International Nuclear Information System (INIS)

Objective: To explore the interventional method to treat biliary recurrent jaundice after T tube drainage in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods: 7 biliary metallic stents were placed in 7 patients with recurrent jaundice after T-tube drainage in cholangiocarcinoma cases. Results: Stent placement was once successful in all 7 cases with successful rate of 100%. For all cases, TBIL, ALT, GTP and AKP values 7 days postoperatively were significantly lower than that of preoperation together with subsidence of jaundice satisfactorily for 100% after the treatment. Conclusions: Percutaneous placement of biliary metallic stents was effective economic, minimal invasive and safe for palliation of biliary recurrent jaundice after T tube drainage in cholangiocarcinoma-induced obstructive ...

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To compare clinical effectiveness of Viabil-covered stents versus uncovered metallic Wallstents, for palliation of malignant jaundice due to extrahepatic cholangiocarcinoma, 60 patients were enrolled in a prospective and randomized study. In half of the patients a bare Wallstent was used, and in the other half a Viabil biliary stent. Patients were followed up until death. Primary patency, survival, complication rates, and mean cost were calculated in both groups. Stent dysfunction occurred in 9 (30%) patients in the bare stent group after a mean period of 133.1 days and in 4 (13.3%) patients in the covered stent group after a mean of 179.5 days. The incidence of stent dysfunction was significantly lower in the covered stent group (P = 0.046). Tumor ingrowth occurred exclusively in the bare ...

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We wanted to determine the technical and clinical efficacy of using a PTFE-covered self-expandable nitinol stent for the palliative treatment of malignant biliary obstruction. Thirty-seven patients with common bile duct strictures caused by malignant disease were treated by placing a total of 37 nitinol PTFE stents. These stents were covered with PTFE with the exception of the last 5 mm at each end; the stent had an unconstrained diameter of 10 mm and a total length of 50 80 mm. The patient survival rate and stent patency rate were calculated by performing Kaplan-Meier survival analysis. The bilirubin, serum amylase and lipase levels before and after stent placement were measured and then compared using a Wilcoxon signed-rank test. The average follow-up duration was 27.9 weeks (range: 2 81 weeks). Placement was ...

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We wanted to determine the technical and clinical efficacy of placing a self-expandable PTFE-covered nitinol stent for the management of inoperable malignant biliary obstruction. Thirty six patients with inoperable malignant biliary obstructions were treated by placement of self-expandable PTFE-covered nitinol stents (S and G Biotech Corporation, Seongnam, Korea). Clinical evaluation was done with assessment of the serum bilirubin and alkaline phosphatase levels, which were measured before and after stent placement within 1 week, at 1 month and at 3 months. The patient survival rate and stent patency rate were calculated with performing Kaplan-Meier survival analysis. Successful stent placement was achieved in all the patients without procedure-related complication. Pancreatitis as an early complication occurred in two cases. The serum ...

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Objective: To evaluate the effect of PTBD in treating malignant biliary obstruction caused by hilar cholangiocarcinoma. Methods: We retrospectively analyzed the data of 103 patients(M:62,F:41)with malignant obstructive jaundice caused by hilar cholangiocarcinoma. After taking percutaneous transhepatic cholangiography, metallic stent or plastic external catheter or external-internal catheter for drainage was deployed and then followed up was undertaken with clinical and radiographic evaluation and laboratory. examination. Results: All patients went though PTBD successfully (100%). According to Bismuth classification, all 103 cases consisted of I type(N=30), II type (N=30), III type (N=26) and IV type (N=17). Thirty-nine cases were placed with 47 stents and 64 eases with drainage tubes. 4 cases installed two stems for bilateral drainage, 2 cases installed two stents because of long segmental strictures ...

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AIM: The purpose of the study was to evaluate the percutaneous use of the new nitinol SMARTeR stents in patients with biliary obstruction. MATERIALS AND METHODS: Four stents were placed in three patients percutaneously under ultrasound and fluoroscopic guidance. RESULTS: The deployment of the stents was successful in all three patients. All stents maintained their patency and position after short-term follow-up. CONCLUSION: The nitinol SMARTeR stent is useful in the management of patients with biliary obstruction although accurate placement across the ampulla was found to be technically more difficult than with the Wallstent. Larger, long-term follow-up studies are required to evaluate the long-term patency of these new devices.

UK PubMed Central (United Kingdom)

The covered self-expandable metallic stent (SEMS) has been developed to overcome the problem of tissue in­growth, However, stent migration is a well-known com­­plication of covered...Full Text Available

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We wanted to evaluate the usefulness of a new type of a complex expandable nitinol stent that was designed to reduce the stent's propensity to migration during the treatment of malignant gastroduodenal obstructions. Two types of expandable nitinol stent were constructed by weaving a single thread of 0.2mm nitinol wire in a tubular configuration: an uncovered stent 18mm in diameter and a covered stent 16mm in diameter. Both ends of the covered stent were fabricated by coaxially inserting the covered stent into the tubular uncovered stent and then attaching the two stents together with using nylon monofilament. Under fluoroscopic guidance, the stent was placed in 29 consecutive patients (20 men and 9 women, mean age: 65 years) who were suffering with malignant gastric ...

UK PubMed Central (United Kingdom)

Incidence of esophageal cancer (EC) is rising more rapidly in the Western world than that of any other cancer. Despite advances in therapy, more than 50% of patients have incurable disease at the time...Full Text Available

British Library Electronic Table of Contents (United Kingdom)

Background This study aimed to evaluate the feasibility, safety, and follow-up results of endoscopic papilletomy (ESP) with pancreatic and biliary duct stent placement for ampullary tumors. The therapeutic approach to benign ampullary tumors remains unsettled. The ESP procedure is a curative treatment option for benign papillary tumors, but ESP raises concerns about a relatively high risk for procedure-related complications such as pancreatitis. A pancreatic stent may protect against complications. Methods Between September 2000 and June 2008, 36 patients with ampullary tumors confined to the mucosa and no intraductal tumor growth underwent ESP. The preprocedural diagnostic tools included endoscopic ultrasound, transpapillary intraductal ultrasound, and endoscopic retrograde cholangiopancr...

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Objective: To evaluate the treatment of malignant biliary stenoses and occlusions using a new stent. Methods: In a prospective study, 25 patients with malignant obstructive jaundice were treated with SMART stents. The handling and the quality of stent expansion were documented. Stent function was assessed 2-4 days after intervention by cholangiography and laboratory tests. A follow-up was performed three months, after stent placement. Results: All lesions were treated successfully, with a total of 35 stents implanted. In 14 patients a further balloon dilatation was performed after stent placement (8-10 mm diameter/40-80 mm length). The mean serum bilirubin level decreased significantly from 11.6 mg/dl to 4.6 mg/dl after intervention (p<0.05). The follow-up showed a mean serum bilirubin level at 4.0 mg/dl. In 4 ...

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Inferior vena cava (IVC) obstruction is a well-described clinical entity. Most IVC obstructions from malignant neoplasms are a direct result of tumor compression [Oviedo J, Cerda S. Vascular invasion by hepatocellular carcinoma. Arch Pathol Lab Med 2001;125: 454-5; Furui S, Sawada S, et al. Gianturco stent placement in malignant caval obstruction: analysis of factors for predicting the outcome. Radiology 1995;195:147-52; Fletcher WS, Lakin PC, et al. Results of treatment of inferior vena cava syndrome with expandable metallic stents. Arch Surg 1998;133:935-8]. The symptoms of IVC obstruction include progressive ascites, scrotal edema and lower body edema. These constellations of symptoms are described as IVC syndrome and are devastating to a patient with end-stage cancer. We describe a palliative therapy utilizing Luminexx nitinol self-expanding stents to treat intracaval hepatoma thrombus obstructing ...

