scholarly journals What are the ideal characteristics of a venous stent?

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Ilaria Massi ◽  
Paolo Zamboni
Keyword(s):  
Essential Feature ◽  
Large Diameter ◽  
Preclinical Study ◽  
Radial Force ◽  
Eagle Syndrome ◽  
Crosssectional Area ◽  
Venous Stents ◽  
Venous Wall ◽  
The Ideal

Historically, the stents used in the venous system were not dedicated scaffolds. They were largely adapted arterial stents. An essential feature of a venous stent is compliance, in order to adapt its crosssectional area to the vein. It should also be crush resistant, corrosion resistant and fatigue resistant. The material should be radiopaque, for follow-up. Another characteristic of the ideal venous stent is flexibility, to adapt its shape to the vein, not vice versa. The scaffold should be uncovered too, in order to avoid the occlusion of collaterals. The ideal venous stent should not migrate, so it is necessary a large diameter and a long length. The radial force is important to prevent migration. However, current stents derived from arterial use display high radial force, which could affect the patency of the thin venous wall. Alternatively, if the stent has an anchor point, that permits a passive anchoring, the radial force required to avoid migration will be lower. Dedicated venous stents were not available until very recently. Furthermore, there is a preclinical study about a new compliant nitinol stent, denominated Petalo CVS. Out of the commonest causes of large veins obstruction, dedicated venous stent could also treat other diseases described more recently, such as the jugular variant of the Eagle syndrome, JEDI syndrome and jugular lesions of the chronic cerebrospinal venous insufficiency that result unfavorable for angioplasty according to Giaquinta classification.

Eagle Syndrome: an underdiagnosed cause of orofacial pain

2021 ◽  
Vol 14 (1) ◽  
pp. e238161
Author(s):  
João Ferreira de Barros ◽  
Maria Vieira Rodrigues ◽  
Leonor Aurélio Barroso ◽  
Isabel Cruz Amado
Keyword(s):  
Orofacial Pain ◽  
Rare Condition ◽  
Styloid Process ◽  
High Clinical Suspicion ◽  
Body Sensation ◽  
Cervical Approach ◽  
Considerable Length ◽  
Eagle Syndrome

Eagle Syndrome (ES), also termed stylohyoid syndrome or styloid syndrome, is a rare condition characterised by a cluster of symptoms related to an elongation of the styloid process (SP) of the temporal bone. These may range from mild pharyngeal foreign body sensation and dysphagia to severe orofacial pain. High clinical suspicion is necessary owing to the unspecific clinical picture and limited diagnostic clues. Until a definitive diagnosis is achieved, these patients may develop symptoms which significantly impact their quality of life. The aim of this article is to report a case of ES in which a considerable length of SP was documented. Diagnosis was made years after the initial complaints and several medical workups by different specialties. Surgical resection of the elongated process by cervical approach was the adopted treatment modality. Patient recovery and follow-up was satisfactory, with remission of the afflicting symptoms.

scholarly journals Clinical and Radiological Results over the Medium Term of Isolated Acetabular Revision

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Nicola Piolanti ◽  
Lorenzo Andreani ◽  
Paolo Domenico Parchi ◽  
Enrico Bonicoli ◽  
Francesco Niccolai ◽  
...  
Keyword(s):  
Groin Pain ◽  
Large Diameter ◽  
Acetabular Revision ◽  
Acetabular Cup ◽  
Medium Term ◽  
Retrospective Design ◽  
Radiological Results ◽  
Functional Scores ◽  
Clinical And Radiological Results

Acetabular cup loosening is associated with pain, reduced function, and instability of the implant. If such event happens while the femoral implant is in a satisfactory position and is well fixed to the bone, isolated acetabular revision surgery is indicated. The aim of this single-center retrospective study was to evaluate the clinical and radiological results over the medium term (12-month follow-up mean 36, max 60) of isolated acetabular revisions surgery using a porous hemispheric revision shell matched with a cemented all-poly cup and large diameter femoral head (>32). 33 patients were enrolled. We collect any relevant data from the clinical board. Routine clinical and radiographic examinations were performed preoperatively; the postoperative follow-up was made at 1, 3, and 6 months and yearly thereafter. At the last available follow-up, we report satisfactory improvement of functional scores in all the patients; 2 patients (6.1%) showed thigh pain and only 4 hips (12.11%) presented mild groin pain; all the femoral components are well fixed and there were no potential or pending rerevisions. With bias due to the follow-up and to the retrospective design of the study, we report clinical, functional, and radiological satisfactory results.

