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Sample records for balloon catheter dilatation

  1. Balloon catheter dilatation of benign urethral strictures

    International Nuclear Information System (INIS)

    The authors report their experience of benign urethral stricture dilatation by balloon catheter in 11 male patients. Ten posterior and 2 anterior urethral strictures were treated; in 1 patients several narrowings coexisted at various levels. Etiology was inflammatory in 4 cases, iatrogen in 3, post-traumatic in 2, and equivocal in 2. The patients were studied both before and soon after dilatation by means of retrograde and voiding cystourethrogram and uroflowgraphy; the follow-up (2-14 months) was performed by urodynamic alone. In all cases, dilatation was followed by the restoration of urethral gauge, together with prompt functional improvement of urodynamic parameters. The latter result subsisted in time in 9 patients. In 2 cases recurrences were observed demonstrated at once by clinics and urodynamics. Both lesions were successfully re-treated. Neither early not late complication occurred. In spite of the limited material, the valuable results obtained, together with the absence of complications, the peculiar morphology of recurrences, and the chance of repeating it make the procedure advisable as a valid alternative to conventional techniques for these pathologies

  2. Balloon catheter dilatation of esophageal strictures

    International Nuclear Information System (INIS)

    The authors performed 27 fluoroscopically guided balloon dilatation in 12 patients of esophageal stricture during recent 3 years. The causes of esophageal stricture were corrosive esophagitis (N=2) and congenital narrowing (N=1), including postoperative narrowing in achalasia (N=3), esophageal varix (N=3), lye stricture (N=2) and esophageal cancer (N=1). Successful dilatation of the stricture was achieved during the procedure in 10 patients(83%). Major complication such as esophageal rupture was not found. The authors conclude that fluoroscopically guided esophageal balloon dilatation is a safe and effective method for treatment of symptomatic esophageal strictures

  3. Balloon catheter dilatation of esophageal strictures

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    Kim, Jeung Sook; Yoon, Yup; Sung, Dong Yook; Choi, Woo Suk; Nam, Kyung Jin; Lim, Jae Hoon [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    1990-07-15

    The authors performed 27 fluoroscopically guided balloon dilatation in 12 patients of esophageal stricture during recent 3 years. The causes of esophageal stricture were corrosive esophagitis (N=2) and congenital narrowing (N=1), including postoperative narrowing in achalasia (N=3), esophageal varix (N=3), lye stricture (N=2) and esophageal cancer (N=1). Successful dilatation of the stricture was achieved during the procedure in 10 patients(83%). Major complication such as esophageal rupture was not found. The authors conclude that fluoroscopically guided esophageal balloon dilatation is a safe and effective method for treatment of symptomatic esophageal strictures.

  4. Balloon catheter dilatation in esophageal achalasia: long term follow-up

    International Nuclear Information System (INIS)

    To evaluate the clinical efficacy of balloon catheter dilatation in the treatment of esophageal achalasia. Seven patients(three males and four females) with esopha-geal achalasia were treated with balloon catheter dilatation. Balloon catheters of variable sizes were used depending on patient's conditions. The patients were followed up over a period of 12-39 months. Balloon catheter dilatation in esophageal achalasia was successful in all patients without esophageal perforation. All patients were relieved from dysphagia. Recurrence was not found in 5 patients on long term follow-up study, but was seen in 2 patients after 18 and 21 months, respectively. Balloon catheter dilatation was a safe and effective method in the treatment of esophageal achalasia with low recurrence rate of 29% on follow-up study

  5. Balloon catheter dilatation in esophageal achalasia: long term follow-up

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    Shin, Cheol Yong; Park, Hyun Mee; Kim, So Eun; Lee, Shin Hyung; Kim, Seung Hyeon; Lee, Chang Joon [National Medical Center, Seoul (Korea, Republic of)

    1994-12-15

    To evaluate the clinical efficacy of balloon catheter dilatation in the treatment of esophageal achalasia. Seven patients(three males and four females) with esopha-geal achalasia were treated with balloon catheter dilatation. Balloon catheters of variable sizes were used depending on patient's conditions. The patients were followed up over a period of 12-39 months. Balloon catheter dilatation in esophageal achalasia was successful in all patients without esophageal perforation. All patients were relieved from dysphagia. Recurrence was not found in 5 patients on long term follow-up study, but was seen in 2 patients after 18 and 21 months, respectively. Balloon catheter dilatation was a safe and effective method in the treatment of esophageal achalasia with low recurrence rate of 29% on follow-up study.

  6. The dilatations with the balloon catheter in treatment of the patients with the benign oesophageal stenoses

    International Nuclear Information System (INIS)

    Between January 1989 and June 1995 the authors dilated in the Department of Radiology in University Hospital Bohunice the benign stenosis of the oesophagus with balloon dilatation catheter in 76 of other patients. The aetiology of the stenosis was long-term reflux oesophagitis in the 39 patients (51%), achalasia 14 patients, 18%) postoperative benign stenosis in anastomosis (7 patients, 9%), corrosive stricture (5 patients, 6,5%), post-radiation stricture (5 patients, 6,5%) and epidermolysis bulosa oesophagi (2 patients, 3%). In four patients (5%) the aetiology of the stenosis was unknown. The standing of the dilatation was from 15 second to 6 minutes and dilatation was technically successful in all cases. First the authors used Owman Oesophageal Dilatation Kit (William COOK), before three years they started to used Rigiflex ORW Dilators Kit (Microvasive). In the patients with achalasia the authors currently used Rigiflex ABD Achalasia Balloon Dilator (Microvasive). (authors). 2 tabs., 3 figs., 14 refs

  7. Balloon catheter dilatation for mitral stenosis and severe pulmonary hypertension

    International Nuclear Information System (INIS)

    Objective: To determine the safety and efficacy of percutaneous balloon mitral valvuloplasty (PBMV) for patients with mitral stenosis and severe pulmonary hypertension, and to assess the changes in pulmonary systolic pressure during follow-up. Methods: Forty-two patients with rheumatic mitral stenosis and severe pulmonary hypertension (pulmonary systolic pressure > 75 mmHg) underwent PBMV using standard Inoue technique, and the changes in clinical functional status and echo Doppler pulmonary systolic pressure during follow-up were assessed. Results: PBMV was successful in 39 patients. Immediately after the procedure, mitral valve area increased from (0.83 +- 0.12) cm2 to (1.75 +- 0.11) cm2, pulmonary systolic pressure decreased from (85 +- 7) mmHg to (61 +- 13) mmHg (all P < 0.001). Severe mitral regurgitation occurred in 3 patients, one of whom underwent mitral valve replacement. During follow-up (average 6 months), in 39 patients with successful PBMV, the clinical functional status was improved and pulmonary systolic pressure was further decreased despite unchanged mitral valve area. Conclusions: PBMV was safe and effective for patients with mitral stenosis and severe pulmonary hypertension. Clinical functional status was improved and pulmonary systolic pressure was continuously decreased during the short-term follow-up

  8. The balloon dilatation and large profile catheter maintenance method for the management of the bile duct stricture following liver transplantation

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    Choo, Sung Wook; Shin, Sung Wook; Do, Young Soo; Park, Kwang Bo; Sung, Yon Mi; Choo, In Wook [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Liu, Wei Chiang [Sungae General Hospital, Seoul (Korea, Republic of)

    2006-03-15

    We wanted to evaluate the therapeutic efficacy of the percutaneous balloon dilatation and large profile catheter maintenance method for the management of patients with anastomotic biliary strictures following liver transplant. From May 1999 to June 2003, 12 patients with symptomatic benign biliary stricture complicated by liver transplantation were treated with the percutaneous balloon dilatation and large profile catheter maintenance method (1-6 months). The patients were eight males and four females, and their ages ranged from 20 to 62 years (mean age: 44 years). Ten patients underwent living donor liver transplantation and two underwent cadaveric liver transplantation. Postoperative biliary strictures occurred from two to 21 months (mean age: 18 months) after liver transplantation. The initial technical success rate was 92%. Patency of the bile duct was preserved for eight to 40 months (mean period: 19 months) in 10 of 12 (84%) patients. When reviewing two patients (17%), secondary balloon dilatations were needed for treating the delayed recurrence of biliary stricture. In one patients, no recurrent stenosis was seen during the further 10 months follow-up after secondary balloon dilatation. Another patient did not response to secondary balloon dilatation, and he was treated by surgery. Eleven of 12 patients (92%) showed good biliary patency for 8-40 months (mean period: 19 months) of follow-up. The percutaneous balloon dilatation and large profile catheter maintenance method is an effective therapeutic alterative for the treatment of most biliary strictures that complicate liver transplantation. It has a high success rate and it should be considered before surgery.

  9. The treatment of post-operative and peptic esophageal strictures after esophageal atresia repair: A program including dilatation with balloon catheters

    International Nuclear Information System (INIS)

    Nine patients, 6 weeks to 17 years of age with esophageal atresia (EA), developed esophageal strictures and were treated with 26 balloon catheter dilatations over a period of 3 years; 6 are now asymptomatic. Five of the 9 patients had suspected reflux esophagitis, confirmed in 3 by biopsy and treated medically prior to dilatation. Seven of the 9 patients had a primary anastomosis, 1 a gastric tube, and 1 a colonic interposition. Most dilatations in the group of 7 were performed with balloon (B) ≥ the diameter of the distal esophagus (E) (B/E ≥ 1). The 3 residually symptomatic patients inlcude an infant dilated conservatively (B/E < 1) to facilitate later bougienage, 1 patient with a recurrent stricture after stopping medical therapy band home bougienage, and 1 infant who had a persistent anastomotic stricture, suspected by untreated reflux esophagitis, and a perforation during the second balloon dilatation. Balloon catheter esophageal dilatation, as an alternative to bougienage, is usually a safe and effective procedure when reflux esophagitis is diagnosed and treated prior to dilatation. (orig.)

  10. Percutaneous Balloon Dilatation and Catheter Maintenance Method in the Patients with Biliary Strictures after Living Donor Liver Transplantation

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    Park, Dae Hong; Byun, Sung Su; Kim, Jeong Ho; Kim, Keon Kuk; Hwang, Hee Young; Kim, Hyung Sik; Choi, Hye Young; Park, Jae Hyung [Dept. of Gachon University School of Medicine, Gil Hospital, Incheon (Korea, Republic of)

    2013-04-15

    The aim of this study was to evaluate the therapeutic efficacy of the percutaneous balloon dilatation and catheter maintenance (BDCM) method for postoperative biliary strictures following living donor liver transplantation (LDLT). Eighteen patients (14 duct-to-duct anastomosis and 4 hepaticojejunostomy) with post-LDLT biliary stricture were treated by the percutaneous BDCM method. A good response was defined as residual stricture over 3.5 mm after repetitive BDCM and refractory response as residual stricture below 3.5 mm. If they demonstrated good results on follow-up studies after catheter withdrawal, all the patients quit the therapy. We evaluated the technical and clinical success rates, major complication rate, mean total procedure time and mean follow-up duration. The percutaneous BDCM method was technically successful without major complication. Nine patients improved biliary stricture (good response, mean 5.5 mm), and the other 9 patients showed residual stricture with the diameter below 3.5 mm (refractory response, mean 2.5 mm). However, all the patients were improved clinically without significant complication. The total procedure time was 1-15 months (mean 7.3 months) and follow-up duration was 6-54 months (mean 24 months). The percutaneous BDCM method for post-LDLT biliary strictures was an effective therapy even in the patients showing a refractory response. It seemed that total procedure time could be reduced if the response was determined earlier.

  11. Percutaneous Balloon Dilatation and Catheter Maintenance Method in the Patients with Biliary Strictures after Living Donor Liver Transplantation

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the therapeutic efficacy of the percutaneous balloon dilatation and catheter maintenance (BDCM) method for postoperative biliary strictures following living donor liver transplantation (LDLT). Eighteen patients (14 duct-to-duct anastomosis and 4 hepaticojejunostomy) with post-LDLT biliary stricture were treated by the percutaneous BDCM method. A good response was defined as residual stricture over 3.5 mm after repetitive BDCM and refractory response as residual stricture below 3.5 mm. If they demonstrated good results on follow-up studies after catheter withdrawal, all the patients quit the therapy. We evaluated the technical and clinical success rates, major complication rate, mean total procedure time and mean follow-up duration. The percutaneous BDCM method was technically successful without major complication. Nine patients improved biliary stricture (good response, mean 5.5 mm), and the other 9 patients showed residual stricture with the diameter below 3.5 mm (refractory response, mean 2.5 mm). However, all the patients were improved clinically without significant complication. The total procedure time was 1-15 months (mean 7.3 months) and follow-up duration was 6-54 months (mean 24 months). The percutaneous BDCM method for post-LDLT biliary strictures was an effective therapy even in the patients showing a refractory response. It seemed that total procedure time could be reduced if the response was determined earlier.

  12. Occlusion of the abdominal aorta by balloon dilation catheter assisting surgical excision of a sacrum chordoma: case report.

    Science.gov (United States)

    Ozgiray, Erkin; Cağli, Sedat; Zileli, Mehmet; Cinar, Celal; Oran, Ismail

    2009-07-01

    Chordoma is known to be the most common primary tumor of the sacrum. Its surgery is challenging from many aspects. A large amount of bleeding is one of the biggest issues. A 52-year-old woman was admitted to our clinic with a huge mass at sacrum. The mass was diagnosed as chordoma after a needle biopsy. Prior to the surgery, a balloon dilation catheter (BDC) was placed in the distal abdominal aorta via the femoral artery. Just after the skin incision, the BDC was inflated with contrast medium and total occlusion of the aorta was achieved. At the end of the operation we observed that total hemorrhage had decreased dramatically. No complications were recorded except hypertension during the occlusion of the aorta which was expected. The patient was discharged after two weeks of hospitalization post-operatively without any neurological deficit. Our report is the second in the neurosurgical literature to our knowledge. Although this result is preliminary and needs to be replicated and expanded upon, our first experience with this method is effective for decreasing the amount of bleeding. We believe that our method prevents hemo-dynamical problems caused by massive bleeding and complications secondary to massive transfusion. PMID:19621292

  13. Balloon dilatations of esophageal strictures

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    Seo, Jeong Jin; Juhng, Seon Kwan; Kim, Jae Kyu; Chung, Hyon De [Chonnam National University College of Medicine, Seoul (Korea, Republic of)

    1990-04-15

    Most benign esophageal strictures can be successfully dilated with conventional bougienage technique. But occasionally strictures are so tight, lengthy, or sometimes irregular that this technique fail, and surgical intervention is required. Since 1974 Gruentzig balloon catheter has succeed when used for strictures in the cardiac and peripheral vasculatures, the biliary and urinary tracts, the colon of neonates after inflammatory disease and also in the esophagus. Fluoroscopically guided balloon catheters were used to dilate 30 esophageal strictures in 30 patients over 3 years at Department of Diagnostic Radiology, Chonnam University, College of Medicine. The distribution of age was from 7 years to 71 days and the ratio of male to female was 15:15. The causes of benign stricture (23 cases) were post-operative strictures (13), chemical (4), achalasia (3), chronic inflammation (2), esophageal rupture (1) and those of malignant stricture (7 cases) were post-radiation stricture of primary esophageal cancer (6) and metastatic esophageal cancer (1). The success rate of procedure was 93% (28/30). The causes of failure were the failure of passage of stricture due to markedly dilated proximal segment of esophagus (1 case) and too long segment of stricture (1 case). Complication of procedure was the diverticular-formation of esophagus in 3 cases, but has no clinical significance in follow-up esophagography. In conclusion, fluoroscopically guided balloon dilation of esophageal stricture appears to be safe, effective treatment and may be have theoretical advantages over conventional bougienage and also should be considered before other methods of treatment are used.

  14. Balloon dilatations of esophageal strictures

    International Nuclear Information System (INIS)

    Most benign esophageal strictures can be successfully dilated with conventional bougienage technique. But occasionally strictures are so tight, lengthy, or sometimes irregular that this technique fail, and surgical intervention is required. Since 1974 Gruentzig balloon catheter has succeed when used for strictures in the cardiac and peripheral vasculatures, the biliary and urinary tracts, the colon of neonates after inflammatory disease and also in the esophagus. Fluoroscopically guided balloon catheters were used to dilate 30 esophageal strictures in 30 patients over 3 years at Department of Diagnostic Radiology, Chonnam University, College of Medicine. The distribution of age was from 7 years to 71 days and the ratio of male to female was 15:15. The causes of benign stricture (23 cases) were post-operative strictures (13), chemical (4), achalasia (3), chronic inflammation (2), esophageal rupture (1) and those of malignant stricture (7 cases) were post-radiation stricture of primary esophageal cancer (6) and metastatic esophageal cancer (1). The success rate of procedure was 93% (28/30). The causes of failure were the failure of passage of stricture due to markedly dilated proximal segment of esophagus (1 case) and too long segment of stricture (1 case). Complication of procedure was the diverticular-formation of esophagus in 3 cases, but has no clinical significance in follow-up esophagography. In conclusion, fluoroscopically guided balloon dilation of esophageal stricture appears to be safe, effective treatment and may be have theoretical advantages over conventional bougienage and also should be considered before other methods of treatment are used

  15. Percutaneous Transhepatic Balloon Dilatation of Benign Biliary Strictures

    OpenAIRE

    Trambert, Jonathan J.; Bron, Klaus M.; Zajko, Albert B.; Starzl, Thomas E.; Iwatsuki, Shunzaburo

    1987-01-01

    Between February 1981 and June 1984, 15 patients with benign biliary strictures were treated with percutaneous transhepatic balloon dilatation. Three of these patients had received liver transplants. The treatment began with a course of balloon dilatation therapy, after which a stent catheter was left across the stricture. Six weeks later, after duct patency had been shown by cholangiography, the stent catheter was removed from all but two patients, both of whom had intrahepatic sclerosing ch...

  16. Balloon catheter coronary angioplasty

    International Nuclear Information System (INIS)

    The author has produced a reference and teaching book on balloon angioplasty. Because it borders in surgery and is performed on an awake patient without circulatory assistance, it is a complex and demanding procedure that requires thorough knowledge before it is attempted. The text is divided into seven sections. The first section describes coronary anatomy and pathophysiology, defines the objectives and mechanisms of the procedure and lists four possible physiologic results. The next section describes equipment in the catheterization laboratory, catheters, guidewires and required personnel. The following section is on the procedure itself and includes a discussion of examination, testing, technique and follow-up. The fourth section details possible complications that can occur during the procedure, such as coronary spasms, occlusion, thrombosis, perforations and ruptures, and also discusses cardiac surgery after failed angioplasty. The fifth section details complex or unusual cases that can occur. The sixth and seventh sections discuss radiation, alternative procedures and the future of angioplasty

  17. Restenosis following balloon dilation of benign esophageal stenosis

    Institute of Scientific and Technical Information of China (English)

    Ying-Sheng Cheng; Ming-Hua Li; Ren-Jie Yang; Hui-Zhen Zhang; Zai-Xian Ding; Qi-Xin Zhuang; Zhi-Ming Jiang; Ke-Zhong Shang

    2003-01-01

    AIM: To elucidate the mechanism of restenosis following balloon dilation of benign esophageal stenosis.METHODS: A total of 49 rats with esophageal stenosis were induced in 70 rats using 5 ml of 50 % sodium hydroxide solution and the double-balloon method, and an esophageal restenosis (RS) model was developed by esophageal stenosis using dilation of a percutaneous transluminal coronary angioplasty (PTCA) balloon catheter. These 49 rats were divided into two groups: rats with benign esophageal stricture caused by chemical burn only (control group, n=21) and rats with their esophageal stricture treated with balloon catheter dilation (experimental group, n=28). Imaging analysis and immunohistochemistry were used for both quantitative and qualitative analyses of esophageal stenosis and RS formation in the rats, respectively.RESULTS: Cross-sectional areas and perimeters of the esophageal mucosa layer, muscle layer, and the entire esophageal layers increased significantly in the experimental group compared with the control group. Proliferating cell nuclear antigen (PCNA) was expressed on the 5th day after dilation, and was still present at 1 month. Fibronectin (FN)was expressed on the 1st day after dilation, and was still present at 1 month.CONCLUSION: Expression of PCNA and FN plays an important role in RS after balloon dilation of benign esophageal stenosis.

  18. Esophageal achalasia : results of balloon dilation

    International Nuclear Information System (INIS)

    To evaluate the clinical effectiveness of fluoroscopically guided balloon dilation in the treatment of esophageal achalasia. Under fluoroscopic guidance, 21 balloon dilation procedures were performed in 14 patients with achalasia. A balloon with a diameter of 20 mm was used for the initial attempt.If the patient tolerated this well, the procedure was repeated with a 10-20 mm balloon, placed alongside at the same session. If, however the patient complained of severe chest pain and/or a postprocedural esophagogram showed an improvement,the additional balloon was not used. For patients whose results were unsatisfactory, the dilation procedure was repeated at sessions three to seven days apart. Succesful dilation was achieved in 13 of 14 patients(92.9%), who needed a total of 20 sessions of balloon dilation, ranging from one to three sessions per patient(mean, 1.54 sessions). Esophageal rupture occured in one of 14 patients(7.1%) ; of the 13 patients who underwent a successful dilation procedure, 12(92.3%) were free of recurrent symptoms during the follow-up period of 1-56(mean, 18.5) months. The remaning patient(7.7%) had a recurrence seven months after dilation. Fluoroscopically guided balloon dilation seems to be safe and effective in the treatment of esophageal achalasia

  19. Esophageal achalasia : results of balloon dilation

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    Ki, Won Woo; Kang, Sung Gwon; Yoon, Kwon Ha; Kim, Nam Hyeon; Lee, Hyo Jeong; Yoon, Hyun Ki; Sung, Kyu Bo; Song, Ho Young [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-08-01

    To evaluate the clinical effectiveness of fluoroscopically guided balloon dilation in the treatment of esophageal achalasia. Under fluoroscopic guidance, 21 balloon dilation procedures were performed in 14 patients with achalasia. A balloon with a diameter of 20 mm was used for the initial attempt.If the patient tolerated this well, the procedure was repeated with a 10-20 mm balloon, placed alongside at the same session. If, however the patient complained of severe chest pain and/or a postprocedural esophagogram showed an improvement,the additional balloon was not used. For patients whose results were unsatisfactory, the dilation procedure was repeated at sessions three to seven days apart. Succesful dilation was achieved in 13 of 14 patients(92.9%), who needed a total of 20 sessions of balloon dilation, ranging from one to three sessions per patient(mean, 1.54 sessions). Esophageal rupture occured in one of 14 patients(7.1%) ; of the 13 patients who underwent a successful dilation procedure, 12(92.3%) were free of recurrent symptoms during the follow-up period of 1-56(mean, 18.5) months. The remaning patient(7.7%) had a recurrence seven months after dilation. Fluoroscopically guided balloon dilation seems to be safe and effective in the treatment of esophageal achalasia.

  20. Balloon dilatation of alimentary tract strictures

    International Nuclear Information System (INIS)

    From a series of balloon dilatations of alimentary tract strictures 11 patients with different types of gastric and oesophagogastric anastomotic stenoses are reported. The dilatation of gastric outflow tract obstructions was highly effective in the treatment of retention. In 7 out of 8 cases with gastric outflow stenosis surgery could be entirely avoided and replaced by balloon dilatation. The importance of eliminating retention in the healing of gastric ulcer is discussed. Fistulation in oesophagogastric anastomoses due to stenosis of the outflow portion was successfully treated. The importance of achieving a free outflow tract in order to prevent insufficiency of the anastomosis and formation of a fistula is stressed. (orig.)

  1. Balloon dilatation of intrahepatic biliary strictures in liver transplantation

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of balloon dilatation in the treatment of intrahepatic biliary strictures in patients with liver transplantation. Methods: Of the 100 patients with liver transplantation, 16 patients had intrahepatic biliary strictures and received balloon dilatation treatment. Results: Initial technical balloon dilatation was successful in 14 caes but failed in 2 cases. There were no procedure-related complications. 4 restenosis occurred and they were treated with repeated balloon dilatation treatment. Conclusion: Balloon dilatation represented an effective and relatively safe treatment for biliary stricture in liver transplant recipients. For restenosis, balloon dilatation was also an effective treatment

  2. [Expansion dilatation balloons for cervical ripening in obstetric practice].

    Science.gov (United States)

    Ducarme, G; Grange, J; Vital, M

    2016-02-01

    During recent decades, mechanical devices have been substituted by pharmacological methods. Their place in the therapeutic arsenal remains important with a renewed obstetrical interest for these devices. Due to a lack of data they are still not recommended as first-line. This review thus attempted to examine the use of expansion dilatation balloons (Foley catheter and double-balloons) to analyze their effectiveness in case of native uterus and previous cesarean section. Twenty-seven clinical trials had compared balloons catheter and prostaglandins in patients without a history of uterine scar. The risk of cesarean section did not differ. Mechanical methods seemed to be more effective in achieving delivery within 24hours, with fewer episodes of excessive uterine contractions, but they necessitated more oxytocin during labor. Ten clinical trials analyzed dilatation balloons in patients with previous cesarean section. More than 70% women had favorable cervical ripening (Bishop score>6), and vaginal delivery was reported between 35 and 70% of patients. The risk of uterine rupture was low between 0.64 and 0.72%, with neither increased risk of severe neonatal and maternal morbidity nor increased risk of infectious morbidity. Mechanical methods are effective and safe for third trimester cervical ripening, mainly in women with previous cesarean section. Potential advantages may include wide availability and reduction of some of the side effects. PMID:26774842

  3. Fluoroscopically Guided Balloon Dilation for Postintubation Tracheal Stenosis

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    Lee, Woong Hee; Kim, Jin Hyoung, E-mail: m1fenew@daum.net; Park, Jung-Hun [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center (Korea, Republic of)

    2013-10-15

    Purpose: Little was known about the safety and long-term efficacy of fluoroscopically guided balloon dilation for postintubation tracheal stenosis. The purpose of this study was to evaluate the safety and long-term efficacy of fluoroscopically guided balloon dilation in patients with postintubation tracheal stenosis. Methods: From February 2000 to November 2010, 14 patients underwent fluoroscopically guided balloon dilation for postintubation tracheal stenosis. Technical success, clinical success, and complications were evaluated. Patients were followed up for recurrent symptoms. Results: In all patients, fluoroscopically guided balloon dilation was technically and clinically successful with no major complications. Following the initial procedure, six patients (43 %) remained asymptomatic during a follow-up period. Obstructive symptoms recurred in eight patients (57 %) within 6 months (mean, 1.7 months), who were treated with repeat balloon dilation (n = 4) and other therapies. Of the four patients who underwent repeat balloon dilation, three became asymptomatic. One patient became asymptomatic after a third balloon dilation. On long-term (mean, 74 months) follow-up, 71 % of patients experienced relief of symptoms following fluoroscopically guided balloon dilation. Conclusions: Fluoroscopically guided balloon dilation may be safe, is easy to perform, and resulted in effective treatment in patients with postintubation tracheal stenosis.

  4. Balloon Dilatation of Pediatric Subglottic Laryngeal Stenosis during the Artificial Apneic Pause: Experience in 5 Children

    Directory of Open Access Journals (Sweden)

    J. Lisý

    2014-01-01

    Full Text Available Introduction. Balloon dilatation is a method of choice for treatment of laryngeal stenosis in children. The aim of procedure in apneic pause is to avoid new insertion of tracheostomy cannula. Patients and Methods. The authors performed balloon dilatation of subglottic laryngeal strictures (SGS in 5 children (3 girls and 2 boys without tracheotomy. Two of them with traumatic and inflammatory SGS had a tracheal cannula removed in the past. The other 3 children with postintubation SGS had never had a tracheostomy before. The need for tracheostomy due to worsening stridor was imminent for all of them. Results. The total of seven laryngeal dilatations by balloon esophagoplasty catheter in apneic pause was performed in the 5 children. The procedure averted the need for tracheostomy placement in 4 of them (80%. Failure of dilatation in girl with traumatic stenosis and concomitant severe obstructive lung disease led to repeated tracheostomy. Conclusion. Balloon dilatation of laryngeal stricture could be done in the absence of tracheostomy in apneic pause. Dilatation averted threatening tracheostomy in all except one case. Early complication after the procedure seems to be a negative prognostic factor for the outcome of balloon dilatation.

  5. The Evaluation of Endoscopic Balloon Dilation Treatment for

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    Shokri-Shirvani Javad

    2009-10-01

    Full Text Available Balloon dilatation of stricture is one of the new treatment methods among patients with gastric outlet obstruction (GOO. However, the prevalence and underlying etiologies of GOO in various populations are different. The goal of the present study was to determine the effectiveness of endoscopic balloon dilatation and factors that would affect its success rate patients with benign etiology for GOO. Forty-five patients with the symptoms of benign GOO were randomly selected. Gastric outlet was delineated using double channel videoendoscopy. The information of initial balloon dilation was collected from recorded files. Balloon dilatation was repeated during the mean follow up of 9.9 ± 5.8 months. The severity of gastric pain was measured immediately before balloon dilatation and one month after procedure and was rated on a 10 cm visual analogue scale. The mean age of patients was 43.7 ± 18.1 years and 86.7% of them were men. Furthermore, 71.1% were H pylori positive. Response rate to endoscopic balloon dilatation was 80% and 8 patients underwent surgical resection. Weight loss was more frequent in non-responding group. The pain severity was significantly reduced more in responding subjects. No meaningful relationships were found between the responses to balloon dilatation and positive H pylori and cigarette smoking. Endoscopic balloon dilation is safe and effective for most patients with benign gastric outlet obstruction and has favorable long-term outcome.

  6. Thrombus aspiration catheter is a Dottering balloon.

    Science.gov (United States)

    Sheshagiri Rao, D; Barik, Ramachandra; Prasad, Akula Siva

    2016-01-01

    Coronary angiogram in a young man with history of STEMI with delayed presentation revealed subtotal occlusion of left anterior descending artery (LAD) with large thrombotic filling defect distal to the critical lesion. PCI was preferred without delay because of ongoing chest pain. Several runs of thrombus aspiration failed to detect any visible thrombus. However, the immediate angiogram after thrombus aspiration showed complete distal embolization of the thrombus which could have been achieved by Dottering or balloon dilatation. In contrary to the general perception, does thrombus aspiration push more thrombus than it can aspirate? PMID:27543477

  7. Boston's balloon dilatation for treatment of cardiac achalasia

    International Nuclear Information System (INIS)

    Objective: To review and summarize effectiveness and method of the Boston's balloon dilation in cardiac achalasia. Methods: The intensified guide wire was inserted into stomach through mouth cavity under TV control. The Boston's balloon was inserted to the cardiac stricture through the guide wire and dilatated with 15% contrast medium with to a maximum diameter for five minutes and then the balloon was dilatated again for 3-5 minutes, all together for 3-4 times. The severe stricture must be pre-dilatated with 20-25 mm diameter balloon. Results: The balloon insertion was technically successful in all 26 patients. The once success of balloon dilation was achieved in 24 patients and twice in other 2. Follow-up time was from 2 weeks to 31 months (mean 10.6 months). Recurrent stenosis had not occurred in all patients. Remission rate of dysphagia was 100%. Esophageal reflux occurred in 3 patients. Conclusions: The Boston's balloon dilatation is simple and effective for treatment of cardiac achalasia. The method sometimes may replace surgical procedure

  8. Balloon dilatation of the esophageal stricture in infants and children

    International Nuclear Information System (INIS)

    Balloon dilatation has been applied in treating of various pathologic narrowing of the hollow viscus. It is now accepted as a very effective modality especially in treating esophageal stenosis obviating surgical procedure. We performed 128 balloon dilatations in 29 patients with the number of dilatations in each patient ranging from once to 12 times. The age distribution of the patients was from 3 weeks to 6 years, with the median age of 3 months. Twenty nine patients consisted of 25 postoperative esophageal strictures (21 esophageal atresia with tracheoesophageal fistula, 1 congenital esophageal stenosis, 2 tracheobronchial remnant, and 1 congenital esophageal stenosis with esophageal atresia), 2 achalasia, 1 congenital esophageal stenosis, and 1 corrosive esophagitis. We had successful dilatation in 22 patients, who showed subsequent relief of symptoms and improvement in the diameter of stenotic segment. In 14 patients, esophageal perforation occurred during the procedure, one requiring emergency thoracotomy and the other three conservative management. Seven patients had no improvement in stenotic sites after several balloon dilatations. Failed cases were congenital stenosis, achalasia, corrosive esophagitis and four postoperative strictures. We believe that balloon dilatation is the procedure of choice in the treatment of postoperative esophageal stricture in infants and children and is a safe method as the perforation which can complicate the procedure could be managed conservatively

  9. Balloon dilatation of the esophageal stricture in infants and children

    Energy Technology Data Exchange (ETDEWEB)

    Choo, Sung Wook; Kim, In One; Kim, Woo Sun; Yeon, Kyung Mo; Kim, Woo Ki; Park, Kwi Won; Han, Man Chung [Seoul Natioal University College of Medicine, Seoul (Korea, Republic of); Lee, Gi Jae [Inje University Paik Hospital, Seoul (Korea, Republic of); Yu, Pil Mun [Dankuk University College of Medicine, Seoul (Korea, Republic of)

    1992-09-15

    Balloon dilatation has been applied in treating of various pathologic narrowing of the hollow viscus. It is now accepted as a very effective modality especially in treating esophageal stenosis obviating surgical procedure. We performed 128 balloon dilatations in 29 patients with the number of dilatations in each patient ranging from once to 12 times. The age distribution of the patients was from 3 weeks to 6 years, with the median age of 3 months. Twenty nine patients consisted of 25 postoperative esophageal strictures (21 esophageal atresia with tracheoesophageal fistula, 1 congenital esophageal stenosis, 2 tracheobronchial remnant, and 1 congenital esophageal stenosis with esophageal atresia), 2 achalasia, 1 congenital esophageal stenosis, and 1 corrosive esophagitis. We had successful dilatation in 22 patients, who showed subsequent relief of symptoms and improvement in the diameter of stenotic segment. In 14 patients, esophageal perforation occurred during the procedure, one requiring emergency thoracotomy and the other three conservative management. Seven patients had no improvement in stenotic sites after several balloon dilatations. Failed cases were congenital stenosis, achalasia, corrosive esophagitis and four postoperative strictures. We believe that balloon dilatation is the procedure of choice in the treatment of postoperative esophageal stricture in infants and children and is a safe method as the perforation which can complicate the procedure could be managed conservatively.

  10. The Accordion Sign in the Transplant Ureter: Ramifications During Balloon Dilation of Strictures

    Energy Technology Data Exchange (ETDEWEB)

    Kriegshauser, J. Scott, E-mail: skriegshauser@mayo.edu; Naidu, Sailen G. [Mayo Clinic Hospital, Department of Radiology (United States); Chang, Yu-Hui H. [Mayo Clinic, Department of Biostatistics (United States); Huettl, Eric A. [Mayo Clinic Hospital, Department of Radiology (United States)

    2015-04-15

    PurposeThis study was designed to demonstrate the accordion sign within the transplant ureter and evaluate its ramifications during balloon dilation of strictures.MethodsA retrospective electronic chart and imaging review included demographic characteristics, procedure reports, and complications of 28 renal transplant patients having ureteral strictures treated with percutaneous balloon dilation reported in our transplant nephrology database during an 8-year period. The accordion sign was deemed present or absent on the basis of an imaging review and was defined as present when a tortuous ureter became kinked and irregular when foreshortened after placement of a wire or a catheter. Procedure-related urine leaks were categorized as occurring at the stricture if within 2 cm; otherwise, they were considered away from the stricture.ResultsThe accordion sign was associated with a significantly greater occurrence of leaks away from the stricture (P = 0.001) but not at the stricture (P = 0.34).ConclusionsThe accordion sign is an important consideration when performing balloon dilation procedures on transplant ureteral strictures, given the increased risk of leak away from the stricture. Its presence should prompt additional care during wire and catheter manipulations.

  11. Intragastric balloon for morbid obesity causing chronic gastric dilatation

    Energy Technology Data Exchange (ETDEWEB)

    Pretolesi, F.; Derchi, L.E. [Dept. of Radiology, University of Genoa (Italy); Redaelli, G.; Papagni, L. [IRCCS, Ist. Auxologico Italiano, Milan (Italy)

    2001-04-01

    We describe the radiographic findings observed in a morbidly obese and diabetic patient with an intragastric air-filled balloon introduced as a therapeutic measure to reduce food intake. The balloon was associated with chronic gastric dilatation and had to be removed 3 months after insertion. However, together with diet and behavioural therapy, it proved effective in reducing body weight and ameliorating glycaemic control. Although rarely used, intragastric balloons for the treatment of morbid obesity are still encountered in radiological practice. Radiologists must be able to recognize them and to understand their complications. (orig.)

  12. Intragastric balloon for morbid obesity causing chronic gastric dilatation

    International Nuclear Information System (INIS)

    We describe the radiographic findings observed in a morbidly obese and diabetic patient with an intragastric air-filled balloon introduced as a therapeutic measure to reduce food intake. The balloon was associated with chronic gastric dilatation and had to be removed 3 months after insertion. However, together with diet and behavioural therapy, it proved effective in reducing body weight and ameliorating glycaemic control. Although rarely used, intragastric balloons for the treatment of morbid obesity are still encountered in radiological practice. Radiologists must be able to recognize them and to understand their complications. (orig.)

  13. Cryo-balloon catheter position planning using AFiT

    Science.gov (United States)

    Kleinoeder, Andreas; Brost, Alexander; Bourier, Felix; Koch, Martin; Kurzidim, Klaus; Hornegger, Joachim; Strobel, Norbert

    2012-02-01

    Atrial fibrillation (AFib) is the most common heart arrhythmia. In certain situations, it can result in life-threatening complications such as stroke and heart failure. For paroxsysmal AFib, pulmonary vein isolation (PVI) by catheter ablation is the recommended choice of treatment if drug therapy fails. During minimally invasive procedures, electrically active tissue around the pulmonary veins is destroyed by either applying heat or cryothermal energy to the tissue. The procedure is usually performed in electrophysiology labs under fluoroscopic guidance. Besides radio-frequency catheter ablation devices, so-called single-shot devices, e.g., the cryothermal balloon catheters, are receiving more and more interest in the electrophysiology (EP) community. Single-shot devices may be advantageous for certain cases, since they can simplify the creation of contiguous (gapless) lesion sets around the pulmonary vein which is needed to achieve PVI. In many cases, a 3-D (CT, MRI, or C-arm CT) image of a patient's left atrium is available. This data can then be used for planning purposes and for supporting catheter navigation during the procedure. Cryo-thermal balloon catheters are commercially available in two different sizes. We propose the Atrial Fibrillation Planning Tool (AFiT), which visualizes the segmented left atrium as well as multiple cryo-balloon catheters within a virtual reality, to find out how well cryo-balloons fit to the anatomy of a patient's left atrium. First evaluations have shown that AFiT helps physicians in two ways. First, they can better assess whether cryoballoon ablation or RF ablation is the treatment of choice at all. Second, they can select the proper-size cryo-balloon catheter with more confidence.

  14. Upper and midureteral calculi: Percutaneous extraction with an occlusion balloon catheter

    Energy Technology Data Exchange (ETDEWEB)

    Beckmann, C.F.; Roth, R.A.; Luedke, M.D.

    1986-06-01

    In 44 patients with one or more calculi in the upper two-thirds of the ureter, single-stage percutaneous nephrolithotomy was performed through a middle or upper calyceal nephrostomy after cystoscopic placement of an occlusion balloon catheter distal to the calculus; in 42, the procedure was successful. The occlusion balloon catheter permitted retrograde opacification of all systems for enhanced renal puncture. In the last 30 patients an attempt was made either to push the calculus upward mechanically or to flush it upward into the renal pelvis with carbon dioxide or dilute contrast material. This was successful in 24 of these patients. Prior overnight occlusion of the ureter by means of ureteral dilatation further facilitates dislodgement of the calculus, which was successful in 12 of 13 patients.

  15. Treatment of urethral strictures with balloon dilation: A forgotten tale

    Directory of Open Access Journals (Sweden)

    Konstantinos Stamatiou

    2015-09-01

    Full Text Available Urethral stricture is a common condition that can lead to serious complications such as urinary infections and renal insufficiency secondary to urinary retention. Treatment options include catheterization and dilation, urethroplasty and endoscopic internal urethrotomy as well. Although treatment option depends on the type, length and aetiology of stricture, the choice can be influenced to varying degrees by the simplicity of the method, the preferences of the patient the available accoutrements and the patient health condition. Both urethroplasty and endoscopic internal urethrotomy require anaesthesia and thus are not suitable for many elder and unfit for surgical treatment patients. On the other hand, dilations are easy to perform in every day clinical practice however they have been associated with iatrogenic urethral trauma. In contrast, balloon dilation under vision dilates by radial application of forces against the stricture, avoiding the potentially shearing forces associated with sequential rigid dilation. Since it reduces the possibility of an iatrogenic urethral trauma and the subsequent spongiofibrosis may lead into improved therapeutic outcomes. In this report we describe a technique for the treatment of urethral strictures with balloon dilation in elder and unfit for surgical treatment patients.

  16. Longitudinal stent elongation during retraction of entrapped jailed guidewire in a side branch with balloon catheter support: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Taniguchi, Norimasa; Mizuguchi, Yukio; Takahashi, Akihiko, E-mail: a-takahashi@wine.ocn.ne.jp

    2015-01-15

    A 72-year-old man underwent primary percutaneous coronary intervention for a subtotal occlusion in the mid-portion of the left anterior descending artery involving a large diagonal branch. After successful stenting with a 3.0/24 mm bare metal stent, during which, the diagonal branch was protected with a coronary guidewire, conventional retrieval of the jailed guide wire was impossible. Subsequently, several attempts at a strong retraction of the wire with the support of a balloon catheter enabled retrieval of the trapped wire. Optical coherence tomography performed after post-dilatation, revealed that the stent was elongated to the left main coronary artery, and the structure of the strut had become coarse in the proximal portion. The stent was believed to have become entangled with the balloon catheter when the guidewire was being pulled. This case suggests that retrieving the jailed guidewire with a balloon catheter carries a potential risk of entrapment in the deformed stent.

  17. Membranous duodenal stenosis: Initial experience with balloon dilatation in four children

    Energy Technology Data Exchange (ETDEWEB)

    Rijn, R.R. van [Department of Radiology, Academic Medical Centre Amsterdam (Netherlands); Lienden, K.P. van [Department of Radiology, Academic Medical Centre Amsterdam (Netherlands); Fortuna, T.L. [Dalhousie University, Medical school, Halifax (Canada); Department of Diagnostic Imaging, Hospital for Sick Children, Toronto (Canada); D' Alessandro, L.C.A. [University of Western Ontario, Schulich School of Medicine, London (Canada); Department of Diagnostic Imaging, Hospital for Sick Children, Toronto (Canada); Connolly, B. [Department of Diagnostic Imaging, Hospital for Sick Children, Toronto (Canada); Chait, P.G. [Department of Diagnostic Imaging, Hospital for Sick Children, Toronto (Canada)]. E-mail: peter.chait@rogers.com

    2006-07-15

    Introduction: We present a novel approach to the treatment of membranous duodenal stenosis (MDS). To our knowledge this is the first paper to describe balloon dilatation for this entity. Material and methods: Four children, 2 boys and 2 girls, aged between 8 and 28 days, underwent duodenal balloon dilatation. Balloon dilatation was performed under general anaesthesia using standard angiography balloons per os. Balloon diameters ranged from 6 to 14 mm. Results: All balloon dilatations were successful. None of the procedures showed procedural or post-procedural complications. None of the patients subsequently required surgical intervention. To date all children are doing well. Discussion: The initial experience with balloon dilation of MDS showed a 100% success rate, without procedural or post-procedural complications. The results obtained in this small group of patients suggest that the use of balloon dilatation in cases of MDS may be a safe technique that can be readily performed by an experienced interventional radiologist.

  18. Membranous duodenal stenosis: Initial experience with balloon dilatation in four children

    International Nuclear Information System (INIS)

    Introduction: We present a novel approach to the treatment of membranous duodenal stenosis (MDS). To our knowledge this is the first paper to describe balloon dilatation for this entity. Material and methods: Four children, 2 boys and 2 girls, aged between 8 and 28 days, underwent duodenal balloon dilatation. Balloon dilatation was performed under general anaesthesia using standard angiography balloons per os. Balloon diameters ranged from 6 to 14 mm. Results: All balloon dilatations were successful. None of the procedures showed procedural or post-procedural complications. None of the patients subsequently required surgical intervention. To date all children are doing well. Discussion: The initial experience with balloon dilation of MDS showed a 100% success rate, without procedural or post-procedural complications. The results obtained in this small group of patients suggest that the use of balloon dilatation in cases of MDS may be a safe technique that can be readily performed by an experienced interventional radiologist

  19. The Effect of Balloon Dilation at the Vallecular Using Videofluoroscopic Swallowing Study on Patient Who Has a Dysphagia

    OpenAIRE

    Kim, Yong Kyun; Kim, Min Tae; Kim, Seong Kyun

    2013-01-01

    Authors have previously experienced the effect of balloon dilation at the vallecular by utilizing the video-fluoroscopic swallowing study (VFSS) and the urethral catheter to physically stretch and spread in the direction of the posterior inferior towards the patients who have claimed for dysphagia symptoms due to epiglottic dysfunction. A 72-year-old male patient has been diagnosed with rectal cancer and have been treated with an ileocolostomy after the intubation. After the removal of trache...

  20. Hemodynamic evaluation of transluminal iliac artery balloon dilatation.

    Science.gov (United States)

    Breslau, P J; van Soest, M; Janevski, B; Jörning, P J

    1985-10-01

    In order to document the hemodynamic results of transluminal iliac artery balloon dilatation, 23 aortoiliac segments were evaluated before and after treatment. Hemodynamic parameters were: intra-arterial common femoral pressure measurements, indirect ankle pressure measurements and femoral velocity waveform analysis. The segments were divided into group (a) aortoiliac segments with an open superficial femoral artery (n = 8), and group (b) aortoiliac segments with an occluded superficial femoral artery (n = 15). In group (a) all patients were free of symptoms and ankle pressure improved significantly six months after dilatation. Velocity waveform analysis of the common femoral artery did not correlate with this improvement. In group (b) intra-arterial pressure measurements showed improvement in 60% (9/15) after six months. Ankle pressure measurements and velocity waveform analysis did not correlate with the intra-arterial pressure changes. Transluminal iliac artery balloon dilatation of iliac stenosis in patients with an open superficial femoral artery can be evaluated by indirect ankle pressure measurements. In patients with iliac stenosis in combination with occluded superficial femoral arteries intra-arterial pressure measurements are needed to demonstrate hemodynamic improvement. PMID:2932658

  1. Balloon dilatation of post-surgical ano-rectal strictures in two infants

    Energy Technology Data Exchange (ETDEWEB)

    Wilder, W.M.; Melhem, R.E.

    1989-08-01

    Balloon dilatation of ano-rectal strictures offers an alternative to surgical repair of such lesions. This procedure has been described in higher colonic strictures secondary to necrotizing enterocolitis in infants but not in post-surgical ano-rectal strictures. Two cases of successful balloon dilatation are reported. Anal sphincter injury resulting in fecal incontinence, as previously reported, did not occur. (orig.).

  2. Placement of a Hemodialysis Catheter using the Dilated Right External Jugular Vein as a Primary Route

    Energy Technology Data Exchange (ETDEWEB)

    Park, Mi Hyun [Dankook University Hospital, Cheonan (Korea, Republic of); Shin, Byung Seok [Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2010-08-15

    To evaluate the feasibility that a dilated right external jugular vein (EJV) could be a primary venous access site for large bore hemodialysis catheter placement. Between January 2008 and April 2009, a total of 173 hemodialysis catheters (14.5 F) were placed. Among them, we evaluated the clinical data of 42 patients who underwent placement through a dilated right EJV. We evaluated technical success, duration of catheterization in days, and the presence of complications. Technical success was achieved for 41 patients (98%). Catheter placement was unsuccessful in one patient due to narrowing of the EJV. The catheter dwell time ranged between 14 and 305 days (mean; 76 days, total catheter days: 3,111 days). A total of 26 hemodialysis catheters were removed due to complications (n=2) and termination of hemodialysis via the hemodialysis catheter (n=24). There was air embolization (n=1) and catheter kinking (n=3) during procedures and catheter related infections (n=2) during the follow-up period. The incidence of catheter related infection was 0.06 per 100 catheter days. No cases of catheter malfunction or symptomatic venous thrombosis were observed. We suggest that a dilated right EJV could be considered as a preferred primary route for hemodialysis catheter placement with easy access

  3. Per anal balloon dilatation of a post-necrotizing enterocolitis stricture of the sigmoid colon

    Energy Technology Data Exchange (ETDEWEB)

    Renfrew, D.L.; Smith, W.L.; Pringle, K.C.

    1986-05-01

    Per anal balloon dilatation of a sigmoid colon stricture caused by necrotizing enterocolitis allowed identification of a more proximal lesion which would otherwise have gone radiographically undetected. Repeated dilatations at two weeks and four weeks following the initial dilatation of the stricture resulted in relief of the stricture and obviated the need for surgical treatment of this lesion.

  4. Evaluation of a Dedicated Balloon Catheter for Infrapopliteal Difficult Calcified Lesions in Diabetic Patients With Critical Limb Ischemia

    International Nuclear Information System (INIS)

    The purpose of this study was to assess the technical performance and immediate procedural outcome of a new balloon catheter in the treatment of calcified lesions in infrapopliteal arterial disease. Sixty-one patients (81 vessels) with infrapopliteal arterial disease were evaluated. Seventy-four of the 81 treated vessels had total occlusions. The ReeKross 18 peripheral transluminal angioplasty catheter (ClearStream, Wexford, Ireland) is an 0.018-inch guidewire system with 4F sheath compatibility and a rigid shaft intended for enhanced pushability. Only technical procedural outcomes were recorded. In 37 of 61 patients (50 infrapopliteal severely stenosed or occluded vessels), an attempt with a standard balloon was made before the ReeKross 18 was used. In 24 patients, the ReeKross 18 was used as the primary catheter in 23 cases involving crural arteries and in 8 cases involving the foot. The ReeKross 18 crossed the lesion in 55 of 59 (93.2%) patients and 72 of 77 (94.5%) vessels, respectively. Postdilatation results for the 51 patients (64 target lesions) in whom ReeKross 18 balloon dilation was achieved showed <30% residual stenosis in all but 4 patients (5 lesions). Of the patients treated with the ReeKross 18 as the primary catheter, the technical success rate (no adjunctive treatment/stent) was obtained in 20 of 24 (83.3%) patients (27 of 31 [87.1%] target lesions). In the treatment of difficult calcified lesions, the choice of a high-pushability angioplasty catheter, such as the ReeKross 18, warrants consideration.

  5. Deflation of the ′obstinate′ Foley′s urinary catheter balloon : a new technique.

    Directory of Open Access Journals (Sweden)

    Ramakantan R

    1989-01-01

    Full Text Available We have successfully deflated "obstinate" Foley′s urinary catheter balloons in 15 cases in the last six months with the help of a simple bedside procedure using an angiographic guide-wire.

  6. Long-term outcome of a modified balloon dilatation in the treatment of patients with achalasia

    Directory of Open Access Journals (Sweden)

    Doder Radoje

    2013-01-01

    Full Text Available Background/Aim. Balloon dilatation is a standard approach to the initial achalasia treatment. Modified dilatation is also applied to rise efficacy and to lower complications. Methods. A total of 57 patients were analysed within a median follow-up of 8.2 years. No premedication was used, dilatation was performed up to the pain treshold, while introduction and positioning of a dilatator was done in combination of endoscopic and radiological control. Dilatation effect was estimated by both Kim Symptom Scoring and objective parameters: body weight rise and radiological scintigraphic findings. Results. Excellent and good results were obtained in 50 (88% of the patients, while in 7 (12% of the patients surgery was performed. There was no difference in dilatation efficacy regarding sex of the patients, but the results were better in the patients above 40 years. Duration of symptoms, body weight loss, esophageal lumen width do not indicate the definitive dilatation outcome. Esophageal scintigraphy and body weight increase were in a direct correlation with the effect of dilatation measured with the Kim Symptom Scoring. After the one to two repeated dilatations the efficacy increased from 74% to 88% justifying the repetition of dilatation. In 2 (3.57% of the patients, that is in 2.65% of the totally dilated patients, perforation was recorded. There was no lethal outcome of dilatation, and the other complications were not clinically significant. Conclusion. Modified balloon dilatation can be recommended for initial method in achalasia treatment due to high efficacy, easy performance in daily hospital while complications are in standard range.

  7. Evaluation of interventional angioplasty by using thrombolysis and balloon dilatation in treating pulmonary embolism

    International Nuclear Information System (INIS)

    Objective: To evaluate the interventional angioplasty by using thrombolysis and balloon dilatation in the treatment of pulmonary embolism. Methods: Eight patients with pulmonary embolism were treated with interventional management including fragmentation of the thrombus, thrombolysis with urokinase flush infusion, balloon dilatation and continuing low-dose infusion for 24 hours. Anticoagulation with heparin was given simultaneously. Results: The pulmonary artery was completely recanalized in three patients, and partially recanalized in five patients. The blood oxygen saturation reached 100% in 3 cases and was over 93% in 5 cases. Conclusion: Interventional angioplasty by means of thrombolysis or balloon dilatation is an effective therapy for pulmonary embolism in reopening the embolized pulmonary artery, bringing the pulmonary hemodynamics to normal condition and correcting the hypoxemia. (authors)

  8. 166Ho labelled DTPA derivative for radiation brachytherapy using catheter balloons

    International Nuclear Information System (INIS)

    Full text: Brachytherapy is one of the effective treatments for in-stent restenosis. Filling the dilatation catheter balloon with radioactive solutions has the advantages of an accurate source positioning and uniform dose delivery to the vessel walls. In addition, it can be used easily with an existing catheter. Moreover, a solution based beta ray source allows for the treatment of large vessels. Of the variety of radioisotopes prepared in a soluble form for use as a liquid radiation source, Ho-166 is a good radioisotope, because it can be readily produced by irradiating a natural Ho target using a low or medium flux research reactor (165Ho has 100% natural abundance). For X ray imaging, various iodinated X ray contrast agents having the 1,3,5-triiodobenzoic acid platform are used, mainly for computed tomography (CT) and angiographic applications. In the present study, we prepared a new DTPA bisamide derivative, DTPA-BTIPA (3-amino- 2,4,6-triiodoisophthalic acid) containing iodine in the structure. 166Ho was labeled with DTPA-BTIPA as a possible agent for IVRT for the prevention of restenisis. The optimum condition of the radiolabeling of DTPA-BTIPA with Ho-166 was achieved by varying different reaction parameters. To estimate the 166Ho-complex as a liquid radiation source for a potential clinical application of IVRT, which is readily excreted through the urinary system in the event of a balloon rupture, a dynamic imaging was acquired. 166Ho-(DTPA- BTIPA) was prepared by a simple mixing at room temperature. High radiochemical stability (>98%) was maintained over a period of 6 h at room temperature. The radioactivity curve in the kidneys of the rabbit administered with 166Ho-(DTPA-BTIPA) via an ear vein showed that the 166Ho-(DTPA- BTIPA) was rapidly cleared through the kidneys. The average of Tmax and T1/2 of 166Ho-(DTPA-BTIPA) in the kidneys were 2.26 ± 0.78 min and 7.80 ± 1.16 min, respectively. The serial static image scans of the rabbit administered with 166

  9. Is endoscopic papillary balloon dilatation really a risk factor for post-ERCP pancreatitis?

    Science.gov (United States)

    Fujisawa, Toshio; Kagawa, Koichi; Hisatomi, Kantaro; Kubota, Kensuke; Nakajima, Atsushi; Matsuhashi, Nobuyuki

    2016-01-01

    Endoscopic papillary balloon dilatation (EPBD) is useful for decreasing early complications of endoscopic retrograde cholangio-pancreatography (ERCP), including bleeding, biliary infection, and perforation, but it is generally avoided in Western countries because of a relatively high reported incidence of post-ERCP pancreatitis (PEP). However, as the efficacy of endoscopic papillary large-balloon dilatation (EPLBD) becomes widely recognized, EPBD is attracting attention. Here we investigate whether EPBD is truly a risk factor for PEP, and seek safer and more effective EPBD procedures by reviewing past studies. We reviewed thirteen randomised control trials comparing EPBD and endoscopic sphincterotomy (EST) and ten studies comparing direct EPLBD and EST. Three randomized controlled trials of EPBD showed significantly higher incidence of PEP than EST, but no study of EPLBD did. Careful analysis of these studies suggested that longer and higher-pressure inflation of balloons might decrease PEP incidence. The paradoxical result that EPBD with small-calibre balloons increases PEP incidence while EPLBD does not may be due to insufficient papillary dilatation in the former. Insufficient dilatation could cause the high incidence of PEP through the use of mechanical lithotripsy and stress on the papilla at the time of stone removal. Sufficient dilation of the papilla may be useful in preventing PEP.

  10. Treatment of hepatic venous stenosis by transfemoral venous balloon dilation following living donor liver transplantation: a case report

    Institute of Scientific and Technical Information of China (English)

    Weiwei Jiang; Yangsui Liu; Lianbao Kong

    2009-01-01

    Hepatic venous stenosis may be a cause of graft failure in living donor liver transplantation (LDLT). Balloon dilation and metallic frame approaches have been used successfully to treat hepatic venous stenosis. Here, we report the effect of transfemoral venous balloon dilation for treating a child with hepatic venous stenosis after LDLT.

  11. Double-Balloon Catheter for Isolated Liver Perfusion: An Experimental Study

    International Nuclear Information System (INIS)

    Purpose: Further development of a previously described interventional method for isolated liver perfusion (ILP) with a new double-lumen balloon catheter, and evaluation of the side-effects of such isolation.Methods: In six pigs a double-balloon occlusion catheter was placed via the transjugular approach with its tip in the portal vein. One of the balloons was positioned in the inferior vena cava (IVC), cranial to the origin of the hepatic veins and the other balloon in the portal vein. By the transfemoral approach, a single-balloon occlusion catheter was placed in the IVC caudal to the origin of the hepatic veins. A third catheter was placed by the transfemoral route with the occlusion balloon in the proper hepatic artery. After inflation of all balloons 99Tcm-labelled human serum albumin was recirculated through the liver. The isolation was evaluated by repeated measurement of radioactivity levels in peripheral blood. Laboratory tests of liver and pancreas function, and hemoglobin, were taken before, at the end of, and 3 days after the procedure. Blood gases were tested at the beginning and end of the procedure.Results: One pig died during the procedure due to technical failure and was excluded from the study. In the other pigs leakage from the isolated liver to the systemic circulation increased slowly, up to 9.7% (mean) during 30 min of recirculation of the perfusate through the liver. Laboratory tests were normal in all pigs except insignificant acidosis directly after the procedure and the slight elevation of s-ALAT after 3 days.Conclusions: Only minor leakage from the liver to the systemic circulation was noted during ILP performed with a new, double-balloon catheter. There were no serious side effects

  12. Application of new balloon catheters in the treatment of congenital heart defects

    Science.gov (United States)

    Fiszer, Roland; Szkutnik, Małgorzata; Smerdziński, Sebastian; Chodór, Beata; Białkowski, Jacek

    2016-01-01

    Introduction Balloon angioplasty (BAP) and aortic or pulmonary balloon valvuloplasty (BAV, BPV) are well-established treatment options in congenital heart defects. Recently, significant technological progress has been made and new catheters have been implemented in clinical practice. Aim To analyze the results of BAP, BAV and BPV with the new balloon catheter Valver and its second generation Valver II, which the company Balton (Poland) launched and developed. These catheters have not been clinically evaluated yet. Material and methods We performed 64 interventions with Valver I and Valver II. With Valver I the following procedures were performed: 17 BPV (including 9 in tetralogy of Fallot – TOF), 10 BAV and 27 BAP in coarctations of the aorta (CoA) – including 9 native and 18 after surgery. With Valver II ten interventions were done – 3 BPV, 2 pulmonary supravalvular BAP (after switch operations), 2 BAP of recoarctations and 3 other BAP. Age of the patients ranged from a few days to 40 years. Results All procedures were completed successfully, without rupture of any balloon catheters. The pressure gradient drop was statistically significant in all groups: BPV in isolated pulmonary valvular stenosis 28.1 mm Hg (mean), BPV in TOF 18.7 mm Hg, BAV 32.8 mm Hg, BAP in native CoA 15.4 mm Hg and in recoarctations 18.6 mm Hg. In 3 cases during rapid deflation of Valver I, wrinkles of the balloons made it impossible to insert the whole balloon into the vascular sheath (all were removed surgically from the groin). No such complication occured with Valver II. Conclusions Valver balloon catheters are an effective treatment modality in different valvular and vascular stenoses. PMID:27625686

  13. Esophageal Transit Scintigraphy, Manometry, and Barium Swallow in Assessment of Response to Balloon Dilatation in Achalasia

    Directory of Open Access Journals (Sweden)

    M.J. Ehsani Ardakani

    2006-08-01

    Full Text Available Background/Objective: Achalasia is a motility disorder of unknown etiology, characterized by absent esophageal peristalsis and loss of lower esophageal sphincter relaxation. Balloon dilatation is the most effective non-surgical treatment for patients with achalasia. Manometry, scintigraphy and radiology are three techniques that provide an objective measure of success after balloon dilatation. The objective of this study was to determine the best predictor of success after balloon dilatation in patients with achalasia. Patients and Methods: 17 patients with achalasia of cardia who referred to Taleghani Hospital in 2003, were evaluated, both symptomatically and objectively (esophageal manometry, timed barium esophagogram, and scintigraphic emptying index, before and after treating with pneumatic dilatation of esophagus. The degree of patient symptom improvements after treat-ment was recorded and correlated with improvement in some indices derived by the above-mentioned three methods. Results: 12 (70.6% of 17 patients had score improvements of ≥80%. All the pre-treatment diagnostic indices were significantly (P<0.05 different from those after therapy. There was no significant difference between the two groups in terms of improvement in symptoms according to the indices of barium swallow or scintigraphy. No association between the patient symptom scores and improvement in either the barium height or emptying index was found. Conclusion: In evaluation of efficacy of pneumatic dilatation of esophagus for treatment of achalasia, we should not only rely on transit or barium study.

  14. Long-term results of endoscopic balloon dilatation of lower GI tract strictures in Crohn's disease

    International Nuclear Information System (INIS)

    Over the last few years there have been several reports on endoscopic balloon dilatation of Crohn's strictures of the lower gastrointestinal (GI) tract. However, to date, long-term results are not available. Our objective is to examine the long-term results of endoscopic treatment in a prospective study conducted over a period of 10 years, 1997 to January 2007. Here, we report our initial findings. A total of 25 patients (20 female and five male: aged 18-75 years) with at least one symptom of stricture, with the standard colonoscopy not able to be passed and with a scarred Crohn's stricture of the lower GI were included in the study. The main symptom was abdominal pain. The endoscopic balloon dilatation was performed with an 18 mm balloon under endoscopic and radiological control. Eleven strictures were located in the colon, 13 at the anastomosis after ileocoecal resection, three at the Bauhin valve and four in the ileum. Four patients had two strictures and one patient had three strictures. Of the 31 strictures, in 30 was balloon dilatation successful in a single endoscopic session, so that eventually the strictures could be passed easily with the standard colonoscopy. In one patient with a long stricture of the ileum involving the Bauhin valve and an additional stricture of the ileum which were 15 cm apart, sufficient dilatation was not possible. This patient therefore required surgery. Improvement of abdominal symptoms was achieved in all cases with technically successful balloon dilatation. Although in one case, perforation occurred after dilatation of a recurrent stricture. Available follow-up was in the range 54-118 months (mean of 81 months). The relapse rate over this period was 46% but 64% of relapsing strictures could be successfully dilated again. Only in four patients was surgery required during this followup period. We conclude from these initial results that endoscopic balloon dilatation especially for short strictures in Crohn's disease, can be

  15. A system for visualization and automatic placement of the endoclamp balloon catheter

    OpenAIRE

    Furtado, H.; Stüdeli, T.; Sette, M; Samset, E.; Gersak, B

    2010-01-01

    The European research network "Augmented Reality in Surgery" (ARIS*ER) developed a system that supports minimally invasive cardiac surgery based on augmented reality (AR) technology. The system supports the surgical team during aortic endoclamping where a balloon catheter has to be positioned and kept in place within the aorta. The presented system addresses the two biggest difficulties of the task: lack of visualization and difficulty in maneuvering the catheter. The system was developed usi...

  16. Cryo-Balloon Catheter Localization Based on a Support-Vector-Machine Approach.

    Science.gov (United States)

    Kurzendorfer, Tanja; Mewes, Philip W; Maier, Andreas; Strobel, Norbert; Brost, Alexander

    2016-08-01

    Cryo-balloon catheters have attracted an increasing amount of interest in the medical community as they can reduce patient risk during left atrial pulmonary vein ablation procedures. As cryo-balloon catheters are not equipped with electrodes, they cannot be localized automatically by electro-anatomical mapping systems. As a consequence, X-ray fluoroscopy has remained an important means for guidance during the procedure. Most recently, image guidance methods for fluoroscopy-based procedures have been proposed, but they provide only limited support for cryo-balloon catheters and require significant user interaction. To improve this situation, we propose a novel method for automatic cryo-balloon catheter detection in fluoroscopic images by detecting the cryo-balloon catheter's built-in X-ray marker. Our approach is based on a blob detection algorithm to find possible X-ray marker candidates. Several of these candidates are then excluded using prior knowledge. For the remaining candidates, several catheter specific features are introduced. They are processed using a machine learning approach to arrive at the final X-ray marker position. Our method was evaluated on 75 biplane fluoroscopy images from 40 patients, from two sites, acquired with a biplane angiography system. The method yielded a success rate of 99.0% in plane A and 90.6% in plane B, respectively. The detection achieved an accuracy of 1.00 mm±0.82 mm in plane A and 1.13 mm±0.24 mm in plane B. The localization in 3-D was associated with an average error of 0.36 mm±0.86 mm. PMID:26978663

  17. Intra-aortic balloon occlusion catheter for treating hemorrhagic shock after massive duodenal ulcer bleeding.

    Science.gov (United States)

    Shigesato, Shintaro; Shimizu, Tetsunosuke; Kittaka, Tadahiro; Akimoto, Hiroshi

    2015-03-01

    Clamping the descending aorta by emergency thoracotomy is a well-known effective procedure to stop bleeding from lesions under the diaphragm. We successfully treated a case of cardiopulmonary arrest resulting from a massive duodenal ulcer hemorrhage using an intraaortic balloon occlusion (IABO) catheter instead of the conventional technique. Our experience suggests that IABO catheters can be used to treat patients with hemorrhagic shock regardless of the presence of cardiopulmonary arrest. This can be a life-saving procedure, which prevents ischemic brain injury. This article describes the advantages of using IABO catheters and our experience with this case. PMID:25633531

  18. Initial Experience with Balloon-Occluded Trans-catheter Arterial Chemoembolization (B-TACE) for Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    PurposeThis study was performed to evaluate the accumulation of lipiodol emulsion (LE) and adverse events during our initial experience of balloon-occluded trans-catheter arterial chemoembolization (B-TACE) for hepatocellular carcinoma (HCC) compared with conventional TACE (C-TACE).MethodsB-TACE group (50 cases) was compared with C-TACE group (50 cases). The ratio of the LE concentration in the tumor to that in the surrounding embolized liver parenchyma (LE ratio) was calculated after each treatment. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Effects (CTCAE) version 4.0.ResultsThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). Only elevation of alanine aminotransferase was more frequent in the B-TACE group, showing a statistically significant difference (Mann–Whitney test: P < 0.05). While B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation, there was no statistically significant difference in incidence between the groups. Multivariate logistic regression analysis suggested that the significant risk factor for liver abscess/infarction was bile duct dilatation (P < 0.05).ConclusionThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation

  19. Initial Experience with Balloon-Occluded Trans-catheter Arterial Chemoembolization (B-TACE) for Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Maruyama, Mitsunari, E-mail: mitunari@med-shimane.u.ac.jp; Yoshizako, Takeshi, E-mail: yosizako@med.shimane-u.ac.jp; Nakamura, Tomonori, E-mail: t-naka@med.shimane-u.ac.jp; Nakamura, Megumi, E-mail: megumi@med.shimane-u.ac.jp; Yoshida, Rika, E-mail: yoshidar@med.shimane-u.ac.jp; Kitagaki, Hajime, E-mail: kitagaki@med.shimane-u.ac.jp [Shimane University Faculty of Medicine, Department of Radiology (Japan)

    2016-03-15

    PurposeThis study was performed to evaluate the accumulation of lipiodol emulsion (LE) and adverse events during our initial experience of balloon-occluded trans-catheter arterial chemoembolization (B-TACE) for hepatocellular carcinoma (HCC) compared with conventional TACE (C-TACE).MethodsB-TACE group (50 cases) was compared with C-TACE group (50 cases). The ratio of the LE concentration in the tumor to that in the surrounding embolized liver parenchyma (LE ratio) was calculated after each treatment. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Effects (CTCAE) version 4.0.ResultsThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). Only elevation of alanine aminotransferase was more frequent in the B-TACE group, showing a statistically significant difference (Mann–Whitney test: P < 0.05). While B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation, there was no statistically significant difference in incidence between the groups. Multivariate logistic regression analysis suggested that the significant risk factor for liver abscess/infarction was bile duct dilatation (P < 0.05).ConclusionThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation.

