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At least 577 records · Page 32Linked to original sources
PubMed2006

Successful recanalization by in-stent percutaneous transluminal angioplasty with distal protection for acute carotid stent thrombosis.

A 71-year-old male presented with severe left cervical internal carotid artery stenosis manifesting as repeated transient ischemic attacks consisting of right hemiparesis and motor aphasia. Carotid artery stenting (CAS) under distal protection was performed to prevent further ischemic events. This procedure was uneventful. However, the patient exhibited progressive right hemiparesis and motor aphasia 3 days after CAS. Emergent angiography revealed carotid artery occlusion due to in-stent thrombosis. In-stent percutaneous transluminal angioplasty (PTA) was performed under distal protection. The carotid artery was recanalized with small residual thrombus. The neurological deficits almost completely disappeared after PTA. Follow-up angiography 9 months after stenting showed restenosis but no in-stent thrombosis. Carotid thrombosis after CAS can be resolved by in-stent PTA under distal protection and subsequent treatment with antithrombotic agents.

Aged↗
PubMed1985

The recanalized umbilical vein in portal hypertension: a myth.

The demonstration of a vessel in the falciform ligament, traditionally presumed to be a reopened umbilical vein, is an important sonographic sign of portal hypertension. This vessel was sought in 200 umbilicoportographies (all portal hypertensive) and in 41 autopsy-dissected falciform ligaments (34 normal and seven cirrhotic). The normal falciform ligament contained one to three tiny collapsed paraumbilical veins. In cirrhotics, the number and caliber of paraumbilical veins increased. A reopened umbilical vein was never found. The authors conclude that the umbilical vein does not recanalize in portal hypertension. The vessel involved is actually an enlarged paraumbilical vein.

Adult↗
PubMedDate not supplied

Recanalization of arteries by laser radiation.

Following the success of balloon angioplasty as a non-operative technique for the recanalization of stenosed arteries, particularly those of the heart itself, work is being carried out to determine whether it would be possible to use laser radiation for this purpose. Both Nd:YAG and argon radiation have been shown to be capable of destroying atheromatous plaque, the major problem in vivo being perforation of the artery wall. The technique shows promise but much experimental work remains to be done.

Animals↗
PubMed1998

Delayed aneurysm regrowth and recanalization after Guglielmi detachable coil treatment. Case report.

Guglielmi detachable coil (GDC) treatment for complicated cerebral aneurysms is an attractive option that has become widely accepted in recent years. This technique is usually considered only if the patient harbors an aneurysm that is not a good candidate for surgical clipping. However, the definition of "surgical candidate" varies among institutions, and many patients worldwide are being treated with GDCs as primary therapy. Although most centers currently perform follow-up angiography at 6 months to 1 year, others do not routinely perform it after an initially good result. The authors present a case that indicates longer follow up may be necessary and illustrates some of the pitfalls of GDC treatment. This 56-year-old man presented to the emergency room with a Hunt and Hess Grade II subarachnoid hemorrhage and was found to have a wide-necked basilar apex aneurysm. Because of associated medical comorbidities, it was decided to treat the aneurysm with endovascular techniques. The patient did well on follow-up angiography at 1 year postprocedure. However, at approximately 2 years follow up, the aneurysm was demonstrated to have dramatically recanalized and regrown, requiring open surgical intervention. Endovascular coiling was insufficient to treat this aneurysm and complicated definitive surgical management because a large coil mass had been placed in the operative field. It can be inferred from this case that angiographic follow up of these types of lesions may be beneficial up to 2 years after GDC treatment.

Basilar Artery↗
PubMed2005

Antegrade recanalization of a completely embolized vertebral artery after endovascular treatment of a ruptured intracranial dissecting aneurysm. Report of two cases.

Occlusion of the parent artery is a traditional method of treatment of unclippable cerebral aneurysms. Surgical or endovascular occlusion of the parent artery proximal to the aneurysm has been recommended for the treatment of dissecting aneurysms located in the vertebrobasilar circulation. Nevertheless, occlusion of the parent artery may not result in permanent exclusion of the aneurysm from the systemic circulation because, occasionally, postoperative rebleeding occurs after proximal occlusion. Alternatively, endovascular occlusion of the affected site, including the aneurysmal dilation, and parent artery, is a safe and reliable treatment for dissecting aneurysms. The authors present two rare cases of ruptured vertebral artery (VA) dissecting aneurysms that were treated by endovascular occlusion of the affected site including the aneurysm and parent artery by using Guglielmi detachable coils. In both cases the VA recanalized in an antegrade fashion during the follow-up period. Based on these unique cases, the authors suggest that a careful angiographic follow up of dissecting aneurysms is required, even in patients successfully treated with endovascular occlusion of the affected artery and aneurysm.

