scholarly journals Choice of cerebral protection devices for carotid stenting

2021 ◽  
pp. 29-37
Author(s):  
A. O. Korobkov ◽  
S. V. Volkov ◽  
S. A. Bagin ◽  
S. V. Lavrenko
Keyword(s):  
Carotid Stenting ◽  
Cerebral Protection ◽  
Long Term Results ◽  
X Ray ◽  
Atherosclerotic Stenosis ◽  
Ischemic Complications ◽  
Proximal Protection ◽  
Protection Devices ◽  
Internal Carotid Arteries

The article analyzes a retrospective analysis of long-term results of 316 carotid stentings performed in patients with atherosclerotic stenosis of the extracranial parts of the internal carotid arteries using various types of cerebral protection devices – filters and proximal protection devices and their combinations. As a result of the analysis, we obtained data on the influence of the choice of cerebral protection devices on the risks of ischemic complications. The topic under consideration will be of interest to specialists in X-ray endovascular diagnostics and treatment, cardiovascular surgeons, and neurologists.

scholarly journals Why carotid endarterectomy is method of choice in treatment of carotid stenosis

2008 ◽  
Vol 136 (3-4) ◽  
pp. 181-186 ◽  
Author(s):  
Djordje Radak ◽  
Lazar Davidovic
Keyword(s):  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Stent Implantation ◽  
Radical Neck Dissection ◽  
Carotid Stenting ◽  
Long Term Results ◽  
Radiation Induced ◽  
The Common ◽  
Graft Interposition

Procedures used in treatment of carotid stenosis are endarterectomy, PTA with stent implantation, resection with graft interposition and by-pass procedure. Segmental lesions are found more often and treated by the first two mentioned procedures. In case of longer lesions and extension to the greater part of the common carotid artery, the other two procedures are performed. For the past few years, the main dilemma has been whether to perform carotid endarterectomy or PTA with stent implantation. Both early and long-term results speak in favour of carotid endarterectomy, regardless of an increased number of PTA and carotid stenting. At the same time, PTA and carotid stenting are more expensive procedures. Both methods have their defined and important roles in treatment of segmental occlusive carotid lesions. Severe cardiac, pulmonary and renal conditions, which increase the risk of general anaesthesia, are not an absolute indication for PTA and stenting, since endarterectomy can be done in regional anaesthesia. Main indications for PTA with stent implantation are: surgically inaccessible lesions (at or above C2; or subclavian); radiation- induced carotid stenosis; prior ipsilateral radical neck dissection; prior carotid endarterectomy (restenosis).

Long-Term Results after Silicone Prosthesis Replacement of the Proximal Pole of the Scaphoid Bone in Advanced Scaphoid Nonunion

2002 ◽  
Vol 27 (5) ◽  
pp. 417-423 ◽  
Author(s):  
P. HAUSSMANN
Keyword(s):  
Scaphoid Fracture ◽  
Long Term Results ◽  
Partial Replacement ◽  
Scaphoid Bone ◽  
Proximal Fragment ◽  
Carpal Collapse ◽  
X Ray ◽  
Silicone Prosthesis ◽  
Prosthesis Replacement

The treatment of scaphoid fracture nonunion with a small proximal fragment with disturbed circulation and radioscaphoid arthrosis is difficult, and the result is often unsatisfactory. For this reason, in 1981 the replacement of the proximal fragment by a silicone lunate prosthesis was recommended for such cases. From 1980 to 1984, 11 patients (all male, average age 42 [range, 25–59] years) with the conditions described above were treated by silicone prosthesis partial replacement of the scaphoid. In one patient, the prosthesis had to be removed due to dislocation, and in another patient an arthrodesis of the wrist had to be carried out after 5 years due to increasing pain. All nine remaining patients were followed up after an average of 14 (range, 12–16) years, and were clinically and radiologically re-examined and assessed using the evaluation scheme proposed by Martini (1999) . The overall results were satisfactory. Specifically, the outcome was good in one case, satisfactory in six cases, and poor in two cases. Concerning the individual criteria, the best scores were observed in “subjective overall assessment” and in “work and sports”, whilst the worst were found in “movement” and “X-ray”. For all patients, X-ray examination revealed both postoperative arthrosis and extensive multiple cystoid osteolysis, presumably due to silicone synovitis. Nevertheless, most patients were free of symptoms. None of the patients felt that further treatment was necessary. Silicone prosthesis partial replacement of the scaphoid leads to long-term reduction in pain and adequate hand function. However, it is not capable of preventing carpal collapse and carpal arthrosis. Furthermore, since in several cases a progressive silicone synovitis developed, the method was rightly abandone d after 1984.

