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BMJ (Clinical Research Ed.) Oct 1996
Topics: Angioplasty; Coronary Disease; Humans; Recurrence; Stents
PubMed: 8876082
DOI: 10.1136/bmj.313.7062.892 -
Turk Kardiyoloji Dernegi Arsivi : Turk... Mar 2022Percutaneous transluminal angioplasty has gained increasing popularity in the treatment of peripheral artery disease. However, the increase in the frequency of this...
Percutaneous transluminal angioplasty has gained increasing popularity in the treatment of peripheral artery disease. However, the increase in the frequency of this procedure also increases the risk of complications. Percutaneous transluminal angioplasty has serious and general complications in terms of device and technique at puncture and dilatation sites. In this case, we describe the easy and practical management of deflating an undeflated ballon in the right superficial femoral artery.
Topics: Angioplasty; Angioplasty, Balloon; Femoral Artery; Humans; Peripheral Arterial Disease; Punctures
PubMed: 35400638
DOI: 10.5543/tkda.2022.21129 -
JPMA. the Journal of the Pakistan... Mar 2023Peripheral arterial disease (PAD) in diabetic patients is often overlooked due to associated neuropathy. The very first presentation of these patients is with an... (Review)
Review
Peripheral arterial disease (PAD) in diabetic patients is often overlooked due to associated neuropathy. The very first presentation of these patients is with an Ischaemic ulcer or toe gangrene. Diabetics have a very high amputation rate compared to non-diabetic patients due to diffuse multi-segmental disease in the calcified tibial arteries. Early detection of the condition is a challenge in these patients. Even ankle-brachial pressure index may not be reliable. Both surgical and endovascular options are effective in wound healing. Endovascular techniques include percutaneous transluminal angioplasty with and without stenting, sub-intimal angioplasty, percutaneous transluminal angioplasty with drug-coated balloons, covered stents, and use of atherectomy devices. The current narrative review was planned to discuss the essentials of diagnosing PAD in diabetic patients and its various treatment options.
Topics: Humans; Peripheral Arterial Disease; Angioplasty; Diabetes Mellitus; Endovascular Procedures; Stents; Treatment Outcome; Angioplasty, Balloon
PubMed: 36932767
DOI: 10.47391/JPMA.4590 -
BMJ (Clinical Research Ed.) Apr 1997
Topics: Angioplasty; Aortic Aneurysm, Abdominal; Blood Vessel Prosthesis; Humans; Stents
PubMed: 9146373
DOI: 10.1136/bmj.314.7088.1139 -
Systematic Reviews Dec 2018The worldwide incidence and prevalence of diabetes mellitus (DM) are increasing. DM has a high social and economic burden due to its complications and associated...
BACKGROUND
The worldwide incidence and prevalence of diabetes mellitus (DM) are increasing. DM has a high social and economic burden due to its complications and associated disorders. Peripheral arterial disease (PAD) is closely related to DM. More than 85% of patients with DM will develop PAD in their lifetime, and between 10 and 25% of patients with DM will have a foot ulcer. In such cases, it is important to determine for each patient whether it is necessary and feasible to revascularise the affected limb as well as the optimal technique. Percutaneous transluminal angioplasty (PTA) is designed to restore blood flow through the vessel lumen by various devices including balloons, drug-coated balloons, bare stents, drug-eluting stents and endovascular atherectomes. This systematic review aims to evaluate the effects of PTA in the treatment of lower limb arterial ulcers in diabetic patients.
METHODS
We will search randomised controlled trials (RCTs) and quasi-RCTs in the following databases (e.g., MEDLINE via PubMed, EMBASE, Lilacs, Cochrane Central Register of Controlled Trials, Ibecs, CINAHL, AMED, World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov , and OpenGrey). Our search strategy will use the following free-text terms and controlled vocabulary (e.g., Emtree, MeSH) for 'foot ulcer', 'leg ulcer', 'diabetic foot', 'Peripheral Arterial Disease', 'Diabetes Complications', 'Peripheral Vascular Diseases', 'critical limb ischemia', 'below the knee ulcer', 'angioplasty', 'stents', 'stenting', and 'endovascular procedures'. There will be no limits on date or language of publication. Two authors will, independently, select studies and assess the data from them. Risks of bias (RoB) of included studies will be evaluated using the Cochrane's RoB tool. If possible, we will perform and report structured summaries of the included studies and meta-analyses. Results are not available as this is a protocol for a systematic review, and we are currently in the phase of building a sensitive search strategy.