International Nuclear Information System (INIS)

The incidence of hilar cholangiocarcinoma is very rare worldwide. Radical resection is the only prognostic factor for long survival in patients with hilar cholangiocarcinoma. Postoperative radiation therapy can improve local control and survival rates for patients with palliative resection, but it remains controversial in patients with radical resection. Biliary drainage can effectively release bile duct obstruction for the majority of patients with locally advanced disease, and may even prolong survival when combined with radiation therapy. Radiation therapy includes extrernal beam therapy alone, external beam therapy with intraluminal brachytheapy and new radiation technique, such as three dimentional conformal therapy and intensity modulated radiation therapy. The propective randomized clinical study is needed for further investigation in the role of combined modality therapy especially for hilar cholangiocarcinoma. (authors)

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Aim: To evaluate magnetic resonance cholangiography (MRC) with high-resolution dynamic gadolinium-enhanced magnetic resonance imaging (MRI) in determining the imaging features of hilar cholangiocarcinoma that relate to tumour extent and influence resectability. Materials and methods: Twenty-six patients that underwent resection were reviewed. Tumour location and extent, lobar atrophy, the degree of portal vein and hepatic artery involvement were recorded. The findings were correlated with surgical and histopathological findings. Results: Biliary assessment was concordant in 14 and discordant in eight of 14 stented and four of 12 non-stented patients. In 63/82 veins and 43/74 arteries results were fully concordant. The mean sensitivity, specificity, positive and negative predictive values (PPV, NPV) in predicting involvement of the main portal vein (MPV) at surgery were 83.3, 100, 100, and 92.5%; of the left main branch of ...

UK PubMed Central (United Kingdom)

This article is a story of networking of palliative care at the corporate level. This gives an insight that if you have will and dedication then you can imagine and make it true that networking can...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundThis study focuses on the role of an Internet-based group for people who have an autoimmune liver disease, primary biliary cirrhosis. Primary biliary...Full Text Available

Science.gov (United States)

Coronary Bifurcation Lesion

UK PubMed Central (United Kingdom)

Goals of workThe goal of this study was to evaluate, at a population level, the association between specialized palliative care services (SPCS) and short- and long-term caregiver...Full Text Available

British Library Electronic Table of Contents (United Kingdom)

Background: Mechanisms underlying the association between myocardial bridge (MB)-stenting and in-stent restenosis (ISR) are still unclear. Objective: To assess the impact of MB on ISR using intravascular ultrasound (IVUS). Methods: In the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial, 100 left anterior descending artery (LAD) culprit lesions (79 treated with paclitaxel-eluting stents [PES] and 21 treated with bare metal stents) were imaged with serial IVUS immediately postprocedure and at 13 months. Results: At baseline the LAD stent extended into the MB segment beyond the culprit lesion in seven patients (MB-stent group). In the remaining 93 patients the LAD stent was implanted only in the culprit lesion without extending into t...

UK PubMed Central (United Kingdom)

To evaluate the role of chronic inflammation in the development of gallstones and biliary tract cancer, we examined the risk associated with 62 single nucleotide polymorphisms (SNPs), including...Full Text Available

UK PubMed Central (United Kingdom)

We report herein a case of thoraco diaphragmatico biliary fistula in a 24-year-old male who was managed conservatively with antibiotics and tube thoracostomy and had complete radiological clearance.

UK PubMed Central (United Kingdom)

BackgroundVascular stents are small tubular scaffolds used in the treatment of arterial stenosis (narrowing of the vessel). Most vascular stents are metallic and are deployed either...Full Text Available

UK PubMed Central (United Kingdom)

AIM: To find out whether a newly designed big cup nitinol stent is suitable for treatment of patients with gastric outlet obstruction resulting from gastric cancer.METHODS: The new stent is composed...Full Text Available

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The aim of this study was to evaluate imaging features of different coronary artery stents during multislice CT Angiography (MSCTA). Nineteen stents made of varying material (steel, nitinol, tantalum) and of varying stent design were implanted in plastic tubes with an inner diameter of 3 mm to simulate a coronary artery. The tubes were filled with iodinated contrast material diluted to 200 Hounsfield units (HU), closed at both ends and positioned in a plastic container filled with oil (-70 HU). The MSCT scans were obtained perpendicular to the stent axes (detector collimation 4 x 1 mm, table feed 2 mm/rotation, 300 mAs, 120 kV). Axial images and multiplanar reformations were evaluated regarding artifact size, lumen visibility, and intraluminal attenuation values. Artifacts characterized by artifactual thickening of the stent struts leading to apparent reduction in the lumen diameter ...

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The purpose of this study was to evaluate the safety and the retrievability of a new covered retrievable nitinol tracheobronchial stent. Stents were knitted from 0.2mm nitinol wire, covered with polyurethane, and were 20-22mm in diameter and 2cm in length. Under fluoroscopic guidance, a stent was placed in the normal right bronchus intermedius of ten dogs. Using a retrieval hook, stent retrieval was attempted after 1 month(N=5) or 2 months(N=5). After removal, the dogs were sacrificed and their their tracheobronchial trees were examined grossly and histologically. Eleven stents were successfully placed in ten dogs. Migration and expectoration occurred in four of ten stents in nine dogs(40%). Five stents were successfully removed from six dogs(83%). Without significant difference between the two groups, mild to moderate mucosal hyperplasia ...

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The aim of this study was to qualitatively and quantitatively study MR artifacts of various stents on the basis of in vitro experiments. We were particularly interested whether sequence type and orientation of the stent with respect to the static magnetic field influences the artifact. We examined 18 stents of different material (nitinol, stainless steel, cobalt alloy), different design of the stent meshes (AccuLink, OmniLink, DynaLink, Xact, Protoge, Wallstent Monorail), different diameter (5-10 mm) and different length (18-58 mm) with a turbo spin echo (TSE), a 2D-fast low angle shot (FLASH) and a 3D-FLASH sequence. The MR images were examined qualitatively with respect to possible artifacts. Furthermore we examined the MR data quantitatively: The contrast-noise-ratio (CNR) was determined both within the stent and outside (within the tube); based on these values we calculated the ...

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No abstract prepared.

British Library Electronic Table of Contents (United Kingdom)

Biodegradable helicoidal stent prototypes made up of layers of poly-L-lactic acid (PLLA) and poly(L-lactic-co-glycolic acid) (PLGA) polymers were fabricated by temperature conditioning the stents at different stages of fabrication. The process incorporated elastic memory, or self-expandability in the stent, which is desirable to minimize stent recoil. The collapse pressures of such stents were studied, with and without in vitro degradation. The effects of thickness and the composition of each layer on the collapse pressure were modeled using the simple series model. Results of the in vitro studies for over 3 months showed that collapse pressure of the stents depended mainly on the degradation and other side-effects brought about by the degradation of different polymer compositions. General...