  20. Use of ballon catheters of Gruntzing type for dilatation of pyrolic and diodenal stenosis

    International Nuclear Information System (INIS)

    The paper is concerned with original methods of ballon dilatation with high-pressure low-profile ballon catheters of Gruntzig type of pyloric and duodenal stenoses. A new informative method of recording of this procedure and its results with computer for radiography was decribed. In 10 patients this method was used. No complications were noted. Therefore this method could be recommended for a wider clinical use

  1. A rectal balloon catheter as internal immobilization device for conformal radiotherapy of prostate cancer

    International Nuclear Information System (INIS)

    Background: As known from the literature, prostate motion depends on different bladder and/or rectum fillings. The aim of this study was to analyze the influence of a rectum balloon catheter, used as an internal immobilization device, on prostate and rectum motion during the treatment course. Moreover we have analysed if the balloon enables an increase of the distance between the prostate and the posterior rectum wall. Results: An increase of the distance between the prostate and the posterior rectal wall of 8 mm was observed at the base of the prostate when using the rectum balloon. Moreover prostate motion in the ventrodorsal direction ≥4 mm (1 SD) was reduced from 6/10 patients (60%) to 1/10 patients (10%) using the rectal balloon. In general, deviations in the latero-lateral and cranio-caudal directions were less (mean ≤ 2 mm, 1 SD), no difference between both examination series (with and without balloon) was observed. Conclusion: Rectal balloon catheter offers a possibility to reduce prostate motion and rectum filling variations during treatment course. In addition it enables an increase in the distance between prostate and posterior rectal wall, which could enable an improved protection of the posterior rectal wall. (orig./AJ)

  2. Ureteropelvic junction obstruction and ureteral strictures treated by simple high-pressure balloon dilation

    DEFF Research Database (Denmark)

    Osther, P J; Geertsen, U; Nielsen, H V

    1998-01-01

    congenital UPJO, previous stones, sequelae of endoscopic and open surgery, radiotherapy, and urinary tract reconstruction. A retrograde ureteroscopic approach was used. Evaluation included clinical and radiographic examinations and renal scintigraphy with diuretic wash-out. The procedure was repeated in 21...... in strictures secondary to reconstructive and ureteroscopic surgery, with a success rate of 91%. In congenital UPJO, the results were less encouraging: in patients with a symptom debut after the age of 18 years, balloon dilation was successful in 57% of cases; in patients with symptom debut before...... the age of 18 years, success was achieved in only 25% of cases. There were no major complications. It was concluded that simple high-pressure balloon dilation is a safe and reasonably effective technique for the management of most ureteral strictures and congenital UPJO with symptom debut in adult...

  3. Balloon dilatation and thrombus extraction for the treatment of cerebral venous sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Shao-Feng Shui

    2014-01-01

    Full Text Available Background and Purpose: This study aimed to investigate the efficacy and safety of balloon dilatation and thrombus extraction for the treatment of cerebral venous sinus thrombosis (CVST. Materials and Methods: Twenty-six cases of digital subtraction angiography-confirmed CVST were treated with balloon dilatation and thrombus extraction. Active treatment of primary disease was carried out after cerebral venous sinus recanalization, and the subsequent anticoagulant therapy lasted for 6 months. Results: Recanalization of the cerebral venous sinus was achieved in all 26 patients, and no endovascular treatment-related complications occurred during or after the procedure. At discharge, the Glasgow Coma Scale (GCS of the patients had improved from an average of 12.3 points to 15 points, and clinical symptoms were improved in 100% of the patients. Follow-up times ranged from 12-62 months (mean follow-up time of 42.3 months and no thrombus re-formation or new neurological deficits occurred during that time. Conclusion: Based on our small study population, balloon dilatation and thrombus extraction appears to be a safe and effective treatment for cerebral venous sinus thrombosis. However, further research is needed to confirm this.

  4. A system for visualization and automatic placement of the endoclamp balloon catheter

    Science.gov (United States)

    Furtado, Hugo; Stüdeli, Thomas; Sette, Mauro; Samset, Eigil; Gersak, Borut

    2010-02-01

    The European research network "Augmented Reality in Surgery" (ARIS*ER) developed a system that supports minimally invasive cardiac surgery based on augmented reality (AR) technology. The system supports the surgical team during aortic endoclamping where a balloon catheter has to be positioned and kept in place within the aorta. The presented system addresses the two biggest difficulties of the task: lack of visualization and difficulty in maneuvering the catheter. The system was developed using a user centered design methodology with medical doctors, engineers and human factor specialists equally involved in all the development steps. The system was implemented using the AR framework "Studierstube" developed at TU Graz and can be used to visualize in real-time the position of the balloon catheter inside the aorta. The spatial position of the catheter is measured by a magnetic tracking system and superimposed on a 3D model of the patient's thorax. The alignment is made with a rigid registration algorithm. Together with a user defined target, the spatial position data drives an actuator which adjusts the position of the catheter in the initial placement and corrects migrations during the surgery. Two user studies with a silicon phantom show promising results regarding usefulness of the system: the users perform the placement tasks faster and more accurately than with the current restricted visual support. Animal studies also provided a first indication that the system brings additional value in the real clinical setting. This work represents a major step towards safer and simpler minimally invasive cardiac surgery.

  5. Radiation recall secondary to adjuvant docetaxel after balloon-catheter based accelerated partial breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Nathan W. [Summer Intern, Mayo Clinic Arizona, Scottsdale, AZ (United States); Wong, William W., E-mail: wong.william@mayo.ed [Department of Radiation Oncology, Mayo Clinic Arizona, 13400 E. Shea Boulevard, Scottsdale, AZ 85259 (United States); Karlin, Nina J. [Division of Oncology, Mayo Clinic Arizona, Scottsdale, AZ (United States); Gray, Richard J. [Department of Surgery, Mayo Clinic Arizona, Scottsdale, AZ (United States)

    2010-08-15

    For early stage breast cancer, wide local excision and post-operative whole breast irradiation is a standard treatment. If adjuvant chemotherapy is recommended, radiation is usually given after completion of chemotherapy. In recent years, accelerated partial breast irradiation (APBI) with balloon-cathetered based brachytherapy has become an option for selected patients. For these patients, adjuvant chemotherapy would have to be administered after radiation. The sequence of treatment with radiation followed by chemotherapy results in increased risk of radiation recall reaction (RRD) in these patients. Docetaxel is becoming a more commonly used drug as adjuvant treatment for breast cancer. Here we report a case of docetaxel induced RRD after APBI with balloon-cathetered based brachytherapy. Such reaction would have an adverse impact on the cosmetic outcome and quality of life of the patient. For patients who develop an intense skin reaction after the administration of docetaxel following APBI, RRD should be considered in the differential diagnosis.

  6. Evaluating condom catheter balloon tamponade in non-traumatic postpartum haemorrhage resistant to medical management

    Directory of Open Access Journals (Sweden)

    Syed Nawaz Ahmad

    2016-06-01

    Conclusions: Placement of a condom catheter balloon can successfully treat non-traumatic PPH refractory to medical management. It is simple, inexpensive, easily, available and in those with successful placement no procedure related morbidity was observed. The potential for it to be used by inexperienced operators in areas with limited resources makes it a useful tool in management of PPH. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 1874-1878

  7. Percutaneous balloon dilatation of stenotic calyceal diverticular infundibula in patients with recurrent urinary tract infections

    Energy Technology Data Exchange (ETDEWEB)

    Keeling, Aoife N. [Department of Academic Radiology, Beaumont Hospital, Beaumont Road, Dublin 9 (Ireland); Wang, Tim T. [Department of Biosurgery and Surgical Technology, Surgical Epidemiology and Quality Unit, Imperial College London, St. Mary' s Hospital, London W2 1NY (United Kingdom); Lee, Michael J., E-mail: mlee@rcsi.ie [Department of Academic Radiology, Beaumont Hospital, Beaumont Road, Dublin 9 (Ireland)

    2011-02-15

    Aim: Renal calyceal diverticula are usually detected as incidental findings on intravenous pyelograms (IVPs) and rarely manifest any clinical signs or symptoms. However, they can interfere with patient's quality of life in a number of instances causing pain, recurrent urinary tract infections (UTIs), abscess, systemic sepsis and calculus formation. The purpose of this study was to review the clinical indications, procedure technique and clinical outcome in all patients referred to Interventional Radiology for the percutaneous management of renal calyceal diverticula. Materials and methods: A retrospective review of all patients treated with percutaneous balloon dilatation of calyceal diverticular infundibula in the Interventional Radiology Department over a 10-year period was performed. Data collected included clinical details, laboratory indices, IVP and CT findings, procedure details and clinical outcome. Results: A total of three patients were treated over the course of the study period. All patients were young females who presented as a result of recurrent urinary tract infections. The calyceal diverticula were diagnosed incidentally on routine IVPs, with CT eloquently confirming the plain film findings in two cases. Technical procedure success was achieved in all cases, avoiding surgical intervention. Clinical follow-up revealed no further UTIs following dilatation. Conclusion: Fluoroscopic guided percutaneous balloon dilatation of renal calyceal diverticular infundibula following direct diverticular puncture is a safe and well tolerated method to reduce UTI and potentially avoid future stone formation.

  8. Percutaneous balloon dilatation of stenotic calyceal diverticular infundibula in patients with recurrent urinary tract infections.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2012-02-01

    AIM: Renal calyceal diverticula are usually detected as incidental findings on intravenous pyelograms (IVPs) and rarely manifest any clinical signs or symptoms. However, they can interfere with patient\\'s quality of life in a number of instances causing pain, recurrent urinary tract infections (UTIs), abscess, systemic sepsis and calculus formation. The purpose of this study was to review the clinical indications, procedure technique and clinical outcome in all patients referred to Interventional Radiology for the percutaneous management of renal calyceal diverticula. MATERIALS AND METHODS: A retrospective review of all patients treated with percutaneous balloon dilatation of calyceal diverticular infundibula in the Interventional Radiology Department over a 10-year period was performed. Data collected included clinical details, laboratory indices, IVP and CT findings, procedure details and clinical outcome. RESULTS: A total of three patients were treated over the course of the study period. All patients were young females who presented as a result of recurrent urinary tract infections. The calyceal diverticula were diagnosed incidentally on routine IVPs, with CT eloquently confirming the plain film findings in two cases. Technical procedure success was achieved in all cases, avoiding surgical intervention. Clinical follow-up revealed no further UTIs following dilatation. CONCLUSION: Fluoroscopic guided percutaneous balloon dilatation of renal calyceal diverticular infundibula following direct diverticular puncture is a safe and well tolerated method to reduce UTI and potentially avoid future stone formation.

  9. Percutaneous balloon dilatation of stenotic calyceal diverticular infundibula in patients with recurrent urinary tract infections

    International Nuclear Information System (INIS)

    Aim: Renal calyceal diverticula are usually detected as incidental findings on intravenous pyelograms (IVPs) and rarely manifest any clinical signs or symptoms. However, they can interfere with patient's quality of life in a number of instances causing pain, recurrent urinary tract infections (UTIs), abscess, systemic sepsis and calculus formation. The purpose of this study was to review the clinical indications, procedure technique and clinical outcome in all patients referred to Interventional Radiology for the percutaneous management of renal calyceal diverticula. Materials and methods: A retrospective review of all patients treated with percutaneous balloon dilatation of calyceal diverticular infundibula in the Interventional Radiology Department over a 10-year period was performed. Data collected included clinical details, laboratory indices, IVP and CT findings, procedure details and clinical outcome. Results: A total of three patients were treated over the course of the study period. All patients were young females who presented as a result of recurrent urinary tract infections. The calyceal diverticula were diagnosed incidentally on routine IVPs, with CT eloquently confirming the plain film findings in two cases. Technical procedure success was achieved in all cases, avoiding surgical intervention. Clinical follow-up revealed no further UTIs following dilatation. Conclusion: Fluoroscopic guided percutaneous balloon dilatation of renal calyceal diverticular infundibula following direct diverticular puncture is a safe and well tolerated method to reduce UTI and potentially avoid future stone formation.

  10. Metallic stent placement in hemodialysis graft patients after insufficient balloon dilation

    Energy Technology Data Exchange (ETDEWEB)

    Liang, Huei-Lung; Pan, Huay-Ben; Lin, Yih-Huie; Chen, Chiung-Yu; Lai, Pin-Hong; Yang, Chien-Fang [Kaohsiung Veterans General Hospital, Kaohsiung (China); Chung, Hsiao-Min; Wu, Tung-Ho; Chou, Kang-Ju [National Yangming University, Taipei (China)

    2006-06-15

    We wanted to report our experience of metallic stent placement after insufficient balloon dilation in graft hemodialysis patients. Twenty-three patients (13 loop grafts in the forearm and 10 straight grafts in the upper arm) underwent metallic stent placement due to insufficient flow after urokinase thrombolysis and balloon dilation. The indications for metallic stent deployment included 1) recoil and/or kinked venous stenosis in 21 patents (venous anastomosis: 17 patients, peripheral outflow vein: four patients); and 2) major vascular rupture in two patients. Metallic stents 8-10mm in diameter and 40-80 mm in length were used. Of them, eight stents were deployed across the elbow crease. Access patency was determined by clinical follow-up and the overall rates were calculated by Kaplan-Meier survival analysis. No procedure-related complications (stent fracture or central migration) were encountered except for a delayed Wallstent shortening/migration at the venous anastomosis, which resulted in early access failure. The overall primary and secondary patency rates ({+-}standard error) of all the vascular accesses in our 23 patients at 3, 6, 12 and 24 months were 69%{+-}9 and 88%{+-}6,41% {+-}10 and 88%{+-}6, 30%{+-}10 and 77%{+-}10, and 12%{+-}8 and 61%{+-}13, respectively. For the forearm and upper-arm grafts, the primary and secondary patency rates were 51%{+-}16 and 86%{+-}13 vs 45%{+-}15 and 73%{+-}13 at 6 months, and 25%{+-}15 and 71%{+-}17 vs 23%{+-}17 and 73%{+-}13 at 12 months ({rho} = .436 and .224), respectively. Metallic stent placement is a safe and effective means for treating peripheral venous lesions in dialysis graft patients after insufficient balloon dilation. No statistically difference in the patency rates between the forearm and upper-arm patient groups was seen.

  11. Emergency balloon dilation or stenting of critical coarctation of aorta in newborns and infants: An effective interim palliation

    Directory of Open Access Journals (Sweden)

    Francis Edwin

    2009-01-01

    Full Text Available Background: Management of native uncomplicated coarctation in neonates remains controversial with current evidence favoring surgery. The logistics of organizing surgical repair at short notice in sick infants with critical coarctation can be challenging. Methods and Results: We reviewed data of 10 infants (mean age of 2.9 ±1.6 weeks who underwent catheter intervention for severe coarctation and left ventricular (LV dysfunction between July 2003 and August 2007. Additional cardiac lesions were present in 7. Mean systolic gradient declined from 51±12 mm Hg to 8.7±6.7 mm Hg after dilation. The coarctation segment was stented in five patients. Procedural success was achieved in all patients with no mortality. Complications included brief cardiopulmonary arrest (n =1, sepsis (n = 1 and temporary pulse loss (n = 2. LV dysfunction improved in all patients. Average ICU stay was 5±3.4 days and hospital stay was 6.5±3.4 days. On follow-up (14.1±10.5 months, all developed restenosis after median period of 12 weeks (range four to 28 weeks. Three (two with stents underwent elective coarctation repair, two underwent ventricular septal defect (VSD closure and coarctation repair and one underwent pulmonary artery (PA banding. Two patients who developed restenosis on follow-up were advised surgery, but did not report. Two (one with stent underwent redilatation and are being followed with no significant residual gradients. Conclusion: Balloon dilation ± stenting is an effective interim palliation for infants and newborns with critical coarctation and LV dysfunction. Restenosis is inevitable and requires to be addressed.

  12. Conservative treatment of transmural perforation with mediastinal leakage after balloon dilation: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Hyo Sung; Han, Young Min; Chung, Gyung Ho [Chonbuk National University Medical School, Chonju (Korea, Republic of)

    2005-08-15

    A 43-years-old man was admitted complaining of swallowing difficulties. The esophagography revealed severe stenosis at the esophagogastric anastomotic site. Esophagography after balloon dilatation showed a transmural perforation with mediastinal leakage. The patient was treated conservatively for one week at which time the esophagography showed no further leakage at the anastomotic site and the good passage of barium. A 2-year follow-up chest computed tomography (CT) showed good patency of the esophageal lumen and the marked resorption of barium in the mediastinum.

  13. Endoscopic assessment of effacement of balloon waist during pneumatic dilatation of primary achalasia cardia under topical anesthesia

    International Nuclear Information System (INIS)

    Balloon dilatation of Primary Achalasia Cardia (PAC) is usually performed under antegrade endoscopic guidance, with conscious sedation. The main goals of this prospective study were to assess the safety and efficacy of pneumatic dilatation without conscious sedation and to determine the endoscopic signs of effacement of the balloon waist. Pneumatic dilatation was successfully performed as outdoor procedure without conscious sedation in patients (n= 25; mean age 42.56 years) with endoscopic and radiologic diagnosis of PAC. Immediate relief of symptoms was observed in 23 (92%) cases. Effacement of the balloon waist under endoscopic vision was appreciated in all cases in the present study. Common complications of pneumatic dilatation were chest pain in all (100%) subjects and mild local bleeding in 17 (68%) patients. There was no cancellation of procedure. Re-dilatation was required in 2 (8%) cases. The duration of follow-up was from 6 weeks to 23 months. Pneumatic dilatation of PAC can be safely performed as same day procedure, without conscious sedation. Obliteration of the balloon waist can be readily determined by antegrade endoscopic assessment of stretch on the lower oesophageal sphincter (EASL). (author)

  14. Trans-catheter closure of atrial septal defect: Balloon sizing or no balloon sizing - single centre experience

    Directory of Open Access Journals (Sweden)

    Gupta Saurabh

    2011-01-01

    Full Text Available Background : Selecting the device size using a sizing balloon could oversize the ostium secundum atrial septal defect (OSASD with floppy margins and at times may lead to complications. Identifying the firm margins using trans-esophageal echocardiography (TEE and selecting appropriate-sized device optimizes ASD device closure. This retrospective study was undertaken to document the safety and feasibility of device closure without balloon sizing the defect. Methods : Sixty-one consecutive patients who underwent trans-catheter closure of OSASD guided by balloon sizing of the defect and intra procedural fluoroscopy (group I and 67 consecutive patients in whom TEE was used for defect sizing and as intraprocedural imaging during device deployment (group II were compared. The procedural success rate, device characteristics, and complications were compared between the two groups. Results : The procedure was successful in 79.7 % patients. The success rate in group II (60 of 67, 89.6% was significantly higher than in group I (41 of 61, 67.2 % (P = 0.002. Mean upsizing of ASD device was significantly lower in group II (P < 0.001. TEE also provided better success rate with smaller device in subjects with large ASD (>25 mm and in those who were younger than 14 years of age. There were four cases of device embolization (two in each group; of which one died in group II despite successful surgical retrieval. Conclusion : Balloon sizing may not be essential for successful ASD device closure. TEE-guided sizing of ASD and device deployment provides better success rate with relatively smaller sized device.

  15. A Simple Radiological Technique for Demonstration of Incorrect Positioning of a Foley Catheter with Balloon Inflated in the Urethra of a Male Spinal Cord Injury Patient

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2006-01-01

    Full Text Available In a male patient with cervical spinal cord injury, the urinary bladder may go into spasm when a urethral catheter is removed and a new Foley catheter is inserted. Before the balloon is inflated, the spastic bladder may push the Foley catheter out or the catheter may slip out of a small-capacity bladder. An inexperienced health professional may inflate the balloon of a Foley catheter in the urethra without realizing that the balloon segment of the catheter is lying in the urethra instead of the urinary bladder. When a Foley balloon is inflated in the urethra, a tetraplegic patient is likely to develop autonomic dysreflexia. This is a medical emergency and requires urgent treatment. Before the incorrectly placed Foley catheter is removed, it is important to document whether the balloon has been inflated in the urinary bladder or not. The clinician should first use the always available tools of observation and palpation at the bedside without delays of transportation. A misplaced balloon will often be evident by a long catheter sign, indicating excessive catheter remaining outside the patient. Radiological diagnosis is not frequently required and, when needed, should employ the technique most readily available, which might be a body and pelvic CT without intravenous contrast. An alternative radiological technique to demonstrate the position of the balloon of the Foley catheter is described. Three milliliters of nonionic X-ray contrast medium, Ioversol (OPTIRAY 300, is injected through the side channel of the Foley catheter, which is used for inflating the balloon. Then, with a catheter-tip syringe, 30 ml of sterile Ioversol is injected through the main lumen of the Foley catheter. Immediately thereafter, an X-ray of the pelvis (including perineum is taken. By this technique, both the urinary bladder and balloon of the Foley catheter are visualized by the X-ray contrast medium. When a Foley catheter has been inserted correctly, the balloon of the

  16. Transhepatic Balloon Dilatation of Early Biliary Strictures in Pediatric Liver Transplantation: Successful Initial and Mid-Term Outcome

    International Nuclear Information System (INIS)

    Purpose: To evaluate the initial and mid-term outcomes of transhepatic balloon dilatation for the treatment of early biliary strictures in lateral left-segment liver transplants in young children.Methods: Between April 1997 and May 2001, seven children aged 9 months to 6 years with nine benign strictures in left-segment liver grafts were treated percutaneously. Sessions of two or three dilations were performed three or four times at average intervals of 10-20 days. In each session, the biliary stenoses were gradually dilated using balloons of 3-7 mm. Follow-up ranged from 12 to 54 months (mean 27 months, median 12 months). Clinical success was defined as resolution of the stenosis, normalization of liver enzymes and lack of clinical symptoms. Results: Technical success was achieved in all nine strictures. Hemobilia occurred in one patient and was successfully treated. On follow-up, all patients had complete clinical recovery with normalization of liver function and imaging of patent bile ducts. Conclusion: Balloon dilatation is an effective and relatively safe method for the treatment of early biliary strictures in left-segment liver transplantation in young children. We recommend this approach as the initial treatment for early strictures. Metal stents or surgery should be reserved for patients with late appearance of strictures or failure of balloon dilatation

  17. Hypertensive lower esophageal sphincter (HLES: Prevalence,symptoms genesis and effect of pneumatic balloon dilatation

    Directory of Open Access Journals (Sweden)

    Gad El-Hak Nabil

    2006-01-01

    Full Text Available Background: Summary and background data: The Hypertensive lower esophageal sphincter (HLES is an unusual primary motor disorder of the esophagus. The significance of this motility disorder is still questionable. Objective: The objectives were: (a identification of the prevalence of HLES in these patients, (b identification of the common presenting symptoms of HLES, (c study of the correlation of the symptoms with LESP and (d study of the effectiveness of pneumatic balloon dilation in cases that fail to respond to medical treatment. Methods: A retrospective study that includes four thousand one hundred and seventy patients, who were subjected to esophageal manometry in the period from January 1994 to December 2003, among whom sixty-six patients with HLES (LESP> 40 mmHg were found. In addition to manometry, upper endoscopy was done to forty-nine patients, upper GI barium studies to thirtyeight patients and esophageal pH- metry to sixteen patients. Results: showed that most of our patients were females (45 females and 21 males, with a mean age of 36.6 ±±14 years. Patients with dysphagia (57.5% had the highest LESP (52.1 ±±21, mmHg while patients with chest pain (47% had the highest distal esophageal contraction amplitude (153.9 ±± 93.2 mmHg. Endoscopy showed varying degrees of esophagitis in 17 patients (34%. Barium studies showed corkscrew esophagus in seven patients (18.4% and dilated esophagus in nine patients (23.7%. LESP was highest in patients with dilated esophagus (57.5 ±± 33.4 mmHg. All our patients were subjected to medical treatment, of which twelve patients underwent pneumatic dilation with successfully reduced LESP and symptoms relief in 91% of patients. Conclusions: It was concluded that the prevalence of HLES is around 1.6, in which dysphagia and chest pain are the usual presenting symptom, and that pneumatic balloon dilatation is very effective when properly applied. It will probably occupy the same position it has in

  18. Are Balloon Based Strategies Better Than Conventional Radiofrequency Catheter Ablation: Exploring New Frontiers In The Treatment Of Atrial Fibrillation

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    Alexander Fuernkranz MD

    2009-02-01

    Full Text Available Paroxysmal atrial fibrillation can be eliminated with continuous circular linear lesions around the pulmonary veins using radiofrequency ablation. Due to the technical complexity of this procedure balloon-based devices have been developed to simplify pulmonary vein isolation. Cryoballoon ablation provides excellent safety and is technically less demanding when compared to radiofrequency catheter ablation in selected patients. In this review, advantages as well as drawbacks of this emerging technology in relation to standard catheter ablation are discussed.

  19. Simple balloon dilation for drug-eluting in-stent restenosis: An optical coherent tomography analysis

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    Arikawa, Ryo [Division of Cardiology, Tenyoukai Central Hospital, Izumi-cho, Kagoshima City, Kagoshima (Japan); Yamaguchi, Hiroshi, E-mail: hyamaguchi@tsm.bbiq.jp [Division of Cardiology, Tenyoukai Central Hospital, Izumi-cho, Kagoshima City, Kagoshima (Japan); Takaoka, Junichiro; Miyamura, Akihiro; Atsuchi, Nobuhiko; Ninomiya, Toshiko; Atsuchi, Yoshihiko [Division of Cardiology, Tenyoukai Central Hospital, Izumi-cho, Kagoshima City, Kagoshima (Japan); Ohishi, Mitsuru [Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Science, Kagoshima University, Kagoshima (Japan); Terashima, Mitsuyasu [Department of Cardiology, Toyohashi Heart Center, Toyohashi (Japan); Kaneda, Hideaki [Okinaka Memorial Institute for Medical Research, Tokyo (Japan)

    2015-01-15

    Background: Although drug-eluting stent (DES) has significantly reduced restenosis, the treatment of DES-in-stent restenosis (ISR) remains a challenge with high restenosis rate. Methods: We examined whether morphologic appearance of restenosis tissue by optical coherent tomography (OCT) had an impact on outcomes after balloon angioplasty for DES-ISR. The morphologic appearance of restenosis tissue was qualitatively assessed for tissue structures such as homogeneous, layered, and heterogeneous patterns. Results: Using OCT, 50 patients with DES-ISR were divided into 2 groups: 25 lesions with homogeneous or layered patterns (homo/layered group) and 25 lesions with heterogeneous patterns (hetero group). Acute gain was larger in the hetero group (1.33 ± 0.41 mm vs. 1.06 ± 0.32 mm in the homo/layered group, P = 0.03). On intravascular ultrasound analysis, post-procedural percent neointimal area was smaller in the hetero group (27.4 ± 9.2% vs. 34.0 ± 11.2% in the homo/layered group, P = 0.05). Angiographic follow-up was performed in 37 lesions (74%). Follow-up minimal lumen diameter was larger in the hetero group (1.75 ± 0.89 mm vs. 1.01 ± 0.81 mm in the homo/layered group, P = 0.04). Target lesion revascularization rates tended to be lower in the hetero group (20% vs. 43% in the homo/layered group, P = 0.12). Conclusions: Balloon angioplasty was more effective for DES-ISR with heterogeneous tissue appearance than DES-ISR with homogeneous/layered tissue appearance. OCT assessment of DES-ISR morphology may be a useful adjunct in determining clinical strategies. Simple balloon dilatation is a possible treatment strategy for DES-ISR lesions with a heterogeneous appearance on OCT images.

  20. Urethral dilation in prostatic malignancies for obstructive uropathy secondary to radiation-induced edema

    International Nuclear Information System (INIS)

    This paper evaluates transurethral prostatic balloon dilation in patients with symptomatic obstructive uropathies secondary to radiation-induced edema during external beam irradiation for prostatic adenocarcinoma. From 1987 to 1990, six patients with obstructive uropathy during external beam were treated with balloon dilation. With ultrasound-directed needle biopsy, fewer patients undergo TURP for diagnosis of malignancy and relief of symptoms. The urethra may become compromised by prostate edema during irradiation, increasing obstructive symptoms or urinary retention. Six patients presented requiring relief of symptoms. Options included Turp, catheter drainage, or urethral balloon dilation. All were treated with dilation. Three patients were treated at completion of therapy, and two patients underwent dilation after obstruction

  1. Rigiflex Balloon dilation without fluoroscopy for treatment of Achalasia: A long-term follow-up of 99 patients

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    "Mikaeli J

    2002-06-01

    Full Text Available Achalasia is a well- defined esophageal motor disorder. Graded pneumatic dilation using Rigiflex ballon is one of the therapeutic modalities that had not been evaluated in a large long-term study. We aimed at evaluating long-term efficacy of graded Rigiflex pneumatic dilation in the treatment of achalasia. Symptomatic patients with achalasia who had been referred to our center were consecutively enrolled. The diagnosis was established by clinical, radiographic and endoscopic criteria. Exclusion criteria included pregnancy, coagulopathy, serious medical illness or malignancy. Initially all patients were clinically scored based on the severity of five main symptoms and then underwent pneumatic dilation wit at 3 cm ballon. Symptom scores were evaluated at 1, 6, 12 .. months. Clinical recurrence was defined as an increase of symptom with 3.5 cm balloon dilation. If recurrence occurred again, third dilation was done with a 4 cm ballon. Over a five-year period, 99 patients [mean age: 35.6 (3.0-72 years.] were followed to an average length of 47.4 (18-20 months. 35 patients needed- retreatment, only 6 of them required third dilation. After third dilation two patients did not reveal improvement and underwent cardiomyotomy. Over this time period, cumulative remission rate was 65% without redilation and 94% with redilation. The mean remission period was 44.7 months (95% CI, 43.52-51.27 for single pneumatic dilation by use of Kaplan- Meier survival analysis. There was no significant predictive value for age, gender, previous treatment and severity of initial score to outcome (P>0.4 by use of Cox regression analysis. Pneumatic dilation by a Rigiflex balloon using a graded approach is effective long-term therapy for achalasia in majority of patients.

  2. Virtual 5-French intra-aortic pumping using a Glidesheath Slender and 6-French intra-aortic balloon catheter

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Akihiko, E-mail: a-takahashi@wine.ocn.ne.jp; Taniguchi, Norimasa; Mizuguchi, Yukio; Yamada, Takeshi; Nakajima, Shunsuke; Hashimoto, Sho; Hata, Tetsuya

    2015-07-15

    Objectives: The aim of this study was to evaluate the feasibility and safety of the 6-Fr Glidesheath Slender, which has equivalent outer size to the conventional 5-Fr sheath, for use with the 6-Fr intra-aortic balloon pump (IABP) catheter. Methods: Between May 2014 and March 2015, 24 patients with acute coronary syndrome underwent percutaneous coronary intervention using a 6-Fr IABP catheter through a 6-Fr Glidesheath Slender for support. The adverse events, including access site complications, kinking of the sheath during the procedure, and any evidence of balloon pump failure, were retrospectively investigated. Results: Insertion of the IABP catheter through either the femoral or brachial artery was successful in all patients. The mean support time was 32.4 ± 22.0 h. No major hemorrhagic event or severe limb ischemia was observed. Kinking of the shaft occurred during insertion in one patient; however, the subsequent balloon pumping was well maintained and did not require exchange of the sheath or IABP catheter. No kind of IABP failure was observed. Conclusion: Although this sheath was originally designed to allow radial access, our results suggest that the use of the Glidesheath Slender is feasible for insertion of the 6-Fr IABP catheter through the brachial and femoral arteries, and may reduce vascular complications in patients who undergo percutaneous coronary intervention.

  3. Virtual 5-French intra-aortic pumping using a Glidesheath Slender and 6-French intra-aortic balloon catheter

    International Nuclear Information System (INIS)

    Objectives: The aim of this study was to evaluate the feasibility and safety of the 6-Fr Glidesheath Slender, which has equivalent outer size to the conventional 5-Fr sheath, for use with the 6-Fr intra-aortic balloon pump (IABP) catheter. Methods: Between May 2014 and March 2015, 24 patients with acute coronary syndrome underwent percutaneous coronary intervention using a 6-Fr IABP catheter through a 6-Fr Glidesheath Slender for support. The adverse events, including access site complications, kinking of the sheath during the procedure, and any evidence of balloon pump failure, were retrospectively investigated. Results: Insertion of the IABP catheter through either the femoral or brachial artery was successful in all patients. The mean support time was 32.4 ± 22.0 h. No major hemorrhagic event or severe limb ischemia was observed. Kinking of the shaft occurred during insertion in one patient; however, the subsequent balloon pumping was well maintained and did not require exchange of the sheath or IABP catheter. No kind of IABP failure was observed. Conclusion: Although this sheath was originally designed to allow radial access, our results suggest that the use of the Glidesheath Slender is feasible for insertion of the 6-Fr IABP catheter through the brachial and femoral arteries, and may reduce vascular complications in patients who undergo percutaneous coronary intervention

  4. The efficacy of balloon dilation in achalasia is the result of stretching of the lower esophageal sphincter, not muscular disruption.

    Science.gov (United States)

    Borhan-Manesh, F; Kaviani, M J; Taghavi, A R

    2016-04-01

    Pneumatic dilation (PD) of the lower esophageal sphincter (LES) in achalasia is a major palliative treatment. It is generally believed, although never substantiated, that therapeutic efficacy of ballooning in achalasia is the result of the disruption and tearing of the muscular layers of the LES. To clarify this issue, we investigated the frequency of muscular disruption at the LES, 24 hours after PD, by employing the endoscopic ultrasound (EUS), in a group of 43 consented patients with achalasia. Between July 2009 and March2012, 51 consecutive adult patients with tentative diagnosis of achalasia, some with recurrence of symptoms after an earlier treatment with balloon dilation, were evaluated and underwent PD, using Rigiflex balloon without major adverse effect. Out of the 51 evaluated, 43 eligible and consenting patients who underwent EUS, 24 hours after PD, using Olympus GF-UE 160 echoendoscope and an Aloka Prosound probe at 7.5 MHZ, are the subjects of this study. The EUS in 43 eligible patients revealed an intact LES in 36 (83.7%), small area of muscular disruption in 5 (11.6%) and small hematoma in 2 patients (4.6%). Our data convincingly demonstrate that the clinical effectiveness of balloon dilation in achalasia is not the result of muscular disruption, but of circumferential stretching of the LES. Our findings on the mechanism of action of PD in achalasia could result in modifying the current method of dilation for a safer procedure, by slowing the rate of inflation and allowing the sphincter to slowly stretch itself to the distending balloon. PMID:25765473

  5. Endoscopic papillary large balloon dilation alone without sphincterotomy for the treatment of large common bile duct stones

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    Chen Wen-Chi

    2011-06-01

    Full Text Available Abstract Background Lethal pancreatitis has been reported after treatment for common bile duct stones using small endoscopic papillary balloon dilation. Methods We retrospectively evaluated the safety and efficacy of using large balloon dilation alone without the use of sphincterotomy for the treatment of large common bile duct stones in Kaohsiung Veterans General Hospital. Success rate of stone clearance, procedure-related adverse events and incidents, frequency of mechanical lithotripsy use, and recurrent stones were recorded. Results A total of 247 patients were reviewed in the current study. The mean age of the patients was 71.2 years. Most of them had comorbidities. Mean stone size was 16.4 mm. Among the patients, 132 (53.4% had an intact gallbladder and 121 (49% had a juxtapapillary diverticulum. The mean size of dilating balloon used was 13.2 mm. The mean duration of the dilating procedure was 4.7 min. There were 39 (15.8% patients required the help of mechanical lithotripsy while retrieving the stones. The final success rate of complete retrieval of stones was 92.7%. The rate of pancreatic duct enhancement was 26.7% (66/247. There were 3 (1.2% adverse events and 6 (2.4% intra-procedure bleeding incidents. All patients recovered completely after conservative and endoscopic treatment respectively, and no procedure-related mortality was noted. 172 patients had a follow-up duration of more than 6 months and among these, 25 patients had recurrent common bile duct stones. It was significantly correlated to the common bile duct size (p = 0.036 Conclusions Endoscopic papillary large balloon dilation alone is simple, safe, and effective in dealing with large common bile duct stones in relatively aged and debilitated patients.

  6. A light-reflecting balloon catheter for atraumatic tissue defect repair.

    Science.gov (United States)

    Roche, Ellen T; Fabozzo, Assunta; Lee, Yuhan; Polygerinos, Panagiotis; Friehs, Ingeborg; Schuster, Lucia; Whyte, William; Casar Berazaluce, Alejandra Maria; Bueno, Alejandra; Lang, Nora; Pereira, Maria J N; Feins, Eric; Wasserman, Steven; O'Cearbhaill, Eoin D; Vasilyev, Nikolay V; Mooney, David J; Karp, Jeffrey M; Del Nido, Pedro J; Walsh, Conor J

    2015-09-23

    A congenital or iatrogenic tissue defect often requires closure by open surgery or metallic components that can erode tissue. Biodegradable, hydrophobic light-activated adhesives represent an attractive alternative to sutures, but lack a specifically designed minimally invasive delivery tool, which limits their clinical translation. We developed a multifunctional, catheter-based technology with no implantable rigid components that functions by unfolding an adhesive-loaded elastic patch and deploying a double-balloon design to stabilize and apply pressure to the patch against the tissue defect site. The device uses a fiber-optic system and reflective metallic coating to uniformly disperse ultraviolet light for adhesive activation. Using this device, we demonstrate closure on the distal side of a defect in porcine abdominal wall, stomach, and heart tissue ex vivo. The catheter was further evaluated as a potential tool for tissue closure in vivo in rat heart and abdomen and as a perventricular tool for closure of a challenging cardiac septal defect in a large animal (porcine) model. Patches attached to the heart and abdominal wall with the device showed similar inflammatory response as sutures, with 100% small animal survival, indicating safety. In the large animal model, a ventricular septal defect in a beating heart was reduced to <1.6 mm. This new therapeutic platform has utility in a range of clinical scenarios that warrant minimally invasive and atraumatic repair of hard-to-reach defects. PMID:26400910

  7. Comparative dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for brain tumors

    OpenAIRE

    Samia de Freitas Brandao; Tarcisio Passos Ribeiro de Campos

    2013-01-01

    Objective Comparative analysis of dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for treatment of brain tumors. Materials and Methods Simulations of intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT were performed with the MCNP5 code, modeling the treatment of a brain tumor on a voxel computational phantom representing a human head. Absorbed dose rates were converted int...

  8. Inferior knee arterial endoluminal angioplasty in treating severe lower limb ischemia though the DEEP balloon catheter

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of inferior knee arterial endoluminal angioplasty for treating severe lower limb ischemia with the use of the DEEP balloon catheter. Methods: Eleven patients (17 limbs) with severe ischemia of lower extremities from August 2007 to April 2008 were retrospectively studied. All involved limbs suffered from rest pain including 6 limbs (6/17)complicated with ulcer, 2 (2/17) with toe gangrene or 3 (3/17)with both of the complaints. ABI (Ankle bxancial index) were 0.2-0.5 and 0.51-0.7 in 12 limbs and 5 limbs respectively, with average value 0.47. Results: The success rate of operation was 100% (17/17). Pain relieved obviously in 13 limbs (13/17) and reduced in 2 limbs (2/17). 2 limbs (2/17) still suffered from pain and underwent upper-knee amputation and other 2 with ulcerations(2/ 17)were healed. 3 (3/17) with toe gangrene underwent partial foot amputation, 1 with dried gangrene remained unchanged and the other was lost. Another one showed ulcer healed and toe was lost. Increase of ABI was more than 0.5 in 10 limbs(10/17) and 0.3-0.5 in 5 limbs(5/17) with average value of 0.83. 10 patients with sixteen limbs were followed up in an average period of 4.3 months (1-9 months). Of the 15 immediate pain-relieved limbs, 12(12/15) limbs remained free of pain and pain recurred in 3 other limbs; and 2 of them with pain-reduced after PTA again; the other 1 underwent amputation, Average value of ABI was 0.70. Conclusions: Inferior arterial endoluminal angioplasty for the treatment of severe limb ischemia with application of the DEEP balloon catheter show high successful rate and short-term encouraging clinical results but mid-term and long-terms follow up should be undertaken for further investigation. (authors)

  9. Dissection of Extracranial Internal Carotid Artery Due to Balloon Guiding Catheter Resulting in Asymptomatic Internal Carotid Artery Occlusion

    Directory of Open Access Journals (Sweden)

    Akpinar

    2016-04-01

    Full Text Available Dissection of the internal carotid artery (ICA is a rare condition that accounts for a significant proportion of ischemic strokes in young adults. Iatrogenic dissection as a complication of neurointerventional procedures is a traumatic dissection which has been reported relatively rare in the literature. In this report, a case of dissection of the ICA is reported that was caused by repetitive movement of the balloon guiding catheter during stent-assisted thrombectomy (SAT, resulting in occlusion of the ICA.

  10. Feasibility of Endovascular Radiation Therapy Using Holmium-166 Filled Balloon Catheter in a Swine Hemodialysis Fistula Model: Preliminary Results

    Energy Technology Data Exchange (ETDEWEB)

    Won, Jong Yun; Lee, Kwang Hun; Lee, Do Yun [Dept. of Radiology, Research Institute of Radiological Science, Yensei University College of Medicine, Seoul (Korea, Republic of); Kim, Myoung Soo [Dept. of Radiology, Yensei University College of Medicine, Seoul (Korea, Republic of); Kang, Byung Chul [Dept. of Radiology, Internal Medicine, EwhaWoman' s University School of Medicine, Seoul (Korea, Republic of); Kim, Seung Jung [Dept. of Internal Medicine, EwhaWoman' s University School of Medicine, Seoul (Korea, Republic of)

    2011-08-15

    To describe how to make a swine hemodialysis fistula model and report our initial experience to test the feasibility of endovascular radiation therapy with Holmium-166 filled balloon catheters. The surgical formation of arterio-venous fistula (AVF) was performed by end-to-side anastomosis of the bilateral jugular vein and carotid artery of 6 pigs. After 4 weeks, angiograms were taken and endovascular radiation was delivered to the venous side of AVF with Holmium-166 filled balloon catheters. Pigs were sacrificed 4 weeks after the radiation and AVFs were harvested for histological examination. All animals survived without any morbidity during the experimental periods. The formation of fistula on the sides of necks was successful in 11 of the 12 pigs (92%). One AVF failed from the small jugular vein. On angiograms, 4 of the 11 AVFs showed total occlusion or significant stenosis and therefore, endovascular radiation could not be performed. Of 7 eligible AVFs, five underwent successful endovascular radiation and two AVFs did not undergo radiation for the control. Upon histologic analysis, one non-radiated AVF showed total occlusion and others showed intimal thickening from the neointimal hyperplasia. Formation of the swine carotid artery-jugular vein hemodialysis fistula model was successful. Endovascular radiation using a Holmium-166 filled balloon catheter was safe and feasible.

  11. Endoscopic balloon dilatation of postsurgical intestinal strictures in Crohn's disease: case report and review of the literature.

    Science.gov (United States)

    Ljubicić, Neven; Bisćanin, Alen; Nikić, Ines; Budimir, Ivan; Nikolić, Marko; Pavić, Tajana

    2013-09-01

    Strictures are one of the most common complications of Crohn's disease. If symptomatic and resistant to medical anti-inflammatory therapy, and especially in cases of acute obstruction, surgical correction may be unavoidable. Although surgical treatment is dramatically effective in curing Crohn's disease strictures, a high rate of postsurgical restenosis has been recognized, ultimately requiring additional surgery. To avoid the risks and costs entailed by repeated surgical resection, endoscopic balloon dilatation (EBD) has been proposed as a conservative treatment option for intestinal strictures in Crohn's disease, in which the stricture is pneumatically dilated with through-the-scope balloons of different diameters. The main clinical indication for EBD is the appearance of obstructive symptoms associated with the stricture, especially if they are postoperative and shorter than 4 centimeters. Usually more than one dilatation session is required for every stricture. EBD is applied infrequently, possibly due to the perceived risk of perforation and early stricture recurrence, but studies have demonstrated that EBD has a high success rate, a low chance of complications, excellent symptomatic response, as well as good short-term and long-term outcomes, proving that it is a relatively simple and successful technique that provides long-term effective palliation of the symptoms with minimal risk in patients with simple strictures, and offers a reasonable alternative to surgery. PMID:24558771

  12. Plasma levels following application of paclitaxel-coated balloon catheters in patients with stenotic or occluded femoropopliteal arteries

    International Nuclear Information System (INIS)

    Purpose: Paclitaxel-coated balloon catheters inhibit restenosis after coronary and peripheral angioplasty (PCI,PTA). The aim of this study was to investigate paclitaxel plasma levels and laboratory parameters following PTA with paclitaxel-coated balloons (PCB) in peripheral arteries. Materials and Methods: This single treatment arm, multicenter study included 14 patients with Rutherford stage 1 - 5 with occlusions of up to 5 cm or ≥ 70 % diameter stenosis of the superficial femoral or popliteal arteries (SFA, PA). PTA was performed using up to three PCB catheters. The paclitaxel plasma levels and safety laboratory parameters were determined by collecting blood samples pre-intervention, immediately post-intervention, at 0.5, 1, 2, 4, 8, 24 hours and 1 and 4 weeks post-intervention (p. i.). Vital signs were monitored to assess clinical safety. Results: PTA was performed successfully in all patients. Paclitaxel plasma levels were always below a level and duration known to cause systemic side effects. A mean peak paclitaxel plasma level (40 ng/ml) was reached immediately p. i. and decreased rapidly below detectable levels in more than half of the patients already 2 hours p. i. The paclitaxel plasma concentrations returned to values below detectable levels at 24 hours p. i. in all patients. Laboratory parameters and vital signs did not give any reason for safety concerns. No adverse events associated with balloon coating were observed. Conclusion: The results of 14 patients with peripheral arterial occlusive disease show no systemic bioavailability of paclitaxel > 24 hours after PTA with one or more PCB catheters, indicating that the PCB catheter is safe with regard to possible systemic effects. (orig.)

  13. Diffusing, side-firing, and radial delivery laser balloon catheters for creating subsurface thermal lesions in tissue

    Science.gov (United States)

    Chang, Chun-Hung; Fried, Nathaniel M.

    2016-02-01

    Infrared lasers have been used in combination with applied cooling methods to preserve superficial skin layers during cosmetic surgery. Similarly, combined laser irradiation and tissue cooling may also allow development of minimally invasive laser therapies beyond dermatology. This study compares diffusing, side-firing, and radial delivery laser balloon catheter designs for creation of subsurface lesions in tissue, ex vivo, using a near-IR laser and applied contact cooling. An Ytterbium fiber laser with 1075 nm wavelength delivered energy through custom built 18 Fr (6-mm-OD) balloon catheters incorporating either 10-mm-long diffusing fiber tip, 90 degree side-firing fiber, or radial delivery cone mirror, through a central lumen. A chilled solution was flowed through a separate lumen into 9-mm-diameter balloon to keep probe cooled at 7°C. Porcine liver tissue samples were used as preliminary tissue model for immediate observation of thermal lesion creation. The diffusing fiber produced subsurface thermal lesions measuring 49.3 +/- 10.0 mm2 and preserved 0.8 +/- 0.1 mm of surface tissue. The side-firing fiber produced subsurface thermal lesions of 2.4 +/- 0.9 mm2 diameter and preserved 0.5 +/- 0.1 mm of surface tissue. The radial delivery probe assembly failed to produce subsurface thermal lesions, presumably due to the small effective spot diameter at the tissue surface, which limited optical penetration depth. Optimal laser power and irradiation time measured 15 W and 100 s for diffusing fiber and 1.4 W and 20 s, for side-firing fiber, respectively. Diffusing and side-firing laser balloon catheter designs provided subsurface thermal lesions in tissue. However, the divergent laser beam in both designs limited the ability to preserve a thicker layer of tissue surface. Further optimization of laser and cooling parameters may be necessary to preserve thicker surface tissue layers.

  14. Unintended Thermal Injuries from Radiofrequency Ablation: Organ Protection with an Angioplasty Balloon Catheter in an Animal Model

    Directory of Open Access Journals (Sweden)

    Martha-Grace Knuttinen

    2014-01-01

    Full Text Available Objectives: The aim of this study was to investigate a novel approach of using a balloon catheter as a protective device to separate liver from the diaphragm or nearby bowel during radiofrequency ablation (RFA of hepatic dome tumors in an animal model. Materials and Methods: All experimental procedures were approved by animal Institutional Review Board. Using a 3 cm RF needle electrode, 70 hepatic ablation zones were created using ultrasound in 7 pigs. 50 lesions were created using balloon interposition between liver and diaphragm; 20 lesions were created using the balloon device interposed posteriorly between liver and bowel. Additional 21 control lesions were performed. Animals were sacrificed immediately; diaphragm and bowel were then visually inspected and sectioned. Diaphragmatic and bowel injury was then classified according to the depth of thickness. Results: Control lesions caused full thickness injury, either to diaphragm or bowel. During ablation of lesions with balloon interposition, there was significantly less diaphragmatic injury, P < 0.001 and less bowel injury, P < 0.01. Conclusion: Using balloon interposition as a protective device has advantages over previous saline infusion or CO 2 insufflation, providing a safe way to expand percutaneous RFA of liver tumors located on the undersurface of the diaphragm. In addition, this method may be used in protection of other organs adjacent to areas being ablated.

  15. Balloon dilatation in children for oesophageal strictures other than those due to primary repair of oesophageal atresia, interposition or restrictive fundoplication

    Energy Technology Data Exchange (ETDEWEB)

    Fasulakis, Stephen [Royal Children' s Hospital, Melbourne (Australia); Andronikou, Savvas [Royal Children' s Hospital, Melbourne (Australia); Department of Paediatric Radiology, Red Cross Children' s Hospital, Klipfontein Road, Rondebosch, 7700, Cape Town (South Africa)

    2003-10-01

    Balloon dilatation of the oesophagus in children has been performed predominantly for treating strictures, which are the result of primary repair of oesophageal atresia, interposition surgery or restrictive Nissen's fundoplication. Reports of the use of this technique for alternative causes of stricture are few. To report our experience and success with balloon dilatation of strictures due to caustic ingestion, achalasia, oesophagitis, congenital stenosis, and epidermolysis bullosa (EB) and to make comparisons with our treatment of patients with primary repair of oesophageal atresia (OA), as well as with reports in the English language literature. Retrospective review of fluoroscopically guided balloon oesophageal dilatation procedures in 19 patients over a 5-year period, and comparison of those performed for OA repair complications with those due to other diseases. The average radiation dose, per procedure, was calculated by a medical physicist. Ten patients had strictures as a result of primary repair of OA. Three patients had stricture as a result of EB, two from achalasia, two from caustic injury, one due to an oesophageal web and one from reflux oesophagitis. Our results show that the technique can also be curative for the last group and that it may be used intermittently to alleviate symptoms in ongoing diseases. We have not experienced any complications and have also calculated that, even with prolonged use of multiple procedures, the radiation exposure is comparable to other radiological techniques. Patients with alternative causes for oesophageal stricture may be treated to resolution within 2 years using balloon dilatation. Ongoing diseases such as EB require ongoing dilatation, but balloon dilatation of strictures has been successful in alleviating swallowing difficulty. Patients with stricture from OA repair sometimes need ongoing dilatation. Radiation exposure for multiple procedures, over an extended period, is comparable to that from a single

  16. Balloon dilatation in children for oesophageal strictures other than those due to primary repair of oesophageal atresia, interposition or restrictive fundoplication

    International Nuclear Information System (INIS)

    Balloon dilatation of the oesophagus in children has been performed predominantly for treating strictures, which are the result of primary repair of oesophageal atresia, interposition surgery or restrictive Nissen's fundoplication. Reports of the use of this technique for alternative causes of stricture are few. To report our experience and success with balloon dilatation of strictures due to caustic ingestion, achalasia, oesophagitis, congenital stenosis, and epidermolysis bullosa (EB) and to make comparisons with our treatment of patients with primary repair of oesophageal atresia (OA), as well as with reports in the English language literature. Retrospective review of fluoroscopically guided balloon oesophageal dilatation procedures in 19 patients over a 5-year period, and comparison of those performed for OA repair complications with those due to other diseases. The average radiation dose, per procedure, was calculated by a medical physicist. Ten patients had strictures as a result of primary repair of OA. Three patients had stricture as a result of EB, two from achalasia, two from caustic injury, one due to an oesophageal web and one from reflux oesophagitis. Our results show that the technique can also be curative for the last group and that it may be used intermittently to alleviate symptoms in ongoing diseases. We have not experienced any complications and have also calculated that, even with prolonged use of multiple procedures, the radiation exposure is comparable to other radiological techniques. Patients with alternative causes for oesophageal stricture may be treated to resolution within 2 years using balloon dilatation. Ongoing diseases such as EB require ongoing dilatation, but balloon dilatation of strictures has been successful in alleviating swallowing difficulty. Patients with stricture from OA repair sometimes need ongoing dilatation. Radiation exposure for multiple procedures, over an extended period, is comparable to that from a single

  17. Successful balloon dilatation of both orifices in a case of double-orifice mitral valve with severe rheumatic stenosis.

    Science.gov (United States)

    Nath, Ranjit Kumar; Soni, Dheeraj Kumar

    2016-08-01

    A 24-year-old female patient presented to us with progressive dyspnea on exertion for last three year. She was not a known case of rheumatic heart disease. Her physical examination showed regular pulse and her blood pressure was 100/76 mm Hg. Cardiac palpation showed grade 3 parasternal heave and auscultation revelled an accentuated first heart sound, loud P2 and mid-diastolic long rumbling murmur at apex and pansystolic murmur of tricuspid regurgitation at lower left sterna border. Chest X-ray showed evidence of grade 3 pulmonary venous congestion. Transthoracic and transesophageal two-dimensional echocardiography revealed a double-orifice mitral valve of complete bridge type at the leaflet level. Both orifice sizes were unequal, with the anterolateral orifice being smaller than its counterpart. There was moderate subvalvular fusion and both commisures were fused. Color doppler examination showed two separate mitral diastolic flows with mean gradients of 22 mm and 20 mm of Hg, respectively. There was no mitral regurgitation and no left atrial or appendage clot was seen by transesophageal echocardiography. Transseptal puncture was done by the modified fluoroscopic method. Posteromedial orifice was crossed with a 24 mm Inoue balloon and dilated using the stepwise dilation technique. Anterolateral orifice was not crossed by Inuoe balloon after multiple attempts. A TYSHAK (NuMAD Canada Inc.) balloon (16 × 40mm) was taken over the wire and inflated successfully across the anterolateral orifice with the help of transthoracic echocardiography guidance. Mean gradient become 9 and 8 mm across the medial and lateral orifice. Patient was discharged in stable condition after two day. © 2015 Wiley Periodicals, Inc. PMID:26389694

  18. Balloon dilation of jejunal afferent loop functional stenosis following left hepatectomy and hepaticojejunostomy long time after pylorus-preserving pancreaticoduodenectomy: a case report.

    Science.gov (United States)

    Yoon, Young-In; Hwang, Shin; Ko, Gi-Young; Lee, Jae-Jun; Kang, Chul-Min; Seo, Ji-Hyun; Kwon, Yong-Jae; Cheon, Sung-Jin

    2015-05-01

    We present a rare case of functional stenosis of the jejunal loop following left hepatectomy and hepaticojejunostomy long after pylorus-preserving pancreaticoduodenectomy (PPPD), which was successfully managed by balloon dilation. A 70-year-old Korean man had undergone PPPD 6 years before due to 1.8 cm-sized distal bile duct cancer. Sudden onset of obstructive jaundice led to diagnosis of recurrent bile duct cancer mimicking perihilar cholangiocarcinoma of type IIIb. After left portal vein embolization, the patient underwent resection of the left liver and caudate lobe and remnant extrahepatic bile duct. The pre-existing jejunal loop and choledochojejunostomy site were used again for new hepaticojejunostomy. The patient recovered uneventfully, but clamping of the percutaneous transhepatic biliary drainage (PTBD) tube resulted in cholangitis. Biliary imaging studies revealed that biliary passage into the afferent jejunal limb was significantly impaired. We performed balloon dilation of the afferent jejunal loop by using a 20 mm-wide balloon. Follow-up hepatobiliary scintigraphy showed gradual improvement in biliary excretion and the PTBD tube was removed at 1 month after balloon dilation. This very unusual condition was regarded as disuse atrophy of the jejunal loop, which was successfully managed by balloon dilation and intraluminal keeping of a large-bore PTBD tube for 1 month. PMID:26155279

  19. Stroke risk associated with balloon based catheter ablation for atrial fibrillation: Rationale and design of the MACPAF Study

    Directory of Open Access Journals (Sweden)

    Schultheiss Heinz-Peter

    2010-07-01

    Full Text Available Abstract Background Catheter ablation of the pulmonary veins has become accepted as a standard therapeutic approach for symptomatic paroxysmal atrial fibrillation (AF. However, there is some evidence for an ablation associated (silent stroke risk, lowering the hope to limit the stroke risk by restoration of rhythm over rate control in AF. The purpose of the prospective randomized single-center study "Mesh Ablator versus Cryoballoon Pulmonary Vein Ablation of Symptomatic Paroxysmal Atrial Fibrillation" (MACPAF is to compare the efficacy and safety of two balloon based pulmonary vein ablation systems in patients with symptomatic paroxysmal AF. Methods/Design Patients are randomized 1:1 for the Arctic Front® or the HD Mesh Ablator® catheter for left atrial catheter ablation (LACA. The predefined endpoints will be assessed by brain magnetic resonance imaging (MRI, neuro(psychological tests and a subcutaneously implanted reveal recorder for AF detection. According to statistics 108 patients will be enrolled. Discussion Findings from the MACPAF trial will help to balance the benefits and risks of LACA for symptomatic paroxysmal AF. Using serial brain MRIs might help to identify patients at risk for LACA-associated cerebral thromboembolism. Potential limitations of the study are the single-center design, the existence of a variety of LACA-catheters, the missing placebo-group and the impossibility to assess the primary endpoint in a blinded fashion. Trial registration clinicaltrials.gov NCT01061931

  20. Long-Term Results From the Contura Multilumen Balloon Breast Brachytherapy Catheter Phase 4 Registry Trial

    International Nuclear Information System (INIS)

    Purpose: To describe the long-term outcomes from a completed, multi-institutional phase 4 registry trial using the Contura multilumen balloon (CMLB) breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI) in patients with early-stage breast cancer. Methods and Materials: Three hundred forty-two evaluable patients were enrolled by 23 institutions between January 2008 and February 2011. All patients received 34 Gy in 10 fractions, delivered twice daily. Rigorous target coverage and normal tissue dose constraints were observed. Results: The median follow-up time was 36 months (range, 1-54 months). For the entire patient cohort of 342 patients, 10 patients experienced an ipsilateral breast tumor recurrence (IBTR). Eight of these IBTR were classified as true recurrences/marginal miss (TRMM), and 2 were elsewhere failures (EF). Local recurrence-free survival was 97.8% at 3 years. For the entire cohort, 88% of patients had good to excellent overall cosmesis. The overall incidence of infection was 8.5%. Symptomatic seroma was reported in only 4.4% of patients. A separate analysis was performed to determine whether improved outcomes would be observed for patients treated at high-volume centers with extensive brachytherapy experience. Three IBTR were observed in this cohort, only 1 of which was classified as a TRMM. Local recurrence-free survival at high-volume centers was 98.1% at 3 years. Overall cosmetic outcome and toxicity were superior in patients treated at high-volume centers. In these patients, 95% had good to excellent overall cosmesis. Infection was observed in only 2.9% of patients, and symptomatic seroma was reported in only 1.9%. Conclusion: Use of the CMLB for APBI delivery is associated with acceptable long-term local control and toxicity. Local recurrence-free survival was 97.8% at 3 years. Significant (grade 3) toxicity was uncommon, and no grade 4 toxicity was observed. Treatment at high-volume centers was associated

  1. Long-Term Results From the Contura Multilumen Balloon Breast Brachytherapy Catheter Phase 4 Registry Trial

    Energy Technology Data Exchange (ETDEWEB)

    Cuttino, Laurie W., E-mail: lcuttino@mcvh-vcu.edu [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Arthur, Douglas W. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Vicini, Frank [Michigan Healthcare Professionals/21st Century Onoclogy, Farmington Hills, Michigan (United States); Todor, Dorin [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Julian, Thomas [Allegheny Hospital, Temple School of Medicine, Pittsburgh, Pennsylvania (United States); Mukhopadhyay, Nitai [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States)

    2014-12-01

    Purpose: To describe the long-term outcomes from a completed, multi-institutional phase 4 registry trial using the Contura multilumen balloon (CMLB) breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI) in patients with early-stage breast cancer. Methods and Materials: Three hundred forty-two evaluable patients were enrolled by 23 institutions between January 2008 and February 2011. All patients received 34 Gy in 10 fractions, delivered twice daily. Rigorous target coverage and normal tissue dose constraints were observed. Results: The median follow-up time was 36 months (range, 1-54 months). For the entire patient cohort of 342 patients, 10 patients experienced an ipsilateral breast tumor recurrence (IBTR). Eight of these IBTR were classified as true recurrences/marginal miss (TRMM), and 2 were elsewhere failures (EF). Local recurrence-free survival was 97.8% at 3 years. For the entire cohort, 88% of patients had good to excellent overall cosmesis. The overall incidence of infection was 8.5%. Symptomatic seroma was reported in only 4.4% of patients. A separate analysis was performed to determine whether improved outcomes would be observed for patients treated at high-volume centers with extensive brachytherapy experience. Three IBTR were observed in this cohort, only 1 of which was classified as a TRMM. Local recurrence-free survival at high-volume centers was 98.1% at 3 years. Overall cosmetic outcome and toxicity were superior in patients treated at high-volume centers. In these patients, 95% had good to excellent overall cosmesis. Infection was observed in only 2.9% of patients, and symptomatic seroma was reported in only 1.9%. Conclusion: Use of the CMLB for APBI delivery is associated with acceptable long-term local control and toxicity. Local recurrence-free survival was 97.8% at 3 years. Significant (grade 3) toxicity was uncommon, and no grade 4 toxicity was observed. Treatment at high-volume centers was associated

  2. Palliative balloon dilation of pulmonic stenosis in a dog with tetralogy of Fallot.

    Science.gov (United States)

    Weder, C; Ames, M; Kellihan, H; Bright, J; Orton, C

    2016-09-01

    A 6-month-old Beagle with tetralogy of Fallot underwent balloon valvuloplasty of the pulmonary valve. Balloon valvuloplasty was successful and resulted in palliation of clinical signs and an improved quality of life for approximately 9 months. After 9 months, the dog became symptomatic and a modified Blalock-Taussig shunt procedure was successfully performed. Based on this report, balloon valvuloplasty in dogs with tetralogy of Fallot appears to be a feasible technique that may result in improvement of clinical signs. In addition, it may allow for the delay of the more invasive surgical palliation and provide time for weight gain and development of the pulmonary vascular bed for greater ease of surgical shunt creation. PMID:27025569

  3. Randomized comparison of final kissing balloon dilatation versus no final kissing balloon dilatation in patients with coronary bifurcation lesions treated with main vessel stenting: the Nordic-Baltic Bifurcation Study III

    DEFF Research Database (Denmark)

    Niemelä, Matti; Kervinen, Kari; Erglis, Andrejs;

    2011-01-01

    BACKGROUND: It is unknown whether the preferred 1-stent bifurcation stenting approach with stenting of the main vessel (MV) and optional side branch stenting using drug-eluting stents should be finalized by a kissing balloon dilatation (FKBD). Therefore, we compared strategies of MV stenting with...... twenty-six patients had a quantitative coronary assessment. At 8 months, the rate of binary (re)stenosis in the entire bifurcation lesion (MV and side branch) was 11.0% versus 17.3% (P=0.11), in the MV was 3.1% versus 2.5% (P=0.68), and in the side branch was 7.9% versus 15.4% (P=0.039) in the FKBD...

  4. Percutaneous Placement of Metallic Stents in Malignant Biliary Obstruction: One-Stage or Two-Stage Procedure? Pre-Dilate or Not?

    International Nuclear Information System (INIS)

    The aim of this paper was to evaluate the necessity of percutaneous transhepatic catheter drainage and balloon dilation procedures performed before stent insertion. One hundred and twenty-six patients with unresectable malignant biliary obstruction underwent palliative therapy by means of percutaneous transhepatic placement of 183 metallic biliary endoprotheses. Forty-four (35%) patients underwent metallic stent insertion in a one-stage procedure and 82(65%) had undergone percutaneous transhepatic catheter drainage before stent insertion. Balloon dilation of the stenosis before stent placement (pre-dilation) was performed in 53 (42%) of 126 patients. The rate of the 30-day mortality was 11%, with no procedure-related deaths. The total rate of early complications was 29%, and 84% of these complications were due to percutaneous transhepatic catheter drainage and pre-dilation procedures. Percutaneous transhepatic catheter drainage and pre-dilation had no clinical or statistically significant effect on the patients' survival and stent patency rate. Percutaneous transhepatic catheter drainage and balloon dilation increased the cost of stent placement 18% and 19%, respectively. Palliation of malignant biliary obstruction with percutaneous transhepatic stent insertion should be done directly, in the simplest way, without performing percutaneous transhepatic catheter drainage and balloon dilation before stent placement. It is more useful, safe, and cost-effective

  5. Comparative dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Brandao, Samia de Freitas, E-mail: samiabrandao@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear; Campos, Tarcisio Passos Ribeiro de [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil)

    2013-06-15

    Objective: comparative analysis of dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for treatment of brain tumors. Materials and methods: simulations of intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT were performed with the MCNP5 code, modeling the treatment of a brain tumor on a voxel computational phantom representing a human head. Absorbed dose rates were converted into biologically weighted dose rates. Results: intracavitary balloon catheter brachytherapy with I-125 produced biologically weighted mean dose rates of 3.2E-11, 1.3E-10, 1.9E-11 and 6.9E-13 RBE.Gy.h{sup -1}.p{sup -1}.s, respectively, on the healthy tissue, on the balloon periphery and on the /{sub 1} and /{sub 2} tumor infiltration zones. On the other hand, Cf-252 brachytherapy combined with BNCT produced a biologically weighted mean dose rate of 5.2E-09, 2.3E-07, 8.7E-09 and 2.4E-09 RBE.Gy.h{sup -1}.p{sup -1}.s, respectively on the healthy tissue, on the target tumor and on the /{sub 1} and /{sub 2} infiltration zones. Conclusion: Cf-252 brachytherapy combined with BNCT delivered a selective irradiation to the target tumor and to infiltration zones, while intracavitary balloon catheter brachytherapy with I-125 delivered negligible doses on the tumor infiltration zones. (author)

  6. Comparative dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for brain tumors

    Directory of Open Access Journals (Sweden)

    Samia de Freitas Brandao

    2013-07-01

    Full Text Available Objective Comparative analysis of dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for treatment of brain tumors. Materials and Methods Simulations of intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT were performed with the MCNP5 code, modeling the treatment of a brain tumor on a voxel computational phantom representing a human head. Absorbed dose rates were converted into biologically weighted dose rates. Results Intracavitary balloon catheter brachytherapy with I-125 produced biologically weighted mean dose rates of 3.2E-11, 1.3E-10, 1.9E-11 and 6.9E-13 RBE.Gy.h-1.p-1.s, respectively, on the healthy tissue, on the balloon periphery and on the I 1 and I 2 tumor infiltration zones. On the other hand, Cf-252 brachytherapy combined with BNCT produced a biologically weighted mean dose rate of 5.2E-09, 2.3E-07, 8.7E-09 and 2.4E-09 RBE.Gy.h-1.p-1.s, respectively on the healthy tissue, on the target tumor and on the I 1 and I 2 infiltration zones. Conclusion Cf-252 brachytherapy combined with BNCT delivered a selective irradiation to the target tumor and to infiltration zones, while intracavitary balloon catheter brachytherapy with I-125 delivered negligible doses on the tumor infiltration zones.

