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1.
Ideggyogy Sz ; 74(3-4): 129-134, 2021 Mar 30.
Artículo en Húngaro | MEDLINE | ID: mdl-33938665

RESUMEN

In SARS-CoV-2 positive patients with corresponding neurological symptoms the presence of carotid bifurcation macrothrombus should always be considered. Hypercoagulopathy caused by viral endotheliitis, systemic inflammation and cytokine storm play an important role in its development. Here we present two patients treated with different treatment strategies because of carotid bifurcation macrothrombus as a complication of SARS-CoV-2 infection. In both cases, the soft macrothrombus was eliminated and the patients' neurological condition were improved. Intravenous thrombolysis, acute carotid stenting with embolic filter protection device and mechanical thrombectomy with aspiration are effective treatments.


Asunto(s)
Accidente Cerebrovascular , Trombosis , Humanos , Stents , Trombectomía , Trombosis/diagnóstico por imagen , Trombosis/etiología , Trombosis/terapia , Resultado del Tratamiento
2.
Arch Esp Urol ; 74(4): 389-396, 2021 May.
Artículo en Español | MEDLINE | ID: mdl-33942730

RESUMEN

OBJECTIVE: Aim of our study was to evaluate the effectiveness and safety of the preoperative placement of JJ stent compared to not doing in patients undergoing ureteroscopy for ureteral and kidney stone. MATERIALS AND METHODS: Prospective, observational, multicenter study. Adult patients, who underwent ureteroscopy treatment for ureteral and kidney stone, were recruited from August 2017 to March 2019, in 23 Argentine institutions. The variables analyzed included: demographic data, stone size and location, stone-free rate (SFR) and complications. RESULTS: 580 patients were included. 473 with ureteral stone (309 with and 164 without prior JJ stent) and 107 with kidney stone (77 with and 30 without prior JJ stent). The SFR was higher in the group with previous JJ stent, both in the treatment of ureteral stone (82.2% vs. 90.9%, OR 2.15 (1.17 to 3.96)), and in the treatment of kidney stone (73.3% vs. 89.6%, OR 3.14 (1.02 to 9.61)). No differences were established in the complication rate both in the treatment of ureteral stone (6.1 vs. 6.1%, OR 0.98 (0.45 to 2.19)) and in the treatment of kidney stone (6.7 vs. 5.2%, OR 0.76 (0.13 a 4.46)). CONCLUSIONS: The preoperative placement of JJ stent, increases SFR in the treatment of ureteral and kidney stone, but not decrease the complication rate.


Asunto(s)
Cálculos Renales , Uréter , Adulto , Humanos , Cálculos Renales/cirugía , Estudios Prospectivos , Stents , Resultado del Tratamiento , Uréter/cirugía
3.
Arch Esp Urol ; 74(4): 435-440, 2021 May.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33942736

RESUMEN

OBJECTIVES: To describe first clinical results in term of safety, complications and short term efficacy of temporary placement of UVENTA urethral stent in the treatment of urethral and bladder neck strictures. METHODS: UVENTA urethral stent (Taewoong Medical) is a temporary self expandable covered metallic stent. Anti-migration system and different radial force distribution are the two main innovations. This is a retrospective evaluation of UVENTA stent temporary placements for urethral diseases in two urological Centers. RESULTS: 15 patients underwent UVENTA stent placement between 2016 and 2018. Stent placement was easy and quick in all cases. Considering indwelling period: one patient reported urethral pain related to the stent in the first month, three patients had urinary infection treated with antibiotics; temporary stress incontinence was noted in 21% of bulbar-membranous stents; stent migrations was noted in 3 out of 4 bladder neck cases whereas no bulbar-membranous stents migrated. At removal no significant incrustation, stone or tissue ingrowth were noted, as well as new proximal or distal strictures. Stent removal was uncomplicated in all cases. Median follow up is 9.5 months (6-24). Considering strictures overall success rate is 73% (11/15): 82% for bulbar urethra (9/11) and 50% for bladder neck (2/4). CONCLUSIONS: UVENTA urethral stent showed a satisfying safety profile with few and low grade complications. Absence of migration and damage on healthy mucosa are main achievements. Further cases are needed to confirm these results and to really explore its efficacy.


