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Guide stents

Tommaso Gori
An impaired function of the coronary endothelium is an important determinant of all stages of atherosclerosis, from initiation, to mediation of functional phenomena-such as spasm and plaque erosion, to atherothrombotic complications. Endothelial function is modified by therapies, including stent implantation. Finally, endothelial function changes over time, in response to physical stimuli and pharmocotherapies, and its assessment might provide information on how individual patients respond to specific therapies...
December 2, 2018: International Journal of Molecular Sciences
Tanyaporn Chantarojanasiri, Natsuyo Yamamoto, Yousuke Nakai, Tomotaka Saito, Kei Saito, Ryunosuke Hakuta, Kazunaga Ishigaki, Tsuyoshi Takeda, Rie Uchino, Naminatsu Takahara, Suguru Mizuno, Hirofumi Kogure, Saburo Matsubara, Minoru Tada, Hiroyuki Isayama, Kazuhiko Koike
Background and study aims  While endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collection (PFC) is recommended to be performed ≥ 4 weeks after onset of acute pancreatitis (AP), early (< 4 weeks) interventions are needed in some symptomatic cases. Despite feasibility of early percutaneous drainage, there have been few studies about early EUS-guided drainage of PFC. Patients and methods  Consecutive patients who received EUS-guided drainage (EUS-PCD) of infected or symptomatic PFC at the University of Tokyo were retrospectively studied...
December 2018: Endoscopy International Open
Adrien Sportes, Gheoghe Airinei, Ralph Kamel, Jean Jacques Raynaud, Robert Benamouzig
Background and study aims  Endoscopic retrograde cholangiopancreatography (ERCP) in patients with a preexisting duodenal stent is particularly challenging and has a low success rate. Endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) has been increasingly used as an alternative to percutaneous transhepatic biliary drainage after failed ERCP. EUS-guided choledochoduodenostomy (EUS-CD) and EUS-guided hepaticogastrostomy (EUS-HGS) have been reported to have similar efficacity. Recently, a novel dedicated fully-covered lumen-apposing metal stent (LAMS) has been developed for EUS-CD (Hot AXIOS; Boston Scientific, Massachusetts, United States)...
December 2018: Endoscopy International Open
Parth J Parekh, Mohammad H Shakhatreh, Paul Yeaton
Background and study aims  Endoscopic ultrasound (EUS)-guided gastroenterostomy is a novel, off-label, procedure that has been facilitated by availability of a novel lumen apposing metal stent (LAMS) (Axios, Boston Scientific, Marlbourough Massachusetts, United States). The literature suggests its efficacy to be comparable to surgical gastrojejunostomy. In theory, this procedure overcomes the issues associated with woven enteral stents, which are subject to continuous, straightening, axial forces. We report the adverse event of tissue ingrowth in an Axios stent placed as an EUS-guided gastroduodenostomy, resulting in recurrence of gastric outlet obstruction, treated by a stent-inside-stent technique...
December 2018: Endoscopy International Open
Mario D'Oria, Marco Pipitone, Francesco Riccitelli, Davide Mastrorilli, Cristiano Calvagna, Francesca Zamolo, Filippo Griselli
PURPOSE: To report an alternative approach for rescue of an occluded aortofemoral bypass using the Gore Excluder Iliac Branch Endoprosthesis (IBE). CASE REPORT: A 52-year-old man presented with acute right limb ischemia because of displaced and occluded iliac stents and was treated with aortofemoral bypass. On the third postoperative day, there was early bypass failure due to distal embolization from aortic thrombus. After fluoroscopy-guided balloon thrombectomy of the bypass, an endovascular bailout strategy was used...
November 30, 2018: Journal of Endovascular Therapy
Shigemitsu Shirai, Keisuke Hirano, Kenji Makino, Yosuke Honda, Masakazu Tsutsumi, Shinsuke Mori, Yasunari Sakamoto, Norihiro Kobayashi, Motoharu Araki, Masahiro Yamawaki, Yoshiaki Ito
Following an era of the use of several drug-coated balloons in angioplasty, "leave nothing behind" and stent-less strategies have been gaining attention. In stent-less strategies, it is necessary to avoid major dissections and limit flow. Balloon dilation is an important step in vessel preparation. In this study, we report a novel pre-dilation technique. We performed prolonged balloon inflation for >10 min after normal ballooning in a procedure to treat an occluded lesion in the superficial femoral artery (SFA)...
