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At least 433 records · Page 24Linked to original sources
PubMed1990

[Peripheral Simpson atherectomy. Indications and results of a new transluminal procedure for vascular recanalization].

A report is given on the experience acquired to date with a new catheter method (Simpson atherectomy, S-AE) for reducing arteriosclerotic stenoses in the pelvic and leg arteries of 47 patients. If the correct instrument size is selected, one can regularly perform complete atherectomies in femoropopliteal vessels. The result of recanalization is not affected by the form of the stenosis, but eccentric, calcified or ulcerated lesions are ideal indications. Percutaneous transluminal angioplasty and atherectomy can be used as complementary methods to optimize percutaneous peripheral vascular recanalization. The histological findings, methodological limitations, and clinical results are discussed.

Adult↗
PubMed1990

[The effect of percutaneous transluminal coronary recanalization (PTCR) on late potentials detected by signal-averaged electrocardiogram in patients with previous myocardial infarction].

The purpose of this study was to assess the effect of percutaneous transluminal coronary recanalization (PTCR) on late potentials (LP) in patients with previous myocardial infarction (MI). The signal-averaged ECG was recorded by Fukuda VCM-3000 in 54 patients with anterior MI (average of 32 months after onset of MI). Fifty four patients were divided into two groups: Group A was comprised of 29 patients who underwent PTCR, and Group B was comprised of 25 patients who didn't receive PTCR. Ventricular arrhythmias detected by 24 hour Holter monitoring, and left ventriculographic findings were also evaluated. The presence of LP was defined as low amplitude signals (less than 15 microV) in the last 40 msec of the filtered QRS complex. The incidence of LP was significantly higher in Group B than in Group A (32% vs 7%, p less than 0.01). The presence of PVCs and ejection fraction (EF), LV end-diastolic volume (EDV), LV end-systolic volume (ESV) and % abnormally contracting segment (% ACS) were not significantly different in each respective groups. However, ESV and % ACS were significantly larger (p less than 0.05), and EF was significantly smaller (p less than 0.01) in patients with LP (+) than in patients with LP (-). LP was present in two patients who had undergone PTCR (TIMI grade 2) unsuccessfully, whereas it was not present in the 27 patients with successful PTCR (TIMI grade 3). It was concluded that successful recanalization of the infarct-related arteries may reduce the incidence of LP.

Aged↗
PubMed1989

Laser thermal probe recanalization of occluded arteries.

Applications of laser energy for treatment of vascular disease have recently received much attention; metal-tipped laser probes are being investigated as a device for recanalization of occluded arteries, especially as an adjunct to balloon dilatation. Developments in instrumentation and techniques have reduced the incidence of complications, notably perforation, to an acceptable level. Initial data show that recanalization of iliac, femoral, and popliteal lesions can be accomplished in a majority of cases, with the chance of success being inversely proportional to the length of occlusion. Results in the tibial vessels are disappointing. Patency of the treated vessels at 12 months appears to be superior to that of percutaneous transluminal angioplasty for similar lesions but inferior to that of surgical bypass for all occlusions greater than 3 cm in length.

Angioplasty, Balloon↗
PubMed1989

[Percutaneous recanalization of occluded upper leg arteries using laser treatment].

Percutaneous transluminal laser recanalization was attempted in 21 patients with occluded superficial femoral arteries and 'life style limiting claudication'. Primary success was achieved in 20 (95%) of these total occlusions. In 7/21 no laser energy was required. At one month only 1 patient had claudication and the mean Doppler ankle/arm systolic pressure ratio had increased by 0.36 +/- 0.19 (p less than 0.001) at rest and 0.47 +/- 0.34 (p less than 0.001) after exercise. Complications directly attributable to the procedure were: perforation (1), peripheral embolic episodes (2), haematoma (1), transient vasospasm (2). All complications could be treated non-surgically. These preliminary data suggest that laser recanalization of relatively short occlusions of the superficial femoral artery, followed by balloon dilatation, may be accomplished with satisfactory acute and short-term results, but not without risk.

Aged↗
PubMed1989

[Dynamic function of the recanalized coronary artery in patients with myocardial infarct undergoing thrombolytic therapy].

