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Ductal stenting

Rachel E NeMoyer, Mihir M Shah, Omar Hasan, John L Nosher, Darren R Carpizo
INTRODUCTION: Benign strictures of the biliary system are challenging and uncommon conditions requiring a multidisciplinary team for appropriate management. PRESENTATION OF CASE: The patient is a 32-year-old male that developed a hilar stricture as sequelae of a gunshot wound. Due to the complex nature of the stricture and scarring at the porta hepatis a combined interventional radiologic and surgical approach was carried out to approach the hilum of the right and left hepatic ducts...
March 3, 2018: International Journal of Surgery Case Reports
Smita Akkinapally, Shilpa G Hundalani, Madhulika Kulkarni, Caraciolo J Fernandes, Antonio G Cabrera, Binoy Shivanna, Mohan Pammi
BACKGROUND: Prostaglandin E1 (PGE1) is used to keep the ductus arteriosus patent and can be life-saving in neonates with ductal-dependent cardiac lesions. PGE1 is used to promote mixing of pulmonary and systemic blood flow or improve pulmonary or systemic circulations, prior to balloon atrial septostomy or surgery. PGE1 therapy may cause several short-term and long-term adverse effects. The efficacy and safety of PGE1 in neonates with ductal-dependent cardiac lesions has not been systematically reviewed...
February 27, 2018: Cochrane Database of Systematic Reviews
Eva Kapravelou, David Anderson, Gareth J Morgan
The use of hybrid techniques to avoid neonatal cardiopulmonary bypass in high-risk individuals is well reported in the setting of hypoplastic left heart syndrome. We describe the use of that technique as a bridging procedure in high-risk neonates with an interrupted aortic arch. We report three cases where hybrid branch pulmonary artery banding and ductal stent implantation has been successfully used to defer complete repair, allowing recovery, maturity, and weight gain. This strategy may be considered for patients deemed at high risk for primary neonatal repair...
March 2018: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Diogo Turiani Hourneaux De Moura, Martin Coronel, Danielle Azevedo Chacon, Ryan Tanigawa, Dalton M Chaves, Sérgio E Matuguma, Marcos E Lera Dos Santos, José Jukemura, Eduardo Guimarâes Hourneaux De Moura
Pancreatic cancer is the second most common malignancy of the gastrointestinal tract in the US, and adenocarcinoma has been identified as the most common type of pancreatic cancer. Different types of pancreatic cancers have been classified: adenocarcinoma, ductal adenosquamous carcinoma, solid pseudopapillary tumors, endocrine neoplasms, acinar cell carcinoma, squamous cell carcinoma, cystic tumors, primary lymphoma of the pancreas, and metastatic lesions of the pancreas. Adenosquamous carcinoma is extremely rare, behave in a very aggressive way and is responsible for the 1 to 4% of the pancreatic exocrine neoplastic lesions...
October 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Dongwook Oh, Jae Hoon Lee, Tae Jun Song, Do Hyun Park, Sung Koo Lee, Myung-Hwan Kim, Sang Soo Lee
OBJECTIVES: Fully covered self-expandable metal stents (FCSEMSs) placement has been tried for pancreatic ductal strictures in chronic pancreatitis. However, the long-term outcome of this procedure remains unknown. This study aimed to investigate the procedural and long-term outcomes of FCSEMS placement in patients with benign refractory pancreatic ductal strictures. METHODS: Between August 2011 and September 2015, 18 patients underwent endoscopic treatment with FCSEMSs for a benign refractory pancreatic ductal stricture...
February 17, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Kaitlin Balduf, T K Susheel Kumar, Umar Boston, Shyam Sathanandam, Marc V Lee, Tim Jancelewicz, Christopher J Knott-Craig
BACKGROUND: Hypoplastic left heart syndrome (HLHS) is the second most common congenital heart disease associated with congenital diaphragmatic hernia (CDH). The reported survival of neonates with CDH and HLHS is only 1-5%. We review our experience with CDH and HLHS and compare our outcomes to published literature. METHODS: Retrospective review of all neonates with CDH and HLHS at our institution over a 10 year period was performed. The morphology of cardiac and diaphragm defects, clinical course, treatment strategies and outcomes were reviewed and an algorithmic approach is proposed...
February 12, 2018: Seminars in Thoracic and Cardiovascular Surgery
Lee Benson, Glen Van Arsdell
No abstract text is available yet for this article.
