bonnie A; Casey, Leanne M

    2011-07-01

    This paper identified and reviewed technological adjuncts to increase client adherence to therapy. Three areas of adherence were identified, namely treatment dropout and non-attendance, engagement during and between therapy sessions, and aftercare. Database searches were conducted in each of these areas to identify relevant studies published between the years of 1990 and 2010. Adjuncts designed to replace or reduce direct therapist contact, change the medium of communication between the client and therapist, or alter the content or style of the therapy were not included in this review. Adjuncts were reviewed in light of theories of adherence, including Self Determination Theory, the Transtheoretical Model, and the Theory of Planned Behaviour. Adjuncts reviewed included appointment reminders, exercises and monitoring delivered by mobile phone, and exercises and data collection delivered by computer. Limitations and directions for future research were addressed and discussed. PMID:21497153

  14. A Systems Approach to Strategic Success with Adjunct Faculty

    ERIC Educational Resources Information Center

    Smith, Vernon C.

    2007-01-01

    Rio Salado is a nontraditional community college that is highly integrated in the global economy. This chapter describes the Rio Salado College systems approach, which relies almost exclusively on adjunct faculty to accomplish its mission, vision, and purposes.

  15. Successful technical and clinical outcome using a second generation balloon expandable coronary stent for transplant renal artery stenosis: Our experience.

    PubMed

    Salsamendi, Jason; Pereira, Keith; Baker, Reginald; Bhatia, Shivank S; Narayanan, Govindarajan

    2015-10-01

    Transplant renal artery stenosis (TRAS) is a vascular complication frequently seen because of increase in the number of renal transplantations. Early diagnosis and management is essential to optimize a proper graft function. Currently, the endovascular treatment of TRAS using angioplasty and/or stenting is considered the treatment of choice with the advantage that it does not preclude subsequent surgical correction. Treatment of TRAS with the use of stents, particularly in tortuous transplant renal anatomy presents a unique challenge to an interventional radiologist. In this study, we present three cases from our practice highlighting the use of a balloon-expandable Multi-Link RX Ultra coronary stent system (Abbott Laboratories, Abbott Park, Illinois, USA) for treating high grade focal stenosis along very tortuous renal arterial segments. Cobalt-Chromium alloy stent scaffold provides excellent radial force, whereas the flexible stent design conforms to the vessel course allowing for optimal stent alignment. PMID:26629289

  16. Successful technical and clinical outcome using a second generation balloon expandable coronary stent for transplant renal artery stenosis: Our experience

    PubMed Central

    Salsamendi, Jason; Pereira, Keith; Baker, Reginald; Bhatia, Shivank S; Narayanan, Govindarajan

    2015-01-01

    Transplant renal artery stenosis (TRAS) is a vascular complication frequently seen because of increase in the number of renal transplantations. Early diagnosis and management is essential to optimize a proper graft function. Currently, the endovascular treatment of TRAS using angioplasty and/or stenting is considered the treatment of choice with the advantage that it does not preclude subsequent surgical correction. Treatment of TRAS with the use of stents, particularly in tortuous transplant renal anatomy presents a unique challenge to an interventional radiologist. In this study, we present three cases from our practice highlighting the use of a balloon-expandable Multi-Link RX Ultra coronary stent system (Abbott Laboratories, Abbott Park, Illinois, USA) for treating high grade focal stenosis along very tortuous renal arterial segments. Cobalt–Chromium alloy stent scaffold provides excellent radial force, whereas the flexible stent design conforms to the vessel course allowing for optimal stent alignment. PMID:26629289

  17. Theoretical and experimental analysis of mylar balloons

    NASA Astrophysics Data System (ADS)

    Romaguera, Antonio; Démery, Vincent; Davidovitch, Benny

    2015-03-01

    In the present study, we present a theoretical and experimental study of the problem known as the mylar balloon shape. The problem consists of inflating a balloon made of two circular discs of an unstretchable material sewed at the edge. A solution for this problem was given by W. H. Paulsen in 1994 for constrain free. In our analyzes, we fixed the height of the balloon and measure the inflated diameter. As a result, we were able to map the constrained shape in terms of the original mylar balloon's shape. The basic assumption of this problem is that the gravitational, stretching and bending energies are negligible compared with the mechanical energy - pV . Controlling the pressure and the height of the balloon, we are able to find the condition where these assumptions fail, specially in the limit h --> 0 for fixed p. A remarkable feature of this problem is the presence of wrinkles across the equator of the balloon. A precise description for that region must include the large deformation from the flat disc initial condition. We will also present some experimental data on the wrinkle's length and its connection with the pressure and height of the balloon.

  18. Tricyclic antidepressant overdose treated with adjunctive lipid rescue and plasmapheresis.

    PubMed

    Odigwe, Chibuzo Clement; Tariq, Madiha; Kotecha, Tulsi; Mustafa, Usman; Senussi, Nizar; Ikwu, Isaac; Bhattarcharya, Anirban; Ngene, John Ifeanyi; Ojiako, Kizito; Iroegbu, Nkemakolam

    2016-07-01

    Tricyclic antidepressant poisoning remains a major cause of morbidity and mortality, particularly in the setting of suicidal attempts. The current standard of care for treatment is the administration of sodium bicarbonate infusion. Adjunctive lipid emulsion therapy and plasmapheresis have received attention recently. We report an 18-year-old patient who was successfully managed with lipid emulsion and plasmapheresis as adjuncts to sodium bicarbonate treatment and review some of the recent literature. PMID:27365872

  19. Tricyclic antidepressant overdose treated with adjunctive lipid rescue and plasmapheresis

    PubMed Central

    Tariq, Madiha; Kotecha, Tulsi; Mustafa, Usman; Senussi, Nizar; Ikwu, Isaac; Bhattarcharya, Anirban; Ngene, John Ifeanyi; Ojiako, Kizito; Iroegbu, Nkemakolam

    2016-01-01

    Tricyclic antidepressant poisoning remains a major cause of morbidity and mortality, particularly in the setting of suicidal attempts. The current standard of care for treatment is the administration of sodium bicarbonate infusion. Adjunctive lipid emulsion therapy and plasmapheresis have received attention recently. We report an 18-year-old patient who was successfully managed with lipid emulsion and plasmapheresis as adjuncts to sodium bicarbonate treatment and review some of the recent literature. PMID:27365872

  20. The testing of balloon fabrics

    NASA Technical Reports Server (NTRS)

    Edwards, Junius David; Moore, Irwin L

    1920-01-01

    Report describes methods and materials used in waterproofing and fireproofing airplane fabrics using dopes. The determination of the probable life of a balloon fabric in service by experimental means is of great value in choosing the most suitable fabrics for a given purpose and in pointing the way to improvements in compounding and construction. The usefulness of exposure to the weather for this purpose has been amply demonstrated. Various attempts have been made to reproduce by artificial means the conditions promoting deterioration in service, but without marked success. Exposure to the weather remains the most satisfactory method for this purpose, and a consideration of the characteristics of such tests is therefore important. This report presents the results of a typical series of exposure tests made in 1917.

  1. Fracture characteristics of balloon films

    NASA Technical Reports Server (NTRS)

    Portanova, Marc A.

    1989-01-01

    An attempt was made to determine the failure modes of high altitude scientific balloons through an investigation of the fracture characteristics of the thin polyethylene films. Two films were the subject of the evaluation, Winzen Int.'s Stratafilm SF-85 and Raven Industries' Astro-E. Research began with an investigation of the film's cold brittleness point and it's effect on the ultimate strength and elasticity of the polyethylene film. A series of preliminary investigations were conducted to develop an understanding of the material characteristics. The primary focus of this investigation was on the notch sensitivity of the films. Simple stress strain tests were also conducted to enable analysis employing fracture toughness parameters. Studies were conducted on both film types at 23 C (room temperature), -60 C, -90 C, and -120 C.

  2. Resistance to Clopidogrel among Iranian Patients Undergoing Angioplasty Intervention

    PubMed Central

    Haji Aghajani, Mohammad; Kobarfard, Farzad; Safi, Olia; Sheibani, Kourosh; Sistanizad, Mohammad

    2013-01-01

    To study the resistance to standard dosage of clopidogrel among Iranian patients following percutaneous coronary intervention measured by platelet aggregation test. Patients undergoing percutaneous coronary intervention in Imam Hussein Medical center, Tehran, Iran, who were under treatment with aspirin, but had no history of clopidogrel usage, entered the study. Patients received standard dosage of clopidogrel (Plavix®, Sanofi, France, 600 mg loading dose and 75 mg/day afterward). Platelet aggregation was measured using light transmission aggregometer. The response to the drug was categorized as complete resistance (platelet aggregation decreased less than 10%), intermediate resistance (platelet aggregation decreased between 10 to 30%) and complete response (platelet aggregation decreased to 30% or more). All patients were evaluated for major adverse cardio vascular events one month after the angioplasty based on MACE criteria by phone contact. Thirty-one patients with a mean age of 59 ± 13 entered the study. Sixty-five percent of patients showed complete response to clopidogrel (95% CI: 45% to 81%), 22% showed intermediate resistance (95% CI: 10-41%) and 13% showed complete resistance (95% CI: 4-30%). One month after the angioplasty, no major adverse cardiovascular event was recorded. Based on our findings, it seems that there is no major difference between Iranian population and other studies regarding the resistance to clopidogrel. Due to the limited number of participants in our study, further investigations with higher number of patients are recommended to more precisely calculate the percentage of resistance among Iranian patients. PMID:24250685

  3. Early Results of Retrograde Transpopliteal Angioplasty of Iliofemoral Lesions

    SciTech Connect

    Saha, Saumitra; Gibson, Matthew; Magee, Timothy R.; Galland, Robert B.; Torrie, E. Peter H.

    2001-12-15

    Purpose: To assess whether the retrograde transpopliteal approach is a safe, practical and effective alternative to femoral puncture for percutaneous transluminal angioplasty (PTA).Methods: Forty PTAs in 38 patients were evaluated. Intentional subintimal recanalization was performed in 13 limbs. Ultrasound evaluation of the popliteal fossa was carried out 30 min and 24 hr post procedurally in the first 10 patients to exclude local complications. All patients had a follow-up of at least 6 weeks.Results: The indication for PTA was critical ischemia in seven limbs and disabling claudication in the remainder.Stenoses (single or multiple) were present in 24 and occlusion in 15.The superficial femoral artery (SFA) was the commonest segment affected(36) followed by common femoral artery (CFA) in four and iliac artery in four. Technical success was achieved in 38 of 39 limbs where angioplasty was carried out. In one limb no lesion was found.Immediate complications were distal embolization in two and thrombosis in one. None of these required immediate surgery. There were no puncture site hematomas or popliteal arteriovenous fistulae.Symptomatic patency at 6 weeks was 85%. Further reconstructive surgery was required in three limbs and amputation in two.Conclusion: The transpopliteal approach has a high technical success rate and a low complication rate with a potential to develop into an outpatient procedure. It should be considered for flush SFA occulsions or iliac disease with tandem CFA/SFA disease where the contralateral femoral approach is often technically difficult.

  4. Exploring expectations and needs of patients undergoing angioplasty.

    PubMed

    Aazami, Sanaz; Jaafarpour, Molouk; Mozafari, Mosayeb

    2016-09-01

    This study aimed to explore needs and expectations of Iranian patients who undergone angioplasty procedures. Coronary artery disease is the leading cause of morbidity and mortality worldwide. Recently, Percutaneous Coronary Intervention (PCI) has frequently been used as a substitute for coronary artery surgery, representing a less invasive and more cost-effective procedure. However, little information is known about the experiences and needs of patients undergone PCI. This research involved a qualitative study that employed the content analysis method. A semi-structured in-depth interview protocol was carried out using a face-to-face approach. Researchers reached to theoretical saturation by interviewing 18 patients who undergone angioplasty. Constant comparison analysis was used with simultaneous data collection. Three themes emerged from this study including Uncertainty, Procedural knowledge and Social Support. The findings from this study enhance our understanding on expectations and needs of patients who undergone PCI. These findings help nurses and health-care providers to develop and provide pre and post-procedural care according to each individual needs and experiences. This Iranian study not only contributes to other international study but also, emphasizes on the need for pre-procedural awareness and post-procedural support of patients who undergone PCI. PMID:27568316

  5. Accurate Determination of the Volume of an Irregular Helium Balloon

    ERIC Educational Resources Information Center

    Blumenthal, Jack; Bradvica, Rafaela; Karl, Katherine

    2013-01-01

    In a recent paper, Zable described an experiment with a near-spherical balloon filled with impure helium. Measuring the temperature and the pressure inside and outside the balloon, the lift of the balloon, and the mass of the balloon materials, he described how to use the ideal gas laws and Archimedes' principal to compute the average molecular…

  6. Investigating Diffusion and Entropy with Carbon Dioxide-Filled Balloons

    ERIC Educational Resources Information Center

    Jadrich, James; Bruxvoort, Crystal

    2010-01-01

    Fill an ordinary latex balloon with helium gas and you know what to expect. Over the next day or two the volume will decrease noticeably as helium escapes from the balloon. So what happens when a latex balloon is filled with carbon dioxide gas? Surprisingly, carbon dioxide balloons deflate at rates as much as an order of magnitude faster than…

  7. The Role of Coagulation and Inflammation After Angioplasty in Patients with Peripheral Arterial Disease

    SciTech Connect

    Wahlgren, C.M. Sten-Linder, M.; Egberg, N.; Kalin, B.; Blohme, L.; Swedenborg, J.

    2006-08-15

    Purpose. Restenosis remains a frequent complication after angioplasty in peripheral arterial disease. Inflammation plays a critical role in the vascular response to injury. Effective medical treatment to improve patency after angioplasty is still elusive. The aims of this prospective clinical study were to investigate changes in blood coagulation and inflammatory markers after angioplasty and their significance for restenosis. Methods. Thirty-four patients with peripheral arterial disease underwent angioplasty of the iliac and superficial femoral arteries. Ten patients undergoing diagnostic angiography were included in the study as controls. Plasma levels of tissue factor, prothrombin fragment 1 + 2, D-dimer, P-selectin, C-reactive protein (CRP), and fibrinogen were analyzed before and after angioplasty. Patients were followed up with angiography after 6 months to assess restenosis. Results. CRP was elevated the day after angioplasty (6.6 mg/l, p = 0.0001) and tended to peak after 1 week (11 mg/l, p = 0.09). There was a significant increase of D-dimer and P-selectin 1-4 hr after angioplasty (0.4 mg/l, p = 0.001 and 68 ng/ml, p = 0.05, respectively). None of the biochemical markers was a statistically significant predictor of restenosis. Conclusion. We have observed a much more prolonged inflammatory response than previously noted, but only minor changes in coagulation activity after angioplasty. The biochemical markers, before and after angioplasty, were not related to restenosis. Further studies are needed to delineate the molecular mechanisms behind these observations and their involvement in thrombosis and restenosis. If these pathways are further defined, improved treatment strategies, including antithrombotic treatments and statins, could be tailored to modulate postprocedural inflammation.

  8. A balloon-borne integrating nephelometer

    SciTech Connect

    Brown, G.S.; Apple, M.L. ); Weiss, R.E. )

    1990-09-01

    A balloon-borne integrating nephelometer has been successfully developed and flown by Sandia National Laboratories and Radiance Research. This report details instrument design, calibration and data conversion procedure. Free and tethered balloon transport and telemetry systems are described. Data taken during March 1989 South-Central New Mexico free flight ascents are presented as vertical profiles of atmospheric particle scattering coefficient, temperature and balloon heading. Data taken during December 1989 Albuquerque, New Mexico tethered flights are also presented as vertical profiles. Data analysis shows superior instrument performance. 5 refs., 22 figs.

  9. A stress index model for balloon design

    NASA Technical Reports Server (NTRS)

    Smith, I. S.

