Myocardial Protection during Reoperative Cardiac Surgery: Early Experience with a New Technique.
Authors: Velissaris T, Khan OA, Asopa S, Calver A, Ohri SK
We recently introduced a new adjunct to myocardial preservation in patients with a patent left internal mammary artery graft who were undergoing reoperative cardiac surgery. The purpose of this study was to review our early experience with this technique.The technique consists of preoperative insertion of a suitably sized angioplasty balloon catheter into the proximal part of the graft under fluoroscopic guidance. Intraoperative inflation of the balloon results in occlusion of the graft during aortic cross-clamping. We have used this technique in 9 patients. The case records of these patients were retrospectively reviewed.There were 5 men and 4 women with a mean age of 71 +/- 11 years and a mean Euro-SCORE of 10 +/- 3. The medi......
POSTED 03/06/2010 at 05:20 PM --
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Revascularization options in patients with chronic kidney disease.
Authors: Ashrith G, Elayda MA, Wilson JM
Cardiovascular disease is the leading cause of death in patients who have chronic kidney disease or end-stage renal disease and are undergoing hemodialysis. Chronic kidney disease is a recognized risk factor for premature atherosclerosis. Unfortunately, most major randomized clinical trials that form the basis for evidence-based use of revascularization procedures exclude patients who have renal insufficiency. Retrospective, observational studies suggest that patients with end-stage renal disease and severe coronary occlusive disease have a lower risk of death if they undergo coronary revascularization rather than medical therapy alone. Due to a lack of prospective studies, however, the relative merits of percutaneous versus surgical revasculari......
POSTED 03/06/2010 at 05:20 PM --
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Catheter-directed thrombolysis with conventional aspiration thrombectomy for lower extremity deep vein thrombosis.
CONCLUSION: Catheter-directed thrombolysis with conventional aspiration thrombectomy is an effective treatment for lower extremity deep vein thrombosis and produces satisfactory clinical results.
PMID: 20191009 [PubMed - in process] (Source: Yonsei Medical Journal)...
POSTED 02/28/2010 at 06:00 PM --
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Period Prevalence of Iliofemoral Venous Occlusive Disease by Doppler Ultrasound Imaging and Corresponding Treatment in a Tertiary Care Facility
Patients with iliofemoral deep venous thrombosis (DVT) are at highest risk for post-thrombotic morbidity, including the post-thrombotic syndrome. Invasive therapies such as catheter-directed thrombolysis (CDL), thrombectomy with or without balloon angioplasty, and stenting improves venous patency, venous valve function, and quality of life in patients with acute iliofemoral DVT. What is the current prevalence of acute iliofemoral DVT and how aggressively is it being treated? We hypothesized that the 10-year period prevalence of iliofemoral DVT among acute DVT cases is greater than previously reported and that thrombus removal to treat acute iliofemoral DVT is little utilized in current practice. (Source: Journal of Vascular Surgery)...
POSTED 02/28/2010 at 06:00 PM --
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Stroke study puts 2 procedures on equal footing
Stenting and surgery are both effective ways to limit stroke risks, research suggests. Which to choose may be a matter of patient preference.
For patients with a hardening of the neck arteries that can lead to a stroke, balloon angioplasty and stenting are virtually as effective and safe as the long-used gold standard of surgical removal of the plaque, according to the largest comparison of the two procedures ever conducted. (Source: Los Angeles Times - Science)...
POSTED 02/26/2010 at 08:30 AM --
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TriReme Medical, Inc. Receives FDA 510K Clearance For Glider(TM) PTA Balloon Catheter
TriReme Medical, Inc. (TMI) announced that it has received FDA clearance for its newest product, the Glider™ balloon catheter, for percutaneous transluminal angioplasty (PTA) of lesions in the peripheral vasculature including the iliac, femoral, ilio-femoral, popliteal, infra-popliteal, and renal arteries. Approximately 12 million Americans are affected by peripheral arterial disease (PAD). Those patients suffer from chronic pain, significant mobility limitations and debilitating quality of life. Left untreated, PAD can lead to a limb loss and even to death... (Source: Health News from Medical News Today)...