scholarly journals The Newest Generation of Drug-eluting Stents and Beyond

2018 ◽  
Vol 13 (1) ◽  
pp. 54 ◽  
Author(s):  
Dae-Hyun Lee ◽  
Jose M de la Torre Hernandez ◽  
◽  
Keyword(s):  
Control Release ◽  
Radial Force ◽  
Coronary Stents ◽  
Drug Eluting Stents ◽  
Optimal Duration ◽  
Drug Eluting ◽  
The Ideal

There has been a great evolution in the development of coronary stents in order to avoid both restenosis and thrombosis. Improvements have led to improvements in the design and conformation of metallic or resorbable structures, with an adequate balance between trackability and radial force, the development of antiproliferative drugs and the polymers to control release and allow adequate endothelialisation and an optimal duration of the antiplatelet regimen. Some suggestions are provided about the ideal characteristics of future coronary stents.

scholarly journals Piezo-Assisted Turbinoplasty: A Novel Rapid and Safe Technique

2019 ◽  
Vol 36 (03) ◽  
pp. 235-241
Author(s):  
Enrico Robotti ◽  
Ali Khazaal ◽  
Francesco Leone
Keyword(s):  
Postoperative Bleeding ◽  
Novel Technique ◽  
Turbinate Hypertrophy ◽  
Safe Technique ◽  
One Year ◽  
The Ideal

AbstractConsensus is still lacking on the ideal treatment of turbinate hypertrophy concurrent with rhinoseptoplasty. A novel technique of turbinoplasty consisting of incision-bone fracturing by the use of piezoelectric technique—intramucosal microcauterization—lateralization is described in detail. A series of 157 consecutive patients is reviewed with a maximum follow-up of one year. The technique is fast and easy and allows predictability in avoiding postoperative bleeding and preventing remedialization of the lateralized turbinates. Due to the technology required, its use is suggested especially when piezo is employed during other steps of rhinoseptoplasty.

The Ideal LT-Recipient - Single Center Experience From Two Decades Long Term Follow-Up.

2014 ◽  
Vol 98 ◽  
pp. 730
Author(s):  
W. Schoening ◽  
N. Buescher ◽  
R. Neuhaus ◽  
A. Pascher ◽  
G. Puhl ◽  
...  
Keyword(s):  
Single Center ◽  
Single Center Experience ◽  
Long Term Follow Up ◽  
The Ideal

Excellent results of large-diameter ceramic-on-ceramic bearings in total hip arthroplasty

2018 ◽  
Vol 100-B (11) ◽  
pp. 1434-1441 ◽  
Author(s):  
W. G. Blakeney ◽  
Y. Beaulieu ◽  
B. Puliero ◽  
M. Lavigne ◽  
A. Roy ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Short Form ◽  
Large Diameter ◽  
Ucla Activity Score ◽  
Total Hip ◽  
Ceramic On Ceramic

Aims This study reports the mid-term results of total hip arthroplasty (THA) performed using a monoblock acetabular component with a large-diameter head (LDH) ceramic-on-ceramic (CoC) bearing. Patients and Methods Of the 276 hips (246 patients) included in this study, 264 (96%) were reviewed at a mean of 67 months (48 to 79) postoperatively. Procedures were performed with a mini posterior approach. Clinical and radiological outcomes were recorded at regular intervals. A noise assessment questionnaire was completed at last follow-up. Results There were four re-operations (1%) including one early revision for insufficient primary fixation (0.4%). No hip dislocation was reported. The mean University of California, Los Angeles (UCLA) activity score, 12-Item Short-Form Health Survey (SF-12) Mental Component Summary (MCS) score, SF-12 Physical Component Summary (PCS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and Forgotten Joint Score (FJS) were 6.6 (2 to 10), 52.8 (25.5 to 65.7), 53.0 (27.2 to 66.5), 7.7 (0 to 63), and 88.5 (23 to 100), respectively. No signs of loosening or osteolysis were observed on radiological review. The incidence of squeaking was 23% (n = 51/225). Squeaking was significantly associated with larger head diameter (p < 0.001), younger age (p < 0.001), higher SF-12 PCS (p < 0.001), and UCLA scores (p < 0.001). Squeaking did not affect patient satisfaction, with 100% of the squeaking hips satisfied with the surgery. Conclusion LDH CoC THAs have demonstrated excellent functional outcomes at medium-term follow-up, with very low revision rate and no dislocations. The high incidence of squeaking did not affect patient satisfaction or function. LDH CoC with a monoblock acetabular component has the potential to provide long term implant survivorship with unrestricted activity, while avoiding implant impingement, liner fracture at insertion, and hip instability. Cite this article: Bone Joint J 2018;100-B:1434–41.

