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https://www.readbyqxmd.com/read/28527771/aspirin-versus-aspirin-plus-clopidogrel-as-antithrombotic-treatment-following-transcatheter-aortic-valve-replacement-with-a-balloon-expandable-valve-the-arte-aspirin-versus-aspirin%C3%A2-clopidogrel-following%C3%A2-transcatheter-aortic-valve-implantation-randomized%C3%A2
#1
Josep Rodés-Cabau, Jean-Bernard Masson, Robert C Welsh, Bruno Garcia Del Blanco, Marc Pelletier, John G Webb, Faisal Al-Qoofi, Philippe Généreux, Gabriel Maluenda, Martin Thoenes, Jean-Michel Paradis, Chekrallah Chamandi, Vicenç Serra, Eric Dumont, Mélanie Côté
OBJECTIVE: The aim of this study was to compare aspirin plus clopidogrel with aspirin alone as antithrombotic treatment following transcatheter aortic valve replacement (TAVR) for the prevention of ischemic events, bleeding events, and death. BACKGROUND: Few data exist on the optimal antithrombotic therapy following TAVR. METHODS: This was a randomized controlled trial comparing aspirin (80 to 100 mg/day) plus clopidogrel (75 mg/day) (dual-antiplatelet therapy [DAPT]) versus aspirin alone (single-antiplatelet therapy [SAPT]) in patients undergoing TAVR with a balloon-expandable valve...
May 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28526046/balloon-versus-stenting-in-severe-ischaemia-of-the-leg-3-basil-3-study-protocol-for-a-randomised-controlled-trial
#2
Benjamin D Hunt, Matthew A Popplewell, Huw Davies, Lewis Meecham, Hugh Jarrett, Gareth Bate, Margaret Grant, Smitaa Patel, Catherine Hewitt, Lazaros Andronis, Jonathan J Deeks, Andrew Bradbury
BACKGROUND: Severe limb ischaemia (SLI) is defined as the presence of rest pain and/or tissue loss secondary to lower extremity atherosclerotic peripheral arterial disease. The superficial femoral and popliteal arteries are the most commonly diseased vessels in such patients and are being increasingly treated using endovascular revascularisation techniques. However, it is currently unknown whether drug-eluting stents and drug-coated balloons confer additional clinical benefits over more established techniques using plain balloons and bare metal stents, or whether they represent a cost-effective use of NHS resources...
May 19, 2017: Trials
https://www.readbyqxmd.com/read/28525971/left-ventricular-mural-thrombus-and-dual-coronary-embolization-associated-with-hyperthyroid-cardiomyopathy-and-atrial-fibrillation-a-case-report
#3
Guohui Liu, Ping Yang, Yuquan He
BACKGROUND: The majority of acute myocardial infarction (AMI) events are caused by thrombotic occlusion of the coronary artery, secondary to atherosclerotic plaque erosion or rupture. However, coronary embolism (CE), while rare, is being increasingly recognized as an important cause of AMI. We present the case of a patient with multi-site coronary artery embolization associated with hyperthyroid-related cardiomyopathy and atrial fibrillation. CASE PRESENTATION: A 49-year-old female with a history of hyperthyroidism and atrial fibrillation (AF) was admitted to our hospital presenting with right upper limb pain and swelling...
May 19, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28525672/testing-of-a-novel-percutaneous-temporary-aortic-valve-in-a-rabbit-model-of-acute-severe-aortic-regurgitation-an-experimental-study
#4
Paul C Ho
PURPOSE: Device management of hemodynamic instability due to acute aortic regurgitation is not available. A novel, catheter-based, temporary aortic valve (TAV) has been in development. Early prototypes (balloon-based TAV) have undergone proof-of-concept studies in mathematical, bench and animal models. The redesigned membrane-based TAV prototype is evaluated in a rabbit model of acute severe aortic regurgitation. METHODS: Acute aortic regurgitation was simulated by deploying a self-expanding endovascular stent across the aortic annulus...
May 18, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28525663/management-of-male-and-female-neurogenic-stress-urinary-incontinence-in-spinal-cord-injured-sci-patients-using-adjustable-continence-therapy
#5
Enrico Ammirati, Alberto Manassero, Alessandro Giammò, Roberto Carone
INTRODUCTION: Artificial urinary sphincter (AUS) is an option for the treatment of neurogenic stress urinary incontinence (nSUI), but complications and re-operation rates are high, and there is no clear indication from guidelines (1). The aim of our study is to evaluate the effectiveness of a less invasive continence device in neurogenic population: Adjustable Continence Therapy ProACT/ACT®. METHODS: We retrospectively includedpatients with spinal cord injuries in this study, complaining of nSUI and treated at our Institution with Pro-ACT/ACT® implantation...
