Lumbar Percutaneous Automated Nucleotomy

The purpose of this study was to evaluate 2 years' experience with percutaneous automated nucleotomy. Adult patients with small to medium sized disk hernias corresponding to clinical symptoms, and without evidence of free fragments or stenosis were treated on an outpatient basis. All patients had sciatica and conservative treatment had failed for at least 3 months. Using the Nucleotome R system, access to the disk was achieved in all but 6 of 172 disks in 152 patients. Degenerative disk disease or pain was the reason for technical failures. Four other procedures were discontinued because of pain and moderate hemorrhage. Except for one case of diskitis, no serious complications occurred. Of the patients in a prospective study, 63 had a follow-up period of 4 months or more. The overall clinical success rate was 62%, and was not significantly influenced by patient sex or age, duration of symptoms, level treated, disk degeneration or amount of nucleus material removed. The results are promising; however, this study indicates a need for refined patient selection in order to decrease the number of failures.

Download Full-text

Endovenous radiofrequency powered segmental thermal ablation (Closure FAST) of great saphenous veins

Phlebologie ◽

10.1055/s-0037-1622301 ◽

2010 ◽

Vol 39 (02) ◽

pp. 69-71 ◽

Cited By ~ 6

Author(s):

T. M. Proebstle ◽

Keyword(s):

Side Effects ◽

Thermal Ablation ◽

Clinical Success ◽

Clinical Success Rate ◽

Duplex Ultrasound ◽

Multicenter Trial ◽

Saphenous Veins ◽

Clinical Control ◽

Prospective Multicenter Trial

Summary Background: Radiofrequency powered segmental thermal ablation Closure FAST has become a globally engaged technology for ablation of incompetent great saphenous veins (GSVs). Mid-term results of slowly resolving side effects are still not described. Methods: RSTA-treated GSVs (n = 295) were followed for 24 months in a prospective multicenter trial. Clinical control visits included flow and reflux analysis by duplex-ultrasound and assessment of treatment related side effects at all times. Results: 280 of 295 treated GSVs (94.9%) were available for 24 months follow-up. According to the method of Kaplan and Meier at 24 months after the intervention 98.6% of treated legs remained free of clinically relevant axial reflux. The average VCSS score improved from 3.9 ± 2.1 at screening to 0.7 ± 1.2 at 24 months follow-up (p < 0.0001). While only 41.1% of patients were free of pain before treatment, at 24 months 99.3% reported no pain and 96.4% did not experience pain during the 12 months before. At 24 months n=3 legs showed pigmentation along the inner thigh and one leg showed study-treatment related paresthesia. Conclusion: Radiofrequency powered segmental thermal ablation Closure FAST showed a very moderate side-effect profile in conjunction with a high and durable clinical success rate.

Download Full-text

Ferric sulfate as pulpotomy agent in primary teeth: twenty month clinical follow-up

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.24.4.d7u6405nw1132705 ◽

2000 ◽

Vol 24 (4) ◽

pp. 269-272 ◽

Cited By ~ 28

Author(s):

Hamijeta Ibricevic ◽

Qumasha Al-Jame

Keyword(s):

Success Rate ◽

Primary Teeth ◽

Root Resorption ◽

Clinical Success ◽

Clinical Success Rate ◽

Ferric Sulfate ◽

Primary Molar ◽

Molar Teeth ◽

The Moment

Seventy primary molar teeth, carious exposed, symptom free, without any sign of root resorption in children aged from 3 to 6 years (main age 4.3yr) were treated with conventional pulpotomy procedures. Ferric sulfate 15.5% solution (applied for 15 second for 35 teeth) and formocresol solution (five minute procedure of Buckley's formula for next 35 teeth) have been used as pulpotomy agents. In both groups, pulp stumps were covered with zinc-oxide eugenol paste. Permanent restorations were stainless steel crowns. Clinical check up was every three-months and radiographic follow-up time was six and twenty months after treatment. Our results within this period revealed 100% clinical success rate in both groups. Radiographic success rate was in both groups 97.2%, while in 2.8% cases has shown internal root resorption. On the basis of these results, we can recommend ferric sulfate as a pulpotomy agent in primary teeth in substitution for formocresol at the moment.

