Balloon sclerotherapy: A new method for the treatment of truncal varicose veins

VASA ◽  
2008 ◽  
Vol 37 (2) ◽  
pp. 165-173 ◽  
Author(s):  
Leu ◽  
Inderbitzi
Keyword(s):  
Side Effects ◽  
Varicose Veins ◽  
Guide Wire ◽  
Balloon Catheter ◽  
Minimal Invasive ◽  
Systemic Effects ◽  
Sclerosing Agent ◽  
Cheap Method ◽  
Extensive Test ◽  
Isolated Segment

Background: Truncal varicose veins may be treated by conventional surgery or endovenous therapy. Endovenous ablation, such as laser or radiofrequency treatment, is less invasive but technically demanding, not cheap and has still the possibility of important side-effects. Moreover the treatment requires in the best case tumescent anesthesia. Catheter based endovenous sclerotherapy has the potential of systemic effects of sclerosing agent and air. We therefore aimed to develop a simple, minimal-invasive and cheap method for the treatment of truncal varicose veins reducing the potential risk of systemic effects of the sclerosing agent to a minimum. Methods: A double lumen double balloon catheter was developed. Thereby a treatment site within a vein can be isolated from blood for localized administration of a sclerotherapeutic agent. Later, a substantial portion of the therapeutic agent can be removed from the isolated segment thus minimizing the amount necessary. Occlusion of longer varicose segments is achieved by pointwise repetition of the manoeuvre or careful retraction of the expanded balloons with the "catched" sclerotherapeutic agent in between. Results: The application was filed as United States Patent No. 6,726,67 B2. 18 balloon prototypes successfully passed an extensive test series (leak tests, dimension tests, mandrel –, guide wire – and introducer compatibility tests, destructive tests). Three patients with varicosity of the greater saphenous vein and the vena saphena accessoria lateralis, respectively, were successfully treated with complete occlusion of the vessels 10, 6 and 2 months after the intervention. Conclusions: Balloonsclerotherapy combines two well-established procedures (balloon catheter therapy and sclerotherapy, namely) and promises to be a minimal-invasive and cheap endovenous therapy of truncal varicose veins, requiring local anesthesia at the puncture site only and reducing possible systemic side effects of the sclerosing agent.

Pain Perception and Side Effects During Saline Infusion Sonohysterography With a Balloon Catheter

2020 ◽  
Vol 39 (9) ◽  
pp. 1829-1837
Author(s):  
Firoozeh Ahmadi ◽  
Nadia Jahangiri ◽  
Fatemeh Zafarani ◽  
Ahmad Vosough
Keyword(s):  
Side Effects ◽  
Pain Perception ◽  
Balloon Catheter ◽  
Saline Infusion ◽  
Saline Infusion Sonohysterography

Guide wire extension may not be essential to pass an over-the-wire balloon catheter

1995 ◽  
Vol 36 (1) ◽  
pp. 59-60 ◽  
Author(s):  
Tanvir Ahmad ◽  
John G. Webb ◽  
Ronald G. Carere ◽  
Arthur Dodek
Keyword(s):  
Guide Wire ◽  
Balloon Catheter ◽  
Wire Extension ◽  
The Wire

Minor disorders of pregnancy

2017 ◽  
Author(s):  
Janet Medforth ◽  
Linda Ball ◽  
Angela Walker ◽  
Sue Battersby ◽  
Sarah Stables
Keyword(s):  
Side Effects ◽  
Varicose Veins

A general discussion of the concept of key minor disorders of pregnancy is followed by an explanation of the incidence, causes, side effects, and recommended management of a range of minor disorders, including nausea, constipation, indigestion and heartburn, varicose veins, haemorrhoids, backache, and frequency of micturition.

S268 – Cost-Effective Balloon Sinuplasty

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P164-P165
Author(s):  
Paul E Lomeo ◽  
Judith Finneman
Keyword(s):  
Frontal Sinus ◽  
Guide Wire ◽  
New Technology ◽  
Balloon Catheter ◽  
Cost Savings ◽  
Cost Effective ◽  
The United States ◽  
Balloon Sinuplasty ◽  
Guide Catheter ◽  
The Cost

