Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Protective Devices”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 343 records · Page 19Linked to original sources
PubMed2006

Vertebral artery origin stent placement with distal protection: technical and clinical results.

OBJECTIVE: To report the feasibility, safety, and 1-month results of performing stent placement for vertebral origin stenosis with the use of a distal protection device. Distal protection devices have been shown to reduce the number of cerebral emboli and subsequent ischemic events when used as adjuncts to percutaneous carotid intervention; however, one case of the use of a distal protection device for vertebral artery has been reported in the literature. METHODS: We retrospectively determined rates of technical success and 1-month stroke or death associated with stent placement by using distal protection (Filter EX; Boston Scientific, Natick, Mass) in patients with symptomatic vertebral artery origin stenosis. Technical success was defined as successful deployment of distal protection device and stent at target lesion followed by successful retrieval of the device and a final residual stenosis of less than 30%. Other outcomes ascertained included any stroke, death, and semiquantitative assessment of particulate material retained by the filter device. RESULTS: The mean age of the 12 treated patients was 68 years (range, 52-88 years) and the group included 9 men and 3 women. The mean percentage of vertebral artery origin stenosis was 71 +/- 6%. Femoral and radial approaches were used in 9 and 3 cases, respectively. Technical success was achieved in 11 of the 12 patients in whom distal protection device placement was attempted. Postprocedure residual stenosis was 5 +/- 4%. Eight devices held macroscopically visible embolic debris (large and small amounts in 3 and 5 devices, respectively). No stroke or death was observed in the 1-month follow-up. CONCLUSION: The present study demonstrates the feasibility of performing stent placement for vertebral artery origin stenosis by using a distal protection device. Further studies are required to determine the effectiveness of this approach for vertebral artery origin atherosclerosis.

Aged↗
PubMed2004

Distal protection of bifurcating vessels: a novel approach.

Distal protection devices protect only a single distal vessel. We describe a novel technique to protect both branches following a thrombus-containing bifurcation lesion. The combination of an occlusive balloon and an arterial filter system provides an attractive solution to the challenging environment of a lesion at high risk for distal embolization supplying more than a single major branch.

Angioplasty, Balloon, Coronary↗
PubMed2006

Carotid angioplasty and stenting under protection. Techniques, results and limitations.

A carotid stenosis is responsible for about 30% of strokes occurring. Carotid endarterectomy (CEA) is considered to be the gold standard treatment of a carotid stenosis. Carotid angioplasty and stenting (CAS) is emerging as a new alternative treatment for a carotid artery stenosis, but the risk of neurological complications and brain embolism remains the major drawback to this procedure. Therefore, in order to reduce the risks, we need: 1) good indications, good patient and lesion selection; 2) correct techniques; 3) brain protection devices (cerebral protection devices should be routinely used and are mandatory for any procedure); 4) 3 types of protection devices are available, but filters are the most commonly used (all protection devices have limitations and cannot prevent from all embolic events; however, neurological complications can be reduced by 60%); 5) a good choice of the stent and correct implantation (all stents are not equivalent and have different geometrical effects); 6) pharmacological adjuncts; 7) a good team. Recent studies have shown that CAS has superior short-term outcomes than CEA in high surgical risk patients, but there are enough reported data to conclude that CAS is also not inferior to CEA in low-risk patients. CAS under protection is the standard of care and is maybe becoming the gold standard treatment of a carotid stenosis at least in some subgroups of patients.

Angiography↗
PubMed2003

Filter devices for cerebral protection during carotid angioplasty and stenting.

The risk of embolization during carotid artery stenting (CAS) has been the foremost reason for the cautious acceptance of this percutaneous alternative to carotid endarterectomy. To address this issue, numerous embolic protection devices are being evaluated as an adjunct to CAS for neuroprotection. Among the 3 main categories of these devices, distal filters, which trap embolic debris while maintaining distal cerebral perfusion, have attracted the most corporate interest. This review focuses on the emerging field of embolic protection filters for use in CAS.

Angioplasty, Balloon↗
PubMed2006

Flow-reversal device for cerebral protection during carotid artery stenting--acute and long-term results.

OBJECTIVE: Several types of cerebral (embolic) protection devices have been used in patients undergoing carotid stenting. This study assessed results achieved with a flow-reversal system. METHOD: Carotid stenting was performed in 56 patients (mean age, 68 +/- 9 years). The mean percentage of stenosis was 77%+/- 10%. During the procedure, cerebral protection was achieved by means of balloon occlusion of the common and external carotid artery with use of a Parodi Anti-Emboli System. The patients' neurologic status was assessed during the intervention; at discharge; 1, 6, and 12 months after the procedure; and yearly thereafter. RESULTS: The procedure was technically successful in all cases. One patient had a minor stroke 6 hours after the intervention. No major strokes, deaths, or myocardial infarctions occurred. During long-term follow-up (to 40 months), 2 patients died of a secondary complication after intracerebral bleeding and stroke and 1 died as a result of ventricular fibrillation. Restenosis did not exceed 50% of vessel diameter in any patient. CONCLUSIONS: The acute results indicate that proximal occlusion and flow reversal for cerebral protection during carotid stenting is a safe and effective method. The low restenosis and complication rate during long-term follow-up is in accordance with other series of carotid angioplasty and shows that the occlusion balloons do not cause any long-term side effects.