  7. Comparative dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for brain tumors

    International Nuclear Information System (INIS)

    Objective: comparative analysis of dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for treatment of brain tumors. Materials and methods: simulations of intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT were performed with the MCNP5 code, modeling the treatment of a brain tumor on a voxel computational phantom representing a human head. Absorbed dose rates were converted into biologically weighted dose rates. Results: intracavitary balloon catheter brachytherapy with I-125 produced biologically weighted mean dose rates of 3.2E-11, 1.3E-10, 1.9E-11 and 6.9E-13 RBE.Gy.h-1.p-1.s, respectively, on the healthy tissue, on the balloon periphery and on the /1 and /2 tumor infiltration zones. On the other hand, Cf-252 brachytherapy combined with BNCT produced a biologically weighted mean dose rate of 5.2E-09, 2.3E-07, 8.7E-09 and 2.4E-09 RBE.Gy.h-1.p-1.s, respectively on the healthy tissue, on the target tumor and on the /1 and /2 infiltration zones. Conclusion: Cf-252 brachytherapy combined with BNCT delivered a selective irradiation to the target tumor and to infiltration zones, while intracavitary balloon catheter brachytherapy with I-125 delivered negligible doses on the tumor infiltration zones. (author)

  8. Balloon Dilatation: A Helpful Technique for Removal of a Stuck Dialysis Line

    International Nuclear Information System (INIS)

    We describe a useful technique for the removal of an irretrievable/stuck long-term intravenous catheter. The alternative would have meant removing it surgically or snaring it in a case of extremely difficult venous access. The process we used was effective in this particular case.

  9. Balloon Dilatation: A Helpful Technique for Removal of a Stuck Dialysis Line

    Energy Technology Data Exchange (ETDEWEB)

    Farooq, Ammad, E-mail: faroamm@aol.com; Jones, Vaughan, E-mail: Vaughan.jones@wales.nhs.uk; Agarwal, Sanjay, E-mail: sanjay.agarwal@wales.nhs.uk [Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board, Department of Radiology (United Kingdom)

    2012-12-15

    We describe a useful technique for the removal of an irretrievable/stuck long-term intravenous catheter. The alternative would have meant removing it surgically or snaring it in a case of extremely difficult venous access. The process we used was effective in this particular case.

  10. Effects of structural injure in the bile bacterial contamination after balloon transduodenal sphincteroplasty (papillary dilation in dogs

    Directory of Open Access Journals (Sweden)

    Zavadinack Netto Martin

    2006-01-01

    Full Text Available PURPOSE: To evaluate, in dogs, the biliary sphincter subjected to dilation by hydrostatic balloon by the point of view of structural alterations of the papilla and the biochemestry and bacterial contamination of the bile. METHODS: Twenty dogs were submitted to laparotomy, duodenotomy, and enlargement of the major duodenal papilla- GA(n=10 - with balloon of 8mm inflated with pressure of 0,5atm, during 2 minutes or to the sham procedure - GB(n=10. Blood samples collected on times t(0day, t(7days and t(28days were subjected to dosages of alkaline phosphatase (ALP and gamma-glutamyltransferase (GGT for cholestasis evaluation. The collected material from the gall bladder at the same times were registered and numbered to be submitted to culture in BHI, blood agar (rich, non-selective element and Mac Conkey (selective element for Gram-negative bacillus. On the 28th day three fragments of the papilla were tranversally cut by the choledoc axis 3mm from the duodenal papilla and the cuts, stained with hematoxylin-eosin and Masson's tricome, were evaluated according to their inflammatory reaction. RESULTS: The GGT and ALP averages on the three periods in the groups A and B did not show significant differences, not being characterizes the cholestasis. The bacterian contamination was significantly higher in GA (2,19 than in GB (1,96; the contamination was lower in the initial time compared with 7 and 28 days (t0dilation or its simple manipulation leads to the bacterial contamination of the gall bladder, not associated with cholestasis. The morphologic lesions are more intense in the late phase, not associated with an eventual papilla esthenosis.

  11. Esophagogastric junction distensibility measurements during hydraulic dilation therapy in achalasia patients.

    Science.gov (United States)

    Kappelle, Wouter F W; Bogte, Auke; Siersema, Peter D

    2016-02-01

    Increasing evidence suggests that esophagogastric junction (EGJ) distensibility is predictive of long-term clinical success after achalasia treatment. A new commercially available hydraulic dilation balloon is capable of measuring EGJ opening diameters whilst simultaneously dilating the EGJ. Deployed alongside the endoscope under direct visualization, it is used for dilation of the lower esophageal sphincter in patients with achalasia. Impedance measurement electrodes are incorporated in the catheter shaft in the dilation balloon, which allows measuring the diameter of the EGJ and displaying it in real time before, during and after dilation. This obviates the need for fluoroscopy during the dilation procedure. The extent of recoil of the EGJ after dilation potentially provides a measurement that could be incorporated into a clinical rule for predicting therapeutic success after dilation. PMID:26679629

  12. Comparison of the Efficacy of Foley Catheter Balloon with Dinoprostone Gel for Cervical Ripening at Term

    OpenAIRE

    Smiti Nanda; Archit Dahiya; Kanika Malik; Krishna Dahiya

    2012-01-01

    Objective: The purpose of this study was to compare the efficacy of extra-amniotic Foley catheter with intra cervical Dinoprostone gel for preinduction cervical ripening. Study Design: A randomized, prospective study was conducted in the Department of Obstetrics and Gynecology, PGIMS Rohtak on 100 pregnant women admitted for induction of labor. Fifty patients were randomized to receive Dinoprostone gel and 50 patients to receive intracervical, extra-amniotic Foley catheter. Results: The two g...

  13. Drug-eluting balloon catheters for lower limb peripheral arterial disease: the evidence to date

    Directory of Open Access Journals (Sweden)

    Barkat M

    2016-05-01

    Full Text Available Mohamed Barkat,1 Francesco Torella,1 George A Antoniou2 1Liverpool Vascular and Endovascular Service, Royal Liverpool University Hospital, Liverpool, 2Department of Vascular and Endovascular Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Manchester, UK Abstract: A significant proportion of patients with severe lower limb peripheral arterial disease require revascularization. Over the past decade, an endovascular-first approach even for complex disease has gained widespread use among vascular specialists. An important limitation of percutaneous transluminal balloon angioplasty or stenting remains the occurrence of restenosis. Drug-coated balloons have emerged as an exciting technology developed to overcome the limitations of standard balloon angioplasty and stenting. Drug-eluting devices inhibit neointimal growth of vascular smooth muscle cells with the potential of preventing restenosis. This review provides a synopsis of the up-to-date evidence on the role of drug-coated balloons in the treatment of lower limb peripheral arterial disease. Bibliographic searches were conducted using MEDLINE, EMBASE, and the Cochrane Library electronic database. Eleven randomized clinical trials, two systematic reviews, and a published registry providing the best available evidence were identified. Current evidence suggests that angioplasty with drug-coated balloon is reliable, safe, and efficient in increasing patency rates and reducing target lesion revascularization and restenosis. However, it remains unknown whether these improved results can translate into beneficial clinical outcomes, as current randomized clinical trials have failed to demonstrate a significant benefit in limb salvage and mortality. Further randomized trials focusing on clinical and functional outcomes of drug-eluting balloons and on cost versus clinical benefit are required. Keywords: drug-eluting balloon, drug-coated balloon, angioplasty, peripheral arterial

  14. New developments in the clinical use of drug-coated balloon catheters in peripheral arterial disease

    Science.gov (United States)

    Naghi, Jesse; Yalvac, Ethan A; Pourdjabbar, Ali; Ang, Lawrence; Bahadorani, John; Reeves, Ryan R; Mahmud, Ehtisham; Patel, Mitul

    2016-01-01

    Peripheral arterial disease (PAD) involving the lower extremity is a major source of morbidity and mortality. Clinical manifestations of PAD span the spectrum from lifestyle limiting claudication to ulceration and gangrene leading to amputation. Advancements including balloon angioplasty, self-expanding stents, drug-eluting stents, and atherectomy have resulted in high technical success rates for endovascular therapy in patients with PAD. However, these advances have been limited by somewhat high rates of clinical restenosis and clinically driven target lesion revascularization. The recent introduction of drug-coated balloon technology shows promise in limiting neointimal hyperplasia induced by vascular injury after endovascular therapies. This review summarizes the contemporary clinical data in the emerging area of drug-coated balloons.

  15. Antegrade deligation of iatrogenic distal ureteric obstruction utilising a high pressure balloon dilatation technique.

    LENUS (Irish Health Repository)

    Rajendran, Simon

    2012-02-01

    BACKGROUND: Iatrogenic trauma is the leading cause of ureteric injury with an incidence in abdominal and pelvic surgery varying between 0.4 and 2.5%. CASE: We report a case of ureteric obstruction caused by a haemostatic clip. There was associated rupture of the ureter proximal to the clip with intra-peritoneal leakage of urine. The patient was unfit for surgery and was managed by a novel procedure of endoluminal balloon deligation. CONCLUSION: Ureteric injuries are rare but potentially serious complications. They require prompt diagnosis and management depends on the patients\\' clinical condition, extent of injury and interval from injury to diagnosis. We have successfully demonstrated a new technique to treat ureteric obstruction caused by a haemostatic clip with associated ureteral rupture in a patient unfit for surgery.

  16. Endoscopic papillary balloon dilatation may preserve sphincter of Oddi function after common bile duct stone management: evaluation from the viewpoint of endoscopic manometry

    OpenAIRE

    Sato, H; Kodama, T; Takaaki, J; Tatsumi, Y.; Maeda, T; Fujita, S; Fukui, Y.; H. Ogasawara; Mitsufuji, S

    1997-01-01

    Background—Endoscopic papillary balloon dilatation (EPBD) has been reported as a safe and effective alternative to endoscopic sphincterotomy in the management of common bile duct (CBD) stones; its effect on papillary function has yet to be elucidated. 
Aim—To investigate sphincter of Oddi (SO) motility before and after EPBD to determine its effect on SO function. 
Patients and methods—The papillary function of 10 patients with CBD stones was studied using endoscopic manometry befo...

  17. Large-diameter balloon dilation for the treatment of achalasia of cardia: an analysis of mid-to-long term efficacy in 80 cases

    International Nuclear Information System (INIS)

    Objective: To discuss the technical points of large-diameter (40 mm) balloon dilation in treating achalasia of cardia, and to assess its mid-to-long term efficacy. Methods: A total of 80 patients of achalasia of cardia with a disease course of 3-23 years were enrolled in this study. According to Mellow-Pinkas standard of the dysphagia grading (from 0 to Ⅳ), the patients were classified into grade Ⅰ (n=6), grade Ⅱ (n=60) and grade Ⅲ (n=14). The diagnosis was confirmed by barium meal examination in all patients. Under spraying anesthesia of pharyngeal portion with 2% lidocaine, the intensified guide wire was inserted into the stomach through mouth under fluoroscopy guidance. The Boston's balloon (40 mm in diameter) was pushed along the guidewire to the stricture site at the cardia and was gradually inflated with 15% contrast medium by using the 'graded intermittent inflation' technique. Namely, the balloon was inflated to a maximum diameter and was kept in this condition for five minute, and then the balloon was deflated for 3-5 minutes. The above procedure was repeated 2-3 times. For the severe stricture, pre-dilatation with 20-25 mm diameter balloon was carried out. As a routine, postoperative measures to prevent possible bleeding and infection were adopted. The patient was allowed to take cool liquid diet 2-3 hours after the procedure, to have semi-liquid diet within three days and then to take normal diet. The patients were followed up for 2-10 years. Results: The balloon insertion was technically successful in all of the 80 patients. The success rate of single and twice manipulations was 96.3% (77/80) and 3.7% (3/80), respectively. Postoperative rupture of the cardia region was seen in one patient, and surgical repair had to be carried out. The follow-up time ranged from 2 years to 10 years (mean 6.27 years). No recurrent stenosis occurred in all patients. The remission rate of dysphagia was 100%. The swallowing function returned to normal in 90% of

  18. Effect of Final Kissing Balloon Dilatation after One-stent Technique at Left-main Bifurcation: A Single Center Data

    Institute of Scientific and Technical Information of China (English)

    Zhan Gao; Bo Xu; Yue-Jin Yang; Shu-Bin Qiao; Yong-Jian Wu; Tao Chen; Liang Xu

    2015-01-01

    Background:Whether final kissing balloon (FKB) dilatation after one-stent implantation at left-main (LM) bifurcation site remains unclear.Therefore,this large sample and long-term follow-up study comparatively assessed the impact of FKB in patients with unprotected LM disease treated with one-stent strategy.Methods:Total 1528 consecutive patients underwent LM percutaneous coronary intervention in one center from January 2004 to December 2010 were enrolled; among them,790 patients treated with one drug-eluting stent crossover LM to left anterior descending (LAD) with FKB (n =230) or no FKB (n =560) were comparatively analyzed.Primary outcome was the rate of major adverse cardiovascular events,defined as a composite of death,myocardial infarction (MI) and target vessel revascularization (TVR).Results:Overall,The prevalence of true bifurcation lesions,which included Medina classification (1,1,1),(1,0,1),or (0,1,1),was similar between-groups (non-FKB:37.0% vs.FKB:39.6%,P =0.49).At mean 4 years follow-up,rates of major adverse cardiovascular events (non-FKB:10.0% vs.FKB:7.8%,P =0.33),death,MI and TVR were not significantly different between-groups.In multivariate propensity-matched regression analysis,FKB was not an independent predictor of adverse outcomes.Conclusions:For patients treated with one-stent crossover LM to LAD,clinical outcomes appear similar between FKB and non-FKB strategy.

  19. Patient effective doses during intracoronary irradiation with a Rhenium 188 full filled balloon catheter after percutaneous transluminal coronary artery

    International Nuclear Information System (INIS)

    Intracoronary irradiation with a full filled Re188 balloon catheter treatment technique (IRT) after Percutaneous Transluminal Coronary Artery (PTCA) should represent an addition patient exposure dose with respect to common PTCA procedure. Our proposes were determinate the absorbed doses and estimate the risk for fatal cancer in 25 patients (15 males, mean age: 559 years old) treated during an IRT randomized clinical trial carried out in our institution as part of IAEA technical cooperation project. 20 Gy was always the prescribed doses for each patient. The average Re188 concentrated activity used and treatment time were 5256±2371 MBq/ml in 1.5-2 ml and 466±195 seconds, respectively. Two thermoluminescent dosimeters were attached in the chest and pelvis for each patient treated. Calibration for attenuation and scattered radiations was done. The maximal and mean value effective dose obtained for chest patient region were 18 mSv and 15±6 mSv, respectively and for pelvis patient region the results were 10 mSv and 8±3 mSv, respectively. The total risk to develop fatal cancer was 0.084% for patient treated. The patient effective doses is slightly superior to those reported for common procedures as PTCA. The IRT is considered a quite safe procedure, but in order to exposure radiation level optimization the continuous review of procedure should be constantly done. (Author)

  20. Patient effective doses during intracoronary irradiation with a Rhenium 188 full filled balloon catheter after percutaneous transluminal coronary artery

    Energy Technology Data Exchange (ETDEWEB)

    Ponce V, L.; Peix G, A.; Llerena R, L.; Santana V, L. [Instituto de Cardiologia, La Habana (Cuba); Lopez D, A. [Hospital Hermanos Amejeiras, La Habana (Cuba)

    2006-07-01

    Intracoronary irradiation with a full filled Re188 balloon catheter treatment technique (IRT) after Percutaneous Transluminal Coronary Artery (PTCA) should represent an addition patient exposure dose with respect to common PTCA procedure. Our proposes were determinate the absorbed doses and estimate the risk for fatal cancer in 25 patients (15 males, mean age: 559 years old) treated during an IRT randomized clinical trial carried out in our institution as part of IAEA technical cooperation project. 20 Gy was always the prescribed doses for each patient. The average Re188 concentrated activity used and treatment time were 5256{+-}2371 MBq/ml in 1.5-2 ml and 466{+-}195 seconds, respectively. Two thermoluminescent dosimeters were attached in the chest and pelvis for each patient treated. Calibration for attenuation and scattered radiations was done. The maximal and mean value effective dose obtained for chest patient region were 18 mSv and 15{+-}6 mSv, respectively and for pelvis patient region the results were 10 mSv and 8{+-}3 mSv, respectively. The total risk to develop fatal cancer was 0.084% for patient treated. The patient effective doses is slightly superior to those reported for common procedures as PTCA. The IRT is considered a quite safe procedure, but in order to exposure radiation level optimization the continuous review of procedure should be constantly done. (Author)

  1. Modeling correlation indices between bladder and Foley′s catheter balloon dose with CT-based planning using limited CT slices in intracavitary brachytherapy for carcinoma of cervix

    Directory of Open Access Journals (Sweden)

    Oinam Arun

    2008-01-01

    Full Text Available Purpose: To derive and validate an index to correlate the bladder dose with the catheter balloon dose using limited computed tomography (CT slices. Materials and Methods: Applicator geometry reconstructed from orthogonal radiographs were back-projected on CT images of the same patients for anatomy-based dosimetric evaluation. The correlation indices derived using power function of the catheter balloon dose and the bladder volume dose were validated in 31 patients with cervical cancer. Results: There was significant correlation between International Commission on Radiation Units (ICRU-38 balloon reference dose (Dr and the dose received by 25% bladder volume (D 25 (P < 0.0001. Significant correlation was also found between the reference dose of mid-balloon point (D rm and the dose to D 25 (P < 0.0001. Average percentage difference [100 x (observed index - expected index / expected index] of observed value of I′ 25 (index for the dose to D25 bladder with respect to mid-balloon reference point from that of expected value was 0.52%, when the index was modeled with reference dose alone. Similarly the average percentage difference for I′10cc (index for the dose to 10 cc volume of bladder with respect to mid balloon point was 0.84%. When this index was modeled with absolute bladder volume and reference dose, standard deviation of the percentage difference between observed and expected index for D rm reduced by approximately 2% when compared to D r . Conclusion: For clinical applications, correlation index modeled with reference dose and volume predicts dose to absolute volume of bladder. Correlation index modeled with reference dose gives a good estimate of dose to relative bladder volume. From our study, we found D rm to be a better indicator of bladder dose than D r .

  2. Outcomes of Percutaneous Management of Anastomotic Ureteral Strictures in Renal Transplantation: Chronic Nephroureteral Stent Placement with and without Balloon Dilatation

    International Nuclear Information System (INIS)

    PurposeThis study was designed o evaluate outcomes of percutaneous management of anastomotic ureteral strictures in renal transplants using nephroureteral stents with or without balloon dilatation.MethodsA retrospective audit of 1,029 consecutive renal transplants was performed. Anastomotic ureteral strictures were divided into two groups: nephroureteral stent only (NUS) and NUS+PTA (nephroureteral stent plus percutaneous transluminal angioplasty), with each cohort subdivided into early versus late presentation (obstructive uropathy occurring <90 day or >90 days from transplant, respectively). Overall and 6-month technical success were defined as removal of NUS any time with <30 % residual stenosis (any time lapse less or more than 6 months) and at >6 months, respectively. Patency was evaluated from NUS removal to last follow-up for both groups and compared.ResultsSixty-seven transplant patients with 70 ureteric anastomotic strictures (6.8 %, n = 70/1,029) underwent 72 percutaneous treatments. 34 % were late (>90 days, n = 24/70), and 66 % were early (<90 days, n = 46/70). Overall technical success was 82 % (n = 59/72) and 6-month success was 58 % (n = 42/72). Major and minor complications were 2.8 % (n = 2/72), and 12.5 % (n = 9/72). NUS+PTA did not improve graft survival (p = 0.354) or patency (p = 0.9) compared with NUS alone. There was no difference in graft survival between treated and nontreated groups (p = 0.74).ConclusionsThere is no advantage to PTA in addition to placement of NUS, although PTA did not negatively impact graft survival or long-term patency and both interventions were safe and effective. Neither the late or early groups benefited from PTA in addition to NUS. Earlier obstructions showed greater improvement in serum creatinine than later obstructions

  3. Outcomes of Percutaneous Management of Anastomotic Ureteral Strictures in Renal Transplantation: Chronic Nephroureteral Stent Placement with and without Balloon Dilatation

    Energy Technology Data Exchange (ETDEWEB)

    Uflacker, A., E-mail: andreuflacker@gmail.com; Sheeran, D., E-mail: dsheeran9@gmail.com; Khaja, M., E-mail: mkhaja@mac.com [University of Virginia/Interventional Radiology (United States); Patrie, J., E-mail: jp4h@virginia.edu [UVA Health System/Radiology (United States); Elias, G., E-mail: gae2y@virginia.edu [VCU Medical Center/Radiology (United States); Saad, W., E-mail: wspikes@yahoo.com [University of Michigan Health System (United States)

    2015-06-15

    PurposeThis study was designed o evaluate outcomes of percutaneous management of anastomotic ureteral strictures in renal transplants using nephroureteral stents with or without balloon dilatation.MethodsA retrospective audit of 1,029 consecutive renal transplants was performed. Anastomotic ureteral strictures were divided into two groups: nephroureteral stent only (NUS) and NUS+PTA (nephroureteral stent plus percutaneous transluminal angioplasty), with each cohort subdivided into early versus late presentation (obstructive uropathy occurring <90 day or >90 days from transplant, respectively). Overall and 6-month technical success were defined as removal of NUS any time with <30 % residual stenosis (any time lapse less or more than 6 months) and at >6 months, respectively. Patency was evaluated from NUS removal to last follow-up for both groups and compared.ResultsSixty-seven transplant patients with 70 ureteric anastomotic strictures (6.8 %, n = 70/1,029) underwent 72 percutaneous treatments. 34 % were late (>90 days, n = 24/70), and 66 % were early (<90 days, n = 46/70). Overall technical success was 82 % (n = 59/72) and 6-month success was 58 % (n = 42/72). Major and minor complications were 2.8 % (n = 2/72), and 12.5 % (n = 9/72). NUS+PTA did not improve graft survival (p = 0.354) or patency (p = 0.9) compared with NUS alone. There was no difference in graft survival between treated and nontreated groups (p = 0.74).ConclusionsThere is no advantage to PTA in addition to placement of NUS, although PTA did not negatively impact graft survival or long-term patency and both interventions were safe and effective. Neither the late or early groups benefited from PTA in addition to NUS. Earlier obstructions showed greater improvement in serum creatinine than later obstructions.

  4. Monte Carlo calculations of dose distribution for intramural delivery of radioisotopes using a direct injection balloon catheter

    International Nuclear Information System (INIS)

    Purpose: A unique method of delivering radiation dose to the coronary vessel wall to prevent restenosis is by direct injection of radioactive compounds into the vessel wall using a specially designed angioplasty balloon catheter. The radiation dose distribution resulting from such intramural delivery was investigated using Monte Carlo simulations. Materials and methods: The radioisotope source distribution was modeled for two configurations within the vessel wall: (1) uniform to a depth of 0.5 mm and (2) confined to discrete pools surrounding the delivery injection ports. Monte Carlo MCNP4B computer simulations were utilized to estimate the associated radiation dose distribution for the following radioisotopes: 188Re, 186Re, 32P, 153Sm, 111In, 123I, and 99mTc. Results: For the uniform case where the radioisotopes are distributed uniformly to the depth of 0.5 mm into the vessel wall, an essentially constant radiation dose is delivered within the source distribution. Outside of the source volume, the dose falls off at a rate depending on the emission properties of the particular radioisotope. The nonuniform case involving discrete pools of activity showed the dose distribution being confined largely to the regions surrounding the delivery ports with significant regions between these ports receiving very little dose. Conclusions: Direct injection of selected radioisotopes into the arterial wall appears to represent a potentially effective method for delivering radiation dose for the prevention of restenosis. Sufficiently high doses may be obtained from relatively low activity and the dose falls off rapidly outside of the target area for certain radioisotopes

  5. Efficacy of Proximal Aspiration Thrombectomy for Using Balloon-Tipped Guide Catheter in Acute Intracranial Internal Carotid Artery Occlusion

    Science.gov (United States)

    Kim, Yong-Won; Hwang, Yang-Ha; Park, Jaechan; Kim, Yong-Sun

    2016-01-01

    Objective Mechanical thrombectomy (MT) for acute intracranial internal carotid artery (ICA) occlusion is often complicated by difficult revascularization and non-involved territory embolization possibly related with larger clot-burden. This study aims to evaluate the efficacy of proximal aspiration thrombectomy (PAT) using a balloon-tipped guide catheter for clot-burden reduction in such cases with period-to-period analysis (period 1 : standard MT without PAT; period 2 : PAT first, then standard MT for the remaining occlusion). Methods Eighty-six patients who underwent MT for acute intracranial ICA occlusion were included in this analysis from the prospectively maintained stroke registry (33 patients in period 1 and 53 in period 2). In period 2, 'responder' was defined as a case where some amount of clot was retrieved by PAT and the following angiography showed partial or full recanalization. Results Fifteen of fifty-three patients in period 2 (28.3%) were 'responders' to PAT. There was a significantly higher incidence of atrial fibrillation in the 'responder' subgroup. Period 2 showed a significantly shorter puncture-to-reperfusion time (94.5 minutes vs. 56.0 minutes; p=0.002), a significantly higher Thrombolysis in Cerebral Infarction of 2b-3 reperfusion (45.5% vs. 73.6%; p=0.009), but only a trend for better 3-month favorable outcome (mRS 0–2; 36.4% vs. 54.7%; p=0.097). There was no increase in the incidence of procedure-related complications or intracranial hemorrhage in period 2. Conclusion A strategy of PAT before standard MT may result in shorter puncture-to-reperfusion time and better angiographic outcome than a strategy of standard MT for acute intracranial ICA occlusion.

  6. Unusual Complication of Suprapubic Cystostomy in a Male Patient with Tetraplegia: Traction on Foley Catheter Leading to Extrusion of Foley Balloon from Urinary Bladder and Suprapubic Urinary Fistula – Importance of Securely Anchoring Suprapubic Catheter with Adhesive Tape or BioDerm Tube Holder

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2007-01-01

    Full Text Available Suprapubic cystostomy is recommended to patients with neuropathic bladder to prevent complications of long-term urethral catheter drainage. We present a 50-year-old male patient with tetraplegia who had long-term urethral catheter drainage. Following flexible cystoscopy, he developed a urine leak from the right side of the scrotum. Suprapubic cystostomy was performed. After suprapubic cystostomy, the urinary fistula healed completely. A follow-up cystourethrogram confirmed an intact urethra with no leak of contrast. Six weeks later, this patient presented with a hole below the suprapubic cystostomy through which a small amount of urine was leaking. A keyhole dressing had been applied around the suprapubic catheter and the catheter was hanging loosely, thus permitting traction on the catheter, especially when the urine bag was full. Computerised tomography of the pelvis showed extrusion of the Foley balloon from the urinary bladder, but the tip of the catheter was still located within the bladder. The extruded catheter was removed and a Foley catheter was inserted, ensuring that the balloon was inflated within the urinary bladder. The suprapubic catheter was secured firmly to the anterior abdominal wall with a BioDerm Tube Holder, thus preventing any traction on the catheter or Foley balloon. The urine leak through the hole below the suprapubic cystostomy stopped and the sinus healed. This case illustrates the need to anchor the suprapubic catheter securely to the anterior abdominal wall with adhesive tape or BioDerm Tube Holder to prevent traction and consequent displacement of the catheter or Foley balloon.

  7. Prospective multi-centre randomised trial comparing induction of labour with a double-balloon catheter versus dinoprostone

    DEFF Research Database (Denmark)

    Løkkegaard, E; Lundstrøm, M; Kjær, Michael;

    2015-01-01

    randomised to double-balloon or vaginal dinoprostone (3 mg) groups. There was a significantly higher failure rate for labour induction in the balloon group (relative risk: 1.25, 95% confidence interval [CI]: 1.02-1.49). Median induction time was 27.3 h in the balloon group and 29.8 h in the dinoprostone...

  8. Endovascular Repair Using Suture-Mediated Closure Devices and Balloon Tamponade following Inadvertent Subclavian Artery Catheterization with Large-Caliber Hemodialysis Catheter

    Science.gov (United States)

    Park, Taek Kyu; Yang, Jeong Hoon

    2016-01-01

    Accidental subclavian artery cannulation is an uncommon but potentially serious complication of central venous catheterization. Removal of a catheter inadvertently placed in the subclavian artery can lead to substantial bleeding, as achieving hemostasis in this area through manual compression presents considerable difficulty. Additionally, surgical treatment might be unsuitable for high-risk patients due to comorbidities. Here, we report a case of an inadvertently-inserted 11.5-French hemodialysis catheter in the subclavian artery during internal jugular venous catheterization. We performed percutaneous closure of the subclavian artery using three 6-French Perclose Proglide® devices with a balloon tamponade in the proximal part of the subclavian artery. Closure was completed without embolic neurological complications. PMID:27482271

  9. Guideline recommended door-to-balloon time can be achieved in transradial primary PCI — the usefulness of a dedicated radial guide catheter

    Energy Technology Data Exchange (ETDEWEB)

    Malaiapan, Yuvaraj, E-mail: yuvim@y7mail.com; Leung, Michael; Ahmar, Walid; Hutchison, Adam W.; Prasad, Sandhir; Katticaran, Therma; Cameron, James D.; Harper, Richard W.; Meredith, Ian T.

    2013-01-15

    Background: Radial access for primary percutaneous coronary intervention (PPCI) is well established in terms of safety and efficacy. However, there are limited data on the impact of the use of a single dedicated radial guide catheter in primary PCI using radial access. Aims: To determine the overall cardiac catheterisation laboratory to balloon time (CCL2BT) and door to balloon (D2BT) time in transradial PPCI. To determine the impact of a single dedicated radial guide catheter on CCLD2BT and D2BT in transradial PPCI compared to conventional transfemoral PPCI. Methods: The procedural and clinical outcomes of consecutive patients who had transradial primary PCI between 2005 and 2009 were included in this study and compared with a matched cohort who underwent transfemoral primary PCI. Results: Overall D2BT and inpatient MACE were similar between the radial (n = 53) and femoral (n = 53) groups (85 and 82 min, P = 0.889; 0% and 1.8% P = 0.317 respectively). An increase in the CCL2BT and procedural times was noted in the radial compared to the femoral group (34 min versus 29 min P = 0.028; 15.8 min versus 11.6 min P = 0.001). When a single radial guide catheter was used for the entire procedure, there was no difference in CCL2BT, D2BT and procedural times between the radial and femoral groups (31 min versus 29 min P = 0.599; 74 min versus 82 min P = 0.418; 50 min versus 47 min P = 0.086). Conclusion: The radial approach is safe and results in guideline recommended D2BT in STEMI. The use of a dedicated radial guide catheter reduces treatment time, demonstrating equivalent times to a femoral approach.

  10. Detecting DNA synthesis of neointimal formation after catheter balloon injury in GK and in Wistar rats: using 5-ethynyl-2'-deoxyuridine

    Directory of Open Access Journals (Sweden)

    Guo Jingsheng

    2012-12-01

    Full Text Available Abstract Background Neointimal formation plays an important role in the pathogenesis of coronary restenosis after percutaneous coronary intervention (PCI, especially in patients with diabetes mellitus. Recently, some studies have shown that 5-ethynyl-2'-deoxyuridine (EdU incorporation can serve as a novel alternative to the 5-bromo-2'-deoxyuridine (BrdU antibody detection method for detection of DNA synthesis in regenerating avian cochlea, chick embryo and the adult nervous system. However, few studies have been performed to assess the suitability of EdU for detecting DNA synthesis in vascular neointima. Methods The carotid artery balloon injury model was established in Goto-Kakizaki (GK and Wistar rats. A Cell-LightTM EdU Kit was used to detect EdU-labeled cell nuclei of common carotid arteries at day 7 after catheter balloon injury. Different methods of injecting EdU were tested. The protein levels of proliferating cell nuclear antigen (PCNA and p-Akt (Ser473, as well as the mRNA levels of PCNA were evaluated by Western blotting and quantitative real-time PCR (qRT-PCR, respectively. Immunohistochemical staining was also employed to visualize PCNA-positive cells. Results At day 7 after catheter balloon injury, far more EdU-positive and PCNA-positive cells were observed in GK rats. When comparing groups that received different EdU doses, it was found that the percentage of EdU-positive cells at a dose of 100 mg/kg body weight was than at doses of 25 mg/kg and 50 mg/kg. The number of positive cells was significantly higher in the repeated injection group compared to the single injection group. Further, after balloon injury DNA synthesis in GK rats was more notable than in Wistar rats. Neointimal formation in GK rats was more obvious than in Wistar rats. The protein levels of PCNA and p-Akt (Ser473 and the mRNA levels of PCNA were increased in injured rats as compared to uninjured rats, and were significantly higher in GK rats than in Wistar rats

  11. Initial Experience with Computed Tomography and Fluoroscopically Guided Placement of Push-Type Gastrostomy Tubes Using a Rupture-Free Balloon Catheter

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the safety and feasibility of percutaneous radiologic gastrostomy placement of push-type gastrostomy tubes using a rupture-free balloon (RFB) catheter under computed tomography (CT) and fluoroscopic guidance. A total of 35 patients (23 men and 12 women; age range 57–93 years [mean 71.7]) underwent percutaneous CT and fluoroscopically guided gastrostomy placement of a push-type gastrostomy tube using an RFB catheter between April 2005 and July 2008. Technical success, procedure duration, and complications were analyzed. Percutaneous radiologic gastrostomy placement was considered technically successful in all patients. The median procedure time was 39 ± 13 (SD) min (range 24–78). The average follow-up time interval was 103 days (range 7–812). No major complications related to the procedure were encountered. No tubes failed because of blockage, and neither tube dislodgement nor intraperitoneal leakage occurred during the follow-up period. The investigators conclude that percutaneous CT and fluoroscopically guided gastrostomy placement with push-type tubes using an RFB catheter is a safe and effective means of gastric feeding when performed by radiologists.

  12. The Efficacy and Safety of Endoscopic Balloon Dilation Combined with Stenting in Patients with Biliary Anastomotic Strictures After Orthotopic Liver Transplantation.

    Science.gov (United States)

    Peng, Chunyan; Ma, Chao; Xu, Guifang; Shen, Shanshan; Lv, Ying; Zou, Xiaoping

    2015-06-01

    Endoscopic balloon dilation combined with stenting has been increasingly used in managing biliary anastomotic strictures (BAS) after orthotopic liver transplantation (OLT). However, data on the efficacy and safety vary among different studies. To obtain reliable estimates for the efficacy and safety of this endoscopic combination therapy in post-OLT BAS. A systematic search was conducted in the literature published until June 2012. The outcomes of individual study were transformed into comparable data using the Freeman-Tukey double arcsine transformation method. Fixed-effect or random-effect models were built to simulate the outcomes. Subgroup analysis and meta-regression were used to explore the sources of clinical heterogeneity. Clinical resolution and recurrence were defined as the primary outcomes and complications and mortality as secondary outcomes. Nineteen studies (15 retrospective, 4 prospective; 17 full-texts, 2 abstracts) were included, with a total of 745 patients. Fully covered self-expandable metal stent was only reported in one study, achieving a resolution rate of 92.3 %, recurrence rate of 8.3 %, and complication rate of 7.7 %. For 18 studies using plastic stents, the pooled resolution rate was 86 % (95 % CI 80-91 %; I (2) = 74.7 %). Abstracts, study design, and the delay from OLT to BAS diagnosis were contributing factors for heterogeneity in resolution. The pooled recurrence rate was 9 % (95 % CI 5-13 %; I (2) = 59.6 %). Longer stenting duration predicted less recurrence (OR = 0.95, p = 0.002). The pooled complication rate was 14 % (95 % CI 8-21 %, I (2) = 71.2 %). No procedure-related mortality was reported. Endoscopic balloon dilation combined with stenting is a relatively effective and safe modality in post-OLT BAS. PMID:25552252

  13. MR-Guided Percutaneous Angioplasty: Assessment of Tracking Safety, Catheter Handling and Functionality

    International Nuclear Information System (INIS)

    Purpose: Magnetic resonance (MR)-guided percutaneous vascular interventions have evolved to a practical possibility with the advent of open-configuration MR systems and real-time tracking techniques. The purpose of this study was to assess an MR-tracking percutaneous transluminal angioplasty (PTA) catheter with regard to its safety profile and functionality. Methods: Real-time, biplanar tracking of the PTA catheter was made possible by incorporating a small radiofrequency (RF) coil in the catheter tip and connecting it to a coaxial cable embedded in the catheter wall. To evaluate potentially hazardous thermal effects due to the incorporation of the coil, temperature measurements were performed within and around the coil under various scanning and tracking conditions at 1.5 Tesla (T). Catheter force transmission and balloon-burst pressure of the MR-tracking PTA catheter were compared with those of a standard PTA catheter. The dilatative capability of the angioplasty balloon was assessed in vitro as well as in vivo, in an isolated femoral artery segment in a swine. Results: The degree of heating at the RF coil was directly proportional to the power of the RF pulses. Heating was negligible with MR tracking, conventional spin-echo and low-flip gradient-echo sequences. Sequences with higher duty cycles, such as fast spin echo, produced harmful heating effects. Force transmission of the MR-tracking PTA catheter was slightly inferior to that of the standard PTA catheter, while balloon-burst pressures were similar to those of conventional catheters. The MR-tracking PTA catheter functioned well both in vitro and in vivo. Conclusion: The in vivo use of an MR-tracking PTA catheter is safe under most scanning conditions

  14. Medical operating personnel exposition levels during intracoronary irradiation using a Re188 full filled balloon catheter after percutaneous transluminal coronary artery

    Energy Technology Data Exchange (ETDEWEB)

    Ponce V, F.; Peix G, A.; Llerena R, L.; Santana V, L. [Instituto de Cardiologia, La Habana (Cuba); Lopez D, A. [Hospital Hermanos Amejeiras, La Habana (Cuba)

    2006-07-01

    The intracoronary irradiation using a full filled conventional balloon catheter with Rhenium 188 (Re188) after Percutaneous Transluminal Coronary Artery (PTCA) is a new relative treatment technique to reduce restenosis where the medical operating personnel are exposed to additional radiation ionizing level in the cath lab. In this study a radiation exposure level to medical operating personnel in the cath lab were measured with a Geiger Muller detector in 7 place to different distance from patient (to chest and abdominal region) catheter tabletop during a randomized clinical trial carried out in 25 patients whose were treated. The average concentrated Re188 activity used and treatment time were 5256{+-}2371 MBq/ml in 1.5-2 ml and 466{+-}195 seconds. At 3 cm from right arm patient the average maximum exposition rate were 0,63 mSv/h and 0,51 mSv h, to chest and abdominal patient level, respectively, where also average exposed dose per treated patient was 0,06 mSv and 0,05 mSv, respectively. Our results show that intracoronary irradiation with Re188 in the cath lab do not increase significatively the exposure radiation level to medical operating staff during treatment procedure and it is safe according national and international radiation protection regulations. (Author)

  15. Medical operating personnel exposition levels during intracoronary irradiation using a Re188 full filled balloon catheter after percutaneous transluminal coronary artery

    International Nuclear Information System (INIS)

    The intracoronary irradiation using a full filled conventional balloon catheter with Rhenium 188 (Re188) after Percutaneous Transluminal Coronary Artery (PTCA) is a new relative treatment technique to reduce restenosis where the medical operating personnel are exposed to additional radiation ionizing level in the cath lab. In this study a radiation exposure level to medical operating personnel in the cath lab were measured with a Geiger Muller detector in 7 place to different distance from patient (to chest and abdominal region) catheter tabletop during a randomized clinical trial carried out in 25 patients whose were treated. The average concentrated Re188 activity used and treatment time were 5256±2371 MBq/ml in 1.5-2 ml and 466±195 seconds. At 3 cm from right arm patient the average maximum exposition rate were 0,63 mSv/h and 0,51 mSv h, to chest and abdominal patient level, respectively, where also average exposed dose per treated patient was 0,06 mSv and 0,05 mSv, respectively. Our results show that intracoronary irradiation with Re188 in the cath lab do not increase significatively the exposure radiation level to medical operating staff during treatment procedure and it is safe according national and international radiation protection regulations. (Author)

  16. Novel paclitaxel-coated angioplasty balloon catheter based on cetylpyridinium salicylate: Preparation, characterization and simulated use in an in vitro vessel model

    Energy Technology Data Exchange (ETDEWEB)

    Petersen, Svea, E-mail: svea.petersen@uni-rostock.de [Institute for Biomedical Engineering, University of Rostock, Friedrich-Barnewitz-Straße 4, 18119 Rostock (Germany); Kaule, Sebastian [Institute for Biomedical Engineering, University of Rostock, Friedrich-Barnewitz-Straße 4, 18119 Rostock (Germany); Stein, Florian [Institute for Chemistry, Analytical and Technical Chemistry University of Rostock, Albert-Einstein-Straße 3a, 18059 Rostock (Germany); Minrath, Ingo; Schmitz, Klaus-Peter [Institute for Biomedical Engineering, University of Rostock, Friedrich-Barnewitz-Straße 4, 18119 Rostock (Germany); Kragl, Udo [Institute for Chemistry, Analytical and Technical Chemistry University of Rostock, Albert-Einstein-Straße 3a, 18059 Rostock (Germany); Sternberg, Katrin [Institute for Biomedical Engineering, University of Rostock, Friedrich-Barnewitz-Straße 4, 18119 Rostock (Germany)

    2013-10-15

    Drug-coated balloons (DCB), which have emerged as therapeutic alternative to drug-eluting stents in percutaneous cardiovascular intervention, are well described with regard to clinical efficiency and safety within a number of clinical studies. In vitro studies elucidating the correlation of coating method and composition with DCB performance are however rare but considered important for the understanding of DCB requirements and the improvement of established DCB. In this context, we evaluated the applicability of a pipetting, dip-coating, and spray-coating process for the establishment of DCB based on paclitaxel (PTX) and the ionic liquid cetylpyridinium salicylate (Cetpyrsal) as novel innovative additive in three different compositions. Among tested methods and compositions, the pipetting process with 50 wt.% PTX resulted in most promising coatings as drug load was less controllable by the other processes and higher PTX contents led to considerable drug crystallization, as visualized by electron microscopy, accelerating PTX loss during short-term elution. Applying these conditions, homogeneous coatings could be applied on balloon catheter, whose simulated use in an in vitro vessel model revealed percental drug losses of 36 and 28% during transit and percental drug transfers of 12 and 40% under expansion for coatings applied in expanded and folded balloon condition, respectively. In comparison to literature values, these results support the high potential of Cetpyrsal as novel DCB matrix regarding low drug loss and efficient drug transfer. - Highlights: • We provide detailed in vitro data for definition of DCB coating requirements. • An in vitro vessel model for evaluating drug delivery from DCB is presented. • Innovative ionic liquid-based coatings for DCB are developed. • The coating shows low drug loss and efficient drug transfer.

  17. Novel paclitaxel-coated angioplasty balloon catheter based on cetylpyridinium salicylate: Preparation, characterization and simulated use in an in vitro vessel model

    International Nuclear Information System (INIS)

    Drug-coated balloons (DCB), which have emerged as therapeutic alternative to drug-eluting stents in percutaneous cardiovascular intervention, are well described with regard to clinical efficiency and safety within a number of clinical studies. In vitro studies elucidating the correlation of coating method and composition with DCB performance are however rare but considered important for the understanding of DCB requirements and the improvement of established DCB. In this context, we evaluated the applicability of a pipetting, dip-coating, and spray-coating process for the establishment of DCB based on paclitaxel (PTX) and the ionic liquid cetylpyridinium salicylate (Cetpyrsal) as novel innovative additive in three different compositions. Among tested methods and compositions, the pipetting process with 50 wt.% PTX resulted in most promising coatings as drug load was less controllable by the other processes and higher PTX contents led to considerable drug crystallization, as visualized by electron microscopy, accelerating PTX loss during short-term elution. Applying these conditions, homogeneous coatings could be applied on balloon catheter, whose simulated use in an in vitro vessel model revealed percental drug losses of 36 and 28% during transit and percental drug transfers of 12 and 40% under expansion for coatings applied in expanded and folded balloon condition, respectively. In comparison to literature values, these results support the high potential of Cetpyrsal as novel DCB matrix regarding low drug loss and efficient drug transfer. - Highlights: • We provide detailed in vitro data for definition of DCB coating requirements. • An in vitro vessel model for evaluating drug delivery from DCB is presented. • Innovative ionic liquid-based coatings for DCB are developed. • The coating shows low drug loss and efficient drug transfer

  18. Central Vein Dilatation Prior to Concomitant Port Implantation

    International Nuclear Information System (INIS)

    Implantation of subcutaneous port systems is routinely performed in patients requiring repeated long-term infusion therapy. Ultrasound- and fluoroscopy-guided implantation under local anesthesia is broadly established in interventional radiology and has decreased the rate of complications compared to the surgical approach. In addition, interventional radiology offers the unique possibility of simultaneous management of venous occlusion. We present a technique for recanalization of central venous occlusion and angioplasty combined with port placement in a single intervention which we performed in two patients. Surgical port placement was impossible owing to occlusion of the superior vena cava following placement of a cardiac pacemaker and occlusion of multiple central veins due to paraneoplastic coagulopathy, respectively. In both cases the affected vessel segments were dilated with balloon catheters and the port systems were placed thereafter. After successful dilatation, the venous access was secured with a 25-cm-long, 8-Fr introducer sheath, a subcutaneous pocket prepared, and the port catheter tunneled to the venipuncture site. The port catheter was introduced through the sheath with the proximal end connected to a 5-Fr catheter. This catheter was pulled through the tunnel in order to preserve the tunnel and, at the same time, allow safe removal of the long sheath over the wire. The port system functioned well in both cases. The combination of recanalization and port placement in a single intervention is a straightforward alternative for patients with central venous occlusion that can only be offered by interventional radiology.

  19. Technical note: subclavian artery misplacement of a 12F Shaldon catheter: percutaneous repair with a local closure device under temporary balloon tamponade; Technische Mitteilung: Entfernung eines fehlplatzierten 12F Shaldon Katheters aus der A. subclavia und Abdichtung mittels Verschlusssystem bei temporaerer Ballonblockade

    Energy Technology Data Exchange (ETDEWEB)

    Wildberger, J.E.; Katoh, M.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Fussen, R. [Anaesthesiologische Klinik, Medizinisches Zentrum Kreis Aachen GmbH (Germany)

    2006-06-15

    A case of subsequent percutaneous repair using a local closure device with a collagen block (VasoSeal {sup registered}) and temporary balloon tamponade after inadvertent subclavian artery misplacement of a 12F Shaldon catheter is reported. Balloon occlusion safely prevented displacement of collagen into the vascular lumen by occluding the 12F entry site. Furthermore, collagen-induced coagulation was facilitated. (orig.)

  20. Dilemma with the route of venous access for hemodialysis catheter insertion in a patient with dilated ischemic cardiomyopathy treated by cardiac resynchronization therapy

    Directory of Open Access Journals (Sweden)

    Devanahalli Ashokananda

    2016-01-01

    Full Text Available A 68 year old patient requiring urgent dialysis due to raising potassium was referred to our center. He had 3 indwelling catheters in his heart via right subclavian vein. His left subclavian and interngal jugular veins were thrombosed possibly due to earlier indwelling catheters. The dilemma was if right internal jugular venous route could be used for insertion of dialysis catheter. Under fluoroscopic guidance, right internal jugular vein was cannulated with the dialysis catheter without problems. This case is being presented to highlight the need for imaging both by ultrasound and radiography during the procedure.

  1. Balloon dacryocystoplasty study in the management of adult epiphora.

    LENUS (Irish Health Repository)

    Fenton, S

    2012-02-03

    PURPOSE: To determine the efficacy of dacryocystoplasty with balloon dilation in the treatment of acquired obstruction of the nasolacrimal system in adults. METHODS: Balloon dacryocystoplasty was performed in 52 eyes of 42 patients under general anaesthetic. A Teflon-coated guidewire was introduced through the canaliculus and manipulated through the nasolacrimal system and out of the nasal aperture. A 4 mm wide 3 cm coronary angioplasty balloon catheter was threaded over the guidewire in a retrograde fashion and dilated at the site of obstruction. RESULTS: There was complete obstruction in 30% of cases and partial obstruction in 70%. The most common site of obstruction was the nasolacrimal duct. The procedure was technically successful in 94% of cases. The overall re-obstruction rate was 29% within 1 year of the procedure. There was an anatomical failure rate of 17% for partial obstruction and 69% for complete obstruction within 1 year. CONCLUSIONS: Balloon dacryocystoplasty has a high recurrence rate. There may be a limited role for this procedure in partial obstructions. Further refinements of the procedure are necessary before it can be offered as a comparable alternative to a standard surgical dacryocystorhinostomy.

  2. Application of uterine tamponade with balloon catheter for treatment of postpartum hemorrhage%应用子宫填塞球囊导管治疗产后出血的初步经验

    Institute of Scientific and Technical Information of China (English)

    阮颖清

    2012-01-01

    Objective To investigate the efficacy and safety of uterine tamponade with balloon catheter for the treatment of postpartum hemorrhage.Methods The data on 24 patients with postpartum hemorrhage who had received uterine tamponade with balloon catheter during the period of January 2010 to February 2012 were retrospectively analyzed.The average age of the patients was 27.5 years old ( 22-34 ).Of the 24 patients,12 had uterine inertia,4 had placenta previa,and 8 had placenta accrete.Results All the patients were cured by uterine tamponade with balloon catheter,and no one needed to undergo hysterectomy.The primary effectiveness rate of hemostasis was 91.6%.Two patients had rebleeding,and the tamponade balloon was inflated again to stop bleeding.The tamponade balloon was removed after 24 hours.None had rebleeding,nor hysterectomy needed.The total effectiveness rate of hemostasis was 100%.No patients required hysterectomy or were dead.All the patients were followed up for 1 to 24 months postoperatively and had a normal uterine involution and menstrual restoration within 1 to 3 months.No puerperal infection or symptoms of premature ovarian failure occurred.Conclusions Application of uterine tamponade with balloon catheter in the treatment of postpartum hemorrhage is safe,effective,and worth popularizing clinically.%目的 探讨应用子宫填塞球囊导管治疗产后出血的疗效及安全性.方法 对我院2010年1月-2012年2月,24例使用子宫填塞球囊导管治疗产后出血患者进行回顾性分析.患者年龄22~34岁,平均27.5岁,其中产后出血病因宫缩乏力12例、前置胎盘4例,胎盘粘连8例.结果 全部病例均能应用子宫填塞球囊导管达到止血目的,无一例行子宫切除术.一次止血有效率达91.6%.2例患者出现再发出血,再次充盈气囊止血后,两例患者于24小时再尝试取出水囊,未再发大出血,总止血有效率达100%.无一例需行子宫切除术或死亡,术后随访1~24

  3. Dilated cardiomyopathy

    Science.gov (United States)

    Cardiomyopathy - dilated ... The most common causes of dilated cardiomyopathy are: Heart disease caused by a narrowing of the arteries Poorly controlled high blood pressure There are many other causes of dilated ...

  4. Comparison of the efficacy of intra-cervical foley's catheter balloon with PGE2 gel in pre-induction cervical ripening

    OpenAIRE

    Fareed Perveena; Mahajan Neha; Siraj Farhana

    2016-01-01

    Background: The aim of this study was to compare the efficacy of intracervical Foleys catheter and intracervical PGE2 gel in preinduction cervical ripening. Methods: This randomized, prospective study was conducted in the Department of Obstetrics and Gynecology, Government Medical College Srinagar from Mar 2011- Mar 2013. Total 200 patients at term with a Bishop's score

  5. Gastric varices with spontaneous gastrorenal shunt: treated by retrograde gastrorenal shunt balloon occlusion combined with percutaneous transhepatic gastric varices embolization

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy and the safety of retrograde gastrorenal shunt balloon occlusion combined with percutaneous transhepatic gastric varices embolization to treat the gastric varices with spontaneous gastrorenal shunt. Methods: From Nov. 2006 to Jun. 2010, retrograde gastrorenal shunt balloon occlusion combined with percutaneous transhepatic gastric varices embolization was performed on 8 patients who had gastric varices with spontaneous gastrorenal shunt. All the patients were men and the age ranged from 40 to 61 years. The balloon catheter was inserted into the spontaneous gastrorenal shunt through the right femoral vein, then percutaneous transhepatic splenic vein venography was performed to identify the number and morphology of gastric varices. After that gastric varices embolization was performed while the balloon catheter was dilated, which was withdrawn one day after the procedure. Results: Technical success of interventional treatment was achieved in all 8 cases with no significant complications. The increase of average portal venous pressure was 5.5 cm H2O (1 cm H2O=0.098 kPa, preoperative 35.0 to 41.0 cm H2O, postoperative 39.0 to 45.5 cm H2O). After follow up of 1 to 46 months, no recurrence haemorrhage occurred. Conclusion: Retrograde gastrorenal shunt balloon occlusion combined with percutaneous transhepatic gastric varices embolization can be safely performed and could be one of the effective choices for patients who had gastric varices with spontaneous gastrorenal shunt, which is not suitable to treat by the endoscopic sclerotherapy. (authors)

  6. Percutaneous gastrostomy performed by radiologists using balloon replacement tubes. A simple interventional technique for the placement of nutritional catheters without endoscopy or surgery

    International Nuclear Information System (INIS)

    Patients afflicted with stenotic head and neck or esophageal tumors often require artificial enteral feeding. Frequently passage of an endoscope through the esophagus is impossible in these patients. Interventional, fluoroscopically assisted, percutaneous gastrostomy (PG) by balloon replacement tubes is a feasible and successful alternative to percutaneous endoscopic gastrostomy (PEG) and the method of choice in patients where the esophagus cannot be passed with an endoscope anymore. Technical success rate is very high and serious complications are rare. Radiological PG is a feasible, equivalent alternative to PEG also in all other patients. We recommend PG with balloon gastrostomy tubes in conjunction with gastropexy performed with three to four T-fasteners, which are left in place for seven days in order to prevent dislocation and leakage. (orig.)

  7. Intimal Hyperplasia in Balloon Dilated Coronary Arteries is Reduced by Local Delivery of the NO Donor, SIN-1 Via a cGMP-Dependent Pathway

    Directory of Open Access Journals (Sweden)

    Arner Anders

    2011-06-01

    Full Text Available Abstract Background To elucidate the mechanism by which local delivery of 3-morpholino-sydnonimine (SIN-1 affects intimal hyperplasia after percutaneous transluminal coronary angioplasty (PTCA. Methods Porcine coronary arteries were treated with PTCA and immediately afterwards locally treated for 5 minutes, with a selective cytosolic guanylate cyclase inhibitor, 1 H-(1,2,4oxadiazole(4,3-alphaquinoxaline-1-one (ODQ + SIN-1 or only SIN-1 using a drug delivery-balloon. Arteries were angiographically depicted, morphologically evaluated and analyzed after one and eight weeks for actin, myosin and intermediate filaments (IF and nitric oxide synthase (NOS contents. Results Luminal diameter after PCI in arteries treated with SIN-1 alone and corrected for age-growth was significantly larger as compared to ODQ + SIN-1 or to controls (p Conclusions After PTCA local delivery of high concentrations of the NO donor SIN-1 for 5 minutes inhibited injury induced neointimal hyperplasia. This favorable effect was abolished by inhibition of guanylyl cyclase indicating mediation of a cyclic guanosine 3',5'-monophosphate (cGMP-dependent pathway. The momentary events at the time of injury play crucial role in the ensuring development of intimal hyperplasia.

  8. Intraluminal Projection of Descending Thoracic Aorta and Intraaortic Balloon Pump Catheter Examined by Transesophageal Echocardiography in Patients Undergoing Coronary Artery Bypass Surgery

    OpenAIRE

    Orihashi, Kazumasa; Oka, Yasu

    1991-01-01

    The thoracic descending aorta (DTA) was examined in 57 patients undergoing coronary artery bypass grafting (41 men and 16 women: 63.0 ± 10.6 years old) using two-dimensional transesophageal echocardiography. An intraaortic balloon pump (IABP) was instituted in ten patients. A short-axis view of DTA was examined for intraluminal projection from the diaphragm level to the aortic arch level. In a frozen-frame image, the area and the height of the projection at each clockwise direction was measur...

  9. Percutaneous transvenous balloon occlusion of arteriovenous fistula

    International Nuclear Information System (INIS)

    The closure of arteriovenous fistulas, using a balloon catheter introduced through the vein draining the fistula, is discussed. The application of this method to the closure of an iatrogenic vertebrovertebral fistula is described. (orig.)

  10. Management of post-surgical biliary leakage with percutaneous transhepatic biliary drainage (PTBD) and occlusion balloon (OB) in patients without dilatation of the biliary tree: preliminary results

    International Nuclear Information System (INIS)

    To compare the outcome of patients affected by biliary leak after major biliary surgery and treated with percutaneous transhepatic biliary drainage (PTBD) alone with that of similar patients treated with PTBD and concurrent positioning of an occlusion balloon (PTBD-OB). We retrospectively reviewed the results of the use of PTBD or PTBD-OB performed at our institution from 2004 to 2008 in patients with post-surgical biliary leak. Sixteen patients entered the evaluation. PTDB alone was performed in 9 men (age 59.7 ± 13.4 years [mean ± standard deviation]; median 60 years), while PTBD-OB was performed in 7 patients (5 men, 2 women, age 71.3 ± 9.3 years; median 68 years). No significant difference between groups was found regarding age (p = 0.064) and sex (p = 0.175) distribution, number of procedures (3.1 ± 1.62; 2 vs 1.7 ± 1.1; 1, p = 0.151), and days of disease before recovery, death or modification of treatment (51.6 ± 66.8; 23 vs 18.6 ± 15.1; 14, p = 0.266). The number of patients treated with PTBD-OB who fully recovered (7/7, 100%) was significantly higher than that of patients treated with PTBD alone (4/9, 44%, p = 0.034). This procedure appears to be clinically effective, being associated with a higher probability of recovery in patients treated for post-surgical biliary leak. Further studies are needed to confirm these preliminary results. (orig.)

  11. Management of post-surgical biliary leakage with percutaneous transhepatic biliary drainage (PTBD) and occlusion balloon (OB) in patients without dilatation of the biliary tree: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Pedicini, Vittorio; Poretti, Dario; Brambilla, Giorgio [Humanitas Clinical Institute, Department of Diagnostic Imaging, Rozzano, Milan (Italy); Mauri, Giovanni; Trimboli, Manuela [Humanitas Clinical Institute, Department of Diagnostic Imaging, Rozzano, Milan (Italy); University of Milan School of Medicine, Unit of Radiology, Ospedale San Paolo, Milan (Italy); Sconfienza, Luca Maria; Sardanelli, Francesco [University of Milan School of Medicine, Unit of Radiology, IRCCS Policlinico San Donato, Department of Medical and Surgical Sciences, Milan (Italy); Cornalba, Gianpaolo [University of Milan School of Medicine, Unit of Radiology, Ospedale San Paolo, Milan (Italy)

    2010-05-15

    To compare the outcome of patients affected by biliary leak after major biliary surgery and treated with percutaneous transhepatic biliary drainage (PTBD) alone with that of similar patients treated with PTBD and concurrent positioning of an occlusion balloon (PTBD-OB). We retrospectively reviewed the results of the use of PTBD or PTBD-OB performed at our institution from 2004 to 2008 in patients with post-surgical biliary leak. Sixteen patients entered the evaluation. PTDB alone was performed in 9 men (age 59.7 {+-} 13.4 years [mean {+-} standard deviation]; median 60 years), while PTBD-OB was performed in 7 patients (5 men, 2 women, age 71.3 {+-} 9.3 years; median 68 years). No significant difference between groups was found regarding age (p = 0.064) and sex (p = 0.175) distribution, number of procedures (3.1 {+-} 1.62; 2 vs 1.7 {+-} 1.1; 1, p = 0.151), and days of disease before recovery, death or modification of treatment (51.6 {+-} 66.8; 23 vs 18.6 {+-} 15.1; 14, p = 0.266). The number of patients treated with PTBD-OB who fully recovered (7/7, 100%) was significantly higher than that of patients treated with PTBD alone (4/9, 44%, p = 0.034). This procedure appears to be clinically effective, being associated with a higher probability of recovery in patients treated for post-surgical biliary leak. Further studies are needed to confirm these preliminary results. (orig.)

  12. Long-term follow-up of neoadjuvant intraarterial chemotherapy using an original four-lumen double-balloon (4L-DB) catheter for locally advanced uterine cervical cancer

    International Nuclear Information System (INIS)

    We report the therapeutic potential, long-term survival, and toxicity of neoadjuvant intraarterial chemotherapy (NAIC) using an original four-lumen double-balloon (4L-DB) catheter followed by radical hysterectomy and/or radiotherapy in patients with locally advanced cervical cancer. Sixty patients with stage IIB-IVA cervical squamous cell cancer were treated with NAIC which included cisplatin (60-70 mg/m2, day 1), mitomycin-C (10-20 mg/m2, day 1), and pirarubicin hydrochloride (THP; 10-20 mg/m2, day 1) for two courses every 21 days. The median follow up among surviving patients was 93.7 months. Among 60 eligible patients, 22 had a complete response (CR; 36.7%) including 12 with a pathologic CR (20.0%). Thirty-six patients had a partial response (60.0%), and stable disease was observed in only 2 patients (3.3%). Moreover, we found that the platinum concentration in the cervix was correlated with the clinical response (P<0.001). The 10-year progression-free survival (PFS) and 10-year survival were 90.9% and 90.9%, respectively, in patients with stage IIB disease and 66.0% and 70.7%, respectively, in patients with stage III disease. Leukopenia occurred in 86.7% of patients, but it was not very severe (grade 3, 4 in 13.3% of patients). Our results with NAIC using the 4L-DB catheter in locally advanced cervical cancer demonstrate that a high platinum concentration has beneficial effects on primary lesions and improves long-term progression-free and overall survival. (author)

  13. Thrombolysis together with vascular dilatation for the treatment of acute left iliofemoral venous thrombosis: which procedure should be carried out first?

    International Nuclear Information System (INIS)

    Objective: To investigate the short-term efficacy and complication occurrence of two interventional therapeutic orders, i.e. thrombolysis followed by vascular dilatation and vascular dilatation followed by thrombolysis, in treating acute left iliofemoral venous thrombosis. Methods: Forty-five patients with acute left iliofemoral venous thrombosis were divided into two groups. Patients in group A (n=21) were treated with catheter-directed thrombolysis through the catheterization of left iliofemoral vein via the left popliteal vein, and balloon dilatation or stent implantation would follow if there was any residual stenosis after thrombolysis. Patients in group B (n=24) were treated with balloon dilatation for the left iliac vein and thrombus first, which was followed by catheter-directed thrombolysis through the catheter inserted in the left iliofemoral vein via the left popliteal vein access. Stent implantation would be applied if there was any residual stenosis after thrombolysis. In all patients the optional filter was placed in the inferior vena cava and the filter was removed within two weeks. Results: In both group A and group B, balloon dilation was applied in 18 and 24 cases (P=0.09) respectively, and stenting was employed in 11 and 16 cases respectively (P=0.24). The mean urokinase used in group A was (427±49.71) × 104 unit, which was much higher than that used in group B, which was (315.00±62.48) × 104 unit. The difference between the two groups was significant (P<0.001). In group A, thrombus in cava filters was found in 2 cases and complication occurred in 7 cases. The edema reduction rate in group A was (71±19)% at one week and (98±3)% at one month after the treatment, that was (81±12)% and (99±2)% respectively in group B, thrombus in cava filters was found in 8 cases and complication occurred in 2 cases. Conclusion: For the treatment of acute left iliofemoral venous thrombosis, balloon dilatation followed by thrombolysis can well reduce the use

  14. Intravascular ultrasound imaging of peripheral arteries as an adjunct to balloon angioplasty and atherectomy.

    Science.gov (United States)

    Korogi, Y; Hirai, T; Takahashi, M

    1996-01-01

    This article reviews many of the applications of intravascular ultrasound (US) imaging for peripheral arterial diseases. In vitro studies demonstrate an excellent correlation between ultrasound measurements of lumen and plaque cross-sectional area compared with histologic sections. In vivo clinical studies reveal the enhanced diagnostic capabilities of this technology compared with angiography. Intravascular US imaging can provide valuable information on the degree, eccentricity, and histologic type of stenosis before intervention, and on the morphological changes in the arterial wall and the extent of excision after intervention. Intravascular US may also serve as a superior index for gauging the diameter of balloon, stent, laser probe, and/or atherectomy catheter appropriate for a proposed intervention. Significant new insights into the mechanisms of balloon angioplasty and atherectomy have been established by intravascular US findings. Intravascular US imaging has been shown to be a more accurate method than angiography for determining the cross-sectional area of the arterial lumen, and for assessing severity of stenosis. Quantitative assessment of the luminal cross-sectional area after the balloon dilatation should be more accurate than angiography as intimal tears or dissections produced by the dilatation may not be accurately evaluated with angiography. At the present time, intravascular US is still a controversial imaging technique. Outcome studies are currently being organized to assess the clinical value and cost effectiveness of intravascular ultrasound in the context of these interventional procedures. PMID:8653738

  15. Engineering Considerations Of Catheters For Intravascular Ultrasonic Measurements

    Science.gov (United States)

    Martin, Roy W.; Johnson, Christopher C.

    1989-08-01

    The mechanical properties of commonly used fluid transfusion or pressure monitoring catheters are similar to the properties required of catheters which include sensing devices. Consequently, bending and torsional stiffness of commercial catheters and tubes were measured at both room and body temperature. Five of these usually placed with the aid of fluoroscopy had an average Young's modulus of 5714x101 dyne/cm at 21°C which decreased 29% at body temperature; a shear modulus of 70.5x101 dyne/cm 4 at 21°C which decreased 13% at body temperature, and plastic deformation of 8% when loaded for 1 minute at 37°. Four of these were composed of a composite material. Catheters which are balloon directed during insertion had moduli values approximately 1/3 of these or less. The drag forces produced on balloons used on such catheters were measured for fluid velocities ranging from 10-50 cm/sec. Using this information the average force applied to a balloon throughout a cardiac cycle was calculated; values of 1280 dynes for a .6 ml balloon and 2490 dynes for a 1 ml balloon were found. The maximum wall thicknesses to catheter radii for single lumen catheters were determined for various material moduli which would allow the catheter tip to be directed by a balloon during its passage into the right heart.

  16. Increased Production of Sonic Hedgehog by Ballooned Hepatocytes

    OpenAIRE

    Rangwala, Fatima; Cynthia D Guy; Lu, Jiuyi; SUZUKI, Ayako; Burchette, James L.; Abdelmalek, Manal F; Chen, Wei; Diehl, Anna Mae

    2011-01-01

    Ballooned hepatocytes distinguish nonalcoholic steatohepatitis (NASH) from steatosis. Such cells contain dilated endoplasmic reticulum and ubiquitin aggregates, characteristics of endoplasmic reticulum stress. Hepatocyte ballooning increases risk for fibrosis in NASH, suggesting ballooned hepatocytes release pro-fibrogenic factors. Hedgehog ligands function as pro-fibrogenic factors in liver diseases, but mechanisms for Hedgehog ligand production remain poorly understood. We evaluated the hyp...

  17. Pulmonary Arterial Hypertension in Adults: Novel Drugs and Catheter Ablation Techniques Show Promise? Systematic Review on Pharmacotherapy and Interventional Strategies

    Directory of Open Access Journals (Sweden)

    Salvatore Rosanio

    2014-01-01

    Full Text Available This systematic review aims to provide an update on pharmacological and interventional strategies for the treatment of pulmonary arterial hypertension in adults. Currently US Food and Drug Administration approved drugs including prostanoids, endothelin-receptor antagonists, phosphodiesterase type-5 inhibitors, and soluble guanylate-cyclase stimulators. These agents have transformed the prognosis for pulmonary arterial hypertension patients from symptomatic improvements in exercise tolerance ten years ago to delayed disease progression today. On the other hand, percutaneous balloon atrioseptostomy by using radiofrequency perforation, cutting balloon dilatation, or insertion of butterfly stents and pulmonary artery catheter-based denervation, both associated with very low rate of major complications and death, should be considered in combination with specific drugs at an earlier stage rather than late in the progression of pulmonary arterial hypertension and before the occurrence of overt right-sided heart failure.