In order to study the efficacy of thrombolytic therapy from the standpoint of preserving contractile function of the left ventricle myocardium, the time course of changes in residual stenosis of the recanalized coronary artery was assessed in 36 patients with myocardial infarction. It has been shown that residual stenosis of the infarction-bound coronary artery determines in many respects the degree of preserving contractile function of the myocardium in cases of successful coronary thrombolysis. In approximately 50% of the cases of the recovery of the coronary blood flow under the action of streptokinase, residual stenosis of the infarction-bound artery regressed by day 28 of the disease. However, contractile function of the left ventricle myocardium may be expected to be preserved during successful thrombolysis only in cases where residual stenosis of the recanalized vessel regresses rapidly (within the first 24 hours since the occurrence of an anginal attack).

Angiography, Digital Subtraction↗
PubMed1989

[Mechanical recanalization of chronic coronary artery occlusion by balloon dilatation. Hemodynamic and ventricular kinetic long-term results].

Abundant collaterals may prevent infarction in a region of myocardium supplied by an acutely occluded coronary artery. However, these patients often present with severe angina on exertion which cannot be sufficiently treated with antianginal drugs but require revascularization. Beginning in 1984, recanalization of chronic coronary artery occlusion using balloon catheters was attempted in 48 patients at Medizinische Klinik III, University of Cologne. Interventional therapy was successful in 29/48 patients (60%). The mean diameter narrowing of residual stenoses was 35%. Invasive follow-up at 3 months was possible in 17 of these 29 patients. Restenosis was noted in 41% and reocclusion was found in 18%. In contrast to angiographic findings, clinical symptoms were clearly improved in the majority of cases (88%). This correlates with increased regional contractility of the myocardial region supplied by the previously occluded artery. Contractility was also improved in patients with significant restenosis. The clinical benefit and the improvement of regional myocardial function indicate that it is justified to attempt balloon recanalization in highly symptomatic patients with short distance coronary occlusions despite the relatively high incidence of restenosis and reocclusion.

Angioplasty, Balloon, Coronary↗
PubMed1989

The role of pre-resectional laser recanalization for obstructing carcinomas of the colon and rectum.

The Nd:YAG laser has proved its efficacy for recanalizing obstructing lesions throughout the gastrointestinal tract. In a preliminary report using the Nd:YAG laser as a pre-resectional treatment for functionally obstructing colorectal carcinoma we showed that this modality accomplished good decompression, allowing for formal bowel preparation, a definitive one-stage operation with no increased mortality or morbidity, and that the use of the Nd:YAG laser was significantly cost-effective. Our cumulative experience from 1985 to 1988 includes 11 patients; nine underwent pre-resection laser therapy followed by primary resection and anastomosis, and two underwent abdominoperineal resection. Tumors were located above the peritoneal reflection in nine patients and below in two patients. All patients had orthograde bowel preparation with Golytley the day after laser therapy and underwent definitive surgery. There were no wound or intra-abdominal infections or postoperative fatalities. These 11 laser-treated patients were compared with age-matched controls who had undergone earlier colonic diversion. No significant differences were noted for age, sex, tumor location or differentiation, stage, or overall survival. Comparisons between laser-treated patients and controls for the preoperative length of stay and total length of stay were significantly different (p = 0.002 and p = 0.001, respectively). When comparing laser-treated patients and controls, preoperative and total hospital costs were significantly different (p = 0.003 and p = 0.01). We have found that pre-resectional laser recanalization has allowed for primary resection and anastomosis in patients who have obstructing left colon and rectal carcinomas without compromising patient safety.

Carcinoma↗
PubMed1985

Coronary artery spasm immediately after percutaneous transluminal coronary recanalization.

A 55-year-old man developed acute inferior myocardial infarction. A coronary arteriogram performed within two hours later showed complete occlusion of the right coronary artery, which was not resolved by two doses of 300 micrograms of intracoronary nitroglycerin. It was recanalized with 50% luminal diameter narrowing after 600,000 units of urokinase. Immediately after this thrombolytic therapy, the patient experienced chest pain, and the coronary artery became completely obstructed again. The pain was promptly relieved by 300 micrograms of intracoronary nitroglycerin, with disappearance of the obstruction. The observations during the procedure indicate that coronary artery spasm can occur after successful thrombolytic therapy on an occluded artery, inducing postinfarction angina, and might culminate in a second complete occlusion after percutaneous transluminal coronary recanalization.

Angioplasty, Balloon↗
PubMed1988

[Sequential magnetic resonance images of a case of cerebral sinus thrombosis--imaging of the thrombosed sinus and its recanalization].