Asunto(s)
Stents , Uretra , Remoción de Dispositivos , Humanos , Masculino , Estudios Retrospectivos , Uretra/cirugía
4.
Medicina (B Aires) ; 81(2): 282-285, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33906148

RESUMEN

Total anomalous pulmonary venous drainage is a rare and diverse anomaly, accounting for 1% to 3% of patients with congenital heart disease. Newborns with diagnosis of an obstructed total anomalous pulmonary venous dainage are extremely ill soon after birth and often present with severe cyanosis, pulmonary hypertension and low cardiac output requiring urgent surgical intervention. Transcatheter palliative stenting of the obstructive vertical vein can be an acceptable alternative as a bailout intervention before complete surgical correction is undertaken. This report of two cases highlights the feasibility, safety and effectiveness of the interventional palliative procedure and confirms that this technique can be an acceptable and attractive bridge in the algorithm of medical decisions during the evaluation of these critical patients.


Asunto(s)
Cardiopatías Congénitas , Hipertensión Pulmonar , Venas Pulmonares , Drenaje , Humanos , Recién Nacido , Venas Pulmonares/diagnóstico por imagen , Venas Pulmonares/cirugía , Stents
5.
Zh Nevrol Psikhiatr Im S S Korsakova ; 121(3. Vyp. 2): 38-45, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33908231

RESUMEN

OBJECTIVE: To analyze hospital and long-term results of stenting of the V1 segment of the vertebral artery (VA) in the first hours after acute cerebral hemopoiesis/transient ischemic attack (stroke/TIA) in the vertebrobasilar territory (VT). MATERIAL AND METHODS: The current retrospective study from 2012 to 2019 included 169 patients with hemodynamically significant stenosis of the V1 segment of the VA, who underwent emergency stenting in the first hours after the onset of stroke. The mean time between the development of stroke and correction was 368.5±129.8 minutes. The average time between admission to the medical institution and submission to the X-ray operating room was 89.2±10.7 minutes. VA stenting was performed through the transfemoral approach. In 118 cases (69.8%) a drug eluting stent was implanted, in 51 (30.2%) a bare metal stent was implanted. 90% of VA segment V1 stenosis was diagnosed in 48 patients before the onset of stroke. Of these, 33 received conservative therapy for vertebrobasilar insufficiency (VBI) for 2.5±1.0 months in anticipation of regression of the disease. The remaining 15 did not have VBI symptoms and did not need active drug treatment. Ultimately, within this sample, the time interval between the visualization of stenosis and the onset of stroke was 3.0±1.0 months. In 17 patients, stroke/TIA in VT became recurrent. The period between two neurological events was 1.5±0.5 months. Nine patients did not wait for the planned intervention due to the development of an adverse neurological event before the appointed date of hospitalization. The other 8 did not appear for the interventional correction on time due to subjective reasons and were again admitted to the medical facility on an urgent basis. RESULTS: During the hospital follow-up period, no adverse cardiovascular events were recorded. When assessing the dynamics in the neurological status, there was a significant regression of the deficit by the time of discharge from the hospital. In the long-term follow-up period (38.2±20.4 months), a fatal outcome was recorded in 2.4% of cases (n=4). Non-fatal myocardial infaction was diagnosed in 5 patients (2.9%). Restenosis of the stent in the VA was visualized in 56 patients (33.1%). In 17 cases, it became symptomatic (10.0%). All patients underwent repeated stenting with a successful result of the procedure. CONCLUSION: Emergency stenting of hemodynamically significant stenosis of the V1 segment of the VA in the acute period of stroke in VT is a safe and effective method of revascularization characterized by the absence of adverse cardiovascular events at the hospital stage of observation.


