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At least 1,261 records · Page 70Linked to original sources
PubMed1977

Use of the smooth Teflon clip to prevent pulmonary embolism in the postoperative period.

This report details experience with 50 patients who had vena caval interruption with a smooth Teflon (Moretz) clip placed at the time of surgery for other conditions in a high-risk patient population. No fatal pulmonary emboli were encountered; one patient developed bilateral iliofemoral venous thrombosis during the immediate postoperative period (Table 9). Another patient developed iliofemoral venous thrombosis and a nonfatal embolus two years after the vena caval interruption. Two patients developed postoperative edema, but no incapacitating edema and no ulcers were noted. Many of our patients were subjected to further risk of venous thrombosis and pulmonary embolism when hospitalization for medical care or operative procedures was required subsequent to the initial procedure. Vena caval interruption with a smooth Teflon clip can be recommended to prevent pulmonary embolism in high-risk patients who require surgery and to provide continuing protection during subsequent illness; however, extremity sequelae are minimal.

Adult↗
PubMed1977

Corneal edema: iris-clip lens implantation and simple intracapsular extraction compared.

Corneal edema following intracapsular lens extraction and iris-clip lens implantation was compared by assessing corneal thickness and epithelial edema. In a retrospective study the corneal thickness of twenty patients who had intracapsular lens extraction in one eye only was compared with twenty-six patients with iris-clip lens implants in one eye. There was no significant increase in corneal thickness in the operated eye in either group. In a prospective randomized controlled study, a smaller number of patients, had serial measurements of corneal thickness pre- and postoperatively. There was an increase in thickness in the immediate postoperative period for both groups. However, there was no significant difference between eyes which had simple extraction and those which had implants. The implanted eyes however had greater mean increase endothelial trauma in the initial period, compared to eyes with cataract extraction alone.

Aged↗
PubMed1977

Iridocapsular lenses versus iris-clip lenses: comparison of the results and complications of 100 of each.

The results and complications of implantation of 100 iridocapsular and 100 iris-clip lenses are evaluated. The follow-up period for the first group varied from one to 25 months (mean 12 months) and from one to 43 months (mean 27 months) for the second group. I performed all of the operations and most of the follow-up examinations. Of the patients with iridocapsular lenses, 86 percent and of those with iris-clip lenses, 87 percent obtained a visual acuity of 0.5 (6/12) or better. Binocular vision, positive depth perception, and a small degree of aniseikonia (3% or less) are evident optical benefits. The complicatioons most frequently necessitating a second operation were retained lens material (17%) and repositioning the pseudophakos (6%) in the iridocapsular group. The four-loop lenses caused fewer problems; in one case, posterior luxation necessitated its removal.

Adolescent↗
PubMedDate not supplied

[Temporary preventive clipping of the major brain arteries in the surgical treatment of arterial aneurysms].

Preventive temporary clipping of the carrying arteries reduces the incidence of intraoperative hemorrhage in anterior connecting arterial aneurysms from 26 to 13%, in middle cerebral arterial arterial aneurysms from 29 to 4%. In anterior connecting arterial aneurysms, the use of preventive temporary clipping of the carrying arteries fails to affect surgical outcomes. In middle cerebral arterial arterial aneurysms, this procedure decreases postoperative mortality from 17 to 12% by reducing the incidence of intraoperative hemorrhage; however, the rates of disability due to possible brain ischemia in the middle cerebral arterial bed rates increases from 32 to 40%.

Aneurysm, Ruptured↗
PubMed1997

[Aortic valve replacement with the Toronto stentless porcine valve in a patient with clipping for cerebral arterial aneurysm].

A 48-year-old man, who had a cerebral arterial aneurysm, was admitted in our institution for operation of aortic valve stenosis. At first, he underwent clipping for cerebral arterial aneurysm under precise management of his hemodynamic condition. After the clipping operation, we performed aortic valve replacement with the Toronto stentless porcine valve because no anticoagulant therapy was ideal for patient with cerebrovascular disease and larger effective orifice area was preferable for stenotic aortic annulus. By means of echocardiography, mean pressure gradient of the aoric valve decreased from 42 mmHg to 22 mmHg after the valve operation. He was discharged from the hospital on the 23rd postoperative day, and he has been doing well without thromboembolic events and bleeding complications for five postoperative months. This experience suggest that the Toronto stentless porcine valve might be one of the valve of choice for patients with aortic valve disease and cerebrovascular disease.

