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At least 433 records · Page 24Linked to original sources
PubMed2003

Fenestration of the internal carotid artery associated with arterial dissections.

An increasing number of cases with fenestration that is frequently associated with aneurysms have been reported, largely in the vertebral and basilar arteries and less commonly in the middle and anterior cerebral arteries by angiography as well as by autopsy. However, the anomaly of the internal carotid artery associated with bilateral arterial dissections is exceedingly rare. This represents the first reported case of fenestration of the internal carotid artery associated with arterial dissections. The embryological basis and clinical significance of this anomalous condition are discussed and treatment for arterial dissection is presented.

Carotid Artery, Internal↗
PubMed2001

Aortic intimal dehiscence: a complication of percutaneous balloon fenestration for aortic dissection.

A patient with acute type B dissection and a tube configuration of the intimal flap presented with signs of advanced mesenteric and renal ischemia as well as decreased pulses in the lower extremities. The patient was referred for emergency percutaneous fenestration of the abdominal aorta as a salvage procedure and a possible bridge to later surgery. After fenestration, femoral pulses became transiently stronger and then disappeared. The patient died after exploratory laparotomy. Postmortem examination demonstrated dehiscence of the infrarenal abdominal aortic intima with occlusion of the aortic bifurcation.

Acute Disease↗
PubMed2003

[Multiseptated arachnoid cyst treated with fenestration after valvular insufficiency in an adult. ].

Treatment of symptomatic arachnoid cysts is based on two procedures: cyst fenestration versus derivation of CSF. Multiseptated cysts represent a very special group. We present the case of a 75 year old woman with a symptomatic multiseptated arachnoid cyst, developing subacute bleeding in one of the cavities. Final diagnosis was obtained after MRI. CSF derivation became insufficient with clear improvement after fenestration and communication to subarachnoid space.

Aged↗
PubMed2006

Conditionally immortalized human glomerular endothelial cells expressing fenestrations in response to VEGF.

Glomerular endothelial cells (GEnC) are specialized cells with important roles in physiological filtration and glomerular disease. Despite their unique features, GEnC have been little studied because of difficulty in maintaining them in cell culture. We have addressed this problem by generation of conditionally immortalized (ci) human GEnC using technology with which we have previously produced ci podocytes. Primary culture GEnC were transduced with temperature-sensitive simian virus 40 large tumour antigen and telomerase using retroviral vectors. Cells were selected, cloned, and then characterized by light and electron microscopy (EM), response to vascular endothelial growth factor (VEGF), and tumour necrosis factor (TNF)alpha, expression of endothelial markers by focused gene array, immunofluorescence and Western blotting, and formation and behaviour of monolayers. CiGEnC proliferated at the permissive temperature (33 degrees C) and became growth arrested at the non-permissive temperature (37 degrees C). CiGEnC retained morphological features of early-passage primary culture GEnC up to at least p41, confirming successful immortalization. EM demonstrated fenestrations, increased in number by VEGF. mRNA analysis confirmed expression of the endothelial markers platelet endothelial cell adhesion molecule 1, intercellular adhesion molecule 2, VEGF receptor 2, and von Willebrand factor, validated by immunofluorescence and Western blotting. CiGEnC also expressed Tie2, and TNFalpha upregulated E-selectin. CiGEnC formed monolayers with barrier properties responsive to cyclic adenosine 3',5' monophosphate (cAMP) and thrombin. CiGEnC retain the markers and behaviour of primary culture GEnC. They express fenestrations which are upregulated in response to VEGF. These cells are a unique resource for further study of GEnC and their roles in glomerular filtration, glomerular disease, and response to glomerular injury.

Biomarkers↗
PubMed1999

The induction by topical minoxidil of increased fenestration in the perifollicular capillary wall.

We report the induction by topical minoxidil of increased fenestration in the perifollicular capillary wall. Male 30-day-old Wistar rats were divided into two groups, i.e. an experimental group which received 4% minoxidil solution topically on the dorsal skin, and a control group which received only vehicle solution topically. Using transmission electron microscopy, follicular and subepidermal capillaries and dermal fibres were compared between both groups. There were no obvious differences in subepidermal capillaries or dermal fibres between the two groups. However, topically applied minoxidil increased fenestration in follicular capillary walls around anagen hair bulbs.

Administration, Topical↗
PubMed1999

A fenestrated covered suprarenal aortic stent.

OBJECTIVE: to address the clinical problem of inadequate neck length of abdominal aortic aneurysms in endoluminal surgery. DESIGN: a covered suprarenal aortic stent was designed with a fenestration to preserve blood flow in a targeted renal artery. METHOD AND MATERIAL: a Dacron-covered stent was accurately cut to size with a fenestration according to pre-imaging studies. RESULTS: the stent was successfully deployed in canine models, preserving the visceral and renal artery of interest. CONCLUSION: by accurately placing a covered stent in the aorta and preserving the blood flow to its branches, it may be possible to extend the indications for endoluminal aortic aneurysm grafting.