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To evaluate the efficacy of a paclitaxel-eluting nitinol stent on the inhibition of pseudointimal hyperplasia in a transjugular intrahepatic portosystemic shunt. Twelve pigs were used in this study. Two types of 10-mm diameter and 60-mm long nitinol stents were made for a transjugular intrahepatic portosystemic shunt by coating them with a polyurethane solution, with and without paclitaxel. Each transjugular intrahepatic portosystemic shunt was created successfully in the 12 swine with 7 paclitaxel-eluting stents and 5 polyurethane stents. Five swine in each group were followed-up for 14 days due to the death of 2 swine given the paclitaxel-eluting stents. The proliferation of the pseudointima was evaluated on both follow-up portograms and histopathology examinations. The mean maximum pseudointimal hyperplasia is expressed as the percentage of the stent radius. ...

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Hepatobiliary scintigraphy is the only non-invasive technique providing real-time assessment of hepatocytes function and bile progression from the liver to the intestine; for this reason it is of great importance in the study of jaundice and many other disorders of the liver and the biliary tract in children. Ultrasonography is the initial method of evaluating the intra- and extrahepatic bile ducts dilatation: the differential diagnosis between biliary atresia and neonatal hepatitis cannot however be done without hepatobiliary scintigraphy. Cystic fibrosis patients also require hepatobiliary scintigraphy; liver and biliary tract disease can really occur independently of the underlying disease severity and the presence of steatorrhoea. Hepatobiliary imaging in children who have undergone liver transplantation is of major importance; it can assess vascularity, parenchymal function biliary drainage, ...

International Nuclear Information System (INIS)

Objective: To evaluate the effect of metallic stent combined with stereotactic conformal radiotherapy (SCRT) for hilar cholangiocarcinoma. Methods: Fifty-four patients with hilar cholangiocarcinoma were analyzed, including 31 treated with stent plus stereotactic conformal radiotherapy (combined group) and 23 with metallic stent alone (control group). Results: The mean survival time of combined group was 11.1 #+-# 4.6 months, compared with 5.1 #+-# 2.8 months of the control group, giving a significant difference between the two groups (P<0.01). Conclusion: The combination of metallic stent and stereotactic conformal radiotherapy is more effective than metallic stent alone for unresectable hilar cholangiocarcinoma. (authors)

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Coiling or infusion of embolic materials into a wide necked aneurysm can be performed with stenting. The purpose of our study is to assess the technical feasibility of aneurysm treatment with glue embolization after stenting. We used four Wallstents for surgically repairing eight canine carotid aneurysms. After confirmation of the aneurysms on the angiogram, we introduced a 6-7 F guiding catheter in order to deploy the stents. After stenting, we passed a microcatheter into the aneurysm lumen through the stent mesh. 28% glue was slowly injected until the glue cast completely filled the lumen. We evaluated the passage of a microcatheter through the stent meshwork, formation of the glue cast and the stents' ability to protection for any leakage of glue. The follow-up angiogram was obtained for two dogs, one to three times until 8 weeks, and ...

UK PubMed Central (United Kingdom)

BackgroundAirway complications are among the most challenging problems after lung transplantation, and Self-Expandable Metallic Stents (SEMS) are used to treat airway complications...Full Text Available

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Infrainguinal peripheral occlusive disease is increasingly being treated by endovascular techniques. Bare metal stainless steel, self-expanding nitinol stents, drug-eluting and covered stents (stent grafts) are becoming increasingly more important adjuncts to percutaneous translumninal angioplasty in the treatment of peripheral artery disease. In this article the available evidence supporting the use of stents in the femoropopliteal and tibial arteries will be described as well as their limitations. Future stent developments will also be discussed. (orig.) [German] Die endovaskulaere Therapie spielt bei der Therapie der peripheren arteriellen Verschlusskrankheit (PAVK) eine wichtige Rolle. Unbeschichtete ballonexpandierbare Stahlstents, selbstexpandierende Nitinolstents sowie medikamentenbeschichtete und ''covered stents'' ...

UK PubMed Central (United Kingdom)

AIM: To compare 2 different types of covered esophageal nitinol stents (Ultraflex and Choostent) in terms of efficacy, complications, and long-term outcome.METHODS: A retrospective review of...Full Text Available

Science.gov (United States)

Carotid Artery Disease; Stroke; Amaurosis Fugax; Transient Ischemic Attack (TIA)

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The feasibility of self-expanding nitinol stents for treatment of infragenicular arteries following unsuccessful balloon angioplasty was assessed. Options for lower limb percutaneous revascularization are limited, especially for complex vessel obstruction. Depending on the lesion and the experience of the interventionalist, the failure rate of balloon angioplasty (PTA) ranges between 10 and 40%. Until recently, no self-expanding stent for the use in the infragenicular arteries was available. This is the first report of the results for 18 consecutive patients who received 4F sheath compatible self-expanding nitinol stents following unsuccessful PTA or early restenosis. Twenty-four stents were implanted in 21 lesions for various indications residual stenosis >50% due to heavy calcification, flow-limiting dissection, occluding thrombus resistant to thrombolyis, thrombaspiration, and PTA, and early ...

International Nuclear Information System (INIS)

Radiotherapy has been reported to be of benefit in prolonging the survival of patients with cholangiocarcinoma. This study examined whether radiotherapy in addition to endoscopic stenting improved survival. The survival advantage of radiotherapy in those with a type II/III stricture is seen only in the first 10 months after diagnosis. The costs of radiotherapy and significantly increased time spent in hospital, however, raise doubts over its routine use in the management of non-resectable cholangiocarcinoma. (Author).

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The purpose of this study was to test a large sample of different coronary artery stents using four image reconstruction approaches with respect to lumen visualization, lumen attenuation, and image noise in 64-slice multidetector-row computed tomography (MDCT) in vitro and to provide a catalogue of currently used coronary artery stents when imaged with state-of the-art MDCT. We examined 68 different coronary artery stents (57 stainless steel, four cobalt-chromium, one cobalt-alloy, two nitinol, four tantalum) in a coronary artery phantom (vessel diameter 3 mm, intravascular attenuation 250 HU, extravascular density -70). Stents were imaged in axial orientation with standard parameters: 32x0.6 collimation, pitch 0.24, 680 mAs, 120 kV, rotation time 0.37 s. Four different image reconstructions were obtained with varying convolution kernels and section thicknesses: (1) soft, 0.6 mm, (2) soft, 0.75, (3) ...

International Nuclear Information System (INIS)

Objective: Traditional nasolacrimal duct stenting possesses some shortcoming including difficulty of pulling ball head guide wire from the nasal cavity with turbinate hypertrophy and nasal septal deviation. The new method of nose-oral tube track establishment can overcome the forementioned and increase the successful rate. Methods: 5 F catheter and arterial sheath were modified to be nasolacrimal duct stent delivery device respectively. Antegrade dacryocystography was taken firstly to display the obstructed site and followed by the modified protocol of inserting the guide wire through nasolacrimal duct and nasal cavity, and establishing the stent delivery track for retrograde stent placement. Results: 5 epiphora patients with failure implantation by traditional method were all succeeded through the modified stenting (100%). During 6-mouth follow-up, no serious complications and ...