Aortic Valve Stenosis↗
PubMed1997

[Clipping of the thoracic duct with video-assisted thoracic surgery in the treatment of chylothorax after pulmonary resection].

We describe a procedure for video-assisted thoracoscopic clipping of the thoracic duct to treat postoperative chylothorax. This technique was successfully performed on a 62-year-old man who developed chylothorax following right lower lobectomy and partial resection of the 11th and 12th vertebral bodies for squamous cell lung cancer. Because conservative therapy for 7 days failed to reduce the amount of pleural effusion, we performed thoracoscopic examination of the thoracic duct and found a site leaking chylous fluid. The thoracic duct was successfully and easily clipped resulting in complete elimination of the effusion in 2 days. Generally, chylothorax complicating pulmonary resection has been managed by medical treatment first, followed by surgical intervention in case that fail to respond to initial therapy. The newly designed video-assisted thoracic surgery procedure reduces the trauma, shortens the drainage period and hospital stay, and provides better exposure of the thoracic duct. We believe that this procedure can be carried out shortly after the occurrence of chylothorax.

Chylothorax↗
PubMed1997

Refusion of anterior cerebral artery after aneurysm clipping--a case report.

Herein, we are describing an unusual case suffering from a left anterior cerebral artery aneurysm (A1). Both the anterior cerebral arteries were supplied by the left internal carotid artery as was found in digital substraction angiography (DSA) preoperatively. The postoperative angiograms revealed that left anterior cerebral artery was supplied from the left internal carotid artery and the right anterior cerebral artery by the right internal carotid artery respectively. This finding of cerebral angiograms is interesting and rarely mentioned in the literature. Its hemodynamic change and pathogenesis were unclear and different to that of the coronary circulation, ischemic change of gut and skeletal muscle. The causes may include: 1) vasospasm at the anterior communicating artery after manipulation at surgery; 2) desiccation or shrivelling the adjacent artery by intraoperative electrocoagulation; 3) occlusion the anterior communicating artery by the wing of clip. 4) the deprivation of the blood flow from the left internal carotid artery after totally or partially narrowing left A1 by an aneurysm clip. The redistribution of blood volume in the previously hypoplastic right anterior cerebral artery and decreased caliber of the left anterior cerebral artery (A1) are likely playing a role in this case.

Cerebral Angiography↗
PubMed1998

[Indications for external ventricular drainage after clipping of ruptured aneurysms in the acute stage].

The indication for external ventricular drainage after clipping of ruptured aneurysms in the acute stage is evaluated. Since 1990, 234 patients who presented with subarachnoid hemorrhage (SAH) and underwent aneurysmal clipping in the acute stage were evaluated retrospectively. Patients with ventricular dilatation had intraoperative placement of a ventriculostomy to obtain intraoperative brain relaxation, but the ventricular catheter was removed at the end of the surgery. All these patients were managed postoperatively in a similar fashion with no ventricular drainage, avoidance of dehydration complemented by a course of sodium ozagrel and nicardipine or fasudil hydrochloride. Acute hydrocephalus was defined as clinically and radiographically demonstrated ventricular dilatation that developed within 2 weeks of the onset of SAH and that required ventricular drainage. Three surgical approaches were employed; pterional approach (PA) for the aneurysms of the anterior circulation and upper basilar artery in 207 patients, interhemispheric approach (IHA) for the aneurysms of the pericallosal artery in 11 patients and lateral suboccipital approach (LSA) for the aneurysms of the vertebral arteries in 16 patients. No significant differences were found among these three approach groups in Fisher CT classification and the Hunt & Kosnik gradings. Four patients developed acute hydrocephalus within two weeks of surgery: three patients were operated on via LSA and one through IHA. Compared to the IHA or LSA, PA was superior for reestablishing cerebrospinal fluid circulation, because it is possible to remove more subarachnoid clot in the basal cisterns than to do so in the other two approaches. Opening of the lamina terminalis and the Liliequist membrane are also possible using PA. In conclusion, PA can prevent development of acute hydrocephalus, whereas postoperative ventricular drainage may be necessary in patients operated upon via IHA or LSA.