  18. Treatment of anastomotic stricture after biliary-intestinal anastomosis with percuta-neous transhepatic cholangial drainage and balloon dilatation%经皮经肝球囊扩张治疗胆肠吻合术后吻合口狭窄

    Institute of Scientific and Technical Information of China (English)

    贾宝雷; 梁峰; 李虎城

    2015-01-01

    目的:探讨经皮经肝胆管穿刺引流术( PTCD)联合球囊扩张术治疗胆肠吻合术后吻合口狭窄的可行性及疗效。方法回顾性分析军事医学科学院附属医院普外科2009年3月至2011年12月采用PTCD联合球囊扩张术治疗胆肠吻合术后吻合口狭窄23例的疗效,评估胆道通畅程度、黄疸指数及肝功能。结果本组行PTCD联合球囊扩张术23例,19例治疗效果明显,1例植入金属支架。术后胆肠吻合口狭窄、黄疸指数及肝功能均明显改善,无严重并发症发生。结论 PTCD联合球囊扩张术治疗胆肠吻合术后吻合口狭窄疗效好,并发症发生率低,是较为安全可行的微创治疗措施。%Objective To evaluate the effect and feasibility of balloon dilatation for treatment of anastomotic stricture after biliary-intestinal anastomosis with percutaneous transhepatic cholangial drainage( PTCD) .Methods A total of 23 pa-tients with anastomotic stricture after biliary-intestinal anastomosis who had undergone PTCD+balloon dilatation were ana-lyzed retrospectively between Mar 2009 to Dec 2011.The patency of bile duct, jaundice index and liver function were recor-ded.Results PTCD+balloon dilatation was completed successfully in all cases, and a metallic stent was implanted in one case.Anastomotic stricture, postoperative jaundice index and liver function were improved significantly after operation.No serious complications occurred.Conclusion PTCD+balloon dilatation has good curative effect on anastomotic stricture. The complication rate is low.It is a safe, feasible and effective minimally invasive treatment.

  19. Paschke Dilations

    OpenAIRE

    Westerbaan, Abraham; Westerbaan, Bas

    2016-01-01

    In 1973 Paschke defined a factorization for completely positive maps between C*-algebras. In this paper we show that for normal maps between von Neumann algebras, this factorization has a universal property, and coincides with Stinespring's dilation for normal maps into B(H ).

  20. 大豆异黄酮对球囊损伤血管内膜增生的影响%Effect of Isoflavone on Balloon Catheter-Induced Neointimal Hyperplasia in Rabbit Carotid Artery

    Institute of Scientific and Technical Information of China (English)

    牟德堂; 邱仁峰

    2015-01-01

    目的:探讨大豆异黄酮对球囊损伤模型兔颈动脉后再狭窄的预防。方法:建立兔右颈动脉球囊损伤模型,实验分单纯球囊损伤组(Inj)、去势后球囊损伤组(Ovx+Inj)、去势球囊损伤后补充雌激素组(Ovx+Inj+E2)、去势球囊损伤后补充大豆异黄酮组(Ovx+Inj+Iso),于28 d行彩超检查,监测损伤动脉内-中膜的厚度及内膜的光滑程度,后分组等数分别处死动物,分别计算损伤血管腔内膜/中膜面积比值。结果:Inj组与Ovx+Inj组内膜、中膜增厚明显,管腔狭窄明显,Ovx+Inj+E2组和Ovx+Inj+Iso组各时段血管形态学分析显示内膜增生程度低于Inj组与Ovx+Inj组(P<0.05)。结论:大豆异黄酮可明显抑制损伤血管内膜增生及中膜平滑肌细胞增殖,发挥其血管保护作用。%Objective:To investigate the effects of phytoestrogen isoflavone on balloon catheter-induced hyperplasia of carotid artery.Method:Forty-eight female New Zealand rabbits were randomly divided into four groups: control (balloon-induced carotid artery injury only); ovariectomy control (ovariectomy and carotid artery injury), oestrogen (ovariectomy, carotid artery injury and nilestriol, 5 mg/kg daily for 28 days), and isoflavone (ovariectomy, carotid artery injury and isoflavone 120 mg/kg daily for 28 days). The arterial wall thickness was assessed by coloured ultrasonography.Rusult:The medial layer thickness in the isoflavone group was less than in the ovariectomy control group (0.28±0.03 vs.0.35±0.04 mm,P<0.01), and the intimal/medial layer (I/M) ratio was the isoflavone group was also less than in the ovariectomy control group (16.85±3.79 vs.48.94±8.92,P<0.01).There was no statistically significant difference in the medial layer thickness or I/M ratio between the isoflavone and the oestrogen groups.Conclusion:Soybean isoflavones can play a role of protecting blood vessels to inhibit neointimal hyperplasia and the

  1. Balloon-assisted coiling through a 5-French system

    International Nuclear Information System (INIS)

    We present a catheter technique that utilizes a 5F system for the purpose of balloon-assisted coiling in the setting of intracranial aneurysms. A standard 5F short sheath is placed in the common femoral artery, and a 5F diagnostic catheter is placed through the sheath and used for selective vessel angiography. When endovascular intervention is pursued, the diagnostic catheter is placed in the appropriate vessel and systemic heparinization is ensured. Over an exchange length wire, the 5F vertebral catheter and 5F short sheath are exchanged for a 5F Shuttle (Cook) sheath. We then routinely place a 10, 14 or 18 microcatheter over an appropriately gauged microguidewire into the aneurysm. As needed, balloon catheters are then placed across the neck of the aneurysm for remodeling purposes. During the course of the procedure, control angiography is performed through the Shuttle sheath. Following the placement of coils, the microcatheter and balloon catheter are removed and a final biplane image is obtained via the 5F Shuttle sheath. This technique has been employed in 15 patients who required balloon-assisted coiling of an intracranial aneurysm. There were no technical difficulties or arterial access site complications from the procedures. Catheter mobility and torque were not affected, nor was the quality of our imaging. We conclude that this small-diameter system provides ample ''room'' for catheter placement and interventional treatment while reducing the known risks of postprocedural complications. Angiographic images remain excellent and are comparable to those obtained by larger catheters. (orig.)

  2. Dilatations Revisited

    CERN Document Server

    La, H S

    1996-01-01

    Dilatation, i.e. scale, symmetry in the presence of the dilaton in Minkowski space is derived from diffeomorphism symmetry in curved spacetime, incorporating the volume-preserving diffeomorphisms. The conditions for scale invariance are derived and their relation to conformal invariance is examined. In the presence of the dilaton scale invariance automatically guarantees conformal invariance due to diffeomorphism symmetry. Low energy scale-invariant phenomenological Lagrangians are derived in terms of dilaton-dressed fields, which are identified as the fields satisfying the usual scaling properties. The notion of spontaneous scale symmetry breaking is defined in the presence of the dilaton. In this context, possible phenomenological implications are advocated and by computing the dilaton mass the idea of PCDC (partially conserved dilatation current) is further explored.

  3. Local Administration of NF-κ B Decoy Oligonucleotides to Prevent Restenosis after Balloon Angioplasty: An Experimental Study in New Zealand White Rabbits

    International Nuclear Information System (INIS)

    Purpose. To evaluate the efficacy of NF-κ B oligonucleotides (ODN) administered by local administration with the channeled balloon catheter to prevent restenosis after balloon angioplasty in restenotic iliac arteries of New Zealand white rabbits. Materials and Methods. In vitro, 8000 rabbit vascular smooth muscle cells (rVSMC) where transfected with a liposomal carrier (TfX50) with 100 ng of decoy and scrambled ODN. Inhibition of proliferation was measured using a MTT assay after 24 hours in comparison to control. In vivo, 22 male New Zealand White rabbits were fed a 1% cholesterol diet and received denudation of both common iliac arteries with a 3 mm balloon catheter to induce an arterial stenosis. Four weeks after stenosis induction, local application of NF-κ B in two different concentrations (1 μg: n = 14; 10 μg: n = 8) was performed randomly on one common iliac artery. Scrambled oligonucleotides without specific binding capacities were injected into the contralateral side. The channeled balloon catheter allows simultaneous balloon dilation (8 atm) of the stenosis and local application of a drug solution (2 atm). Four weeks after local drug delivery the animals were killed and the vessels were excised and computerized morphometric measurements were performed. Results. NF-κ B decoy ODN but not scrambled ODN inhibited proliferation of rVSMC in vitro. Following local ODN application in the animals, no acute vascular complications were seen. NF-κ B ODN resulted in a statistically non significant reduction of neointimal area compared to the control group. The neointimal area was 0.97 mm2 using 1 μg NF-κ B ODN compared to 0.98 mm2 in the control group. The higher dose resulted in a neointimal area of 0.97 mm2 compared to 1.07mm2 at the control side. Conclusions. Local drug delivery of NF-κ B ODN using the 'channeled balloon' catheter could not reduce neointimal hyperplasia in stenostic rabbit iliac arteries. Application modalities have to be improved to

  4. Midterm outcome of a half-blind, random, control research: a new therapy that treat hypovascular liver cancer with balloon catheter to block the main artery temporarily, and then pressurize chemoembolization

    International Nuclear Information System (INIS)

    Objective: To investigate efficacy and effect on liver function of the experimental therapy with balloon catheter to block the main artery temporarily and then pressurize chemoembolization to treat hypovascular liver cancer. Methods: Eighty patients with hypovascular liver cancer requiring interventional therapy were randomly divided into two groups. The experimental group was treated with the new therapy and the control group was treated with traditional therapy. The lipiodol-filling status and maximum diameter of the tumor was analyzed for a midterm outcome, and the change of AFP and liver function were evaluated. Mann-Whitney test was used for data between two groups, Friedman test was used for data of each group, and Spearman nonparameter relevant analysis was used for efficacy indexes. Results: (1) All Patients have confirmed diagnosis of hypocvascular liver cancer and got balanced baseline. (2) Lipiodol-filling status:the clinical efficacy and benefit rates of patients from experimental group were higher than that from control group and showed statistically significant difference in 1, 3, 12 months (Z=-2.135, -2.939, -2.686; P=0.034, 0.004, 0.007), but no statistically significant difference in 6 month (Z=-1.170, P=0.242). The status of lipiodol-filling of experimental group (χ2=2.593, P=0.459) was more stable than control group (χ2=10.886, P=0.012). (3) Maximum diameter of the tumor: the clinical efficacy and benefit rates of patients from experimental group were higher than that from control group and showed statistically significant difference in 3, 12 months (Z=-2.734, -2.733; P=0.006, 0.006), but no statistically significant difference in 1,6 month (Z=-1.692, -1.895; P=0.091, 0.058). But neither of two groups showed statistically significant difference in change of maximum diameter of the tumor (χ2=5.500, P=0.139;χ2=6.509, P=0.089). Relation between lipiodol-filling and maximum diameter showed positive correlation in 3 month (r=0.257, P=0.035). (4

  5. Percutaneous balloon mitral valvuloplasty by the Inoue balloon technique: the procedure of choice for treatment of mitral stenosis.

    Science.gov (United States)

    Cheng, T O; Holmes, D R

    1998-03-01

    The Inoue technique of percutaneous balloon mitral valvuloplasty, introduced in 1984, is a truly startling advance in cardiology in modern times. It is time to reeducate our colleagues that when they hear the opening snap in patients with mitral stenosis, they should automatically open these stenotic mitral valves with an Inoue balloon catheter rather than submit these patients to surgical correction. PMID:9514461

  6. Dilated cardiomyopathy

    International Nuclear Information System (INIS)

    Radionuclide techniques are easily obtainable, noninvasive examinations that provide useful information in the evaluation, diagnosis and management of patients with dilated cardiomyopathy. The gated blood pool scan allows the assessment of ventricular size, configuration, and wall and septal thickness. These data allow the functional class of the cardiomyopathy (congestive, restrictive or hypertrophic) to be defined. Often THallium-201 myocardial perfusion imaging adds further information and is particularly useful in distinguishing congestive cardiomyopathy from severe coronary artery disease and in depicting septal abnormalities in hipertrophic cardiomyopathy. Useful as these techniques are, they are not substitutes for conventional approaches to diagnosis. Careful history taking and physical examination, as well as scrutiny of the electrocardiogram, chest X-ray and echocardiogram should be standard practice for the evaluation of patients with suspected cardiomyopathy. Judicious use of noninvasive techniques may obviate the need for cardiac catheterization in many patients

  7. Dilating Eye Drops

    Science.gov (United States)

    ... Frequently Asked Questions Español Condiciones Chinese Conditions Dilating Eye Drops En Español Read in Chinese What are dilating eye drops? Dilating eye drops contain medication to enlarge ( ...

  8. The clinical research office of the endourological society percutaneous nephrolithotomy global study: tract dilation comparisons in 5537 patients

    DEFF Research Database (Denmark)

    Lopes, Tomé; Sangam, Kandasami; Alken, Peter; Barroilhet, Benjamin Silva; Saussine, Christian; Shi, Lei; de la Rosette On Behalf Of The Clinical Research Office Of The Endourological Society Percutaneous Nephrolithotomy Study Group, Jean; Osther, Palle Jørn Sloth

    2011-01-01

    dilation was performed using a balloon or telescopic/serial dilator. Patient characteristics, perioperative complications, and treatment outcomes were assessed by the treating physician. Postoperative complications were graded according to the modified Clavien grading system. Results: A total of 5537...... balloon dilation in North America (82.6%). In Europe, the rates of balloon (50.7%) and telescopic/serial (49.3%) dilation procedures were similar. The rates of bleeding (9.4% vs 6.7%), blood transfusions (7.0% vs 4.9%), and drop in mean hematocrit level (4.5% vs 2.5%) were higher in the balloon vs...... between centers in Asia, Europe, and the United States. In the balloon dilation group, a total longer operative time and higher bleeding and transfusion rates were observed. The differences in outcome may be influenced by patient heterogeneity, including previous anticoagulation therapy or surgical...

  9. Encrusted and incarcerated urinary bladder catheter: what are the options?

    Directory of Open Access Journals (Sweden)

    Christopher C.K. Ho

    2010-11-01

    Full Text Available Urinary bladder catheter encrustations are known complications of long-term urinary catheterisation, which is commonly seen in clinical practice. These encrustations can impede deflation of the balloon and therefore cause problems in the removal of the catheter. The options in managing an encrusted and incarcerated urinary bladder catheter include extracorporeal shock wave lithotripsy and lithoclast. We describe here another technique of dealing with a stuck and encrustated catheter, via direct crushing of the encrustations with a rigid cystoscope inserted through a suprapubic cystostomy tract.

  10. Newly Designed Y-configured Single-Catheter Stenting for the Treatment of Hilar-Type Nonanastomotic Biliary Strictures After Orthotopic Liver Transplantation

    International Nuclear Information System (INIS)

    Purpose: This study was designed to introduce our novel technique of percutaneous single catheter placement into the hilar bile ducts strictures while fulfilling the purpose of bilateral biliary drainage and stenting. We investigated the efficacy and safety of the technique for the treatment of hilar nonanastomotic biliary strictures. Methods: Ten patients who were post-orthotopic liver transplantation between July 2000 and July 2010 were enrolled in this study. Percutaneous Y-configured single-catheter stenting for bilateral bile ducts combined with balloon dilation was designed as the main treatment approach. Technical success rate, clinical indicators, complications, and recurrent rate were analyzed. Results: Technical success rate was 100%. Nine of the ten patients had biochemical normalization, cholangiographic improvement, and clinical symptoms relief. None of them experienced recurrence in a median follow-up of 26 months after completion of therapy and removal of all catheters. Complications were minor and limited to two patients. The one treatment failure underwent a second liver transplantation but died of multiple system organ failure. Conclusions: Percutaneous transhepatic Y-configured single-catheter stenting into the hilar bile ducts is technically feasible. The preliminary trial of this technique combined with traditional PTCD or choledochoscopy for the treatment of hilar biliary strictures after orthotopic liver transplantation appeared to be effective and safe. Yet, further investigation is needed.

  11. Unusual Complication of Suprapubic Cystostomy in a Male Patient with Tetraplegia: Traction on Foley Catheter Leading to Extrusion of Foley Balloon from Urinary Bladder and Suprapubic Urinary Fistula – Importance of Securely Anchoring Suprapubic Catheter with Adhesive Tape or BioDerm Tube Holder

    OpenAIRE

    Subramanian Vaidyanathan; Peter L. Hughes; Soni, Bakul M.

    2007-01-01

    Suprapubic cystostomy is recommended to patients with neuropathic bladder to prevent complications of long-term urethral catheter drainage. We present a 50-year-old male patient with tetraplegia who had long-term urethral catheter drainage. Following flexible cystoscopy, he developed a urine leak from the right side of the scrotum. Suprapubic cystostomy was performed. After suprapubic cystostomy, the urinary fistula healed completely. A follow-up cystourethrogram confirmed an intact urethra w...

  12. The application of biliary catheter folding technique in the treatment of hilar nonanastomotic biliary strictures after orthotopic liver transplantation

    International Nuclear Information System (INIS)

    Objective: To introduce a newly-designed percutaneous single catheter folding technique, by which bilateral biliary drainage and stenting can be completed through single access, and to assess the effectiveness and safety of this technique in treating hilar nonanastomotic strictures occurred after orthotopic liver transplantation. Methods: A total of 10 patients with nonanastomotic strictures, who were encountered during the period from July 2000 to July 2010 in authors' hospital, were enrolled in this study. Balloon dilatation was used for the biliary tract stenosis. After the placement of biliary drainage tube, the catheter was folded into 'Y' shape within the biliary duct at hepatic portal region, and triaxial supporting drainage, i.e. the left hepatic duct, the right hepatic duct and the common hepatic duct, was established. The technical success rate, the clinical efficacy, the complications and the recurrence were documented and analyzed. Results: Technical success rate was 100% (10/10). In 9 patients, the clinical symptoms were obviously relieved, the biochemical indexes were gradually restored to normal and the imaging findings were markedly improved. During the follow-up lasting 26 months (median), no recurrence was seen. Minor complications occurred in two cases. One patient died after he received second orthotopic liver transplantation because of failure to respond to initial treatment. Conclusion: Percutaneous transhepatic biliary catheter folding technique is technically feasible. The results of this study indicate that this technique carries satisfactory success rate and is very effective and safe for the treatment of hilar nonanastomotic strictures occurred after orthotopic liver transplantation. (authors)

  13. Comparison of 7 and 8 French guiding catheters for elective PTCA: results of a prospective randomized trial.

    Science.gov (United States)

    Talley, J D; Wilkins, C; Ciccone, J; Hattel, L J

    1994-11-01

    A prospective randomized trial was performed to detect technical and clinical differences of 7F compared to 8F guiding catheters (GC) used in elective coronary angioplasty (PTCA). One hundred and fifteen patients undergoing elective PTCA with standard balloon dilatation catheters were randomized to 7F (55 pts) or 8F (58 pts) guiding catheters. The endpoints were primarily coronary artery and peripheral vascular complications; and secondarily, technical details and quantitative and qualitative angiographic quality. There was no difference between 7F or 8F GC for development of coronary or peripheral vascular complications. With 7F GC there was less blood loss (Hct, 3.5 +/- 3.4% vs. 6.5 +/- 9.6%, P = .033), and less contrast medium (160 +/- 88 mL vs. 200 +/- 119 mL, P = .049) used. Angiographic quality was similar, although visualization of lesions in the left anterior descending coronary artery in the left anterior oblique projection was improved with the 8F GC. There is no advantage of 7F GC for the prevention of coronary or peripheral vascular complications, although there was less blood loss and contrast medium used with the 7F systems. PMID:7874712

  14. A complex dissected chronic occlusion: targeted balloon dilatation of false lumen to access true lumen, combined localized subintimal tracking and reentry, parallel wire, contralateral injection and a useful antegrade lumen re-entry technique

    Directory of Open Access Journals (Sweden)

    James W. Tam

    2012-02-01

    Full Text Available Chronic total occlusion (CTO angioplasty is one of the most challenging procedures remaining for the interventional operator. Recanalizing CTOs can improve exercise capacity, symptoms, left ventricular function and possibly reduce mortality. Multiple strategies such as escalating wire, parallel wire, seesaw, contralateral injection, subintimal tracking and re-entry (STAR, retrograde wire techniques (controlled antegrade retrograde subintimal tracking, CART, reverse CART, confluent balloon, rendezvous in coronary, and other techniques have all been described. Selection of the most appropriate approach is based on assessment of vessel course, length of occluded segment, presence of bridging collaterals, presence of bifurcating side branches at the occlusion site, and other variables. Today, with significant operator expertise and the use of available techniques, the literature reports a 50-95% success rate for recanalizing CTOs.

  15. Laser balloon vascular welding using a dye-enhanced albumin solder

    Science.gov (United States)

    Ott, Beat; Zueger, Benno J.; Erni, Dominique; Banic, Andrej; Schaffner, Thomas; Weber, Heinz P.; Frenz, Martin

    2001-05-01

    Porcine posterior tibial arteries (n equals 50) and saphenous veins (n equals 32) have been welded end-to-end using an 808 nm diode laser combined with an indocyanine green enhanced albumin solder. For comparison, the same welding procedure has been performed with a Holmium:YAG laser without solder. Both lasers were running in continuous wave (cw) regime at a power limited below 1.2 W. The vascular stumps were approached to each other over a coronary dilatation catheter in order to obtain a precise alignment. The balloon catheter simplified vessel handling and the tight vessel positioning prevented a solder penetration into the lumen. Standard histology revealed for both welding techniques a lateral tissue damage between 2 and 3 mm. The vessels welded with the 808 nm diode laser using albumin solder showed considerably higher tensile strength (1 N compared to 0.3 N) than vessels welded exclusively by Ho:YAG laser radiation. In contrast, leaking pressure (350 +/- 200 mmHg) and bursting pressure 457 +/- 200 mmHg) were independent of the welding technique used.

  16. 20例支架外侧球囊扩张挽救冠状动脉分支疗效和安全性观察%Clinical efficacy and safety of the balloon dilation outside the main branch stent to reopen the occlusion of side branch in bifurcation lesions

    Institute of Scientific and Technical Information of China (English)

    李成祥; 王琼; 高好考; 王海昌

    2013-01-01

    Objective To evaluate the clinical efficacy and safety of the balloon dilation outside the main branch (MB) stent to reserve the occlusion of side branch (SB) in bifurcation lesions. Methods There were totally 20 bifurcation lesions in 20cases. The SB guide wire was jailed before deployment of the MB stent. MB stenting can cause plaque shift, spasm, protrusion of the stent struts into the SB, and/or SB ostial conformational changes including total occlusion. A new guide wire could not rewire through the stent struts and find the ostium of SB, so we use small-diameter balloon through the SB gailed wire to find the ostium and the small balloon was dilated at low pressure. Finally a new guide wire recrossed the SB and completed the exchange guide wire, finished by the kissing balloon. The incidence of the branch compromise, follow-up results were observed. Results No SB dissection was recorded. CK-MB levels were increased in 1 case. No acute myocardial infarction occurred. During 12 - 18 moths follow-up, there was no major adverse cardiac event ( MACE) due to stent thrombosis. Conclusions Small-diameter balloon outside the stent was passed through the jailed wire into the side branch. The modified approach facilitated the rewiring in SB. The modified strategy of small-diameter balloon opening outside of the stent can significantly save the loss of side branch, prevent the stenosis of branch openings, shorten the time of exchange guide wire and kissing balloon, and improve the safety of operation.%目的 评价主支支架外侧球囊扩张技术,便于导丝重新进入已闭塞的分支,进而挽救分支血管的安全性及疗效.方法 20例冠心病患者共20个真性分叉病变,分叉病变中位于左主干/前降支3例(占15%),前降支/第一对角支9例(占45%),回旋支/钝缘支3例(占15%),右冠状动脉/后降支或后侧支5例(占25%).所有分叉病变分支预留挤压(jailed)导丝,主支病变置入支

  17. Experience with esophageal dilatations in children

    Directory of Open Access Journals (Sweden)

    G. Christopoulos-Geroulanos .

    2007-03-01

    Full Text Available SUMMARY Aim: Esophageal stenosis requiring treatment is a serious complication of a variety of otherwise benign conditions in children. Dilatation is the treatment of choice. However, the method and acceptable duration are largely a matter of personal preference. We present our experience with 81 children undergoing dilatations for benign strictures due to a variety of causes and discuss the resulting problems. Material: During the period 1987-2001, eighty-one children were treated for strictures of the esophagus. The causes were: correction of esophageal atresia (EATEF, gastroesophageal reflux (GER, stricture of the cerevical anastomosis following esophageal replacement (ER, burn due to ingestion of caustic agents (CB, tight fundoplication (TF, achalasia (EA, congenital esophageal stenosis (CES and stenosis following sclerotherapy of esophageal varices (EV. All dilatations were performed under general anesthesia. Balloon dilatations were performed under fluoroscopic control following endoscopic insertion of the guide-wire. Results: The results were excellent or good in 58 children (78.3%. Twenty-four children (25.9% had to be treated surgically either to stabilize the result of the dilatations or to correct an intractable stenosis. Complications occurred in 6 children (7.4%: Four suffered a rupture at the level of the stricture following bougienage. Transverse suture of the longitudinal tear resulted in cure of the stenosis in 3. In the fourth, a cervical esophagostomy and gastrostomy had to be placed. Finally one child had a subdiaphragmatic rupture at the esophago-gastric junction, also following bougienage, treated with drainage. Strictures following esophageal replacement required the most dilatations (mean 11.3 per patient. An increased number of procedures were also required in esophageal burns (mean 6.3. Conclusion: 1 Esophageal dilatation is an effective treatment for strictures. 2 Rupture is a serious complication best treated

  18. Catheter Migration of a Port-a-Cath System

    International Nuclear Information System (INIS)

    A patient with axillary venous thrombosis caused by lymph node compression and the presence of a displaced catheter in the vascular lumen is presented. In this case, percutaneous interventional radiological procedures (balloon angioplasty and snare loop method) in conjunction with medical treatment were effective in limiting the post-thrombotic syndrome and restoring the proper positioning of the catheter, thereby saving the central venous access

  19. Utilidade do Ultrassom intracardíaco no isolamento de veias pulmonares usando cateter-balão a laser Utilidad del ultrasonido intracardíaco en el aislamiento de venas pulmonares usando catéter-balón láser Utility of intracardiac ultrasound imaging to guide pulmonary vein ablation using laser balloon catheter

    Directory of Open Access Journals (Sweden)

    Luiz Leite

    2009-12-01

    . Se obtuvo el aislamiento completo en 38/59 (64%, y fue significantemente más común sin derrame: [30/38 (79% versus 8/23 (35%, pBACKGROUND: Pulmonary vein isolation (PVI with balloon catheter has been used as the endpoint for AF ablation. OBJECTIVE: To determine the usefulness of intracardiac ultrasound (ICUS to guide PVI using laser balloon catheter. METHODS: 59 PVs were ablated in 27 dogs. Doppler imaging was used to identify blood flow leaks between PV and balloon. After each energy delivery, the circular mapping catheter was repositioned to check if isolation had been achieved. The leak position was then correlated with the gap position at the pathological study. Multivariate logistic regression analysis was undertaken. RESULTS: 59 PV were ablated. Mean burn time was 279±177 sec, mean balloon diameter was 23±3 mm, and mean balloon length was 25±4 mm. Complete isolation was achieved in 38/59 (64% cases, and it was significantly more common when there was no leak: [30/38 (79% versus 8/23 (35%, p<0.001]. This occurred regardless of time of laser application (302±223 sec. vs. 266±148 sec., p=ns, laser power (3.5 W/cm, 4.5 W/cm, and 5.5 W/cm, balloon diameter (24± 3 mm vs. 22± 3 mm, p=ns and length (27±4 mm vs. 24±4mm, p=ns. The positive predictive value for predicting incomplete isolation was 65% and the negative predictive value was 83%. CONCLUSION: An identifiable leak between PV and the LBA device seen at the ICUS is predictive of lower PV isolation rates. ICUS may be useful for leak detection to avoid ineffective energy application during circumferential PV ablation. This could also be helpful when other types of energy are used.

  20. Treatment of chronic frontal sinusitis with difficult anatomy: A hybrid balloon technique in four cases

    OpenAIRE

    Fleischman, Gitanjali M.; Miller, Justin D.; Kim, Grace G.; Zanation, Adam M.; Ebert, Charles S.

    2014-01-01

    The presence of frontal cells poses unique challenges when using endoscopic approaches. This study describes the use of a balloon dilation system as an aid for functional endoscopic sinus surgery (FESS) to access the frontal sinus in cases that would traditionally require open approaches. We present a case series of four patients with chronic rhinosinusitis refractive to medical management who underwent FESS with the aid of a balloon dilation system at a tertiary referral center. All patients...

  1. Local drug-delivery balloon for proliferative occlusive in-stent restenosis after drug-eluting stent

    Institute of Scientific and Technical Information of China (English)

    Gianluca Rigatelli; Paolo Cardaioli; Fabio Dell'Avvocata; Massimo Giordan

    2011-01-01

    Drug-coated balloon has been developed as an alternative to drug-eluting stents for in-stent restenosis but the performance of drug infusion balloon in such setting has not been previously described. We present a case of particularly aggressive in-stent restenosis after drug eluting stent implantation treated with a new kind of drug infusion balloon developed in order to overcome the impossibility to inflate regular drug-coated balloon for several dilatation.

  2. Achalasia: pneumatic Dilation. Experience in a reference hospital

    International Nuclear Information System (INIS)

    Chalasia has an incidence of 1:100.000. The therapy for achalasia, focus on reducing the pressure gradient across the LES, which can be achieved by forceful pneumatic dilation of the gastroesophageal junction, surgical myotomy or by pharmacological agents, injected endoscopically or taken orally. Pneumatic balloon dilation is regarded as the first-Line treatment, with an initial success rate of 85% to 90%. The objective of this study is to show our experience with pneumatic balloon dilation in the patients with diagnosis of achalasia from the hospital La Samaritana during a period from February 2002 to February 2005. Patients diagnosed with achalasia from the department of gastroenterology and endoscopy of the Hospital La Samaritana during period of February 2002 to February 2005 was included. Procedures were made in fluoroscopy room. The patients received intravenous sedation and analgesia. We used a Regiflex balloon, 3.5 cm diameter. Balloons were inflated with saline water and water-soluble contrast during one minute. We diagnosed 19 patients with achalasia during period from February 2002 to February 2005, 14 were females and 5 males (26%); we made pneumatic dilation in 11 patients (60%), 9 were females (82%) with mean age 38.9 years (ranged from 16 to 13 years). Three patients (21%) underwent once pneumatic dilation and the rest (8 patients) underwent twice (73%). We don't report any perforation. So far we have followed the patients ambulatory during period from 6 months to 2 years. We find recurrence one year after of the pneumatic dilation in a female patient 22 years old (9%). The pneumatic dilation as cost-effective therapy, with a good initial success, but in the longer the follow-up lower the success rate and low morbidity (4). We suggest making only two pneumatic dilations. Today, there isn't consensus on the optimal endoscopic dilation technique and we believe that the sedation must be included in this procedure. In the future, we need more comparative

  3. Monitoring of gadolinium-BOPTA uptake into the vessel wall during magnetic resonance (MR)-guided angioplasty of the peripheral arteries with a paclitaxel/gadolinium-BOPTA-coated balloon. An experimental study at 3 Tesla

    International Nuclear Information System (INIS)

    Purpose: The success of paclitaxel distribution within the vessel wall during paclitaxel-coated balloon angioplasty to prevent restenosis cannot be monitored under X-ray guidance. The aim of this pilot study was to demonstrate the feasibility of monitoring Gadolinium-BOPTA delivery within the vessel wall during magnetic resonance (MR)-guided paclitaxel/Gadolinium-BOPTA-coated balloon angioplasty of the peripheral arteries. Materials and methods: 6 pigs (47 ± 2 kg) were investigated. All experiments were performed using a 3 Tesla MR scanner. MR-guided bilaterial angioplasty of the iliac arteries was performed using a paclitaxel/MR contrast agent-coated balloon catheter. The feasibility of monitoring the delivery of Gadolinium-BOPTA to the vessel was assessed in 4 animals. In two additional animals, bilateral stenosis was surgically induced in the iliac arteries. Delivery of paclitaxel to the vessel wall was monitored using a 3 D T1-weighted gradient echo (GE) sequence for delineation of the vessel wall. Normalized signal intensity (SI) of the vessel wall was measured before and repeatedly after the intervention for 45 min. in all animals. Results: Paclitaxel/gadolinium-BOPTA-coated balloon angioplasty was successfully accomplished in all iliac arteries (n = 12). In animals with stenosis MR-angiography demonstrated successful dilatation (n = 4). The normalized SI of the vessel wall on T1-weighted GE images significantly increased after the intervention in all animals with and without stenosis for more than 45 min. (p < 0.001). Conclusion: Monitoring of Gadolinium-BOPTA into the vessel wall during MR-guided coated balloon angioplasty is feasible. This is a first step towards providing a tool for the online control of homogenous drug delivery after paclitaxel-coated balloon angioplasty. (orig.)

  4. Monitoring of gadolinium-BOPTA uptake into the vessel wall during magnetic resonance (MR)-guided angioplasty of the peripheral arteries with a paclitaxel/gadolinium-BOPTA-coated balloon. An experimental study at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Neizel, M.; Kelm, M. [University Hospital Duesseldorf (Germany). Dept. of Cardiology, Pneumology and Angiology; Ruebben, A.; Weiss, N. [Aachen Resonance, Aachen (Germany); Guenther, R.W. [University Hospital Aachen (Germany). Dept. of Radiology; Krombach, G.A. [University Hospital Giessen (Germany). Dept. of Radiology

    2014-04-15

    Purpose: The success of paclitaxel distribution within the vessel wall during paclitaxel-coated balloon angioplasty to prevent restenosis cannot be monitored under X-ray guidance. The aim of this pilot study was to demonstrate the feasibility of monitoring Gadolinium-BOPTA delivery within the vessel wall during magnetic resonance (MR)-guided paclitaxel/Gadolinium-BOPTA-coated balloon angioplasty of the peripheral arteries. Materials and methods: 6 pigs (47 ± 2 kg) were investigated. All experiments were performed using a 3 Tesla MR scanner. MR-guided bilaterial angioplasty of the iliac arteries was performed using a paclitaxel/MR contrast agent-coated balloon catheter. The feasibility of monitoring the delivery of Gadolinium-BOPTA to the vessel was assessed in 4 animals. In two additional animals, bilateral stenosis was surgically induced in the iliac arteries. Delivery of paclitaxel to the vessel wall was monitored using a 3 D T1-weighted gradient echo (GE) sequence for delineation of the vessel wall. Normalized signal intensity (SI) of the vessel wall was measured before and repeatedly after the intervention for 45 min. in all animals. Results: Paclitaxel/gadolinium-BOPTA-coated balloon angioplasty was successfully accomplished in all iliac arteries (n = 12). In animals with stenosis MR-angiography demonstrated successful dilatation (n = 4). The normalized SI of the vessel wall on T1-weighted GE images significantly increased after the intervention in all animals with and without stenosis for more than 45 min. (p < 0.001). Conclusion: Monitoring of Gadolinium-BOPTA into the vessel wall during MR-guided coated balloon angioplasty is feasible. This is a first step towards providing a tool for the online control of homogenous drug delivery after paclitaxel-coated balloon angioplasty. (orig.)

  5. Central venous catheters and catheter locks in children with cancer

    DEFF Research Database (Denmark)

    Handrup, Mette Møller; Møller, Jens Kjølseth; Schrøder, Henrik

    2013-01-01

    To determine if the catheter lock taurolidine can reduce the number of catheter-related bloodstream infections (CRBSI) in pediatric cancer patients with tunneled central venous catheters (CVC).......To determine if the catheter lock taurolidine can reduce the number of catheter-related bloodstream infections (CRBSI) in pediatric cancer patients with tunneled central venous catheters (CVC)....

  6. Suprapubic catheter care

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000145.htm Suprapubic catheter care To use the sharing features on this page, please enable JavaScript. A suprapubic catheter (tube) drains urine from your bladder. It is ...

  7. Central venous catheter - flushing

    Science.gov (United States)

    ... of your catheter and what company made it. Write this information down and keep it handy. To flush your catheter, you will need: Clean paper towels Saline syringes (clear), and maybe heparin syringes ( ...

  8. Suprapubic catheter change resulting in terminal ileal perforation

    Directory of Open Access Journals (Sweden)

    Chih-Peng Chang

    2014-06-01

    Full Text Available Suprapubic cystostomy is commonly performed in patients with neurogenic bladder or bladder outlet obstruction. The most serious complication is bowel injury, which usually occurs during catheter insertion. Bowel perforation during suprapubic catheter exchange is rare. We herein report an extremely rare case of terminal ileal perforation resulting from a change of suprapubic catheter. After insertion of the suprapubic catheter, a feculent material was noted in the terminal ileum. A cystography revealed that the contrast medium passed directly into the terminal ileum and colon. A computed tomographic scan confirmed the presence of a balloon tip in the terminal ileum. Terminal ileum perforation was diagnosed. Emergent laparotomy and loop ileostomy were performed. The patient's recovery was uneventful.

  9. Análise estrutural da laringofaringe e suas implicações na miotomia do cricofaríngeo, na injeção de toxina botulínica e na dilatação por balão Laryngopharyngeal structural analysis and its morphofunctional correlation with cricopharyngeal myotomy, botulinum toxin injection and balloon dilation

    Directory of Open Access Journals (Sweden)

    Milton Melciades Barbosa Costa

    2003-06-01

    positivamente para a melhoria do fluxo faringoesofágico por diminuição da resistência local. A eficiência deste procedimento será dependente da existência de alguma força de ejeção e elevação hiolaríngea. O fascículo transverso do músculo cricofaríngeo é fitado, de pequena espessura, para ser infiltrado por via transcutânea com a toxina botulínica. Talvez por via endoscópica, à semelhança das miotomias, o indicado seria desnervar somente o fascículo transverso do músculo cricofaríngeo. Neste contexto dose, diluição e pontos de infiltração assumem importante papel no uso terapêutico desta neurotoxina em nível do cricofaríngeo. A dilatação por balão pneumático da transição faringoesofágica não parece ser procedimento adequado para região que não apresente estenose fibrótica a ser rompida. Em razão das características anatômicas da transição faringoesofágica, a pressão média de repouso, como registrada pelo método manométrico, não avalia adequadamente a ineficiência ou efetividade da miotomia, da desnervação ou do resultado da dilatação por balão pneumático.BACKGROUND: The cricopharyngeal muscle is of the skeletal type and, in this way, unable to sustain continuous contraction for long periods. Despite of this it has been considered as the responsible by the high pressure area, registered by manometry into the pharyngoesophageal transition. For this reason, it has been the object of therapeutics that promote the rupture of its integrity. AIMS: To give the anatomical bases to define the limits of participation of the cricopharyngeal muscle in the pharyngoesophageal transition function. To consider a morphological and functional alternative to explain the high pressure area on pharyngoesophageal transition and the implications of the myotomy, use of the botulinum toxin and balloon dilatation on pharyngoesophageal transition function. MATERIAL AND METHOD: Study of the laryngopharyngeal region in their morphologic

  10. Incidence of dilated cardiomyopathy

    OpenAIRE

    Abelmann, Walter H.

    1985-01-01

    Full reliable data on the incidence and prevalence of dilated cardiomyopathy are not available. In the United States, at least 0.7% of cardiac deaths are attributable to cardiomyopathy. Dilated cardiomyopathy probably contributes the great majority of these cases. The mortality rate for cardiomyopathy in males is twice that of females, and for blacks it is 2.4 times that of whites. Cardiomyopathy was diagnosed in 0.67% of patients discharged from hospitals in 1979 with diagnoses of disease of...

  11. Percutaneous treatment of extrahepatic bile duct stones assisted by balloon sphincteroplasty and occlusion balloon

    International Nuclear Information System (INIS)

    To describe the technical feasibility and usefulness of extrahepatic biliary stone removal by balloon sphincteroplasty and occlusion balloon pushing. Fifteen patients with extrahepatic bile duct stones were included in this study. Endoscopic stone removal was not successful in 13 patients, and two patients refused the procedure due to endoscopy phobia. At first, all patients underwent percutaneous transhepatic biliary drainage (PTBD). A few days later, through the PTBD route, balloon assisted dilatation for common bile duct (CBD) sphincter was performed, and then the stones were pushed into the duodenum using an 11.5 mm occlusion balloon. Success rate, reason for failure, and complications associated with the procedure were evaluated. Eight patients had one stone, five patients had two stones, and two patients had more than five stones. The procedure was successful in 13 patients (13/15). In 12 of the patients, all stones were removed in the first trial. In one patients, residual stones were discovered on follow-up cholangiography, and were subsequently removed in the second trial. Technical failure occurred in two patients. Both of these patients had severely dilated CBD and multiple stones with various sizes. Ten patients complained of pain in the right upper quadrant and epigastrium of the abdomen immediately following the procedure, but there were no significant procedure-related complications such as bleeding or pancreatitis. Percutaneous extrahepatic biliary stone removal by balloon sphincteroplasty and subsequent stone pushing with occlusion balloon is an effective, safe, and technically feasible procedure which can be used as an alternative method in patients when endoscopic extrahepatic biliary stone removal was not successful

  12. Percutaneous treatment of extrahepatic bile duct stones assisted by balloon sphincteroplasty and occlusion balloon

    Energy Technology Data Exchange (ETDEWEB)

    Park, Yong Sung; Kim, Ji Hyung; Choi, Young Woo; Lee, Tae Hee; Hwang, Cheol Mog; Cho, Young Jun; Kim, Keum Won [Konyang University Hospital, Daejeon (Korea, Republic of)

    2005-12-15

    To describe the technical feasibility and usefulness of extrahepatic biliary stone removal by balloon sphincteroplasty and occlusion balloon pushing. Fifteen patients with extrahepatic bile duct stones were included in this study. Endoscopic stone removal was not successful in 13 patients, and two patients refused the procedure due to endoscopy phobia. At first, all patients underwent percutaneous transhepatic biliary drainage (PTBD). A few days later, through the PTBD route, balloon assisted dilatation for common bile duct (CBD) sphincter was performed, and then the stones were pushed into the duodenum using an 11.5 mm occlusion balloon. Success rate, reason for failure, and complications associated with the procedure were evaluated. Eight patients had one stone, five patients had two stones, and two patients had more than five stones. The procedure was successful in 13 patients (13/15). In 12 of the patients, all stones were removed in the first trial. In one patients, residual stones were discovered on follow-up cholangiography, and were subsequently removed in the second trial. Technical failure occurred in two patients. Both of these patients had severely dilated CBD and multiple stones with various sizes. Ten patients complained of pain in the right upper quadrant and epigastrium of the abdomen immediately following the procedure, but there were no significant procedure-related complications such as bleeding or pancreatitis. Percutaneous extrahepatic biliary stone removal by balloon sphincteroplasty and subsequent stone pushing with occlusion balloon is an effective, safe, and technically feasible procedure which can be used as an alternative method in patients when endoscopic extrahepatic biliary stone removal was not successful.

  13. Treatment of tuberculous bronchostenosis: balloon bronchoplasty

    International Nuclear Information System (INIS)

    The purpose of this study is to evaluate the efficacy of the balloon bronchoplasty in the treatment of the tuberculous bronchostenosis. Balloon bronchoplasty was performed in thirteen patients with stenosis of the left main bronchus (two with combined left upper and lower lobar bronchostenosis) using a inflatable balloon catheter under a fluoroscopic guide. We analysed the changes in the severity of dyspnea and wheezing, serial FEV1/FVC as a parameter of the airflow obstruction, and bronchial diameter and lung volume on chest radiographs. The extent of pulmonary tuberculosis was correlated with the improvement of FEV1/ FVC. There was an improvement of dyspnea in 69% (9/13), decrease of wheezing in 69% (9/13), significant increase of FEV1/FVC in 18% (2/11). The increase of the bronchial diameter and lung volume were seen in 84% (11/13) and 53% (7/13), respectively. The significant increase of FEV1/FVC was seen in 28% (2/7) of the patients with lung involvement of tuberculous less than one third of left upper lobe, whereas there was no increase in those of more than one third. The was no complication except transient leukocytosis, fever and blood-tinged sputum. In conclusion, balloon bronchoplasty is effective in the treatment of medically intractable tuberculous bronchostenosis, and can be considered as an initial method of treatment

  14. Cutting Balloon-Assisted Angioplasty of an Anastomotic Carotid-Brachial Bypass Graft Stenosis: A Case Report

    International Nuclear Information System (INIS)

    Neointimal hyperplasia leads to anastomotic stenosis in bypass grafts. These stenoses are often resistant to conventional balloon dilatation. We present a case of a carotid-brachial bypass graft stenosis, which was treated by a 5-mm cutting balloon angioplasty with a good angiographic and clinical result

  15. Implantation of Hickman catheters

    International Nuclear Information System (INIS)

    Hickmann catheters are used mainly in patients with hematologic diseases, especially lymphatic and myelotic leukemias, and malignant lymphomas. They facilitate the administration of chemotherapeutics, hyperosmolar solutions and other substances with local toxicity as well as frequent taking of blood samples. Usually Hickmann catheters are placed by surgical cutdown on a jugular vein. In lieu of this surgical placement, we recommend the implantation of Hickman catheters by means of interventional radiology techniques. In a period of 13 months 78 Hickman catheters were placed in 67 patients. 37 catheters (=47%) stayed more than one month, 8 catheters (=10%) stayed 5 to 8 months in the central venous system. 26, respectively 6, of these catheters are until now in situ. Lethal or life threatening complications did not occur. There were no infections at the introduction site of the catheter. The main complications were: Pneumothorax without drainage: 3.2%, pneumothorax with drainage: 3.2%, slipping back of the tip of the catheter: 4.8%, thrombosis of the subclavian vein: 3.2%, fluid in the pleural cavity: 1.6%. In correspondance to the literature the complications of Hickman catheter placement by means of interventional radiology are less serious than by means of surgical cutdown. Further advantages are: General anesthesia can be avoided (less strain on severely ill patients, no problems to wean from assisted ventilation in patients with respiratory insufficiency), the smooth curve of the implanted catheter avoids sharp kinking and occlusion of the lumen, very small skin incisions are sufficient (lesser risk of hematomas in patients with thrombopenia), time and cost are reduced in comparison to surgical placement. (orig.)

  16. Single Balloon Enteroscopy-Assisted ERCP Using Rendezvous Technique for Sharp Angulation of Roux-en-Y Limb in a Patient with Bile Duct Stones

    Directory of Open Access Journals (Sweden)

    Takao Itoi

    2009-01-01

    Full Text Available The acute angulation of Roux-en-Y (R-Y limb precludes endoscopic access for endoscopic retrograde cholangiopancreatography (ERCP even using a balloon enteroscopy. Here, we describe a case of successful single balloon enteroscopy (SBE-assisted ERCP using a rendezvous technique in a patient with sharply angulated R-Y limb in a 79-year-old woman who had bile duct stones. Method. At first, a guidewire was passed antegradely through the major papilla after the needle puncture using percutaneous transhepatic biliary drainage technique. A hydrophilic guidewire with an ERCP catheter was antegradely advanced beyond the Roux limb. After a guidewire was firmly grasped by a snare forceps, it was pulled out of the body, resulting that the enteroscope could advance to the papilla. After papillary dilation, complete removal of bile duct stones was achieved without any procedure-related complication. In conclusion, although further study is needed, SBE-assisted ERCP using a rendezvous technique may have a potential for selected patients.

  17. Efeito da L-arginina na neoproliferação intimal e no remodelamento arterial após lesão por balão, em ilíacas de coelhos hipercolesterolêmicos The effect of L-arginine on neointimal proliferation and artery remodeling on an iliac artery lesion caused by a balloon catheter in hypercholesterolemic rabbits

    Directory of Open Access Journals (Sweden)

    José Knopfholz

    2006-10-01

    Full Text Available OBJETIVO: A neoproliferação intimal e o remodelamento têm sido implicados como os maiores fatores causadores de reestenose. O objetivo deste trabalho é estudar a ação da L-arginina por via oral, nesses dois fatores, após lesão por balão, em artérias ilíacas de coelhos hipercolesterolêmicos. MÉTODOS: Foram utilizados dezenove coelhos, que foram divididos em dois grupos: controle (GC e arginina (GA, respectivamente com dezenove e dezessete artérias estudadas. Os animais foram submetidos a lesão por balão de angioplastia, em suas artérias ilíacas, quinze dias após início de dieta hipercolesterolêmica a 2%. A seguir, os animais do GA passaram a receber uma solução de L-arginina, por via oral, na dose de 1 g/kg/dia. Após o sacrifício, no 15º dia após a lesão por balão, procedeu-se a cortes histológicos das artérias, as quais foram coradas e fixadas. Utilizou-se como representativa do desenvolvimento da lesão a razão da área da neoíntima (em mm² pela camada média (em mm². Por sua vez, a razão da área total do vaso em sua porção medial (de maior contato com o balão pela área total do vaso no segmento referencial (de menor contato com o balão foi a definidora do remodelamento. RESULTADOS: A média do espessamento neointimal (NI/M foi de 0,8151±0,2201 no GC e de 0,3296±0,1133 no GA. Não houve diferença entre os tipos de remodelamento entre os dois grupos estudados. CONCLUSÃO: No modelo experimental utilizado, a L-arginina foi capaz de reduzir o espessamento intimal em coelhos hipercolesterolêmicos e não teve ação sobre o remodelamento arterial.OBJECTIVE: It has been implied that neointimal proliferation and remodeling are the major causes of restenosis. The objective of this study is to assess the effect of orally administered L-arginine on these two factors in hypercholesterolemic rabbits that had suffered an injury to their iliac arteries caused by a catheter balloon. METHODS: The study included

  18. Patient with Eating Disorder, Carnitine Deficiency and Dilated Cardiomyopathy.

    Science.gov (United States)

    Fotino, A Domnica; Sherma, A

    2015-01-01

    Dilated cardiomyopathy is characterized by a dilated and poorly functioning left ventricle and can result from several different etiologies including ischemic, infectious, metabolic, toxins, autoimmune processes or nutritional deficiencies. Carnitine deficiency-induced cardiomyopathy (CDIM) is an uncommon cause of dilated cardiomyopathy that can go untreated if not considered. Here, we describe a 30-year-old woman with an eating disorder and recent percutaneous endoscopic gastrotomy (PEG) tube placement for weight loss admitted to the hospital for possible PEG tube infection. Carnitine level was found to be low. Transthoracic echocardiogram (TTE) revealed ejection fraction 15%. Her hospital course was complicated by sepsis from a peripherally inserted central catheter (PICC). She was discharged on a beta-blocker and carnitine supplementation. One month later her cardiac function had normalized. Carnitine deficiency-induced myopathy is an unusual cause of cardiomyopathy and should be considered in adults with decreased oral intake or malabsorption who present with cardiomyopathy. PMID:27159507

  19. [Suprapubic catheter insertion].

    Science.gov (United States)

    Neumann, Eva; Schwentner, Christian

    2016-01-01

    The suprapubic catheter enables a percutaneous drainage of urine. The insertion is made superior of the pubic bone through the abdominal wall into the bladder. It allows a permanent drainage of urine bypassing the urethra. The insertion of a suprapubic catheter requires knowledge and expertise. This paper summarizes the basic background and allows to follow the practical application step by step. PMID:26800072

  20. A prospective randomized comparative study of intra-cervical Foley's catheter insertion versus PGE2 gel for pre-induction cervical ripening

    OpenAIRE

    Manisha M. Laddad; Nitin S. Kshirsagar; Anand V. Karale

    2013-01-01

    Background: The success of induced labor depends on the degree of ripening of cervix. Pharmacological preparations are in widespread use for cervical ripening but are not free from side-effects and complications. Mechanical methods, i.e. the use of Foley catheter balloon, though effective have not gained much popularity because of the fear of infection. Therefore, this study has been conducted to prove the efficacy and safety of extra amniotic Foley catheter balloon and to compare it with int...

  1. Laparoscopic Heller Myotomy for Non-Dilated Esophageal Achalasia in Children with Intraoperative Stepped Dilation Under Image Guidance: Attempting Complete Myotomy.

    Science.gov (United States)

    Miyano, Go; Miyake, Hiromu; Koyama, Mariko; Morita, Keiichi; Kaneshiro, Masakatsu; Nouso, Hiroshi; Yamoto, Masaya; Fukumoto, Koji; Urushihara, Naoto

    2016-05-01

    This study presents a modified surgical approach to laparoscopic myotomy for achalasia using stepped dilation with a Rigiflex balloon and contrast medium under image guidance. A 10-year-old boy with persistent dysphagia and vomiting had ingested only liquids for 3 months, losing >10 kg in body weight. Barium swallow and esophageal manometry diagnosed esophageal achalasia with mild esophageal dilatation. After failed pneumatic dilatation, laparoscopic Heller myotomy with Dor fundoplication was performed. Prior to surgery, a Rigiflex balloon dilator was placed within the esophagus near the diaphragmatic hiatus. A four-port technique was used, and mobilization of the esophagus was limited to the anterior aspect. A 5-cm Heller myotomy was performed, extending another 2 cm onto the anterior gastric wall. During myotomy, the Rigiflex balloon was serially dilated from 30 to 50 mL, and filled with contrast medium under fluoroscopic image guidance in order to maintain appropriate tension on the esophagus to facilitate myotomy, and to confirm adequate myotomy with sufficient release of lower esophageal sphincter by resecting residual circular muscle fibers. Residual circular muscle fibers can be simultaneously visualized under both fluoroscopic image guidance and direct observation through the laparoscope, and they were cut precisely until the residual notch fully disappeared. Dor fundoplication was completed. The operative time was 180 minutes, and oral intake was started after esophagography on postoperative day 1. As of the 12-month follow-up, the patient has not shown any symptoms, and his postoperative course appeared satisfactory. PMID:26845662

  2. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients.

    Directory of Open Access Journals (Sweden)

    Hee Young Cho

    Full Text Available The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation.We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL.Sixty-four patients (46.7% required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1% had placenta previa totalis. The overall success rate was 75% (48/64 for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all p<0.05. The drainage amount over 1 hour was 500 mL (20-1200 mL in the balloon failure group and 60 mL (5-500 mL in the balloon success group (p<0.01.Intrauterine tamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.

  3. Weather Balloon Ascent Rate

    Science.gov (United States)

    Denny, Mark

    2016-05-01

    The physics of a weather balloon is analyzed. The surprising aspect of the motion of these balloons is that they ascend to great altitudes (typically 35 km) at a more or less constant rate. Such behavior is not surprising near the ground—say for a helium-filled party balloon rising from street level to the top of the Empire State building—but it is unexpected for a balloon that rises to altitudes where the air is rarefied. We show from elementary physical laws why the ascent rate is approximately constant.

  4. Commutative dilation theory

    Czech Academy of Sciences Publication Activity Database

    Ambrozie, Calin-Grigore; Müller, Vladimír

    Basel: Springer, 2015 - (Alpay, D.), s. 1093-1124 ISBN 978-3-0348-0666-4 Institutional support: RVO:67985840 Keywords : commuting multioperator * dilation * von Neumann inequality Subject RIV: BA - General Mathematics http://link.springer.com/referenceworkentry/10.1007%2F978-3-0348-0667-1_58

  5. Auditing urinary catheter care.

    Science.gov (United States)

    Dailly, Sue

    Urinary catheters are the main cause of hospital-acquired urinary tract infections among inpatients. Healthcare staff can reduce the risk of patients developing an infection by ensuring they give evidence-based care and by removing the catheter as soon as it is no longer necessary. An audit conducted in a Hampshire hospital demonstrated there was poor documented evidence that best practice was being carried out. Therefore a urinary catheter assessment and monitoring tool was designed to promote best practice and produce clear evidence that care had been provided. PMID:22375340

  6. Dilated cardiomyopathy following trastuzumab chemotherapy

    Directory of Open Access Journals (Sweden)

    Saurabh Karmakar

    2012-01-01

    Cardiotoxicity manifesting as dilated cardiomyopathy is a rarely reported adverse effect of trastuzumab. We hereby report a case of dilated cardiomyopathy, which occurred following trastuzumab chemotherapy in a 32-year-old female. The patient responded to discontinuation of trastuzumab and standard medical treatment. Extensive search of Indian literature revealed no reported case of dilated cardiomyopathy occurring due to trastuzumab.

  7. Bursting water balloons

    CERN Document Server

    Lund, Hugh M

    2011-01-01

    The impact and rupture of water-filled balloons upon a flat, rigid surface is studied experimentally, for which three distinct stages of the flow are observed. Due to the impact, waves are formed on the balloon's surface for which the restoring force is tension in the latex. Immediately following rupture of the membrane, a shear instability created by the retraction of the balloon is observed. At later times, a larger-scale growth of the interfacial amplitude is observed, that may be regarded as a manifestation of a phenomenon known as the Richtmyer-Meshkov instability. This flow is closely related to the classical understanding of the Richtmyer-Meshkov instability for when there exists a density difference between the fluids inside and outside the balloon. Further, it is shown experimentally that this growth of the interface may also occur when there is no density difference across the balloon, a situation that does not arise for the standard Richtmyer-Meshkov instability.

  8. Dilation and Curettage (D&C)

    Science.gov (United States)

    ... For Patients About ACOG Dilation and Curettage (D&C) Home For Patients Search FAQs Dilation and Curettage ( ... February 2016 PDF Format Dilation and Curettage (D&C) Special Procedures What is dilation and curettage (D& ...

  9. Long-term results of graded pneumatic dilatation under endoscopic guidance in patients with primary esophageal achalasia

    Institute of Scientific and Technical Information of China (English)

    Ahmet Dobrucali; Yusuf Erzin; Murat Tuncer; Ahmet Dirican

    2004-01-01

    AIM: Achalasia is the best known primary motor disorder of the esophagus in which the lower esophageal sphincter(LES) has abnormally high resting pressure and incomplete relaxation with swallowing. Pneumatic dilatation remains the first choice of treatment. The aims of this study were to determine the long term clinical outcome of treating achalasia initially with pneumatic dilatation and usefulness of pneumatic dilatation technique under endoscopic observation without fluoroscopy.METHODS: A total of 65 dilatations were performed in 43patients with achalasia [23 males and 20 females, the mean age was 43 years (range, 19-73)]. All patients underwent an initial dilatation by inflating a 30 mm balloon to 15 psi under endoscopic control. The need for subsequent dilatation was based on symptom assessment. A 3.5 cm balloon was used for repeat procedures.RESULTS: The 30 mm balloon achieved a satisfactory result in 24 patients (54%) and the 35 mm ballon in 78% of the remainder (14/18). Esophageal perforation as a short-term complication was observed in one patient (2.3%). The only late complication encountered was gastroesophageal reflux in 2 (4%) patients with a good response to dilatation. The mean follow-up period was 2.4 years (6 mo - 5 years). Of the patients studied, 38 (88%) were relieved of their symptoms after only one or two sessions. Five patients were referred for surgery(one for esophageal perforation and four for persistent or recurrent symptoms). Among the patients whose follow up information was available, the percentage of patients in remission was 79% (19/24) at 1 year and54% (7/13) at 5 years.CONCLUSION: Performing balloon dilatation under endoscopic observation as an outpatient procedure is simple, safe and efficacious for treating patients with achalasia and referral of surgical myotomy should be considered for patients who do not respond to medical therapy or individuals that do not desire pneumatic dilatations.

  10. Balloon Design Software

    Science.gov (United States)

    Farley, Rodger

    2007-01-01

    PlanetaryBalloon Version 5.0 is a software package for the design of meridionally lobed planetary balloons. It operates in a Windows environment, and programming was done in Visual Basic 6. By including the effects of circular lobes with load tapes, skin mass, hoop and meridional stress, and elasticity in the structural elements, a more accurate balloon shape of practical construction can be determined as well as the room-temperature cut pattern for the gore shapes. The computer algorithm is formulated for sizing meridionally lobed balloons for any generalized atmosphere or planet. This also covers zero-pressure, over-pressure, and super-pressure balloons. Low circumferential loads with meridionally reinforced load tapes will produce shapes close to what are known as the "natural shape." The software allows for the design of constant angle, constant radius, or constant hoop stress balloons. It uses the desired payload capacity for given atmospheric conditions and determines the required volume, allowing users to design exactly to their requirements. The formulations are generalized to use any lift gas (or mixture of gases), any atmosphere, or any planet as described by the local acceleration of gravity. PlanetaryBalloon software has a comprehensive user manual that covers features ranging from, but not limited to, buoyancy and super-pressure, convenient design equations, shape formulation, and orthotropic stress/strain.

  11. The usefulness of a perfusion balloon in a case of late stent thrombosis that caused simultaneous double vessel occlusion.

    Science.gov (United States)

    Nakabayashi, Keisuke; Okada, Hisayuki; Asano, Ryotaro; Nakazawa, Naomi; Nomura, Hidekimi; Oka, Toshiaki

    2016-07-01

    Simultaneous stent thrombosis in different coronary arteries requires rapid management. A 70-year-old man experienced simultaneous stent thrombosis at the left anterior descending and circumflex arteries. We used a perfusion balloon to prevent thrombus production at the left anterior descending artery, and completed percutaneous coronary intervention at the left circumflex artery in 10 min. The perfusion balloon was dilated during the procedure. In both vessels, Thrombolysis in myocardial infarction flow grade 3 was achieved after balloon deflation. Thus, use of a perfusion balloon for simultaneous double vessel occlusion helped avoid the need for redundant stent placement and shortened the procedure time. PMID:25971225

  12. Early development of bacterial community diversity in emergently placed urinary catheters

    Directory of Open Access Journals (Sweden)

    Foxman Betsy

    2012-06-01

    Full Text Available Abstract Background Approximately 25% of hospitalized patients have a urinary catheter, and catheter associated urinary tract infection is the most common nosocomial infection in the US, causing >1 million cases/year. However, the natural history of the biofilms that rapidly form on urinary catheters and lead to infection is not well described. Findings We characterized the dynamics of catheter colonization among catheters collected from 3 women and 5 men in a trauma burn unit with different indwelling times using TRFLP and culture. All patients received antibiotic therapy. Results: Colony-forming units increased along the extraluminal catheter surface from the catheter balloon to the urethra, but no trend was apparent for the intraluminal surface. This suggests extraluminal bacteria come from periurethral communities while intraluminal bacteria are introduced via the catheter or already inhabit the urine/bladder. Richness of operational taxonomic units (OTUs increased over time on the intraluminal surface, but was constant extraluminally. Conclusions OTU community composition was explained best by time rather than axial location or surface. Our results suggest that catheter colonization can be very dynamic, and possibly have a predictable succession.

  13. Preparatory catheter-directed thrombolysis together with assisted endovascular angioplasty for the treatment of chronic occlusive arterial disorders of lower extremities

    International Nuclear Information System (INIS)

    Objective: To evaluate the safety and efficacy of preparatory catheter-directed thrombolysis together with assisted endovascular angioplasty in treating chronic occlusive arterial disorders of lower extremities. Methods: From January 2008 to December 2009, preparatory catheter-directed thrombolysis together with assisted endovascular angioplasty was performed in 12 patients with chronic occlusive arterial disorders of lower extremities, including 8 males and 4 females with an average age of 56.3 years (within a range of 38-71 years). All 12 patients had a history of chronic ischemia of lower limb,the mean ill duration was 19.3 months (3-48 months). All patients complained of intermittent claudication with a mean distance of 125 m (50-200 m). Rest pain occurred in 5 patients (42%), toe necrosis was seen in 3 patients (25%) and critically ischemic limb in 4 patients (33%). Ankle-brachial index (ABI) was 0.00 0.65 with a mean of 0.33. In all 12 patients catheter-directed thrombolysis with rt-PA or urokinase was initially carried out, which was followed by endovascular angioplasty (balloon dilatation or stent placement) in two days. The clinical data and the therapeutic results were analyzed. Results: Technical success was achieved in all 12 patients. The mean time of thrombolysis was 48 hours. Of 12 patients, rt-PA was employed in 4 and urokinase in 8. The occluded length of the diseased arteries before the treatment was 60-150 mm, with a mean of 80 mm. After catheter-directed thrombolysis,the occluded length decreased to 10-50 mm (mean of 30 mm). Endovascular angioplasty was successfully completed in all patients after thrombolysis therapy. Postoperative ABI was 0.64-1.0 (mean of 0.86), which was increased by 0.53 when compared to the preoperative figure. During the perioperative period neither complications needed to be surgically treated nor death occurred. All patients were followed up, and the arteries remained open after one year in all cases. Conclusion

  14. The Descending Helium Balloon

    Science.gov (United States)

    Helseth, Lars Egil

    2014-01-01

    I describe a simple and fascinating experiment wherein helium leaks out of a rubber balloon, thereby causing it to descend. An estimate of the volumetric leakage rate is made by measuring its rate of descent.

  15. Framings and dilations

    OpenAIRE

    Larson, David R.; Szafraniec, Franciszek Hugon

    2013-01-01

    The notion of framings, recently emerging in P. G. Casazza, D. Han, and D. R. Larson, Frames for Banach spaces, in {\\em The functional and harmonic analysis of wavelets and frames} (San Antonio, TX, 1999), {\\em Contemp. Math}. {\\bf 247} (1999), 149-182 as generalization of the reconstraction formula generated by pairs of dual frames, is in this note extended substantially. This calls on refining the basic dilation results which still being in the flavor of {\\em th\\'eor\\`eme principal} of B. S...

  16. Percutaneous dilatational tracheostomy

    DEFF Research Database (Denmark)

    Johnsen, R.

    2015-01-01

    Introduction Since the introduction and development of percutaneous dilatational tracheostomy (PDT), this procedure is accepted and incorporated in ICUs worldwide. In spite of obvious benefits for the patients, who obtain more comfort and mobility and less use of sedatives, the procedure also...... implies the risk of several complications, some of which may be lethal. Severe complications include hemorrhage, displacement and pneumothorax. Different methods of PDT are described in the literature, each with disadvantages and benefits. The aim of this study was to analyze complications due to PDTs...

  17. Resistive ballooning mode equation

    Energy Technology Data Exchange (ETDEWEB)

    Bateman, G.; Nelson, D. B.

    1978-10-01

    A second-order ordinary differential equation on each flux surface is derived for the high mode number limit of resistive MHD ballooning modes in tokamaks with arbitrary cross section, aspect ratio, and shear. The equation is structurally similar to that used to study ideal MHD ballooning modes computationally. The model used in this paper indicates that all tokamak plasmas are unstable, with growth rate proportional to resistivity when the pressure gradient is less than the critical value needed for ideal MHD stability.

  18. Navigation for fluoroscopy-guided cryo-balloon ablation procedures of atrial fibrillation

    Science.gov (United States)

    Bourier, Felix; Brost, Alexander; Kleinoeder, Andreas; Kurzendorfer, Tanja; Koch, Martin; Kiraly, Attila; Schneider, Hans-Juergen; Hornegger, Joachim; Strobel, Norbert; Kurzidim, Klaus

    2012-02-01

    Atrial fibrillation (AFib), the most common arrhythmia, has been identified as a major cause of stroke. The current standard in interventional treatment of AFib is the pulmonary vein isolation (PVI). PVI is guided by fluoroscopy or non-fluoroscopic electro-anatomic mapping systems (EAMS). Either classic point-to-point radio-frequency (RF)- catheter ablation or so-called single-shot-devices like cryo-balloons are used to achieve electrically isolation of the pulmonary veins and the left atrium (LA). Fluoroscopy-based systems render overlay images from pre-operative 3-D data sets which are then merged with fluoroscopic imaging, thereby adding detailed 3-D information to conventional fluoroscopy. EAMS provide tracking and visualization of RF catheters by means of electro-magnetic tracking. Unfortunately, current navigation systems, fluoroscopy-based or EAMS, do not provide tools to localize and visualize single shot devices like cryo-balloon catheters in 3-D. We present a prototype software for fluoroscopy-guided ablation procedures that is capable of superimposing 3-D datasets as well as reconstructing cyro-balloon catheters in 3-D. The 3-D cyro-balloon reconstruction was evaluated on 9 clinical data sets, yielded a reprojected 2-D error of 1.72 mm +/- 1.02 mm.