Acute Disease↗
PubMed2002

Distal filter protection during saphenous vein graft stenting: technical and clinical correlates of efficacy.

OBJECTIVES: The aim of this study was to evaluate the clinical, angiographic, and technical factors related to successful stenting of diseased saphenous vein grafts (SVGs) using a novel filter-based distal protection device. BACKGROUND: Protection of the distal microvasculature with a balloon occlusion and aspiration system has been shown to reduce atherothrombotic embolization and peri-procedural myocardial infarction (MI) after percutaneous coronary intervention (PCI) in SVGs. The safety, efficacy, and technical factors relating to procedural success with filter-based distal protection devices are unknown. METHODS: Percutaneous coronary intervention was performed in 60 lesions in 48 patients undergoing SVG intervention with the FilterWire EX distal protection system in a phase I experience at six sites. A larger phase II study was then performed in 248 lesions in 230 SVGs at 65 U.S. centers. RESULTS: Cumulative adverse events to 30 days occurred in 21.3% of patients in phase I, including a 19.1% rate of MI. Numerous anatomic, device-specific, and operator-related contributors to these adverse events were identified, resulting in significant changes to the protocol and instructions for use. Subsequently, despite similar clinical and angiographic characteristics to the phase I patients, the 30-day adverse event rate in phase II was reduced to 11.3% (p = 0.09), due primarily to a lower incidence of peri-procedural Q-wave and non-Q-wave MI. CONCLUSIONS: Distal protection during SVG PCI with the FilterWire EX is associated with a low rate of peri-procedural adverse events compared to historical controls. A unique set of anatomic, technical, and operator-related issues exist with distal filters which, if ignored, may reduce their effectiveness.

Aged↗
PubMed1990

A simple device to protect against osteoradionecrosis induced by interstitial irradiation.

The incidence of osteoradionecrosis has declined since the introduction of preventive oral hygiene programs and meticulous dental evaluations before and after irradiation. Nevertheless, radiation dose per se still remains an important factor in osteoradionecrosis. Interstitial radiation has received much attention in the past decade since the use of flexible afterloading systems. It has become common practice in large oncology centers to implant radiation carriers in bulky tumor in the oral cavity and/or oropharynx. For interstitial radiation, with or without external radiation, minimal tumor doses are often cited to be more than 70 Gy. Unfortunately, if the mandible receives more than 70 Gy, it is at risk for the development of osteoradionecrosis. Therefore a simple protective lead device has been designed for routine use in brachytherapy in oral cavity tumors to reduce the dose to the mandible. This device will diminish the potential risk of osteoradione-crosis development.

Brachytherapy↗
PubMed2005

Epicardial and microvascular reperfusion with primary percutaneous coronary intervention.

Restoration of normal flow and tissue-level perfusion are key factors in the reduction of mortality in acute myocardial infarction. The goal of reperfusion during primary percutaneous coronary intervention (PCI) should be to restore not only epicardial patency and flow, but also downstream myocardial tissue perfusion. This review will focus on the techniques able to evaluate and quantify epicardial and microvascular perfusion and on the available therapeutic tools that may be useful in primary PCI. After primary PCI, rates of TIMI flow grade 3 of 80 to 100% have been reported. Furthermore, after stenting during primary PCI more than one third of patients have persistently abnormal corrected TIMI frame counts related to increased downstream resistance. Achievement of TIMI flow grade 3 is no longer sufficient to define an optimal result of primary PCI and restoration of normal tissue-level perfusion is also required. Coronary no/slow reflow and myocardial hypoperfusion after otherwise successful recanalization of infarct-related arteries may involve more than just classical non-reperfusion of the myocardium that is already dead: distal embolization of debris or microparticulate atheromatous material, capillary edema, inflammation, and neurohormonal reflexes and vasoconstriction may play a crucial role. Evolving treatments of the no-reflow phenomenon are directed toward the restoration of microvascular flow abnormalities because these either directly or indirectly contribute to cell death. Promising adjunctive therapies that may reduce microemboli include intensive antiplatelet therapy with aspirin and ticlopidine, platelet glycoprotein IIb/IIIa inhibitors, coronary vasodilators, and embolization protection devices. Therapy targeting microvascular vasospasm also appears promising. Finally a variety of interventional new approaches have been focused on the setting of primary PCI, like atherectomy and thrombectomy devices, distal protection devices, hypothermia and hyperoxemic therapy, that are under investigation in numerous trials before they can be used routinarily.

Angioplasty, Balloon, Coronary↗
PubMed1999

Evaluation of a novel protective gas mask during medical unit activity.