UK PubMed Central (United Kingdom)

The heterogeneity of metastatic breast cancer mandates the need to select therapies taking into account tumor and patient characteristics. Chemotherapy is indicated in the palliative setting especially...Full Text Available

UK PubMed Central (United Kingdom)

Background:Parity has been linked to gallbladder cancer and gallstones, but the effects of other reproductive factors are less clear.Methods:We examined...Full Text Available

UK PubMed Central (United Kingdom)

Background:This study evaluated the outcomes of patients with complex or persistent thoracobiliary fistulae following penetrating liver trauma, who underwent endoscopic biliary intervention...Full Text Available

UK PubMed Central (United Kingdom)

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a widely used diagnostic and therapeutic modality in the management of biliary and pancreatic disease. Some of the complications of the procedure,...Full Text Available

International Nuclear Information System (INIS)

/sup 99m/Tc biliary imaging was performed on a 34-year-old woman who was being investigated for suspected cholelithiasis. A left-sided liver was detected. On subsequent radionuclide imaging, partial visceral situs inversus and asplenia were demonstrated. Extensive roentgenographic investigation, ECG, echocardiogram, and laparotomy confirmed the radionuclide findings. Asplenia syndrome may exist without cardiovascular abnormalities and thus be undiscovered. Radionuclide imaging is important in the diagnosis of this syndrome.

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The objective of this study was to compare contrast-enhanced magnetic resonance angiography (CE MRA) and multislice computed tomographic angiography (MS CTA) in the follow-up of thoracic stent-graft placement. The CE MRA and MS CTA were performed following nitinol stent-graft treatment due to thoracic aneurysm (n=4), intramural bleeding (n=2) and type-B aortic dissection (n=5). Corresponding evaluation of arterial-phase imaging characteristics focused on the stent-graft morphology and leakage assessment. Stent-graft and aneurysm extensions were comparable between both techniques. Complete exclusion (aneurysm, n=4; dissection, n=2) was assessed with high confidence with CE MRA and MS CTA. Incomplete exclusion (intramural bleeding, n=2; dissection, n=3) was assigned to lower confidence scores on CE MRA compared with MS CTA. On CE MRA the stent-graft lumen demonstrated an inhomogeneous ...

International Nuclear Information System (INIS)

Stenting for stenosis of the proximal vertebral artery (VA) is commonly performed via a femoral approach. However, iliofemoral occlusive disease such as arteriosclerosis obliterans sometimes prevents safe transfemoral access. In certain situations where both femoral access and ipsilateral brachial access are difficult because of a concomitant vascular diseases or particular anatomic setting, a contralateral brachial approach using the brachiobrachial pull-through technique may allow efficient and accurate stenting. A case of VA origin symptomatic stenosis successfully treated with stenting using the new pull-through technique from the contralateral brachial artery to the brachial artery on the affected side is described. (orig.)

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Purpose: To evaluate the success rates of the implantation of stent grafts in the treatment of peripheral aneurysms. Materials and methods: in 13 patients with 15 aneurysms at the common iliac artery (n = 6), external iliac artery (n = 1), hypogastric artery (n = 2), femoral artery (n = 2) or popliteal artery (n = 4), implantation of dacron-covered nitinol stents was performed. The patients were followed up for three to 20 months (mean, 8.8 months) with intravenous digital subtraction angiography, CT or colour-coded Doppler sonography. Results: In all cases, the aneurysm was successfully occluded after stent implantation. In one case with a popliteal aneurysm, kinking of the vessel caused thrombosis of the stent. The stent was successfully reopened. The aneurysm however, had to be surgically treated 9 months later. The primary and secondary patency rates at 6 months were 93% and ...

UK PubMed Central (United Kingdom)

Background. New-generation drug-eluting stents (DES) may solve several problems encountered with first-generation DES, but there is a lack of prospective head-to-head comparisons between...Full Text Available

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As an alternative to surgery, endovascular therapy with stent grafts has become the second main treatment option for infrarenal abdominal aortic aneurysms. Unlike surgery, endovascular treatment with stent grafts is also applicable in patients unfit for open repair. Despite current improvements in endovascular repair devices, significant anatomic barriers still exclude this technique for a large number of patients. Computed tomography, magnetic resonance imaging, and ultrasound are essential for diagnostics, preintervention planning, and postintervention follow-up of abdominal aneurysms treated with stent grafts. This review covers etiology, pathology, and diagnostic aspects. Materials and methods for endovascular treatment of abdominal aortic aneurysms are presented in detail, and clinical results and complications are discussed. (orig.) [German] Die endovaskulaere Therapie des infrarenalen Bauchaortenaneurysmas hat sich ...

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Purpose: To evaluated artifacts of unexpended stents and to determine their exact position for MR-guided percutaneous transluminal angioplasty using real-time sequences. Materials and Methods: By using an in vitro model, 11 unexpended stents - 9 nitinol, 1 stainless steel, and 1 cobalt alloy - were investigated by MR. Each stent was studied in a vessel-phantom filled with saline solution. Imaging was performed using five different realtime sequences: fast low angle shot (Flash 2D), fast imaging with steady precession (true FISP, FISP, interactive true FISP) and segmented echo planar imaging (seg. EPI). Artifacts of the introducer system and the stent were calculated by four blinded radiologists (scale: 1 - artifacts, making an excellent contribution to visualization; 2 - artifacts, making mainly a contribution to visualization; 3 - artifacts, making no contribution to visualization). Furthermore, an ...

International Nuclear Information System (INIS)

Described is the diagnosis for the cancer extension of cholangiocarcinoma by various imaging techniques and processes to support the current surgical procedure based on preoperative biliary drainage. The cancer tends to locally extend horizontally and/or vertically and its diagnosis is important for surgical indication. For the indication, multi-detector raw CT (MDCT) and MR cholangio-pancreatography (MRCP) are useful and particularly, the former can give multi-phase (arterial, portal and delayed) images to reconstruct multiplanar (MPR) and CT angiographic 3D images, which have made the previous invasive examinations like angiography and percutaneous transportal contrasting unnecessary. MDCT and MRCP can almost complete the diagnosis of the extension. The operative procedure is decided dependently on the site of the lesion, and of which diagnosis, whether it is hepatic hilar/on upper bile duct or middle/lower ductal, is different. MDCT-MPR and MRCP are virtually ...

International Nuclear Information System (INIS)

The purpose of this study was to evaluate the safety and efficacy of TACE with microspheres preloaded with doxorubicin in unresectable intrahepatic cholangiocarcinoma (UCH). Twenty patients with UCH were observed; 9 refused, preferring other palliative care or chemotherapy, and 11 agreed to be treated with one or more cycles of DC beads loaded with doxorubicin (100-150 mg) in a TACE procedure between February 2006 and September 2007. A total of 29 individual TACE procedures were performed. Follow-up imaging was performed on all patients before, immediately after, and 4 weeks after each TACE procedure to evaluate the response and need for further treatment. Each patient received i.v hydration, antibiotics, and medications against nausea and pain before TACE. Survival rate was calculated using Kaplan-Meier survival curve. A response rate of 100% followed RECIST criteria was observed. Eight of eleven patients are alive, with a median survival of 13 months. TACE was ...

