Periprocedural and Long-Term Outcomes of Stent Implantation for De Novo Subclavian Artery Disease

2019 ◽  
Vol 53 (4) ◽  
pp. 284-291
Author(s):  
Hirokazu Onishi ◽  
Toru Naganuma ◽  
Koji Hozawa ◽  
Tomohiko Sato ◽  
Hisaaki Ishiguro ◽  
...  
Keyword(s):  
Subclavian Artery ◽  
Stent Implantation ◽  
De Novo ◽  
Clinical Success ◽  
Primary Patency ◽  
Success Rates ◽  
Long Term Outcomes ◽  
Procedural Success

Introduction: The purpose of the current study was to investigate the periprocedural and long-term outcomes of stent implantation for de novo subclavian artery (SCA) disease. Material and Methods: We retrospectively investigated consecutive patients with de novo SCA lesions undergoing elective endovascular therapy procedures at our center between April 2004 and September 2015. All patients were included in the analyses of periprocedural outcomes, including procedural and clinical success. Subsequently, patients who completed the clinical follow-up and were assessed with brachial systolic pressure differences between the diseased and the contralateral arms, or angiographic stenosis, after stent implantation with procedural success were included in the analyses of long-term outcomes, including primary patency. Results: There were 62 patients (median 71.0 years, interquartile range 65.3-76.0 years; 45 men) with 62 de novo SCA lesions included in the analyses of periprocedural outcomes. There were 46 stenoses (74.2%) and 16 occlusions (25.8%). Our results indicated high procedural success rates for overall (95.2%), stenotic (97.8%), and occlusive (87.5%) lesions. Similarly, high clinical success rates were observed for overall (91.9%), stenotic (93.5%), and occlusive (87.5%) lesions. The median follow-up time was 6.0 years (interquartile range, 2.6-8.3 years). There were 48 patients with 48 de novo SCA lesions included in the analyses of long-term outcomes. Primary patency estimates were 97.7% (1 year), 97.7% (3 years), 93.1% (5 years), and 87.6% (7 years). Also, we observed a high estimate for freedom from reintervention for the target vessel (93.8%). Conclusion: Stent implantation for de novo SCA disease can be performed successfully and safely with favorable periprocedural and long-term outcomes.

scholarly journals Long-term outcomes of ocular adnexal lesions in IgG4-related ophthalmic disease

2019 ◽  
Vol 104 (3) ◽  
pp. 345-349 ◽  
Author(s):  
Toshinobu Kubota ◽  
Masao Katayama ◽  
Reiko Nishimura ◽  
Suzuko Moritani
Keyword(s):  
Exploratory Study ◽  
Watchful Waiting ◽  
Systemic Corticosteroid ◽  
De Novo ◽  
Corticosteroid Treatment ◽  
Consensus Guidelines ◽  
Long Term Outcomes ◽  
Ophthalmic Disease

AimsTo determine the long-term outcomes of ocular adnexal lesions in immunoglobulin G4-related ophthalmic disease (IgG4-ROD).MethodsThis retrospective, non-randomised exploratory study included 82 patients with ocular adnexal lesions. We evaluated the long-term outcomes in 71 patients during the median follow-up period of 30 months, who underwent either watchful waiting (n=20; range 12–90 months) or systemic corticosteroid treatment, delivered according to consensus guidelines (n=51; range 9– 115 months). We also analysed factors that might contribute to recalcitrance to treatment.ResultsOf 82 patients, 40 (49%) were male, and the median patient age was 60 years old. Twenty-one (26%) patients with extraocular muscle (EOM) and/or trigeminal nerve branch (CN V) enlargements had a significantly high frequency of multiple ocular adnexal lesions (p<0.0001, Fisher’s exact test). In addition, two patients developed EOM and/or CN V enlargements de novo over time. Twenty patients with solitary lacrimal gland enlargements preferred watchful waiting, due to mild symptoms. Of these, 18 (90%) lesions remained dormant throughout a median follow-up of 27 months. Among 51 patients treated with corticosteroids, 31 (61%) experienced relapses after treatment and required systemic low-dose maintenance treatment. A multivariate analysis indicated that EOM and/or CN V enlargements comprised a risk factor for relapse (HR 2.7; 95% CI 1.1 to 6.7).ConclusionsThis exploratory study showed that different types of ocular adnexal lesions in IgG4-ROD displayed distinct proliferative activities. Our results suggested that EOM and/or CN V enlargements might be secondary lesions that confer refractoriness to systemic corticosteroid treatment recommended by consensus guidelines.