Anterior diaphragmatic hernias in children: long-term surgical outcomes

2021 ◽  
Vol 16 (3) ◽  
pp. 7-15
Author(s):  
D.A. Morozov ◽  
◽  
D.V. Khaspekov ◽  
E.A. Okulov ◽  
V.G. Masevkin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Diaphragmatic Hernia ◽  
Complex Analysis ◽  
Long Term Results ◽  
Long Term Outcomes ◽  
X Ray ◽  
Hernial Sac ◽  
Chest X Ray ◽  
Diaphragmatic Hernias

Anterior diaphragmatic hernia (ADH) is a rare congenital pathology that occurs in children with a frequency of 1:4800 (1–6% of all congenital diaphragmatic hernias). There are many controversial aspects in the surgical treatment of patients with ADH: the choice of surgical approach, the method of diaphragmatic repair and the feasibility of excision of the hernial sac. Objective. To conduct a comparative analysis of the surgical treatment of patients with ADH in different clinics, assessing longterm outcomes. Patients and methods. The medical records of 7 children with ADH who underwent surgical repair in different clinics (in time period from 2009 to 2019) were retrospecively reviewed. Evaluating the long-term results of ADH repair was made by telephone and online surveys of the parents of patients and by outpatient examination of children (chest x-ray in two projections). Results. In a ten-year period, 7 patients (4 boys and 3 girls) were operated on with a diagnosis of “anterior diaphragmatic hernia” at the age of 3 months to 12 years. In most children, a hernia was discovered accidentally by chest x-ray. Laparoscopic correction was performed in 5 (71%) cases, thoracoscopic correction – in 2 cases (29%). The main difference in surgical tactics in ADH patients was the manipulation with the hernial sac – the hernial sac was excised in 4 (57%) patients, but it was left in three cases (43%). The defect closure was performed by “full-thickness” separated sutures that fix the diaphragm to the anterior abdominal wall during laparoscopy (5) and to the chest tissue during thoracoscopy (2); in some cases, additional fixation to the rib (4) was performed. Sutures were tied extracorporeally and buried in the subcutaneous layer in 6 (86%) patients. Average follow-up was 7 years. While evaluating long-term outcomes no ADH recurrence were found. Conclusions. There are still many controversial aspects in the surgical treatment of ADH patients. In our opinion, multicenter studies with complex analysis of long-term results are required to standardize the surgical treatment of such patients. Key words: anterior diaphragmatic hernia, Larrey hernia, long-term outcomes, Morgani hernia

Isoelastic Cementless Total Hip Replacement in Rheumatoid Arthritis. Long-Term Results

1992 ◽  
Vol 2 (2) ◽  
pp. 43-46
Author(s):  
U. Fusco ◽  
R. Capelli ◽  
A. Avai ◽  
M. Gerundini ◽  
L. Colombini ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Hip Replacement ◽  
The Other ◽  
Long Term Results ◽  
X Rays ◽  
X Ray ◽  
The Mean ◽  
Cementless Total Hip Replacement

Between 1980 and 1987 we have implanted 46 isoelastic cementless THR in 40 patients affected with rheumatoid arthritis. We have reviewed 38 hips clinically and by X-ray. The mean follow-up was 8,5 years. Harris hip scores ranged from 30.6 preoperatively to 73,4 post-operatively when reviewed. While on the other hand Merle D'Aubigné hip scores ranged from 7,06 pre-operatively to 15,59 post-operatively. All patients have been satisfied, and X-rays showed an improvement for both Charnely and Gruen X-ray score.

Long-term results of carotid stenting and risk factors in patients with severe carotid artery stenosis undergoing subsequent cardiac surgery

2018 ◽  
Vol 93 (3) ◽  
pp. E134-E139 ◽  
Author(s):  
Najibullah Habib ◽  
Bakhtawar K. Mahmoodi ◽  
Maarten J. Suttorp ◽  
Johannes C. Kelder ◽  
Selma C. Tromp ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Stenting ◽  
Artery Stenosis ◽  
Long Term Results