  19. A comparison of two methods to measure coronary flow reserve in the setting of coronary angioplasty: intracoronary blood flow velocity measurements with a Doppler catheter, and digital subtraction cineangiography

    NARCIS (Netherlands)

    P.W.J.C. Serruys (Patrick); F. Zijlstra (Felix); G-J. Laarman (GertJan); J.H.C. Reiber (Johan); K.J. Beatt (Kevin); J.R.T.C. Roelandt (Jos)

    1989-01-01

    textabstractIntracoronary blood flow velocity measurements with a Doppler balloon catheter and the radiographic assessment of myocardial perfusion with contrast media, before and after the intracoronary administration of papaverine, have previously been used to investigate regional coronary flow res

  20. Simultaneous stent expansion/balloon deflation technique to salvage failed balloon remodeling.

    Science.gov (United States)

    Ladner, Travis R; He, Lucy; Davis, Brandon J; Froehler, Michael T; Mocco, J

    2016-04-01

    Herniation, with possible embolization, of coils into the parent vessel following aneurysm coiling remains a frequent challenge. For this reason, balloon or stent assisted embolization remains an important technique. Despite the use of balloon remodeling, there are occasions where, on deflation of the balloon, some coils, or even the entire coil mass, may migrate. We report the successful use of a simultaneous adjacent stent deployment bailout technique in order to salvage coil prolapse during balloon remodeling in three patients. Case No 1 was a wide neck left internal carotid artery bifurcation aneurysm, measuring 9 mm×7.9 mm×6 mm with a 5 mm neck. Case No 2 was a complex left superior hypophyseal artery aneurysm, measuring 5.3 mm×4 mm×5 mm with a 2.9 mm neck. Case No 3 was a ruptured right posterior communicating artery aneurysm, measuring 4 mm×4 mm×4.5 mm with a 4 mm neck. This technique successfully returned the prolapsed coil mass into the aneurysm sac in all cases without procedural complications. The closed cell design of the Enterprise VRD (Codman and Shurtleff Inc, Raynham, Massachusetts, USA) makes it ideal for this bailout technique, by allowing the use of an 0.021 inch delivery catheter (necessary for simultaneous access) and by avoiding the possibility of an open cell strut getting caught on the deflated balloon. We hope this technique will prove useful to readers who may find themselves in a similar predicament. PMID:25801773

  1. Bootstrapping Time Dilation Decoherence

    Science.gov (United States)

    Gooding, Cisco; Unruh, William G.

    2015-10-01

    We present a general relativistic model of a spherical shell of matter with a perfect fluid on its surface coupled to an internal oscillator, which generalizes a model recently introduced by the authors to construct a self-gravitating interferometer (Gooding and Unruh in Phys Rev D 90:044071, 2014). The internal oscillator evolution is defined with respect to the local proper time of the shell, allowing the oscillator to serve as a local clock that ticks differently depending on the shell's position and momentum. A Hamiltonian reduction is performed on the system, and an approximate quantum description is given to the reduced phase space. If we focus only on the external dynamics, we must trace out the clock degree of freedom, and this results in a form of intrinsic decoherence that shares some features with a proposed "universal" decoherence mechanism attributed to gravitational time dilation (Pikovski et al in Nat Phys, 2015). We note that the proposed decoherence remains present in the (gravity-free) limit of flat spacetime, emphasizing that the effect can be attributed entirely to proper time differences, and thus is not necessarily related to gravity. Whereas the effect described in (Pikovski et al in Nat Phys, 2015) vanishes in the absence of an external gravitational field, our approach bootstraps the gravitational contribution to the time dilation decoherence by including self-interaction, yielding a fundamentally gravitational intrinsic decoherence effect.

  2. Brain Abscess after Esophageal Dilatation

    DEFF Research Database (Denmark)

    Gaïni, S; Grand, M; Michelsen, J

    2007-01-01

    Brain abscess formation is a serious disease often seen as a complication to other diseases and to procedures. A rare predisposing condition is dilatation therapy of esophageal strictures. A case of brain abscess formation after esophageal dilatations is presented. A 59-year-old woman was admitted...... with malaise, progressive lethargy, fever, aphasia and hemiparesis. Six days before she had been treated with esophageal dilatation for a stricture caused by accidental ingestion of caustic soda. The brain abscess was treated with surgery and antibiotics. She recovered completely. This clinical case...... illustrates the possible association between therapeutic esophageal dilatation and the risk of brain abscess formation....

  3. Inability to pass a urethral catheter: the bedside role of the flexible cystoscope.

    Science.gov (United States)

    Beaghler, M; Grasso, M; Loisides, P

    1994-08-01

    An all too common cause of urologic consultation is the inability to place a urethral catheter. Often other health care providers have unsuccessfully attempted catheter placement. Urethral false passages, perforations, and edema are common sequelae. Diseases such as urethral strictures, bladder neck contractures, and prostate cancer are often the underlying etiologies for failed catheterization. Traditionally, the use of filiforms and followers or the placement of a suprapubic tube is required to drain the lower urinary tract. Bedside flexible endoscopy was performed in this series not only to define the area and etiology of urethral obstruction, but also to facilitate catheter placement. Fifty-four patients were studied prospectively. Initial endoscopic assessment was based on bedside flexible cystoscopy. Most procedures were performed under topical lidocaine anesthetic. Under direct vision a 0.038 inch standard guide wire was directed through the area or areas of obstruction. Strictures, fibrosis, and false passages were dilated using a series of graduated Nottingham dilators over the guide wire. A Council-tipped urethral catheter was then placed over the guide wire to assure bladder drainage. In 52 of the 54 patients urethral obstructions were dilated and drainage catheters were placed into the bladder. No complications were encountered. This technique is simple, it avoids suprapubic puncture, and it minimizes unneeded trips to the operating room. PMID:8048205

  4. Balloon brachytherapy: how I do it

    International Nuclear Information System (INIS)

    To describe the technical aspects of insertion of MammoSite Radiation System, cosmetic issues, patients selection for the procedure and their satisfaction. Seventy patients underwent brachytherapy after insertion of the MammoSite catheter and received a boost HDR totaling 1500 cGy in six fractions over a three day period. Each patient then received 5 weeks of external beam radiotherapy to the whole breast. Only T1-2 patients were treated. All patients had excellent cosmetic results. The complications (minimal skin erythema, hematoma, balloon leak, seroma, were minimal. The safety and effectiveness of the MammoSite Radiation Therapy System as a replacement for whole breast irradiation in the treatment of breast cancer has not yet been established. (author)

  5. Cephalic arch stenosis in autogenous brachiocephalic hemodialysis fistulas: results of cutting balloon angioplasty

    DEFF Research Database (Denmark)

    Heerwagen, Søren Thorup; Lönn, Lars; Schroeder, Torben V; Hansen, Marc Allan

    2010-01-01

    Cephalic arch stenosis is a known cause of hemodialysis access failure in patients with brachiocephalic fistulas (BCFs). Outcomes of endovascular treatment are affected by resistance of the stenosis to balloon dilation, a high vein rupture rate and the development of early restenosis. The purpose...

  6. Roentgenoendovascular dilatation of brachycephalic arteries

    International Nuclear Information System (INIS)

    The authors reported the technique, methods of and indications for roentgenoendovascular dilation in stenotic and occlusive lesions of the brachycephalic branches of the aorta. A total of 102 vascular dilations were perfomed in 76 patients resulting in a good angiographic and clinical effect. In 2 patients the first world prosthetics was performed using an original coiled nitinol prosthesis

  7. FAST WATERSHED-BASED DILATION

    OpenAIRE

    Jakub Smołka

    2014-01-01

    A watershed-based region growing image segmentation algorithm requires a fast watershed-based dilation implementation for effective operation. This paper presents a new way for watershed image representation and uses this representation for effective implementation of dilation. Methods for improving the algorithm speed are discussed. Presented solutions may also be used for solving other problems where fast set summation is required.

  8. Catheter-related bloodstream infection.

    Science.gov (United States)

    Goede, Matthew R; Coopersmith, Craig M

    2009-04-01

    Catheter-related bloodstream infections (CR-BSIs) are a common, frequently preventable complication of central venous catheterization. CR-BSIs can be prevented by strict attention to insertion and maintenance of central venous catheters and removing unneeded catheters as soon as possible. Antiseptic- or antibiotic-impregnated catheters are also an effective tool to prevent infections. The diagnosis of CR-BSI is made largely based on culture results. CR-BSIs should always be treated with antibiotics, and except in rare circumstances the infected catheter needs to be removed. PMID:19281894

  9. Universal stratospheric balloon gradiometer

    Science.gov (United States)

    Tsvetkov, Yury; Filippov, Sergey; Brekhov, Oleg; Nikolaev, Nikolay

    The study of the interior structure of the Earth and laws of its evolution is one of the most difficult problems of natural science. Among the geophysical fields the anomaly magnetic field is one of the most informational in questions of the Earth’s crust structure. Many important parameters of an environment are expedient for measuring at lower altitudes, than satellite ones. So, one of the alternatives is stratospheric balloon survey. The balloon flight altitudes cover the range from 20 to 50 km. At such altitudes there are steady zone air flows due to which the balloon flight trajectories can be of any direction, including round-the-world (round-the-pole). For investigation of Earth's magnetic field one of the examples of such sounding system have been designed, developed and maintained at IZMIRAN and MAI during already about 25 years. This system consists of three instrumental containers uniformly placed along a vertical 6 km line. Up today this set has been used only for geomagnetic purposes. So we describe this system on example of the measuring of the geomagnetic field gradient. System allows measuring a module and vertical gradient of the geomagnetic field along the whole flight trajectory and so one’s name is - stratospheric balloon magnetic gradiometer (SMBG). The GPS-receivers, located in each instrumental container, fix the flight coordinates to within several tens meters. Process of SBMG deployment, feature of the exit of rope from the magazine at the moment of balloon launching has been studied. Used magazine is cellular type. The hodograph of the measuring base of SBMG and the technique of correction of the deviations of the measuring base from the vertical line (introduction of the amendments for the deviation) during the flight have been investigated. It is shown that estimation of the normal level of values of the vertical gradient of the geomagnetic field is determined by the accuracy of determining the length of the measuring base SBMG

  10. Venus Altitude Cycling Balloon Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The ISTAR Group ( IG) and team mate Thin Red Line Aerospace (TRLA) propose a Venus altitude cycling balloon (Venus ACB), an innovative superpressure balloon...

  11. Mars Solar Balloon Lander Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The Mars Solar Balloon Lander (MSBL) is a novel concept which utilizes the capability of solar-heated hot air balloons to perform soft landings of scientific...

  12. JACEE long duration balloon flights

    International Nuclear Information System (INIS)

    JACEE balloon-borne emulsion chamber detectors are used to observe the spectra and interactions of cosmic ray protons and nuclei in the energy range 1-100A TeV. Experience with long duration mid-latitude balloon flights and characteristics of the detector system that make it ideal for planned Antarctic balloon flights are discussed. 5 refs., 2 figs

  13. Application of Mitomycin C after dilation of an anastomotic stricture in a newborn with necrotizing enterocolitis

    Directory of Open Access Journals (Sweden)

    Jonathan Green

    2016-01-01

    Full Text Available Necrotizing enterocolitis (NEC is a common life-threatening condition in premature infants. Bacterial translocation, localized inflammation and subsequent perforation often require surgery for source control and definitive treatment. Small and large intestinal strictures may result from either creation of a surgical anastomosis or the disease process itself. Current methods to treat strictures include, balloon dilation and surgical resection with or without anastomosis. We report the diagnosis and surgical management of a premature infant treated for NEC, who developed an anastomotic stricture and was successfully treated with topical Mitomycin C after balloon stricturoplasty.

  14. Dilated uropathies in children

    International Nuclear Information System (INIS)

    These uropathies are frequent in children and are often diagnosed by ante-natal ultrasound examination. The dilatation, hydronephrosis or uretero-hydro-nephrosis may be due to a large pattern of malformations, either anatomical dysplasia, vesico-ureteric reflux or obstruction of the pelvi-ureteric junction, of the vesical-ureteric junction or due to a chronic urethral obstruction. The investigations must determine the exact urinary tract abnormalities, the renal function and the uro-dynamic change. They are guided by the ultrasound findings and cystography. In obstructive malformation, the MAG3 renogram with furosemide test is the best way to precise the uro-dynamic status, but it requires a careful technique in children and its interpretation is sometimes equivocal. DMSA scan is very useful to give precise separate kidney function and to follow the maturational change with age. All the results must be carefully analysed ; the final therapeutic decision and specially surgery is dependent of the type of uropathy and its natural history. In many cases, surgical treatment is only indicated after a longer follow-up and repeated evaluations. (authors). 11 refs., 2 figs

  15. Bootstrapping Time Dilation Decoherence

    CERN Document Server

    Gooding, Cisco

    2015-01-01

    We present a general relativistic model of a spherical shell of matter with a perfect fluid on its surface coupled to an internal oscillator, which generalizes a model recently introduced by the authors to construct a self-gravitating interferometer [1]. The internal oscillator evolution is defined with respect to the local proper time of the shell, allowing the oscillator to serve as a local clock that ticks differently depending on the shell's position and momentum. A Hamiltonian reduction is performed on the system, and an approximate quantum description is given to the reduced phase space. If we focus only on the external dynamics, we must trace out the clock degree of freedom, and this results in a form of intrinsic decoherence that shares some features with a proposed "universal" decoherence mechanism attributed to gravitational time dilation [2]. We show that the proposed decoherence remains present in the (gravity-free) limit of flat spacetime, indicating that the effect can be attributed entirely to ...

  16. Comments on ideal ballooning

    International Nuclear Information System (INIS)

    Ideal ballooning modes are investigated for the case of plane magnetized slab geometry. Toroidal effects are simulated by a gravitational acceleration periodically varying along magnetic field lines. High shear is shown to be very effective in stabilizing these modes even when field line curvature is most unfavorable to their stability

  17. Vessel dilatation in coronary angiograms

    International Nuclear Information System (INIS)

    Amongst 166 patients with aneurysms, ectasia or megaloarteries shown on coronary angiograms, 86.1% had dilated vessels as part of generalised coronary sclerosis (usually in patients with three-vessel disease). In 9%, dilatation was of iatrogenic origin and in 4.8% it was idiopathic. One patient had Marfan's syndrome. Amongst 9 000 patients, there were eight with megalo-arteries without stenosis; six of these had atypical angina and three suffered an infarct. Patients with definite dilatation of the coronary artery and stagnation of contrast flow required treatment. (orig.)

  18. Vessel dilatation in coronary angiograms

    Energy Technology Data Exchange (ETDEWEB)

    Hinterauer, L.; Goebel, N.

    1983-11-01

    Amongst 166 patients with aneurysms, ectasia or megaloarteries shown on coronary angiograms, 86.1% had dilated vessels as part of generalised coronary sclerosis (usually in patients with three-vessel disease). In 9%, dilatation was of iatrogenic origin and in 4.8% it was idiopathic. One patient had Marfan's syndrome. Amongst 9 000 patients, there were eight with megalo-arteries without stenosis; six of these had atypical angina and three suffered an infarct. Patients with definite dilatation of the coronary artery and stagnation of contrast flow required treatment.

  19. Percutaneous Balloon Angioplasty for Severe Native Aortic Coarctation in Young Infants Less Than 6 Months: Medium- to Long-term Follow-up

    Science.gov (United States)

    He, Lan; Liu, Fang; Wu, Lin; Qi, Chun-Hua; Zhang, Li-Feng; Huang, Guo-Ying

    2015-01-01

    Background: Although balloon angioplasty (BA) has been performed for more than 20 years, its use as a treatment for native coarctation of the aorta (CoA) during childhood, especially in young infants, remains controversial. This study aimed to assess the effects and potential role of percutaneous transcatheter BA for native CoA as an alternative therapy to surgical repair in young infants. Methods: The 37 patients aged from 6 days to 6 months with severe CoA in congestive heart failure or circulatory shock were admitted for BA. Patient's weight ranged from 2.4 to 6.1 kg. All 37 patients were experiencing cardiac dysfunction, and eight patients were in cardiac shock with severe metabolic acidosis. Eleven patients had an isolated CoA, whereas the others had a CoA associated with other cardiac malformations. Cardiac catheterization and aortic angiography were performed under general anesthesia with intubation. Transfemoral arterial approaches were used for the BA. The size of the balloon ranged from 3 mm × 20 mm to 8 mm × 20 mm, and a coronary artery balloon catheter was preferred over a regular peripheral vascular balloon catheter. Results: The femoral artery was successfully punctured in all but one patient, with that patient undergoing a carotid artery puncture. The systolic peak pressure gradient (PG) across the coarctation was 41.0 ± 16.0 mmHg (range 13–76 mmHg). The mean diameter of the narrowest coarctation site was 1.7 ± 0.6 mm (range 0.5–2.8 mm). All patients had successful dilation; the PG significantly decreased to 13.0 ± 11.0 mmHg (range 0–40 mmHg), and the diameter of coarctation significantly improved to 3.8 ± 0.9 mm (range 2.5–5.3 mm). No intraoperative complications occurred for any patients. However, in one case that underwent a carotid artery puncture, a giant aneurysm formed at the puncture site and required surgical repair. The following observations were made during the follow-up period from 6-month to 7-year: (1) The PG across the

  20. Percutaneous Balloon Angioplasty for Severe Native Aortic Coarctation in Young Infants Less Than 6 Months: Medium-to Long-term Follow-up

    Institute of Scientific and Technical Information of China (English)

    Lan He; Fang Liu; Lin Wu; Chun-Hua Qi; Li-Feng Zhang; Guo-Ying Huang

    2015-01-01

    Background:Although balloon angioplasty (BA) has been performed for more than 20 years,its use as a treatment for native coarctation of the aorta (CoA) during childhood,especially in young infants,remains controversial.This study aimed to assess the effects and potential role of percutaneous transcatheter BA for native CoA as an alternative therapy to surgical repair in young infants.Methods:The 37 patients aged from 6 days to 6 months with severe CoA in congestive heart failure or circulatory shock were admitted for BA.Patient's weight ranged from 2.4 to 6.1 kg.All 37 patients were experiencing cardiac dysfunction,and eight patients were in cardiac shock with severe metabolic acidosis.Eleven patients had an isolated CoA,whereas the others had a CoA associated with other cardiac malformations.Cardiac catheterization and aortic angiography were performed under general anesthesia with intubation.Transfemoral arterial approaches were used for the BA.The size of the balloon ranged from 3 mm × 20 mm to 8 mm × 20 mm,and a coronary artery balloon catheter was preferred over a regular peripheral vascular balloon catheter.Results:The femoral artery was successfully punctured in all but one patient,with that patient undergoing a carotid artery puncture.The systolic peak pressure gradient (PG) across the coarctation was 41.0 ± 16.0 mmHg (range 13-76 mmHg).The mean diameter of the narrowest coarctation site was 1.7 ± 0.6 mm (range 0.5-2.8 mm).All patients had successful dilation;the PG significantly decreased to 13.0 ± 1 1.0 mmHg (range 0-40 mmHg),and the diameter of coarctation significantly improved to 3.8 ± 0.9 mm (range 2.5-5.3 mm).No intraoperative complications occurred for any patients.However,in one case that underwent a carotid artery puncture,a giant aneurysm formed at the puncture site and required surgical repair.The following observations were made during the follow-up period from 6-month to 7-year:(1) The PG across the coarctation measured by

  1. Intravascular ultrasound imaging following balloon angioplasty.

    Science.gov (United States)

    Tobis, J M; Mahon, D J; Moriuchi, M; Honye, J; McRae, M

    1991-01-01

    Despite its long history and reliability, contrast angiography has several inherent limitations. Because it is a two-dimensional projection image of the lumen contour, the wall thickness cannot be measured and the plaque itself is not visualized. This results in an underestimation of the amount of atherosclerotic disease by angiography. An assessment of atherosclerosis could be improved by an imaging modality: (1) that has an inherent larger magnification than angiography and (2) that directly visualizes the plaque. Intravascular ultrasound fulfils these criteria. This presentation will provide evidence that intravascular ultrasound may prove complimentary or even superior to angiography as an imaging modality. Intravascular ultrasound demonstrates excellent representations of lumen and plaque morphology of in vitro specimens compared with histology. There is very close intraobserver and interobserver variability of measurements made from intravascular ultrasound images. Phantom studies of stenoses in a tube model demonstrate that angiography can misrepresent the severity of stenosis when the lumen contour is irregular and not a typical ellipse, whereas intravascular ultrasound reproduces the cross-sectional morphology more accurately since it images the artery from within. In vitro studies of the atherosclerotic plaque tissue characteristics compare closely with the echo representation of fibrosis, calcification, and lipid material. In addition, in vitro studies of balloon angioplasty demonstrate that intravascular ultrasound accurately represents the changes in the structure of artery segments following balloon dilatation. PMID:1833473

  2. Dilatancy in Slow Granular Flows

    Science.gov (United States)

    Kabla, Alexandre J.; Senden, Tim J.

    2009-06-01

    When walking on wet sand, each footstep leaves behind a temporarily dry impression. This counterintuitive observation is the most common illustration of the Reynolds principle of dilatancy: that is, a granular packing tends to expand as it is deformed, therefore increasing the amount of porous space. Although widely called upon in areas such as soil mechanics and geotechnics, a deeper understanding of this principle is constrained by the lack of analytical tools to study this behavior. Using x-ray radiography, we track a broad variety of granular flow profiles and quantify their intrinsic dilatancy behavior. These measurements frame Reynolds dilatancy as a kinematic process. Closer inspection demonstrates, however, the practical importance of flow induced compaction which competes with dilatancy, leading more complex flow properties than expected.

  3. Multisensory signalling enhances pupil dilation

    OpenAIRE

    Silvia Rigato; Gerulf Rieger; Vincenzo Romei

    2016-01-01

    Detecting and integrating information across the senses is an advantageous mechanism to efficiently respond to the environment. In this study, a simple auditory-visual detection task was employed to test whether pupil dilation, generally associated with successful target detection, could be used as a reliable measure for studying multisensory integration processing in humans. We recorded reaction times and pupil dilation in response to a series of visual and auditory stimuli, which were prese...

  4. Radiologic placement of Hickman catheters

    International Nuclear Information System (INIS)

    Hickman catheter inserter has previously been predominantly accomplished surgically by means of venous cutdown or percutaneous placement in the operating room. The authors describe their method and results for 55 consecutive percutaneous placements of Hickman catheters in the interventional radiology suite. Complication rates were comparable to those for surgical techniques. Radiologic placement resulted in increased convenience, decreased time and cost of insertion, and super fluoroscopic control of catheter placement and any special manipulations. Modern angiographic materials provide safer access to the subclavian vein than traditional methods. The authors conclude that radiologic placement of Hickman catheters offers significant advantages over traditional surgical placement

  5. Allograft Pancreatic Duct Dilatation Following Bladder Drained Simultaneous Pancreas-Kidney Transplantation: Clinical Significance

    Directory of Open Access Journals (Sweden)

    Ciancio G

    2000-05-01

    Full Text Available OBJECTIVE: Radiologic imaging of the allograft pancreatic duct dilatation is an uncommon multifactorial finding that is not well described. The purpose of this investigation is to determine the clinical correlation of this finding. DESIGN: Retrospective study. SETTING: University Hospital, USA. SUBJECTS: One hundred forty five simultaneous pancreas-kidney transplants have been performed for treatment of type I diabetes mellitus and end-stage renal disease between February 1993 and December 1999 at the University of Miami. MAIN OUTCOME MEASURES: In 5 recipients, the pancreatic duct was noted to be dilated by ultrasound 1-18 months post-transplant. RESULTS: In all 5 recipients a Foley catheter was placed as the first line of treatment. This reduced the size of the pancreatic duct in one patient, who presented with normal serum amylase and lipase and hyperglycemia. A pancreas biopsy done with Foley catheter in place showed fibrosis with no evidence of rejection. Four patients with dilated pancreatic duct presented with increased serum amylase and lipase; however improvement of the pancreatic duct dilatation was seen only after anti-rejection therapy. One of the patients developed recurrence of pancreatic duct dilatation and a video-urodynamic study subsequently demonstrated voiding with abdominal straining and no detrusor activity. He ultimately underwent enteric conversion with resolution of pancreatic duct dilatation. CONCLUSIONS: This infrequent complication of dilated transplant pancreatic duct could be multifactorial. It could suggest the diagnosis of reflux pancreatitis, which should resolve with bladder decompression. In fact, 1 patient presented with reflux pancreatitis caused by external sphincter detrusor pseudodyssynergia. However, this ultrasound finding may also be associated with pancreas rejection (4/5 patients.

  6. NOS inhibition blunts and delays the compensatory dilation in hypoperfused contracting human muscles

    OpenAIRE

    Casey, Darren P.; Joyner, Michael J.

    2009-01-01

    We previously demonstrated that skeletal muscle blood flow is restored in the exercising forearm during experimental hypoperfusion via local dilator and/or myogenic mechanisms. This study examined the role of nitric oxide (NO) in the restoration of blood flow to the active muscles during hypoperfusion. Eleven healthy subjects (10 men/1 woman; 25 ± 1 yr of age) performed rhythmic forearm exercise (10% and 20% of maximum) while hypoperfusion was evoked by balloon inflation in the brachial arter...

  7. A Case of a Senile Systemic Amyloidosis Patient Presenting With Angina Pectoris and Dilated Cardiomyopathy

    OpenAIRE

    Kang, Gu Hyun; Ryu, Dong Ryeol; Song, Pil Sang; Song, Young Bin; Hahn, Joo-Yong; Choi, Seung-Hyuck; Gwon, Hyeon-Cheol

    2011-01-01

    A 77-year-old man visited our hospital complaining of aggravated exertional chest pain. He was diagnosed with syndrome X 7 years ago and underwent medical treatment in a regional hospital. Coronary angiography and echocardiography did not show any significant abnormalities. On the seventh in-hospital day, cardiogenic shock developed and echocardiography showed a dilated left ventricular (LV) cavity and severe LV systolic dysfunction. We thus inserted an intra-aortic balloon pump for hemodynam...

  8. Obesity and gastric balloon

    Directory of Open Access Journals (Sweden)

    Mohammed I Yasawy

    2014-01-01

    Full Text Available Background: The obesity epidemic, which is among the most common nutritional disorders, is rising rapidly worldwide. It leads to several health problems such as metabolic disorders, stroke, and even cancer. Efforts to control obesity with exercise and diet have a limited value in obese patients and different approaches to do this have been tried. In this paper, we share our experience with bioenteric intragastric balloon (BIB in treating obesity: Its safety, tolerability, and its efficacy in weight reduction. Materials and Methods: From January 2009 to September 2012, a total of 190 gastric balloons was inserted on patients at the endoscopy unit in King Fahd Hospital of the University, Al-Khobar. This is an evaluation of the first 100 patients. All the patients had a body mass index of over 30 kg/m 2 and were within the age range of 17-55 with a mean age of 32 years. After consent, preballoon investigation tests and anesthesia evaluation, BIB was inserted under monitored anesthesia care sedation in the endoscopy suite. The balloon was filled with 500-700 mls of stained saline. All patients′ were given an analgesic and antiemetic for a week and antisecretory proton pump inhibitor′s for 6 months. Diet and the importance of the exercise were part of the preballoon insertion phase and protocol. The balloon was removed after 6-12 months. Results: The weight loss response to BIB in the 100 patients are classified into four groups: In the uncooperative, noncompliant patients - the maximum weight loss was 7 kg, while in the most compliant patients the weight loss reached up to 39 kg. In addition, there was significant improvement into diabetes mellitus, hypertension, dyslipidemia, and fatty liveras. Its safety and tolerability were extremely acceptable. Conclusion: Our data indicates that in well-selected patients, BIB is an effective device, which with minimum complications helps to achieve body weight loss and resolve many obesity related

  9. Obesity and gastric balloon

    OpenAIRE

    Yasawy, Mohammed I; Al-Quorain, Abdulaziz A.; Anas M Hussameddin; Yasawy, Zakia M.; Al-Sulaiman, Raid M.

    2014-01-01

    Background: The obesity epidemic, which is among the most common nutritional disorders, is rising rapidly worldwide. It leads to several health problems such as metabolic disorders, stroke, and even cancer. Efforts to control obesity with exercise and diet have a limited value in obese patients and different approaches to do this have been tried. In this paper, we share our experience with bioenteric intragastric balloon (BIB) in treating obesity: Its safety, tolerability, and its efficacy in...

  10. Clad ballooning model in MELCOR

    International Nuclear Information System (INIS)

    Clad ballooning may substantially decrease the flow of fluids through the affected core region and may expose the inner cladding surface to oxidation in the vicinity of rupture sites. The cladding ballooning model was not included in MELCOR 1.8.4. and consideration of incorporating the cladding ballooning model is scheduled as a post-1.8.4 release activity. The purpose of this paper is to analyze the effect of the clad ballooning model by the modified MELCOR 1.8.4 with this model. The typical accident sequence of a large LOCA scenario is selected. The clad ballooning model accelerates the accident progression compared to that without the ballooning model. The amount of hydrogen does not change much and it may be caused by ignoring the effect of flow area change. Future study is planning to analyze the flow redistribution

  11. Severity of dilated cardiomyopathy (DCM)

    International Nuclear Information System (INIS)

    In order to assess the severity of dilated cardiomyopathy, thallium scan was performed in 60 cases. In 16 of all, serial thallium scan was performed in the periods of average 26 months. In these cases, extension of perfusion defect was observed from apical to inferoposterior regions. Therefore, we classified dilated cardiomyopathy into three groups by thallium scan; (I) dilated left ventricular type (n = 16), (II) apical hypoperfusion type (n = 12), (III) inferoposterior perfusion defect type (n = 32). These groups were correlated with hemodynamic findings. All patients had also cardiac catheterization and gated blood pool scan. As results, group III had high incidence of right ventricular and lung thallium uptake and patchy pattern compared to other groups. Group III had also high incidence of dyspnoea on exertion, S3 and ECG abnormalities. In hemodynamics, end-diastolic ventricular volume index and end-systolic ventricular volume index increased and, right ventricular ejection fraction and left ventricular ejection fraction decreased according to the severity of dilated cardiomyopathy from group I to III. In addition, the incidence of mitral regurgitation and dyskinesis was observed highly in group III. In conclusion, perfusion defect was frequently demonstrated in dilated cardiomyopathy without coronary artery stenosis. And right and left ventricular function was depressed according to the extension of perfusion defect. (author)

  12. Breakthrough in Mars balloon technology

    Science.gov (United States)

    Kerzhanovich, V. V.; Cutts, J. A.; Cooper, H. W.; Hall, J. L.; McDonald, B. A.; Pauken, M. T.; White, C. V.; Yavrouian, A. H.; Castano, A.; Cathey, H. M.; Fairbrother, D. A.; Smith, I. S.; Shreves, C. M.; Lachenmeier, T.; Rainwater, E.; Smith, M.

    2004-01-01

    Two prototypes of Mars superpressure balloons were flight tested for aerial deployment and inflation in the Earth's stratosphere in June, 2002. One was an 11.3 m diameter by 6.8 m high pumpkin balloon constructed from polyethylene film and Zylon (PBO) tendons, the second was a 10 m diameter spherical balloon constructed from 12 μm thick Mylar film. Aerial deployment and inflation occurred under parachute descent at 34 km altitude, mimicing the dynamic pressure environment expected during an actual Mars balloon mission. Two on-board video cameras were used on each flight to provide real-time upward and downward views of the flight train. Atmospheric pressure and temperature were also recorded. Both prototypes successfully deployed from their storage container during parachute descent at approximately 40 m/s. The pumpkin balloon also successfully inflated with a 440 g charge of helium gas injected over a 1.5-min period. Since the helium inflation system was deliberately retained after inflation in this test, the pumpkin balloon continued to fall to the ocean where it was recovered for post-flight analysis. The less robust spherical balloon achieved only a partial (~70%) inflation before a structural failure occurred in the balloon film resulting in the loss of the vehicle. This structural failure was diagnosed to result from the vigorous oscillatory motion of the partially inflated balloon, possibly compounded by contact between the balloon film and an instrumentation box above it on the flight train. These two flights together represent significant progress in the development of Mars superpressure balloon technology and pave the way for future flight tests that will include post-deployment flight of the prototype balloons at a stable altitude.

  13. Titan Balloon Convection Model Project

    Data.gov (United States)

    National Aeronautics and Space Administration — This innovative research effort is directed at determining, quantitatively, the convective heat transfer coefficients applicable to a Montgolfiere balloon operating...

  14. Dilatation effect of ''quantum clocks''

    International Nuclear Information System (INIS)

    The relativistic dilatation effect of the life-time of unstable microparticles combined with quantum symmetry of their description results in the ''quantum-dilatation'' dilemma. It is due to the classical character of the relativity theory which here reveals itself in the classical world-line of the clock necessary in order to deduce the dilatation effect from the Lorentz transformation. It is shown how to solve this dilemma, basing on the relation continuum C4. Two types of measurements of time intervals, the direct and indirect one, are analyzed. The former type corresponds to the external space-time continuum, where any direct measurement takes place, and the latter, to the internal relation continuum C4, where the internal structures of isolated micro-systems are sunk. (author)

  15. Fluid dynamics of dilatant fluid

    DEFF Research Database (Denmark)

    Nakanishi, Hiizu; Nagahiro, Shin-ichiro; Mitarai, Namiko

    2012-01-01

    of the state variable, we demonstrate that the model can describe basic features of the dilatant fluid such as the stress-shear rate curve that represents discontinuous severe shear thickening, hysteresis upon changing shear rate, and instantaneous hardening upon external impact. An analysis of the......A dense mixture of granules and liquid often shows a severe shear thickening and is called a dilatant fluid. We construct a fluid dynamics model for the dilatant fluid by introducing a phenomenological state variable for a local state of dispersed particles. With simple assumptions for an equation...... model reveals that the shear thickening fluid shows an instability in a shear flow for some regime and exhibits the shear thickening oscillation (i.e., the oscillatory shear flow alternating between the thickened and the relaxed states). The results of numerical simulations are presented for one- and...

  16. Mechanical Thrombectomy of Iliac Vein Thrombosis in a Pig Model Using the Rotarex and Aspirex Catheters

    Energy Technology Data Exchange (ETDEWEB)

    Minko, P., E-mail: peterminko@yahoo.com; Bücker, A. [University Hospital Homburg/Saar, Department of Diagnostic and Interventional Radiology (Germany); Laschke, M.; Menger, M. [University Hospital Homburg/Saar, Institute of Clinical and Experimental Surgery (Germany); Bohle, R. [University Hospital Homburg/Saar, Department of Pathology (Germany); Katoh, M. [University Hospital Homburg/Saar, Department of Diagnostic and Interventional Radiology (Germany)

    2013-06-08

    PurposeTo investigate the efficacy and safety of mechanical thrombectomy for iliac vein thrombosis using Rotarex and Aspirex catheters in a pig model.Materials and MethodsIliac vein thrombosis was induced in six pigs by means of an occlusion-balloon catheter and thrombin injection. The presence of thrombi was verified by digital subtraction angiography (DSA) and computed tomography (CT). Thrombectomy was performed using 6F and 8F Rotarex and 6F, 8F, and 10F Aspirex catheters (Straub Medical AG, Wangs, Switzerland). After intervention, DSA and CT were repeated to evaluate the efficacy of mechanical thrombectomy and to exclude local complications. In addition, pulmonary CT was performed to rule out pulmonary embolism. Finally, all pigs were killed, and iliac veins were dissected to perform macroscopic and histological examination.ResultsThrombus induction was successfully achieved in all animals as verified by DSA and CT. Subsequent thrombectomy lead to incomplete recanalization of the iliac veins with residual thrombi in all cases. However, the use of the 6F and 8F Rotarex catheters caused vessel perforation and retroperitoneal hemorrhage in all cases. Application of the Aspirex device caused one small transmural perforation in a vessel treated with a 10F Aspirex catheter, and this was only seen microscopically. Pulmonary embolism was detected in one animal treated with the Rotarex catheters, whereas no pulmonary emboli were seen in animals treated with the Aspirex catheters.ConclusionThe Aspirex catheter allowed subtotal and safe recanalization of iliac vein thrombosis. In contrast, the use of the Rotarex catheter caused macroscopically obvious vessel perforations in all cases.

  17. Mechanical Thrombectomy of Iliac Vein Thrombosis in a Pig Model Using the Rotarex and Aspirex Catheters

    International Nuclear Information System (INIS)

    PurposeTo investigate the efficacy and safety of mechanical thrombectomy for iliac vein thrombosis using Rotarex and Aspirex catheters in a pig model.Materials and MethodsIliac vein thrombosis was induced in six pigs by means of an occlusion-balloon catheter and thrombin injection. The presence of thrombi was verified by digital subtraction angiography (DSA) and computed tomography (CT). Thrombectomy was performed using 6F and 8F Rotarex and 6F, 8F, and 10F Aspirex catheters (Straub Medical AG, Wangs, Switzerland). After intervention, DSA and CT were repeated to evaluate the efficacy of mechanical thrombectomy and to exclude local complications. In addition, pulmonary CT was performed to rule out pulmonary embolism. Finally, all pigs were killed, and iliac veins were dissected to perform macroscopic and histological examination.ResultsThrombus induction was successfully achieved in all animals as verified by DSA and CT. Subsequent thrombectomy lead to incomplete recanalization of the iliac veins with residual thrombi in all cases. However, the use of the 6F and 8F Rotarex catheters caused vessel perforation and retroperitoneal hemorrhage in all cases. Application of the Aspirex device caused one small transmural perforation in a vessel treated with a 10F Aspirex catheter, and this was only seen microscopically. Pulmonary embolism was detected in one animal treated with the Rotarex catheters, whereas no pulmonary emboli were seen in animals treated with the Aspirex catheters.ConclusionThe Aspirex catheter allowed subtotal and safe recanalization of iliac vein thrombosis. In contrast, the use of the Rotarex catheter caused macroscopically obvious vessel perforations in all cases

  18. Percutaneous gastrostomy performed by radiologists using balloon replacement tubes. A simple interventional technique for the placement of nutritional catheters without endoscopy or surgery; Perkutane Gastrostomie mit Ballon-PEG-Ersatzsonden durch den Radiologen. Eine interventionelle Technik zur einfachen Einlage von Ernaehrungskathetern ohne chirurgischen oder endoskopischen Eingriff

    Energy Technology Data Exchange (ETDEWEB)

    Dinkel, H.P.; Triller, J. [Bern Univ. (Switzerland). Inst. fuer Diagnostische Radiologie

    2001-06-01

    Patients afflicted with stenotic head and neck or esophageal tumors often require artificial enteral feeding. Frequently passage of an endoscope through the esophagus is impossible in these patients. Interventional, fluoroscopically assisted, percutaneous gastrostomy (PG) by balloon replacement tubes is a feasible and successful alternative to percutaneous endoscopic gastrostomy (PEG) and the method of choice in patients where the esophagus cannot be passed with an endoscope anymore. Technical success rate is very high and serious complications are rare. Radiological PG is a feasible, equivalent alternative to PEG also in all other patients. We recommend PG with balloon gastrostomy tubes in conjunction with gastropexy performed with three to four T-fasteners, which are left in place for seven days in order to prevent dislocation and leakage. (orig.) [German] Patienten mit HNO-Tumoren oder malignen Oesophagusstenosen muessen oft mit einem gastroenteralen Stoma versorgt werden. Haeufig sind die Tumoren so stenosierend, dass eine perkutane endoskopische Gastrostomie (PEG) nicht mehr moeglich ist und eine chirurgische Gastrostomie durchgefuehrt wird. Wir berichten ueber die radiologisch-perkutane Gastrostomie (PG). Die perkutane Gastrostomie ist Methode der Wahl bei stark stenosierenden oesophagealen Prozessen. Auch bei anderen Patienten (ohne Passagehindernis) stellt die PG eine gleichwertige Alternative zur PEG dar. Die Erfolgsrate der PG liegt nahe 100%, Komplikationen sind selten. Wir empfehlen Ballon-arretierte Sonden (sog. Ballonersatzsonden) in Verbindung mit der perkutanen Gastropexie mit 3-4 Fadenzugankern, die fuer etwa 7 Tage belassen werden. (orig.)

  19. Stingray balloon used in slender percutaneous coronary intervention for chronic total occlusion.

    Science.gov (United States)

    Wu, Eugene B; Ikari, Yuji

    2013-07-01

    Slender chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using 5 Fr radial Ikari catheter is possible in simple CTO cases. We report a case where we initially thought the LAD CTO was short and easy, but we found that the CTO had a considerable amount of calcium and also some tortuosity, making simple wire crossing impossible. We used a Stingray balloon to perform re-entry by tracking the balloon over an Ultimate Bros 3 gram wire using an extension wire. We successfully punctured into true lumen and completed stenting through a slender 5 Fr system. This case demonstrates the beauty of combining the advances in CTO PCI from the East and the West together and also demonstrates the possibility of using the Stingray system in a 5 Fr guiding catheter. PMID:23813075

  20. Influence of catheter insertion on the hemodynamic environment in coronary arteries.

    Science.gov (United States)

    Tian, Xiaopeng; Sun, Anqiang; Liu, Xiao; Pu, Fang; Deng, Xiaoyan; Kang, Hongyan; Fan, Yubo

    2016-09-01

    Intravascular stenting is one of the most commonly used treatments to restore the vascular lumen and flow conditions, while perioperative complications such as thrombosis and restenosis are still nagging for patients. As the catheter with crimped stent and folded balloon is directly advanced through coronary artery during surgery, it is destined to cause interference as well as obstructive effect on blood flow. We wonder how the hemodynamic environment would be disturbed and weather these disturbances cause susceptible factors for those complications. Therefore, a realistic three-dimensional model of left coronary artery was reconstructed and blood flow patterns were numerically simulated at seven different stages in the catheter insertion process. The results revealed that the wall shear stress (WSS) and velocity in left anterior descending (LAD) were both significantly increased after catheter inserted into LAD. Besides, the WSS on the catheter, especially at the ending of the catheter, was also at high level. Compared with the condition before catheter inserted, the endothelial cells of LAD was exposed to high-WSS condition and the risk of platelet aggregation in blood flow was increased. These influences may make coronary arteries more vulnerable for perioperative complications. PMID:27394085

  1. Nationwide Eclipse Ballooning Project

    Science.gov (United States)

    Colman Des Jardins, Angela; Berk Knighton, W.; Larimer, Randal; Mayer-Gawlik, Shane; Fowler, Jennifer; Harmon, Christina; Koehler, Christopher; Guzik, Gregory; Flaten, James; Nolby, Caitlin; Granger, Douglas; Stewart, Michael

    2016-05-01

    The purpose of the Nationwide Eclipse Ballooning Project is to make the most of the 2017 rare eclipse event in four main areas: public engagement, workforce development, partnership development, and science. The Project is focused on two efforts, both student-led: online live video of the eclipse from the edge of space and the study of the atmospheric response to the eclipse. These efforts, however, involving more than 60 teams across the US, are challenging in many ways. Therefore, the Project is leveraging the NASA Space Grant and NOAA atmospheric science communities to make it a success. The first and primary topic of this poster is the NASA Space Grant supported online live video effort. College and high school students on 48 teams from 31 states will conduct high altitude balloon flights from 15-20 locations across the 8/21/2017 total eclipse path, sending live video and images from near space to a national website. Video and images of a total solar eclipse from near space are fascinating and rare. It’s never been done live and certainly not in a network of coverage across a continent. In addition to the live video to the web, these teams are engaged in several other science experiments as secondary payloads. We also briefly highlight the eclipse atmospheric science effort, where about a dozen teams will launch over one hundred radiosondes from across the 2017 path, recording an unprecedented atmospheric data sample. Collected data will include temperature, density, wind, humidity, and ozone measurements.

  2. What Is a Comprehensive Dilated Eye Exam?

    Science.gov (United States)

    ... su oculista What is a comprehensive dilated eye exam? Listen You may think your eyes are healthy, ... eye care professional for a comprehensive dilated eye exam is the only way to really be sure. ...

  3. An Endovascular Approach to the Entrapped Central Venous Catheter After Cardiac Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Desai, Shamit S., E-mail: shamit.desai@northwestern.edu [Northwestern Memorial Hospital, Department of Radiology (United States); Konanur, Meghana [Northwestern University Feinberg School of Medicine (United States); Foltz, Gretchen [Mallinckrodt Institute of Radiology at Washington University, Interventional Radiology (United States); Malaisrie, S. Chris [Northwestern Memorial Hospital, Department of Cardiothoracic Surgery (United States); Resnick, Scott, E-mail: sresnick@northwestern.edu [Northwestern University Feinberg School of Medicine, Department of Radiology, Interventional Radiology, Northwestern Memorial Hospital (United States)

    2016-03-15

    PurposeEntrapment of central venous catheters (CVC) at the superior vena cava (SVC) cardiopulmonary bypass cannulation site by closing purse-string sutures is a rare complication of cardiac surgery. Historically, resternotomy has been required for suture release. An endovascular catheter release approach was developed.Materials and MethodsFour cases of CVC tethering against the SVC wall and associated resistance to removal, suggestive of entrapment, were encountered. In each case, catheter removal was achieved using a reverse catheter fluoroscopically guided over the suture fixation point between catheter and SVC wall, followed by the placement of a guidewire through the catheter. The guidewire was snared and externalized to create a through-and-through access with the apex of the loop around the suture. A snare placed from the femoral venous access provided concurrent downward traction on the distal CVC during suture release maneuvers.ResultsIn the initial attempt, gentle traction freed the CVC, which fractured and was removed in two sections. In the subsequent three cases, traction alone did not release the CVC. Therefore, a cutting balloon was introduced over the guidewire and inflated. Gentle back-and-forth motion of the cutting balloon atherotomes successfully incised the suture in all three attempts. No significant postprocedural complications were encountered. During all cases, a cardiovascular surgeon was present in the interventional suite and prepared for emergent resternotomy, if necessary.ConclusionAn endovascular algorithm to the “entrapped CVC” is proposed, which likely reduces risks posed by resternotomy to cardiac surgery patients in the post-operative period.

  4. An Endovascular Approach to the Entrapped Central Venous Catheter After Cardiac Surgery

    International Nuclear Information System (INIS)

    PurposeEntrapment of central venous catheters (CVC) at the superior vena cava (SVC) cardiopulmonary bypass cannulation site by closing purse-string sutures is a rare complication of cardiac surgery. Historically, resternotomy has been required for suture release. An endovascular catheter release approach was developed.Materials and MethodsFour cases of CVC tethering against the SVC wall and associated resistance to removal, suggestive of entrapment, were encountered. In each case, catheter removal was achieved using a reverse catheter fluoroscopically guided over the suture fixation point between catheter and SVC wall, followed by the placement of a guidewire through the catheter. The guidewire was snared and externalized to create a through-and-through access with the apex of the loop around the suture. A snare placed from the femoral venous access provided concurrent downward traction on the distal CVC during suture release maneuvers.ResultsIn the initial attempt, gentle traction freed the CVC, which fractured and was removed in two sections. In the subsequent three cases, traction alone did not release the CVC. Therefore, a cutting balloon was introduced over the guidewire and inflated. Gentle back-and-forth motion of the cutting balloon atherotomes successfully incised the suture in all three attempts. No significant postprocedural complications were encountered. During all cases, a cardiovascular surgeon was present in the interventional suite and prepared for emergent resternotomy, if necessary.ConclusionAn endovascular algorithm to the “entrapped CVC” is proposed, which likely reduces risks posed by resternotomy to cardiac surgery patients in the post-operative period

  5. Unital Dilations of Completely Positive Semigroups

    OpenAIRE

    Gaebler, David J.

    2013-01-01

    Dilations of completely positive semigroups to endomorphism semigroups have been studied by numerous authors. Most existing dilation theorems involve a non-unital embedding, corresponding to the embedding of $B(H)$ as a corner of $B(K)$ for Hilbert spaces $H \\subset K$. A 1986 paper of Jean-Luc Sauvageot shows how to achieve a unital dilation, but does not specify how to do so while also preserving continuity properties of the original semigroup. This thesis further develops Sauvageot's dilat...

  6. Delayed bowel perforation following suprapubic catheter insertion

    OpenAIRE

    Mehta Ajay; Ahmed Shwan J; Rimington Peter

    2004-01-01

    Abstract Background Complications of suprapubic catheter insertion are rare but can be significant. We describe an unusual complication of a delayed bowel perforation following suprapubic catheter insertion. Case presentation A gentleman presented with features of peritonitis and feculent discharge along a suprapubic catheter two months after insertion of the catheter. Conclusion Bowel perforation is the most feared complication of suprapubic catheter insertion especially in patients with low...

  7. Hydrodynamics of catheter biofilm formation

    CERN Document Server

    Sotolongo-Costa, Oscar; Rodriguez-Perez, Daniel; Martinez-Escobar, Sergio; Fernandez-Barbero, Antonio

    2009-01-01

    A hydrodynamic model is proposed to describe one of the most critical problems in intensive medical care units: the formation of biofilms inside central venous catheters. The incorporation of approximate solutions for the flow-limited diffusion equation leads to the conclusion that biofilms grow on the internal catheter wall due to the counter-stream diffusion of blood through a very thin layer close to the wall. This biological deposition is the first necessary step for the subsequent bacteria colonization.

  8. Oversampling of wavelet frames for real dilations

    DEFF Research Database (Denmark)

    Bownik, Marcin; Lemvig, Jakob

    2012-01-01

    We generalize the Second Oversampling Theorem for wavelet frames and dual wavelet frames from the setting of integer dilations to real dilations. We also study the relationship between dilation matrix oversampling of semi-orthogonal Parseval wavelet frames and the additional shift invariance gain...

  9. Symptomatic severe tricuspid insufficiency as a late complication of pulmonary balloon valvuloplasty.

    Science.gov (United States)

    Rohn, V; Slais, M; Vondráček, V

    2010-01-01

    The authors describe an unusual case of a young adult patient with symptomatic tricuspid valve insufficiency as a late consequence of pulmonary valve balloon dilatation in childhood. Patient was successfully treated by tricuspid valve repair with neo-chordae implantation and a ring plasty. Two years after the operation the patient, an active sportsman, is asymptomatic with trace tricuspid regurgitation on the echo examination. PMID:20946724

  10. Stone extraction balloon-guided repeat self-expanding metal stent placement

    Institute of Scientific and Technical Information of China (English)

    Hyung; Hun; Kim; Jeong; Seop; Moon; Soo; Hyung; Ryu; Jung; Hwan; Lee; You; Sun; Kim

    2010-01-01

    Self-expanding metal stent (SEMS) placement offers safe and effective palliation in patients with upper gastrointestinal obstruction due to a malignancy. Well described complications of SEMS placement include tumor growth, obstruction, and stent migration. SEMS occlusions are treated by SEMS redeployment, argon plasma coagulation application, balloon dilation, and surgical bypass. At our center, we usually place the second SEMS into the first SEMS if there is complete occlusion by the tumor. We discovered a...

  11. Pulmonary valve regurgitation following balloon valvuloplasty for pulmonary valve stenosis: Single center experience

    Directory of Open Access Journals (Sweden)

    Asim Yousuf Al Balushi

    2013-01-01

    Full Text Available Background: Pulmonary valve regurgitation following balloon valvuloplasty for moderate to severe pulmonary valve stenosis is a known late outcome of this procedure. Objective: The aim of the study was to characterise the status of pulmonary regurgitation on follow up after pulmonary valve balloon dilatation (PVBD, and to study the determinant of the severity of PR. Materials and Methods: We retrospectively reviewed 50 consecutive patients, aged 2 days to 18 years, with isolated pulmonary valve stenosis, who had undergone PVBD in 2004-2009 and were assessed with follow-up Doppler echocardiography. The impact of balloon to annulus ratio, age, and valve anatomy on the late development of moderate and severe pulmonary valve regurgitation following balloon valvuloplasty was analysed. Results: Six patients (12% had no pulmonary valve regurgitation; 32 (64% had mild, 9 (18% had moderate, and 3 (6% had severe pulmonary valve regurgitation at a mean follow-up of 4 years. Balloon to annulus ratio, age, and valve anatomy were not statistically significant predictors for moderate and severe pulmonary valve regurgitation. Conclusions: The majority of patients in our population had mild pulmonary valve regurgitation. Moderate to severe pulmonary valve regurgitation was well tolerated at midterm follow-up. Age, balloon to annulus ratio, and valve anatomy were not statistically significant predictors for the late development of moderate and severe valve regurgitation. Large and longer follow-up studies are needed to address this question.

  12. Multisensory signalling enhances pupil dilation.

    Science.gov (United States)

    Rigato, Silvia; Rieger, Gerulf; Romei, Vincenzo

    2016-01-01

    Detecting and integrating information across the senses is an advantageous mechanism to efficiently respond to the environment. In this study, a simple auditory-visual detection task was employed to test whether pupil dilation, generally associated with successful target detection, could be used as a reliable measure for studying multisensory integration processing in humans. We recorded reaction times and pupil dilation in response to a series of visual and auditory stimuli, which were presented either alone or in combination. The results indicated faster reaction times and larger pupil diameter to the presentation of combined auditory and visual stimuli than the same stimuli when presented in isolation. Moreover, the responses to the multisensory condition exceeded the linear summation of the responses obtained in each unimodal condition. Importantly, faster reaction times corresponded to larger pupil dilation, suggesting that also the latter can be a reliable measure of multisensory processes. This study will serve as a foundation for the investigation of auditory-visual integration in populations where simple reaction times cannot be collected, such as developmental and clinical populations. PMID:27189316

  13. Placement of an implantable port catheter in the biliary stent: an experimental study in dogs

    International Nuclear Information System (INIS)

    To investigate the feasibility of port catheter placement following a biliary stent placement. We employed 14 mongrel dogs as test subject and after the puncture of their gaIl bladders using sonographic guidance, a 10-mm in diameter metallic stent was placed at the common duct. In 12 dogs, a 6.3 F port catheter was placed into the duodenum through the common duct and a port was secured at the subcutaneous space following stent placement. As a control group, an 8.5 F drain tube was placed into the gallbladder without port catheter placement in the remaining two dogs. Irrigation of the bile duct was performed every week by injection of saline into the port, and the port catheter was replaced three weeks later in two dogs. Information relating to the success of the procedure, complications and the five-week follow-up cholangiographic findings were obtained. Placement of a biliary stent and a port catheter was technically successful in 13 (93%) dogs, while stent migration (n=3), gallbladder rupture (n=1) and death (n=5) due to subcutaneous abscess and peritonitis also occurred. The follow-up was achieved in eight dogs (seven dogs with a port catheter placement and one dog with a drain tube placement). Irrigation of the bile duct and port catheter replacement were successfully achieved without any complications. Cholangiograms obtained five weeks after stent placement showed diffuse biliary dilation with granulation tissue formation. However, focal biliary stricture was seen in one dog with stent placement alone. Placement of a port catheter following biliary stent placement seems to be feasible. However, further investigation is necessary to reduce the current complications

  14. New ferromagnetic catheters for MR imaging

    International Nuclear Information System (INIS)

    Newly developed ferromagnetic catheters are more conspicuous than conventional radiographic catheters on MR images because they produce characteristic ferromagnetic signal patterns (FSPs). The authors systematically imaged ferromagnetic catheters (ferromagnetic concentration, 0.1--1.0 weight/weight%) in phantoms at 0.38 T and 1.5 T and compared their appearance with that of three radiographic catheters. The radiographic catheters always produced a signal void. The ferromagnetic catheters produced FSPs when perpendicular to the magnetic field, and the FSPs depended on the ferromagnetic concentration, strength of the main magnetic field, and the direction and strength of the frequency-encoding gradient. The ferromagnetic catheters produced no FSP when parallel to the magnetic field. Ferromagnetic catheters produce conspicuous FSPs on MR images, which depend on catheter position and the MR imaging parameters selected

  15. Intracorporeal knotting of a femoral nerve catheter

    Directory of Open Access Journals (Sweden)

    Ghanem, Mohamed

    2015-01-01

    Full Text Available Peripheral nerve catheters are effective and well-established tools to provide postoperative analgesia to patients undergoing orthopedic surgery. The performance of these techniques is usually considered safe. However, placement of nerve catheters may be associated with a considerable number of side effects and major complications have repeatedly been published. In this work, we report on a patient who underwent total knee replacement with spinal anesthesia and preoperative insertion of femoral and sciatic nerve catheters for postoperative analgesia. During insertion of the femoral catheter, significant resistance was encountered upon retracting the catheter. This occurred due to knotting of the catheter. The catheter had to be removed by operative intervention which has to be considered a major complication. The postoperative course was uneventful. The principles for removal of entrapped peripheral catheters are not well established, may differ from those for neuroaxial catheters, and range from cautious manipulation up to surgical intervention.

  16. US Air Force Balloon Observations

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Worksheets containing pilot balloon data computed from releases at Air Force stations in the western United States. Elevation and azimuth angles are used to compute...

  17. [Balloon valvuloplasty in stenotic bioprosthesis].

    Science.gov (United States)

    Astudillo, R; Farell, J; Ariza, H; González Carmona, V M; Abundes, A; Tello, R; López Cuellar, M

    1992-01-01

    The results of balloon valvuloplasty performed on five patients with stenotic bioprosthesis treated in the Hospital de Cardiología Centro Médico Nacional Siglo XXI, are presented. All five bioprosthesis were right sided, two in tricuspid position, one in pulmonary valve position and two in valvulated conduits from right ventricle to pulmonary artery. In all cases a pressure gradient reduction was achieved, an improvement of clinical functional class and heart failure manifestations were obtained. Mansfields balloons were used. One in two patients, and two balloons in three. We had not complications with the procedure. We conclude that balloon valvuloplasty on bioprosthesis is a safe and dependable procedure to be used in right sided bioprosthesis. PMID:1482221

  18. Superpressure Tow Balloon for Extending Durations and Modifying Trajectories of High Altitude Balloon Systems Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The proposed innovation involves the concept of using a Superpressure Tow Balloon (STB) with existing NASA high altitude balloon designs to form a tandem balloon...

  19. Upregulation of basement membrane-degrading metalloproteinase secretion after balloon injury of pig carotid arteries.

    Science.gov (United States)

    Southgate, K M; Fisher, M; Banning, A P; Thurston, V J; Baker, A H; Fabunmi, R P; Groves, P H; Davies, M; Newby, A C

    1996-12-01

    Basement membrane-degrading metalloproteinases (gelatinases) appear necessary for vascular smooth muscle cell migration and proliferation in culture and for intimal migration of cells after balloon injury to the rat carotid artery. We investigated in the present study the secretion of gelatinases from pig carotid artery tissue after balloon injury. Segments of injured artery and segments proximal and distal to the area of injury were removed 3, 7, and 21 days after balloon dilatation. Medial explants from these segments were then cultured for 3 days, and the serum-free conditioned media were subjected to gelatin zymography. Production of 72- and 95-kD gelatinases was quantified by densitometry. Balloon-injured segments secreted significantly more 72- and 95-kD gelatinase than did paired distal segments at all time points. Release of both gelatinase activities was increased at 3 and 7 days relative to segments from uninjured arteries but declined again by 21 days after balloon injury. Similar results were found for gelatinase levels in extracts of arterial tissue. Consistent with the protein secretion data, in situ hybridization demonstrated that the mRNAs for both gelatinases were upregulated after balloon injury. Expression was prominent in medial smooth muscle cells, particularly around foci of necrosis, and in neointimal cells 3 and 7 days after balloon injury; 72-kD gelatinase mRNA persisted after 21 days and was prominent in regrown endothelial cells. The upregulation of gelatinase activity paralleled the time course of smooth muscle cell migration and proliferation in this model. We conclude that increased gelatinase production occurs in response to balloon injury and may play a role in permitting migration and proliferation of vascular smooth muscle cells. PMID:8943956

  20. Spinal canal extension of hyperalimentation catheter without neurologic sequela

    International Nuclear Information System (INIS)

    An attempt at placement of a left femoral vein hyperalimentation catheter resulted in entrance of the catheter into the spinal canal. Catheter location was documented by injections of nonionic contrast material into the catheter without neurologic sequellae. (orig.)

  1. Which criteria demand additive stenting during catheter-directed thrombolysis?

    DEFF Research Database (Denmark)

    Bækgaard, N; Just, S; Foegh, P

    2014-01-01

    Many factors are necessary for obtaining satisfactory results after catheter-directed thrombolysis (CDT) for iliofemoral deep venous thrombosis (DVT). Selections of patients, composition of the thrombolytic fluid, anticoagulation per- and post-procedural, recognition and treatment of persistent...... obstructive lesions of the iliac veins are the most important contributors. Stenting has been known for 15 to 20 years. The first publication on CDT in 1991 was combined with ballooning the iliac vein, an additive procedure which has been abandoned as an isolated procedure. This chapter will discuss selection......, indication, such as an iliac compression syndrome, and outcome of iliac stenting in combination with CDT. The reported frequency of stenting used after CDT is very inconsistent, therefore this will be discussed in details. It is concluded that selection for stenting is of the greatest importance, when CDT is...

  2. Dilation theory yesterday and today

    CERN Document Server

    Arveson, William

    2009-01-01

    Paul Halmos' work in dilation theory began with a question and its answer: Which operators on a Hilbert space can be extended to normal operators on a larger Hilbert space? The answer is interesting and subtle. The idea of representing operator-theoretic structures in terms of conceptually simpler structures acting on larger Hilbert spaces has become a central one in the development of operator theory and, more generally, noncommutative analysis. The work continues today. In this article we summarize some of these diverse results and their history.

  3. Review of catheter thrombectomy devices.

    Science.gov (United States)

    Suarez, Jose A; Meyerrose, Gary E; Phisitkul, Sorot; Kennedy, Shalyn; Roongsritong, Chanwit; Tsikouris, James; Huang, Shoei K Stephen

    2004-01-01

    Acute massive pulmonary embolism (PE) is a frequently fatal event that causes significant compromise of hemodynamic stability. Unfortunately, mortality rates for PE have remained relatively constant despite advances in prophylactic and treatment measures. In addition to embolus size, symptom recognition for diagnosis and emergent treatment are two distinct factors that dictate survival. Treatment generally includes thrombolytic agents; however, not all patients are candidates for aggressive thrombolytic management. Development of catheter thrombectomy devices provides an alternative treatment modality for severe cases when thrombolytics are contraindicated. Catheter thrombectomy devices have undergone major advances over the last decade, but literature support of their success is limited. PMID:14988612

  4. FAQs about Catheter-Associated Bloodstream Infections

    Science.gov (United States)

    ... or groin. The catheter is often used to draw blood, or give fluids or medications. It may ... an antiseptic solution before using the catheter to draw blood or give medications. Healthcare providers also clean ...

  5. The pupil dilation response to visual detection

    Science.gov (United States)

    Privitera, Claudio M.; Renninger, Laura W.; Carney, Thom; Klein, Stanley; Aguilar, Mario

    2008-02-01

    The pupil dilation reflex is mediated by inhibition of the parasympathetic Edinger-Westphal oculomotor complex and sympathetic activity. It has long been documented that emotional and sensory events elicit a pupillary reflex dilation. Is the pupil response a reliable marker of a visual detection event? In two experiments where viewers were asked to report the presence of a visual target during rapid serial visual presentation (RSVP), pupil dilation was significantly associated with target detection. The amplitude of the dilation depended on the frequency of targets and the time of the detection. Larger dilations were associated with trials having fewer targets and with targets viewed earlier during the trial. We also found that dilation was strongly influenced by the visual task.

  6. 21 CFR 876.5090 - Suprapubic urological catheter and accessories.

    Science.gov (United States)

    2010-04-01

    .... This generic type of device includes the suprapubic catheter and tube, Malecot catheter, catheter punch... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Suprapubic urological catheter and accessories... Suprapubic urological catheter and accessories. (a) Identification. A suprapubic urological catheter...

  7. [Monitoring cervical dilatation by impedance].

    Science.gov (United States)

    Salvat, J; Lassen, M; Sauze, C; Baud, S; Salvat, F

    1992-01-01

    Several different physics procedures have been tried to mechanize the recording of partograms. Can a measure of impedance of tissue Z using potential difference V, according to Ohm's law V = Z1, and 1 is a constant, be correlated with a measure of cervical dilatation using vaginal examination? This was our hypothesis. The tissue impedance meter was made to our design and applied according to a bipolar procedure. Our work was carried out on 28 patients. 10 patients were registered before labour started in order to test the apparatus and to record the impedance variations without labour taking place, and 18 patients were registered in labour to see whether there was any correlation. The level of impedance in the cervix without labour was 302.7 Ohms with a deviation of 8.2. Using student's t tests it was found that there was a significant correlation (p less than 0.001) in four measurements between the impedance measure and measures obtained by extrapolating the degrees of dilatation calculated from vaginal examination. This is a preliminary study in which we have defined the conditions that are necessary to confirm these first results and to further develop the method. PMID:1401774

  8. The challenge to balloon science

    Science.gov (United States)

    Jones, W. Vernon

    A thorough review of the NASA balloon program in 1995 confirmed both the inherent importance of balloon science investigations and their value for developing technology for future space missions. A follow-on study in 1996 looked into restructuring the entire suborbital program, in order to find more efficient and effective ways of doing business. These studies were mandated by the adverse impact of NASA's declining budgets and work force constraints on all aspects of space research. The challenge is to accomplish more with less. The balloon program began stepping up to this challenge several years ago with the advent of 10 - 20 day long-duration flights in Antarctica. We must now push ahead with enhanced flight capabilities and with new science instrument technologies, as we forge alliances with other modes of low-cost access to space. Specifically, the development of sealed superpressure balloons could extend flight duration by another order of magnitude, to about 100 days, making ballooning even more competitive with space missions.

  9. BLOCKING SUN WITH ORBITING BALLOONS

    Energy Technology Data Exchange (ETDEWEB)

    Chul Park [Department of Aerospace Engineering, Kor ea Advanced Institute of Science and Technology, Daejeon (Korea)

    2008-09-30

    Sun's radiation power reaching Earth's surface can be reduced by letting large balloons circle the Earth in orbits at approximately 1000 km altitude. These balloons, made of plastic films 1 mm in thickness, of a diameter of approximately 46 km, will weigh about 10,000 tons each. A balloon will consist of one hundred of 100 ton pieces. They are transported to the orbit piece by piece, and are assembled there into the spherical shape. They are kept inflated with the vapor pressure of potassium and the electrostatic forces. The inclination angles of these balloons with respect to the solar ecliptic plane can be varied from zero to 90 degrees, although efficiency is highest with the zero degree inclination. If zero degree inclination is chosen, twenty-three of these will reduce the average sun's radiation by 0.01%. In the 1000 km orbits, which are stable and are populated only by space debris, these balloons will serve also to remove the debris.

  10. Sensor System for Super-Pressure Balloon Performance Modeling Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Long-duration balloon flights are an exciting new area of scientific ballooning, enabled by the development of large super-pressure balloons. As these balloons...

  11. Transhepatic venous catheters for hemodialysis

    Directory of Open Access Journals (Sweden)

    Mohamed El Gharib

    2014-06-01

    Conclusion: Based on our findings, transhepatic hemodialysis catheters have proven to achieve good long-term functionality. A high level of maintenance is required to preserve patency, although this approach provides remarkably durable access for patients who have otherwise exhausted access options.

  12. Interventional catheter methods for complex tetralogy of fallot and 'Critical' PS/pulmonary atresia with intact interventional septum

    International Nuclear Information System (INIS)

    TOF is generally accepted as the index lesion used for evaluating the overall quality of a congenital cardiac program. To achieve good results , the evaluation and management of TOF requires an intimate collaboration between all members of the cardiac team involved in the care of these children, especially the interventional catheterizer and the surgeon. Each program has to develop its own approach, relying on the collective strengths of their staff. Any weak link in this chain will often have a profoundly negative effect upon the patient , which may be difficult to correct later. Whereas the cathlab was the sole source of the anatomic and physiologic data for surgical planning, much of the information, especially intracardiac anatomy and physiology, can now be acquired with echocardiography, and if necessary, enhanced with MRI and CT. The role of diagnostic angiography is reserved for the elucidation of complex and small vascular structures beyond the resolution and specificity of less invasive methods, such as pulmonary artery branches, coronary arteries and arterial collaterals. This anatomy becomes particularly important when staging procedures for TOF in the infant with small pulmonary arteries or atresia, when is the greatest potential for enhancing arterial size and vascular bed growth. Our approach is to perform early correction which will insure antegrade flow into the small pulmonary arteries, by opening the outflow tract (patch or conduit), and when feasible, closing the VSD. Aortic to pulmonary arterial shunts are avoided. Direct access into the pulmonary arteries allows additional catheter-based interventions. Which may include balloon dilation and stenting, which avoiding any deformity from peripheral shunts. Aortic collaterals perfusing lung segments competing with antegrade flow into the branch pulmonary arteries may need Giannturco coil occlusion. Those with small pulmonary arteries may require multiple ballooning/stenting interventions to increase

  13. Parallel wire balloon angioplasty for undilatable venous stenosis in hemodialysis fistula

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Tae Beom; You, Jin Jong; Cho, Jae Min [Gyeongsang National University Hospital, Jinju (Korea, Republic of)] (and others)

    2007-05-15

    The purpose of this study was to assess the value of the parallel wire balloon angioplasty technique for treating dysfunctional hemdialysis fistula with rigid stenosis, and this type of lesion was resistant to conventional angioplasty. Between March 2002 and August 2003, we included 6 patients (mean age: 59, males: 2, females: 4) who were treated via parallel the wire balloon angioplasty technique and their hemodialysis fistula has stenoses that were resistant to conventional angioplasty. We performed conventional angioplasty in all patients, but we failed to achieve sufficient dilatation. In the cases of highly resistant stenosis, an additional 0.016 inch wire was inserted into the 7 F vascular sheath. During angioplasty, a 0.016 inch guide wire was inserted between the balloon and the stenosis and then it was pushed to and fro until the balloon indentation disappeared. After the procedure, we performed angiography to identify the residual stenosis and the procedure-related complications. The undilatable stenoses in 5 patients were successfully resolved without complications via the parallel wire angioplasty technique. In one patient, indentation of balloon was not resolved, but the residual stenosis was both minimal and hemodynamically insignificant. The parallel wire angioplasty technique seems to be a feasible and cost-effective method for treating a dysfunctional hemodialysis fistula with undilatable and rigid stenosis.