Asunto(s)
Isquemia Encefálica , Stents Liberadores de Fármacos , Accidente Cerebrovascular , Insuficiencia Vertebrobasilar , Isquemia Encefálica/etiología , Estudios de Seguimiento , Humanos , Estudios Retrospectivos , Stents , Accidente Cerebrovascular/etiología , Resultado del Tratamiento , Insuficiencia Vertebrobasilar/diagnóstico por imagen , Insuficiencia Vertebrobasilar/cirugía
6.
Medicine (Baltimore) ; 100(15): e25484, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33847656

RESUMEN

BACKGROUND: Percutaneous coronary intervention (PCI) has become one of the effective methods for the treatment of coronary heart disease (CHD). However, it is easy to have in-stent restenosis (ISR), even cardiovascular events after PCI, which affects the therapeutic effects. The incidence of ISR in diabetes mellitus (DM) patients increased by 2 to 4 times. Early identification of the risk factors of ISR in DM patients after PCI may help clinical staff to prevent and intervene as soon as possible, so it is very important to improve the clinical outcomes of DM patients. Although scholars at home and abroad have studied and summarized the risk factors of ISR in DM patients after PCI, the conclusions are different. Therefore, in this study, meta-analysis was used to summarize the risk factors of ISR in DM patients after PCI, and to explore the characteristics of high-risk groups of ISR, thus providing reference for early identification and prevention of ISR. METHODS: We will search related literature from PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine Database, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Database. Eligible studies will be screened based on inclusion criteria. Meanwhile, data extraction, risk of bias assessment, publication bias assessment, subgroup analysis, and quality assessment will be performed. Review Manager Version 5.3 software will be applied for data analysis. Each process is independently conducted by 2 researchers. If there is any objection, it will be submitted to a third researcher for resolution. RESULTS: We will disseminate the findings of this systematic review and meta-analysis via publications in peer-reviewed journals. CONCLUSIONS: The results of this analysis can be used to generate a risk prediction model and provide an intervention strategy for the occurrence of ISR in DM patients after PCI. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/WC87Y.


Asunto(s)
Enfermedad Coronaria/cirugía , Reestenosis Coronaria/prevención & control , Cardiomiopatías Diabéticas/cirugía , Intervención Coronaria Percutánea/efectos adversos , Complicaciones Posoperatorias/prevención & control , Stents/efectos adversos , Adulto , Enfermedad Coronaria/fisiopatología , Reestenosis Coronaria/etiología , Diabetes Mellitus , Cardiomiopatías Diabéticas/fisiopatología , Femenino , Humanos , Incidencia , Masculino , Metaanálisis como Asunto , Estudios Observacionales como Asunto , Complicaciones Posoperatorias/etiología , Proyectos de Investigación , Medición de Riesgo , Factores de Riesgo , Revisiones Sistemáticas como Asunto
7.
Harefuah ; 160(4): 210-214, 2021 Apr.
Artículo en Hebreo | MEDLINE | ID: mdl-33899368

RESUMEN

INTRODUCTION: Treatment of atherosclerotic renal artery stenosis (RAS) is still controversial. Several randomized controlled trials have shown that percutaneous transluminal renal angioplasty with stenting (PTRAS) is not superior to medical treatment, and the procedure is commonly reserved for malignant hypertension, flash pulmonary edema or deterioration of kidney function. The most challenging symptomatic RAS cases are patients with severe stenosis resulting in acute kidney injury (AKI) requiring acute hemodialysis. The risk-benefit ratio in these cases is uncertain. While those patients might benefit the most from revascularization, the success rate after prolonged time on dialysis is unknown. This is a representative case study of a patient with solitary kidney and high grade RAS who presented with anuric AKI indicated for hemodialysis. Twenty-eight days after starting hemodialysis the patient underwent PTRAS as a rescue therapy and 5 days after the procedure urine output resumed, the patient became polyuric and kidney function improved and the patient stopped hemodialysis.


Asunto(s)
Lesión Renal Aguda , Angioplastia de Balón , Obstrucción de la Arteria Renal , Lesión Renal Aguda/etiología , Lesión Renal Aguda/terapia , Angioplastia , Humanos , Riñón , Obstrucción de la Arteria Renal/complicaciones , Obstrucción de la Arteria Renal/terapia , Diálisis Renal , Stents , Resultado del Tratamiento
8.
Zhongguo Yi Liao Qi Xie Za Zhi ; 45(2): 119-124, 2021 Apr 08.
Artículo en Chino | MEDLINE | ID: mdl-33825367

RESUMEN

Effects of heat treatment conditions (including temperature and time) on the shape memory recovery and corrosion resistance of NiTi self-expanding vascular stents were studied based on working mechanism and clinical use. The Af temperature, dimensional recovery, crush resistance with radially applied load and point applied load of stents and corrosion resistance were characterized in diffident heat treatment conditions. The research results allow the conclusion that the stent treated at 500 ℃ for 10 min has optimum performance, and corrosion resistance meets the requirements.