November 26, 2018: Annals of Vascular Surgery
Yoshinobu Onuma, Yuki Katagiri, Francesco Burzotta, Niels Ramsing Holm, Nicolas Amabile, Takayuki Okamura, Gary S Mintz, Olivier Darremont, Jens Flensted Lassen, Thierry Lefèvre, Yves Louvard, Goran Stankovic, Patrick W Serruys
Coronary artery bifurcation lesions comprise approximately 15-20% of all PCI and constitute a complex lesion subgroup. Intravascular optical coherence tomography (OCT) is a promising adjunctive tool for guiding coronary bifurcation with its unrivalled high resolution. Compared to angiography, intravascular OCT has a clear advantage to depict ostial lesion(s) in bifurcation without misleading 2-dimensional appearance of the conventional angiography such as overlap and foreshortening. In addition, OCT has the ability of reconstructing a bifurcation in three dimension and assessing the side branch ostium from 3D reconstruction of main vessel pullback, which can be applied to ensure the optimal recrossing position of the wire after main vessel stenting...
November 27, 2018: EuroIntervention
Daniel Quandt, Walter Knirsch, Ina Michel-Behnke, Erwin Kitzmüller, Miko Obradovic, Frank Uhlemann, Oliver Kretschmar
BACKGROUND: Stent implantation into growing vessels is a common treatment option in infants and children with congenital heart disease (CHD) and corresponding vessel lesions. After stent implantation in small children, repetitive stent redilations are frequently necessary to accommodate for somatic growth. Until now, all available stents have limited final expansion diameters. MATERIAL AND RESULTS: The new Bentley BeGrow™ stent system for newborns and infants is a L605 cobalt‑chromium, pre-mounted, balloon expandable stent, which is compatible with a 4 French sheath and 0...
November 19, 2018: International Journal of Cardiology
Hozan Mufty, Steffen Rex, Inge Fourneau, Geert Maleux
Endovascular treatment of both type A and type B aortic dissection complicated by organ malperfusion is gaining increasing interest and evidence. Different fenestration techniques of the dissection membrane have already been described. We present a 53-year-old patient with complicated type A aortic dissection after previous repair of the ascending aorta. The patient was treated with dissection membrane fenestration and 'chees-wire' technique. Due to the mobility of the dissection flap, we encountered problems to perforate the dissection membrane with the use of a needle...
November 23, 2018: Annals of Vascular Surgery
Zhijie Wang, Shengbing Zhao, Qianqian Meng, Shuling Wang, Yan Chen, Fuming Wang, Qiang Li, Jun Yao, Yiqi Du, Zhendong Jin, Yu Bai, Zhaoshen Li, Dong Wang
BACKGROUND AND OBJECTIVE: Endoscopic transmural drainage has been recognized as the first-line treatment for pancreatic fluid collection (PFC). Currently, three different types of stents have been extensively applied, including double pigtail plastic stent (PS), fully covered self-expanding metal stent (FCSEMS) and novel lumen-apposing metal stent (LAMS). Nonetheless, limited data are available about the comparison among them in terms of their clinical outcomes and safety for endoscopic ultrasound (EUS)-guided drainage of PFC...
November 26, 2018: Journal of Gastroenterology and Hepatology
Yousuke Nakai, Hirofumi Kogure, Hiroyuki Isayama, Kazuhiko Koike
Endoscopic transpapillary biliary drainage is the current standard of care for unresectable hilar malignant biliary obstruction (MBO) and bilateral metal stent placement is shown to have longer patency. However, technical and clinical failure is possible and percutaneous transhepatic biliary drainage (PTBD) is sometimes necessary. Endoscopic ultrasound-guided biliary drainage (EUS-BD) is increasingly being reported as an alternative rescue procedure to PTBD. EUS-BD has a potential advantage of not traversing the biliary stricture and internal drainage can be completed in a single session...
November 29, 2018: Clinical Endoscopy
Junsu Lee, Jin Ho Chang
Complete blockage of a coronary artery, called chronic total occlusion (CTO), frequently occurs due to atherosclerosis. To reopen the obstructed blood vessels with a stent, guidewire crossing is performed with the help of angiography that can provide the location of CTO lesions and the image of guidewire tip. Since angiography is incapable of imaging inside a CTO lesion, the surgeons are blind during guidewire crossing. For this reason, the success rate of guidewire crossing relies upon the proficiency of the surgeon, which is considerably reduced from 69...
November 21, 2018: Sensors
Takeshi Ogura, Nobu Nishioka, Akira Miyano, Rieko Kamiyama, Kazuhide Higuchi
No abstract text is available yet for this article.
