How effective is cyanoacrylate closure in small saphenous vein insufficiency? A single center experience

Vascular ◽  
2021 ◽  
pp. 170853812110514
Author(s):  
Görkem Yiğit
Keyword(s):  
Success Rate ◽  
Saphenous Vein ◽  
Treatment Method ◽  
Technical Failure ◽  
Single Center ◽  
Single Center Experience ◽  
Kaplan Meier ◽  
The Mean ◽  
Anatomic Success

Objectives The present study was aimed to evaluate the efficacy and early outcomes of n-butyl cyanoacrylate (NBCA) ablation in small saphenous vein (SSV) insufficiency. Methods In this single-center, retrospective, single-arm study, NBCA ablation was performed in 80 patients with SSV insufficiency between September 2018 and May 2020. Primary outcomes (anatomic success rate and occlusion rate) and secondary outcomes (VCSS and AVVQ scores) of the patients were analyzed. Results No technical failure and device-related complications were encountered. Anatomic success rate was 100% after procedures. Each treated SSV was occluded on colored Doppler ultrasonography immediately after the procedure, and all veins remained occluded at 2 weeks after the procedure. Partial recanalization was observed in five patients at 12-month follow-up. Kaplan–Meier analysis revealed an occlusion rates at 6 months and 12 months follow-up were 97.5% and 93.75%, respectively. The mean pretreatment VCSS (4.72 ± 2.04) decreased to 1.61 ± 0.93, 0.87 ± 0.58, and 0.73 ± 0.52 at 2 weeks, 6 months, and 12 months after treatment, respectively ( p < .001). The mean pretreatment AVVQ score (11.92 ± 2.23) decreased to 8.2 ± 1.89, 4.2 ± 1.16, and 3.32 ± 1.19 at 2 weeks, 6 months, and 12 months after treatment, respectively ( p < .001). The Clinical, Etiologic, Anatomic, and Pathophysiology clinical classification at 12 months demonstrated a significant reduction in disease severity compared with preoperative values ( p < .001). There was no mortality and major adverse events including anaphylaxis and pulmonary thromboembolism (PTE) related to procedure after follow-ups. Moreover, there were no symptoms or signs of any sural nerve injury and no cases of skin necrosis, infection, or hyperpigmentation. In addition, no hematoma, deep venous thrombosis, and hypersensitivity reactions were observed. Phlebitis-like abnormal reaction was observed in three patients (3.8%). Conclusions In conclusion, in patients with SSV insufficiency, NBCA ablation with VenaBlock® system appears to be an effective and reliable treatment method. At the 12-month follow-up, the NBCA of SSVs showed a low recanalization rate and had a satisfactory improvement on the VCSS and AVVQ scores.

MO291RITUXIMAB IS EFFECTIVE AND SAFE IN ADULTS WITH STEROID-DEPENDENT NEPHROTIC SYNDROME: A LONG-TERM, SINGLE-CENTER EXPERIENCE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Gemma Patella ◽  
Alessandro Comi ◽  
Giuseppe Coppolino ◽  
Nicolino Comi ◽  
Giorgio Fuiano ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Case Series ◽  
Adult Patients ◽  
Single Center ◽  
Single Center Experience ◽  
Steroid Dependent ◽  
The Mean ◽  
Steroid Dependent Nephrotic Syndrome

