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https://www.readbyqxmd.com/read/28325633/trends-in-the-use-of-stents-and-drug-eluting-stents-in-sinus-surgery
#1
REVIEW
Leah J Hauser, Justin H Turner, Rakesh K Chandra
Stenting has long been used in the paranasal sinuses with the goals of maintaining a patent sinus cavity during the postoperative healing process and preventing restenosis from inflammation or scarring. More recently, drug-eluting stents have been introduced. Steroid-impregnated dressings and implants appear to be safe, although likely have increased systemic absorption compared with topical nasal steroid sprays and rinses. There is evidence to support the use of steroid-releasing implants in the ethmoid cavity in the postoperative period; however, more study is needed to truly define the role of these implants...
March 18, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28235953/nickel-associated-delayed-multiple-white-matter-lesions-after-stent-assisted-coil-embolization-of-intracranial-unruptured-aneurysm
#2
Hun Soo Park, Ichiro Nakagawa, Shohei Yokoyama, Daisuke Wajima, Takeshi Wada, Yasushi Motoyama, Kimihiko Kichikawa, Hiroyuki Nakase
Metal-induced encephalopathy after stent-assisted coil embolization is extremely rare. The present report describes two patients who presented with symptomatic intracranial parenchymal edematous lesions after stent-assisted coil embolization. A 64-year-old woman underwent stent-assisted coil embolization for a left internal carotid artery aneurysm; 21 days after the procedure she presented with right hand weakness and MRI revealed multifocal white matter lesions. Another woman aged 52 years underwent stent-assisted coil embolization for right vertebral artery aneurysm; 18 days after the procedure she presented with left-sided sensory disturbance and MRI demonstrated multiple white matter lesions...
February 24, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28219914/nickel-associated-delayed-multiple-white-matter-lesions-after-stent-assisted-coil-embolization-of-intracranial-unruptured-aneurysm
#3
Hun Soo Park, Ichiro Nakagawa, Shohei Yokoyama, Daisuke Wajima, Takeshi Wada, Yasushi Motoyama, Kimihiko Kichikawa, Hiroyuki Nakase
Metal-induced encephalopathy after stent-assisted coil embolization is extremely rare. The present report describes two patients who presented with symptomatic intracranial parenchymal edematous lesions after stent-assisted coil embolization. A 64-year-old woman underwent stent-assisted coil embolization for a left internal carotid artery aneurysm; 21 days after the procedure she presented with right hand weakness and MRI revealed multifocal white matter lesions. Another woman aged 52 years underwent stent-assisted coil embolization for right vertebral artery aneurysm; 18 days after the procedure she presented with left-sided sensory disturbance and MRI demonstrated multiple white matter lesions...
February 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28207528/idiopathic-retroperitoneal-fibrosis-causing-unilateral-ureteral-and-sigmoid-colon-obstruction-a-case-report
#4
Ting Yan, Yujuan Wang, Zhijun Liu, Xiaolei Zhang, Qian Wu, Mingrong Xi
OBJECTIVE: The present report aimed to present a unique case of idiopathic retroperitoneal fibrosis (RPF) presenting features of unilateral ureteral and sigmoid colon obstruction. RPF is a rare disorder with unclear etiology. CASE REPORT: A 43-year-old female had a 10-day history of lower right abdominal and lumbar pain. Gynecological examination, ultrasound, and computed tomography (CT) were all suggestive of right ovarian tumor. An enhanced CT showed right-sided hydronephrosis...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28128720/surgical-complications-after-pediatric-renal-transplant
#5
Hakan Sözen, Kibriya Fidan, Onur Özen, Oğuz Söylemezoğlu, Aydın Dalgıç
OBJECTIVES: Renal transplant is the most appropriate treatment for both adult and pediatric patients with end-stage renal failure. Here, we analyzed surgical complications after pediatric renal transplant at our center. MATERIALS AND METHODS: We retrospectively analyzed data from patient files and hospital charts of pediatric patients who had renal transplant at our center (Gazi University, Ankara, Turkey). Our immunosuppression protocol, a calcineurin inhibitor-based triple regimen, was applied to all recipients (steroids, mycophenolic acid)...