November 23, 2018: Endoscopy
Leslie Mertz
When an artery is blocked, stents are often the best way to open up the vessel. A mesh stent is tightly crimped over a tiny balloon and guided to the troubled spot; the balloon is inflated, expanding the stent, which forces the vessel open. Blood flow is restored.
November 2018: IEEE Pulse
Viviane G Nasr, Ryan Callahan, Zachary Wichner, Kirsten C Odegard, James A DiNardo
Pulmonary vein stenosis (PVS) is a rare disorder that leads to progressive narrowing of the extrapulmonary veins. PVS has been reported in both children and adults and in its worse iteration leads to pulmonary hypertension, right ventricular failure, and death. Multiple etiologies of PVS have been described in children and adults. This review will focus on intraluminal PVS in children. Intraluminal PVS has an estimated incidence ranging from 0.0017% to 0.03%. It is associated with conditions such as prematurity, bronchopulmonary dysplasia, necrotizing enterocolitis, Smith-Lemli-Opitz syndrome, and Down syndrome...
November 16, 2018: Anesthesia and Analgesia
Saransh Jain, Sundeep Lakhtakia, D N Reddy
A 40-year-old male underwent EUS guided drainage for symptomatic large WON (15 x 9 cm) due severe acute pancreatitis 6 months ago. The initial steps of EUS guided cysto-gastrostomy with BFMS (needle puncture, passage of guidewire, creation of fistula using co-axial 6Fr cystotome and dilation of track with 4mm balloon) were uneventful. However, there was significant resistance to cross the wall of WON while passing the stent assembly (NAGI stent, Taewoong Medical) over the guidewire. Subsequently, the stent assembly was withdrawn and its inspection revealed that conical plastic tip was loose and migrated within the blunt sheath of the delivery system...
November 18, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Babikir Kheiri, Mohammed Osman, Ahmed Abdalla, Tarek Haykal, Adam Chahine, Meghan Gwinn, Sahar Ahmed, Mustafa Hassan, Ghassan Bachuwa, Deepak L Bhatt
BACKGROUND: Despite the high prevalence of ischemic heart disease in older patients, there is a substantial lack of evidence to guide clinical decision-making in this population. Hence, we performed a meta-analysis to determine the safety and efficacy of percutaneous coronary intervention (PCI) with drug-eluting stents (DES) versus bare-metal stents (BMS). METHODS: Electronic databases were searched for randomized trials comparing DES with BMS in patients ≥70 years-old...
November 7, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Alberto Larghi, Mihai Rimbaș, Andrea Tringali, Ivo Boškoski, Gianenrico Rizzatti, Guido Costamagna
Radiofrequency ablation (RFA) acts by delivering thermal energy within the tissue, the result of a high-frequency alternating current released from an active electrode, leading to coagulative necrosis and cellular death. Recently, a biliary catheter working on a guide-wire has been developed and a number of studies have been performed so far. The present paper provides a comprehensive review of the literature on the results of the use of RFA for the clinical management of patients with unresectable malignant biliary strictures, benign biliary strictures, and residual adenomatous tissue in the bile duct after endoscopic papillectomy...
November 16, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Masahiro Itonaga, Masayuki Kitano, Keiichi Hatamaru, Takashi Tamura, Junya Nuta, Yuki Kawaji, Mamoru Takenaka, Kosuke Minaga, Masatoshi Kudo, Takeshi Ogura, Kazuhide Higuchi, Yasutaka Chiba
OBJECTIVES: When endoscopic retrograde cholangiopancreatography (ERCP) fails in patients with malignant distal biliary obstruction, endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) is an alternative. It associates with high technical and clinical success rates but also high adverse events rates. This prospective cohort study was aimed to evaluate the clinical efficacy and safety of EUS-CDS with our newly developed partially-covered self-expandable metal stent with a thin delivery system...
November 16, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Kazuhiro Minami, Eisuke Iwasaki, Takao Itoi, Seiichiro Fukuhara, Masayasu Horibe, Takashi Seino, Shintaro Kawasaki, Tadashi Katayama, Yoichi Takimoto, Hiroki Tamagawa, Yujiro Machida, Yasuo Hamamoto, Haruhiko Ogata, Takanori Kanai
Background and study aims  We report the effectiveness of a newly developed plastic stent for preventing bile leakage after endoscopic ultrasonography (EUS)-guided antegrade stenting. This treatment was performed on a 59-year-old woman with malignant obstructive jaundice caused by peritoneal metastasis. First, we attempted transpapillary drainage using short-type single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography, but we could not achieve it. We then attempted EUS-guided antegrade stenting through the intrahepatic bile duct from the esophagojejunal anastomosis...
November 2018: Endoscopy International Open
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