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Chronic occlusion

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https://www.readbyqxmd.com/read/29790720/recanalization-of-ctos-with-soundbitetm-active-wire
#1
Marianne Brodmann, Eric Thérasse, Andrew Benko, Louis-Philippe Riel, Steven Dion, Philippe Généreux, Martin Brouillette
BACKGROUND: The aim of this study was to examine the safety and efficacy of the SoundBite™ Crossing System for the recanalization of infrainguinal chronic total occlusion (CTO) lesions. CTOs are frequent among patients with severe claudication or critical limb ischemia. Failure to recanalize CTOs remains common and is associated with poor prognosis. The SoundBite™ Crossing System (SoundBite Medical Solutions Inc., Montreal, Canada) is a newly developed device that uses a 0.018-inch wire (SoundBite™ Active Wire) to deliver acoustic shock waves to the distal tip of a steerable guidewire to facilitate directed penetration of the proximal cap and crossing of the occlusion...
May 23, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29790719/less-is-more-as-less-as-reasonably-achievable-stenting-alaras-strategy-in-the-femoropopliteal-area
#2
Koen Deloose, Joren Callaert
BACKGROUND: Although evidence supports that the performance of drug coated balloons seems to be lesion complexity independent, it is quite clear that in long lesions, severe calcified lesions and chronic total occlusions, the bail out stent ratio is very high and that the "leaving nothing behind" strategy remains a dream in a lot of our daily cases. On the other side of the spectrum, "full metal jackets" of nitinol stents are creating even more problems. Stent fractures, intimal hyperplasia and reintervention difficulties complicate the recurrent vascular disease treatment...
May 23, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29790262/the-efficacy-and-tolerability-of-5-aminolevulinic-acid-5-thermosetting-gel-photodynamic-therapy-pdt-in-the-treatment-of-mild-to-moderate-acne-vulgaris-a-two-center-prospective-assessor-blinded-proof-of-concept-study
#3
Stefano Maria Serini, Maria Vittoria Cannizzaro, Annunziata Dattola, Virginia Garofalo, Esther Del Duca, Alessandra Ventura, Massimo Milani, Elena Campione, Luca Bianchi
BACKGROUND: Acne vulgaris is a chronic inflammatory skin disease, commonly treated with topical or systemic drugs, according to the severity of the condition. Retinoids and antibiotic compounds are considered cornerstone approaches in this condition. However, low adherence to the therapy and the issue of bacterial resistance undermine the efficacy in the long term. Photodynamic therapy (PDT) with 20% aminolevulinic acid (ALA) has shown to be effective in the treatment of inflammatory acne...
May 22, 2018: Journal of Cosmetic Dermatology
https://www.readbyqxmd.com/read/29789906/percutaneous-intentional-intra-luminal-assisted-recanalization-pilar-technique-of-challenging-chronic-total-occlusions-using-a-high-frequency-vibration-device
#4
Stephanie Volpi, Amine Chouiter, Francois Saucy, Steven Hajdu, Anne-Marie Jouannic, Salah D Qanadli
OBJECTIVES: Recanalization of peripheral chronic total occlusions (CTO) is technically challenging especially in cases of in-stent and/or pre-stent and heavily calcified lesions. A high-frequency vibrational device (HFVD) was first used as a secondary-intention device in CTO recanalizations when they were refractory to a guidewire. The aim of this study was to assess the safety and efficacy of the HFVD as a first-line treatment for challenging CTOs and thus to define the percutaneous intentional intraluminal-assisted recanalization (PILAR) technique...
May 22, 2018: European Radiology
https://www.readbyqxmd.com/read/29789335/prediction-of-thrombotic-and-bleeding-events-after-percutaneous-coronary-intervention-credo-kyoto-thrombotic-and-bleeding-risk-scores
#5
Masahiro Natsuaki, Takeshi Morimoto, Kyohei Yamaji, Hirotoshi Watanabe, Yusuke Yoshikawa, Hiroki Shiomi, Yoshihisa Nakagawa, Yutaka Furukawa, Kazushige Kadota, Kenji Ando, Takashi Akasaka, Keiichi Igarashi Hanaoka, Ken Kozuma, Kengo Tanabe, Yoshihiro Morino, Toshiya Muramatsu, Takeshi Kimura
BACKGROUND: Prediction of thrombotic and bleeding risk is important to optimize antithrombotic therapy after percutaneous coronary intervention. METHODS AND RESULTS: We developed the prediction rules for thrombotic and bleeding events separately in Japanese patients. Derivation and validation cohorts consisted of 4778 patients from CREDO-Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) registry cohort 2 and 4669 patients from RESET (Randomized Evaluation of Sirolimus-Eluting Versus Everolimus-Eluting Stent Trial) and NEXT (Nobori Biolimus-Eluting Versus Xience/Promus Everolimus-Eluting Stent Trial)...