Aortic Dissection↗
PubMed1995

Recanalization of coronary occlusions using the Magnarail system: technique and procedural outcome.

Angioplasty for occluded coronary arteries is less successful than for sub-total stenoses. The Magnarail system (Schneider) has been designed to improve success rates. We used the system in 112 patients with coronary occlusions (TIMI flow < or = 1) which the operator felt suitable for angioplasty. It was successful (defined as < 50% stenosis) in 75.9% overall, 65.9% in occlusions > 3 months and 83.3% < 3 months. Intimal dissection occurred in 26 instances, more commonly after right coronary angioplasties. One patient died and one procedure was complicated by coronary perforation treated surgically. The procedure was less successful in the right coronary artery (p = 0.02). Coronary calcification (p = 0.03), the absence of a tapered occlusion (p = 0.04) and the absence of collaterals from another vascular territory (p = 0.04) were all associated with angiographic failure. The mean fluoroscopy time for the procedures was 22.8 +/- 16.9 minutes. The Magnarail system seems highly effective in recanalization of coronary occlusions.

Adult↗
PubMed1999

Coronary vasospasm as a cause of angina following interventional recanalization.

Angina following a coronary intervention may be due to vasospasm rather than restenosis. Two cases of angina following a previously successful recanalization are described. In both cases vasospasm was documented as the cause of angina, determined in one case by using an ergonovine provocative test and in the other by using lesion response to nitroglycerine. Rather than another intervention, vasodilator treatment was instituted, with effective symptom amelioration.

Angina Pectoris↗
PubMed1998

[Recanalization of the ductus arteriosus in a child with non-Hodgkin's lymphoma].

Dissertation describes the case of 7.5-year-old boy with recanalization of the ductus arteriosus. In this patient treated because of the non-Hodgkin lymphoma during the chemotherapy the respiratory failure occurred and mechanical ventilation was required. After the respiratorotherapy in the controlled echocardiography examination the patency of previously closed ductus arteriosus, was described. There was no description of the similar case in available references.

Child↗
PubMed1975

Tubal ligation and pregnancy: mechanism of recanalization after tubal ligation.

The mechanism of recanalization after resection of a segment of the fallopian tube by the Pomeroy sterilization method is discussed. At the level of resection, the epithelial lining of the fallopian tube tends to regenerate, covering the split ends and planes of cleavage of the resected surfaces and forming slitlike spaces and blind pouches lined by tall columnar cells. Scarring and subsequent retraction of both severed ends of the tubes tend to result in approximation; in some cases, the resected ends and the epithelial lining bridge the gap between the lumina, re-establishing patency of the tube. Surgical procedures that prevent approximation of the resected ends of the fallopian tubes or methods that seal the lumina should produce failure rates lower than those obtained with the classic Pomeroy sterilization method.

Adult↗
PubMed2001

Accuracy of technetium-99m tetrofosmin myocardial perfusion imaging in the detection of spontaneous recanalization in patients with acute anterior myocardial infarction.

To avoid the haemorrhagic risk of unnecessary thrombolysis in acute myocardial infarction (MI), early and precise diagnosis of spontaneous recanalization (SR) of the infarct-related artery is required. To clarify the accuracy of technetium-99m tetrofosmin myocardial single-photon emission tomography (SPET) in the detection of SR in patients with acute anterior MI, electrocardiography (ECG), echocardiography and 99mTc-tetrofosmin SPET imaging were performed in 49 patients with acute anterior MI before emergency coronary angiography. Defect score was calculated as the sum of the perfusion defects of each segment: from 3 (complete defect) to 0 (normal perfusion). Echocardiographic asynergic score (the sum of asynergic grades) and the greatest ST elevation of the 12-lead ECG on admission were also measured. SR was defined as Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow on emergency coronary angiography. Defect score in 11 patients with SR (9.2 +/- 3.7) was significantly lower than that in 38 patients without SR (18.5 +/- 5.0) (P < 0.001), whereas there were no significant differences in asynergic score and ST elevation between the two groups. From the receiver operating characteristic curves, the optimal cut-off points of defect score, asynergic score and ST elevation for the detection of SR were calculated to be 12, 13 and 3.5, respectively. The sensitivity and specificity of the scintigraphic defect score (91% and 89%) were significantly higher than those of the asynergic score (64% and 68%) and ST elevation (73% and 71%). Thus, 99mTc-tetrofosmin SPET imaging on admission is a very accurate method for the detection of SR in patients with acute anterior MI.