Asunto(s)
Aleaciones , Calor , Corrosión , Ensayo de Materiales , Stents , Propiedades de Superficie , Temperatura , Titanio
9.
Zhongguo Yi Liao Qi Xie Za Zhi ; 45(2): 183-187, 2021 Apr 08.
Artículo en Chino | MEDLINE | ID: mdl-33825379

RESUMEN

Biliary stent has been widely used in the treatment of biliary stricture and obstruction, it can relieve the pain of patients effectively, but bacterial infection and stent obstruction are still troublesome after surgery. We introduce the mechanism of infection and stent blockage caused by bacterial invasion after biliary stent implantation, and expound the formation mechanism of bacterial biofilm and bile sludge in this review. Antibacterial biliary stent is an effective way to inhibit biliary tract infection, the literatures on antibacterial modification of biliary stent with different antibacterial methods in domestic and abroad are reviewed, and the research prospect of antibacterial biliary stent is summarized and prospected.


Asunto(s)
Sistema Biliar , Colestasis , Antibacterianos/farmacología , Bilis , Humanos , Stents
10.
Angiol Sosud Khir ; 27(1): 48-51, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33825728

RESUMEN

Analysed in the article are the results of ultrasonographic examination of patency of venous stents implanted in 86 patients with obstructive lesions of the iliofemoral segment of deep veins. The authors proposed an algorithm of triplex scanning, making it possible to optimize ultrasonographic examination, as well as increasing the accuracy of assessing the state of the stent and patency of the stented segments of veins. The first stage was to examine the state of the stented venous segment in the mode of grey-scale scanning (B-mode), for which purpose the study was performed in the longitudinal and transverse projections. This made it possible to determine the qualitative state of the stent as either presence or absence of its migration and deformation, completeness of expansion, extravasal compression. The second stage was to locate the venous stent in the mode of colour Doppler mapping (CD-mode), thus making it possible to assess stent patency. The third stage was examination in the spectral Doppler mode with the use of the distal compression test. Ultrasonographically detected phasic, respiration-synchronized blood flow with an increase of its linear velocity proximal to the stent in distal compression (positive compression test) is suggestive of no obstructive alterations in the stent's lumen. Determination of the blood flow velocity makes it possible to evaluate the stent patency or stenotic alterations. Monophasic low-velocity blood flow in the ipsilateral common femoral artery may also be indirectly indicative of impaired stent patency (pronounced stenosis, thrombosis, occlusion). The proposed algorithm of ultrasonographic triplex study of patency of venous stents may be used in out-patient conditions repeatedly and safely for the patient.


Asunto(s)
Vena Ilíaca , Trombosis de la Vena , Algoritmos , Vena Femoral , Humanos , Vena Ilíaca/diagnóstico por imagen , Flebografía , Estudios Retrospectivos , Stents , Resultado del Tratamiento , Grado de Desobstrucción Vascular
11.
Angiol Sosud Khir ; 27(1): 53-64, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33825729

