Using the Casper Stent in Carotid Angioplasty: A Single Center Experience

Abstract Objectives To establish the success rate in endovascular internal carotid artery (ICA) stenosis recanalization using the double-layer stent Casper-RX (Microvention, Inc 35 Enterprise, Aliso Viejo, California, United States of America) and to identify the main comorbidities in individuals with ICA stenosis, morphological characteristics of the stenosis, diagnostic methods, intraoperative complications, as well as morbidity and mortality within 30 days of the surgical procedure. Materials and Methods Retrospective analysis of 116 patients undergoing ICA angioplasty with a degree of stenosis ≥ 70% using Casper-RX stenting who underwent this procedure from April 2015 to December 2019. Results Technical success was achieved in 99.1% of the patients. Three of them had postprocedural complications: one transient ischemic attack (TIA) and two puncture site hematomas. A cerebral protection filter was not used in only two procedures, as these consisted of dissection of the carotid. There was satisfactory recanalization and adequate accommodation of the stents in the previously stenosed arteries, with no restenosis in 99.4% of the cases. Conclusion The endovascular treatment of extracranial carotid stenoses using the Casper-RX stent showed good applicability and efficacy. Although only two cases of thromboembolic complications occurred during the procedure, further investigation and studies on the effectiveness of this new device are needed.

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Radiomorphology of the Habib Sealer-Induced Resection Plane during Long-Time Followup:A Longitudinal Single Center Experience after 64 Radiofrequency-AssistedLiver Resections

HPB Surgery ◽

10.1155/2010/403097 ◽

2010 ◽

Vol 2010 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Robert Kleinert ◽

Roger Wahba ◽

Christoph Bangard ◽

Klaus Prenzel ◽

Arnulf H. Hölscher ◽

...

Keyword(s):

Liver Resection ◽

Morphological Characteristics ◽

Postoperative Mortality ◽

Coagulation Necrosis ◽

Time Interval ◽

Safe Alternative ◽

Time Points ◽

Single Center Experience ◽

Long Time

Background. Radiofrequency (RF-) assisted liver resection devices like the Habib sealer induce a necrotic resection plane from which a small margin of necrotic liver tissue remains in situ. The aim of the present paper was to report our long-time experience with the new resection method and the morphological characteristics of the remaining necrotic resection plane. Methods. 64 RF-assisted liver resections were performed using the Habib sealer. Followup was assessed at defined time points. Results. The postoperative mortality was 3,6% and morbidity was 18%. The followup revealed that the necrotic zone was detectable in all analyzed CT and MRI images as a hypodense structure without any contrast enhancement at all time points, irrespectively of the time interval between resection and examination. Conclusion. Liver resection utilizing radiofrequency-induced resection plane coagulation is a safe alternative to the established resection techniques. The residual zone of coagulation necrosis remains basically unchanged during a followup of three years. This has to be kept in mind when evaluating the follow up imaging of these patients.

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Surgical Approach to Splenic Hydatid Cyst: Single Center Experience

International Surgery ◽

10.9738/intsurg-d-13-00138.1 ◽

2013 ◽

Vol 98 (4) ◽

pp. 346-353 ◽

Cited By ~ 10

Author(s):

Cengiz Eris ◽

Sami Akbulut ◽

Mehmet Kamil Yildiz ◽

Hasan Abuoglu ◽

Mehmet Odabasi ◽

...

Keyword(s):