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 Immediately Restored Fixed Full-arch Prosthesis on Implants Placed in Both Fresh and Healed Sockets by Means of Flat-one-bridge Technique. A 7-year Retrospective Study. Running Head: Prosthetic Passivation of Implants in Full-arch Bridges

2021 ◽  
Author(s):  
Enrica Giammarinaro ◽  
Simone Marconcini ◽  
Ugo Covani ◽  
Andrea Mascolo ◽  
Marco Del corso ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Success ◽  
Implant Survival ◽  
Long Term Outcomes ◽  
Arch Bridges ◽  
One Year ◽  
Provisional Restoration ◽  
Running Head

Abstract Background: Aim of this retrospective study was to document the long-term clinical efficacy of a surgical-prosthetic technique (Flat-one-Bridge) involving immediate restoration of both post-extractive and non-post-extractive implants supporting full-arch restorations. Methods: Implants were placed adapting the axis to the available bone. Flat definitive abutments were connected at surgery and never disconnected in order to compensate for eventual implants dis-parallelism. Bone grafting was performed when needed. Patients received a screw-retained provisional restoration within 48 hours of surgery and a final screw-retained prosthesis within one year. Results: Sixty-six patients received 494 implants distributed in 75 prosthesis. The median follow-up was 86 months (range 82-168 months). Only three implants failed at the last follow-up. Implant survival was 99.6%. Conclusion: The Flat-one-Bridge prosthetic protocol is a viable procedure with excellent long-term outcomes. No difference could be observed between post-extractive and non post-extractive implants in terms of clinical success.

Drug-Coated Balloon Angioplasty in Atherosclerosis Patients With Popliteal Artery Involvement

2018 ◽  
Vol 25 (5) ◽  
pp. 581-587 ◽  
Author(s):  
Tomoharu Dohi ◽  
Andrej Schmidt ◽  
Dierk Scheinert ◽  
Yvonne Bausback ◽  
Daijiro Kabata ◽  
...  
Keyword(s):  
Popliteal Artery ◽  
De Novo ◽  
Vessel Diameter ◽  
Primary Patency ◽  
Lesion Length ◽  
Endovascular Interventions ◽  
Long Term Follow Up ◽  
Drug Coated Balloon

Purpose: To investigate outcomes of drug-coated balloon (DCB) angioplasty in endovascular interventions including or restricted to the popliteal artery. Methods: A retrospective analysis was conducted of 266 patients [median age 72 years, interquartile range (IQR) 62, 78; 166 men] treated with DCB angioplasty in 281 de novo lesions including the popliteal artery between December 2011 and January 2015 at a single center. The median lesion length was 270 mm (IQR 150, 373). The study outcomes were primary patency and predictors of restenosis [reported as the hazard ratio (HR) with 95% confidence interval (CI)]. Results: The primary patency was 77.4% at a median 12.2 months (IQR 5.7, 18.8). Independent variables associated with restenosis included baseline Rutherford category (HR 1.36, 95% CI 1.05 to 1.77, p=0.02), reference vessel diameter (HR 0.77, 95% CI 0.63 to 0.95, p=0.02), dissection (HR 1.69, 95% CI 1.022.79, p=0.04), and standard nitinol stent use (HR 2.08, 95% CI 1.14 to 3.79, p=0.02). Conclusion: Outcomes after DCB angioplasty in lesions including the popliteal artery were acceptable compared with previous studies. Further investigation with long-term follow-up is needed to confirm these results.

Endovascular bypass for salvage of vascular access in hemodialysis catheter-consigned patients

2018 ◽  
Vol 19 (6) ◽  
pp. 585-592 ◽  
Author(s):  
Matt Chiung-Yu Chen ◽  
Mei-Jui Weng ◽  
Huei-Lung Liang
Keyword(s):  
Vascular Access ◽  
Clinical Success ◽  
Primary Patency ◽  
Secondary Patency ◽  
Success Rates ◽  
Access Site ◽  
Hemodialysis Catheter ◽  
Kaplan Meier ◽  
The Mean

Purpose: This study was performed to retrospectively assess the efficacy of percutaneous creation of an intervascular bypass with or without stent graft deployment (endovascular bypass) for salvage of abandoned vascular access sites in hemodialysis catheter-consigned patients. Methods: Salvage of abandoned vascular access sites was attempted in 16 patients with hemodialysis catheters. These vascular access sites were salvaged using endovascular bypass techniques to redirect the access flow to a nonarterialized vein as a new outflow conduit or cannulation segment. The postintervention primary, assisted primary, and secondary patency rates of the access site and bypass were calculated using the Kaplan–Meier method. Results: The procedural and clinical success rates were both 100%. The postintervention primary patency rate of the bypass and access site at 360 days was 75.7 ± 12.5% and 56.8 ± 14.9%, respectively. The mean follow-up period was 461.9 days (range: 121–900 days). No major complications were observed. One bare bypass tunnel rupture and one pseudoaneurysm were noted during the procedure. Conclusion: Salvage of abandoned vascular access sites for hemodialysis catheter-consigned patients can be technically feasible and clinically successful using endovascular bypass techniques in selected patients when surgical revision is not considered or is not possible.

scholarly journals Transarterial embolization for renal angiomyolipomas: A single centre experience in 79 patients

