scholarly journals Endovascular treatment of intractable epistaxis - results of a 4-year local audit

2004 ◽  
Vol 8 (3) ◽  
pp. 9 ◽  
Author(s):  
Ian C Duncan ◽  
P.A. Fourie ◽  
C.E. Le Grange ◽  
H.A. Van der Walt
Keyword(s):  
Success Rate ◽  
Morbidity Rate ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Artery Ligation ◽  
Endovascular Embolisation ◽  
Long Term Follow Up ◽  
Initial Procedure ◽  
Intractable Epistaxis

A total of 57 endovascular embolisation procedures were performed for intractable epistaxis in 51 patients over a 4-year period at the Unitas Interventional Unit near Pretoria. Long-term follow-up was possible in 36 patients. Three cases were due to trauma and 2 directly related to previous facial surgery, 1 patient had hereditary haemorrhagic telangiectasia (HHT), and the remaining 45 cases (88.2%) were classed as idiopathic. Eight patients (15.7%) had a rebleed between 1 and 33 days after the initial embolisation. Four were re-embolised once, 1 was re-embolised twice (the HHT patient), and 2 underwent additional ethmoid artery ligation (with no further bleeding). This gives a primary short-term success rate (in all 51 cases) of 86.3% and a secondary assisted success rate of 94.1% for embolisation alone. Long-term follow- up was obtained in 36 patients, with 35 (97.2%) reporting no further bleeding after the initial procedure(s). Only the patient with HHT developed multiple recurrent bleeds. The mortality rate was 0%, the major morbidity rate 2% (1 stroke), and the minor morbidity rate 25% (N = 36), which included transient facial pain, headaches and femoral problems related to access. Our results compare favourably with other published series. In conclusion, endovascular embolisation for intractable epistaxis is available locally as an alternative technique for the treatment

A long term view of myringoplasty in children

1990 ◽  
Vol 104 (10) ◽  
pp. 758-762 ◽  
Author(s):  
J. D. Blanshard ◽  
A. K. Robson ◽  
I. Smith ◽  
A. R. Maw
Keyword(s):  
Success Rate ◽  
Significant Influence ◽  
Hearing Gain ◽  
Graft Take ◽  
Late Failure ◽  
Special Clinic ◽  
Long Term Follow Up

AbstractFifty-nine type 1 tympanoplasties in children under 14 years of age were assessed by recall to a special follow-up clinic up to 15 years post-operatively. Overall 78 per cent of tympanic membranes were found to be intact with a late failure of grafts noted in 6 per cent of cases. An improvement in the audiological threshold was found in 51 per cent, 24 per cent were unchanged, the remaining 25 per cent suffered a deterioration which was seen both immediately post-operatively and thereafter until reviewed in the special clinic. The age at operation, size of the perforation, grade of surgeon carrying out the operation and prior adenoidectomy had no statistically significant influence on the success rate or the audiologicaloutcome. Revision procedures achieved similar graft take rates to the initial procedures but fared worse audiologically. We conclude that in the majority the operation was successful but hearing gain was not as good as expected and subject to late deterioration. A long term follow-up is important to detect this and other complications.

Symptomatic Retethering of the Spinal Cord After Section of a Tight Filum Terminale

Neurosurgery ◽  
2011 ◽  
Vol 68 (6) ◽  
pp. 1594-1602 ◽  
Author(s):  
Raymund L. Yong ◽  
Tracey Habrock-Bach ◽  
Mariko Vaughan ◽  
John R. Kestle ◽  
Paul Steinbok
Keyword(s):  
Tethered Cord ◽  
Invasive Procedure ◽  
Pediatric Neurosurgery ◽  
Filum Terminale ◽  
Initial Surgery ◽  
Long Term Follow Up ◽  
Initial Procedure ◽  
Tight Filum Terminale