January 27, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28109377/antineutrophil-cytoplasmic-antibody-associated-multiple-giant-saccular-aortic-aneurysms
#6
Ryoji Kinoshita, Tomohiro Mizuno, Tsuyoshi Hachimaru, Keiji Oi, Masafumi Yashima, Eiki Nagaoka, Tatsuki Fujiwara, Hidehito Kuroki, Dai Tasaki, Hirokuni Arai
We describe a very rare case of a 67-year-old man with multiple saccular aortic aneurysms throughout the entire aorta due to antineutrophil cytoplasmic antibody-associated vasculitis (AAV). The patient underwent staged aortic surgical procedures, including stent-graft insertion for a left iliac artery aneurysm, thoracic endovascular aortic repair for a descending aortic aneurysm, and total replacement of the ascending aorta and aortic arch with the use of high-dose steroids to control inflammation. The histologic findings demonstrated that the damage to the vasa vasorum of the adventitia resulting from AAV caused ischemia of the media, resulting in the formation of saccular aneurysmal changes...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28092201/evaluation-of-a-steroid-releasing-sinus-implant-for-the-treatment-of-patients-undergoing-frontal-sinus-surgery-for-chronic-rhinosinusitis
#7
Sean Bury, Ameet Singh
Management of the frontal sinus places great demands on the otolaryngologist. Given that the fronto-ethmoidal region is susceptible to recurrent inflammation, scarring, and stenosis, maintaining long-term patency of the frontal sinus is a difficult challenge. Oral and topical anti-inflammatory therapy, post-operative stenting, and 'home-brew' drug elution have been used for the treatment of the frontal sinus with mixed success. Recently an implant has been approved for post-operative placement into the frontal recess...
February 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28089777/bioresorbable-vascular-scaffold-to-treat-malignant-in-stent-restenosis-in-a-patient-with-nickel-allergy
#8
Alfonso Jurado-Román, María T López-Lluva, Ignacio Sánchez-Pérez, Jesús Piqueras-Flores, Ramón Maseda, Fernando Lozano-Ruíz-Poveda
Nickel is the most frequent allergen in patients with allergic contact dermatitis and nickel allergy has been associated with recurrent in-stent restenosis. However, it is often misdiagnosed because of a low suspicion threshold. It should be discarded in patients with recurrent in-stent restenosis, especially if their medical history reveals prior contact dermatitis. It is also noteworthy and rarely specified that even newer generation stents that use novel metal alloys also contain low amounts of nickel. To avoid the implantation of new stents containing this metal, when percutaneous coronary intervention is indicated, drug eluting balloons or bioresorbable vascular scaffolds associated with small doses of steroids could provide good alternatives of treatment...
January 2, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27977475/trabecular-micro-bypass-stent-use-in-necrotizing-scleritis
#9
Simrenjeet Sandhu, Lisa Heckler, Dean Mah, Michael W Dorey
PURPOSE: In this case report, we describe the successful implantation of multiple trabecular micro-bypass iStents in a patient with necrotizing scleritis. DESIGN: The study design is a case report. PARTICIPANTS: The participant was a patient who underwent multiple micro-bypass iStent surgery. METHODS: A 71-year-old man with primary open-angle glaucoma, diagnosed with necrotizing scleritis and treated with steroids consequently resulting in significantly elevated intraocular pressure in the right eye...