RESUMEN

The article deals with problems of endovascular treatment of acute tandem and isolated occlusions of arteries of the anterior cerebral circulation, as well as the problem of reocclusions and new occlusions of these target arteries in the early postoperative period after thrombectomy. PURPOSE: To determine the effect of reocclusions and new, previously not identified occlusions of the carotid artery and middle cerebral artery after cerebral thrombectomy on the outcomes of ischaemic stroke, as well as to substantiate feasibility of endovascular policy without simultaneous carotid stenting in thrombectomy in case of tandem occlusions of arteries of the anterior cerebral circulation. PATIENTS AND METHODS: We studied the results of endovascular treatment of 52 patients with acute ischaemic stroke, including 26 patients with combined occlusions of the internal carotid and middle cerebral arteries (group 1) and 26 patients with isolated occlusion of the M1 segment of the middle cerebral artery or its equivalent (group 2). The groups were compared using the Chi-squared and Mann-Whitney test, and the effect of the factors was assessed by calculating the relative risk. RESULTS: Disability of patients in group 1 was significantly two-fold higher as compared with group 2. Differences in mortality and frequency of a good functional outcome (0-2 points on the Rankin scale) were, on the contrary, insignificant. Reocclusion of the internal carotid artery demonstrated no significant influence on outcomes of the disease in combined type of the lesion. Reocclusion of the target vessel after thrombectomy significantly decreased the probability of a good functional outcome in patients 1.7-fold (p<0.05), as well as increased the relative risk of disability 4-fold in initially isolated occlusion of the middle cerebral artery (p<0.05). CONCLUSION: Surgical policy aimed at thrombectomy from the middle cerebral artery in the presence of tandem occlusions of the internal carotid artery and middle cerebral artery without emergency carotid stenting is safe and efficient in acute period of ischaemic stroke. Reocclusion of the middle cerebral artery after performed thrombectomy related to its isolated occlusion increased the probability of patients' disability. Newly identified in the postoperative period occlusion of the internal carotid artery in thrombectomy from the middle cerebral artery also increased the risk of disability.


Asunto(s)
Isquemia Encefálica , Procedimientos Endovasculares , Accidente Cerebrovascular , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/etiología , Circulación Cerebrovascular , Procedimientos Endovasculares/efectos adversos , Humanos , Estudios Retrospectivos , Stents , Trombectomía , Resultado del Tratamiento
12.
Angiol Sosud Khir ; 27(1): 65-71, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33825730

RESUMEN

Presented herein is a clinical case report concerning successful simultaneous surgical treatment of a female patient with a complication after transcatheter treatment for chronic dissection of the descending portion of the thoracic aorta. The woman was subjected to elective transcatheter isolation of chronic dissection of the descending thoracic aorta using a stent graft with complete coverage of the zone of the origin of the left subclavian artery. Repeat control imaging studies several months after the intervention revealed residual blood flow through the false channel, directed retrogradely from the distal edge of the stent graft to the left subclavian artery. Besides, the patient was also found to have local dissection of the distal part of the ascending aorta (zone 0). An operative intervention was performed: sternotomy, prosthetic repair of the ascending portion of the aorta and part of the aortic arch, as well as transposition of the left subclavian artery to the left common carotid artery. The control imaging studies confirmed radical removal of the false aneurysm of the ascending aorta and the presence of total thrombosis of the false channel at the level of the stent graft.


Asunto(s)
Aneurisma Disecante , Aneurisma de la Aorta Torácica , Implantación de Prótesis Vascular , Procedimientos Endovasculares , Aneurisma Disecante/diagnóstico , Aneurisma Disecante/etiología , Aneurisma Disecante/cirugía , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/cirugía , Aneurisma de la Aorta Torácica/diagnóstico , Aneurisma de la Aorta Torácica/cirugía , Implantación de Prótesis Vascular/efectos adversos , Femenino , Humanos , Stents , Resultado del Tratamiento
13.
Angiol Sosud Khir ; 27(1): 159-163, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33825743

RESUMEN

A false aneurysm of the axillary artery is an extremely rare complication of a lesion of this vessel. As few as several dozens of similar cases have been described in the available literature. We herein report a clinical case concerning surgical treatment of a 41-year-old patient who after a knife-inflicted injury had developed a 66x67 mm pseudoaneurysm of the axillary artery. The treatment consisted of several stages, thus requiring 2 hospitalizations. The first stage included an attempt to resect the aneurysm in an open fashion, followed by deployment of stent grafts in the axillary artery to exclude the aneurysm from circulation. The second stage consisted in elimination of the aneurysmal cavity, followed by decompression of the branches of the brachial plexus and the axillary vein. The patient was discharged on postoperative day 10 after the second surgical intervention.


