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https://www.readbyqxmd.com/read/30396311/optical-coherence-tomography-translation-from-3d-printed-vascular-models-of-the-anterior-cerebral-circulation-to-the-first-human-images-of-implanted-surface-modified-flow-diverters
#1
Mario Martínez-Galdámez, Jorge Escartín, Boris Pabón, Carlos Diaz, Roberto Martín-Reyes, Antonio Hermosín, Eduardo Crespo, Claudio Rodríguez, Gonzalo Monedero, Krishna Joshi, Demetrius K Lopes
BACKGROUND: The new generation of flow diverters includes a surface modification with a synthetic biocompatible polymer, which makes the device more biocompatible and less thrombogenic. Optical coherence tomography (OCT) can be used to visualize perforators, stent wall apposition, and intra-stent thrombus. Unfortunately real world application of this technology has been limited because of the limited navigability of these devices in the intracranial vessels. In this report, we share our experience of using 3D-printed neurovascular anatomy models to simulate and test the navigability of a commercially available OCT system and to show the application of this device in a patient treated with the new generation of surface modified flow diverters...
November 5, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/30391212/fulminant-presentation-of-a-failed-tavr-valve-successful-revision-with-a-transcatheter-approach-case-report-and-review-of-the-literature
#2
REVIEW
Ashleigh Long, Paul Mahoney
Transcatheter Aortic Valve Replacement (TAVR) has evolved as a strategy for managing aortic stenosis in a growing proportion of patients considered at high or intermediate surgical risk. Though early data has demonstrated excellent durability and life span of transcatheter valves up to five years, there is an absence of case based studies in the literature regarding transcatheter valve failure after TAVR, and outcomes of subsequent redo TAVR Valve-in-Valve (VIV) procedures. We report here a successful case of emergent, catheter-based treatment for severe, highly symptomatic valve in valve restenosis of a 5 year old Sapien valve...
October 18, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/30354632/high-speed-rotational-atherectomy-versus-modified-balloons-prior-to-drug-eluting-stent-implantation-in-severely-calcified-coronary-lesions
#3
Mohamed Abdel-Wahab, Ralph Toelg, Robert A Byrne, Volker Geist, Mohamed El-Mawardy, Abdelhakim Allali, Tobias Rheude, Derek R Robinson, Mohammad Abdelghani, Dmitriy S Sulimov, Adnan Kastrati, Gert Richardt
BACKGROUND: Balloon dilatation or debulking seems to be essential to allow successful stent implantation in calcified coronary lesions. Compared with standard balloon predilatation, debulking using high-speed rotational atherectomy (RA) is associated with higher initial procedural success albeit with higher in-stent late lumen loss at intermediate-term follow-up. Whether modified (scoring or cutting) balloons (MB) could achieve similar procedural success compared with RA is not known...
October 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/30354405/effect-of-baseline-impedance-on-ablation-lesion-dimensions
#4
Michael Barkagan, Markus Rottmann, Eran Leshem, Changyu Shen, Alfred E Buxton, Elad Anter
BACKGROUND: Radiofrequency ablation using irrigated catheters is performed using a power-controlled mode. However, lesion size is dependent on current delivery at a particular impedance, such that a power value alone may not reflect actual energy delivery, resulting in lesion size variability at similar power settings. We hypothesized that modulating baseline impedance at fixed power settings affects ablation lesion dimensions. METHODS: In 20 ex vivo swine hearts, radiofrequency ablation was performed using an irrigated catheter at a fixed power setting of 30 W per 20 seconds and a multistepped impedance load (100-210Ω)...
October 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/30351245/spinal-cord-blood-flow-in-patients-with-acute-spinal-cord-injuries
#5
Mathew J Gallagher, Florence Hogg, Argyro Zoumprouli, Marios C Papadopoulos, Samira Saadoun
The effect of traumatic spinal cord injury on spinal cord blood flow in humans is unknown. Whether intervention to achieve the recommended mean arterial pressure guideline of 85-90 mmHg improves spinal cord blood flow is also unclear. Here, we use laser speckle contrast imaging intraoperatively to visualize blood flow at the injury site in 22 patients with acute, severe spinal cord injuries (American spinal injuries association Impairment Scale, grades A-C). In 17/22 patients, injury site metabolism was also monitored with a microdialysis catheter placed intradurally on the surface of the injured cord...