February 6, 2018: Circulation
Uygar Yörüker, Hakan Akintürk
This article reviews our experience using hybrid stage I palliation in the neonatal period and subsequently with comprehensive stage II palliation for hypoplastic left heart syndrome. Between June 1998 and April 2017, 154 patients with the diagnosis of hypoplastic left heart syndrome and variants underwent a hybrid stage I palliation (bilateral pulmonary artery banding and ductal stenting). One hundred thirty-nine patients could be further univentricularly palliated. One hundred twenty-one patients underwent a comprehensive stage II operation with an operative mortality of 6...
March 2018: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
Akihiko Higashida, Takaya Hoashi, Masataka Kitano, Masatoshi Shimada, Tomohiro Nakata, Hideto Ozawa, Kenichi Kurosaki, Hajime Ichikawa
OBJECTIVES: To assess the feasibility of hybrid Stage I palliation consisting of bilateral pulmonary artery bandings and ductal stenting for patients with 2 ventricular cavities and hypoplastic left heart structures. METHODS: Eleven consecutive patients who underwent hybrid Stage I palliation between 2010 and 2017 were enrolled. The diagnoses were interrupted aortic arch/coarctation of the aorta, ventricular septal defect and significant left ventricular (LV) outflow tract obstruction in 5 patients, critical aortic stenosis and reduced LV contraction in 3 patients and hypoplastic left heart complex in 3 patients...
January 24, 2018: Interactive Cardiovascular and Thoracic Surgery
Rinkesh Kumar Bansal, Gaurav Kumar Patil, Rajesh Puri, Narendra S Choudhary, Saurabh R Patle, Zubin D Sharma, Randhir Sud
Background and aim:  There is paucity of data about endoscopic pancreatic sphincteroplasty (EPS) after endoscopic pancreatic sphincterotomy (EPST) in the treatment of chronic pancreatitis. The aim of this study was to establish the indications for EPS, complications related to it, and to examine its effectiveness in managing chronic pancreatitis after a year of follow-up. Methods:  We evaluated the safety and efficacy of pancreatic balloon dilation coupled with sphincterotomy for the treatment of chronic pancreatitis...
December 2017: Endoscopy International Open
Rizwan Rehman, Mood Che Marhisham, Mazeni Alwi
Patent ductus arteriosus (PDA) stenting has gained acceptance for palliation in cyanotic congenital heart disease. The PDA in tetralogy of Fallot with pulmonary atresia (ToF-PA) arises, in the left aortic arch, from underneath the arch and connects to the proximal left pulmonary artery, often resulting in stenosis. The PDA is usually elongated and tortuous, making stent implantation challenging. Shorter duration of palliation, aggravation of branch pulmonary artery stenosis resulting in poor growth and difficulty at surgery makes ductal stenting controversial...
January 2018: Future Cardiology
Po-Chin Liang, Kai-Wen Huang, Chien-Chih Tung, Ming-Chu Chang, Fuh-Yu Chang, Jau-Min Wong, Yu-Ting Chang
This study aimed to investigate the drug delivery efficacy and bio-effectiveness of a novel photodynamic therapy (PDT)-matrix drug delivery system for cholangiocarcinoma (CCA). Metallic stents were coated with polyurethane (PU) as the first layer. A 2-hydroxyethyl methacrylate (2-HEMA)/ethylene glycol dimethacrylate (EGDMA)/benzoyl peroxide (BPO) layer and a poly(ethylene-co-vinyl acetate) (PEVA)/poly(n-butyl methacrylate) (PBMA)/polyvinylpyrrolidone K30 (K30) layer containing various concentrations of Photofrin were then incorporated onto the stent as the second and third layers...
November 22, 2017: Biomedical Microdevices
Ryan A Romans, Aimee K Armstrong, Ranjit Aiyagari
In patients with ductal-dependent CHD, ductal restriction can be life-threatening. We present the use of urgent hybrid palliation involving placement of bilateral pulmonary artery bands and ductus arteriosus stent implantation in a 1.5 kg premature infant with interrupted aortic arch and ductal restriction.
February 2018: Cardiology in the Young
Apeksha Shah, Richard Denicola, Cynthia Edirisuriya, Ali A Siddiqui
Pancreatic fluid collections are a frequent complication of acute pancreatitis. The revised Atlanta criterion classifies chronic fluid collections into pseudocysts and walled-off pancreatic necrosis (WON). Symptomatic PFCs require drainage options that include surgical, percutaneous, or endoscopic approaches. With the advent of newer and more advanced endoscopic tools and expertise, minimally invasive endoscopic drainage has now become the preferred approach. An endoscopic ultrasonography (EUS)-guided approach for pancreatic fluid collection drainage is now the preferred endoscopic approach...