Acute Disease↗
PubMed1976

[Ambulatory tubal sterilization using a plastic clip].

The ambulant sterilization of the ovarien tubes with the plastic clip represents a notable method among the operative sterilization methods. With this method, failures can be totally avoided. The bloodless proceeding in the intraperitoneal region results in a minimum of operational risks. The postoperative morbidity is 0%. The clip sterilization takes a few minutes and can be done with intubation or Trapanal/fluothane narcosis in the ambulance. The possibility of refertilization is still to be discussed. From April 1974 till April 1975 this method for sterilization was employed in 97 patients. There were no complications or failures seen.

Animals↗
PubMed1998

Temporary clipping in the surgery of endocranial aneurysms.

The authors' experience in the routine use of temporary clipping procedures in the surgery of endocranial aneurysms is reported. To analyse the validity of such a method we compared the outcome in a series of 153 aneurysms operated according to the traditional procedure (temporary clipping of the afferent vessel only in the case of intraoperative rupture of the aneurysmatic sac) with that of a more recent series of 225 in which the procedure was applied routinely. An unsatisfactory surgical outcome was found in 12.5% and 6.6% of patients respectively, with a corresponding unfavourable outcome in 5.6% and 2.6%.

Humans↗
PubMed1998

Problems with post-clipping aneurysmal rests.

The postclipping aneurysmal rest is a uncommon but sometimes dangerous event, that is generally underestimated. We distinguish the aneurysmal rest on the basis of its morphology in: 1) partial neck, 2) whole neck, 3) partial neck + partial sac, 4) whole neck + partial sac; on the basis of the relationship with the clip in: 1) proximal, 2) distal, 3) proximal + distal; on the basis of its size in: 1) small (< 2 mm), 2) medium (2-4 mm), 3) large (> 4 mm). From the surgical point of view the aneurysmal rests in our opinion can be classified as unavoidable, avoidable and intentional. Then we analyze the literature data in regard to the possible evolution and the risk of the rest and emphasize the importance of intraoperative angiography which has shown itself to be useful in avoiding aneurysmal rests. There is no consensus of opinion with regard to the type of treatment of the aneurysmal rest. In our opinion the factors which must be considered when deciding on the surgical treatment of a rest are: the age of the patient, mode of presentation of the previous aneurysm, the expertise of the surgeon and the approaches and the techniques used in the first operation, clinical presentation of the rest and its evolution, the surgeon's experience and the possibility of endovascular therapy. Finally we analyze some of the technical aspects of re-operation in relation to the anatomical relationship among the parent artery, the rest and the old clip.

Humans↗
PubMed1976

Renal prostaglandin synthesis in experimental renal clip hypertension in the rat.

1. The hypothesis that suppression of prostaglandin E (PGE) synthesis by indomethacin exacerbates renal clip hypertension in the rat was investigated. 2. Indomethacin exacerbated hypertension in renal clip rats. 3. In vitro PGE synthesis determined by gas liquid chromatography (GLC) was suppressed in medullary tissue from the hypertensive animals irrespective of indomethacin treatment. 4. The findings support the concept that PGs participate in blood pressure regulation in experimental renal hypertension.

Animals↗
PubMedDate not supplied

Comparison of laparoscopic sterilization via spring-loaded clip and tubal ring.

The spring-loaded clip and tubal ring techniques of laparoscopic female sterilization were compared for ease of performance, safety and effectiveness at the Asociación Demográfica Salvadoreña in San Salvador, where they were randomly assigned to a total of 299 patients. Rates of technical/equipment difficulties and procedural difficulties during laparoscopy were similar for both techniques. Procedure-related surgical complications occurred in three ring patients as a result of tubal transection. Pain during the procedure was more severe for tubal ring patients. Results suggest that both techniques can be safely and effectively used for laparoscopic sterilization.

Adult↗
PubMedDate not supplied

Increased uterine and ovarian vascular resistance following Filshie clip sterilization: preliminary findings obtained with color Doppler ultrasonography.