October 23, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/30316394/radical-prostatectomy-for-localized-prostate-cancer-in-renal-transplant-recipients-13-cases-studied-at-a-single-center
#6
K Iwamoto, J Iizuka, Y Hashimoto, T Kondo, T Takagi, K Hata, K Unagami, M Okumi, H Ishida, K Tanabe
OBJECTIVES: We aimed to evaluate the feasibility and efficacy of surgical prostatectomy in renal transplant recipients (RTRs). METHODS: Between January 2008 and February 2017, we identified 13 RTRs who were diagnosed with localized prostate cancer and underwent radical prostatectomy. We reviewed all available clinicopathologic data for these 13 patients. RESULTS: The median patient age was 61 years and median serum prostate-specific antigen (PSA) was 8...
October 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/30262107/host-derived-nitric-oxide-and-its-antibacterial-effects-in-the-urinary-tract
#7
Lovisa Svensson, Mirjana Poljakovic, Isak Demirel, Charlotte Sahlberg, Katarina Persson
Urinary tract infection (UTI) is one of the most common bacterial infections in humans, and the majority are caused by uropathogenic Escherichia coli (UPEC). The rising antibiotic resistance among UPEC and the frequent failure of antibiotics to effectively treat recurrent UTI and catheter-associated UTI motivate research on alternative ways of managing UTI. Abundant evidence indicates that the toxic radical nitric oxide (NO), formed by activation of the inducible nitric oxide synthase, plays an important role in host defence to bacterial infections, including UTI...
2018: Advances in Microbial Physiology
https://www.readbyqxmd.com/read/30183487/intestinal-luminal-putrescine-is-produced-by-collective-biosynthetic-pathways-of-the-commensal-microbiome
#8
Atsuo Nakamura, Takushi Ooga, Mitsuharu Matsumoto
The intestinal microbiome produces various metabolites that may harm or benefit the host. However, the production pathways of these metabolites have not been well characterised. The polyamines putrescine and spermidine required for physiological process are also produced by intestinal microbiome. The production and release of these polyamines by microbiome are poorly understood, though we have confirmed that intestinal bacteria produced putrescine from arginine. In this study, we characterised polyamine synthesis by analysing the collective metabolic functions of the intestinal microbiome...
September 5, 2018: Gut Microbes
https://www.readbyqxmd.com/read/30158093/appraisal-of-key-trials-in-aortic-and-mitral-fields
#9
Piera Capranzano, Nicolas M Van Mieghem, Corrado Tamburino
Aortic stenosis and mitral regurgitation are increasingly treated by percutaneous interventions including transcatheter aortic valve implantation (TAVI) and several mitral valve repair techniques, changing the landscape of valvular therapies in which surgery was predominant. Several randomised studies on TAVI have led to the use of this procedure in patients at intermediate or higher operative risk and have set strong foundations for future trials aiming to expand indications or to overcome several residual issues with TAVI...
August 31, 2018: EuroIntervention
https://www.readbyqxmd.com/read/30153670/tgf%C3%AE-is-specifically-upregulated-on-circulating-cd14-cd16-and-cd14-cd16-monocytes-in-patients-with-atrial-fibrillation-and-severe-atrial-fibrosis
#10
David Heinzmann, Stefan Fuß, Saskia V Ungern-Sternberg, Jürgen Schreieck, Meinrad Gawaz, Michael Gramlich, Peter Seizer
BACKGROUND/AIMS: Fibrotic remodeling of the atria plays a key role in the pathogenesis of atrial fibrillation (AF). As little is known about the contribution of circulating monocytes in atrial remodeling and the pathophysiology of AF, we investigated profibrotic factors in different subsets of circulating monocytes obtained from patients with atrial fibrillation undergoing catheter ablation. METHODS: A 3D high density voltage mapping was performed in sinus rhythm to evaluate the extent of low-voltage areas (LVAs) in the atria of 71 patients with persistent AF...
2018: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/30142025/ultrasound-assisted-catheter-directed-thrombolysis-compared-with-anticoagulation-alone-for-treatment-of-intermediate-risk-pulmonary-embolism
#11
Andrew J Schissler, Robert J Gylnn, Piotr S Sobieszczyk, Aaron B Waxman
It is unclear if ultrasound-assisted catheter-directed thrombolysis (UACDT) confers benefit over anticoagulation (AC) alone in the management of intermediate-risk ("submassive") pulmonary embolism (PE), defined by evidence of right ventricular (RV) dysfunction in hemodynamically stable patients. This study sought to evaluate any lasting advantage of UACDT on mortality and resolution of RV dysfunction in intermediate-risk PE at a large academic medical center. Adults aged ≤ 86 years admitted with intermediate-risk PE from 2011 to 2016 were retrospectively identified...