    1987-01-01

    A NASA stress index model, SINDEX, is discussed which establishes the relative stress magnitudes along a balloon gore as a function of altitude. Application of the model to a data base of over 550 ballon flights demonstrates the effectiveness of the method. The results show a strong correlation between stress levels, failure rates, and the point of maximum stress coinciding with the observed failure locations. It is suggested that the model may be used during the balloon design process to lower the levels of stress in the balloon.

  10. The balloon and the airship technological heritage

    NASA Technical Reports Server (NTRS)

    Mayer, N. J.

    1981-01-01

    The balloon and the airship are discussed with emphasis on the identification of commonalities and distinctions. The aerostat technology behind the shape and structure of the vehicles is reviewed, including a discussion of structural weight, internal pressure, buckling, and the development of a stable tethered balloon system. Proper materials for the envelope are considered, taking elongation and stress into account, and flight operation and future developments are reviewed. Airships and tethered balloons which are designed to carry high operating pressure with low gas loss characteristics are found to share similar problems in low speed flight operations, while possessing interchangeable technologies.

  11. Recent Developments in Balloon Support Instrumentation at TIFR Balloon Facility, Hyderabad.

    NASA Astrophysics Data System (ADS)

    Vasudevan, Rajagopalan

    2012-07-01

    The Balloon Facility of Tata Institute of Fundamental Research has been conducting stratospheric balloon flights regularly for various experiments in Space Astronomy and Atmospheric Sciences. A continuous improvement in Balloon flight Support instrumentation by the Control Instrumentation Group to keep in space with the growing complexities of the scientific payloads have contributed to the total success of balloon flights conducted recently. Recent improvements in display of Balloon position during balloon flight by showing on real time the balloon GPS position against Google TM maps is of immense help in selecting the right spot for payload landing and safe recovery . For further speeding up the payload recovery process, a new GPS-GSM payload system has been developed which gives SMS of the payload position information to the recovery team on their cell phones. On parallel footing, a new GPS- VHF system has been developed using GPS and Radio Modems for Balloon Tracking and also for obtaining the payload impact point. On the Telecommand side, a single board Telecommand/ Timer weighing less than 2 Kg has been specially developed for use in the mesosphere balloon test flight. The interference on the existing Short Range Telemetry System has been eliminated by introducing a Band Pass Filter and LNA in the Receiving system of the modules, thereby enhancing its reliability. In this paper , we present the details of the above mentioned developments.

  12. Deployment Instabilities of Lobed-Pumpkin Balloon

    NASA Astrophysics Data System (ADS)

    Nakashino, Kyoichi

    A lobed-pumpkin balloon, currently being developed in ISAS/JAXA as well as in NASA, is a promising vehicle for long duration scientific observations in the stratosphere. Recent ground and flight experiments, however, have revealed that the balloon has deployment instabilities under certain conditions. In order to overcome the instability problems, a next generation SPB called 'tawara' type balloon has been proposed, in which an additional cylindrical part is appended to the standard lobed-pumpkin balloon. The present study investigates the deployment stability of tawara type SPB in comparison to that of standard lobed-pumpkin SPB through eigenvalue analysis on the basis of finite element methods. Our numerical results show that tawara type SPB enjoys excellent deployment performance over the standard lobed-pumpkin SPBs.

  13. The Helium Balloon Project: Expanding Student Horizons...

    ERIC Educational Resources Information Center

    Leyden, Michael B.

    1973-01-01

    An activity involving future elementary school teachers designed around inexpensive balloons which when launched contained postcards to determine the geographic location of the landing. The investigation is student-centered, involving unknown questions, and was conducted for enjoyment. (DF)

  14. Mass and radius of cosmic balloons

    NASA Technical Reports Server (NTRS)

    Wang, Yun

    1994-01-01

    Cosmic balloons are spherical domain walls with relativistic particles trapped inside. We derive the exact mass and radius relations for a static cosmic balloon using Gauss-Codazzi equations. The cosmic balloon mass as a function of its radius, M(R), is found to have a functional form similar to that of fermion soliton stars, with a fixed point at 2GM(R)/R approximately or equal to 0.486 which corresponds to the limit of infinite central density. We derive a simple analytical approximation for the mass density of a spherically symmetric relativistic gas star. When applied to the computation of the mass and radius of a cosmic balloon, the analytical approximation yields fairly good agreement with the exact numerical solutions.

  15. Nimbus 4/IRLS Balloon Interrogation Package (BIP)

    NASA Technical Reports Server (NTRS)

    1971-01-01

    The balloon interrogation package (BIP), an integral part of the overall interrogation, recording, and location subsystems (IRLS) for the Nimbus 4 program, is described. The BIP is a self-contained, integrated transponder designed to be carried aloft by a constant altitude, superpressure balloon to an altitude of 67,000 or 78,000 feet. After launch the BIP senses high-altitude balloon overpressure and temperature, and upon receipt of an interrogated command from the IRLS aboard the Nimbus 4 satellite, the BIP enodes the data on a real-time basis into a pulse-code modulation (PCM) format and transmits this data to the satellite. A summary of the program activity to produce 30 BIP systems and to support balloon launches from Ascension Island is presented.

  16. Applications of Balloon-Based Launch Systems

    NASA Astrophysics Data System (ADS)

    Gizinski, Stephen J., III; Wanagas, John D.

    1992-08-01

    A balloon-based launch system concept is described for providing effective transportation to space for small satellites and experimental vehicles, which is based on the U.S. SDI concept of Balloon-Based Launch Systems (BBLSs). Design concepts for three BBLSs are presented: (1) suborbital microgravity system, (2) suborbital hypervelocity system, and (3) orbital delivery system. The paper summarizes the study constraints and highlights the aspects of each of the proposed BBLS configurations, with special attention given to the energy requirements for various missions, motor characteristics, launch sites, and balloon flight trains. The initial results showed that the use of a balloon as the first stage to a rocket system provides significant utility to small-payload principal investigators and technical visionaries for whom space access was not previously affordable.

  17. Investigations of Balloon and Aeroplane Fabrics

    NASA Technical Reports Server (NTRS)

    Gibbons, Willis A; Smith, Omar H

    1917-01-01

    Report presents the experimental results of fabrics used for balloons and aeroplanes. Tensile properties, surface roughness, skin friction, flammability, permeability, and water absorption were tested for different combinations of materials.

  18. Is the earth's magnetotail balloon unstable?

    NASA Technical Reports Server (NTRS)

    Lee, D.-Y.; Wolf, R. A.

    1992-01-01

    In the past, the onset of magnetospheric substorms has been attributed to the plasma tearing mode instabilities. This paper investigates the ideal MHD ballooning instability of the near-and middle-tail magnetosphere region, as a first step toward determining whether it could trigger the tearing mode, by using the energy principle to investigate whether standard 2D tail models with the 'hard' ionospheric boundary condition are unstable to ballooning instability. Numerical results are presented for compressible ballooning modes that are symmetric about the center of the current sheet. It is shown that, for such a hard boundary condition, no reasonable magnetotail configuration exists that would be unstable to compressible symmetric ballooning but stable against interchange.

  19. Ballooning Ideas for the Science Classroom.

    ERIC Educational Resources Information Center

    Park, John C.; Carter, Glenda S.

    1988-01-01

    Introduces three demonstrations using rubber balloons: rate of reaction, air pressure, and solubility of gases in liquids. Provides the materials, procedure, questions, further investigation, and discussion in each demonstration. (YP)

  20. The Pressure Curve for a Rubber Balloon.

    ERIC Educational Resources Information Center

    Merritt, D. R.; Weinhaus, F.

    1978-01-01

    Derives an equation relating the internal pressure of a rubber balloon to its radius. Shows that the theoretical pressure curve is experimentally verifiable, and discusses the problem of equilibrium configuration of two interconnected ballons. (Author/GA)

  1. Incorporation of Scientific Ballooning into Science Education

    NASA Astrophysics Data System (ADS)

    Chanover, N.; Stochaj, S.; Petty, C.

    1999-12-01

    We are augmenting the science curriculum of the Roswell Independent School District in Roswell, NM, to take advantage of the proximity of a NASA scientific balloon base. The basic science related to balloon experimentation is being incorporated into the K-12 science curriculum via the discussion of topics such as atmospheric properties, weather, phases of matter, plotting skills, and communications in the context of a high-altitude balloon flight. These efforts will culminate in the construction of balloon-borne instruments by high school students, which will be launched during the spring of 2000. A demonstration flight, launched in the spring of 1999, was used to build student enthusiasm and community support for this program, which is funded by the NASA/IDEAS program.

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

    PubMed Central

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

    2001-01-01

    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

  3. Is echocardiography or magnetic resonance imaging superior for precoarctation angioplasty evaluation?

    PubMed

    Mendelsohn, A M; Banerjee, A; Donnelly, L F; Schwartz, D C

    1997-09-01

    We compared the dimensions of the aorta obtained by two-dimensional transthoracic echocardiography (echo) (median, 2.5 mo preangioplasty) and magnetic resonance imaging (MRI) (median, 4.2 mo preangioplasty) to those obtained by angiography (cath) in 13 patients (age, 7.7 +/- 1.6 yr; mean +/- SEM) who underwent evaluation for coarctation balloon angioplasty between April 1993-January 1996. Echo measurements were obtained from the suprasternal and subcostal sagittal planes, MRI measurements from axial and sagittal oblique views, and cath measurements from the straight lateral or oblique views. Measurements of the diameters of the aortic isthmus, coarctation, descending aorta at the diaphragm, and isthmus length were made by all three modalities. Presence of aorto-aortic collaterals was determined, and the coarctation length was delineated. Investigators were blinded to other measurement data prior to statistical analysis. Data analysis by repeated analysis of variance (ANOVA) and Student-Newman-Keuls testing revealed no statistically significant difference between systolic pressure gradient by clinical examination (32.2 +/- 5.9 mm Hg), peak instantaneous Doppler evaluation (37.5 +/- 2.9 mm Hg), or preangioplasty systolic pressure gradient (32.1 +/- 3.3 mm Hg). With the exception of measurements of the descending aorta (echo, 11.7 +/- 0.9 mm vs. MRI, 13.3 +/- 0.8 mm vs. cath, 14.0 +/- 1.3 mm; P = 0.04), there was no statistically significant difference in dimensions of the aortic isthmus (9.2 +/- 0.6 mm vs. 10.5 +/- 0.9 mm vs. 10.8 +/- 0.9 mm), coarctation site diameter (4.8 +/- 0.6 mm vs. 5.6 +/- 0.9 mm vs. 5.3 +/- 0.8 mm), or isthmus length (12.4 +/- 2.1 mm vs. 12.1 +/- 2.2 mm vs. 10.9 +/- 1.7 mm). The correlation coefficients derived from comparisons of MRI vs. cath to echo vs. cath were similar for all dimensions except for isthmus length (P < 0.01). MRI demonstrated aorto-aortic collaterals more frequently than echo, while echocardiography better demonstrated

  4. Hemorheological and oxygen free radical associated alterations during and after percutaneous transluminal coronary angioplasty.

    PubMed

    Késmárky, G; Tóth, K; Vajda, G; Habon, L; Halmosi, R; Róth, E

    2001-01-01

    Percutaneous transluminal coronary angioplasty (PTCA) is a frequently used method in the treatment of coronary artery disease. Coronary stenosis, endothelial injury, and ischemia-reperfusion caused by the balloon inflation and deflation during this procedure can cause several changes in blood flow. In our study 19 patients (mean age: 58 +/- 9 years) undergoing PTCA were examined. For the laboratory measurements several blood samples were taken from the femoral vein and the coronary sinus before and 30 minutes after PTCA, and from the cubital vein 1, 2, 5 days and 1, 6 months after PTCA. Among hemorheologic parameters hematocrit, plasma fibrinogen level, plasma and whole blood viscosities were measured and corrected blood viscosity value was calculated. To characterize the oxidative stress, samples were analyzed for thiobarbituric acid reactive substances (TBARS) of blood as a marker of lipidperoxidation and changes in the antioxidant system were investigated by measuring the activity of superoxide dismutase, catalase and the concentration of glutathione; superoxide generating capacity of isolated leukocytes and platelet aggregation were examined as markers of cellular activation. Plasma fibrinogen concentration increased markedly during the first and second day after PTCA (p < 0.001), which was accompanied by the elevation of plasma viscosity (p < 0.05). Plasma fibrinogen returned to the baseline at the one-month check-up visit, but there was a significant increase in its concentration by the end of the sixth month follow-up. Apparent whole blood viscosity at 90 s (-1) showed gradually increasing values up to the one- and six-month check-up visits (p < 0.01), which can partially be explained by the elevation of hematocrit. Corrected blood viscosity was significantly elevated on the fifth day already (p < 0.01), and one month later also. Superoxide production of leukocytes showed an increasing tendency (p = 0.05), and blood TBARS was elevated after one day (p < 0

  5. Advances in scientific balloon thermal modeling

    NASA Astrophysics Data System (ADS)

    Bohaboj, T.; Cathey, H.

    The National Aeronautics and Space Administration's Balloon Program Office has long acknowledged that the accurate modeling of balloon performance and flight prediction is dependant on how well the balloon is thermally modeled. This ongoing effort is focused on developing accurate balloon thermal models that can be used to quickly predict balloon temperatures and balloon performance. The ability to model parametric changes is also a driver for this effort. This paper will present the most recent advances made in this area. This research effort continues to utilize the ``Thermal Desktop'' addition to AUTO CAD for the modeling. Recent advances have been made by using this analytical tool. A number of analyses have been completed to test the applicability of this tool to the problem with very positive results. Progressively detailed models have been developed to explore the capabilities of the tool as well as to provide guidance in model formulation. A number of parametric studies have been completed. These studies have varied the shape of the structure, material properties, environmental inputs, and model geometry. These studies have concentrated on spherical ``proxy models'' for the initial development stages and then to transition to the natural shaped zero pressure and super pressure balloons. An assessment of required model resolution has also been determined. Model solutions have been cross checked with known solutions via hand calculations. The comparison of these cases will also be presented. One goal is to develop analysis guidelines and an approach for modeling balloons for both simple first order estimates and detailed full models. This paper presents the step by step advances made as part of this effort, capabilities, limitations, and the lessons learned. Also presented are the plans for further thermal modeling work.

  6. Advances in Scientific Balloon Thermal Modeling

    NASA Technical Reports Server (NTRS)

    Bohaboj, T.; Cathey, H. M., Jr.

    2004-01-01

    The National Aeronautics and Space Administration's Balloon Program office has long acknowledged that the accurate modeling of balloon performance and flight prediction is dependant on how well the balloon is thermally modeled. This ongoing effort is focused on developing accurate balloon thermal models that can be used to quickly predict balloon temperatures and balloon performance. The ability to model parametric changes is also a driver for this effort. This paper will present the most recent advances made in this area. This research effort continues to utilize the "Thrmal Desktop" addition to AUTO CAD for the modeling. Recent advances have been made by using this analytical tool. A number of analyses have been completed to test the applicability of this tool to the problem with very positive results. Progressively detailed models have been developed to explore the capabilities of the tool as well as to provide guidance in model formulation. A number of parametric studies have been completed. These studies have varied the shape of the structure, material properties, environmental inputs, and model geometry. These studies have concentrated on spherical "proxy models" for the initial development stages and then to transition to the natural shaped zero pressure and super pressure balloons. An assessment of required model resolution has also been determined. Model solutions have been cross checked with known solutions via hand calculations. The comparison of these cases will also be presented. One goal is to develop analysis guidelines and an approach for modeling balloons for both simple first order estimates and detailed full models. This papa presents the step by step advances made as part of this effort, capabilities, limitations, and the lessons learned. Also presented are the plans for further thermal modeling work.

  7. Hybrid designs for super-pressure balloons

    NASA Astrophysics Data System (ADS)

    Schur, W.; Baginski, F.