Download Full-text

Revascularization versus apical barrier technique with mineral trioxide aggregate plug: A systematic review

Giornale Italiano di Endodonzia ◽

10.4081/j.gien.2018.10 ◽

2018 ◽

Vol 32 (1) ◽

pp. 9-16 ◽

Cited By ~ 3

Author(s):

Luiz Alexandre Chisini ◽

Guillermo Grazioli ◽

Alejandro Francia ◽

Alissa Schmidt San Martin ◽

Flavio Fernando Demarco ◽

...

Keyword(s):

Clinical Success ◽

Mineral Trioxide Aggregate ◽

Clinical Success Rate ◽

Permanent Teeth ◽

Radiographic Outcomes ◽

Bias Risk ◽

Radiographic Measurements ◽

High Bias ◽

The Mean

Aim: To compare the clinical and radiographic outcomes observed in Necrotic Immature Permanent Teeth (NIPT) after revascularization or apexification with MTA-apical plug. Methodology: PubMed/MEDLINE, Web of science and Scopus were the databases used, up to July 30th, 2017, for article research. Independent reviewers read the titles and abstracts of all reports that met inclusion/exclusion criteria: prospective or retrospective clinical studies comparing the revascularization of root canal and apexification. Clinical success of therapies, deposition and thickening of lateral dentinal walls (root width) and the continuation of root development (root length) were investigated. Bias risk of included studies was assessed using the Cochrane risk of bias. Results: From 1642 records, five papers fulfilled all inclusion criteria. Overall, 91 teeth were submitted to revascularization and 64 teeth to apexification with MTA. The mean follow-up was 23.2 months in revascularization and 21.8 in apexification. Clinical success rate was of 87.9% in the revascularization group and 90.6% in the apexification group. An increase on lateral dentinal walls thickening was observed in most revascularization cases (13%) while MTA as apical plug suggest a mild resorption of the root (1.3%). High bias risk was observed on included studies. Conclusions: Apexification with MTA-apical plug provides similar clinical success to revascularization. However, radiographic measurements showed an improvement in thickening of lateral dentinal walls in most of the revascularization cases in addition to a higher dental development. However, these results should be interpreted with caution.

Download Full-text

Long-Term Management of Recurrent Cholecystitis after Initial Conservative Treatment: Endoscopic Transpapillary Gallbladder Stenting

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2018/3983707 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7

Author(s):

Hideki Kamada ◽

Hideki Kobara ◽

Naohito Uchida ◽

Kiyohito Kato ◽

Takayuki Fujimori ◽

...

Keyword(s):

High Risk ◽

Acute Cholecystitis ◽

Success Rate ◽

Clinical Success ◽

Clinical Success Rate ◽

Technical Success ◽

Technical Success Rate ◽

High Risk Patients ◽

Risk Patients

Background. Endoscopic transpapillary gallbladder stenting (ETGBS) is an effective procedure for treating high-risk patients with acute cholecystitis and severe comorbidities. However, the efficacy of ETGBS for recurrent cholecystitis (RC) remains unclear. This study aimed to explore its efficacy in patients with RC for whom cholecystectomy is contraindicated because of its high surgical risk.Methods. Data on 19 high-risk patients who had undergone ETGBS for RC after initial conservative therapy in our institution between June 2006 and May 2012 were retrospectively examined. The primary outcome was the clinical success rate, which was defined as no recurrences of acute cholecystitis after ETGBS until death or the end of the follow-up period. Secondary outcomes were technical success rate and adverse events (AEs).Results. The clinical success rate of ETGBS was 100%, the technical success rate 94.7%, and AE rate 5%: one patient developed procedure-related mild acute pancreatitis. The clinical courses of all patients were as follows: four died of nonbiliary disease, and the remaining 15 were subsequently treated conservatively. The median duration of follow-up was 14.95 months (range 3–42 months).Conclusions. ETGBS is an effective alternative for managing RC in high-risk patients with severe comorbidities.

Download Full-text

One-year results of gastric peroral endoscopic myotomy for refractory gastroparesis: a French multicenter study

Endoscopy ◽

10.1055/a-1205-5686 ◽

2020 ◽

Author(s):

Olivier Ragi ◽

Jérémie Jacques ◽

Julien Branche ◽

Sarah Leblanc ◽

Geoffroy Vanbiervliet ◽

...