Hydatid Cyst ◽

Surgical Approach ◽

Treatment Options ◽

Clinical Findings ◽

Partial Cystectomy ◽

Diagnostic Methods ◽

Septic Complications ◽

Single Center Experience ◽

Medicinal Treatment ◽

Splenic Hydatid Cyst

Abstract The benefits and risks of surgery for splenic hydatid cyst (SHC) remain controversial. We aimed to share our experience about a surgical approach for SHC. Sixteen consecutive patients with SHC disease who underwent open splenectomy at our hospital between January 2006 and July 2012 were retrospectively evaluated. Data on the patients' demographic features, clinical findings, radiological and serological diagnostic methods, and surgical and medicinal treatment options were collected and used to generate descriptive profiles of diagnosis, treatment course, and outcome. The patient population was composed of 6 females and 10 males, with an age range of 18 to 79 years (mean age: 47.0 ± 18.0). Radiological examinations detected hydatid cysts in spleen alone (n = 7) or both spleen and liver (n = 9). Preoperative serological testing identified 13 of the patients as IHA positive. All except 1 patient received a 10- to 21-day preoperative course of albendazole therapy and all patients received vaccination 1 week prior to surgery. Seven patients underwent splenectomy. The remaining patients underwent splenectomy with partial cystectomy and omentopexy (n = 6), partial cystectomy and unroofing (n = 1), pericystectomy (n = 1), or pericystectomy with partial nephrectomy (n = 1). All except one patient received a 10- to 45-day postoperative course of albendazole. No patients developed serious complications or signs of recurrence during the follow-up. The clinical profile of SHC disease at our hospital includes diagnosis by radiological methods, splenectomy treatment by simple or concomitant procedures according to the patient's symptoms, cyst size, number and localization, and compression of adjacent organs, and adjunct vaccination to decrease risk of postoperative septic complications. This profile is associated with low risk of complications and high therapeutic efficacy.

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Retrospective Evaluation of Pediatric Patients With Abdominal Tuberculosis: A Single Center Experience

Çocuk Enfeksiyon Dergisi/Journal of Pediatric Infection ◽

10.5578/ced.202065 ◽

2020 ◽

Vol 54 (4) ◽

pp. 204-211

Author(s):

Sevgi Yaşar Durmuş ◽

Gönül Tanır ◽

Ayşe Seçil Ekşioğlu ◽

Türkan Aydın Teke ◽

Yasemin Taşçı Yıldız ◽

...

Keyword(s):

Histopathological Examination ◽

Extrapulmonary Tuberculosis ◽

Abdominal Tuberculosis ◽

Diagnostic Methods ◽

Mycobacterium Tuberculosis Infection ◽

Reactive Protein ◽

Single Center Experience ◽

Antituberculosis Treatment ◽

History Of ◽

The Mean

Objective: Abdominal tuberculosis is a kind of extrapulmonary tuberculosis that can usually occur during the lymphohematogenous spread of first Mycobacterium tuberculosis infection, develop by neighborhood from an abdominal focus or a mesenteric lymph node. The aim of this study is to evaluate pediatric cases diagnosed with abdominal tuberculosis. Material and Methods: Between 2012-2018, seven patients diagnosed with abdominal tuberculosis through patients who diagnosed with extrapulmonary tuberculosis in our hospital, were included in study. Demographic and clinical characteristics, diagnostic methods, commenced treatments and clinical follow up of patients were listed from medical records. Results: Of patients, four were female. The mean age was 144.2 ± 42.7 months. None of the patients had a history of tuberculosis contact. The median complaint time was 20 days (5-180). The most frequent complaint was abdominal pain and the most frequent physical examination finding was abdominal tenderness. Mean white blood cell count was 9.26 x 103 ± 4.77 x 103 μ/L, C reactive protein level: 79.9 ± 54.9 mg/dL, erytrocyte sedimentation rate: 45 ± 30 mm/h. Tuberculin skin test was positive in two patients, interferon gamma releasing assay was positive in three patients, and in two patients, both tests were positive. There were findings suggesting tuberculosis on pulmonary imaging in five patients and abdominal imaging in all patients. Histopathological examination of the specimens of six patients revealed findings consistent with tuberculosis. The presence of M. tuberculosis was confirmed microbiologically in clinical specimens taken from three patients. The most common abdominal tuberculosis type was mesenteric lymphadenitis. The mean time from admission to diagnosis was 15 ± 12.8 days. All patients recieved antituberculosis treatment. Conclusion: Abdominal tuberculosis should be kept in mind, in patients presenting with abdominal complaints lasting more than five days. Ultrasonography and computed tomography are useful to determine abdominal tuberculosis type. The disease can be sucsessfully treated with standart antituberculosis treatment.

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Clinical Results and Problems of Percutaneous Transluminal Angioplasty and Stenting for Extracranial Internal Carotid Stenoses

Interventional Neuroradiology ◽

10.1177/15910199010070s104 ◽

2001 ◽

Vol 7 (1_suppl) ◽

pp. 41-44

Author(s):

M. Tsuura ◽

T. Terada ◽

O. Masuo ◽

H. Matsumoto ◽

T. Itakura ◽

...