February 2017: Journal of Glaucoma
https://www.readbyqxmd.com/read/27913724/novel-application-of-steroid-eluting-stents-in-choanal-atresia-repair-a-case-series
#10
John N Bangiyev, Nandini Govil, Anthony Sheyn, Michael Haupert, Prasad John Thottam
PURPOSE: To describe the application of mometasone furoate eluting sinus stent technology in the treatment of choanal atresia (CA) in the hopes of preventing postsurgical stenosis. METHODS: We analyzed 3 consecutive patients aged 4 days to 16 years undergoing repair of CA at a tertiary pediatric hospital. Mometasone furoate eluting sinus stents were placed intraoperatively. Postoperative need for revision surgery as well as routine surveillance endoscopy were used to determine success of surgery...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27888909/topical-therapies-for-refractory-chronic-rhinosinusitis
#11
REVIEW
Akshay Sanan, Mindy Rabinowitz, Marc Rosen, Gurston Nyquist
Topical therapy has become an important tool in the otolaryngologist's armamentarium for refractory chronic rhinosinusitis (CRS). Daily high-volume sinonasal saline irrigation and standard metered-dose topical nasal steroid therapy are supported by the most evidence. Nonstandard topical sinonasal steroid therapies are a potential option for refractory CRS. Current evidence recommends against the use of topical antifungal therapy and topical antibiotic therapy delivered using spray and nebulized techniques in routine cases of CRS...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27853071/a-destabilized-case-of-stable-effort-angina-pectoris-induced-by-low-dose-adenosine-triphosphate
#12
Daisuke Sueta, Sunao Kojima, Yasuhiro Izumiya, Megumi Yamamuro, Koichi Kaikita, Seiji Hokimoto, Hisao Ogawa
A 79-year-old man was diagnosed with sudden deafness. He had previously experienced a suspected episode of angina pectoris. At a local hospital, after 500 mg of hydrocortisone and 80 mg adenosine triphosphate (ATP) were administered, he became aware of chest discomfort. An electrocardiogram revealed serious ST-segment depressions. He was diagnosed with a non-ST elevated myocardial infarction (NSTEMI). Emergency coronary angiography revealed triple vessel disease, and the lesion was successfully stented. The mechanisms whereby the stable effort angina pectoris destabilized in this case were thought to include a reduction of the local blood flow because of an ATP product and probable thrombus formation in response to the administered steroids...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27835929/endoscopic-treatment-of-benign-esophageal-strictures-a-literature-review
#13
Laurent Poincloux, Olivier Rouquette, Armand Abergel
Benign esophageal strictures arise from various etiologies and are frequently encountered. Although endoscopic dilation is still the first-line therapy, recurrent strictures do occur in approximately 10% of the cases and remains a challenge to gastroenterologists. Areas covered: A literature search was performed using PubMed and Google Scholar databases for original and review articles on endoscopic treatment of benign esophageal strictures. This review outlines the main available treatment options and its controversies in the management of refractory benign esophageal strictures...
January 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27803770/update-on-endoscopic-management-of-gastric-outlet-obstruction-in-children
#14
REVIEW
Hsun-Chin Chao
Endoscopic balloon dilatation (EBD) and surgical intervention are two most common and effective treatments for gastric outlet obstruction. Correction of gastric outlet obstruction without the need for surgery is an issue that has been tried to be resolved in these decades; this management has developed with EBD, advanced treatments like local steroid injection, electrocauterization, and stent have been added recently. The most common causes of pediatric gastric outlet obstruction are idiopathic hypertrophic pyloric stenosis, peptic ulcer disease followed by the ingestion of caustic substances, stenosis secondary to surgical anastomosis; antral web, duplication cyst, ectopic pancreas, and other rare conditions...
October 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27738457/the-effect-of-steroid-therapy-on-postoperative-inflammatory-response-after-endovascular-abdominal-aortic-aneurysm-repair
#15
Kazuto Maruta, Atsushi Aoki, Tadashi Omoto, Hirofumi Iizuka, Hiroyuki Kawaura
Objectives: Unexpected systemic inflammatory response with high fever and increase in C-reactive protein (CRP) occurred frequently after endovascular abdominal aortic aneurysm repair (EVAR). This excessive inflammatory response affects the postoperative course. We evaluated the effects of steroid on the postoperative inflammatory response after EVAR. Methods: Steroid therapy, intravenous infusion of methylprednisolone 1000 mg just after the anesthesia induction, was started since December 2012. After induction of the steroid therapy, 25 patients underwent EVAR with steroid therapy (Group S)...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/27687827/esophageal-stricture-after-endoscopic-submucosal-dissection-treated-successfully-by-temporary-stent-placement
#16
Takahisa Yamasaki, Toshihiko Tomita, Mayu Takimoto, Yoshio Ohda, Tadayuki Oshima, Hirokazu Fukui, Jiro Watari, Hiroto Miwa
The growing use of endoscopic submucosal dissection (ESD) has enabled the highly curative treatment of early esophageal cancer. The circumferential extent of the tumor is reportedly related to the frequency of post-treatment stricture, with postoperative esophageal stricture reported to occur frequently when the post-resection mucosal defect exceeds 75 % of the esophageal luminal circumference. In some clinical cases, locally injected or orally administered steroids aimed at preventing post-treatment stricture fail to prevent re-stricture...
