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Minimally Invasive Superficial Femoral Artery Endarterectomy: Early Experience with a Modified Technique
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector Eur J Vasc Endovasc Surg 16, 254-258 (1998) ENDOVASCULAR AND SURGICAL TECHNIQUES Minimally Invasive Superficial Femoral Artery Endarterectomy: Early Experience with a Modified Technique M. S. Whiteley 1, T. R. Magee 1, E. P. H. Torrie 2 and R. B. Galland* Department of ~Surgery and 2Radiology, Royal Berkshire Hospital, London Road, Reading, U.K. Objectives: To describe our experience of a modified technique for carrying out remote endarterectomy for superficial femoral artery occlusive disease. Methods: A 4-French arterial dilator is inserted using a Smart needle into the popliteal artery below the occlusion. A remote endarterectomy is carried out through an arteriotomy in the proximal superficial femoral artery. The atheroma is cut distal to the lower extent of disease using a Moll ring cutter. The lower flap of atheroma is secured with an intraluminaI stent inserted from the arteriotomy in the superficial femoral artery. The arteriotomy is extended into the common femoral artery and closed with a vein patch. Results: The procedure was completed in 21 of 26 limbs. In 18 cases the superficial femoral artery remained patent at 30 days. Of the 21 cases all but four stayed in hospital for one night. A successful femoropopliteal bypass was carried out in the five patients in whom the procedure was not completed. Conclusion: Insertion of the dilator into the popliteal artery distal to the occlusion before carrying out the remote endarterectomy has two advantages. Firstly, the stent insertion is carried out in the correct plane and prevents dissection of the distal cut atheroma when attempting to pass the guidewire from above. -
Coronary Artery Perforation
Published online: 2019-09-20 THIEME 110 InterventionalCoronary Artery Rounds Perforation Deb et al. Coronary Artery Perforation Tripti Deb1 Jyotsna Maddury2 Prasant Kr. Sahoo3 1Department of Interventional Cardiology, Apollo Hospitals, Address for correspondence Jyotsna Maddury, MD, DM, FACC, Hyderabad, Telangana, India Department of Cardiology, Nizam’s Institute of Medical Sciences 2Department of Cardiology, Nizam’s Institute of Medical Sciences (NIMS), Punjagutta, Hyderabad, Telangana 500082, India (NIMS), Punjagutta, Hyderabad, India (e-mail: [email protected]). 3Department of Interventional Cardiology, Apollo Hospitals, Bhubaneswar, Odisha, India Ind J Car Dis Wom 2019;4:110–120 Abstract Percutaneous coronary intervention (PCI) is considered as the standard treatment of obstructive coronary artery disease in indicated patients. Even though PCI gives symp- Keywords tomatic angina improvement, but associated with serious complications like coronary ► coronary artery artery perforation (CAP), the incidence is quite low. With the more complex lesions for perforation successful angioplasty, different devices are required, which in turn increase the inci- ► percutaneous coro- dence of CAP in these patients. Here we review the classification, incidence, pathogen- nary intervention esis, clinical sequela, risk factors, predictors, and management of CAP in the current ► coronary artery era due to PCI. perforation ► management of coro- nary perfusion Introduction Consequences of Coronary Artery Perforation Percutaneous coronary intervention (PCI) for obstructive coronary artery diseases is accepted and has standardized Consequences of CAP depend on the location and severity. procedure with minimal complication rates, including iat- Location wise, if CAP occurs to the right or left ventricle, if not rogenic coronary artery perforation (CAP). Although angio- massive, then usually no immediate clinical consequences graphically significant coronary artery dissection is known occur. -
Targeting Endothelial Kruppel-Like Factor 2 (KLF2) in Arteriovenous
Targeting Endothelial Krüppel-like Factor 2 (KLF2) in Arteriovenous Fistula Maturation Failure A dissertation submitted to the Graduate School of the University of Cincinnati in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY (Ph.D.) in the Biomedical Engineering Program Department of Biomedical Engineering College of Engineering and Applied Science 2018 by Keith Louis Saum B.S., Wright State University, 2012 Dissertation Committee: Albert Phillip Owens III, Ph.D. (Committee Chair) Begona Campos-Naciff, Ph.D Christy Holland, Ph.D. Daria Narmoneva, Ph.D. Prabir Roy-Chaudhury, M.D., Ph.D Charuhas Thakar, M.D. Abstract The arteriovenous fistula (AVF) is the preferred form of vascular access for hemodialysis. However, 25-60% of AVFs fail to mature to a state suitable for clinical use, resulting in significant morbidity, mortality, and cost for end-stage renal disease (ESRD) patients. AVF maturation failure is recognized to result from changes in local hemodynamics following fistula creation which lead to venous stenosis and thrombosis. In particular, abnormal wall shear stress (WSS) is thought to be a key stimulus which alters endothelial function and promotes AVF failure. In recent years, the transcription factor Krüppel-like factor-2 (KLF2) has emerged as a key regulator of endothelial function, and reduced KLF2 expression has been shown to correlate with disturbed WSS and AVF failure. Given KLF2’s importance in regulating endothelial function, the objective of this dissertation was to investigate how KLF2 expression is regulated by the hemodynamic and uremic stimuli within AVFs and determine if loss of endothelial KLF2 is responsible for impaired endothelial function. -
