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At least 649 records · Page 36Linked to original sources
PubMed1995

Systemic thromboembolism leading to myocardial infarction and stroke after fenestrated total cavopulmonary connection.

Thromboembolic phenomena involving the caval veins, right atrium, and pulmonary artery are recognised complications after the Fontan operation and other forms of total cavopulmonary connection. A rare case of systemic thromboembolism is reported in a 3 year old girl who had repeated coronary and cerebral thromboembolic events after a fenestrated total cavopulmonary shunt operation. A survey of the 18 paediatric cardiac units in the United Kingdom and Ireland showed a wide discrepancy in anticoagulation policies after Fontan-type operations. Prevention of thrombotic complications by lifelong postoperative anticoagulation may outweigh the risk of haemorrhage.

Aspirin↗
PubMed1992

Percutaneous visceral pleural biopsy with fenestrated cup biopsy forceps.

When there is an exudative pleural effusion often both the parietal and the visceral pleura are affected, but the usual practice is to perform a percutaneous parietal pleural biopsy alone for diagnosis. Percutaneous visceral pleural biopsy was carried out in 20 patients with exudative pleural effusions with fenestrated cup biopsy forceps. In all 20 biopsies pleural tissue was obtained and it was diagnostic in 19 cases. The procedure is painless and appears safe.

Adolescent↗
PubMed1993

Thoracoscopic pericardial fenestration: diagnostic and therapeutic aspects.

The cause of cardiac tamponade is only established in 50% of cases. This problem is most commonly treated by pericardiocentesis alone, pericardiotomy being reserved for cases of recurrence and pericardiectomy for those patients presenting with constrictive pericarditis. A series of 16 patients treated with pericardial fenestration via a thoracoscope is presented. Pericardial and pleural biopsies were performed, together with cytological and biochemical analysis of the pericardial and pleural fluid where present. This procedure established the aetiology of effusion in all cases. In malignant pericardial effusion bleomycin was used for pericardial sclerosis. This resulted in fewer recurrences than in those patients where sclerosis was not attempted (12.5% v 60%).

Adult↗
PubMed2003

Results of endoscopic septal fenestration in the treatment of isolated ventricular hydrocephalus.

A surgical series detailing the results and complications of neuroendoscopy for the treatment of isolated lateral ventricular hydrocephalus (ILVH) has yet to be presented. This retrospective case review of 32 patients examines our experience at the Primary Children's Medical Center with endoscopic fenestration of the septum pellucidum (septostomy) for ILVH. The patients who underwent endoscopic septostomy between the years of 1993 and 2001 were identified from our database. Forty-three septostomies were performed, with a mean follow-up of 30.9 months. Fifty-three percent of initial septostomies remained patent. Nine patients had a least one more septostomy performed after failure of their initial septostomy. All but one was successful. Including repeat septostomies, 81% of the patients had relief of their ILVH on the last follow-up. No septostomy failures occurred later than 6 months postoperatively. A history of multiple previous shunt procedures was highly predictive of initial septostomy failure, increasing this risk 4.5 times. Complications involved significant intraventricular hemorrhage, wound breakdown, shunt infection and sterile meningitis in four cases. We conclude that endoscopic septostomy is a reasonable treatment option for ILVH, avoiding additional shunts. Outcome is negatively affected by multiple prior shunt procedures. Favorable results can be achieved with repeat septostomies in patients who have failed prior septostomy. Lasting results are expected for septostomies that remain patent after 6 months.

Adolescent↗
PubMed1983

Quantitative changes in the size of fenestrations of the elastic laminae of sheep thoracic aorta studied with SEM1.

The elastic laminae were extracted from thoracic aortas of 6 adult sheep by treating them in 0.1 N NaOH at 75 degrees C, and the surface of internal elastic lamina (IEL) was observed for windows by scanning electron microscopy. The fenestration analysis on IEL showed that mean diameters of the holes ranged from 0.46 microns (+/- 0.013 SEM) to 1.35 microns (+/- 1.019 SEM), which is smaller than those of human cerebral arteries (7.0 +/- 0.34 at the apex of the bifurcation and 2.1 +/- 0.13 SEM microns in the straight sections; [3]), and mean densities ranged from 6,513 to 31,544/mm2. Both size and density of windows are found to increase when the digestion time in the hot alkaline solution is increased form 1 to 3 h. It is concluded that the IEL of the sheep thoracic aorta has smaller windows than human cerebral arteries and because of the wall thickness the thoracic aorta requires longer digestion times than human cerebral arteries.