May 22, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29787393/recanalization-of-chronic-occlusion-of-the-middle-cerebral-artery-with-tissue-plasminogen-activator-treatment-a-case-report
#6
Seung Jae Lee, Jin Sung Cheong, Han Uk Ryu, Hyun Goo Kang
OBJECTIVES: Patients with chronic proximal middle cerebral artery (MCA) occlusion do not present with severe symptoms, but early recanalization of acute occlusion is associated with high morbidity and mortality. Tissue plasminogen activator (tPA) is a recombinant thrombolytic agent approved for treating ischemic stroke, although only a few cases of tPA administration in chronic MCA occlusion have yielded positive results. METHODS: A 71-year-old patient had a history of right MCA territorial infarction with the occlusion occurring 12 years ago (November 2005)...
May 21, 2018: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/29784127/endovascular-iliocaval-reconstruction-for-chronic-iliocaval-thrombosis-the-data-where-we-are-and-how-it-is-done
#7
Jeffrey Forris Beecham Chick, Ravi N Srinivasa, Kyle J Cooper, Neil Jairath, Anthony N Hage, Brooke Spencer, Steven D Abramowitz
Iliocaval thrombosis, or thrombosis of the inferior vena cava and iliac veins, is associated with significant morbidity in the form of limb-threatening compromise from phlegmasia cerulean dolens, development of post-thrombotic syndrome, and death secondary to pulmonary embolism. Endovascular iliocaval reconstruction is an effective treatment for iliocaval thrombosis with high levels of technical success, favorable clinical outcomes and stent patency rates, and few complications. It is often able to relieve the debilitating symptoms experienced by affected patients and is a viable option for patients who fail conservative management...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29784054/systematic-literature-review-and-assessment-of-patient-reported-outcome-instruments-in-sickle-cell-disease
#8
Grammati Sarri, Menaka Bhor, Seye Abogunrin, Caroline Farmer, Savita Nandal, Rashid Halloway, Dennis A Revicki
BACKGROUND: Sickle cell disease (SCD) is a chronic condition associated with high mortality and morbidity. It is characterized by acute clinical symptoms such as painful vaso-occlusive crises, which can impair health-related quality of life (HRQL). This study was conducted to identify validated patient-reported outcome (PRO) instruments for use in future trials of potential treatments for SCD. METHODS: A systematic literature review (SLR) was performed using MEDLINE and EMBASE to identify United States (US)-based studies published in English between 1997 and 2017 that reported on validated PRO instruments used in randomized controlled trials and real-world settings...
May 21, 2018: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29780037/past-and-present-work-practices-of-european-interventional-cardiologists-in-the-context-of-radiation-protection-of-the-eye-lens-results-of-the-euraloc-study
#9
Joanna Karolina Domienik-Andrzejewska, Olivera Ciraj-Bjelac, Panagiotis Askounis, Peter Covens, Octavian Dragusin, Sophie Jacob, Jad Farah, Emilio Gianicolo, Renato Padovani, Pedro Manuel Peixoto Teles, Anders Widmark, Lara Struelens
This paper investigates over five decades of work practices in interventional cardiology with special emphasis on radiation protection. The analysis is based on the data from more than 400 cardiologists from different European countries recruited for EURALOC study collected in the period from 2014 to 2016. Information on the types of procedures performed and their annual mean number, fluoroscopy time, access site choice, X-ray units and radiation protection means used was collected using an occupational questionnaire...