Long-term Results of 100 Cases of Hodgkin's Disease treated with Chemoterapy

1967 ◽  
Vol 53 (2) ◽  
pp. 111-128 ◽  
Author(s):  
Sergio Di Pietro
Keyword(s):  
Survival Rate ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Clinical Stage ◽  
Long Term Results ◽  
Good Survival ◽  
Fourth Stage ◽  
X Ray ◽  
The Third

Long-term results of 100 cases of Hodgkin's disease, treated with chemotherapy associated or not with X-ray therapy from 1949 to 1900, are reported. The median, survival rate was of 36 months: at 5 years the rate was 25 %. The survival rate at 5 years was 34,2 % for the 38 women and 19.3 % for the 62 men treated. Of 66 cases of the third clinical stage 31.6 % was alive at 5 years; the corresponding value for the 40 cases of the fourth stage was 15 %. The best survival rate was observed in the group of women of the third clinical stage with involvement of ilo-mediastinic lymph nodes in the first period of the disease (52.6% at 5 years). As to the four histological varieties of our cases, one can observe that the «paragranuloma» and the «scleronodular» types show a fairly good survival rate, not depending on the clinical stage, whereas the «polymorphous» and «sarcomatous» ones cause a more severe prognosis for the patients of the fourth clinical stage. The age of the patients, evidence or not of « systemic » symptoms, and the duration of the disease before the first treatment don't seem to have any significant influence on the survival rate. The best results were obtained with chemotherapy-X-ray therapy association in the group of patients of the third stage (survival rate of 39.5 % at 5 years). No difference is noted, on the contrary, between long-term results of chemotherapy alone and those of chemotherapy associated with X-therapy in the fourth stage.

scholarly journals Evaluation of Carotid Artery Stenting with Distal Filter Protection Device

2018 ◽  
Vol 4 (02) ◽  
pp. 057-064
Author(s):  
Pankaj Banode ◽  
Ashutosh Kharche
Keyword(s):  
Predictive Value ◽  
Carotid Stenting ◽  
Minor Stroke ◽  
Technical Success ◽  
Embolic Protection ◽  
Closed Cell ◽  
First Choice ◽  
Proximal Protection ◽  
Protection Devices ◽  
Distal Filter

Abstract Objectives To assess the use of proximal protection devices in consecutive patients as the preferred means of cerebral embolic protection for primary carotid stenting. Methods and Results This was a prospective single-center study to evaluate the technical and clinical success of proximal protection devices as the first choice for embolic protection in symptomatic (≥ 50%) and asymptomatic (≥ 70%) carotid stenosis. Proximal protection devices were used for embolic protection in 115 consecutive patients. No patients were excluded for anatomical reasons. The filter used was of diameters 6 mm in all cases (Emboshield NAV filter device, Abbotts Healthcare Pvt. Ltd. [Lake Bluff, Il]). In all cases, self-expanding closed-cell designed stent was used (X-act closed-cell self-expanding nitinol carotid-tapered stent, Abbotts Healthcare Pvt. Ltd.). Plaque characterization was done by using real-time high-resolution ultrasound (HR USG) equipment (Aloka Prosound Alpha 7 [Chiyoda, Tokyo, Japan]) using high-frequency linear transducers (> 7 MHz). Follow-up duration was 30 days. Mean age was 61.9 ± 8.27 years. There was male predominance observed in study accounting for 73 out of total 115 studied population. Fifty-six of 115 (48.89%) treated stenoses were symptomatic. Technical success was achieved in 115 of 115 (100%) cases. In both the cases, additional distal filter devices were used. Carotid stenting was successful in 115 (100%) lesions. This study observed higher number of debris in symptomatic and high-risk plaques. This study also observed higher sensitivity, specificity, and accuracy of updated classification for assessing risk of microembolism (captured debris) (sensitivity 73.91%, specificity 95.65%, positive predictive value [PPV] 91.89%, negative predictive value [NPV] 84.62%, accuracy 86.95%). In our study, minor stroke was seen in three (2.61%) patients within 48 hours, and no adverse events were seen within 48 hours to 1 month. Conclusion Proximal protection is a safe method as the first choice for embolic protection. It can be used with a high rate of technical success.

scholarly journals Long-term results of carotid stenting are competitive with surgery

2005 ◽  
Vol 41 (2) ◽  
pp. 213-221 ◽  
Author(s):  
Patrice Bergeron ◽  
Michel Roux ◽  
Patrick Khanoyan ◽  
Valérie Douillez ◽  
Jacques Bras ◽  
...  
Keyword(s):  
Carotid Stenting ◽  
Long Term Results
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