Animals↗
PubMedDate not supplied

[Results of uncemented revision arthroplasty of the hip with the MRP-stem using an intrafemoral approach with vascularized distal fenestration].

AIM: THR is one of the most successful principles in orthopaedics. With the increasing number of primary THR more and more revision arthroplasties of the hip are necessary. Many factors including loss of bone stock, instability of the joint, infection, fractures, removal of the implant or cement mantles are a challenging condition for the surgeon. Many approaches and techniques for the removal of cement mantles are published. We prefer the intrafemoral approach with an distal vascularized femoral window. METHOD: We want to describe our surgical technique and report the short term results of 45 revision arthroplasties of the hip using the uncemented modular titanium MRP stem. Mean follow-up was 2.6 years (min:1 year, max: 7 years). RESULTS: Mean Harris hip score increased from preoperative 53,2 (16 - 89) to postoperative 90.4 (35 - 100) points. We could find remodelling of the bone and spontaneous refill of bony defects in all cases. After 14 weeks we could find bony consolidation of the femoral window. The Trendelenburg sign was positive preoperatively in 26 cases, postoperatively in 11 cases. Just one single dislocation of the revised hip occurred postoperatively. CONCLUSION: The intrafemoral approach with distal vascularized femoral fenestration is a mild approach without further weakening of the pelvitrochanteric muscles. Removal of cement mantles is possible without any problems. Using the vascularized technique of the femoral fenestration prompt bony consolidation can be achieved.

Arthroplasty, Replacement, Hip↗
PubMed2006

[Guidance of interventions in subintimal recanalization and fenestration of dissection membranes using a novel dual-lumen intravascular ultrasound catheter].

PURPOSE: To evaluate the feasibility and effectiveness of IVUS-guided puncture for gaining controlled target lumen reentry in subintimal recanalization of chronic iliac/femoral artery occlusions and in fenestration of aortic dissections. MATERIALS AND METHODS: Between 5/2004 and 12/2005 12 consecutive patients (7 male, 5 female; mean age 64.6 +/- 12.0 years) with chronic critical limb ischemia and ischemic complications of aortic dissection were treated using the Pioneer catheter. This 6.2-F dual-lumen catheter combines a 20-MHz IVUS transducer with a pre-shaped extendable, hollow 24-gauge nitinol needle. This coaxial needle allows real-time IVUS-guided puncture of the target lumen and after successful reentry a 0.014" guidewire may be advanced through the needle into the target lumen. 7 patients were treated for aortic dissection and 5 patients (with failed previous attempts at subintimal recanalization) for chronic arterial occlusion. Patients with aortic dissection (5 type A dissections, 2 type B dissections) had developed renal ischemia (n = 2), renal and mesenteric ischemia (n = 2), or low extremity ischemia (n = 3). Patients with chronic arterial occlusions (2 common iliac artery occlusions, 3 superficial femoral artery occlusions) experienced ischemic rest pain (n = 4), and a non-healing foot ulcer (n = 1). RESULTS: The technical success rate using the Pioneer catheter was 100%. The recanalization/fenestration time was 37 +/- 12 min. Procedure-related complications did not occur. In 10 cases a significant improvement of clinical symptoms was evident. One patient with aortic dissection and ischemic paraplegia required subsequent surgical intervention. One patient had persistent ischemic rest pain despite successful recanalization of a superficial femoral artery occlusion. CONCLUSION: The Pioneer catheter is a reliable device which may be helpful for achieving target lumen reentry in subintimal recanalization of chronic occlusions and in fenestration of aortic dissections.

Aged↗
PubMed1989

[Recurrent functional ovarian cysts following laparoscopy fenestration].

The laparoscopic fenestration of functional ovarian cysts with a benign appearance is well known. After aspiration of the contents of the cyst, a window is cut in the cyst wall for an endocystic inspection. In this way, samples for cytology as well as histopathology are obtained. A laparoscopic fenestration was performed on 104 patients. During a mean follow-up time of 20 months, we found a recurrence of 8% in 91 patients. In the presence of pelvic adhesions, the functional cysts tend to reoccur. Corpus luteum cysts have a higher recurrence-rate than follicular cysts. In our study postoperative hormon-therapy recorded no protective effect.

Endometriosis↗
PubMed1996

[Intravascular ultrasound for monitoring percutaneous fenestration of a membrane from an aortic dissection].

