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Endoluminal Stent

Antonino Granata, Michele Amata, Mario Traina
A 32-year-old gentleman underwent a laparoscopic wedge resection of the stomach for gastrointestinal stromal tumor, with subsequent anastomotic dehiscence treated with urgent surgical revision. Following acute abdominal pain and severe sepsis, the patient was directly referred for a total gastrectomy with esophago-jejunal anastomosis. This article is protected by copyright. All rights reserved.
March 11, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Rajsrinivas Parthasarathy, Vipul Gupta, Aditya Gupta
OBJECTIVES: Blister like aneurysm (BLA) is extremely challenging to treat; endoluminal reconstruction has emerged as the most promising treatment method. When to treat after the ictus, the timing of administration of antiplatelet and causal relationship between platelet function testing results and thromboembolism is unclear. We theorized that Prasugrel with a lower incidence of resistance may be a safe suitable alternative to clopidogrel in patients treated with a flow diverter. METHODS: Prospectively collected data from consecutive patients treated for a ruptured blister with a flow diverter was reviewed...
March 6, 2018: British Journal of Radiology
Amandeep S Taggar, Kenneth L Pitter, Gil'ad N Cohen, Mark Schattner, Hans Gerdes, Arnold J Markowitz, David Ilson, Paul Brady, John J Cuaron, Karyn A Goodman, Abraham J Wu
PURPOSE: Management of locally recurrent or persistent esophageal cancer (EC) after standard chemoradiation is challenging. This study updates our experience of treating medically inoperable EC patients with endoluminal high-dose-rate brachytherapy (EHDRBT) including the patients treated with a novel multiballoon channel centering esophageal applicator. METHODS AND MATERIALS: Thirty-three consecutive patients with early-stage primary (n = 7), posttreatment persistent (n = 7), and recurrent (n = 19) EC treated with EHDRBT at our institution were included...
February 26, 2018: Brachytherapy
Richard Tsai, Demetrios Raptis, Constantine Raptis, Vincent M Mellnick
Traumatic abdominal aortic injury (TAAI) is a severe complication of penetrating and blunt trauma with significant morbidity and mortality, particularly if diagnosis is delayed. In patients with life-threatening injuries, accurate and prompt diagnosis of TAAI can be made with computed tomography (CT). Once the diagnosis of TAAI is made, the radiologist should provide an accurate description of the aortic lesion and the extent of injury in order to guide management whether it be non-operative, open aortic repair, or endoluminal stent repair...
February 28, 2018: Abdominal Radiology
C E Munro, Gfw Stamp, A W Phillips, S M Griffin
The use of endoluminal stents to treat anastomotic leaks post oesophagogastric resection remains controversial. While some advocate stents to expedite recovery, others advise caution due to the risk of major morbidity and mortality. We describe a case of anastomotic leak following total gastrectomy for adenocarcinoma treated with a self-expanding metallic stent. Complications with the initial stent were treated with a further stent, which compromised the function of the oesophagus and eroded into the aorta, necessitating a colonic reconstruction and endovascular aortic stenting...
January 24, 2018: Annals of the Royal College of Surgeons of England
Ying-Nan Tsai, Hsiu-Po Wang, Chih-Kun Huang, Po-Chin Chang, I-Chang Lin, Chi-Ming Tai
Postoperative leak is a serious complication of bariatric surgery and often results in significant morbidity and mortality. Stent placement is a less invasive alternative to surgery for the treatment of bariatric surgical leak. We evaluated the efficacy and complications of covered self-expandable metal stents (SEMS) in the treatment of post-bariatric surgical leak. We retrospectively reviewed patients who underwent stent placement for leak after bariatric surgery. Leak was diagnosed by upper gastrointestinal series or was visualized during the endoscopy...
January 2018: Kaohsiung Journal of Medical Sciences
Panagiotis Kallidonis, Dimitrios Kotsiris, Francesco Sanguedolce, Panteleimon Ntasiotis, Evangelos Liatsikos, Athanasios Papatsoris
Objective: To review the literature on the effectiveness, safety and long-term patency of ureteric metal mesh stents (MSs), as a variety of MSs have been used for managing malignant ureteric obstruction over the last three decades. Materials and methods: A systematic review using the search string; Ureter∗ AND (stent OR endoprosthesis) AND metal∗ was conducted on PubMed, Scopus, Web of science and Cochrane Library online databases in May 2016. Prospective, retrospective, and comparative studies including MSs were included...