October 2018: Pulmonary Circulation
https://www.readbyqxmd.com/read/30123589/urinary-catheter-colonization-by-multidrug-resistant-cedecea-neteri-in-patient-with-benign-prostatic-hyperplasia
#12
Peter S Ginn, Serina B Tart, Stephen M Sharkady, Dorothea K Thompson
Cedecea neteri , a member of the Enterobacteriaceae family, has only been identified as a human pathogen in a few previous clinical cases, thus complicating assessment of this organism's pathogenicity and medical relevance. Documented infections attributed to C. neteri primarily involved bacteremia in severely immunocompromised patients. We report a rare case of urinary catheter colonization by a multidrug-resistant C. neteri strain in a patient of advanced age with benign prostatic hyperplasia and other chronic comorbidities...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/30082262/a-five-year-and-single-centre-experience-on-ultrasound-asssisted-catheter-directed-thrombolysis-in-patients-with-pulmonary-embolism-at-high-risk-and-intermediate-high-risk
#13
Cihangir Kaymaz, Ozgur Yasar Akbal, Aykun Hakgor, H Ceren Tokgoz, Ali Karagoz, Ibrahim Halil Tanboga, Seda Tanyeri, Berhan Keskin, Sevim Turkday, Durmus Demir, Cem Dogan, Zubeyde Bayram, Rezzan Deniz Acar, Busra Guvendi, Nihal Ozdemir, Victor F Tapson, Stavros Konstantinides
AIMS: In this single-centre study, we evaluated short- and long-term efficacy and safety outcomes of ultrasound-assisted thrombolysis (USAT) performed in patients with acute pulmonary embolism (PE) at intermediate-high- and high-risk (IHR,HR). METHODS AND RESULTS: Study group comprised retrospectively evaluated 141 patients with PE who underwent USAT. Tissue-type plasminogen activator (t-PA) dosage was 36.1±15.3 mg, and infusion duration was 24.5±8.1 hours. The USAT was associated with improvements in echocardiographic measures of right-ventricle systolic function, pulmonary-arterial (PA) obstruction score, right to left ventricle diameter ratio (RV/LV), right to left atrial diameter ratio and PA pressures, irrespective of the risk (p<0...
August 7, 2018: EuroIntervention
https://www.readbyqxmd.com/read/30079135/balloon-occluded-transcatheter-arterial-chemoembolization-for-hepatocellular-carcinoma
#14
REVIEW
Takeshi Hatanaka, Hirotaka Arai, Satoru Kakizaki
Transcatheter arterial chemoembolization (TACE) is widely accepted as a treatment for patients with hepatocellular carcinoma (HCC) in the intermediate stage according to the Barcelona Clinic Liver Cancer (BCLC) guidelines. Recently, balloon-occluded TACE (B-TACE) was developed in Japan. Despite the lack of a clear definition, B-TACE is generally defined as the infusion of emulsion of chemotherapeutic agents with lipiodol followed by gelatin particles under the occlusion of feeding arteries by a microballoon catheter, which leads to the dense lipiodol emulsion (LE) accumulation in HCC nodules...
July 27, 2018: World Journal of Hepatology
https://www.readbyqxmd.com/read/30062537/diagnostic-performance-of-machine-learning-based-computed-fractional-flow-reserve-ffr-derived-from-coronary-computed-tomography-angiography-for-the-assessment-of-myocardial-ischemia-verified-by-invasive-ffr
#15
Xiuhua Hu, Minglei Yang, Lu Han, Yujiao Du
To explore the diagnostic performance of a machine-learning-based (ML-based) computed fractional flow reserve (cFFR) derived from coronary computed tomography angiography (CCTA) in identifying ischemia-causing lesions verified by invasive FFR in catheter coronary angiography (ICA). We retrospectively studied 117 intermediate coronary artery lesions [40-80% diameter stenosis (DS)] from 105 patients (mean age 62 years, 32 female) who had undergone invasive FFR. CCTA images were used to compute cFFR values on the workstation...
July 30, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/30060093/nuances-of-endovascular-treatment-of-transverse-sigmoid-sinus-stenosis-with-stenting-venoplasty-in-a-patient-with-pseudotumor-cerebri-2-dimensional-operative-video
#16
Leonardo Rangel-Castilla, Adnan H Siddiqui
We present a case of a patient with pseudotumor cerebri (PC) and transverse/sigmoid junction sinus (TSJS) stenosis treated with stenting venoplasty. A 54-yr-old man with a history of hypertension, hyperlipidemia, and chronic obstructive pulmonary disease presented with subacute onset of progressive headaches, blurred vision, and papilledema. He was clinically diagnosed with PC. Left TSJS stenosis was suspected on magnetic resonance venography and confirmed with digital subtraction angiography and venography...