International Nuclear Information System (INIS)

Chronic mesenteric arterial ischemia is an uncommon condition associated a high morbidity and mortality. It is most Commonly caused by atherosclerotic occlusive disease. Patients may suffer epigastric or periumbilical postprandial pain ten to thirty minutes after eating. A case of chronic mesenteric artery stenosis, the diagnosis was performance with colonoscopy and biopsy. We present a case report of a patient with chronic mesenteric ischemia. Mesenteric arteriography was performed and documented estenosis of the mesenteric superior artery. Then percutaneous arteriography with angioplasty and implant of stent was performed. The patients became completely asymptomatic and normal colon mucous is observed in control colonoscopy. The purpose of this report is to present the case endoscopy, clinic and radiological features and to describe the percutaneous angioplasty and implant of stent. We believe that angioplasty treatment offers and improvement ...

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The purpose of this study was to evaluate the usefulness of a multifunctional gastrointestinal coil catheter for stent placement in 98 patients with colorectal strictures. The catheter was used in 98 consecutive patients for stent placement in the rectum (n = 24), recto-sigmoid (n = 13), sigmoid (n = 38), descending (n = 6), transverse (n = 11), splenic flexure (n = 3), hepatic flexure (n = 2), and ascending (n = 1) colon. The catheter was made of a stainless steel coil (1.3 mm in inner diameter), a 0.4-mm nitinol wire, a polyolefin tube, and a hemostasis valve. Usefulness of the catheter was evaluated depending on whether the catheter could pass a stricture over a guide wire and whether measurement of the stricture length was possible. The passage of the catheter over a guide wire beyond the stricture was technically successful and well tolerated in 93 (94.9%) of 98 patients. In the failed five patients, it was not possible to negotiate the ...

UK PubMed Central (United Kingdom)

Background:Endothelin-1 may be involved in the development of diabetic microangiopathy. We studied the effect of endothelin-1 blockade on myocardial microcirculation during coronary...Full Text Available

UK PubMed Central (United Kingdom)

Gastrointestinal perforations are conservatively managed at endoscopy by through-the-scope endoclips and covered self expandable stents, according to the size and tissue features of the perforation....Full Text Available

UK PubMed Central (United Kingdom)

BackgroundObservational clinical studies have shown that patients with diabetes have less favorable results after percutaneous coronary intervention compared with the non-diabetic...Full Text Available

UK PubMed Central (United Kingdom)

Endovascular treatment of post-traumatic pseudoaneurysms has become a viable, less invasive option when compared to open repair. Due to the relative youth of this technology, studies have yet to be...Full Text Available

UK PubMed Central (United Kingdom)

Tracheobronchial balloon dilation and stent placement have been well used in the treatment of patients with benign and/or malignant diseases. Balloon dilation is the first option in the treatment of...Full Text Available

UK PubMed Central (United Kingdom)

Endovascular surgery is a new multidisciplinary field that applies the recently innovated techniques of angioscopy, intraluminal ultrasound, balloon angioplasty, laser, mechanical atherectomy, and stents....Full Text Available

UK PubMed Central (United Kingdom)

Hemoptysis in patients with lung cancer is not uncommon and sometimes have dangerous consequences. Hemoptysis has been managed with various treatment options other than surgery and medicine, such as...Full Text Available

UK PubMed Central (United Kingdom)

ObjectiveTo determine if an aggressive approach to coronary revascularisation with oversized balloons is counterproductive, we studied the effect of increasing balloon‐to‐artery...Full Text Available

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Objective: To determine the efficacy of a covered stent prototype designed for protected carotid angioplasty to reduce cerebral embolization. Material and Method: The covered stent tested is made of nitinol, coated with a polyurethane membrane (MembraX{sup TM}; porous size 80 {mu}m). In a bench-top model (flow-rate 650 ml/min, pulsatile flow [dicrote] 123 Pulses/min, pressure 100/60 mm Hg [mean pressure 80 mmHg]) with inserted human carotid (n=6) stent implantation was performed (8/32 mm). Passed particles (mg) were determined in the effluent of a 100 {mu}m filter prior to intervention, after stent deployment and after final dilation (5 mm). Results: When stenting carotid arteries obtained from human cadavers, the highest rate of particle embolization was measured while crossing the lesion with the delivery device (6,8 mg; for all p<0,05), embolization after additional ...

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The purpose of this study was to investigate the feasibility and the optimal conditions of radiofrequency (RF) ablation by using the stent-type electrode upon the saphenous vein of goats for the endovenous treatment of varicose veins. A self-expandable nitinol stent electrode (6 mm diameter, 2 cm length, cell size; 1.3 x 2 mm) was designed to expose the distal 1 cm segment to allow for contact with the venous wall. The proximal part of the electrode was connected to the RF generator by insulated copper wires located within the stent electrode introducer. Initially, to optimize the power setting, ablation of 6 saphenous veins in 3 goats was performed with power settings of 10, 20 and 30 W. Pull back rate of the electrode was 2 and 4 cm/min for each power level, respectively. The goats were sacrificed 4-6 weeks later and histologic examinations of the saphenous veins were done. For the second part of the experiment, RF ...

Science.gov (United States)

A 67-year-old man presented with gastrointestinal bleeding resulting from a fistula between the aortic stump and the fourth part of the duodenum 14 months after an axillobifemoral bypass, graft excision, and aortic stump closure for aortic graft infection. The patient initially refused any attempt at definitive surgical treatment so coil embolization of the aortic stump was performed via a brachial approach. Coil embolization may be a useful adjunct in the management of such difficult problems. This approach may buy time and allow careful planning of a definitive treatment or may serve as a palliative procedure in inoperable patients. PMID:15947052

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The incidence of hepatocellular carcinoma (HCC) is increasing in developed countries and the general status of HCC patients is now by far better than a few years ago, allowing physicians to propose some different treatments of these patients. Among these treatments, intra-arterial injection of 131-iodine-labelled Lipiodol could be used in palliative, curative or adjuvant settings. After a brief summary of the modalities of this treatment, requiring the collaboration of Gastro-enterologists, Oncologists, Radiologists and Nuclear Medicine physicians, the different possibilities of therapeutic uses of this new approach are described and an outlook of these developments is proposed. (author)

International Nuclear Information System (INIS)

The aim of this retrospective study was to determine the safety and efficacy of chemoembolization (TACE) as palliative treatment for patients with unresectable intrahepatic cholangiocarcinoma (CCA) and to compare the results with those in the literature. Fifteen patients with histology-proven CCA (5 men, 10 women) had received palliative treatment with TACE over a 6-year period. The treatment protocol comprised repeated TACE at a minimum of 8-week intervals. TACE was performed with a mixture of 10 ml Lipiodol and 10 mg mitomycin C injected into the tumor-supplying vessels. Follow-up investigations after 8-10 weeks comprised contrast-enhanced multislice spiral CT and laboratory control. Statistical evaluation included survival analysis using the Kaplan-Meier method. During the investigation period 58 TACEs (3.9 #+-# 3.8; 1-15) were performed in 15 patients. Mean tumor size was 10.8 #+-# 4.6 cm (range, 2.0-18.0 cm). Unifocal tumor disease was ...

International Nuclear Information System (INIS)

Objective: To evaluate the diagnostic value of 64 multidetector-row CT angiography for internal carotid artery (ICA) stenosis and the application in the follow-up of carotid endarterectomy and percutaneous transluminal stenting. Methods: Forty transient ischemic attack (TIA) patients with interpretable CTA and DSA of the cervical carotid arteries were selected from May 2005 to December 2005. This yielded a total of 80 vessels. The CTA curved planar reformations (CPR) and DSA images referenced to the distal cervical internal carotid were graded by two senior neuroradiologists blindly, according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) guidelines. The paired-t test was used to verify the statistical significant difference between pre-operating and post-operating of carotid endarterectomy or percutaneous transluminal stenting in measuring the vascular diameter and area of cross section using CTA. Results: When the ...