Asunto(s)
Aneurisma Falso , Aneurisma , Implantación de Prótesis Vascular , Adulto , Aneurisma/diagnóstico , Aneurisma/etiología , Aneurisma/cirugía , Aneurisma Falso/diagnóstico , Aneurisma Falso/etiología , Aneurisma Falso/cirugía , Arteria Axilar/cirugía , Humanos , Stents , Resultado del Tratamiento
14.
Zhonghua Yi Xue Za Zhi ; 101(14): 1026-1030, 2021 Apr 13.
Artículo en Chino | MEDLINE | ID: mdl-33845542

RESUMEN

Objective: To evaluate the results of excimer laser ablation (ELA) in the treatment of lower limb atherosclerotic obliterans (ASO). Methods: From June 2019 to March 2020, patients who underwent ELA combined with drug-coated balloon (DCB) for lower limb atherosclerotic obliterans (ASO) were enrolled. Demographics, lesion characteristics, procedure-related outcomes and complications were collected and analyzed. Results: Thirty patients were enrolled, including 21 males and 9 females. The mean age was (76.5±10.5) years. The mean lesion length was (11.7±6.4) cm. A total of 41 lesions, including in-stent restenosis (ISR) in 12 (29.3%), chronic totally occlusion (CTO) at initial treatment in 24 (58.5%), and severe stenosis in 5 (12.2%) patients. Sixteen (51.6%) patients were classified as Peripheral Arterial Calcium Scoring System (PACSS) category 4. The technical success rate was 93.5%. Incidence of distal embolization and bailout stenting was 12.9% and 6.5%, respectively. The mean follow-up time was (6.6±3.0) months. Ankle-brachial index (ABI) was significantly increased from 0.43(0.32,0.55) preoperatively to 0.91(0.87,1.01) postoperatively (Z=-5.43, P<0.01) and 0.82(0.73,1.02) (Z=-3.99, P<0.01) three months after surgery. The 3-month major-amputation free survival rate was 96.7%, primary patency rate was 100%, the target lesion reintervention (TLR) rate was 0 and ulcer healing rate was 76.9%. Conclusion: Debulking of ELA is feasible and effective for both ISR and CTO at initial treatment, providing a new option for DCB preparation and reducing stent implantation.


Asunto(s)
Angioplastia de Balón , Terapia por Láser , Enfermedad Arterial Periférica , Anciano , Anciano de 80 o más Años , Aterectomía , Femenino , Arteria Femoral , Humanos , Extremidad Inferior , Masculino , Enfermedad Arterial Periférica/cirugía , Arteria Poplítea , Recurrencia , Stents , Resultado del Tratamiento , Grado de Desobstrucción Vascular
15.
BMC Surg ; 21(1): 184, 2021 Apr 07.
Artículo en Inglés | MEDLINE | ID: mdl-33827521

RESUMEN

BACKGROUND: Percutaneous transhepatic gallbladder drainage (PTGBD) is indicated for patients with acute cholecystitis (AC) who are not indicated for urgent surgery, but external tubes reduce quality of life (QOL) while waiting for elective surgery. The objective of the present study was to investigate the feasibility of laparoscopic cholecystectomy after endoscopic trans-papillary gallbladder stenting (ETGBS) comparing with after PTGBD. METHODS: Intraoperative and postoperative outcomes of patients with ETGBS and PTGBD were retrospectively compared. RESULTS: Eighteen ETGBS and ten PTGBD patients were compared. Differences in the duration of ETGBS and PTGBD [median 209 min (range 107-357) and median 161 min (range 130-273), respectively, P = 0.10], median blood loss [ETGBS 2 (range 2-180 ml) and PTGBD 24 (range 2-100 ml), P = 0.89], switch to laparotomy (ETGBS 11% and PTGBD 20%, P = 0.52), and median postoperative hospital stay [ETGBS 8 (range 4-24 days) and ETGBS 8 (range 4-16 days), P = 0.99]. Thickening of the cystic duct that occurred in 60% of the ETGBS patients and none of the PTGBD patients (P = 0.005) interfered with closure of the duct by clipping. No obstruction occurred in ETGBS patients. CONCLUSION: ETGBS did not make laparoscopic cholecystectomy less feasible than after PTGBD. This is a pilot study, and further investigations are needed to validate the results of the present study.