Abstract Background and Aims Steroid-dependent nephrotic syndrome (SDNS) may require a prolonged multi-drug therapy with risk of drug toxicity and renal failure. Rituximab (RTX) treatment has been found to be helpful in reducing the steroid dosage and the need for immunosuppressants (ISs), but little data are currently available regarding very long-term outcomes in adults. We herein describe a long-term, single-center experience of RTX use in a large series of adults with SDNS. Method We studied 23 adult patients with SDNS (mean age 54.2±17.1 y; 65% male; BMI 28.5±4.7), mostly consequent to membranous (47.8%) or focal glomerulonephritis (30.2 %) who were eligible to start a RTX regimen. Before entering the RTX protocol, proteinuria and eGFR were 7.06±3.87 g/24h and 65.9±28.2 ml/min/1.73 m2, respectively; albumin and CD19/CD20 ratio were 2.9±0.9 g/L and 0.99±0.01 respectively; the mean number of ISs was 2.39±0.89 and the mean annual rate of relapses was 2.2±0.9. Results Patients were followed over a mean follow-up of 64 months (range: 12-144). After RTX (mean dose: 1202.1±372.4 mg) the rate of relapses was virtually nullified (p&lt;0.001). eGFR remained roughly stable (62.1±19.8 ml/min/1.73 m2, p=NS), while proteinuria, albumin, CD19/CD20 and BMI all significantly improved (p ranging from 0.01 to 0.001). The mean number of additional ISs was also reduced (0.44±0.12; p&lt;0.001) and RTX enabled discontinuation of steroids in 13/23 (56.5%) patients. No major adverse events related to therapy were recorded. Conclusion Findings from this large case-series with a remarkable very long follow-up reinforce the role of RTX as an efficient and safe weapon to improve outcomes in adult patients suffering from SDNS.

Efficacy of Lift (Ligation of Intersphincteric Fistula Tract) for Complex and Recurrent Anal Fistulas - A Single-Center Experience and A Review of the Literature

2015 ◽  
Vol 86 (11) ◽  
Author(s):  
Michał Romaniszyn ◽  
Piotr Julian Walega ◽  
Wojciech Nowak
Keyword(s):  
Success Rate ◽  
Current Literature ◽  
Operating Time ◽  
Late Complications ◽  
Fistula Tract ◽  
Single Center ◽  
Anal Fistulas ◽  
Single Center Experience ◽  
Intersphincteric Fistula

AbstractLigation of intersphincteric fistula tract in treatment of anal fistulas (LIFT) is being said to have satisfactory results in short and long follow up, with low risk of complications. This study was designed to evaluate the results in patients with complex and recurrent fistulas in comparison with simple transsphincteric anal fistulas.was to present a single-center experience in LIFT procedure in treatment of both simple and complex anal fistulas, including recurrent fistulas, in comparison with a review of current literature.A series of 17 patients were qualified to LIFT procedure. 5 patients were treated for simple transsphincteric, 6 for complex fistulas, 6 with fistulas recurrent after fistulotomy. Median age was 47, most of the patients were male (16/17). Mean follow up was 11 months.Mean operating time was 55 minutes counting from surgical site disinfection to final dressing of the wound. Of the 17 patients the overall success rate was 53%. As expected, best results were achieved in patients with simple fistulas (80% success rate), then complex (50%), and recurrent fistulas (only 33%). There were no early nor late complications of the surgery.As expected, in simple transsphincteric fistulas the results were satisfactory, taking into account low complication rate. Complex and recurrent fistulas seem to be risk factors of LIFT failure. The results are consistent with data published by other authors, based on the review of the current literature, and it seems there is still room for improvement, so further research is required.

scholarly journals Medical, Technical and Audiological Outcomes of Hearing Rehabilitation with the Bonebridge Transcutaneous Bone-Conduction Implant: A Single-Center Experience

2019 ◽  
Vol 8 (10) ◽  
pp. 1614 ◽  
Author(s):  
Brkic ◽  
Riss ◽  
Scheuba ◽  
Arnoldner ◽  
Gstöttner ◽  
...  
Keyword(s):  
Hearing Aids ◽  
Bone Conduction ◽  
Technical Failure ◽  
Single Center ◽  
Hearing Rehabilitation ◽  
Device Failure ◽  
Hearing Gain ◽  
Bone Conduction Implant ◽  
The Mean