DISCUSSION
While there are several available endovascular techniques for revascularisation, it is unclear which technique has better outcomes for ulcers below the knee in diabetic patients. A systematic review is required to validate and demonstrate these techniques and their outcomes to allow an evidence-based clinical decision.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42017065171.
Topics: Angioplasty; Diabetes Mellitus; Endovascular Procedures; Humans; Leg Ulcer; Peripheral Arterial Disease; Stents; Systematic Reviews as Topic
PubMed: 30537989
DOI: 10.1186/s13643-018-0897-0 -
European Journal of Vascular and... Sep 2009The aim of this study was to determine accurate estimates of the success rate of subintimal angioplasty in terms of ability to recanalise occluded vessels, patency over... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The aim of this study was to determine accurate estimates of the success rate of subintimal angioplasty in terms of ability to recanalise occluded vessels, patency over time and limb salvage rates.
DESIGN
A meta-analysis of published literature.
MATERIALS
All studies reporting unique patient data published in English language between 1989 and 2008.
METHODS
Separate meta-analyses were performed for immediate technical success, 12-month patency rates and 12-month limb salvage rates. Longer-term outcomes were analyzed in separate meta-analyses. Meta-regression was applied to determine whether any of these outcomes had improved over time.
RESULTS
Pooled estimates for technical success, primary patency at 12 months and limb salvage at 12 months were 85.7% (95% confidence interval: 83.3%-87.7%, 2810 limbs), 55.8% (95% confidence interval: 47.9%-63.4%, 1342 limbs), and 89.3% (95% confidence interval: 85.5%-92.2%, 2810 limbs), respectively. Regression analysis demonstrated no significant change in outcomes over time. There was some evidence of publication bias, however, after adjusting for this there was little change in the pooled outcome estimates.
CONCLUSIONS
This study demonstrates that the outcomes for subintimal angioplasty are good and that this method should be considered as an alternative to surgical bypass.
Topics: Angioplasty; Constriction, Pathologic; Extremities; Humans; Limb Salvage; Peripheral Vascular Diseases; Publication Bias; Regression Analysis; Time Factors; Treatment Outcome; Vascular Patency
PubMed: 19570689
DOI: 10.1016/j.ejvs.2009.05.014 -
Journal of Electrocardiology 2022Acute coronary occlusion results in increased T-wave amplitude and ST-segment elevation in the ECG leads facing the ischemic region.
BACKGROUND
Acute coronary occlusion results in increased T-wave amplitude and ST-segment elevation in the ECG leads facing the ischemic region.
MATERIAL AND METHODS
We performed continuous ECG recording in 34 patients during balloon occlusion of the left anterior descending (LAD), left circumflex (LCx) and right coronary artery (RCA). Delta (Δ) ST and ΔT amplitudes were calculated by subtracting the preinflation values from the values measured during balloon inflation.
RESULTS
Occlusion of the LAD resulted in greater increase in the amplitude of the T wave than of the ST segment in lead V2 (ΔT +3.4 mm, inter-quartile range [IQR] 1-6 mm; ΔST +1.4 mm, 0.5-3 mm). During RCA occlusion, ΔST and ΔT didn't differ significantly. LCx occlusion resulted in significant differences between ΔST and ΔT in all leads, except aVF and V3-V4. In two patients (LCx), we observed a biphasic ST-T response: an initial negative change of the T-wave amplitude was followed by a positive change in leads V1-V2. In leads II, III, aVF and V4-V6, there was an initial positive change, followed by a final negative change towards the end of the occlusion.
CONCLUSION
Continuous 12‑lead ECG recording during balloon occlusion of the LCx resulted in significant differences between the ΔST and ΔT values in all leads except aVF and V3-V4. LAD and RCA occlusion resulted in less evident differences between the ST-segment and T-wave changes. A change in polarity of T-wave changes during balloon occlusion (initial negative and final positive change, or vice versa) proved to be a rare finding.
