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retrograde access

Vladimir M Kushnir, Daniel K Mullady, Koushik Das, Gabriel Lang, Thomas G Hollander, Faris M Murad, Sara A Jackson, Nicole A Toney, Sydney D Finkelstein, Steven A Edmundowicz
BACKGROUND: Routine cytology of biliary stricture brushings obtained during endoscopic retrograde cholangiopancreatography (ERCP) has suboptimal sensitivity for malignancy. We compared the individual and combined ability of cytology, fluorescence in situ hybridization (FISH) analysis and PCR-based mutation profiling (MP) to detect malignancy in standard biliary brushings. METHODS: We performed a prospective study of patients undergoing ERCP using histology or 1 year follow-up to determine patient outcomes...
August 13, 2018: Journal of Clinical Gastroenterology
Jeffrey P Gordon, Jackson J Liang, Rajeev Pathak, Erica S Zado, Fermin C Garcia, Matthew D Hutchinson, Pasquale Santangeli, Robert D Schaller, David S Frankel, Francis E Marchlinski, Gregory E Supple
BACKGROUND: Catheter ablation of ventricular arrhythmias (VA) from the papillary muscles (PM) is challenging due to limited catheter stability and contact on the PMs with their anatomic complexity and mobility. OBJECTIVE: To evaluate the effectiveness of cryoablation as an adjunctive therapy for PM VAs when radiofrequency (RF) ablation has failed. METHODS: We evaluated a retrospective series of patients who underwent cryoablation for PM VAs when RF ablation had failed...
August 14, 2018: Journal of Cardiovascular Electrophysiology
Sachiko Hirota, Umeo Takahama
Adzuki beans are used to prepare foods with glutinous and non-glutinous rice in Japan, and adzuki bean pigments are able to color rice starch a purplish red. This study deals with the adzuki bean extract-dependent suppression of starch digestion of non-glutinous rice flour (joshinko in Japanese), which was gelatinized in boiling water and then cooled to 37 °C. Accompanying the treatment of joshinko with pancreatin, amylose and amylopectin were released from the joshinko particles, and the released amylose and amylopectin were further digested...
August 10, 2018: Foods (Basel, Switzerland)
August Ysa, Marta Lobato, Roberto Gómez, Amaia Arruabarrena, Ana M Quintana, Ederi Mikelarena, Matthew Metcalfe, Juan L Fonseca
PURPOSE: To describe a simple maneuver to facilitate the retrograde puncture of challenging tibial vessels in the lower leg. TECHNIQUE: Because of the depth of the tibial vessels at the mid to upper calf, especially in obese or muscular patients, a 7- or 9-cm, 21-G micropuncture needle is often needed to reach the artery. However, the low profile of the needle contributes to its flexibility and therefore the tendency to bend as it progresses through the deep tissues, hindering access to the target vessel...
August 13, 2018: Journal of Endovascular Therapy
Hyun Yong Lee, Young Nam Roh, Hyoung Tae Kim, Ui Jun Park
Flush ostial occlusion of the superficial femoral artery (SFA) is challenging for endovascular treatment. Neither ipsilateral nor contralateral access is easy. The drawback of ipsilateral common femoral artery (CFA) access is that the CFA is too short for catheter manipulation and sheath engagement. Contralateral retrograde CFA access could have merit, but it has the drawback of poor pushability and torquability in the manipulation of devices. The most challenging part of flush ostial occlusion is the difficulty of wire engagement into the SFA orifice...
August 6, 2018: Annals of Vascular Surgery
Maxime K Collard, Jérôme Danion, François Cauchy, Fabiano Perdigao, Sarah Leblanc, Frédéric Prat, Olivier Soubrane, Olivier Scatton
BACKGROUND: Roux-en-Y hepaticojejunostomy (HJ) currently represents the gold standard after resection of the biliary confluence. This non-physiological reconstruction poses several problems such as repeated cholangitis or stricture without conventional endoscopic access. Our aim was to describe and to report both feasibility and results of duct-to-duct anastomosis with removable internal biliary drain (RIBS) as an alternative technique to the HJ after resection of the biliary confluence in patients undergoing major liver resection...
