Use of Balloon Inflation to Facilitate Endoscopic Removal of Metallic Airway Stents

SummaryTo characterize the extent of early activation of the hemostatic system following angioplasty, we obtained blood samples from the involved coronary artery of 11 stable angina patients during the procedure and measured sensitive markers of thrombin formation (fibrino-peptide A, prothrombin fragment 1.2, and soluble fibrin) and of platelet activation ((3-thromboglobulin). Levels of hemostatic markers in venous blood obtained from 14 young individuals with low pretest probability for coronary artery disease were not significantly different from levels in venous blood or intracoronary samples obtained prior to angioplasty. Also, there was no translesional (proximal and distal to the lesion) gradient in any of the hemostatic markers before or after angioplasty in samples obtained between 18 and 21 min from the onset of the first balloon inflation. Furthermore, no significant difference was noted between angioplasty and postangioplasty intracoronary concentrations. We conclude that intracoronary hemostatic activation does not occur in the majority of patients during and immediately following coronary angioplasty when high doses of heparin and aspirin are administered.

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ENDOSCOPIC REMOVAL OF TUBULOVILLOUS ADENOMA WITH HIGH-GRADE FOCAL DYSPLASIA IN THE DISTAL COMMON BILE DUCT

10.1055/s-0039-1681498 ◽

2019 ◽

Author(s):

R Alvaro Bendezu Garcia ◽

X Andujar Murcia ◽

C Loras Alastruey

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

High Grade ◽

Endoscopic Removal ◽

Tubulovillous Adenoma ◽

Distal Common Bile Duct

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´FORGOTTEN´ RETROPERITONEAL DOUBLE-PIGTAIL PLASTIC STENT CAUSING COLONIC FISTULIZATION AND ANEMIA 6 YEARS LATER: ENDOSCOPIC REMOVAL

10.1055/s-0040-1704823 ◽

2020 ◽

Author(s):

A Terán ◽

M Moris ◽

CD Pozo ◽

M Pascual ◽

JC Rodriguez Duque ◽

...

Keyword(s):

Endoscopic Removal ◽

Plastic Stent

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Predisposing Factors, Demographics, Angiographic Features, and the Possible Role of Inflammation in Coronary Perforations—A 10-year Single-center Experience

The American Heart Hospital Journal ◽

10.15420/ahhj.2011.9.2.87 ◽

2011 ◽

Vol 9 (2) ◽

pp. 87 ◽

Cited By ~ 1

Author(s):

Preeti Chandra ◽

Saurav Chatterjee ◽

Nishant Koradia ◽

Deepak Thekkoott ◽

Bilal Malik ◽

...

Keyword(s):

Risk Factors ◽

Artery Bypass ◽

Bypass Graft ◽

Coronary Intervention ◽

Predisposing Factors ◽

Covered Stents ◽

Optimal Management ◽

Balloon Inflation ◽

Catheterization Laboratory ◽

Cell Counts

Background:Coronary perforation during percutaneous coronary intervention is a rare but dreaded complication. The risk factors, optimal management, and outcome remain obscure.Objectives:To determine the predisposing factors, optimal management, and preventive strategies. We retrospectively looked at coronary perforations at our catheterization laboratory over the last 10 years. We reviewed patient charts and reports. Two independent operators, in a blinded approach, reviewed all procedural cineangiograms. Data were analyzed by simple statistical methodology.Results:Nine patients were treated conservatively and six patients were treated with prolonged balloon inflation. Six patients were treated with polytetrafluoroethylene (PTFE)-covered stents. One patient required emergency coronary artery bypass graft. No deaths were reported. Subjects with perforations also had a significantly higher total white blood cell count (means 12,134 versus 6,155, 95 % confidence interval [CI], p< 0.0001, n=22), total absolute neutrophil count (means 74.2 % versus 57.1 %, 95 % CI, p<0.0001, n=22), and neutrophil:lymphocyte ratio (means 3.65 versus 1.50, 95% CI, p<0.0001, n=22).Conclusions:Coronary perforations are rare but potentially fatal events. Hypertension, small vessel diameter, high balloon:artery ratio, use of hydrophilic wires, and presence of myocardial bridging appear to be possible risk factors. Most perforations can be treated conservatively or with prolonged balloon inflation using perfusion balloons. Use of PTFE-covered stents could be a life-saving measure in cases of large perforations. Subjects with perforations also had greater systemic inflammation as indicated by elevated white cell counts.

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Percutaneous Coronary Intervention for Complex Bifurcation Lesions

Interventional Cardiology Review ◽

10.15420/icr.2010.5.1.58 ◽

2010 ◽

Vol 5 (1) ◽

pp. 58

Author(s):

Yves Louvard ◽

Morice Marie-Claude ◽

Thomas Hovasse ◽

Thierry Lefèvre ◽

◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Intervention ◽

Side Branch ◽

Drug Eluting Stents ◽

Open Angle ◽

Balloon Inflation ◽

Percutaneous Coronary ◽

Drug Eluting ◽

Bifurcation Lesions ◽

Stent Diameter

Coronary bifurcations are prone to the development of atherosclerosis. They pose technical difficulties for angioplasty treatment and are a predictor of stent thrombosis and restenosis. Treatment of coronary bifurcations is still subject to debate, especially when the side branch (SB) is large, not easily accessible and narrowed by a long lesion. There is currently no indexed treatment for this type of lesion (Medina classification), as the strategy of provisional SB stenting with drug-eluting stents (DES) has proved to be equally efficient as the dualstent technique. Complex techniques are associated with poor outcome in certain lesion types, such as T-stenting when the angle between the two distal branches is small or the crush and culotte technique in the presence of an open angle. Provisional SB stenting may be used when primary dual stenting is required, with a low risk of failure provided that the following guidelines are implemented: stenting of the main branch through the protected SB with a stent diameter adapted to the distal main branch, immediate optimisation of the proximal stent segment (Finet’s law), guidewire exchange, kissing balloon inflation with non-compliant balloons selected according to the diameter of the distal branches and T-stenting of the SB before final kissing inflation.

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