Bone-conduction implants are a standard therapeutic option for patients with conductive, unilateral, or mixed hearing loss who either do not tolerate conventional hearing aids or can benefit from surgery. The aim of this study was to evaluate long-term medical and technical outcomes, and audiological results with the Bonebridge transcutaneous bone-conduction implant. This retrospective study included all patients implanted with a bone-conduction hearing implant at a tertiary medical referral center between March 2012 and October 2018. Medical and technical outcomes included the mean length of implant usage, medical and technical complications (skin and wound infection, lack of benefit, technical failure), explantations and revisions, coupling approaches, implant failure rate, implant survival and the implant loss for added follow-up years. Auditory results were measured by functional hearing gain and the Freiburger monosyllabic test at 65 dB sound pressure level. Sixty-four patients were included in the study; five of these were implanted bilaterally (69 devices). Five unilaterally implanted patients were lost to follow-up. The mean follow-up was 27.1 months (range: 0.2 months–6.3 years). The mean implant usage was 25.9 months (range: 0.2 months–6.3 years). Fifty-seven implants (89.1%) were in use at the end of the follow-up period. Complications occurred in six ears (9.4%). Five implants (7.8%) were explanted without reimplantation. Device failure occurred in one implant (1.6%), which was possibly caused by recurrent head trauma. The rate of implant loss due to technical device failure (damage to device) was 1 per 72 follow-up years. The mean improvement on the Freiburger monosyllabic test (52.1%, p = 0.0001), and in functional hearing gain across frequencies (26.5 dB, p = 0.0001) was significant. This single-center follow-up reveals the medical and technical reliability of a transcutaneous bone-conduction implant for hearing rehabilitation because complication and revision rates were low. The majority of patients still used the device at the end of the observation period. Implantation resulted in favorable hearing outcomes in comparison to that of unaided conditions. Cautious patient selection mainly regarding co-morbidities, the history of chronic otologic diseases and proper surgical technique seems to be crucial in reducing complications.

scholarly journals Early Treatment of Ruptured Blood Blister-Like Aneurysms of the Internal Carotid Artery With Flow Diverters Using Single Antiplatelet Therapy: A Single-Center Experience With Long-Term Follow-Up

2021 ◽  
Vol 12 ◽  
Author(s):  
Anil Tanburoglu ◽  
Cagatay Andic
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Early Treatment ◽  
Internal Carotid ◽  
Single Center ◽  
Related Complication ◽  
Single Center Experience ◽  
The Mean

Background and Purpose: Blood Blister-like aneurysms (BBAs) of the internal carotid artery (ICA) are rare entities of cerebral aneurysms. FD use in acutely ruptured aneurysms, timing of treatment and antiplatelet regimen are main debate topics in clinical practice when the treatment decision is flow diversion. The aim of this study is to report the safety and efficacy of a single-center FD treatment for ruptured BBAs in the early phase of SAH using the SAPT regimen.Material and Method: This study involved a retrospective analysis of a prospectively collected database. Records of patients admitted to our clinic and treated by endovascular route on ruptured BBA between January 2013 and December 2020 were reviewed. Ruptured supraclinoid ICA BBAs treated with FD devices with SAPT within 48 h from ictus of SAH are included. BBA of atypical anatomic locations, other endovascular techniques performed, and delayed admissions (&gt;48 h) were excluded from the study. Demographic, clinical and angiographic features of patients and aneurysms, FD types and numbers, periprocedural complications, immediate and follow-up angiographic and clinical outcomes were recorded.Results: A total of six patients with ruptured BBAs treated via FDs within 48 h and used SAPT were included in the study. The mean age was 41.6 years (range from 34 to 45 years), and four of six patients were female. All patients were treated within 48 h after ictus, and the mean treatment day was 1.33 days. One patient received ticagrelor, and five patients received prasugrel as SAPT for one year after treatment. No procedure-related death and rebleeding were recorded. One (16.7 %) treatment responsive procedure-related complication occurred (transient ischemia). Overall good outcome rate was 83.3%. One patient died due to pneumonia. The immediate control angiograms showed complete occlusions of BBAs in one patient (16.6%). The complete occlusion rate was 100 % for five survivors at the control angiogram. The median follow-up was 49.5 months.Conclusion: This single-center experience suggests that early treatment (&lt;2 days) within SAH of ruptured BBAs with FDs using SAPT is safe and effective in terms of clinical and radiological long-term outcomes.