May 16, 2017: Urologia
https://www.readbyqxmd.com/read/28523446/in-vitro-quantification-of-luminal-denudation-after-crimping-and-balloon-dilatation-of-endothelialized-covered-stents
#6
Shigeo Ichihashi, Frederic Wolf, Thomas Schmitz-Rode, Kimihiko Kichikawa, Stefan Jockenhoevel, Petra Mela
PURPOSE: Covered stents have been demonstrated to reduce restenosis; however, the membrane's limited biocompatibility can still lead to thrombus formation. To obtain optimal surface hemocompatibility, endothelialization of the luminal surface has been proposed. However, the effect of delivery procedures, such as crimping and balloon dilatation, on the endothelial layer has not been quantified. This study investigated the impact of such procedures on endothelialized covered stents in vitro...
May 18, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28523173/thrombotic-responses-to-coronary-stents-bioresorbable-scaffolds-and-the-kounis-hypersensitivity-associated-acute-thrombotic-syndrome
#7
REVIEW
Nicholas G Kounis, Ioanna Koniari, Anastasios Roumeliotis, Grigorios Tsigas, George Soufras, Nicholas Grapsas, Periklis Davlouros, George Hahalis
Percutaneous transluminal coronary angioplasty with coronary stent implantation is a life-saving medical procedure that has become, nowadays, the most frequent performed therapeutic procedure in medicine. Plain balloon angioplasty, bare metal stents, first and second generation drug-eluting stents, bioresorbable and bioabsorbable scaffolds have offered diachronically a great advance against coronary artery disease and have enriched our medical armamentarium. Stented areas constitute vulnerable sites for endothelial damage, endothelial dysfunction, flow turbulence, hemorheologic changes, platelet dysfunction, coagulation changes and fibrinolytic disturbances...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28523137/complex-multimodality-central-airway-management-of-aspergillus-pseudomembranous-tracheobronchitis
#8
Samjot Singh Dhillon, Marwan Saoud, Kassem Harris
A 69-year-old woman developed central airway obstruction due to invasive Aspergillus infection resulting in pseudomembranous tracheobronchitis (PTB). Several challenges were encountered in the airway management of this patient including her having relatively smaller airways which were more prone to obstruction by pseudomembranes and made airway interventions difficult. The patient had clinical deterioration in spite of antifungal therapy and bronchoscopic debridement. The multimodality airway techniques included the use of smaller biliary balloons for dilatation, using a hybrid stent to slowly dilate and maintain patency of right main stem and finally the insertion of right secondary carina peripheral Y stent, which resulted in clinical improvement and allowed time for antifungal therapy to take effect...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28522945/current-status-of-endoscopic-balloon-dilation-for-crohn-s-disease
#9
REVIEW
Fumihito Hirai
The therapeutic target in Crohn's disease (CD) has been raised to the achievement of mucosal healing. Although effective treatments that target cytokines and other molecules has been widely used for CD, intestinal strictures are still a major cause of surgery. Endoscopic balloon dilation (EBD) is known to be an effective and safe intervention for intestinal strictures in CD. Since frequent intestinal resection often results in short bowel syndrome and can decrease the quality of life, EBD can help avoid surgery...
April 2017: Intestinal Research
https://www.readbyqxmd.com/read/28521609/adrenal-obliteration-by-balloon-occluded-retrograde-venous-ethanol-injection-in-a-swine-model
#10
Akitoshi Inoue, Shinichi Ohta, Norihisa Nitta, Shizuka Tsuboi, Akinaga Sonoda, Yuki Tomozawa, Shobu Watanabe, Kenichi Mukaisho, Kiyoshi Murata
PURPOSE: To evaluate the effects of adrenal obliteration by balloon-occluded retrograde venous ethanol injection. MATERIAL AND METHODS: We inserted a micro-balloon catheter into the left adrenal vein of six pigs and retrogradely injected absolute ethanol (0.06 ml/kg) under balloon occlusion. Two pigs were sacrificed on day 3, 7, and 14 after the procedure, respectively. We evaluated adrenal cortical and medullary hormones of the left renal vein, venograms, magnetic resonance imaging scans obtained before and after the procedure, autopsy and microscopic findings, and the weight of the bilateral adrenal glands...