Magnetic resonance images of a case of superior sagittal sinus thrombosis before and after complete recanalization are presented. The patient was a 61-year-old man with two days history of intermittent right hemiconvulsion followed by post-ictal hemiplegia. Mild erythrocytosis was noted on admission. CT scans revealed left frontal hemorrhagic infarction with empty delta sign in the middle portion of the superior sagittal sinus. Left carotid angiogram showed occlusion of two frontal cortical veins and retrograde filling of these veins into the cavernous sinus. Lack of filling of the middle and anterior part of the superior sagittal sinus was noted. These studies led to the diagnosis of superior sagittal sinus thrombosis associated with hemorrhagic infarction. He was treated with intravenous infusion of low molecular dextran and venesection. Neither heparin, urokinase, hyperosmolar solutions nor steroids were used because of the presence of hemorrhagic infarction and of the lack of signs of increased intracranial pressure. He completely recovered neurologically and recanalization of the superior sagittal sinus was confirmed angiographically eight weeks after the onset. Magnetic resonance images were taken with a Siemens 1.5 T Magnetom scanner using spin-echo pulse sequences. A T 1-weighted mid-sagittal magnetic resonance image ten days after the onset showed hyperintensity in the middle part of the superior sagittal sinus which corresponded to the thrombus. Both T 1 and T 2 weighted coronal images revealed a small area of hypointensity indicating the existence of residual blood flow in the superior sagittal sinus in addition to the thrombus both in the sinus and in the cortical vein.(ABSTRACT TRUNCATED AT 250 WORDS)

Carotid Arteries↗
PubMed1985

[Regional continuous intraarterial infusion of urokinase in the acute stage of cervical and intracranial major artery occlusion--particularly on a case of successful improvement after therapeutic recanalization].

We recently applied regional continuous intraarterial infusion of urokinase (UK) for five cases suffering from occlusion of the cervical and intracranial major arteries within nine hours from the onset to the start of infusion. In this paper we reported mainly about a 55-year male patient of occlusion of the left cervical internal carotid artery, which was recanalized by regional continuous intraarterial UK infusion, with discussion about the manipulation of UK infusion, indication of patient and management after recanalization.

Acute Disease↗
PubMed1982

[Recanalization by intracoronary infusion of streptokinase in acute myocardial infarction. Hospital course in 204 patients (author's transl)].

A multicenter study evaluated the early management and subsequent hospital course of 204 patients with acute myocardial infarction who were receiving intracoronary infusions of streptokinase (STK). The in-hospital mortality in 37 patients with thrombotic occlusion of the infarct-related vessel, in whom recanalization could not be achieved, was 24%. However, the cardiac mortality in 129 patients who were successfully treated by percutaneous transluminal coronary recanalization (PTCR) was only 5.4%. Cardiac deaths (5 patients) and nonfatal reinfarctions (20 patients) occurred in the early period in the cardiac care unit (CCU) in 21% of the latter group and, despite anticoagulation measures, could not be consistently prevented. Hemorrhagic complications, necessitating blood transfusion, occurred in 15 (7.4%) of the total 204 patients in the group, usually in the acute CCU stage, and were positively related to decline of fibrinogen serum concentrations below 100 mg/dl and to use of the Judkins technique. The later course of most of the patients on the general ward was uneventful until hospital discharge. Thus there were only 2 more cardiac deaths, and of 64 successfully treated STK-PTCR patients who left the CCU without clinical indications of reinfarction and agreed to repeat coronary angiography before hospital discharge, the infarct-related vessel was patent in 59 patients and reoccluded in only 5 (7.8%).

Aged↗
PubMed1978

[Recanalization of the thrombus as a way for secondary blood flow restoration in a prosthetic major vein].

According to the authors data a secondary restoration of the lumen of a previously obstructed prothesis approaching a half of the initial diameter of the vein is not infrequent in the plasty of the main veins of a growing organism. This restoration results from pronounced processes of the recanalization of the intraprosthetic thrombus, which are observed in the plasty of the external jugular vein and anterior vena cava. It has been found that the recanalization occurs through the formation of some longitudinal canals in the thrombus. These canals join the capillaries growing through the pores of the prothesis which transform into venous vessels with the endothelial lining, vascular apparatus and directed blood flow,

Animals↗
PubMed1980

Successful transluminal recanalization in the legs.

Recanalization of blocked vessels by means of transluminal recanalization is a highly successful procedure provided there is proper patient selection. The results vary according to the skill of the operator, and when successful, they are most dramatic.

Arteriosclerosis↗
PubMed1995

[Crossing chronic coronary artery occlusions with a "laser wire" after failed attempted recanalization with other techniques].