POSTED 02/26/2010 at 06:00 AM --
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TriReme Medical, Inc. Receives FDA 510K Clearance For Glider(TM) PTA Balloon Catheter
TriReme Medical, Inc. (TMI) announced that it has received FDA clearance for its newest product, the Glider™ balloon catheter, for percutaneous transluminal angioplasty (PTA) of lesions in the peripheral vasculature including the iliac, femoral, ilio-femoral, popliteal, infra-popliteal, and renal arteries... (Source: Medical Devices News From Medical News Today)...
POSTED 02/26/2010 at 06:00 AM --
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Stroke study puts 2 procedures on equal footing
For patients with a hardening of the neck arteries that can lead to a stroke, balloon angioplasty and stenting are virtually as effective and safe as the long-used gold standard of surgical removal of the plaque, according to the largest comparison of the... (Source: OrlandoSentinel: Medical Research)...
POSTED 02/26/2010 at 12:30 AM --
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Navigation within the heart and vessels in clinical practice
The field of interventional cardiology has developed at an unprecedented pace on account of the visual and imaging power provided by constantly improving biomedical technologies. Transcatheter-based technology is now routinely used for coronary revascularization and noncoronary interventions using balloon angioplasty, stents, and many other devices. In the early days of interventional practice, the operating physician had to manually navigate catheters and devices under fluoroscopic imaging and was exposed to radiation, with its comcomitant necessity for wearing heavy lead aprons for protection. Until recently, very little has changed in the way procedures have been carried out in the catheterization laboratory. The technological capacity to remotely manipulate devices, using robotic arms ......
POSTED 02/22/2010 at 06:00 PM --
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Technical and Clinical Results After Percutaneous Angioplasty in Nonmedial Fibromuscular Dysplasia: Outcome After Endovascular Management of Unifocal Renal Artery Stenoses in 30 Patients
Abstract Although percutaneous transluminal renal angioplasty (PTRA) is associated with excellent results in medial fibromuscular dysplasia
(FMD), the clinical and technical outcome in the less common nonmedial subtype of FMD is not clearly known. Angiographic PTRA
results and clinical follow-up were documented, to report technical and clinical results in 30 patients with unifocal, nonmedial
dysplastic stenoses. Balloon angioplasty was technically successful in only 65% of the lesions. Additional stenting, performed
after PTRA failure in six patients, increased the initial technical success rate to 82%. Stenting was used in another lesion
after restenosis, and long-term patency was achieved in only three of the seven stented lesions. Frequent restenoses and unusual
complic......
POSTED 02/18/2010 at 12:56 AM --
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Stuck coronary angioplasty balloon: A surgical emergency
Abstract A 69-year-old patient underwent percutaneous coronary angioplasty and stenting of a calcified tight mid-circumflex coronary
artery lesion between the origins of first two obtuse marginal arteries. The balloon got stuck inside the stent in a partially
deflated condition and could not be retrieved. Under cardiopulmonary bypass, with cardioplegic arrest, the stent-balloon-catheter
were extracted through coronary arteriotomy following endarterectomy of the calcified lesion. The patient had reversed saphenous
vein grafts to the two obtuse marginal arteries.
Content Type Journal ArticleCategory Case ReportDOI 10.1007/s12055-009-0019-7Authors
Biswa Ranjan Panda, Christian Medical College Department of Cardiothoracic Surgery Vellore Tamil Nadu India 632004Viji Samuel......
POSTED 02/18/2010 at 12:53 AM --
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Diagnostic Criteria and Yield of Real-Time Transcranial Doppler Monitoring of Intra-Arterial Reperfusion Procedures.
CONCLUSIONS: Our velocity, intensity, and flow signatures criteria for TCD monitoring of IA reperfusion procedures detect reocclusion, hyperperfusion, or thromboembolism and air embolism in nearly half of all procedures. This hemodynamic information can be particularly helpful when neurological assessment is limited or delayed.
PMID: 20167923 [PubMed - as supplied by publisher] (Source: Stroke)...
POSTED 02/17/2010 at 06:00 PM --
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Cephalic arch stenosis in autogenous brachiocephalic hemodialysis fistulas: Results of cutting balloon angioplasty.
Conclusion: Treatment of cephalic arch stenosis with CBA did not improve patency compared to published results of conventional PTA, but our results indicate that CBA may lower the frequency of required re-interventions.
PMID: 20175059 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)...