British Library Electronic Table of Contents (United Kingdom)

ObjectivesThe SPIRIT V (A Clinical Evaluation of the XIENCE V Everolimus-Eluting Coronary Stent System in the Treatment of Patients With De Novo Coronary Artery Lesions) study is a post-market surveillance experience of the XIENCE V (Abbott Vascular, Santa Clara, California) everolimus-eluting stent (EES) in patients with higher-risk coronary anatomy. BackgroundPrevious pre-approval studies have shown the safety and efficacy of EES in highly selected groups of patients. MethodsThe SPIRIT V trial is a prospective, open label, single arm, multicenter study. Two thousand seven hundred patients with multiple de novo coronary artery lesions suitable for treatment with a planned maximum of 4 EES were enrolled at 93 centers in Europe, Asia Pacific, Canada, and South Africa. Lesions had a referenc...

International Nuclear Information System (INIS)

Surface doses received by patients and operators were measured during 30 interventional radiological procedures (ten percutaneous transhepatic biliary drainages, ten percutaneous nephrostomies, ten percutaneous transluminal angioplasties). In addition, organ doses to the patient were determined using an Alderson-Rando phantom. These served as a basis for calculating the so-called somatic dose indices. It was found that the somatic radiation risk to the patient is relatively small despite prolonged periods of fluoroscopy. However, exposure of the hands and lenses of the operator could easily reach the limits thought acceptable while carrying out these procedures with additional angiography. (orig).

British Library Electronic Table of Contents (United Kingdom)

BackgroundAlthough self-expandable metal stent (SEMS) insertion is widely used for relief of malignant colorectal obstructions, the immediate technical and clinical failure rates of SEMSs and the associated risk factors remain largely unknown. ObjectiveTo identify rates and factors predictive of technical and clinical failure of SEMSs when their use is attempted for the decompression of malignant colorectal obstruction. DesignRetrospective chart review. SettingA tertiary-care academic medical center in South Korea. PatientsThis study involved a total of 412 patients with malignant colorectal obstruction in whom SEMS insertion was attempted. InterventionPlacement of colonic SEMSs. Main Outcome MeasurementsTechnical success and immediate and long-term clinical success rates. ResultsTechnical...

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The key to the future for electric utilities will not be found in legislation or regulation. Title VII of the Energy Policy Act of 1992 will prove to be just as ineffectual in improving the industry's position as was the Public Utility Regulatory Policies Act of 1978. These legislative palliatives, which produced so much commotion and so many reams of heated commentary, are largely irrelevant to a successful future for electric utilities. The key will be found in economics, not in law, and the future will lie in completing Thomas A. Edison's century-old vision for the industry, half of which the industry has heretofore ignored. The industry must embrace the complete vision and evolve from electric utilities into [open quotes]end-use energy utilities.[close quotes

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The paper discusses a number of recent studies investigating into the energy conservation and environmental impacts of electric heating systems (off-peak storage systems). In future, i.e. in and after 1993, off-peak storage systems will be evaluated through comparative analyses of oil-fired heating systems, pollutant emission analyses, the eventual success of pollution abatement measures designed for power plant emissions to keep within the legal limiting values, and the possible abandonment of pollution abatement measures abroad. Opposing the electric heating studies submitted by the electric power industry the author refutes their favourable results referring to the palliative selection of inadequate or vague parameters. Assuming average power plant pollutant emissions of 180 mg/standard/sup 3/ the nitrogen oxide emissions of oil-fired heating systems (134.1 kg/Tj) are found to be below those of off-peak storage systems (242.5 kg/Tj).

British Library Electronic Table of Contents (United Kingdom)

Nonfunctioning pancreatic endocrine tumors (PETs) are rare and generally asymptomatic. A 68-year-old woman who had refused treatment for a pancreatic mass, revealed by ultrasonography to be 55 mm in diameter, was referred to us again 29 months later with jaundice. Investigations showed an 82-mm tumor in the head of pancreas, exposed from the papilla of Vater to the duodenal lumen. After biliary decompression and drainage, we performed pancreatoduodenectomy with resection of the portal vein and superior mesenteric vein, followed by reconstruction using a cylindrically customized autologous graft harvested from the right ovarian vein. The tumor was resected curatively. Microscopically, it consisted of trabecular and ribbon-like arrangement of neoplastic cells. Immunohistochemical staining wa...

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To understand the effect of heat treatment and mechanical polishing of a Nitinol wire on the chemical composition and physical morphology of the wire surface. Stents with a diameter of 1.0 cm, length of 8-10 cm, and composed of a Nitinol wire, were heat-treated at 500 .deg. C for 30 minutes, and mechanically polished with walnut shell granules. The wire surface morphology was studied with both an optical and a scanning electron microscope (SEM). In addition, an elemental analysis was performed by Energy Dispersive X-ray spectroscopy (EDX). Long microcracks along the wire direction and short microcracks across the wire were observed by SEM from the raw Nitinol wire. Upon heat treatment, the color of the wire turned blue, and Na, K, Cl, Si, Al atoms were seen from the EDX of the heat treated wire, which were absent in the original wire. The microcracks disappeared with the mechanical polishing, and the Na, K, Cl, Si, Al atoms all disappeared after the mechanical ...

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The aim of the paper is to review the role of interventional radiology in the management of hemodialysis vascular access and complications in renal transplantation. The evaluation of patients with hemodialysis vascular access is complex. It includes the radiology/ultrasound (US) evaluation of the peripheral veins of the upper extremities with venous mapping and the evaluation of the central vein prior to the access placement and radiological detection and treatment of the stenosis and thrombosis in misfunctional dialysis fistulas. Preoperative screening enables the identification of a suitable vessel to create a hemodynamically-sound dialysis fistula. Clinical and radiological detection of the hemodynamically significant stenosis or occlusion demands fistulography and endovascular treatment. Endovascular prophylactic dilatation of stenosis greater than 50% with associated clinical abnormalities such as flow-rate reduction is warranted to prolong access patency. The technical success ...

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Each disease affecting the bile ducts tends to produce characteristic pattern of biliary dilatation: recurrent pyogenic cholangitis causes dilatation and straightening of the larger (central) intrahepatic ducts: clonorchiasis causes dilatation of the smaller (peripheral) intrahepatic ducts; and carcinoma along the extrahepatic ducts causes (proportional) dilatation and tortuosity of both larger and smaller intrahepatic ducts. To evaluate the specificity of the pattern and morphology of the dilated biliary tree on CT scans (CT characterization) three independent radiologists who were unifamiliar with the cases were asked to classify 62 CT scans in patients with obstructive jaundice. The case population consisted of 14 cases with recurrent pyogenic cholangitis, 18 cases with clonorchiasis and 30 cases with carcinoma along the extrahepatic ducts, which were intermixed randomly. Classification was made only on the basis of CT characterization: ...

