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1.
Phys Rev E ; 108(3-2): 035209, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37849111

RESUMO

Laser-direct-drive fusion target designs with solid deuterium-tritium (DT) fuel, a high-Z gradient-density pusher shell (GDPS), and a Au-coated foam layer have been investigated through both 1D and 2D radiation-hydrodynamic simulations. Compared with conventional low-Z ablators and DT-push-on-DT targets, these GDPS targets possess certain advantages of being instability-resistant implosions that can be high adiabat (α≥8) and low hot-spot and pusher-shell convergence (CR_{hs}≈22 and CR_{PS}≈17), and have a low implosion velocity (v_{imp}<3×10^{7}cm/s). Using symmetric drive with laser energies of 1.9 to 2.5MJ, 1D lilac simulations of these GDPS implosions can result in neutron yields corresponding to ≳50-MJ energy, even with reduced laser absorption due to the cross-beam energy transfer (CBET) effect. Two-dimensional draco simulations show that these GDPS targets can still ignite and deliver neutron yields from 4 to ∼10MJ even if CBET is present, while traditional DT-push-on-DT targets normally fail due to the CBET-induced reduction of ablation pressure. If CBET is mitigated, these GDPS targets are expected to produce neutron yields of >20MJ at a driven laser energy of ∼2MJ. The key factors behind the robust ignition and moderate energy gain of such GDPS implosions are as follows: (1) The high initial density of the high-Z pusher shell can be placed at a very high adiabat while the DT fuel is maintained at a relatively low-entropy state; therefore, such implosions can still provide enough compression ρR>1g/cm^{2} for sufficient confinement; (2) the high-Z layer significantly reduces heat-conduction loss from the hot spot since thermal conductivity scales as ∼1/Z; and (3) possible radiation trapping may offer an additional advantage for reducing energy loss from such high-Z targets.

2.
Phys Rev Lett ; 131(1): 015102, 2023 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-37478441

RESUMO

In the dynamic-shell (DS) concept [V. N. Goncharov et al., Novel Hot-Spot Ignition Designs for Inertial Confinement Fusion with Liquid-Deuterium-Tritium Spheres, Phys. Rev. Lett. 125, 065001 (2020).PRLTAO0031-900710.1103/PhysRevLett.125.065001] for laser-driven inertial confinement fusion the deuterium-tritium fuel is initially in the form of a homogeneous liquid inside a wetted-foam spherical shell. This fuel is ignited using a conventional implosion, which is preceded by a initial compression of the fuel followed by its expansion and dynamic formation of a high-density fuel shell with a low-density interior. This Letter reports on a scaled-down, proof-of-principle experiment on the OMEGA laser demonstrating, for the first time, the feasibility of DS formation. A shell is formed by convergent shocks launched by laser pulses at the edge of a plasma sphere, with the plasma itself formed as a result of laser-driven compression and relaxation of a surrogate plastic-foam ball target. Three x-ray diagnostics, namely, 1D spatially resolved self-emission streaked imaging, 2D self-emission framed imaging, and backlighting radiography, have shown good agreement with the predicted evolution of the DS and its stability to low Legendre mode perturbations introduced by laser irradiation and target asymmetries.

3.
Philos Trans A Math Phys Eng Sci ; 379(2189): 20200011, 2021 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-33280561

RESUMO

Laser-direct drive (LDD), along with laser indirect (X-ray) drive (LID) and magnetic drive with pulsed power, is one of the three viable inertial confinement fusion approaches to achieving fusion ignition and gain in the laboratory. The LDD programme is primarily being executed at both the Omega Laser Facility at the Laboratory for Laser Energetics and at the National Ignition Facility (NIF) at Lawrence Livermore National Laboratory. LDD research at Omega includes cryogenic implosions, fundamental physics including material properties, hydrodynamics and laser-plasma interaction physics. LDD research on the NIF is focused on energy coupling and laser-plasma interactions physics at ignition-scale plasmas. Limited implosions on the NIF in the 'polar-drive' configuration, where the irradiation geometry is configured for LID, are also a feature of LDD research. The ability to conduct research over a large range of energy, power and scale size using both Omega and the NIF is a major positive aspect of LDD research that reduces the risk in scaling from OMEGA to megajoule-class lasers. The paper will summarize the present status of LDD research and plans for the future with the goal of ultimately achieving a burning plasma in the laboratory. This article is part of a discussion meeting issue 'Prospects for high gain inertial fusion energy (part 2)'.

