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retrograde access

Toshikatsu Nitta, Yoshihide Chino, Jun Kataoka, Masahito Ohta, Tomo Tominaga, Kensuke Fujii, Takashi Ishibashi
INTRODUCTION: A 50-year-old Japanese man presented with obstructive jaundice. We performed endoscopic retrograde biliary drainage before biliary decompression. CT showed a thickened gallbladder wall with low-density areas and a 35-mm gallstone; the stone was impacted in the gallbladder neck and cystic duct. The patient was therefore diagnosed with Mirizzi syndrome (type II or III) and scheduled for laparoscopic treatment. We performed subtotal cholecystectomy and intraoperative choledochoscopy because we recognized a fistula between the gallbladder and common bile duct preoperatively...
December 13, 2018: Asian Journal of Endoscopic Surgery
A Claire Watkins, Alla Avramenko, Raphael Soler, Dominique Fabre, Stephan Haulon
The off-the-shelf t-Branch device (Cook Medical, Bloomington, Ind) significantly advanced the endovascular treatment of ruptured thoracoabdominal aortic aneurysms. Improved techniques for expeditious implantation of the t-Branch may improve clinical outcomes for this emergent procedure. Currently, implantation is described using axillary and femoral access. We describe the repair of a ruptured thoracoabdominal aortic aneurysm exclusively through femoral access aided by a steerable sheath and newer generation, low-profile bridging stents...
December 2018: Journal of Vascular Surgery Cases and Innovative Techniques
Frédéric Borel, Julien Branche, Grégory Baud, Romain Gérard, François Pattou, Robert Caiazzo
BACKGROUND: The incidence of biliary lithiasis is increased after bariatric surgery due to rapid weight loss [1]. Trans-oral endoscopic management in cases of common bile duct gallstone complication is not possible in patients with Roux-en-Y gastric bypass (RYGB) due to the modified anatomy. Access to the biliary tree after RYGB with a classical direct surgical approach of common bile duct and choledocoscopy can be used, but may be complicated in situations of acute cholangitis because of the fragility of common duct, or in cases of previous cholecystectomy...
December 11, 2018: Obesity Surgery
Thierry Corcos
Since its introduction by Lucien Campeau three decades ago, percutaneous radial artery approach at the forearm has been shown to provide advantages over the femoral approach and has become the standard approach for coronary angiography and intervention. Though infrequent, vascular complications still remain, mainly radial artery occlusion. Therefore, a more distal radial approach at the snuffbox or at the dorsum of hand has been suggested, initially by anethesiologists for perioperative patient monitoring, and more recently by Babunashvili et al...
December 11, 2018: Catheterization and Cardiovascular Interventions
Jeffrey J Siracuse, Alik Farber, Thomas W Cheng, Stephen J Raulli, Douglas W Jones, Jeffrey A Kalish, Matthew R Smeds, Denis Rybin, Marc L Schermerhorn
OBJECTIVE: Ipsilateral antegrade access (AA) is an alternative access option for contralateral retrograde access (RA) in treating infrainguinal occlusive disease. Our goal was to assess whether AA is associated with higher access site complications. METHODS: The Vascular Quality Initiative database was searched from 2010 to 2017 for all infrainguinal peripheral vascular interventions. Cases without access through the common femoral artery or those with multiple accesses were excluded...
December 4, 2018: Journal of Vascular Surgery
Tzevat Tefik, Salvatore Buttice, Bhaskar Somani, Selçuk Erdem, Tayfun Oktar, Faruk Özcan, Taner Koçak, İsmet Nane, Olivier Traxer
BACKGROUND: Ureteral access sheaths (UASs) are commonly used in retrograde intra-renal surgery (RIRS). Despite their advantages, there is a risk of ureteral trauma during their placement and subsequent stricture following surgery. The aim of this study was to evaluate the UAS force of insertion (FOI) during placement and its impact on ureteral trauma. METHODS: Seven female patients who underwent RIRS for kidney stones were included in the study. A digital force gauge (Chatillon DFX II; Ametek Test and Calibration Instruments, Largo, Florida, USA) was connected to the distal end of the UAS and the UAS FOI was continuously measured during insertion...