Topics: Angioplasty, Balloon; Angioplasty, Balloon, Coronary; Arrhythmias, Cardiac; Coronary Occlusion; Electrocardiography; Humans
PubMed: 35738147
DOI: 10.1016/j.jelectrocard.2022.06.003 -
The Journal of Cardiovascular Surgery Dec 2006Open surgical repair of thoracoabdominal aortic aneurysms (TAAA) bridges the aneurysm with a large, conventional, unstented graft and restores flow to the visceral... (Review)
Review
Open surgical repair of thoracoabdominal aortic aneurysms (TAAA) bridges the aneurysm with a large, conventional, unstented graft and restores flow to the visceral arteries through short grafts or direct sutured connections between the visceral arterial orifices and the primary conduit. The combination of retrograde visceral bypass and endovascular aneurysm exclusion substitutes an endovascular stent-graft for a standard graft, stented overlaps for sutured anastomoses, and transluminal insertion for direct aortic exposure. Compared to open surgery, the combination treatment requires less dissection, and causes less hemodynamic instability, and lower complication rates, particularly paraplegia. The multi-branched stent-graft substitutes endovascular visceral bypass through branches of the stent-graft for surgical visceral bypass through branches of a conventional extraluminal graft, which has the potential to further reduce surgical dissection, hemodynamic instability, and complication rates. We favor a modular approach in which short, axially oriented cuffs are extended into the visceral arteries, using self-expanding covered stents. In the past year, we have used this approach to implant multi-branched thoracoabdominal stent-graft in 16 patients. In our opinion, this approach will eventually assume a prominent role in the management of TAAA.
Topics: Angioplasty; Aortic Aneurysm, Abdominal; Aortic Aneurysm, Thoracic; Blood Vessel Prosthesis Implantation; History, 20th Century; History, 21st Century; Humans; Prosthesis Design; Stents
PubMed: 17043607
DOI: No ID Found -
Journal of Medicine and Life Feb 2022Carotid artery stenosis is responsible for up to 12% of all ischemic strokes. The prevalence of bilateral carotid artery stenosis is nearly 8-39% among patients with...
Carotid artery stenosis is responsible for up to 12% of all ischemic strokes. The prevalence of bilateral carotid artery stenosis is nearly 8-39% among patients with stroke, and its management is still controversial. This study aimed to report the treatment results of bilateral carotid artery stenosis with simultaneous bilateral angioplasty and stenting (sbCAS) in a single institution during the last 10 years. 315 patients underwent carotid stenting in the Scientific-Practical Center of Endovascular Neuroradiology, NAMS of Ukraine during 2010-2020. 39 (12.4%) patients (mean age 57.9±2.1 - 28 men) underwent sbCAS. Primary clinical endpoints (stroke, myocardial infarction, or death) and secondary endpoints (hemodynamic depression (HD) - hypotension (<90 mmHg) or bradycardia (<60 bpm) and hyperperfusion syndrome (HPS) were evaluated. All sbCAS were technically successful, and a reduction of stenosis was noted in each case. There were two periprocedural neurological complications, one transient ischemic attack (TIA), and one minor stroke with the Modified Rankin Scale (mRS) - 3 at discharge. No myocardial infarction (MI) or death during hospitalization was noted. 28 patients (71.8%) had HD, and 2 (5.1%) had HPS. All patients except those with periprocedural stroke were discharged or transferred to another hospital without neurological deterioration. sbCAS is an effective and relatively safe procedure for carefully selected patients with bilateral carotid stenosis. Patients with bilateral carotid stenosis should be carefully examined, and the best treatment strategy should be assessed using a multidisciplinary approach taking into account the possibility of sbCAS.
Topics: Angioplasty; Carotid Stenosis; Female; Humans; Male; Middle Aged; Myocardial Infarction; Retrospective Studies; Risk Factors; Stents; Stroke; Treatment Outcome
PubMed: 35419100
DOI: 10.25122/jml-2021-0274 -
The Keio Journal of Medicine Sep 2001More than 20 years have passed since percutaneous transluminal coronary angioplasty (PTCA) was introduced for the treatment of coronary artery disease. During the first... (Review)
Review
More than 20 years have passed since percutaneous transluminal coronary angioplasty (PTCA) was introduced for the treatment of coronary artery disease. During the first decade, PTCA outcome had improved significantly. However, acute occlusive complications and restenosis remained as significant limitations of the procedure. During the second decade, new procedures, such as stents and atherectomy (directional coronary atherectomy, and Rotablator) had been introduced and had a significant impact on the outcome of percutaneous coronary intervention (PCI). In addition to the improvements in the equipment, the use of glycoprotein IIb/IIIa inhibitors to prevent platelet aggregation has reduced procedure-related complications. PCI continues to evolve with new developments such as distal protection devices to prevent distal embolism, brachytherapy and drug-eluting stents to prevent restenosis. These new technologies may play a significant role in expanding the applications of PCI in the future.
Topics: Angioplasty, Balloon, Coronary; Atherectomy, Coronary; Coronary Angiography; Coronary Disease; Humans; Recurrence; Stents
PubMed: 11594037
DOI: 10.2302/kjm.50.152