Keyword(s):

Success Rate ◽

Multicenter Study ◽

Clinical Success ◽

Clinical Success Rate ◽

Peroral Endoscopic Myotomy ◽

Gastric Retention ◽

Endoscopic Myotomy ◽

Cardinal Symptom

Abstract Background: Data on the long-term outcomes of gastric peroral endoscopic myotomy (G-POEM) for refractory gastroparesis are lacking. We report the results of a large multicenter long-term follow-up study of G-POEM for refractory gastroparesis. Methods: This was a retrospective multicenter study of all G-POEM operations performed in seven expert French centers for refractory gastroparesis with at least 1 year of follow-up. The primary endpoint was the 1-year clinical success rate, defined as at least a 1-point improvement in the Gastroparesis Cardinal Symptom Index (GCSI). Results: 76 patients were included (60.5 % women; age 56 years). The median symptom duration was 48 months. The median gastric retention at 4 hours (H4) before G-POEM was 45 % (interquartile range [IQR] 29 % – 67 %). The median GCSI before G-POEM was 3.6 (IQR 2.8 – 4.0). Clinical success was achieved in 65.8 % of the patients at 1 year, with a median rate of reduction in the GCSI score of 41 %. In logistic regression analysis, only a high preoperative GCSI satiety subscale score was predictive of clinical success (odds ratio [OR] 3.41, 95 % confidence interval [CI] 1.01 – 11.54; P = 0.048), while a high rate of gastric retention at H4 was significantly associated with clinical failure (OR 0.97, 95 %CI 0.95 – 1.00; P = 0.03). Conclusions: The results confirm the efficacy of G-POEM for the treatment of refractory gastroparesis, as evidenced by a 65.8 % clinical success rate at 1 year. Although G-POEM is promising, prospective sham-controlled trials are urgently needed to confirm its efficacy and identify the patient populations who will benefit most from this procedure.

Download Full-text

Long-term follow-up of abandoned transvenous defibrillator leads: a nationwide cohort study

EP Europace ◽

10.1093/europace/euaa086 ◽

2020 ◽

Vol 22 (7) ◽

pp. 1097-1102

Author(s):

Anders Fyhn Elgaard ◽

Jens Brock Johansen ◽

Jens Cosedis Nielsen ◽

Christian Gerdes ◽

Sam Riahi ◽

...

Keyword(s):

Clinical Success ◽

Extraction Procedure ◽

Clinical Success Rate ◽

High Volume ◽

Lead Extraction ◽

Related Data ◽

Major Complications ◽

Long Term Follow Up

Abstract Aims Commonly, a dysfunctional defibrillator lead is abandoned and a new lead is implanted. Long-term follow-up data on abandoned leads are sparse. We aimed to investigate the incidence and reasons for extraction of abandoned defibrillator leads in a nationwide cohort and to describe extraction procedure-related complications. Methods and results All abandoned transvenous defibrillator leads were identified in the Danish Pacemaker and ICD Register from 1991 to 2019. The event-free survival of abandoned defibrillator leads was studied, and medical records of patients with interventions on abandoned defibrillator leads were audited for procedure-related data. We identified 740 abandoned defibrillator leads. Meantime from implantation to abandonment was 7.2 ± 3.8 years with mean patient age at abandonment of 66.5 ± 13.7 years. During a mean follow-up after abandonment of 4.4 ± 3.1 years, 65 (8.8%) abandoned defibrillator leads were extracted. Most frequent reason for extraction was infection (pocket and systemic) in 41 (63%) patients. Procedural outcome after lead extraction was clinical success in 63 (97%) patients. Minor complications occurred in 3 (5%) patients, and major complications in 1 (2%) patient. No patient died from complication to the procedure during 30-day follow-up after extraction. Conclusion More than 90% of abandoned defibrillator leads do not need to be extracted during long-term follow-up. The most common indication for extraction is infection. Abandoned defibrillator leads can be extracted with high clinical success rate and low risk of major complications at high-volume centres.