HISTORY AND CLINICAL FINDINGS: A 51-year-old man, having experienced sudden retrosternal pain was admitted to another hospital with suspected myocardial infarction. He also had dysaesthesia and later paresis of the left leg. There was no sign of acute infarction in the ECG. However, computed tomography revealed aortic dissection, type III (DeBakey). The left pedal pulses were diminished. The patient was transferred to our hospital for further diagnosis and treatment. At a blood pressure of 110/60 mm Hg the occlusion pressure of the leg artery was 55 mm Hg on the left and 95 mm Hg on the right. INVESTIGATIONS: Transoesophageal echocardiography detected no abnormality of the aortic valve and ascending aorta. But distal to the origin of the left subclavian artery it demonstrated a free floating membrane of an aortic dissection and computed tomography showed its extension to the aortic bifurcation. TREATMENT AND COURSE: At first, because of the incomplete ischaemia syndrome affecting the left leg, a percutaneous fenestration of the dissection membrane was performed. After conventional angiography intravascular ultrasound imaging was also undertaken; it revealed that the membrane was almost completely occluding the left iliac artery. Under ultrasound monitoring a puncture needle and two balloon catheters were introduced across the membrane and thus a window created in it. The clinical findings quickly disappeared and the patient was discharged without further operation. CONCLUSION: Monitoring with intravascular ultrasound imaging makes it possible to perform safely a percutaneous fenestration of the membrane of an aortic dissection and to obtain immediate evidence of its success.

Aortic Dissection↗
PubMed1998

Microanatomical considerations for the fenestration of the septum pellucidum.

The anatomical foundations for the endoscopic fenestration of the septum pellucidum have not been presented previously in an isolated fashion. Using a surgical microscope, the microsurgical anatomy of the septum pellucidum, lateral ventricles, and surrounding structures was examined in ten adult brains injected with silicone rubber. The mean anteroposterior length of the septum pellucidum was 41 mm (range 40-42). Its mean height was 13.11 mm (range 12-15) at the level of the foramen of Monro; 10 mm (range 9-11) at the frontal horns, and 8 mm (range 7-10) at the ventricular atrium. One to three septal veins delimited 2 or 3 avascular areas in the septum pellucidum. We found an anterior area which was consistently avascular and large enough to be fenestrated safety. More posterior areas, while avascular, were inconsistent in their size and shape.

Adult↗
PubMed2000

Percutaneous balloon fenestration in a case of traumatic abdominal aortic dissection with lower extremity ischemia.

A 38-year-old man was involved in a traffic accident and experienced a heavy blow to the abdomen. He had traumatic abdominal aortic dissection with right lower extremity ischemia. He underwent percutaneous balloon fenestration, which is safe and minimally invasive, for relief of right lower extremity ischemia. He has been working for 2 years without any signs of vascular compromise. Percutaneous balloon fenestration is one of the few treatments for traumatic abdominal aortic dissection.

Abdominal Injuries↗
PubMed2000

Endoscopic fenestration of a symptomatic cyst of the septum pellucidum.

We present the case of a 25-year-old woman suffering from chronic severe headaches and syncope associated with an expanding cyst of the septum pellucidum. After a simple endoscopic fenestration of the cyst the symptoms resolved, resulting in an excellent clinical outcome. This case shows that simple endoscopic fenestration may produce a rapid and maintained symptomatic improvement in patients with an expanding cyst of the septum pellucidum.

Adult↗
PubMed1998

Unilateral fenestration in the treatment of lumbar spinal stenosis.

The results of decompression by fenestration restricted to the clinically relevant level and side in 50 cases of spinal stenosis are presented. Forty-two patients underwent unilateral and 37 single level procedures. The mean follow-up time was 32 months. Patient assessment of outcome was: 32% excellent, 28% good, 28% fair, 4% marginal and 8% poor. This is comparable to published series. Two patients developed contralateral leg symptoms during the study. MRI showed neither case to be due to progressive stenosis. It is proposed that fenestration type surgery restricted to the clinically relevant level and side provides adequate spinal decompression whilst minimizing the extent of the surgical intervention.

Adult↗
PubMed2003

Nuclear envelope breakdown in starfish oocytes proceeds by partial NPC disassembly followed by a rapidly spreading fenestration of nuclear membranes.

Breakdown of the nuclear envelope (NE) was analyzed in live starfish oocytes using a size series of fluorescently labeled dextrans, membrane dyes, and GFP-tagged proteins of the nuclear pore complex (NPC) and the nuclear lamina. Permeabilization of the nucleus occurred in two sequential phases. In phase I the NE became increasingly permeable for molecules up to approximately 40 nm in diameter, concurrent with a loss of peripheral nuclear pore components over a time course of 10 min. The NE remained intact on the ultrastructural level during this time. In phase II the NE was completely permeabilized within 35 s. This rapid permeabilization spread as a wave from one epicenter on the animal half across the nuclear surface and allowed free diffusion of particles up to approximately 100 nm in diameter into the nucleus. While the lamina and nuclear membranes appeared intact at the light microscopic level, a fenestration of the NE was clearly visible by electron microscopy in phase II. We conclude that NE breakdown in starfish oocytes is triggered by slow sequential disassembly of the NPCs followed by a rapidly spreading fenestration of the NE caused by the removal of nuclear pores from nuclear membranes still attached to the lamina.

