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At least 613 records · Page 34Linked to original sources
PubMed1990

Functional properties of the Kensey arterial recanalization catheter. In vitro investigations.

The properties of the Kensey catheter (Cordis Corp., Miami Lakes, FL), a new rotational device for recanalization of arterial occlusions, were studied in vitro. There was no effective centering of the catheter tip in the vessel and no measurable dilatation of the vessel lumen during rotation of the catheter tip. Flow studies confirmed recirculation and repeated exposure of particles at the catheter tip. The vortex induced by the rotating cam disappeared in stenotic segments. The maximum size of the pulverized specimen material was 20 microns for the normal arterial wall, 90 microns for the calcified and atheromatous plaque, and 900 microns for the fresh venous thrombus. For plaque material, an additional reduction of large particles to 30 microns was seen with a decrease in force and an increase in rotation speed. The size of thrombus particles decreased with an increase of rotation speed and the duration of treatment.

Arterial Occlusive Diseases↗
PubMed1989

[Recanalization and dilatation in chronic occlusion of the renal artery: 2 case reports].

The authors describe their experience in two cases of mechanic desobliteration and subsequent percutaneous transluminal angioplasty in a chronically occluded renal artery. It has become obvious that although this surgery has been so far performed only rarely it is technically viable and may exert a favourable therapeutic effect on hypertension of renovascular etiology as well as angioplasty of stenosing lesion of kidney arteries. The paper also discusses a possibility of influencing renal function by this method. The authors arrive at the conclusion that recanalization of a chronic occlusion of renal artery extends the presently relatively stabilized indications for percutaneous transluminal angioplasty in this localization.

Adult↗
PubMed1989

[Clinical features of patients with spontaneous recanalization of the infarct-related artery during evolving acute myocardial infarction].

The clinical features of 124 patients with incompletely obstructed infarct-related arteries during the early stages of myocardial infarction (Group 1) were compared with those of 212 patients having completely occluded coronary arteries (Group 2). Coronary angiography was performed within 12 hours after onset of symptoms in all cases. Patients treated with emergency coronary angioplasty were excluded from the study. Thrombolytic therapy, performed in both groups whenever intracoronary thrombi were detected, was successful in 61% of Group 2. Results were as follows: 1. In Group 1, three-vessel disease was observed more frequently than one-vessel disease (49 vs 27%, p less than 0.005). 2. The peak level of CPK was higher in Group 2 (p less than 0.001), and left ventricular ejection fraction was higher in Group 1 (66 +/- 16 vs 56 +/- 14%, p less than 0.01). 3. Either significant ST elevation or the Q wave was more commonly absent in Group 1 (31 vs 12%, p less than 0.01; 49 vs 12%, p less than 0.001). 4. Improvement of ejection fraction was observed in Group 1, but not in Group 2 even if the infarct-related artery was recanalized within six hours. 5. Extension of an infarct area was more common in Group 1 compared to Group 2 which was successfully treated with thrombolytic therapy (12 vs 3.9%, p less than 0.05). 6. The most important cause of death was extension of an infarct area in Group 1 and pump failure in Group 2, though hospital mortality rates were similar in both groups. It was concluded that patients with myocardial infarction having incompletely obstructed infarct-related coronary arteries have better left ventricular function and higher rates of non-Q myocardial infarction compared with those who had completely obstructed coronary arteries. However, extensions of infarcted areas commonly occur in these patients.

Aged↗
PubMed1986

[Coronary recanalization by transluminal angioplasty in the acute phase of myocardial infarct].

Recanalization by transluminal coronary angioplasty (TCA) was attempted as the first measure in 41 patients having symptoms for less than 4h. The obstruction could rapidly be removed (between 14 and 50 min) in 38 patients (92%). Five patients (12%) died: one in shock at the end of the operation, two died on the 5th and 8th postoperative day and two from heart failure on the 8th and 15th postoperative day. Three patients were urgently operated on for severe tritruncal lesions after a successful TCA. Among the 27 patients under control between 1 and 12 months, six reocclusions were noted (5 asymptomatic, 1 with clinical recurrence), 5 had recurrent stenosis (3 of them were treated by a 2nd angioplasty) and 16 (60%) exhibited permanent good results. The global ejection fraction was not modified, neither the telediastolic and telesystolic volumes. A significant improvement in segmental kinetics was observed in 6 patients with anterior and in 5 patients with inferior infarction. In this group of patients the ejection fraction was improved (67.2 +/- 2.3 vs 52.8 +/- 2.2, p less than 0.001), the IVDT was unchanged (81.7 +/- 6.8 vs 90.7 +/- 5.1, NS). IVTS was lower (27.5 +/- 3.5 vs 41.9 +/- 2.8, p less than 0.001). Further work is, however, needed to confirm these results.