    The desire of the scientific community to fly large payloads at mid latitudes over durations of months while keeping altitude has propelled NASA on the path of developing an Ultra Long Duration Balloon (ULDB) design. The first design considered for ULDB was a spherical balloon, but the strength of its fabric composite fell far short of the capacity goal set by NASA. Therefore, an alternative design, the pumpkin-shape balloon, was chosen. For large balloons with a large number of gores, the pumpkin design is found to be susceptible to flawed deployment. While research on pumpkin balloon deployment is on-going, the spherical balloon design has stirred new interest for certain applications. Current spherical super-pressure designs have a load skirt that consists of straps that are attached tangentially to the fully inflated sphere. The attachment points constitute stress raisers, and the straps provide an opportunity for entanglement. The pneumatic envelope is a compliant structure that accommodates concentrated loads by large out-of-plane deformation. By embedding sufficient unidirectional strength elements in the skin that radiate from the nadir upward, we will demonstrate that the load skirt is unnecessary and the entanglement problem is avoided. We will use analytical investigations to establish the advantages of this hybrid design.

  8. [Intra-aortic balloon pump (IABP) counterpulsation. Do we still need it and if so when?].

    PubMed

    Russ, M

    2015-09-01

    Intra-aortic balloon pump (IABP) counterpulsation was for a long time considered to be an indispensable standard for support of drug therapy for all forms of acute left-sided cardiac failure and especially in cardiogenic shock due to infarction. The advantages of the system seemed to be obvious; however, many of the postulated effects on the hemodynamics, microcirculation and coronary perfusion could not be confirmed later in prospective studies. It was found that IABP had no influence on microcirculation disorders in cardiogenic shock due to infarction. In a meta-analysis on the application for acute myocardial infarction without shock, no effect was found on mortality. The benefit as adjunct therapy for percutaneous coronary interventions (PCI) in cardiogenic shock due to infarction places a question mark over both IABP-SHOCK studies; however, in constellations without PCI the additional benefit of IABP cannot be excluded which is why the procedure could be an option in this situation. PMID:26340798

  9. Gondola development for CNES stratospheric balloons

    NASA Astrophysics Data System (ADS)

    Vargas, A.; Audoubert, J.; Cau, M.; Evrard, J.; Verdier, N.

    The CNES has been supporting scientific ballooning since its establishment in 1962. The two main parts of the balloon system or aerostat are the balloon itself and the flight train, comprising the house-keeping gondola, for the control of balloon flight (localization and operational telemetry & telecommand - TM/TC), and the scientific gondola with its dedicated telecommunication system. For zero pressure balloon, the development of new TM/TC system for the housekeeping and science data transmission are going on from 1999. The main concepts are : - for balloon house-keeping and low rate scientific telemetry, the ELITE system, which is based on single I2C bus standardizing communication between the different components of the system : trajectography, balloon control, power supply, scientific TM/TC, .... In this concept, Radio Frequency links are developed between the house keeping gondola and the components of the aerostat (balloon valve, ballast machine, balloon gas temperature measurements, ...). The main objectives are to simplify the flight train preparation in term of gondola testing before flight, and also by reducing the number of long electrical cables integrated in the balloon and the flight train; - for high rate scientific telemetry, the use of functional interconnection Internet Protocol (IP) in interface with the Radio Frequency link. The main idea is to use off-the-shelf IP hardware products (routers, industrial PC, ...) and IP software (Telnet, FTP, Web-HTTP, ...) to reduce the development costs; - for safety increase, the adding, in the flight train, of a totally independent house keeping gondola based on the satellite Inmarsat M and Iridium telecommunication systems, which permits to get real time communications between the on-board data mobile and the ground station, reduced to a PC computer with modem connected to the phone network. These GEO and LEO telecommunication systems give also the capability to operate balloon flights over longer distance

  10. More accurate assessment of stenotic lesions in percutaneous transluminal angioplasty.

    PubMed

    Janevski, B K; Breslau, P J; Jorning, P J

    1986-01-01

    Eighty patients underwent percutaneous transluminal dilatation and recanalisation of atheromatous lesions of the arteries of the lower extremities in the University Hospital of Maastricht in the period of 1980 to 1984. Out of 80 attempted procedures of the iliac and femoro-popliteal tract 71 (89%) were technically possible and were considered initially successful. In all cases of iliac artery lesions a retrograde arteriogram was performed prior to PTA. Intra-arterial pressure measurements at rest and after hyperemia were used for exact assessment of the hemodynamic significance of the stenosis before and after PTA. A follow-up of all patients successfully treated by angioplasty was performed. The early hemodynamic success rate of PTA for iliac lesions was 90 per cent and for femoral-popliteal segment 83 per cent. There was no morbidity or mortality. The cumulative 3-year patency rate for both segments was 74 per cent. PMID:2943842

  11. Results of coronary surgery after failed elective coronary angioplasty in patients with prior coronary surgery.

    PubMed

    Weintraub, W S; Cohen, C L; Curling, P E; Jones, E L; Craver, J M; Guyton, R; King, S B; Douglas, J S

    1990-11-01

    The results of coronary artery bypass surgery after failed elective coronary angioplasty in patients who have undergone prior coronary surgery are unknown. Coronary angioplasty may be performed to relieve angina after surgery either to the native coronary vessels or to grafts. Failure of attempted coronary angioplasty may mandate repeat coronary surgery, often in the setting of acute ischemia. From 1980 to 1989, 1,263 patients with prior coronary bypass surgery underwent angioplasty; of these patients, 46 (3.6%) underwent reoperation for failed angioplasty during the same hospital stay. Of the 46 patients who underwent reoperation, 33 had and 13 did not have acute ischemia. In the group with ischemia, 3 patients (9.1%) died and 14 (42.4%) died or had a Q wave myocardial infarction in the hospital compared with no deaths (p = NS) and no deaths or Q wave myocardial infarction (p = 0.005) in the group without ischemia. At 3 years, the actuarial survival rate was 88 +/- 6% in the group with ischemia, whereas there were no deaths in the group without ischemia (p = NS), and freedom from death or myocardial infarction was 51 +/- 10% in the group with ischemia, versus no events in the group without ischemia (p = 0.006). In most patients with prior coronary bypass surgery, coronary angioplasty was performed without the need for repeat coronary bypass surgery. Should coronary angioplasty fail, reoperation in patients without acute ischemia can be performed with overall patient survival comparable to that of elective reoperative coronary bypass without coronary angioplasty.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2229784

  12. Subintimal Angioplasty for Peripheral Arterial Occlusive Disease: A Systematic Review

    SciTech Connect

    Met, Rosemarie Lienden, Krijn P. Van; Koelemay, Mark J. W.; Bipat, Shandra; Legemate, Dink A.; Reekers, Jim A.

    2008-07-15

    The objective of this study was to summarize outcomes of subintimal angioplasty (SA) for peripheral arterial occlusive disease. The Cochrane Library, Medline and Embase databases were searched to perform a systematic review of the literature from 1966 through May 2007 on outcomes of SA for peripheral arterial occlusive disease of the infrainguinal vessels. The keywords 'percutaneous intentional extraluminal revascularization,' 'subintimal angioplasty,' 'peripheral arterial disease,' 'femoral artery,' 'popliteal artery,' and 'tibial artery' were used. Assessment of study quality was done using a form based on a checklist of the Dutch Cochrane Centre. The recorded outcomes were technical and clinical success, primary (assisted) patency, limb salvage, complications, and survival, in relation to the clinical grade of disease (intermittent claudication or critical limb ischemia [CLI] or mixed) and location of lesion (femoropopliteal, crural, or mixed). Twenty-three cohort studies including a total of 1549 patients (range, 27 to 148) were included in this review. Methodological and reporting quality were moderate, e.g., there was selection bias and reporting was not done according to the reporting standards. These and significant clinical heterogeneity obstructed a meta-analysis. Reports about length of the lesion and TASC classification were too various to summarize or were not mentioned at all. The technical success rates varied between 80% and 90%, with lower rates for crural lesions compared with femoral lesions. Complication rates ranged between 8% and 17% and most complications were minor. After 1 year, clinical success was between 50% and 70%, primary patency was around 50% and limb salvage varied from 80% to 90%. In conclusion, taking into account the methodological shortcomings of the included studies, SA can play an important role in the treatment of peripheral arterial disease, especially in the case of critical limb ischemia. Despite the moderate patency

  13. Recent materials problems relating to catastrophic balloon failures

    NASA Technical Reports Server (NTRS)

    Smith, I. S.

    1985-01-01

    Balloons fabricated of thin polyethylene materials have provided relatively inexpensive and reliable scientific research platforms for approximately three decades. Reliability of the modern day balloon, as launched by the U.S.A. National Scientific Balloon Facility (NSBF), has been approximately 85 percent. Recent balloon failures, coupled with an increased ocurrence of catastrophic failures, created grave concern over the integrity of the present balloon inventory of the U.S.A. National Aeronautics and Space Administration (NASA). An investigative team was established by NASA to review the circumstances surrounding the catastrophic balloon failures, determine the cause and to make recommendations to correct the problem and to prevent its reoccurrence. The most probable cause of failure as determined by the investigation was the polyethylene balloon film, although the film had passsed the established standard quality control measures of the film manufacturer. The approach, findings, and conclusions of the investigation are presented along with planned procedures to assure future quality balloon film for NASA balloons.

  14. Angioplasty or Primary Stenting for Infrapopliteal Lesions: Results of a Prospective Randomized Trial

    SciTech Connect

    Randon, C. Jacobs, B.; De Ryck, F.; Vermassen, F.

    2010-04-15

    Excellent results with small stents in coronary arteries have led endovascular therapists to their use in infrapopliteal vessels. However, to date no level I evidence exists to recommend primary stenting over infrapopliteal angioplasty alone. The aim of this randomized single-center trial was to compare their 1-year outcome. A total of 38 limbs in 35 patients with critical limb ischemia were randomized to angioplasty (22 pts) or primary stenting (16 pts). Target lesions were infrapopliteal occluded (36) or stenotic (20) lesions ranging from <2 to >15 cm in length. The mean age was 72 years. At 12 months, there was no statistical difference in survival (angioplasty, 69.3%; primary stenting, 74.7%), in limb salvage (angioplasty, 90%; primary stenting, 91.7%), or in primary and secondary patency (angioplasty, 66 and 79.5%; primary stenting, 56 and 64%) between the groups Renal insufficiency was the only significant negative predicting factor for limb salvage in both groups. In conclusion, the 1-year results for both groups were broadly similar. Stenting has its place in infrapopliteal angioplasty if the procedure is jeopardized by a dissection or recoil, but our results do not support primary stenting in all cases.

  15. The French Balloon Program 2013 - 2017

    NASA Astrophysics Data System (ADS)

    Dubourg, Vincent; Vargas, André; Raizonville, Philippe

    2016-07-01

    With over 50 years' experience in the field, the French Centre National d'Etudes Spatiales (CNES) goes on supporting - as designer and operator - a significant scientific ballooning program. In particular so because balloons still give a unique and valuable access to near space science. From 2008 to 2013, an important renovation effort was achieved, beginning by Zero Pressure Balloons (ZPB) systems, to comply with more stringent Safety constraints and to the growing reliability and performance requirements from scientific missions. The paper will give an overview of the CNES new capabilities and services for operational balloon activities, and their availability status. The scientific launch campaigns of the past two years will be presented. A focus will be made on the results of the Stratoscience 2015 flight campaign from Timmins, Ontario, using the NOSYCA command and control system for ZPB, qualified in flight in 2013. In particular, the PILOT telescope successfully flew during the 2015 campaign, key figures about the flight and mission will be given. An outlook of the new stratospheric long duration flight systems currently in process of developement at CNES will be given, as well as the presentation of the Stratéole 2 project, dedicated to the survey of the low stratosphere and upper troposphere in equatorial regions, with a fleet of small suprer pressure balloons (SPB). As far as tropospheric balloons are concerned, the Aeroclipper initiative will be presented, aiming at qualifying a quasi-tethered balloon, pushed by the winds close to the sea surface, for the study of cyclones. The scientific launch campaigns and the main payloads in the study for the near future will also be presented.

  16. Clinical significance of perfusion defects by thallium-201 single photon emission tomography following oral dipyridamole early after coronary angioplasty

    SciTech Connect

    Jain, A.; Mahmarian, J.J.; Borges-Neto, S.; Johnston, D.L.; Cashion, W.R.; Lewis, J.M.; Raizner, A.E.; Verani, M.S.

    1988-05-01

    The clinical significance of myocardial perfusion defects present early after angiographically successful percutaneous transluminal coronary angioplasty was assessed in 53 patients using thallium-201 single photon emission computed tomography combined with pharmacologic vasodilation induced by a large dose (300 mg) of orally administered dipyridamole. Myocardial tomographic images were obtained at a mean of 20 +/- 6 h (SD) before and 2.9 +/- 2.7 days after angioplasty. Before angioplasty, 15 (28%) of the 53 patients developed angina after dipyridamole administration, in contrast to only 3 (7.5%) of 40 patients after angioplasty (p less than 0.001). The mean percent luminal area stenosis decreased from 93 +/- 6% before angioplasty to 34 +/- 17% after angioplasty (p less than 0.001). Myocardial perfusion defects, present in 49 (93%) of the 53 patients before angioplasty, were reversible in 44 patients (83%), all of whom underwent dilation of arteries supplying the ischemic areas. After angioplasty, 26 (65%) of 40 patients had no ischemic defects, whereas 14 (35%) of the patients still had an ischemic defect in the vascular territory of the dilated artery. After a mean follow-up period of 21.7 months, 13 (33%) of 39 patients developed restenosis, 10 of whom had an ischemic defect early after angioplasty. Restenosis developed in 10 (71%) of 14 patients with an ischemic defect after angioplasty, but in only 3 (11.5%) of the patients without an ischemic defect (p = 0.007). In conclusion, thallium-201 tomography after oral dipyridamole affords convenient assessment of the physiologic significance of coronary stenosis present before angioplasty and the residual stenosis after angioplasty.

  17. Adjunctive Brexpiprazole: A Review in Major Depressive Disorder.

    PubMed

    McKeage, Kate

    2016-02-01

    Brexpiprazole (Rexulti(®)) is a serotonin-dopamine activity modulator, with a unique receptor binding profile and low intrinsic D2 activity suggestive of a lower potential than aripiprazole to cause activation-like adverse effects, such as akathisia. The drug was recently approved by the US FDA for adjunctive therapy with antidepressant treatment (ADT) in patients with major depressive disorder (MDD). In two phase III trials, adjunctive oral brexpiprazole 2 or 3 mg once daily was more effective than monotherapy with ADT in improving depressive symptoms in adults with MDD who demonstrated an incomplete response to previous treatment with ADT. Adjunctive brexpiprazole was generally well tolerated in clinical trials, which included treatment periods of up to 52 weeks. Results of ongoing trials should help position the drug in the treatment of MDD. In the meantime, brexpiprazole provides a valid option for patients with persistent symptoms despite standard antidepressant therapy. PMID:26849053

  18. Balloon-assisted maturation for arteriovenous fistula maturation failure: an early period experience

    PubMed Central

    Park, Sun Cheol; Ko, Seung Yeon; Kim, Ji Il; Moon, In Sung

    2016-01-01

    Purpose Balloon-assisted maturation (BAM) is emerging as a salvage management for arteriovenous fistula maturation failure (AVF MF). However, BAM is a relatively new, yet controversial technique for AVF maturation. Therefore, we evaluated the effectiveness of BAM for AVF MF. Methods Between January 2012 and December 2014, 249 AVFs were created. The total MF rate was 24.8%. But, only 110 AVFs were enrolled, including 74 brachiocephalic (BC) AVFs and 36 radiocephalic (RC) AVFs. The follow-up period was 12 months. Among those, there were 42 MFs (22 BC AVFs and 20 RC AVFs) and 68 maturation successes (MS) (52 BC AVFs and 16 RC AVFs). BAM was involved in MF group. We compared the clinical characteristics, AVF flows, and AVF flow ratios of MF and MS groups. Also, we evaluated the etiology, management, and result of MF. Results There was no difference in clinical characteristics between MF and MS groups. In MF group, 39 balloon angioplasties (BAs) for 42 AVF MFs were performed. Number of BA was 1.45 ± 0.57 and duration of BA was 21.30 ± 21.24 weeks. BAM rate was 46.2%. For 1 year after AVF creation, AVF flows of MS group were significantly larger than those of MF group (P < 0.05) but there was no difference in AVF flow ratio between MF and MS groups (P > 0.05). Conclusion BA for AVF MF is a relatively applicable and effective modality. Although a large volume study is necessary, we suggest BAM is an effective salvage management for AVF MF. PMID:27186572

  19. An Overview of the NASA Balloon Program

    NASA Technical Reports Server (NTRS)

    Pierce, David L.