Keyword(s):

Internal Carotid ◽

Balloon Catheter ◽

Clinical Results ◽

Transluminal Angioplasty ◽

Symptomatic Case ◽

Carotid Stenoses ◽

Angioplasty And Stenting ◽

Ica Stenosis ◽

Percutaneous Transluminal ◽

Extracranial Ica

110 patients with extracranial ICA stenosis were treated by PTA or stenting. In 21 of 55 cases of only PTA and in 40 of 55 cases of stenting, we used our blocking balloon systems to prevent distal embolism. The morbidity and the mortality rates were 5.4% and 0%, respectively. There was only one embolic complication in cases of PTA or stenting where blocking balloon systems were used. In contrast, distal embolism occurred in 3 of 34 cases of PTA without blocking balloon systems (one symptomatic case) and in 4 of 15 cases of stenting without blocking balloon systems (3 symptomatic cases). Our blocking balloon catheter system is a useful device to reduce the risk of symptomatic distal embolism.

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Intravascular Ultrasound with Percutaneous Transluminal Angioplasty for Supra-Aortic Arteries

Interventional Neuroradiology ◽

10.1177/15910199980040s103 ◽

1998 ◽

Vol 4 (1_suppl) ◽

pp. 27-30

Author(s):

J. Uno ◽

M. Kawashima ◽

M. Miyazono ◽

T. Nakamura ◽

H. Gi

Keyword(s):

Intravascular Ultrasound ◽

Percutaneous Transluminal Angioplasty ◽

Mixed Type ◽

Morphological Characteristics ◽

Transluminal Angioplasty ◽

Plaque Morphology ◽

Atheromatous Plaques ◽

Ica Stenosis ◽

Fatty Plaque ◽

Percutaneous Transluminal

One of the major complications during or after percutaneous transluminal angioplasty (PTA) is distal embolism. We performed intravascular ultrasound (IVUS) to assess the morphological characteristics of atheromatous plaques which caused stenosis of arteries. In 7 cases of ICA stenosis, IVUS demonstrated hyperechoic plaques which were considered to be fibrous. Mixed type of plaque was observed in one case of ICA stenosis and another one case of ICA stenosis had plaque which was hyperechoic with acoustic shadowing. In all cases of SCA stenosis, plaques were hypoechoic, indicating fatty plaque. Distal embolism occurred after PTA in the case of ICA stenosis which had a mixed type of plaque. It is important to evaluate plaque morphology to prevent distal embolism. PTA is considered to he contraindicated in cases of ICA stenosis having hypoechoic plaques or ulceration.

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Comparison between LigaSure™ and Harmonic® in Laparoscopic Sleeve Gastrectomy: A Single-Center Experience on 422 Patients

Journal of Obesity ◽

10.1155/2019/3402137 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

N. Velotti ◽

M. Manigrasso ◽

K. Di Lauro ◽

A. Vitiello ◽

G. Berardi ◽

...

Keyword(s):

Bariatric Surgery ◽

Postoperative Complications ◽

Operative Time ◽

Intraoperative Complications ◽

Hospital Costs ◽

Point Of View ◽

Morbidly Obese ◽

Biomedical Sciences ◽

Single Center Experience ◽

User Friendly

Background. New laparoscopic devices, such as electrothermal bipolar-activated devices (LigaSure™ (LS)) or ultrasonic systems (Harmonic® scalpel (HS)), have been applied recently to bariatric surgery allowing to reduce blood loss and surgical risks. The aim of this study was to retrospectively compare intraoperative performance of HS and LS, postoperative results, and clinical outcomes in a large cohort of patients undergoing LSG. Methods. Data from 422 morbidly obese patients undergoing LSG in our Bariatric Unit at the Advanced Biomedical Sciences Department of the “Federico II” University of Naples (Italy) between January 2009 and December 2017 were retrospectively analyzed. Subjects were divided into two groups (HS and LS), and operative time, intraoperative complications, and postoperative (within 30 days from surgery) complications were compared. Bleeding from the omentum or from the staple line, use of hemostatic clips, and absorbable hemostat were recorded as intraoperative complications; hemorrhages, abscess formation, gastric leaks, fever, and mortality were considered as postoperative complications. Results. Statistical analysis showed no difference in terms of baseline demographics between the two cohorts. Operative time (48 ± 9 vs 49 ± 6 min, p=0.646) and the rates of intraoperative and postoperative complications did not significantly differ between groups. Conclusion. Harmonic® and LigaSure™ are both useful tools in bariatric surgery, and these two advanced power devices are user-friendly and can facilitate surgeon work; from this point of view, the choice of the energy device should be based on the preference of the surgeon and on the hospital costs policy and availability.