May 19, 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/28520916/a-comparison-of-diffusion-weighted-imaging-abnormalities-following-balloon-remodeling-for-aneurysm-coil-embolization-in-the-ruptured-vs-unruptured-setting
#11
Stephen R Lowe, Tarun Bhalla, Holly Tillman, M Imran Chaudry, Aquilla S Turk, Raymond D Turner, Alejandro M Spiotta
BACKGROUND: The prothrombotic milieu seen in subarachnoid hemorrhage (SAH) poses a unique challenge to neurovascular surgeons with regard to device use and microcatheter practice. OBJECTIVE: To determine how demographic factors and balloon practices impact diffusion-weighted imaging (DWI) abnormalities and outcomes in patients with SAH compared to those without (non-SAH). METHODS: We retrospectively analyzed 77 patients with SAH treated by balloon-assisted coiling in a single institution compared with 81 consecutive patients with unruptured aneurysms treated by balloon-assisted coiling at the same institution...
May 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28520685/pelvic-fracture-pattern-predicts-the-need-for-hemorrhage-control-intervention-results-of-an-aast-multi-institutional-study
#12
Todd W Costantini, Raul Coimbra, John B Holcomb, Jeanette M Podbielski, Richard D Catalano, Allie Blackburn, Thomas M Scalea, Deborah M Stein, Lashonda Williams, Joseph Conflitti, Scott Keeney, Christy Hoey, Tianhua Zhou, Jason Sperry, Dimitra Skiada, Kenji Inaba, Brian H Williams, Joseph P Minei, Alicia Privette, Robert C Mackersie, Brenton R Robinson, Forrest O Moore
BACKGROUND: Early identification of patients with pelvic fractures at risk of severe bleeding requiring intervention is critical. We performed a multi-institutional study to test our hypothesis that pelvic fracture patterns predict the need for a pelvic hemorrhage control intervention. METHODS: This prospective, observational, multicenter study enrolled patients with pelvic fracture due to blunt trauma. Inclusion criteria included shock on admission (systolic blood pressure <90 mm Hg or heart rate >120 beats/min and base deficit >5, and the ability to review pelvic imaging)...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28520650/balloon-dilatation-of-the-minor-duodenal-papilla-up-to-4-mm-is-safe-in-a-porcine-model
#13
Philip C Müller, Daniel C Steinemann, Peter Sauer, Kaspar Z'graggen, Georg R Linke, Beat P Müller-Stich
OBJECTIVES: Balloon dilatation of the minor duodenal papilla is a treatment option for symptomatic pancreas divisum. The histologic effects of balloon dilatation have not yet been evaluated. The aim of this study is to investigate the tolerated extent of dilatation of the minor papilla. MATERIALS AND METHODS: A dilatation of the minor papilla was performed in freshly explanted pancreas of pigs using biliary balloon dilatators. Three organs were not dilated (control group), in each 8 organs a dilatation of 4, 6, and 8 mm, respectively, was performed...
May 17, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28517024/treatment-of-severe-alcoholic-hepatitis-past-present-and-future
#14
REVIEW
Nicolas Lanthier, Peter Stärkel
Alcoholic hepatitis manifests as a clinical syndrome characterized by recent jaundice and liver function deterioration in an actively drinking patient. The principal cause of alcoholic hepatitis is alcoholic steatohepatitis defined histologically by the coexistence of steatosis, hepatocyte ballooning and satellitosis. While non-severe alcoholic hepatitis usually responds to alcohol abstinence, severe alcoholic hepatitis, identified by Maddrey scoring ≥ 32, has a bad prognosis and is traditionally treated by a 28-day course of prednisone therapy...
May 18, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28516757/gastric-perforation-caused-by-an-intragastric-balloon-endoscopic-findings
#15
In Kyung Yoo, Hoon Jai Chun, Yoon Tae Jeen
Intragastric balloon (IGB) insertion has been most frequently used in the West as an effective endoscopic treatment for morbid obesity, in practice. Recently, there is a growing number of cases requiring IGB deployment for obesity treatment in Korea. One of the reported complications of IGB use is gastric perforation. A 47-year-old woman was admitted to the hospital with mild symptoms, 7 weeks after having an IGB placed. Esophagogastroduodenoscopy was performed and gastric ulcer perforation was observed in the ulcer base, where food particles were impacted...