    2009-01-01

    The U. S. National Aeronautics and Space Administration (NASA) Balloon Program conducts a total of 16 to 20 missions per year in support of the NASA scientific community. The NASA Balloon Program continues a long tradition for support and advancement of scientific ballooning for attitudes up to 49 h. These missions support investigations sponsored by NASA's Science Mission Directorate. The long duration (weeks currently; with the real possibility of multi-month) and large area/mass payloads able to fly in near-space conditions offer exciting opportunities for both development and actual science for many of NASA's highest priority areas for current and future missions. These can typically be carried out at less than ten percent of the cost of a corresponding satellite mission, and on much shorter timescales. The Balloon Program is arguably the most scientifically compelling of the various NASA sub-orbital programs and provides the most complete and effective springboard for both scientists and engineers to go on to carry out the space-science missions of the future - as demonstrated by numerous successful missions and their Principal Investigators, as well as leaders in NASA space science, over the past three decades. Progress continues toward the development of the super pressure balloon and support systems for support of ultra-long duration, constant altitude missions from any latitude.

  20. Ballooning mode instability at the plasmapause

    NASA Technical Reports Server (NTRS)

    Lakhina, G. S.; Mond, M.; Hameiri, E.

    1990-01-01

    The ballooning mode instability, which can excite hydromagnetic waves at the plasmapause, is studied in the presence of azimuthal plasma flows induced during geomagnetically disturbed periods. A general sufficient criterion for the ballooning mode stability is derived, for a change in the potential energy greater than or equal to 0, which involves the integration over an entire field line. A local stability analysis at the equatorial plasmapause region shows that the ballooning modes could be spontaneously generated via instability under at least two conditions: one is similar to the usual interchange condition, and the second to the quasi-interchange modes. Both of these local instability conditions can be derived from the general stability criterion. Finally an exact solution for the equilibrium state with flow is derived analytically, and the change in the potential energy is computed numerically. It is found that, in the cases studied, the flow does not spontaneously excite the ballooning modes; it only further stabilizes (or destabilizes) the ballooning spectrum if originally the system is stable (or unstable). The analysis would be useful for the interpretation of some of the low-frequency modes observed at the ground and near the equatorial plasmapause.

  1. Small Dense Low Density Lipoprotein Particles Are Associated with Poor Outcome after Angioplasty in Peripheral Artery Disease

    PubMed Central

    Mosimann, Kathrin; Husmann, Marc; Thalhammer, Christoph; Wilkinson, Ian; Berneis, Kaspar; Amann-Vesti, Beatrice R.

    2014-01-01

    Purpose In patients suffering from symptomatic peripheral artery disease (PAD), percutaneous revascularization is the treatment of choice. However, restenosis may occur in 10 to 60% in the first year depending on a variety of factors. Small dense low density lipoprotein (sdLDL) particles are associated with an increased risk for cardiovascular events, but their role in the process of restenosis is not known. We conducted a prospective study to analyze the association of sdLDL particles with the outcome of balloon angioplasty in PAD. The composite primary endpoint was defined as improved walking distance and absence of restenosis. Methods Patients with angiographically documented PAD of the lower extremities who were scheduled for lower limb revascularization were consecutively recruited for the study. At baseline and at three month follow-up triglyceride, total cholesterol, LDL size and subclasses and HDL cholesterol and ankle-brachial index (ABI) were measured. Three months after the intervention duplex sonography was performed to detect restenosis. Results Sixty-four patients (53% male) with a mean age of 68.6±9.9 years were included. The proportion of small- dense LDL particles (class III and IV) was significantly lower (33.1±11.0% vs. 39.4±12.1%, p = 0.038) in patients who reached the primary end-point compared with those who did not. Patients with improved walking distance and without restenosis had a significantly higher LDL size at baseline (26.6±1.1 nm vs. 26.1±1.1 nm, p = 0.046) and at follow-up (26.7±1.1 nm vs. 26.2±0.9 nm, p = 0.044) than patients without improvement. Conclusions Small-dense LDL particles are associated with worse early outcome in patients undergoing percutaneous revascularization for symptomatic PAD. PMID:25265512

  2. Wind-Driven Montgolfiere Balloons for Mars

    NASA Technical Reports Server (NTRS)

    Jones, Jack A.; Fairbrother, Debora; Lemieux, Aimee; Lachenmeier, Tim; Zubrin, Robert

    2005-01-01

    Solar Montgolfiere balloons, or solar-heated hot air balloons have been evaluated by use on Mars for about 5 years. In the past, JPL has developed thermal models that have been confirmed, as well as developed altitude control systems to allow the balloons to float over the landscape or carry ground sampling instrumentation. Pioneer Astronautics has developed and tested a landing system for Montgolfieres. JPL, together with GSSL. have successfully deployed small Montgolfieres (<15-m diameter) in the earth's stratosphere, where conditions are similar to a Mars deployment. Two larger Montgolfieres failed, however, and a series of larger scale Montgolfieres is now planned using stronger, more uniform polyethylene bilaminate, combined with stress-reducing ripstitch and reduced parachute deceleration velocities. This program, which is presently under way, is a joint effort between JPL, WFF, and GSSL, and is planned for completion in three years.

  3. Near ultraviolet spectrograph for balloon platform

    NASA Astrophysics Data System (ADS)

    Sreejith, A. G.; Safonova, Margarita; Murthy, Jayant

    2015-06-01

    Small and compact scientific payloads may be easily designed constructed and own on high altitude balloons. Despite the fact that large orbital observatories provide accurate observations and statistical studies of remote and/or faint space sources, small telescopes on board balloons or rockets are still attractive because of their low cost and rapid response time. We describe here a near ultraviolet (NUV) spectrograph designed to be own on a high{altitude balloon platform. Our basic optical design is a modified Czerny-Turner system using off the shelf optics. We compare different methods of aberration corrections in such a system. We intend the system to be portable and scalable to different telescopes. The use of reflecting optics reduces the transmission loss in UV. We plan on using an image intensified CMOS sensor operating in photon counting mode as the detector of choice.

  4. Unconventional ballooning structures for toroidal drift waves

    SciTech Connect

    Xie, Hua-sheng Xiao, Yong

    2015-09-15

    With strong gradients in the pedestal of high confinement mode (H-mode) fusion plasmas, gyrokinetic simulations are carried out for the trapped electron and ion temperature gradient modes. A broad class of unconventional mode structures is found to localize at arbitrary poloidal positions or with multiple peaks. It is found that these unconventional ballooning structures are associated with different eigen states for the most unstable mode. At weak gradient (low confinement mode or L-mode), the most unstable mode is usually in the ground eigen state, which corresponds to a conventional ballooning mode structure peaking in the outboard mid-plane of tokamaks. However, at strong gradient (H-mode), the most unstable mode is usually not the ground eigen state and the ballooning mode structure becomes unconventional. This result implies that the pedestal of H-mode could have better confinement than L-mode.

  5. Unconventional ballooning structures for toroidal drift waves

    NASA Astrophysics Data System (ADS)

    Xie, Hua-sheng; Xiao, Yong

    2015-09-01

    With strong gradients in the pedestal of high confinement mode (H-mode) fusion plasmas, gyrokinetic simulations are carried out for the trapped electron and ion temperature gradient modes. A broad class of unconventional mode structures is found to localize at arbitrary poloidal positions or with multiple peaks. It is found that these unconventional ballooning structures are associated with different eigen states for the most unstable mode. At weak gradient (low confinement mode or L-mode), the most unstable mode is usually in the ground eigen state, which corresponds to a conventional ballooning mode structure peaking in the outboard mid-plane of tokamaks. However, at strong gradient (H-mode), the most unstable mode is usually not the ground eigen state and the ballooning mode structure becomes unconventional. This result implies that the pedestal of H-mode could have better confinement than L-mode.

  6. Test flights of the NASA ultra-long duration balloon

    NASA Astrophysics Data System (ADS)

    Cathey, H. M.

    2004-01-01

    The National Aeronautics and Space Administration (NASA) Ultra-Long Duration Balloon development project is attempting to extend the potential flight durations for large scientific balloon payloads. The culmination of each of the development steps has been the fabrication and test flight of progressively larger balloons. This new super-pressure balloon is a pumpkin balloon design. This paper concentrates on the super-pressure balloon development test flights that have been, and are currently being planned by the NASA Balloon Program Office at Goddard Space Flight Center's Wallops Flight Facility. Descriptions of two test flights from early 2001 are presented along with lessons learned. Results are also presented of a July 2002 test flight of a full-scale 610,500 m 3 balloon with a 2800 kg suspended load that incorporated the lessons learned.

  7. Ignition of Hydrogen Balloons by Model-Rocket-Engine Igniters.

    ERIC Educational Resources Information Center

    Hartman, Nicholas T.

    2003-01-01

    Describes an alternative method for exploding hydrogen balloons as a classroom demonstration. Uses the method of igniting the balloons via an electronic match. Includes necessary materials to conduct the demonstration and discusses potential hazards. (SOE)

  8. Crash in Australian outback ends NASA ballooning season

    NASA Astrophysics Data System (ADS)

    Harris, Margaret

    2010-06-01

    NASA has temporarily suspended all its scientific balloon launches after the balloon-borne Nuclear Compton Tele scope (NCT) crashed during take-off, scattering a trail of debris across the remote launch site and overturning a nearby parked car.

  9. Performance of latex balloons for optical computed tomography

    NASA Astrophysics Data System (ADS)

    Jordan, K.; Walsh, A.; Peng, M.; Battista, J.

    2013-06-01

    Latex balloons filled with radiation sensitive hydrogels were evaluated as 3D dosimeters with optical computed tomography (CT) readout. Custom balloons, with less than 10 cm diameters, were made from latex sheets. Commercial, 13 cm diameter, clear balloons were investigated for larger volumes. Ferrous-xylenol orange and genipin gelatin gels selected for 1 and 30 Gy experiments, respectively. The thin stretched latex membrane allowed optical imaging to within 1 mm of the interior balloon edge. Reconstructed dose distributions demonstrated valid measurements to within 2 mm of the balloon surface. The rubber membrane provides a hybrid approach to deforming hydrogels. Uniform irradiation of a deformed gel resulted in a uniform dose being measured when scanned in the relaxed, initial balloon shape. The 13 cm diameter balloons were also effective and inexpensive vessels for hydrogels due to their high clarity, thinness and mechanical strength. Latex balloons represent an inexpensive method to obtain useful information from nearly the entire dosimeter volume.

  10. Educating the Educator: Teaching Airway Adjunct Techniques in Athletic Training

    ERIC Educational Resources Information Center

    Berry, David C.; Seitz, S. Robert

    2011-01-01

    The 5th edition of the "Athletic Training Education Competencies" ("Competencies") now requires athletic training educators (ATEs) to introduce into the curriculum various types of airway adjuncts including: (1) oropharyngeal airways (OPA), (2) nasopharyngeal airways (NPA), (3) supraglottic airways (SGA), and (4) suction. The addition of these…

  11. The Attraction of Adjunct Faculty to Rural Community Colleges

    ERIC Educational Resources Information Center

    Charlier, Hara Dracon

    2010-01-01

    As rural community colleges face mounting fiscal pressure, the ability to attract adjunct faculty members to support the institutional mission becomes increasingly important. Although the professional literature documents differences between rural, suburban, and urban community colleges, the effect of this institutional diversity on the role and…

  12. SEQUENTIAL INOCULATION AS AN ADJUNCT IN ENTERIC VIRUS PLAQUE ENUMERATION

    EPA Science Inventory

    The potential utility of sequentially inoculating a virus sample onto two different cultures of similar dissimilar cell lines was evaluated in conjunction with IDU (5-iodo-2'-deoxyuridine) treatment of the cells as a potential adjunct in viral plaque formation assays. his evaluat...

  13. Price of Gas Fuels Tough Choices for Adjuncts

    ERIC Educational Resources Information Center

    Grasgreen, Allie

    2008-01-01

    The cost of gasoline has made the art of juggling two or more teaching jobs at different institutions all the more difficult for many adjunct faculty members, as continuing price hikes at the nation's gasoline stations cut into salaries that often do not cover living expenses to begin with. These new pressures are particularly evident in…

  14. Transformations: The World Religions Survey through an Adjunct Feminist Lens

    ERIC Educational Resources Information Center

    Downie, Alison

    2015-01-01

    This essay describes a transformation in my experience as an adjunct teaching underprepared students from one of shame toward a desire to assert the value of this work. Insights from my feminist theological training helped me to affirm the importance of encouraging transformative learning in teaching the academically marginalized and prompted my…

  15. Orientation to Teaching for Adjunct Faculty (Instructors Manual).

    ERIC Educational Resources Information Center

    Greive, Donald; France, Richard E.

    Guidelines for conducting and facilitating a workshop designed as an orientation for both beginning and experienced adjunct faculty at community colleges are presented in this instructor's manual. The manual contains the following 11 sections, each defining an objective or activity to be undertaken during the workshop, and providing…

  16. Adjunct Faculty in Developmental Education: Best Practices, Challenges, and Recommendations

    ERIC Educational Resources Information Center

    Datray, Jennifer L.; Saxon, D. Patrick; Martirosyan, Nara M.

    2014-01-01

    Adjunct and part-time faculty are an important resource for developmental education programs. Developmental courses and services are developed to serve underprepared, at-risk college students typically near the beginning of their college matriculation. According to Schults (2001), approximately 65% of the faculty teaching developmental education…

  17. Predicting the Satisfaction and Loyalty of Adjunct Faculty

    ERIC Educational Resources Information Center

    Hoyt, Jeff E.

    2012-01-01

    Satisfaction with the quality of students, autonomy, faculty support, honorarium, and preference for teaching were significant predictors of adjunct faculty loyalty. With the exception of autonomy, these factors along with a heavy teaching load, collaborative research with full-time faculty, and satisfaction with teaching schedule were predictive…

  18. To Many Adjunct Professors, Academic Freedom Is a Myth.

    ERIC Educational Resources Information Center

    Schneider, Alison

    1999-01-01

    Reports that adjunct faculty, which accounts for half the professoriate, does not have academic freedom and can lose jobs for such usually protected activities as teaching controversial material, fighting grade changes, or organizing unions. Accounts of such activities are offered from Jefferson Community College (Kentucky), Chestnut Hill College…

  19. A Simple Spreadsheet Strikes a Nerve among Adjuncts

    ERIC Educational Resources Information Center

    Stratford, Michael

    2012-01-01

    Energized by his fellow adjunct professors who had gathered for a national meeting last month in Washington, District of Columbia, Joshua A. Boldt flew home to Athens, Georgia, opened his laptop, and created a Google document. On his personal blog, the writing instructor implored colleagues to contribute to the publicly editable spreadsheet,…

  20. Morphological characterization of selected balloon films and its effects on balloon performances

    NASA Technical Reports Server (NTRS)

    Said, Magdi A.

    1994-01-01

    Morphological characterization of several polyethylene balloon films have been studied using various techniques. The objective is to determine, if any, differentiating structural or morphological features that can be related to the performance of these balloon film materials. The results of the study indicate that the films are composed of either linear low denstiy polyethylene (LLDPE) or low density polyethylene (LDPE). A selective examination of these data imply that films limited degree of branching and larger crystallites size (same % crystallinity) showed good mechanical properties that appear to correlate with their high level of success in balloon flights.

