Percutaneous Transluminal Laser Angioplasty versus Balloon Dilation for Treatment of Popliteal Artery Occlusions

2002 ◽  
Vol 9 (6) ◽  
pp. 882-888 ◽  
Author(s):  
Hermann J. Steinkamp ◽  
Jürgen Rademaker ◽  
Christian Wissgott ◽  
Dierk Scheinert ◽  
Michael Werk ◽  
...  
Keyword(s):  
Popliteal Artery ◽  
Balloon Dilation ◽  
Laser Angioplasty ◽  
Secondary Patency ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Percutaneous Transluminal ◽  
Term Benefit

Purpose: To compare the immediate results, complication rates, and long-term outcomes of percutaneous transluminal laser angioplasty (PTLA) versus balloon dilation alone in the treatment of popliteal artery occlusions. Methods: In a prospective nonrandomized study conducted between December 1994 and June 2000, 215 symptomatic patients with unilateral popliteal occlusions were treated with either dilation alone (88 patients: 52 men; mean age 62 years, range 48–83) or PTLA (127 patients: 70 men; mean age 64 years, range 49–86) using a 308-nm excimer laser followed by dilation. The average occlusion length was 10.4 cm (range 3–14). Results: PTLA was successful in recanalizing 105 (82.7%) arteries, while the recanalization rate for dilation alone was only 70.4% (62/88; p=0.045). After a mean follow-up of 36 months (range 6–52), the primary and secondary patency rates were 21.7% and 50.8%, respectively, in patients with PTLA and 16.3% and 35.2% in the angioplasty group (p=0.762). The complication rates associated with both techniques were similar. Conclusions: Although initial recanalization may be better with PTLA, it does not appear to add any long-term benefit over balloon dilation alone.

scholarly journals 439 Conservative Versus Surgical Management of Complicated Diverticulitis - A Retrospective Study of Long-Term Outcomes

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E Durity ◽  
G Elliott ◽  
T Gana
Keyword(s):  
Complicated Diverticulitis ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Female Ratio ◽  
Stoma Reversal ◽  
Group A ◽  
Grade 3 ◽  
Group B

Abstract Introduction Management of complicated diverticulitis has shifted towards a conservative approach over time. This study evaluates the feasibility and long-term outcomes of conservative management. Method We retrospectively evaluated a consecutive series of patients managed with perforated colonic diverticulitis from 2013-2017. Results Seventy-three (73) patients were included with a male to female ratio of 1:2. Thirty-one (31) underwent Hartmann’s procedure (Group A) and 42 patients were managed with antibiotics +/- radiological drainage (Group B). Mean follow-up was 64.9 months (range 3-7 years). CT Grade 3 and 4 disease was observed in 64.5% and 40.4% of Group A and Group B patients, respectively. During follow-up, 9 (21.4%) Group B patients required Hartmann’s. Group A had longer median length of stay compared to Group B (25.1 vs 9.2 days). Post-operative complications occurred in 80.6% with 40% being Clavien-Dindo grade III or higher in group A. Stoma reversal was performed in 8 patients (25.8%). Conclusions In carefully selected cases, complicated diverticulitis including CT grade 3 and 4 disease, can be managed conservatively with acceptable recurrence rates (16.7% at 30 days, 4.8% at 90 days, 19.0% at 5 years). Surgical intervention on the other hand, carries high post-operative complication rates and low stoma reversal rates.

Management of Canine Y-T Humeral Fractures Using Titanium Polyaxial Locking Plates in 17 Dogs

2022 ◽  
Vol 58 (1) ◽  
pp. 7-16
Author(s):  
Claudio Motta ◽  
Philip Witte ◽  
Andrew Craig
Keyword(s):  
Functional Impairment ◽  
Complication Rates ◽  
Load Testing ◽  
Inclusion Criteria ◽  
Long Term Outcomes ◽  
Long Term Follow Up ◽  
Mild Impairment ◽  
Condylar Fractures