4.
Nature ; 565(7741): 581-586, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30700868

RESUMO

Focusing laser light onto a very small target can produce the conditions for laboratory-scale nuclear fusion of hydrogen isotopes. The lack of accurate predictive models, which are essential for the design of high-performance laser-fusion experiments, is a major obstacle to achieving thermonuclear ignition. Here we report a statistical approach that was used to design and quantitatively predict the results of implosions of solid deuterium-tritium targets carried out with the 30-kilojoule OMEGA laser system, leading to tripling of the fusion yield to its highest value so far for direct-drive laser fusion. When scaled to the laser energies of the National Ignition Facility (1.9 megajoules), these targets are predicted to produce a fusion energy output of about 500 kilojoules-several times larger than the fusion yields currently achieved at that facility. This approach could guide the exploration of the vast parameter space of thermonuclear ignition conditions and enhance our understanding of laser-fusion physics.

5.
Phys Rev Lett ; 120(8): 085001, 2018 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-29543010

RESUMO

Cross-beam energy transfer (CBET) results from two-beam energy exchange via seeded stimulated Brillouin scattering, which detrimentally reduces ablation pressure and implosion velocity in direct-drive inertial confinement fusion. Mitigating CBET is demonstrated for the first time in inertial-confinement implosions at the National Ignition Facility by detuning the laser-source wavelengths (±2.3 Å UV) of the interacting beams. We show that, in polar direct-drive, wavelength detuning increases the equatorial region velocity experimentally by 16% and alters the in-flight shell morphology. These experimental observations are consistent with design predictions of radiation-hydrodynamic simulations that indicate a 10% increase in the average ablation pressure.

7.
Phys Rev Lett ; 117(2): 025001, 2016 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-27447511

RESUMO

A record fuel hot-spot pressure P_{hs}=56±7 Gbar was inferred from x-ray and nuclear diagnostics for direct-drive inertial confinement fusion cryogenic, layered deuterium-tritium implosions on the 60-beam, 30-kJ, 351-nm OMEGA Laser System. When hydrodynamically scaled to the energy of the National Ignition Facility, these implosions achieved a Lawson parameter ∼60% of the value required for ignition [A. Bose et al., Phys. Rev. E 93, 011201(R) (2016)], similar to indirect-drive implosions [R. Betti et al., Phys. Rev. Lett. 114, 255003 (2015)], and nearly half of the direct-drive ignition-threshold pressure. Relative to symmetric, one-dimensional simulations, the inferred hot-spot pressure is approximately 40% lower. Three-dimensional simulations suggest that low-mode distortion of the hot spot seeded by laser-drive nonuniformity and target-positioning error reduces target performance.

8.
Green Chem ; 15(1): 181-198, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25110461

RESUMO

A central goal of green chemistry is to avoid hazard in the design of new chemicals. This objective is best achieved when information about a chemical's potential hazardous effects is obtained as early in the design process as feasible. Endocrine disruption is a type of hazard that to date has been inadequately addressed by both industrial and regulatory science. To aid chemists in avoiding this hazard, we propose an endocrine disruption testing protocol for use by chemists in the design of new chemicals. The Tiered Protocol for Endocrine Disruption (TiPED) has been created under the oversight of a scientific advisory committee composed of leading representatives from both green chemistry and the environmental health sciences. TiPED is conceived as a tool for new chemical design, thus it starts with a chemist theoretically at "the drawing board." It consists of five testing tiers ranging from broad in silico evaluation up through specific cell- and whole organism-based assays. To be effective at detecting endocrine disruption, a testing protocol must be able to measure potential hormone-like or hormone-inhibiting effects of chemicals, as well as the many possible interactions and signaling sequellae such chemicals may have with cell-based receptors. Accordingly, we have designed this protocol to broadly interrogate the endocrine system. The proposed protocol will not detect all possible mechanisms of endocrine disruption, because scientific understanding of these phenomena is advancing rapidly. To ensure that the protocol remains current, we have established a plan for incorporating new assays into the protocol as the science advances. In this paper we present the principles that should guide the science of testing new chemicals for endocrine disruption, as well as principles by which to evaluate individual assays for applicability, and laboratories for reliability. In a 'proof-of-principle' test, we ran 6 endocrine disrupting chemicals (EDCs) that act via different endocrinological mechanisms through the protocol using published literature. Each was identified as endocrine active by one or more tiers. We believe that this voluntary testing protocol will be a dynamic tool to facilitate efficient and early identification of potentially problematic chemicals, while ultimately reducing the risks to public health.

