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At least 775 records · Page 43Linked to original sources
PubMed1993

[Laser versus rotation angioplasty in the recanalization of chronic femoropopliteal arterial occlusions].

Between June 1987 and July 1989 laser angioplasty, and between July 1989 and December 1991 rotation angioplasty was used as the method of choice for the recanalisation of chronic (minimal duration 3 months) arterial occlusions in the femoro-popliteal region. The technical success rate and final results following supplementary balloon dilatation were identical and there was no significant difference between the two groups (laser 87%, rotation 87.7%). For long occlusions (more than 150 mm), the success rate for rotation angioplasty was 60% and significantly higher than for laser angioplasty at 40%. Complication rates for rotation angioplasty were 24.3%, higher than laser angioplasty with 20.3%. This was due to the higher incidence of emboli of 12.1% compared with the laser technique of 7.3%. Cumulative patency rates after two years showed no significant difference (uncorrelated/correlated: laser 53.4%/67.8%; rotation 56.6%/67.5%). Using lytic and aspiration techniques, the higher incidence of embolisation during rotation angioplasty had no adverse effect on final outcome. If both methods are available, it is advisable to treat long occlusions by rotation angioplasty because of the high immediate success rate, whereas short occlusions are best dealt by laser angioplasty because of the lower incidence of embolisation.

Aged↗
PubMed1990

[Radiologic recanalization of veins, vascular prostheses and arteries in cases of insufficient dialysis fistulas].

Two hundred and sixty-five radiological recanalisations have been carried out in 196 patients with stenoses or occlusions of haemodialysis shunts (167 Cimino shunts, 29 prosthetic shunts). Balloon dilatation was successful in 93% (144 out of 155) stenoses of the shunt vein; redilatation was occasionally necessary, but at six, 12 and 24 months, the patency rate was 75% (56/75), 62% (40/64) and 34% (19/55). Eighty occlusions of shunt veins or prosthetic shunts in 71 patients were treated by a combination of a local fibrinolysis and balloon dilatation or by balloon dilatation alone. Primary recanalisation rate was 56% (14/25) and 65% (36/55), respectively; the six, 12 and 24 months patency rates were 73% (22/30), 54% (7/13) and 14% (1/7). All six recanalisations of the shunt artery--five stenoses and one occlusion--proved successful. In 19 patients with oedema of the arm, 30 dilatations of central veins were performed (18 stenoses, one occlusion). The recanalisation rate was 97% (29/30), the six months patency rate was 57% (8/14). The long-term results of radiological recanalisation are comparable with surgical revision by patch plasty or thrombectomy, but the radiological techniques are simpler, can be carried out on out patients and can be repeated if necessary.

Arteriovenous Shunt, Surgical↗
PubMed1988

[Vascular recanalization using an electric thermal cauterizing catheter--in vitro experiences with a new catheter system].

Recanalisation of arteriosclerotic occlusions by means of laser angioplasty, Kensey catheter and the "hot tip" catheter is undergoing early, successful clinical trials. The thermo-cautery catheter described in this paper uses the well known technique of cutting with high frequency electric currents in order to achieve vascular recanalisation. Seven attempts were made to recanalise occlusions at post mortem; four were successful, but perforation occurred in three. Histologically we found a narrow rim of carbonisation of tissues surrounded by a zone of homogenisation and a transitional zone.

Angioplasty, Balloon↗
PubMed1995

[The recanalization of the chronically occluded infarct vessel in single-vessel coronary disease. The reduction of cardiac events in long-term clinical follow-up].