December 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27679466/spontaneous-biliary-peritonitis-with-common-bile-duct-stones-report-of-a-case
#17
Ryoga Hamura, Koichiro Haruki, Jun Tsutsumi, Sumio Takayama, Hiroaki Shiba, Katsuhiko Yanaga
Spontaneous biliary peritonitis is rare in adults. We herein report a case of spontaneous biliary peritonitis. An 84-year-old man was admitted to our hospital for abdominal pain for 5 days. He developed fever, jaundice, and abdominal rigidity. Computed tomography (CT) revealed massive ascites in the omental bursa and around the liver. The ascites obtained by diagnostic paracentesis was dark yellow-green in color, which implied bile leakage. With a diagnosis of bile peritonitis, the patient underwent emergency exploratory laparotomy...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27649104/intraparenchymal-hematoma-as-a-late-complication-of-retrograde-intrarenal-surgery
#18
Sedat Yahsi, Senol Tonyali, Cavit Ceylan, Kenan Y Yildiz, Levent Ozdal
A 34 year-old woman was admitted to our hospital with left flank pain. A non-contrast enhanced computerized tomography (NCCT) revealed a 1.5x2cm left proximal ureter stone. Patient was scheduled for ureterorenoscopy (URS) and stone removal. She was submitted to retrograde intrarenal surgery (RIRS). At the postoperative 1st day, the patient began to suffer from left flank pain. A NCCT was taken, which revealed a subcapsular hematoma and perirenal fluid. The patient was managed conservatively with intravenous fluid, antibiotic and non-steroidal anti-inflammatory drug therapy and was discharged at the postoperative 6th day...
March 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27633158/use-of-a-lumen-apposing-metal-stent-to-treat-gi-strictures-with-videos
#19
Shayan Irani, Sujai Jalaj, Andrew Ross, Michael Larsen, Ian S Grimm, Todd H Baron
BACKGROUND AND AIMS: Benign gastrointestinal strictures occur typically in the esophagus and pyloric channel, but can occur anywhere in the GI tract and at anastomotic sites. Such strictures can be treated with dilation, incisional therapy, steroid injection and stents. Our aim was to describe the use of a lumen-apposing metal stent (LAMS) to treat short, benign gastrointestinal strictures. PATIENTS AND METHODS: Retrospective review of consecutive patients who underwent LAMS placement for various benign strictures at 2 tertiary care centers from August 2014 to November 2015...
September 12, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27540582/transpapillary-biliary-stenting-is-a-risk-factor-for-pancreatic-stones-in-patients-with-autoimmune-pancreatitis
#20
Hiroyuki Matsubayashi, Yoshihiro Kishida, Tomohiro Iwai, Katsuyuki Murai, Masao Yoshida, Kenichiro Imai, Yusuke Yamamoto, Masataka Kikuyama, Hiroyuki Ono
BACKGROUND AND STUDY AIM: Pancreatic stones occasionally develop in autoimmune pancreatitis (AIP), often worsen endocrine and exocrine functions, and occasionally cause pain attacks. However, the risks of pancreatic stones in AIP have been poorly studied. The aim of this study was to analyze the risk factors associated with pancreatic stone formation in cases of AIP. PATIENTS AND METHODS: In total, 50 patients with AIP (39 males, 11 females; mean age 64.0 years), followed up for at least a year, were analyzed for their demographic and clinical findings and pancreatic stone occurrence...
August 2016: Endoscopy International Open
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