August 8, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Martin Goetz, Nisar P Malek
Introduction:  The ideal endoscopic retrograde cholangiopancreatography (ERCP) tissue sampling technique should be simple, inexpensive, and yield sufficient tissue for histology while permitting contrast-guided targeting under fluorescence and multiple passes into the bile duct. Current techniques do not fulfill these requirements comprehensively. We designed a catheter for optimized targeting of large intrabiliary biopsies. Methods:  A 3.5-mm sterile, single-use prototype catheter was developed, with three independent lumina extending continuously to the distal tip for three distinct functions to be available simultaneously: passage of large volume biopsy forceps (1...
August 2018: Endoscopy International Open
Jeffrey B Edwards, Mathew D Wooster, Adam Tanious, Martin R Back
OBJECTIVE: Renal artery anomalies occur at a rate of 1-2% and present a challenge to vascular surgeons performing aortic surgery. We describe adjuncts used to manage such anatomic variants. METHODS: A single surgeon registry of all abdominal aortic aneurysms repaired in an academic center was retrospectively reviewed. Patients with prior renal transplants, congenital pelvic kidneys, or horseshoe kidneys were included. Open repair was reserved for patients with no endovascular or hybrid repair options...
August 3, 2018: Annals of Vascular Surgery
Vladimir Makaloski, Nikolaos Tsilimparis, Fiona Rohlffs, Konstantinos Spanos, E Sebastian Debus, Tilo Kölbel
PURPOSE: To describe how to use a steerable sheath from a femoral access to catheterize antegrade branches in a branched aortic stent-graft. TECHNIQUE: Following femoral cutdown, a stent-graft with antegrade branches destined for renovisceral target vessels was deployed in the desired position. A steerable sheath with a tip that rotates up to 180° was introduced from the common femoral artery and navigated to the antegrade branches for consecutive catheterization of the target vessels and deployment of one or more bridging stents per branch...
August 5, 2018: Journal of Endovascular Therapy
Luigi Biasco, Enrico Ferrari, Giovanni Pedrazzini, Francesco Faletra, Tiziano Moccetti, Francesco Petracca, Marco Moccetti
During the last ten years, transcatheter aortic valve implantation (TAVI) has become a reliable and valid alternative treatment for elderly patients with severe symptomatic aortic valve stenosis requiring valve replacement and being at high or intermediate surgical risk. While common femoral arteries are the access site of choice in the vast majority of TAVI patients, in up to 15-20% of TAVI candidates this route might be precluded due to the presence of diffuse atherosclerotic disease, tortuosity or small vessel diameter...
2018: Frontiers in Cardiovascular Medicine
Finnur Mellemgaard, Rune B Strandby, Julie Blockmann, Steen C Kofoed, Lars B Svendsen, Michael P Achiam
INTRODUCTION: Single-operator cholangioscopy (SOC) is increasingly used for evaluation of the biliary tree following endoscopic retrograde cholangiopancreaticography (ERCP). This study aimed to determine the visual and histological success rates of SOC at a single Danish tertiary referral centre. METHODS: All patients undergoing SOC between 2008 and 2015 were retrospectively included from a prospectively maintained database. Patient characteristics and proced-ure-related variables were obtained from medical records...
August 2018: Danish Medical Journal
José A Salvadó, Ruben Olivares, José M Cabello, Renato Cabello, Sergio Moreno, Jessica Pfeifer, Cristóbal Román, Alfredo Velasco
Introduction: Reusable endoscopes have some limitations regarding their continued use. To sort out these problems, several disposable devices have appeared on the market. Our objective is to show our clinical results with a new digital flexible single-use ureteroscope. Materials and methods: This study presents a prospective series of patients who underwent endoscopic surgery as treatment for renal stones using the digital disposable endoscope Uscope 3022™. Demographic, procedure and stone information were registered including surgery time, stone-free rate, need of ureteral catheterization and complications, among others...
2018: Central European Journal of Urology
G Aulakh, B Shokouhi, K Beneng
Midazolam, a benzodiazepine, is commonly used for intravenous sedation for dental procedures and, together with other benzodiazepines, can cause anterograde amnesia. Retrograde amnesia, however, is rare. It is defined as a loss of access to memory of events that occurred, or information that was learned, before the injury or event that caused the amnesia. We know of no reports of this occurring after the intravenous use of midazolam alone and few after general anaesthesia. We present two cases of retrograde amnesia: one after intravenous sedation and one after general anaesthesia...