December 2017: Current Treatment Options in Gastroenterology
Sudhir Gupta, Nitin Gaikwad, Amol Samarth, Niraj Sawalakhe, Tushar Sankalecha
Pancreatic ascites and effusion is a challenging complication to manage, hence our aim was to evaluate the efficacy of pancreatic endotherapy in pancreatic ascites and pleural effusion. Endotherapy included endoscopic retrograde cholangiopancreatography (ERCP) with a pancreatogram and pancreatic stent placement across the leak in patients with pancreatic ascites/effusion. A total of 53 patients were included after successful cannulation. The male:female ratio was 7.8:1. The pancreatogram revealed a leak from the pancreatic duct in 20/53 (37...
March 27, 2017: Medical Sciences: Open Access Journal
Stephan J Wu, Tacy Downing, Christopher Mascio, Matthew J Gillespie, Yoav Dori, Jonathan J Rome, Andrew C Glatz
Children requiring reimplantation of a branch pulmonary artery (PA) are at risk for postoperative stenosis and impaired growth of the reimplanted PA. Outcomes and risk factors for reintervention and impaired growth are incompletely described. We reviewed data on patients who underwent reimplantation of a branch PA between 1/1/99 and 5/1/15 at a single center. The primary outcome was reintervention to treat postoperative stenosis. The secondary outcome was "catch-up" growth (faster diameter growth of the affected PA compared with the unaffected PA from the preoperative to follow-up measurements...
November 2, 2017: Pediatric Cardiology
Iman Andalib, Enad Dawod, Michel Kahaleh
The last decade has seen dramatic shift in paradigm in the management of pancreatic fluid collections with the rise of endoscopic therapy over radiologic or surgical management. Endosonographic drainage is now considered the gold standard therapy for pancreatic pseudocyst. Infected pancreatic necroses are being offered endoscopic necrosectomy that has been facilitated by the arrival on the market of large diameter lumen-apposing metal stent. Severe pancreatitis or failure to thrive should receive enteral nutrition while pancreatic ductal disruption or strictures are best treated by pancreatic stenting...
October 31, 2017: Journal of Clinical Gastroenterology
Hangyan Wang, Dianrong Xiu, Ming Tao
Several risk factors for pancreatic fistula had been widely reported, but there was no research focusing on the exocrine output of remnant gland.During the study period of January 2015 to September 2016, 82 patients accepted pancreaticoduodenectomy (PD, end-to-end dunking pancreaticojejunostomy with internal stent tube). All the data were collected, including preoperative medical status, operative course, final pathology, gland texture, pancreatic duct diameter, size of the stent, length of pancreatic juice in the stent tube, width of the pancreatic stump, diameter of the jejunum and the status of postoperative pancreatic fistula (POPF)...
November 2017: Medicine (Baltimore)
Masatake Nishiwaki, Chiemi Mizuno, Kota Yano, Hirohisa Oya, Ichiro Amano, Junko Matsumoto, Izumi Tanaka, Naoki Sawai, Masayuki Mizuno, Toshihide Shima, Yoshiharu Miyamoto, Takeshi Okanoue
An 85-year-old woman underwent endoscopic retrograde cholangiopancreatography (ERCP) for obstructive jaundice. Selective bile duct cannulation was unsuccessful because of periampullary diverticula (PAD). A pancreatic spontaneous dislodgement stent (PSDS) (5F diameter, 3 cm, straight type) was inserted to prevent post-ERCP pancreatitis. Three days after ERCP, she complained of abdominal pain, and computed tomography revealed retroperitoneal perforation because of PSDS migration to the PAD. If the papillary orifice is observed at the diverticular rim or in the diverticula, a pigtailed PSDS on the duodenal side or flanged stent on the pancreatic ductal side should be inserted in order to prevent this rare adverse event...
November 1, 2017: Internal Medicine
Andrew C Glatz, Christopher J Petit, Bryan H Goldstein, Michael S Kelleman, Courtney E McCracken, Alicia McDonnell, Timothy Buckey, Christopher E Mascio, Subi Shashidharan, R Allen Ligon, Jingning Ao, Wendy Whiteside, W Jack Wallen, Christina M Metcalf, Varun Aggarwal, Hitesh Agrawal, Athar M Qureshi
BACKGROUND: Infants with ductal-dependent pulmonary blood flow may undergo palliation with either a patent ductus arteriosus (PDA) stent or a modified Blalock-Taussig (BT) shunt. A balanced multicenter comparison of these 2 approaches is lacking. METHODS: Infants with ductal-dependent pulmonary blood flow palliated with either a PDA stent or a BT shunt from January 2008 to November 2015 were reviewed from the 4 member centers of the Congenital Catheterization Research Collaborative...
February 6, 2018: Circulation
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