9.
Catheter Cardiovasc Interv ; 71(1): 108-11, 2008 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-18098211

RESUMO

OBJECTIVE: We report our experience with the elective placement of below-knee, drug-eluting stents in patients with chronic limb ischemia. BACKGROUND: Infrapopliteal percutaneous transluminal angioplasty has been associated with a lower rate of procedural success and high rate of restenosis because of the small size of the tibial vessels and the prevalence of calcified and diffuse atherosclerotic disease. Prior published data reports 3-year patency rates below 25%. Bare metal stents have been reported in bailout situations. Drug-eluting stents have markedly reduced restenosis compared to bare metal stents in the coronary vasculature, but there is little data supporting the use of these devices below the knee. METHODS: Elective placement of drug-eluting stents in infrapopliteal lesions was performed on 10 patients with severe (> or =Fontaine Stage IIb) claudication (n = 1) or limb-threatening ischemia (n = 9) (rest pain, nonhealing ulcers and gangrene). RESULTS: A total of 17 drug-eluting stents were electively placed in 12 below-knee arteries in 10 patients, resulting in an average of 1.7 +/- 0.7 stents per patient. The mean lesion length was 24.8 +/- 10.9 mm, the mean total stent length was 38.3 +/- 19.1 mm, and the mean nominal stent diameter was 2.8 +/- 0.3 mm. One patient required target vessel revascularization (TVR) at 3 weeks because of stent thrombosis. TVR was 10% at 12.4 +/- 6.5 months of follow-up. Clinically driven angiography in three different patients was performed at 4, 15, and 16 months and confirmed drug-eluting stent patency in each case. CONCLUSIONS: The use of below-knee drug-eluting stents is feasible and appears to be safe in our small series of complex infrapopliteal lesions causing chronic limb ischemia. The occurrence of a single case of stent thrombosis warrants continued observation in this cohort. Prospective clinical trials will be necessary to confirm the benefits and justify the costs of this strategy for treating patients with infrapopliteal culprit lesions and chronic limb ischemia.


Assuntos
Stents Farmacológicos , Claudicação Intermitente/terapia , Isquemia/terapia , Perna (Membro)/irrigação sanguínea , Idoso , Doença Crônica , Comorbidade , Constrição Patológica , Feminino , Humanos , Isquemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Recidiva
10.
Neuroscience ; 140(4): 1201-8, 2006 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-16757118

RESUMO

Fast neurotransmitter release at presynaptic terminals occurs at specialized transmitter release sites where docked secretory vesicles are triggered to fuse with the membrane by the influx of Ca2+ ions that enter through local N type (CaV2.2) calcium channels. Thus, neurosecretion involves two key processes: the docking of vesicles at the transmitter release site, a process that involves the scaffold protein RIM (Rab3A interacting molecule) and its binding partner Munc-13, and the subsequent gating of vesicle fusion by activation of the Ca2+ channels. It is not known, however, whether the vesicle fusion complex with its attached Ca2+ channels and the vesicle docking complex are parts of a single multifunctional entity. The Ca2+ channel itself and RIM were used as markers for these two elements to address this question. We carried out immunostaining at the giant calyx-type synapse of the chick ciliary ganglion to localize the proteins at a native, undisturbed presynaptic nerve terminal. Quantitative immunostaining (intensity correlation analysis/intensity correlation quotient method) was used to test the relationship between these two proteins at the nerve terminal transmitter release face. The staining intensities for CaV2.2 and RIM covary strongly, consistent with the expectation that they are both components of the transmitter release sites. We then used immunoprecipitation to test if these proteins are also parts of a common molecular complex. However, precipitation of CaV2.2 failed to capture either RIM or Munc-13, a RIM binding partner. These findings indicate that although the vesicle fusion and the vesicle docking mechanisms coexist at the transmitter release face they are not parts of a common stable complex.