Abstract BACKGROUND: Section of a tight filum terminale is a minimally invasive procedure compared with cord untethering procedures used for more complex spinal abnormalities. Anecdotal evidence suggests, however, that the risk of symptomatic retethering resulting from scarring might be higher than previously thought. OBJECTIVE: To determine the frequency of symptomatic retethering after section of a tight filum terminale and to explore possible risk factors. METHODS: We reviewed databases at 2 pediatric neurosurgery centers for all patients who had surgery for a suspected tight filum terminale between January 1982 and June 2009. RESULTS: We identified 152 patients. The median length of follow-up was 78 months. Thirteen patients (8.6%) went on to retether symptomatically at a median time of 23.4 months after the initial procedure. Eight had early retethering (within 2 years) and 5 had late retethering (after 7 years). Compared with late retetherers, early retetherers were older at initial surgery (median, 9.4 vs 0.9 years of age), had a higher level of the conus (median, L1/L2 vs L3/L4), had more arachnoiditis after initial surgery, and required more repeat untethering procedures. Late retetherers were younger at initial surgery than those who did not retether (median, 0.9 vs 4.5 years of age). CONCLUSION: Symptomatic retethering is not uncommon after a simple filum snip, and long-term follow-up is warranted. Two distinct patterns of retethering were observed. Arachnoiditis caused by infection or a cerebrospinal fluid fistula may predispose to early retethering, whereas early surgery for prevention of tethered cord symptoms may predispose to late retethering.

scholarly journals CAROTID ARTERY STENTING IN OCTOGENARIANS: SUCCESS RATE, COMPLICATIONS AND LONG-TERM FOLLOW-UP OF A SINGLE-CENTER COHORT

2016 ◽  
Vol 67 (13) ◽  
pp. 299
Author(s):  
Juergen Kammler ◽  
Hermann Blessberger ◽  
Alexander Kypta ◽  
Michael Lichtenauer ◽  
Thomas Lambert ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Success Rate ◽  
Carotid Artery Stenting ◽  
Single Center ◽  
Long Term Follow Up

A Long-Term Follow-Up of the Effect of Repeated Corticosteroid Injections for Stenosing Tenovaginitis

1989 ◽  
Vol 14 (2) ◽  
pp. 242-243
Author(s):  
P. FAUNØ ◽  
H. J. ANDERSEN ◽  
O. SIMONSEN
Keyword(s):  
Success Rate ◽  
Single Injection ◽  
Adult Patients ◽  
Complete Relief ◽  
Duration Of Symptoms ◽  
Associated Diseases ◽  
Long Term Follow Up ◽  
Corticosteroid Injections

Ninety-three consecutive adult patients with stenosing tenovaginitis of 104 digits have been treated by corticosteroid injections repeated at three week intervals up to thrice in partial responders. At follow-up after 3–15 years, partial relapse had occurred in two patients, who now and then experienced triggering but without pain or locking. Complete relief of symptoms was obtained in 76%. There were no complications and the success rate was independent of sex, age, duration of symptoms, the digit involved, or associated diseases. These results are superior to those previously reported following a single injection.

scholarly journals XEN Glaucoma Implant for the Management of Glaucoma in Naïve Patients versus Patients with Previous Glaucoma Surgery

2021 ◽  
Vol 10 (19) ◽  
pp. 4417
Author(s):  
Katarzyna Lewczuk ◽  
Joanna Konopińska ◽  
Joanna Jabłońska ◽  
Jacek Rudowicz ◽  
Patrycja Laszewicz ◽  
...  
Keyword(s):  
Success Rate ◽  
Glaucoma Surgery ◽  
Minimal Invasiveness ◽  
Refractive Outcomes ◽  
Long Term Follow Up ◽  
Initial Procedure ◽  
The Mean ◽  
Group 2 ◽  
Group 1

This retrospective study analyzed the surgical and refractive outcomes of a XEN Gel Implant (Allergan, Abbvie Company, Irvine, CA, USA) in naïve patients versus those with previous glaucoma surgery. We evaluated the efficacy of XEN implantation in 86 glaucoma patients during a long-term follow-up period. Patients were divided into two groups: naïve patients (Group 1) and patients with previous glaucoma surgery (Group 2). Eyes that received a XEN Gel Stent placement from December 2014 to October 2019 were included. Intraocular pressure (IOP) change, corrected distance visual acuity (CDVA), change in glaucoma medications, frequency of slit lamp revision procedures, and frequency of secondary glaucoma surgeries were the primary outcomes. In Group 1, the mean IOP before surgery was decreased significantly from 25.00 ± 7.52 mmHg to 16.83 ± 5.12 mmHg by the end of the study. In Group 2, the mean IOP decreased significantly from 25.35 ± 7.81 mmHg to 17.54 ± 5.34 mmHg. The mean IOP decrease from baseline was 29% in Group 1 and 27% in Group 2 (p = 0.567). There were no significant differences between the groups in the IOP baseline level, the final level, or the change between preoperative and final levels. The qualified success rate for Group 2 was 68.7% versus 76.5% for Group 1 for the initial procedure and 15.4% vs. 20.2%, respectively, for complete success rate (p > 0.05). However, at the end of the follow-up, more patients achieved an IOP < 18 mmHg in Group 1 than in Group 2. Despite the need for more anti-glaucoma medications, repeat XEN Gel implantation appears to show promising results in patients with previously failed anti-glaucoma procedures, owing to its minimal invasiveness.