July 17, 2018: British Journal of Oral & Maxillofacial Surgery
Desislava D Kostova-Lefterova, Nadelin N Nikolov, Stefan S Stanev, Boyka B Stoyanova
OBJECTIVE: Hybrid surgical methods such as remote endarterectomy and endovascular revascularization are fluoroscopy-guided procedures successfully replacing conventional open surgery for treatment of peripheral artery disease (PAD). The aim of this study was to: (1) evaluate the dose parameters describing exposure of patients undergoing endovascular or hybrid revascularization of the lower limb (below the inguinal ligament); (2) compare the data available in the literature with the evaluations of patients' dose values and related factors for patients undergoing such procedures; (3) examine the correlation of doses with certain parameters; (4) estimate the peak skin dose and assess the potential for radiation induced skin injuries during the procedures...
July 20, 2018: British Journal of Radiology
Takeshi Ogura, Nobu Nishioka, Kazuhide Higuchi
No abstract text is available yet for this article.
July 18, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Sébastien Perou, Augustin Pirvu, Jessica Morel, Jean-Luc Magne, Amandine Elie, Rafaelle Spear
OBJECTIVE: We evaluated the results of femoral bifurcation endarterectomy using the eversion technique with transection of the superficial femoral artery (FBEE). METHODS: We included all patients from January 2006 to December 2015 who underwent a femoral revascularization using the eversion technique, with or without antegrade or retrograde revascularization. Data were retrospectively collected. Primary and primary assisted patency of the femoral bifurcation were analyzed...
July 13, 2018: Annals of Vascular Surgery
Lidia Jureczko, Karolina Dobronska, Marcin Kolacz, Piotr Radziszewski, Piotr Dobronski
Introduction: Percutaneous nephrolithotomy (PNL) is an endoscopic treatment of renal lithiasis. It is usually two-staged: it begins in the lithotomy position for ureteral catheter placement and retrograde pyelography, and subsequently an optimal renal access is obtained in the prone position. Some patients under epidural anesthesia do not tolerate the prone position and the PNL cannot be continued. This may be related to changes occurring within the circulatory system. The aim of this prospective randomized double-blind study was to evaluate the changes of the cardiac index (CI) during PNL...
June 2018: Archives of Medical Science: AMS
Şenol Tonyalı, Mehmet Yılmaz, Mustafa Karaaslan, Cavit Ceylan, Levent Işıkay
OBJECTIVE: To determine the possible factors effecting stone-free status (SFS) after single-session retrograde intrarenal surgery (RIRS) for renal stones. MATERIAL AND METHODS: We retrospectively analyzed the charts of 100 consecutive patients who underwent RIRS. Unilateral procedures performed for single renal stones were included in the study. The studied parameters included patient demographics, stone characteristics (size, volume, location and attenuation according to Hounsfield unit [HU]), operation time, presence of preoperative double-J stent (DJS), use of ureteral access sheath (UAS) and SFS...
July 5, 2018: Turkish Journal of Urology
Haruo Yoshimasu, Takaaki Yasuda, Akihiro Kurihara
Patients with dissociative retrograde amnesia, under the influence of high stress, lose access to past autobiographical event memories that should have been remembered. Patients with dissociative anterograde amnesia cannot recall extremely emotional experiences. If dissociative anterograde amnesia is experienced repeatedly in daily life, something in daily life becomes a fear stimulus. Fear conditioning in dissociative anterograde amnesia is often related to past memories of child abuse that can not be recalled due to dissociative amnesia...
July 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
Shin Watanabe, Olympia Bikou, Roger J Hajjar, Kiyotake Ishikawa
Mitral regurgitation (MR) is among the most common valvular heart diseases in clinics. MR induces volume overload of the heart and leads to heart failure (HF). Because physiological and molecular mechanisms in nonischemic HF are distinct from that of ischemic HF, a clinically relevant animal model of nonischemic HF is important for understanding the pathophysiology and developing new therapeutics targeting this HF phenotype. Additionally, the large animal model of MR provides opportunities to test new surgical and percutaneous approaches for correcting mitral valve insufficiency...
2018: Methods in Molecular Biology
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