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Masafumi Tomita, Shuji Saito, Shinichiro Makimoto, Shuntaro Yoshida, Hiroyuki Isayama, Tomonori Yamada, Takeaki Matsuzawa, Toshiyuki Enomoto, Rika Kyo, Toshio Kuwai, Nobuto Hirata, Mamoru Shimada, Tomio Hirakawa, Koichi Koizumi, Yoshihisa Saida
BACKGROUND: Self-expandable metallic stenting (SEMS) for malignant colorectal obstruction (MCO) as a bridge to elective surgery (BTS) is a widely used procedure. The aim of this study was to assess short-term outcomes of SEMS for MCO as BTS. METHODS: This study analyzed pooled data from BTS patients who were enrolled in two multicenter prospective single-arm observational clinical studies that used different stent types. Both studies were conducted by the Japan Colonic Stent Safe Procedure Research Group (JCSSPRG)...
July 13, 2018: Surgical Endoscopy
John D Horowitz, Peter R Sage
No abstract text is available yet for this article.
July 2018: Circulation. Cardiovascular Interventions
Sorin J Brener, Giuseppe Tarantini, Martin B Leon, Patrick W Serruys, Pieter C Smits, Clemens von Birgelen, Aaron Crowley, Ori Ben-Yehuda, Gregg W Stone
BACKGROUND: Despite advances in technology and technique, a substantial proportion of patients still die within several years after percutaneous coronary intervention (PCI). The relative rates of cardiovascular and noncardiovascular death after PCI remain uncertain. METHODS AND RESULTS: We pooled individual patient-level data from 21 randomized clinical trials of PCI performed in 32 882 patients. All studies had independent adjudication of clinical events. We calculated the relative ratio of cardiovascular to noncardiovascular death in each trial up to 5 years and identified predictors of all-cause, cardiovascular, and noncardiovascular death...
July 2018: Circulation. Cardiovascular Interventions
Woo Jin Jang, Sung Gyun Ahn, Young Bin Song, Seung-Hyuk Choi, Woo Jung Chun, Ju Hyeon Oh, Sung Woo Cho, Bum Sung Kim, Jung Han Yoon, Bon-Kwon Koo, Cheol Woong Yu, Yang Soo Jang, Seung-Jea Tahk, Hyo-Soo Kim, Hyeon-Cheol Gwon, Sung Yun Lee, Joo-Yong Hahn
BACKGROUND: Whether prolonged dual antiplatelet therapy (DAPT) improves clinical outcomes after percutaneous coronary intervention for coronary bifurcation lesion is uncertain. METHODS AND RESULTS: We evaluated 2082 patients who were treated with drug-eluting stent for bifurcation lesions and were event free (no death, myocardial infarction [MI], cerebrovascular accident, stent thrombosis, or any revascularization) at 12 months after the index procedure. Patients were divided into 2 groups: DAPT ≥12-month group (n=1776) and DAPT <12-month group (n=306)...
July 2018: Circulation. Cardiovascular Interventions
Youssef Teklali, Yohann Robert, Bernard Boillot, Camille Overs, Christian Piolat, Pierre Yves Rabattu
AIMS: The aims of this study were to evaluate the efficacy and safety of endoscopic treatment of primary obstructive megaureter in children, and to assess its long-term outcome. METHODS: Case files of 35 children who had endoscopic treatment of symptomatic primary obstructive megaureter between 2006 and 2016 were retrospectively analyzed. All children had ureterovesical junction dilatation with one or more ureteral dilators, and insertion of a JJ stent. An analysis of the case files and a comparison between pre- and postoperative ultrasound and scintigraphy findings were performed...
June 28, 2018: Journal of Pediatric Urology
Kjetil Søreide, Thomas G Weiser, Rowan W Parks
BACKGROUND: Pancreatic injury is rare and optimal diagnosis and management is still debated. The aim of this study was to review the existing data and consensus on management of pancreatic trauma. METHODS: Systematic literature review until May 2018. RESULTS: Pancreas injury is reported in 0.2-0.3% of all trauma patients. Severity is scored by the organ injury scale (OIS), with new scores including physiology needing validation. Diagnosis is difficult, clinical signs subtle, and imaging by ultrasound (US) and computed tomography (CT) non-specific with <60% sensitivity for pancreatic duct injury...