OBJECTIVE: The prognostic significance of recanalisation of a chronically occluded infarct vessel in single-vessel coronary disease remains controversial, in contrast to early re-opening of the infarct vessel in the acute state of infarction. It was the purpose of this prospective study to discover whether successful recanalisation in the former influences the incidence of cardiac events (death, infarction, by-pass operation) and clinical symptoms in the long term. PATIENTS AND METHOD: Recanalisation procedures were successful in 58, unsuccessful in 41 of 99 patients (81 men, 18 women; mean age 55 [28-79] years) with anterior wall (n = 53) or posterior wall (n = 46) myocardial infarction (AMI and PMI, respectively). The two groups were similar with respect to age, sex, left-ventricular function, indication, exercise capacity and premedication. But the interval between infarction and recanalisation was shorter in the patients who had successful recanalisation (5.1 +/- 5.3 vs 7.8 +/- 7.6 months; P < 0.05). Mean follow-up period for all patients was 55.8 +/- 8.9 months after the recanalisation procedure. RESULTS: There were significantly fewer cardiac events after successful than failed recanalisation, both for the total group of patients (5% vs 23%; P < 0.01) and those with AMI (9 vs 36%; P = 0.012). In the patients with PMI there was only a trend in favour of those with successful recanalisation (0% vs 14%; P = 0.058). Symptomatic improvement was reported by 73% of patients after successful but only 40% after failed recanalisation (P < 0.01). CONCLUSION: The results provide pointers towards prognostic indications of recanalisation even after chronic occlusion of the infarct vessel. The procedure should therefore be attempted if the occlusion is morphologically suitable.

Angioplasty, Balloon, Coronary↗
PubMed1983

[Vascular recanalization procedure in interventional neuroradiology].

Thirty-two patients are described. Sixteen patients were treated by local intra-arterial fibrinolysis (LIF) for lesions of the intracranial vessels. In nine patients there was a vertebrobasilar thrombosis, in four patients an occlusion of the middle cerebral artery and in three patients a sinus thrombosis. The results of percutaneous transluminal angioplasty (PTA) in fourteen patients are reported; they included dilatation of the subclavian artery in 12 and the vertebral artery in two of them. Dilatation of post-operative fibrous stenosis of the internal carotid artery in two patients is described. The technique for local intra-arterial fibrinolysis and recommended doses for streptokinase are given. The use of Doppler sonographic monitoring during PTA is recommended, particularly as for delayed return to normal flow in the vertebral artery.

Angioplasty, Balloon↗
PubMed2000

Recanalization of chronic total coronary occlusions: the impact of a new specific guidewire on primary success rate.

BACKGROUND: Although chronic total occlusions are encountered frequently in patients with coronary artery disease, an effective strategy to deal with them has yet to be devised. Various new guidewires have been designed in an attempt to negotiate chronic occlusions successfully. The authors have analysed the impact of the Athlete guidewire on procedural success in this lesion subset. METHODS: Sixty-two consecutive patients undergoing percutaneous intervention for chronic total occlusions over a two-year period were retrospectively studied. For the initial attempt, conventional guidewires were used. In case of failure, further attempts were made using the Athlete guidewire. Procedural success rates with the use of conventional and Athlete guidewires were assessed. RESULTS: Failure of the first attempt with the conventional guidewire occurred in 32 (51.6%) patients and success was achieved in 30 (48.4%) patients. In the former patients, a second attempt was made using the Athlete guidewire to cross the occlusion. The second attempt was successful in 20 patients (60%) in whom the first attempt was unsuccessful, while in the remaining 12 (40%) patients the occlusion could not be crossed even during the second attempt and the procedure was then terminated. Following the use of the Athlete guidewire, the success rate increased to 62% (p < 0.001). No complication occurred during the first attempt, while one patient had a coronary perforation using the Athlete guidewire, which was managed successfully without the need for bypass surgery. CONCLUSION: The use of the Athlete guidewire is feasible and safe, and enhances the chances of successfully treating chronic total occlusions during percutaneous coronary revascularization procedures.

Journal Article↗
PubMed1990

Evaluation of clinical results following laser recanalization of the peripheral arteries.

As experience is gained with laser-assisted angioplasty and as long-term follow-up results become available, a realistic and objective view of its role in the treatment of patients with occlusive disease of arteries in the peripheral vascular tree is becoming available. Comparison with results of conventional treatment methods is warranted. Experience in treating patients with vascular lesions is helpful in patient selection, management during the procedure, and follow-up care. Evaluation of experience in 169 procedures, with a follow-up time of 1 month to 3 years indicates what direction evolving patency rates are taking.

Adult↗