Assuntos
Proteínas Aviárias/metabolismo , Canais de Cálcio Tipo N/metabolismo , Proteínas de Ligação ao GTP/metabolismo , Neurotransmissores/metabolismo , Terminações Pré-Sinápticas/metabolismo , Animais , Proteínas Aviárias/análise , Encéfalo/metabolismo , Canais de Cálcio Tipo N/análise , Embrião de Galinha , Proteínas de Ligação ao GTP/análise , Sinaptossomos/química , Sinaptossomos/metabolismo , Proteína rab3A de Ligação ao GTP/análise , Proteína rab3A de Ligação ao GTP/metabolismo
11.
Phys Rev Lett ; 96(11): 115005, 2006 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-16605835

RESUMO

Heat-flow-induced dynamic overpressure at the perturbed ablation front of an inertial confinement fusion target can stabilize the ablative Richtmyer-Meshkov-like instability and mitigate the subsequent ablative Rayleigh-Taylor (RT) instability. A series of experiments was performed on the OMEGA laser to quantify the dynamic overpressure stabilization during the shock transit. Analysis of the experimental data using hydrocode simulations shows that the observed oscillatory evolution of the ablation-front perturbations depends on Dc, the size of the thermal conduction zone, and the fluid velocity in the blowoff region Vb1 that are sensitive to the thermal transport model used. We show that the simulations match the experiment well when the time dependence of the heat-flux inhibition is taken into account using a recently developed nonlocal heat-transport model [V. N. Goncharov et al., Phys. Plasmas 13, 012702 (2006)].

12.
Phys Rev Lett ; 95(7): 075501, 2005 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-16196790

RESUMO

Extended x-ray absorption fine structure (EXAFS) measurements have demonstrated the phase transformation from body-centered-cubic (bcc) to hexagonal-close-packed (hcp) iron due to nanosecond, laser-generated shocks. The EXAFS spectra are also used to determine the compression and temperature in the shocked iron, which are consistent with hydrodynamic simulations and with the compression inferred from velocity interferometry. This is a direct, atomic-level, and in situ proof of shock-induced transformation in iron, as opposed to the previous indirect proof based on shock-wave splitting.

13.
Water Sci Technol ; 49(4): 255-60, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15077980

RESUMO

A TAML catalyst (0.5 microM, 0.23 mg/L of effluent) combined with hydrogen peroxide (6.5 mM, 0.19 g/L of effluent) were capable of permanently removing 46% of the colour from bleach plant effluent (Eop, pine-derived) in one hour at 5,000 L effluent per day. Increasing concentrations to 2 microM catalyst (0.9 mg/L of effluent) and 22 mM peroxide (0.75 g/L of effluent), resulted in removal of 78% of the colour. In addition, 29% of the chlorinated organic material (AOX) was also removed. A laboratory investigation indicated that the oxidative process predominantly removed phenolic structures. The low aromatic content of the effluent meant that the majority of the organic material was not substantially altered during treatment. Thus chemical oxygen demand was essentially unchanged. This technology was able to remediate colour from effluents derived from both softwood (pine) and hardwood (eucalypt). Laboratory studies on catalyst life-time during effluent treatment, demonstrated that activity was maintained for a sufficient period to eliminate all the chromophore available to the active species, but that the catalyst did not survive long enough to be discharged into the receiving environment. Microtox tests showed that catalyst degradation products were not toxic to the receiving environment.


Assuntos
Resíduos Industriais , Eliminação de Resíduos Líquidos/métodos , Poluentes da Água/isolamento & purificação , Purificação da Água/métodos , Catálise , Peróxido de Hidrogênio/química , Oxidantes/química , Oxirredução , Papel , Fotoquímica , Pigmentos Biológicos/isolamento & purificação , Medição de Risco , Poluentes da Água/intoxicação
14.
Catheter Cardiovasc Interv ; 54(1): 1-5, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11553939

RESUMO

The safety and efficacy of endoluminal stenting in treating atherosclerotic vertebral artery disease was evaluated in 38 vessels in 32 patients. Indications for revascularization included diplopia (n = 4), blurred vision (n = 4), dizziness (n = 23), transient ischemic attacks (n = 4), drop attack (n = 1), gait disturbance (n = 1), headache (n = 2), and asymptomatic critical stenosis (n = 1). Success (< 20% residual diameter stenosis, without stroke or death) was achieved in all 32 patients (100%). One patient experienced a transient ischemic attack (TIA) 1 hr after the procedure. At follow-up (mean, 10.6 months), all patients (100%) were alive and 31/32 (97%) were asymptomatic. One patient (3%) had in-stent restenosis at 3.5 months and underwent successful balloon angioplasty. Endoluminal stenting of vertebral artery lesions is safe, effective, and durable as evidenced by the low recurrence rate. Primary stent placement is an attractive option for atherosclerotic vertebral artery stenotic lesions. Cathet Cardiovasc Intervent 2001;54:1-5.