No consensus exists for use of anticoagulation for calf vein thrombosis

Vascular ◽  
2013 ◽  
Vol 22 (2) ◽  
pp. 93-97 ◽  
Author(s):  
Michael J Anstadt ◽  
T Calloway Robertson ◽  
Ross Milner
Keyword(s):  
Online Survey ◽  
Practice Patterns ◽  
Low Molecular Weight ◽  
Multiple Choice Questions ◽  
Single Institution ◽  
Vein Thrombosis ◽  
Ivc Filters ◽  
Calf Vein ◽  
The Ideal

The ideal treatment of calf vein thrombosis (CVT) remains undefined. We assessed practice patterns at a single institution for CVT. Physicians were sent an online survey with 8 multiple choice questions about management of CVT. A total of 99 physicians of varying specialties participated in the survey. A total of 48.5% anticoagulate patients with CVT and 51.5% do not. Of those who anticoagulate, 62.3% use low molecular weight heparin and 11% use IV heparin. Treatment duration is 3 months for 58% and 6 months for 30% of responders. Of those who do not anticoagulate, 71.2% reassess for clot propagation or resolution with a duplex exam. IVC filters are used by 46% when there is a contraindication to anticoagulation and 13.7% when clot propagation is noted on follow-up scan. These results suggest that there is no consensus treatment of CVT. There is a higher than expected rate of IVC filters placed for CVT.

scholarly journals EROSITA: AGN SCIENCE, BACKGROUND DETERMINATION, AND OPTICAL FOLLOW-UP SPECTROSCOPY

2013 ◽  
Vol 53 (A) ◽  
pp. 793-798
Author(s):  
Thomas Boller
Keyword(s):  
Small Sample ◽  
Scientific Success ◽  
X Ray ◽  
Photometric Redshift ◽  
Sky Survey ◽  
Extended Sources ◽  
Small Sample Sizes ◽  
Primary Instrument ◽  
The Ideal

More than 20 years after the highly impacting ROSAT all-sky survey in the soft X-ray spectral range, we are close to the next major X-ray all/sky surveys with eROSITA. eROSITA will be the primary instrument on-board the Russian “Spectrum–Roentgen–Gamma” (SRG) satellite which will be launched from Baikonur in 2014 and placed in an L2 orbit. It will perform the first imaging all-sky survey in the medium energy X-ray range up to 10 keV with an unprecedented spectral and angular resolution. The eROSITA all sky X-ray survey will take place in a very different context than the ROSAT survey. There is now a wealth of complete, ongoing and planned surveys of the sky in broad range of wavelengths from the gamma, X-ray to the radio. A significant amount of science can be accomplished through the multi-frequency study of the eROSITA AGN and cluster sample, including optical confirmation and photometric redshift estimation of the eROSITA extended sources and AGNs. Optical spectroscopy has been, and will for the foreseeable future be, one of the main tools of astrophysics allowing studies of a large variety of astronomical objects over many fields of research. The fully capitalize on the eROSITA potential, a dedicated spectroscopic follow-up program is needed. 4MOST is the ideal instrument to secure the scientific success of the eROSITA X-ray survey and to overcome the small sample sizes together with selection biases that plagued past samples. The aim is to have the instrument commissioned in 2017, well matched to the data releases of eROSITA and Gaia. The design and implementation of the 4MOST facility simulator aimed to optimize the science output for eROSITA is described in necessary details.

