| 1. |
- Acosta, Stefan, et al.
(författare)
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Endovascular Therapeutic Approaches for Acute Superior Mesenteric Artery Occlusion.
- 2009
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Ingår i: Cardiovascular and Interventional Radiology. - : Springer Science and Business Media LLC. - 1432-086X .- 0174-1551. ; 32, s. 896-905
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to characterize the outcome of attempted endovascular intervention in patients with acute embolic or thrombotic superior mesenteric artery (SMA) occlusion. The records of 21 patients during a 3-year period between 2005 and 2008 were retrieved from the in-hospital registry. The first group included 10 patients (6 women and 4 men; median age 78 years) with acute embolic occlusion of the SMA. The median duration of symptoms from symptom onset to angiography was 30 hours (range 6 to 120). Synchronous emboli (n = 12) occurred in 6 patients. Embolus aspiration was performed in 9 patients, and 7 of these had satisfactory results. Complementary local thrombolysis was successful in 2 of 3 patients. Residual emboli were present at completion angiography in all 7 patients who underwent successful aspiration embolectomy, and bowel resection was necessary in only 1 of these patients. One serious complication occurred because of a long SMA dissection. The in-hospital survival rate was 90% (9 of 10 patients). The second group included 11 patients (10 women and 1 man; median age 68 years) with atherosclerotic acute SMA occlusions. The median time of symptom duration before intervention was 97 hours (range 17 to 384). The brachial, femoral, and SMA routes were used in 6, 7, and 5 patients, respectively. SMA stenting was performed through an antegrade (n = 7) or retrograde (n = 3) approach. Bowel resection was necessary in 4 patients. No major complications occurred. The in-hospital survival rate was 82% (9 of 11 patients). Endovascular therapy of acute SMA occlusion provides a good alternative to open surgery.
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| 2. |
- Allers, Mats, et al.
(författare)
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A New Method of Selective, Rapid Cooling of the Brain: An Experimental Study.
- 2006
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Ingår i: Cardiovascular and Interventional Radiology. - : Springer Science and Business Media LLC. - 1432-086X .- 0174-1551. ; 29:2, s. 260-263
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To determine whether retrograde perfusion of cooled blood into one internal jugular vein (IJV) in the pig can selectively reduce the brain temperature without affecting the core body temperature (CBT). Methods: In 7 domestic pigs, the left IJV was catheterized on one side and a catheter placed with the tip immediately below the rete mirabile. Thermistors were placed in both brain hemispheres and the brain temperature continuously registered. Thermistors placed in the rectum registered the CBT. From a catheter in the right femoral vein blood was aspirated with the aid of a roller pump, passed through a cooling device, and infused into the catheter in the left IJV at an initial rate of 200 ml/min. Results: Immediately after the start of the infusion of cooled blood (13.8 degrees C) into the IJV, the right brain temperature started to drop from its initial 37.9 degrees C and reached 32 degrees C within 5 min. By increasing the temperature of the perfusate a further drop in the brain temperature was avoided and the brain temperature could be kept around 32 degrees C during the experiment. In 4 of the animals a heating blanket was sufficient to compensate for the slight drop in CBT during the cooling period. Conclusions: We conclude that brain temperature can be reduced in the pig by retrograde perfusion of the internal jugular vein with cooled blood and that the core body temperature can be maintained with the aid of a heating blanket.
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| 3. |
- Berry, Max, 1969, et al.