  1. The Ultimate Mountaintop: Astronomy Aboard Stratospheric Balloons

    NASA Technical Reports Server (NTRS)

    Wanjek, Christopher; White, Nicholas E. (Technical Monitor)

    2000-01-01

    As funding, for astronomy dwindles and the competition for observation time heats up, more astronomers may turn to balloons. Far above the Keck telescope on Hawaii's Mauna Kea, higher still than the hostile snowcapped peaks of Mt. Everest, there exists a 40-kilometer summit that will place their telescopes above 99% of the atmosphere. With the prospect of 100-day and even 1,000-day balloons, the climb to the summit is more and more tempting. Surely, given enough cash, most astronomers would opt for a lunar base or a platform beyond the Earth. Until then, many seem happy to settle for a stratospheric mountaintop.

  2. High altitude balloon experiments at IIA

    NASA Astrophysics Data System (ADS)

    Nayak, Akshata; Sreejith, A. G.; Safonova, Margarita; Murthy, Jayant

    Recent advances in balloon experiments as well as in electronics have made it possible to fly scientific payloads at costs accessible to university departments. We have begun a program of high altitude ballooning at the Indian Institute of Astrophysics, Bengaluru. The primary purpose of this activity is to test low-cost ultraviolet (UV) payloads for eventual space flight, but we will also try scientific exploration of the phenomena occurring in the upper atmosphere, including sprites and meteorite impacts. We present the results of the initial experiments carried out at the CREST campus of IIA, Hosakote, and describe our plans for the future.

  3. Performance of the EUSO-Balloon electronics

    NASA Astrophysics Data System (ADS)

    Barrillon, P.; Bacholle, S.; Bayer, J.; Blaksley, C.; Blin, S.; Cafagna, F.; Dagoret, S.; Fornaro, C.; Gorodetzky, P.; Jung, A.; Karczmarczyk, J.; De La Taille, C.; Medina Tanco, G.; Miyamoto, H.; Moretto, C.; Osteria, G.; Park, I.; Perfetto, F.; Prévôt, G.; Prat, P.; Rabanal Reina, J.; Rojas, J.; Santiago, L.; Scotti, V.; Silva, H.; Szabelski, J.

    2016-01-01

    The 24th of August 2014, the EUSO-Balloon instrument went for a night flight for several hours, 40 km above Timmins (Canada) balloon launching site, concretizing the hard work of an important part of the JEM-EUSO collaboration started 3 years before. This instrument consists of a telescope made of two lenses and a complex electronic chain divided in two main sub-systems: the PDM (Photo Detector Module) and the DP (Data Processor). Each of them is made of several innovative elements developed and tested in a short time. This paper presents their performances before and during the flight.

  4. Exponential Growth of Nonlinear Ballooning Instability

    SciTech Connect

    Zhu, P.; Hegna, C. C.; Sovinec, C. R.

    2009-06-12

    Recent ideal magnetohydrodynamic (MHD) theory predicts that a perturbation evolving from a linear ballooning instability will continue to grow exponentially in the intermediate nonlinear phase at the same linear growth rate. This prediction is confirmed in ideal MHD simulations. When the Lagrangian compression, a measure of the ballooning nonlinearity, becomes of the order of unity, the intermediate nonlinear phase is entered, during which the maximum plasma displacement amplitude as well as the total kinetic energy continues to grow exponentially at the rate of the corresponding linear phase.

  5. Catalytic Generation of Lift Gases for Balloons

    NASA Technical Reports Server (NTRS)

    Zubrin, Robert; Berggren, Mark

    2011-01-01

    A lift-gas cracker (LGC) is an apparatus that generates a low-molecular-weight gas (mostly hydrogen with smaller amounts of carbon monoxide and/or carbon dioxide) at low gauge pressure by methanol reforming. LGCs are undergoing development for use as sources of buoyant gases for filling zero-gauge-pressure meteorological and scientific balloons in remote locations where heavy, high-pressure helium cylinders are not readily available. LGCs could also be used aboard large, zero-gauge-pressure, stratospheric research balloons to extend the duration of flight.

  6. Test flights of the NASA ultra long duration balloon

    NASA Astrophysics Data System (ADS)

    Cathey, H.

    The NASA Ultra Long Duration Balloon development project is attempting to extend the potential flight durations for large scientific balloon payloads. The culmination of each of the development steps has been the fabrication and test flight of progressively larger balloons. This new super-pressure balloon is a pumpkin balloon design. This paper concentrates on the super-pressure balloon development test flights that have been, and are currently being planned by the National Aeronautics and Space Administration (NASA) Balloon Program Office at Goddard Space Flight Center's Wallops Flight Facility. Two Ultra Long Duration balloon test flights took place from Australia in early 2001. The results from these flights, as well as the challenges presented, will be discussed. With these lessons learned and incorporating both material and design improvements, a test flight of a full-scale 610,500m3 balloon with a 2,800 kg suspended load will be completed in Spring of 2002 from Ft. Sumner, New Mexico. This balloon, the largest single celled super- pressure balloon ever flown, has been sized to satisfy the requirements for the planned ULDB CREAM mission in late 2003. A description of the balloon design, including the modifications made as a result of the lessons learned from the two Australia flights, will be presented. The results, highlighting balloon performance, from the Spring 2002 test flight will be presented. This will include information related to the balloon preparation, flight operations, and flight performance. A review of the radiative environmental influences on the balloon related to this flight will be presented. A second test flight of a full-scale Ultra Long Duration Balloon is scheduled for December of 2002. This flight is expected to be one orbit or approximately 15 days. The plans for this Southern Hemisphere, Australia launched, global flight will also be presented.

  7. Substances To Fill Lighter-Than-Air Balloons

    NASA Technical Reports Server (NTRS)

    Jones, Jack A.

    1995-01-01

    Various combinations of solid and liquid chemicals proposed as sources of hydrogen and other gases for inflating lighter-than-air balloons. In all cases energy used to propel balloon upward or downward comes from temperature differences in planet's atmosphere itself. Phase changes and/or reversible chemical reactions used to vary quantities of gases in balloons as functions of pressure and temperature and, as functions of altitude: provides means to control altitude of balloon.

  8. Adjunctive Inferior Vena Cava Filter Placement for Acute Pulmonary Embolism

    SciTech Connect

    Jha, V. M.; Lee-Llacer, J.; Williams, J.; Ubaissi, H.; Gutierrez, G.

    2010-08-15

    Inferior vena cava (IVC) filters are sometimes placed as an adjunct to full anticoagulation in patients with significant pulmonary embolism (PE). We aimed to determine the prevalence of adjunctive IVC filter placement in individuals diagnosed with PE, as well as the effect of adjunctive filter placement on mortality in patients with right heart strain associated with PE. This was a retrospective study of patients with acute PE treated with full anticoagulation admitted to a single academic medical center. Information abstracted from patient charts included presence or absence of right heart strain and of deep-vein thrombosis, and whether or not an IVC filter was placed. The endpoint was in-hospital mortality. Over 2.75 years, we found that 248 patients were diagnosed with acute PE, with an in-hospital mortality rate of 4.4%. The prevalence of adjunctive IVC filter placement was 13.3% (33 of 248), and the prevalence of documented right heart strain was 27.0% (67 of 248). In-hospital mortality was 10.2% in the non-filter-treated group (5 of 49), whereas there were no deaths in the filter-treated group (0 of 18); however, the difference was not statistically significant (P = 0.37). Both the presence of deep-vein thrombosis and of right heart strain increased the likelihood that an adjunctive IVC filter was placed (P < 0.0001 and P < 0.001, respectively). At our institution, patients were treated with IVC filters in addition to anticoagulation in 13.3% of cases of acute PE. Prospective studies or large clinical registries should be conducted to clarify whether this practice improves outcomes.

  9. Development overview of the revised NASA Ultra Long Duration Balloon

    NASA Astrophysics Data System (ADS)

    Cathey, H. M.

    2008-11-01

    The desire for longer duration stratospheric flights at constant float altitudes for heavy payloads has been the focus of the development of the National Aeronautics and Space Administration’s (NASA) Ultra Long Duration Balloon (ULDB) effort. Recent efforts have focused on ground testing and analysis to understand the previously observed issue of balloon deployment. A revised approach to the pumpkin balloon design has been tested through ground testing of model balloons and through two test flights. The design approach does not require foreshortening, and will significantly reduce the balloon handling during manufacture reducing the chances of inducing damage to the envelope. Successful ground testing of model balloons lead to the fabrication and test flight of a ˜176,000 m3 (˜6.2 MCF Million Cubic Foot) balloon. Pre-flight analytical predictions predicted that the proposed flight balloon design to be stable and should fully deploy. This paper provides an overview of this first test flight of the revised Ultra Long Duration Balloon design which was a short domestic test flight from Ft. Sumner, NM, USA. This balloon fully deployed, but developed a leak under pressurization. After an extensive investigation to the cause of the leak, a second test flight balloon was fabricated. This ˜176,000 m3 (˜6.2 MCF) balloon was flown from Kiruna, Sweden in June of 2006. Flight results for both test flights, including flight performance are presented.

  10. 14 CFR 61.115 - Balloon rating: Limitations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Balloon rating: Limitations. 61.115 Section...) AIRMEN CERTIFICATION: PILOTS, FLIGHT INSTRUCTORS, AND GROUND INSTRUCTORS Private Pilots § 61.115 Balloon rating: Limitations. (a) If a person who applies for a private pilot certificate with a balloon...

  11. 21 CFR 884.5050 - Metreurynter-balloon abortion system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Metreurynter-balloon abortion system. 884.5050... Devices § 884.5050 Metreurynter-balloon abortion system. (a) Identification. A metreurynter-balloon abortion system is a device used to induce abortion. The device is inserted into the uterine...

  12. 21 CFR 884.5050 - Metreurynter-balloon abortion system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Metreurynter-balloon abortion system. 884.5050... Devices § 884.5050 Metreurynter-balloon abortion system. (a) Identification. A metreurynter-balloon abortion system is a device used to induce abortion. The device is inserted into the uterine...

  13. 21 CFR 884.5050 - Metreurynter-balloon abortion system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Metreurynter-balloon abortion system. 884.5050... Devices § 884.5050 Metreurynter-balloon abortion system. (a) Identification. A metreurynter-balloon abortion system is a device used to induce abortion. The device is inserted into the uterine...

  14. Rough surface improves stability of air- sounding balloons

    NASA Technical Reports Server (NTRS)

    Scoggins, J. R.

    1965-01-01

    Aerodynamic stability of balloons used for measuring the intensity and direction of atmospheric winds at various elevations is improved by incorporating a rough surface on the balloons. The rough-surfaced balloon is useful for collecting wind profiles and other meteorological data.

  15. Auditory Risk of Exploding Hydrogen-Oxygen Balloons

    ERIC Educational Resources Information Center

    Gee, Kent L.; Vernon, Julia A.; Macedone, Jeffrey H.

    2010-01-01

    Although hydrogen-oxygen balloon explosions are popular demonstrations, the acoustic impulse created poses a hearing damage risk if the peak level exceeds 140 dB at the listener's ear. The results of acoustical measurements of hydrogen-oxygen balloons of varying volume and oxygen content are described. It is shown that hydrogen balloons may be…

  16. A Utilization-Focused Evaluation of a Community College Adjunct Faculty Professional Development Program

    ERIC Educational Resources Information Center

    Edenfield, Gordon

    2010-01-01

    Nationally adjunct faculty comprise almost 70% of all two-year institution faculty while in the Virginia Community College System (VCCS) adjunct faculty teach 60% of the community college courses, and should past trends continue, the number of adjunct faculty members is expected to grow 10% within the next fifteen years (Caliber, 2007; Phillipe &…

  17. Perceptions of the Other: Voices of Adjunct and Fulltime Community College Faculty

    ERIC Educational Resources Information Center

    Backlin, William Wayne

    2012-01-01

    The practice of hiring adjunct instructors was initially considered to be an anomalous event (Todd, 2004). Community college employment of adjunct instructors, however, witnessed a 50% increase during the 1970s (Cain, 1999) and, by 1984, adjunct instructor utilization in community colleges rose dramatically with an additional 80% growth. Over a…

  18. Emotional Intelligence, Job Satisfaction, and Students' Perceptions of the Quality of Online Adjunct Faculty

    ERIC Educational Resources Information Center

    Sander, Sara K.

    2011-01-01

    This study explored the relationship between emotional intelligence and students' perceptions of quality of online adjunct faculty and the relationship between emotional intelligence and the job satisfaction of online adjunct faculty. Online adjunct faculty participants completed the Trait Emotional Intelligence Questionnaire--Short Form…

  19. Expectations, Motivations, and Barriers to Professional Development: Perspectives from Adjunct Instructors Teaching Online

    ERIC Educational Resources Information Center

    Dailey-Hebert, Amber; Mandernach, B. Jean; Donnelli-Sallee, Emily; Norris, Virgil Rusty

    2014-01-01

    Adjunct instructors are the fastest growing population of faculty in the academy; and, given the current economic condition and its impact on institutions of higher learning, the proportion of adjunct faculty is likely to increase (Gappa, Austin & Trice, 2007; NCES, 2011). Yet the adjunct population continues to remain disconnected from the…

  20. Five Years Later: Maryland Adjuncts Tell Us (Again) Who They Are and What They Want

    ERIC Educational Resources Information Center

    Dolan, Dallas M.; Hall, Marilyn S.; Karlsson, Carl Richard; Martinak, M. Linda

    2013-01-01

    Adjunct faculty make up a large contingent of faculty teaching in today's colleges and universities. In fact, the use of adjunct faculty allows these institutions to fulfill their educational missions. Much is written in the popular press and in periodicals dedicated to higher education about adjunct faculty. While some of this is accurate, a…

  1. A Model of Primary Atherosclerosis and Post-Angioplasty Restenosis in Mice

    PubMed Central

    Leidenfrost, Jeremy E.; Khan, M. Faisal; Boc, Kenneth P.; Villa, Brian R.; Collins, Emily T.; Parks, William C.; Abendschein, Dana R.; Choi, Eric T.

    2003-01-01

    Although mice deficient in various genes are providing greater insight into the mechanisms of restenosis after angioplasty, there have been limitations with murine models not simulating human vascular disease. To develop a more clinically applicable model of primary atherosclerosis and restenosis following angioplasty of the primary lesion, we fed apolipoprotein E-deficient mice a Western diet and occluded the left common carotid artery for 2 days. Three weeks after flow was restored, the temporarily occluded carotids demonstrated atherosclerotic lesions containing foam cells, cholesterol clefts, necrotic cores, and fibrous capsules. The atherosclerotic carotids in other animals underwent angioplasty with a beaded probe, resulting in plaque and medial layer disruption. Three weeks after angioplasty, although there was significant neointimal lesion formation, the luminal narrowing did not change significantly secondary to overall vessel enlargement (positive remodeling). Neointimal lesions were composed of smooth-muscle cells and extracellular matrix observed adjacent to the original atherosclerotic plaques. Similarly, even at 3 months after the angioplasty the lumen was maintained despite greater neointimal lesion formation caused by progressive positive remodeling. This new murine model of primary atherosclerosis and postangioplasty intimal hyperplasia and remodeling mimics the human disease pattern of postangioplasty intimal hyperplasia. Used in transgenic animals, this model will likely facilitate understanding of the mechanisms of restenosis in humans. PMID:12875996

  2. Clinical Outcomes of Infrapopliteal Angioplasty in Patients With Critical Limb Ischemia

    PubMed Central

    Ryu, Hyeon Min; Kim, Jung-Sun; Ko, Young Guk; Hong, Myeong-Ki; Jang, Yangsoo

    2012-01-01

    Background and Objectives With recent advances in equipment and techniques, infrapopliteal angioplasty has shown results that are comparable to those of surgical bypass in patients with critical limb ischemia (CLI). In this study, we evaluated the efficacy and the feasibility of infrapopliteal angioplasty in patients with CLI. Subjects and Methods Between March 2002 and May 2008, infrapopliteal angioplasty was performed on 118 limbs of 101 patients (79 males; mean age 66 years) with CLI (Rutherford category 4, 5 or 6). Freedom from reintervention, limb salvage, and overall survival were analyzed. Results The median follow-up duration was 30 months. Initial technical and clinical success rates were 69.5% and 83.1%, respectively. No major complication requiring surgical intervention developed after angioplasty. Among 82 limbs with initial technical success, the rate of freedom from any reintervention at 2 years was 70.7% and that from limb salvage was 97.6%. Young age and Rutherford category 6 at initial presentation were independent predictors associated with poor 2 year primary patency in these patients with CLI. Overall survival at 1 year was 86.4% and that at 2 years 76.3%. A history of cerebrovascular accident was an independent predictor associated with poor 2 year survival in these patients. Conclusion Infrapopliteal angioplasty as a primary choice of treatment in CLI patients showed favorable clinical outcomes and feasibility. PMID:22563339

  3. Effect of percutaneous transluminal coronary angioplasty on coronary reserve

    SciTech Connect

    Lassar, T.; Hendrix, L.; Ray, G.; Schmidt, D.