Acute Disease↗
PubMed2002

Severe obstruction of the superior vena cava caused by tumor invasion. Recanalization using a PTFE-covered Z stent.

Bare stents are commonly used for the treatment of malignant vena cava stenoses. However, the therapeutic effect of treatment using bare stents for cases with intraluminal tumor invasion is not satisfactory. We report a case with severe obstruction of the superior vena cava caused by tumor invasion of mediastinal lymph node metastases from colon cancer, which was successfully treated by the recanalization of superior vena cava using a polytetrafluoroethylene-covered Z stent. The covered stent could not be fully expanded at first, and re-obstruction developed at the stented site due to thrombus formation soon after stenting. So, the additional balloon dilatation made the stent expend fully on another day of stenting. After the balloon dilatation blood flow improved immediately and the clinical symptoms associated with the superior vena cava obstruction resolved. Thereafter no symptomatic recurrence has been observed in 12 months of follow-up period.

Angioplasty, Balloon↗
PubMedDate not supplied

[Endoscopic treatment and recanalization with a needle-knife in the total stenosis of the esophago-jejunal anastomosis].

This is to report on a 44-year old female patient diagnosed with gastric cancer who was surgically treated with a total D-2 radical gastrectomy, block splenectomy and a lateral esophagus-jejunal anastomosis. A month after surgery and various post-surgery complications, a total stenosis of the esophagus-jejunal anastomosis was detected which was endoscopically solved with a needle-knife type obtaining an adequate recanalization of the lumen, which is the subject of this report.

Adult↗
PubMed2003

Aortic root and extensive coronary dissections complicating recanalization of chronic right coronary artery occlusion: refraining from stenting may have a favorable outcome!

Aortic root dissection is a rare, potentially life-threatening complication of revascularization procedures. We report a case of recanalization of chronic total occlusion of the right coronary artery. A huge coronary dissection with a false lumen was created using commercially available guidewires during attempts to establish a connection with the distal true vessel lumen. In addition, an aortic root dissection from the right coronary cusp occurred. The patient was asymptomatic and a decision was made to refrain from stent deployment in order not to close communications between the false, true lumen and branches. The hospital stay was uneventful and the patient was discharged on conservative management. Control angiography at 3 months revealed patency of the right coronary artery with complete healing of the aortic wall dissection and improved clinical status of the patient.

Aortic Dissection↗
PubMed2002

[The influence of percutaneous coronary recanalization of total coronary occlusions on the heart rate variability ].

In patients following a myocardial infarction, heart rate variability is an important prognostic factor. Decreased heart rate variability is associated with a higher mortality rate. This study evaluated the influence of recanalisation by percutaneous coronary intervention (PCI) in totally occluded coronary arteries on the heart rate variability in patients with myocardial akinesis in the recanalised artery area. The study group included 22 men (average age 52.8 +/- 7.7) after successful PCI recanalization of the totally occluded artery. All patients had akinesis in the recanalised artery area. All patients underwent 24-hour continuous electrocardiographic Holter monitoring with HRV analysis and echocardiographic dobutamine tests both before the PCI and 6 months afterwards. The population was divided into two groups: group A (10 patients) had contractility adjustments in echocardiographic tests that were performed 6 months after the PCI. Group B (12 patients) did not have contractility adjustments. Before the PCI, there were no differences in the wall motion score index (WMI) or the time-domain HRV parameters between the two groups. After 6 months, there was a significant increase in the WMI value in group A, whereas this index remained unchanged in group B. In group A the time-domain HRV parameters had improved 6 months after the PCI, whereas they remained unchanged in group B. Successful percutaneous revascularization of the totally occluded coronary artery in patients with myocardial akinesis in the occluded artery area leads to an increase in HRV parameters. This improvement occurred only in patients that had a contractility adjustment after the PCI in previous akinetic segments of myocardium.