July 11, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Seena Safavy, Emmanuel Mitsinikos, Bradford Tropea, Allen Chang, Hetal Patel
INTRODUCTION: Inguinoscrotal bladder hernia is a very rare pathology, occurring in up to 4% of all inguinal hernias in the general population. We present a case of an inguinoscrotal bladder hernia causing obstructive uropathy and sepsis. CASE PRESENTATION: A 59-year-old obese man presented with left-sided flank and abdominal pain that radiated to his left groin. On initial clinical examination, there was no evidence of an inguinal hernia. A computed tomography scan revealed a left inguinoscrotal bladder hernia with associated left-sided upper tract urinary obstruction...
June 18, 2018: Permanente Journal
Maoyin Pang, Michael J Bartel, Donnesha B Clayton, Bhaumik Brahmbhatt, Timothy A Woodward
BACKGROUND:  Proximal esophageal stents are poorly tolerated and have a high risk of complications. We report our experience using fully covered, biliary, self-expandable metal stents (B-SEMS) and narrow-diameter, esophageal, self-expandable metal stents (NDE-SEMS) for this group of patients. METHODS:  24 patients underwent placement of B-SEMS or NDE-SEMS for proximal esophageal lesions between 1 January 2011 and 31 July 2016. The outcomes included improvement of dysphagia, healing of fistulas, and adverse events...
July 13, 2018: Endoscopy
Sherri Rose, Sharon-Lise Normand
Postmarket comparative effectiveness and safety analyses of therapeutic treatments typically involve large observational cohorts. We propose double robust machine learning estimation techniques for implantable medical device evaluations where there are more than two unordered treatments and patients are clustered in hospitals. This flexible approach also accommodates high-dimensional covariates drawn from clinical databases. The Massachusetts Data Analysis Center percutaneous coronary intervention cohort is used to assess the composite outcome of 10 drug-eluting stents among adults implanted with at least one drug-eluting stent in Massachusetts...
July 13, 2018: Biometrics
S Sinha, S Z Jaumdally, F Cassim, J Wicht, L Kaestner, A Panackal, C H Jehle, P Govender, S De Jager, E De Wet, M Dewar, M E Kolia, S Salukazana, C Moolman, A P Van den Heever, B Kowlessur, G Pinto, J Lazarus
BACKGROUND: Ureteral stenting is generally a theatre-based procedure that requires a multidisciplinary team and on-table imaging. Limited hospital bed numbers and theatre time in our centre in Cape Town, South Africa, have led us to explore an alternative approach. OBJECTIVES: To see whether outpatient insertion of ureteric stents under local anaesthesia without fluoroscopy was a possible and acceptable alternative to theatre-based ureteral stenting. METHODS: Ureteral stenting (double-J stents and ureteric catheters) was performed with flexible cystoscopy under local anaesthesia and chemoprophylaxis, but without fluoroscopic guidance, in an outpatient setting...
May 25, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Dina Chaaro Benallal, Solene Hoibian, Fabrice Caillol, Erwan Bories, Christian Presenti, Jean Phillippe Ratone, Marc Giovannini
No abstract text is available yet for this article.
July 12, 2018: Endoscopic Ultrasound
Jarkko P Hytönen, Jouni Taavitsainen, Johannes T T Laitinen, Anna Partanen, Kari Alitalo, Olli Leppänen, Seppo Ylä-Herttuala
BACKGROUND: Antiproliferative drugs in drug eluting stents (DES) are associated with complications due to impaired re-endothelialization. Additionally, adventitial neovascularization has been suggested to contribute to in-stent restenosis (ISR). Since Vascular Endothelial Growth Factors (VEGFs) are the key mediators of angiogenesis, we investigated feasibility and efficacy of local gene therapy for ISR utilizing soluble decoy VEGF receptors to reduce biological activity of adventitial VEGFs...
July 9, 2018: Journal of Molecular and Cellular Cardiology
Benoit Bordaçahar, Fabiano Perdigao, Sarah Leblanc, Maximilien Barret, Jean-Christophe Duchmann, Marie Anne Guillaumot, Stanislas Chaussade, Olivier Scatton, Frédéric Prat
BACKGROUND AND AIMS: Anastomotic biliary strictures (ABSs) are one of the most frequent adverse events that occur after orthotopic liver transplantation (OLT). Multiple plastic stents (MPSs) have been validated for this indication. More recently, fully covered self-expandable metallic stents (FCSEMSs) have been used with positive outcomes, but also have a higher rate of migration, which may limit success. Our primary objective was to compare stent migration rates observed with "standard" FCSEMSs (Std-FCSEMSs) and so-called "anti-migration" FCSEMSs (Am-FCSEMSs), which are newly designed with reversed proximal side flaps...