Objectives Balloon sinuplasty is a new procedure that is gaining popularity in the United States. However, with all new technology, there is an increase in cost. Balloon sinuplasty increases the overhead for the facility where it is being performed and does not affect reimbursement. To decrease the cost of new technology, the physician, facility, and the company must all think of creative methods to acheive this goal. Methods In our institution, we had 60 patients that had balloon sinuplasties performed, with all of them involving both maxilary and frontal sinus. Re-useable olive-tip cannula was used instead of the company's recommended disposable guide catheter for the frontal and maxillary sinuses. In using the olive-tip as a guide catheter, the guide wire and balloon catheter are easily directed to the opening of both the maxillary and frontal sinus. Results The outcome from all 60 patients was successful, with none returning for revision. In using the olive-tip cannula instead of the disposable catheter guide for the maxillary and frontal sinuses, there was a savings of $37,500 for the institution. Conclusions The use of an olive-tip cannula from the basic FESS set decreases the cost of performing balloon sinuplasty. This suction-tip can replace the catheter guide without compromising the surgical procedure and is easy to use by the experienced sinus surgeon. There was a cost savings of $625 per procedure when using an olive-tip cannula instead of the company's recommended catheter guide.

scholarly journals A pilot study to assess the feasibility of endoscopic placement of a transurethral urinary balloon catheter in male sheep cadavers

2019 ◽  
Vol 61 (1) ◽  
Author(s):  
Marlene Sickinger ◽  
Reto Neiger ◽  
Axel Wehrend
Keyword(s):  
Urinary Catheter ◽  
Guide Wire ◽  
Balloon Catheter ◽  
Small Ruminants ◽  
Stricture Formation ◽  
Correct Position ◽  
Mucous Membranes ◽  
Transurethral Catheter ◽  
Endoscopic Placement ◽  
Male Sheep

Abstract Surgery of obstructive urolithiasis in small ruminants is often unsatisfactory due to postoperative development of strictures. The present study aimed to establish an endoscopic technique for the placement of a transurethral urinary catheter into the bladder of rams. This catheter was used as a removable stent-like drainage. The procedure was performed in three sheep rams that were euthanized and placed for surgery in 45° Trendelenburg position. In one ram, cystotomy was performed via right paramedian laparotomy. A 3 mm flexible fiberscope was introduced into the urinary bladder and advanced via urethra to the tip of the penis. Placing a guide wire through the endoscopic working channel into the urethra enabled the retrograde insertion of a transurethral urinary catheter into the bladder. In two rams, retrograde insertion of a fiberscope was performed. Again, a guidewire was used to insert a balloon catheter into the bladder. Paramedian right laparotomy was performed to ascertain the correct position of the balloon. Both techniques, antero- and retrograde endoscopy, were possible and could be successfully performed. Mucous membranes and urinary microliths were easily observed. Repeated advancing of the endoscope or the catheter resulted in marked damage of the mucous membranes. The patency of the urethra may be restored by means of endoscopic placement of a transurethral catheter in male small ruminants. The applicability and clinical outcome of this procedure as well as the effects on stricture formation should be further examined with controlled clinical studies.

Retrograde Dilation of Postsaccal Lacrimal Stenosis

1994 ◽  
Vol 103 (2) ◽  
pp. 110-114 ◽  
Author(s):  
Franz Josef Steinkogler ◽  
Andreas Kuchar ◽  
Ernst Huber ◽  
Franz Karnel
Keyword(s):  
Guide Wire ◽  
Balloon Catheter ◽  
Balloon Dilation ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Nasolacrimal Duct ◽  
Balloon Catheters ◽  
Nasolacrimal Duct Stenosis ◽  
Silicone Intubation ◽  
Transluminal Coronary Angioplasty ◽  
Duct Stenosis

The causes of nasolacrimal duct stenosis in adults can vary greatly. In general, the symptoms can also vary, but most cases share a tendency toward recurring inflammations in the prestenotic area. The treatment of these disorders is limited to either conservative therapy to control inflammation or surgically invasive measures. By using balloon catheters, usually applied in percutaneous transluminal coronary angioplasty (PTCA), dilation of the relative postsaccal stenosis can be performed under radiographic control. An exact diagnosis using various testing methods, including digital dacryocystography for detailed localization and documentation of any pathologic changes, is decisive to success. Only in cases of incomplete postsaccal stenosis is retrograde balloon dilation of the distal nasolacrimal duct indicated. A guide wire, designed for the PTCA balloon catheter set, is introduced via the canaliculus to the nasal cavity antegradely and caught with a thin hook and pulled from the naris, under visual control with an image converter. The balloon catheter is retrogradely threaded over the guide wire. The balloon is then placed at the site of the pathologic stenosis under radiographic control and dilated with high pressure. To ensure the permeability of the system, monocanalicular silicone intubation has to be performed immediately afterwards. This procedure has been performed successfully on 6 patients with a follow-up of 6 to 27 months. These initial results give rise to the hope that this minimally invasive, interdisciplinary technique represents a new alternative in the treatment of incomplete postsaccal lacrimal stenosis.