A description of the ‘smile sign’ and multi-pass technique for endovenous laser ablation of large diameter great saphenous veins

2017 ◽  
Vol 33 (8) ◽  
pp. 534-539 ◽  
Author(s):  
Emma B Dabbs ◽  
Laurensius E Mainsiouw ◽  
Judith M Holdstock ◽  
Barrie A Price ◽  
Mark S Whiteley
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Large Diameter ◽  
Diameter Distribution ◽  
Short Term ◽  
Endovenous Laser Ablation ◽  
Saphenous Veins ◽  
Vein Diameter

Aims To report on great saphenous vein diameter distribution of patients undergoing endovenous laser ablation for lower limb varicose veins and the ablation technique for large diameter veins. Methods We collected retrospective data of 1929 (943 left leg and 986 right leg) clinically incompetent great saphenous vein diameters treated with endovenous laser ablation over five years and six months. The technical success of procedure, complications and occlusion rate at short-term follow-up are reported. Upon compression, larger diameter veins may constrict asymmetrically rather than concentrically around the laser fibre (the ‘smile sign’), requiring multiple passes of the laser into each dilated segment to achieve complete ablation. Results Of 1929 great saphenous veins, 334 (17.31%) had a diameter equal to or over 15 mm, which has been recommended as the upper limit for endovenous laser ablation by some clinicians. All were successfully treated and occluded upon short-term follow-up. Conclusion We suggest that incompetent great saphenous veins that need treatment can always be treated with endovenous laser ablation, and open surgery should never be recommended on vein diameter alone.

Erlotinib Is Not Effective In Patients (Pts) With JAK-2 V617F Positive Polycythemia Vera

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1597-1597
Author(s):  
Mohamad Cherry ◽  
Mohamad Khawandanah ◽  
Zhizhuang Joe Zhao ◽  
Samer A Srour ◽  
Howard Ozer ◽  
...  
Keyword(s):  
Polycythemia Vera ◽  
Conflicts Of Interest ◽  
Growth Factor Receptor ◽  
Median Number ◽  
Preclinical Study ◽  
Spleen Size ◽  
University Of Oklahoma ◽  
Grade 3

Abstract Introduction Erlotinib is an epidermal growth factor receptor small-molecule inhibitor and is FDA approved for the treatment of lung and pancreatic cancers. In preclinical study, in vitro colony culture assays revealed that erlotinib at micro-molar concentrations effectively suppressed the growth and expansion of Polycythemia Vera (PV) hematopoietic progenitor cells while having little effect on normal cells. Several JAK inhibitors are being studied for the management of PV, one of which has been approved for the treatment of myelofibrosis (ruxolitinib). Aim To study the clinical effect of erlotinib in pts diagnosed with JAK2V617F + PV. Methods We conducted a single arm, prospective phase II study at the University of Oklahoma and the Oklahoma City VA hospitals in pts with WHO defined JAK-2 V617F positive PV from June 2010 to August 2012. Appropriate IRB approval was obtained in accordance with Hilsinki declaration. Pts had to be requiring phlebotomy. Toxicity was assessed by treating physicians using NCI version 4. Dose modification for erlotinib was done using label recommendations. Results Five Caucasian pts were enrolled (3 (60%) males, with median age at enrollment of 63 years, range 26-79). Pts had pretreatment median hemoglobin14.4 g/dL (10.4 -19.2 g/dL), median platelet count 511 x109 (424-681 x109), median white blood cell (WBC) 14.4 x109(7.8- 18.3 x109). Three pts had splenomegaly prior to treatment. Median number of prior pharmacologic treatments (hydroxyurea, anagralide or interferon) was 1, range 0-2. Pts were given erlotinib 150 mg orally daily for 16 weeks: responders (phlebotomy free or decrease in spleen size) were allowed to continue a total of 1 year of treatment, while non-responders were taken off the study. Three (60%) patients received therapy for 16 weeks and did not achieve hematological response or improvement in spleen size. Two (40%) pts were taken off the study after 2 doses secondary to severe toxicities (grade 3 colitis in 1 case, and grade 3 facial rash in 1case). No therapy continued beyond 16 weeks (due to toxicity or lack of response). All pts in the study developed rash (grade 1 – 3) and diarrhea (grade 1 – 2). Three pts developed mucositis (see Table 1). No death was observed during the study and follow up period (median follow up was 23 months, range 12-37 months). Study was closed due to lack of efficacy. Conclusions Despite in vitro efficacy of erlotinib as potent inhibitor of JAK-2 activity, erlotinib is not effective in pts with JAK-2 V617F positive PV with poor toxicity profile. Poor accrual was related to potential toxicity of erlotinib compared to alternative treatments in view of lack of clinical efficacy. Disclosures: No relevant conflicts of interest to declare.

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