December 2017: Arab Journal of Urology
Marc Bludau, Hans F Fuchs, Till Herbold, Martin K H Maus, Hakan Alakus, Felix Popp, Jessica M Leers, Christiane J Bruns, Arnulf H Hölscher, Wolfgang Schröder, Seung-Hun Chon
BACKGROUND: Esophageal perforations and postoperative leakage of esophagogastrostomies are considered to be life-threatening conditions due to the potential development of mediastinitis and consecutive sepsis. Vacuum-assisted closure (VAC) techniques, a well-established treatment method for superficial infected wounds, are based on a negative pressure applied to the wound via a vacuum-sealed sponge. Endoluminal VAC (E-VAC) therapy as a treatment for GI leakages in the rectum was introduced in 2008...
April 2018: Surgical Endoscopy
Piero V Valli, Joachim C Mertens, Arne Kröger, Christoph Gubler, Christian Gutschow, Paul M Schneider, Peter Bauerfeind
BACKGROUND AND STUDY AIMS:  Endoluminal vacuum therapy (EVT) has evolved as a promising option for endoscopic treatment of foregut wall injuries in addition to the classic closure techniques using clips or stents. To improve vacuum force and maintain esophageal passage, we combined endosponge treatment with a partially covered self-expandable metal stent (stent-over-sponge; SOS). PATIENTS AND METHODS:  Twelve patients with infected upper gastrointestinal wall defects were treated with the SOS technique...
February 2018: Endoscopy
Helga C A W Alhinho, Flávio C Ferreira, Rodrigo C L Medeiros, Álvaro A B Ferraz, Josemberg M Campos
BACKGROUND: Gastric leak is a severe complication of gastric bypass that is associated with significant morbidity and mortality. Anastomosis dehiscence usually occurs at gastrojejunal anastomosis and can appear simultaneously with gastric leak, for which treatment can be a challenge. Fistula may have several clinical impacts, depending on patient-related factors, fistula characteristics, onset time, and therapy proposal. Abdominal toilet, drainage, gastrostomy, and revisional surgery constitute the traditional approaches to dehiscence and fistula closure, with variable results...
February 2018: Obesity Surgery
R Kallel, R Hakim, G Rangé
Stent thrombosis (ST) is still a dreadful and threatening complication of percutaneous coronary intervention (PCI) with a high risk of morbi-mortality. Nevertheless, it becomes exceptional (0.6% at 1 year and 0.15%/year later) thanks to improvement of stents and use of new P2Y12 inhibitors. Endo-coronary imaging and especially Optical Coherence Tomography (OCT) change radically its understanding with revealing quiet systematic morphologic endoluminal abnormalities (97% of the cases). OCT becomes an essential tool in practice (ESC recommendation class IIa) and allows a therapeutic strategy optimization...
December 2017: Annales de Cardiologie et D'angéiologie
Michael Karsy, Jian Guan, Andrea A Brock, Anubhav Amin, Min S Park
PURPOSE OF REVIEW: Stents and flow diverters have revolutionized the treatment of cerebrovascular disease. Guglielmi coils, flexible microcatheters, and first-generation intracranial stents, such as Neuroform (Stryker Neurovascular) and Enterprise stents (Codman/DePuy-Synthes), have paved the way for the development of the Pipeline Embolization Device (PED) (ev3/Covidien/Medtronic) and other endovascular approaches. RECENT FINDINGS: This review discusses the historical development of flow diverter technologies from the PED to similar devices, such as the Surpass stent (Stryker Neurovascular), the Flow-Redirection Endoluminal Device (FRED; MicroVention, Inc...
October 28, 2017: Current Neurology and Neuroscience Reports
Guy Pines, Ilan Bar, Amir Elami, Shimon Sapojnikov, Ofir Hikri, Dennis Ton, Bruce Mosenkis, Ehud Melzer
BACKGROUND: Endoscopic vacuum-assisted closure (EVAC) therapy is increasingly being used as a new promising method for repairing upper gastrointestinal defects of different etiologies with high success rates. EVAC therapy consists of placing a sponge either within the lumen or within an abscess cavity connected with a nasogastric (NG) tube to a negative pressure system, thus decreasing bacterial contamination and edema and promoting granulation tissue proliferation, thereby gradually decreasing the cavity size until complete closure...