Adult↗
PubMed1986

An unusual complication of chronic pancreatitis: a recanalized portal tree communicating with a pancreatic pseudocyst.

A patient with chronic pancreatitis was admitted for digestive bleeding from esophageal varices. Portal thrombosis and cavernomatous periportal collateral circulation were found at laparotomy. The partially recanalized portal tree was excluded from the portal circulation and filled with pancreatic juice due to a communication with a pancreatic pseudocyst. Splenectomy, partial left pancreatectomy, Roux en Y pancreatico-cysto-jejunostomy, and external drainage of the portal tree were performed. The postoperative course was uneventful and the patient is symptom-free and doing well 2 yr after surgery.

Adult↗
PubMed1983

[Coronary angioplasty immediately after coronary recanalization in the acute phase of myocardial infarct].

The author report the case of a 48 years old patient, admitted to hospital 3 hours and a half after an anterior myocardial infarct which was well tolerated. Coronary recanalization with urokinase-plasminogen removed the obstruction of the middle part of the anterior interventricular artery 1 hour and a half after the patient's arrival. Selective left coronary angiography demonstrated a narrow stenosis, in the order of 98%, in the proximal part of the AIV artery. Angioplasty was attempted immediately, in view of the ease with which the guide wire was passed through the initial thrombosis and the good haemodynamic tolerance. The residual stenosis was estimated to be 20% after the angioplasty and at the examination 48 hours later. The ECG on discharge from hospital showed a QS appearance in V1 to V3 with R in V4. An improvement in the ejection fraction (EF) and in the end-diastolic volumes was found: EF: 48% compared to 38%, EDV (cc/m2): 79 compared to 120. The clinical course at two months is very satisfactory, with no residual angina and a negative stress test. This special procedure, combining a double therapeutic catheterization, lasted 1 hour 50 minutes and allowed the progression of the myocardial infarction to be halted and also avoided a subsequent aorto-coronary graft operation.

Angioplasty, Balloon↗
PubMed1981

[Recanalization of the hepatic ducts in high obstructive blockage].

Forty three patients were subjected to 48 operations for restoration of the passability of lobular ducts when the latter were obturated by tumor (36 patients) and by alveococcus (7 patients). Ten patients died immediately after operation. Death was caused by acute hepato-renal insufficiency and acute pancreatitis. Duration of life after operation was from 7 months to 3 years. Best results were obtained in patients with alveococcus of the portal fissure. The authors make a conclusion that recanalization of main biliary ducts in obturation ileus is less traumatic as compared with other operations, improves the general state of the patient and prolongs the duration of their life.

Adult↗
PubMed1978

[Long-term results after transluminal recanalization of arterial obliterations (author's transl)].

The study provides information on 22 patients in whom a total of 24 transluminal recanalization procedures were carried out because of obliterations of the A. femoralis superficialis. In addition to 6 primary failures, there were 7 occlusions within 12 hours to 6 months after treatment. Eleven patients were examined 18 to 36 months after surgery. Of these only one patient had a new occlusion. The results are compared with those of other study groups. Morphologic vascular changes are considered to be the cause of the relatively high number of primary failures. The significance of prophylaxis with anticoagulants is pointed out.

Aged↗
PubMed1993

Recanalization of chronic arterial occlusions: low-speed rotational angioplasty. 5 years experience in peripheral and coronary vessels.