Animals↗
PubMed1985

Distribution of sialoglycoconjugates on the luminal surface of the endothelial cell in the fenestrated capillaries of the pancreas.

Sialic acid-bearing molecules on the luminal surface of the vascular endothelium in mouse and rat pancreatic capillaries were detected electron microscopically by using a procedure with ferritin hydrazide (FH), after preferential oxidation of sialyl residues with sodium periodate. The distribution of FH on the endothelial surface demonstrated the existence of microdomains with various densities of sialoglycoconjugates oxidizable by sodium periodate and accessible to the tracer. On the plasmalemma proper, FH binding sites were heterogeneously distributed. Their concentration on various microdomains decreased as follows: plasmalemma proper greater than coated pits greater than stomal diaphragms of plasmalemmal vesicles and transendothelial channels, and fenestral diaphragms. The membrane of plasmalemmal vesicles and transendothelial channels was not labeled by FH. Nonspecific binding of FH to the nonoxidized endothelial surface or that oxidized after neuraminidase treatment was relatively low.

Animals↗
PubMed1992

Ectasia and fenestration of the anterior cerebral artery associated with persistent trigeminal artery: case report.

Multiple vascular anomalies in a 22-year-old patient who had signs and symptoms of vestibulocochlear dysfunction are reported. Angiography revealed a fenestration of the proximal segment of the left anterior cerebral artery, an ectasia of the left anterior and posterior cerebral arteries, and a persistence of the right trigeminal artery. The rarity of the association is documented, and the clinical significance is discussed.

Adult↗
PubMed2004

Fenestration of the lamina terminalis as a valuable adjunct in aneurysm surgery.

OBJECTIVE: Hydrocephalus, vasospasm, and frontobasal injury are common complications after aneurysmal subarachnoid hemorrhage (SAH) from anterior communicating artery aneurysms. Previous studies have suggested that fenestration of the lamina terminalis (FLT) during surgery may be associated with reduced rates of shunt-dependent hydrocephalus and vasospasm. We report 106 patients affected by anterior communicating artery aneurysms and Fisher Grade 3 aneurysmal SAH and the affect of FLT on shunt-dependent hydrocephalus, vasospasm, and frontobasal injury. METHODS: During a 3-year period, 53 patients underwent FLT and 53 did not. We prospectively evaluated admission and discharge clinical grades, hydrocephalus at admission, occurrence of clinical vasospasm, need for interventional vasospasm therapy, frontobasal hypodensity incidence, and permanent ventriculoperitoneal shunting requirement. Follow-up ranged from 3 to 35 months (mean, 17.9 mo). RESULTS: Shunting incidence after aneurysmal SAH with hydrocephalus was 4.25% in patients who underwent FLT and 13.9% in patients who did not (P < 0.001). Clinical cerebral vasospasm occurred in 29.6% of patients who underwent FLT and in 54.7% of patients who did not (P < 0.001). Frontobasal hypodensity was identified postoperatively in 0% of patients who underwent FLT and in 5% of patients who did not. Good outcome was reported in 69.81% of patients who underwent FLT and in 33.96% of patients who did not (P < 0.001). Poor outcome was associated with higher Hunt and Hess grades, need for ventricular drainage, elevated intracranial pressure, and multiple interventional vasospasm therapies. No complications were linked to FLT. CONCLUSION: FLT was associated with statistically significant decreases in shunting rates, incidence of vasospasm, and better outcomes. We recommend its routine use in patients with Fisher Grade 3 anterior communicating artery aneurysmal SAH.

Adolescent↗
PubMed1997

Metabolism of the intravenously administered recombinant human basic fibroblast growth factor, trafermin, in liver and kidney: degradation implicated in its selective localization to the fenestrated type microvasculatures.

The fate of trafermin (recombinant human basic fibroblast growth factor) was examined after intravenous administration of its iodinated form to rats. Autoradiography at 5 and 30 min after the injection showed that 125I-trafermin is localized specifically in the fenestrated endothelium through binding to heparan sulfate proteoglycans (HSPG) in liver, kidney, adrenal, spleen, hypophysis and bone marrow. Metabolites in the organs were examined at 5 min and 24 h after the injection. More than 73% of radioactivity in liver and kidney was extractable at either time point, and a large majority of the extracted radioactivity was heparin-binding. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) revealed that the substantial radioactivity recovered from liver and kidney can commonly be attributed to a peptide with the same molecular weight as the intact trafermin (B-1, 17.7 kDa) and only three truncated metabolites (B-2, 15.0 kDa; B-3, 7.2 kDa; B-4, 4.2 kDa). Because no truncated metabolites were found in serum, these metabolites seem to be produced inherently in liver and kidney. Although they all retained heparin-binding capacity, only B-1 and B-2 exhibited a stimulatory effect on proliferation of endothelial cells, and these bioactive peptides disappeared completely from liver within a day, indicating a rapid inactivation process in the organs. Taken together with the morphological evidence on autoradiography, it seems most likely that the injected trafermin could be inactivated in sinusoidal endothelial cells, probably through a well-known internalization mechanism of the basic fibroblast growth factor-HSPG complex.