3Rd Quarter 2001 Bulletin
In This Issue... Promoting Colorectal Cancer Screening Important Information and Documentaion on Promoting the Prevention of Colorectal Cancer ....................................................................................................... 9 Intestinal and Multi-Visceral Transplantation Coverage Guidelines and Requirements for Approval of Transplantation Facilities12 Expanded Coverage of Positron Emission Tomography Scans New HCPCS Codes and Coverage Guidelines Effective July 1, 2001 ..................... 14 Skilled Nursing Facility Consolidated Billing Clarification on HCPCS Coding Update and Part B Fee Schedule Services .......... 22 Final Medical Review Policies 29540, 33282, 67221, 70450, 76090, 76092, 82947, 86353, 93922, C1300, C1305, J0207, and J9293 ......................................................................................... 31 Outpatient Prospective Payment System Bulletin Devices Eligible for Transitional Pass-Through Payments, New Categories and Crosswalk C-codes to Be Used in Coding Devices Eligible for Transitional Pass-Through Payments ............................................................................................ 68 Features From the Medical Director 3 he Medicare A Bulletin Administrative 4 Tshould be shared with all General Information 5 health care practitioners and managerial members of the General Coverage 12 provider/supplier staff. Hospital Services 17 Publications issued after End Stage Renal Disease 19 October 1, 1997, are available at no-cost from our provider Skilled Nursing Facility -
ICD~10~PCS Complete Code Set Procedural Coding System Sample
ICD~10~PCS Complete Code Set Procedural Coding System Sample Table.of.Contents Preface....................................................................................00 Mouth and Throat ............................................................................. 00 Introducton...........................................................................00 Gastrointestinal System .................................................................. 00 Hepatobiliary System and Pancreas ........................................... 00 What is ICD-10-PCS? ........................................................................ 00 Endocrine System ............................................................................. 00 ICD-10-PCS Code Structure ........................................................... 00 Skin and Breast .................................................................................. 00 ICD-10-PCS Design ........................................................................... 00 Subcutaneous Tissue and Fascia ................................................. 00 ICD-10-PCS Additional Characteristics ...................................... 00 Muscles ................................................................................................. 00 ICD-10-PCS Applications ................................................................ 00 Tendons ................................................................................................ 00 Understandng.Root.Operatons..........................................00 -
Ventricular Long Axis Function: Amplitudes and Timings
Umeå University Medical Dissertations New Series No 895 - ISSN 0346-6612 _______________________________________________________________ From the Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden Ventricular Long Axis Function: Amplitudes and Timings Echocardiographic Studies in Health and Disease Frederick Bukachi Umeå 2004 © Copyright: Frederick Bukachi ISBN 91-7305-661-8 Printed in Sweden by Solfjädern offset AB Umeå, 2004 To my family Frida, Anthony, Arnold and Maria Time brings wisdom to the mind and healing to the heart. Anonymous Table of contents Table of contents................................................................................................................. 1 Abstract ................ ............................................................................................................. 3 List of original studies ........................................................................................................4 Abbreviations...................................................................................................................... 5 1. Introduction............................................................................................................. 6 2. Ventricular long axis ............................................................................................... 6 2.1. General overview and historical perspective................................................ 6 2.2. Anatomy of long axis .................................................................................. -
Transpulmonary Closure of Giant Persistent Ductus Arteriosus Under Cardiopulmonary Bypass and Normothermic Cardioplegia