Chronic complete occlusions still represent the major technical limitation of percutaneous transluminal angioplasty, both in peripheral and coronary vessels. The clinical use of low-speed rotational angioplasty started in 1986 for the peripheral and in 1987 for the coronary arteries, and has already become part of the clinical routine in several centres. Up to now more than 350 patients with peripheral and 250 patients with coronary occlusions have been treated in Frankfurt; a multicentre questionnaire already contains information about 1,252 patients with peripheral vessel obstructions. In peripheral occlusions the acute success rate was more than 80% if low speed rotational angioplasty was used as the first attempt; after failure of conventional techniques still more than 60% of the vessels could be recanalized successfully. In addition to occlusions of the arteries of the lower limb, indications now may include the iliac artery and the subclavian artery. In each of the patients with chronic coronary occlusions an attempt with conventional techniques had failed before. Following a learning curve, which was also influenced by a better understanding of morphological preconditions, the acute success has now reached 70%. Both in patients with peripheral and those with coronary occlusions the technique turned out to be a safe procedure. Early angiographically documented long-term results in both indications are comparable with conventional balloon techniques. It is concluded that the use of low-speed rotational angioplasty (ROTACS) can improve the results of non-operative invasive treatment, both in peripheral and in coronary arteries.

Angioplasty↗
PubMed1993

Percutaneous recanalization and stents of the biliary tree.

Biliary obstruction can be treated by surgical, endoscopic or percutaneous methods. Interventional radiology has the following recanalization methods to offer: external-internal drainage, balloon dilatation of strictures and permanent stent placement. Metallic expandable stents are becoming very popular. In many centers, endoscopic interventions of the biliary tract have replaced the percutaneous route as a primary procedure. Combined radiologic and endoscopic methods are helpful in complicated interventions.

Catheterization↗
PubMed1993

A case of spontaneous recanalization following renal infarction.

A 30-year-old-male was admitted to our hospital with a tentative diagnosis of appendicitis. We found no signs of peritonitis, and therefore suspected urinary tract calculi. Intravenous pyelography revealed his right kidney to be nonfunctional, while retrograde pyelography was normal. Angiography revealed right renal infarction. Renovascular hypertension was present, and treatment with captopril was prescribed. Two years later without medication he had normal blood pressure and plasma renin activity. Intravenous pyelography revealed a right kidney functioning well, and digital subtraction angiography (DSA) revealed spontaneous recanalization of his right renal artery.

Adult↗
PubMed1996

-Recanalization of chronic coronary artery occlusions: effect on clinical symptoms and left ventricular function-.

UNLABELLED: Angioplasty of chronically occluded coronary arteries is discussed controversially. This study was performed to investigate the potential benefit of recanalization procedures. Between 1/91 and 10/93 occlusion angioplasty was attempted in 408 patients. 322 persons were followed with repeat angiography performed in 177 patients. Quantitative analysis of left ventricular function was performed in 34 patients before and after successful occlusion angioplasty. Primary reopening rate was about 71% with highest success rate for occluded LAD (82%). Angiographic controls showed open arteries in 80 (45.2%) patients, 53 (30.0%) had restenosis and 44 (24.8%) reocclusion. Anginal status was improved by one CCS-class or more in 197 patients (61%), mean exercise workload increased from 115.8 watts to 136.1 watts (p < 0.0001). Out of 34 patients, 25 (73.5%) showed improvement of regional ventricular function, mean ejection fraction increased from 56.9% to 64.1% (p < 0.001). Follow-up angiography revealed open arteries in 58% of patients if dissection was absent. When dissection type B, C or D NHLBI was present, only 32% of the vessels were open. CONCLUSION: In selected patients occlusion angioplasty is feasible with acceptable primary results. Anginal complaints and functional status were influenced positively, left ventricular function showed improvement indicating the presence of hibernating myocardium. In patients with suboptimal primary results (dissection) repeat angiography may be indicated.

Adult↗
PubMed1996

Endovascular recanalization of the aorto-iliac segment: imaging and approaches.

Endovascular catheter techniques are most useful and successful in the aorto-iliac arteries. As in other territories, wire recanalization, balloon angioplasty, and endoluminal stent placement are most applicable. For the surgeon, imaging considerations are most important since the operating room must be equipped with the proper capabilities for endovascular surgery. Techniques of catheterization and angiographic visualization of the arteries must be learned and understood clearly before these procedures are undertaken. A variety of occlusive lesions involving the aorta and iliac arteries can be treated adequately by means of nonsurgical catheter-based methods which add a significant new dimension to the vascular surgeon.

Angioplasty, Balloon↗