January 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Ezel Yaltirik Bilgin, Baran Önal, Hakan Emmez, Koray Akkan, Erhan Ilgit, Erkan Bilgin, Emetullah Cindil, Alp Ozgun Borcek
AIM: We report our experience with flow diverter devices in the treatment of intracranial aneurysms arising from anterior circulation with mid and long-term follow-up. MATERIAL AND METHODS: 78 aneurysms in 61 patients (range 25-81 years, 13 male, 48 female) were treated with flow diverter devices. 40 (51,3%) aneurysms were treated with pipeline embolization device (PED), 24 (30,8%) aneurysms were treated with SILK stent, 12(15,4%) aneurysms were treated with flow redirection endoluminal device (FRED) and two aneurysms were treated with P64 Flow Modulation Device (P64)...
July 11, 2017: Turkish Neurosurgery
Yoshikazu Matsuda, Joonho Chung, Kiffon Keigher, Demetrius Lopes
OBJECT: The aim of this study is to demonstrate the differences between the new Low-profile Visualized Intraluminal Support (LVIS Blue) stenting device and the Flow Redirection Endoluminal Device (FRED) using a series of bench-top evaluations and optical coherence tomography (OCT) images in a cadaveric preparation of the basilar artery. METHODS: The first part of the evaluation was bench-top microscopic documentation of metal coverage for LVIS Blue and FRED stents...
September 22, 2017: Journal of Neurointerventional Surgery
Luis E Savastano, Neeraj Chaudhary, Carlos Murga-Zamalloa, Michael Wang, Thomas Wang, B Gregory Thompson
BACKGROUND: Angioscopy - or endovascular endoscopy - is a catheter-based technique employing a flexible fiberoptic angioscope to directly visualize arterial lumen. Poor resolution and excessive stiffness of pre-existent angioscopes limited their use clinically. Recent advances resulted in novel fused optical fiber bundle angioscopes with improved flexibility and imaging resolution. Use of these devices in endovascular neurosurgery is still largely unexplored. OBJECTIVE: To evaluate image quality and feasibility of optical angioscopes for diagnostic and interventional neuro-angioscopy in carotid arteries of human cadavers...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
D Benedix, F Meyer, F Fischbach, A Janitzky, Z Halloul
Introduction Abnormal links between the arterial system and other luminal systems are a challenge to those in charge of their adequate diagnostic and therapeutic management. Objective Scientific case report on an individual who underwent successful treatment combining vascular-surgical and interventional radiology techniques for a rare right uretero-iliac artery fistula based on personal clinical experience, a selective literature research and a detailed discussion of current recommendations for diagnostic workup and subsequent treatment...
September 20, 2017: Aktuelle Urologie
J T Ali, R D Rice, E A David, J D Spicer, J J Dubose, L Bonavina, S Siboni, T A O'Callaghan, X Luo-Owen, S Harrison, C G Ball, J Bini, G A Vercruysse, D Skarupa, C C Miller Iii, A L Estrera, K G Khalil
The treatment of esophageal perforation (EP) remains a significant clinical challenge. While a number of investigators have previously documented efficient approaches, these were mostly single-center experiences reported prior to the introduction of newer technologies: specifically endoluminal stents. This study was designed to document contemporary practice in the diagnosis and management of EP at multiple institutions around the world and includes early clinical outcomes. A five-year (2009-2013) multicenter retrospective review of management and outcomes for patients with thoracic or abdominal esophageal perforation was conducted...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Shayan Irani, Todd H Baron, Takao Itoi, Mouen A Khashab
PURPOSE OF REVIEW: Gastric outlet obstruction (GOO) can result from benign and malignant causes. Until recently, surgical gastrojejunostomy was the treatment of choice for patient with benign and malignant GOO with a good functional status. Endoscopic placement of luminal self-expandable metal stents is currently widely accepted as the first line of treatment for malignant GOO because of its effectiveness and minimally invasive nature. The main shortcoming of luminal stents is the high incidence of recurrent GOO most commonly because of tumor ingrowth/overgrowth...
September 2017: Current Opinion in Gastroenterology
M Mizandari, T Azrumelashvili, J Kumar, N Habib
PURPOSE: The aim of this study is to provide a technical detail and feasibility of percutaneous image-guided pancreatic duct (PD) drainage and to discuss its subtleties in a series of patients with obstructed PD. MATERIALS AND METHODS: Thirty patients presenting with PD obstruction from pancreatic head tumour or pancreatitis were subjected to percutaneous image-guided PD drainage under a guidance of ultrasound or computed tomography. Following the successful puncture of PD, a locking loop drainage catheter was placed using conventional guidewire techniques under real-time fluoroscopy guidance...
July 5, 2017: Cardiovascular and Interventional Radiology
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