Assuntos
Angioplastia com Balão , Arteriosclerose/terapia , Stents , Artéria Vertebral/cirurgia , Insuficiência Vertebrobasilar/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Arteriosclerose/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Resultado do Tratamento , Artéria Vertebral/diagnóstico por imagem , Insuficiência Vertebrobasilar/diagnóstico por imagem
15.
Catheter Cardiovasc Interv ; 53(2): 259-63, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11387617

RESUMO

Pseudoaneurysm formation of the femoral artery is a well-known complication following catheter-based vascular procedures. Ultrasound-guided compression or surgical correction are commonly used for its repair. We describe a new method of treatment for femoral pseudoaneurysm. The pseudoaneurysm is visualized by contralateral angiography and thrombosed with a percutaneous thrombin injection while the distal vessel is isolated with a brief balloon inflation. Fluoroscopically guided percutaneous thrombin injection is a promising, minimally invasive technique for the treatment of iatrogenic pseudoaneurysm, especially in patients with compromised distal circulation.


Assuntos
Falso Aneurisma/tratamento farmacológico , Artéria Femoral , Hemostáticos/uso terapêutico , Trombina/uso terapêutico , Adolescente , Idoso , Idoso de 80 Anos ou mais , Humanos , Injeções/métodos , Masculino , Pessoa de Meia-Idade
16.
J Biol Chem ; 276(28): 26411-20, 2001 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-11333261

RESUMO

Using confocal imaging of Rhod-2-loaded HeLa cells, we examined the ability of mitochondria to sequester Ca(2+) signals arising from different sources. Mitochondrial Ca(2+) (Ca(2+)mit) uptake was stimulated by inositol 1,4,5-trisphosphate (InsP(3))-evoked Ca(2+) release, capacitative Ca(2+) entry, and Ca(2+) leaking from the endoplasmic reticulum. For each Ca(2+) source, the relationship between cytosolic Ca(2+) (Ca(2+)cyt) concentration and Ca(2+)mit was complex. With Ca(2+)cyt < 300 nm, a slow and persistent Ca(2+)mit uptake was observed. If Ca(2+)cyt increased above approximately 400 nm, Ca(2+)mit uptake accelerated sharply. For equivalent Ca(2+)cyt increases, the rate of Ca(2+)mit rise was greater with InsP(3)-evoked Ca(2+) signals than any other source. Spatial variation of the Ca(2+)mit response was observed within individual cells. Both the fraction of responsive mitochondria and the amplitude of the Ca(2+)mit response were graded in direct proportion to stimulus concentration. Trains of repetitive Ca(2+) oscillations did not maintain elevated Ca(2+)mit levels. Only low frequency Ca(2+) transients (<1/15 min) evoked repetitive Ca(2+)mit signals. Our data indicate that there is a lag between Ca(2+)cyt and Ca(2+)mit increases but that mitochondria will accumulate calcium when it is elevated over basal levels regardless of its source. Furthermore, in addition to the characteristics of Ca(2+) signals, Ca(2+) uniporter desensitization and proximity of mitochondria to InsP(3) receptors modulate mitochondrial Ca(2+) responses.


Assuntos
Cálcio/metabolismo , Mitocôndrias/metabolismo , Citoplasma/metabolismo , Células HeLa , Humanos , Transporte de Íons
17.
Catheter Cardiovasc Interv ; 52(4): 457-67, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11285598

RESUMO

Percutaneous techniques have dramatically changed our approach to coronary and peripheral revascularization. Intracranial atherosclerosis is a highly morbid disease; however, techniques for revascularization are still in evolution. The authors comprise a multidisciplinary team of neurologists, neuroradiologists, and interventional cardiologists who have collaborated in treating fifteen patients with symptomatic intracranial stenosis who have failed medical therapy. The acute success rate (100%) and one-year freedom from death and stroke (93.4%) using balloon angioplasty and provisional stenting are encouraging. A surprising observation in this patient cohort was that 53% of patients had improvement or resolution of a deficit that was chronic and presumed to be permanent and irreversible. This type of chronic but reversible deficit is termed "brain angina". The background, rationale for a multidisciplinary team, techniques, and preliminary results of intracranial angioplasty with provisional stenting are presented.