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Poly-Lactic-Acid (PLA) was evaluated for coating of vascular endoprotheses in the treatment of experimental arterio-venous-fistulae (AVF). Bilateral carotid-external jugular AVF were created in 5 adult dogs. 7 PLA coated nitinol stents were placed via a transfemoral approach covering 5 AVF. The contralateral AVF remained untreated. Angiography was performed immediately after stent placement, at weeks 1 and 3 and at months 3, 6 and 9. All grafts were removed and underwent histologic examination. In 2 cases the occlusion of the AVF was successful, while misplacement occurred in 3 cases. Occlusion of the parent vessel was disclosed in 3 cases. Histologic examination revealed a mild inflammatory reaction with the presence of macrophages. There was no foreign-body reaction or fragmentation of the arterial vessel wall. PLA, which is a well-known biodegradable material, showed a good mid-term biocompatibility. Elastic mismatch of the non-elastic ...

International Nuclear Information System (INIS)

MRI provides a non-invasive diagnostic tool complementing echocardiography on one hand, and showing advantages over echocardiography, on the other hand, especially after corrective procedures. The multiple different MRI sequences need to be adapted to examinations of children and patients with congenital heart disease (CHD), and can be used to detect morphologic changes, blood-flow in the heart and thoracic vessels and diastolic or systolic function of myocardium. Several factors determine the success of the examination of a complex congenital heart disease or a postoperative situs. Pediatric radiologists and radiologists experienced in congenital heart diseases have to work in close cooperation. Echocardiography should be performed before MRI. The results of prior examinations and the clinical history of the patients, including possible palliative or reconstructive operations, must be available before MRI to guide the planning of the examination. With a systematic ...

Science.gov (United States)

Of 1850 patients with cholelithiasis diagnosed in the past 17 years, 1116 female and 734 male, 598 patients (32.3%) presented with one or more of three major symptoms, i.e., abdominal pain, fever and jaundice, whereas the remainder (67.7%) had none of these symptoms. The proportion of the asymptomatic patients was similar in all age groups, being around 70%. Only 20 per cent of 680 asymptomatic patients, followed for 10 to 17 years (median 13.3 years), developed biliary symptoms. Older patients over 70 years of age had a higher rate of change to the symptomatic group, as compared with younger patients under 70, 29.5% vs. 19.3%, respectively. During this period, carcinoma of the gallbladder developed in one of the asymptomatic patients (0.1%). Oral dissolution therapy was successful in only 4.2 per cent of attempted cases and associated with a recurrence rate of as high as 20%. We conclude that asymptomatic gallstone patients should only be followed up by ultrasound ...

Science.gov (United States)

A population of female civil servants in Rome, Italy, was investigated to determine the prevalence of symptomatic and asymptomatic gallstone disease and to define the associated factors. Field activities started in February 1981 and concluded in April 1982. Diagnosis was assessed by real time ultrasonography. Prevalence of gallstone disease increased with age from 2.5% in the 20- to 29-year-old age group to 25.0% in the 60- to 64-year-old age group, based on both presence of gallstones and history of cholecystectomy. Only one third of the women with gallstones had complained of at least one episode of biliary pain in the last five years. Frequency of "minor" dyspeptic symptoms was not different between women with and those without gallstones. In a multiple logistic function analysis, a positive association was found between age, body mass index, parity, and prevalence of gallstone disease. No association was demonstrated between the presence of gallstones or ...

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The purpose of this study was to determine the feasibility of virtual endoscopy, named as ''virtual CT laparoscopy'', in the hepatobiliary system prior to laparoscopic cholecystectomy. We applied this technique to 28 patients suspected of having biliary disease. These images were compared and analyzed qualitatively based on visualization of the structures critical to operative cholangiography and surgical findings. Twenty-four patients, who underwent laparoscopic cholecystectomy, were evaluated as follows: the common bile duct and the hepatic duct were adequately visualized in 23 (96%) of the 24 patients, the cystic duct in 21 (88%), the gallbladder opacification in 20 (83%), the liver inferior surface in 20 (83%). Four patients had anatomic variations detected virtual CT laparoscopy and were proven by operative cholangiography and surgical findings. We emphasize that our new technique may contribute to the laparoscopy during ...

International Nuclear Information System (INIS)

Forty resected cases of intrahepatic cholangiocarcinoma were classified into four types according to the gross appearance; type I: mass forming type (n=8), type II: mass forming with periductal infiltrating type (n=20), type III: periductal infiltrating type (n=9) and type IV: intraductal growth type (n=3). Diagnostic features of these four types were studied. Peripheral enhancement was a common angiographic feature and tumor stains were recognized in 88%, 20%, 0%, 33%, respectively. Angiography and dynamic computed tomography (D-CT) were useful in differential diagnosis with hepatocellular carcinoma. Accuracy rate in diagnosis of portal vein involvement by angiography and D-CT was 82% and 91%, respectively. MRI was more useful in tumor detection than D-CT in cases with attenuation difference, in 55% of type II and in 75% of type III. Increase of arterial involvement, biliary tract involvement and portal vein involvement, incidence of lymph nodes metastases became ...

DEFF Research Database (Denmark)

BACKGROUND AND AIM OF THE STUDY: Abnormal flow conditions across aortic bioprosthetic valves may result in degenerative processes. Thus, it is important to implant biological valve prostheses with velocity profiles similar to those of native valves. The study aim was to compare blood velocity and velocity gradient profiles downstream of stented and stentless aortic valves implanted in pigs, and in native porcine valves. METHODS: Stented valve prostheses (Mitroflow, n = 7) or stentless valve prostheses (Solo, n = 5 or Toronto SPV, n = 7) were implanted into pigs; the native valve was retained in eight animals. After weaning the animals from cardiopulmonary bypass, cardiac magnetic resonance imaging was performed to determine the blood velocities and velocity gradient profiles. RESULTS: The native valves had a significantly lower peakvelocity (92 +/- 26 cm/s) than the artificial valves (Solo: 247 +/- 107 cm/s; Toronto: 252 +/- 41 cm/s; Mitroflow: ...

International Nuclear Information System (INIS)

Purpose: To assess long-term outcomes following percutaneous transluminal angioplasty (PTA) of congenital aortic coarctation in adults.Methods: Seventeen patients underwent PTA for symptomatic adult coarctation of the aorta. Sixteen patients, with a mean age of 28 years (range 15-60 years), were reviewed at a mean interval after angioplasty of 7.3 years (range 1.5-11 years). Assessment included magnetic resonance imaging (MRI), Doppler echocardiography, and clinical examination. Current clinical measurements were compared with pre- and immediate post-angioplasty measurements.Results: At follow-up 16 patients were alive and well. The patient not included in follow-up had undergone surgical repair and excision of the coarctation segment following PTA. Mean brachial systolic blood pressure for the group decreased from 174 mmHg before angioplasty to 130 mmHg at follow-up (p 0.0001). The mean gradient had fallen significantly from 50.9 to 17.8 at follow-up (p = 0.001). The average number of ...

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Recently, the development of shape memory alloy (SMA) actuators, in the forms of wire, thin film and stent have been found increasingly in the fields of materials science and smart structures and engineering. The increase in attraction for using these materials is due to their many unique materials, mechanical, thermal and thermal-mechanical properties, which in turn, evolve their subsequent shape memory, pseudo-elasticity and super-elasticity properties. In this paper, a common type of SMA actuator, Nitinol wires, were embedded into advanced composite structures to modulate the structural dynamic responses, in terms of natural frequency and damping ratio by using its shape memory and pseudo-elastic properties. A simple theoretical model is introduced to estimate the natural frequency of the structures before and after actuating the embedded SMA wires. The damping ratios of different SMA composite beams were measured through experimental approaches. The natural ...