(författare)
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Porcine transfer study: virtual reality simulator training compared with porcine training in endovascular novices
- 2007
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Ingår i: Cardiovasc Intervent Radiol. - : Springer Science and Business Media LLC. - 0174-1551. ; 30:3, s. 455-61
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To compare the learning of endovascular interventional skills by training on pig models versus virtual reality simulators. METHODS: Twelve endovascular novices participated in a study consisting of a pig laboratory (P-Lab) and a virtual reality laboratory (VR-Lab). Subjects were stratified by experience and randomized into four training groups. Following 1 hr of didactic instruction, all attempted an iliac artery stenosis (IAS) revascularization in both laboratories. Onsite proctors evaluated performances using task-specific checklists and global rating scales, yielding a Total Score. Participants completed two training sessions of 3 hr each, using their group's assigned method (P-Lab x 2, P-Lab + VR-Lab, VR-Lab + P-Lab, or VR-Lab x 2) and were re-evaluated in both laboratories. A panel of two highly experienced interventional radiologists performed assessments from video recordings. ANCOVA analysis of Total Score against years of surgical, interventional radiology (IR) experience and cumulative number of P-Lab or VR-Lab sessions was conducted. Inter-rater reliability (IRR) was determined by comparing proctored scores with the video assessors in only the VR-Lab. RESULTS: VR-Lab sessions improved the VR-Lab Total Score (beta = 3.029, p = 0.0015) and P-Lab Total Score (beta = 1.814, p = 0.0452). P-Lab sessions increased the P-Lab Total Score (beta = 4.074, p < 0.0001) but had no effect on the VR-Lab Total Score. In the general statistical model, both P-Lab sessions (beta = 2.552, p = 0.0010) and VR-Lab sessions (beta = 2.435, p = 0.0032) significantly improved Total Score. Neither previous surgical experience nor IR experience predicted Total Score. VR-Lab scores were consistently higher than the P-Lab scores (Delta = 6.659, p < 0.0001). VR-Lab IRR was substantial (r = 0.649, p < 0.0008). CONCLUSIONS: Endovascular skills learned in the virtual environment may be transferable to the real catheterization laboratory as modeled in the P-Lab.
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| 4. |
- Bilos, Linda, et al.
(författare)
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EndoVascular and Hybrid Trauma Management (EVTM) for Blunt Innominate Artery Injury with Ongoing Extravasation
- 2017
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Ingår i: Cardiovascular and Interventional Radiology. - New York, USA : Springer. - 0174-1551 .- 1432-086X. ; 40:1, s. 130-134
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Tidskriftsartikel (refereegranskat)abstract
- Innominate artery (IA) traumatic injuries are rare but life-threatening, with high mortality and morbidity. Open surgical repair is the treatment of choice but is technically demanding. We describe a case of blunt trauma to the IA with ongoing bleeding, treated successfully by combined (hybrid) endovascular and open surgery. The case demonstrates the immediate usage of modern endovascular and surgical tools as part of endovascular and hybrid trauma management.
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| 5. |
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| 6. |
- Cwikiel, Wojciech, et al.
(författare)
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Disappearance of esophageal carcinoma after stenting combined with endoscopic laser therapy
- 1995
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Ingår i: Cardiovascular and Interventional Radiology. - 0174-1551. ; 18:4, s. 247-250
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Tidskriftsartikel (refereegranskat)abstract
- A 92-year-old man with dysphagia secondary to squamous cell carcinoma of the esophagus was palliated repeatedly with endoscopic laser therapy and insertion of esophageal stents. During the treatment period of 32 months, the patient could be fed perorally while ingrowth of tumor, development of new stenoses at the edges of the stents, and breakage of one stent were encountered. A tracheoesophageal fistula developed at the upper edge of the first stent. The patient died from aspiration pneumonia. At autopsy, no cancer cells were found in the esophagus. Combined endoscopic laser treatment and stent therapy may keep a patient free from dysphagia during a long period of time and also may result in the complete disappearance of tumor growth in the esophagus.
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| 7. |
- Cwikiel, Wojciech, et al.
(författare)
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Endovascular Treatment of Two Pseudoaneurysms Originating From the Left Ventricle.
- 2013
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Ingår i: Cardiovascular and Interventional Radiology. - : Springer Science and Business Media LLC. - 1432-086X .- 0174-1551. ; 36:6, s. 1677-1680
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Tidskriftsartikel (refereegranskat)abstract
- A 67-year-old woman resented with an acute type A aortic dissection, which was treated surgically with aortic valve replacement as a composite graft with reimplantation of the coronary arteries. At the end of surgery, a left-ventricular venting catheter was placed through the apex and closed with a buffered suture. Consecutive computed tomography (CT) examinations verified a growing apex pseudoaneurysm. Communication between the ventricle and the pseudoaneurysm was successfully closed with an Amplatz septal plug by the transfemoral route. Follow-up CT showed an additional pseudoaneurysm, which also was successfully closed using the same method.