    1984-01-01

    This study was done to assess the effect of percutaneous transluminal coronary angioplasty (PTCA) on regional myocardial perfusion (RMP) in the region distal to a stenosis in 48 patients. Quantitative RMP in ml/100g/min was measured from the washout of Xe-133 following selective injection into the involved coronary artery. After successful dilation, determined by a reduction in %stenosis to a less than or equal to 50% lesion and in pressure gradient across the lesion, the RMP measurement was repeated. In these patients, means %stenosis was 85% pre PTCA and 29% post PTCA with mean pressure gradient of 60 Hg pre PTCA and 21 mm Hg post PTCA. 21 of these 48 patients also had RMP measured after isoproterenol (ISO) both pre and post PTCA to increase myocardial oxygen demand to assess coronary reserve. Heart rate (HR) and systolic blood pressure (SBP) were constant pre and post PTCA which allowed a valid comparison. The results are presented. A group of 13 patients with normal coronary arteries and ventricular function showed a mean control RMP of 78 +- 15 and a mean ISO RMP of 140 +- 26. The data demonstrate that following successful PTCA quantitative RMP improves both at rest and with an ISO challenge and is similar to RMP in normal coronary arteries.

  4. Balloon Ascent: 3-D Simulation Tool for the Ascent and Float of High-Altitude Balloons

    NASA Technical Reports Server (NTRS)

    Farley, Rodger E.

    2005-01-01

    The BalloonAscent balloon flight simulation code represents a from-scratch development using Visual Basic 5 as the software platform. The simulation code is a transient analysis of balloon flight, predicting the skin and gas temperatures along with the 3-D position and velocity in a time and spatially varying environment. There are manual and automated controls for gas valving and the dropping of ballast. Also, there are many handy calculators, such as appropriate free lift, and steady-state thermal solutions with temperature gradients. The strength of this simulation model over others in the past is that the infrared environment is deterministic rather than guessed at. The ground temperature is specified along with the emissivity, which creates a ground level IR environment that is then partially absorbed as it travels upward through the atmosphere to the altitude of the balloon.

  5. Pumpkins and onions and balloon design

    NASA Astrophysics Data System (ADS)

    Winker, J. A.

    The reach for a capability to make long flights (months) with heavy payloads (tonnes) has long been pursued. The closest we have come is with polar flights devoid of a significant diurnal cycle. Superpressure technology, with its ability to survive diurnal cycles, is an obvious choice, but materials limitations have been an obstacle to realizing these ambitious goals. Now comes an assortment of new synthetic materials, coupled with a special variety of superpressure balloon which, in combination, is poised to yield a solution for our enhanced duration/payload quest. In this paper we are looking not at materials, but only at a balloon concept. This concept is a "natural shape" oblate spheroid balloon whose shape is chosen to exploit properties of component materials, particularly newly available ones. The current variation of this concept is called a "pumpkin" balloon. The most visible work on this shape is that done by France's CNES, Japan's ISAS, and in the USA by NASA's Wallops Flight Facility. But the basic design idea is not new; it extends back at least a half century. This paper traces the origins of the shape, its evolution through various iterations, and it speculates on some of the recent thinking regarding construction details.

  6. Enacting Organizational Culture: Balloons in the Air

    ERIC Educational Resources Information Center

    Shapiro, Elayne

    2006-01-01

    This article presents an activity that encourages students to create and analyze an organizational culture. In this activity, students perform two rounds of "keeping balloons in the air" with a brief interlude to try and improve performance. Next, they conduct an in-depth discussion of elements of organizational culture that affect productivity.…

  7. Teacher's Guide for Balloons and Gases.

    ERIC Educational Resources Information Center

    Griffith, Joe H.; And Others

    This guide was developed to provide children with an opportunity to prepare and collect several common gases and to discover and work with some of their properties. The guide is divided into five major sections: (1) introduction, (2) materials, (3) activities, (4) balloons aloft, and (5) an appendix. The introduction provides information…

  8. Balloon fabrics made of Goldbeater's skins

    NASA Technical Reports Server (NTRS)

    Chollet, L

    1922-01-01

    Goldbeater's skin, which is the prepared outside membrane of the large intestine of an ox, is examined as a balloon fabric and details of how goldbeater's skin is prepared for use are provided. The construction techniques employed by Germany, France, and England are all discussed.

  9. Teaching Earth Science Using Hot Air Balloons

    ERIC Educational Resources Information Center

    Kuhl, James; Shaffer, Karen

    2008-01-01

    Constructing model hot air balloons is an activity that captures the imaginations of students, enabling teachers to present required content to minds that are open to receive it. Additionally, there are few activities that lend themselves to integrating so much content across subject areas. In this article, the authors describe how they have…

  10. Balloon-borne radiometer profiler: Field observations

    SciTech Connect

    Shaw, W.J.; Whiteman, C.D.; Anderson, G.A.; Alzheimer, J.M.; Hubbe, J.M.; Scott, K.A.

    1995-03-01

    This project involves the development of the capability of making routine soundings of broadband radiative fluxes and radiative flux divergences to heights of 1500m AGL. Described in this document are radiometers carried on a stabilized platform in a harness inserted in the tetherline of a tethered balloon meteriological sounding system. Field test results are given.

  11. Space and Earth Observations from Stratospheric Balloons

    NASA Astrophysics Data System (ADS)

    Peterzen, Steven; Ubertini, Pietro; Masi, Silvia; Ibba, Roberto; Ivano, Musso; Cardillo, Andrea; Romeo, Giovanni; Dragøy, Petter; Spoto, Domenico

    Stratospheric balloons are rapidly becoming the vehicle of choice for near space investigations and earth observations by a variety of science disciplines. With the ever increasing research into climatic change, instruments suspended from stratospheric balloons offer the science team a unique, stable and reusable platform that can circle the Earth in the polar region or equatorial zone for thirty days or more. The Italian Space Agency (ASI) in collaboration with Andoya Rocket Range (Andenes, Norway) has opened access in the far northern latitudes above 78o N from Longyearbyen, Svalbard. In 2006 the first Italian UltraLite Long Duration Balloon was launched from Baia Terra Nova, Mario Zuchelli station in Antarctica and now ASI is setting up for the their first equatorial stratospheric launch from their satellite receiving station and rocket launch site in Malindi, Kenya. For the equatorial missions we have analysed the statistical properties of trajectories considering the biennal oscillation and the seasonal effects of the stratospheric winds. Maintaining these launch sites offer the science community 3 point world coverage for heavy lift balloons as well as the rapidly deployed Ultralight payloads and TM system ASI developed to use for test platforms, micro experiments, as well as a comprehensive student pilot program

  12. MHD Ballooning Instability in the Plasma Sheet

    SciTech Connect

    C.Z. Cheng; S. Zaharia

    2003-10-20

    Based on the ideal-MHD model the stability of ballooning modes is investigated by employing realistic 3D magnetospheric equilibria, in particular for the substorm growth phase. Previous MHD ballooning stability calculations making use of approximations on the plasma compressibility can give rise to erroneous conclusions. Our results show that without making approximations on the plasma compressibility the MHD ballooning modes are unstable for the entire plasma sheet where beta (sub)eq is greater than or equal to 1, and the most unstable modes are located in the strong cross-tail current sheet region in the near-Earth plasma sheet, which maps to the initial brightening location of the breakup arc in the ionosphere. However, the MHD beq threshold is too low in comparison with observations by AMPTE/CCE at X = -(8 - 9)R(sub)E, which show that a low-frequency instability is excited only when beq increases over 50. The difficulty is mitigated by considering the kinetic effects of ion gyrorad ii and trapped electron dynamics, which can greatly increase the stabilizing effects of field line tension and thus enhance the beta(sub)eq threshold [Cheng and Lui, 1998]. The consequence is to reduce the equatorial region of the unstable ballooning modes to the strong cross-tail current sheet region where the free energy associated with the plasma pressure gradient and magnetic field curvature is maximum.

  13. Strategic Plans for NASA Research Ballooning

    NASA Astrophysics Data System (ADS)

    Jones, W. V.

    Strategic planning is underway to maximize the return from the increased capabilities anticipated in scientific research ballooning. Circumpolar flights around Antarctica were initiated in the early 1990's to help offset the impact of losing Shuttle/Spacelab missions for the observational sciences following the Challenger accident. The Antarctic Long-Duration Balloon (LDB) program, conducted in partnership with the U.S. National Science Foundation Office of Polar Programs, has been even more successful than originally envisioned. In essence, there have been two LDB missions per year, with an average duration of about 14 days, using conventional zero-pressure balloons. Two LDB flights of similar duration in the Northern Hemisphere have shown the value of developing a routine capability that would complement the Antarctic flights. The development of super-pressure balloons should allow LDB flights at any latitude, and it is reasonable to expect that mission durations can be extended to 60 - 100 days. Assuming that the technical issues will be resolved and international agreements can be secured, scientists will be able to reap the benefits of frequent access to near-space for cutting-edge research and technology development, thereby reducing the impact of restrictions on the use of the International Space Station and the Shuttle retirement in the next decade.

  14. Balloon Observations of Relativistic Electron Precipitation

    NASA Astrophysics Data System (ADS)

    Millan, R. M.; Woodger, L. A.

    2015-12-01

    Relativistic electron precipitation events lasting from minutes to hours have been observed by balloon-borne instrumentation since 1996. This collection of observations, including the recent BARREL observations, all occur in the noon to midnight sector. EMIC waves have been suggested as the precipitation mechanism for this type of event [Lorentzen et al., 2000 and Millan et al., 2002]. A recent study by Li et al., [2014] performed a case study which modeled the radiation belt relativistic electron pitch angle diffusion from EMIC waves which showed convincing agreement between the modeled results and the BARREL x-ray observations. A survey of the BARREL REP events suggests this type of precipitation is a very localized phenomena with most events only being observed by a single balloon at a time despite the extensive L-value and local time coverage of observations during the campaign. This result is consistent with the findings of Blum et al., [2013]. Furthermore, the balloon observations show local time energy dependence consistent with the SAMPEX observations reported by Comess et al, [2013]. In this work we address the following questions: based on the REP events observed by balloon-borne instrumentation, are these characteristics true for all identified REP events and does this support EMIC waves as the precipitation mechanism? Due to the localized region of precipitation, do these events represent a significant radiation belt loss process?

  15. MAXIS Balloon Observations of Electron Microburst Precipitation

    NASA Astrophysics Data System (ADS)

    Millan, R. M.; Hunter, A. E.; McCarthy, M. P.; Lin, R. P.; Smith, D. M.

    2003-12-01

    Quantifying and understanding losses is an integral part of understanding relativistic electron variability in the radiation belts. SAMPEX observations indicate that electron microburst precipitation is a major loss mechanism during active periods; the loss of relativistic electrons during a six hour period due to microburst precipitation was recently estimated to be comparable to the total number of trapped electrons in the outer zone (Lorentzen et al., 2001). Microburst precipitation was first observed from a balloon (Anderson and Milton, 1964), but these early measurements were only sensitive to <100 keV. The first balloon-based observations of microbursts sensitive to MeV energies were obtained during the MAXIS 2000 long duration balloon campaign. MAXIS was launched from McMurdo Station in Antarctica carrying a germanium spectrometer, a BGO scintillator and two X-ray imagers designed to measure the bremsstrahlung produced by precipitating electrons. The balloon circumnavigated the south pole in 18 days covering magnetic latitudes ranging from 58o-90o South. During the week following a moderate geomagnetic storm (with Dst reaching -91 nT), MAXIS detected a total of over 16 hours of microburst precipitation. We present high resolution spectra obtained with the MAXIS germanium spectrometer which allow us to determine the precipitating electron energy distribution. The precipitating distribution will then be compared to the trapped distribution measured by the GPS and LANL satellites. We also examine the spatial distribution of the precipitation.

  16. Pinhole Effects on Venus Superpressure Balloon Lifetime

    NASA Technical Reports Server (NTRS)

    Hall, Jeffery L.; Yavrouian, Andre H.

    2013-01-01

    Experimental results are presented for a series of experiments that addressed the effect of small pinhole defects on the potential lifetime of a Venus superpressure balloon. The experiments were performed on samples of a candidate balloon envelope material through which a single small hole of 80 to 300 microns in diameter was deliberately made in each one by puncturing with a metal pin. The material was mounted horizontally in a test apparatus and then a 2-3 mm thick layer of sulfuric acid was placed on top to mimic balloon wetting at Venus. Acid penetration and damage manifested itself as a darkening of the aluminum metal and adhesive layers around the hole in the balloon material. There were no test conditions under which the acid simply fell through the pinhole due to gravity because the surface tension forces always compensated at this size. Very little acid-damaged material was observed for the smallest 80 micron pinholes while gas flowed through the hole due to balloon-like pressurization: the black spot size was approximately 0.2 mm in diameter after 6 days with 86% sulfuric acid. The damage area grew more quickly in the absence of gas flowing out of an 80 micron hole, namely at a rate of 2 mm/day. It was concluded that the flow of escaping gas out of the hole provides a substantial reduction of the rate of acid penetration and damage. Larger diameter pinholes of approximately 300 micron diameter showed larger growth rates of 0.7 mm/day with gas flow and 1.7 mm/day without. The pinhole size did not change over the duration of these experiments because the material has an outer layer of fluoropolymer film that remained intact during the process and thereby held the hole size constant. None of the damage rates measured in these experiments pose a threat to the lifetime of the balloon over the projected course of a 30 day mission because the affected area is too small to cause a structural failure either through direct damage or increased solar heating and

  17. Stratospheric Balloon Platforms for Near Space Access

    NASA Astrophysics Data System (ADS)

    Dewey, R. G.

    2012-12-01

    For over five decades, high altitude aerospace balloon platforms have provided a unique vantage point for space and geophysical research by exposing scientific instrument packages and experiments to space-like conditions above 99% of Earth's atmosphere. Reaching altitudes in excess of 30 km for durations ranging from hours to weeks, high altitude balloons offer longer flight durations than both traditional sounding rockets and emerging suborbital reusable launch vehicles. For instruments and experiments requiring access to high altitudes, engineered balloon systems provide a timely, responsive, flexible, and cost-effective vehicle for reaching near space conditions. Moreover, high altitude balloon platforms serve as an early means of testing and validating hardware bound for suborbital or orbital space without imposing space vehicle qualifications and certification requirements on hardware in development. From float altitudes above 30 km visible obscuration of the sky is greatly reduced and telescopes and other sensors function in an orbit-like environment, but in 1g. Down-facing sensors can take long-exposure atmospheric measurements and images of Earth's surface from oblique and nadir perspectives. Payload support subsystems such as telemetry equipment and command, control, and communication (C3) interfaces can also be tested and operationally verified in this space-analog environment. For scientific payloads requiring over-flight of specific areas of interests, such as an active volcano or forest region, advanced mission planning software allows flight trajectories to be accurately modeled. Using both line-of-sight and satellite-based communication systems, payloads can be tracked and controlled throughout the entire mission duration. Under NASA's Flight Opportunities Program, NSC can provide a range of high altitude flight options to support space and geophysical research: High Altitude Shuttle System (HASS) - A balloon-borne semi-autonomous glider carries

  18. Mechanical properties of ANTRIX balloon film and fabrication of single cap large volume balloons

    NASA Astrophysics Data System (ADS)

    Suneel Kumar, B.; Sreenivasan, S.; Subba Rao, J. V.; Manchanda, R. K.

