RESUMO
PURPOSE: This study aimed to compare the efficacy of two different catheters in hybrid surgery for salvage of thrombosed hemodialysis accesses. MATERIALS AND METHODS: The hybrid salvage procedure (surgical thrombectomy followed by endovascular angioplasty) of the thrombosed hemodialysis access, was performed using adherent clot (AC) catheter in 140 cases and Fogarty balloon catheter in 68 cases. Procedure-related outcomes such as the clot removal status, clinical success, complications, and primary patency rates were analyzed retrospectively. RESULTS: The proportion of cases with good clot removal scores in the AC catheter and Fogarty balloon catheter groups was 77.9% and 91.2%, respectively (P=0.018). Clinical success was achieved in 90.7% of the cases in the AC catheter group and in 98.5% of the cases in the balloon catheter group (P=0.035). The mean patency rates of the two groups were 50.7% and 63.2% at 3 months, 40.7% and 47.1% at 6 months, and 17.9% and 19.1% at 12 months. The complication rates (12.1% and 5.9%) and primary patency rates between the two catheters were not statistically different (P=0.328). On the analysis of the patency rate on access type of autologous (P=0.169) and prothetic graft (P=0.423), there was no significant difference between the two catheter groups. CONCLUSION: In terms of clot removal and clinical success, the AC catheter did not demonstrate better outcomes than the Fogarty balloon catheter. However, primary patency was not related to the type of catheter. Adherent clot catheter can be a useful alternative to Fogarty balloon catheter for thrombosed hemodialysis access.
RESUMO
A bronchial artery aneurysm (BAA) is uncommon and usually associated with chronic inflammatory lung disease or a systemic vascular condition, which is rarely the etiology of mediastinal hemorrhage. A middle-aged person presented with spontaneous hemothorax and hemomediastinum. A diagnostic evaluation identified a bronchial artery aneurysm as the source. To prevent further rupture, we performed a bronchial artery embolization. In the absence of trauma or other causes for hemothorax and mediastinal hemorrhage, the possibility of a BAA should be considered. A bronchial artery aneurysm can be managed by interventional techniques as well as surgery.
RESUMO
The action of cytochalasins, actin-disrupting agents on human Kv1.5 channel (hKv1.5) stably expressed in Ltk(-) cells was investigated using the whole cell patch-clamp technique. Cytochalasin B inhibited hKv1.5 currents rapidly and reversibly at +60 mV in a concentration-dependent manner with an IC(50) of 4.2 microM. Cytochalasin A, which has a structure very similar to cytochalasin B, inhibited hKv1.5 (IC(50) of 1.4 microM at +60 mV). Pretreatment with other actin filament disruptors cytochalasin D and cytochalasin J, and an actin filament stabilizing agent phalloidin had no effect on the cytochalasin B-induced inhibition of hKv1.5 currents. Cytochalasin B accelerated the decay rate of inactivation for the hKv1.5 currents. Cytochalasin B-induced inhibition of the hKv1.5 channels was voltage dependent with a steep increase over the voltage range of the channel's opening. However, the inhibition exhibited voltage independence over the voltage range in which channels are fully activated. Cytochalasin B produced no significant effect on the steady-state activation or inactivation curves. The rate constants for association and dissociation of cytochalasin B were 3.7 microM/s and 7.5 s(-1), respectively. Cytochalasin B produced a use-dependent inhibition of hKv1.5 current that was consistent with the slow recovery from inactivation in the presence of the drug. Cytochalasin B (10 microM) also inhibited an ultrarapid delayed rectifier K(+) current (I(K,ur)) in human atrial myocytes. These results indicate that cytochalasin B primarily blocks activated hKv1.5 channels and endogenous I(K,ur) in a cytoskeleton-independent manner as an open-channel blocker.