ABSTRACT The objective of this study was to document the short- and medium-to-long-term outcomes and complication rates of Y-T humeral condylar fractures fixed using titanium polyaxial locking plate (T-PLP). A retrospective review was performed of the medical records and radiographs of dogs with a Y-T humeral condylar fracture treated with T-PLP at a single veterinary referral center (2012–2018). Seventeen cases met the inclusion criteria. Medium- to long-term follow-up (.6 mo) information was derived using the Liverpool Osteoarthritis in Dogs (LOAD) questionnaire. Recorded complications were catastrophic (1/17) and minor (2/17). Gait at 10–12 wk following surgery was subjectively assessed as good or excellent for 13 cases. Radiographic bone union was achieved in 7/12 cases at 4–6 wk. LOAD scores obtained a mean of 15 mo (range 6–29 mo) following surgery and indicated no or mild impairment in 15/16 and moderate functional impairment in 1. The application of T-PLP for the treatment of Y-T humeral condylar fractures resulted in adequate stabilization allowing successful fracture healing and medium- to long-term outcomes comparable to previous reports. According to results of LOAD testing, the medium- to long-term follow-up suggests that clients were aware of mild to moderate functional impairment in all cases.

P1920Long-term outcomes of pulmonary vein isolation using second-generation cryoballoon during atrial fibrillation ablation: A single-center large-scale study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
U Canpolat ◽  
D Kocyigit ◽  
M U Yalcin ◽  
C Coteli ◽  
Y Z Sener ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Large Scale ◽  
Second Generation ◽  
Significant Proportion ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Free Survival

Abstract Background Currently available second-generation cryoballoon (CB2) is accepted as an effective and safe tool for pulmonary vein isolation (PVI). Although much more data exists about 1-year outcomes of CB2 ablation, data on long-term outcomes are scarce. Objective: We aimed to assess the long-term outcomes of PVI using CB2 in a large-scale symptomatic AF population at our tertiary referral center. Methods In this non-randomized prospective observational study, a total of 486 patients with paroxysmal (71%) or persistent (29%) AF who underwent index PVI using CB2 at our hospital between January 2013 and June 2017 were enrolled. Atrial tachyarrhythmia (ATa) free survival was defined as absence of AF, atrial flutter or atrial tachycardia recurrence >30 s following 3-months blanking period. Predictors of recurrence were evaluated by univariate and multivariate Cox proportional hazards regression models. Results Acute procedural success rate was 99.8% (1898/1902 PVs). Mean procedural and fluoroscopy time were 64.9±9.2 and 12.1±2.6, respectively. At median 39 (IQR: 26–56) months follow-up, ATa free survival was 78.6% after a single procedure (280/345 [81.2%] for paroxysmal AF vs 102/141 [72.3%] for persistent AF, p=0.019) and 84.4% after a mean 1.48±0.42 ablations.Cox regression analysis showed that left atrium diameter, duration of AF history and early ATa recurrence were found as the independent predictors of late recurrence. PNP was observed in 17 (3.5%) patients. Figure 1 Conclusions Second-generation CB based PVI is effective to maintain sinus rhythm in a significant proportion of paroxysmal and early persistent AF patients with an acceptable complication rates at long-term follow-up.

First-Stage Long Buccal Mucosal Graft (BMG) Urethroplasty on Adult Failed Hypospadia Surgery Repair: Our Initial Experience

2018 ◽  
Vol 24 (8) ◽  
pp. 6151-6154
Author(s):  
Adistra Imam Satjakoesoemah ◽  
Prahara Yuri ◽  
Yonas Hutasoit
Keyword(s):  
External Genitalia ◽  
Complication Rates ◽  
Initial Experience ◽  
Long Term Outcomes ◽  
Penile Shaft ◽  
Buccal Mucosal Graft ◽  
Male External Genitalia ◽  
The Right

Hypospadia is one of the most common congenital anomalies of male external genitalia and the only proper management for most cases is repair surgery. Nevertheless, initial hypospadia repair could end up failed, followed by subsequent various complications. BMG has gain popularity due to its good long-term outcomes and favourable complication rates, especially for residual hypospadia. A 24-year-old male came to our outpatient department complaining his urethral orificium was located on the penile shaft since birth. He had a previous hypospadia repair surgery conducted by non-urologist surgeon at the age of seven. Several months after the repair surgery, his penis slightly rotated to the right side and urine remain came out through the hole on his ventral penile shaft. We performed first-stage inlay BMG urethroplasty using a long (6×1 cm) and short (2×1 cm) graft patch. The graft patches were quilted in proximal-distally fashion rather than side-by-side. No scarring or contracture on the neourethral plate was noted during two months of follow-up. We have successfully performed our initial experience on first-stage inlay BMG urethroplasty using a long and short graft patch. Within two months, the graft were completely take without any complications. The second-stage urethroplasty, consisting of tubularization and glansplasty will be performed 6 months after the first procedure.