POSTED 02/14/2010 at 06:00 PM --
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Twitter Weekly Updates for 2010-02-14
Do not let NHS use private services – http://bmj.com/cgi/content/long/340/feb12_2/c884 #
New blog post: test http://barl.in/9dZoo8 #
Healthcare Capitalism at it's worst – One Grand Deal Too Many Costs Lobbyist His Job – http://nyti.ms/cVLexq – #
PAUL KRUGMAN – Republicans and Medicare – NYTimes.com – http://goo.gl/9Ve2 #
Stent Graft versus Balloon Angioplasty for Failing Dialysis-Access Grafts http://bit.ly/bATDgy #
Why former employees say Microsoft can't innovate Betanews – http://goo.gl/J8lu – the beer belly principle – applies 2 mobility and rehab 2 #
New blog post: Completely Off Topic – Shaking Hands Spreads More Germs Than Kissing http://bit.ly/bEX52o #
After years of digging, Jim Flavin (ex DCC) makes a great......
POSTED 02/13/2010 at 05:00 PM --
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Stent Graft versus Balloon Angioplasty for Failing Dialysis-Access Grafts
This important RCT concludes that in treatment of venous anastomotic stenosis of hemodialysis grafts, angioplasty plus placement of a stent provides better longer-term patency and freedom from repeat interventions than balloon angioplasty.:
Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function: A Randomized Trial.
Effect of dipyridamole plus aspirin on hemodialysis graft patency
Cognitive-behavioral group therapy is an effective treatment for major depression in hemodialysis patients.
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POSTED 02/12/2010 at 07:36 PM --
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NEJM: Stent grafts best balloon angioplasty for renal disease
Stent grafts have proven to provide more long-term relief and independence from repeat interventions than standard balloon angioplasty for the percutaneous revision of venous anastomotic stenosis in patients with a prosthetic hemodialysis graft, according to Ziv Haskal, MD, of the division of vascular and interventional radiology at the University of Maryland Medical Center in Baltimore, and colleagues. (Source: Health Imaging News)...
POSTED 02/12/2010 at 11:33 AM --
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Stent Grafts Top "Gold Standard" Balloon Angioplasty For Dialysis Patients
A randomized multicenter study of 190 patients at 13 medical centers shows - for the first time - the "superior" benefit of stent grafts over balloon angioplasty for maintaining function of dialysis access grafts in kidney failure patients who undergo dialysis. Until now, no other therapy has proven more effective than angioplasty... (Source: Transplants / Organ Donations News From Medical News Today)...
POSTED 02/12/2010 at 07:00 AM --
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Stent Grafts Top "Gold Standard" Balloon Angioplasty For Dialysis Patients
A randomized multicenter study of 190 patients at 13 medical centers shows - for the first time - the "superior" benefit of stent grafts over balloon angioplasty for maintaining function of dialysis access grafts in kidney failure patients who undergo dialysis. Until now, no other therapy has proven more effective than angioplasty. At six months, the stent grafts allowed dialysis patients to continue life-saving treatment with significantly fewer interruptions and invasive procedures, according to a study published in the Feb. 11 issue of the New England Journal of Medicine... (Source: Health News from Medical News Today)...
POSTED 02/12/2010 at 07:00 AM --
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Stent Grafts Top "Gold Standard" Balloon Angioplasty For Dialysis Patients
A randomized multicenter study of 190 patients at 13 medical centers show for the first time the "superior" benefit of stent grafts over balloon angioplasty for maintaining function of dialysis access grafts in kidney failure patients who undergo dialysis. Until now, no other therapy has proven more effective than angioplasty. At six months, the stent grafts allowed dialysis patients to continue life-saving treatment with significantly fewer interruptions and invasive procedures, according to a study published in the Feb. 11 issue of the New England Journal of Medicine... (Source: Health News from Medical News Today)...
POSTED 02/12/2010 at 04:00 AM --
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Stent Grafts Top "Gold Standard" Balloon Angioplasty For Dialysis Patients
A randomized multicenter study of 190 patients at 13 medical centers show for the first time the "superior" benefit of stent grafts over balloon angioplasty for maintaining function of dialysis access grafts in kidney failure patients who undergo dialysis. Until now, no other therapy has proven more effective than angioplasty... (Source: Medical Devices News From Medical News Today)...
POSTED 02/12/2010 at 04:00 AM --
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