    2008-11-01

    The zero pressure plastic balloons used for high altitude studies are generally made from polyethylene material. Tensile properties of the thin film polymer are the key parameters for material selection due to extremely low temperature of -90 °C encountered by the balloons in the tropopause region during the ascent at equatorial latitudes. The physical and structural properties of the material determine the uniformity of the stress distribution over the entire shell. Load stresses from the suspended load propagate via load tapes heat sealed along with the gore seals as per the balloon design. A balance between this heat seal strength and the film strength is a desirable property of the basic resin in terms of the bubble strength, gauge uniformity, and long-term storage properties. In addition, the design of the top shell of the balloon and its stress distribution play an important role since only a fraction of the balloon is deployed during the filling operation and the ascent. In this paper we describe the mechanical properties of the 'ANTRIX' film developed by us and the optimized design of single cap balloons, which have been successfully used in our experiments over the past 5 years.

  19. Investigating Diffusion and Entropy with Carbon Dioxide-Filled Balloons

    NASA Astrophysics Data System (ADS)

    Jadrich, James; Bruxvoort, Crystal

    2010-09-01

    Fill an ordinary latex balloon with helium gas and you know what to expect. Over the next day or two the volume will decrease noticeably as helium escapes from the balloon. So what happens when a latex balloon is filled with carbon dioxide gas? Surprisingly, carbon dioxide balloons deflate at rates as much as an order of magnitude faster than helium balloons. An investigation into the details of this phenomenon provides students with an excellent opportunity to apply the kinetic theory of gases and the ideal gas law, and it can also be exploited for a dramatic in-class demonstration of diffusion and the second law of thermodynamics.

  20. Outcome of rheumatoid arthritis following adjunct statin therapy

    PubMed Central

    Das, Subham; Mohanty, Manjushree; Padhan, Prasanta

    2015-01-01

    Objective: Rheumatoid arthritis (RA) is characterized by symmetric peripheral polyarthritis, inflammatory synovitis, and articular destruction. Statins, 3-hydroxy-3-methylglutaryl coenzyme A-reductase inhibitors, mediate significant vascular risk reduction in patients with coronary artery disease by promoting reduction in plasma levels of low-density-lipoprotein cholesterol. Extensive in vitro data, experimental studies and more recently few clinical trials have strongly suggested statins to possess an important role in RA mainly mediated by their anti-inflammatory and immunomodulatory properties. The objective of this study was to evaluate the effect of adjunct statin therapy in comparison to standard disease modifying antirheumatic drugs (DMARD) therapy in patients with RA. Materials and Methods: In this observational study, diagnosed RA patients of age group between 40 and 60 years were selected as per the inclusion criteria from the rheumatology outdoor. From the selected patients, we identified two separate groups of patients. Group 1 included 30 patients of RA currently under DMARD therapy with adjunct statin medication. Group 2 included 30 patients of RA currently under DMARD therapy. Patients were followed up over 6 months. Standard parameters such as disease activity score (DAS28), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were recorded for comparing the outcome of RA in both groups. Results: Out of a total of 60 patients who took part in the study, significant beneficial role of adjunct statin medication was found in this study when prescribed along with conventional DMARDs in active RA patients. The mean DAS28, considered by far as the most important index of clinical disease activity in RA, was found to be significantly lower (P < 0.05) in the adjunct statin-treated group (group 1) than that of the conventional DMARD treated group (group 2) after 6 months of continuous therapy. Other two important biochemical markers of RA

  1. Concepts for autonomous flight control for a balloon on Mars

    NASA Technical Reports Server (NTRS)

    Heinsheimer, Thomas F.; Friend, Robyn C.; Siegel, Neil G.

    1988-01-01

    Balloons operating as airborne rovers have been suggested as ideal candidates for early exploration of the Martian surface. An international study team composed of scientists from the U.S.S.R., France, and the U.S.A. is planning the launching in 1994 of a balloon system to fly on Mars. The current likely design is a dual thermal/gas balloon that consists of a gas balloon suspended above a solar-heated thermal balloon. At night, the thermal balloon provides no lift, and the balloon system drifts just above the Martian surface; the lift of the gas balloon is just sufficient to prevent the science payload from hitting the ground. During the day, the balloon system flies at an altitude of 4 to 5 kilometers, rising due to the added lift provided by the thermal balloon. Over the course of a single Martian day, there may be winds in several directions, and in fact it can be expected that there will be winds simultaneously in different directions at different altitudes. Therefore, a balloon system capable of controlling its own altitude, via an autonomous flight control system, can take advantage of these different winds to control its direction, thereby greatly increasing both its mission utility and its longevity.

  2. Balloon-occluded antegrade transvenous obliteration with or without balloon-occluded retrograde transvenous obliteration for the management of gastric varices: concept and technical applications.

    PubMed

    Saad, Wael E A; Kitanosono, Takashi; Koizumi, Jun

    2012-09-01

    Alternative routes for transvenous obliteration are sometimes resorted in the management of gastric varices. These alternative routes can be classified into A, portal venous access routes and B, systemic venous access routes. The portal venous approach to transvenous obliteration is called balloon-occluded antegrade transvenous obliteration (BATO) and is a collective definition, including 1-percutaneous transhepatic obliteration (PTO), 2-through an existing transjugular intrahepatic portosystemic shunt [(Trans-TIPS), and 3-trans-iliocolic vein obliteration (TIO)]. PTO is usually out of necessity; however, trans-TIPS approach is usually used out of serendipity (because the low-risk access route is there). The TIPS for the trans-TIPS BATO is not formed for mere access, but is done to create a TIPS or is done when there is a preexisting TIPS. The trans-TIPS approach can be resorted to in the United States in up to 19% of balloon-occluded retrograde transvenous obliteration (BRTO) cases. PTO is resorted to, out of necessity, in the United States and Japan in 10% of BRTO cases (2%-19% of BRTO cases) and can increase the technical and obliterative success rate of the transvenous obliteration procedure from 84%-98% to 98%-100%. The advantage of BATO as an adjunct to BRTO (combining a BRTO and BATO approach to obliterate the gastric varices) is not only limited to increasing the technical success rate of the obliterative procedure. BATO reduces the risk of overspill of the sclerosant from the gastric variceal system into the portal vein. Moreover, if the BATO is performed from a trans-TIPS approach, any overspill of the sclerosant mixture will partly (if not mostly) go through the patent TIPS to the systemic circulation (lung) rather than the intrahepatic portal vein branches (prevent portal vein embolization). This article discusses the clinical and technical applications, technical considerations, and the outcomes of BATO. PMID:23021832

  3. NASA super-pressure balloons - designing to meet the future

    NASA Astrophysics Data System (ADS)

    Cathey, Henry M., Jr.

    2001-08-01

    The NASA Ultra Long Duration Balloon project presents a new challenge in balloon design by extending flight duration for large heavy payloads. The pumpkin balloon design is innovative and presents many new challenges. This paper encapsulates the NASA Ultra Long Duration Balloon Vehicle developments, presents them to the Science Community, and shows points of interaction with the users. The capabilities and limitations are presented to allow potential users to make informed choices in the development of balloon class payloads. Brief summaries of test flights and the cause and effect relationship between suspended load and float altitude are presented. A focus on innovation and the future using the Ultra Long Duration Balloon super-pressure balloon technology is also presented.

  4. NASA balloon design and flight - Philosophy and criteria

    NASA Technical Reports Server (NTRS)

    Smith, I. S., Jr.

    1993-01-01

    The NASA philosophy and criteria for the design and flight of scientific balloons are set forth and discussed. The thickness of balloon films is standardized at 20.3 microns to isolate potential film problems, and design equations are given for specific balloon parameters. Expressions are given for: flight-stress index, total required thickness, cap length, load-tape rating, and venting-duct area. The balloon design criteria were used in the design of scientific balloons under NASA auspices since 1986, and the resulting designs are shown to be 95 percent effective. These results represent a significant increase in the effectiveness of the balloons and therefore indicate that the design criteria are valuable. The criteria are applicable to four balloon volume classes in combination with seven payload ranges.

  5. Overview of the NASA balloon R&D program

    NASA Technical Reports Server (NTRS)

    Smith, I. Steve, Jr.

    1994-01-01

    The catastrophic balloon failure during the first half of the 1980's identified the need for a comprehensive and continuing balloon research and development (R&D) commitment by NASA. Technical understanding was lacking in many of the disciplines and processes associated with scientific ballooning. A comprehensive balloon R&D plan was developed in 1986 and implemented in 1987. The objectives were to develop the understanding of balloon system performance, limitations, and failure mechanisms. The program consisted of five major technical areas: structures, performance and analysis, materials, chemistry and processing, and quality control. Research activitites have been conducted at NASA/Goddard Space Flight Center (GSFC)-Wallops Flight Facility (WFF), other NASA centers and government facilities, universities, and the balloon manufacturers. Several new and increased capabilities and resources have resulted from this activity. The findings, capabilities, and plan of the balloon R&D program are presented.

  6. Chimeric DNA-RNA hammerhead ribozyme targeting transforming growth factor-beta 1 mRNA inhibits neointima formation in rat carotid artery after balloon injury.

    PubMed

    Ando, Hideyuki; Fukuda, Noboru; Kotani, Motoko; Yokoyama, Shin ichiro; Kunimoto, Satoshi; Matsumoto, Koichi; Saito, Satoshi; Kanmatsuse, Katsuo; Mugishima, Hideo

    2004-01-12

    We designed and synthesized a chimeric DNA-RNA hammerhead ribozyme targeting transforming growth factor (TGF)-beta 1 mRNA and found that this ribozyme effectively and specifically inhibited growth of vascular smooth muscle cells. We examined the effects of the chimeric DNA-RNA hammerhead ribozyme targeting TGF-beta 1 mRNA on neointima formation and investigated the underlying mechanism to develop a possible gene therapy for coronary artery restenosis after percutaneous transluminal coronary angioplasty. Expression of mRNAs encoding TGF-beta 1, p27kip1, and connective tissue growth factor (CTGF) in carotid artery increased after balloon injury. Fluorescein-isothiocyanate (FITC)-labeled ribozyme was taken up into the midlayer smooth muscle of the injured carotid artery. Both 2 and 5 mg of ribozyme reduced neointima formation by 65% compared to that of controls. Ribozyme markedly decreased expression of TGF-beta 1 mRNA and protein in injured vessel. Mismatch ribozyme had no effect on expression of TGF-beta 1 mRNA protein in injured vessel. Ribozyme markedly decreased expression of fibronectin, p27kip1, and CTGF mRNAs in injured vessel, whereas a mismatch ribozyme had no effect on these mRNAs. These findings indicate that the chimeric DNA-RNA hammerhead ribozyme targeting TGF-beta 1 mRNA inhibits neointima formation in rat carotid artery after balloon injury with suppression of TGF-beta 1 and inhibition of extracellular matrix and CTGF. In conclusion, the hammerhead ribozyme against TGF-beta 1 may have promise as a therapy for coronary artery restenosis after percutaneous transluminal coronary angioplasty. PMID:14729108

  7. Report on the Activities of National Balloon Facility, Hyderabad

    NASA Astrophysics Data System (ADS)

    Vasudevan, Rajagopalan; Sreenivasan, S.; Suneel Kumar, B.; Kulkarni, P. M.

    2012-07-01

    More than five and half decades back, the Indian Balloon Group at Tata Institute of Fundamental Research, Mumbai started development of stratospheric zero pressure balloon technology and today it is one among the leading balloon groups in the world. For the past 40 years, the Institute has been operating a Scientific Balloon Facility at Hyderabad and carried out 478 balloon flights for various disciplines of space sciences like primary cosmic ray studies, X ray, Gamma Ray, Infra Red Astronomies and Atmospheric science maintaining 100% success rate during the past nine years. The Balloon Facility has the capability to build balloons of volume up to 750,000 Cu.M. as well as carrying out R & D in all aspects of scientific ballooning like balloon engineering, balloon material development, general and flight support instrumentation. A continued effort in R & D for ultra thin balloon material for High Altitude Sounding Flights has resulted in lowering the thickness of the proven indigenous Antrix film initially from 6 to 3.8 microns in the first phase and further reduction to 2.7 microns in the second phase. A test balloon of volume 5000 Cu.M. using the 2.7 micron film attained a record altitude of 45.0 Km. amsl with 1 Kg. GPS sonde payload. A 60,000 Cu.M. balloon fabricated out of 3.8 micron film capable of reaching 47 Km. Altitude with 10 Kg. Payload is awaiting trial. This report briefly describes our balloon activities during the past two years. In atmospheric sciences, aerosol studies were made with OPC,QCM,Aethelometer, Nephelometer,MWR, CIMEL Sun Photometer and Raman LIDAR.Measuments of vertical profile of Meteorological parameters and ozone upto stratosphere using GPS Radiosonde and Ozone sonde is made respectively.Study of Ionospheric tomography is done with CADI and CRABEX.

  8. Reliability of pressure recordings via catheters used for transluminal coronary angioplasty.

    PubMed

    Busch, U W; Sebening, H; Beeretz, R; Heinze, R

    1984-06-01

    Because of common difficulties in obtaining adequate pressure tracing during transluminal coronary angioplasty, the pressure transmission characteristics of catheter systems used for angioplasty were determined. Transmission of cine wave pressures (0.2 to 14 Hz) and of arterial pressure pulses reproduced in vitro was evaluated. Following adequate elimination of air bubbles from the system, the Grüntzig dilatation catheters yielded satisfactory frequency response curves and thus good reproduction of arterial pressure waveforms. The Simpson-Robert catheter showed clearly inferior frequency response characteristics, explaining the more significant damping of the pressure tracings. However, mean pressures were reliably recorded with each type. PMID:15227077

  9. Social Networking Sites: An Adjunctive Treatment Modality for Psychological Problems

    PubMed Central

    Menon, Indu S.; Sharma, Manoj Kumar; Chandra, Prabha S.; Thennarasu, K.

    2014-01-01

    Background: Social networking is seen as a way to enhance social support and feeling of well-being. The present work explores the potentials of social networking sites as an adjunctive treatment modality for initiating treatment contact as well as for managing psychological problems. Materials and Methods: Interview schedule, Facebook intensity questionnaire were administered on 28 subjects with a combination of 18 males and 10 females. They were taken from the in-patient and out-patient psychiatry setting of the hospital. Results: Facebook was the most popular sites and used to seek emotional support on the basis of the frequent updates of emotional content that users put in their profile; reconciliations, escape from the problems or to manage the loneliness; getting information about illness and its treatment and interaction with experts and also manifested as problematic use. Conclusions: It has implications for developing social networking based adjunctive treatment modality for psychological problems. PMID:25035548

  10. Influence of local delivery of the protein tyrosine kinase receptor inhibitor tyrphostin-47 on smooth-muscle cell proliferation in a rat carotid balloon-injury model.