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| 8. |
- Ebeling Barbier, Charlotte, et al.
(författare)
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Percutaneous Closure in Transfemoral Aortic Valve Implantation : A Single-Centre Experience
- 2015
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Ingår i: Cardiovascular and Interventional Radiology. - : Springer Science and Business Media LLC. - 0174-1551 .- 1432-086X. ; 38:6, s. 1438-1443
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To report the experience of a percutaneous closure device used for transfemoral transcatheter aortic valve implantation (TAVI) in an unselected patient and operator population.MATERIALS AND METHODS: Eighty-two consecutive patients (32 women, 50 men) who underwent transfemoral TAVI between September 2009 and February 2014 at our hospital were retrospectively reviewed for percutaneous closure device (PCD) failure, vascular complications, and bleeding. The diameter and calcification of the common femoral artery (CFA) and the thickness of the subcutaneous fat layer in the groin were assessed on computed tomography images.RESULTS: The incidences of PCD failure and minor and major vascular complications were 19.5 % (n = 16/82), 19.5 % (n = 16/82), and 7 % (n = 6/82) respectively. 8.5 % (n = 7/82) had a minor perioperative bleeding, 6 % (n = 5/82) had a major bleeding, and none had any life-threatening bleeding. When PCD failed, haemostasis was obtained with fascia suturing, covered stent placement, or with surgical cutdown. Thirty-day mortality and 1-year all-cause mortality were 8.5 % (n = 7/82) and 19.5 % (n = 16/82), respectively. In a multiple regression analysis, the CFA diameter and the presence of severe calcification were independently related to PCD failure (correlation coefficient = -0.24, p = 0.027 and correlation coefficient = 0.23, p = 0.036, respectively).CONCLUSION: PCD failure was related to a small CFA diameter and to a severely calcified CFA. Failure could largely be managed with minimally invasive techniques such as covered stents or fascia suturing.
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| 9. |
- Harnek, Jan, et al.
(författare)
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Insertion of Self-Expandable Nitinol Stents Without Previous Balloon Angioplasty Reduces Restenosis Compared with PTA Prior to Stenting.
- 2002
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Ingår i: Cardiovascular and Interventional Radiology. - : Springer Science and Business Media LLC. - 1432-086X .- 0174-1551. ; 25:3, s. 430-436
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Tidskriftsartikel (refereegranskat)abstract
- 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 intima p <0.05) and 83% and 74% higher intima/media ratio (p <0.05) compared with groups 1 and 3, respectively. Conclusion: Insertion of a self-expandable nitinol stent without previous PTA results in less intimal hyperplasia than if PTA is performed prior to stenting, suggesting that direct stenting can be used in angioplasty sessions with a favorable outcome.
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| 10. |
- Hinchliffe, R, et al.
(författare)
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Endovascular Aneurysm Repair: Current and Future Status.
- 2008
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Ingår i: Cardiovascular and Interventional Radiology. - : Springer Science and Business Media LLC. - 0174-1551 .- 1432-086X. ; 31, s. 451-459
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Tidskriftsartikel (refereegranskat)abstract
- Endovascular aneurysm repair has rapidly expanded since its introduction in the early 1990s. Early experiences were associated with high rates of complications including conversion to open repair. Perioperative morbidity and mortality results have improved but these concerns have been replaced by questions about long-term durability. Gradually, too, these problems have been addressed. Challenges of today include the ability to roll out the endovascular technique to patients with adverse aneurysm morphology. Fenestrated and branch stent-graft technology is in its infancy. Only now are we beginning to fully understand the advantages, limitations, and complications of such technology. This paper outlines some of the concepts and discusses the controversies and challenges facing clinicians involved in endovascular aneurysm surgery today and in the future.
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