May 21, 2018: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
https://www.readbyqxmd.com/read/29777839/-mesenteric-steal-physiology-as-a-cause-of-claudication-and-chronic-mesenteric-ischemia
#10
Aleem K Mirza, J Michael Bacharach
Aortoiliac occlusive disease (AOID) results in varying degrees of pelvic and lower extremity arterial insufficiency. Treatment approach has evolved and endovascular therapies are being successfully reported for high-grade lesion. However, Trans Atlantic Inter-Society Consensus (TASC) D often necessitates open revascularization. Disease limited to the infrarenal segment does not typically affect intestinal perfusion in the absence of visceral aortic or mesenteric vessel involvement. Chronic mesenteric ischemia most commonly occurs due to atherosclerotic disease of two or three of the mesenteric vessels...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29777754/hmgb1-neutralization-attenuates-hippocampal-neuronal-death-and-cognitive-impairment-in-rats-with-chronic-cerebral-hypoperfusion-via-suppressing-inflammatory-responses-and-oxidative-stress
#11
Yue Hei, Rong Chen, Xicai Yi, Qianfa Long, Dakuan Gao, Weiping Liu
High mobility group box-1 (HMGB1) acts as a proinflammatory molecule once released into the extracellular space and inhibition of HMGB1 signaling has been reported be neuroprotective in neurodegenerative diseases. Besides, chronic cerebral hypoperfusion (CCH) causes cognitive impairment in neurodegenerative diseases. Here we tested the protective role of HMGB1 inhibition using anti-HMGB1 neutralizing antibody (Ab) against CCH in rats after bilateral common carotid artery occlusion (2VO). 169 male Sprague-Dawley rats underwent 2VO or sham operation...
May 16, 2018: Neuroscience
https://www.readbyqxmd.com/read/29777578/sirt3-deficiency-impairs-neurovascular-recovery-in-ischemic-stroke
#12
Xiao Yang, Ke-Yi Geng, Yan-Shuang Zhang, Jin-Fan Zhang, Ke Yang, Jia-Xiang Shao, Wei-Liang Xia
AIMS: Sirt3 is one member of the NAD+ -dependent protein deacetylase family and plays crucial roles in diverse aspects of mammalian biological function. Then the role of Sirt3 on ischemia stroke is unknown. METHODS: To examine the effect of Sirt3 on ischemic stroke, we performed transient middle cerebral artery occlusion (tMCAO) in adult male Sirt3 knockout (KO) and wild-type (WT) mice. RESULTS: The level of Sirt3 in infarct region is decreased after ischemic stroke...
May 18, 2018: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/29776835/the-combination-of-mannitol-and-temozolomide-increases-the-effectiveness-of-stem-cell-treatment-in-a-chronic-stroke-model
#13
Chunggab Choi, Hye Min Kim, Jeeheun Shon, Jiae Park, Hyeong-Taek Kim, Suk Ho Kang, Seung-Hun Oh, Nam Keun Kim, Ok Joon Kim
BACKGROUND: The blood-brain barrier (BBB) presents a significant challenge to the therapeutic efficacy of stem cells in chronic stroke. Various methods have been developed to increase BBB permeability, but these are associated with adverse effects and are, therefore, not clinically applicable. We recently identified that combination drug treatment of mannitol and temozolomide improved BBB permeability in vitro. Here, we investigated whether this combination could increase the effectiveness of stem cell treatment in an animal model of chronic ischemic stroke...
May 15, 2018: Cytotherapy
https://www.readbyqxmd.com/read/29776790/-modern-treatment-of-mesenteric-ischemia
#14
Alexandre Nuzzo, Audrey Huguet, Olivier Corcos
Acute mesenteric ischemia is a highly morbid affliction which requires urgent care. Acute mesenteric ischemia consists in an ischemia injury of the small bowel, secondary to vascular insufficiency, either occlusive (thrombosis, embolism, arterial, venous) or non-occlusive (low flow or vasospasm). Given that the superior mesenteric artery supplies the small bowel as well as the right part of the colon, any ischemic process involving the right colon should be considered an acute mesenteric ischemia until proven otherwise...