  14. Balloon Exoplanet Nulling Interferometer (BENI)

    Science.gov (United States)

    Lyon, Richard G.; Clampin, Mark; Woodruff, Robert A.; Vasudevan, Gopal; Ford, Holland; Petro, Larry; Herman, Jay; Rinehart, Stephen; Carpenter, Kenneth; Marzouk, Joe

    2009-01-01

    We evaluate the feasibility of using a balloon-borne nulling interferometer to detect and characterize exosolar planets and debris disks. The existing instrument consists of a 3-telescope Fizeau imaging interferometer with 3 fast steering mirrors and 3 delay lines operating at 800 Hz for closed-loop control of wavefront errors and fine pointing. A compact visible nulling interferometer is under development which when coupled to the imaging interferometer would in-principle allow deep suppression of starlight. We have conducted atmospheric simulations of the environment above 100,000 feet and believe balloons are a feasible path forward towards detection and characterization of a limited set of exoplanets and their debris disks. Herein we will discuss the BENI instrument, the balloon environment and the feasibility of such as mission.

  15. Button self-retaining drainage catheter

    International Nuclear Information System (INIS)

    To help improve patient acceptance of long-term internal/external catheter access to the biliary tract in those with benign biliary obstruction, a simple design allows the catheter end to remain flush with the skin. It consists of a clothes button affixed to the drainage catheter with a wood screw after the catheter has been cut off at the skin exit. This button/screw device has been used successfully in 22 patients over the last 10 years; catheter exchanges were easily accomplished

  16. Delayed bowel perforation following suprapubic catheter insertion

    Directory of Open Access Journals (Sweden)

    Mehta Ajay

    2004-12-01

    Full Text Available Abstract Background Complications of suprapubic catheter insertion are rare but can be significant. We describe an unusual complication of a delayed bowel perforation following suprapubic catheter insertion. Case presentation A gentleman presented with features of peritonitis and feculent discharge along a suprapubic catheter two months after insertion of the catheter. Conclusion Bowel perforation is the most feared complication of suprapubic catheter insertion especially in patients with lower abdominal scar. The risk may be reduced with the use of ultrasound scan guidance.

  17. On turbulence in dilatant dispersions

    Science.gov (United States)

    Baumert, Helmut Z.; Wessling, Bernhard

    2016-07-01

    This paper presents a new theory on the behaviour of shear-thickening (dilatant) fluids under turbulent conditions. The structure of a dilatant colloidal fluid in turbulent motion may be characterized by (at least) four characteristic length scales: (i) the ‘statistically largest’ turbulent scale, {λ }0, labeling the begin of the inertial part of the wavenumber spectrum; (ii) the energy-containing scale, { L }; (iii) Kolmogorov’s micro-scale, {λ }{ K }, related with the size of the smallest vortices existing for a given kinematic viscosity and forcing; (iv) the inner (‘colloidal’) micro-scale, {λ }i, typically representing a major stable material property of the colloidal fluid. In particular, for small ratios r={λ }i/{λ }{ K }∼ { O }(1), various interactions between colloidal structures and smallest turbulent eddies can be expected. In the present paper we discuss particularly that for ρ ={λ }0/{λ }{ K }\\to { O }(1) turbulence (in the narrow, inertial sense) is strangled and chaotic but less mixing fluid motions remain. We start from a new stochastic, micro-mechanical turbulence theory without empirical parameters valid for inviscid fluids as seen in publications by Baumert in 2013 and 2015. It predicts e.g. von Karman’s constant correctly as 1/\\sqrt{2 π }=0.399. In its generalized version for non-zero viscosity and shear-thickening behavior presented in this contribution, it predicts two solution branches for the steady state: The first characterizes a family of states with swift (inertial) turbulent mixing and small {λ }{ K }, potentially approaching {λ }i. The second branch characterizes a state family with ρ \\to { O }(1) and thus strangled turbulence, ρ ≈ { O }(1). Stability properties and a potential dynamic commuting between the two solution branches had to be left for future research.

  18. (Mis)placed central venous catheter in the left superior intercostal vein

    International Nuclear Information System (INIS)

    Chest X-ray is routinely performed to check the position of the central venous catheter (CVC) inserted through the internal jugular or subclavian vein, while the further evaluation of CVC malfunction is usually performed by contrast venography. In patients with superior vena cava obstruction, the tip of the catheter is often seen in collateral mediastinal venous pathways, rather than in the superior vena cava. In such cases detailed knowledge of thoracic vessel anatomy is necessary to identify the exact location of the catheter. We report a case of 32-year-old female patient with relapsing mediastinal lymphoma and previous superior vena cava obstruction with collateral azygos-hemiazygos venous pathways. The patient had CVC inserted through the left subclavian vein and its position was detected by CT to be in the dilated left superior intercostal vein and accessory hemiazygos vein. Considering that dilated accessory hemiazygos vein can tolerate infusion, the CVC was left in place and the patient had no complaints related to CVC (mal)position. Furthermore, we present anatomical and radiological observations on the azygos-hemiazygos venous system with the special emphasis on the left superior intercostal vein. Non-contrast CT scans can be a valuable imaging tool in the detection of the CVC position, especially in patients with renal insufficiency and contrast media hypersensitivity

  19. Ballonnen in zee = balloons as marine litter

    NARCIS (Netherlands)

    Franeker, van J.A.

    2008-01-01

    Releasing balloons seems harmless. However, remains of balloons, especially valves and ribbons are becoming a common and persistent type of marine litter found on beaches. Following Dutch Queens day 2007, large numbers of Dutch balloons were found in Normandy, France. Animals may become entangled in

  20. Global electrodynamics from superpressure balloons

    Science.gov (United States)

    Holzworth, R. H.; Hu, H.

    1995-01-01

    Electric field and conductivity measurements in the stratosphere between November 1992 and March 1993 have been made using superpressure balloons in the southern hemisphere. Over 400 payload-days of data have been made during a record setting experiment called ELBBO (Extended Life Balloon Borne Observatories). This experiment resulted in 4 flights aloft simultaneously for over 2 months including one flight which lasted over 4 months. Electrodynamical coupling between the atmosphere and ionosphere is studied using the measured electric fields, and a simple empirical model of the stratospheric conductivity. Altitude profiles of conductivity have been obtained from several superpressure balloon flights using the large end-of-flight altitude swings on the last few days of each flight (as the balloon begins to loose superpressure). Coupling between the fields and atmospheric inertial waves has been observed. Effects and dynamics of the global circuit suggest that standard models are missing significant phenomena. Large scale ionospheric convection activity has been studied from the polar cap to the middle latitudes. Cusp latitude fields have been continuously measured for many days in a row.

  1. Calcium phosphate in catheter encrustation.

    Science.gov (United States)

    Cox, A J; Harries, J E; Hukins, D W; Kennedy, A P; Sutton, T M

    1987-02-01

    Encrusted catheters from nine female patients were the source of samples of deposits which were examined by X-ray diffraction, atomic absorption spectroscopy, infra-red spectroscopy and extended X-ray absorption fine structure (EXAFS) spectroscopy. In eight samples the only crystalline phase which could be clearly distinguished by X-ray diffraction was ammonium magnesium orthophosphate hexahydrate, NH4MgPO4 X 6H2O, which occurs naturally as the mineral struvite. However, atomic absorption spectroscopy revealed an appreciable concentration of calcium in all samples. Calcium phosphates have previously been detected in catheter deposits. Infra-red and EXAFS spectra were consistent with the calcium phosphate being present as a poorly crystalline hydroxyapatite. Thus the deposits appear to consist of a mixture of crystalline struvite and a form of hydroxyapatite which is not fully crystalline. PMID:3030487

  2. Design of a cost-effective, hemodynamically adjustable model for resuscitative endovascular balloon occlusion of the aorta (REBOA) simulation.

    Science.gov (United States)

    Keller, Benjamin A; Salcedo, Edgardo S; Williams, Timothy K; Neff, Lucas P; Carden, Anthony J; Li, Yiran; Gotlib, Oren; Tran, Nam K; Galante, Joseph M

    2016-09-01

    Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct technique for salvaging patients with noncompressible torso hemorrhage. Current REBOA training paradigms require large animals, virtual reality simulators, or human cadavers for acquisition of skills. These training strategies are expensive and resource intensive, which may prevent widespread dissemination of REBOA. We have developed a low-cost, near-physiologic, pulsatile REBOA simulator by connecting an anatomic vascular circuit constructed out of latex and polyvinyl chloride tubing to a commercially available pump. This pulsatile simulator is capable of generating cardiac outputs ranging from 1.7 to 6.8 L/min with corresponding arterial blood pressures of 54 to 226/14 to 121 mmHg. The simulator accommodates a 12 French introducer sheath and a CODA balloon catheter. Upon balloon inflation, the arterial waveform distal to the occlusion flattens, distal pulsation within the simulator is lost, and systolic blood pressures proximal to the balloon catheter increase by up to 62 mmHg. Further development and validation of this simulator will allow for refinement, reduction, and replacement of large animal models, costly virtual reality simulators, and perfused cadavers for training purposes. This will ultimately facilitate the low-cost, high-fidelity REBOA simulation needed for the widespread dissemination of this life-saving technique. PMID:27270855

  3. Genetics Home Reference: dilated cardiomyopathy with ataxia syndrome

    Science.gov (United States)

    ... dilated cardiomyopathy with ataxia syndrome dilated cardiomyopathy with ataxia syndrome Enable Javascript to view the expand/collapse ... Open All Close All Description Dilated cardiomyopathy with ataxia (DCMA) syndrome is an inherited condition characterized by ...

  4. The Application of Dual-wire Balloon in The Treatment of Coronary Bifurcation Lesions

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objectives To assess the efficiency and safety of dual-wire balloon angioplasty side branch combined stenting the main branch in the treatment of coronary bifurcation lesions. Methods This study included thirty-six patients with 41 coronary bifurcation lesions. Selective dual-wire balloon angioplasty was performed in side branch and/or in main branch, and implantation of stents was performed in main branch only. Clinical outcome and major adverse cardiac events were observed inhospital and follow-up. Results Success rate of side branch dilatation before main branch stenting was 100%; main branch direct stenting performed in 4 cases; success main branch dilatation performed in the other 37 cases; kissing technique was performed successfully in 5 cases, which side branch was jailed after main branch stenting with TIMI grade 0-2 flow. No Q-wave myocardial infarction, acute revascularization and death occurred during in-hospital.Clinical follow-up was available in all patients. No Q-wave myocardial infarction, revascularization and death occurred, angina pectoris recurred in three patients,released by strengthen drug treatment. Conclusions Dual-wire balloon angioplasty side branch combined stenting the main branch is simple, safe and effective for the treatment of coronary bifurcation lesions.

  5. Transhepatic venous catheters for hemodialysis

    OpenAIRE

    Mohamed El Gharib; Gamal Niazi; Waleed Hetta; Yahya Makkeyah

    2014-01-01

    Purpose: To describe our experience with the technique of transhepatic venous access for hemodialysis and to evaluate its functionality and complications. Patients and methods: From March 2012 till October 2012, 23 patients with age ranging from 12 to 71 years old having end-stage renal disease (ESRD) were included in our study and were subjected to transhepatic venous catheter insertion. In 21 patients there were not any remaining patent peripheral venous accesses. In 2 patients there wer...

  6. Segment-Structured Diamond-Like Carbon Coatings on Polymer Catheter

    Science.gov (United States)

    Nakagawa, Taku; Ohishi, Ryusuke; Ohtake, Naoto; Takai, Osamu; Tsutsui, Nobumasa; Tsutsui, Yasuhiro; Muraki, Yasuhiro; Ogura, Jyunpei

    Diamond-like carbon (DLC) has remarkable mechanical and tribological properties. Besides those mechanical properties, it has been clarified that DLC shows high biocompatibility in recent years. DLC coating can give high strength, abrasion resistance, and biocompatibility for surface of substrates. Hence DLC is a candidate for the coating material for medical devices such as artificial organ, joint, catheter, etc. The objective of this study is to develop safety protection films for implantable medical polymer devices utilizing segment-structured DLC (S-DLC) coatings. S-DLC and continuous-structured DLC were deposited on polyurethane and nylon sheet for balloon catheters. As a result, friction coefficient of DLC coated polyurethane sheet was approximately one-sixth of that of pristine polyurethane sheet, and S-DLC showed very low friction coefficient of μ=0.1-0.15. DLC coating can prevent polyurethane sheet from worn out. The puncture-resistance of nylon sheets increased 0.2MPa on average by DLC coatings regardless of the film structure. It was confirmed that DLC inhibits adsorption of blood coagulation factor. In conclusion, we succeed to verify that these DLC films can improve tribological property, abrasion-resistance, puncture-resistance, and anti-thrombogenicity of polymer catheters. Moreover, segment-structured DLC films exhibits high performance for protection of polymer material for polymer catheters.

  7. Optimization of dialysis catheter function.

    Science.gov (United States)

    Gallieni, Maurizio; Giordano, Antonino; Rossi, Umberto; Cariati, Maurizio

    2016-03-01

    Central venous catheters (CVCs) are essential in the management of hemodialysis patients, but they also carry unintended negative consequences and in particular thrombosis and infection, adversely affecting patient morbidity and mortality. This review will focus on the etiology, prevention, and management of CVC-related dysfunction, which is mainly associated with inadequate blood flow. CVC dysfunction is a major cause of inadequate depuration. Thrombus, intraluminal and extrinsic, as well as fibrous connective tissue sheath (traditionally indicated as fibrin sheath) formation play a central role in establishing CVC dysfunction. Thrombolysis with urokinase or recombinant tissue plasminogen activator (rTPA) can be undertaken in the dialysis unit, restoring adequate blood flow in most patients, preserving the existing catheter, and avoiding an interventional procedure. If thrombolytics fail, mainly because of the presence of fibrous connective tissue sheath, catheter exchange with fibrin sheath disruption may be successful and preserve the venous access site. Prevention of CVC dysfunction is important for containing costly pharmacologic and interventional treatments, which also affect patients' quality of life. Prevention is based on the use of anticoagulant and/or thrombolytic CVC locks, which are only partially effective. Chronic oral anticoagulation with warfarin has also been proposed, but its use for this indication is controversial and its overall risk-benefit profile has not been clearly established. PMID:26951903

  8. Balloon sinuplasty: a new concept in the endoscopic nasal surgery

    Directory of Open Access Journals (Sweden)

    Nogueira Júnior, João Flávio

    2008-12-01

    Full Text Available Introduction: Sinus diseases affect millions of people annually. Clinical treatment is effective in most patients, but in case of failure of this therapy the functional endoscopic surgery is currently the treatment choice for surgical treatment. The objective of the functional endoscopic surgery is to increase the aeration and drainage of the involved paranasal sinuses, which allows for the adequate functioning of the nasal mucosa mucociliary clearance. However, this method still has some limitations, mainly because it removes the nasal mucosa and bone tissue, and it may lead to physiologic alterations of the nasosinusal mucosa and cicatricial fibrosis. Many of these patients could be benefited from less invasive methods, with larger nasal mucosa preservation. Since 2006, an even less invasive procedure was remarked in our specialty: the balloon dilatation of the paranasal sinus ostia. Objective: The objective of this article is to define the concept of sinuplasty, its action mechanism, and present the necessary material for the procedures performance; to describe the techniques with the equipment in a nasosinusal endoscopic surgery simulator model and review the current literature about the indications, complications, results, and follow-up of patients submitted to this procedure. Balloon sinuplasty is safe and appears to be effective in the improvement of the quality of life of patients not responsive to conventional clinical therapy. New applications and indications for this equipment should be described and researched.

  9. Percutaneous balloon dilatation of stenotic calyceal diverticular infundibula in patients with recurrent urinary tract infections.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2011-02-01

    Renal calyceal diverticula are usually detected as incidental findings on intravenous pyelograms (IVPs) and rarely manifest any clinical signs or symptoms. However, they can interfere with patient\\'s quality of life in a number of instances causing pain, recurrent urinary tract infections (UTIs), abscess, systemic sepsis and calculus formation. The purpose of this study was to review the clinical indications, procedure technique and clinical outcome in all patients referred to Interventional Radiology for the percutaneous management of renal calyceal diverticula.

  10. Assessment of the "long sheath" technique for percutaneous aortic balloon valvuloplasty.

    Science.gov (United States)

    Plante, S; Beatt, K J; van den Brand, M; Di Mario, C; Meier, B; Serruys, P W

    1990-02-01

    A 100 cm-long 16.5 F valvuloplasty catheter introducer was assessed as an adjunct for percutaneous transluminal aortic valvuloplasty (PTAV) via the femoral artery in 31 patients with severe aortic stenosis. Observed improvements in peak systolic gradient (81.6 +/- 29.9 mm Hg vs. 35.5 +/- 16.0 mm Hg, P less than 0.000001) and aortic valve area (0.6 +/- 0.4 cm2 vs. 1.0 +/- 0.6 cm2, P less than 0.00001) were similar to those achieved in a control group (C) of 17 patients in which no femoral sheath was used. However, a shorter procedure duration (211 +/- 81 min vs. 117 +/- 30 min, P less than 0.001) and a reduced rate of vascular complications at the femoral puncture site (41% vs. 6.5%) were observed in patients in whom the long sheath (LS) technique was used. The frequency of other PTAV-related complications was comparable (C = 35%, LS = 29%, P = n.s.). Other technical advantages of this device are: 1) prevention of looping and bending of the balloon catheter in tortuous vessels and easy positioning of the balloon across the aortic orifice provided by the LS trackability, 2) stabilisation of the balloon during inflation, 3) monitoring of supravalvular aortic pressure provided by the side-arm of the LS and reliable measurement of systolic gradient, and 4) the ability to perform aortograms without the need of another catheter in the ascending aorta. Thus, in our experience, the long sheath technique is a valuable adjunct for PTAV. PMID:2306775

  11. Decay law and time dilatation

    CERN Document Server

    Giacosa, Francesco

    2015-01-01

    We study the decay law for a moving unstable particle. The usual time-dilatation formula states that the decay width for an unstable state moving with a momentum $p$ and mass $M$ is $\\tilde{\\Gamma}_{p}=\\Gamma M/\\sqrt{p^{2}+M^{2}}$ with $\\Gamma$ being the decay width in the rest frame. In agreement with previous studies, we show that in the context of QM as well as QFT this equation is \\textit{not} correct provided that the quantum measurement is performed in a reference frame in which the unstable particle has momentum $p$ (note, a momentum eigenstate is \\textit{not} a velocity eigenstate in QM). We then give, to our knowledge for the first time, an analytic expression of an improved formula and we show that the deviation from $\\tilde{\\Gamma}_{p}$ has a maximum for $p/M=\\sqrt{2/3},$ but is typically \\textit{very} small. Then, the result can be easily generalized to a momentum wave packet. As a next step, we show that care is needed when one makes a boost of an unstable state with zero momentum/velocity: namel...

  12. Clinical significance of main pancreatic duct dilation on computed tomography: Single and double duct dilation

    Institute of Scientific and Technical Information of China (English)

    Mark D Edge; Maarouf Hoteit; Amil P Patel; Xiaoping Wang; Deborah A Baumgarten; Qiang Cai

    2007-01-01

    AIM: To study the patients with main pancreatic duct dilation on computed tomography (CT) and thereby to provide the predictive criteria to identify patients at high risk of significant diseases, such as pancreatic cancer, and to avoid unnecessary work up for patients at low risk of such diseases.METHODS: Patients with dilation of the main pancreatic duct on CT at Emory University Hospital in 2002 were identified by computer search. Clinical course and ultimate diagnosis were obtained in all the identified patients by abstraction of their computer database records.RESULTS: Seventy-seven patients were identified in this study. Chronic pancreatitis and pancreatic cancer were the most common causes of the main pancreatic duct dilation on CT. Although the majority of patients with isolated dilation of the main pancreatic duct (single duct dilation) had chronic pancreatitis, one-third of patients with single duct dilation but without chronic pancreatitis had pancreatic malignancies, whereas most of patients with concomitant biliary duct dilation (double duct dilation) had pancreatic cancer.CONCLUSION: Patients with pancreatic double duct dilation need extensive work up and careful follow up since a majority of these patients are ultimately diagnosed with pancreatic cancer. Patients with single duct dilation, especially such patients without any evidence of chronic pancreatitis, also need careful follow-up since the possibility of pancreatic malignancy, including adenocarcinoma and intraductal papillary mucinous tumors, is still high.

  13. Peripheral Applications of Drug-Coated Balloons: Past, Present and Future

    Energy Technology Data Exchange (ETDEWEB)

    Krokidis, Miltiadis, E-mail: mkrokidis@hotmail.com; Spiliopoulos, Stavros, E-mail: stavspiliop@upatras.gr; Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr; Sabharwal, Tarun, E-mail: tarun_sabharwal@yahoo.co.uk [Guy' s and St. Thomas' Hospitals, NHS Foundation Trust, Department of Radiology (United Kingdom)

    2013-04-15

    Drug-coated balloon (DCB) technologies represent the latest and hottest development in the field of endovascular treatment of peripheral arterial disease. Initial experience with paclitaxel-coated balloon use in the femoral artery has demonstrated lower mid-term restenosis and superior mid-term clinical outcomes in terms of improved wound healing and reduced repeat angioplasty rates compared with standard balloon angioplasty. Many companies are presently developing and/or improving DCB catheters and therefore ongoing, technical improvements of the already existing platforms, new drugs, and innovative carriers are expected. The ongoing basic research studies and various multicenter randomized, controlled trials that are currently in progress will offer valuable scientific insights regarding the long-term effectiveness and other crucial issues, such as efficacy in various vascular beds, optimal balloon dosage, and post angioplasty antiplatelet therapy. Future applications of these devices also could include in-stent restenosis, anastomotic stenosis of surgical bypass, and benign stenoses of the central venous system. The authors envision that DCB angioplasty will evolve to a major paradigm shift in the endovascular treatment of occlusive vascular diseases.

  14. Flush Foley's catheter: The most easy way

    OpenAIRE

    Vijay P. Agrawal

    2013-01-01

    Introduction: Foley catheters are used for monitoring urine output in anesthetized patients, comatose patients, incontinent patients, acute urinary retention, paralysed patients, trauma patients, urethral surgeries, ureterectomy, kidney disease, before and after cesarean sections etc. When a Foley catheter becomes clogged, it can cause various complications. For which it is flushed or replaced.Objectives: To find a simple way to flush a Foleys catheter.Material & Methods: Patient was expl...

  15. Reuse of catheters for angiography. 2. Contribution

    International Nuclear Information System (INIS)

    The reuse of sterile medical devices designated for single use is a controversal practice, known to be performed in many countries. As far as catheters for angiography are concerned, various methods for cleaning and sterilisation are in use. However, interactions of detergents and ethylene oxide used in reprocessing with polyethylene materials of the catheters have not been investigated systematically. This paper presents a physico-chemical characterisation of common angiographic catheters. The interaction of polyethylene and ethylene oxide is examined. (orig.)

  16. Interventional treatment of common congenital heart diseases: the common view of Chinese medical experts. Part Four: Percutaneous balloon valvuloplasty for pulmonary and aortic valve stenosis

    International Nuclear Information System (INIS)

    Percutaneous balloon valvuloplasty has become the treatment of first choice for pulmonary valve stenosis. Congenital aortic valve stenosis can also be relieved by percutaneous balloon dilatation. Percutaneous valvuloplasty is indicated for patients with isolated pulmonary valve stenosis when the transvalvular peak systolic pressure gradient is over 40 mmHg and for patients with aortic valve stenosis when the pressure gradient exceeds 60 mmHg. A careful selection of patients, standardized procedure, individualized selection of the balloon type, size and length, and careful avoidance of any damage to chorda tendineae and to surrounding tissue are keys to achieving a successful procedure. Balloon valvuloplasty should be selectively performed in new-born and in infant since complications of the procedure are inversely related to age. (authors)

  17. Transvaginal closure of the bladder neck and placement of a suprapubic catheter for destroyed urethra after long-term indwelling catheterization.

    Science.gov (United States)

    Zimmern, P E; Hadley, H R; Leach, G E; Raz, S

    1985-09-01

    We report on 6 women with continuous urinary incontinence as a late complication of an indwelling urethral catheter for neurogenic bladder. Pressure necrosis by the balloon resulted in progressive destruction of the entire urethra, with subsequent incontinence despite the catheter. Surgical attempts at bladder neck closure to correct the incontinence generally have been unsuccessful. Instead of supravesical urinary diversion, we performed transvaginal closure of the bladder neck and percutaneous placement of a permanent suprapubic tube cystostomy. All 6 patients remained dry after closure and none has shown upper urinary tract deterioration at followup for as long as 5 years. PMID:4040980

  18. A Mars 2011 Balloon Mission Trade Study

    Science.gov (United States)

    Smith, I.; Lew, T.; Perry, W.

    Mars Scouts are competitively selected PI-led missions to further Mars exploration in ways that satisfy NASA s overall objectives but are not currently in the planned line of missions The current 2006 Announcement of Opportunity AO for Mars Scouts has just closed The goal of this SwRI study was to develop a new balloon mission concept to where it could be credibly proposed for the AO The balloon system was defined in the study as consisting of two parts the balloon flight system BFS and the balloon deployment inflation system DIS The BFS includes the balloon envelope accessory hardware and gondola The balloon includes the envelope seams end fittings load core inflation tube diffusers payload tether shock attenuator and separation hardware The DIS includes the balloon container deployment hardware sequencer tankage gas and control hardware Trade studies were performed to better define the mission design space These studies included 1 effect of varied atmospheric thermal loads 2 effect of varying latitudes 3 effect of payload mass for varying altitudes 4 effect of radiative material properties on balloon size mass 5 effect of material areal densities on balloon size mass and 6 effect of inflation gas on system masses Results of the balloon trade study for the Mars 2011 mission opportunity will be presented

  19. A young man with acute dilated cardiomyopathy associated with methylphenidate

    Directory of Open Access Journals (Sweden)

    Tor-Bjarne Nymark

    2008-05-01

    Full Text Available Tor-Bjarne Nymark1, A Hovland2, H Bjørnstad2, E W Nielsen1,31Section for Emergency Medicine; 2Department of Cardiology, Nordland Hospital, Bodø, Norway; 3University of Tromsø, Tromsø, NorwayAbstract: An 18-year-old obese man with a body mass index of 40, diagnosed with attention-deficit hyperactivity disorder and treated with methylphenidate (Concerta® was acutely admitted to hospital with hypoxia and dyspnoea. On investigation signs of liver-, renal-, and heart-failure were found. Noradrenalin infusion was started. Echocardiography showed dilated left ventricle and an ejection fraction (EF of 25%. Liver function improved, noradrenalin and dobutamine were tapered, but three days after admission a new echocardiography showed an EF of 10%. The patient was transferred to the National Hospital (Rikshospitalet, Oslo, where intensified treatment including intra aortic balloon pump (IABP was instituted. Cardiac function improved, and 3 weeks later the IABP was disconnected. EF at this point was 15%. The patient was denied heart transplantation due to various cofactors. The investigation concluded with a probable relationship between his cardiomyopathy and the use of methylphenidate (Concerta.Keywords: cardiomyopathy, heart failure, ADHD, methylphenidate

  20. PEBS - Positron Electron Balloon Spectrometer

    CERN Document Server

    Von Doetinchem, P; Kirn, T; Yearwood, G R; Schael, S

    2007-01-01

    The best measurement of the cosmic ray positron flux available today was performed by the HEAT balloon experiment more than 10 years ago. Given the limitations in weight and power consumption for balloon experiments, a novel approach was needed to design a detector which could increase the existing data by more than a factor of 100. Using silicon photomultipliers for the readout of a scintillating fiber tracker and of an imaging electromagnetic calorimeter, the PEBS detector features a large geometrical acceptance of 2500 cm^2 sr for positrons, a total weight of 1500 kg and a power consumption of 600 W. The experiment is intended to measure cosmic ray particle spectra for a period of up to 20 days at an altitude of 40 km circulating the North or South Pole. A full Geant 4 simulation of the detector concept has been developed and key elements have been verified in a testbeam in October 2006 at CERN.

  1. An Erupted Dilated Odontoma: A Rare Presentation.

    Science.gov (United States)

    Sharma, Gaurav; Nagra, Amritpreet; Singh, Gurkeerat; Nagpal, Archna; Soin, Atul; Bhardwaj, Vishal

    2016-01-01

    A dilated odontoma is an extremely rare developmental anomaly represented as a dilatation of the crown and root as a consequence of a deep, enamel-lined invagination and is considered a severe variant of dens invaginatus. An oval shape of the tooth lacking morphological characteristics of a crown or root implies that the invagination happened in the initial stages of morphodifferentiation. Spontaneous eruption of an odontoma is a rare occurrence and the occurrence of a dilated odontoma in a supernumerary tooth is even rarer with only a few case reports documented in the English literature. We present an extremely rare case of erupted dilated odontoma occurring in the supernumerary tooth in anterior maxillary region in an 18-year-old male, which, to the best of our knowledge, is the first ever case reported in English literature. PMID:26989523

  2. On Demand Urethral Dilatation Versus Intermittent Urethral Dilatation: Results and Complications in Women With Urethral Stricture

    OpenAIRE

    Heidari, Fatemeh; Abbaszadeh, Shahin; Ghadian, Alireza; Tehrani Kia, Farahnaz

    2014-01-01

    Background: The treatment of urethral stricture in female patients is through dilatation of the urethra by tubes of increasing diameter. There are two main methods: intermittent dilatation and on demand dilatation. Objectives: The main aim of this study was to compare the results of these two methods, and to determine the best one. Patients and Methods: In this clinical trial study, we reviewed the documents of women diagnosed with urethral stricture, who came to the Baqiyatallah Clinic from ...

  3. Image Denoising Based on Dilated Singularity Prior

    OpenAIRE

    Wufan Chen; Zhiwu Liao; Shaoxiang Hu

    2012-01-01

    In order to preserve singularities in denoising, we propose a new scheme by adding dilated singularity prior to noisy images. The singularities are detected by canny operator firstly and then dilated using mathematical morphology for finding pixels “near” singularities instead of “on” singularities. The denoising results for pixels near singularities are obtained by nonlocal means in spatial domain to preserve singularities while the denoising results for pixels in smooth regions are obtained...

  4. DILATE: a 2-d structural program for the dilation response of hexagonal ducts

    International Nuclear Information System (INIS)

    An analytical method is introduced for determining the dilation of hexagonal ducts in fast reactors. The method, which is valid for temperatures where creep is linearly dependent on stress, was implemented in a fast-running computer called DILATE. A bench-mark program is presented, which shows the results of the DILATE program in close agreement with the results of the finite element program MARC-CDC. User instructions for the DILATE program are described in detail and a listing of the program is included

  5. DILATE: a 2-d structural program for the dilation response of hexagonal ducts

    Energy Technology Data Exchange (ETDEWEB)

    Chan, D.P.

    1980-02-01

    An analytical method is introduced for determining the dilation of hexagonal ducts in fast reactors. The method, which is valid for temperatures where creep is linearly dependent on stress, was implemented in a fast-running computer called DILATE. A bench-mark program is presented, which shows the results of the DILATE program in close agreement with the results of the finite element program MARC-CDC. User instructions for the DILATE program are described in detail and a listing of the program is included.

  6. [The dilatation of auditive tube (Bougirage tubaire) by dilators in XIX century].

    Science.gov (United States)

    Kierzek, Andrzej

    2006-01-01

    The treatment of auditiory tube chronic catarrh in XIX century by pharmagological drugs, by special apparatuses of surprising technical sophistication, by electrisation and faradisation is discussed first of all. The dilatation of auditory tube by dilators was the diagnostical and therapeutical methods, especially preferenced by Victor Urbantschitsch, Hermann Schwartze, Jean P. Bonnafonte, Albert Calmettes and Bronisław Taczanowski, Teodor Heiman and Samuel Meyerson. The dilators were building of celluloid, whale-bone, silver and were absorbed by argentum nitrate, vaseline. The technique, difficulties and effects of dilatation are described in more detail. The complications of this operation is presented finally. PMID:17131853

  7. [Catheter jejunostomy in elective abdominal surgery].

    Science.gov (United States)

    Bodoky, A; Heberer, M; Iwatschenko, P; Harder, F

    1985-10-01

    Needle catheter jejunostomy is used to a varying extent today. Therefore, the need for nutritional support was evaluated following elective abdominal surgery and compared to experiences with postoperative enteral feeding. Oesophagectomy, total gastrectomy and the Whipple procedure were identified as good indications for catheter jejunostomy, whereas with other types of operation an individual decision is required. PMID:3935397

  8. Audit of catheter urine culture requests.

    OpenAIRE

    Manek, N; Napier Rees, E

    1992-01-01

    An audit to assess the appropriateness of catheter urine culture requests was carried out for a period of one month. The requests were followed up by members of the Infection Control Team at ward level. The laboratory report had no impact on the removal of the catheter in asymptomatic or symptomatic patients, although the reports did aid antibiotic prescribing in symptomatic patients.

  9. Audit of catheter urine culture requests.

    Science.gov (United States)

    Manek, N; Napier Rees, E

    1992-01-01

    An audit to assess the appropriateness of catheter urine culture requests was carried out for a period of one month. The requests were followed up by members of the Infection Control Team at ward level. The laboratory report had no impact on the removal of the catheter in asymptomatic or symptomatic patients, although the reports did aid antibiotic prescribing in symptomatic patients. PMID:1740523

  10. Soft thrombus formation in radiofrequency catheter ablation

    NARCIS (Netherlands)

    Demolin, JM; Eick, OJ; Munch, K; Koullick, E; Nakagawa, H; Wittkampf, FHM

    2002-01-01

    During RF catheter ablation, local temperature elevation can result in coagulum formation on the ablation electrode, resulting in impedance rise. A recent study has also demonstrated the formation of a so-called soft thrombus during experimental ablations. This deposit poorly adhered to the catheter

  11. Catheter-Associated Urinary Tract Infections

    Science.gov (United States)

    ... Top of page What is a urinary tract infection? A urinary tract infection (UTI) is an infection that involves ... page What is a catheter-associated urinary tract infection (CAUTI)? A catheter-associated urinary tract infection (CAUTI) occurs when germs (usually bacteria) ...

  12. Attitudes Towards Catheter Ablation for Atrial Fibrillation

    DEFF Research Database (Denmark)

    Vadmann, Henrik; Pedersen, Susanne S; Nielsen, Jens Cosedis;

    2015-01-01

    BACKGROUND: Catheter ablation for atrial fibrillation (AF) is an important but expensive procedure that is the subject of some debate. Physicians´ attitudes towards catheter ablation may influence promotion and patient acceptance. This is the first study to examine the attitudes of Danish...

  13. Intravascular β-irradiation with a liquid 188Re-filled balloon for the prevention of restenosis in rabbit model

    International Nuclear Information System (INIS)

    Objective: To investigate the effects of intravascular β-irradiation with a liquid 188Re-filled balloon on restenosis in rabbit model, and to evaluate the feasibility of the intravascular irradiation. Methods: The bilateral iliac arteries of 14 rabbits were injured by catheter balloon overdilation. A random side iliac artery of the rabbit was irradiated by a liquid 188Re-filled balloon with the radioactivity of 15 Gy at a depth of 0.5 mm beneath the skin close to the artery, and the other iliac artery served as a control. At 12 weeks after operation, quantitative angiography, histopathology and immunohistochemistry analysis were performed in the injured iliac arteries to evaluate the effects of irradiation. Results: There was significant increase in iliac artery diameter [(1.94 +- 0.19) vs (1.77 +- 0.28) mm, P2, P188Re-filled balloon irradiation group compared with control group. Conclusions: Intravascular β-irradiation by a liquid 188Re-filled balloon with 15 Gy at 0.5 mm tissue depth beneath the skin close to the artery in rabbit model could inhibit neointimal proliferation and prevent restenosis. The intravascular brachytherapy with irradiation for prevention of restenosis is technically feasible

  14. Hyperspectral Polarimeter for Monitoring Balloon Strain Project

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA's latest generation of superpressure, ultra long duration balloons (ULDB) extend the flight time for stratospheric experiments to levels previously...

  15. Nonoperative replacement of a jejunostomy feeding catheter.

    Science.gov (United States)

    Stogdill, B J; Page, C P; Pestana, C

    1984-02-01

    Nonoperative replacement of lost or occluded jejunal feeding catheters proved successful in 8 of 11 patients. This technique is recommended as a nonoperative means of replacing a needle catheter jejunostomy when it is accidentally lost or becomes occluded. Adherence to sterile technique and gentle advancement of the guide wire to avoid injury to the bowel are important. Since the technique depends on an established tract between the skin and the bowel, catheter replacement should not be attempted when the feeding catheter is lost or becomes occluded in the immediate postoperative period. In addition, confirmation of catheter patency and intraluminal position with sterile water-soluble contrast medium is critical to the safe use of this technique. PMID:6421183

  16. Development of Bend Sensor for Catheter Tip

    Science.gov (United States)

    Nagano, Yoshitaka; Sano, Akihito; Fujimoto, Hideo

    Recently, a minimally invasive surgery which makes the best use of the catheter has been becoming more popular. In endovascular coil embolization for a cerebral aneurysm, the observation of the catheter's painting phenomenon is very important to execute the appropriate manipulation of the delivery wire and the catheter. In this study, the internal bend sensor which consists of at least two bending enhanced plastic optical fibers was developed in order to measure the curvature of the catheter tip. Consequently, the painting could be more sensitively detected in the neighborhood of the aneurysm. In this paper, the basic characteristics of the developed sensor system are described and its usefulness is confirmed from the comparison of the insertion force of delivery wire and the curvature of catheter tip in the experiment of coil embolization.

  17. Controlled transient respiratory arrest along with rapid right ventricular pacing for improving balloon stability during balloon valvuloplasty in pediatric patients with congenital aortic stenosis - A retrospective case series analysis

    Directory of Open Access Journals (Sweden)

    Gupta Sampa

    2010-01-01

    Full Text Available Rapid right ventricular pacing is safe, effective, and established method to provide balloon stability during balloon aortic valvuloplasty (BAV. Controlled transient respiratory arrest at this point of time may further reduce left ventricular stroke volume, providing an additional benefit to maintain balloon stability. Two groups were studied. Among the 10 patients, five had rapid pacing alone (Group A, while the other five were provided with cessation of positive pressure breathing as well (Group B. The outcomes of BAV in the two groups of patients were studied. One patient in Group A had failed balloon dilatation even after the fourth attempt, while in Group B there were no failures. The peak systolic gradient reduction was higher in Group B (70.05% in comparison to 52.16% of group A. In Group A, five subjects developed aortic regurgitation (grade 2 in four and grade 3 in one, while no grade 3 aortic regurgitation developed in any patient in Group B. Controlled transient respiratory arrest along with rapid ventricular pacing may be effective in maintaining balloon stability and improve the outcome of BAV.

  18. Controlled transient respiratory arrest along with rapid right ventricular pacing for improving balloon stability during balloon valvuloplasty in pediatric patients with congenital aortic stenosis--a retrospective case series analysis.

    Science.gov (United States)

    Gupta, Sampa Dutta; Das, Soumi; Ghose, Tapas; Sarkar, Achyut; Goswami, Anupam; Kundu, Sudeshna

    2010-01-01

    Rapid right ventricular pacing is safe, effective, and established method to provide balloon stability during balloon aortic valvuloplasty (BAV). Controlled transient respiratory arrest at this point of time may further reduce left ventricular stroke volume, providing an additional benefit to maintain balloon stability. Two groups were studied. Among the 10 patients, five had rapid pacing alone (Group A), while the other five were provided with cessation of positive pressure breathing as well (Group B). The outcomes of BAV in the two groups of patients were studied. One patient in Group A had failed balloon dilatation even after the fourth attempt, while in Group B there were no failures. The peak systolic gradient reduction was higher in Group B (70.05% in comparison to 52.16% of group A). In Group A, five subjects developed aortic regurgitation (grade 2 in four and grade 3 in one, while no grade 3 aortic regurgitation developed in any patient in Group B). Controlled transient respiratory arrest along with rapid ventricular pacing may be effective in maintaining balloon stability and improve the outcome of BAV. PMID:20826965

  19. Percutaneous transhepatic bipolar radiofrequency catheter ablation for the treatment of malignant obstructive jaundice:preliminary experience in 20 c ases%经皮经肝双极射频消融导管恶性梗阻性黄疸20例

    Institute of Scientific and Technical Information of China (English)

    崔宁; 李晓群

    2014-01-01

    Objective To investigate the feasibility, safety and clinical effect of percutaneous transhepatic bipolar radiofrequency catheter ablation in treating malignant obstructive jaundice. Methods Twenty patients with inoperable malignant biliary obstruction were enrolled in this study. Of the 20 cases , 2 had biliary stent re-occlusion. Percutaneous transhepatic bipolar radiofrequency catheter ablation was carried out in all patients. The ablation power was 5 - 12 W, single ablation time was 60 - 120 s, the average duration of ablation was 4.66 min (1.5 - 8.5 min), and the mean effective ablation extent was 5.76 cm (4 -10 cm). After ablation, balloon catheter was inserted to dilate the occluded segment, which was followed by implantation of biliary metal stent. The clinical efficacy , safety and complications were recorded. Results Percutaneous transhepatic bipolar radiofrequency catheter ablation was successfully completed in all the 20 patients. Implantation of biliary metal stent was performed in 17 patients , among them balloon dilatation was employed in 11 patients before stent implantation , simple balloon dilatation with no stent implantation was employed in one patient, and ablation was adopted after biliary stent re-occlusion occurred in two patients. After the ablation, no complications such as biliary fistula, biliary tract infections, liver penetrating injuries, peritonitis, etc. occurred. Biliary drainage was successfully completed in all patients. The median follow-up period was three months(0.5-10 months); the stent patency rate at the end of one and three months was 100% (19/19) and 79% (11/14) respectively. The one-month and 3-month survival rate was 95% (19/20) and 93% (14/15) respectively. During the follow-up period, 8 of the 20 patients were alive and 12 died. The median survival time was 144 days (13 - 330 days) and the median time of stent patency was 60 days (30-210 days). Of the 12 fatal patients, 8 died of cachexia with multi- system failure

  20. Treatment of Achalasia by Pneumatic Dilatation & Esophagomyotomy

    Directory of Open Access Journals (Sweden)

    M. H. Emami

    2008-01-01

    Full Text Available Background/Objective: Esophagomyotomy and pneumatic dilatation are routine treatments of achalasia. The aim of this study is determine treat-ment effects of these methods."nPatients and Methods: This historical cohort study was done in Esfahan city in 2006. Sixty-six patients with achalasia that treated with pneumatic dilatation (n=46 and esophagomyotomy (n=20 were studied. The data of age, clinical recovery, complications, and satisfaction were collected. Data were analyzed with T-test and x2 and p<0.05 was different significantly."nResults: Clinical recovery was 70% with esophagomyotomy vs 80.5% with pneumatic dilatation (p>0.05. Mean of satisfaction was 8.5±2.37 in esophagomyotomy group Vs 7.68±2.49 in pneumatic dilatation group (P>0.05. Complications were not different significantly in two groups. Radiologic recovery was 66/6% in esophagomyotomy group vs 23.5% in dilatation group (P<0.5."nConclusion: Clinical recovery complications and sat-isfaction in two groups were not different significantly. This study shows need for long-term follow up in two groups.

  1. Materials for Multifunctional Balloon Catheters With Capabilities in Cardiac Electrophysiological Mapping and Ablation Therapy

    OpenAIRE

    Kim, Dae-Hyeong; Lu, Nanshu; Ghaffari, Roozbeh; Kim, Yun-Soung; Lee, Stephen P.; Xu, Lizhi; Wu, Jian; Kim, Rak-Hwan; Song, Jizhou; Liu, Zhuangjian; Viventi, Jonathan; de Graff, Bassel; Elolampi, Brian; Mansour, Moussa; Slepian, Marvin J.

    2011-01-01

    Development of advanced surgical tools for minimally invasive procedures represents an activity of central importance to improvements in human health. A key materials challenge is in the realization of bio-compatible interfaces between the classes of semiconductor and sensor technologies that might be most useful in this context and the soft, curvilinear surfaces of the body. This paper describes a solution based on biocompatible materials and devices that integrate directly with the thin ela...

  2. Treatment of an Extensive Maxillary Cyst Using Nasal Airway and Balloon Catheter Devices

    OpenAIRE

    Atsushi Kasamatsu; Chonji Fukumoto; Morihiro Higo; Yosuke Endo-Sakamoto; Katsunori Ogawara; Masashi Shiiba; Hideki Tanzawa; Katsuhiro Uzawa

    2014-01-01

    Introduction. Large maxillary cysts occasionally expand into the maxilla and erode the maxillary sinus and nasal cavity. The Caldwell-Luc procedure is the recommended treatment for large maxillary sinus cysts. However, it is hard to preserve the nasal space in the case of large maxillary sinus cysts that penetrate into the nasal cavity. Methods. A 22-year-old man who had large maxillary sinus cysts was referred to our department for a surgical treatment. After removing the cyst from the maxil...

  3. New developments in the clinical use of drug-coated balloon catheters in peripheral arterial disease

    OpenAIRE

    Patel, Mitul

    2016-01-01

    Jesse Naghi, Ethan A Yalvac, Ali Pourdjabbar, Lawrence Ang, John Bahadorani, Ryan R Reeves, Ehtisham Mahmud, Mitul Patel Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California, San Diego, CA, USA Abstract: Peripheral arterial disease (PAD) involving the lower extremity is a major source of morbidity and mortality. Clinical manifestations of PAD span the spectrum from lifestyle limiting claudication to ulceration and gangrene leading to amputation. Advanc...

  4. Prospective Multicenter Trial Evaluating Balloon-Catheter Partial-Breast Irradiation for Ductal Carcinoma in Situ

    International Nuclear Information System (INIS)

    Purpose: To determine outcomes of accelerated partial-breast irradiation (APBI) with MammoSite in the treatment of ductal carcinoma in situ (DCIS) after breast-conserving surgery. Methods and Materials: We conducted a prospective, multicenter trial between 2003 and 2009. Inclusion criteria included age >18 years, core needle biopsy diagnosis of DCIS, and no prior breast cancer history. Patients underwent breast-conserving surgery plus MammoSite placement. Radiation was given twice daily for 5 days for a total of 34 Gy. Patients were evaluated for development of toxicities, cosmetic outcome, and ipsilateral breast tumor recurrence (IBTR). Results: A total of 41 patients (42 breasts) completed treatment in the study, with a median follow up of 5.3 years. Overall, 28 patients (68.3%) experienced an adverse event. Skin changes and pain were the most common adverse events. Cosmetic outcome at 6 months was judged excellent/good by 100% of physicians and by 96.8% of patients. At 12 months, 86.7% of physicians and 92.3% of patients rated the cosmetic outcome as excellent/good. Overall, 4 patients (9.8%) developed an IBTR (all DCIS), with a 5-year actuarial rate of 11.3%. All IBTRs were outside the treatment field. Among patients with IBTRs, the mean time to recurrence was 3.2 years. Conclusions: Accelerated partial-breast irradiation using MammoSite seems to provide a safe and cosmetically acceptable outcome; however, the 9.8% IBTR rate with median follow-up of 5.3 years is concerning. Prospective randomized trials are necessary before routine use of APBI for DCIS can be recommended

  5. Prospective Multicenter Trial Evaluating Balloon-Catheter Partial-Breast Irradiation for Ductal Carcinoma in Situ

    Energy Technology Data Exchange (ETDEWEB)

    Abbott, Andrea M.; Portschy, Pamela R. [Division of Surgical Oncology, University of Minnesota, Minneapolis, Minnesota (United States); Lee, Chung [Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota (United States); Le, Chap T. [Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota (United States); Han, Linda K. [Department of Surgery, Indiana University, Indianapolis, Indiana (United States); Washington, Tara [Vantage Oncology, Redhawk and Wildomar Centers California, Wildomar, California (United States); Kinney, Michael [Center for Advanced Breast Care, Arlington Heights, Illinois (United States); Bretzke, Margit [Surgical Specialists of Minnesota, Minneapolis, Minnesota (United States); Tuttle, Todd M., E-mail: tuttl006@umn.edu [Division of Surgical Oncology, University of Minnesota, Minneapolis, Minnesota (United States)

    2013-11-01

    Purpose: To determine outcomes of accelerated partial-breast irradiation (APBI) with MammoSite in the treatment of ductal carcinoma in situ (DCIS) after breast-conserving surgery. Methods and Materials: We conducted a prospective, multicenter trial between 2003 and 2009. Inclusion criteria included age >18 years, core needle biopsy diagnosis of DCIS, and no prior breast cancer history. Patients underwent breast-conserving surgery plus MammoSite placement. Radiation was given twice daily for 5 days for a total of 34 Gy. Patients were evaluated for development of toxicities, cosmetic outcome, and ipsilateral breast tumor recurrence (IBTR). Results: A total of 41 patients (42 breasts) completed treatment in the study, with a median follow up of 5.3 years. Overall, 28 patients (68.3%) experienced an adverse event. Skin changes and pain were the most common adverse events. Cosmetic outcome at 6 months was judged excellent/good by 100% of physicians and by 96.8% of patients. At 12 months, 86.7% of physicians and 92.3% of patients rated the cosmetic outcome as excellent/good. Overall, 4 patients (9.8%) developed an IBTR (all DCIS), with a 5-year actuarial rate of 11.3%. All IBTRs were outside the treatment field. Among patients with IBTRs, the mean time to recurrence was 3.2 years. Conclusions: Accelerated partial-breast irradiation using MammoSite seems to provide a safe and cosmetically acceptable outcome; however, the 9.8% IBTR rate with median follow-up of 5.3 years is concerning. Prospective randomized trials are necessary before routine use of APBI for DCIS can be recommended.

  6. Simulation of stratospheric balloon environment

    International Nuclear Information System (INIS)

    The behavior of materials used for the construction of stratospheric balloons is studied at DERTS by means of irradiations performed in reals time and simulating the exact flight environment. Two chambers were designed in the laboratory and are described together with the experimental procedure. In order to reduce cost and save time, it is worth accelerating the simulation when only a preliminary evaluation of the sample's properties is required. For this reason, a systematic study was undertaken in order to evaluate the respective effects of different parameters on the material degradation. The results of this study are given

  7. Radiological Interventions for Correction of Central Venous Port Catheter Migrations

    International Nuclear Information System (INIS)

    The purpose of the study is to evaluate radiological-interventional central venous port catheter corrections in migrated/malpositioned catheter tips. Thirty patients with migrated/malpositioned port catheter tips were included in this retrospective analysis. To visualize the catheter patency, a contrast-enhanced port catheter series was performed, followed by transfemoral port catheter correction with various 5F angiographic catheters (pigtail, Sos Omni), goose-neck snare, or combinations thereof. One patient showed spontaneous reposition of the catheter tip. In 27 of 29 patients (93%), radiological-interventional port catheter correction was successful. In two patients, port catheter malposition correction was not possible because of the inability to catch either the catheter tip or the catheter in its course, possibly due to fibrin sheath formation with attachment of the catheter to the vessel wall. No disconnection or port catheter dysfunction was observed after correction. In migrated catheter tips, radiological-interventional port catheter correction is a minimally invasive alternative to port extraction and reimplantation. In patients with a fibrin sheath and/or thrombosis, port catheter correction is often more challenging

  8. Radiological Interventions for Correction of Central Venous Port Catheter Migrations

    International Nuclear Information System (INIS)

    Purpose. The purpose of this study was to evaluate radiological-interventional central venous port catheter corrections in migrated/malpositioned catheter tips. Materials and Methods. Thirty patients with migrated/malpositioned port catheter tips were included in this retrospective analysis. To visualize the catheter patency a contrast-enhanced port catheter series was performed, followed by transfemoral port catheter correction with various 5-F angiographic catheters (pigtail; Sos Omni), gooseneck snares, or combinations thereof. Results. One patient showed spontaneous reposition of the catheter tip. In 27 of 29 patients (93%), radiological-interventional port catheter correction was successful. In two patients port catheter malposition correction was not possible, because of the inability to catch either the catheter tip or the catheter in its course, possibly due to fibrin sheath formation with attachment of the catheter to the vessel wall. No disconnection or port catheter dysfunction was observed after correction. Conclusions. We conclude that in migrated catheter tips radiological-interventional port catheter correction is a minimally invasive alternative to port extraction and reimplantation. In patients with a fibrin sheath and/or thrombosis port catheter correction is often more challenging

  9. Balloon-assisted percutaneous vertebroplasty in patients with osteoporotic compression fractures - first results

    International Nuclear Information System (INIS)

    Purpose: To determine the feasibility, efficacy and safety of balloon-assisted percutaneous vertebroplasty (BA-VP) in patients with osteoporotic vertebral compression fractures (VCFs). Materials and Methods: In 47 patients (29 women, 18 men; mean age: 70 years and 4 months) with severe VCFs, 66 BA-VPs were performed via a unipedicular access. After initial puncture (under combined fluoroscopy and CT guidance) of the vertebral body (VB), the needle was retraced by 1.5 cm, and a 12-mm Fogarty balloon catheter was introduced and inflated using 2-4 ml diluted contrast media (CM). After the subsequent removal of the catheter and repositioning of the needle, vertebroplasty was performed. Results: The mean volume of PMMA injected was 4.4 ml (2.5-7.2 ml). Pain reduction (measured by the Visual Analogue Scale) was achieved in 95% of the patients, dropping from on average 8.0 preinterventionally to 2.2 after a mean follow-up of 8 months. A reduction of the pain relieving medication was achieved in 68% of the cases and patient activity improved markedly. No severe or clinically relevant complications were observed. Cement leakage occurred by filling of epidural and paravertebral veins in 9.1 and 6.1% of the cases, respectively. Leakage into the paravertebral soft tissues was seen in 3.0% of the patients and to the adjacent disc space in 10.6% of the cases. (orig.)

  10. Catheter-tip fixation of a percutaneously implanted port-catheter system to prevent dislocation

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the incidence of catheter tip dislocation in patients with percutaneously implanted port-catheters for hepatic arterial chemotherapy with catheter tip fixation. Forty-seven patients (31 men and 16 women; mean age 66 years) with unresectable advanced liver cancers (primary liver cancer, n=19; metastatic liver cancer, n=28) underwent percutaneously implantable port-catheter system placement with the tip fixed at the gastroduodenal artery with coils and side hole opened at the common hepatic artery. In 39 patients, n-butyl cyanoacrylate (NBCA) mixed with Lipiodol was added for fixation. The position of the side hole after the indwelling port-catheter system was investigated, and the correction method in cases with catheter dislocation was determined. In 2 (25%) of the 8 patients without NBCA fixation, dislocation of the catheter was noted, in contrast to none (0%) of 37 patients with NBCA fixation. Two patients in whom NBCA was used could not undergo long-term intra-arterial chemotherapy because of hepatic arterial thrombotic occlusion which occurred after placement of the indwelling catheter, and were excluded from the evaluation. Fixation of the catheter tip with combined use of coils and NBCA-Lipiodol mixture to the gastroduodenal artery is important to prevent dislocation of the port-catheter system. (orig.)

  11. Universal decoherence due to gravitational time dilation

    CERN Document Server

    Pikovski, Igor; Costa, Fabio; Brukner, Caslav

    2013-01-01

    Phenomena inherent to quantum theory on curved space-time, such as Hawking radiation, are typically assumed to be only relevant at extreme physical conditions: at high energies and in strong gravitational fields. Here we consider low-energy quantum mechanics in the presence of weak gravitational time dilation and show that the latter leads to universal decoherence of quantum superpositions. Time dilation induces a universal coupling between internal degrees-of-freedom and the centre-of-mass of a composite particle and we show that the resulting entanglement causes the particle's position to decohere. We derive the decoherence timescale and show that the weak time dilation on Earth is already sufficient to decohere micro-scale objects. No coupling to an external environment is necessary, thus even completely isolated composite systems will decohere on curved space-time. In contrast to gravitational collapse models, no modification of quantum theory is assumed. General relativity therefore can account for the e...

  12. Radiofrequency catheter oblation in atrial flutter

    International Nuclear Information System (INIS)

    Objective: To evaluate the radiofrequency catheter ablation for type I atrial flutter through application of Holo catheter labelling with anatomic imaging localization to ablate the isthmus of IVCTA during complete double-way block. Methods: Eleven cases with type I atrial flutter undergone Holo catheter labelling technique and consecution with conduction time change of coronary venous sinus orifice with-right atrial lower lateral wall pace excitation, were performed with radiofrequency catheter ablation for the isthmus outcoming with complete double-way conduction block. Results: All together 11 cases with 4 of atrial flutter and 7 of sinus rhythm were undergone radiofrequency catheter ablation resulting with double-way conduction block of the isthmus accompanied by prolongation of right atrial conduction time 56.0 ± 2.3 ms and 53.0 ± 4.6 ms respectively. The right atrial excitation appeared to be in clockwise and counter-clockwise of single direction. No recurrence occurred during 3-34 months follow up with only one showing atrial fibrillation. Conclusions: The application of Holo catheter labelling technique with anatomic imaging localization to achieve the double-way conduction block by radiofrequency catheter ablation of TVC-TA isthmus, is a reliable method for treating atrial flutter

  13. New device for dilatation of percutaneous biliary tract

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Sung-Gwon; Lim, Myung-Gwan; Cho, Young-Kook; Suh, Chang-Hae [Inha Univ. Hospital, Inchon (Korea, Republic of); Yoon, Hyun Ki; Song, Ho-Young; Sung, Kyu Bo [Asan Medical Center, Ulsan Univ. College of Medicine, Ulsan (Korea, Republic of); Shin, Joo-Won [Ulgi Hospital, Seoul (Korea, Republic of)

    1997-06-01

    To evaluate the usefulness of percutaneous transhepatic biliary drainage (PTBD) tract dilatation using a Nipro set. We dilated 28 percutaneous biliary drainage tracts up to 18F; 26 procedures involved PTBD, and two, cholecystostomy. A Nipro set was used for dilatation, the purposes of which were stone removal (n=18) and choledochoscopic biopsy (n=10). For dilatation, local anesthesia was used in all cases. In all patients, tract dilatation was successful. In 21 of 28 cases, dilatation of the right PTBD tract was involved, and in five of 28, dilatation of the left tract. In two cases, tract dilatation was done in cholecystostomy tracts. Complications encountered were pain (n=17), bradycardia (n=2), hemobilia (n=2), bleeding (n=1), and fever (n=1). In choledocoscopy, tract dilatation using a Nipro set is safe and simple.

  14. The GuideLiner Catheter: A Useful Tool in the Armamentarium of the Interventional Cardiologist

    Directory of Open Access Journals (Sweden)

    Marouane Boukhris

    2015-12-01

    Full Text Available Regardless of the clinical setting, a good back-up represents one of the most important conditions to ensure guide wire and balloon advancement and stent delivery. As a “mother and child” system, the GuideLiner catheter (Vascular Solutions Inc., Minneapolis, MN, USA provides an extension to the guide catheter with better coaxial alignment and stability. We report two didactic cases showing the usefulness of the GuideLiner device in everyday catheterization laboratory practice. The first case was a primary percutaneous coronary intervention (PCI in a 71-year-old diabetic man admitted for inferior ST-elevation myocardial infarction, related to tight proximal stenosis in a dominant tortuous and calcified left circumflex. The second case was an elective PCI in a 76-year-old man admitted for stable angina (Canadian Cardiovascular Society [CCS] class III, related to focal intra-stent restenosis of a saphenous venous graft to the left anterior descending. In both cases, the GuideLiner catheter provided a good back-up insuring the success of PCI and drug-eluting stents implantation, with a good in-hospital outcome. 

  15. RECYCLING OF CATHETER FOR EMBRYO RECOVERY: A TOOL FOR COSTS REDUCTION IN EQUINE EMBRYO TRANSFER

    Directory of Open Access Journals (Sweden)

    Alberto Lopes Gusmao

    2010-06-01

    Full Text Available The embryo transfer is becoming a widespread practice.Most embryos are collected from spontaneous single ovulatingmares and result in 50% of embryo recovery, increasing the costsof production. To illustrate, the price of a catheter for embryosrecovery range from US$ 194.00 to US$ 250.00 (R$ 350.00 to R$450.00. Therefore, the aim of this work was to verify if catheterwith damaged balloon can be recuperated and reused withoutaltering its efficiency. For this study, two groups were used: acontrol group (GI, n=10, on which the nonsurgical recovery of theembryos of mares was performed with the catheter with originalballoon; and another group (GII, n=20, in which a restored catheterwas utilized. The mares of GI had an embryo recovery rate of60%, and GII mares had an embryo recovery rate of 55%. Therewas not statistical difference between groups I and II (P>0.05.Considering that the material used to restore the catheter costsUS$16.66 (R$30.00, this data show that the recuperation of thecatheters for embryo recovery in mares may reduce costs withoutcompromising the rates of embryo recovery.

  16. Early Cosmic Ray Research with Balloons

    International Nuclear Information System (INIS)

    The discovery of cosmic rays by Victor Hess during a balloon flight in 1912 at an altitude of 5350 m would not have been possible without the more than one hundred years development of scientific ballooning. The discovery of hot air and hydrogen balloons and their first flights in Europe is shortly described. Scientific ballooning was mainly connected with activities of meteorologists. It was also the geologist and meteorologist Franz Linke, who probably observed first indications of a penetrating radiation whose intensity seemed to increase with the altitude. Karl Bergwitz and Albert Gockel were the first physicists studying the penetrating radiation during balloon flights. The main part of the article deals with the discovery of the extraterrestrial radiation by V. Hess and the confirmation by Werner Kolhörster

  17. [Catheter-associated urinary tract infections].

    Science.gov (United States)

    Liedl, B

    2015-09-01

    In patients with indwelling urethral catheters significant bacteriuria develops within 4 weeks of indwelling time in practically 100% of the cases. Catheter encrustation and obstruction can occur in approximately 40% of patients. Symptomatic ascending urinary tract infections, urethral complications and urolithiasis can occur in significant numbers in the long term. Regular educational and surveillance programs in nursing homes, hospitals and in home care are important to instruct personnel in hygiene procedures, to learn the indications for catheterization, to keep the indwelling time of catheters as short as possible, to detect any complications early and to initiate appropriate diagnostics and therapy by the urologist. PMID:26275988

  18. Catheter meaning for the adolescents in dialysis

    Directory of Open Access Journals (Sweden)

    Liliana Cristina Morales

    2009-12-01

    Full Text Available Goal: Terminal renal failure affects all the person’s life dimensions. The impact of this illness during adolescence is quite dramatic because the adolescent must live with the illness demands and the demands from this crucial developmental stage. Knowledge regarding the impact of the dialysis catheter on the adolescent’s life is spare. Methodology: A phenomenological study was carried out with 8 female and male adolescents that were in dialysis. Findings: The adolescents had to learn to live with the dialysis catheter in their body. The catheter became an obstacle to achieve their identity and deteriorated their physical appearance and peer relationships.

  19. Evaluation of radiation exposure dose at double-balloon endoscopy for the patients with small bowel disease

    Science.gov (United States)

    Nagura, Asuka; Nakamura, Masanao; Watanabe, Osamu; Yamamura, Takeshi; Funasaka, Kohei; Ohno, Eizaburo; Miyahara, Ryoji; Kawashima, Hiroki; Koyama, Shuji; Hinami, Tomoki; Goto, Hidemi; Hirooka, Yoshiki

    2016-01-01

    ABSTRACT Double-balloon endoscopy (DBE) is useful for the diagnosis and treatment of small bowel diseases. Although fluoroscopy is used to confirm the position of endoscope at DBE, the endoscopist does not have the knowledge with regard to the radiation exposure dose. In this study, we evaluated the absorbed dose during DBE in patients with suspected or established small bowel diseases. This was a retrospective study in which the estimated fluoroscopic radiation absorbed doses loaded on the small bowel and skin were determined according to the data of the referential X-ray experiment with a human body phantom. The subjects were 415 DBEs preformed in total. The mean small bowel absorbed doses on antegrade and retrograde DBEs were 42.2 and 53.8 mGy, respectively, showing that the organ dose applied in retrograde DBE was significantly higher (P<0.0001). The mean skin absorbed doses of them were 79.2 and 101.0 mGy, respectively, showing that the dose was also significantly higher on retrograde DBE (P<0.0001). Of 27 cases who were applied endoscopic balloon dilation, the mean fluoroscopy time was 16.0 minutes, and mean small bowel and skin absorbed doses were 121.9 and 228.9 mGy, respectively. In conclusion, endoscopist should be careful for reducing the organ exposure dose at DBE, particularly for the lower abdominal region. Abbreviations: Double-balloon enteroscopy (DBE), endoscopic balloon dilation (EBD), endoscopic mucosal resection (EMR), double-balloon endoscopic retrograde cholangiopancreatography (DBERCP), percutaneous coronary intervention (PCI) PMID:27578908

  20. Understanding the dilation and dilation relaxation behavior of graphite-based lithium-ion cells

    Science.gov (United States)

    Bauer, Marius; Wachtler, Mario; Stöwe, Hendrik; Persson, Jon V.; Danzer, Michael A.

    2016-06-01

    The dilation of lithium-ion cells is sensitive towards swelling phenomena caused by both graphite staging processes and lithium plating on graphite anodes. In this work, the dilation behavior of graphite/NMC pouch cells is studied with a focus on relaxation phenomena occurring after current pulses. In order to prevent misleading interpretations due to thermal effects, thermal expansion is quantified and a method for the thermal compensation of dilation data is developed. Dilation data are recorded for quasi-equilibrium cycling as well as for current pulses at high rates. In the quasi-equilibrium case, the staging behavior is characterized based on dilation and voltage data. By comparison with a graphite half-cell measurement, the major effects in full cell dilation are confirmed to be anode related. In the high rate case, the dilation responses to the actual pulse and the subsequent relaxation phases are recorded systematically. Positive and negative relaxation phenomena are observed depending on the SOC. They are ascribed to both graphite staging and lithium plating processes. A model is presented explaining the unexpected relaxation effects by a temporary coexistence of three or more staging compounds during high rate lithiation and delithiation. Our data thereby confirm the shrinking annuli model introduced by Heβ and Novák.