Asunto(s)
Colecistectomía Laparoscópica , Colecistitis Aguda , Cirugía Asistida por Computador , Colecistitis Aguda/cirugía , Endoscopía , Estudios de Factibilidad , Vesícula Biliar/cirugía , Humanos , Proyectos Piloto , Estudios Retrospectivos , Stents , Cirugía Asistida por Computador/métodos
17.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 46(3): 249-256, 2021 Mar 28.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-33927071

RESUMEN

OBJECTIVES: To analyze the effect of hyperlipoproteinemia (α) on immediate expansion after coronary stent implantation guided by intravascular ultrasound (IVUS). METHODS: A total of 160 patients (175 lesions) with coronary heart disease diagnosed by coronary artery angiography, who were performed percutaneous intervention guided by IVUS in the Department of Cardiology, Third Xiangya Hospital, Central South University, were enrolled retrospectively.According to the concentration of lipoproteina, the patients were divided into 2 groups: a hyperlipoproteinemia (α) group and a control group. Cardiac ejection fraction was measured with echocardiography. Logistic regression was used to analyze the influential factors for hyperlipoproteinemia (α). The target vessel was examined by IVUS to analyze the immediate expansion effect of hyperlipoproteinemia (α) after stent implantation. RESULTS: The mean stent expansion index, lesion length, stent number, stent symmetry index and posterior balloon diameter were (94.73±18.9)%, (52.92±29.1) mm, (2.11±0.85), (83.62±13.07)%, and (9.46±2.00) mm in the hyperlipoproteinemia (α) group, respectively. Compared with the control group, there were significantly difference (all P<0.05). Multivariable regression analysis showed that the decreased creatinine clearance rate was an independent risk factor for hyperlipoproteinemia (α) (P<0.05). CONCLUSIONS: Hyperlipoproteinemia (α) appears to be a predictor of stent underexpansion, and the decreased creatinine clearance rate is an independent risk factor for hyperlipoproteinemia (α).


Asunto(s)
Enfermedad de la Arteria Coronaria , Intervención Coronaria Percutánea , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/cirugía , Humanos , Lipoproteínas , Intervención Coronaria Percutánea/efectos adversos , Estudios Retrospectivos , Factores de Riesgo , Stents/efectos adversos , Resultado del Tratamiento , Ultrasonografía Intervencional
18.
Pan Afr Med J ; 38: 149, 2021.
Artículo en Francés | MEDLINE | ID: mdl-33912319

RESUMEN

Retroperitoneal fibrosis (RPF) is a rare disease characterized by the formation of a fibro-inflammatory plaque in the retroperitoneal space in front of the abdominal aorta. It is responsible for the sheathing of the ureters. It is characterized by unspecific clinical signs, and it is often detected based on obstructive uropathy. We conducted a retrospective, descriptive study in the Department of Urology B and in the Department of Nephrology of the Ibn Sina University Hospital over a period of 10 years from January 2006 to December 2016. The study enrolled 18 patients, including 11 men and 7 women, with an average age of 51.4 years ± 11.2. Diagnosis was based on lumbar pain in 14 patients. Obstructive renal failure was reported in 15 patients and the diagnosis of RPF was based on uroscanner. Etiological assessment revealed 2 cases with a history of neoplasia, 2 cases of inflammatory disease and 1 case of retroperitoneal surgery; chronic drug intake was noted in more than half of the patients. In all patients, treatment was based on double J stent placement, while systemic treatment with corticosteroids and immunosuppressants was used on the basis of the evolutionary profile. Ureterolysis was immediately performed in 3 patients. Outcome was favorable, with significant improvement in renal function in 12 patients. A relapse occurred in 2 patients after 2 years of follow-up. Retroperitoneal fibrosis (RPF) should be suspected in patients with general signs associated with obstructive renal disease. Secondary causes should be systematically investigated, with particular emphasis on hyper IgG4 disease and neoplastic diseases.