Intraocular pressure control after combined phacotrabeculectomy versus trabeculectomy alone

2021 ◽  
pp. 112067212199999
Author(s):  
Matteo Sacchi ◽  
Gianluca Monsellato ◽  
Edoardo Villani ◽  
Rosario Alfio Umberto Lizzio ◽  
Elena Cremonesi ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Success Rate ◽  
Pressure Control ◽  
High Dose ◽  
Topical Steroids ◽  
Success Rates ◽  
Kaplan Meier ◽  
The Mean ◽  
Baseline Characteristics

Purpose: We compared the efficacy and safety of trabeculectomy and phacotrabeculectomy in patients with glaucoma. Materials and methods: We retrospectively analyzed consecutive patients who underwent trabeculectomy or phacotrabeculectomy. Patients in the trabeculectomy group were pseudophakic. We established three different intraocular pressure (IOP) thresholds (A: <21 mmHg, B: <18 mmHg, and C: <15 mmHg) to measure complete (without medication) and qualified (with medication) success. Success criteria were analyzed through Kaplan-Meier survival curves. Results: Sixty-seven eyes were included (40 trabeculectomy, 27 phacotrabeculectomy). The mean follow-up period was 25.70 ± 14.439 months. The baseline characteristics were similar between the groups. The complete and qualified success rates according to criterion C were significantly higher in the trabeculectomy group ( p = 0.033, p = 0.021, respectively); however, there was a trend toward a higher success rate for all criteria in favor of trabeculectomy. Bleb needling was more frequent in the phacotrabeculectomy group. The mean IOP significantly decreased from 26.46 ± 7.07 to 12.27 ± 4.06 at 12 months ( p < 0.001). The final mean IOP was significantly lower in the trabeculectomy than in the phacotrabeculectomy group (10.95 ± 3.08 vs 13.00 ± 4.56, p = 0.0003). Conclusion: In pseudophakic eyes, trabeculectomy alone achieves a higher success rate, lower mean IOP, and less frequent bleb needlings. More frequent follow-up and prolonged postoperative use of high-dose topical steroids should be considered in patients undergoing phacotrabeculectomy.

scholarly journals Deep Sclerectomy with Nonabsorbable Implant (T-Flux) in Patients with Pseudoexfoliation Glaucoma

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Pavel Studeny ◽  
Alina-Dana Baxant ◽  
Jana Vranova ◽  
Pavel Kuchynka ◽  
Jitka Pokorna
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Success Rate ◽  
Treatment Method ◽  
Deep Sclerectomy ◽  
Choroidal Detachment ◽  
Pseudoexfoliation Glaucoma ◽  
The Mean

Purpose.To evaluate the effectiveness of deep sclerectomy with T-flux implant (DS T-flux) in patients with pseudoexfoliation glaucoma (PExG).Methods.20 eyes of 18 patients with medically uncontrolled PExG have undergone DS T-flux implantation. Postoperatively we evaluated the IOP values and the frequency of complications. The minimum follow-up time was 12 months (20 eyes) and the maximum 24 months (10 eyes).Results.The mean preoperative IOP was36.8±8.7 mmHg. The IOP significantly decreased throughout all postoperative periods (P<0.05) and reached 1 day after surgery11.45±6.6 mmHg; 3 months13.45±3.6 mmHg; 12 months14±2.8 mmHg; and 24 months14.80±2.4 mmHg. Complete success rate, defined as IOP ≤ 18 mmHg without medication, was 85% (17/20 eyes) at 12 months. Qualified success rate, defined as IOP ≤ 18 mmHg with or without medication, was 100% (20/20 eyes). The most frequent postoperative complications were mild hyphaema (9 patients, 45%), choroidal detachment (3 patients, 15%), and hypotony—IOP < 5 mmHg (2 patients, 10%).Conclusions.DS with T-flux implant is a safe and effective surgical treatment method for medically uncontrolled PExG. The number of complications is low.

scholarly journals The etiology and prognosis of canalicular laceration repair using canalicular anastomosis combined with bicanalicular stent intubation