Animals↗
PubMed1997

Using fenestration technique to treat a large dentigerous cyst.

Dentigerous cysts are commonly encountered in the practice of dentistry and oral and maxillofacial surgery. Treatment modalities range from enucleation to marsupialization, and are based on the premise that the pathological process can be controlled locally with minimal injury to the adjacent host structures. In a child, however, loss of permanent tooth buds in the management of a large dentigerous cyst can be devastating. This article describes the technique of fenestration, which removes this entity and preserves the developing dentition.

Child↗
PubMed2005

Intimal dehiscence in the abdominal aorta following balloon fenestration for type B dissection.

PURPOSE: To report a case of intimal dehiscence associated with endovascular intervention in patients with aortic dissection. CASE REPORT: A 65-year-old man presented with a type B dissection extending to the level of the common iliac arteries. Two Talent stent-grafts were placed in the descending thoracic aorta to close the entry point, but 2 lumens remained. Three days later, abdominal pain prompted another imaging session, which demonstrated a large cylindrical filling defect in the abdominal aorta ("tube-in-tube") assumed to be a partially or completely dehisced intima. Fenestration marginally improved flow to the visceral vessels, and the patient improved clinically. However, 4 days later, recurrent ischemic symptoms prompted surgery; a complete dehiscence of the aortic intima starting at the descending aorta extended to the distal abdominal aorta. The aorta was resected, but the patient died from disseminated intravascular coagulation. CONCLUSIONS: Intimal flap dehiscence associated with an endovascular procedure in the management of aortic dissection is an uncommon complication. Early detection and prompt surgical intervention of such a complication could save the patient's life. Endovascular procedures are unlikely to resolve the hemodynamic problem caused by a dehisced, distally migrated, collapsed intima.

Aged↗
PubMed2006

Congenital fenestration of the palate: A case of embryologic syzygy.

Congenital fenestration of the secondary palate is the rarest type of facial cleft. Of the 26 putative cases in the literature, only 5 had confirmation of the cleft during the neonatal period. This report documents such a cleft in an infant and presents the likely pathogenesis.

Cleft Palate↗
PubMed2001

Guided bone regeneration for dehiscence and fenestration defects on implants using an absorbable polymer barrier.

BACKGROUND: Guided bone regeneration (GBR) using a non-absorbable barrier has provided clinicians the ability to place implants in sites compromised by insufficient bone, including immediate extraction sites. Recent evidence suggests that successful GBR outcomes may be possible using bioabsorbable polymer barriers. METHODS: This report presents a case series of 9 patients with 8 fenestration and 3 dehiscence defects on implants consecutively treated with GBR. A bioabsorbable polymer barrier of poly(DL-lactide) was used in conjunction with a composite graft of freeze-dried bone allograft (FDBA)/demineralized freeze-dried bone allograft (DFDBA) mixed in a ratio of 1:1. Second-stage surgeries were performed at 4 to 8.5 months (5. 7 months average) post-placement. Biopsy material from 2 sites was obtained while exposing the implant for healing abutment connection. RESULTS: Ten of the 11 defects (90.9%) achieved complete coverage of the osseous defects. Histologic evaluations revealed the formation of viable bone, frequently in close amalgamation with residual graft particles. CONCLUSION: These case reports suggest that a poly(DL-lactide) polymer can be used as a physical barrier with a composite bone replacement graft to achieve successful GBR results of dehiscence/fenestration defects when placing implants.

Absorbable Implants↗
PubMed1977

The effect of fenestration on intraosseous drainage in osteoarthritis of the hip.

Eight patients with osteoarthritis of the hip, rest pain and intraosseous hypertension of the proximal femur obtained ameliorated rest pain and reduced intraosseous hypertension 3 months after a fenestration operation in the region of the greater trochanter. They were investigated with intraosseous phlebography of the proximal femur. Six patients showed delayed intraosseous drainage and 7 had altered patterns of drainage before the operation. Three months after the operation the phlebograms showed an even more prolonged drainage time. However, this difference was not of a statistically significant magnitude. Drainage patterns remained mainly unchanged.

Adult↗