Published online: 2019-11-25 THIEME 36 TranspulmonaryPoint of Technique Closure of Giant Persistent Ductus Arteriosus Chowdhury et al. Transpulmonary Closure of Giant Persistent Ductus Arteriosus under Cardiopulmonary Bypass and Normothermic Cardioplegia Ujjwal K. Chowdhury1 Sukhjeet Singh1 Niwin George1 Lakshmi Kumari Sankhyan1 Poonam Malhotra Kapoor2 1Department of Cardiothoracic and Vascular Surgery, All India Address for correspondence Ujjwal K. Chowdhury, MCh, Institute of Medical Sciences, New Delhi, India Department of Cardiothoracic and Vascular Surgery, All 2Department of Cardiac Anaesthesia, All India Institute of Medical India Institute of Medical Sciences, New Delhi 110029, India Sciences, New Delhi, India (e-mail: [email protected]). J Card Crit Care TSS 2020;3:36–38 Abstract A 25-year-old female patient with a giant, short, calcified, hypertensive, window duc- tus arteriosus underwent successful closure via transpulmonary approach under nor- Keywords mothermic cardiopulmonary bypass without circulatory arrest using a Foley catheter ► giant ductus for temporary occlusion. arteriosus ► adult ductus ► cardiopulmonary bypass ► transpulmonary closure ► calcified ductus Introduction chylothorax, or recanalization. Postoperative computerized tomographic angiography revealed complete ductal inter‑ Despite 80 years of experience, correction of persistent duc‑ ruption with no residual shunt or ductal aneurysm (►Fig. 3). tus arteriosus remains a surgical challenge in the subset of 1. Primary median sternotomy is performed. patients -
TAXUS™ Express 2 ™ Paclitaxel-Eluting
TAXU S ® Express 2® Paclitaxel-Eluting Coronary Stent System Patient Information Guide Table of Contents Notes Coronary Artery Disease . 2 Who is at Risk? . .3 Diagnosis of Coronary Artery Disease . 3 Treatment of Coronary Artery Disease . 3 Angioplasty . 4 Coronary Artery Stents . 4 Restenosis . 5 Your Drug-Eluting Stent, the TAXUS ® Express 2® Paclitaxel-Eluting Coronary Stent System . 7 Drug-Eluting Stents . 7 The Express ® Stent Platform for the TAXUS ® Express ® Stent . 7 The Polymer Coating on the TAXUS Express Stent . 7 The Drug that is Released from the TAXUS Express Stent . 8 When should the TAXUS Express Stent NOT be Used . 8 What are the Risks & Potential Benefits of Treatment with the TAXUS Express Stent? . 9 Alternative Practices and Procedures . 11 The Angioplasty Procedure . 12 Preparation for the Procedure . 12 Angioplasty and Stent Placement Procedure . 12 Post-Treatment . 13 After the Procedure . 13 Activity . 14 Medications . 14 Follow-Up Examinations . 15 Magnetic Resonance Imaging (MRI) . 15 Frequently Asked Questions . 16 Glossary . 17 Patient Information Card . Inside Back Cover 1 Notes Coronary Artery Disease Coronary Artery Disease (CAD) is usually caused by atherosclerosis, and affects the coronary arteries that surround the heart. These coronary arteries supply blood with oxygen and other nutrients to the heart muscle to make it function properly. CAD occurs when the inner walls of the coronary arteries thicken due to a buildup of cholesterol, fatty deposits, calcium, and other elements. This material is known as plaque. As plaque develops, the vessel narrows. When the vessel narrows (for example with physical exertion or mental stress), Aorta blood flow through the vessel is reduced so less oxygen and Right Left other nutrients reach Coronary Coronary the heart muscle. -
Clinical Appropriateness Guidelines: Percutaneous Coronary Intervention
Clinical Appropriateness Guidelines: Percutaneous Coronary Intervention Appropriate Use Criteria Effective Date: January 2, 2018 Proprietary Date of Origin: 08/27/2015 Last revised: 08/01/2017 Last reviewed: 09/07/2017 8600 W Bryn Mawr Avenue South Tower - Suite 800 Chicago, IL 60631 P. 773.864.4600 Copyright © 2018. AIM Specialty Health. All Rights Reserved www.aimspecialtyhealth.com Table of Contents Description and Application of the Guidelines ........................................................................3 Percutaneous Coronary Intervention .......................................................................................4 Table of Contents | Copyright © 2018. AIM Specialty Health. All Rights Reserved. 2 Description and Application of the Guidelines AIM’s Clinical Appropriateness Guidelines (hereinafter “AIM’s Clinical Appropriateness Guidelines” or the “Guidelines”) are designed to assist providers in making the most appropriate treatment decision for a specific clinical condition for an individual. As used by AIM, the Guidelines establish objective and evidence-based, where possible, criteria for medical necessity determinations. In the process, multiple functions are accomplished: ● To establish criteria for when services are medically necessary ● To assist the practitioner as an educational tool ● To encourage standardization of medical practice patterns ● To curtail the performance of inappropriate and/or duplicate services ● To advocate for patient safety concerns ● To enhance the quality of healthcare ● To promote the most efficient and cost-effective use of services AIM’s guideline development process complies with applicable accreditation standards, including the requirement that the Guidelines be developed with involvement from appropriate providers with current clinical expertise relevant to the Guidelines under review and be based on the most up to date clinical principles and best practices. Relevant citations are included in the “References” section attached to each Guideline. -