2020 ◽  
Author(s):  
Hongwei Wang ◽  
Xiuhong Qin ◽  
Jiali Ji ◽  
Yang Lu ◽  
Li Xu ◽  
...  
Keyword(s):  
Success Rate ◽  
Motor Vehicle ◽  
Vehicle Accidents ◽  
Tarsal Plate ◽  
Plate Fracture ◽  
The Mean ◽  
Trauma Injury ◽  
Electric Bike ◽  
Anatomic Success

Abstract Background: To evaluate the etiology of lacrimal canalicular laceration and explore possible risk factors influencing prognosis.Methods: A total of 142 patients (142 eyes) with lacrimal canalicular lacerations were reviewed and surgically repaired using canalicular anastomosis combined with bicanalicular stent intubation between March 2017 and March 2018. The analyzed data contained demographic information, types of trauma, injury location, associated additional ocular injuries and surgerical outcomes at follow-up. The main outcome measures were anatomic success rate, functional success rate, and complications of surgery.Results: The mean patient age was 42.07 years(ranging from 1-75 years) and 112 (78.87%) were men. Upper and lower canalicular lacerations were found in 14 (9.86%) and 112 (78.87%)patients, respectively, and both canalicular lacerations were found in 16 patients (11.27%). Electric bike accidents were the leading cause of injury with 76(53.52%)patients. There were 100 (70.42%)patients who had lid lacerations without tarsal plate fracture and 42 (29.58%)patients who had lid lacerations with tarsal plate fracture. Anatomic success rate was 98.59%, and functional success rate was 83.8%. Functional reconstruction failure rates were higher in patients with indirect injuries, lid lacerations with tarsal plate fracture, and with punctum splitting(P<0.05). Surgical complications were detected in the form of lacrimal punctum ectropion in 3(2.11%)patients, punctum splitting in 2(1.41%)patients, stent extrusion and loss in 2(1.41%)patients. Conclusions: Electric bike accidents have become the leading cause of injury instead of the motor vehicle accidents because of changes in lifestyle. The indirect injuries, lid lacerations with tarsal plate fracture and with punctum splitting, were significantly more likely to lead to a poor prognosis, as comfirmed by the lower functional success rate of surgery.

scholarly journals Diagnosis and Treatment of Catamenial Pneumothorax: A Report of a Single-Center Experience

2020 ◽  
pp. 1-2
Author(s):  
Michos Thrasyvoulos ◽  
Michos Thrasyvoulos ◽  
Stamatelopoulos Athanasios ◽  
Roumpaki Anastasia ◽  
Vakouftsi Alexia- Christina ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Retrospective Review ◽  
Spontaneous Pneumothorax ◽  
Single Center ◽  
Catamenial Pneumothorax ◽  
Recurrent Pneumothorax ◽  
Single Center Experience ◽  
Menstrual History ◽  
The Mean

Introduction: Catamenial pneumothorax (CP) is defined as spontaneous pneumothorax occurring within 72 hours before or after the onset of menstruation. Its etiology is not well understood, and its management remains controversial. Methods: A retrospective review was carried out in all female patients with spontaneous pneumothorax who were treated at our department, the last 20 years. Result: Five patients were suffered of CP. The median age was 27.4 (21-33). The side of the pneumothorax was right in four patients and bilateral in one. None of them were diagnosed with endometriosis. Four were treated surgically, while the last one was managed conservatively. Small fenestrations on the central tendon of the diaphragm was found in one patient. The mean hospital stay was 6.2 days. The follow-up examination did not confirm any recurrence. Conclusion: In this study, we investigated the clinical features of CP. A menstrual history and its temporal relation to a pneumothorax should be assessed on every woman presenting with recurrent pneumothorax. Surgical treatment must be selected as definitive for CP and must be combined with hormone therapy, as it prevents recurrence.

scholarly journals Endovascular treatment of medium and large intracranial aneurysms with large volume coils: A single-center experience