scholarly journals Long Term Outcomes Following Syme’s Amputation

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Michael Pinzur ◽  
Adam Schiff ◽  
Elissa Finkler
Keyword(s):  
Functional Mobility ◽  
Diabetic Patients ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Transtibial Amputation ◽  
Amputation Level ◽  
Objective Information ◽  
Prosthetic Fitting

Category: Ankle, Diabetes, Trauma Introduction/Purpose: The metabolic cost of walking following Syme’s ankle disarticulation amputation is minimally more than similar non-amputees. The ability to end-bear makes prosthetic fitting relatively simple, and very few patients require extensive rehabilitation or placement in a skilled nursing or rehabilitation facility. In spite of these potential benefits, there is a paucity of objective information on the actual long term outcomes. Methods: Fifty-one patients were identified who underwent single stage Syme’s ankle disarticulation amputation with excision of the lateral and medial malleoli by a single surgeon during a twenty three year period. None of these patients had sufficient tissue to allow amputation at the transmetatarsal or tarsal-metatarsal levels. Thirty-three underwent amputation due to diabetic forefoot infection, eleven secondary to crush injury, three for non-diabetic infection, three for non-correctable acquired deformity and one for neoplasm. The average age at surgery for the di-abetic patients was 62.1 (range 36-81) years, with a follow-up of 6.8 (4-11.6) years. The nondi-abetic patients averaged 37.8 (range 21-65) years, with a follow-up of 9.3 (range 2.2-25.0) years. Patients who were alive and could be contacted were invited to complete a Short Musculoskele-tal Functional Assessment (SMFA) questionnaire that was scored for functional, mobility and bothersome indices. Results: Seventeen of the 33 diabetics died. Four (12.1%) were converted to the transtibial amputation level. One of the non-diabetics had died and one (5.5%) was converted to the transtibial amputation level. Eleven of the thirty-three patients who were con-tacted completed the SMFA. All of these patients demonstrated favorable outcome scores in the mobility, functional and bothersome indices (non-diabetic mean mobility score of 17.2, function-al index of 14.7 and bothersome of index of 16.7 compared to 34.7, 29.9 and 30.6 in the diabetic patients, respectively). Conclusion: The objective information derived from this investigation supports the opinion that patients with Syme’s ankle disarticulation amputation appear to fare better than sim-ilar patients with transtibial amputation. This data also refutes the notion of high complication rates and difficulties with prosthetic fitting. These patients require less rehabilitation and achieve improved levels of functional independence as demonstrated by favorable functional, mobility, and bothersome indices.

Long-Term Outcomes of Staged Basilic Vein Transposition for Hemodialysis Access in Children

2017 ◽  
Vol 18 (5) ◽  
pp. 366-370 ◽  
Author(s):  
Elias Kfoury ◽  
Christopher J. Demaree ◽  
Mun J. Poi ◽  
Jesus M. Matos ◽  
Carlos F. Bechara ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Primary Patency ◽  
Secondary Patency ◽  
Hemodialysis Access ◽  
Basilic Vein ◽  
Long Term Outcomes ◽  
Av Fistula ◽  
Functional Maturation

Introduction Children requiring long-term hemodialysis often face significant challenges due to their young age and small-vessel caliber for arteriovenous (AV) access creation. In this study, we report our experience of staged basilic vein transposition (BVT) in pediatric patients. Methods All patients undergoing staged BVT at a tertiary care pediatric hospital from 2003 to 2015 were reviewed. Indications for staged BVT included inadequate cephalic conduit or failed AV fistula using cephalic vein. Pertinent clinical variables were analyzed to determine treatment outcomes. Results Forty-two children (24 males, 57%) underwent 46 staged BVT during the study period. Median age was 12.8 ± 4.8 years (range 3-18). The mean weight was 47 ± 5.1 kg (range, 13-126 kg), with four children (10%) weighing ≤20 kg. Mean operative times for initial brachiobasilic AV fistula and staged BVT were 39 ± 12 minutes and 66 ± 17 minutes, respectively. Mean follow-up period was 5.4 ± 1.8 years. Functional maturation was achieved in 93% of BVTs. Early fistula thrombosis within 30 days following BVT occurred in four patients (10%). Late BVT thrombosis occurred in 13 patients (31%). Primary patency rates at 2 years and 4 years were 78% and 72%, respectively. Secondary patency rates at 2 years and 4 years were 86% and 82%, respectively. Conclusions Staged BVT is a durable and reliable autologous hemodialysis access in children who do not have adequate cephalic venous conduit.