The success rate of catheter recanalization of occluded coronary arteries is 50% to 80%. The reason for failure is frequently an occlusion which is to hard. As examples, two patients are reported with very hard coronary artery occlusions which were 5 months and 2 years old, respectively. There had been prior unsuccessful attempted treatment with other techniques. These occlusions could be recanalized with an 0.018 inch laser wire. Afterwards, a balloon dilatation could be carried out via the laser wire. The procedure was successful in both cases.

Adult↗
PubMed1994

[Coronary recanalization in acute myocardial infarction: early coronary angiography].

In acute myocardial infarction the early patency of the infarct-related artery is positively correlated with improved left ventricular function and survival. Coronary artery reperfusion is commonly achieved by intravenous administration of thrombolytic agents. Methods of mechanical recanalization, mainly percutaneous transluminal coronary angioplasty (PTCA), have been proposed and tested as alternative or adjunctive ways to thrombolysis. Early coronary angiography provides reliable and irreplaceable information concerning mechanical intervention utility and feasibility. Therefore, it is incorporated in the mechanical revascularization strategies at various stages in the setting of acute myocardial infarction. In the primary, direct PTCA strategy early coronary arteriography is done for planning and carrying out mechanical revascularization as an alternative to intravenous thrombolytic therapy. This strategy may be particularly effective in patients presenting with cardiogenic shock, large infarctions, contraindications to thrombolytic therapy, and prior bypass surgery. Coronary angiography in evolving myocardial infarction has also been proposed to set the stage for rescue PTCA when thrombolysis has proved to be ineffective. Nevertheless, there are currently no unequivocal data to judge the value of the rescue PTCA strategy. After unsuccessful thrombolysis, this approach should be considered in patients with a large infarction, with cardiogenic shock, with left ventricular dysfunction and with refractory ischemia. Early, routine coronary angiography after lytic recanalization is not recommended. In fact, the strategy of immediate arteriography plus PTCA after thrombolytic therapy does not improve outcome but leads to several deleterious effects.

Angioplasty, Balloon, Coronary↗
PubMed1994

[Transcervical salpingography and tubal recanalization].

The results of transcervical salpingography and tubal recanalization by means of modified Thurmond and Rösch's technique were reported. Proximal tubal obstruction was diagnosed in 20 infertile women by X-ray hysterosalpingography and/or laparoscopy. Our results showed that tubal recanalization was achieved in 19(95%) of 20 patients, four patients became pregnanCy following the procedure. Distal tubal diseases were seen in 8 of 20 patients. Follow up studies revealed tubal patency was maintained in 7(54%) of 13 patients. The mean radiation dosage received by the patient was 6.35mGy. Compared with Thurmond and Rösch technique the modified technique has the advantage of decreasing the time of fluoroscopy and is a safe, effective and simple method for the diagnosis and treatment of infertile women with proximal tubal obstruction.

Adult↗
PubMed1993

[Recanalization of venule following experimental retinal branch vein occlusion].

Retinal branch vein occlusion was experimentally produced in monkey (macaca irus) by dye laser photocoagulation. Venous dilatation, retinal edema and punctate hemorrhages were the ophthalmoscopic changes immediately after the occurrence of venous occlusion by photocoagulation. Fluorescein angiography revealed delay of retinal circulation and dye leakage from these venules. Fluorescein angiography on the 2nd day revealed caliber irregularities in the venules distal to the photocoagulated points. Histopathologically, thrombus formation and partial defect of the endothelial cells were observed in the venules in the areas which showed recovery with immature endothelial cells on the 4th day. Young endothelial cells proliferating along the endothelial basement membrane, which remained around the thrombi, and recanalization were observed on the 7th day. These results reveals a process of recanalization in the thrombogenous retinal venous occlusion.

Animals↗
PubMed1993

[Primary femoral recanalization using a slowly rotating catheter system].

Over a period of 2 years, 26 patients with chronic occlusions of the superior femoral and popliteal arteries were referred for recanalization. In two cases, the origin of the superior femoral artery could not be detected. A primary recanalization was achieved in 21 of 24 patients by the catheter system used by us (Viadyn). A stent (extensor) had to be implanted in one case because of a considerable lesion of the intima. A short-term clot lysis was indicated for another patient. On the basis of our results, rotation angioplasty with a slowly rotating catheter system seems to be the therapeutic method of choice for chronic arterial occlusions in the thigh.

Aged↗