2022 ◽  
Vol 13 ◽  
pp. 9
Author(s):  
Giancarlo Saal-Zapata ◽  
Basavaraj Ghodke ◽  
Melanie Walker ◽  
Ivethe Pregúntegui-Loayza ◽  
Rodolfo Rodríguez-Varela
Keyword(s):  
Endovascular Treatment ◽  
Clinical Outcomes ◽  
Large Volume ◽  
Intracranial Aneurysms ◽  
Intraoperative Complications ◽  
Complication Rates ◽  
Single Center ◽  
Single Center Experience ◽  
The Mean

Background: Large volume coils are an alternative to conventional coils for the treatment of intracranial aneurysms. However, there are no published reports documenting occlusion and complication rates in medium and large intracranial aneurysms. Therefore, we present our results in this subgroup of aneurysms. Methods: A single-center, retrospective analysis of consecutive patients treated with Penumbra coils 400 in aneurysms ≥7 mm was performed. Demographics, aneurysm features, procedural details, intraoperative complications, clinical outcomes, and occlusion rates were analyzed. Results: Thirty-three patients were included for analysis, and a total of 33 intracranial aneurysms were analyzed. Mean age was 57.6 years (SD ± 12.4) and 85% of the patients were women. Large aneurysms represented 46% of cases. Paraclinoid (55%) followed by posterior communicating (30.3%) aneurysms was the most frequently treated. Ruptured and saccular aneurysms were found in 49% and 63% of the cases, respectively. The mean aneurysmal dimensions were 14.2 mm width, 11.9 mm length, 5.4 mm neck, and 2.4 dome-to-neck ratio. A dome-neck ratio <2 was identified in 39% of cases. The mean number of coils per aneurysm was 4.8. Immediate modified Raymond–Roy Grades 1, 2, and 3A were achieved in 15%, 21%, and 64%, respectively. Twenty-six patients were evaluated at a mean follow-up period of 11 months, with an adequate occlusion of 92% and a good clinical outcome (modified Rankin score ≤2) in 96% of patients. Conclusion: Endovascular treatment with PC400 coils is an effective and safe option for medium and large intracranial aneurysms with high occlusion rates, few complications, and good clinical outcomes at follow-up.

scholarly journals Single Center Experience in Vascular and Endovascular Surgery during the COVID-19 Pandemic: Walking on the Icy Road

2021 ◽  
Vol 4 (9) ◽  
pp. 01-06
Author(s):  
Görkem Yiğit
Keyword(s):  
Normal Distribution ◽  
Cardiovascular Surgery ◽  
Interventional Treatment ◽  
Continuous Variables ◽  
Single Center ◽  
Single Center Experience ◽  
The Mean ◽  
Vascular Emergencies ◽  
Drug Eluting Balloon

Background: Along with other areas of specialization, the cardiovascular surgery clinic is a department that has a significant contribution to the COVID-19 pandemic process with both the management of vascular emergencies and the rapid and effective use of interventional methods. This study aims to present endovascular and open vascular surgical procedures performed in single center between March 2020 and December 2020 during the ongoing pandemic. Materials and methods: A total of 230 patients underwent open surgery 60 patients and endovascular / interventional treatment 170 patients by the Cardiovascular Surgery clinic were included in the study. It was aimed to determine the procedural details of the patients, follow-up results, complications and mortality rates. The compatibility of the variables to normal distribution was examined using visual and analytical methods. The Shapiro-Wilk test was used to check the normal distribution of continuous variables. Results: In the open vascular surgery group, the mean age was 51.4±23.2 years (range 12–90 years). Sixteen (26.7%) patients were female and 44 (73.3%) male. The median follow-up from the time of the open vascular procedure was 4.3±1.2 months. There were ten (16.7%) minor complications. There were five deaths after procedures. In the endovascular / interventional group, the mean age was 58.5±18.6 years (range 18–94 years). Ninety one (53.5%) patients were female and 79 (46.5%) male. The median follow-up from the time of the drug-eluting balloon angioplasty and pharmacomechanical thrombectomy patients were 4.0±1.1 months. There were thirty four (20%) minor complications and two deaths after procedures. Conclusion: Our experience and successful results shows how surgical and interventional procedures participated in the care of hospitalized COVID-19 patients during the height of the coronavirus pandemic.

Sign in / Sign up

Export Citation Format

Share Document