scholarly journals Management of colorectal anastomotic stricture with multidiameter balloon dilation: long-term results

2020 ◽  
Vol 24 (12) ◽  
pp. 1271-1276
Author(s):  
R.-H. Chan ◽  
S.-C. Lin ◽  
P.-C. Chen ◽  
W.-T. Lin ◽  
C.-H. Wu ◽  
...  
Keyword(s):  
Anastomotic Stricture ◽  
Balloon Dilation ◽  
Long Term Results ◽  
Endoscopic Dilation ◽  
Long Term Outcomes ◽  
Recurrence Rates ◽  
Aggressive Management ◽  
Anastomotic Strictures

Abstract Background Postoperative colorectal anastomotic strictures are quite common. As such, many techniques have been available to address such a problem, one of which is endoscopic dilation. The aim of the present study was to evaluate the long-term outcomes following endoscopic dilation using a multidiameter balloon. Methods A retrospective study was conducted on patients with postoperative anastomotic stenosis treated with endoscopic dilation using a multidiameter balloon at our institution, in January 2005–December 2019 were retrospectively reviewed, excluding those with tumor recurrence. Perioperative factors, complications, and recurrence rates were analyzed. Results There were 40 patients, (22 males and 18 females, mean age 64.6 ± 10.7 years, range 33–84 years). The median follow-up period was 56 months (interquartile range 22.5–99 months). Only 1 complication occurred, micro-perforation due to guided wire injury, which was managed conservatively. Five (12.5%) patients developed restenosis and underwent repeat balloon dilation. None of the five recurrences required more aggressive management, such as redo anastomosis. Conclusions Endoscopic multidiameter balloon dilation is a safe and effective method for treating benign colorectal anastomotic strictures.

Long-term outcomes of laser-assisted uvulopalatoplasty in 168 patients with snoring

2006 ◽  
Vol 120 (11) ◽  
pp. 932-938 ◽  
Author(s):  
T Iyngkaran ◽  
J Kanagalingam ◽  
R Rajeswaran ◽  
C Georgalas ◽  
B Kotecha
Keyword(s):  
Weight Loss ◽  
Telephone Survey ◽  
Subjective Improvement ◽  
Long Term Outcomes ◽  
Sleep Studies ◽  
The Mean ◽  
Term Benefit ◽  
Sleep Nasendoscopy

Laser-assisted uvulopalatoplasty (LAUP) is an established treatment for snoring. Our institution has been using a modification of the Kamami technique since 1995. Between January 1995 and December 2001, 469 patients underwent LAUP for snoring. A telephone survey of these patients and their partners was conducted retrospectively. One hundred and sixty-eight patients and their partners were interviewed and the findings analysed.Of the 168 patients, 122 had LAUP alone, 42 had LAUP and tonsillectomy and four had LAUP and septoplasty. The median follow-up time was 59 months (range 19 to 98 months).Seventy-four per cent reported improvement at six weeks, 69 per cent reported improvement at nine months and 55 per cent reported improvement at the time of interview. To assess the degree of improvement, patients and their partners were asked to grade any improvement in percentage terms. The mean subjective improvement scores were 57 per cent at six weeks (95 per cent confidence interval (CI) 50–64 per cent), 45 per cent at nine months (95 per cent CI 38–59 per cent) and 30 per cent at the time of interview (95 per cent CI 23–35 per cent). Patients who reported weight gain since surgery did not have a poorer outcome than those who reported no weight change or weight loss. Neither did weight loss predict a better outcome. The procedure was generally well tolerated, with only 30 patients (18 per cent) reporting complications (mainly minor).The benefits of LAUP wane with time and the results are best in the first 12 months following surgery. Our study suggests that 55 per cent of patients selected after sleep studies and sleep nasendoscopy will enjoy long-term benefit.