November 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Kamaljot S Kaler, Egor Parkhomenko, Cyrus Y Lin, Zachary A Valley, William K Kim, Zhamshid Okhunov, Roshan M Patel, Jaime Landman
Background: A minority of urologists performing percutaneous nephrolithotomy (PCNL) achieve their own nephrostomy access. In an effort to simplify the access part of PCNL, we herein describe our initial experience with endoscopic-guided retrograde percutaneous access in the prone split-leg position. Case Presentation(s): After informed consent, a confirmed negative urine culture, and 1 week pretreatment with tamsulosin, four carefully selected PCNL patients underwent endoscopic-guided retrograde access in a prone split-leg position using the Lawson catheter...
2018: Journal of Endourology Case Reports
Demetrios A Raptis, Michael A Beal, David C Kraft, Hersh S Maniar, Andrew J Bierhals
Aortic stenosis is the most prevalent valvular cardiovascular disease affecting the population over the age of 65 years. Transcatheter aortic valve replacement (TAVR) was developed as a minimally invasive surgical intervention to treat aortic stenosis in patients at high risk for surgical complications. Although the most commonly used approach for placement of a transcatheter aortic valve is in retrograde fashion via a transfemoral approach, narrowed luminal diameters, extensive atherosclerotic disease, or significant tortuosity may limit use of this route...
November 23, 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Giuseppe Giusti, Antonello De Lisa
The study was performed to evaluate the efficacy of our modified supine position (called "Double-S") in percutaneous nephrolithotripsy (PCNL) and to make a contribution to the question: "Is there a better position in PCNL?". The superiority of one position is still under debate in the scientific community. In our study, we described and compared our position with the standard prone one to evaluate the possible benefits. This is a prospective randomized clinical trial conducted for 17 months...
November 19, 2018: Urolithiasis
Carlo Zivelonghi, Jan P van Kuijk, Maarten J Suttorp, Jan A S van der Heyden, Frank D Eefting, Benno J Rensing, Jurrien M Ten Berg, Pierfrancesco Agostoni
Percutaneous recanalization of coronary chronic total occlusions (CTOs) traditionally relies on the use of dual access and large bore catheters, with trans-femoral approach adoption in most of the cases. Aim of this manuscript is to describe an alternative algorithm, that we called "Minimalistic Hybrid Algorithm", in order to minimize the use of double access, large bore catheters, and femoral approach thus reducing patient's discomfort and possibly procedural complications. This algorithm can be interpreted as an evolution of the classic "Hybrid Algorithm" and requires the operator to be confident with all techniques known in this conventional algorithm...
November 9, 2018: International Journal of Cardiology
Bo Li, Changcheng Liu, Liangshan Wang, Jin Wang, Yucai Hu, Chengxiong Gu
BACKGROUND: Endo-epicardial radiofrequency catheter ablation (RFCA) of ventricular tachycardia (VT) as a first-line strategy has been shown to improve outcomes. This study sought to evaluate the feasibility and validity of open-chest epicardial and transapical endocardial substrate ablation for VT with left ventricular aneurysm (LVA) applying to routine cardiac surgery. METHODS: Porcine models of LVA with VT were developed and were divided into a study group (RFCA from the epicardium via direct-view and endocardium via transapical access) and a control group (endocardial RFCA via retrograde transaortic access)...
November 16, 2018: Perfusion
Vladimir Kovač
PURPOSE: To analyze and clarify conflicting aspects of fusion and total disc replacement (TDR) surgery in literature. METHOD: Using keywords, 23 literature reviews, 41 studies accepted by "importance criteria" from the Internet, and 16 articles "published in 2018" were chosen. Altogether 80 studies. RESULTS: General assessment was mentioned as affirmative for TDR in 40 papers, five were negative, 24 without clear decision...
November 13, 2018: International Orthopaedics
Selcuk Sarikaya, Cagri Senocak, Ismail Selvi, Ridvan Ozbek, Omer Faruk Bozkurt
INTRODUCTION: Fluoroscopy is used for access sheath insertion and postoperative control during retrograde intrarenal surgery (RIRS) operation but with this technique both patient and operation team are exposed to radiation. The use of fluoroscopy is disadvantage for both patient and surgeon. Considering results of recent studies, it is clearly seen that fluoroscopy doesn't affect the success and complication rates of RIRS. In this study, we aimed to compare the results of both fluoroscopy and fluoroscopy-free groups, to show if there is a significant difference...
November 2018: Archivos Españoles de Urología
Khalid M Alotaibi
Purpose: A new minimally invasive approach for endopyelotomy for the treatment of ureteropelvic junction obstruction (UPJO) is described. The results are compared with those of other lines of treatment. Materials and Methods: A total of 39 patients with UPJO underwent percutaneous retropelvic endopyelotomy. Retrograde percutaneous renal access, using the Lawson catheter and deflecting guidewire, was done for creation of the nephrostomy tract. Using holmium laser through a 28-Fr nephroscope, a small window was made in the posterolateral surface of the renal pelvis...