July 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/30059979/pyruvate-is-an-effective-substitute-for-glutamate-in-regulating-porcine-nitrogen-excretion
#17
Yunxia Li, Zhiru Tang, Tiejun Li, C Chen, Feiruo Huang, Jing Yang, Qingqing Xu, Jifu Zhen, Zhaoliang Wu, Mao Li, Jiajing Sun, Jinchao Chen, Xiangxin Zhang, Liuting Wu, Rui An, Shengjun Zhao, Qingyan Jiang, Weiyun Zhu, Yulong Yin, Zhihong Sun
This study was performed to determine if pyruvate, which acts as a critical intermediate in energy metabolism, can substitute the role of glutamate as a metabolic fuel and effectively reduce nitrogen excretion in pigs. First, the experiment in vitro was carried out to investigate the effects of culturing porcine small intestinal epithelial cell line with pyruvate on the oxidation. Then, barrows weighing 40 kg were used in the experiment investigating the changes of nitrogen balance in response to addition of pyruvate to low-protein diets...
July 27, 2018: Journal of Animal Science
https://www.readbyqxmd.com/read/30056080/patient-and-dosimetric-predictors-of-genitourinary-and-bowel-quality-of-life-after-prostate-sbrt-secondary-analysis-of-a-multi-institutional-trial
#18
Kyle Wang, Ronald C Chen, Brent L Kane, Clinton A Medbery, Kelly J Underhill, James R Gray, Anuj V Peddada, Donald B Fuller
PURPOSE: SBRT is an emerging option for localized prostate cancer. However, there are no standard dosimetric guidelines and normal tissue tolerances for extreme hypofractionation are not well defined. We analyzed dosimetric correlations with patient-reported urinary and bowel quality of life (QOL) on a prospective trial. METHODS: Patients with low/intermediate-risk prostate cancer from 18 institutions were enrolled on a Phase II trial from 2007-2012 and treated using robotic SBRT to 38 Gy in 4 fractions on consecutive days...
July 26, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/30030111/high-dose-rate-interstitial-brachytherapy-as-monotherapy-in-one-fraction-of-20-5-gy-for-the-treatment-of-localized-prostate-cancer-toxicity-and-6-year-biochemical-results
#19
Pedro J Prada, María Ferri, Juan Cardenal, Ana García Blanco, Javier Anchuelo, Iván Díaz de Cerio, Andrés Vázquez, Maite Pacheco, Ignacio Raba, Samuel Ruiz
PURPOSE: To evaluate acute and late genitourinary toxicity, the gastrointestinal toxicity, and the long-term biochemical control after high-dose-rate (HDR) monotherapy in one fraction (20.5 Gy). MATERIALS AND METHODS: Between May 2011 and October 2014, 60 consecutive patients with low- and intermediate-risk prostate cancer were treated; the median followup was 51 months (range 30-79). All patients received one implant and one fraction of 20.5 Gy HDR real-time U/S planned with transperineal hyaluronic acid injection into the perirectal...
July 18, 2018: Brachytherapy
https://www.readbyqxmd.com/read/30025734/a-randomized-trial-of-the-optimum-duration-of-acoustic-pulse-thrombolysis-procedure-in-acute-intermediate-risk-pulmonary-embolism-the-optalyse-pe-trial
#20
Victor F Tapson, Keith Sterling, Noah Jones, Mahir Elder, Uttam Tripathy, Jayson Brower, Robert L Maholic, Charles B Ross, Kannan Natarajan, Pete Fong, Lee Greenspon, Houman Tamaddon, Amir R Piracha, Tod Engelhardt, John Katopodis, Vasco Marques, Andrew S P Sharp, Gregory Piazza, Samuel Z Goldhaber
OBJECTIVES: The aim of this study was to determine the lowest optimal tissue plasminogen activator (tPA) dose and delivery duration using ultrasound-facilitated catheter-directed thrombolysis (USCDT) for the treatment of acute intermediate-risk (submassive) pulmonary embolism. BACKGROUND: Previous trials of USCDT used tPA over 12 to 24 h at doses of 20 to 24 mg for acute pulmonary embolism. METHODS: Hemodynamically stable adults with acute intermediate-risk pulmonary embolism documented by computed tomographic angiography were randomized into this prospective multicenter, parallel-group trial...
July 23, 2018: JACC. Cardiovascular Interventions
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