scholarly journals EVALUATION OF THE MINIMAL EFFECTIVE FOAM SCLEROSANT CONCENTRATION AT SCLEROTHERAPY OF VARICOSE VEINS IN THE LOWER EXTREMITIES

2019 ◽  
Vol 111 (3) ◽  
pp. 11-20
Author(s):  
Khrystyna Korolova
Keyword(s):  
Side Effects ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Histopathological Examination ◽  
Varicose Veins ◽  
Post Treatment ◽  
Vein Wall ◽  
Negative Side ◽  
Chemical Agents ◽  
Negative Side Effects

Chronic venous insufficiency is a widespread, global problem and continuously progresses with increasing age. Actual is a question of treatment of various classes of chronic venous insufficiency. Today, due to the widespread introduction of instrumental techniques and chemical agents, the era of minimally invasive interventions that compete with classical venectomies has begun. The gold standard for treating the initial manifestations of chronic venous insufficiency is sclerotherapy. It has been used to treat varicose veins since the beginning of the last century. In chemical sclerotherapy, various chemical agents are used, which, first of all, contribute to damage, dehydration and destruction of endothelial cells, which leads to the elimination of veins. All sclerosants are a compromise between efficacy and toxicity. In the scientific world, discussions are still ongoing and there is insufficient clinical data regarding the optimal choice of sclerosant and its concentration. The aim of this study was to study the histopathological changes in the vein wall, which can be caused by different concentrations of foam sclerosants, and to study the main negative side effects that occur in patients treated with these concentrations of sclerosants. Our study included 40 patients who were hospitalized from December 2017 to May 2019 with major varicose veins in combination with reticular varicose veins or telangiectasias (C2 - C4a class of varicose veins according to CEAP classification), patients underwent open venectomy followed by repeated sclerotherapy in distant period. Patients were randomized into 3 main groups of 10 people who were injected with the most common concentrations of polidocanol: 0.5%, 1% and 3%. The comparison group was 10 people with a similar pathology. Polidocanol was injected in foam form the day before surgery - venectomy. During venectomy, previously marked segments of the veins were carefully removed and sent for histopathological examination. general assessment was carried out according to a system that reflected the degree of damage to the vein wall in points. Three weeks after venectomy, all patients underwent sclerotherapy of small veins using sclerosants of the same concentration as before surgery. Clinical evaluation of post-treatment negative events was performed twice: on the second day and in a month. The results of the study confirm that changes in the vascular wall are already caused when using 0.5% foam polidocanol. The most pronounced and profound changes are caused by the action of 3% foam polidocanol, which is accompanied by a large number of negative side effects in the post-treatment period. The most optimal for sclerotherapy of veins with a diameter of 5-7 mm is 1% concentration. When this concentration is injected, there is enough damage to the vein for its further obliteration, which is not accompanied by as many negative manifestations as a higher concentration. The results of the study may be useful for phlebologists who use sclerotherapy to treat the initial manifestations of chronic venous insufficiency.

Long-term safety and efficacy study of intranasal ipratroprium bromide

1990 ◽  
Vol 104 (2) ◽  
pp. 123-125 ◽  
Author(s):  
C. A. Milford ◽  
T. A. Mugliston ◽  
V. J. Lund ◽  
I. S. Mackay
Keyword(s):  
Side Effects ◽  
Open Trial ◽  
Systemic Effects ◽  
Efficacy Study ◽  
Safety And Efficacy ◽  
Treatment Side Effects ◽  
Main Complaint ◽  
One Year

AbstractForty patients presenting with watery rhinorrhoea as their main complaint were entered in an open trial of long-term intranasal ipratroprium bromide. Fourteen of these (35 per cent) found it to be beneficial and completed one year of treatment. Side-effects were seen in 28 patients (70 per cent) but these were local and mild in nature. All resolved during the trial as patients adjusted the dosage to individual severity and frequency of symptoms. No significant systemic effects were noted during the course of therapy. Ipratroprium is a useful drug in the treatment of watery rhinorroea and appears safe for long-term use.

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