[Recanalization of the middle cerebral artery evaluated using transcranial Doppler and early clinical recuperation during infusion of thrombolytic treatment].
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Since 1982, there have been many reports regarding percutaneous transluminal coronary angioplasty of totally occluded coronary arteries. Technical advances and operator experience have allowed us to achieve success in most patients. Restenosis and reocclusion after total occlusion percutaneous coronary intervention (PCI) continue to present a challenge and reduce long-term effectiveness of the procedure. In addition, brachytherapy and drug-eluting stents may have a major impact on outcome. Both technologies require study in the setting of complex lesion total occlusion PCI; there may be a light at the end of this tunnel.
BACKGROUND AND PURPOSE: The details of stent reconstruction in the vascular lumen and of the adaptation of carotid stents, the vessel wall, and the vascular anatomy are only occasionally reported. The purpose of this study was to determine the immediate and longer-term anatomic results after implantation of self-expanding carotid stents. METHODS: In a retrospective study, pre- and postprocedural angiograms and duplex sonograms from 40 consecutive carotid stent procedures in 39 patients (22 men, 17 women; mean age, 67 years; age range, 53-84 years) with high-grade (> or =70 %) internal carotid artery (ICA) stenoses were evaluated to assess the expansion of the vascular lumen, apposition of the stent, and geometric changes in the ICA after the implantation of rolling-membrane and carotid Wallstents (n = 22) or Easy Wallstents (n = 18). RESULTS: Optimal widening of the lumen and apposition of the stent were achieved in 11 (28%) of 40 arteries. Residual stenoses (n = 16), free stent filaments not attached to the vessel wall (n = 21), and stent-induced kinking of the ICA (n = 6) were minor shortcomings of stent reconstruction. Because of one death, peri-interventional morbidity and mortality rates were 3%. During follow-up (median, 24 months), one high-grade restenosis, one ipsilateral stroke, and two ipsilateral transient ischemic attacks were observed. CONCLUSION: Suboptimal anatomic results frequently occur after endovascular treatment of atherosclerotic carotid artery stenosis with self-expanding Wallstents. With the exception of one symptomatic restenosis, no major complications or longer-term sequelae were clearly related to these findings, but further controlled follow-up studies of larger samples are required.
INTRODUCTION: Vasectomy is a simple and common operation used worldwide for contraception. The present study sought to determine the rate of recanalisation after vasectomy and whether it is associated with the level of surgical experience. MATERIAL AND METHODS: Altogether 2563 vasectomies were conducted from 1 January 1997 to 1 January 2001. Postoperative semen analysis was performed in all subjects to ensure sterility. RESULTS: Seventy-nine per cent of patients submitted a semen sample for analysis. Fifteen per cent of the samples contained sperm. These subjects were asked to provide additional samples until azoospermia was diagnosed. Out of the 2563 vasectomies, 36 patients were reoperated, thus yielding a calculated incidence of recanalisation of 1.4%. The rate of recanalisation could not be associated with the level of experience by the operating surgeon. DISCUSSION: Vasectomy is a safe surgical procedure that can be performed with a low rate of failure by surgeons with limited surgical experience. Our results indicate that intermittent appearance of sperm can occur early after vasectomy. Consequently, reoperation should be performed on a conservative basis and solely in subjects in whom repeated semen analysis has failed to provide evidence of azoospermia.
We compared early and long-term follow-up results of balloon angioplasty and stenting of chronic coronary occlusions. The initial success rate was 75% (82 of 109 patients). Proportion of patients free of angina was 57 and 69% after successful balloon angioplasty and stenting, respectively. Stenting of coronary occlusions yielded better immediate angiographic results than did balloon angioplasty: residual stenosis and minimal diameter of artery after stenting were 13.5-12.4% and 2.7-0.2 mm, respectively; those after balloon angioplasty were 23.2-15.6% and 2.3-0.2 mm, p<0,05, respectively. Four-year clinical outcome was better in stenting than in angioplasty group: free of angina were 52 and 22% of patients in stenting and angioplasty group, respectively (p<0,05). There was no difference at follow-up between two groups in the rate of myocardial infarction, death, repeat revascularization. Repeat coronary angiography was performed after 38-24 months in 44% of patients. The rate of 'late' restenosis was 32% in stenting and 73% in balloon angioplasty group (p<0,05); mean stenosis and minimal diameter of artery after stenting were 43.5-12.4% and 1.7-0.6 mm, respectively; those after balloon angioplasty were 67.5-15.6% and 0.72+0.5 mm, respectively (p<0,05).
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Functional occlusion of the left internal thoracic artery T graft is reported. The patient underwent triple coronary artery bypass grafting with bilateral internal thoracic artery, anastomosing in situ to the left internal thoracic artery to the left anterior descending artery, free right internal thoracic artery to the obtuse marginal and posterolateral branch of the left circumflex artery. Early angiography showed occlusion of the in situ left internal thoracic artery to the moderately stenosed left anterior descending artery and patent side arm to circumflex. However, mid-term angiography revealed restoration of the left internal thoracic artery flow. A negative exercise stress test was noted throughout the postoperative period. Flow competition with a native coronary artery may be responsible for functional occlusion of the left internal thoracic artery.
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Nineteen patients with dysphagia were treated by endoscopic injection of ethanol, to induce tumoral necrosis. Dysphagia was present in patients with inoperable, unresectable or recurrent esophagogastric cancer. Prior treatment, patients had a mean dysphagia grade of 3.22. After the first session, they had a mean of 2.05. An optimum dysphagia grade mean was 1.47. The period intertreatment was X 45 days. There were no complications associated with the method. The results suggest this therapy is a good palliative procedure that, in a short time and with a low cost, can improve the life quality in selected patients.
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