2017 ◽  
Vol 45 (2) ◽  
pp. 706-713 ◽  
Author(s):  
Chengen Wang ◽  
Min Yang ◽  
Xiaoqiang Tong ◽  
Jian Wang ◽  
Haitao Guan ◽  
...  
Keyword(s):  
Medical Records ◽  
Clinical Success ◽  
Tumour Size ◽  
Transarterial Embolization ◽  
Arterial Embolization ◽  
Success Rates ◽  
Single Centre Experience ◽  
Computed Tomography Scans

Objective To evaluate the long-term efficacy and safety of selective arterial embolization (SAE) in the treatment of renal angiomyolipomas (AMLs). Methods This was a retrospective review of medical records and imaging findings from patients with renal AMLs who attended our clinic and received SAE between January 2007 and January 2014. Only patents with complete medical records, preoperative computed tomography scans using typical imaging and follow-up data were included. Results A total of 79 patients were enrolled in the study. Technical and clinical success rates were 100% and 91% ( n = 72), respectively. Only two patients experienced major complications. Post-embolization syndrome (i.e. fever, abdominal pain, nausea or vomiting) was reported in 68 (86%) patients, but all symptoms were mild and resolved with conservative measures. Mean radiological and clinical follow-up periods were 16.8 and 35.9 months, respectively. In 75 (95%) patients, tumours decreased in size; mean ± SD tumour size significantly decreased from 8.4 ± 3.5 cm pre-embolization to 6.7 ± 3.0 cm post-embolization . Conclusions This study provides long-term evidence that SAE is a safe and effective method in the treatment of patients with renal AMLs.

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.

scholarly journals Long-Term Outcomes of Initial Trabeculectomy in Glaucoma Associated with Granulomatous and Non-Granulomatous Uveitis

2021 ◽  
Author(s):  
Faisal A. Almobarak ◽  
Ali H. Alharbi ◽  
Ibrahim Aljadaan ◽  
Hassan Aldhibi
Keyword(s):  
Intraocular Pressure ◽  
Postoperative Complications ◽  
Late Onset ◽  
Success Rates ◽  
Long Term Outcomes ◽  
Granulomatous Uveitis ◽  
The Mean ◽  
Retrospective Comparative Study

Abstract Purpose To evaluate the outcomes of initial trabeculectomy in granulomatous and non-granulomatous uveitis. Methods Retrospective comparative study of 68 eyes that underwent an initial trabeculectomy. Results The mean follow-up was 74.18 and 74.86 months in both groups (p = 0.95). The intraocular pressure decreased from 40.03 mmHg (± 7.2) and 36.48 mmHg (± 11.3) to 14.00 mmHg (± 6.2) and 13.48 mmHg (± 5.7), the number of medications decreased from 3.73 (± 0.7) and 3.58 (± 0.9) to 1.00 (± 1.4) and 1.13 (± 1.4) on the last follow-up (p < 0.01) in the granulomatous and non-granulomatous groups, respectively. More eyes in the granulomatous uveitis group developed delayed postoperative complications like cataract, transient hypotony and glaucoma progression. Success rates were 64.9 and 71.0%, while failure rates were 35.1 and 29.0% in both groups (p = 0.84). Conclusions Trabeculectomy seems to have comparable IOP control and survival in granulomatous and non-granulomatous uveitis. Nevertheless, more eyes in the granulomatous uveitis group developed late onset complications.

Analysis of branch artery orifice angulation: Feasibility of the shelf technique for the treatment of wide-neck bifurcation aneurysms

2020 ◽  
pp. 159101992097625
Author(s):  
Mehmet Onay ◽  
Ali Burak Binboga ◽  
Cetin Murat Altay
Keyword(s):  
Excellent Agreement ◽  
Clinical Success ◽  
Success Rates ◽  
Angle Measurements ◽  
Long Term Follow Up ◽  
Double Stent ◽  
Α Angle ◽  
Wide Neck

Background and purpose The aim of this study was to investigate the feasibility of the shelf technique by analyzing the angle between the two branch orifices and to present its safety and effectiveness compared with that of the double-stent technique. Materials and methods Patients with complex wide-neck bifurcation aneurysms (WNBAs) who underwent stent-assisted coiling (SAC) were reviewed. The study sample was divided into two groups: single SAC (shelf technique) and double SAC. The angle between the lines connecting the superior and inferior points of each branch orifice (α angle) was measured by two neurointerventional radiologists in both groups. The inter- and intraobserver repeatability and consistency of the α angle were assessed. The effect of the α angle on the feasibility of using the shelf technique to treat WNBA was analyzed. Technical and clinical success rates were investigated by comparing both groups. Results Forty-eight patients (32 shelf technique and 16 double-stent technique) were included. There was excellent agreement between the intra- and interobserver repeatability and consistency of α angle measurements. The α angle was smaller in the shelf technique group than in the double-SAC group (p < 0.001). The technical and clinical success rates of both groups were similar based on long-term follow-up (p > 0.05). Conclusion WNBA treatment with the shelf technique is safe and effective. The α angle is a useful parameter to evaluate the performance of the shelf technique. The shelf technique is more suitable for WNBAs with a narrow α angle.

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