Download Full-text

Computer-Aided Rehabilitation Supported by Zygomatic Implants: A Cohort Study Comparing Atrophic with Oncologic Patients after Five Years of Follow-Up

Journal of Clinical Medicine ◽

10.3390/jcm9103254 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3254 ◽

Cited By ~ 1

Author(s):

Gerardo Pellegrino ◽

Francesco Basile ◽

Daniela Relics ◽

Agnese Ferri ◽

Francesco Grande ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Success ◽

Clinical Success Rate ◽

Zygomatic Implants ◽

Oncologic Patients ◽

Computer Aided ◽

Prosthetic Complications ◽

Maxillary Atrophy

The aim of this study was to evaluate the survival and clinical success rate, complications, and patients’ quality of life after computer-aided rehabilitation supported by zygomatic implants in cases of severe maxillary atrophy (ten patients) and in bone defects in oncologic patients (ten patients). All patients underwent computer-aided planning and surgery. Seventy-three zygomatic implants were placed. The mean follow-up period was 39.9 months. Implant survival and clinical success rate, the effectiveness of planning the implant length, biological and prosthetic complications, and the quality of life were evaluated. The five-year implant survival rate for patients with maxillary atrophy and oncologic patients was 97.4% and 96.7%, respectively. The prosthetic survival rate was 100%. Two implant failures occurred in the first year. One implant failure was observed in each group. Minor biological and prosthetic complications occurred in both groups without significant differences. All complications were managed without affecting the treatment. The quality of life increased by 71.3% in the atrophic group and by 82.9% in the oncologic group. Zygomatic implant rehabilitation seems to be a reliable technique for patients with maxillary atrophy and for oncologic patients. The three-dimensional computer-aided approach allows the surgeon to plan the surgery and increase its predictability. Early prosthesis loading certainly allows for better functional outcomes.

Download Full-text

Outcomes of the Use of Fully Covered Esophageal Self-Expandable Stent in the Management of Colorectal Anastomotic Strictures and Leaks

Diagnostic and Therapeutic Endoscopy ◽

10.1155/2014/187541 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 7

Author(s):

Chad J. Cooper ◽

Angel Morales ◽

Mohamed O. Othman

Keyword(s):

Anastomotic Leak ◽

Clinical Success ◽

Anastomotic Stricture ◽

Clinical Success Rate ◽

Stent Migration ◽

Metal Stents ◽

The Novel ◽

Anastomotic Leaks ◽

Anastomotic Strictures

Introduction. Colorectal anastomotic leak or stricture is a dreaded complication leading to significant morbidity and mortality. The novel use of self-expandable metal stents (SEMS) in the management of postoperative colorectal anastomotic leaks or strictures can avoid surgical reintervention. Methods. Retrospective study with particular attention to the indications, operative or postoperative complications, and clinical outcomes of SEMS placement for patients with either a colorectal anastomotic stricture or leak. Results. Eight patients had SEMS (WallFlex stent) for the management of postoperative colorectal anastomotic leak or stricture. Five had a colorectal anastomotic stricture and 3 had a colorectal anastomotic leak. Complete resolution of the anastomotic stricture or leak was achieved in all patients. Three had recurrence of the anastomotic stricture on 3-month flexible sigmoidoscopy follow-up after the initial stent was removed. Two of these patients had a stricture that was technically too difficult to place another stent. Stent migration was noted in 2 patients, one at day 3 and the other at day 14 after stent placement that required a larger 23 mm stent to be placed. Conclusions. The use of SEMS in the management of colorectal anastomotic leaks or strictures is feasible and is associated with high technical and clinical success rate.

Download Full-text

Elective Percutaneous Coronary Interventions (PCI) in 100 Cases in a Centre Without On-site Cardiac Surgery Support

Medicine Today ◽

10.3329/medtoday.v24i1.14106 ◽

2013 ◽

Vol 24 (1) ◽

pp. 8-11

Author(s):

Md Nurul Afsar Badrul ◽

Kamal Ahmed ◽

Sufia Rahman

Keyword(s):