scholarly journals Alternate Sequential Suture Tightening: A Novel Technique for Uncontrolled Postpartum Hemorrhage

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Sharda Brata Ghosh ◽  
Y. M. Mala
Keyword(s):  
Postpartum Haemorrhage ◽  
Internal Iliac Artery ◽  
Successful Outcome ◽  
Artery Ligation ◽  
Novel Technique ◽  
Long Term Follow Up ◽  
Internal Iliac ◽  
Fertility Potential

Objective. The most commonly described technique of modified B-Lynch suture may not be suitable for all the patients presenting with flabby, atonic uterus.Study Design. A retrospective analysis of twelve patients with uncontrolled postpartum haemorrhage, who underwent this procedure from March 2007 to September 2012, was conducted. In this novel technique, sutures are passed in the lower uterine segment and are tightened alternately to control uterine bleeding.Results. Average duration of the procedure was 4 minutes (range 2–7 minutes). Average blood loss was 1625 mL (range 1300–1900 mL). Eleven patients (91.66%) were seen to have a successful outcome with only this technique. No patient required hysterectomy and one patient (8.33%) required additional bilateral internal iliac artery ligation. All the patients had a minimum follow-up of 2 yrs and none of them reported any infertility problems.Conclusion. This technique is simple, quick, and effective. There was no adverse effect on the fertility potential for the observed 2 years; however, a long-term follow-up is required to comment on its actual rate. This technique cannot replace the standard modified B-Lynch technique for uncontrolled postpartum haemorrhage but can be used for unresponsive, flabby, and atonic uterus.

Complications following midfoot amputation in neuropathic and dysvascular feet

1989 ◽  
Vol 79 (6) ◽  
pp. 277-280 ◽  
Author(s):  
R Sage ◽  
MS Pinzur ◽  
R Cronin ◽  
HF Preuss ◽  
H Osterman
Keyword(s):  
Success Rate ◽  
Wound Dehiscence ◽  
Aggressive Management ◽  
Long Term Follow Up ◽  
Early Wound

A review of 64 midfoot amputations performed between 1980 and 1985 revealed that complications occurred in 42% of the series. These included early wound dehiscence and late re-ulceration after the patient began walking again. By providing aggressive management and appropriate local revisions, 84% of the original group's limbs were salvaged at a functionally significant level. These findings underscore the fact that midfoot amputation requires diligent immediate and long-term follow-up if an acceptable success rate is to be achieved.

Use of Polypropylene Mesh in Addition to Internal Obturator Transposition: A Review of 59 Cases (2000–2004)

2007 ◽  
Vol 43 (3) ◽  
pp. 136-142 ◽  
Author(s):  
Stephanie Szabo ◽  
Brent Wilkens ◽  
Robert M. Radasch
Keyword(s):  
Medical Treatment ◽  
Success Rate ◽  
Recurrence Rate ◽  
Polypropylene Mesh ◽  
Mesh Reinforcement ◽  
Long Term Follow Up ◽  
Perineal Swelling ◽  
Poor Outcomes

Fifty-nine dogs with a total of 69 perineal hernias that were repaired by internal obturator transposition and polypropylene mesh reinforcement were reviewed. Thirty-six dogs were available for follow-up at a mean of 29.4 months postoperatively. Six dogs had complications within the first 60 days of surgery, such as perineal swelling, persistent tenesmus, and incisional infections. Twenty-two dogs had excellent outcomes; seven dogs needed continued medical treatment after surgery; and seven dogs had poor outcomes. Hernias recurred in five dogs. The incisional infection rate was 5.6%; the recurrence rate was 12.5%; and the overall success rate was 80.5% for the 36 dogs with long-term follow-up.

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