Asunto(s)
Dolor de la Región Lumbar/etiología , Insuficiencia Renal/etiología , Fibrosis Retroperitoneal/diagnóstico , Corticoesteroides/administración & dosificación , Adulto , Femenino , Estudios de Seguimiento , Hospitales Universitarios , Humanos , Inmunosupresores/administración & dosificación , Masculino , Persona de Mediana Edad , Marruecos , Fibrosis Retroperitoneal/complicaciones , Fibrosis Retroperitoneal/terapia , Estudios Retrospectivos , Stents , Obstrucción Ureteral/diagnóstico , Obstrucción Ureteral/etiología
19.
Arq Gastroenterol ; 58(1): 71-76, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33909800

RESUMEN

BACKGROUND: Hepatobiliary surgery and hepatic trauma are frequent causes of bile leaks and this feared complication can be safely managed by endoscopic retrograde cholangiopancreatography (ERCP). The approach consists of sphincterotomy alone, biliary stenting or a combination of the two but the optimal form remains unclear. OBJECTIVE: The aim of this study is to compare sphincterotomy alone versus sphincterotomy plus biliary stent placement in the treatment of post-surgical and traumatic bile leaks. METHODS: We retrospectively analyzed 31 patients with the final ERCP diagnosis of "bile leak". Data collected included patient demographics, etiology of the leak and the procedure details. The treatment techniques were divided into two groups: sphincterotomy alone vs. sphincterotomy plus biliary stenting. We evaluated the volume of the abdominal surgical drain before and after each procedure and the number of days needed until cessation of drainage post ERCP. RESULTS: A total of 31 patients (18 men and 3 women; mean age, 51 years) with bile leaks were evaluated. Laparoscopic cholecystectomy was the etiology of the leak in 14 (45%) cases, followed by conventional cholecystectomy in 9 (29%) patients, hepatic trauma in 5 (16%) patients, and hepatectomy secondary to neoplasia in 3 (9.7%) patients. The most frequent location of the leaks was the cystic duct stump with 12 (38.6%) cases, followed by hepatic common duct in 10 (32%) cases, common bile duct in 7 (22%) cases and the liver bed in 2 (6.5%) cases. 71% of the patients were treated with sphincterotomy plus biliary stenting, and 29% with sphincterotomy alone. There was significant difference between the volume drained before and after both procedures (P<0.05). However, when comparing sphincterotomy alone and sphincterotomy plus biliary stenting, regarding the volume drained and the days needed to cessation of drainage, there was no statistical difference in both cases (P>0.005). CONCLUSION: ERCP remains the first line treatment for bile leaks with no difference between sphincterotomy alone vs sphincterotomy plus stent placement.


Asunto(s)
Colecistectomía Laparoscópica , Esfinterotomía , Bilis , Femenino , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/cirugía , Estudios Retrospectivos , Esfinterotomía Endoscópica/efectos adversos , Stents
20.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 38(2): 303-309, 2021 Apr 25.
Artículo en Chino | MEDLINE | ID: mdl-33913290

RESUMEN

Lower extremity movement is a complex and large range of limb movement. Arterial stents implanted in lower extremity are prone to complex mechanical deformation, so the stent is required to have high comprehensive mechanical properties. In order to evaluate the mechanical property of different stents, in this paper, finite element method was used to simulate and compare the mechanical properties of six nitinol stents (Absolute Pro, Complete SE, Lifestent, Protégé EverFlex, Pulsar-35 and New) under different deformation modes, such as radial compression, axial compression/tension, bending and torsion, and the radial support performance of the stents was verified by experiments. The results showed that the comprehensive performance of New stent was better than other stents. Among which the radial support performance was higher than Absolute Pro and Pulsar-35 stent, the axial support performance was better than Complete SE, Lifestent and Protégé EverFlex stent, the flexibility was superior to Protégé Everflex stent, and the torsion performance was better than Complete SE, Lifestent and Protégé Everflex stent. The TTR2 type radial support force tester was used to test the radial support performance of 6 types, and the finite element analysis results were verified. The mechanical properties of the stent are closely related to the structural size. The result provides a reference for choosing a suitable stent according to the needs of the diseased location in clinical applications.


Asunto(s)
Arteria Femoral , Stents , Aleaciones , Análisis de Elementos Finitos , Extremidad Inferior , Fenómenos Mecánicos , Diseño de Prótesis , Estrés Mecánico
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