  1. Which criteria demand additive stenting during catheter-directed thrombolysis?

    Science.gov (United States)

    Bækgaard, N; Just, S; Foegh, P

    2014-05-19

    Many factors are necessary for obtaining satisfactory results after catheter-directed thrombolysis (CDT) for iliofemoral deep venous thrombosis (DVT). Selections of patients, composition of the thrombolytic fluid, anticoagulation per- and post-procedural, recognition and treatment of persistent obstructive lesions of the iliac veins are the most important contributors. Stenting has been known for 15 to 20 years. The first publication on CDT in 1991 was combined with ballooning the iliac vein, an additive procedure which has been abandoned as an isolated procedure. This chapter will discuss selection, indication, such as an iliac compression syndrome, and outcome of iliac stenting in combination with CDT. The reported frequency of stenting used after CDT is very inconsistent, therefore this will be discussed in details. It is concluded that selection for stenting is of the greatest importance, when CDT is used for iliofemoral DVT, but strict criteria for stenting are not available in the existing literature. The potential value of intravascular ultrasound (IVUS) is also discussed. PMID:24843096

  2. Outcomes of Catheter Ablation of Ventricular Tachycardia in the Setting of Structural Heart Disease.

    Science.gov (United States)

    Betensky, B P; Marchlinski, F E

    2016-07-01

    Sustained ventricular tachycardias are common in the setting of structural heart disease, either due to prior myocardial infarction or a variety of non-ischemic etiologies, including idiopathic dilated cardiomyopathy, hypertrophic cardiomyopathy, and arrhythmogenic right ventricular cardiomyopathy. Over the past two decades, percutaneous catheter ablation has evolved dramatically and has become an effective tool for the control of ventricular arrhythmias. Single and multicenter observational studies as well as several prospective randomized trials have begun to investigate long-term outcomes after catheter ablation procedures. These studies encompass a wide range of mapping and ablation techniques, including conventional activation mapping/entrainment criteria, substrate modification guided by pacemapping, late potential and abnormal electrogram ablation, scar de-channeling, and core isolation. While large-scale, multicenter prospective randomized clinical trials are somewhat limited, the published data demonstrate favorable outcomes with respect to a reduction in overall ventricular tachycardia (VT) burden, reduction of implantable cardioverter defibrillator (ICD) shocks, and discontinuation of anti-arrhythmic medications across varying disease subtypes and convincingly support the use of catheter ablation as the standard of care for many patients with VT in the setting of structural heart disease. PMID:27234813

  3. Antimicrobial-impregnated catheters for the prevention of catheter-related bloodstream infections.

    Science.gov (United States)

    Lorente, Leonardo

    2016-05-01

    Central venous catheters are commonly used in critically ill patients. Such catheterization may entail mechanical and infectious complications. The interest in catheter-related infection lies in the morbidity, mortality and costs that it involved. Numerous contributions have been made in the prevention of catheter-related infection and the current review focuses on the possible current role of antimicrobial impregnated catheters to reduce catheter-related bloodstream infections (CRBSI). There is evidence that the use of chlorhexidine-silver sulfadiazine (CHSS), rifampicin-minocycline, or rifampicin-miconazol impregnated catheters reduce the incidence of CRBSI and costs. In addition, there are some clinical circumstances associated with higher risk of CRBSI, such as the venous catheter access and the presence of tracheostomy. Current guidelines for the prevention of CRBSI recommended the use of a CHSS or rifampicin-minocycline impregnated catheter in patients whose catheter is expected to remain in place > 5 d and if the CRBSI rate has not decreased after implementation of a comprehensive strategy to reduce it. PMID:27152256

  4. Uterine Balloon Tamponade in Combination with Topical Administration of Tranexamic Acid for Management of Postpartum Hemorrhage

    Directory of Open Access Journals (Sweden)

    Masato Kinugasa

    2015-01-01

    Full Text Available While uterine balloon tamponade is an effective modality for control of postpartum hemorrhage, the reported success rates have ranged from the level of 60% to the level of 80%. In unsuccessful cases, more invasive interventions are needed, including hysterectomy as a last resort. We developed a modified tamponade method and applied it to two cases of refractory postpartum hemorrhage after vaginal delivery. The first case was accompanied by uterine myoma and low-lying placenta. After an induced delivery, the patient had excessive hemorrhage due to uterine atony. Despite oxytocin infusion and bimanual uterine compression, the total blood loss was estimated at 2,800 mL or more. The second case was diagnosed as placental abruption complicated by fetal death and severe disseminated intravascular coagulation, subsequently. A profuse hemorrhage continued despite administration of uterotonics, fluid, and blood transfusion. The total blood loss was more than 5,000 mL. In each case, an intrauterine balloon catheter was wrapped in gauze impregnated with tranexamic acid, inserted into the uterus, and inflated sufficiently with sterile water. In this way, mechanical compression by a balloon and a topical antifibrinolytic agent were combined together. This method brought complete hemostasis and no further treatments were needed. Both the women left hospital in stable condition.

  5. Pupil dilation betrays the timing of decisions

    Directory of Open Access Journals (Sweden)

    Wolfgang Einhauser

    2010-02-01

    Full Text Available The notion of mind-reading by carefully observing another individual's physiological responses has recently become commonplace in popular culture, particularly in the context of brain imaging. The question remains, however, whether outwardly accessible physiological signals indeed betray a decision before a person voluntarily reports it. In one experiment we asked observers to push a button at any time during a 10-second period (“immediate overt response”. In a series of three additional experiments observers were asked to select one number from five sequentially presented digits but concealed their decision until the trial’s end (“covert choice”. In these experiments observers either had to choose the digit themselves under conditions of reward and no reward, or were instructed which digit to select via an external cue provided at the time of the digit presentation. In all cases pupil dilation alone predicted the choice (timing of button response or chosen digit, respectively. Consideration of the average pupil-dilation responses, across all experiments, showed that this prediction of timing was distinct from a general arousal or reward-anticipation response. Furthermore, the pupil dilation appeared to reflect the post-decisional consolidation of the selected outcome rather than the pre-decisional cognitive appraisal component of the decision. Given the tight link between pupil dilation and norepinephrine levels during constant illumination, our results have implications beyond the tantalizing mind-reading speculations. These findings suggest that similar noradrenergic mechanisms may underlie the consolidation of both overt and covert decisions.

  6. Surface dilatational viscosity of Langmuir monolayers

    Science.gov (United States)

    Lopez, Juan; Vogel, Michael; Hirsa, Amir

    2003-11-01

    With increased interest in microfluidic systems, interfacial phenomena is receiving more attention. As the length scales of fluid problems decrease, the surface to volume ratio increases and the coupling between interfacial flow and bulk flow becomes increasingly dominated by effects due to intrinsic surface viscosities (shear and dilatational), in comparison to elastic effects (due to surface tension gradients). The surface shear viscosity is well-characterized, as cm-scale laboratory experiments are able to isolate its effects from other interfacial processes (e.g., in the deep-channel viscometer). The same is not true for the dilatational viscosity, because it acts in the direction of surface tension gradients. Their relative strength scale with the capillary number, and for cm-scale laboratory flows, surface tension effects tend to dominate. In microfluidic scale flows, the scaling favors viscosity. We have devised an experimental apparatus which is capable of isolating and enhancing the effects of dilatational viscosity at the cm scales by driving the interface harmonically in time, while keeping the interface flat. In this talk, we shall present both the theory for how this works as well as experimental measurements of surface velocity from which we deduce the dilatational viscosity of several monolayers on the air-water interface over a substantial range of surface concentrations. Anomalous behavior over some range of concentration, which superficially indicates negative viscosity, maybe explained in terms of compositional effects due to large spatial and temporal variations in concentration and corresponding viscosity.

  7. Pupils dilate for vocal or familiar music.

    Science.gov (United States)

    Weiss, Michael W; Trehub, Sandra E; Schellenberg, E Glenn; Habashi, Peter

    2016-08-01

    Previous research reveals that vocal melodies are remembered better than instrumental renditions. Here we explored the possibility that the voice, as a highly salient stimulus, elicits greater arousal than nonvocal stimuli, resulting in greater pupil dilation for vocal than for instrumental melodies. We also explored the possibility that pupil dilation indexes memory for melodies. We tracked pupil dilation during a single exposure to 24 unfamiliar folk melodies (half sung to la la, half piano) and during a subsequent recognition test in which the previously heard melodies were intermixed with 24 novel melodies (half sung, half piano) from the same corpus. Pupil dilation was greater for vocal melodies than for piano melodies in the exposure phase and in the test phase. It was also greater for previously heard melodies than for novel melodies. Our findings provide the first evidence that pupillometry can be used to measure recognition of stimuli that unfold over several seconds. They also provide the first evidence of enhanced arousal to vocal melodies during encoding and retrieval, thereby supporting the more general notion of the voice as a privileged signal. (PsycINFO Database Record PMID:27123682

  8. Stuck suction catheter in endotracheal tube

    Directory of Open Access Journals (Sweden)

    Monish S Raut

    2015-01-01

    Full Text Available Endotracheal tube (ETT suction is essential to clear secretions so that airway patency can be maintained. Stuck suction catheter in ETT is an uncommon event, and it can be dangerous in patients with difficult airway cases.

  9. Venous port catheter dislocation as an unusual cause of pneumonia

    Directory of Open Access Journals (Sweden)

    Umut Serhat Sanrı

    2014-06-01

    Full Text Available The use of central venous port catheter is a very useful method for long-term therapy in patients with malignancy. Catheter insertion technique and maintenance of equipment is very important to the prevention of catheter-related complications. The most frequent complications are deep venous thrombosis, port infection, catheter obstruction. İn this article, pneumonia occurrence after chemotherapy infusion in a patient who has a completely extravasated central venous port catheter discussed.

  10. Accuracy of image-guided radiotherapy of prostate cancer based on the BeamCath urethral catheter technique

    DEFF Research Database (Denmark)

    Poulsen, Per Rugaard; Fokdal, Lars; Petersen, Jørgen B.B.;

    2007-01-01

    -right (LR), 2.8 mm in the cranial-caudal (CC), and 1.6 mm in the anteroposterior (AP) directions, respectively. When the balloon radius differed more than 1mm between the CT scans (14 of 64 cases) the SD in the CC direction increased to 4.5 mm. The SD of the prostate movement relative to the pelvic bone...... was 0.6 mm (LR), 2.4 mm (CC), and 2.8 mm (AP), while the prostate movement relative to external skin markers was considerably larger. Removal of the catheter resulted in a mean cranial prostate movement of 1.5mm relative to the pelvic bone. Caudal catheter displacements of 7-30 mm were observed in 5...

  11. Advanced Imaging Catheter: Final Project Report

    Energy Technology Data Exchange (ETDEWEB)

    Krulevitch, P; Colston, B; DaSilva, L; Hilken, D; Kluiwstra, J U; Lee, A P; London, R; Miles, R; Schumann, D; Seward, K; Wang, A

    2001-07-20

    Minimally invasive surgery (MIS) is an approach whereby procedures conventionally performed with large and potentially traumatic incisions are replaced by several tiny incisions through which specialized instruments are inserted. Early MIS, often called laparoscopic surgery, used video cameras and laparoscopes to visualize and control the medical devices, which were typically cutting or stapling tools. More recently, catheter-based procedures have become a fast growing sector of all surgeries. In these procedures, small incisions are made into one of the main arteries (e.g. femoral artery in the thigh), and a long thin hollow tube is inserted and positioned near the target area. The key advantage of this technique is that recovery time can be reduced from months to a matter of days. In the United States, over 700,000 catheter procedures are performed annually representing a market of over $350 million. Further growth in this area will require significant improvements in the current catheter technology. In order to effectively navigate a catheter through the tortuous vessels of the body, two capabilities must exist: imaging and positioning. In most cases, catheter procedures rely on radiography for visualization and manual manipulation for positioning of the device. Radiography provides two-dimensional, global images of the vasculature and cannot be used continuously due to radiation exposure to both the patient and physician. Intravascular ultrasound devices are available for continuous local imaging at the catheter tip, but these devices cannot be used simultaneously with therapeutic devices. Catheters are highly compliant devices, and manipulating the catheter is similar to pushing on a string. Often, a guide wire is used to help position the catheter, but this procedure has its own set of problems. Three characteristics are used to describe catheter maneuverability: (1) pushability -- the amount of linear displacement of the distal end (inside body) relative to

  12. An Unusual Complication of Suprapubic Catheter Insertion

    Directory of Open Access Journals (Sweden)

    Krishnan Ananthakrishnan

    2006-01-01

    Full Text Available A patient who had a small bowel mesentery perforation following insertion of a suprapubic catheter (SPC is described. He had no bowel complaints immediately following the procedure, but presented 10 weeks later with insidious onset bowel obstruction due to the kink caused by the catheter. This complication occurred despite cystoscopy control and adequate bladder distension prior to the procedure. This isolated case illustrates the fact that regardless of the ease and frequency of SPC insertion, complications do occur.

  13. Wound catheter techniques for postoperative analgesia

    OpenAIRE

    VINTAR, NELI

    2009-01-01

    Wound catheter technique is a technique of postoperative analgesia in which the surgeon places a catheter to infuse local anesthetic into wounds at the end of the procedure. It can be used in abdominal colorectal surgery or after holecystectomies, was studied after caesarean delivery. It was effective after some orthopaedic procedures such as shoulder and knee surgery, at the donor site in the iliac crest. It can be used in plastic surgery after breast surgery. It is technically efficie...

  14. Haemolyzed samples: responsibility of short catheters.

    Science.gov (United States)

    Raisky, F; Gauthier, C; Marchal, A; Blum, D

    1994-01-01

    The haemolysis of blood samples is a source of error in the electrolytic and enzymatic determination in clinical biochemistry. This circumstance seems dependent on the material used for the venepuncture. In this study we compared three kinds of material in 350 patients who were sampled in the emergency department. This randomized study compared the haemolysis of blood samples collected with stainless steel needles and short catheters, either Teflon FEP (Cathlon Critikon) or polyurethane Vialon (Insyte Becton-Dickinson). Quantification of hemolysis was performed by assay of the optical density of plasma haemoglobin. Results were analysed, after verification of the randomization, by one-way analysis of variance by ranks. This study demonstrated a highly significant relation between occurrence of haemolysis and the sampling material, used according to its technical obligations. Haemolysis occurred frequently when short catheters were used in 42% and 55% of cases with the Teflon and Vialon catheters, respectively. Haemolysis was much less frequent with stainless steel needles (12%). This difference was even more marked for haemoglobin levels above 1.5 milligrams of plasma, where the incidence was 4.2%, 9% and 30%, respectively, for the stainless steel needles, the Teflon catheter and the Vialon catheter. This study induced our emergency department to take more blood samples with a needle, even if an infusion was to be given subsequently, or to take them using a Teflon catheter. PMID:7840428

  15. Airborne Internet Providing Tethered Balloon System

    Directory of Open Access Journals (Sweden)

    Suvriti Dhawan1

    2015-12-01

    Full Text Available In this paper we shall introduce a new system for providing wireless network communication over a specified area using ’lighter than air’ balloons. This technology will replace the existing fiber optic network system. This will be done by using a tethered balloon along with the payload (containing a receiver, a transmitter and a radio communication device.This payload will be suspended from the ground at an altitude (depending on the area of coverage required. Users under this area will be able to access this system directly for internet connectivity. This system can be used over large areas like universities, companies and societies to provide internet facility to their users through Wi-Fi or over an area where the user is specified (commercial purposes. Currently Google is working on similar idea called the ’Google Loon’ in which they use high altitude balloons which float at an altitude twice as high as air planes and the weather. They recently tested this system over New-Zealand by providing internet to their pilot testers on ground. Their balloons not being stationary, move with directional winds and have to be replaced one after the other to maintain consistency. This can be a huge problem over the areas where upper atmospheric winds are not in favorable direction. We can resolve this problem by using our stationary tethered balloon system which can communicate with the loon balloons to provide internet facility over a desired area. Moreover when our balloon will communicate with the loon balloon it will increase the coverage area as the loon balloon has to communicate to a point which is above the ground. Our system will not only replace the existing fiber optic system but it will also be selfsustaining i.e. It will generate its own power using solar panels.

  16. Investigating Diffusion and Entropy with Carbon Dioxide-Filled Balloons

    Science.gov (United States)

    Jadrich, James; Bruxvoort, Crystal

    2010-01-01

    Fill an ordinary latex balloon with helium gas and you know what to expect. Over the next day or two the volume will decrease noticeably as helium escapes from the balloon. So what happens when a latex balloon is filled with carbon dioxide gas? Surprisingly, carbon dioxide balloons deflate at rates as much as an order of magnitude faster than…

  17. Accurate Determination of the Volume of an Irregular Helium Balloon

    Science.gov (United States)

    Blumenthal, Jack; Bradvica, Rafaela; Karl, Katherine

    2013-01-01

    In a recent paper, Zable described an experiment with a near-spherical balloon filled with impure helium. Measuring the temperature and the pressure inside and outside the balloon, the lift of the balloon, and the mass of the balloon materials, he described how to use the ideal gas laws and Archimedes' principal to compute the average molecular…

  18. The balloon and the airship technological heritage

    Science.gov (United States)

    Mayer, N. J.

    1981-01-01

    The balloon and the airship are discussed with emphasis on the identification of commonalities and distinctions. The aerostat technology behind the shape and structure of the vehicles is reviewed, including a discussion of structural weight, internal pressure, buckling, and the development of a stable tethered balloon system. Proper materials for the envelope are considered, taking elongation and stress into account, and flight operation and future developments are reviewed. Airships and tethered balloons which are designed to carry high operating pressure with low gas loss characteristics are found to share similar problems in low speed flight operations, while possessing interchangeable technologies.

  19. Looners: Inside the world of balloon fetishism

    OpenAIRE

    McIntyre, Karen E

    2011-01-01

    In the spring of 1997, Shaun had just broken up with a boyfriend, and his roommate had moved out. Living alone for the first time and relieved of the fear that someone might walk in the door, he was finally able to indulge his fantasy. The young man sat on his couch and started blowing up balloons. Shaun had loved playing with balloons since he was a child. When he hit puberty, he felt his first orgasm rubbing against a balloon. It was then that his relationship with the object took ...

  20. Cutting Balloon angioplasty for cardiac transplant vasculopathy.

    OpenAIRE

    Takano, Y.; Currier, JW; Yeatman, LA; Kobashigawa, JA; Rogers, AD; Cianfichi, LJ; Fishbein, MC; Tobis, JM

    2002-01-01

    We performed Cutting Balloon angioplasty on 20 lesions in 11 heart transplant recipients 7.5 +/- 3.8 years after transplantation. The mean percentage of diameter stenosis decreased from 88.3% +/- 13.8% to 19.6% +/- 13.7% after Cutting Balloon angioplasty without complication. Seven patients underwent follow-up angiography at 4.9 +/- 1.7 months in a total of 12 lesions, and all lesions showed restenosis with a mean diameter stenosis of 84.4% +/- 19.2%. Cutting Balloon angioplasty can be used t...

  1. Clinical experience of cerebral protection with balloon occlusion during carotid artery stenting

    International Nuclear Information System (INIS)

    Purpose: To asses the technical feasibility and the results of cerebral protection with the GuardWire Plus Temporary Occlusion and Aspiration System during carotid artery stenting for high-grade stenosis. Patients and Methods: In 20 patients 20 carotid artery stenoses were treated with stent placement under cerebral protection. A contralateral carotid occlusion was an exclusion criteria for the use of the protection device. In all cases only aspiration, but no flushing was used before deflation of the occlusion balloon. In 17 of 20 patients diffusion-weighted (DW-)MRT imaging of the brain was performed before and 24 hours after the procedure. Results: The stent implantation was successfully performed in all patients. In 3 patients neurologic symptoms occurred during the occlusion time. In these 3 patients the symptoms immediately disappeared after deflation of the balloon. In one case there was dilatation of the internal carotid artery at the site of the balloon inflation. In 3 of the 17 DW-MR images new ipsilateral cerebral lesions, in one case a new contralateral lesion occurred after the procedure. Conclusions: The cerebral protection procedure is technically feasible. The occlusion of the internal carotid artery was not tolerated by all patients. The DW-MR imaging demonstrated cerebral lesions indicating the occurrence of cerebral microemboli during the procedure. Further investigations are necessary to determine if the use of the cerebral protection device will improve the results of the carotid artery stenting for high-grade stenoses. (orig.)

  2. Segmental dilatation of colon associated with anorectal malformation

    Directory of Open Access Journals (Sweden)

    Mahajan J

    2007-01-01

    Full Text Available Children with segmental dilatation of the colon suffer severe constipation and are clinically indistinguishable from Hirschsprung disease. Segmental dilatation of colon is rare in neonates. In this report, a neonate with unusual combination of segmental dilatation of the colon and high anorectal malformation is presented.

  3. 21 CFR 870.1310 - Vessel dilator for percutaneous catheterization.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vessel dilator for percutaneous catheterization... Vessel dilator for percutaneous catheterization. (a) Identification. A vessel dilator for percutaneous catheterization is a device which is placed over the guide wire to enlarge the opening in the vessel, and which...

  4. Can clinicians accurately assess esophageal dilation without fluoroscopy?

    Science.gov (United States)

    Bailey, A D; Goldner, F

    1990-01-01

    This study questioned whether clinicians could determine the success of esophageal dilation accurately without the aid of fluoroscopy. Twenty patients were enrolled with the diagnosis of distal esophageal stenosis, including benign peptic stricture (17), Schatski's ring (2), and squamous cell carcinoma of the esophagus (1). Dilation attempts using only Maloney dilators were monitored fluoroscopically by the principle investigator, the physician and patient being unaware of the findings. Physicians then predicted whether or not their dilations were successful, and they examined various features to determine their usefulness in predicting successful dilation. They were able to predict successful dilation accurately in 97% of the cases studied; however, their predictions of unsuccessful dilation were correct only 60% of the time. Features helpful in predicting passage included easy passage of the dilator (98%) and the patient feeling the dilator in the stomach (95%). Excessive resistance suggesting unsuccessful passage was an unreliable feature and was often due to the dilator curling in the stomach. When Maloney dilators are used to dilate simple distal strictures, if the physician predicts successful passage, he is reliably accurate without the use of fluoroscopy; however, if unsuccessful passage is suspected, fluoroscopy must be used for confirmation. PMID:2210278

  5. A cooled water-irrigated intraesophageal balloon to prevent thermal injury during cardiac ablation: experimental study based on an agar phantom

    International Nuclear Information System (INIS)

    A great deal of current research is directed to finding a way to minimize thermal injury in the esophagus during radiofrequency catheter ablation of the atrium. A recent clinical study employing a cooling intraesophageal balloon reported a reduction of the temperature in the esophageal lumen. However, it could not be determined whether the deeper muscular layer of the esophagus was cooled enough to prevent injury. We built a model based on an agar phantom in order to experimentally study the thermal behavior of this balloon by measuring the temperature not only on the balloon, but also at a hypothetical point between the esophageal lumen and myocardium (2 mm distant). Controlled temperature (55 0C) ablations were conducted for 120 s. The results showed that (1) the cooling balloon provides a reduction in the final temperature reached, both on the balloon surface and at a distance of 2 mm; (2) coolant temperature has a significant effect on the temperature measured at 2 mm from the esophageal lumen (it has a less effect on the temperature measured on the balloon surface) and (3) the pre-cooling period has a significant effect on the temperature measured on the balloon surface (the effect on the temperature measured 2 mm away is small). The results were in good agreement with those obtained in a previous clinical study. The study suggests that the cooling balloon gives thermal protection to the esophagus when a minimum pre-cooling period of 2 min is programmed at a coolant temperature of 5 deg. C or less. (note)

  6. A cooled water-irrigated intraesophageal balloon to prevent thermal injury during cardiac ablation: experimental study based on an agar phantom

    Energy Technology Data Exchange (ETDEWEB)

    Lequerica, Juan L [Cardiac Research Laboratory, Instituto de Biomedicina, Spanish Council for Scientific Research (CSIC), Valencia (Spain); Berjano, Enrique J [Institute for Research and Innovation on Bioengineering, Valencia Polytechnic University, Valencia (Spain); Herrero, Maria [Cardiac Research Laboratory, Instituto de Biomedicina, Spanish Council for Scientific Research (CSIC), Valencia (Spain); Melecio, Lemuel [Cardiac Research Laboratory, Instituto de Biomedicina, Spanish Council for Scientific Research (CSIC), Valencia (Spain); Hornero, Fernando [Department of Cardiac Surgery, Consorcio Hospital General Universitario, Valencia (Spain)

    2008-02-21

    A great deal of current research is directed to finding a way to minimize thermal injury in the esophagus during radiofrequency catheter ablation of the atrium. A recent clinical study employing a cooling intraesophageal balloon reported a reduction of the temperature in the esophageal lumen. However, it could not be determined whether the deeper muscular layer of the esophagus was cooled enough to prevent injury. We built a model based on an agar phantom in order to experimentally study the thermal behavior of this balloon by measuring the temperature not only on the balloon, but also at a hypothetical point between the esophageal lumen and myocardium (2 mm distant). Controlled temperature (55 {sup 0}C) ablations were conducted for 120 s. The results showed that (1) the cooling balloon provides a reduction in the final temperature reached, both on the balloon surface and at a distance of 2 mm; (2) coolant temperature has a significant effect on the temperature measured at 2 mm from the esophageal lumen (it has a less effect on the temperature measured on the balloon surface) and (3) the pre-cooling period has a significant effect on the temperature measured on the balloon surface (the effect on the temperature measured 2 mm away is small). The results were in good agreement with those obtained in a previous clinical study. The study suggests that the cooling balloon gives thermal protection to the esophagus when a minimum pre-cooling period of 2 min is programmed at a coolant temperature of 5 deg. C or less. (note)

  7. Recent Developments in Balloon Support Instrumentation at TIFR Balloon Facility, Hyderabad.

    Science.gov (United States)

    Vasudevan, Rajagopalan

    2012-07-01

    The Balloon Facility of Tata Institute of Fundamental Research has been conducting stratospheric balloon flights regularly for various experiments in Space Astronomy and Atmospheric Sciences. A continuous improvement in Balloon flight Support instrumentation by the Control Instrumentation Group to keep in space with the growing complexities of the scientific payloads have contributed to the total success of balloon flights conducted recently. Recent improvements in display of Balloon position during balloon flight by showing on real time the balloon GPS position against Google TM maps is of immense help in selecting the right spot for payload landing and safe recovery . For further speeding up the payload recovery process, a new GPS-GSM payload system has been developed which gives SMS of the payload position information to the recovery team on their cell phones. On parallel footing, a new GPS- VHF system has been developed using GPS and Radio Modems for Balloon Tracking and also for obtaining the payload impact point. On the Telecommand side, a single board Telecommand/ Timer weighing less than 2 Kg has been specially developed for use in the mesosphere balloon test flight. The interference on the existing Short Range Telemetry System has been eliminated by introducing a Band Pass Filter and LNA in the Receiving system of the modules, thereby enhancing its reliability. In this paper , we present the details of the above mentioned developments.

  8. Shielded Mars Balloon Launcher (SMBL) Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Aurora Flight Sciences, along with its partner Vertigo Industries, proposes a novel approach to deployment of balloon-based payloads into the Martian atmosphere....

  9. Retrieving Balloon Data in Flight Project

    Data.gov (United States)

    National Aeronautics and Space Administration —   NASA has plans to fly stratospheric ULDBs for missions of 100 days or more in the next few years. As these balloons circumnavigate the globe multiple...

  10. Attitude determination for balloon-borne experiments

    CERN Document Server

    Gandilo, N N; Amiri, M; Angile, F E; Benton, S J; Bock, J J; Bond, J R; Bryan, S A; Chiang, H C; Contaldi, C R; Crill, B P; Devlin, M J; Dober, B; Dore, O P; Farhang, M; Filippini, J P; Fissel, L M; Fraisse, A A; Fukui, Y; Galitzki, N; Gambrel, A E; Golwala, S; Gudmundsson, J E; Halpern, M; Hasselfield, M; Hilton, G C; Holmes, W A; Hristov, V V; Irwin, K D; Jones, W C; Kermish, Z D; Klein, J; Korotkov, A L; Kuo, C L; MacTavish, C J; Mason, P V; Matthews, T G; Megerian, K G; Moncelsi, L; Morford, T A; Mroczkowski, T K; Nagy, J M; Netterfield, C B; Novak, G; Nutter, D; O'Brient, R; Pascale, E; Poidevin, F; Rahlin, A S; Reintsema, C D; Ruhl, J E; Runyan, M C; Savini, G; Scott, D; Shariff, J A; Soler, J D; Thomas, N E; Trangsrud, A; Truch, M D; Tucker, C E; Tucker, G S; Tucker, R S; Turner, A D; Ward-Thompson, D; Weber, A C; Wiebe, D V; Young, E Y

    2014-01-01

    An attitude determination system for balloon-borne experiments is presented. The system provides pointing information in azimuth and elevation for instruments flying on stratospheric balloons over Antarctica. In-flight attitude is given by the real-time combination of readings from star cameras, a magnetometer, sun sensors, GPS, gyroscopes, tilt sensors and an elevation encoder. Post-flight attitude reconstruction is determined from star camera solutions, interpolated by the gyroscopes using an extended Kalman Filter. The multi-sensor system was employed by the Balloon-borne Large Aperture Submillimeter Telescope for Polarimetry (BLASTPol), an experiment that measures polarized thermal emission from interstellar dust clouds. A similar system was designed for the upcoming flight of SPIDER, a Cosmic Microwave Background polarization experiment. The pointing requirements for these experiments are discussed, as well as the challenges in designing attitude reconstruction systems for high altitude balloon flights. ...

  11. Magnetometer for Balloons and UAVs Project

    Data.gov (United States)

    National Aeronautics and Space Administration — This Phase I SBIR project will investigate a new, low-cost approach to atomic magnetometry that is suited for operation from UAVs and research balloons. Atomic...

  12. Strategies for the control of catheter encrustation.

    Science.gov (United States)

    Stickler, D J; Evans, A; Morris, N; Hughes, G

    2002-06-01

    Two general strategies have been adopted to develop catheter materials that resist encrustaion by bacterial biofilms: (a) the incorporation of antimicrobial agents into the polymers and (b) the production of materials with surface properties which prevent the adherence of bacterial cells. Our experience to develop non-adherent surfaces which abstracts design from nature is reported. Compounds based on 2-methacryloloxyethylphosphorylcholine co-polymerised with long-chain alkyl methacrylates have been produced which have structural and surface properties similar to those of the outer membranes of erythrocytes. These PC-coatings have been applied onto catheter base materials where they produce polar surfaces that are extremely hydrophilic. In experiments using a laboratory model of the catheterised bladder we found that the PC-coatings did not reduce colonisation of latex or silicone catheters by crystalline Proteus mirabilis biofilm. There were no significant difference between the amounts of calcium and magnesium salts deposited on coated and non-coated catheters. In a further set of experiments the PC-coatings did not significantly increase the mean times for which catheters drained freely. In a parallel clinical study, the performance of PC-coated ureteral stents was investigated. Scanning electron microscopy and bacteriological analysis on 44 PC-coated stents that had been implanted in patients for 12-week periods and 28 control stents suggested that the PC-coated devices were less vulnerable to encrustation and colonisation by bacterial biofilm than normal stents. It was of interest that in contrast to encrusted catheters, urease producing species such as P. mirabilis were rarely isolated from the stents. The main organisms colonising the stents were enterococci and coagulase-negative staphylococci. These results suggest that the mechanisms of catheter and stent encrustation may be different and require different strategies for control. PMID:12135840

  13. Test ventilation with smoke, bubbles, and balloons

    Energy Technology Data Exchange (ETDEWEB)

    Pickering, P.L.; Cucchiara, A.L.; McAtee, J.L.; Gonzales, M.

    1987-01-01

    The behavior of smoke, bubbles, and helium-filled balloons was videotaped to demonstrate the mixing of air in the plutonium chemistry laboratories, a plutonium facility. The air-distribution patterns, as indicated by each method, were compared. Helium-filled balloons proved more useful than bubbles or smoke in the visualization of airflow patterns. The replay of various segments of the videotape proved useful in evaluating the different techniques and in identifying airflow trends responsible for air mixing. 6 refs.

  14. Intrabiliary radiation inhibits smooth muscle formation and biliary duct remodelling after balloon overstretching injury in dogs

    Institute of Scientific and Technical Information of China (English)

    何贵金; 高沁怡; 莫宾; 戴显伟; 姜维国; 孙铎; 陈平健

    2004-01-01

    Background Internal metallic stents have been widely used in clinical practice, but a high postoperative restenosis rate limits its application. The purpose of this study was to determine the effect of intrabiliary radiation on muscle formation and biliary duct remodeling after biliary duct balloon injury in dogs. Methods Twenty male dogs (15-20 kg) were randomly divided into treatment group (n=10) and control group (n=10). Balloon overstretching injury was induced using a balloon catheter placed across the biliary duct. Subsequently, a 103Pd radioactive stent was positioned at the target site in each animal in the treatment group, providing the injured biliary duct with a radiation dose of 12.58×107 Bq. Dogs in the control group received Ni-Ti stents. All the dogs were killed one month after initial injury. The injured sections were dissected free from the dogs, and were processed for histological and morphological study. Cross-sections were stained with hematoxylin-eosin, Masson's trichrome, and Verhoef-van Giesen. Muscle formation area and lumen area were determined using a computer-assisted image analysis system. Results Compared with the control group, 103Pd radioactive stents significantly reduced muscle formation area (78.3%, P<0.01), and percentage area of stenosis [control stents: (60.0±21.6)%, 103Pd radioactive stents: (31.6±9.5)%]. In addition, in the treatment group, the biliary duct lumen area was significantly larger than that in the control group (P<0.01). Conclusions 103Pd radioactive stents providing a radioactive dose of 12.58×107 Bq are effective in reducing muscle formation and biliary duct remodeling after balloon overstretching injury.

  15. An Ergodic Dilation of Completely Positive Maps

    CERN Document Server

    Pandiscia, Carlo

    2011-01-01

    We shall prove the following Stinespring-type theorem: there exists a triple $(\\pi,\\mathcal{H},\\mathbf{V})$ associated with an unital completely positive map $\\Phi:\\mathfrak{A}\\rightarrow \\mathfrak{A}$ on C* algebra $\\mathfrak{A}$ with unit, where $\\mathcal{H}$ is a Hilbert space, $\\pi:\\mathfrak{A\\rightarrow B}(\\mathcal{H})$ is a faithful representation and $\\mathbf{V}$ is a linear isometry on $\\mathcal{H}$ such that $\\pi(\\Phi(a)=\\mathbf{V}^*\\pi(a)\\mathbf{V}$ for all $a$ belong to $\\mathfrak{A}$. The Nagy dilation theorem, applied to isometry $\\mathbf{V}$, allows to construct a dilation of ucp-map, $\\Phi$, in the sense of Arveson, that satisfies ergodic properties of a $\\Phi $-invariante state $\\phi$ on $\\mathfrak{A}$, if $\\Phi$ admit a $\\phi $-adjoint.

  16. Universal decoherence due to gravitational time dilation

    Science.gov (United States)

    Pikovski, Igor; Zych, Magdalena; Costa, Fabio; Brukner, Caslav

    2016-05-01

    The absence of quantum behavior on macroscopic scales is usually attributed to decoherence -- the suppression of quantum superpositions due to interaction with an environment. Here we show that time dilation provides a universal decoherence mechanism for any complex system. The effect takes place even for isolated particles that do not interact with any external environment and causes decoherence of position and momentum of the center of mass of the system. While time dilation is very weak on earth, it is already sufficient to decohere gram-scale objects and complex molecules. The results show that novel phenomena arise at the interplay between quantum theory and general relativity even in the low energy limit. Possible experimental verifications of the effect are briefly discussed.

  17. Stability of wavelet frames with matrix dilations

    DEFF Research Database (Denmark)

    Christensen, Ole; Sun, Wenchang

    2006-01-01

    Under certain assumptions we show that a wavelet frame {Tau(A(j), b(j,k))psi} (j,k is an element of Z) := {vertical bar detA(j)vertical bar(-1/2) psi(A(j)(-1)(x - b(j,k)))} (j,k is an element of Z) in L-2(R-d) remains a frame when the dilation matrices A(j) and the translation parameters b(j,k) are...

  18. Mixed Mode cohesive law with interface dilatation

    DEFF Research Database (Denmark)

    Sørensen, Bent F.; Goutianos, Stergios

    2014-01-01

    shear stresses opposing the crack face displacements. A phenomenological Mixed Mode cohesive zone law, derived from a potential function, is developed to describe the above mentioned fracture behaviour under monotonic opening. The interface dilatation introduces two new lengths. The cohesive law is...... implemented in the commercial finite element program Abaqus. The model is validated and tested against experimental results under various mode mixities. © 2013 Elsevier Ltd. All rights reserved....

  19. Nursing care in gastric dilatation in dogs

    OpenAIRE

    A. Valente; Rego, A.; R. NASCIMENTO; Oliveira, J; Vala, Helena; Mesquita, JR.; Nóbrega, C.

    2013-01-01

    Gastric Dilatation is a potentially fatal gastrointestinal pathology caused by aerophagy. It is mainly caused by rapid consumption of food, excitation or exercising near the time of feeding, which promotes the entrance of air into the stomach (Robbins et al, 2011). With this work we aim to emphasize the care given by veterinary nurses in this pathology. FCT e CI&DETS (Pest – OE/CEU/UI4016/2011)

  20. The Mutations Associated with Dilated Cardiomyopathy

    OpenAIRE

    Ruti Parvari; Aviva Levitas

    2012-01-01

    Cardiomyopathy is an important cause of heart failure and a major indication for heart transplantation in children and adults. This paper describes the state of the genetic knowledge of dilated cardiomyopathy (DCM). The identification of the causing mutation is important since presymptomatic interventions of DCM have proven value in preventing morbidity and mortality. Additionally, as in general in genetic studies, the identification of the mutated genes has a direct clinical impact for the f...

  1. Comparison between children dilated computer and retinoscopy

    OpenAIRE

    Li-Li Qi; Li-Li Sun; Ji Li

    2015-01-01

    AIM: To investigate the dilation effect of computer optometry and retinoscopy optometry before and after mydriasis in children and to understand whether the application of computer refractor in children.METHODS: Therelated data of 500 children cases(1 000 eyes)with ametropia in our hospital were analyzed. The children firstly received computer optometry, and then use the 10g/L atropine sulfate eye gel drops, respectively. After 3d, they were performed computer optometry and retinoscopy, and c...

  2. Dilation volumes of sets of bounded perimeter

    DEFF Research Database (Denmark)

    Kiderlen, Markus; Rataj, Jan

    This paper analyzes the first order behavior (that is, the right sided derivative) of the volume of the dilation A ⊕ tQ as t converges to zero. Here A and Q are subsets of n-dimensional Euclidean space, A has bounded perimeter and Q is compact. If Q consists of two points only, x and x+u, say, this...

  3. Dilational surface rheology of polymer solutions

    Science.gov (United States)

    Noskov, B. A.; Bykov, A. G.

    2015-06-01

    The review concerns main achievements in dilational rheology of polymer adsorption films at the gas/liquid interfaces reported in the last fifteen years. The theoretical foundations of methods of surface rheology and the key results obtained in studies of solutions of amphiphilic nonionic polymers, polyelectrolytes, proteins and their complexes with low-molecular-mass surfactants are discussed. Interest in the surface dilational rheology is mainly caused by a small number of available experimental methods for investigation of the surface of liquids, by the fact that traditional methods of measurement of the surface tension that are widely used in studies of solutions of low-molecular-mass surfactants provide little information when applied to polymer solutions owing to very slow establishment of equilibrium as well as by weak dependence of the surface tension on the polymer concentration. Progress in the surface rheology is driven by the recent studies of the stability of foams and emulsions that demonstrated a key role of the dilational surface rheological properties in the dynamics of liquid-phase disperse systems. The bibliography includes 191 references.

  4. Gondola development for CNES stratospheric balloons

    Science.gov (United States)

    Vargas, A.; Audoubert, J.; Cau, M.; Evrard, J.; Verdier, N.

    The CNES has been supporting scientific ballooning since its establishment in 1962. The two main parts of the balloon system or aerostat are the balloon itself and the flight train, comprising the house-keeping gondola, for the control of balloon flight (localization and operational telemetry & telecommand - TM/TC), and the scientific gondola with its dedicated telecommunication system. For zero pressure balloon, the development of new TM/TC system for the housekeeping and science data transmission are going on from 1999. The main concepts are : - for balloon house-keeping and low rate scientific telemetry, the ELITE system, which is based on single I2C bus standardizing communication between the different components of the system : trajectography, balloon control, power supply, scientific TM/TC, .... In this concept, Radio Frequency links are developed between the house keeping gondola and the components of the aerostat (balloon valve, ballast machine, balloon gas temperature measurements, ...). The main objectives are to simplify the flight train preparation in term of gondola testing before flight, and also by reducing the number of long electrical cables integrated in the balloon and the flight train; - for high rate scientific telemetry, the use of functional interconnection Internet Protocol (IP) in interface with the Radio Frequency link. The main idea is to use off-the-shelf IP hardware products (routers, industrial PC, ...) and IP software (Telnet, FTP, Web-HTTP, ...) to reduce the development costs; - for safety increase, the adding, in the flight train, of a totally independent house keeping gondola based on the satellite Inmarsat M and Iridium telecommunication systems, which permits to get real time communications between the on-board data mobile and the ground station, reduced to a PC computer with modem connected to the phone network. These GEO and LEO telecommunication systems give also the capability to operate balloon flights over longer distance

  5. Stereotactic catheter placement for Ommaya reservoirs.

    Science.gov (United States)

    Kennedy, Benjamin C; Brown, Lauren T; Komotar, Ricardo J; McKhann, Guy M

    2016-05-01

    Ommaya reservoirs are an important surgical therapy for the chronic intrathecal administration of chemotherapy for patients with leptomeningeal carcinomatosis. Surgical accuracy is paramount in these patients with typically normal sized ventricles, and may be improved with stereotactic guidance. This paper aimed to review a large series of stereotactic Ommaya catheter placements, examining accuracy and complications. We conducted a retrospective review of 109 consecutive adult patients who underwent stereotactic Ommaya catheter placement for leptomeningeal carcinomatosis or central nervous system lymphoma at Columbia University Medical Center, USA, from 1998-2013. The rate of accurate placement in the ventricular system was 99%, with the only poor catheter position due to post-placement migration. The rate of peri-operative complications was 6.4%. Hemorrhagic complications occurred in patients with thrombocytopenia or therapeutic anti-coagulation pre-operatively or during the post-operative period. Use of stereotaxy for catheter placement of Ommaya reservoirs is safe and effective, and should be considered when placing a catheter into non-hydrocephalic ventricles. PMID:26778516

  6. Catheter-associated urinary tract infections.

    Science.gov (United States)

    Liedl, B

    2001-01-01

    In the past few years it has been clearly demonstrated that the concept of bacterial biofilm production permits an understanding and provides some explanation of the pathogenesis, diagnosis and treatment of catheter-associated urinary tract infections. This concept describes the colonization of catheter surfaces and the movement of bacteria against the urinary flow. It explains the antibacterial resistance of these matrix-enclosed sessile populations of bacteria. The catheter encrustation can be observed as mineralizing bacterial biofilm. The differentiation in swarming cells exposing a much higher activity of the enzyme urease is responsible for the predominant role of Proteus mirabilis in obstructing encrustations. The guidelines for the prevention of catheter-associated urinary tract infections were developed over the past decades by clinicians and are still valid. They can now be better understood taking into consideration these new theories. As overuse of urethral catheters and non-compliance of their recommended use are still apparent, educational and surveillance programmes are needed to help maintain good standards of care. PMID:11148750

  7. How to manage an arterial catheter.

    Science.gov (United States)

    Parry, Andrew; Higginson, Ray

    2016-03-16

    Rationale and key points This article provides nurses with information on the safe and effective use and management of arterial catheters, the gold standard for accurate blood pressure measurement and routine serial blood gas sampling in critical care. Arterial catheters are used when real-time blood pressure monitoring is required, such as when there is a risk of significant blood loss. ▶ Arterial catheters provide real-time blood pressure monitoring, enabling rapid identification of changes in blood pressure and guiding fluid resuscitation. ▶ Arterial catheters can be used to take blood samples without having to perform multiple arterial or venous punctures. Reflective activity Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How this article will change your practice when managing a patient with an arterial catheter. 2. Any further learning needs you have identified. Subscribers can upload their reflective accounts at: rcni.com/portfolio . PMID:26982866

  8. A Rare Case of Jejunal Arterio-Venous Fistula: Treatment with Superselective Catheter Embolization with a Tracker-18 Catheter and Microcoils

    International Nuclear Information System (INIS)

    Arterio-venous fistulas may develop spontaneously, following trauma or infection, or be iatrogenic in nature. We present a rare case of a jejunal arterio- venous fistula in a 35-year-old man with a history of pancreatic head resection that had been performed two years previously because of chronic pancreatitis. The patient was admitted with acute upper abdominal pain, vomiting and an abdominal machinery-type bruit. The diagnosis of a jejunal arterio-venous fistula was established by MR imaging. Transfemoral angiography was performed to assess the possibility of catheter embolization. The angiographic study revealed a small aneurysm of the third jejunal artery, abnormal early filling of dilated jejunal veins and marked filling of the slightly dilated portal vein (13-14 mm). We considered the presence of segmental portal hypertension. The patient was treated with coil embolization in the same angiographic session. This case report demonstrates the importance of auscultation of the abdomen in the initial clinical examination. MR imaging and color Doppler ultrasound are excellent noninvasive tools in establishing the diagnosis. The role of interventional radiological techniques in the treatment of early portal hypertension secondary to jejunal arterio-venous fistula is discussed at a time when this condition is still asymptomatic. A review of the current literature is included

  9. Impact of short-term hemodialysis catheters on the central veins: a catheter venographic study

    Energy Technology Data Exchange (ETDEWEB)

    Oguzkurt, Levent E-mail: loguzkurt@yahoo.com; Tercan, Fahri; Torun, Dilek; Yildirim, Tuelin; Zuemruetdal, Ayseguel; Kizilkilic, Osman

    2004-12-01

    Objective: To determine the incidence of pericatheter sleeve formation, thrombus formation, and stenosis of the central veins in hemodialysis patients with temporary catheters. Methods and material: In this prospective study, 57 patients (40 males, 17 females) with temporary dialysis catheters had catheter venography by pulling back the catheter just before removal. Patient's age range was 25-87 years (mean age, 51 years). The venographic studies were evaluated for pericatheter sleeve formation, thrombus formation, and stenosis of the brachiocephalic vein (BCV) and the superior vena cava (SVC). The IJV could only be evaluated if there was adequate filling during contrast administration. In a subgroup of patients who had had only right IJV or only right SCV catheters, impact of these catheters on the central veins was compared. Results: The catheter location was right internal jugular vein (IJV) in 26 cases, right subclavian vein (SCV) in 27 cases, left IJV in 1 case, and left SCV in 3 cases. Thirty-two patients (56%) had had only one temporary catheter and the rest had had more than one inserted. The mean dwell time for the catheters was 21 days (range 7-59 days). A pericatheter sleeve was detected on venography in 32 (56%) patients and thrombus formation was noted in 16 patients (28%). A total of 41 patients (72%) exhibited pericatheter sleeve and/or thrombus formation. While 19 of the 32 patients (59%) without previous catheterization had a sleeve around the catheter, only 13 (52%) of 25 patients who had had multiple catheters inserted had a sleeve (P>0.05). Of the eight patients (14%) with BCV stenosis, two had >50% stenosis. Only one patient (2%) had mild stenosis of the SVC. Three patients out of 15 (20%) who had diagnostic venography for the IJV had severe stenosis of the vein. Pericatheter sleeve formation was more frequent in women (P<0.05). However, there were no statistical differences with respect to pericatheter sleeve formation, luminal filling

  10. The importance of effective catheter securement.

    Science.gov (United States)

    Fisher, Jayne

    This article examines the importance of securing/fixing indwelling urinary catheters. The Oxford English dictionary interlinks the two words-'secure' and 'fix'-as having the same meaning. To secure the catheter should not be confused with 'support', whereby the weight of the urine drainage bag is supported with the use of velcro straps or a sleeve. The author introduces the need for the concept of this practice to be at the forefront of nurses' minds in all settings, and this is demonstrated through the use of case studies. Current guidance in this area is reviewed, as well as the problems that can arise when catheters are not secured properly and the available products for health professionals to use. PMID:20948482

  11. Everting (toposcopic) catheter for broad clinical application.

    Science.gov (United States)

    Shook, D R; Doppman, J L; Cattau, E L; Goldstein, S R

    1986-05-01

    The advanced development of the clinical everting (toposcopic) catheter is described. A detailed discussion of the design and outline of the fabrication techniques are followed by a thorough performance evaluation and summary of the first two clinical applications. The everting element is a low-durometer thermoplastic polyurethane elastomer. Surface treatments include the bonding of a hydrophilic polymeric coating, optimized for lubricity, to the sliding internal surfaces of the catheter. Eversion pressures and infusion/aspiration flow rates have been measured under various conditions and the infusate-in-blood mixing potential investigated. A preliminary assessment is given of the clinical performance of the catheter in the vascular delivery of chemotherapy and standard endoscopic retrograde cholangiopancreatography. PMID:3724105

  12. The French Balloon Program 2013 - 2017

    Science.gov (United States)

    Dubourg, Vincent; Vargas, André; Raizonville, Philippe

    2016-07-01

    With over 50 years' experience in the field, the French Centre National d'Etudes Spatiales (CNES) goes on supporting - as designer and operator - a significant scientific ballooning program. In particular so because balloons still give a unique and valuable access to near space science. From 2008 to 2013, an important renovation effort was achieved, beginning by Zero Pressure Balloons (ZPB) systems, to comply with more stringent Safety constraints and to the growing reliability and performance requirements from scientific missions. The paper will give an overview of the CNES new capabilities and services for operational balloon activities, and their availability status. The scientific launch campaigns of the past two years will be presented. A focus will be made on the results of the Stratoscience 2015 flight campaign from Timmins, Ontario, using the NOSYCA command and control system for ZPB, qualified in flight in 2013. In particular, the PILOT telescope successfully flew during the 2015 campaign, key figures about the flight and mission will be given. An outlook of the new stratospheric long duration flight systems currently in process of developement at CNES will be given, as well as the presentation of the Stratéole 2 project, dedicated to the survey of the low stratosphere and upper troposphere in equatorial regions, with a fleet of small suprer pressure balloons (SPB). As far as tropospheric balloons are concerned, the Aeroclipper initiative will be presented, aiming at qualifying a quasi-tethered balloon, pushed by the winds close to the sea surface, for the study of cyclones. The scientific launch campaigns and the main payloads in the study for the near future will also be presented.

  13. [Phlebitogenicity of venous catheters of Vialon].

    Science.gov (United States)

    Fassolt, A

    1985-12-01

    During three days 132 surgical patients with postoperative infusion treatment were checked on the frequency of venous reactions in the arms when catheters/cannulas of 4 different materials were used and the outcome compared. A significant result was obtained in connection with the I-cath catheter made of vialon (a polyurethanelike resin polymer) and the L-cath of polyurethane. Phlebitis was decreased to 27.3% resp. 24.2% - approximately half of its usual frequency - when I-cath of polyvinyl-chloride and FEP-teflon vasofix cannulas were applied (both 51.5%). The different predisposing factors of infusion phlebitis are under discussion. PMID:4093198

  14. Catheter ablation of inappropriate sinus tachycardia.

    Science.gov (United States)

    Gianni, Carola; Di Biase, Luigi; Mohanty, Sanghamitra; Gökoğlan, Yalçın; Güneş, Mahmut F; Horton, Rodney; Hranitzky, Patrick M; Burkhardt, J David; Natale, Andrea

    2016-06-01

    Catheter ablation for inappropriate sinus tachycardia (IST) is recommended for patients symptomatic for palpitations and refractory to other treatments. The current approach consists in sinus node modification (SNM), achieved by ablation of the cranial part of the sinus node to eliminate faster sinus rates while trying to preserve chronotropic competence. This approach has a limited efficacy, with a very modest long-term clinical success. To overcome this, proper patient selection is crucial and an epicardial approach should always be considered. This brief review will discuss the current role and limitations of catheter ablation in the management of patients with IST. PMID:26310299

  15. Comparison of Pneumatic Dilation with Pneumatic Dilation Plus Botulinum Toxin for Treatment of Achalasia

    Directory of Open Access Journals (Sweden)

    Alireza Bakhshipour

    2010-03-01

    Full Text Available Among the therapeutic options for achalasia are pneumatic dilatation (PD, an appropriate long-term therapy, and botulinum toxin injection (BT that is a relatively short-term therapy. This study aimed to compare therapeutic effect of repetitive pneumatic dilation with a combined method (botulinum toxin injection and pneumatic dilation in a group of achalasia patients who are low responder to two initial pneumatic dilations. Thirty- four patients with documented primary achalasia that had low response to two times PD (<50% decrease in symptom score and barium height at 5 minute in timed esophagogram after 3month of late PD were randomized to receive pneumatic dilation (n=18 or botulinum toxin injection and pneumatic dilation by four weeks interval (n=16, PD and BT+PD groups respectively. Symptom scores were evaluated before and at 1, 6 and 12 months after treatment. Clinical remission was defined as a decrease in symptom score ≥ 50% of baseline. There were no significant differences between the two groups in gender, age and achalasia type. Remission rate of patients in BT-PD group in comparison with PD group were 87.5% vs. 67.1% (P = 0.7, 87.5% vs. 61.1% (P = 0.59 and 87.5% vs. 55.5% (P = 0.53 at 1, 6 and 12 months respectively .There were no major complications in either group. The mean symptom score decreased by 62.71% in the BT-PD group (P < 0.002 and 50.77% in the PD group (P < 0.01 at the end of the first year. Despite a better response rate in BT+PD group, a difference was not statistically significant. A difference may be meaningful if a large numbers of patients are included in the study.

  16. Comparison of catheter tip migration using flexible and stimulating catheters inserted into the adductor canal in a cadaver model.

    Science.gov (United States)

    Webb, Christopher A J; Kim, T Edward; Funck, Natasha; Howard, Steven K; Harrison, T Kyle; Ganaway, Toni; Keng, Heidi; Mariano, Edward R

    2015-06-01

    Use of adductor canal blocks and catheters for perioperative pain management following total knee arthroplasty is becoming increasingly common. However, the optimal equipment, timing of catheter insertion, and catheter dislodgement rate remain unknown. A previous study has suggested, but not proven, that non-tunneled stimulating catheters may be at increased risk for catheter migration and dislodgement after knee manipulation. We designed this follow-up study to directly compare tip migration of two catheter types after knee range of motion exercises. In a male unembalmed human cadaver, 30 catheter insertion trials were randomly assigned to one of two catheter types: flexible or stimulating. All catheters were inserted using an ultrasound-guided short-axis in-plane technique. Intraoperative knee manipulation similar to that performed during surgery was simulated by five sequential range of motion exercises. A blinded regional anesthesiologist performed caliper measurements on the ultrasound images before and after exercise. Changes in catheter tip to nerve distance (p = 0.547) and catheter length within the adductor canal (p = 0.498) were not different between groups. Therefore, catheter type may not affect the risk of catheter tip migration when placed prior to knee arthroplasty. PMID:25510467

  17. Prevention of catheter-related Pseudomonas aeruginosa infection by levofloxacin-impregnated catheters in vitro and in vivo

    Institute of Scientific and Technical Information of China (English)

    Yan Ping; Liu Wei; Kong Jinliang; Wu Hong; Chen Yiqiang

    2014-01-01

    Background Implanted medical catheter-related infections are increasing,hence a need for developing catheter polymers bonded to antimicrobials.We evaluated preventive effects of levofloxacin-impregnated catheters in catheterrelated Psuedomonas aeruginosa (strain PAO1) infection.Methods Drug release from levofloxacin-impregnated catheters was measured in vitro.Levofloxacin-impregnated catheters and polyvinyl chloride (PVC) catheters were immersed in 5 ml 50% Luria Bertani medium containing 108 CFU/ml Pseudomonas aeruginosa then incubated for 6,12,24 or 48 hours at 37℃ when bacteria adhering to the catheters and bacteria in the growth culture medium were determined.Impregnated and PVC catheters were singly implanted subcutaneously in mice,50 μl (107CFU) of PAO1 was injected into catheters.After the first and fifth days challenge,bacterial counts on implanted catheters and in surrounding tissues were determined microbiologically.Bacterial colonization and biofilm formation on implanted catheters were assessed by scanning electron microscopy.Results Drug release from levofloxacin-impregnated catheters was rapid.Levofloxacin-impregnated catheters had significantly fewer bacteria compared to PVC in vitro.After first and fifth day of challenge,no or significantly fewer bacteria adhered to impregnated catheters or in surrounding tissues compared to PVC.Scanning electron microscopical images after first day displayed from none to significantly fewer bacteria adhering to impregnated implanted catheters,compared to bacteria and microcolonies adhering to PVC catheters.After the fifth day,no bacteria were found on impregnated catheters,compared to clusters surrounding mucus-like substance and coral-shaped biofilms with polymorphonuclear leukocyte on PVC catheters.After the first day of challenge,secretion occurred in all implanted catheters with surrounding tissues mildly hyperaemic and swollen.After the fifth day,minute secretions inside impregnated catheters and no

  18. Catheter-Related Sepsis Due to Rhodotorula glutinis

    OpenAIRE

    Hsueh, Po-Ren; Teng, Lee-Jene; Ho, Shen-Wu; Luh, Kwen-Tay

    2003-01-01

    We describe a central venous catheter-related (Port-A-Cath; Smiths Industries Medical Systems [SIMS] Deltec, Inc., St. Paul, Minn.) infection caused by Rhodotorula glutinis in a 51-year-old man with nasopharyngeal carcinoma. He was treated with fluconazole for 8 weeks and had the catheter removed. Two isolates of R. glutinis recovered from blood specimens (one obtained via peripheral veins and one via the catheter) before administration of fluconazole and one recovered from the removed cathet...

  19. Force control of flexible catheter robots for beating heart surgery

    OpenAIRE

    Kesner, Samuel Benjamin; Howe, Robert D.

    2011-01-01

    Recent developments in cardiac catheter technology promise to allow physicians to perform most cardiac interventions without stopping the heart or opening the chest. However, current cardiac devices, including newly developed catheter robots, are unable to accurately track and interact with the fast moving cardiac tissue without applying potentially damaging forces. This paper examines the challenges of implementing force control on a flexible robotic catheter. In particular, catheter frictio...

  20. Ballooning mode instability at the plasmapause

    Science.gov (United States)

    Lakhina, G. S.; Mond, M.; Hameiri, E.

    1990-01-01

    The ballooning mode instability, which can excite hydromagnetic waves at the plasmapause, is studied in the presence of azimuthal plasma flows induced during geomagnetically disturbed periods. A general sufficient criterion for the ballooning mode stability is derived, for a change in the potential energy greater than or equal to 0, which involves the integration over an entire field line. A local stability analysis at the equatorial plasmapause region shows that the ballooning modes could be spontaneously generated via instability under at least two conditions: one is similar to the usual interchange condition, and the second to the quasi-interchange modes. Both of these local instability conditions can be derived from the general stability criterion. Finally an exact solution for the equilibrium state with flow is derived analytically, and the change in the potential energy is computed numerically. It is found that, in the cases studied, the flow does not spontaneously excite the ballooning modes; it only further stabilizes (or destabilizes) the ballooning spectrum if originally the system is stable (or unstable). The analysis would be useful for the interpretation of some of the low-frequency modes observed at the ground and near the equatorial plasmapause.

  1. 21 CFR 868.5120 - Anesthesia conduction catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction catheter. 868.5120 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5120 Anesthesia conduction catheter. (a) Identification. An anesthesia conduction catheter is a flexible tubular device used to...

  2. Damage of Central Catheters in Home Parenteral Nutrition Patients

    Directory of Open Access Journals (Sweden)

    Błasiak Renata

    2015-11-01

    Full Text Available According to the ESPEN and ASPEN guidelines, in the case of a long-term (>3-month parenteral nutrition should be administered via a subcutaneous central venous catheter (CVC. There are three types of mechanical complications of tunnelled central catheter: catheter rupture, occlusion by TPN depositing and thrombofibrotic occlusion.

  3. Small Bowel Obstruction Due to Suprapubic Catheter Placement

    OpenAIRE

    Bonasso, Patrick C.; Brandon Lucke-Wold; Uzer Khan

    2016-01-01

    Suprapubic catheter placement has associated complications such as bowel injury, bladder injury, or bleeding. This case describes the management of an elderly patient who had suprapubic catheter placement complicated by small bowel obstruction. The catheter had continued production of urine. Further patient treatment required abdominal exploration and bowel resection.

  4. Small Bowel Obstruction Due to Suprapubic Catheter Placement

    Directory of Open Access Journals (Sweden)

    Patrick C. Bonasso

    2016-07-01

    Full Text Available Suprapubic catheter placement has associated complications such as bowel injury, bladder injury, or bleeding. This case describes the management of an elderly patient who had suprapubic catheter placement complicated by small bowel obstruction. The catheter had continued production of urine. Further patient treatment required abdominal exploration and bowel resection.

  5. Small Bowel Obstruction Due to Suprapubic Catheter Placement.

    Science.gov (United States)

    Bonasso, Patrick C; Lucke-Wold, Brandon; Khan, Uzer

    2016-07-01

    Suprapubic catheter placement has associated complications such as bowel injury, bladder injury, or bleeding. This case describes the management of an elderly patient who had suprapubic catheter placement complicated by small bowel obstruction. The catheter had continued production of urine. Further patient treatment required abdominal exploration and bowel resection. PMID:27335801

  6. Activity of sparfloxacin on Staphylococcus epidermidis attached to plastic catheters.

    Science.gov (United States)

    Pascual, A; García, I; Ramirez de Arellano, E; Perea, E J

    1995-08-01

    The activity of sparfloxacin on Staphylococcus epidermidis biofilms on different plastic catheters was evaluated. Sparfloxacin showed high bactericidal activity against S. epidermidis biofilms on Vialon and polyvinylchloride catheters. The combination of sparfloxacin with amikacin or rifampicin significantly increased its activity against bacterial biofilms on polyurethane and Teflon catheters. PMID:8522473

  7. 21 CFR 884.6110 - Assisted reproduction catheters.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction catheters. 884.6110 Section... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6110 Assisted reproduction catheters. (a) Identification. Assisted reproduction catheters are devices used in...

  8. 21 CFR 868.5350 - Nasal oxygen catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nasal oxygen catheter. 868.5350 Section 868.5350...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5350 Nasal oxygen catheter. (a) Identification. A nasal oxygen catheter is a device intended to be inserted through a patient's nostril...

  9. Not to Knot a Catheter. Case Report of the Knotting of a Suprapubic Catheter

    Directory of Open Access Journals (Sweden)

    S. A. Farook

    2007-01-01

    Full Text Available A 20-month-old boy, who underwent left nephrectomy, had a suprapubic catheter inserted that knotted within the bladder. This case report identifies possible causes for such occurrences and how best to manage them.

  10. Not to Knot a Catheter. Case Report of the Knotting of a Suprapubic Catheter

    OpenAIRE

    Farook, S. A.; Kariholu, U.; Kousidis, G.; Powlis, M.

    2007-01-01

    A 20-month-old boy, who underwent left nephrectomy, had a suprapubic catheter inserted that knotted within the bladder. This case report identifies possible causes for such occurrences and how best to manage them.

  11. A comparison of the priming properties of two central venous catheters and one pulmonary artery catheter.

    Science.gov (United States)

    Sanderson, P M

    1995-01-01

    The time taken to prime the individual lumina of two multilumen central venous catheters (Viggo-Spectramed 14G 20 cm Hydrocath and Vialon 14G 20 cm Deltacath) and one pulmonary artery catheter (Viggo-Spectramed 110 cm 7.5F Pentacath) at flows between 5 ml.h-1 and 99 ml.h-1 is reported. The catheters supplied by different manufacturers but of identical length and gauge have significantly different priming times (p < 0.001). A protocol which may be used to prime the individual lumina of the three catheters studied is described. By means of an in vitro test the accuracy of this protocol is validated. PMID:7702147

  12. Catheter Removal versus Retention in the Management of Catheter-Associated Enterococcal Bloodstream Infections

    Directory of Open Access Journals (Sweden)

    Jonas Marschall

    2013-01-01

    Full Text Available BACKGROUND: Enterococci are an important cause of central venous catheter (CVC-associated bloodstream infections (CA-BSI. It is unclear whether CVC removal is necessary to successfully manage enterococcal CA-BSI.

  13. The risks and benefits of suprapubic catheters.

    Science.gov (United States)

    Yates, Ann

    Suprapubic catheterisation can improve some patients' quality of life but the insertion procedure, as well as changing and managing the catheter, carry risks of infection and other negative patient outcomes. This article highlights the advantages and disadvantages, indications and contraindications, and the potential benefits, so health professionals can understand the relevant issues and assess and inform patients accordingly. PMID:27017651

  14. Complications after placement of peritoneal catheter

    Directory of Open Access Journals (Sweden)

    Đurđević-Mirković Tatjana

    2011-01-01

    Full Text Available Introduction. Peritoneal dialysis is one of the modalities used for treatment of end-stage chronic kidney failure. Nowadays, this method is complementary to haemodialysis and renal transplantation. Owing to the rich vascularization of the peritoneum, it is used in the processes of osmosis and diffusion, enabling the removal of uremic material from the body. The procedure includes introduction of peritoneal fluid via the peritoneal catheter. Complications. The catheter is placed through the anterior abdominal wall with its tip positioned in the small pelvis. There are several techniques for catheter placement considered minimally invasive, which, however, may be associated with various complications. These complications can be divided into mechanical (catheter dysfunction, cuff protrusion, hernia, dialysate leaks, visceral perforation and infectious (early peritonitis, exit site or tunnel infection, surgical wounds. In most cases, such complications are rare and can be successfully managed using conservative therapy; however, in some situations severe complications can endanger the life of the patient. On-time recognition of complications, particularly in patients at risk, is of paramount importance for an effective treatment. The development of complications can increase the morbidity and the chance of treatment failure, and therefore transfer to haemodialysis. Conclusion. The preoperative evaluation and determination of the risk factors as well as the early recognition and adequate management of complications are essential in their prevention.

  15. Treatment of giant pulmonary interstitial emphysema by ipsilateral bronchial occlusion with a Swan-Ganz catheter

    International Nuclear Information System (INIS)

    Unilateral giant pulmonary interstitial emphysema (PIE) can be seen as a complication of chronic ventilation in extremely low-birth-weight babies. Many can be managed by conventional pulmonary care which includes positioning, suctioning, chest physiotherapy, gentle conventional ventilation and high-frequency ventilation. Some may need invasive procedures such as lung puncture, pleurotomies and excisional surgery. This is the group in which single-lung ventilation may be beneficial and circumvent the need for an invasive procedure. We describe the technique of single-lung ventilation using a Swan-Ganz catheter to block the main stem bronchus on the diseased side in air-leak syndromes. A retrospective chart review was done on 17 newborns undergoing single-lung ventilation using this technique at the Children's Hospital of New York, Columbia University, from 1986 to 2000. The technique was successful in the management of severe, neonatal unilateral lung disease not responsive to conventional modes of therapy in all but two neonates as seen by a significant improvement in pH and a decrease in PaCO2 levels. In one neonate malpositioning of the Swan-Ganz catheter balloon could have contributed to the development of pneumothorax. The described technique of single-lung ventilation provides a safe, minimally invasive and economically feasible method of management of unilateral giant PIE in newborns not responsive to conventional modes of therapy with minimal complications. (orig.)

  16. Treatment of giant pulmonary interstitial emphysema by ipsilateral bronchial occlusion with a Swan-Ganz catheter

    Energy Technology Data Exchange (ETDEWEB)

    Rastogi, Shantanu [College of Physicians and Surgeons, Columbia University, Division of Neonatology, Department of Pediatrics, The Children' s Hospital of New York, New York, NY (United States); Maimonides Medical Center, Department of Pediatrics, Brooklyn, NY (United States); Gupta, Archana; Wung, Jen-Tien [College of Physicians and Surgeons, Columbia University, Division of Neonatology, Department of Pediatrics, The Children' s Hospital of New York, New York, NY (United States); Berdon, Walter E. [College of Physicians and Surgeons, Columbia University, Pediatric Radiology, The Children' s Hospital of New York, New York, NY (United States)

    2007-11-15

    Unilateral giant pulmonary interstitial emphysema (PIE) can be seen as a complication of chronic ventilation in extremely low-birth-weight babies. Many can be managed by conventional pulmonary care which includes positioning, suctioning, chest physiotherapy, gentle conventional ventilation and high-frequency ventilation. Some may need invasive procedures such as lung puncture, pleurotomies and excisional surgery. This is the group in which single-lung ventilation may be beneficial and circumvent the need for an invasive procedure. We describe the technique of single-lung ventilation using a Swan-Ganz catheter to block the main stem bronchus on the diseased side in air-leak syndromes. A retrospective chart review was done on 17 newborns undergoing single-lung ventilation using this technique at the Children's Hospital of New York, Columbia University, from 1986 to 2000. The technique was successful in the management of severe, neonatal unilateral lung disease not responsive to conventional modes of therapy in all but two neonates as seen by a significant improvement in pH and a decrease in PaCO{sub 2} levels. In one neonate malpositioning of the Swan-Ganz catheter balloon could have contributed to the development of pneumothorax. The described technique of single-lung ventilation provides a safe, minimally invasive and economically feasible method of management of unilateral giant PIE in newborns not responsive to conventional modes of therapy with minimal complications. (orig.)

  17. The mechanism of lesion formation by focused ultrasound ablation catheter for treatment of atrial fibrillation

    Science.gov (United States)

    Sinelnikov, Y. D.; Fjield, T.; Sapozhnikov, O. A.

    2009-10-01

    The application of therapeutic ultrasound for the treatment of atrial fibrillation (AF) is investigated. The results of theoretical and experimental investigation of ultrasound ablation catheter are presented. The major components of the catheter are the high power cylindrical piezoelectric element and parabolic balloon reflector. Thermal elevation in the ostia of pulmonary veins is achieved by focusing the ultrasound beam in shape of a torus that transverses the myocardial tissue. High intensity ultrasound heating in the focal zone results in a lesion surrounding the pulmonary veins that creates an electrical conduction blocks and relief from AF symptoms. The success of the ablation procedure largely depends on the correct choice of reflector geometry and ultrasonic power. We present a theoretical model of the catheter’s acoustic field and bioheat transfer modeling of cardiac lesions. The application of an empirically derived relation between lesion formation and acoustic power is shown to correlate with the experimental data. Developed control methods combine the knowledge of theoretical acoustics and the thermal lesion formation simulations with experiment and thereby establish dosimetry that contributes to a safe and effective ultrasound ablation procedure.