October 2018: Urology Annals
Rohit Philip Thomas, Martin Köcher, Marie Černa, Petr Utíkal
Internal iliac artery aneurysms (IIAAs), although rare, are associated with a significant risk of mortality, if they rupture. Endovascular approach with exclusion of the aneurysm sac from antegrade and retrograde perfusion is proved to be a feasible treatment option. However, this option is not always technically possible with a preexisting endovascular aneurysm repair (EVAR) or surgical aortoiliac reconstruction with ligation of internal iliac artery origin. We report another safe treatment option of an enlarging IIAA associated with a type II endoleak after EVAR and a standard endovascular treatment was not possible...
October 31, 2018: Cardiovascular and Interventional Radiology
Yu-Jyun Cheng, Hsin-Yi Yang, Ching-Fang Tsai, Jen-Shyang Lin, Hung-Chang Lee, Chun-Yan Yeung, Solomon Chih-Cheng Chen
OBJECTIVE: Pediatric acute pancreatitis (AP) may be different from adult AP in various respects. This study focuses on the epidemiology and medical resource use of pediatric AP in Taiwan. METHODS: Patients aged 0-18 years with AP were identified from the Taiwan National Health Insurance Research Database based on the International Classification of Diseases, Ninth Revision (ICD-9) code of AP 577.0. The medical resource use was measured by length of hospital stay (LOS) and hospital charges...
October 24, 2018: Journal of Pediatric Gastroenterology and Nutrition
Saygin Turkyilmaz, Ali Aycan Kavala
OBJECTIVES: To evaluate access success according to plaque cap morphology in subjects with lower limb chronic total occlusion. METHODS: A retrospective study was performed for a three-year period. Subjects with lower extremity chronic total occlusion (Rutherford category 3-6, ischaemia) were included in the study. Cap morphology was classified according to The chronic total occlusion crossing approach based on plaque cap morphology (CTOP) classification system. When describing the classification by a traditional antegrade approach, Types I, II, III and IV were defined as follows: Type I: concave proximal and distal caps; Type II: concave proximal and convex distal caps; Type III: convex proximal and concave distal caps; Type IV: convex proximal and distal caps...
October 23, 2018: Vascular
Y Law, N Tsilimparis, S Aleed, F Rohlffs, N Schofer, E S Debus, G Müller, T Kölbel
INTRODUCTION: Thoracic endovascular aortic repair (TEVAR) with self-expanding endo-graft is increasingly used as a viable treatment option for adult aortic coarctation (AC). METHODS: We hereby reported a 55 years old gentleman with late presentation of AC, treated by a novel strategy with thoracic endograft and in situ laser fenestration for left subclavian artery (LSA) revascularization. RESULTS: AC was incidentally discovered during coronary angiogram as an investigation for his angina pectoris...
October 17, 2018: Annals of Vascular Surgery
Malou Zeymer, Gerhard von der Emde, Mario F Wullimann
The African weakly electric fish Gnathonemus petersii is capable of cross-modal object recognition using its electric sense or vision. Thus, object features stored in the brain are accessible by multiple senses, either through connections between unisensory brain regions or because of multimodal representations in multisensory areas. Primary electrosensory information is processed in the medullary electrosensory lateral line lobe, which projects topographically to the lateral nucleus of the torus semicircularis (NL)...
2018: Frontiers in Neuroanatomy
Diogo Libânio, Sílvia Giestas, David Martinez-Ares, Frederico Ferreira, Jorge Canena, Manuela Certo, Luís Lopes
Introduction: Endoscopic retrograde cholangiopancreatography is the method of choice for biliary drainage, although in some cases standard biliary access is difficult or even impossible. Endoscopic ultrasound (EUS)-guided endoluminal procedures are an alternative in these cases, although experience with these techniques is still limited. Clinical Case: We present two cases of successful EUS-guided biliary drainage. In the first case, a hepaticogastrostomy was performed in a patient with stage IV gastric adenocarcinoma with obstructive jaundice due to compression of the hilum, where malignant gastric stenosis and previous palliative gastrojejunostomy precluded access to the second part of the duodenum...
September 2018: GE Portuguese Journal of Gastroenterology
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