Low yield pressure of the lower esophageal sphincter is associated with esophageal reflux, and fundoplication must increase yield pressure if it is to prevent reflux. We attempted to increase yield pressure endoscopically in the dog by using the Nd:YAG laser to produce a fibrous scar at the cardia in the approximate line of the gastric sling fibers. Ten beagle dogs were studied. In a pilot study with two dogs, 15 watts for 4.2 sec were found to produce a scar deep into the muscle coat of the stomach. Three configurations of scar were used. One produced significant rises in yield pressure in all four of the dogs treated, the second produced a significant rise in one of the two dogs treated, and the third caused a significant drop in yield pressure in the one dog treated. One dog died of gastric perforation 10 days after lasering, but no other animal experienced any ill effects. These findings may have therapeutic implications for the management of esophageal reflux.

Animals↗

PubMedDate not supplied

Treatment of chronic iliac artery occlusions by means of percutaneous endovascular stent placement.

PURPOSE: A retrospective evaluation of outcomes in patients with chronic iliac occlusions treated with insertion of metallic endovascular stents, without previous thrombolysis, on an intention-to-treat basis. MATERIALS AND METHODS: Seventy-two patients with chronic iliac occlusion underwent attempted stent placement from either the ipsilateral or contralateral femoral artery. There were 49 men and 23 women. Mean age was 63.1 years (range, 39-88 years). A total of 89 stents were deployed in 67 patients. Follow-up was from 24 to 69 months (mean, 37.5 months). RESULTS: Stents were successfully deployed in 67 patients (93%), with two early failures, giving a primary success rate of 90%. There were five significant and four insignificant procedural complications. There were four late failures (all within the first year) and four non-stent-related deaths. CONCLUSION: Endovascular stent placement offers an alternative to surgery in the treatment of chronic iliac occlusions.

Arterial Occlusive Diseases↗