May 18, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28516094/combined-transapical-transcatheter-aortic-valve-replacement-and-thoracic-endovascular-aortic-repair-for-severe-aortic-stenosis-and-arch-aneurysm
#16
Yuanjia Zhu, Eric E Roselli, Jay J Idrees, Samir Kapadia, Lars G Svensson
An 83-year-old male with multiple comorbidities presented with critical aortic stenosis and a saccular aortic arch aneurysm. Through a mini thoracotomy, a balloon expandable transcatheter aortic valve was delivered transapically. A thoracic stent graft was then delivered through the prosthetic valve and deployed in the arch, while a covered stent was deployed in the left common carotid artery. Three-year postoperative computed tomography showed a thrombosed arch aneurysm with decreased size. This case demonstrates the feasibility of using combined transapical transcatheter technologies to treat multicomponent disease in a high-risk patient during a single operation...
October 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28515828/primary-percutaneous-coronary-intervention-using-balloon-assisted-sliding-and-tracking-blast-of-diagnostic-catheter-to-negotiate-double-hairpin-loop-of-radial-artery
#17
Santosh Kumar Sinha, Vikas Mishra, Mukesh Jitendra Jha, Mahmadula Razi, Anupam Mahrotra, Nasar Abdali, Lokendra Rekwal, Vikas Chaturvedi, Anupam Kumar Singh, Ramesh Thakur
During transradial intervention, sharp edge of the guide catheter tip may act like a "razor-blade" and can prevent the catheter navigation especially in situation like double hair pin loop. Here, we report primary percutaneous coronary intervention (PCI) through diagnostic catheter using an innovative technique, balloon-assisted sliding and tracking (BLAST), to overcome this double hairpin loop, thus saving time and contrast volume.
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515824/cardiogenic-shock-acute-severe-mitral-regurgitation-and-complete-heart-block-after-cavo-tricuspid-isthmus-atrial-flutter-ablation
#18
Thein Tun Aung, Edward Samuel Roberto, Kevin D Kravitz
Radiofrequency (RF) ablation is the first-line management of cavo-tricuspid isthmus dependent atrial flutter. It has been performed with 95% success rate. Adverse events are very rare. We report the first case of acute severe mitral regurgitation (MR) and complete heart block developed after successful atrial flutter ablation. A 62-year-old female with mild MR presented with palpitations. Surface electrocardiogram was suggestive of isthmus dependent atrial flutter. A duodecapolar mapping catheter showed an atrial flutter with cycle length of 280 ms...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515596/balloon-occluded-retrograde-transvenous-obliteration-for-bleeding-gastric-varices-eyes-see-what-the-mind-knows
#19
Pushpinder S Khera, Lee Myungsu, Choi Joonsung
Approximately one in six patients with portal hypertension who develop varices at sites of portosystemic venous collaterals has gastric varices due to hepatofugal flow into the gastric veins. Bleeding from gastric varices, though less common, has a higher mortality and morbidity compared to bleeding esophageal varices, which are easier to manage endoscopically. The efferent channel for gastric varices is mostly the gastrorenal shunt (GRS) which opens into the left renal vein. Balloon-occluded transvenous obliteration (BRTO) involves accessing the GRS with an aim to temporarily occlude its outflow using a balloon catheter and at the same time injecting sclerosant mixture within the varix so as to cause its thrombosis and thereby obliteration...
January 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28514261/doppler-ultrasound-evaluation-of-circulatory-support-devices
#20
Zachary Nuffer, Andrey Rupasov, Shweta Bhatt
In the setting of mechanical circulatory support devices, including ventricular assist devices, extracorporeal membrane oxygenation, intraaortic balloon pumps, and the total artificial heart, the spectral Doppler waveform is significantly altered, reflecting systemic hemodynamic changes. As the prevalence of these devices increases, a better understanding of both the devices themselves and their associated Doppler ultrasound findings is necessary for accurate image interpretation. This article reviews the clinical indications, pathophysiology, and sonographic findings of these devices, with emphasis on the variation in arterial Doppler waveforms that can be seen with normal function, as well as the major complications...
May 16, 2017: Ultrasound Quarterly
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