The effect of Filshie clip sterilization on uterine and ovarian circulation was studied with color Doppler ultrasonography in 16 women before and twice after the operation. As a whole, the vascular resistance was slightly raised in the largest uterine artery and in the fundal parts of the uterine arteries; likewise in the ovarian arteries 2 days after sterilization. The resistance in the uterine arteries approached the presterilization level at 3 months after the operation, although these changes were not statistically significant. Two women had pelvic pain in the first days after the procedure, and they were compared with the symptom-free patients. Two days after sterilization, the patients with pain had significantly higher vascular resistance in all parts of the uterine arteries as compared to the symptom-free patients. After 3 months the difference had decreased in the largest uterine arteries and in the middle parts of the uterine arteries, but in the fundal parts the resistance was still higher than before sterilization. Vascular resistance in the ovarian arteries was increased in both groups, although the elevation was more pronounced in patients with pain. These preliminary findings imply that sterilization may cause an increase in the local vascular resistance, which is measurable by color Doppler sonography.

Adult↗
PubMed1976

Puerperal weck clip sterilization: study II (second study of two consecutive studies).

Forty-five puerperal inverted V Weck clip applications have been completed with either the Samuel's or (modified) Weck pistol-grip applicator. Of the 45 applications, 31 have been followed for 25 to 36 months (69%), 12 have been followed for 13 to 25 months (27%), and 2 have been followed for 9 to 12 months (4%). The failure rate thus far is 2.2%. No mechanical difficulties were encountered with the Samuel's or the (modified) Weck pistol-grip applicator. Reversibility has been observed in one interval patient, while pre-admission evaluation of a puerperal patient suggests postremoval tubal patency.

Evaluation Studies as Topic↗
PubMed1983

[A rare complication following the insertion of a bleier-secu-clip].

A case of bilateral torsion of the fallopian tubes, the right with a hydro-salpinx is reported. This occurred 8 months following tubal sterilization following by the Bleier Secu-clips in a case of acute abdominal pain following tubal sterilization the differential diagnosis of a torsion of the fallopian tube with swelling of the infracted tube must be considered in addition to a torsion of an ovarian cyst.

Abdomen, Acute↗
PubMed2003

Hepatic resection and percutaneous ethanol injection as treatments of small hepatocellular carcinoma: a Cancer of the Liver Italian Program (CLIP 08) retrospective case-control study.

BACKGROUND: Patients with small hepatocellular carcinoma (HCC) are usually treated with hepatic resection or percutaneous ethanol injection (PEI). GOALS: To compare the effects of hepatic resection versus PEI on survival in a matched case-control study. STUDY Patients with single-nodule HCC (<or=5 cm) who were treated with hepatic resection (cases) or PEI (controls) were eligible. Matching criteria were date of diagnosis, Child-Pugh stage, and age at diagnosis. Kaplan-Meier survival curve of the control group was drawn weighing each stratum by the inverse of its size. Treatments were compared by a stratified Cox's model, adjusted by CLIP score. RESULTS: Of 912 patients, 197 were eligible and 82 (17 cases and 65 controls) were matched, creating 17 strata. Nine (53%) cases and 41 (63%) controls died. Cox model showed no survival difference between the two groups; hazard ratio of PEI versus hepatic resection was 1.04 (95% CI = 0.43-2.52). One- and 3-year survival rates in the hepatic resection and PEI groups were 82% versus 91% and 63% versus 65%, respectively. CONCLUSIONS: Patients with small HCC treated with hepatic resection or PEI have similar survival rates. In view of the higher cost and morbidity of hepatic resection, a prospective randomized study is warranted.

Aged↗
PubMed1978

Menstrual patterns after laparoscopic sterilization using a spring-loaded clip.

Details of the menstrual cycles in 504 women were recorded before laparoscopic sterilization with a spring-loaded clip and at six months and one year after the procedure. The operation did not affect the length of the menstrual cycle or duration of menstrual flow, nor the patient's assessment of the amount of blood losss or the incidence of dysmenorrhoea. The previous method of contraception was significantly related to subsequent menstrual patterns.

Adult↗