    PubMed

    Gottsauner-Wolf, M; Jang, Y; Lincoff, A M; Cohen, J L; Labhasetwar, V; Poptic, E J; Forudi, F; Guzman, L A; DiCorleto, P E; Levy, R J; Topol, E J; Ellis, S G

    1997-03-01

    Smooth-muscle cell proliferation in response to arterial injury represents an important etiologic factor in restenosis after angioplasty. Tyrphostin-47, a protein tyrosine kinase inhibitor, inhibits smooth-muscle cell proliferation in vitro. In this study tyrphostin-47 was incorporated into matrixes to determine whether prolonged local delivery would result in a reduction of neointimal proliferation after arterial injury in a rat carotid balloon-injury model. A polymer matrix (polylactic polyglycolic acid copolymer and pluronic gel F-127, mean matrix weight 7.83 +/- 0.39 mg) was loaded with tyrphostin-47 (25% w/w). Release studies demonstrated delivery of 11% of the incorporated drug over a 21-day release period. In cell culture, tyrphostin-47 released from the polymer matrix produced a reduction in smooth-muscle cell proliferation (p < 0.0007). Balloon denudation injury of the left common carotid artery of 34 animals was performed. In 12 animals, polymer matrixes containing tyrphostin-47 were wrapped around the injured arteries to provide prolonged drug delivery (estimated dosage 28 micrograms/kg/24 hr); in 10 animals a polymer matrix without tyrphostin-47 was implanted; and in 12 animals only balloon injury was performed. The mean neointimal cross-sectional areas, luminal areas, and intima/media ratios were not significantly different among animals receiving local treatment with tyrphostin-47, sham polymer after injury, or balloon injury without polymer implantation. We conclude that despite inhibition of smooth-muscle cell proliferation by tyrphostin-47 in vitro, sustained local delivery of this tyrosine kinase inhibitor does not result in a reduction of neointimal proliferation in the rat carotid injury model. PMID:9060802

  11. A Comprehensive Evaluation of Perioperative Adjuncts During Minimally Invasive Parathyroidectomy

    PubMed Central

    Chen, Herbert; Mack, Eberhard; Starling, James R.

    2005-01-01

    Objective: To determine the utility of several perioperative adjuncts for parathyroid localization during parathyroid surgery, we prospectively compared the accuracy of sestamibi–single photon emission computed tomography (SPECT) scanning, radioguided surgery, and intraoperative parathyroid hormone (ioPTH) testing. Summary and Background Data: Minimally invasive parathyroidectomy (MIP) is rapidly becoming the procedure of choice in patients with primary hyperparathyroidism (HPT). Several perioperative adjuncts can be used to localize parathyroid adenomas, including sestamibi-SPECT scanning, radioguided surgery, and ioPTH testing. However, the relative value of each of these technologies is unclear. Methods: Between March 2001 through September 2004, 254 patients with primary HPT underwent parathyroidectomy. All patients had preoperative imaging studies and underwent radioguided surgery with a gamma probe and ioPTH testing. The use of each perioperative adjunct was determined based on the intraoperative findings. Results: The mean age of patients was 61 ± 1 year. The mean calcium and parathyroid hormone levels were 11.4 ± 0.1 mg/dL and 136 ± 6 pg/mL, respectively. Of the 254 patients, 206 (81%) had a single parathyroid adenoma, 28 (11%) had double adenomas, 19 (8%) had hyperplasia, and one had parathyroid cancer. All resected parathyroid glands were hypercellular (mean weight = 895 ± 86 mg). The cure rate after parathyroidectomy was 98%. The positive predictive values for sestamibi scanning, radioguided surgery, and ioPTH testing were 81%, 88%, and 99.5%, respectively. Conclusions: This series is one of the largest to date that prospectively compares the use of sestamibi scanning, radioguided surgery, and ioPTH testing. Of all the perioperative adjuncts used during parathyroid surgery, ioPTH testing has the highest sensitivity, positive predictive value, and accuracy. Thus, the inherent variability of sestamibi scanning and radioguided techniques emphasizes

  12. Dobutamine stress--Doppler echocardiography before and after coronary angioplasty.

    PubMed

    el-Said, E S; Fioretti, P M; Roelandt, J R; McNeill, A J; Rijsterborgh, H; Forster, T; Di Mario, C; Linker, D T

    1993-08-01

    To determine if dobutamine-induced myocardial ischaemia causes abnormalities in Doppler parameters of left ventricular ejection and filling and to assess early effects of successful coronary angioplasty (PTCA) on these parameters, dobutamine stress echocardiography and Doppler studies were performed once in 11 normal volunteers and twice in 17 patients (within 1 day pre- and post-PTCA). Dobutamine induced wall motion abnormalities, ST changes and angina in 11, five and five patients, respectively, before and three, two and one patients, respectively, after PTCA. Doppler indices of both systolic and diastolic function were comparable at rest, before and after PTCA. Dobutamine induced similar increases in peak aortic velocity and average acceleration in healthy individuals (39% and 53%) and in patients with one-vessel disease both before (38% and 39%) and after PTCA (39% and 40%). In the three patients with multivessel disease, peak aortic velocity showed a blunted response (-0.3%) before PTCA but increased by 17% after PTCA, while acceleration decreased both before (12%) and after PTCA (14%). There were significant differences (P < 0.0001) between healthy individuals and pre-PTCA patients in the effect of dobutamine on peak early (E) filling velocity (+34% vs -19%), E-acceleration (+35% vs -26%), peak early to atrial filling velocity ratio (E/A) (-0.7% vs -37%) and diastolic time velocity integral (TVI) (+34% vs -22%). After PTCA, the response of Doppler diastolic indices improved during dobutamine, as shown by the increase in E and E-acceleration (+8%, +24%), respectively) and by the decline in the reduction of E/A and TVI (-17% and -10%, respectively). Thus, the response of Doppler diastolic parameters to dobutamine stress is a sensitive indicator of significant coronary disease and is superior to changes in ejection indices. Successful PTCA resulted in an improved diastolic filling response to dobutamine stress. PMID:8404930

  13. Prediction of Prolonged Hemodynamic Instability During Carotid Angioplasty and Stenting

    PubMed Central

    Rhim, Jong Kook; Park, Jeong Jin; Choi, Hyuk Jai; Cho, Young Dae; Sheen, Seung Hun; Jang, Kyung-Sool

    2016-01-01

    Purpose The aim of this study was to assess the risk factors of prolonged hemodynamic instability (HDI) after carotid angioplasty and stenting (CAS). Herein, a simplified predictive scoring system for prolonged HDI is proposed. Materials and Methods Sixty-six patients who had CAS from 2011 to 2016 at a single institution were evaluated. Prolonged HDI was defined as systolic blood pressure >160 mm Hg or <90 mm Hg or heart rate <50 beats/min, lasting over 30 minutes despite medical treatments. For the study, clinical data and radiologic data, including plaque morphology and stenosis were analyzed. Results Prolonged HDI was observed in 21 patients (31.8%). Multivariable analysis revealed that calcification (OR, 6.726; p=0.006), eccentric stenosis (OR, 3.645; p=0.047) and extensive plaque distribution (OR, 7.169; p=0.006) were related to prolonged HDI. According to these results, a simplified scoring scale was proposed based on the summation of points: 2 points for calcified plaque, 2 points for extensive plaque distribution, and 1 point for eccentric stenosis. The percentages of prolonged HDI according to the total score were as follows: score 0, 8.7%; score 1, 20.0%; score 2, 38.5%; score 3, 72.7%; score 4, 66.7%; score 5, 100%. From the analysis, the total score in patients with prolonged HDI was significantly higher than those without prolonged HDI (p<0.001). Conclusion Prolonged HDI can be associated with calcification of plaque, eccentric stenosis and extensive plaque distribution, and a simplified scoring system enables prediction of prolonged HDI according to our cohort. PMID:27621949

  14. [Exercise tolerance in patients after successful percutaneous transluminal coronary angioplasty].

    PubMed

    Tsumoto, S; Nakagawa, Y; Asakuma, S; Naruse, H; Komasa, N; Ohyanagi, M; Tateishi, J; Yasutomi, N; Fujitani, K; Iwasaki, T

    1991-01-01

    In 32 patients with successful percutaneous transluminal coronary angioplasty (PTCA), we performed treadmill exercise tests (TMET) before and about one month after PTCA to assess the correlation between the improvement in coronary artery lesions and exercise tolerance. Either the Bruce protocol (B: n = 12) or the modified Bruce protocol (MB: n = 20) was used; with the latter being applied to patients whose cardiac function seemed depressed. In 15 patients, oxygen consumption (VO2) was measured by analyzing the expired gases, 13 patients underwent exercise thallium-201 myocardial perfusion scintigraphy before and after PTCA, whose results were compared with those of TMET. In both B and MB protocols, the treadmill walking time was significantly prolonged after PTCA, compared to that before PTCA (B: 7.4 +/- 1.3 vs 9.5 +/- 1.9, MB: 11.4 +/- 3.5 vs 12.7 +/- 3.5 min). Heart rates (HR) and rate pressure products (RPP) were significantly increased after PTCA in both protocols (HR B: 139 +/- 18 vs 154 +/- 17, MB: 121 +/- 20 vs 137 +/- 19 bpm, RPP B: 26,500 +/- 5,600 vs 30,300 +/- 6,700, MB: 19,400 +/- 6,200 vs 22,700 +/- 6,600 mmHg.bpm), however, systolic blood pressure did not change significantly after PTCA in either protocol. While there was a significant improvement in VO2 after PTCA (21.6 +/- 6.3 vs 25.7 +/- 4.2 ml/kg/min), the O2-pulse remained unchanged. Thallium-201 myocardial scintigraphy revealed improvement of myocardial perfusion in 8 of the 13 cases examined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1841916

  15. Salvage of Immature Arteriovenous Fistulas with Percutaneous Transluminal Angioplasty

    SciTech Connect

    Shin, Sung Wook; Do, Young Soo Choo, Sung Wook; Lieu, Wei Chiang; Choo, In-Wook

    2005-05-15

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

  16. Exploring the potential of adjunct therapy in tuberculosis.

    PubMed

    Rayasam, Geetha Vani; Balganesh, Tanjore S

    2015-08-01

    A critical unmet need for treatment of drug-resistant tuberculosis (TB) is to find novel therapies that are efficacious, safe, and shorten the duration of treatment. Drug discovery approaches for TB primarily target essential genes of the pathogen Mycobacterium tuberculosis (Mtb) but novel strategies such as host-directed therapies and nonmicrobicidal targets are necessary to bring about a paradigm shift in treatment. Drugs targeting the host pathways and nonmicrobicidal proteins can be used only in conjunction with existing drugs as adjunct therapies. Significantly, host-directed adjunct therapies have the potential to decrease duration of treatment, as they are less prone to drug resistance, target the immune responses, and act via novel mechanism of action. Recent advances in targeting host-pathogen interactions have implicated pathways such as eicosanoid regulation and angiogenesis. Furthermore, several approved drugs such as metformin and verapamil have been identified that appear suitable for repurposing for the treatment of TB. These findings and the challenges in the area of host- and/or pathogen-directed adjunct therapies and their implications for TB therapy are discussed. PMID:26073420

  17. Adjunctive metformin for antipsychotic-induced hyperprolactinemia: A systematic review.

    PubMed

    Bo, Qi-Jing; Wang, Zhi-Min; Li, Xian-Bin; Ma, Xin; Wang, Chuan-Yue; de Leon, Jose

    2016-03-30

    This systematic review examines adjunctive metformin therapy for the treatment of antipsychotic-induced hyperprolactinemia. A computerized search of databases in Chinese and the international databases in English provided three trials with a total of 325 patients including one randomized clinical trial (RCT) and two observational studies (single-group, before-after design). A meta-analysis could not be conducted. The quality of evidence ranged from "very low" to "moderate". Metformin patients had a significant decrease in serum prolactin level with a mean of 54.6μg/l in the three trials. In the RCT, menstruation restarted in 67% of those with menstrual disturbances versus 5% in placebo. In one observational study, 91% of patients no longer had signs or symptoms of galactorrhea. In the RCT, adverse drug reactions (ADRs) occurred at similar incidence rates among metformin and placebo patients, except that no significant increases in nausea, insomnia and agitation occurred which were not associated with discontinuations. Our systematic review indicated that adjunctive metformin significantly lowered prolactin level and relieved prolactin-related symptoms in patients with antipsychotic-induced hyperprolactinemia. Future higher quality RCTs need to verify the currently available limited evidence based on three trials which suggest that adjunctive metformin may be used effectively and safely for antipsychotic-induced hyperprolactinemia. PMID:26822064

  18. Percutaneous Mitral Valve Dilatation: Single Balloon versus Double Balloon - A Finite Element Study

    SciTech Connect

    Schievano, Silvia; Kunzelman, Karyn; Nicosia, Mark; Cochran, R. P.; Einstein, Daniel R.; Khambadkone, Sachin; Bonheoffer, Philipp

    2009-01-01

    Background: Percutaneous mitral valve (MV) dilatation is performed with either a single balloon (SB) or double balloon (DB) technique. The aim of this study was to compare the two balloon system results using the finite element (FE) method. Methods and Results: An established FE model of the MV was modified by fusing the MV leaflet edges at commissure level to simulate a stenotic valve (orifice area=180mm2). A FE model of a 30mm SB (low-pressure, elastomeric balloon) and an 18mm DB system (high-pressure, non-elastic balloon) was created. Both SB and DB simulations resulted in splitting of the commissures and subsequent stenosis dilatation (final MV area=610mm2 and 560mm2 respectively). Stresses induced by the two balloon systems varied across the valve. At the end of inflation, SB showed higher stresses in the central part of the leaflets and at the commissures compared to DB simulation, which demonstrated a more uniform stress distribution. The higher stresses in the SB analysis were due to the mismatch of the round balloon shape with the oval mitral orifice. The commissural split was not easily accomplished with the SB due to its high compliance. The high pressure applied to the DB guaranteed the commissural split even when high forces were required to break the commissure welds. Conclusions: The FE model demonstrated that MV dilatation can be accomplished by both SB and DB techniques. However, the DB method resulted in higher probability of splitting of the fused commissures and less damage caused to the MV leaflets by overstretching.

  19. Local arterial wall drug delivery using balloon catheter system.

    PubMed

    Tesfamariam, Belay

    2016-09-28

    Balloon-based drug delivery systems allow localized application of drugs to a vascular segment to reduce neointimal hyperplasia and restenosis. Drugs are coated onto balloons using excipients as drug carriers to facilitate adherence and release of drug during balloon inflation. Drug-coated balloon delivery system is characterized by a rapid drug transfer that achieves high drug concentration along the vessel wall surface, intended to correspond to the balloon dilation-induced vascular injury and healing processes. The balloon catheter system allows homogenous drug delivery to the vessel wall, such that the drug release per unit surface area is kept constant along balloons of different lengths. Optimization of the balloon coating matrix is essential for efficient drug transfer and tissue retention until the artery remodels to a normal set point. Challenges in the development of balloon-based drug delivery to the arterial wall include finding suitable excipients for drug formulation to enable drug release to a targeted lesion site effectively, maintain coating integrity during transit, prolong tissue retention and reduce particulate generation. This review highlights various factors involved in the successful design of balloon-based delivery systems, including drug release kinetics, matrix coating transfer, transmural drug partitioning, dissolution rate and release of unbound active drug. PMID:27473765

  20. Overview of the Scientific Balloon Activity in Japan

    NASA Astrophysics Data System (ADS)

    Yoshida, Tetsuya

    Institute of Space and Astronautical Science (ISAS) of Japan Aerospace Exploration Agency (JAXA) has conducted scientific ballooning in Japan for almost fifty years. Recent stratospheric balloon operations at Taiki Aerospace Research Field (TARF), Hokkaido, produce significant space science achievements. We have also developed new TT&&C system onboard which realize user-friendly interface between payloads and the balloon system. For the developments of next generation balloons, a tawara-shaped superpressure balloon (SPB) fabricating with polyethylene film was inflated in the TARF hangar in order to verify its pressure resistance. Since polyethylene balloons can float on the recovery, we will be able to carry out flight tests of tawara-shaped SPB repeatedly with no impact on the ocean pollution. The development of high altitude balloons with ultra-thin film was successful, and the flight performance will be presented in another presentation. In order to realize long duration balloon flights, which are quite difficult to be conducted in Japan, Japanese community eager to have complementary balloon campaigns in foreign countries. After two year discussion with Australian government and the University of New South Wales, ISAS will carry out two balloon launches at Alice Springs, Northern Territory, in 2014 Austral summer. Plans and schedule of this Australian campaign will also be discussed in this presentation.