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RADIANT{trademark} is manufactured by United States Surgical Corporation, Vascular Therapies Division, (formerly Progressive Angioplasty Systems). The system comprises a liquid {beta}-radiation source, a shielded isolation/transfer device (ISAT), modified over-the-wire or rapid exchange delivery balloons, and accessory kits. The liquid {beta}-source is Rhenium-188 in the form of sodium perrhenate (NaReO{sub 4}), Rhenium-188 is primarily a {beta}-emitter with a physical half-life of 17.0 hours. The maximum energy of the {beta}-particles is 2.1 MeV. The source is produced daily in the nuclear pharmacy hot lab by eluting a Tungsten-188/Rhenium-188 generator manufactured by Oak Ridge National Laboratory (ORNL). Using anion exchange columns and Millipore filters the effluent is concentrated to approximately 100 mCi/ml, calibrated, and loaded into the (ISAT) which is subsequently transported to the cardiac catheterization laboratory. The delivery catheters are modified Champion{trademark} ...

International Nuclear Information System (INIS)

Our aim was to investigate the diagnostic reliability of multidetector-row computed tomography (MDCT) for preoperative assessment of local tumoral spread in hilar cholangiocarcinoma. Thirteen of 30 consecutive patients with hilar cholangiocarcinoma who underwent surgery, excluding 17 patients who underwent biliary drainage or preoperative portal embolization, were retrospectively evaluated. Using MDCT systems of 4 detector rows or 16 detector rows, plain and dynamic contrast-enhanced images of three phases were obtained. Extent of tumor spread and lymph node metastasis were assessed with MDCT and compared with histopathological findings. The Bismuth-Corlette classification of hilar cholangiocarcinoma with MDCT were type I, 1 patient; type IIIa, 3 patients; type IIIb, 4 patients; and type IV, 5 patients; those with histopathological findings were type I, 1 patient; type IIIa, 2 patients; type IIIb, 4 patients; and type IV, 6 patients. One patient diagnosed as type ...

International Nuclear Information System (INIS)

Computed tomography would be a better method to detect and characterize a Thorotrast-induced liver tumour. The selective opacification of the RES by Thorotrast creates an intrinsic opacification of the liver similar in effect to contrast agents being evaluated for liver CT, such as ethoioidized oil emulsion. The computed tomographic appearance of Thorotrast-associated cholangiocarcinoma is usually a large, inhomogenous mass composed of disordered area of tissue of high density due to Thorotrast deposits, and of very low density. Thorotrast-induced cholangiocarcinoma originates in the peripheral biliary tree suprounding the highest mean concentration of Thorotrast deposition, so that visible soft tissue masses in the higher density spots in the liver are not produced in the early stage. The tendency for the opacity of the liver to decrease slowly with time and result in an uneven trabeculation and high density spots suggests that small tumors may be difficult to ...

International Nuclear Information System (INIS)

Purpose: Extrahepatic cholangiocarcinoma is a rare malignancy. Despite radical resection, survival remains poor, with high rates of local and distant failure. To clarify the role of radiotherapy with chemotherapy, we performed a retrospective analysis of resected patients who had undergone chemoradiotherapy. Methods and Materials: A total of 45 patients (13 with proximal and 32 with distal disease) underwent resection plus radiotherapy (median dose, 50.4 Gy). All but 1 patient received concurrent fluoropyrimidine-based chemotherapy. The median follow-up was 30 months for all patients and 40 months for survivors. Results: Of the 45 patients, 33 underwent adjuvant radiotherapy, and 12 were treated neoadjuvantly. The 5-year actuarial overall survival, disease-free survival, metastasis-free survival, and locoregional control rates were 33%, 37%, 42%, and 78%, respectively. The median survival was 34 months. No patient died perioperatively. Patient age #<=#60 years and perineural ...

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In the treatment of prostatic cancer using a newly proposed intermittent multiportal therapy (DIMT), acute reactions, change in tumor marker levels, and complications more than 6 months after treatment were evaluated. From June 1989 to September 1990, 26 patients with prostatic cancer (stage A2, 3 patients; B, 9; C, 2; D, 10; recurrence, 2) were treated. Fifteen patients were followed up for more than one year, with a mean period of 11.6 months. The treatment schedule is 52.5 Gy in 16 fractions in 4 weeks for radical treatment, and 30.0 Gy in 8 fractions in 2 weeks for palliative treatment. The 360 degree rotation about the patient was divided into 16 fractions, and 2 opposing fractions were used in one day as parallel opposed portals to treat the target volume. The fractions were serially treated one per day, so that 8 treatment days produced a total dose of distribution similar to that for conventional conformational therapy. The size of the irradiation field ...

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Purpose: To determine the value of MRI in the postoperativ evaluation of a singular ventricle compared to echocardiography and cardiac catheterization. Materials and methods: Thirty-one patients (range: 6 months to 30 years) with a functional single ventricle following palliative corrective operations. Five patients had a Blalock-Taussig-Shunt, 8 patients a Glenn-Anastomosis and 18 a cavopulmonary shunt (6 with classic Fontan-Circulation, 12 with modified cavopulmonary anastomosis). The results in terms of postoperative morphologic changes were compared to percutaneous echocardiography (31/31) and cardiac catheterization (6/31). Results: Echocardiography, which was performed on all patients, could not visualize the entire length of the tunnel, the Glenn-Anastomosis or the central pulmonary arteries in 70% of the patients due to an inadequate acoustic window. MRI was able to show the entire tunnel in 11/12 patients and the central pulmonary arteries in 30/31 ...

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To determine the effectiveness and patency of percutaneous intervention in insufficient native arteriovenous hemodialysis fistulae (AVFs). Between March 1997 and September 2001, 67 cases of insufficient native AVFs resulted from central vein lesion, PTA was performed in 48 cases, and thrombolytic therapy with or without PTA in 11. In eight of the cases, in which central vein stenosis had led to the insufficency, percutaneous transluminal angioplasty (PTA) was performed, and in three of the eight, a stent was inserted. Angiography findings and complications, as well as success and patency rates in the non-thrombosis and thrombosis group, were evaluated; the central vein lesion group was analysed separately. Among 84 lesions observed at angiography, three were 54 cases of stenosis, 17 of occlusion, and 13 of combined thrombosis. The lesions were located in a proximal vein (n=51), distal vein (n=14), artery (n=6), and at the site of anastomosis (n=13). In the central ...

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MRI provides a non-invasive diagnostic tool complementing echocardiography on one hand, and showing advantages over echocardiography, on the other hand, especially after corrective procedures. The multiple different MRI sequences need to be adapted to examinations of children and patients with congenital heart disease (CHD), and can be used to detect morphologic changes, blood-flow in the heart and thoracic vessels and diastolic or systolic function of myocardium. Several factors determine the success of the examination of a complex congenital heart disease or a postoperative situs. Pediatric radiologists and radiologists experienced in congenital heart diseases have to work in close cooperation. Echocardiography should be performed before MRI. The results of prior examinations and the clinical history of the patients, including possible palliative or reconstructive operations, must be available before MRI to guide the planning of the examination. With a systematic ...