Success Rate ◽

Clinical Success ◽

Clinical Success Rate ◽

Hospital Death ◽

Percutaneous Coronary Interventions ◽

Vessel Disease ◽

Coronary Interventions ◽

Percutaneous Coronary ◽

The Mean

Since its introduction in 1977, Percutaneous Coronary Interventions (PCI) is an important tool in the treatment of coronary artery disease (CAD). It is a retrospective analysis of data of 100 cases (132 vessels). The mean age was 50.9 years (range 30-70) with 90 (90%) male and 10 (10%) female. Indication of PCI includes acute and old MI, Chronic stable angina and unstable angina were 48 (48%), 33 (33%) and 19(19%) respectively. Procedure done in total 132 vessels among 100 patients. most of the cases were single vessels disease (SVD) {68 (68%} followed by double vessel disease (DVD) {30(30%)} , triple vessel disease (TVD) {02 (02%)} and chronic total occlusion (CTO) {02 (02%)}.Cobalt chromium was commonly used stent (117 (88.6%) followed by drug illuting stent (DES) 12 (9.1%) and bare metal stent (BMS) 3 (2.3%). Among the site of the stent insertion left anterior descending (LAD) 62 (47%), right coronary lesion (RCA) 37 (28), left circumplex artery (LCX) 33 (25%).Maximum stent length was 35 mm, minimum 10mm. Maximum stent diameter was 3.5 mm whereas minimum diameter 2.5 mm. The mean pretreatment reference diameter was 2.55 ± 0.20 mm and post treatment diameter 2.70 ± 0.45 mm. Angiographic, procedural and clinical success rate were 100%, 98% and 98% respectively. Major adverse cardiovascular event (MACE) {periprocedural MI} occurred in 2 (02 %) cases. Minor cardiovascular complications revealed vascular haematoma 2 (02%), bleeding from access site in 1 (01%), transient ventricular fibrillation (VF) in 3 (03%) cases. There was no hospital death, emergency CABG before discharge from hospital. Angiographic, procedural and clinical success rate were excellent with a little MACE and event free survival within 30 days follow up. So, PCI is a safe and effective method of myocardial revascularization irrespective of lesion morphology and type of stents used at immediate and 30 days follow up. DOI: http://dx.doi.org/10.3329/medtoday.v24i1.14106 Medicine TODAY Vol.24(1) 2012 pp.8-11

Download Full-text

Efficacy and safety of EUS-guided gastroenterostomy for benign and malignant gastric outlet obstruction: a systematic review and meta-analysis

Endoscopy International Open ◽

10.1055/a-0996-8178 ◽

2019 ◽

Vol 07 (11) ◽

pp. E1474-E1482 ◽

Cited By ~ 9

Author(s):

Thomas R. McCarty ◽

Rajat Garg ◽

Christopher C. Thompson ◽

Tarun Rustagi

Keyword(s):

Gastric Outlet Obstruction ◽

Clinical Success ◽

Meta Analysis ◽

Outlet Obstruction ◽

Clinical Success Rate ◽

Cochrane Library ◽

Efficacy And Safety ◽

Serious Adverse Events ◽

Malignant Gastric Outlet Obstruction

Abstract Background and study aims Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a novel endoscopic procedure designed to facilitate sustained luminal patency in patients with gastric outlet obstruction. The primary aim of this study was to evaluate the efficacy and safety of EUS-GE for treatment of gastric outlet obstruction. Methods Searches of PubMed, EMBASE, Web of Science, and Cochrane Library databases were performed through April 2019. Patients with benign and malignant gastric outlet obstruction were included. Measured outcomes included: immediate technical and clinical success as well as rate of serious adverse events (AEs). Heterogeneity was assessed with Cochran Q test and I 2 statistics. Publication bias was ascertained by funnel plot and Egger regression testing. Results A total of five studies (n = 199 patients; 45.73 % male) were included in this study. Four retrospective studies and one prospective study were analyzed. Mean age of patients that underwent the EUS-GE procedure was 64.52 ± 1.37 years with a pooled mean follow-up period of 4.32 ± 1.65 months. In 21 % of patients (n = 43), gastric outlet obstruction was due to benign causes. Immediate technical success was 92.90 % (95 % CI; 88.26 – 95.79; I2 = 0.00 %) and reported in all studies. The clinical success rate of EUS-GE was 90.11 % (95 % CI; 84.64 – 93.44; I2 = 0.00 %). Serious AEs occurred in 5.61 % (95 % CI; 2.87 – 10.67; I2 = 1.67 %) of cases and were related to peritonitis, perforation, bleeding, and abdominal pain. Re-intervention rate was 11.43 % (95 % CI; 7.29 – 17.46; I2 = 17.38 %). Conclusions EUS-GE appears to provide an effective and safe minimally invasive alternative for treatment of benign and malignant gastric outlet obstruction.

Download Full-text