  18. Percutaneous Transhepatic Biliary Drainage Using a Ligated Catheter for Recurrent Catheter Obstruction: Antireflux Technique

    OpenAIRE

    Hamada, Tsuyoshi; Tsujino, Takeshi; Isayama, Hiroyuki; Hakuta, Ryunosuke; ITO Yukiko; Nakata, Ryo; Koike, Kazuhiko

    2013-01-01

    Percutaneous transhepatic biliary drainage (PTBD) is an established procedure for biliary obstruction. However, duodenobiliary or jejunobiliary reflux of the intestinal contents through a PTBD catheter sometimes causes recurrent catheter obstruction or cholangitis. A 64-year-old female patient with a history of choledochojejunostomy was referred to our department with acute cholangitis due to choledochojejunal anastomotic obstruction. Emergent PTBD was performed, but frequent obstructions of ...

  19. Near ultraviolet spectrograph for balloon platform

    Science.gov (United States)

    Sreejith, A. G.; Safonova, Margarita; Murthy, Jayant

    2015-06-01

    Small and compact scientific payloads may be easily designed constructed and own on high altitude balloons. Despite the fact that large orbital observatories provide accurate observations and statistical studies of remote and/or faint space sources, small telescopes on board balloons or rockets are still attractive because of their low cost and rapid response time. We describe here a near ultraviolet (NUV) spectrograph designed to be own on a high{altitude balloon platform. Our basic optical design is a modified Czerny-Turner system using off the shelf optics. We compare different methods of aberration corrections in such a system. We intend the system to be portable and scalable to different telescopes. The use of reflecting optics reduces the transmission loss in UV. We plan on using an image intensified CMOS sensor operating in photon counting mode as the detector of choice.

  20. DILATANCY BEHAVIOR IN CONSTANT STRAIN RATE CONSOLIDATION TEST

    Directory of Open Access Journals (Sweden)

    Berty Sompie

    2006-01-01

    Full Text Available Subjected to remolded young clay, this paper shows that a lot of time dependent behavior in the standard consolidation (SC and constant strain rate consolidation (CSRC tests is represented systematically by a simple assumption concerning the time dependency of dilatancy. In the SC test, at the first stage of each loading step little dilatancy takes place and dilatancy begins to occur several minutes after step loading. In CSRC test, some time period after the stress state has entered the normally consolidated region, dilatancy tends to occur rapidly with the increase in stress ratio. Since most of dilatancy has taken place at the earlier stage of consolidation, little dilatancy occurs at the latter stage of CSRC process. This tendency makes the specimen stiffer with the passage of time, and makes the vertical pressure and pore pressure increase substantially at the last stage of CSRC process. Consideration to such behavior may be effective to correctly interpret the result of CSRC test.

  1. Clinical significance of main pancreatic duct dilation on computed tomography: Single and double duct dilation

    OpenAIRE

    Edge, Mark D; Hoteit, Maarouf; Patel, Amil P; Wang, Xiaoping; Baumgarten, Deborah A.; Cai, Qiang

    2007-01-01

    AIM: To study the patients with main pancreatic duct dilation on computed tomography (CT) and thereby to provide the predictive criteria to identify patients at high risk of significant diseases, such as pancreatic cancer, and to avoid unnecessary work up for patients at low risk of such diseases.

  2. Performance of latex balloons for optical computed tomography

    Science.gov (United States)

    Jordan, K.; Walsh, A.; Peng, M.; Battista, J.

    2013-06-01

    Latex balloons filled with radiation sensitive hydrogels were evaluated as 3D dosimeters with optical computed tomography (CT) readout. Custom balloons, with less than 10 cm diameters, were made from latex sheets. Commercial, 13 cm diameter, clear balloons were investigated for larger volumes. Ferrous-xylenol orange and genipin gelatin gels selected for 1 and 30 Gy experiments, respectively. The thin stretched latex membrane allowed optical imaging to within 1 mm of the interior balloon edge. Reconstructed dose distributions demonstrated valid measurements to within 2 mm of the balloon surface. The rubber membrane provides a hybrid approach to deforming hydrogels. Uniform irradiation of a deformed gel resulted in a uniform dose being measured when scanned in the relaxed, initial balloon shape. The 13 cm diameter balloons were also effective and inexpensive vessels for hydrogels due to their high clarity, thinness and mechanical strength. Latex balloons represent an inexpensive method to obtain useful information from nearly the entire dosimeter volume.

  3. An unusual triad: Bilateral dilated odontoma, hypodontia and peg laterals

    OpenAIRE

    Alphy Alphonsa Sebastian; Auswaf Ahsan; Ahkin John George; John Aby

    2013-01-01

    The dilated odontoma is an infrequent developmental alteration that appears in any area of the dental arches and can affect deciduous, permanent and supernumerary tooth. Dens invaginatus is a developmental anomaly resulting from invagination of a portion of crown forming within the enamel organ during odontogenesis. The most extreme form of dens invaginatus is known as dilated odontoma. The aim of this case report is to present a rare case of bilateral dilated odontoma affecting a microdon...

  4. Gastric Necrosis due to Acute Massive Gastric Dilatation

    Directory of Open Access Journals (Sweden)

    Ibrahim Aydin

    2013-01-01

    Full Text Available Gastric necrosis due to acute massive gastric dilatation is relatively rare. Vascular reasons, herniation, volvulus, acute gastric dilatation, anorexia, and bulimia nervosa play a role in the etiology of the disease. Early diagnosis and treatment are highly important as the associated morbidity and mortality rates are high. In this case report, we present a case of gastric necrosis due to acute gastric dilatation accompanied with the relevant literature.

  5. On three-dimensional dilational elastic metamaterials

    International Nuclear Information System (INIS)

    Dilational materials are stable, three-dimensional isotropic auxetics with an ultimate Poisson's ratio of −1. Inspired by previous theoretical work, we design a feasible blueprint for an artificial material, a metamaterial, which approaches the ideal of a dilational material. The main novelty of our work is that we also fabricate and characterize corresponding metamaterial samples. To reveal all modes in the design, we calculate the phonon band structures. On this basis, using cubic symmetry we can unambiguously retrieve all different non-zero elements of the rank-four effective metamaterial elasticity tensor from which all effective elastic metamaterial properties follow. While the elastic properties and the phase velocity remain anisotropic, the effective Poisson's ratio indeed becomes isotropic and approaches −1 in the limit of small internal connections. This finding is also supported by independent, static continuum-mechanics calculations. In static experiments on macroscopic polymer structures fabricated by three-dimensional printing, we measure Poisson's ratios as low as −0.8 in good agreement with the theory. Microscopic samples are also presented. (paper)

  6. Excimer laser coronary angioplasty: experience with a prototype multifibre catheter in patients with stable angina pectoris.

    Science.gov (United States)

    Kochs, M; Haerer, W; Eggeling, T; Hoeher, M; Schmidt, A; Hombach, V

    1992-03-01

    Percutaneous excimer laser coronary angioplasty (ELCA) was performed in a first group of 20 patients with stable angina pectoris caused by significant coronary stenosis, and long-term follow-up was evaluated. Prototype 4 to 5.5 French multifibre catheters with 18-20 quartz fibres of 100 microns diameter, concentrically arranged around a central lumen for taking up a guide wire, were coupled to a commercial XeCl excimer laser. Energy was delivered at a wavelength of 308 nm with a pulse duration of 60 or 120 ns. Operating at a repetition rate of 20 Hz, mean energy transmission was 13.4 +/- 6.8 mJ per pulse. In all but one patient the lesion could be passed by the catheter. Percent diameter stenosis decreased from 77.1 +/- 10.8% to 53.1 +/- 11.8% after ELCA. Complications were frequently observed, intracoronary thrombus formation in eight instances, dissection in six patients and spasm in five cases, causing total vessel occlusion in five procedures. All complications could be managed efficaciously by thrombolytic and vasodilating drugs and/or balloon angioplasty. Subsequent PTCA was performed in case of complication or insufficient stenosis reduction after ELCA in 18 patients with adequate results (residual stenosis, 28.5 +/- 10.2%). Long-term follow-up angiography, which could be performed in 16 of 19 laser treatments, demonstrated significant restenosis in only three patients. Our preliminary results suggest that, using ELCA, ablation of atherosclerotic lesions is feasible in most cases. However, compared with PTCA, stenosis reduction is significantly less, and the acute complication rate is much higher. Thus, further improvements of the catheter system are necessary in order to realize the advantages of excimer laser ablation, which can be demonstrated by experimental studies. PMID:1597220

  7. High altitude balloon experiments at IIA

    Science.gov (United States)

    Nayak, Akshata; Sreejith, A. G.; Safonova, Margarita; Murthy, Jayant

    Recent advances in balloon experiments as well as in electronics have made it possible to fly scientific payloads at costs accessible to university departments. We have begun a program of high altitude ballooning at the Indian Institute of Astrophysics, Bengaluru. The primary purpose of this activity is to test low-cost ultraviolet (UV) payloads for eventual space flight, but we will also try scientific exploration of the phenomena occurring in the upper atmosphere, including sprites and meteorite impacts. We present the results of the initial experiments carried out at the CREST campus of IIA, Hosakote, and describe our plans for the future.

  8. Performance of the EUSO-Balloon electronics

    Science.gov (United States)

    Barrillon, P.; Bacholle, S.; Bayer, J.; Blaksley, C.; Blin, S.; Cafagna, F.; Dagoret, S.; Fornaro, C.; Gorodetzky, P.; Jung, A.; Karczmarczyk, J.; De La Taille, C.; Medina Tanco, G.; Miyamoto, H.; Moretto, C.; Osteria, G.; Park, I.; Perfetto, F.; Prévôt, G.; Prat, P.; Rabanal Reina, J.; Rojas, J.; Santiago, L.; Scotti, V.; Silva, H.; Szabelski, J.

    2016-01-01

    The 24th of August 2014, the EUSO-Balloon instrument went for a night flight for several hours, 40 km above Timmins (Canada) balloon launching site, concretizing the hard work of an important part of the JEM-EUSO collaboration started 3 years before. This instrument consists of a telescope made of two lenses and a complex electronic chain divided in two main sub-systems: the PDM (Photo Detector Module) and the DP (Data Processor). Each of them is made of several innovative elements developed and tested in a short time. This paper presents their performances before and during the flight.

  9. Catalytic Generation of Lift Gases for Balloons

    Science.gov (United States)

    Zubrin, Robert; Berggren, Mark

    2011-01-01

    A lift-gas cracker (LGC) is an apparatus that generates a low-molecular-weight gas (mostly hydrogen with smaller amounts of carbon monoxide and/or carbon dioxide) at low gauge pressure by methanol reforming. LGCs are undergoing development for use as sources of buoyant gases for filling zero-gauge-pressure meteorological and scientific balloons in remote locations where heavy, high-pressure helium cylinders are not readily available. LGCs could also be used aboard large, zero-gauge-pressure, stratospheric research balloons to extend the duration of flight.

  10. Sodium ferulate inhibits neointimal hyperplasia in rat balloon injury model.

    Directory of Open Access Journals (Sweden)

    Jing Zhang

    Full Text Available BACKGROUND/AIM: Neointimal formation after vessel injury is a complex process involving multiple cellular and molecular processes. Inhibition of intimal hyperplasia plays an important role in preventing proliferative vascular diseases, such as restenosis. In this study, we intended to identify whether sodium ferulate could inhibit neointimal formation and further explore potential mechanisms involved. METHODS: Cultured vascular smooth muscle cells (VSMCs isolated from rat thoracic aorta were pre-treated with 200 µmol/L sodium ferulate for 1 hour and then stimulated with 1 µmol/L angiotensin II (Ang II for 1 hour or 10% serum for 48 hours. Male Sprague-Dawley rats subjected to balloon catheter insertion were administrated with 200 mg/kg sodium ferulate (or saline for 7 days before sacrificed. RESULTS: In presence of sodium ferulate, VSMCs exhibited decreased proliferation and migration, suppressed intracellular reactive oxidative species production and NADPH oxidase activity, increased SOD activation and down-regulated p38 phosphorylation compared to Ang II-stimulated alone. Meanwhile, VSMCs treated with sodium ferulate showed significantly increased protein expression of smooth muscle α-actin and smooth muscle myosin heavy chain protein. The components of Notch pathway, including nuclear Notch-1 protein, Jagged-1, Hey-1 and Hey-2 mRNA, as well as total β-catenin protein and Cyclin D1 mRNA of Wnt signaling, were all significantly decreased by sodium ferulate in cells under serum stimulation. The levels of serum 8-iso-PGF2α and arterial collagen formation in vessel wall were decreased, while the expression of contractile markers was increased in sodium ferulate treated rats. A decline of neointimal area, as well as lower ratio of intimal to medial area was observed in sodium ferulate group. CONCLUSION: Sodium ferulate attenuated neointimal hyperplasia through suppressing oxidative stress and phenotypic switching of VSMCs.

  11. Particle Astrophysics in NASA's Long Duration Balloon Program

    International Nuclear Information System (INIS)

    A century after Viktor Hess' discovery of cosmic rays, balloon flights still play a central role in the investigation of cosmic rays over nearly their entire spectrum. We report on the current status of NASA balloon program for particle astrophysics, with particular emphasis on the very successful Antarctic long-duration balloon program, and new developments in the progress toward ultra-long duration balloons

  12. Treatment of achalasia: comparison of temporary stent insertion with pneumatic dilation

    International Nuclear Information System (INIS)

    Objective: To retrospectively analyze and compare the clinical efficacy of temporary stent insertion with pneumatic dilation at the same diameter for the treatment of achalasia based on a long-term follow-up observation. Methods: A total of 101 treated achalasia patients were divided into pneumatic dilation group (group A, n=38) and temporary stent insertion group (group B, n=63). The diameter of the balloon and stent used for the procedure was 30 mm. The total symptom scores (TSSs) and esophageal manometry was used to assess the symptoms and lower esophageal sphincter (LES) pressure improvement. Barium-swallow-esophageal study was employed to objectively evaluate the esophageal emptying function. Barium-swallow-esophageal study was employed to objectively evaluate the esophageal emptying function. TSSs and LES pressure improvement were assessed, recorded and compared during the regular interval follow-up. Results: Forty-nine pneumatic dilations and 65 stent insertions were successfully performed in all patients under fluoroscopic guidance. Complications included pain, reflux and bleeding, which occurred in 9 (23.6%), 8 (21.1%) and 3(8.0%) patients in group A, respectively, while in 27 (42.9%), 8 (12.7%) and 10 (15.9%) patients in group B, respectively. The stent was retained approximately 4-7 days and all stents were retrieved via endoscope. TSSs, esophageal manometry and postoperative barium esophagram showed significant improvement compared to those obtained before treatment (P<0.0001). At the end of follow-up, TSSs and LES pressure in group B were 4.00±1.00 and (43.67±12.66) mmHg, respectively, which were 10.20±0.45 (P=0.0096) and (58.60±8.65) mmHg (P=0.1687), respectively, in group A. The Kaplan-Meier curve revealed that group B obtained a better symptom remission than group A did (Log-rank test; P=0.0212). Conclusion: Long-term follow-up results indicate that for the treatment of achalasia retrievable stent placement is more effective than same diameter

  13. Auditory Risk of Exploding Hydrogen-Oxygen Balloons

    Science.gov (United States)

    Gee, Kent L.; Vernon, Julia A.; Macedone, Jeffrey H.

    2010-01-01

    Although hydrogen-oxygen balloon explosions are popular demonstrations, the acoustic impulse created poses a hearing damage risk if the peak level exceeds 140 dB at the listener's ear. The results of acoustical measurements of hydrogen-oxygen balloons of varying volume and oxygen content are described. It is shown that hydrogen balloons may be…

  14. 21 CFR 884.5050 - Metreurynter-balloon abortion system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Metreurynter-balloon abortion system. 884.5050... Devices § 884.5050 Metreurynter-balloon abortion system. (a) Identification. A metreurynter-balloon abortion system is a device used to induce abortion. The device is inserted into the uterine...

  15. Radiologically placed tunneled peritoneal catheter in palliation of malignant ascites

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate retrospectively the safety and effectiveness of radiologically placed tunneled peritoneal catheter in palliation of malignant ascites. Between July 2005 and June 2009, 41 tunneled peritoneal catheters were placed under ultrasonographic and fluoroscopic guidance in 40 patients (mean age, 55 years; 22 women) who had symptomatic malignant ascites. No procedure related mortality was observed. Major complication occurred in one patient (2.5%) in the form of serious bacterial peritonitis that necessitated catheter removal. Minor complications such as minor bacterial peritonitis, catheter dislodgement, tunnel infection, and catheter blockage occurred in 11 patients (27.5%). The mean duration of survival after catheter placement was 11.8 weeks. All patients expired of their primary malignancies in the follow-up. Radiologically placed tunneled peritoneal catheter is safe and effective in palliation of symptomatic malignant ascites.

  16. Short and middle term outcome of radiofrequency catheter ablation for paroxysmal and sustained atrial fibrillation

    International Nuclear Information System (INIS)

    The aim of this study was to assess short and middle term outcome of radiofrequency catheter ablation for drug-refractory paroxysmal and sustained atrial fibrillation. Subjects were 30 patients of atrial fibrillation (19 paroxysmal, 11 sustained) who underwent extensive pulmonary vein isolation from January 2007 to August 2009 in our department. Twenty three men and seven women, aged from 44 to 76 years, were enrolled. Follow-up period was one to 32 months. Drug free success was 33%, but symptoms and electrocardiogram (EGG) findings were improved in 93 % of the patients by administration of anti-arrhythmic agents. Five of the six patients with bradycardia-tachycardia syndrome was free from pacemaker implantation. Left ventricular ejection fraction was improved in two patients with dilated cardiomyopathy (DCM)-like left ventricular dysfunction. One case had cardiac tamponade and transient ST elevation due to right coronary air embolism were observed in two cases. There were no death and no cerebrovascular events during the procedures and follow-up periods. In conclusion, radiofrequency catheter ablation for paroxysmal and sustained atrial fibrillation in our department may be highly acceptable new method for improving the symptoms and clinical signs of the patients. (author)

  17. Development and in Vitro Characterization of Photochemically Crosslinked Polyvinylpyrrolidone Coatings for Drug-Coated Balloons

    Directory of Open Access Journals (Sweden)

    Svea Petersen

    2013-12-01

    Full Text Available Polyvinylpyrrolidone (PVP is a conventionally applied hydrophilic lubricious coating on catheter-based cardiovascular devices, used in order to ease movement through the vasculature. Its use as drug reservoir and transfer agent on drug-coated balloons (DCB is therefore extremely promising with regard to the simplification of its approval as a medical device. Here, we developed a PVP-based coating for DCB, containing paclitaxel (PTX as a model drug, and studied the impact of crosslinking via UV radiation on drug stability, wash off, and transfer during simulated use in an in vitro vessel model. We showed that crosslinking was essential for coating stability and needed to be performed prior to PTX incorporation due to decreased drug bioavailability as a result of photodecomposition and/or involvement in vinylic polymerization with PVP under UV radiation. Moreover, the crosslinking time needed to be carefully controlled. While short radiation times did not provide enough coating stability, associated with high wash off rates during DCB insertion, long radiation times lowered drug transfer efficiency upon balloon expansion. A ten minutes radiation of PVP, however, combined a minimized drug wash off rate of 34% with an efficient drug transfer of 49%, underlining the high potential of photochemically crosslinked PVP as a coating matrix for DCB.

  18. Preparation and characterisation of polyamide 11/montmorillonite (MMT) nanocomposites for use in angioplasty balloon applications

    Energy Technology Data Exchange (ETDEWEB)

    Halim, Khairul Anwar A. [Department of Polymer Engineering, Athlone Institute of Technology, Athlone (Ireland); School of Materials Engineering, Universiti Malaysia Perlis, Perlis (Malaysia); Farrell, Joseph B. [Department of Polymer Engineering, Athlone Institute of Technology, Athlone (Ireland); Kennedy, James E., E-mail: jkennedy@ait.ie [Department of Polymer Engineering, Athlone Institute of Technology, Athlone (Ireland)

    2013-12-16

    With increased demands on catheter balloon functionality, there is an emphasis to blend new materials which can improve mechanical performance. Polymer nanocomposites were prepared by melt blending polyamide 11 (PA 11) with organically modified montmorillonite nanoclay. The effects of incorporating the nanoclay on the short-term mechanical properties of PA 11 were assessed using a design of experiments (DoEs) approach. X-ray diffraction (XRD), transmission electron microscopy (TEM), differential scanning calorimetry (DSC) and dynamic mechanical thermal analysis techniques (DMA) were used to characterise the morphology of the nanocomposites. Design of experiments studies revealed that the optimum nanocomposites properties can be achieved by carefully controlling the melt compounding parameters. XRD and TEM data proved that exfoliated clay morphologies existed within the matrix at low clay loading (2%). Whereas the interaction between the polymer matrix and nanoclay was quantified in the DMA spectra, showed a significant increase in storage modulus (up to 80%). The reinforcing effect of nanoclay within the PA 11 was further investigated using mechanical testing, where significant increases in the ultimate tensile strength and strain at break of reinforced tri-layer balloon tubing were observed. - Highlights: • TEM reveals the coexistence of exfoliated and intercalated nanostructures. • Isothermal crystallisation studies found that the nano-clays reduced the crystallisation time. • Significant increase in the storage modulus was due to the reinforcing effect of the nano-clay platelets. • It was observed that the activation energy values decreased due to the presence of nanoclay.

  19. Aortic annulus eccentricity before and after transcatheter aortic valve implantation: Comparison of balloon-expandable and self-expanding prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Schuhbaeck, Annika, E-mail: annika.schuhbaeck@uk-erlangen.de [Department of Cardiology, University of Erlangen, Erlangen (Germany); Weingartner, Christina [Department of Cardiology, University of Gießen, Giessen (Germany); Arnold, Martin; Schmid, Jasmin; Pflederer, Tobias; Marwan, Mohamed [Department of Cardiology, University of Erlangen, Erlangen (Germany); Rixe, Johannes; Nef, Holger [Department of Cardiology, University of Gießen, Giessen (Germany); Schneider, Christian [Department of Radiology, University of Gießen, Giessen (Germany); Lell, Michael; Uder, Michael [Department of Radiology, University of Erlangen, Erlangen (Germany); Ensminger, Stephan [Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen (Germany); Feyrer, Richard; Weyand, Michael [Department of Cardiothoracic Surgery, University of Erlangen, Erlangen (Germany); Achenbach, Stephan [Department of Cardiology, University of Erlangen, Erlangen (Germany)

    2015-07-15

    Highlights: • Post-implant geometry of catheter-based aortic valve prostheses is influenced by aortic valve calcification. • Balloon-expandable prostheses are more circular as compared to self-expanding prostheses. • The impact of post-implant geometry on valve function needs to be investigated. - Abstract: Introduction: The geometry of the aortic annulus and implanted transcatheter aortic valve prosthesis might influence valve function. We investigated the influence of valve type and aortic valve calcification on post-implant geometry of catheter-based aortic valve prostheses. Methods: Eighty consecutive patients with severe aortic valve stenosis (mean age 82 ± 6 years) underwent computed tomography before and after TAVI. Aortic annulus diameters were determined. Influence of prosthesis type and degree of aortic valve calcification on post-implant eccentricity were analysed. Results: Aortic annulus eccentricity was reduced in patients after TAVI (0.21 ± 0.06 vs. 0.08 ± 0.06, p < 0.0001). Post-TAVI eccentricity was significantly lower in 65 patients following implantation of a balloon-expandable prosthesis as compared to 15 patients who received a self-expanding prosthesis (0.06 ± 0.05 vs. 0.15 ± 0.07, p < 0.0001), even though the extent of aortic valve calcification was not different. After TAVI, patients with a higher calcium amount retained a significantly higher eccentricity compared to patients with lower amounts of calcium. Conclusions: Patients undergoing TAVI with a balloon-expandable prosthesis show a more circular shape of the implanted prosthesis as compared to patients with a self-expanding prosthesis. Eccentricity of the deployed prosthesis is affected by the extent of aortic valve calcification.

  20. Aortic annulus eccentricity before and after transcatheter aortic valve implantation: Comparison of balloon-expandable and self-expanding prostheses

    International Nuclear Information System (INIS)

    Highlights: • Post-implant geometry of catheter-based aortic valve prostheses is influenced by aortic valve calcification. • Balloon-expandable prostheses are more circular as compared to self-expanding prostheses. • The impact of post-implant geometry on valve function needs to be investigated. - Abstract: Introduction: The geometry of the aortic annulus and implanted transcatheter aortic valve prosthesis might influence valve function. We investigated the influence of valve type and aortic valve calcification on post-implant geometry of catheter-based aortic valve prostheses. Methods: Eighty consecutive patients with severe aortic valve stenosis (mean age 82 ± 6 years) underwent computed tomography before and after TAVI. Aortic annulus diameters were determined. Influence of prosthesis type and degree of aortic valve calcification on post-implant eccentricity were analysed. Results: Aortic annulus eccentricity was reduced in patients after TAVI (0.21 ± 0.06 vs. 0.08 ± 0.06, p < 0.0001). Post-TAVI eccentricity was significantly lower in 65 patients following implantation of a balloon-expandable prosthesis as compared to 15 patients who received a self-expanding prosthesis (0.06 ± 0.05 vs. 0.15 ± 0.07, p < 0.0001), even though the extent of aortic valve calcification was not different. After TAVI, patients with a higher calcium amount retained a significantly higher eccentricity compared to patients with lower amounts of calcium. Conclusions: Patients undergoing TAVI with a balloon-expandable prosthesis show a more circular shape of the implanted prosthesis as compared to patients with a self-expanding prosthesis. Eccentricity of the deployed prosthesis is affected by the extent of aortic valve calcification

  1. Space and Earth Observations from Stratospheric Balloons

    Science.gov (United States)

    Peterzen, Steven; Ubertini, Pietro; Masi, Silvia; Ibba, Roberto; Ivano, Musso; Cardillo, Andrea; Romeo, Giovanni; Dragøy, Petter; Spoto, Domenico

    Stratospheric balloons are rapidly becoming the vehicle of choice for near space investigations and earth observations by a variety of science disciplines. With the ever increasing research into climatic change, instruments suspended from stratospheric balloons offer the science team a unique, stable and reusable platform that can circle the Earth in the polar region or equatorial zone for thirty days or more. The Italian Space Agency (ASI) in collaboration with Andoya Rocket Range (Andenes, Norway) has opened access in the far northern latitudes above 78o N from Longyearbyen, Svalbard. In 2006 the first Italian UltraLite Long Duration Balloon was launched from Baia Terra Nova, Mario Zuchelli station in Antarctica and now ASI is setting up for the their first equatorial stratospheric launch from their satellite receiving station and rocket launch site in Malindi, Kenya. For the equatorial missions we have analysed the statistical properties of trajectories considering the biennal oscillation and the seasonal effects of the stratospheric winds. Maintaining these launch sites offer the science community 3 point world coverage for heavy lift balloons as well as the rapidly deployed Ultralight payloads and TM system ASI developed to use for test platforms, micro experiments, as well as a comprehensive student pilot program

  2. The effect of ballooning model in ISAAC

    International Nuclear Information System (INIS)

    The purpose of this paper is to analyze the ballooning effect in the fuel channel with the ISAAC (Integrated Severe Accident Analysis code for CANDU Plants) computer code which was developed for the severe accident analysis at CANDU plants. Cladding/PT ballooning model parameter in the ISAAC code is used to analyze its effect mainly on the hydrogen production from the fuel channel. According to the current ISAAC version, cladding failure occurs when the cladding temperature exceeds a user-specified failure temperature, resulting in a fission products release from the fuel rod to the primary system. The typical accident sequences of a loss of feed water (LOFW) and a large LOCA (LLOCA) scenario are selected. Unlike the PWRs, the ballooning effect in CANDU plants is not so clear during the low pressure sequences. Instead, pressure tube ballooning during the high pressure sequences decreases the amount of hydrogen generated from the fuel when pressure tube-calandria tube contact occurs, resulting in a cladding and pressure tube temperature decrease. (authors)

  3. A case of balloon rupture during insertion of an intragastric balloon for treatment of morbid obesity

    OpenAIRE

    Bor, Serhat; TURAN, İlker; ÖZÜTEMİZ, Ömer

    2007-01-01

    The therapeutic options for treatment of morbid obesity are diet, exercise, behavioral modifications, medical treatment and bariatric surgery. An alternative approach to surgery is the endoscopic placement in the stomach of balloons which are filled with liquid, providing a sensation of fullness that decreases food consumption. The rate of complications associated with the placement of intragastric balloons is low. A significant late complication is deflation and/or displacement of the...

  4. Stratospheric Balloon Platforms for Near Space Access

    Science.gov (United States)

    Dewey, R. G.

    2012-12-01

    For over five decades, high altitude aerospace balloon platforms have provided a unique vantage point for space and geophysical research by exposing scientific instrument packages and experiments to space-like conditions above 99% of Earth's atmosphere. Reaching altitudes in excess of 30 km for durations ranging from hours to weeks, high altitude balloons offer longer flight durations than both traditional sounding rockets and emerging suborbital reusable launch vehicles. For instruments and experiments requiring access to high altitudes, engineered balloon systems provide a timely, responsive, flexible, and cost-effective vehicle for reaching near space conditions. Moreover, high altitude balloon platforms serve as an early means of testing and validating hardware bound for suborbital or orbital space without imposing space vehicle qualifications and certification requirements on hardware in development. From float altitudes above 30 km visible obscuration of the sky is greatly reduced and telescopes and other sensors function in an orbit-like environment, but in 1g. Down-facing sensors can take long-exposure atmospheric measurements and images of Earth's surface from oblique and nadir perspectives. Payload support subsystems such as telemetry equipment and command, control, and communication (C3) interfaces can also be tested and operationally verified in this space-analog environment. For scientific payloads requiring over-flight of specific areas of interests, such as an active volcano or forest region, advanced mission planning software allows flight trajectories to be accurately modeled. Using both line-of-sight and satellite-based communication systems, payloads can be tracked and controlled throughout the entire mission duration. Under NASA's Flight Opportunities Program, NSC can provide a range of high altitude flight options to support space and geophysical research: High Altitude Shuttle System (HASS) - A balloon-borne semi-autonomous glider carries

  5. [How to manage a pyelocalyceal dilatation?].

    Science.gov (United States)

    Vamadevan, Sanjeev; Klein, Jacques; Iselin, Christophe E

    2015-12-01

    Due to its length and its small diameter, the ureter is exposed to a high obstructive risk which may be ascribed to extremely variable pathologies. Because of a remarkably active peristalsis, the clinical consequence is acute if the obstacle suddenly settles. The radiological sign of appeal is the pyelocalyceal dilatation, which is widely listed in the Western medical system, in consideration of the abundance of the practiced imaging. From the acute situation to the fortuitous discovery, its understanding must be further investigated because of the immediate symptomatic potential impact such as renal colic, which can be associated with sepsis, as well as possible long-term sequelae on renal function. This article aims to help the primary care physician to initiate its diagnosis and treatment. PMID:26785528

  6. Dilatant hardening of fluid-saturated sandstone

    Science.gov (United States)

    Makhnenko, Roman Y.; Labuz, Joseph F.

    2015-02-01

    The presence of pore fluid in rock affects both the elastic and inelastic deformation processes, yet laboratory testing is typically performed on dry material even though in situ the rock is often saturated. Techniques were developed for testing fluid-saturated porous rock under the limiting conditions of drained, undrained, and unjacketed response. Confined compression experiments, both conventional triaxial and plane strain, were performed on water-saturated Berea sandstone to investigate poroelastic and inelastic behavior. Measured drained response was used to calibrate an elasto-plastic constitutive model that predicts undrained inelastic deformation. The experimental data show good agreement with the model: dilatant hardening in undrained triaxial and plane strain compression tests under constant mean stress was predicted and observed.

  7. Supersymmetric Dilatations in the Presence of Dilaton

    CERN Document Server

    La, H S

    1997-01-01

    The supersymmetric generalization of dilatations in the presence of the dilaton is defined. This is done by defining the supersymmetric dilaton geometry which is motivated by the supersymmetric volume preserving diffeomorphisms. The resulting model is classical superconformal field theory with an additional dilaton-axion supermultiplet coupled to the supersymmetric gauge theory, where the dilaton-axion couplings are nonrenormalizable. The possibility of spontaneous scale symmetry breaking is investigated in this context. There are three different types of vacua with broken scale symmetry depending on the details of the dilaton sector: unbroken supersymmetry, spontaneously broken supersymmetry and softly broken supersymmetry. If the scale symmetry is broken in the bosonic vacuum, then the Poincaré supersymmetry must be broken at the same time. If the scale symmetry is broken in the fermionic vacuum but the bosonic vacuum remains invariant, then the Poincaré supersymmetry can be preserved as long as the R-sym...

  8. Randomized Comparison of Final Kissing Balloon Dilatation Versus No Final Kissing Balloon Dilatation in Patients With Coronary Bifurcation Lesions Treated With Main Vessel Stenting. Five Year Clinical Outcome in The Nordic-Baltic Bifurcation Study III

    DEFF Research Database (Denmark)

    Niemelä, Matti; Holm, Niels R; Kervinen, Kari;

    2015-01-01

    reduced angiographic side branch (re)stenosis, especially in patients with true bifurcation lesions. The simple no-FKBD procedures resulted in reduced use of contrast media and shorter procedure and fluoroscopy times. Long-term data on stent thrombosis are needed. Clinical Trial Registration- URL: http...

  9. Distributed pressure sensors for a urethral catheter.

    Science.gov (United States)

    Ahmadi, Mahdi; Rajamani, Rajesh; Timm, Gerald; Sezen, A S

    2015-08-01

    A flexible strip that incorporates multiple pressure sensors and is capable of being fixed to a urethral catheter is developed. The urethral catheter thus instrumented will be useful for measurement of pressure in a human urethra during urodynamic testing in a clinic. This would help diagnose the causes of urinary incontinence in patients. Capacitive pressure sensors are fabricated on a flexible polyimide-copper substrate using surface micromachining processes and alignment/assembly of the top and bottom portions of the sensor strip. The developed sensor strip is experimentally evaluated in an in vitro test rig using a pressure chamber. The sensor strip is shown to have adequate sensitivity and repeatability. While the calibration factors for the sensors on the strip vary from one sensor to another, even the least sensitive sensor has a resolution better than 0.1 psi. PMID:26738054

  10. Pancreas tumor interstitial pressure catheter measurement

    Science.gov (United States)

    Nieskoski, Michael D.; Gunn, Jason; Marra, Kayla; Trembly, B. Stuart; Pogue, Brian W.

    2016-03-01

    This paper highlights the methodology in measuring interstitial pressure in pancreatic adenocarcinoma tumors. A Millar Mikrotip pressure catheter (SPR-671) was used in this study and a system was built to amplify and filter the output signal for data collection. The Millar pressure catheter was calibrated prior to each experiment in a water column at 37°C, range of 0 to 60 inH2O (112 mmHg), resulting in a calibration factor of 33 mV / 1 inH2O. The interstitial pressures measured in two orthotopically grown pancreatic adenocarcinoma tumor were 57 mmHg and 48 mmHg, respectively. Verteporfin uptake into the pancreatic adenocarcinoma tumor was measured using a probe-based experimental dosimeter.

  11. Retrograde Epidural Catheter Relieves Intractable Sacral Pain.

    Science.gov (United States)

    Gupta, Ruchir; Shodhan, Shivam; Hosny, Amr

    2016-01-01

    Pain caused by tumor infiltration of the sacral area remains a major clinical challenge. Patients with poor pain control despite comprehensive medical management may be treated with neuraxial techniques such as continuous epidural or spinal anesthetic. We report a case in which a patient with metastatic breast cancer experienced inadequate pain relief after multiple intravenous pain management regimens as well as intrathecal (IT) drug delivery. The concentration of local anesthetics delivered via the IT catheter was limited due to the patient's baseline motor weakness which would be exacerbated with higher concentrations of local anesthetics. Thus, a decision was made to insert an epidural catheter via a retrograde technique to provide the patient with a "band of anesthesia" which would provide profound sensory blockade without concomitant motor weakness. Pain refractory to other modalities of pain control was successfully treated with the epidural technique. PMID:27162431

  12. Dilated Canine Hearts: A Specimen for Teaching Cardiac Anatomy

    Science.gov (United States)

    Cope, Lee Anne

    2008-01-01

    Dilated canine hearts were used to teach undergraduate students internal and external cardiac anatomy. The specimens were dilated using hydrostatic pressure and then fixed using 5% formalin. These specimens provided the students with an alternative to prepackaged embalmed hearts and anatomical models for studying the external and internal cardiac…

  13. Congenital bile duct dilatation (Caroli's disease - Grumbach's disease)

    International Nuclear Information System (INIS)

    Congenital bile duct dilatation is an autosomal recessive inherited disease. Pathologically tortuous dilated, dyplastic intrahepatic bile ducts were found. It may be associated with hepatic fibrosis (Grumbach's disease), or without (Caroli's disease). A common additional finding is an infantile polycystic kidney. Three cases are reported and the radiological and sonographic findings are discussed. (orig.)

  14. Dilated aortic root and severe aortic regurgitation causing dilated cardiomyopathy in classic Ehlers-Danlos syndrome.

    Science.gov (United States)

    Zainal, Abir; Hamad, Mahmoud Nidal; Naqvi, Syed Yaseen

    2016-01-01

    Ehlers-Danlos syndrome (EDS) is a group of heritable disorders characterised by vast clinical heterogeneity ranging from the classic constellation of symptoms including skin hyperextensibility, joint hypermobility and skin fragility to the exceedingly critical consequences of arterial rupture and visceral perforation. We describe the case of a 65-year-old male with a history of classic EDS who reported of dyspnoea on exertion, orthopnoea, fatigue and palpitations. He was found to have dilated cardiomyopathy with an ejection fraction of 35%, aortic root dilation and severe aortic valve regurgitation. The authors intend to draw attention to the rare cardiac manifestations of this condition and the therapeutic challenges involved in managing such patients. PMID:27413024

  15. Brain 'Embolism' Detected by Magnetic Resonance Imaging During Percutaneous Mitral Balloon Commissurotomy

    International Nuclear Information System (INIS)

    Purpose: The common finding of thrombi between the bifoil balloons when they were extracted after mitral dilation prompted us to look for evidence of minor brain embolisms using the sensitive technique of BMRI (brain magnetic resonance T2-weighted imaging). Methods: BMRI was performed within 48 hr before and after a percutaneous mitral balloon commissurotomy (PMBC) in each of the 63 patients in this study. Results: There was evidence (hyperintensity foci: HI) of a previous asymptomatic brain embolism in 38 of 63 patients before PMBC and a new HI appeared in 18 of 63 patients after the procedure. New HI signals were found exclusively in the white matter in 8 of 18 patients and in only 3 of 18 were HI signs larger than 1 cm. One patient, with an HI signal >1 cm in the thalamus and another 8; 4, patients from western countries vs the others) were not statistically significant, probably because the number of patients in each subgroup was low. Patients in atrial fibrillation had slightly more (not significant) HI before PMBC (15/20, 75%) than patients in sinus rhythm (23/43, 53%), but after PMBC their HI frequencies were similar (atrial fibrillation: 5/20, 25%; sinus rhythm: 13/43, 30%). Conclusion: Brain microembolism is frequent during PMBC, but is often anatomically limited and free from clinical signs in most cases. Brain embolism seems to be related mainly to the procedure itself and not the features of the patient

  16. Stenosis in laparoscopic gastric bypass: management by endoscopic dilation without fluoroscopic guidance Estenosis tras derivación gástrica laparoscópica: tratamiento mediante dilataciones endoscópicas sin control radiológico

    Directory of Open Access Journals (Sweden)

    Jesús Espinel

    2011-10-01

    Full Text Available Objectives: gastric bypass is the surgical procedure that is carried out most frequently in the treatment of morbid obesity. Stenosis of the gastro-jejunal anastomosis is a relatively frequent complication that requires endoscopic management. However, the optimal dilation technique is yet to be determined. The purpose of this study was to evaluate the safety and efficacy of dilation with a hydrostatic balloon (CRE without radioscopic guidance in morbidly obese patients treated by laparoscopic bypass. Material and methods: retrospective review of the data elicited from 525 patients treated against morbid obesity with laparoscopic gastric bypass from January, 2006 to November, 2010. Results: a total of 22/525 patients (4.1% developed stenosis of the anastomosis [20 women (91%, 2 men (9%]. In four patients (18.2%, there was an associated anastomotic ulcer, and in one case, there was a history of bleeding of an ulcer treated with sclerosis one month earlier. The diagnosis of stenosis was done in most patients during the first 90 days after the bypass. All cases were resolved by means of endoscopic dilation without radioscopic guidance, 15 cases (68.1% required a single session, 6 cases (27.2% two sessions, and 1 case (4.5% required four sessions. This last case had an associated anastomotic ulcer. The diameter of the balloons ranged from 12 to 20 mm, generally using diameters of 12-15 mm in the first session, and increasing them in the following sessions according to the previous result. One patient treated with a 20 mm balloon presented with a small tear, without showing any evidence of leak of contrast medium in the radioscopic guidance, and was thus managed conservatively. In the follow-up, no re-stenoses were detected. Conclusions: in our experience, stenosis of the anastomosis in the laparoscopic gastric bypass is an infrequent complication. When it happens, dilation with a hydrostatic balloon is an effective and safe treatment. Radioscopic

  17. Electromagnetic tracking and steering for catheter navigation

    OpenAIRE

    O'Donoghue, Kilian

    2014-01-01

    This thesis explores the use of electromagnetics for both steering and tracking of medical instruments in minimally invasive surgeries. The end application is virtual navigation of the lung for biopsy of early stage cancer nodules. Navigation to the peripheral regions of the lung is difficult due to physical dimensions of the bronchi and current methods have low successes rates for accurate diagnosis. Firstly, the potential use of DC magnetic fields for the actuation of catheter devices with ...

  18. Robotic Catheters for Beating Heart Surgery

    OpenAIRE

    Kesner, Samuel Benjamin

    2011-01-01

    Compliant and flexible cardiac catheters provide direct access to the inside of the heart via the vascular system without requiring clinicians to stop the heart or open the chest. However, the fast motion of the intracardiac structures makes it difficult to modify and repair the cardiac tissue in a controlled and safe manner. In addition, rigid robotic tools for beating heart surgery require the chest to be opened and the heart exposed, making the procedures highly invasive. The novel robot...

  19. Transpleural central venous catheter discovered during thoracotomy

    OpenAIRE

    Ashima Malhotra; Prakash Sharma; Ashvini Kumar; Nikhil Malhotra

    2014-01-01

    We report an uncommon complication of subclavian central venous catheterization, discovered at thoracotomy. The central venous catheter (CVC) was placed by left infraclavicular route after induction of general anesthesia. CVC was secured after aspiration of blood and satisfactory central venous tracing. On thoracotomy, CVC was noticed to traverse the pleural cavity while the tracing was normal. CVC was thus removed consequent to which bleeding from each puncture site was noticed, that were se...

  20. Study on Production Process for improving Quality of Di-bag and Tri-cavity Latex Stomach Catheter%改善胶乳三腔双囊胃管质量的生产工艺研究

    Institute of Scientific and Technical Information of China (English)

    李志锋; 黄茂芳; 许逵; 杨子明

    2014-01-01

    The hardness and tear strength of pipe shaft of the stomach catheter were effectively improved by concentrated natural rubber latex vulcanized with 20 phr methyl methacrylate grafted natural rubber latex (MG49) as fundamental pipe shaft material of stomach catheter ,and solved the difficulty of inserting pipe in clinic by lack of enough hardness of pipe shaft of pure natural latex ,and the process performance and other performance of the products were not effected .The film thickness uniformity of stomach catheter balloon could be improved by using “calcium nitrate + industrial alco‐hol + surfactant” to replace“calcium nitrate + cornstarch mold adhering agent + surfactant” as so‐lidification system .The adhesion and sticky injury between balloon and pipe shaft of stomach catheter could be overcomed by moderate chlorination on the inner surface of stomach catheter balloon .Appro‐priately adjusting the position of the tie lines could effectively reduce the tube map cracking appeared on the film balloon .A good gelatinization effect could be obtained by gelatinizing chloroform value of 2~3 middle and total solid of 25% ~35% at balloon tied line ,and repeating gelatinization 3~4 times .%以浓缩天然胶乳并用20份M G49天甲胶乳作胃管基础管身胶料可有效提高管身硬度和撕裂强度,并解决纯天然胶乳管身硬度不足、临床不易插管的难题,而对产品工艺性能及其他性能无不良影响。用"硝酸钙+工业酒精+表面活性剂"代替"硝酸钙+生粉附型剂+表面活性剂"作凝固体系,可改善胃管球囊胶膜厚度的均匀性。对胃管球囊内表面做适度氯化处理,可克服球囊与胃管管身产生的粘连或粘伤。适当改变绑线位置可有效减少胃管球囊胶膜出现的龟裂纹;球囊绑线处涂覆氯仿值二中~三中(见表9注)、总固体25%~35%的胶料3~4次,可获得较好涂胶效果。

  1. Radiologic Placement of Tunneled Central Venous Catheters in Pediatric Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Ji; Song, Soon Young; Cho, On Koo; Koh, Byung Hee; Kim, Yong Soo; Jeong, Woo Kyoung; Lee, Yong Ho [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2010-08-15

    We evaluated the technical success and complication rates associated with the radiological placement of tunneled central venous catheters in pediatric patients. Between May 1, 2005 and March 31, 2008, a total of 46 tunneled central venous catheters were placed in 34 children (M:F = 22:12; mean age, 9.9 years [9 months to 16.8 years]). All procedures were performed under ultrasonographic and fluoroscopic guidance. Follow-up data were obtained through the retrospective review of the medical records. We used the Kaplan-Meier survival method for the evaluation of survival rate of the catheters. All procedures were technically successful. The observed periprocedural complications included hematoma formation in three patients. The mean catheter life was 189.3 days (total, 8710 days; range, 7-810). Catheters were removed due to death (n=9), the end of treatment (n=8), catheter sepsis (n=4), malfunction (n=8), and accidental removal (n=4). The rate of catheter sepsis and malfunction was 0.459 and 0.919 for every 1000 catheter days, respectively. The expected mean catheter life was 479.6 days as per the Kaplan- Meier analysis. The results suggest that the radiologic placement of a tunneled central venous catheter is an effective technique with a high technical success rate and low complication rate.

  2. Biological safety evaluation of the modified urinary catheter

    Energy Technology Data Exchange (ETDEWEB)

    Kowalczuk, Dorota, E-mail: dorota.kowalczuk@umlub.pl [Department of Medicinal Chemistry, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin (Poland); Przekora, Agata; Ginalska, Grazyna [Department of Biochemistry and Biotechnology, Medical University of Lublin, Chodzki 1, 20-093 Lublin (Poland)

    2015-04-01

    The purpose of this study was to evaluate in vitro safety of the novel tosufloxacin (TOS)-treated catheters with the prolonged antimicrobial activity. The test samples of silicone latex catheter were prepared by the immobilization of TOS on chitosan (CHIT)-coated catheter by means of covalent bonds and non-covalent interactions. Each step of the modification process of catheter surface was observed using ATR–Fourier transform infrared spectroscopy. In vitro cytotoxicity of the modified and unmodified catheters was assessed by direct and indirect tests in accordance with ISO standards using green monkey kidney (GMK) cell line. The MTT, lactate dehydrogenase activity (LDH), WST-8, Sulforhodamine B (SRB) test results and microscopic observation clearly indicated that unmodified silicone latex catheters decrease cell metabolic activity, act as a cytotoxic agent causing cell lysis and induce cell death through necrotic or apoptotic process. We suggest that chitosan coat with TOS immobilized limits leaching of harmful agents from silicone latex material, which significantly enhances survivability of GMK cells and therefore is quite a good protection against the cytotoxic effect of this material. - Highlights: • Characterization of the novel antimicrobial urinary catheters • Monitoring of the catheter modification by FTIR analysis • Confirmation of high cytotoxicity of latex-based catheter used in urological practice • Chitosan-coated and tosufloxacin-treated catheter is less toxic than the untreated one. • The proposed surface modification protects cells against latex-induced death.

  3. Biological safety evaluation of the modified urinary catheter

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate in vitro safety of the novel tosufloxacin (TOS)-treated catheters with the prolonged antimicrobial activity. The test samples of silicone latex catheter were prepared by the immobilization of TOS on chitosan (CHIT)-coated catheter by means of covalent bonds and non-covalent interactions. Each step of the modification process of catheter surface was observed using ATR–Fourier transform infrared spectroscopy. In vitro cytotoxicity of the modified and unmodified catheters was assessed by direct and indirect tests in accordance with ISO standards using green monkey kidney (GMK) cell line. The MTT, lactate dehydrogenase activity (LDH), WST-8, Sulforhodamine B (SRB) test results and microscopic observation clearly indicated that unmodified silicone latex catheters decrease cell metabolic activity, act as a cytotoxic agent causing cell lysis and induce cell death through necrotic or apoptotic process. We suggest that chitosan coat with TOS immobilized limits leaching of harmful agents from silicone latex material, which significantly enhances survivability of GMK cells and therefore is quite a good protection against the cytotoxic effect of this material. - Highlights: • Characterization of the novel antimicrobial urinary catheters • Monitoring of the catheter modification by FTIR analysis • Confirmation of high cytotoxicity of latex-based catheter used in urological practice • Chitosan-coated and tosufloxacin-treated catheter is less toxic than the untreated one. • The proposed surface modification protects cells against latex-induced death

  4. NASA balloon design and flight - Philosophy and criteria

    Science.gov (United States)

    Smith, I. S., Jr.

    1993-01-01

    The NASA philosophy and criteria for the design and flight of scientific balloons are set forth and discussed. The thickness of balloon films is standardized at 20.3 microns to isolate potential film problems, and design equations are given for specific balloon parameters. Expressions are given for: flight-stress index, total required thickness, cap length, load-tape rating, and venting-duct area. The balloon design criteria were used in the design of scientific balloons under NASA auspices since 1986, and the resulting designs are shown to be 95 percent effective. These results represent a significant increase in the effectiveness of the balloons and therefore indicate that the design criteria are valuable. The criteria are applicable to four balloon volume classes in combination with seven payload ranges.

  5. Measurements of gondola motion on a stratospheric balloon flight

    CERN Document Server

    Safonova, Margarita; Sreejith, A G; Sarpotdar, Mayuresh; Ambily, S; Prakash, Ajin; Mathew, Joice; Murthy, Jayant; Anand, Devarajan; Kapardhi, B V N; Kumar, B Suneel; Kulkarni, P M

    2016-01-01

    Balloon experiments are an economically feasible method of conducting observations in astronomy that are not possible from the ground. The astronomical payload may include a telescope, a detector, and a pointing/stabilization system. Determining the attitude of the payload is of primary importance in such applications, to accurately point the detector/telescope to the desired direction. This is especially important in generally unstable lightweight balloon flights. However, the conditions at float altitudes, which can be reached by zero pressure balloons, could be more stable, enabling accurate pointings. We have used the Inertial Measurement Unit (IMU), placed on a stratospheric zero pressure balloon, to observe 3-axis motion of a balloon payload over a fight time of 4.5 hours, from launch to the float altitude of 31.2 km. The balloon was launched under nominal atmospheric conditions on May 8th 2016, from a Tata Institute of Fundamental Research Balloon Facility, Hyderabad.

  6. Interventional radiological imaging and treatment of port catheter dysfunctions

    International Nuclear Information System (INIS)

    To evaluate the impact of interventional radiological imaging and treatment of central venous port catheter complications. Materials and Methods: In this retrospective analysis 429 port catheter dysfunctions were evaluated in 393 port catheter systems for a total of 389 patients over a period of 10 years. The study included 193 (49.1 %) patients with radiologically implanted port catheter systems and 200 (50.9 %) referred patients with surgically implanted port systems. Port catheter dysfunctions were subdivided into early and late complications as well as into non-thrombotic and thrombotic events. After administration of contrast medium, the port system was visualized using digital subtraction angiography. Data were retrospectively collected from the in-house databases and then analyzed descriptively. Results: 429 contrast media injections via port catheters were performed in 393 port catheter systems. There were 359 (83.7 %) late complications and 70 (16.3 %) early complications. In 299 (69.7 %) cases thrombotic events occurred and 130 (30.3 %) non-thrombotic events were recorded. The most common reason for contrast media injection via port catheter system was port catheter-related thrombosis in 269 (62.7 %) cases. 70 (16.3 %) catheter migrations and 30 (7.0 %) fibrin sheath formations were detected. 18 (4.2 %) port needle malfunctions could be resolved through needle exchange. All 15 (3.5 %) catheter disconnections had to be revised in all cases. Also six port explantations were performed in 6 (1.4 %) catheter fractures. Conclusion: The possibilities of angiographic imaging and interventional radiological correction of port catheter dysfunctions must be exploited fully in order to avoid premature port explantation. (orig.)

  7. Critical appraisal of paclitaxel balloon angioplasty for femoral–popliteal arterial disease

    Science.gov (United States)

    Herten, Monika; Torsello, Giovanni B; Schönefeld, Eva; Stahlhoff, Stefan

    2016-01-01

    Peripheral arterial disease, particularly critical limb ischemia, is an area with urgent need for optimized therapies because, to date, vascular interventions often have limited life spans. In spite of initial encouraging technical success after femoropopliteal percutaneous transluminal angioplasty or stenting, postprocedural restenosis remains the major problem. The challenging idea behind the drug-coated balloon (DCB) concept is the biological modification of the injury response after balloon dilatation. Antiproliferative drugs administered via DCBs or drug-eluting stents are able to suppress neointimal hyperplasia, the main cause of restenosis. This article reviews the results of DCB treatments of femoropopliteal and infrapopliteal lesions in comparison to standard angioplasty with uncoated balloons. A systematic literature search was performed in 1) medical journals (ie, MEDLINE), 2) international registers for clinical studies (ie, www.clinicaltrials.gov), and 3) abstracts of scientific sessions. Several controlled randomized trials with follow-up periods of up to 5 years demonstrated the efficacy of paclitaxel –DCB technology. However, calcified lesions seem to affect the efficacy of DCB. Combinations of preconditioning methods with DCBs showed promising results. Although the mechanical abrasion of calcium via atherectomy or laser ablation showed favorable periprocedural results, the long-term impact on restenosis and clinical outcome has to be demonstrated. Major advantages of the DCBs are the rapid delivery of drug at uniform concentrations with a single dose, their efficacy in areas wherein stents have been contraindicated until now (ie, bifurcation, ostial lesions), and in leaving no stent scaffold behind. Reinterventions are easier to perform because DCBs leave no metal behind. Various combinations of DCBs with other treatment modalities may prove to be viable options in future. The follow-up results of clinical studies will evaluate the long

  8. Balloon Dilatation for an Esophageal Stricture by Long-Term Use of a Nasogastric Tube: A Case Report

    OpenAIRE

    Yoon, Yong-Soon; Kim, Jong Yun; Lee, Kwang Jae; Yu, Ki Pi; Lee, Mi Sook

    2014-01-01

    In the present report, we describe a case of long-term follow-up esophageal stricture occurring in a patient with nasogastric tube use. A 63-year-old man who had experienced dislocation of the 6th and 7th cervical vertebrae as the result of an external injury received treatment at another hospital and was admitted to the rehabilitation department of our hospital. After he exhibited normal swallowing in a videofluoroscopic swallowing test, the nasogastric tube was removed and oral feeding with...

  9. A comparative study of one minute versus five seconds endoscopic biliary balloon dilation after small sphincterotomy in choleducolithiasis

    Directory of Open Access Journals (Sweden)

    Ahmad Shavakhi

    2015-01-01

    Conclusions: After a small sphincterotomy, EPBD in the five-second and one-minute BT groups had a similar efficacy. Small sphincterotomy combined with very short BT is a safe and effective method for CBD stone removal.

  10. Prospective comparison between two different magnetic resonance defecography techniques for evaluating pelvic floor disorders: air-balloon versus gel for rectal filling

    Energy Technology Data Exchange (ETDEWEB)

    Francesca, Maccioni; Najwa, Al Ansari; Valeria, Buonocore; Fabrizio, Mazzamurro; Carlo, Catalano [Sapienza University of Rome, Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I Hospital, Rome (Italy); Marileda, Indinnimeo; Massimo, Mongardini [Sapienza University of Rome, Department of Surgical Sciences, Policlinico Umberto I Hospital, Rome (Italy)

    2016-06-15

    to prospectively compare two rectal filling techniques for dynamic MRI of pelvic floor disorders (PFD). Twenty-six patients with PFD underwent the two techniques during the same procedure, one based on rectal placement of a balloon-catheter filled with saline and air insufflation (air-balloon technique or AB); another based on rectal filling with 180 cc of gel (gel-filling technique or GF). The examinations were compared for assessment and staging of PFD, including rectal-descent, rectocele, cystocele, colpocele, enterocele, rectal invagination. Surgery and clinical examinations were the gold standard. AB showed sensitivity of 96 % for rectal descent, 100 % for both rectocele and colpocele, 86 % for rectal invagination and 100 % for enterocele; understaged 11 % of rectal descents and 19 % of rectoceles. GF showed sensitivity of 100 % for rectal descent, 91 % for rectocele, 83 % for colpocele, 100 % for rectal invagination and 73 % for enterocele; understaged 3.8 % of rectal descent and 11.5 % of rectoceles. Both techniques showed 100 % of specificity. Agreement between air-balloon and gel filling was 84 % for rectal descent, 69 % for rectocele, 88 % for rectal invagination, 84 % for enterocele, 88 % for cystocele and 92 % for colpocele. Both techniques allowed a satisfactory evaluation of PFD. The gel filling was superior for rectal invagination, the air-balloon for rectocele and anterior/middle compartment disorders. (orig.)

  11. Indications for needle catheter jejunostomy in elective abdominal surgery.

    Science.gov (United States)

    Heberer, M; Bodoky, A; Iwatschenko, P; Harder, F

    1987-06-01

    Needle catheter jejunostomy for postoperative nutritional support is now employed worldwide. However, there is a large discrepancy regarding indications for this technique which this study attempts to rectify. The need for nutritional support after elective abdominal procedures in 464 patients was analyzed and compared with the experience with needle catheter jejunostomy in 42 patients. The results show that needle catheter jejunostomy is indicated after extensive operations of the upper gastrointestinal tract, for example, esophagectomy, total gastrectomy, and the Whipple procedure. With minor upper gastrointestinal operations, or procedures of the lower gastrointestinal tract, needle catheter jejunostomy should be performed only in patients with poor nutritional status or in the presence of postoperative chemotherapy or radiotherapy. In an unclear situation, liberal insertion of the needle catheter jejunostomy and a postponed decision on enteral feeding is recommended, as there is no significant catheter-related morbidity. PMID:3109269

  12. Technique of Peritoneal Catheter Placement under Fluoroscopic Guidance

    International Nuclear Information System (INIS)

    Peritoneal catheters are mainly used for peritoneal dialysis in patients with end-stage renal disease. Other uses of this catheter include intraperitoneal chemotherapy and gene therapy for ovarian cancer and draining of uncontrolled refractory ascites in patients with liver cirrhosis. Traditionally, surgeons place most of these peritoneal catheters either by laparoscopy or open laparotomy. We detail our percutaneous approach to placing peritoneal catheters using fluoroscopic guidance. We emphasize the use of additional ultrasound guidance, including gray scale and color Doppler ultrasound, to determine the safest puncture site and to guide the initial needle puncture in order to avoid bowel perforation and injury to epigastric artery. We present our experience in placing peritoneal catheters using this technique in 95 patients with various indications. Fluoroscopic guided percutaneous placement of peritoneal catheters is a safe, minimally invasive, and effective alternative to open surgical or laparoscopic placement.

  13. DISCOVER: Dutch Iliac Stent trial: COVERed balloon-expandable versus uncovered balloon-expandable stents in the common iliac artery: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Bekken Joost A

    2012-11-01

    endovascular dilatation or revascularization of the common iliac artery, followed by placement of one or more uncovered balloon-expandable stents. The study group will undergo the same treatment, however one or more PTFE-covered balloon-expandable stents will be placed. When necessary, the aorta, external iliac artery, common femoral artery, superficial femoral artery and deep femoral artery will be treated, using the standard treatment. The primary endpoint is absence of binary restenosis rate. Secondary endpoints are reocclusion rate, target-lesion revascularization rate, clinical success, procedural success, hemodynamic success, major amputation rate, complication rate and mortality rate. Main study parameters are age, gender, relevant co-morbidity, and several patient, disease and procedure-related parameters. Trial registration Dutch Trial Register, NTR3381.

  14. Robotic catheter cardiac ablation combining ultrasound guidance and force control

    OpenAIRE

    Kesner, Samuel Benjamin; Howe, Robert D.

    2014-01-01

    Cardiac catheters allow physicians to access the inside of the heart and perform therapeutic interventions without stopping the heart or opening the chest. However, conventional manual and actuated cardiac catheters are currently unable to precisely track and manipulate the intracardiac tissue structures because of the fast tissue motion and potential for applying damaging forces. This paper addresses these challenges by proposing and implementing a robotic catheter system that uses 3D ultras...

  15. Role of biofilm in catheter-associated urinary tract infection

    OpenAIRE

    Trautner, Barbara W.; Darouiche, Rabih O.

    2004-01-01

    The predominant form of life for the majority of microorganisms in any hydrated biologic system is a cooperative community termed a “biofilm.” A biofilm on an indwelling urinary catheter consists of adherent microorganisms, their extracellular products, and host components deposited on the catheter. The biofilm mode of life conveys a survival advantage to the microorganisms associated with it and, thus, biofilm on urinary catheters results in persistent infections that are resistant to antimi...

  16. Rat Indwelling Urinary Catheter Model of Candida albicans Biofilm Infection

    OpenAIRE

    Nett, Jeniel E.; Brooks, Erin G.; Cabezas-Olcoz, Jonathan; Sanchez, Hiram; Zarnowski, Robert; Marchillo, Karen; Andes, David R.

    2014-01-01

    Indwelling urinary catheters are commonly used in the management of hospitalized patients. Candida can adhere to the device surface and propagate as a biofilm. These Candida biofilm communities differ from free-floating Candida, exhibiting high tolerance to antifungal therapy. The significance of catheter-associated candiduria is often unclear, and treatment may be problematic considering the biofilm drug-resistant phenotype. Here we describe a rodent model for the study of urinary catheter-a...

  17. Development of Thrombus in a Systemic Vein after Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varices

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimatsu, Rika; Yamagami, Takuji; Tanaka, Osamu; Miura, Hiroshi; Nishimura, Tsunehiko [Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto (Japan); Okuda, Kotaro; Hashiba, Mitsuoki [Fukuchiyama City Hospital, Kyoto (Japan)

    2012-06-15

    To retrospectively evaluate the frequency and risk factors for developing thrombus in a systemic vein such as the infrarenal inferior vena cava or the iliac vein, in which a balloon-occluded retrograde transvenous obliteration (B-RTO) catheter was indwelled. Forty-nine patients who underwent B-RTO for gastric varices were included in this study. The B-RTO procedure was performed from the right femoral vein, and the B-RTO catheter was retained overnight in all patients. Pre- and post-procedural CT scans were retrospectively compared in order to evaluate the development of thrombus in the systemic vein in which the catheter was indwelled. Additionally, several variables were analyzed to assess risk factors for thrombus in a systemic vein. In all 49 patients (100%), B-RTO was technically successful, and in 46 patients (94%), complete thrombosis of the gastric varices was achieved. In 6 patients (12%), thrombus developed in the infrarenal inferior vena cava or the right common-external iliac vein. All thrombi lay longitudinally on the right side of the inferior vena cava or the right iliac vein. One of the aforementioned 6 patients required anticoagulation therapy. No symptoms suggestive of pulmonary embolism were observed. Prothrombin time-international normalized ratio and the addition of 5% ethanolamine oleate iopamidol, on the second day, were related to the development of thrombus. Development of a thrombus in a systemic vein such as the inferior vena cava or iliac vein, caused by indwelling of the B-RTO catheter, is relatively frequent. Physicians should be aware of the possibility of pulmonary embolism due to iliocaval thrombosis.

  18. Balloon sacroplasty as a palliative pain treatment in patients with metastasis-induced bone destruction and pathological fractures

    Energy Technology Data Exchange (ETDEWEB)

    Andresen, R.; Luedtke, C.W.; Kamusella, P.; Wissgott, C. [Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide (Germany). Inst. of Diagnostic and Interventional Radiology/Neuroradiology; Radmer, S. [Center of Orthopedics, Berlin (Germany). Orthopedic Surgery and Traumatology; Schober, H.C. [Municipal Hospital Suedstadt Rostock, Academic Teaching Hospital of the University of Rostock (Germany). Dept. of Internal Medicine

    2014-09-15

    Purpose: In the case of metastatic involvement of the sacrum with destruction and consecutive pathological fracture, intense disabling pain is one of the defining factors. The feasibility, safety and pain development with cement augmentation were to be investigated. Materials and Methods: CT-guided balloon sacroplasty was conducted in 10 patients with metastasis-induced bone destruction of the sacrum. After establishment of the entry point, a K-wire was first introduced as far as the central tumor lesion via the short, or transiliac axis. A cannula was then positioned over the wire. Under CT guidance, a balloon catheter was introduced through the cannula and inflated and deflated several times. The PMMA cement was then injected into the preformed cavity. The procedure was completed by a spiral CT control using the thin-slice technique. Pain intensity was determined using a visual analog scale (VAS) before the procedure, on the 2nd postoperative day and 6 months after the intervention. Finally, the patients were asked to state how satisfied they were. Results: Balloon sacroplasty was technically feasible in all patients. The control CT scan showed central distribution of the cement in the tumor lesion. On average 6+/-1.78 (4-10) ml of PMMA cement were introduced per treated lesion. A significant (p < 0.001) reduction in pain according to the VAS occurred in all patients from 9.3+/-0.67 (8-10) pre-operatively to 2.7+/-1.28 (1-5) on the 2nd postoperative day and 2.9+/-0.81 (2-5) 6 months after the intervention. All of the patients were re-mobilized after the procedure and underwent the further therapeutic measures as planned. Conclusion: Balloon sacroplasty is a helpful therapeutic option in the overall palliative treatment of patients with tumor-induced destruction. It is a safe and practicable procedure that markedly reduces disabling pain. (orig.)

  19. Balloon sacroplasty as a palliative pain treatment in patients with metastasis-induced bone destruction and pathological fractures

    International Nuclear Information System (INIS)

    Purpose: In the case of metastatic involvement of the sacrum with destruction and consecutive pathological fracture, intense disabling pain is one of the defining factors. The feasibility, safety and pain development with cement augmentation were to be investigated. Materials and Methods: CT-guided balloon sacroplasty was conducted in 10 patients with metastasis-induced bone destruction of the sacrum. After establishment of the entry point, a K-wire was first introduced as far as the central tumor lesion via the short, or transiliac axis. A cannula was then positioned over the wire. Under CT guidance, a balloon catheter was introduced through the cannula and inflated and deflated several times. The PMMA cement was then injected into the preformed cavity. The procedure was completed by a spiral CT control using the thin-slice technique. Pain intensity was determined using a visual analog scale (VAS) before the procedure, on the 2nd postoperative day and 6 months after the intervention. Finally, the patients were asked to state how satisfied they were. Results: Balloon sacroplasty was technically feasible in all patients. The control CT scan showed central distribution of the cement in the tumor lesion. On average 6+/-1.78 (4-10) ml of PMMA cement were introduced per treated lesion. A significant (p < 0.001) reduction in pain according to the VAS occurred in all patients from 9.3+/-0.67 (8-10) pre-operatively to 2.7+/-1.28 (1-5) on the 2nd postoperative day and 2.9+/-0.81 (2-5) 6 months after the intervention. All of the patients were re-mobilized after the procedure and underwent the further therapeutic measures as planned. Conclusion: Balloon sacroplasty is a helpful therapeutic option in the overall palliative treatment of patients with tumor-induced destruction. It is a safe and practicable procedure that markedly reduces disabling pain. (orig.)

  20. Sonic Thermometer for High-Altitude Balloons

    Science.gov (United States)

    Bognar, John

    2012-01-01

    The sonic thermometer is a specialized application of well-known sonic anemometer technology. Adaptations have been made to the circuit, including the addition of supporting sensors, which enable its use in the high-altitude environment and in non-air gas mixtures. There is a need to measure gas temperatures inside and outside of superpressure balloons that are flown at high altitudes. These measurements will allow the performance of the balloon to be modeled more accurately, leading to better flight performance. Small thermistors (solid-state temperature sensors) have been used for this general purpose, and for temperature measurements on radiosondes. A disadvantage to thermistors and other physical (as distinct from sonic) temperature sensors is that they are subject to solar heating errors when they are exposed to the Sun, and this leads to issues with their use in a very high-altitude environment