Animals↗
PubMed1982

Preferential distribution of anionic sites on the basement membrane and the abluminal aspect of the endothelium in fenestrated capillaries.

Cationized ferritin (CF) was injected interstitially to study the distribution of anionic sites on the basement membrane and abluminal aspect of the endothelium in the fenestrated capillaries of the mouse pancreas and intestinal mucosa. Extensive, but uneven removal of the basement membrane was obtained by collagenase perfusion of the vasculature before CF labeling. In the absence of collagenase treatment, CF label was essentially restricted to the lamina rara externa of the basement membrane and occurred in clusters distributed in a relatively ordered planar lattice. After collagenase digestion, labeling of the lamina rara interna and of the abluminal aspect of the endothelium became possible. In the lamina rara interna, the CF label occurred in clusters with a distribution comparable to that found in the lamina rara externa. On the abluminal aspect of the endothelium, the plasmalemma proper was extensively, though variably, labeled. Coated pits were heavily labeled, whereas the membranes and stomatal diaphragms of plasmalemmal vesicles and transendothelial channels remained free of CF decoration. In contradistinction with the heavy labeling of their luminal aspects, the abluminal surface of the fenestral diaphragms were free of any CF decoration. Pronase treatment removed all anionic sites detectable by CF binding. The findings establish the existence of differentiated microdomains on the abluminal aspect of the endothelial plasmalemma and suggest that the capillary wall selects permeant macromolecules according to charge, in addition to size.

Animals↗
PubMed2003

Healing of artificial fenestration defects by seeding of fibroblast-like cells derived from regenerated periodontal ligament in a dog: a preliminary study.

The purpose of this study was to assess the seeding of fibroblast-like cells to promote periodontal healing in artificial fenestration defects in a dog. Fibroblast-like cells were cultured by incubating regenerated periodontal ligament tissue, that had been surgically taken, underneath a Teflon membrane. Fenestration defects were surgically induced on the maxillary canine and first molar teeth at a spacing of 5 to 5 mm. Passage 4 cells (2 x 10(5) cells) in autologous blood coagulum were placed on root surfaces in two defects; the remaining two defects were used as controls. Healing was evaluated histomorphometrically on postoperative day 42. The main periodontal healing pattern consisted of connective tissue adaptation in three of the four specimens including one control, with cementum formation at 9-12%; one control specimen that exhibited 100% cementum formation. New bone formation was greater in the cell-seeding group (84%) compared with control (39%). In the cell-seeding group, one specimen exhibited total regeneration of bone (100%); however, the connective tissue located between newly formed bone and the root surface was observed to adapt to the dentin surface, with limited cementum formation. Seeding of cells from periodontal ligament may be promising to promote periodontal regeneration, but needs to be investigated in further studies.

Animals↗
PubMed2006

Novel technique to prevent lymphocele recurrence after laparoscopic lymphocele fenestration in renal transplant patients.

PURPOSE: To describe the use of nonabsorbable polymer ligating (NPL) clips to prevent recurrence after laparoscopic lymphocele fenestration and to determine the efficacy and safety of this treatment in renal-transplant patients at our center. PATIENTS AND METHODS: From December 2000 to October 2005, nine patients with a mean age of 38.5 years (range 26-54 years) and symptomatic lymphoceles were treated laparoscopically among 144 renal-transplant patients. The overall incidence of symptomatic lymphocele was 6.2% (9/144). The mean time from transplantation to diagnosis was 55.5 days (range 20-98 days). Patient and lymphocele characteristics, complications, recurrence rate, and outcomes of this procedure were analyzed retrospectively. RESULTS: Laparoscopic treatment was successful in eight patients; the other was converted to open surgery. One patient sustained an allograft-ureteral injury. The mean operative time was 90.7 minutes (range 75-120 minutes), and the mean postoperative stay was 4.1 days (range 1-7 days). Lymphocele recurrence was found in the first two patients after laparoscopic surgery without NPL clips. With a mean follow-up of 42.3 months (range 31-51 months), no recurrence was observed in patients in whom NPL clips were used to maintain the patency of the peritoneal window. No late laparoscopy-related complications occurred. CONCLUSION: Laparoscopic lymphocele fenestration with NPL clips is a safe, technically easy, and efficacious procedure for the treatment of symptomatic lymphoceles after renal transplantion.

Adult↗