Budd–Chiari syndrome with upper gastrointestinal hemorrhage: Characteristic and long-term outcomes of endovascular treatment

Vascular ◽  
2017 ◽  
Vol 25 (6) ◽  
pp. 642-648 ◽  
Author(s):  
Peng-Li Zhou ◽  
Gang Wu ◽  
Xin-Wei Han ◽  
Lei Yan ◽  
Wen-Guang Zhang
Keyword(s):  
Gastrointestinal Hemorrhage ◽  
Primary Patency ◽  
Upper Gastrointestinal Hemorrhage ◽  
Budd Chiari Syndrome ◽  
Long Term Outcomes ◽  
Chiari Syndrome ◽  
Percutaneous Transluminal ◽  
Upper Gastrointestinal

Purpose To identify the characteristics and evaluate the long-term outcomes of endovascular treatment of Budd–Chiari syndrome with upper gastrointestinal hemorrhage. Methods Forty-seven consecutive Budd–Chiari syndrome patients with upper gastrointestinal hemorrhage were referred for the treatment with percutaneous transluminal balloon angioplasty, and subsequently underwent follow-up. Data were retrospectively collected and follow-up observations were performed at 1, 2, 2–5, and 5–8 years postoperatively. Results Cirrhosis was presented in 16 patients, and splenoportography reviewed obvious varices in 18 patients. Percutaneous transluminal balloon angioplasty was technically successful in all patients. Major procedure-related complications occurred in 3 of the 47 patients (6.38%). The cumulative 1, 2, 2–5, and 5–8 year primary patency rates were 100% (46/46), 93.2% (41/44), 90.9% (40/44), and 86.4% (19/22), respectively. The cumulative 1, 2, 2–5, and 5–8 year secondary patency rates were 100% (47/47), 100% (44/44), 100% (44/44), and 95.5% (21/22), respectively. Mean and median duration of primary patency was 65.17 ± 3.78 and 69.0 ± 5.69 months, respectively. No upper gastrointestinal hemorrhage recurred during follow-ups. The mean survival time was 66.97 ± 3.61 months and the median survival time was 69.0 ± 4.10 months. Conclusion PTBA was an effective treatment that can prevent recurrence of the life-threatening complications and ensured long-term satisfactory clinical outcomes for Budd–Chiari syndrome patients with upper gastrointestinal hemorrhage. Percutaneous transhepatic variceal embolization was not recommended for all Budd–Chiari syndrome patients with upper gastrointestinal hemorrhage.

Presence of direct vertebrobasilar perforator feeders in posterior fossa arteriovenous malformations and association with poor outcomes after endovascular treatment

2020 ◽  
Vol 133 (6) ◽  
pp. 1802-1810
Author(s):  
Etienne Lefevre ◽  
Thomas Robert ◽  
Simon Escalard ◽  
Robert Fahed ◽  
Stanislas Smajda ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Posterior Fossa ◽  
Arteriovenous Malformations ◽  
Neurological Deterioration ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Obliteration Rate ◽  
Brain Avms

OBJECTIVETreatment of posterior fossa arteriovenous malformations (PFAVMs) remains controversial as it is always challenging and may lead to major complications. Nonetheless, these lesions are more likely to bleed and generate poorer outcomes than other brain AVMs. The aim of this study was to evaluate the effect of endovascular treatment on long-term outcomes and identify the patient subgroups that might benefit from endovascular treatment.METHODSThe authors performed a retrospective analysis of all consecutive cases of PFAVM managed at the Fondation Rothschild Hospital between 1995 and 2018. Clinical, imaging, and treatment data were prospectively gathered; these data were analyzed with respect to long-term outcomes.RESULTSAmong the 1311 patients with brain AVMs, 114 (8.7%) had a PFAVM, and 88 (77.2%) of these patients had a history of bleeding. Of the 114 PFAVMs, 101 (88.6%) were treated (83 ruptured and 18 unruptured). The mean duration of follow-up was 47.6 months (range 0–240 months). Good neurological outcome at last follow-up was achieved in 79 cases (78.2%). Follow-up angiography showed obliteration of the PFAVM in 68.3% of treated cases. The presence of direct vertebrobasilar perforator feeders was associated with neurological deterioration (OR 5.63, 95% CI 11.15–30.76) and a lower obliteration rate (OR 15.69, 95% CI 2.52–304.03) after endovascular treatment. Other predictors of neurological deterioration and obliteration rate were consistent with the Spetzler-Martin grading system.CONCLUSIONSAdvances in endovascular techniques have enabled higher obliteration rates in the treatment of PFAVMs, but complication rates are still high. Subgroups of patients who might benefit from treatment must be carefully selected and the presence of direct vertebrobasilar perforator feeders must call into question the indication for endovascular treatment.

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