July 9, 2018: Gastrointestinal Endoscopy
Dorota Danielak, Marta Karaźniewicz-Łada, Franciszek Główka
The introduction of ticagrelor, one of the first directly-acting oral antiplatelet drugs, provided new possibilities in the prevention of thrombotic events in patients with acute coronary syndromes (ACS). Current guidelines recommend ticagrelor in dual antiplatelet therapy with aspirin over clopidogrel for prevention of stent thrombosis in patients with ACS. Moreover, in the management of ACS, lipid-lowering treatment with high-intensity statin therapy is advised for secondary prevention of cardiovascular events over the long term...
July 12, 2018: Drugs
Chadin Tharavej, Worawit Kattipatanapong, Suppaut Pungpapong, Suthep Udomsawaengsup, Krit Kitisin, Patpong Navicharern
BACKGROUND: Early postoperative jejunal limb obstruction is a rare complication following gastric surgery with jejunal reconstruction. The condition is mainly attributed to kinking of the jejunal limbs, gastrojejunal or jejunojejunal anastomosis. There has been currently limited information regarding the safety and efficacy of endoscopic treatment in patients with early postoperative jejunal obstruction. We aimed to investigate outcome of endoscopic small-bore naso-jejunal (N-J) tube stenting across the obstructed segment in patients with uncomplicated early postoperative partial jejunal limb obstruction...
July 12, 2018: Surgical Endoscopy
Manabu Kashiwagi, Takashi Tanimoto, Hironori Kitabata
A 74-year old man presented recurrent angina pectoris due to in-stent restenosis (ISR) with severely calcified neointima. In-stent neoatherosclerosis (NA) is associated with late stent failure, and NA with calcified neointima occurs in some cases. Because the presence of neointimal calcification could lead to underexpansion of newly implanted stent for ISR, a scoring balloon was selected for predilatation to obtain maximum extrusion of the neointimal plaque and subsequently, an everolimus-eluting stent was implanted...
2018: Case Reports in Cardiology
Mateusz Jagielski, Marian Smoczyński, Krystian Adrych
No abstract text is available yet for this article.
2018: Przegla̜d Gastroenterologiczny
Piotr Kulig, Krzysztof Lewandowski, Bartłomiej Banaś, Piotr Piekorz, Andrzej Kostka, Maciej Zaniewski
Introduction: Endovascular aneurysm repair as a minimally invasive alternative has become a commonly used surgical method for treating patients with abdominal aortic aneurysm (AAA). Aim: To analyze short-term outcomes of endovascular treatment of AAA patients, including ruptured cases. Material and methods: From 2010 to 2015, 247 patients with AAA were treated using the endovascular aneurysm repair technique. A short-term analysis was conducted - up to 30 days after surgery...
June 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Xueli Cai, Yixin Wei, Shaojun Ren, Zhiping Wu, Xiao Peng, Yuejin Huang, Liangtong Huang, Xiumei Liu, Zhihua Yang
Introduction: Vertebral artery stenosis is a major cause of posterior circulation ischemia in the elderly. There is not a clear consensus on the optimal therapeutic approach for symptomatic extracranial vertebral artery stenosis. Aim: To evaluate the feasibility and efficacy of balloon-expandable stent angioplasty in the treatment of vertebral artery stenosis in the V2 segment. Material and methods: Five patients with vertebral artery stenosis (V2 segment) and treatment of percutaneous transluminal stenting from July 2009 to June 2014 were retrospectively evaluated...
June 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Janusz R Włodarczyk, Jarosław Kużdżał
Introduction: Proximally located oesophageal cancer poses an especially difficult problem in terms of restoration of patency and the stenting procedure. Supplementary percutaneous endoscopic gastrostomy (PEG) may be useful in these patients. Aim: To assess the safety of the stenting procedure in the proximal oesophagus in patients with unresectable upper oesophageal cancer, performed simultaneously with PEG insertion. Material and methods: Patients with obstructing upper oesophageal tumours were scheduled for an oesophageal stenting procedure and simultaneous PEG insertion...
June 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
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