Everolimus Eluting Coronary Stent System
Everolimus Eluting Coronary Stent System Patient Information Guide Table of Contents Coronary Artery Disease (CAD) ........................5 Your Drug-Eluting Stent Procedure ................19 Your Heart ........................................................5 How Do I Prepare for My Procedure? ...........19 What is CAD? ..................................................5 Your Drug-Eluting Stent Placement What are the Symptoms of CAD? ...................5 Procedure ......................................................19 What are the Risk Factors of CAD? ................6 Immediately after Procedure .........................22 How Can My Doctor Tell if I Have CAD? .........7 Take All Medications as Instructed ................22 Follow-up Care ..............................................23 Your Treatment Options .....................................8 Keep Your ID Card Handy .............................23 Surgery .............................................................9 Angioplasty ......................................................9 Preventing CAD ................................................24 Coronary Artery Stents ..................................10 Frequently Asked Questions ...........................25 Drug-Eluting Stents (DES) ...............................11 Definition of Medical Terms ............................26 XIENCE Family of Coronary Stents ................12 Contraindications ...........................................13 Potential Adverse Events Associated with the XIENCE Family of Coronary Stents ..........13 -
Pericardial Bleeding Following Covered Stent Thrombosis: Sharp Blade on Both Sides
CASE REPORT Acta Medica Alanya 2018;2(3): 210-214 OLGU SUNUMU DOI: 10.30565/ medalanya.421746 Pericardial Bleeding Following Covered Stent Thrombosis: Sharp Blade on Both Sides Kaplı Stent Trombozu Sonrası Perikardiyal Kanama: İki Ucu Keskin Bıçak Ali Çoner1*, Davran Çiçek1, Sinan Akıncı1, Tonguç Saba2, Haldun Müderrisoğlu3 1.Department of Cardiology, Başkent University Alanya Education and Research Center, Alanya, Turkey 2.Department of Cardiovascular Surgery, Başkent University, Education and Research Center, Alanya, Turkey 3.Department of Cardiology, Başkent University Hospital, Ankara, Turkey ABSTRACT ÖZ Advancements in coronary stent technology encourage interventional cardiologists Koroner stent alanındaki teknolojik gelişmeler girişimsel kardiyologları daha kom- in performing more complex, percutaneous interventions. Coronary perforation is pleks perkütan girişimler gerçekleştirme konusunda cesaretlendirmektedir. Koroner a lethal complication of percutaneous coronary artery interventions and should be perforasyon perkütan koroner arter girişimleri esnasında görülebilen ölümcül bir managed within seconds to minutes. Despite technological advancements, coronary komplikasyondur ve saniyeler veya dakikalar içerisinde müdahale edilmelidir. perforation incidence has not declined over the years. This consistent incidence of Geçen yıllar içerisinde teknolojik gelişmeler olmasına karşın koroner perforasyon coronary perforation may be related to increased number of complex, percutaneous sıklığı azalmamıştır. Koroner perforasyon sıklığında -
Electrocardiogram-Gated Intravascular Ultrasound Image
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Erasmus University Digital Repository 436 JACC Vol. 30, No. 2 August 1997:436–43 INTERVENTIONAL CARDIOLOGY Electrocardiogram-Gated Intravascular Ultrasound Image Acquisition After Coronary Stent Deployment Facilitates On-Line Three-Dimensional Reconstruction and Automated Lumen Quantification CLEMENS VON BIRGELEN, MD,* GARY S. MINTZ, MD, FACC,† ANTONINO NICOSIA, MD, DAVID P. FOLEY, MB, MRCPI, PHD, WIM J. VAN DER GIESSEN, MD, PHD, NICO BRUINING, BSC, SERGEI G. AIRIIAN, MD, JOS R. T. C. ROELANDT, MD, PHD, FACC, PIM J. DE FEYTER, MD, PHD, FACC, PATRICK W. SERRUYS, MD, PHD, FACC Rotterdam, The Netherlands and Washington, D.C. Objectives. This study evaluates the feasibility, reliability and correlated closely (r >2 0.95), and the minimal stent lumen differed reproducibility of electrocardiogram (ECG)-gated intravascular only minimally (8.6 6 2.8 mm2 vs. 8.5 6 2.8 mm2,p5NS). The ultrasound (IVUS) image acquisition during automated trans- conventional analysis significantly overestimated the minimal ducer withdrawal and automated three-dimensional (3D) bound- stent lumen (9.0 6 2.7 mm2, p < 0.005) in comparison with results ary detection for assessing on-line the result of coronary stenting. of both 3D analyses. Fourteen stents (41%) failed to meet the Background. Systolic-diastolic image artifacts frequently limit criteria by both 3D analyses, all of these not reaching optimal the clinical applicability of such automated analysis systems. expansion, but only 7 (21%) were detected by conventional anal- Methods. In 30 patients, after successful angiography-guided ysis (p < 0.02).