May 15, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29775153/feasibility-safety-and-changes-in-systolic-blood-pressure-associated-with-endovascular-revascularization-of-symptomatic-and-chronically-occluded-cervical-internal-carotid-artery-using-a-newly-suggested-radiographic-classification-of-chronically-occluded-cervical
#15
David Hasan, Mario Zanaty, Robert M Starke, Elias Atallah, Nohra Chalouhi, Pascal Jabbour, Amit Singla, Waldo R Guerrero, Daichi Nakagawa, Edgar A Samaniego, Nnenna Mbabuike, Rabih G Tawk, Adnan H Siddiqui, Elad I Levy, Roberta L Novakovic, Jonathan White, Clemens M Schirmer, Thomas G Brott, Hussain Shallwani, L Nelson Hopkins
OBJECTIVE The overall risk of ischemic stroke from a chronically occluded internal carotid artery (COICA) is around 5%-7% per year despite receiving the best available medical therapy. Here, authors propose a radiographic classification of COICA that can be used as a guide to determine the technical success and safety of endovascular recanalization for symptomatic COICA and to assess the changes in systemic blood pressure following successful revascularization. METHODS The radiographic images of 100 consecutive subjects with COICA were analyzed...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29774174/outpatient-interventions-that-may-enhance-the-care-of-a-patient-with-co-existing-moyamoya-and-down-syndromes
#16
Anita Lwanga, Waldo Herrera, Katya Cruz Madrid, Antony Irungu
Moyamoya vasculopathy is a condition of chronic, progressive occlusion of the distal internal carotid arteries and the Circle of Willis. The resultant ischemia produces compensatory angiogenesis and the growth of a network of collateral blood vessels, which on angiography resemble a "puff of smoke" or "moyamoya" in Japanese. The objective of this case report is to describe the clinical course of a patient with Down and moyamoya syndromes and to enlighten clinicians about strategies that can be taken to enhance the care of similar patients...
March 16, 2018: Curēus
https://www.readbyqxmd.com/read/29769055/one-visceral-artery-may-be-enough-successful-pancreatectomy-in-a-patient-with-total-occlusion-of-the-celiac-and-superior-mesenteric-arteries
#17
Evangelos Tagkalos, Florian Jungmann, Hauke Lang, Stefan Heinrich
BACKGROUND: The anatomic variations of the visceral arteries are not uncommon. The liver arterial blood supply shows 50% variability between humans, with the most common anatomy being one hepatic artery arising from the celiac trunk and one pancreatico-duodenal arcade between the celiac trunk and the superior mesenteric artery. Occlusion of one artery are mostly asymptomatic but may become clinically relevant when surgery of the liver, bile duct or the pancreas is required. If these pathologies are not reversible, an oncologic pancreatic head resection cannot be performed...
May 16, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29766928/parent-artery-sacrifice-for-ruptured-aneurysms-in-acute-and-chronic-phases-a-systematic-review
#18
REVIEW
Xianli Lv, Wei Li, Huijian Ge, Hengwei Jin, Hongwei He, Chuhan Jiang, Youxiang Li
Background: Experience with respect to parent vessel sacrifice (PVS) for unclippable/uncoilable ruptured aneurysms is limited. Objective: The aim of the present systematic review was to evaluate the risk of PVS for unclippable/uncoilable ruptured aneurysms. Materials and Methods: The PUBMED and SCIENCEDIRECT databases were searched using "parent vessel occlusion OR parent artery occlusion" AND "acute subarachnoid hemorrhage" till December 27, 2015, and 1 journal was searched from November 1995 to April 2016 for relevant results...
May 2018: Neurology India
https://www.readbyqxmd.com/read/29764036/-comparison-of-prognostic-value-of-18-f-fdg-pet-ct-myocardial-metabolism-imaging-and-coronary-collateral-circulation-in-patients-with-cto-lesions
#19
G Y Zhai, J L Wang, Y Y Liu, Y J Zhou
Objective: To evaluate the location, extent of viable myocardial of chronic total coronary occlusions(CTO)lesions by (18)F-FDG PET myocardial metabolism imaging and then compare with coronary collateral circulation(CCC) to evaluate the prognostic evaluation in patients with CTO lesions. Methods: A total of Sixty consecutive patients with CTO lesions referred for viability assessment from April 2016 to April 2017 in Department of Cardiology, Beijing Anzhen Hospital were included in the study. These patients underwent (99m)Tc-sestamibi ECG-gated SPECT rest myocardial perfusion imaging and ECG-gated (18)F-FDG PET/CT myocardial metabolic imaging, as well as coronary arteriography were recruited in this study...
May 8, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29762235/quality-and-safety-in-health-care-part-xl-stents-and-unusual-indications-for-a-pci
#20
Jay A Harolds
Percutaneous coronary interventions (PCI) are done for a variety of indications. Data from the CathPCI Registry is highly useful to evaluate the outcomes from performing a PCI procedure in unusual circumstances, such as in cases of chronic total coronary artery occlusion, cardiogenic shock after a myocardial infarction, syncopal patients, asymptomatic patients, and before surgery that is noncardiac. Registry information is also valuable in evaluating the efficacy of coronary stents. This article summarizes some of the information available on these subjects...
May 14, 2018: Clinical Nuclear Medicine
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