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Early Carotid Endarterectomy for Symptomatic Stenosis of Internal Carotid Artery in Patients Affected by Transient Ischemic Attack or Minor-to-Moderate Ischemic Acute Stroke: A Single-Center Experience

Annals of Vascular Surgery ◽

10.1016/j.avsg.2019.10.088 ◽

2020 ◽

Vol 65 ◽

pp. 232-239

Author(s):

Ottavia Borghese ◽

Angelo Pisani ◽

Bertrand Lapergue ◽

Isabelle Di Centa

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Acute Stroke ◽

Carotid Endarterectomy ◽

Transient Ischemic Attack ◽

Internal Carotid ◽

Single Center ◽

Single Center Experience ◽

Ischemic Attack ◽

Symptomatic Stenosis

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Clinical Results of Stenting for Cervical Internal Carotid Stenoses

Interventional Neuroradiology ◽

10.1177/15910199030090s118 ◽

2003 ◽

Vol 9 (1_suppl) ◽

pp. 133-136 ◽

Cited By ~ 1

Author(s):

M. Tsuura ◽

T. Terada ◽

H. Matsumoto ◽

O. Masuo ◽

T. Itakura ◽

...

Keyword(s):

Mortality Rate ◽

Internal Carotid ◽

Balloon Catheter ◽

Clinical Results ◽

The Other ◽

Diffusion Weighted Mri ◽

Diffusion Weighted ◽

Catheter System ◽

Carotid Stenoses ◽

Ica Stenosis

Total 89 patients with cervical ICA stenosis were treated by stenting. In 74 cases of stenting, we used our blocking balloon systems to prevent distal embolism. The morbidity and the mortality rate was 4.5% and 0%, respectively. Two(3%) of 74 cases showed distal embolism when blocking balloon catheter systems(BBCS) were used, while distal embolism occurred in four (27%) of 15 cases of stenting without BBCS. On diffusion-weighted MRI (DWI), hyperintense areas were detected in seven (47%) of 15 lesions when we used BBCS only during postdilatation. On the other hand, use of BBCS during predilatation as well as postdilatation reduced hyperintense areas on DWI, which were detected in three (25%) of 12 patients. Our blocking balloon catheter system is a useful device to reduce the risk of distal embolism, especially when we use it during not only postdilatation but predilatation.

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Ganglion cyst of Guyon’s canal as a rare cause of compression neuropathy of the ulnar nerve (literature review and case report)

Russian journal of neurosurgery ◽

10.17650/1683-3295-2018-20-2-59-65 ◽

2018 ◽

Vol 20 (2) ◽

pp. 59-65

Author(s):

G. Yu. Evzikov ◽

М. G. Bashlachev ◽

A. V. Farafontov

Keyword(s):

Ulnar Nerve ◽

Ganglion Cyst ◽

Clinical Manifestations ◽

Morphological Characteristics ◽

Diagnostic Methods ◽

Guyon’S Canal ◽

Study Objective ◽

Compression Neuropathy ◽

Palmar Surface ◽

Guyon's Canal

The study objectiveis to analyze the existing research literature devoted to this problem and to assess clinical characteristics and specific features of the diagnosis and rational neurosurgical treatment for ganglion cyst of Guyon’s canal (GCGC) that caused compression neuropathy of the ulnar nerve.Materials and methods.Since 1955, researchers reported only 19 cases of ganglion cysts located in the wrist area and associated with tunnel neuropathy of the ulnar nerve. Since this condition is extremely rare, we present our own clinical observations.Results.Using the literature data, we described various types of ulnar nerve compression according to individual nerve characteristics determining clinical manifestations of GCGC. We analyzed the prevalence of GCGC among patients of various age and gender, disease pathogenesis, and main diagnostic methods. A patient with GCGC-associated compression ischemic neuropathy of the ulnar nerve was treated in the neurological clinic of the I. M. Sechenov First Moscow State Medical University in 2016. Using visualization tools, we found a ganglion cyst located on the palmar surface at the level of the hook-shaped bone. The cyst caused medial displacement of the ulnar nerve and ulnar artery. We performed microsurgical decompression of the right ulnar nerve at the level of Guyon’s canal and removed the articular ganglion cyst using a standard procedure. In the postoperative period, we observed partial regression of neurological disorders.Conclusion.To identify the cause of ulnar nerve neuropathy in Guyon’s canal, a physician should consider both clinical and electrophysiological data and the results of ultrasound examination and/or magnetic resonance imaging. A detailed examination of these patients allows clarifying morphological characteristics of the lesion and identifying such a rare lesion as ganglion cyst.

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