Adult↗
PubMed1976

[Experiences with Dotter's percutaneous recanalization of chronic arterial occlusions].

Since 1971 141 patients (mean age 66 years, range 46-85 years) with chronic occlusions of the pelvic (19) and superficial femoral popliteal arteries (122) have been treated by the percutaneous recanalization technique first described by Dotter and Judkins in 1964. Since 1974 we have employed a modification of the original Dotter technique. The occluding material is removed with a double-lumen distensible catheter introduced over a guide wire. Primary success was achieved in 117 (83%) patients. Re-occlusions occurred in 18 patients after 6 months and in 5 patients in the second half of the first year, giving an overall patency rate of 75%. Up to now no further re-occlusions of dilated arterial segments have been observed. Indications for this treatment as compared with vascular surgery are discussed.

Aged↗
PubMed2003

[Recanalizing therapies in acute stroke].

Systemic thrombolysis with rt-PA within 3 hours after symptom onset has developed into a standard therapy for acute stroke patients. Recombinant t-PA is now licensed in Europe for this indication. Within 3 to 6 hours, no general therapeutic standard has been established yet. Currently, the available data are in favor of intra-arterial thrombolysis for patients with proximal occlusions of the middle cerebral artery. Systemic thrombolysis is not generally recommended in this time window, but is used in some centers for selected patients. In addition to thrombolysis and new strategies to improve thrombolysis (including patient selection with MRI), several interventional and surgical recanalization techniques are discussed.

Acute Disease↗
PubMed2003

Spontaneous recanalization of internal carotid artery occlusion evaluated with color flow imaging and contrast arteriography.

AIM: In strokes of embolic origin a partial recanalization of the intracranial occluded vessel occurs with a high incidence (as high as 80%). In the literature, we find few cases of revascularization, detected with color flow imaging (CFI) or with arteriography (AGF), at carotid siphon or at the origin of an occluded internal carotid artery (ICA). Up to now there have been no reliable data on the incidence and clinical consequences of SR of an extracranial ICA occlusion. In this case-report we document 8 cases of SR of occluded ICA observed in the last 10 years in our Care Unit. METHODS: We observed 8 complete ICA occlusion at the origin, detected with CFI (8 of 8) and with AGF (7 of 8). All symptomatic patients and 2 of 5 asymptomatic patients underwent CT scan in the acute phase of stroke. All patients underwent CFI follow-up (every 6-12 monhts) to evaluate contralateral CCA and ICA and the presence of new focal neurological symptoms. All patients assumed BMT (antiplatelet or anticoagulant therapy). RESULTS: SR occurred in 6 patients between 24 and 96 months, in 1 patient within 8 months and 1 patient within 6 months from the diagnosis of ICA occlusion. Diagnosis of SR was based in all patients with CFI and in 4 patients confirmed with AGF. Five patients underwent CT scan that excluded haemorrhagic transformation of previous ischemic areas or new ischemic events (2 patients did CT scan only after SR). All patients underwent CFI follow-up in a 3-88 months period. There were no new focal neurological symptoms in 7 of 8 patients, 1 patient presented aspecific neurological symptoms. CONCLUSION: Diagnosing SR of occluded extracranical ICA seems to be more frequent than expected. SR is an event that has to be researched in follow-up of these patients; besides, it seems to have a relatively benign outcome with respect to the onset of new neurological symptoms.

Aged↗
PubMedDate not supplied

[The transcatheter recanalization of occluded portosystemic shunts].

UNLABELLED: The authors present their personal experience in percutaneous treatment of portosystemic shunt occlusion and stenosis by percutaneous transluminal angioplasty (PTA) and fibrinolytic local infusion. Twelve patients with portosystemic shunt stenosis or occlusion were percutaneously treated. In 8 patients only PTA was performed, 4 were treated with local fibrinolytic infusion, in 3 of the latter cases this treatment was followed by PTA. In all 12 patients recanalization was successful and non complications arose. Six patients died in the following 15 months, none due to rebleeding. In 5 of these patients the shunt was patent at post-mortem examination. In the 6 patients still alive in the follow-up period (2 to 25 months, mean 14.5 months) the shunt was patent in 4 and occluded in 2. IN CONCLUSION: percutaneous treatment with PTA or fibrinolytic local infusion is preferable in non-functioning portosystemic shunt; further surgery is always extremely risky in such patients.

Adult↗