Assuntos
Estenose das Carótidas/terapia , Arteriosclerose Intracraniana/terapia , Stents , Idoso , Idoso de 80 Anos ou mais , Angioplastia com Balão , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
18.
Semin Cell Dev Biol ; 12(1): 3-10, 2001 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11162741

RESUMO

Calcium (Ca2+) is an almost universal intracellular messenger, controlling a diverse range of cellular processes, such as gene transcription, muscle contraction and cell proliferation. The ability of a simple ion such as Ca2+ to play a pivotal role in cell biology results from the facility that cells have to shape Ca2+ signals in the dimensions of space, time and amplitude. To generate the variety of observed Ca2+ signals, different cell types employ components selected from a Ca2+ signalling 'toolkit', which comprizes an array of signalling, homeostatic and sensory mechanisms. By mixing and matching components from the toolkit, cells can obtain Ca2+ signals that suit their physiology.


Assuntos
Sinalização do Cálcio/fisiologia , Animais , Cálcio/metabolismo , Cálcio/fisiologia , Canais de Cálcio/fisiologia , Homeostase/fisiologia , Humanos
19.
J Endovasc Ther ; 8(1): 75-82, 2001 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11220474

RESUMO

PURPOSE: To assess the procedural and long-term clinical outcomes of balloon angioplasty of the profunda femoris artery in patients with severe limb ischemia. METHODS: Thirty-one consecutive patients were evaluated for severe ischemia in 32 limbs: 13 (41%) were categorized Fontaine class 2B, and 19 (59%) were class 3 or 4. The superficial femoral artery was occluded in 20 (62%) limbs; an additional vessel was treated in 22 (69%) limbs. RESULTS: Procedural success was achieved in 91% (31/32) of limbs. The ankle-brachial index increased from 0.5 +/- 0.2 at baseline to 0.7 +/- 0.2 after intervention (p < 0.01). In-hospital limb salvage was 94% (30/32), and in-hospital event-free survival was 90% (28/31). At a mean follow-up of 34 +/- 20 months, no additional amputations were necessary; 3 patients required repeat revascularization, and 5 patients died. Freedom from revascularization was 88% in the 25 survivors. At follow-up, 88% of the patients had Fontaine class 1 or 2A symptoms, and only 12% had Fontaine class 2B or higher (p < 0.001 compared with baseline). CONCLUSIONS: These data suggest that percutaneous profundaplasty is safe, effective, and may be considered as an alternative to surgical therapy in patients with anatomically suitable lesions.


Assuntos
Angioplastia Coronária com Balão , Isquemia/terapia , Perna (Membro)/irrigação sanguínea , Idoso , Idoso de 80 Anos ou mais , Angiografia , Feminino , Artéria Femoral/diagnóstico por imagem , Seguimentos , Humanos , Isquemia/diagnóstico por imagem , Isquemia/cirurgia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Retratamento , Análise de Sobrevida
20.
Ochsner J ; 3(2): 70-7, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21765722

RESUMO

Percutaneous endovascular intervention has revolutionized the treatment of peripheral vascular disease by allowing successful treatment of patients who are not good surgical candidates. Cardiologists with peripheral vascular training are more readily able to identify patients with concomitant peripheral arterial disease. It has been our experience that the technical skills necessary to perform coronary angioplasty are transferable to the peripheral vasculature. However, an understanding of the natural history of peripheral disease and of patient and lesion selection criteria, and the knowledge of other treatment alternatives are essential elements required to perform these procedures safely and effectively. There are inherent advantages for patients when the interventionalist performing the procedure is also the clinician responsible for the pre- and post-procedure care, analogous to the vascular surgeon who cares for patients before and after surgical procedures. In view of the increased incidence of coronary artery disease in patients with atherosclerotic peripheral vascular disease, the participation of a cardiologist in their care seems appropriate.

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