Evaluation of a battalion medical unit drill in a chemical warfare environment was carried out by comparing two respiratory protective devices: a new protective device (the Chemical Team Respirator) and the mask currently used in the Israel Defense Forces (the M-15). After a medical deployment drill conducted with 24 participants and 14 inspectors, comfort, communication, and various aspects of activity were evaluated by structured questionnaires. The new device, consisting of a hood, nose cup, and air blower system, was found to be preferable to the M-15 mask for physical and respiratory comfort, quality of visual field, and performance. The communication capabilities of the unit members, on the other hand, were severely limited by the hearing reduction caused by the hood of the new protective device. We conclude that the new device proved superior to the current mask by facilitating better performance of the team at the drill. Interference with hearing must be dealt with technically or bypassed by modifications in the unit's mode of communication.

Adolescent↗
PubMed1983

External inspiratory resistance of protective respiratory devices: effects on physical performance and respiratory function.

Twenty subjects wearing protective respirators were studied during submaximal exercise (80% of VO2max) on a treadmill. The protective devices were fitted with canister filters of low expiratory resistance and different inspiratory resistances: (0.3, 1.8, 2.8, 3.4, 3.9, and 4.6 cm H2O X sec/liter). The effect of inspiratory resistance on physical endurance, various physiological parameters, and subjective sensations was examined. With the increase in inspiratory resistance, a significant decrease in physical performance, decrease in tidal volume, increased ratio of inspiratory to expiratory time, increased peak inspiratory pressure, and increased CO2 retention were observed. The difficulty in inspiration correlated significantly to inspiratory resistance and seems to be the main reason for cessation of the effort. No acceptable upper limit for the inspiratory resistance of the canister filters was found. Any decrease in the inspiratory resistance of the mask's filter enhanced endurance and performance.

Adult↗
PubMed2000

The influence of airbag and restraining devices on the patterns of facial trauma in motor vehicle collisions.

According to the National Highway Traffic Safety Administration (1990), there were more than 3 million motor vehicle collisions severe enough to lead to significant injury or fatality. Airbags may prevent brain and facial injury caused by these accidents. To date, however, no study has focused primarily on the correlation between facial injuries and the use of airbags and restraining devices. A retrospective analysis was performed on motor vehicle collision data submitted to the Pennsylvania Trauma Outcome Study database from 1990 through 1995. Criteria for submission to the database included admission to the intensive care unit, death during hospitalization, hospitalization for >72 hours, or transfer to or from the receiving hospital. There were 15,450 patients who sustained facial trauma (identified by ICD-9 codes) and were analyzed for patterns of injury and the presence or absence of protective devices. Protective devices were categorized into four groups: airbag alone, airbag with seatbelt, seatbelt or car seat without airbag, and no restraining devices. Statistical analysis was performed using chi-squared test of association. For contingency tables with small expected frequencies, Fisher's exact test was used. There were 9408 male and 6042 female subjects, with a mean age of 38 years (range, 3 to 98 years). There were 11,672 drivers and 3778 passengers. Airbags were deployed in 429 instances. In 276 of these cases, additional restraint was provided with a seatbelt. Airbags were not deployed in 4866 cases when a seatbelt or a car seat was used. In 10,155 cases, no restraining device was employed. There was significantly more facial trauma in patients without protective devices (p < 0.001). Drivers sustained significantly fewer facial fractures when airbags were used, either alone or in combination with a seatbelt (p < 0.001); however, there was no difference in the number of facial lacerations. Among passengers, airbags provided protection from lacerations (p < 0.001) but had no impact on the incidence of facial fractures. In collisions in which airbags were deployed, the use of a seatbelt provided no additional protection from facial fractures or lacerations. In summary, the use of any protective device decreased the incidence of facial fractures and lacerations sustained in motor vehicle collisions (p < 0.001). Airbags provided the best protection of all currently available devices.

Accidents, Traffic↗
PubMed1997

Noise exposures. Effects on hearing and prevention of noise induced hearing loss.

1. Over 30 million workers are exposed to hazardous noise on the worksite. Continual exposure to high noise levels damages and destroys hearing cells within the ear, making noise induced hearing loss an irreversible impairment. 2. Hearing conservation programs are required by law for workers in industrial settings where noise exposures equal or exceed 85 dB(A). Many workers, such as those in construction and agricultural industries, are not covered by these programs. 3. Reducing noise through engineering or administrative controls is the first line of defense. When this is not sufficient, two types of personal hearing protection devices are available: passive hearing protection devices such as ear muffs, canal caps, and ear plugs, which reduce noise mechanically; and active noise reduction devices, which electronically cancel sound waves at the ear. 4. The most effective hearing protection devices are those with which the worker is most comfortable will use 100% of the time. The occupational health nurse has a major role in promoting increased use of hearing protection devices through continued contact with workers, administrators, and safety personnel.

Ear Protective Devices↗